Long COVID Brain Fog Treatment: Findings from a Pilot Randomized Controlled Trial of Constraint-Induced Cognitive Therapy.

Purpose: Long COVID brain fog is often disabling. Yet, no empirically-supported treatments exist. This study's objectives were to evaluate feasibility and efficacy, provisionally, of a new rehabilitation approach, Constraint-Induced Cognitive Therapy (CICT), for post-COVID-19 cognitive sequelae. Design: Sixteen community-residents ≥ 3-months post-COVID-19 infection with mild cognitive impairment and dysfunction in instrumental activities of daily living (IADL) were enrolled. Participants were randomized to Immediate-CICT or treatment-as-usual (TAU) with crossover to CICT. CICT combined behavior change techniques modified from Constraint-Induced Movement Therapy with Speed of Processing Training, a computerized cognitive-training program. CICT was deemed feasible if (a) ≥80% of participants completed treatment, (b) the same found treatment highly satisfying and at most moderately difficult, and (c) <2 study-related, serious adverse-events occurred. The primary outcome was IADL performance in daily life (Canadian Occupational Performance Measure). Employment status and brain fog (Mental Clutter Scale) were also assessed. Results: Fourteen completed Immediate-CICT ( n =7) or TAU ( n =7); two withdrew from TAU before their second testing session. Completers were [ M (S D )]: 10 (7) months post-COVID; 51 (13) years old; 10 females, 4 males; 1 African American, 13 European American. All the feasibility benchmarks were met. Immediate-CICT, relative to TAU, produced very large improvements in IADL performance ( M =3.7 points, p<.001, d =2.6) and brain fog ( M =-4 points, p<.001, d =-2.9). Four of five non-retired Immediate-CICT participants returned-to-work post-treatment; no TAU participants did, p =.048. Conclusions: CICT has promise for reducing brain fog, improving IADL, and promoting returning-to-work in adults with Long COVID. Findings warrant a large-scale RCT with an active-comparison group. IMPACT: Brain fog in adults with Long COVID is often associated with dysfunction in everyday activities and unemployment. Yet, there are no empirically supported treatments targeting cognition in this population. Findings from this small-scale, pilot randomized controlled trial (RCT) suggest that a novel intervention, i.e., Constraint-Induced Cognitive Therapy, is a feasible cognitive rehabilitation method in adults with Long COVID cognitive sequelae with promise of (a) improving performance of cognition-based tasks in daily life and (b) promoting return-to-work. Further studies with larger sample sizes are warranted.Speed of Processing Training (SOPT) has been shown to increase processing speed in older adults without neurological disorders but has not been applied to adults with brain fog due to Long COVID, in whom slowing of cognitive processing speed is common. The results of this pilot RCT suggest that SOPT, in conjunction with behavior change techniques, may increase cognitive processing speed in this brain-injured population.

Charting the longitudinal trajectories and interplay of critical consciousness among youth activists.

Critical consciousness (CC) is associated with beneficial developmental outcomes among youth contending with oppression, yet we know little about how CC develops and how the three dimensions of CC (i.e., critical action, critical motivation, and critical reflection) interrelate over time. Therefore, this study employed second-order latent growth modeling to illuminate the longitudinal interplay between the three dimensions of CC among 518 youth activists (Mage = 16; girls = 53%; 11% Asian, 20% Black, 39% Latinx, 8% Multiracial, and 6% White). Youth demonstrated significant growth in critical reflection and action over time, but not in critical motivation. Participation in community-based activism was positively associated with CC development. Altogether, these findings illuminate channels for fostering youth CC and increase our understanding of CC's dynamic development.

An Emic, Mixed Methods Approach to Defining and Measuring Positive Parenting Among Low-Income, Black Families.

Research Findings: This within-group exploratory sequential mixed methods investigation sought to identify how ethnically diverse, urban-residing, low-income Black families conceptualize positive parenting. During the item development phase 119 primary caregivers from Head Start programs participated in focus groups and interviews. These qualitative data were content analyzed using a three-stage iterative process that resulted in the development of a final set of 72 items for a paper-and-pencil measure. In the measure validation phase of the study initial construct validity of the 72-item measure was assessed with an independent sample of 665 respondents. Common factor analyses revealed five dimensions of positive parenting on the Black Parenting Strengths in Context (BPSC) scale that related in expected ways with other parent self-report measures. Practice and Policy: BPSC dimensions provide initial support for a more nuanced operationalization of positive parenting than currently exists in any single scale for use with this group, and hold promise for better honoring the culture- and context-specific parenting goals and practices that low-income, Black parents subjectively view as important for producing healthy developmental outcomes for their children.

Exploring the factors that influence the perceptions of disability: a qualitative study of mothers of children with disabilities at a community-based rehabilitation centre in Sri Lanka.

BACKGROUND: The prevalence of disability is growing worldwide; however, perceptions regarding disability are not well understood. The aim of this study was to explore factors that influence the perception of disability among mothers of children with disabilities who were attending a community-based rehabilitation facility in Sri Lanka. METHODS: A descriptive qualitative research design was employed. Thirteen semi-structured interviews were conducted with participants receiving rehabilitation services at a community-based facility. Interviews were recorded, transcribed and coded using software for qualitative data. RESULTS: Three major themes emerged from the analysis: (i) level of family and community support; (ii) spiritual and cultural interpretations of disability; and (iii) outcomes of rehabilitation services. Perceptions of disability appeared to be strongly influenced by the social, community and spiritual/cultural support structure in which the mothers lived. In particular, the support from the participant's spouse emerged as a primary factor exerting strong influence on perception, and future outlook, among the participants. Engagement in community-based rehabilitation programming also reinforced positive perceptions, created a sense of hope among participants regarding their child's future, and established aspirations for future education and employment opportunities alongside social integration. CONCLUSION: Knowledge of factors that influence the perception of disability can inform future implementation of public-health and community-based initiatives, and may improve social integration of children with disabilities in lower-resource settings.

Using relational developmental systems theory to link program goals, activities, and outcomes: the sample case of the 4-H Study of Positive Youth Development.

In contemporary developmental science, relational development systems models have been used to frame the positive youth development (PYD) perspective, which posits that youth will thrive when there is alignment between their strengths and ecological resources in their context. Evidence from the 4-H Study of PYD indicates that out-of-school-time youth development programs are key ecological resources enhancing youth thriving. This chapter discusses the particular facets of youth development programs (the "Big Three"-positive and sustained adult-youth relationships, skill-building activities, and youth leadership opportunities) involved in promoting youth thriving. The importance of using theory to design and implement programs is also discussed, and challenges of reaching the diversity of American youth with effective programs are noted.