The Association of School Climate, Depression Literacy, and Mental Health Stigma Among High School Students.

BACKGROUND: Although school climate is linked with youth educational, socioemotional, behavioral, and health outcomes, there has been limited research on the association between school climate and mental health education efforts. We explored whether school climate was associated with students' depression literacy and mental health stigma beliefs. METHODS: Data were combined from 2 studies: the Maryland Safe Supportive Schools Project and a randomized controlled trial of the Adolescent Depression Awareness Program. Five high schools participated in both studies, allowing examination of depression literacy and stigma measures from 500 9th and 10th graders. Multilevel models examined the relationship between school-level school climate characteristics and student-level depression literacy and mental health stigma scores. RESULTS: Overall school climate was positively associated with depression literacy (odds ratio [OR] = 2.78, p < .001) and negatively associated with stigma (Est. = -3.822, p = .001). Subscales of engagement (OR = 5.30, p < .001) and environment were positively associated with depression literacy (OR = 2.01, p < .001) and negatively associated with stigma (Est. = -6.610, p < .001), (Est. = -2.742, p < .001). CONCLUSIONS: Positive school climate was associated with greater odds of depression literacy and endorsement of fewer stigmatizing beliefs among students. Our findings raise awareness regarding aspects of the school environment that may facilitate or inhibit students' recognition of depression and subsequent treatment-seeking.

Minipig and Human Metabolism of Aldehyde Oxidase Substrates: In Vitro-In Vivo Comparisons.

The importance of aldehyde oxidase (AOX) is becoming increasingly recognized in the prediction of human pharmacokinetic parameters from animal data. The objectives of these studies were to ascertain whether an in vitro-in vivo correlation existed in the clearance and metabolic pathways of AOX substrates and to establish whether the minipig represented an appropriate non-rodent model for man in the pre-clinical development of drugs metabolized by AOX. Using the AOX substrates carbazeran, 6-deoxypenciclovir and zaleplon, clearance was estimated from in vitro depletion experiments with minipig and human liver cytosol and microsomes and scaled before comparison with data generated in parallel in vivo studies in minipigs. In vitro and in vivo metabolic pathways were characterized by LC-MS/MS. Scaling of in vitro metabolism data to predict in vivo clearance underestimated in vivo values, although the rank order of clearance for the three compounds was preserved. Prediction of human in vivo clearance from scaled minipig in vivo data produced results which correlated well with published clinical values. Overall, this study is the first to compare minipig in vitro metabolism data with in vivo pharmacokinetic data for compounds metabolized by AOX and provides a scientific rationale for the selection of this species as a model for humans in the development of drugs which are substrates of AOX.

Reproductive Steroid Regulation of Mood and Behavior.

In this article, we examine evidence supporting the role of reproductive steroids in the regulation of mood and behavior in women and the nature of that role. In the first half of the article, we review evidence for the following: (i) the reproductive system is designed to regulate behavior; (ii) from the subcellular to cellular to circuit to behavior, reproductive steroids are powerful neuroregulators; (iii) affective disorders are disorders of behavioral state; and (iv) reproductive steroids affect virtually every system implicated in the pathophysiology of depression. In the second half of the article, we discuss the diagnosis of the three reproductive endocrine-related mood disorders (premenstrual dysphoric disorder, postpartum depression, and perimenopausal depression) and present evidence supporting the relevance of reproductive steroids to these conditions. Existing evidence suggests that changes in reproductive steroid levels during specific reproductive states (i.e., the premenstrual phase of the menstrual cycle, pregnancy, parturition, and the menopause transition) trigger affective dysregulation in susceptible women, thus suggesting the etiopathogenic relevance of these hormonal changes in reproductive mood disorders. Understanding the source of individual susceptibility is critical to both preventing the onset of illness and developing novel, individualized treatments for reproductive-related affective dysregulation. © 2016 American Physiological Society. Compr Physiol 6:1135-1160, 2016e.

Patients' preferred mode of travel to the orthopaedic theatre.

AIM: To determine the preferred mode of travel to the operating theatre for elective orthopaedic patients. METHODS: Data was collected prospectively over a 2-wk period at an elective Orthopaedic Treatment Centre. Patients were asked to complete a patient satisfaction questionnaire following their surgery on their experience and subsequent preferred mode of transport to theatre. The data was then recorded in a tabulated format and analysed with percentages. Fisher's exact test was used to determine if there was any statistical association between patients' preference to walk and various groups; in-patient or day case procedures, and whether patients were < 60 years or > 60 years of age. RESULTS: Seventy patients (40 females and 30 males) fully completed the questionnaire. In total there were 33 d-cases and 37 in-patients. The spectrum of orthopaedic sub-specialties included was knee (41%), hip (17%), foot and ankle (24%), spine (13%) and upper limb (4%). Patient satisfaction for overall experience of travelling to theatre was either excellent (77%) or good (23%). Following their experience of travelling to theatre, 87% (95%CI: 79%-95%) of the total cohort would have preferred to walk to the operating theatre. There was a statistically significant association (P = 0.003) between patients' preference to walk and whether they were day-case or in-patients. Similarly, there was a statistically significance association (P = 0.028) between patients' preference to walk and whether they were < 60 years or > 60 years of age. CONCLUSION: This study confirms the majority of Orthopaedic elective patients would prefer to walk to theatre, when given the choice and if practically possible.

Examining the association between bullying and adolescent concerns about teen dating violence.

BACKGROUND: The school environment is an important context for understanding risk factors for teen dating violence. This study seeks to add to the growing literature base linking adolescent experiences with bullying and involvement with teen dating violence. METHODS: Data were collected from 27,074 adolescents at 58 high schools via a Web-based survey. RESULTS: Three-level hierarchical linear models indicated that adolescents who had been bullied were more concerned about both physical and emotional dating violence among students at their school. Schools that were perceived by students as safer were rated as having lower levels of teen dating violence. Older students and male students consistently reported greater concerns about dating violence. CONCLUSIONS: These results suggest that adolescents who experience bullying may also have concerns about violence in teen dating relationships. Findings also indicate that schools perceived as being unsafe may be an important context for targeting dating violence prevention efforts.

Hippocampal shape abnormalities of patients with childhood-onset schizophrenia and their unaffected siblings.

OBJECTIVE: The hippocampus has been implicated in the pathogenesis of schizophrenia, and hippocampal volume deficits have been a consistently reported abnormality, but the subregional specificity of the deficits remains unknown. The authors explored the nature and developmental trajectory of subregional shape abnormalities of the hippocampus in patients with childhood-onset schizophrenia (COS), their healthy siblings, and healthy volunteers. METHOD: Two hundred twenty-five anatomic brain magnetic resonance images were obtained from 103 patients with COS, 169 from their 79 healthy siblings, and 255 from 101 age- and sex-matched healthy volunteers (age range = 9-29 years). The hippocampus was segmented using FreeSurfer automated image analysis software, and hippocampal shape was evaluated by comparing subjects at more than 6,000 vertices on the left and right hippocampal surfaces. Longitudinal data were examined using mixed model regression analysis. RESULTS: Patients with COS showed significant bilateral inward deformation in the anterior hippocampus. Healthy siblings also showed a trend for anterior inward deformation. However, the trajectory of shape change did not differ significantly between the groups. Inward deformations in the anterior hippocampus were positively related to positive symptom severity, whereas outward surface displacement was positively related to overall functioning. CONCLUSION: This is the first and largest longitudinal three-way analysis of subregional hippocampal shape abnormalities in patients with COS and their healthy siblings compared with healthy controls. The anterior hippocampal abnormalities in COS suggest the pathophysiologic importance of this subregion in schizophrenia. The trend level and overlapping shape abnormalities in the healthy siblings suggest a more subtle, subregionally specific neuroanatomic endophenotype.

Absence of anatomic corpus callosal abnormalities in childhood-onset schizophrenia patients and healthy siblings.

The corpus callosum (CC) has been implicated in the pathogenesis of schizophrenia, and CC deficits have been reported in adults with schizophrenia. We explored the developmental trajectory of the corpus callosum in childhood-onset schizophrenia (COS) patients, their healthy siblings (SIB) and healthy volunteers. We obtained 235 anatomic brain magnetic resonance imaging (MRI) scans from 98 COS patients, 153 scans from 71 of their healthy siblings, and 253 scans from 100 age- and gender-matched healthy volunteers, across ages 9-30 years. The volumes of five sub-regions of the CC were calculated using FreeSurfer, and summed to give the total volume. Longitudinal data were examined using mixed model regression analysis. There were no significant differences for the total or sub-regional CC volumes between the three groups. There were also no significant differences between the groups for developmental trajectory (slope) of the CC. This is the largest longitudinal study of CC development in schizophrenia and the first COS study of the CC to include healthy siblings. Overall, CC volume and growth trajectory did not differ between COS patients, healthy siblings, or healthy volunteers. These results suggest that CC development, at least at a macroscopic level, may not be a salient feature of schizophrenia.

Towards client-centered counseling: development and testing of the WHO Decision-Making Tool.

OBJECTIVE: To describe development and testing of a counseling tool intended to inform family planning clients while helping the family planning provider facilitate the client's decision-making process; and to discuss challenges and requisites for shifting to shared decision-making from the extremes of decision-making dominated by the provider, on one hand, or unaided by the provider, on the other. DEVELOPMENT OF THE TOOL: The WHO Decision-Making Tool for Family Planning Clients and Providers is derived from evidence-based principles of client-centered care and counseling. This article discusses how these principles are manifested in the Tool and how the Tool aids both provider and client in improving counseling. METHODS: Development of the Tool involved formative workshops with providers in Indonesia, Mexico, South Africa and Trinidad and Tobago and observational evaluation research in Indonesia, Mexico, and Nicaragua. Analysis of videotaped counseling sessions quantitatively assessed client-provider communication and decision-making. Also, focus-group discussions, interviews, and a questionnaire collected qualitative data from providers and clients. RESULTS: In general, use of the Tool improved providers' counseling performance: they engaged clients more and gave more and better tailored information. For clients, the Tool increased their communication and involvement. Both the Nicaraguan and Mexican studies found marked shifts toward the client in the locus of decision-making after introduction of the Tool. PRACTICE IMPLICATIONS: Use of the tool improves the performance of both providers and clients in family planning counseling and decision-making. There are challenges, however, at the levels of both the provider and the organization in sustaining these changes and scaling up such initiatives in quality of care.

Embodied infant attention.

Does real time coupling between mental and physical activity early in development have functional significance? To address this question, we examined the habituation of visual attention and the subsequent response to change in two groups of 3-month-olds with different patterns of movement-attention coupling. In suppressors, the typical decrease in body movement at the onset of looks persists into the looks. In rebounders, the initial decrease is more transient and movement quickly returns above baseline. Suppressors and rebounders did not differ on measures of looking during habituation, but when the stimulus changed rebounders looked more than suppressors. When it did not change, they looked less. In addition, during habituation rebounders spent more time looking away from the stimulus. Rapid motor reactivation soon after gaze locks onto a target, characteristic of rebounders, may influence visual foraging and the response to change by keeping attention near a threshold of engagement.

Robust coupling of body movement and gaze in young infants.

In the first few months after birth, rapid bursts of body movement precede and possibly facilitate shifts of gaze during free looking, with potential consequences for perception and cognition. Here we report that the characteristic features of movement-gaze coupling found during free looking are preserved when attention is perturbed by a salient change in the visual environment. Twenty-four 3-month-olds looked at two attractive 3-dimensional objects while body movement and corneal reflections of the objects were recorded. Lateral head movement was measured offline. After approximately 2 s of looking at one stimulus, the nonfixated stimulus either began to rotate back and forth (distracter events) or remained motionless (control events). In distracter events, the motion of the nonfixated stimulus triggered substantial motor quieting, shortened the duration of the look, and shortened the time to reorient gaze compared to control events. Abbreviated motor quieting and small increases in lateral head movement occurred during control events at the same time in the look as the protracted motor quieting and increased head movement in distracter events. Despite these perturbations, the characteristic bursts of body movement that precede shifts of gaze during free looking occurred in both distracter and control events. The results demonstrate the robust nature of early movement-gaze coupling, raise questions about the specific role of attention in the dynamic links between body movement and gaze, and highlight the potential short and long term functional significance of movement-gaze-attention coupling.