Co-designing a digital mental health platform, "Momentum", with young people aged 7-17: A qualitative study.

Introduction: Digital mental health interventions (DMHIs) offer a promising alternative or adjunct treatment method to face-to-face treatment, overcoming barriers associated with stigma, access, and cost. This project is embedded in user experience and co-design to enhance the potential acceptability, usability and integration of digital platforms into youth mental health services. Objective: To co-design a digital mental health platform that provides self-directed, tailored, and modularised treatment for young people aged 7-17 years experiencing anxiety, depression and other related problems. Methods: Sixty-eight participants, aged 7-17 years, engaged in one of 20 co-design workshops. Eight workshops involved children (n = 26, m = 9.42 years, sd = 1.27) and 12 involved adolescents (n = 42, m = 14.57 years, sd = 1.89). Participants engaged in a variety of co-design activities (e.g., designing a website home page and rating self-report assessment features). Workshop transcripts and artefacts (e.g., participants' drawings) were thematically analysed using Gale et al.'s Framework Method in NVivo. Results: Six themes were identified: Interactive; Relatable; Customisable; Intuitive; Inclusive; and Personalised, transparent and trustworthy content. The analysis revealed differences between children's and adolescents' designs and ideas, supporting the need for two different versions of the platform, with age-appropriate activities, features, terminology, and content. Conclusions: This research showcased co-design as a powerful tool to facilitate collaboration with young people in designing DMHIs. Two sets of recommendations were produced: 1) recommendations for the design, functionality, and content of youth DMHIs, supported by child- and adolescent-designed strategies; and 2) recommendations for clinicians and researchers planning to conduct co-design and intervention development research with children and adolescents.

Stepped-care versus therapist-guided, internet-based cognitive behaviour therapy for childhood and adolescent anxiety: A non-inferiority trial.

Objective: This preregistered randomized trial examined whether a stepped-care approach to internet-delivered cognitive behaviour therapy (ICBT-SC) is non-inferior to therapist-guided ICBT (ICBT-TG) for child and adolescent anxiety. Method: Participants were 137 Australians, aged 8-17 years (56 male), with a primary anxiety disorder. This randomized, non-inferiority trial compared ICBT-SC to an evidence-based, ICBT-TG program with assessments conducted at baseline, 12 weeks and 9-months after treatment commencement. All ICBT-SC participants completed the first 5 online sessions without therapist guidance. If they responded to treatment in the first 5 sessions (defined as reductions of anxiety symptoms into non-clinical range), they continued without therapist guidance for the final 5 sessions. If they did not respond to treatment in the first 5 sessions, the final five sessions were supplemented with therapist-guidance (through email). All ICBT-TG participants received therapist guidance (email) after each session, for all 10 sessions. Measures included clinical diagnostic interview (severity rating as primary outcome), as well as parent and child reported anxiety and anxiety-related interference (secondary outcomes). Results: ICBT-SC was found to be non-inferior to ICBT-TG on primary and secondary outcomes, according to clinician, parent and young person report at 12-weeks and 9-months. Treatment satisfaction was moderate to high for both conditions. Significant clinical benefits were evident for participants in both treatments. Of participants who remained in the study, 77 % (50.7 % ITT) of ICBT-SC and 77 % (57.1 % ITT) of ICBT-TG were free of their primary anxiety diagnosis by 9-month follow-up, with no differences between conditions. Conclusion: A stepped-care ICBT approach for clinically anxious children and adolescents may offer an acceptable treatment model that can increase access to evidence-based treatment.

Social Support for Physical Activity Over 9 Years in Adults Aged 60-65 Years at Baseline.

Physical activity is a leading determinant of health and well-being in older adults; however, participation is low. Social support can significantly influence physical activity uptake and maintenance; however, most research is cross-sectional and does not differentiate among types of support. The current study assessed four types of social support for physical activity reported over 9 years by adults aged 60-65 at baseline (n = 1,984). Data were collected using a mail survey at four time points. Data were analyzed using linear mixed models. The most common type of support was emotional, with 25% of participants reporting this often/very often. Total support for activity declined by 16% across the 9 years (p < .001). Companionship had the greatest decline among types (17%-18%, p < .001). More work is needed to understand the factors contributing to the decline in support and how to enable access to support for physical activity in older adults.

The Relationship between Social Support for Physical Activity and Physical Activity across Nine Years in Adults Aged 60-65 Years at Baseline.

Physical activity is consistently recognized as a key component of healthy aging. The current study aimed to investigate the prospective association between social support specific for physical activity (SSPA) and physical activity across nine years among adults aged 60-65 years at baseline (n = 1984). An observational longitudinal design was used, with mail surveys administered to a population-based sample across four waves. SSPA was measured using a score ranging from 5-25, and physical activity was assessed as time spent in walking, or engaging in moderate and vigorous activity, during the previous week. Data were analyzed using linear mixed-effects models. The results demonstrated a positive significant relationship between SSPA and physical activity, accounting for sociodemographic and health variables. Each unit of increase in SSPA was associated with 11 extra minutes of physical activity per week (p < 0.001). There was a significant interaction between SSPA and wave at the final timepoint, such that the relationship was weaker (p = 0.017). The results highlight the value of even small increases in SSPA. SSPA could be targeted to promote physical activity among older adults, but may be more impactful in young-old adults. More research is needed to understand impactful sources of SSPA, underlying mechanisms between SSPA and physical activity, and potential moderation by age.

Frequency of Physical Activity Done with a Companion: Changes Over Seven Years in Adults Aged 60+ Living in an Australian Capital City.

Objectives:This study examined how often adults 60+ years were physically active with a partner, close family, friends, and neighbors, over 7 years. Methods: Data from 2062 adults living in an Australian capital city were collected using a mail survey at four time points and analyzed using multinomial logistic regression. Results: A partner was the most frequent companion at all time points. From baseline to 7 years, the greatest decline was activity with family 1-4x/month (.79 [.64-.98]) and ≥5x/month (.54 [.36-.80]). There were also decreases in activity 1-4x/month with a partner (OR = .75, [.62-.92]), friends (.55 [.44-.68]), and neighbors (.79 [.64-.98]). Physical activity with friends or neighbors ≥5x/month did not decline. Discussion: Findings extend understanding of physical activity and activity companions among older adults. More research is needed to understand factors contributing to changes in activity done with companions.

Reductive dissolution of phosphorus associated with iron-oxides during saturation in agricultural soil profiles.

In soils with a fragipan or poor permeability, water may remain in a soil profile long enough to make it anoxic and reductive. The reductive dissolution of iron (Fe)- and manganese (Mn)-oxides can release associated phosphorus (P). Therefore, the dissolved P would be vulnerable to subsurface flow and could contaminate nearby streams. It was hypothesized that single rainfall events could cause subsurface P concentrations to increase via reductive dissolution in wet winter-spring conditions. Also, dissolution-being microbially mediated-would be buffered by the presence of nitrate (NO3 - ), which is preferred as an electron acceptor over Fe and Mn in microbial reactions. Unsaturated zone monitoring occurred from May to September in 2017 and 2019, using Teflon suction cups below the surface of a grassland soil in New Zealand. Events in July and August in 2017 and 2019 resulted in reducing conditions [Fe(III)/sulfate-reducing] and up to 77 and 96% greater P and Fe release, respectively. In an additional experiment in 2019, 100 mm of flood irrigation was applied, and 10 mg NO3 - -N + carbon was injected into half the cups at the site. The other cups received no N. Cups treated with N yielded up to 45% total dissolved P and 21% less Fe than the no-N cups. A laboratory incubation of soils from the site confirmed that NO3 - inhibited P release. This effect may act to decrease the amount of P lost in subsurface flow in systems regularly fertilized with N but should not be relied on as a method to mitigate P losses.

Plasmids shape the diverse accessory resistomes of Escherichia coli ST131.

The human gut microbiome includes beneficial, commensal and pathogenic bacteria that possess antimicrobial resistance (AMR) genes and exchange these predominantly through conjugative plasmids. Escherichia coli is a significant component of the gastrointestinal microbiome and is typically non-pathogenic in this niche. In contrast, extra-intestinal pathogenic E. coli (ExPEC) including ST131 may occupy other environments like the urinary tract or bloodstream where they express genes enabling AMR and host cell adhesion like type 1 fimbriae. The extent to which commensal E. coli and uropathogenic ExPEC ST131 share AMR genes remains understudied at a genomic level, and we examined this here using a preterm infant resistome. We found that individual ST131 had small differences in AMR gene content relative to a larger shared resistome. Comparisons with a range of plasmids common in ST131 showed that AMR gene composition was driven by conjugation, recombination and mobile genetic elements. Plasmid pEK499 had extended regions in most ST131 Clade C isolates, and it had evidence of a co-evolutionary signal based on protein-level interactions with chromosomal gene products, as did pEK204 that had a type IV fimbrial pil operon. ST131 possessed extensive diversity of selective type 1, type IV, P and F17-like fimbriae genes that was highest in subclade C2. The structure and composition of AMR genes, plasmids and fimbriae vary widely in ST131 Clade C and this may mediate pathogenicity and infection outcomes.

Serum NETosis expression and recurrence risk after regional or volatile anaesthesia during breast cancer surgery: A pilot, prospective, randomised single-blind clinical trial.

BACKGROUND: Some experimental and retrospective clinical studies signal an association between certain anaesthetic techniques and tumour metastasis following breast cancer surgery. Neutrophil Extracellular Trapping (NETosis) is an immunological process, whereby neutrophils engulf tumour antigen then degranulate, leaving a serologic marker. NETosis expression among breast cancer patients is associated with an increased risk of metastasis. We investigated the effect of two distinct anaesthetic techniques on the expression of NETosis in women who underwent potentially curative breast cancer surgery. METHODS: In a parallel-group, randomised controlled trial, a subset of women (n = 40) undergoing breast cancer resection surgery, who were partaking in a larger trial (NCT00418457), were randomly assigned to receive volatile general anaesthesia (GA) or propofol GA combined with paravertebral regional anaesthesia (PPA) for their surgery. Serum was taken and stored before and 24 hours post-operatively. NETosis was measured by ELISA using Neutrophil Myeloperoxidase (MPO) and citrullinated histone H3 (H3Cit) biomarkers, which were the co-primary end points. RESULTS: Patient and breast cancer characteristics did not differ significantly between groups. Recurrence occurred in 7.5% patients. GA patients received more opioids and reported higher post-operative pain than PPA. There was no difference in post-operative MPO in GA vs PPA (10.5 ± 6.6 vs 11.5 ± 4.7 ng mL-1 , P = .60). Regarding CitH3, there was no difference post-operatively in GA vs PPA (3.6 ± 2.3 vs 4.0 ± 5.9, P = .80). NET expression did not differ before or after anaesthesia and surgery in either group, for either biomarker. CONCLUSION: Anaesthetic technique did not affect NETosis expression in breast cancer patients, indicating that it is not a viable marker of the effect of anaesthetic technique on breast cancer recurrence.

Agency-Based Empowerment Interventions: Efforts to Enhance Decision-Making and Action in Health and Development.

This paper outlines the critical role of personal agency in influencing health and development outcomes and presents a framework for implementing non-therapeutic cognitive-behavioral interventions that foster agency, especially for women, in resource-poor settings. The United Nations' Sustainable Development Goals (SDGs) has placed "empowerment" at the center of global targets, particularly to improve individuals' health and development. Despite extensive research on individual and community empowerment, there is limited focus on the role of psychological and behavioral approaches directly fostering individual and collective agency in health programs. Fundamental to this process is the understanding that decision-making is an interaction between mental processes and one's current context. Approaches that allow individuals to understand how their beliefs, values, emotions, and thoughts impact their behaviors and can be modulated to increase their personal agency are needed. This model is illustrated through a pilot behavioral intervention with women engaged in sex work in Pune, India, demonstrating substantive benefits.

Adaptation of the Arizona Cognitive Task Battery for use with the Ts65Dn mouse model (Mus musculus) of Down syndrome.

We propose and validate a clear strategy to efficiently and comprehensively characterize neurobehavioral deficits in the Ts65Dn mouse model of Down syndrome. This novel approach uses neurocognitive theory to design and select behavioral tasks that test specific hypotheses concerning the results of Down syndrome. In this article, we model the Arizona Cognitive Task Battery, used to study human populations with Down syndrome, in Ts65Dn mice. We observed specific deficits for spatial memory, impaired long-term memory for visual objects, acquisition and reversal of motor responses, reduced motor dexterity, and impaired adaptive function as measured by nesting and anxiety tasks. The Ts65Dn mice showed intact temporal ordering, novelty detection, and visual object recognition with short delays. These results phenocopy the performance of participants with Down syndrome on the Arizona Cognitive Task Battery. This approach extends the utility of mouse models of Down syndrome by integrating the expertise of clinical neurology and cognitive neuroscience into the mouse behavioral laboratory. Further, by directly emphasizing the reciprocal translation of research between human disease states and the associated mouse models, we demonstrate that it is possible for both groups to mutually inform each other's research to more efficiently generate hypotheses and elucidate treatment strategies. (PsycINFO Database Record

Patterns and scales of connectivity: temporal stability and variation within a marine metapopulation.

Because many marine invertebrates have a dispersive planktonic phase, the spatial scale of demographic, connectivity among local populations remains a key, but elusive, parameter driving population and metapopulation dynamics. However, temporal variation in the scale of connectivity remains largely undocumented, despite its recognized importance for predicting population responses to environmental changes. To assess the temporal stability of metapopulation connectivity, we conducted a large-scale survey of a blue mussel (Mytilus spp.) metapopulation for five years along a 100-km section of coastline of the Gaspé Peninsula, Québec, Canada. For each year, we estimated the scale of demographic coupling among 27-29 sites within our study region, using the spatial cross-covariance between adult abundance and recruit density across sites. Despite large interannual variability in overall recruit abundance, our analysis revealed stationary spatial distributions of adult and recruit abundance. More importantly, our analysis revealed a consistent demographic coupling among populations at a distance ranging from 12 to 24 km in all but one of the five years studied. The scale of connectivity in this system is thus temporally stable, but can occasionally show irregular fluctuations, and our results provide evidence in support of the integration of time-varying connectivity to marine metapopulation and reserve network theories.

Dentate gyrus mediates cognitive function in the Ts65Dn/DnJ mouse model of Down syndrome.

In the Ts65Dn/DnJ mouse model of Down syndrome (DS), hippocampal deficits of learning and memory are the most robust features supporting this mouse as a valid cognitive model of DS. Although dentate gyrus (DG) dysfunction is suggested by excessive GABAergic inhibition, its role in perturbing DG functions in DS is unknown. We hypothesize that in the Ts65Dn/DnJ mouse, the specific role of the DG is disturbed in its support of contextual and spatial information. Support for this hypothesis comes from rats with DG lesions that show similar deficits. In order to test this hypothesis, we have developed a novel series of spontaneous exploratory tasks that emphasize the importance of recognizing spatial and contextual cues and that involve DG function. The results with this exploratory battery show that Ts65Dn/DnJ mice are impaired in DG-dependent short-term recognition tests involving object recognition with contextual cues, in place recognition and in metric distance recognition relative to wild type littermate controls. Further, whereas Ts65Dn/DnJ mice can recognize object novelty in the absence of contextual cues after a 5-min delay, they cannot do so after a delay of 24 h, suggesting a problem with CA1-mediated consolidation. The results also show that Ts65Dn/DnJ mice are not impaired in tasks (object recognition and configural object recognition) that are mediated by the perirhinal cortex (PRh). These results implicate the DG as a specific therapeutic target and the PRh as a potential therapeutic strength for future research to ameliorate learning and memory in DS.

Suppression of avian influenza transmission in genetically modified chickens.

Infection of chickens with avian influenza virus poses a global threat to both poultry production and human health that is not adequately controlled by vaccination or by biosecurity measures. A novel alternative strategy is to develop chickens that are genetically resistant to infection. We generated transgenic chickens expressing a short-hairpin RNA designed to function as a decoy that inhibits and blocks influenza virus polymerase and hence interferes with virus propagation. Susceptibility to primary challenge with highly pathogenic avian influenza virus and onward transmission dynamics were determined. Although the transgenic birds succumbed to the initial experimental challenge, onward transmission to both transgenic and nontransgenic birds was prevented.

Gender differences in implantable cardioverter-defibrillator patients at the time of insertion.

Gender differences in physical and psychological health and responses in persons receiving implantable cardioverter-defibrillators (ICDs) have been reported but are not well delineated. This study examined symptoms of pain and sleep difficulties, functional status, and psychological responses in 180 (75%) men and 60 (25%) women before and immediately following their first ICD implantation. Women were significantly younger, less likely to be married, and had less history of coronary artery disease than men. Forty-eight percent of women were New York Heart Association class III-IV vs. 27% of men (p<0.05). Women had lower functional status and were more likely to report symptoms of increased pain severity and sleep difficulties. Differences in functional status and pain were reduced after adjusting for New York Heart Association class and age, respectively. There were no differences in depressive symptoms or anxiety. Clinical implications of gender-related responses include the need to address symptoms of heart failure as well as increased pain and sleep difficulties in women at the time surrounding ICD implantation. Longitudinal studies and gender-focused nursing interventions should be developed to promote better understanding of responses and to improve recovery outcomes for ICD patients.