Behavioral Domains Research Articles

The design and evaluation of a bone health teaching module for secondary school students in NSW, Australia.

The growing prevalence of osteoporosis requires preventative management starting from an early age as peak bone mass is typically reached by age 30. However, current Australian adolescents are not adequately addressing key osteoprotective factors. Alarmingly, around 17% have insufficient vitamin D levels, 55% consume insufficient dietary calcium, and 79% are insufficiently active. Addressing these insufficiencies via bone health education and promoting healthier lifestyle choices are crucial to mitigate the risk of osteoporosis later in life. A mixed methods study was undertaken to assess the design and effectiveness of four bone health education modules implemented in PDHPE lessons across NSW secondary schools. Pre- and post-module assessments included a multiple-choice questionnaire on osteoporosis knowledge, and a survey based on the Theory of Planned Behaviour domains to examine influences on healthy bone behaviour. Statistical analysis, qualitative interviews, and focus groups were used to evaluate changes in knowledge and behaviour resulting from the modules. Participation in bone health teaching modules improved students' knowledge and behaviours related to bone health. Subjective norms had the largest influence regarding behaviour changes. Both students and teachers engaged positively with the bone health modules, which were designed by clinicians and delivered by teachers. SO WHAT?: The modules address knowledge gaps and provide strategies from an early age, empowering students and potentially contribute to improving long term bone health. There is a need to focus on promoting positive peer influence and facilitating easy access to bone-healthy behaviours in secondary education settings.

Bibliometric Analysis of Adaptive Behavior Research: Advancing Sustainable Development Goals (SDGs) for Children with Disabilities

Introduction: Adaptive behavior refers to the collection of skills and behaviors that individuals use to function independently in their daily lives, it encompasses the ability to meet personal needs and deal with the natural and social demands of one's environment. This includes a wide range of skills, such as communication, self-care, socialization, and practical skills needed to navigate one's environment. This is useful in providing references to support Sustainable Development Goals (SDG) initiatives, especially to improve access to quality education for children with disabilities. Objective: This study conducts a bibliometric analysis of research on adaptive behavior for children with disabilities from 2014 to 2024. It focuses on identifying patterns, trends, and gaps in the literature to understand the evolution and current state of the field. Theorical Framework: Adaptive behavior is often categorized into different domains, reflecting the various areas of functioning that are essential for independent living and social integration. The three primary domains of adaptive behavior commonly recognized in the literature are conceptual, practical and social domain. Method: The study employs advanced bibliometric techniques, including keyword co-occurrence and citation analysis, to explore the interconnectedness of topics and to forecast future directions in research. It underscores the critical need for reliable and inclusive assessment tools, comprehensive multi-informant evaluations, and interventions that can be integrated into educational settings to support the independence and social integration of children with disabilities. Results and Discussion: The findings of the study through article co-occurrence mapping analysis, four clusters representing adaptive behavior were identified, that is red cluster (psychological and social dimensions), green cluster (developmental and cognitive aspects of disability), blue cluster (adaptive functioning and behavioral outcomes) and yellow cluster (behavioral and diagnostic) portrays an interconnected landscape of research topics, where psychological, developmental, behavioral, and diagnostic themes converge, reflecting the complexity and interdisciplinary nature of research in disabilities. Research Implications: This study contributes practical implications, improving interventions, informing policies, and enhancing community understanding and support for individuals with varying needs in adaptive behavior. This holistic impact underscores the importance of such research in driving both theoretical and practical advancements in the field. Originality/Value: The exploration of adaptive behavior in children with disabilities has emerged as a critical area of study, integrating multifaceted approaches from diagnosis to intervention. The comprehensive review presented in this article not only captures the varied dimensions of adaptive behavior but also underscores the intricate interplay between intellectual, developmental, and social facets of disabilities in children.

Environmental literacy profile in Bantul, Special Region of Yogyakarta

Environmental issues are occurring more frequently, both due to natural causes and human activities. If left unchecked, human activities can worsen environmental conditions. Bantul Regency in the Special Region of Yogyakarta, Indonesia, is one of the regions grappling with this issue, primarily due to waste management and industrial activities. Environmental issues are related to environmental literacy. The lack of education, awareness, and knowledge in society can degrade environmental quality. Environmental literacy plays an important role in enhancing knowledge as well as changing the attitudes and behaviors of society towards the environment. Therefore, it is important to instill environmental literacy in individuals to improve our attitudes towards the environment. This study aims to provide an overview of students's environmental literacy in Bantul Regency. The research uses a survey method conducted in Bantul Regency from September to November 2023. The population of this study includes all 10th-grade students from public high schools in Bantul Regency. The sample consists of 300 10th-grade students from public high schools in the sub-districts of Bantul, Banguntapan, Sewon, Jetis, Piyungan, Imogiri, Pajangan, Srandakan, Sedayu, and Dlingo. The study's results show that the environmental literacy profile of 10th-grade students in Bantul Regency falls into the "average" category, with a percentage score of 65.96%. The highest score in the competency domain is found in Bantul City (81.90%) and falls into the "good" category, while the lowest score is in Dlingo Sub-district (60.93%), categorized as "average" The highest score in the affective domain is in Dlingo Sub-district (70.25%), categorized as "average" while the lowest score is in Jetis Sub-district (66.67%), also categorized as "average." The highest score in the behavior domain is found in Imogiri Sub-district (64.91%), categorized as "average" while the lowest score is in Srandakan Sub-district (55.30%), categorized as "low."

Folate prevents the autism-related phenotype caused by developmental pyrethroid exposure in prairie voles.

Neurodevelopmental disorders (NDDs) have dramatically increased in prevalence to an alarming one in six children, and yet both causes and preventions remain elusive. Recent human epidemiology and animal studies have implicated developmental exposure to pyrethroid pesticides, one of the most common classes of pesticides in the US, as an environmental risk factor for autism and neurodevelopmental disorders. Our previous research has shown that low-dose chronic developmental pyrethroid exposure (DPE) changes folate metabolites in the adult mouse brain. We hypothesize that DPE acts directly on molecular targets in the folate metabolism pathway, and that high-dose maternal folate supplementation can prevent or reduce the biobehavioral effects of DPE. We exposed pregnant prairie vole dams chronically to vehicle or low-dose deltamethrin (3 mg/kg/3 days) with or without high-dose folate supplementation (methylfolate, 5 mg/kg/3 days). The resulting DPE offspring showed broad deficits in five behavioral domains relevant to neurodevelopmental disorders (including the social domain); increased plasma folate concentrations; and increased neural expression of SHMT1, a folate cycle enzyme. Maternal folate supplementation prevented most of the behavioral phenotypes (except for repetitive behaviors) and caused potentially compensatory changes in neural expression of FOLR1 and MTHFR, two folate-related proteins. We conclude that DPE causes neurodevelopmental disorder-relevant behavioral deficits; DPE directly alters aspects of folate metabolism; and preventative interventions targeting folate metabolism are effective in reducing, but not eliminating, the behavioral effects of DPE.

Sustainable practices and household resilience: an empirical analysis of behavior change in times of crises

Understanding sustainability behavior is essential in tackling the global challenge of climate change. The importance of studying sustainability practices and their dynamics grows in light of recent global crises such as the COVID-19 pandemic and the energy crisis following the Ukraine war. These events both challenge and shape individual sustainable practices, offering opportunities for fostering individual sustainable practices and enhancing societal resilience. An online survey was conducted in Germany (n = 571, May 2023) to investigate sustainable behavior dynamics (mobility, energy-saving, and shopping habits) and to identify segments reflecting behavioral shifts. We found relative stability in sustainable mobility choices compared to pre-crisis times, with a tendency towards reduction, as well as an overall increase in energy-saving and sustainable shopping habits. Factor analyses revealed that sustainable mobility behavior (SMB) and sustainable consumer practices (SCP) formed two separate domains. Cluster analyses further identified four segments within each domain, each exhibiting unique behavioral patterns compared to pre-crisis practices. Examining individual variables, adopting more sustainable mobility practices was associated with sociodemographic factors (income, education, and area of living), higher levels of environmental awareness, institutional trust, and increased risk perceptions. Sociodemographic variables had less influence on sustainable consumer practices. Here, higher levels of knowledge, climate change awareness, trust, and risk perceptions played a significant role. Our findings highlight the importance of separately considering behavioral domains in understanding crises-induced changes in sustainability practices. Moreover, it is important to consider specific individual factors and to develop tailored interventions and policies to promote sustainable practices during volatile times.

Effects of one-to-one music therapy in older adults with cognitive impairment: A randomized controlled trial.

This study investigated the effects of music therapy (MT), a nonpharmacological therapy, on cognitive, behavioral, and physiological outcomes in older adults with mild-to-moderate cognitive decline residing in care home settings. A randomized controlled trial design was employed, with 42 care home residents (Mage = 86.25 years) randomly assigned to either a one-to-one 16-week MT intervention or an active control group receiving storytelling. Experimental and control activities were matched on key aspects, and groups were equivalent at baseline concerning demographic factors, general health, cognitive-behavioral characteristics, and cognitive reserve levels. Pre/postintervention neuropsychological and behavioral measures were collected, alongside saliva samples for cortisol/dehydroepiandrosterone ratio and respiratory sinus arrhythmia analysis as indicators of overall stress and autonomic regulation. The MT group exhibited benefits in cognitive, behavioral, and physiological domains, suggesting potential advantages in maintaining cognitive functioning and reducing neuropsychiatric symptoms. Biomarkers indicated possible mechanisms underlying the effectiveness of MT. The 16 one-to-one interactive MT sessions-delivered over 5 months-had a positive impact on older adults with mild-to-moderate cognitive decline living in care home settings. The implications of these findings for healthy aging and suggestions for future research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Taste and smell are associated with dietary intake, eating behavior, nutritional status, and health-related quality of life in children with cancer

Background & aimsSmell and taste changes are frequently reported bothersome treatment symptoms during treatment for childhood cancer and assumed to influence outcomes such as food intake. Since nutritional status of children with cancer is already vulnerable, any detrimental effects on food intake should be prevented. Therefore, understanding the exact relationship between chemosensory changes and dietary intake, eating behavior, and other domains such as health-related quality of life (HRQoL), is important for improving outcomes. MethodsIn this longitudinal study, we followed 87 childhood cancer patients treated for hematological, solid, or brain malignancies. Smell (odor threshold and odor identification) and taste function (total taste score) were objectively investigated using commercial Sniffin’ Sticks and Taste Strips respectively, and by self-report. Dietary intake was measured using a 3-day food dairy. For nutritional status, BMI expressed as standard deviation scores was derived from medical records. Eating behavior and HRQoL were assessed by the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and PedsQL 4.0 Generic Core Scales, respectively. Measurements were taken approximately 6 weeks (T0), 3 months (T1), 6 months after starting chemotherapy (T2), and 3 months after termination of chemotherapy or maintenance phase for children with acute lymphoblastic leukemia (ALL) (T3). Dietary intake, eating behavior, nutritional status, and HRQoL were modelled over time using mixed model analysis. Associations between smell and taste (objective and self-report), as well as patient characteries were studied. ResultsEnergy intake significantly increased during the study period, with a higher age, BMI, and total taste scores associated to this increase. Boys had higher energy intake compared to girls. Eating behavior scores significantly declined, indicating less eating problems. Age, pre-diagnosis eating behavior, self-reported smell changes, and tube feeding were associated to eating behavior. BMI significantly increased, with a higher BMI at diagnosis to be related to a higher BMI during the study period. A lower BMI was found in children receiving tube feeding and self-reported taste changes. HRQoL improved during the study period, with lower HRQoL in children receiving tube feeding and self-reported taste changes. ConclusionBoth objective and subjective measures of taste and smell influence dietary intake, eating behavior, nutritional status, and HRQoL. Individual dietary advice and coping strategies are warranted to prevent detrimental effects of chemosensory changes on food intake and clinical outcomes in children with cancer.

Decomposing the Brain in Autism: Linking Behavioral Domains to Neuroanatomical Variation and Genomic Underpinnings

Decomposing the Brain in Autism: Linking Behavioral Domains to Neuroanatomical Variation and Genomic Underpinnings

The Influence of Cultural Diversity on Team Performance in Multinational Corporations

The primary objective of this research is to examine and analyze the impact of cultural diversity on the overall effectiveness and productivity of teams operating inside international organizations. The primary objective of this research is to bridge the existing knowledge deficit in the domain of cross-cultural management and organizational behavior. This is achieved by conducting an investigation into the intricate association between cultural diversity and team performance inside MNCs. In the context of this study, a mixed-methods approach is considered the most suitable methodology. This methodology enables a thorough examination of the correlation between cultural diversity and team performance, encompassing the utilization of both quantitative and qualitative data. The results emphasize the importance for MNCs to implement comprehensive strategies that take into account the specificities of leadership, organizational culture, and team dynamics in order to effectively use the benefits of cultural diversity. By engaging in such practices, firms can effectively tackle the complexities associated with cultural diversity and bolster their global competitive advantage. Through the implementation of these strategies, MNCs have the opportunity to effectively utilize the advantages presented by cultural diversity, hence enhancing their competitive advantage within the global market.

Prevalence of cardiovascular risk factors according to Life's Essential 8 in children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis including 1 526 173 participants from 42 countries.

Cardiovascular health is a crucial aspect of overall health. The aim of this study was to estimate the prevalence of cardiovascular risk factors among children and adolescents during the COVID-19 pandemic based on the Life's Essential 8 domains. PubMed, Scopus and Web of Science were systematically searched until 24 February 2023. Studies had to meet the following criteria: (1) observational studies, (2) studies reporting proportion of selected risk factors, (3) studies involving children or adolescents, (4) studies that collected data during the COVID-19 pandemic and (5) studies with representative samples. The outcomes included were diet, physical activity, nicotine exposure, sleep health, obesity, dyslipidaemia, diabetes and elevated blood pressure. Sixty-two studies with 1 526 173 participants from 42 countries were included. Of these, 41 studies were used in the meta-analyses. The overall pooled prevalence of risk factors in the behavioural domain was as follows: poor quality diet 26.69% (95% CI 0.00%-85.64%), inadequate physical activity 70.81% (95% CI 64.41%-76.83%), nicotine exposure 9.24% (95% CI 5.53%-13.77%) and sleep disorders 33.49% (95% CI 25.24%-42.28%). The overall pooled prevalence of risk factors in the health domain was as follows: obesity 16.21% (95% CI 12.71%-20.04%), dyslipidaemia 1.87% (95% CI 1.73%-2.01%), diabetes 1.17% (95% CI 0.83%-1.58%) and elevated blood pressure 11.87% (95% CI 0.26%-36.50%). These results highlight the need for prevention strategies to maintain better cardiovascular health from an early age, particularly by increasing physical activity levels, sleep time and promoting the consumption of more fruits and vegetables.

Multivariate patterns linking brain microstructure to temperament and behavior in adolescent eating disorders.

Eating disorders (EDs) are multifaceted psychiatric disorders characterized by varying behaviors, traits, and cognitive profiles thought to drive symptom heterogeneity and severity. Non-invasive neuroimaging methods have been critical to elucidate the neurobiological circuitry involved in ED-related behaviors, but often focused on a limited set of regions of interest and/or symptoms. The current study harnesses multivariate methods to map microstructural and morphometric patterns across the entire brain to multiple domains of behavior and symptomatology in patients. Diffusion-weighted images, modeled with restriction spectrum imaging, were analyzed for 91 adolescent patients with an ED and 48 healthy controls. Partial least squares analysis was applied to map 38 behavioral measures (encompassing cognition, temperament, and ED symptoms) to restricted diffusion in white matter tracts and subcortical structures across 65 regions of interest. The first significant latent variable explained 46.9% of the covariance between microstructure and behavior. This latent variable retained a significant brain-behavior correlation in held-out data, where an 'undercontrolled' behavioral profile (e.g., higher emotional dysregulation, novelty seeking; lower effortful control and interoceptive awareness) was linked to increased restricted diffusion across white matter tracts, particularly those joining frontal, limbic, and thalamic regions. Individually-derived brain and behavior scores for this latent variable were higher in patients with binge-purge symptoms, compared to those with only restrictive eating symptoms. Findings demonstrate the value of applying multivariate modeling to the array of brain-behavior relationships inherent to the clinical presentation of EDs, and their relevance for providing a neurobiologically-informed model for future clinical subtyping and prediction efforts.

Real-world patient experience with medicinal cannabis use for symptom management in an Australian advanced cancer setting: a mixed method, cohort study using the theory of planned behaviour framework

PurposePatient hesitancy to use MC due to the fear of negative social implications leads to intentional non-adherence and compromises therapeutic outcomes. Hence, we aimed to determine the rate of patient adherence to MC and explore factors influencing patient MC use.MethodsDemographic and quantitative data related to MC usage were extracted from medical records for patients prescribed MC at a single cancer centre in metropolitan Sydney. Qualitative data was generated from semi-structured interviews. Interview guides were developed based on the Theory of Planned Behaviour (TBP) domains (i.e. Attitudes, Subjective Norms, Behavioural Intention and Perceived Behavioural Control) to elucidate themes influencing MC use. A mixed method approach involving triangulation of quantitative and qualitative methods was used for data analysis.ResultsTwenty patients were included in the study, and the majority of patients showed adherence (n = 14, 70%). The MC formulation used (p = .018), symptom relief (p = .001) and side effects experienced (p = .007) significantly influenced MC adherence. In addition to side effects experienced, findings for barriers to adherence were convergent or complementary for other medication-related factors, including the inconvenience of MC co-administration with food, cost and unpleasant taste.ConclusionsMC adherence is influenced by its effectiveness for symptom relief whereby appropriate MC formulation selection is crucial and should be determined by the indication (or symptom clusters). Social factors such as the views and experiences of close others had little bearing on MC adherence.

Motor learning is modulated by dopamine availability in the sensorimotor putamen.

Successful motor skill acquisition requires the dynamic interaction of multiple brain regions, with the striatum playing a critical role in this network. Animal studies suggest that dopaminergic mechanisms are involved in the regulation of motor learning-associated striatal plasticity. In humans, however, the contribution of nigrostriatal dopaminergic transmission to motor learning remains elusive beyond its well-characterized role in initiation and fluent execution of movements. In this prospective observational study, we investigated motor sequence learning in individuals who had undergone 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane single-photon emission computed tomography for the differential diagnosis of Parkinson's disease (n = 41) and age-matched healthy controls (n = 20). We found that striatal dopamine transporter depletion exhibited distinct spatial patterns that were associated with impairments in motor sequence learning and the manifestation of Parkinsonian motor symptoms, respectively. Specifically, significant associations between striatal dopamine transporter depletion and impairments in motor sequence learning were confined to posterior putaminal regions, whereas significant associations of striatal dopamine transporter depletion with Parkinsonian motor symptom severity showed a widespread spatial pattern across the entire striatal volume with an anterior maximum. Normative functional connectivity analysis revealed that both behavioural domains shared largely overlapping connectivity patterns with the basal ganglia and supplementary motor area. However, apart from connectivity with more posterior parts of the supplementary motor area, significant functional connectivity with primary motor cortical areas was only present for striatal dopamine transporter availability-related modulation of online motor learning. Our findings indicate that striatal dopaminergic signalling plays a specific role in motor sequence learning beyond its influence on mere motor execution, implicating learning-related sensorimotor striatum recruitment and cortico-striatal plasticity as dopamine-dependent mechanisms.

Abstract 4125581: Association Between Life’s Essential 8 and Premature Atherosclerotic Cardiovascular Disease: A Cross-sectional Study Among Young Adults in the United States

Background: Among patients presenting with atherosclerotic cardiovascular disease (ASCVD), the proportion of young individuals has increased in recent years. Life’s Essential 8 (LE8), containing two domains of health behaviors and health factors, is an updated monitoring measurement of cardiovascular health by assessing 8 modifiable risk factors. Objective: The objective of this study is to investigate the potential relationship between the LE8 score and a history of premature ASCVD among young adults residing in the United States. Methods: This population-based cross-sectional study utilized data from the National Health and Nutrition Examination Survey spanning 2005 to 2018, focusing specifically on adults aged 20 to 45. LE8 score was measured and categorized into low (0-49), moderate (50-79), and high (80-100) levels (Figure 1). Premature ASCVD status was determined by interviews conducted at enrollment, encompassing a self-reported composite disease history of coronary heart disease, angina pectoris, heart attack, and stroke. Following descriptive statistics, weighted multivariable logistic regression and restricted cubic spline models were employed to evaluate the associations between the LE8 score and premature ASCVD. Additionally, subscale and subgroup analysis were developed. Results: Among 17,499 participants, 9846 were eligible for analysis (weighted mean age, 32.7 years; male, 50.3%), and 167 had premature ASCVD history (weighted percentage, 1.46%). The weighted mean LE8 score of the study population was 71.99 (0.3). Following the adjustment for potential confounders, individuals with higher LE8 scores exhibited a reduced risk of developing premature ASCVD (Table 1). A nonlinear relationship was observed and similar patterns were also identified in the association of health behaviors and health factors scores with premature ASCVD (Figure 2). This inverse association was consistently observed across various subgroups, including sex, age strata, ethnicity, education, and income levels, with no significant interactions identified. Conclusions: The LE8 score and its subscale scores exhibited a negative, nonlinear association with premature ASCVD. Maintaining a healthy lifestyle and controlling modifiable risk factors are crucial in preventing premature ASCVD in the younger demographic. Further studies, encompassing prospective cohorts, are needed to confirm this finding.

Sex-dependent effects of early life sensory overstimulation on later life behavioral function in rats

Children today are immersed in electronic technology shortly after birth as they now begin regularly watching television earlier than they did in the past. Many new programs geared towards infants contain lots of lights, color, and sounds, which may constitute a form of sensory overstimulation (SOS) that leads to cognitive and behavioral changes in children and adolescents. Here, we examined the impact of early life SOS exposure on later life behavioral and cognitive function in rodents by exposing developing male and female rats to excessive audiovisual stimulation from postnatal days (PND) 10–40 and assessing anxiety-like behavior, social motivation, compulsive behavior, and spatial learning/cognition from PND 50–60. To evaluate potential SOS effects on hypothalamic–pituitary–adrenal (HPA)-axis function, levels of the stress hormone corticosterone (CORT) were measured at 3 timepoints (e.g., PND 23, 41, 61) post-SOS exposure. Sensory overstimulated males exhibited reduced anxiety-like and compulsive behavior compared to controls, whereas females exhibited reduced social motivation but enhanced spatial learning/cognition compared to controls. No differences in baseline CORT levels were found at any age tested, suggesting no impact of early life SOS on later life basal HPA-axis function. Our results demonstrate sex-specific effects of early life SOS on distinct behavioral domains in early adult rats.

Teacher Support and Student Engagement in the Conduct of Blended Learning Instruction for English as A Foreign Language

With the deep integration of information technology and education, blended learning has emerged as a new paradigm in higher education, combining the strengths of both online and offline learning environments. This approach allows English as Foreign Language (EFL) learners, particularly in the Chinese context, to engage in flexible and continuous learning beyond traditional classroom settings, thereby fostering greater student initiative and self-directed learning. Understanding the impact of teacher support on student engagement within this blended learning framework is crucial for optimizing educational outcomes. This study employed a quantitative descriptive comparative and correlational research design to examine the relationship between various forms of teacher support—instructional, emotional, feedback, and interpersonal—and student engagement among 307 Chinese EFL learners in a blended learning environment. The findings reveal that all forms of teacher support were perceived as high, with feedback provision ranking highest. Similarly, student engagement was also rated highly across behavioral, cognitive, emotional, and social domains. The Pearson correlation coefficient between teacher support and student engagement was found to be 0.75, indicating a significant positive relationship. Based on these findings, a program aimed at enhancing teacher support to further improve student engagement in blended learning environments was developed and recommended.

Psychometric Validation of the CLN2 Quality of Life Questionnaire in Participants with CLN2 Disease Treated with Cerliponase Alfa.

This study evaluated the psychometric properties of the ceroid lipofuscinosis type 2 Quality of Life (CLN2 QoL) questionnaire. Data from children with CLN2 disease aged 3-16 years receiving cerliponase alfa in the BMN 190-201 and BMN 190-202 clinical studies, collected via purposive sampling, were used to assess convergent and divergent validity, internal consistency and reliability. The clinically important difference (CID) was estimated with distribution- and anchor-based methods. Descriptive and inferential statistical analyses were conducted using IBM SPSS. CLN2 QoL data of 22 participants were analysed. Ceiling effects were observed in 22 items (35% threshold); no floor effects were observed. Internal consistency analysis showed good reliability (Cronbach's alpha and Omega reliability >0.7) for four domains at study completion; only one domain had good reliability at baseline. All domains had good test-retest reliability (correlation >0.5) except Feeding With G-Tube and Seizures. Convergent and divergent correlation analysis showed moderate-strong correlations (>0.4) between PedsQL and CLN2 QoL total scores, between the Pediatric Quality of Life Inventory (PedsQL) total score and most CLN2 QoL domains at baseline, and between CLN2 QoL total score and most PedsQL domains at week 97. Known groups validity showed a significant difference in means for the Behaviour domain (p = 0.05) for reasons that could not be clarified. CID was 6.79-12.94 for domains; total score CID was 6.91 using distribution-based and 6.13-13.05 using anchor-based methods. This study is the first to validate the CLN2 QoL and to estimate the CID of this instrument in CLN2 patients. Our results show good validity and reliability of this tool.

Effect of an Educational Program on the Stress level Among Mothers of Neonates Hospitalized in Neonatal Intensive Care Units

Background: Mothers encounter significant psychological distress resulting from the premature birth of their infants, coupled with the need of hospitalization in the Neonatal Intensive Care Unit (NICU), which necessitates prolonged separation from their familial support systems. Aim: to assess the effect of an educational program on the stress level among mothers of neonates hospitalized in neonatal intensive care units. Methods: A quasi-experimental design was undertaken involving 44 mothers of neonates who were admitted to the Neonatal Intensive Care Units (NICUs) at the Children's Hospital and the Maternity & Gynecological Hospital. Researchers used maternal stress scale. Results: Mean score of studied mothers related Sights and sounds domain at preintervention was 24.97 (5.32), while decrease to 15.23 (3.60) postintervention. Also, according to looks and behavior domain mean score was 23.04 (3.90) preintervention, while decrease to 13.61 (2.76) post intervention. Additionally, according to Parental role alteration domain mean score was 26.82 (4.10) preintervention, while decrease to 16.70 (2.34) post intervention. Conclusion: Less than fifty percent of the mothers analyzed exhibited elevated levels of stress prior to the intervention, with approximately one-third demonstrating moderate stress levels. Conversely, following the intervention, less than two-thirds of the participants reported low stress levels, while over one-quarter indicated moderate stress levels. Furthermore, an educational intervention has been demonstrated to reduce maternal stress across various domains, including the auditory and visual realms, the observational and behavioral dimensions, the modifications in parental roles, as well as the overall stress levels experienced by mothers. Recommendations: The formulation of an educational framework aimed at mothers of preterm neonates who have been admitted to the neonatal intensive care unit is essential. It is imperative to furnish parents with psychological empowerment training initiatives designed to facilitate the adoption of proactive coping methodologies to navigate adversities during periods of crisis.

Chronic corticosterone exposure causes anxiety- and depression-related behaviors with altered gut microbial and brain metabolomic profiles in adult male C57BL/6J mice

Chronic exposure to glucocorticoids in response to long-term stress is thought to be a risk factor for major depression. Depression is associated with disturbances in the gut microbiota composition and peripheral and central energy metabolism. However, the relationship between chronic glucocorticoid exposure, the gut microbiota, and brain metabolism remains largely unknown. In this study, we first investigated the effects of chronic corticosterone exposure on various domains of behavior in adult male C57BL/6J mice treated with the glucocorticoid corticosterone to evaluate them as an animal model of depression. We then examined the gut microbial composition and brain and plasma metabolome in corticosterone-treated mice. Chronic corticosterone treatment resulted in reduced locomotor activity, increased anxiety-like and depression-related behaviors, decreased rotarod latency, reduced acoustic startle response, decreased social behavior, working memory deficits, impaired contextual fear memory, and enhanced cued fear memory. Chronic corticosterone treatment also altered the composition of gut microbiota, which has been reported to be associated with depression, such as increased abundance of Bifidobacterium, Turicibacter, and Corynebacterium and decreased abundance of Barnesiella. Metabolomic data revealed that long-term exposure to corticosterone led to a decrease in brain neurotransmitter metabolites, such as serotonin, 5-hydroxyindoleacetic acid, acetylcholine, and gamma-aminobutyric acid, as well as changes in betaine and methionine metabolism, as indicated by decreased levels of adenosine, dimethylglycine, choline, and methionine in the brain. These results indicate that mice treated with corticosterone have good face and construct validity as an animal model for studying anxiety and depression with altered gut microbial composition and brain metabolism, offering new insights into the neurobiological basis of depression arising from gut-brain axis dysfunction caused by prolonged exposure to excessive glucocorticoids.

Exploring challenges and enablers for community pharmacists using electronic prescriptions (Wasfaty) in Makkah region, Saudi Arabia: a qualitative study using the theoretical domains framework.

Transition to electronic prescribing (e-prescribing) systems, such as Wasfaty, represents a significant advancement in healthcare. Introduced by the Saudi Arabian Ministry of Health in 2019, Wasfaty aims to enhance medication availability and streamline healthcare delivery. This study explores the challenges and enablers community pharmacists face when using the Wasfaty system in Saudi Arabia. This study uses the Theoretical Domains Framework (TDF) to analyse behavioural and contextual factors influencing pharmacists' adoption of electronic prescriptions. TDF identifies key challenges and enablers across multiple behavioural domains, making it well-suited for understanding complex healthcare implementation processes. A qualitative study design was employed using the Theoretical Domains Framework (TDF) to understand factors affecting Wasfaty use. Participants were purposively sampled, focusing on community pharmacists experienced with Wasfaty prescriptions. Recruitment and interviews occurred from June to August 2024. Data saturation was achieved at 18 interviews. Transcripts were coded and mapped into TDF domains to identify barriers and enablers. Five key TDF domains influenced Wasfaty use: environmental context and resources; social influences; beliefs about capabilities; social/professional role and identity; and knowledge. Challenges included high prescription volumes, medication shortages, technical difficulties, resistance from elderly patients, and inconsistent training. Some pharmacists reported inadequate training as a barrier, while others highlighted effective programs as enablers. Significant barriers, such as insufficient training and high prescription volumes, impede effective Wasfaty use. However, continuous training, prior experience with electronic systems, and organisational support were crucial enablers. Addressing these challenges through targeted interventions can enhance e-prescription efficiency, improving patient care and outcomes. Findings underscore the importance of ongoing professional development and supportive work environments in fostering pharmacists' competence in electronic systems.