Behavioral Outcomes Research Articles

Emerging roles of cannabinoid receptor CB2 receptor in the central nervous system: therapeutic target for CNS disorders.

The endocannabinoid system (ECS) belongs to the G protein-coupled receptor family of cell membranes and is associated with neuropsychiatric conditions, and neurodegenerative diseases. Cannabinoid 2 receptors (CB2) are expressed in the central nervous system (CNS) on microglia and subgroups of neurons and are involved in various behavioural processes via immunological and neural regulation. The objective of this paper is to summarize and explore the impact of CB2 receptors on neuronal modulation, their involvement in various neurological disorders, and their influence on mood, behavior, and cognitive function. The activation of CB2 appears to protect the brain and its functions from damage under neuroinflammatory actions, making it an attractive target in a variety of neurological conditions such as Parkinson's disease (PD), multiple sclerosis (MS), Alzheimer's disease (AD), and Huntington's disease (HD). During inflammation, there is an overexpression of CB2 receptors, and CB2 agonists show a strong anti-inflammatory effect. These results have sparked interest in the CB2 receptors as a potential target for neurodegenerative and neuroinflammatory disease treatment. In conclusion, CB2 receptors signalling shows promise for developing targeted interventions that could positively affect both immune and neuronal functions, ultimately influencing behavioral outcomes in both health and disease.

Estimation of gestational age-specific reference intervals for coagulation assays in a neonatal intensive care unit using real-world data

BackgroundInterpretation of coagulation testing in neonates currently relies on reference intervals (RIs) defined from older patient cohorts. Direct RI studies are difficult, but indirect estimation may allow us to infer normative neonatal distributions from routinely collected clinical data. ObjectiveAssess the utility of indirect reference interval methods in estimating coagulation reference intervals in critically ill neonates. MethodsWe analyzed first-in-life coagulation testing results from all patients admitted to a level IV neonatal intensive care unit between January 1, 2018, and January 1, 2024. Results obtained after transfusion of any blood product were excluded. Indirect RIs were estimated across gestational age groups using refineR and compared with currently reported intervals for patients less than 1 year of age. ResultsProthrombin times (PTs) and international normalized ratios (INRs) were available for 1128 neonates, while activated partial thromboplastin times (APTTs) were available for 790 neonates. The indirect RI was 10 to 25 seconds in preterm, 10 to 22 seconds in term, and 10 to 24 seconds in all neonates for PT; 0.7 to 2.1 in preterm, 0.8 to 1.8 in term, and 0.8 to 1.9 in all neonates for INR; and 25 to 68 seconds in preterm, 25 to 58 seconds in term, and 25 to 62 seconds in all neonates for APTT. Compared with our current intervals, the indirect RIs would flag 58% fewer PT, 43% fewer INR, and 17% fewer APTT results as abnormal. ConclusionIndirectly estimated RIs in neonates admitted to intensive care show substantial divergence from current, first-year-of-life RIs, leading to an abundance of abnormal flags. The associations between these flags and provider behavior, transfusion practice, or clinical outcomes are areas of future exploration.

Hemodynamics of the Frontopolar and Dorsolateral Pre-Frontal Cortex in People with Multiple Sclerosis During Walking, Cognitive Subtraction, and Cognitive-Motor Dual-Task.

Higher cortical activity has been observed in people with multiple sclerosis (pwMS) during walking and dual-tasking. However, further studies in overground walking and considering pre-frontal cortex (PFC) sub-areas are necessary. To investigate PFC activity during a cognitive-motor dual-task (DT) and its single component tasks, in combination with behavioral outcomes in pwMS. Fifteen pwMS (EDSS 3.5 [2-5.5], 42 ± 11 years) and 16 healthy controls (HC, 45.2 ± 13.2 years) performed 3 conditions: single motor-walking (SWT), single cognitive - subtracting sevens (SCT), and a DT. Meters walked and the number of correct answers were obtained from which, respectively, the motor (mDTC) and cognitive (cDTC) DT costs were calculated. A functional Near-Infrared Spectroscopy covering the frontopolar and dorsolateral PFC (DLPFC) areas was used to concentration of relative oxyhemoglobin (ΔHbO2) and deoxyhemoglobin (ΔHHb) in the PFC. A repeated 2-way ANOVA (group × conditions) was used to compare ΔHbO2/ΔHHb and behavioral outcomes. PwMS walked shorter distances (P < .002) and answered fewer correct numbers (P < .03) than HC in all conditions, while cDTC and mDTC were similar between groups. PwMS presented higher ΔHbO2 in the frontopolar area than HC in the SWT (P < .001). HC increased ΔHbO2 in frontopolar during the SCT (P < .029) and DT (P < .037) compared with the SWT. Higher frontopolar activity in pwMS compared to HC in the SWT suggests reduced gait automaticity. Furthermore, it seems that only HC increased neural activity in the frontopolar in the SCT and DT, which might suggest a limit of cognitive resources to respond to DT in pwMS.

Motivation Theories Affecting Organizational Commitment in the Workplace

In today's working life, as competition is increasing, ensuring the loyalty of employees to the organization is important for organizations to survive. In the literature, it is considered important to determine employees' attitudes toward work through motivation theories in order to ensure commitment to the organization. The sustainability of business organizations is shaped by the level of commitment of the organization's employees, and the goal of organizations is to ensure that their employees do not leave the organization, which draws attention to the importance of motivation theories for organizations. The subject of the study was to explain the evaluation of organizational commitment of organizational employees by providing support from motivation theories. The purpose of the study is to compile the attitudes of employees toward their work environment, motivation theories that affect the organizational commitment of individuals, and studies in the literature in the field of industrial and organizational psychology. The method of the research is based on the studies on organizational commitment and motivation theories in Turkey and the world between 1948 and 2023 in YÖK National Thesis Center, Google Scholar, ProQuest, ResearchGate databases such as "organization", "organizational commitment", "motivation", "motivation theories", "industrial and organizational psychology". It was reached by searching with the keywords. As a result of the search, the universe consisted of 75 articles, books, and master's and doctoral theses. 68 articles, books and dissertation materials were selected as the sample of the research. The importance of the study was explained by including the concept of organizational commitment, factors affecting organizational commitment and behavioral outcomes, motivation theories, employees' values regarding work life, factors affecting their organizational commitment, studies in the literature were evaluated and discussed within the framework of industrial and organizational psychology.

Strategies for Implementing GlobalConsent to Prevent Sexual Violence in University Men (SCALE): Study Protocol for a National Implementation Trial.

Globally, women 15-24 years are at heightened risk of sexual violence victimization, a risk factor for adverse mental, physical, and behavioral health outcomes. Sexual violence is common at universities and most often perpetrated by men, yet few evidence-based prevention strategies targeting men have been tested in low- and middle-income countries. GlobalConsent is a six-module, web-based educational program adapted from an efficacious U.S.-based program. Nine months post-treatment in a randomized trial in Vietnam, GlobalConsent reduced men's sexually violent behavior (Odds Ratio [OR] = 0.71, 95%CI 0.50-1.00) and increased prosocial intervening behavior (OR = 1.51, 1.00-2.28) relative to an attention-control. Evidence regarding optimal implementation strategies for scale up is needed. We will randomize six medical universities in North, Central, and South Vietnam to deliver GlobalConsent using two different packages of implementation strategies that vary in intensity. Higher-intensity strategies will include greater 1) pre- and post-implementation engagement with university leaders and faculty, and 2) greater pre-implementation outreach, follow-up, and incentives for students to promote engagement and completion of GlobalConsent. Higher intensity universities will receive additional training and support for their added activities. We will compare implementation drivers and outcomes, intervention effectiveness, and cost-effectiveness across the two implementation bundles. Our mixed-methods comparative interrupted time-series design includes 1) qualitative interviews and quantitative surveys with university leaders and implementation teams to assess implementation barriers and facilitators; 2) repeated surveys with leaders and faculty, implementation teams, and male students to assess multilevel implementation drivers and outcomes, 3) repeated surveys with male students to assess behavioral outcomes (sexual violence and intervening behavior) and mediating variables (knowledge, attitudes, affect, and capacities), and 4) time diaries and cost tracking to assess cost effectiveness of the two implementation-strategies bundles. This project is the first to assess packages of implementation strategies to deliver an efficacious web-based sexual-violence-prevention program for undergraduate men across all regions of Vietnam and synergizes with a violence-prevention training initiative (D43TW012188). This approach will produce rigorous evidence about how to disseminate GlobalConsent nationally, which holds promise to reduce gender-based health inequities linked to sexual violence as GlobalConsent is brought to scale. NCT06443541. Retrospectively registered with clinicaltrials.gov.

Microbiome contributions to pain: a review of the preclinical literature.

Over the past 2 decades, the microbiome has received increasing attention for the role that it plays in health and disease. Historically, the gut microbiome was of particular interest to pain scientists studying nociplastic visceral pain conditions given the anatomical juxtaposition of these microorganisms and the neuroimmune networks that drive pain in such diseases. More recently, microbiomes both inside and across the surface of the body have been recognized for driving sensory symptoms in a broader set of diseases. Microbiomes have never been a more popular topic in pain research, but to date, there has not been a systematic review of the preclinical microbiome pain literature. In this article, we identified all animal studies in which both the microbiome was manipulated and pain behaviors were measured. Our analysis included 303 unique experiments across 97 articles. Microbiome manipulation methods and behavioral outcomes were recorded for each experiment so that field-wide trends could be quantified and reported. This review specifically details the animal species, injury models, behavior measures, and microbiome manipulations used in preclinical pain research. From this analysis, we were also able to conclude how manipulations of the microbiome alter pain thresholds in naïve animals and persistent pain intensity and duration in cutaneous and visceral pain models. This review summarizes by identifying existing gaps in the literature and providing recommendations for how to best plan, implement, and interpret data collected in preclinical microbiome pain experiments.

Amelioration of Focal Hand Dystonia via Low-Frequency Repetitive Somatosensory Stimulation.

Dystonia presents a growing concern based on evolving prevalence insights. Previous research found that, in cervical dystonia, high-frequency repetitive somatosensory stimulation (RSS; HF-RSS) applied on digital nerves paradoxically diminishes sensorimotor inhibitory mechanisms, whereas low-frequency RSS (LF-RSS) increases them. However, direct testing on affected body parts was not conducted. This study aims to investigate whether RSS applied directly to forearm muscles involved in focal hand dystonia can modulate cortical inhibitory mechanisms and clinical symptoms. We applied HF-RSS and LF-RSS, the latter either synchronously or asynchronously, on forearm muscles involved in dystonia. Outcome measures included paired-pulse somatosensory evoked potentials, spatial lateral inhibition measured by double-pulse somatosensory evoked potentials, short intracortical inhibition tested with transcranial magnetic stimulation, electromyographic activity from dystonic muscles, and behavioral measures of hand function. Both synchronous and asynchronous low-frequency somatosensory stimulation improved cortical inhibitory interactions, indicated by increased short intracortical inhibition and lateral spatial inhibition, as well as decreased amplitude of paired-pulse somatosensory evoked potentials. Opposite effects were observed with high-frequency stimulation. Changes in electrophysiological markers were paralleled by behavioral outcomes: although low-frequency stimulations improved hand function tests and reduced activation of dystonic muscles, high-frequency stimulation operated in an opposite direction. Our findings confirm the presence of abnormal homeostatic plasticity in response to RSS in the sensorimotor system of patients with dystonia, specifically in inhibitory circuits. Importantly, this aberrant response can be harnessed for therapeutic purposes through the application of low-frequency electrical stimulation directly over dystonic muscles. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Hematopoietic Endothelial Progenitor cells enhance motor function and cortical motor map integrity following cerebral ischemia.

Hematopoietic stem cells (HSC) are recruited to ischemic areas in the brain and contribute to improved functional outcome in animals. However, little is known regarding the mechanisms of improvement following HSC administration post cerebral ischemia. To better understand how HSC effect post-stroke improvement, we examined the effect of HSC in ameliorating motor impairment and cortical dysfunction following cerebral ischemia. Baseline motor performance of male adult rats was established on validated motor tests. Animals were assigned to one of three experimental cohorts: control, stroke, stroke + HSC. One, three and five weeks following a unilateral stroke all animals were tested on motor skills after which intracortical microstimulation was used to derive maps of forelimb movement representations within the motor cortex ipsilateral to the ischemic injury. Stroke + HSC animals significantly outperformed stroke animals on single pellet reaching at weeks 3 and 5 (28±3% and 33±3% versus 11±4% and 17±3%, respectively, p < 0.05 at both time points). Control animals scored 44±1% and 47±1%, respectively. Sunflower seed opening task was significantly improved in the stroke + HSC cohort versus the stroke cohort at week five-post stroke (79±4 and 48±5, respectively, p < 0.05). Furthermore, Stroke + HSC animals had significantly larger forelimb motor maps than animals in the stroke cohort. Overall infarct size did not significantly differ between the two stroked cohorts. These data suggest that post stroke treatment of HSC enhances the functional integrity of residual cortical tissue, which in turn supports improved behavioral outcome, despite no observed reduction in infarct size.

The degenerate coding of psychometric profiles through functional connectivity archetypes.

Degeneracy in the brain-behavior code refers to the brain's ability to utilize different neural configurations to support similar functions, reflecting its adaptability and robustness. This study aims to explore degeneracy by investigating the non-linear associations between psychometric profiles and resting-state functional connectivity (RSFC). The study analyzed RSFC data from 500 subjects to uncover the underlying neural configurations associated with various psychometric outcomes. Self-organized maps (SOM), a type of unsupervised machine learning algorithm, were employed to cluster the RSFC data. And identify distinct archetypal connectivity profiles characterized by unique within- and between-network connectivity patterns. The clustering analysis using SOM revealed several distinct archetypal connectivity profiles within the RSFC data. Each archetype exhibited unique connectivity patterns that correlated with various cognitive, physical, and socioemotional outcomes. Notably, the interaction between different SOM dimensions was significantly associated with specific psychometric profiles. This study underscores the complexity of brain-behavior interactions and the brain's capacity for degeneracy, where different neural configurations can lead to similar behavioral outcomes. These findings highlight the existence of multiple brain architectures capable of producing similar behavioral outcomes, illustrating the concept of neural degeneracy, and advance our understanding of neural degeneracy and its implications for cognitive and emotional health.

Early life stress influences epilepsy outcomes in mice.

Stress is a common seizure trigger that has been implicated in worsening epilepsy outcomes. The neuroendocrine response to stress is mediated by the hypothalamic-pituitary-adrenal (HPA) axis and HPA axis dysfunction worsens epilepsy outcomes, increasing seizure burden, behavioral comorbidities, and risk for sudden unexpected death in epilepsy (SUDEP) in mice. Early life stress (ELS) reprograms the HPA axis into adulthood, impacting both the basal and stress-induced activity. Thus, we propose that ELS may influence epilepsy outcomes by influencing the function of the HPA axis. To test this hypothesis, we utilized the maternal separation paradigm and examined the impact on seizure susceptibility. We show that ELS exerts a sex dependent effect on seizure susceptibility in response to acute administration of the chemoconvulsant, kainic acid, which is associated with an altered relationship between seizure activity and HPA axis function. To further examine the impact of ELS on epilepsy outcomes, we utilized the intrahippocampal kainic acid model of chronic epilepsy in mice previously exposed to maternal separation. We find that the relationship between corticosterone levels and the extent of epileptiform activity is altered in mice subjected to ELS. We demonstrate that ELS impacts behavioral outcomes associated with chronic epilepsy in a sex-dependent manner, with females being more affected. We also observe reduced mortality (presumed SUDEP) in female mice subjected to ELS, consistent with previous findings suggesting a role for HPA axis dysfunction in SUDEP risk. These data demonstrate for the first time that ELS influences epilepsy outcomes and suggest that previous life experiences may impact the trajectory of epilepsy.

Theoretical foundations and implications of augmented reality, virtual reality, and mixed reality for immersive learning in health professions education

BackgroundAugmented Reality (AR), Virtual Reality (VR) and Mixed Reality (MR) are emerging technologies that can create immersive learning environments for health professions education. However, there is a lack of systematic reviews on how these technologies are used, what benefits they offer, and what instructional design models or theories guide their use.AimThis scoping review aims to provide a global overview of the usage and potential benefits of AR/VR/MR tools for education and training of students and professionals in the healthcare domain, and to investigate whether any instructional design models or theories have been applied when using these tools.MethodologyA systematic search was conducted in several electronic databases to identify peer-reviewed studies published between and including 2015 and 2020 that reported on the use of AR/VR/MR in health professions education. The selected studies were coded and analyzed according to various criteria, such as domains of healthcare, types of participants, types of study design and methodologies, rationales behind the use of AR/VR/MR, types of learning and behavioral outcomes, and findings of the studies. The (Morrison et al. John Wiley & Sons, 2010) model was used as a reference to map the instructional design aspects of the studies.ResultsA total of 184 studies were included in the review. The majority of studies focused on the use of VR, followed by AR and MR. The predominant domains of healthcare using these technologies were surgery and anatomy, and the most common types of participants were medical and nursing students. The most frequent types of study design and methodologies were usability studies and randomized controlled trials. The most typical rationales behind the use of AR/VR/MR were to overcome limitations of traditional methods, to provide immersive and realistic training, and to improve students’ motivations and engagements. The most standard types of learning and behavioral outcomes were cognitive and psychomotor skills. The majority of studies reported positive or partially positive effects of AR/VR/MR on learning outcomes. Only a few studies explicitly mentioned the use of instructional design models or theories to guide the design and implementation of AR/VR/MR interventions.Discussion and conclusionThe review revealed that AR/VR/MR are promising tools for enhancing health professions education, especially for training surgical and anatomical skills. However, there is a need for more rigorous and theory-based research to investigate the optimal design and integration of these technologies in the curriculum, and to explore their impact on other domains of healthcare and other types of learning outcomes, such as affective and collaborative skills. The review also suggested that the (Morrison et al. John Wiley & Sons, 2010) model can be a useful framework to inform the instructional design of AR/VR/MR interventions, as it covers various elements and factors that need to be considered in the design process.

Psychological profiles in patients receiving maintenance dialysis: Classification, correlates, and behavioral health outcomes.

This study identified psychological profiles based on depressive symptoms, anxiety symptoms, positive affect, and posttraumatic growth in 298 patients receiving maintenance dialysis, and examined their relationships with self-management at baseline and 1-year follow-up. Five psychological response profiles were identified: well-being (42.95%), resilient (26.17%), moderate-distress-with-growth (17.79%), distressed (11.07%), and high-distress-with-growth (2.01%). Patients were more likely to be in the distressed profile if they were younger, had less social support, received peritoneal dialysis, and suffered from a greater symptom burden of kidney disease. The well-being profile showed better self-management behavior at baseline and 1-year follow-up. The distressed profile was associated with worse self-management at baseline and the resilient profile was associated with worse self-management at follow-up. The findings highlighted the beneficial role of positive psychological constructs in promoting self-management behavior, which implied that beyond eliminating psychological distress, it is important to facilitate positive psychological well-being.

A systematic review of research on emotional artificial intelligence in English language education

In learning English as a foreign language (EFL), students often experience foreign language anxiety. Artificial intelligence (AI) applications that provide emotional support and/or create emotional impacts on student learning, so-called emotional AI applications, have received increased attention. However, there is a lack of a systematic review of studies on emotional AI in EFL education. This paper presents a systematic review of research in this field. The results reveal five affordances of emotional AI in EFL education, namely (1) enabling human-like conversations, (2) providing personalized real-time feedback or instructions, (3) translating images into English text, (4) generating personalized learning content and tasks, and (5) recognizing and analyzing emotions. The first three affordances are more frequently used and have shown promising effects on improving students’ behavioral, cognitive, and affective learning outcomes. Moreover, the findings reveal that emotional support is often integrated with cognitive support; providing emotional support alone may not be enough to support student learning. Meanwhile, providing cognitive support alone can enhance both affective and cognitive learning outcomes. Finally, attention should be paid to the factors that might influence the adoption and effects of emotional AI in EFL education.

“When I Spoke, I Spoke From the Heart”: Empirical Insights and Therapeutic Lessons From an Indigenous Counseling Center

Indigenous Peoples in Canada experience inequities in behavioral health outcomes stemming from colonial subjugation, including tacit cultural assimilation through health care. Indigenous communities assert that culturally commensurate health interventions improve wellbeing. This study, conducted with clients and staff at a First Nations behavioral health treatment program, sought to identify how respondents conceived of the therapeutic endeavor with respect to possibilities for remedying colonial injuries such as the abuses of the Indian Residential Schools (IRSs). Thematic analysis of 32 interviews revealed that targeted therapeutic goals as well as specific counselor qualities were important for a positive therapeutic experience for those in the program. Ultimately, assimilative practices, such as the IRSs of the past and mainstream behavioral health treatment programs in the present may collectively contribute to the continuation of inequities in health outcomes for Indigenous Canadians. Decolonizing the therapeutic endeavor offers a potential avenue for positive change.

Network state changes in sensory thalamus represent learned outcomes

Thalamic brain areas play an important role in adaptive behaviors. Nevertheless, the population dynamics of thalamic relays during learning across sensory modalities remain unknown. Using a cross-modal sensory reward-associative learning paradigm combined with deep brain two-photon calcium imaging of large populations of auditory thalamus (medial geniculate body, MGB) neurons in male mice, we identified that MGB neurons are biased towards reward predictors independent of modality. Additionally, functional classes of MGB neurons aligned with distinct task periods and behavioral outcomes, both dependent and independent of sensory modality. During non-sensory delay periods, MGB ensembles developed coherent neuronal representation as well as distinct co-activity network states reflecting predicted task outcome. These results demonstrate flexible cross-modal ensemble coding in auditory thalamus during adaptive learning and highlight its importance in brain-wide cross-modal computations during complex behavior.

Exercise recovers weight gain, but not increased impulsive choice, caused by a high-fat diet

A high-fat diet has negative effects on physical, neurological, and behavioral outcomes. One consistent finding is that a diet high in fat increases impulsive choice behavior—behavior that is linked to a wide range of other negative health behaviors. While the mechanism for this increase in impulsive choice is not well understood, exercise, with its well-known and many benefits, may serve as an effective and accessible way to combat increased impulsive choice associated with a high-fat diet. The goal of this work was to test this possibility. Rats were divided into four groups in a two-by-two factorial design: exercise and control diet, sedentary and control diet, exercise and high-fat diet, sedentary and high-fat diet. Rats in the exercise groups engaged in 30-min of forced, moderate intensity wheel-running exercise five days per week. Rats in the high-fat diet groups ate a diet high in fat. Impulsive choice was measured using a delay discounting task. Exercise prevented weight gain associated with the high-fat diet. Exercise also preserved relative motivation for food reinforcement. However, exercise did not prevent increases in impulsive choice observed for rats that consumed a high-fat diet relative to the rats that consumed the control diet. This work rules out several possible mechanisms by which a high-fat diet may increase impulsive choice behavior. It makes clear that exercise alone may not stave off increases in impulsive choice caused by a high-fat diet. Future work is necessary to uncover the underlying mechanism for this effect and discover interventions, perhaps ones that combine both physically and cognitively demanding activities, to improve health and behavior as it relates to decision making processes.

Early moderate prenatal alcohol exposure and maternal diet impact offspring DNA methylation across species.

Alcohol consumption in pregnancy can affect genome regulation in the developing offspring but results have been contradictory. We employed a physiologically relevant murine model of short-term moderate prenatal alcohol exposure (PAE) resembling common patterns of alcohol consumption in pregnancy in humans. Early moderate PAE was sufficient to affect site-specific DNA methylation in newborn pups without altering behavioural outcomes in adult littermates. Whole-genome bisulfite sequencing of neonatal brain and liver revealed stochastic influence on DNA methylation that was mostly tissue-specific, with some perturbations likely originating as early as gastrulation. DNA methylation differences were enriched in non-coding genomic regions with regulatory potential indicative of broad effects of alcohol on genome regulation. Replication studies in human cohorts with fetal alcohol spectrum disorder suggested some effects were metastable at genes linked to disease-relevant traits including facial morphology, intelligence, educational attainment, autism, and schizophrenia. In our murine model, a maternal diet high in folate and choline protected against some of the damaging effects of early moderate PAE on DNA methylation. Our studies demonstrate that early moderate exposure is sufficient to affect fetal genome regulation even in the absence of overt phenotypic changes and highlight a role for preventative maternal dietary interventions.

Is non-invasive neuromodulation a viable technique to improve neuroplasticity in individuals with acquired brain injury? A review.

This study aimed to explore and evaluate the efficacy of non-invasive brain stimulation (NIBS) as a standalone or coupled intervention and understand its mechanisms to produce positive alterations in neuroplasticity and behavioral outcomes after acquired brain injury (ABI). Cochrane Library, Web of Science, PubMed, and Google Scholar databases were searched from January 2013 to January 2024. Using the PICO framework, transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) randomized controlled trials (RCTs), retrospective, pilot, open-label, and observational large group and single-participant case studies were included. Two authors reviewed articles according to pre-established inclusion criteria. Data related to participant and intervention characteristics, mechanisms of change, methods, and outcomes were extracted by two authors. The two authors performed quality assessments using SORT. Twenty-two studies involving 657 participants diagnosed with ABIs were included. Two studies reported that NIBS was ineffective in producing positive alterations or behavioral outcomes. Twenty studies reported at least one, or a combination of, positively altered neuroplasticity and improved neuropsychological, neuropsychiatric, motor, or somatic symptoms. Twenty-eight current articles between 2020 and 2024 have been studied to elucidate potential mechanisms of change related to NIBS and other mediating or confounding variables. tDCS and TMS may be efficacious as standalone interventions or coupled with neurorehabilitation therapies to positively alter maladaptive brain physiology and improve behavioral symptomology resulting from ABI. Based on postintervention and follow-up results, evidence suggests NIBS may offer a direct or mediatory contribution to improving behavioral outcomes post-ABI. More research is needed to better understand the extent of rTMS and tDCS application in affecting changes in symptoms after ABI.

Impact of childhood adversity and resilience on behavioral outcomes: Well-being and parental support as mediators

This study investigated the relationships between childhood adversity, resilience, and behavioral outcomes in children aged 9–12 years, along with the mediating variables of well-being (an internal factor) and parental support (an environmental factor). We recruited 250 children (125 boys and 125 girls) from schools across districts of Punjab, India. Structural equation modeling results revealed there was a statistically significant relationship between adversity and resilience and that parental support was the primary mediator of this relationship. These findings highlight the significance of environmental factors, such as parents who help their children through hardship, and the relevance of internal factors that play an equal role in influencing behavioral outcomes. Theoretical and practical implications are discussed.

Tobacco retail availability and smoking-A systematic review and meta-analysis.

Health policy makers worldwide have adopted evidence-based legislation, largely directed at consumers, to reduce tobacco-related harm. It is suggested that limiting supply by decreasing retail availability can also reduce cigarette smoking. To inform policy makers this systematic literature review assesses whether reducing availability is associated with smoking behaviours. Systematic literature searches of five databases were carried out up to January 2023. Included studies had at least one exposure (tobacco retail density, proximity or mixed measures thereof) and outcomes of smoking behaviour. Meta-analysis of effect estimates were undertaken if there were at least three studies with similar population, exposure and outcome measures. Sixty-two studies were included, and positive associations were found between tobacco outlet density and cigarette smoking in pregnancy, youth, adults and cessation. Meta-analyses were undertaken for retail density and ever smoking (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.04, 1.37; I2 = 87.3%), and current youth smoking (OR 1.23; 95% CI 1.08, 1.40; I2 = 0.0%), adult smoking (OR 1.11; 95% CI 1.01, 1.22; I2 = 74.8%); and mixed measures of retail availability near schools and current youth smoking (OR 1.03; 95% CI 1.01, 1.05; I2 = 0.0%). There is evidence higher tobacco retail density is consistently associated with cigarette smoking in pregnant women, young people and adults when ecological studies are included in meta-analysis. Meanwhile, evidence synthesis reveals restrictive tobacco retail laws based on proximity or mixed measures near home or very near school may not reduce smoking except in men who smoke heavily. Mechanisms to reduce retailer density should be thus considered part of tobacco control strategies.