Positive Early Experiences Research Articles

Sex-Specific Differences and the Role of Environmental Enrichment in the Expression of Hippocampal CB1 Receptors following Chronic Unpredictable Stress.

Stress-related mental disorders have become increasingly prevalent, thus endangering mental health worldwide. Exploring stress-associated brain alterations is vital for understanding the possible neurobiological mechanisms underlying these changes. Based on existing evidence, the brain endogenous cannabinoid system (ECS) plays a significant role in the stress response, and disruptions in its function are associated with the neurobiology of various stress-related disorders. This study primarily focuses on investigating the impact of chronic unpredictable stress (CUS) on the expression of hippocampal cannabinoid type 1 (CB1) receptors, part of the ECS, in adult male and female Wistar rats. Additionally, it explores whether environmental enrichment (EE) initiated during adolescence could mitigate the CUS-associated alterations in CB1 expression. Wistar rats, shortly after weaning, were placed in either standard housing (SH) or EE conditions for a duration of 10 weeks. On postnatal day 66, specific subgroups of SH or EE animals underwent a 4-week CUS protocol. Western blot (WB) analysis was conducted in the whole hippocampus of the left brain hemisphere to assess total CB1 protein expression, while immunohistochemistry (IHC) was performed on the right hemisphere to estimate the expression of CB1 receptors in certain hippocampal areas (i.e., CA1, CA3 and dentate gyrus-DG). The WB analysis revealed no statistically significant differences in total CB1 protein levels among the groups; however, reduced CB1 expression was found in specific hippocampal sub-regions using IHC. Specifically, CUS significantly decreased CB1 receptor expression in the CA1 and DG of both sexes, whereas in CA3 the CUS-associated decrease was limited to SH males. Interestingly, EE housing proved protective against these reductions. These findings suggest a region and sex-specific endocannabinoid response to chronic stress, emphasizing the role of positive early experiences in the protection of the adolescent brain against adverse conditions later in life.

Design, Play, Procure : Unleashing Gamification’s Potential To Reshape The Interior Design Business Model And Facilitate Direct Interior Furnishing Procurement

This mixed methods research explored user perceptions and engagement dynamics surrounding a proposed gamification concept for interior design and interior furnishing procurement. A multi-phase approach combining exploratory qualitative and quantitative methods with Technology Acceptance Model (TAM), Theory of Planned Behaviour (TPB) and Value Co-Creation (VCC) constructs. Thematic analysis from exploratory qualitative interviews revealed perceived benefits around enhanced collaboration, customization, and engagement, with expectations for effortless spatial visualization and creative experimentation. However, adoption outlook varied across age groups. Exploratory quantitative analysis using PLS-SEM showed perceived usefulness and social influences driving favorable attitudes, while confirmatory quantitative analysis with MRL constructs using CFA and PLS-SEM demonstrated positive early experiences markedly influencing eventual user advocacy. Key Recommendations center on agile, human-centric implementation focused on participative value creation for sustained relevance. Blended physical-digital strategies addressing category-specific barriers are advised, alongside participative value co-creation sustaining designer and client creativity amid digitization. While findings provide measured optimism given strong receptivity and adoption readiness metrics, targeted transition sequencing grounded in user realities, not technical proficiency alone, is imperative for contextually synchronized platform assimilation. Through meticulous multi-method inquiry, this pragmatic research elucidates requisite considerations around human-centric innovation for sustainable industry evolution.

The resounding influence of benevolent childhood experiences.

Research with Indigenous communities has demonstrated the detrimental impacts of intergenerational trauma and disproportionate adverse childhood experiences (ACEs) on health and behavioral outcomes in adulthood. A more balanced narrative that includes positive childhood experiences is needed. The construct of benevolent childhood experiences (BCEs) facilitates assessment of positive early life experiences and their impact on well-being for Indigenous peoples. We consider associations between BCEs and well-being when taking into account ACEs and adult positive experiences. Participants are from Healing Pathways, a longitudinal, community-based panel study with Indigenous families in the Midwestern United States and Canada. Data for the current analyses are derived from 453 participants interviewed at wave 9 of the study. Participants reported high levels of positive childhood experiences in the form of BCEs, with 86.5% of the wave 9 participants reporting experiencing at least six of seven positive indicators. BCEs were positively associated with young adult well-being. This relationship persisted even when accounting for ACEs and adult positive experiences. While ACEs were negatively correlated with young adult well-being, they were not significantly associated with well-being when considering family satisfaction and receiving emotional support. Evidence of high levels of BCEs reflects realities of strong Indigenous families and an abundance of positive childhood experiences.

Positive Early Childhood Experiences and School Readiness among US Preschoolers

To characterize the relationship between positive early childhood experiences (PECEs) and school readiness, and assess whether the PECEs-school readiness relationship was robust to and/or differed across levels of adverse childhood experiences (ACEs). We analyzed national data on children ages 3-5 from 2016 to 2020 (n=26 871) to examine associations between key PECE domains (nurturing relationships, home learning opportunities, safe and stable environments, and family routines) with being on track for school readiness, defined using a pilot, multidimensional measure called "healthy and ready to learn". Weighted univariate, bivariate, and multivariable analyses were conducted to generate nationally representative estimates. Multivariable models adjusted for sociodemographic factors and were assessed both with and without cumulative ACE exposure. Two-fifths of children were healthy and ready to learn. Exposure to PECEs was associated with higher school readiness, irrespective of relative ACE exposure. Compared with those with low PECEs, children with moderate (aOR, 2.19; 95% CI, 1.86-2.58) and high (aOR, 4.37; 95% CI, 3.58-5.34) PECEs had greater odds for being healthy and ready to learn, net of both sociodemographic factors and ACE exposure. Significant associations were robust across demographic groups (eg, race and ethnicity), ACE levels, and ACE types (eg, parental incarceration). Increasing PECEs correspond with greater likelihood of possessing capacities key for school functioning, even amidst ACEs. In concert with efforts to ameliorate early life trauma, caregivers, health care providers, educators, and systems can consider boosting PECEs to foster healthy development in childhood and beyond.

Treating Obsessive-Compulsive Disorder by Invasively Modulating Thoughts, Feelings, or Both

The defining characteristic of pathological compulsions is that they are carried out to reduce momentary distress, even though performing the compulsive act or thought is rationally not in the individual’s true best interest. This inability to flexibly adapt is a prominent component of obsessive-compulsive disorder (OCD) and closely related illnesses such as Tourette syndrome and is also observed in substance use disorders ( 1 Figee M. Pattij T. Willuhn I. Luigjes J. van den Brink W. Goudriaan A. et al. Compulsivity in obsessive-compulsive disorder and addictions. Eur Neuropsychopharmacol. 2016; 26: 856-868 Crossref PubMed Scopus (111) Google Scholar ). Following the 20th century experience with ablative procedures such as capsulotomy, deep brain stimulation (DBS) was applied to the treatment of OCD. Electrodes are most commonly placed within the anterior limb of the internal capsule (ALIC), modulating cortico-basal ganglia-thalamo-cortical parallel white matter loops relevant to limbic, associative, and motor functions, respectively. ALIC stimulation has proven to be a highly effective treatment for severe OCD ( 2 Smith AH, Mayberg HS, Figee M (in press): Neuromodulation and psychiatric disorders. In: Nestler EJ, Charney DS, editors. Neurobiology of Mental Illness, 6th ed. New York: Oxford University Press. Google Scholar ). DBS to a different anatomical location, the subthalamic nucleus (STN), was initially developed for Parkinson’s disease, but positive early experience in patients with comorbid Parkinson’s disease and OCD led to research establishing high-frequency stimulation straight to the STN as clinically efficacious for OCD ( 3 Mallet L. Polosan M. Jaafari N. Baup N. Welter M.L. Fontaine D. et al. Subthalamic nucleus stimulation in severe obsessive-compulsive disorder. N Engl J Med. 2008; 359: 2121-2134 Crossref PubMed Scopus (687) Google Scholar ). In a similar manner, promising early pilot studies led to further exploration of other targets. These include the bed nucleus of the stria terminalis, the “extended amygdala” located between the ALIC and STN targets ( 4 Mosley P.E. Windels F. Morris J. Coyne T. Marsh R. Giorni A. et al. A randomised, double-blind, sham-controlled trial of deep brain stimulation of the bed nucleus of the stria terminalis for treatment-resistant obsessive-compulsive disorder. Transl Psychiatry. 2021; 11: 190 Crossref PubMed Scopus (38) Google Scholar ). More recently, evidence has emerged for the effectiveness of stimulation delivered deeper in the midbrain than the STN, adjacent to the ventral tegmental area (VTA)—a source of dopaminergic projections to the cortex (via the medial forebrain bundle [MFB]) and a recipient of proposed regulatory projections back from the cortex (via the “supralateral MFB”) ( 5 Meyer D.M. Spanier S. Kilian H.M. Reisert M. Urbach H. Sajonz B.E. et al. Efficacy of superolateral medial forebrain bundle deep brain stimulation in obsessive-compulsive disorder. Brain Stimul. 2022; 15: 582-585 Abstract Full Text Full Text PDF Scopus (3) Google Scholar ). SEE CORRESPONDING ARTICLE ON PAGE 1010 SEE CORRESPONDING ARTICLE ON PAGE 1010 The Rostral Zona Incerta: A Subcortical Integrative Hub and Potential Deep Brain Stimulation Target for Obsessive-Compulsive DisorderBiological PsychiatryVol. 93Issue 11PreviewThe zona incerta (ZI) is involved in mediating survival behaviors and is connected to a wide range of cortical and subcortical structures, including key basal ganglia nuclei. Based on these connections and their links to behavioral modulation, we propose that the ZI is a connectional hub for mediating between top-down and bottom-up control and a possible target for deep brain stimulation for obsessive-compulsive disorder. Full-Text PDF

The Foundations for Chronic Low Back Pain Management may Start in Early Life. Exploring the Role of Caregiver Parental Leave on Future Low Back Pain in the Offspring

Chronic low back pain is difficult to treat and despite increased spending on health services, clinical outcomes for people with low back pain have not improved. Innovative, large scale initiatives seem necessary to stem the cost of low back pain. Psychological health contributes to the development and persistence of chronic low back pain and psychological interventions are important in the management of low back pain. Given the contribution of psychological health to low back pain development and management, it raises the question; can we support psychological health in later life by bolstering emotional development in early life, and reduce the burden of this common condition? Positive early life experiences, including those induced by extended paid parental leave, could bolster emotional development and support the psychological health necessary to manage low back pain in later life. We present the current state of evidence demonstrating the potential value of increasing support for parent-child relationships in early life to reduce the burden of low back pain in future generations. The current evidence is limited to cross-sectional associations, but strong preclinical data clearly shows the potential negative impacts of maternal separation on rodent pup health that compels consideration in human populations. PerspectiveThe benefits stemming from enhanced child development include stable emotional foundations, possibly improving psychological health and low back pain management in the future. This perspective raises questions for future studies – within the context of low back pain, what ingredients bolster stable psychological health? And are these ingredients influenced by parental leave?

Risk-taking Behaviour: The Role of Dark Triad Traits, Impulsivity, Sensation Seeking and Adverse Childhood Experience.

Dark Triad Traits, Adverse Childhood Experiences, impulsivity and sensation seeking significantly influence whether one engages in or avoids various risk behaviours and personality throughout life. The present study aimed to investigate how Dark Triad Traits, Adverse Childhood Experience and impulsivity sensation influence risk taking behaviour personality throughout life. The sample included 222 university students from four universities, 82 males (36.9%) and 140 females (63.1%), and aged between 18 and 51 years. The results showed that adverse childhood experiences, psychopathy, narcissism, impulsivity and sensation-seeking predicted risk taking. Machiavellianism, on the other hand, did not significantly predict risk taking. Based on results, adverse childhood experiences predicted risk-taking directly and indirectly through psychopathy, narcissism, impulsivity and sensation seeking. The results indicate that early childhood experiences are a significant factor in personality traits and that positive early experiences could lead to minimising risk taking and reducing levels of impulsivity, sensation-seeking and dark triad traits.

The Experiences, Influences and Concerns of Future Orthopaedic Surgeons: Comparing Uk and non-UK Perspectives

This study aims to identify and analyse the factors that influence or discourage junior doctors in the UK and across the world from wanting to pursue a career in orthopaedics. A prospective, cohort study was carried out via an online questionnaire targeted at aspiring orthopaedic surgeons. A total of 654 respondents met inclusion criteria; 370 (56.6%) were UK-based and 284 (43.4%) were based abroad. The practical and technical nature of orthopaedics was the biggest influencing factor globally. UK respondents were notably more concerned by the financial impact of training (49%) followed by poor work-life balance (36%). Themes from the comments section revealed concern regarding gender bias and a lack of diverse role models within orthopaedics. Reducing the cost and length of training, diversification of role models, removal of bias and increasing positive early experiences may help to encourage people of all backgrounds to pursue a career in orthopaedic surgery.

Early Real-World Physician Experience with an Intracanalicular Dexamethasone Insert.

PurposeTo describe the early real-world experience of physicians with an intracanalicular dexamethasone insert (DEX) in patients undergoing cataract surgery and to capture the clinical impact of adopting this therapy.Patients and Methods23 United States sites including Ambulatory Surgical Center Setting (ASC) and Outpatient Clinical settings. Respondents were physicians who had early experience with DEX in cataract surgery patients. This was a Phase 4 experiential cross-sectional survey study comprised of 3 sequential online physician surveys. Descriptive statistics summarized the surveys’ responses to determine the early impressions of the respondents.ResultsForty-two physicians completed surveys. On average, physicians reported feeling comfortable administering DEX after placing 3 inserts (mean 2.7; standard deviation 1.9). Most physicians (92%) were satisfied with DEX, and all physicians (100%) reported that DEX improved patient compliance. Most physicians (62.5%) indicated they would highly prefer DEX over traditional steroid eyedrops for the management of post-surgical inflammation and pain.ConclusionThe surveys exploring the early use of DEX suggest that DEX is a clinically effective treatment with a rapid initial learning curve and integrates well into clinical use. Physicians had a very positive early experience with DEX, including comfort with insertion and satisfaction. DEX shows promise as a primary treatment choice of physicians for ocular inflammation and pain following cataract surgery by offering patients a hands-free innovative therapy that delivers a preservative-free steroid to the ocular surface over approximately 30 days.

Lessons from the Stories of Women in Neuroscience.

Women have been contributing to the field of neuroscience since its inception, but their accomplishments are often overlooked. Lack of recognition, among other issues, has led to progressively fewer women at each academic stage; although half of neuroscience graduate students are women, women comprise less than one-third of neuroscience faculty, and even fewer full professors. Those who reach this level continue to struggle to get their work recognized. Women from historically excluded backgrounds are even more starkly underrepresented and face added challenges related to racial, ethnic, and other biases. To increase the visibility of women in neuroscience, promote their voices, and learn about their career journeys, we created Stories of Women in Neuroscience (Stories of WiN). Stories of WiN shares the scientific and personal stories of women neuroscientists with diverse backgrounds, identities, research interests, and at various career stages. From >70 women highlighted thus far, a major theme has emerged: there is not a single archetype of a woman neuroscientist, nor a single path to "success." Yet, through these diverse experiences run common threads, such as the importance of positive early research experiences, managing imposter syndrome, the necessity of work-life balance, and the challenges of fitting into-or resisting-the "scientist mold" within a patriarchal, racialized academic system. These commonalities reveal important considerations for supporting women neuroscientists. Through the lens of women highlighted by Stories of WiN, we explore the similarities among their journeys and detail specific actionable items to help encourage, support, and sustain women in neuroscience.

Building Evidence for the Impact of Older Adult Learning on Active Ageing

Lifelong learning constitutes one of the pillars of active ageing on the basis that learning reinforces wellbeing and enables older people to stay healthy and engaged in society. This paper reports on a pretest-posttest study carried out at the University of the Third Age in Malta that measured the impact of late-life learning on levels of active ageing. The findings demonstrated that participation in older adult learning has a strong positive impact on the participants’ levels of active ageing and constitutes a resilient source of social capital in later life, and that people who presumably have had positive early experiences of education are more motivated to engage in late-life learning. The paper concludes that lifelong learning in later life acts as a possible mitigation to the social isolation, cognitive impairment, and age discrimination that people tend to experience in later life.

Developing an explanatory theoretical model for engagement with a web-based mental health platform: results of a mixed methods study

BackgroundWith the growing need for accessible, high-quality mental health services, especially during the COVID-19 pandemic, there has been increasing development and uptake of web-based interventions in the form of self-directed mental health platforms. The Big White Wall (BWW) is a web-based platform for people experiencing mental illness and addiction that offers a range of evidence-based self-directed treatment strategies. Drawing on existing data from a large-scale evaluation of the implementation of BWW in Ontario, Canada (which involved a pragmatic randomized controlled trail with an embedded qualitative process evaluation), we sought to investigate the influences on the extent to which people engage with BWW.MethodsIn this paper we drew on BWW trial participants’ usage data (number of logins) and the qualitative data from the process evaluation that explored participants’ experiences, engagement with and reactions to BWW.ResultsOur results showed that there were highly complex relationships between the influences that contributed to the level of engagement with BWW intervention. We found that a) how people expected to benefit from using a platform like BWW was an important indicator of their future usage, b) moderate perceived symptoms were linked with higher engagement; whereas fewer actual depressive symptoms predicted use and anxiety had a positive linear relationship with usage, and that c) usage depended on positive early experiences with the platform.ConclusionsOur findings suggest that the nature of engagement with platforms such as BWW is not easily predicted. We propose a theoretical framework for explaining the level of user engagement with BWW that might also be generalizable to other similar platforms.

Talent development in women’s cricket: Perceptions and practices of elite players and coaches

Talent development is at the forefront of research in sport, where female athletes remain underrepresented. With ongoing success and rapid participation growth, there is an opportunity to describe and assess talent development in cricket for female athletes. Research in other sports recommends a holistic approach to talent development, where the connection between individual, task and environmental factors is maintained. A series of semi-structured interviews was conducted to draw from the experiential knowledge of 16 elite female athletes and 7 coaches alongside empirical knowledge regarding player development (individual), training task design and talent development environments. Both players and coaches reported positive early learning experiences, linear career trajectories and early entrance into talent programs, suggesting some early specialisation. Exposure to boy’s/men’s cricket appeared to fast-track skill development in players, and player skill adaptability was considered crucial to expert performance by both cohorts. Training design typically involved functional games-based scenarios, or misaligned task deconstruction in contrast to contemporary skill development practices. Aims for discrete stages of the pathway were ambiguous for both cohorts, potentially limiting the value they provide, and transition between stages appeared fluid to coaches in contrast to the rigidity described by players. Finally, growing professionalism in cricket for female athletes through greater investment, contracts and player support has propagated a skill gap between pathway stages identified by both cohorts, which needs addressing. Closing this skill gap can be achieved by improving coaching practices and support at the amateur levels of cricket to develop the next generation of elite female cricketers.

Feeling Stuck: Exploring the Development of Felt Constraint in Romantic Relationships

ObjectiveThis research investigates the processes leading to felt constraint in romantic relationships.BackgroundRomantic commitment can be driven by a genuine desire to remain romantically involved with a partner, or it can be motivated by real or perceived constraints (e.g., shared property, psychological control or coercion, perceived obligations to one's partner) that make leaving relationships challenging. When relationship commitment and stability are driven by constraints rather than personal desire, individuals may feel “stuck” in their romantic unions, leading to negative outcomes for both individuals and couples.MethodUsing data from in‐depth interviews with 35 individuals about their relationship histories, we employed grounded theory techniques to define and explain the process of entering and exiting relationships with high levels of felt constraint (i.e., stuck relationships). The final sample included 14 individuals discussing 21 stuck relationships.ResultsParticipants often entered stuck relationships in their teens and early 20s. Based on positive early experiences, couples quickly accrued barriers to breakup (e.g., cohabitation, marriage, children, family entanglement) that sustained the partnership despite declines in relationship satisfaction. The decision to leave stuck relationships was often motivated by maturing out of the relationship or becoming more aware of alternatives.ConclusionsOur study adds additional support for the notion that constraints are not universally problematic but must be understood within the context of the developing relationship in order to determine their likely consequences.ImplicationsOur findings support relationship education focused on building an individual's capacity to (a) assess the future viability of their partnerships and (b) overcome barriers to breakup if and when that becomes relevant.

Career professionals’ reflections on early exposure to music education: a narrative inquiry

ABSTRACT The value of music education in nurturing the whole child development is increasingly evident as research supports the benefits of incorporating music education into the school curriculum. This study specifically explores the influence music education had on eight purposively selected individuals. A narrative inquiry approach was used to explore and describe the stories of eight career professionals from several different fields who had a positive early music experience in the United States K-12 school, college, and/or other forms of formal music education focusing on their perceptions of how the experiences informed professional careers. The character traits of persistence and focus, the behaviours of discipline and goal orientation, and a way of being expressed through passion and a level of satisfaction in life adventures surfaced as major themes. The stories provided additional insights and knowledge on the potential value of music education in shaping professional success. The findings from this research support the importance of the inclusion of music education into early life experiences to enhance and enrich the personal and professional lives of individuals.

ISSUE TOUCHING SCHOOL QUALITY IN AMHARA REGION

The objective of this study was to explore factors that affect quality education in the Amhara region. A descriptive survey method, purposive and stratified random sampling techniques were used to examine research objective. Tools used in collecting data were questionnaire and focused group discussion. The finding showed that positive early experiences and interactions, disciplined school systems, providing an adequate number of teachers, access to toilets, availability of relatively suitable class sizes, welcoming schools boarding atmospheres, learner centered teaching practices , professional mobility and growth were strengths of schools in the region. However, violation conditions, professional inflexibility, incompatible teachers working conditions, irregularity of students’ class attending, lack of life skill curriculums, schoolsfacilities, shortage of instructional materials, clean water supply and not have ongoing trainings have negative impact on quality education. As a result, it is recommended that a further research on quality education, focusing specifically indicators that support a quality primary education.

The relationship between parental involvement in childhood and depression in early adulthood

BackgroundPositive early life experiences may help prevent depression later in life. We examined the accumulated benefit, timing, and trajectories of positive parental involvement in childhood in association with incident depression in early adulthood. MethodsProspectively assessed Avon Longitudinal Study of Parents and Children (ALSPAC) data (n = 7120) were analyzed. Overall and developmental stage-specific parental involvement scores were estimated from multiple measures from birth to age 7 years. Trajectory groups of parental involvement were derived via latent class growth analysis. At 18 years, depression cases were identified with diagnostic instruments. Multiple imputation was used to handle missingness. We constructed logistic regression models with potential confounders adjusted. ResultsParticipants from trajectory groups with higher average parenting scores over time had 30% to 40% lower odds of developing depression in early adulthood than participants from the group with the lowest average parenting score over time. However, the relationship became non-significant when all covariates were adjusted. A one-unit increase in the overall parenting score corresponded to 12% lower odds of developing depression (adjusted OR=0.88 [0.79–0.98]). Protective effects on incident depression in early adulthood from parental involvement in school age (5–7 years), and not at other ages, were observed (OR=0.87 [0.77–0.99] for a one-unit increase in the parenting score at school age). However, the relationship became non-significant when all covariates were adjusted (OR=0.91 [0.80–1.03]). LimitationsMeasurements of parental involvement were only based on maternal report. The study has limited generalizability to other racial/ethnic groups. ConclusionHigher level of parental involvement during childhood lowers the risk of developing depression in early adulthood. These results suggest positive early life experiences may promote mental health across the life course.

The print exposure of teacher candidates in relation to their achievement and self-ratings of early reading experiences

This study examined the print exposure of teacher candidates (N = 195) in relation to their GPAs, achievement in reading and writing on the SAT, and their self-ratings of their own early (K to Grade 5) reading experiences. Participants came from undergraduate and Masters programs in varied certification areas and from two different universities. Print exposure measures included author recognition tests for both fiction and nonfiction; a questionnaire about participants’ current voluntary reading habits for books, magazines, newspapers, and digital print media; and favorite authors/books questions. Exploratory factor analysis suggested four factors underlying the different print exposure measures: (1) fiction book reading volume; (2) current magazine and newspaper reading; (3) nonfiction book reading volume and (4) current book reading habits for enjoyment. Only fiction and nonfiction book reading volume related positively to participants’ achievement, in writing as well as reading, and to their early reading experience ratings. A subgroup of participants who had taken a specific reading methods course involving structured language content, and who had positive early reading experience self-ratings, had higher performance in the course than did participants with mixed or negative self-ratings, although the two groups did not differ in overall GPA. Findings support the view that different measures of print exposure tap somewhat different aspects of print exposure, with differing relationships to varied indicators of achievement. Results also support concerns about the reading volume and print exposure of some teacher candidates.

"Balancing Expectations with Actual Realities": Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial.

Precision medicine is changing cancer care and placing new demands on oncology professionals. Precision medicine trials for high-risk childhood cancer exemplify these complexities. We assessed clinicians’ (n = 39) and scientists’ (n = 15) experiences in the first year of the PRecISion Medicine for Children with Cancer (PRISM) trial for children and adolescents with high-risk cancers, through an in-depth semi-structured interview. We thematically analysed participants’ responses regarding their professional challenges, and measured oncologists’ knowledge of genetics and confidence with somatic and germline molecular test results. Both groups described positive early experiences with PRISM but were cognisant of managing parents’ expectations. Key challenges for clinicians included understanding and communicating genomic results, balancing biopsy risks, and drug access. Most oncologists rated ‘good’ knowledge of genetics, but a minority were ‘very confident’ in interpreting (25%), explaining (34.4%) and making treatment recommendations (18.8%) based on somatic genetic test results. Challenges for scientists included greater emotional impact of their work and balancing translational outputs with academic productivity. Continued tracking of these challenges across the course of the trial, while assessing the perspectives of a wider range of stakeholders, is critical to drive the ongoing development of a workforce equipped to manage the demands of paediatric precision medicine.

Social-Experience and Temperamental Predictors of Rejection Sensitivity: A Prospective Study

Rejection sensitivity (RS) is the tendency for individuals to anxiously expect, readily perceive, and overreact to interpersonal rejection. Existing theory presumes that early experiences of rejection cause RS, although few studies have assessed this prospectively. Also relatively unstudied are individual differences in temperament that may contribute to RS. In a longitudinal study, we examined whether early social experiences and individual differences in temperament predict RS assessed subsequently. Results showed that positive early social experiences (ages 6 and 9 parents’ relationship quality and age 9 peer support) negatively predicted RS at age 12 and that negative affect (ages 6 and 9) positively predicted age-12 RS. These findings may have important implications for RS-reduction efforts and for understanding the many domain-specific manifestations of RS.