Preemptive airway management planning: A retrospective evaluation of the pediatric difficult airway consultation service.

BACKGROUND/AIMS: The pediatric Difficult Airway Consultation Service (pDACS) was created in 2017 to identify patients with potentially difficult airways and create airway management plans prior to airway management. METHODS: Consults were either nurse-initiated, physician-initiated, or both nurse-and-physician-initiated and were examined for demographic and clinical factors. If a child had difficult airway risk factors, a consult note with airway management recommendations was completed. RESULTS: We included 419 consults from the 4-year study period for analysis. Sixty-one patients had chronic tracheostomies in place and thus, were analyzed separately. Of the remaining 358 consults, 50% (n = 179) were nurse-initiated, 30.2% (n = 108) physician-initiated, and 19.8% (n = 71) nurse-and-physician-initiated consults. Differences in observed frequency of airway edema (difference, 6.3%; 95%CI 0.1%-12.5%; p = .04), cleft lip/palate (difference, 8.1%; 95%CI 0.07%-16.3%, p = .04), craniofacial abnormalities (difference, 12.3%; 95%CI 1.9%-22.7%, p = .02), and trauma/burn (difference, 6.5%; 95%CI 0.09%-12.8%, p = .04) were calculated. Observed frequencies were higher in physician-initiated compared to nurse-initiated consults. Airway edema was also more prevalent in dual nurse-and-physician-initiated consults (difference, 8.7%; 95%CI 1.6%-15.8%; p = .01). Physician-initiated consults were associated with a greater proportion of high-risk difficult airways than nurse-initiated consults (difference, 26.7%; 95%CI 14.0%-39.4%, p < .001). Approximately 41.9% of patients at high-risk for having a difficult airway were identified by nurse-screening only. Using bag-valve-mask was often the primary ventilation recommendation (89.3%, n = 108) and supraglottic airway placement was the most common tertiary plan (74.2%, n = 83). Direct laryngoscopy (47.1%, n = 65) and videolaryngoscopy (40.6%, n = 56) were the most recommended modes of intubation. Three patients with airway emergencies had previously documented airway management plans and were successfully intubated without complications following the primary intubation technique recommended in their consult note. CONCLUSIONS: In our study, nurse-screening identified patients at high-risk for a difficult airway that would likely not have been identified prior to initiation of a screening protocol. Furthermore, airway management plans outlined prior to an emergent difficult airway event may increase first-attempt success at securing the difficult airway, reducing morbidity and mortality.

An exploration into the relationship between insomnia and repetitive negative thinking among cancer survivors.

OBJECTIVE: Insomnia and repetitive negative thinking (RNT) are both prevalent among cancer survivors, yet little work has investigated their interrelationship. To explore the hypothesis that RNT and insomnia are related, we conducted secondary analyses on data from a pilot clinical trial of cognitive behavioral therapy for insomnia (CBT-I) for cancer survivors. METHODS: This study analyzed survey data from 40 cancer survivors with insomnia who participated in a pilot randomized trial of CBT-I. Correlations and linear regression models were used to determine associations between aspects of RNT and related constructs (fear of cancer recurrence [FCR], cancer-specific rumination, worry, and intolerance of uncertainty) and sleep (insomnia and sleep quality), while accounting for psychiatric symptoms such as anxiety and depression. Treatment-related change in RNT was examined using a series of linear mixed models. RESULTS: Evidence for an association between RNT and insomnia among cancer survivors emerged. Higher levels of FCR and cancer-related rumination were correlated with more severe insomnia symptoms and worse sleep quality. Notably, FCR levels predicted insomnia, even after controlling for anxiety and depression. Results identified potential benefits and limitations of CBT-I in addressing RNT that should be examined more thoroughly in future research. CONCLUSIONS: RNT is a potential target to consider in insomnia treatment for cancer survivors.

The associations between repetitive negative thinking, insomnia symptoms, and sleep quality in adults with a history of trauma.

BACKGROUND: Posttraumatic stress disorder (PTSD) and sleep disturbance are highly comorbid and repetitive negative thinking (RNT) is associated with both sleep disturbance and PTSD. However, few studies have examined the association between RNT and sleep disturbance in individuals exposed to trauma, with and without PTSD. METHOD: Associations between trait-level and trauma-related RNT, insomnia, and sleep quality were investigated in a trauma-exposed MTurk (N = 342) sample. Additionally, PTSD symptom severity was tested as a moderator of the associations between RNT and insomnia and sleep quality. RESULTS: Trait-level RNT predicted poorer sleep quality and greater insomnia, regardless of PTSD severity. Trauma-related RNT was also associated with greater insomnia, though the effect was moderated by PTSD severity such that it was significant for participants with low and moderate, but not severe, PTSD. Both trait- and trauma-related RNT were associated with several specific aspects of sleep quality, including: sleep disturbances, daytime dysfunction, use of sleep medications, sleep onset latency, and subjective sleep quality. CONCLUSIONS: This study demonstrates significant associations linking RNT with insomnia and sleep disturbance in trauma-exposed individuals. Clinically, results suggest that it may be helpful to target both general and trauma-related RNT in sleep interventions for trauma-exposed individuals with insomnia.

Representation of race and ethnicity among cancer survivors in trials of cognitive behavioral therapy for insomnia (CBT-I): A systematic review.

PURPOSE: For cancer survivors, insomnia is highly prevalent and debilitating. Although cognitive behavioral therapy for insomnia (CBT-I) is recognized as a gold standard treatment, it is unclear whether benefits of treatment generalize to racial and ethnic minorities in the USA. This systematic review characterizes the representation of racial and ethnic diversity among cancer survivors in CBT-I clinical trials and provides recommendations for research in sleep/cancer survivorship. METHODS: Literature searches were conducted in five electronic databases (PubMed, Cochrane Library via Ovid, PsycINFO via Ovid, Embase, Web of Science Core Collection) using concepts of CBT, insomnia, and cancer survivors. Information about CBT-I intervention details, sample racial demographics, and whether authors explicitly analyzed race and ethnicity were recorded. RESULTS: A total of 1673 citations were retrieved, and 967 citations were uploaded to Covidence. Of these, 135 articles went through full-text review and 13 studies were included. Race and ethnicity were reported in 11/13 trials (84.6%). Of those reporting race and ethnicity, 8/11 (72.7%) trials were comprised of samples that were ≥ 85% non-Hispanic White. Among the trials that explicitly analyzed race and ethnicity, CBT-I was more effective among cancer survivors who were White and highly educated, and non-White cancer survivors were less likely to have private insurance and ability to participate in clinical trials. CONCLUSION: Non-Hispanic White cancer survivors are overrepresented in CBT-I trials, the best available treatment for insomnia. Underrepresentation of racial and ethnic minorities likely contributes to barriers in access and uptake. Recommendations include implementing sustained efforts to expand diversity in CBT-I clinical trials for cancer survivors.

Seasonality in Environment and Population Processes Alters Population Spatial Synchrony.

AbstractPopulation spatial synchrony-the tendency for temporal population fluctuations to be correlated across locations-is common and important to metapopulation stability and persistence. One common cause of spatial synchrony, termed the Moran effect, occurs when populations respond to environmental fluctuations, such as weather, that are correlated over space. Although the degree of spatial synchrony in environmental fluctuations can differ between seasons and different population processes occur in different seasons, the impact on population spatial synchrony is uncertain because prior work has largely assumed that the spatial synchrony of environmental fluctuations and their effect on populations are consistent over annual sampling intervals. We used theoretical models to examine how seasonality in population processes and the spatial synchrony of environmental drivers affect population spatial synchrony. We found that population spatial synchrony can depend not only on the spatial synchrony of environmental drivers but also on the degree to which environmental fluctuations are correlated across seasons, locally, and across space. Moreover, measurements of synchrony from "snapshot" population censuses may not accurately reflect synchrony during other parts of the year. Together, these results show that neglecting seasonality in environmental conditions and population processes is consequential for understanding population spatial synchrony and its driving mechanisms.

A Biomechanical Comparison of All-Inside Versus Transtibial Meniscus Root Repair Techniques.

BACKGROUND: Meniscus root tears are associated with chondral injury, early degenerative change, and a high conversion rate to total knee arthroplasty. It is well-established that meniscus root tears lead to decreased femorotibial contact area, increased peak contact pressures, and increased stress on the articular cartilage. PURPOSE: To evaluate the biomechanical characteristics of the all-inside meniscus root repair procedure and compare it with the previously described transtibial technique. STUDY DESIGN: Controlled laboratory study. METHODS: Nine paired cadaveric knees were prepared by removing skin, subcutaneous tissues, quadriceps muscles, patella, and patellar tendon, while leaving the capsule in place. Pressure-mapping sensors were inserted, and specimens underwent compressive loading to obtain peak pressures, mean pressures, and femorotibial contact area in the medial and lateral compartments. Tests were performed as static compression tests with the knee locked at 0° of flexion. Compression testing was performed in 3 states: meniscus intact, meniscus root cut, and after meniscus root repair with an all-inside repair technique. Additionally, testing was completed on 9 pairs of cadaveric knees to compare stiffness and maximal load to failure between the all-inside and transtibial meniscus root repair techniques. RESULTS: In the medial compartment, there were significant increases in median peak pressures and median mean pressures in the root cut state as compared with the intact state (+636 kPA [95% CI, 246 to 1026] and +190 kPA [95% CI, 49 to 330], respectively). All-inside meniscus root repair restored median peak pressures and median mean pressures to approach those of the intact meniscus (+311 kPA [95% CI, -79 to 701] and +137 kPA [95% CI, -3 to 277]). In the lateral compartment, there were also significant increases in median peak pressures and median mean pressures in the root cut state as compared with the intact state (+718 kPA [95% CI, 246 to 1191] and +203 kPA [95% CI, 51 to 355]). All-inside meniscus root repair restored median peak pressures and median mean pressures such that they were not significantly different from the intact state (+322 kPA [95% CI, -150 to 795] and +18 kPA [95% CI, -134 to 171]). There was no difference between repair techniques regarding load to failure (P = .896). Transtibial meniscus root repair had significantly more stiffness (mean ± SD, 24.8 ± 9.3 N/mm) as compared with the all-inside meniscus root repair technique (13.6 ± 3.8 N/mm, P = .015). CONCLUSION: All-inside meniscus root repair reduced median peak and mean pressures to those of the native intact meniscus with the knee in extension in the cadaveric model. When compared with a transtibial meniscus root repair technique, all-inside repair demonstrated decreased stiffness and a similar load to failure. CLINICAL RELEVANCE: All-inside meniscus root repair restored mean and peak femorotibial pressures to those of the intact meniscus. Additionally, it offers a technically easier technique for management of meniscus root tears.

Retention in nursing education and scholarship programs: Survival analysis of the Veterans Health Administration National Nursing Education Initiative Data.

AIMS: To investigate factors affecting non-completion by registered nurses (RNs) participating in degree programs supported by the scholarship program of the National Nursing Education Initiative of the United States Veterans Health Administration. Secondarily, to assess overall retention in the scholarship program over time. DESIGN: Retrospective longitudinal design using administrative data. METHODS: Defining retention time as the time elapsed from enrollment date to non-completion, we performed survival (retention) analysis (i.e.,Kaplan-Meier survival functions, log-rank tests and Cox regressions) to retrospectively analyzea national sample of RNs (N  = 15,908) enrolled in the scholarship program between the United States federal fiscal years 2000 and 2020. RESULTS: Nurses' mean age was 44 years (range: 19-71), and 86% were females. Six- and 12-month cumulative educational program retention rates were 92% and 84% respectively. The newest group of enrollees (2016-2020), younger nurses (<50 years), and nurses in traditional degree programtype were more likely to complete their academic programs than the earlier groups, older nurses and nurses in non-traditional type, respectively. Male nurses who aspired to advanced occupational levels upon completion were more likely to complete their academic programs compared to those who expected no change from their current level of practice. CONCLUSION: Multiple factors affected non-completion of academic degree programs by RNs enrolled in the scholarship program. More work is needed to examine these plus additional plausible factors and their correlates extensively. IMPACT: Our findings highlighted areas for quality improvement in employee scholarship programs for RNs. The findings are expected to inform tailoring of proactive helpful intervention towards individual needs and prioritization of limited resources to maximize graduation rate from academic programs for scholarship recipients. The study will have impact on nursing workforce policy makers interested in implementing employee scholarship programs, and on their scholarship recipients.

Negative interpretation bias connects to real-world daily affect: A multistudy approach.

Negative interpretation bias, the tendency to appraise ambiguous stimuli as threatening, shapes our emotional lives. Various laboratory tasks, which differ in stimuli features and task procedures, can quantify negative interpretation bias. However, it is unknown whether these tasks globally predict individual differences in real-world negative (NA) and positive (PA) affect. Across two studies, we tested whether different lab-based negative interpretation bias tasks predict daily NA and PA, measured via mobile phone across months. To quantify negative interpretation bias, Study 1 (N = 69) used a verbal, self-referential task whereas Study 2 (N = 110) used a perceptual, emotional image task with faces and scenes. Across tasks, negative interpretation bias was linked to heightened daily NA. However, only negative interpretation bias in response to ambiguous faces was related to decreased daily PA. These results illustrate the ecological validity of negative interpretation bias tasks and highlight converging and unique relationships between distinct tasks and naturalistic emotion. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The relationship between psychiatric symptoms and affective forecasting bias.

BACKGROUND AND OBJECTIVES: Affective forecasting (AF) is the prediction of future emotional states. Negatively biased affective forecasts (i.e., overestimating negative affect) have been associated with trait anxiety, social anxiety, and depression symptoms, but few studies have tested these relationships while covarying commonly co-occurring symptoms. METHODS: In this study, participants (N = 114) completed a computer game in dyads. Participants were randomized into one of two conditions: a condition in which they were led to believe they were at-fault for losing their dyad money (n = 24 dyads) or a condition in which they were told no one was at fault (n = 34 dyads). Prior to the computer game, participants forecasted their affect for each potential game outcome. RESULTS: More severe social anxiety, trait-level anxiety, and depressive symptoms were all associated with more negative AF bias in the at-fault relative to the no-fault condition, and this effect persisted when controlling for other symptoms. Cognitive and social anxiety sensitivity was also associated with more negative AF bias. LIMITATIONS: The generalizability of our findings is innately limited by our non-clinical, undergraduate sample. Future work should replicate and extend our research in more diverse populations and clinical samples. CONCLUSIONS: Overall, our results support that AF biases are observed across a range of psychopathology symptoms and associated with transdiagnostic cognitive risk factors. Future work should continue investigating the etiological role of AF bias in psychopathology.

Treatment-related changes in insomnia, anticipatory pleasure, and depression symptoms: A proof-of-concept study with cancer survivors.

OBJECTIVE/BACKGROUND: Cancer survivors have elevated rates of insomnia and depression. Insomnia increases risk for depression onset, and the Integrated Sleep and Reward (ISR) Model suggests that impairments in reward responding (e.g., ability to anticipate and/or experience pleasure) plays a central role in this relationship. Cognitive behavioral therapy for insomnia (CBT-I) is efficacious for treating chronic insomnia and reducing depression in cancer survivor populations. The effects of CBT-I on anticipatory and consummatory pleasure are theoretically and clinically meaningful, yet remain unexamined. PATIENTS/METHODS: This secondary analysis of a pilot RCT (N = 40 cancer survivors with insomnia) explicated changes in anticipatory and consummatory pleasure and depression symptoms following a 4-session, synchronous, virtual CBT-I program versus enhanced usual care (referral to a behavioral sleep medicine clinic + sleep hygiene handout). Linear mixed models examined changes in anticipatory and consummatory pleasure and depression symptoms as predictors of changes in insomnia severity from baseline to post-intervention and 1-month follow-up. RESULTS: CBT-I buffered against deterioration in anticipatory pleasure but not consummatory pleasure or depression symptoms. Across conditions, increased anticipatory pleasure was associated with insomnia reduction through 1-month follow-up, even after adjusting for changes in depression symptoms. CONCLUSION: CBT-I may improve reward processing deficits in cancer survivors with insomnia. Findings provide support for the ISR Model and implicate pleasure as an important target for insomnia and depression.

A resilient and connected network of sites to sustain biodiversity under a changing climate.

Motivated by declines in biodiversity exacerbated by climate change, we identified a network of conservation sites designed to provide resilient habitat for species, while supporting dynamic shifts in ranges and changes in ecosystem composition. Our 12-y study involved 289 scientists in 14 study regions across the conterminous United States (CONUS), and our intent was to support local-, regional-, and national-scale conservation decisions. To ensure that the network represented all species and ecosystems, we stratified CONUS into 68 ecoregions, and, within each, we comprehensively mapped the geophysical settings associated with current ecosystem and species distributions. To identify sites most resilient to climate change, we identified the portion of each geophysical setting with the most topoclimate variability (high landscape diversity) likely to be accessible to dispersers (high local connectedness). These "resilient sites" were overlaid with conservation priority maps from 104 independent assessments to indicate current value in supporting recognized biodiversity. To identify key connectivity areas for sustaining species movement in response to climate change, we codeveloped a fine-scale representation of human modification and ran a circuit-theory-based analysis that emphasized movement potential along geographic climate gradients. Integrating areas with high values for two or more factors, we identified a representative, resilient, and connected network of biodiverse lands covering 35% of CONUS. Because the network connects climatic gradients across 250,000 biodiversity elements and multiple resilient examples of all geophysical settings in every ecoregion, it could form the spatial foundation for targeted land protection and other conservation strategies to sustain a diverse, dynamic, and adaptive world.

Exploring Predictors of Sleep State Misperception in Women with Posttraumatic Stress Disorder.

OBJECTIVES: Insomnia is a common symptom of posttraumatic stress disorder (PTSD) that is resistant to first-line cognitive behavioral interventions. However, research suggests that, among individuals with PTSD, self-reported sleep impairment is typically more severe than what is objectively observed, a phenomenon termed sleep state misperception. Relatively little research has examined which individuals with PTSD are most likely to exhibit sleep state misperception. This study explored clinical predictors of sleep state misperception in a sample of 43 women with PTSD and clinically significant sleep impairment. METHOD: During a baseline assessment, participants' PTSD symptoms were assessed using a clinical interview and their sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). Objective sleep, self-reported sleep, and PTSD symptoms were then assessed over a 1-week period using actigraphy and daily diaries. RESULTS: Consistent with previous research, women in the study exhibited total sleep time (TST), sleep efficiency (SE), and sleep onset latency (SOL) sleep state misperception. For TST and SE, but not SOL, discrepancies between actigraphy and the PSQI were associated with each clinician-rated PTSD symptom cluster, whereas discrepancies between actigraphy and daily diary were only associated with clinician-rated reexperiencing symptoms. The only self-reported PTSD symptom that was uniquely associated with sleep state misperception was nightmares. This association was no longer significant after controlling for sleep-related anxiety. CONCLUSIONS: Results suggest that women with more severe reexperiencing symptoms of PTSD, particularly nightmares, may be more likely to exhibit TST and SE sleep state misperception, perhaps due to associated sleep-related anxiety.

Curve Characteristics and Surgical Outcomes in Scoliosis Associated With Childhood Sternotomy or Thoracotomy.

BACKGROUND: The purpose of this study is to describe curve characteristics and postoperative outcomes in patients undergoing spinal fusion (SF) to treat thoracogenic scoliosis related to sternotomy and/or thoracotomy as a growing child. METHODS: A retrospective review of electronic medical records of all patients with Post-Chest Incision scoliosis treated with SF was performed at 2 tertiary care pediatric institutions over a 19-year period. Curve characteristics, inpatient, and outpatient postoperative outcomes are reported. RESULTS: Thirty-nine patients (62% female) were identified. Eighteen had sternotomy alone, 14 had thoracotomy alone, and 7 had both. Mean age at the time of first chest wall surgery was 2.5 years (range: 1.0 d to 14.2 y). Eighty-five percent of patients had a main thoracic curve (mean major curve angle 72 degrees, range: 40 to 116 degrees) and 15% had a main lumbar curve (mean major curve angle 76 degrees, range: 59 to 83 degrees). Mean thoracic kyphosis was 40 degrees (range: 4 to 84 degrees). Mean age at the time of SF was 14 years (range: 8.2 to 19.9 y). Thirty-six patients had posterior fusions and 3 had combined anterior/posterior. Mean coronal curve correction measured at the first postoperative encounter was 53% (range: 9% to 78%). There were 5 (13%) neuromonitoring alerts and 2 (5%) patients with transient neurological deficits. Mean length of hospital stay was 9±13 days. At an average follow-up time of 3.1±2.4 years, 17 complications (10 medical and 7 surgical) were noted in 9 patients for an overall complication rate of 23%. There was 1 spinal reoperation in the cohort. 2/17 (12%) complications were Clavien-Dindo-Sink class III and 5/17 (29%) were class IV. CONCLUSION: Kyphotic thoracic curves predominate in patients with Post-Chest Incision scoliosis undergoing SF. Although good coronal and sagittal plane deformity can be expected after a fusion procedure, postoperative complications are not uncommon in medically complex patients, often necessitating longer postoperative stays. LEVEL OF EVIDENCE: Level III.

Femoral acetabular impingement labral pathology on MRI is correlated with greater hip flexion and decreased abduction in collegiate water polo players: A pilot study.

OBJECTIVES: Femoroacetabular impingement (FAI) morphology is associated with hip pain and disability. Water polo players utilise the egg beater motion (method of treading water with legs rotating like an "egg beater"), and it is currently unclear what the relationship is between an egg beater and FAI morphology. Our objective was to associate hip range of motion during egg beater motion to MRI findings. METHODS: Eight National Collegiate Athletic Association (NCAA) Division 1 varsity water polo athletes (5 females and 3 males) were filmed at orthogonal views performing the egg beater motion using two waterproof cameras in synchrony. A model-based image-matching technique was used to determine hip joint angles which were recorded from the software. These athletes also underwent noncontrast MRI scans of both hips using a 3T MRI scanner and completed an 33-item International Hip Outcome Tool (iHOT-33) hip pain outcomes questionnaire. Descriptive statistics are reported as counts and percentages for categorical variables and as means, standard deviations, and a five-number summary for continuous variables. Relationships between the range of motion measures with MRI measures and with iHOT33 scores were analysed using linear regression models. All statistical analyses were completes using a two-sided level of significance of 0.05. RESULTS: The average alpha angles for the right and left hips were 71.80 ±7.50 and 74.10 ±8.40, respectively. There was no statistically significant correlation between hip range of motion in any plane and alpha angle or lateral centre edge angle (CEA) on MRI. The average iHOT33 was 85.9 ± 18.9. Participants who had a labral tear had significantly smaller hip abduction ranges than participants who did not have a labral tear (29° ± 4.1 vs. 35.3° ± 0.6, p = 0.02), and those who had a labral tear had significantly increased hip flexion during egg beater kicking as compared with participants who did not have a labral tear (28.2° ± 6.1 vs. 16.3° ± 4, p = 0.02). There were no differences between right and left alpha angles or between right and left CEA. CONCLUSION: There were no significant correlations between hip range of motion and alpha angle or CEA, but hips with labral pathology had greater hip flexion and more limited hip abduction ranges.

Effects of the COVID-19 pandemic on anhedonia, reward exposure and responsiveness, and sleep in college students.

Objective: The COVID-19 pandemic's effects on college student mental health and its underlying mechanisms are not fully understood. Although necessary, physical distancing abruptly restricts interaction with environmental rewards and disrupts sleep patterns, both of which may contribute to psychological symptoms (eg, depression and anhedonia). This study explored differences in psychological symptoms, reward exposure and responsiveness, and sleep before versus during the pandemic. Methods: Eighty-seven college students completed baseline questionnaires and a one-week daily diary paradigm. The sample was divided into two groups based on data collection before (pre-) or after (post-COVID-19) implementation of state-wide COVID-19 physical distancing measures. Results: Findings highlight higher anhedonia, decrements in exposure to social, professional, and exercise related rewards, lower aniticipatory reward responsiveness, and lower sleep efficiency among college students during the initial months of the pandemic. Conclusions: Findings suggest anhedonia, reward system functioning, and sleep may be important targets to mitigate against college student mental health sequelae during COVID-19.

Relationships Among Sleep Disturbance, Reward System Functioning, Anhedonia, and Depressive Symptoms.

Recent models propose reward system dysfunction as a key mediator of the relationship between sleep and depression and anhedonia. This study explored interrelationships among sleep disturbance, depressive symptoms, anhedonia, and reward responsiveness. Two-hundred and sixty undergraduate students completed questionnaires and a daily diary paradigm assessing sleep, reward responsiveness, depression, anhedonia, and positive affect over 1 week. Baseline sleep disturbance was associated with depressive symptoms, anhedonia, and reward responsiveness. Daily diary sleep parameters showed differential associations with anticipatory versus consummatory reward responsiveness and positive affect. Poorer sleep quality, shorter sleep duration, and longer awakening after sleep onset predicted blunted anticipatory and consummatory reward responsiveness, while increased sleep onset latency and lower sleep efficiency predicted only decreased consummatory reward responsiveness. All sleep indices, except sleep onset latency, were associated with positive affect. Findings demonstrate unique associations between disparate sleep disturbance and reward responsiveness elements, highlighting new treatment mechanisms for anhedonia and depression.

Suppression and acceptance in unipolar depression: Short-term and long-term effects on emotional responding.

OBJECTIVES: Transdiagnostic treatments increasingly include emotion regulation training focused on use of emotional suppression and acceptance. Despite the frequent use of these treatments in depression, little is known about the effects of these strategies in this population. DESIGN: An experimental study. METHODS: Eighty Veterans with unipolar depression participated in a study examining effects of these strategies on emotional responding (subjective, behavioural, and physiological). Physiological measures included: heart rate (HR), respiration (Resp), skin conductance (SC), and corrugator electromyography. On Day 1, participants were randomised to one of three conditions (acceptance, suppression, or control) and underwent an autobiographical sad mood induction. On Day 2, participants underwent a similar mood induction one week later. RESULTS: The suppression group demonstrated reduced physiological reactivity (Resp and SC) on Day 1. However, the suppression group reported decreased positive affect on Day 2. CONCLUSIONS: Results support short-term effectiveness and longer term costs from suppression use among depressed individuals. Findings may inform application of transdiagnostic emotion regulation treatments and suggest suppression functions differently in depressed versus other clinical populations.

The Survivorship Sleep Program (SSP): A synchronous, virtual cognitive behavioral therapy for insomnia pilot program among cancer survivors.

BACKGROUND: For cancer survivors, insomnia is prevalent, distressing, and persists for years if unmanaged. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment yet can be difficult to access and may require modification to address survivorship-specific barriers to sleep. In this 2-phase study, the authors adapted and assessed the feasibility, acceptability, and preliminary effects of synchronous, virtual CBT-I adapted for cancer survivors (the Survivorship Sleep Program [SSP]). METHODS: From April to August 2020, cancer survivors with insomnia (N = 10) were interviewed to refine SSP content and delivery. From October 2020 to March 2021, 40 survivors were recruited for a randomized controlled trial comparing 4 weekly SSP sessions with enhanced usual care (EUC) (CBT-I referral plus a sleep hygiene handout). Feasibility and acceptability were assessed by enrollment, retention, attendance, fidelity, survey ratings, and exit interviews. Insomnia severity (secondary outcome), sleep quality, sleep diaries, and fatigue were assessed at baseline, postintervention, and at 1-month follow-up using linear mixed models. RESULTS: The SSP included targeted content and clinician-led, virtual delivery to enhance patient centeredness and access. Benchmarks were met for enrollment (56% enrolled/eligible), retention (SSP, 90%; EUC, 95%), attendance (100%), and fidelity (95%). Compared with EUC, the SSP resulted in large, clinically significant improvements in insomnia severity (Cohen d = 1.19) that were sustained at 1-month follow-up (Cohen d = 1.27). Improvements were observed for all other sleep metrics except sleep diary total sleep time and fatigue. CONCLUSIONS: Synchronous, virtually delivered CBT-I targeted to cancer survivors is feasible, acceptable, and seems to be efficacious for reducing insomnia severity. Further testing in larger and more diverse samples is warranted.

The Affective Control Scale: Factor structure and associations with posttraumatic stress symptoms in trauma-exposed male veterans.

OBJECTIVE: Posttraumatic stress disorder (PTSD) is characterized by broad-based difficulties with emotion. However, the extent to which the disorder is associated with fear of particular emotions remains less well understood. The Affective Control Scale (ACS) is a frequently used measure of fear of emotion, but relatively little work has been done to validate this measure, particularly for use in psychiatric research. This study examined the ACS's factor structure and its associations with PTSD symptoms among trauma-exposed male veterans. METHOD: Participants (N = 347) completed online assessments, including the ACS and the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). RESULTS: The data supported a bifactor structure with 1 general fear of emotion factor and 4 specific fear of emotion factors (i.e., fear of anger, fear of positive affect, fear of depressed mood, and fear of anxiety). Fear of emotion was positively associated with all 4 DSM-5 PTSD symptom clusters. After controlling for general fear of emotion, fear of particular emotion states was associated with some specific PTSD symptoms. CONCLUSION: Both general and specific fears of emotion were associated with specific PTSD symptoms in trauma-exposed veterans. Despite this, results support the use of a modified ACS total score, capturing general fear of emotion, rather than the subscale scores, capturing fear of specific emotions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Supporting the adaptive capacity of species through more effective knowledge exchange with conservation practitioners.

There is an imperative for conservation practitioners to help biodiversity adapt to accelerating environmental change. Evolutionary biologists are well-positioned to inform the development of evidence-based management strategies that support the adaptive capacity of species and ecosystems. Conservation practitioners increasingly accept that management practices must accommodate rapid environmental change, but harbour concerns about how to apply recommended changes to their management contexts. Given the interest from both conservation practitioners and evolutionary biologists in adjusting management practices, we believe there is an opportunity to accelerate the required changes by promoting closer collaboration between these two groups. We highlight how evolutionary biologists can harness lessons from other disciplines about how to foster effective knowledge exchange to make a substantive contribution to the development of effective conservation practices. These lessons include the following: (1) recognizing why practitioners do and do not use scientific evidence; (2) building an evidence base that will influence management decisions; (3) translating theory into a format that conservation practitioners can use to inform management practices; and (4) developing strategies for effective knowledge exchange. Although efforts will be required on both sides, we believe there are rewards for both practitioners and evolutionary biologists, not least of which is fostering practices to help support the long-term persistence of species.