Impact of Bronchoscopic Lung Volume Reduction with Valves on the Pulmonary Gas Exchange.

Introduction: Bronchoscopic lung volume reduction (BLVR) with endobronchial valves has been shown to be a safe and effective treatment for patients with severe lung emphysema. Previous studies have reported a benefit in pulmonary function, exercise capacity, and quality of life after BLVR-treatment. The effect of BLVR with valves on the pulmonary gas exchange and its association with clinical outcomes has not been analyzed to date. The primary goal of this study was to investigate the impact of BLVR on the pulmonary gas exchange and the impact of the target lobe selection in patients with discordant target lobes in high-resolution computed tomography (HRCT) scan and perfusion scan on the pulmonary gas exchange and clinical outcomes. Methods: In this single-center study, we retrospectively analyzed pulmonary function tests, 6-min-walk-tests, HRCT scans, perfusion scans, and blood gas analyses in 77 patients over the course of 6 months following BLVR treatment. Results: We observed that complete lobar occlusion with bronchoscopic valves leads to a transient impairment of pulmonary gas exchange. Despite this, an overall positive clinical outcome could be shown in patients treated with endobronchial valves. If the target lobe selection based on HRCT and perfusion scans is discrepant, a selection based on the HRCT scan tends to be associated with a better outcome than a selection based on the perfusion scan. Conclusions: Complete lobar occlusion with bronchoscopic valves leads to a transient impairment of pulmonary gas exchange but nevertheless results in an overall positive clinical outcome.

Promoting Peer Connectedness Through Social-Emotional Learning: Evaluating the Intervention Effect Mechanisms and Implementation Factors of a Social-Emotional Learning Programme for 9 to 12-Year-Olds.

There is little evidence regarding the effect mechanisms of social-emotional learning programs on children's peer relationships. The current study evaluated a novel school-based social-emotional learning program for the first year of secondary school assessing effects on social-emotional skills, peer connectedness, happiness, student and teacher classroom climate. The sample included 19 intervention classrooms (n = 399) and 16 waitlist-control classrooms (n = 281), with a mean age of 10.34 (SD = 0.76) and 48.8% girls. The main intervention effect analysis followed a per-protocol approach and was thus conducted with eight classes that finished all sessions (n = 195) and the control group classes (n = 281). It was further hypothesized that increases in social-emotional skills would predict peer connectedness and class climate increases, which would predict happiness. Results indicated significant intervention effects for social skills, peer connectedness and happiness. Classroom climate declined for both groups, seemingly affected by the school transition. Hypothesized relationships between target variables were partly supported with significant effects of social-emotional skills on connectedness and significant effects of peer connectedness on happiness for children reporting connectedness decreases. Additional analyses were conducted including all classrooms to compare the intervention's effectiveness across different implementation progress groups. Significant group differences were found, indicating that implementation aspects impact intervention outcomes. The findings indicate that universal, school-based social-emotional leaning programs are effective approaches to support peer relationships in the context of the school transition. However, more implementation support seems to be needed to ensure best-practice delivery and achieve maximal intervention effectiveness.

Early adolescents' perspectives on factors that facilitate and hinder friendship development with peers at the time of school transition.

Supportive peer relationships are fundamental for mental health and well-being. Hence, peers and friends are a valuable resource, especially at the time of transition from primary to secondary school. Yet, current literature lacks both novel approaches to studying friendship development and how to involve early adolescents in research that is being conducted about them. Within the present study we used novel participatory research methods involving early adolescents who were active in the analysis of their own generated data. We aimed to better understand their perspectives on factors that facilitate and hinder friendship development with peers during the time of school transition between primary and secondary schools. A total of 916 pupils (Mage = 10.44 years, range = 9-16) participated in 54 participatory workshops that were conducted in Austria. We used reflexive thematic analysis to analyze qualitative data from portions of a large series of participatory workshop activities. Moreover, we actively involved participants in the analysis of their own generated data. Themes were structured into personal, interpersonal, and external factors. We found that early adolescents valued kind peers that (a) give them a feeling of safety, (b) show supportive and empathic actions, (c) manage conflicts, (d) avoid negative behavior, (e) spend time with them, and (f) communicate in the offline and online environments. Although shared norms of behavior can support friendship development, friendship jealousy and tolerating bigger friendship groups were identified as important potential barriers. Additionally, external factors (i.e., given circumstances), such as similarities, physical proximity, and duration of acquaintance were included in our data but were perceived as less important by early adolescents. Our results supplement the existing peer relationship literature by showing which factors early adolescents themselves chose as most relevant for friendship development. We conclude with a discussion regarding the implications for school psychology practice and future research.

Toward an Integrated Model of Supportive Peer Relationships in Early Adolescence: A Systematic Review and Exploratory Meta-Analysis.

Supportive peer relationships (SPR) are crucial for mental and physical health. Early adolescence is an especially important period in which peer influence and school environment strongly shape psychological development and maturation of core social-emotional regulatory functions. Yet, there is no integrated evidence based model of SPR in this age group to inform future research and practice. The current meta-analysis synthetizes evidence from 364 studies into an integrated model of potential determinants of SPR in early adolescence. The model encompasses links with 93 variables referring to individual (identity, skills/strengths, affect/well-being, and behavior/health) and environmental (peer group, school, family, community, and internet/technology) potential influences on SPR based on cross-sectional correlational data. Findings suggest the central importance of identity and social-emotional skills in SPR. School environment stands out as a compelling setting for future prevention programs. Finally, we underscore an alarming gap of research on the influence of the virtual and online environment on youth's social realm given its unquestionable importance as a globally expanding social interaction setting. Hence, we propose an integrated model that can serve as organizational framework, which may ultimately lead to the adoption of a more structured and integrated approach to understanding peer relationship processes in youth and contribute to overcoming marked fragmentation in the field.

Intellectual disability literacy and its connection to stigma: A multinational comparison study in three European countries.

Article 8 of the UN Convention on the Rights of People with Disabilities requires governments around the globe to raise awareness on issues of disability in their societies, combatting stereotypes, prejudices and harmful practices. Little comparative data is available on lay people's social representations of intellectual disability and associated stigma, which could inform actions in line with the convention. The present study compared intellectual disability literacy and stigma among adults in the general population in the UK, Austria and Germany (N = 1046), and examined the effects of providing an intellectual disability label on these outcomes. Although participants came from highly developed European countries and prior contact with people with intellectual disabilities was common, the findings pointed to some striking differences between countries. Participants in Austria and Germany were much less likely than those in the UK to identify symptoms of a possible intellectual disability in an unlabelled vignette. They were also much more hostile towards social contact, a difference that was maintained when participants were informed of the intellectual disability label. Labelling showed controversial effects on stigma, both in its effects on social distance and on beliefs about suitable causes and interventions. Overall, the social acceptance of people with intellectual disabilities appears to be much less advanced in Austria and Germany than in the UK, and awareness of intellectual disability much lower, indicating a need for action at societal level.

A systematic review on assessment instruments for dementia in persons with intellectual disabilities.

AIM: This work describes an extensive systematic literature review on assessment instruments for dementia in persons with intellectual disability (ID). Existing instruments for the detection of dementia in persons with ID were collected and described systematically. This allows a direct and quick overview of available tools. Additionally, it contributes to the availability and usability of information about these instruments, thus enhancing further developments in this field. METHODS: A systematic literature search in five databases (CINAHL, PsycInfo, PubMed, Scopus, and Web of Science) was conducted. In order to include gray literature an invisible college approach was used. Relevant studies were identified and selected using defined inclusion and exclusion criteria. After the selection process all instruments were coded and classified. It was determined which concepts they assess, whether they were especially developed or adapted for persons with ID, and whether they were designed to assess dementia. The selection of relevant papers, as well as the coding of instruments was done independently by two researchers. RESULTS: In total, 97 records met the search criteria. Out of these, 114 different instruments were extracted. There were 79 instruments to be completed by the person with ID, and 35 informant-based instruments. Additionally, four test batteries were found. Some of these instruments were neither designed for the assessment of dementia, nor for persons with ID. CONCLUSIONS: There are a variety of different tools used for the assessment of dementia in ID. Nevertheless, an agreed-upon approach or instrument is missing. Establishing this would improve the quality of assessment in clinical practice, and benefit research. Data collected would become comparable and combinable, and allow research to have more informative value.