Children's Sleep and Mental Health During the COVID-19 Pandemic.

PURPOSE OF REVIEW: The COVID-19 pandemic and protracted home confinement required adjustments to schedules and routines generating concern about children's sleep. This review describes general considerations regarding children's sleep, changes and disturbances in their sleep during the pandemic, and the association of sleep measures with health and psychological outcomes in general and in the context of the pandemic. RECENT FINDINGS: A number of studies found an increase in the duration of children's sleep with later bedtimes and waketimes for some children. The research also documented sleep disturbances and associations between children's sleep and psychological outcomes. The extent to which increased sleep duration and changed sleep behaviors translated into improved sleep quality and/or a change in sleep disturbances remains unclear. This review suggests the importance of considering children's sleep in other mass trauma situations including, for example, natural and man-made disasters, as well as pandemics.

Physical Activity and Sedentary Behavior in Children During the COVID-19 Pandemic: Implications for Mental Health.

PURPOSE OF REVIEW: This paper examines children's physical activity and sedentary behavior and associated psychological outcomes coincident with the COVID-19 pandemic. RECENT FINDINGS: Generally, the research has found decreased physical activity and increased sedentary behavior, both of which are associated with various psychological outcomes. The research on sedentary behavior has focused on screen time with minimal consideration of other sedentary behaviors or of specific physical activities or the context in which these behaviors occurred. Changes in children's daily routines and activities have received little attention in the mass trauma research despite the fact that disasters disrupt individual, family, and community life. Thus, the current report contributes to an understanding of the breadth of mass trauma effects, underscores the importance of physical activity and sedentary behavior and their associations with health and psychological outcomes, and is a reminder to consider children's daily lives both during times of crisis and under usual circumstances.

Inconclusive Findings in Studies of the Link Between Media Coverage of Mass Trauma and Depression in Children.

PURPOSE OF REVIEW: This paper reports a review of the empirical research examining the association between mass trauma media contact and depression in children, the factors that may influence the association, and the difficulties encountered in the study of media effects on depression. RECENT FINDINGS: All of the included studies assessed general population samples. Pre-COVID-19 research focused primarily on television coverage alone or on multiple media forms including television, while COVID-19 media studies examined various media forms including social media. Most studies used cross-sectional design and non-probability sampling. The review revealed inconclusive findings across studies. The study of mass trauma media effects on depression in children is complicated by a number of potential confounding factors and by the relatively high prevalence of depression in the general population. Media contact was a relatively minor consideration among other interests in the extant studies which failed to explore numerous issues that warrant attention in future research.

A survey of exercise advice and recommendations in United Kingdom paediatric cardiac clinics.

BACKGROUND: Physical activity and exercise have important health benefits for children and adolescents with CHD. The objective of this study was to survey the provision of advice and recommendations in United Kingdom paediatric CHD clinics. METHODS: A three-page questionnaire was sent out to paediatric cardiac consultants in the United Kingdom, paediatric consultants with expertise in cardiology, and nursing staff (Paediatricians with Expertise in Cardiology Special Interest Group), as well as all members of the British Congenital Cardiovascular Association. The aim of this questionnaire was to determine the extent and scope of current information provision and to assess the importance that clinicians place on this advice. RESULTS: There were 68 responses in total, and the data showed that, of these, 24 (36%) clinicians had never provided paediatric CHD patients with written advice about exercise. Only 27 (39%) clinicians provided physical activity advice at every appointment. Lack of time during consultation (n=39, 56.9%), lack of training (n=38, 55.2%), and uncertainty about appropriate recommendations (n=38, 55.2%) were identified as the main factors preventing clinicians from providing patients with advice about physical activity. CONCLUSION: Although healthcare providers consider physical activity to be very important, the provision of clear, specific advice and recommendations is underutilised; therefore, more education and provision of resources to support the promotion of exercise need to be provided to clinicians and their support teams.

Effects of Displacement in Children Exposed to Disasters.

The literature on children's responses to disasters is well developed with increasing attention to the confounding experiences of displacement. This paper presents an overview of the emotional and behavioral effects of displacement on children and adolescents and describes their educational adjustment in terms of both academic achievement and school behavior. A summary of family effects elucidates how children's functioning is influenced through the family system in which they are embedded. The psychosocial impact of displacement reflects the myriad social losses that children and their families may face. Information from this review of the current literature on the effects of displacement may inform the design and delivery of support and intervention services for children and families following disasters.

Permeation redux: thermodynamics and kinetics of ion movement through potassium channels.

The fundamental biophysics underlying the selective movement of ions through ion channels was launched by George Eisenman in the 1960s, using glass electrodes. This minireview examines the insights from these early studies and the explosive progress made since then.

The Communities Advancing Resilience Toolkit (CART): an intervention to build community resilience to disasters.

Community resilience has emerged as a construct to support and foster healthy individual, family, and community adaptation to mass casualty incidents. The Communities Advancing Resilience Toolkit (CART) is a publicly available theory-based and evidence-informed community intervention designed to enhance community resilience by bringing stakeholders together to address community issues in a process that includes assessment, feedback, planning, and action. Tools include a field-tested community resilience survey and other assessment and analytical instruments. The CART process encourages public engagement in problem solving and the development and use of local assets to address community needs. CART recognizes 4 interrelated domains that contribute to community resilience: connection and caring, resources, transformative potential, and disaster management. The primary value of CART is its contribution to community participation, communication, self-awareness, cooperation, and critical reflection and its ability to stimulate analysis, collaboration, skill building, resource sharing, and purposeful action.

The Communities Advancing Resilience Toolkit (CART): development of a survey instrument to assess community resilience.

While building community resilience to disasters is becoming an important strategy in emergency management, this is a new field of research with few available instruments for assessing community resilience. This article describes the development of the Communities Advancing Resilience Toolkit (CART) survey instrument. CART is a community intervention designed to enhance community resilience to disasters, in part, by engaging communities in measuring it. The survey instrument, originally based on community capacity and related literature and on key informant input, was refined through a series of four field tests. Community organizations worked with researchers in a participatory action process that provided access to samples and helped to guide the research. Exploratory factor analysis performed after each field test led to the identification of four interrelated constructs (also called domains) which represent the foundation for CART Connection and Caring, Resources, Transformative Potential, and Disaster Management. This model was confirmed using confirmatory factor analysis on two community samples. The CART survey can provide data for organizations and communities interested in assessing a community's resilience to disasters. Baseline data, preferably collected pre disaster can be compared to data collected post disaster and/or post intervention.

Mind reading improvements in mentalization-based therapy training.

The psychological strain of many psychiatric disorders arises from difficulties encountered in social interactions. Social withdrawal is often the first symptom of neuropsychiatric disorders. The authors explore the various options for training social cognition skills. Social cognition was assessed using the Movie for the Assessment of Social Cognition (MASC). After completion of mentalization-based therapy (MBT) training, MASC scores improved significantly in health care providers (p = .006, r = .57). Mentalizing (operationalized with reflective functioning [RF]) was assessed in the MBT group (Group A) and compared with RF in a control group (Group B). RF was significantly higher in Group A (RF = 4.35, SD = 1.19) than in Group B (RF = 3.43, SD = 1.70) (p = .0385; Cohen's d = 0.65). MBT might be a promising intervention in social cognition training. Mentalizing skills might be associated with attitude.

Electrostatic contributions of aromatic residues in the local anesthetic receptor of voltage-gated sodium channels.

Antiarrhythmics, anticonvulsants, and local anesthetics target voltage-gated sodium channels, decreasing excitability of nerve and muscle cells. Channel inhibition by members of this family of cationic, hydrophobic drugs relies on the presence of highly conserved aromatic residues in the pore-lining S6 segment of the fourth homologous domain of the channel. We tested whether channel inhibition was facilitated by an electrostatic attraction between lidocaine and pi electrons of the aromatic rings of these residues, namely a cation-pi interaction. To this end, we used the in vivo nonsense suppression method to incorporate a series of unnatural phenylalanine derivatives designed to systematically reduce the negative electrostatic potential on the face of the aromatic ring. In contrast to standard point mutations at the same sites, these subtly altered amino acids preserve the wild-type voltage dependence of channel activation and inactivation. Although these phenylalanine derivatives have no effect on low-affinity tonic inhibition by lidocaine or its permanently charged derivative QX-314 at any of the substituted sites, high-affinity use-dependent inhibition displays substantial cation-pi energetics for 1 residue only: Phe1579 in rNa(V)1.4. Replacement of the aromatic ring of Phe1579 by cyclohexane, for example, strongly reduces use-dependent inhibition and speeds recovery of lidocaine-engaged channels. Channel block by the neutral local anesthetic benzocaine is unaffected by the distribution of pi electrons at Phe1579, indicating that our aromatic manipulations expose electrostatic contributions to channel inhibition. These results fine tune our understanding of local anesthetic inhibition of voltage-gated sodium channels and will help the design of safer and more salutary therapeutic agents.

Focused electric field across the voltage sensor of potassium channels.

Voltage-gated ion channels respond to changes in membrane potential by movement of their voltage sensors across the electric field between cytoplasmic and extracellular solutions. The principal voltage sensors in these proteins are positively charged S4 segments. The absolute magnitude of S4 movement discriminates two competing classes of gating models. In one class, the movement is <10 Angstrom due to the fact that the electric field is focused by aqueous crevices in the channel protein. In an alternative model, based in part on the crystal structure of a potassium channel, the side chains of S4 arginines move their charges across the bilayer's electric field, a distance of >25 Angstrom. Here, using tethered charges attached to an S4 segment, we provide evidence that the electric field falls across a distance of <4 Angstrom, supporting a model in which the relative movement between S4 and the electric field is very small.

Involving children in disaster risk reduction: the importance of participation.

Background: Millions of children are affected by disasters every year. Children need not be passive victims, however, but instead may contribute to disaster risk reduction activities. Objective: This paper provides a theoretical foundation for children's involvement in disaster risk reduction activities. Method: The paper reviews and analyses the literature on children's participation, on their developmental capacity to participate, and on disaster risk reduction activities involving children. Results: Participation yields numerous potential benefits for children, including enhanced personal development and skills, self-efficacy, and interpersonal relationships, and for communities through improved social connections and networks and disaster preparedness. Conclusions: Children are resources to be cultivated and mobilized for disaster preparedness, response, recovery, and resilience. Attention is needed to identify approaches to appropriately enlist, engage, and involve children in disaster risk reduction activities; to promote these efforts; and to evaluate these approaches.

Planteamiento: Millones de niños se ven afectados por desastres cada año. Sin embargo, los niños no necesitan ser víctimas pasivas, sino que pueden contribuir a las actividades de reducción del riesgo de desastres. Objetivo: Este documento proporciona una base teórica para la participación de los niños en actividades de reducción del riesgo de desastres. Método: El documento revisa y analiza la literatura sobre la participación de los niños, acerca de su capacidad de desarrollo para participar y de las actividades de reducción del riesgo de desastres que involucran a los niños. Resultados: la participación ofrece numerosos beneficios potenciales tanto para los niños, que incluyen una mejoría de su desarrollo personal y habilidades, de su autoeficacia y de sus relaciones interpersonales, como para las comunidades a través de mejores conexiones y redes sociales, y una mejor preparación para los desastres. Conclusiones: Los niños son recursos que se pueden cultivar y movilizar para la preparación, la respuesta, la recuperación y la resiliencia ante desastres. Se necesita atención para identificar enfoques para reclutar, involucrar e implicar apropiadamente a los niños en actividades de reducción del riesgo de desastres; para promover estos esfuerzos; y para evaluar estos enfoques.

Emotional Well-Being and Public Health: Proposal for a Model National Initiative.

In 2011, the National Prevention, Health Promotion, and Public Health Council named mental and emotional well-being as 1 of 7 priority areas for the National Prevention Strategy. In this article, we discuss emotional well-being as a scientific concept and its relevance to public health. We review evidence that supports the association between emotional well-being and health. We propose a national emotional well-being initiative and describe its 6 components: systematic measurement of emotional well-being, identification of the drivers of emotional well-being, formation of partnerships with diverse stakeholders, implementation and dissemination of evidence-based interventions to promote emotional well-being and its drivers, development of public health messaging, and identification of and strategies to address disparities in emotional well-being and its drivers. Finally, we discuss ways in which a national emotional well-being initiative would complement current public health efforts and the potential challenges to such an initiative.

A cation-pi interaction between extracellular TEA and an aromatic residue in potassium channels.

Open-channel blockers such as tetraethylammonium (TEA) have a long history as probes of the permeation pathway of ion channels. High affinity blockade by extracellular TEA requires the presence of an aromatic amino acid at a position that sits at the external entrance of the permeation pathway (residue 449 in the eukaryotic voltage-gated potassium channel Shaker). We investigated whether a cation-pi interaction between TEA and such an aromatic residue contributes to TEA block using the in vivo nonsense suppression method to incorporate a series of increasingly fluorinated Phe side chains at position 449. Fluorination, which is known to decrease the cation-pi binding ability of an aromatic ring, progressively increased the inhibitory constant K(i) for the TEA block of Shaker. A larger increase in K(i) was observed when the benzene ring of Phe449 was substituted by nonaromatic cyclohexane. These results support a strong cation-pi component to the TEA block. The data provide an empirical basis for choosing between Shaker models that are based on two classes of reported crystal structures for the bacterial channel KcsA, showing residue Tyr82 in orientations either compatible or incompatible with a cation-pi mechanism. We propose that the aromatic residue at this position in Shaker is favorably oriented for a cation-pi interaction with the permeation pathway. This choice is supported by high level ab initio calculations of the predicted effects of Phe modifications on TEA binding energy.

Modulation of the cardiac sodium channel NaV1.5 by Fyn, a Src family tyrosine kinase.

Dynamic modulation of ion channels can produce dramatic alterations of electrical excitability in cardiac myocytes. This study addresses the effects of the Src family tyrosine kinase Fyn on Na(V)1.5 cardiac sodium channels. Sodium currents were acquired by whole cell recording on HEK-293 cells transiently expressing Na(V)1.5. Acute treatment of cells with insulin caused a depolarizing shift in steady-state inactivation, an effect eliminated by the Src-specific tyrosine kinase inhibitor PP2. Sodium channels were coexpressed with either constitutively active (Fyn(CA)) or catalytically inactive (Fyn(KD)) variants of Fyn. Fyn(CA) caused a 10-mV depolarizing shift of steady-state inactivation compared with Fyn(KD) without altering the activation conductance-voltage relationship. Comparable effects of these Fyn variants were obtained with whole-cell and perforated-patch recording. Tyrosine phosphorylation of immunoprecipitated Na(V)1.5 was increased in cells expressing Fyn(CA) compared with Fyn(KD). We show that Fyn is present in rat cardiac myocytes, and that Na(V)1.5 channels from these myocytes are tyrosine-phosphorylated. In HEK-293 cells the effect of Fyn(CA) on Na(V)1.5 inactivation is abolished by the single point mutation Y1495F, a residue located within the cytoplasmic linker between the third and fourth homologous domains of the sodium channel. We provide evidence that this linker is a substrate for Fyn in vitro, and that Y1495 is a preferred phosphorylation site. These results suggest that cardiac sodium channels are physiologically relevant targets of Src family tyrosine kinases.

Stirring up controversy with a voltage sensor paddle.

Neurons owe their exquisite electrical excitability to voltage-gated ion channels. By creating and shaping the action potential, these voltage-sensitive proteins supply the neuron with crucial communication skills. A steady stream of experimental results, arising from numerous laboratories and employing a diverse repertoire of techniques, has produced a consensus model of the way voltage-gated ion channels sense and respond to changes in membrane potential. In contrast to this consensus mechanism, recent studies of the voltage-gated K(+) channel KvAP suggest a strikingly different mode of action. In this review, these disparate models are compared and critically discussed.