Approaches to improving mental health care for autistic children and young people: a systematic review and meta-analysis.

Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.

Napping behaviour, daytime sleepiness, and arousal in high performance athletes and non-athlete controls.

Napping offers a strategy to manage sleep, aid recovery and enhance performance in elite sport. However, relatively little research attention has focussed on the natural history of athlete napping or tested the widely held assumption that athlete napping is mainly a consequence of degraded night-time sleep. Within a sample of 158 team (n = 76) and individual (n = 80) sport athletes, and 82 non-athlete controls, we analysed napping behaviour in relation to sleep quality, daytime sleepiness, and pre-sleep somatic and cognitive arousal. There was no significant association between athlete/non-athlete status and the prevalence, frequency, or duration of naps. Comparisons of athlete nappers and non-nappers found no significant differences in sleep quantity or quality. While nap propensity was significantly related to higher daytime sleepiness, this influence was moderated or augmented by levels of pre-sleep cognitive arousal. For some nappers, those with higher levels of arousal may need to be sleepier than those with lower levels of arousal in order to successfully initiate daytime sleep. Approximately 50% of athletes did not nap. If the benefits of athlete napping are to be fully exploited, the needs of this substantial group for whom napping may be problematic should be recognised and addressed.

Alcohol Use Predicts Face Perception Impairments and Difficulties in Face Recognition.

Background: Risky alcohol use is related to a variety of cognitive impairments, including memory and visuo-perceptual difficulties. Remarkably, no prior work has assessed whether usage of alcohol can predict difficulties perceiving facial identity. Objectives: Therefore, this study aimed to investigate whether riskier alcohol consumption predicted impairments in face perception and self-reported difficulties in face recognition. Results: Participants (N = 239, male = 77) were over 18 years old and had normal or corrected-to-normal vision. Alcohol use was assessed using the Alcohol Use Disorder Identification Test (AUDIT), while face recognition difficulties were determined by the 20-item Prosopagnosia Index questionnaire (PI20). A subsample of participants (N = 126, male = 51) completed the Cambridge Face Perception task (CFPT) to assess their face perception ability. Multiple linear regressions showed significant models of prediction on both face perception and face recognition when considering AUDIT score and age as predictors. Conclusion: This study suggested, for the first time, that risky alcohol use predicts both poorer visuo-perceptual processing for faces and self-reported difficulties in face recognition.

Expert Views on Evidence-Based Classification for Goalball: A Delphi Study.

Para sport classification aims to minimize the impact of impairments on the outcome of competition. The International Paralympic Committee requires classification systems to be evidence based and sport specific, yet the sport of goalball uses a structure that is not supported by evidence demonstrating its legitimacy for competition. This study aimed to establish expert opinions on how a sport-specific system of classification should be structured in the sport of goalball. Using a three-round Delphi survey, 30 international experts expressed their views across topics linked to goalball classification. Participants were divided as to whether the current system fulfills the aim to minimize the impact of impairment on competition. Most felt that less impairment should be required to compete but that the one-class structure should remain. Experts identified measures of visual function that should be considered and 15 core components of individual goalball performance. Findings constitute a crucial first step toward evidence-based classification in goalball.

Howzat! Expert umpires use a gaze anchor to overcome the processing demands of leg before wicket decisions.

Cricket umpires are required to make high-pressure, match-changing decisions based on multiple complex information sources under severe temporal constraints. The aim of this study was to examine the decision-making and perceptual-cognitive differences between expert and novice cricket umpires when judging leg before wicket (LBW) decisions. Twelve expert umpires and 19 novice umpires were fitted with an eye-tracker before viewing video-based LBW appeals. Dependent variables were radial error (cm), number of fixations, average fixation duration (ms), final fixation duration (ms), and final fixation location (%). Expert umpires were significantly more accurate at adjudicating on all aspects of the LBW law, compared to the novice umpires (p < .05). The expert umpires' final fixation prior to ball-pad contact was directed significantly more towards the stumps (p < .05), whereas the novice umpires directed their final fixation significantly more towards a good length (p < .05). These data suggest that expert umpires utilize specialized perceptual-cognitive skills, consisting of a gaze anchor on the stumps in order to overcome the processing demands of the task. These data have implications for the training of current and aspiring umpires in order to enhance the accuracy of LBW decision-making across all levels of the cricketing pyramid.

Hill on a mountaintop: A longitudinal and cross-sectional analysis of the relative age effect in competitive youth football.

The aim of this study was to examine the origin and persistence of the relative age effect (RAE) in competitive youth football. To examine its origin, birthdates of 121 category one Premier League academy players recruited over 6 years were compared with 691 Under 8 (U8) players in one of the regional grassroots leagues from which academy players are selected. To examine the persistence of the RAE we conducted a longitudinal comparison of retention rates in early-birth and late-birth academy players from U9 to U15, and made a cross-sectional comparison of birthdate distributions from U7 to U18 in 10,857 regional league players. The results revealed birthdate asymmetry in both the academy and grassroots players but a much larger RAE in the academy. Longitudinal analysis revealed that the cumulative probability of retention at the academy was higher for early-birth than late-birth players. A small to medium RAE persisted across grassroots football age groups though it declined somewhat from U15 to U18. The implication of these results for academy player recruitment is discussed.

Seeing the Bigger Picture: Susceptibility to, and Detection of, Deception.

An extended time window was used to examine susceptibility to, and detection of, deception in rugby union. High- and low-skilled rugby players judged the final running direction of an opponent "cutting" left or right, with or without a deceptive sidestep. Each trial was occluded at one of eight time points relative to the footfall after the initial (genuine or fake) reorientation. Based on response accuracy, the results were separated into deception susceptibility and deception detection windows. Signal-detection analysis was used to calculate the discriminability of genuine and deceptive actions (d') and the response bias (c). High-skilled players were less susceptible to deception and better able to detect when they had been deceived, accompanied by a reduced bias toward perceiving all actions as genuine. By establishing the time window in which players become deceived, it will now be possible to identify the kinematic sources that drive deception.

The Effect of Healing Touch on Critical Care Patients' Vital Signs: A Pilot Study.

To determine the impact of Healing Touch on vital signs, adult intensive care unit patients were recruited from multiple hospital sites. Both pain and agitation improved and there was a significant change in hemodynamics that reflected a calming effect. Healing Touch may be considered a respected addition to symptom management.

Use of Noncontact Low-Frequency Ultrasound in Deep Tissue Pressure Injury: A Retrospective Analysis.

PURPOSE: The purpose of this study was to examine the effect of noncontact low-frequency ultrasound (NLFU) on deep tissue pressure injury (DTPI), both hospital-acquired and those present on admission (POA). DESIGN: Retrospective, descriptive study. SAMPLE AND SETTING: Medical records from 44 adult patients with a DTPI treated with NLFU were reviewed; 22 had a hospital-acquired DTPI (HADTPI) and 22 had DTPI POA. Their mean age was 71.3 ± 16.3 years (mean ± SD); 52% were male. The study setting was a 318-bed community hospital in the Mid-Atlantic region of the United States. METHODS: Data were collected from the medical records including demographic and relevant clinical characteristics, DTPI measurements, and DTPI evolution/resolution. Data were summarized and examined using descriptive statistics (eg, frequencies and percentages and means and standard deviations). Differences between groups were examined using paired t tests or the Mann-Whitney U test and the chi-square test as appropriate. In addition, the heel DTPI subgroup (N = 8) was examined separately due to the small sample size. RESULTS: All patients with HADTPI and DTPI POA treated with NLFU exhibited a statistically significant decrease in injury size from initiation to discontinuation of NLFU therapy (24.6 cm vs 14.4 cm, P = .02). No statistically significant difference in wound resolution was found between HADTPI versus DTPI POA (27% vs 18%, P = .47). Mean size of both HADTPI and DTPI POA decreased significantly from 15.9 to 13.4 cm (P = .045) by NLFU therapy. Wounds were classified as resolved at completion of treatment in 23% (10 out of 44) of all treated patients. Of all patients with the potential to be resolved (not discharged early or expired) 63% (10 out of 16) had wounds classified as resolved. CONCLUSION: Study findings suggest that NLFU is a viable and promising treatment option for both HADTPI and DTPI POA. Future studies are needed to confirm these results and to examine efficacy and feasibility of DTPI across care settings.

Anxiety, anticipation and contextual information: A test of attentional control theory.

We tested the assumptions of Attentional Control Theory (ACT) by examining the impact of anxiety on anticipation using a dynamic, time-constrained task. Moreover, we examined the involvement of high- and low-level cognitive processes in anticipation and how their importance may interact with anxiety. Skilled and less-skilled tennis players anticipated the shots of opponents under low- and high-anxiety conditions. Participants viewed three types of video stimuli, each depicting different levels of contextual information. Performance effectiveness (response accuracy) and processing efficiency (response accuracy divided by corresponding mental effort) were measured. Skilled players recorded higher levels of response accuracy and processing efficiency compared to less-skilled counterparts. Processing efficiency significantly decreased under high- compared to low-anxiety conditions. No difference in response accuracy was observed. When reviewing directional errors, anxiety was most detrimental to performance in the condition conveying only contextual information, suggesting that anxiety may have a greater impact on high-level (top-down) cognitive processes, potentially due to a shift in attentional control. Our findings provide partial support for ACT; anxiety elicited greater decrements in processing efficiency than performance effectiveness, possibly due to predominance of the stimulus-driven attentional system.

Priming to promote fluent motor skill execution: exploring attentional demands.

The effect of priming on the speed and accuracy of skilled performance and on a probe-reaction time task designed to measure residual attentional capacity, was assessed. Twenty-four skilled soccer players completed a dribbling task under three prime conditions (fluency, skill-focus, and neutral) and a control condition. Results revealed changes in trial completion time and secondary task performance in line with successfully priming autonomous and skill-focused attention. Retention test data for task completion time and probe-reaction time indicated a linear decrease in the priming effect such that the effect was nonsignificant after 30 min. Results provide further support for the efficacy of priming and provide the first evidence of concurrent changes in attentional demands, consistent with promoting or disrupting automatic skill execution.

Dr Karl Koenig: a brief survey of his extraordinary early years.

Over 70 years ago, an Austrian émigré doctor - Karl Koenig - came to Scotland where he established the Camphill Movement. Today that Movement embraces over 100 communities for children and adults with developmental disabilities in at least 24 countries. One aspect of Koenig's biography that has not been explored concerns his childhood: an extraordinary omission given its inspirational character. Without an appreciation of this critical period in his life, any understanding of his very considerable achievements not least his pioneering success in establishing the Camphill Movement must be incomplete.

The Kinematics of False Intent Conveyed by Deceptive Sidestep Actions.

Researchers have identified kinematic differences between deceptive and non-deceptive rugby reorientation actions. However, the honest and deceptive signals corresponded to 'deception detection' (accuracy increasing) rather than signals that caused deception (accuracy decreasing). In this study, statistical parametric mapping and multilevel modelling were applied to examine the kinematic differences between sidestep and non-deceptive actions during the time window of deception. The analysis compared three-dimensional motion capture data from 144 deceptive actions and 144 genuine actions performed by six high-skilled rugby players. Results indicated that the kinematics of deceptive actions were characterized by a combination of exaggerated head roll, outside foot and centre-of-mass displacement, and attenuated thorax roll and yaw relative to genuine actions. These are candidate sources for the cause of deception, either individually or in combination with other sources. Furthermore, the results indicate that previously identified 'honest' signals may not be reliable sources of information earlier in the action sequence.

Are alcohol-related attentional biases and holistic perception independent processes?

Excessive alcohol consumption is associated with the development of attentional biases for alcohol-related cues and their prioritization in heavy drinkers. Recently, it has been hypothesized that holistic processing may also play a role in this prioritization, with higher alcohol consumers exhibiting stronger holistic perception for alcohol cues. However, it is unclear how processing stimuli holistically may be related to attentional biases. We explored potential relationships between attentional biases, holistic processing, and alcohol consumption in a sample of drinkers using two tasks. In the first, a visual probe task replicated previous findings by showing an increased attentional bias for alcohol-related stimuli in individuals with higher alcohol consumption. Surprisingly, using an inversion paradigm to measure holistic perception in our second task, we showed reduced holistic processing for both alcohol and nonalcohol cues in higher alcohol consumers compared to light alcohol consumers. Although alcohol consumption was positively associated with attentional biases and negatively associated with holistic processing, these cognitive processes were not associated with each other. This study supports a model of visual perception in which attentional biases and holistic processing are independently linked with alcohol use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Temporal and spectral electrooculographic features in a discrete precision task.

This study aimed to evaluate the utility and applicability of electrooculography (EOG) when studying ocular activity during complex motor behavior. Due to its lower spatial resolution relative to eye tracking (ET), it is unclear whether EOG can provide valid and accurate temporal measurements such as the duration of the Quiet Eye (QE), that is the uninterrupted dwell time on the visual target prior to and during action. However, because of its greater temporal resolution, EOG is better suited for temporal-spectral decomposition, a technique that allows us to distinguish between lower and higher frequency activity as a function of time. Sixteen golfers of varying expertise (novices to experts) putted 60 balls to a 4-m distant target on a flat surface while we recorded EOG, ET, performance accuracy, and putter kinematics. Correlational and discrepancy analyses confirmed that EOG yielded valid and accurate QE measurements, but only when using certain processing parameters. Nested cross-validation indicated that, among a set of ET and EOG temporal and spectral oculomotor features, EOG power was the most useful when predicting performance accuracy through robust regression. Follow-up cross-validation and correlational analyses revealed that more accurate performance was preceded by diminished lower-frequency activity immediately before movement initiation and elevated higher-frequency activity during movement recorded from the horizontal channel. This higher-frequency activity was also found to accompany a smoother movement execution. This study validates EOG algorithms (code provided) for measuring temporal parameters and presents a novel approach to extracting temporal and spectral oculomotor features during complex motor behavior.