Parental anxiety and depression are associated with adverse mental health in children with special needs during the COVID-19 pandemic.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has led to restrictions in various areas of life, including social life, work, leisure, health, and education. Vulnerable groups, such as children with special needs and their parents, may be at increased risk of experiencing exacerbated mental health problems during stressful periods such as the COVID-19 lockdowns. Materials and methods: Telephone interviews were conducted with 954 parents of children with special needs. We assessed parental levels of generalized anxiety and depression using the validated GAD-7 and PHQ-8 scales. Parents were asked to rate family burden and their worry about the COVID-19 crisis, as well as their children's adverse mental health symptoms and health behaviors. Parents also reported their children's worries about the COVID-19 crisis. We conducted regressions to examine the relationship between parents' mental health problems and their children's adverse mental health symptoms and health behaviors. Qualitative data from open-ended questions were coded thematically and major themes of parental worry about the COVID-19 crisis were identified. Results: Parental anxiety and depression symptoms predicted adverse mental health symptoms and behaviors in children with special needs. Criteria for current depression were met by 7.9% of parents of children with special needs, whereas 4.7% of the general population in Vorarlberg met the criteria for current depression according to data from the Austrian Health Interview Survey in 2019. Parental self-ratings of both depression and anxiety were highly correlated. The majority of parents reported being burdened (79.1%) or worried (67.8%) about the COVID-19 crisis. The main themes of parental worry about the COVID-19 crisis included COVID-19 infection (40.6%), economic situation (13.1%), uncertainty (8.4%), lack of social contact with family and friends (8.1%), family health status (7.5%), and school life (7.5%). Discussion: Mental health symptoms in parents of children with special needs were strongly associated with increased adverse mental health symptoms and health behaviors in their children. Parents of children with special needs were more likely to be depressed during the COVID-19 pandemic than adults in 2019. We call for additional mental health support to reduce the mental health burden in families with children with special needs.

Teachers Can Make a Difference in Bullying: Effects of Teacher Interventions on Students' Adoption of Bully, Victim, Bully-Victim or Defender Roles across Time.

School bullying is a serious problem worldwide, but little is known about how teacher interventions influence the adoption of bullying-related student roles. This study surveyed 750 early adolescents (50.5% female; average age: 12.9 years, SD = 0.4) from 39 classrooms in two waves, six months apart. Peer ratings of classmates were used to categorize students to five different bullying-related roles (criterion: >1 SD): bully, victim, bully-victim, defender, and non-participant. Student ratings of teachers were used to obtain class-level measures of teacher interventions: non-intervention, disciplinary sanctions, group discussion, and mediation/victim support. Controlling for student- and class-level background variables, two multilevel multinomial logistic regression analyses were computed to predict students' bullying-related roles at wave 2. In the static model, predictors were teacher interventions at wave 1, and in the dynamic model, predictors were teacher intervention changes across time. The static model showed that disciplinary sanctions reduced the likelihood of being a bully or victim, and group discussion raised the likelihood of being a defender. Mediation/victim support raised the likelihood of being a bully. The dynamic model complemented these results by indicating that increases in group discussion across time raised the likelihood of being a defender, whereas increases in non-intervention across time raised the likelihood of being a victim and reduced the likelihood of being a defender. These results show that teacher interventions have distinct effects on students' adoption of bullying-related roles and could help to better target intervention strategies. The findings carry practical implications for the professional training of prospective and current teachers.

Humor Styles, Bullying Victimization and Psychological School Adjustment: Mediation, Moderation and Person-Oriented Analyses.

Humor can be both adaptive and maladaptive and plays a role in bullying victimization and school adjustment. It was hypothesized that humor styles decrease or increase victimization, which in turn affects school adjustment. Furthermore, humor might moderate effects of victimization on school adjustment. Moreover, a person-oriented approach could improve our understanding of group differences in these variables. An online questionnaire retrospectively surveyed emerging adults (N = 172; 77.2% female; mean age: 22.7 years) with respect to humor style use, bullying victimization and school adjustment. Mediation and moderation analyses were computed, and two sets of person-oriented analyses compared victims, bully-victims and noninvolved students on humor styles and school adjustment, and three latent humor-related groups (overall-high, adaptive-high and adaptive-low) on victimization and school adjustment. Victimization fully mediated the positive effect of affiliative humor and partially mediated the negative effect of self-defeating humor on school adjustment. The negative effect of victimization on school adjustment was magnified by self-defeating humor and attenuated by aggressive humor. Bully-victims used both aggressive and self-defeating humor more frequently, and victims used aggressive and affiliative humor less frequently. Furthermore, both victims and bully-victims showed lower school adjustment. Finally, the adaptive-high humor group showed lower victimization and higher school adjustment. Implications for school interventions are discussed.

School Bullying Is Not a Conflict: The Interplay between Conflict Management Styles, Bullying Victimization and Psychological School Adjustment.

It has been argued that adaptive conflict management styles may protect students against bullying victimization and against negative effects of ongoing victimization on psychological school adjustment. Moreover, maladaptive conflict management styles may lead to victimization or intensify negative effects of victimization on school adjustment. Mediation and moderation models were computed to test these effects. Furthermore, a person-oriented approach compared noninvolved students, victims, and bully-victims regarding conflict management styles and school adjustment. A total of 172 individuals (77.2% female, mean age: 22.7 years) completed a retrospective online questionnaire about conflict management styles, bullying victimization and school adjustment during their school years. In the mediation model, conflict management styles were not associated with victimization, but there was a positive direct effect of the integrating style on school adjustment. In the moderation model, the integrating style moderated the negative effect of victimization on school adjustment but did not buffer against the negative effects when victimization was high. Person-oriented comparisons showed that victims used the obliging style more often than bully-victims. Furthermore, victims and bully-victims showed lower school adjustment than noninvolved students. Overall, results corroborate the view that school bullying is qualitatively different from normal peer conflicts. Implications for researchers, policymakers, school principals and teachers are discussed.

Perpetration and Victimization in Offline and Cyber Contexts: A Variable- and Person-Oriented Examination of Associations and Differences Regarding Domain-Specific Self-Esteem and School Adjustment.

Self-esteem has been identified as a predictor of bullying perpetration and victimization, which, in turn, may lead to school adjustment problems. However, findings regarding the direction and strength of these associations have been inconclusive. This study aimed to resolve this by differentiating between offline and cyber contexts and various self-esteem domains. An online sample of 459 adolescents retrospectively completed measures of self-esteem domains and offline/cyber perpetration and victimization, and a subsample of 194 adolescents also completed measures of loneliness and school adjustment. A mediation analysis of bullying-related variables on the effect of self-esteem domains on school adjustment indicated that offline victimization was the only significant mediator. Positive indirect effects were found for social and emotional self-esteem, and negative indirect effects were found for school performance-related self-esteem. Furthermore, person-oriented analyses examined differences in bullying-related roles regarding self-esteem domains, loneliness, and school adjustment. Victim groups showed lower self-esteem in many domains, but cyber victims showed higher body-related self-esteem. Bullies showed lower school performance-related but higher social self-esteem. Both bullies and victims showed lower school adjustment and more loneliness. Implications for theory and practice are discussed, as the findings are relevant for teachers and could be used to develop and deploy more effective anti-bullying programs.

Optimizing Expectations via Mobile Apps: A New Approach for Examining and Enhancing Placebo Effects.

There is growing interest in interventions that enhance placebo responses in clinical practice, given the possibility that this would lead to better patient health and more effective therapy outcomes. Previous studies suggest that placebo effects can be maximized by optimizing patients' outcome expectations. However, expectancy interventions are difficult to validate because of methodological challenges, such as reliable blinding of the clinician providing the intervention. Here we propose a novel approach using mobile apps that can provide highly standardized expectancy interventions in a blinded manner, while at the same time assessing data in everyday life using experience sampling methodology (e.g., symptom severity, expectations) and data from smartphone sensors. Methodological advantages include: 1) full standardization; 2) reliable blinding and randomization; 3) disentangling expectation effects from other factors associated with face-to-face interventions; 4) assessing short-term (days), long-term (months), and cumulative effects of expectancy interventions; and 5) investigating possible mechanisms of change. Randomization and expectancy interventions can be realized by the app (e.g., after the clinic/lab visit). As a result, studies can be blinded without the possibility for the clinician to influence study outcomes. Possible app-based expectancy interventions include, for example, verbal suggestions and imagery exercises, although a large number of possible interventions (e.g., hypnosis) could be evaluated using this innovative approach.

Does it matter who writes down the feedback? A comparison of teacher- vs. student-completed clinical encounter cards during clinical rotations in veterinary studies.

Objective: Despite the fact that feedback (FB) provided by teachers to students is a recognised, effective teaching tool, successful use of feedback during clinical training depends on many factors. In addition to appropriate training and attitude of teachers, sustainable feedback requires an appropriate teaching culture and active commitment on the part of the students to receive, accept and use FB. This study examines the use of two different clinical encounter cards (CECs) during clinical rotation and investigates whether students take a more active part in the feedback process when using these cards. The objective of this study is to test whether it has a positive effect if students write down FB themselves and to verify this positive effect. Methodology: 161 students in their 9th semester of veterinary studies each had to use two clinical encounter cards (types 1 and 2) during their rotations on 10 wards. For this, students had to ask teachers for FB before starting a clinical activity. The oral FB given by the teachers was either written down on the CEC by the teachers (CEC type 1) or by the students (CEC type 2). Furthermore, the students were asked to assess their own performance by means of anchor criteria and to evaluate the quality of the FB provided by the teachers. Based on the entries in the CECs submitted, the following indicators for both CEC types could be calculated: (1) FB quantity and quality (length and specificity), (2) differentiation of self-assessment, as well as (3) level of satisfaction with the FB provided by the teachers. Results: With 2,377 CECs submitted, the mean CEC return rate was 74%. 99% of the cards showed positive FB, 69% contained constructive FB with suggestions for improvement, and 87% suggested specific next steps. On average, the FB written down by teachers was longer (12.4 versus 9.7 words) and more specific (1.9 versus 1.7 out of 3) than FB written down by students. Length and specificity decreased in the course of the semester. Neither the differentiation of self-assessment (proportion of differentiated entering of self-assessment) nor the students' level of satisfaction with the FB differed between the two examined CEC variants. Conclusion: The use of CECs across the cohort was successfully possible; however, the fact that students formulated and wrote down the FB themselves did not result in more comprehensive or more specific FB. Self-assessment and level of satisfaction with the teachers' FB remained unchanged.

Microbial communities involved in biogas production exhibit high resilience to heat shocks.

We report here the impact of heat-shock treatments (55 and 70 °C) on the biogas production within the acidification stage of a two-stage reactor system for anaerobic digestion and biomethanation of grass. The microbiome proved both taxonomically and functionally very robust, since heat shocks caused minor community shifts compared to the controls, and biogas yield was not decreased. The strongest impact on the microbial profile was observed with a combination of heat shock and low pH. Since no transient reduction of microbial diversity occured after the shock, biogas keyplayers, but also potential pathogens, survived the treatment. All along the experiment, the heat-resistant bacterial profile consisted mainly of Firmicutes, Bacteroidetes and Proteobacteria. Bacteroides and Acholeplasma were reduced after heat shocks. An increase was observed for Aminobacterium. Our results prove the stability to thermal stresses of the microbial communities involved in acidification, and the resilience in biogas production irrespectively of the thermal treatment.

Student-Initiated Feedback Using Clinical Encounter Cards during Clinical Rotations in Veterinary Medicine: A Feasibility Study.

Despite its critical role for successful student learning, providing adequate teacher feedback is still a major issue during clinical education. In human medical education, the implementation of clinical encounter cards (CECs) has led to more frequent, timely, and structured teacher feedback. The present study aimed to introduce student-initiated CECs in a veterinary medical setting (clinical rotations). A total of 24 students were randomly assigned to a control group (standard rotations) and an intervention group where they had to ask for teacher feedback using CECs. The feasibility of implementing CECs was evaluated by examining the content of the completed CECs and by using anonymous student and teacher questionnaires. In addition, acceptance of the intervention and changes in feedback behavior were examined from both the teachers' and students' perspectives. Overall, it was shown that using CECs is not only feasible in a veterinary clinical setting but also conducive to more frequent and constructive teacher feedback. However, some teachers postponed completing the CECs due to time pressure, leading to less direct and timely feedback. Moreover, students felt more comfortable asking for feedback from less experienced, younger teachers, and teachers' quantitative ratings and open commentaries seemed to be affected by leniency bias. Finally, a focus group including teachers and students discussed these results in light of their practical experiences. This led to a streamlining of the implementation process and optimizations to facilitate future large-scale implementation. The study has implications for veterinary educators wishing to improve feedback in their institution.

Producing high-strength liquor from mesophilic batch acidification of chicken manure.

This report describes the results from anaerobic batch acidification of chicken manure as a mono-substrate studied under mesophilic conditions. The manure was diluted with tap water to prevent methane formation during acidification and to improve mixing conditions by reducing fluid viscosity; no anaerobic digester sludge has been added as an inoculum. Highest acidification rates were measured at concentrations of 10 gVS L⁻¹ and 20 gVS L⁻¹; the pH value remained high (pH 6.9-7.9) throughout the test duration and unexpected fast methane formation was observed in every single batch. At substrate concentrations of 10 gVS L⁻¹ there was a remarkable methane formation representing a value of 82% of the respective biochemical methane potential of chicken manure. Increasing substrate concentrations did not supress methane formation but impaired acid production. Consequently, the liquor cannot be stored over longer periods but should immediately be used in a digestion process.

Measuring implicit gender-role orientation: the gender initial preference task.

Individuals prefer their name letters over nonname letters, which is known as the name-letter effect (NLE). This research aimed to examine a possible NLE for gender-role orientation (GRO) by rating letters for their gender-typicality in an initial preference task (Gender-IPT). Indeed, a clear NLE appeared: Men rated their initials as more male-typical, whereas women rated them as more female-typical. The Gender-IPT showed good convergent validity with other direct and indirect (Gender Implicit Association Test) measures of GRO as well as predictive validity with sensation seeking and gender-typical everyday life behaviors. The Gender-IPT seems to be a useful and practical indirect measure to assess GRO in a short, convenient, and computer-independent way, complementing other indirect measures of GRO.

Who commits virtual identity suicide? Differences in privacy concerns, Internet addiction, and personality between Facebook users and quitters.

Social networking sites such as Facebook attract millions of users by offering highly interactive social communications. Recently, a counter movement of users has formed, deciding to leave social networks by quitting their accounts (i.e., virtual identity suicide). To investigate whether Facebook quitters (n=310) differ from Facebook users (n=321), we examined privacy concerns, Internet addiction scores, and personality. We found Facebook quitters to be significantly more cautious about their privacy, having higher Internet addiction scores, and being more conscientious than Facebook users. The main self-stated reason for committing virtual identity suicide was privacy concerns (48 percent). Although the adequacy of privacy in online communication has been questioned, privacy is still an important issue in online social communications.

Implicit and explicit self-esteem in the context of internet addiction.

Previous research has repeatedly found that people suffering from some clinical disorders (e.g., bulimia nervosa, depression) possess low explicit (i.e., conscious, deliberate) self-esteem while at the same time displaying high implicit (i.e., unconscious, automatic) self-esteem. This phenomenon has been termed damaged self-esteem and was proposed to be an indicator of psychological distress. Although Internet addiction has been found to be associated with low levels of explicit self-esteem, as well as with high levels of psychological distress, its relation to implicit self-esteem has, to our knowledge, not been investigated thus far. We therefore hypothesized that the phenomenon of damaged self-esteem could also be found amongst people suffering from Internet addiction, and conducted two studies using the Initial Preference Task as a measure of implicit self-esteem. As expected, we found that individuals scoring high on Internet addiction possess low explicit and high implicit self-esteem. This effect was, however, only found for the first name initial of the Initial Preference Task, leading to the conclusion that first and last name initials might tap into different parts of implicit self-esteem.

Body height and occupational success for actors and actresses.

The association of body height with occupational success has been frequently studied, with previous research mainly finding a positive effect among men and positive or null effects among women. Occupational success has almost exclusively been measured so far by short-term success variables (e.g., annual income). In the present study, the relationship of success and height was examined in a group of actors and actresses using a large online database about movies (Internet Movie Database) where heights of actors and actresses are stated. The number of roles played in movies and television series during each actor's lifetime was used as a measure of long-term occupational success. No height effect was found for male actors but a significant negative effect was found for actresses, even after controlling for possible confounding influences (age and birth year). Compared to the general population, actors and actresses were significantly taller; however, actresses who were shorter than average were more likely to achieve greater occupational success, in terms of being featured in more movies.

Let's go formative: continuous student ratings with Web 2.0 application Twitter.

Student ratings have been a controversial but important method for the improvement of teaching quality during the past several decades. Most universities rely on summative evaluations conducted at the end of a term or course. A formative approach in which each course unit is evaluated may be beneficial for students and teachers but has rarely been applied. This is most probably due to the time constraints associated with various procedures inherent in formative evaluation (numerous evaluations, high amounts of aggregated data, high administrative investment). In order to circumvent these disadvantages, we chose the Web 2.0 Internet application Twitter as evaluation tool and tested whether it is useful for the implementation of a formative evaluation. After a first pilot and subsequent experimental study, the following conclusions were drawn: First, the formative evaluation did not come to the same results as the summative evaluation at the end of term, suggesting that formative evaluations tap into different aspects of course evaluation than summative evaluations do. Second, the results from an offline (i.e., paper-pencil) summative evaluation were identical with those from an online summative evaluation of the same course conducted a week later. Third, the formative evaluation did not influence the ratings of the summative evaluation at the end of the term. All in all, we can conclude that Twitter is a useful tool for evaluating a course formatively (i.e., on a weekly basis). Because of Twitter's simple use and the electronic handling of data, the administrative effort remains small.

Glatiramer acetate reduces the risk for experimental cerebral malaria: a pilot study.

BACKGROUND: Cerebral malaria (CM) is associated with high mortality and morbidity caused by a high rate of transient or persistent neurological sequelae. Studies on immunomodulatory and neuroprotective drugs as ancillary treatment in murine CM indicate promising potential. The current study was conducted to evaluate the efficacy of glatiramer acetate (GA), an immunomodulatory drug approved for the treatment of relapsing remitting multiple sclerosis, in preventing the death of C57Bl/6J mice infected with Plasmodium berghei ANKA. METHODS AND RESULTS: GA treatment led to a statistically significant lower risk for developing CM (57.7% versus 84.6%) in treated animals. The drug had no effect on the course of parasitaemia. The mechanism of action seems to be an immunomodulatory effect since lower IFN-gamma levels were observed in treated animals in the early course of the disease (day 4 post-infection) which also led to a lower number of brain sequestered leukocytes in treated animals. No direct neuro-protective effect such as an inhibition of apoptosis or reduction of micro-bleedings in the brain was found. CONCLUSION: These findings support the important role of the host immune response in the pathophysiology of murine CM and might lead to the development of new adjunctive treatment strategies.

Complement factors C1q, C3 and C5 in brain and serum of mice with cerebral malaria.

BACKGROUND: The patho-mechanisms leading to brain damage due to cerebral malaria (CM) are yet not fully understood. Immune-mediated and ischaemic mechanisms have been implicated. The role of complement factors C1q, C3 and C5 for the pathogenesis of CM were investigated in this study. METHODS: C57BL/6J mice were infected with Plasmodium berghei ANKA blood stages. The clinical severity of the disease was assessed by a battery of 40 standardized tests for evaluating neurological functions in mice. Brain homogenates and sera of mice with CM, infected animals without CM and non-infected control animals were analyzed for C1q, C3 and C5 up-regulation by Western blotting. RESULTS: Densitometric analysis of Western blots of brain homogenates yielded statistically significant differences in the levels of C1q and C5 in the analyzed groups. Correlation analysis showed a statistically significant association of C1q and C5 levels with the clinical severity of the disease. More severely affected animals showed higher levels of C1q and C5. No differences in complement levels were observed between frontal and caudal parts of the brain. Densitometric analysis of Western blot of sera yielded statistically lower levels of C1q in infected animals without CM compared to animals of the control group. CONCLUSION: The current study provides direct evidence for up-regulation of complement factors C1q and C5 in the brains of animals with CM. Local complement up-regulation is a possible mechanism for brain damage in experimental cerebral malaria.

Cytokines and chemokines in serum and urine as early predictors to identify septic patients on intensive care unit.

The aim of this prospective cohort study was to address the feasibility of measuring cytokines in serum and urine as early predictor tests for the identification of septic Intensive Care Unit (ICU) patients. The study group consisted of 10 septic and 5 non-septic patients at the onset of sepsis according to modified definitions by the American College of Chest Physicians (ACCP)/Society of Critical Care Medicine (SCCM). Serum and urine samples were taken from septic patients at the onset of sepsis and from non-septic patients, every 12 h for 3 days and thereafter every 24 h until day 10. Levels of TNF-alpha, IL-1beta, IL-6, IL-10, IL-18, IFN-gamma, MCP-1, and PCT (procalcitonin) were measured by ELISA. Apart from serum IL-18 and PCT levels, which were elevated in septic patients (p<0.05), levels of all other cytokines and chemokines in the serum of septic patients did not exceed those of the control group. In urine, in contrast with TNF-alpha, IL-1beta, IL-6, IL-10, IFN-gamma, and MCP-1 in which no differences between the two groups were observed, a distinct trend of elevated IL-18 levels was observed only in the septic group. Whereas elevated serum IL-18 and PCT are clear candidate markers for sepsis criteria, the present data indicating elevated urine IL-18 levels albeit from a limited number of septic patients is an interesting observation. The profile of inflammatory mediators in serum and urine from septic patients herein warrants further investigations in a larger group of patients at the onset of sepsis driven by different infectious foci.