Everyday executive functioning in pediatric obsessive-compulsive disorder: diagnostic specificity, clinical correlations, and outcome.

BACKGROUND: Obsessive-compulsive disorder (OCD) typically onsets during childhood or adolescence and difficulties with executive functioning (EF) may be involved in its onset and maintenance. Yet, few studies have examined everyday EF difficulties in youth with OCD and no study has compared EF in youth with OCD to EF in youth with anxiety disorders, leaving the diagnostic specificity of EF unclear. METHODS: In this study, parents of treatment-seeking children and adolescents with OCD (n = 96, Mage = 13.3, SD = 2.7, 59% girls) or anxiety disorders (n = 67, Mage = 14.0, SD = 2.6, 78% girls) reported on their children's everyday EF using the Behavior Rating Inventory of Executive Function (BRIEF) measure. RESULTS: Compared to community youth, the two clinical groups showed moderately elevated EF deficits but did not differ significantly from each other. EF deficits were not associated with the major symptom dimensions of OCD, age of OCD symptom onset, duration of OCD symptoms, and OCD severity, and did not predict treatment outcome in OCD. CONCLUSIONS: Compared to peers, youth with OCD show moderate difficulties with EF, but very similar difficulties are seen in youth with anxiety disorders, and it is unclear whether these difficulties are of clinical relevance. Among youth with OCD, EF difficulties were not differentially associated with the major symptom dimensions of OCD, which is inconsistent with findings from adults. Difficulties with EF did not predict treatment outcome, indicating that integrating EF modules into OCD treatment may be of limited value, although EF may be important for treatment planning in individual cases.

Elevating the Role of the Outdoor Environment for Adolescent Wellbeing in Everyday Life.

In light of concerns about adolescent mental health, there is a need to identify and examine potential pathways to wellbeing in their daily lives. Outdoor environments can offer multiple pathways to wellbeing through opportunities for restoration, physical activity and socialising. However, urbanisation and new lifestyles revolving around the home and the internet are changing young people's access, use and relationship to the outdoor environment. The authors point out how the research related to adolescents' outdoor environments is generally not treated with the same level of importance or as comprehensively as that for younger children. The aim of this paper is to pave the way for research and planning initiatives on everyday outdoor environments promoting the wellbeing of adolescents and the authors suggest ways in which perspectives from developmental psychology might inform the study of adolescents' outdoor environments. The paper concludes by calling for an elevated focus on the role of outdoor environments in adolescents' everyday lives as a source of wellbeing and more research that makes clear the specific attributes, activities and experiences related to places outdoors which make adolescents feel good.

Testing the psychometric properties of the Swedish version of the EPOCH measure of adolescent well-being.

The EPOCH Measure of Adolescent Well-being measures five positive indicators of the well-being of adolescents: engagement, perseverance, optimism, connectedness and happiness. This five-factor structure along with other indicators of validity and reliability were supported for the original English version and the Chinese version. In this study, we tested the psychometric properties of the Swedish version of the EPOCH with a sample (n = 846) of Swedish high school adolescents aged 16-21 years (Mage = 18, SD = .85). The participants answered a questionnaire containing the EPOCH, Coping Self-Efficacy Scale, and 21-item Depression, Anxiety, and Stress Scale (DASS-21). A confirmatory factor analysis supported a the five-factor, inter-correlated model. The internal consistency was good for all the EPOCH subscales (Cronbach's α = .76-.88, McDonald's ω = .77 -.88). The criterion validity was established by replicating correlations between the five EPOCH subscales and positive (coping self-efficacy) and negative (DASS-21) aspects of well-being. This study shows that the Swedish version of the EPOCH is suitable for assessing multiple dimensions of adolescent well-being.

Outdoor Office Work - An Interactive Research Project Showing the Way Out.

The physical boundaries of office work have become increasingly flexible. Work is conducted at multiple locations outside the office, such as at clients' premises, at home, in cafés, or when traveling. However, the boundary between indoor and outdoor environment seems to be strong and normative regarding how office work is performed. The aim of this study was to explore how office work may be conducted outdoors, understanding how it is being experienced by office employees and identifying its contextual preconditions. Based on a two-year interactive research project, the study was conducted together with a Swedish municipality. Fifty-eight participants engaged in the collaborative learning process, including 40 half-day workshops and reflective group discussions, co-interviews, and participants' independent experimentation of bringing work activities outdoors. Data was collected via interviews, group discussions and a custom-made mobile application. The results showed that a wide range of work activities could be done outdoors, both individually and in collaboration with others. Outdoor work activities were associated with many positive experiences by contributing to a sense of well-being, recovery, autonomy, enhanced cognition, better communication, and social relations, but also with feelings of guilt and illegitimacy. Conditions of importance for outdoor office work to happen and function well were found in the physical environment, where proximity to urban greenspaces stood out as important, but also in the sociocultural and organizational domains. Of crucial importance was managers' attitudes, as well as the overall organizational culture on this idea of bringing office work outdoors. To conclude, if working life is to benefit from outdoor office work, leaders, urban planners and policymakers need to collaborate and show the way out.

Self-Evaluation Differences Among Swedish Children and Adolescents Over a 30-Year Period.

International research has found changes in how today's young people evaluate themselves. The present Swedish research contributes with new findings by distinguishing different patterns of change in self-evaluation in two age groups. The study investigates generational and gender differences in five self-evaluation dimensions in two samples, one from 1983 (N = 3052 10-16-year-old students) and one from 2013 (N = 1303 10-18-year-old students). Three age groups were analyzed. The generational comparison for primary school (ages 10-12) showed higher scores in 2013 than in 1983 for all five self-evaluation dimensions. Interactions between generation and gender were found for psychological well-being, relations to others, school competence evaluations, and the total score, demonstrating, in contrast to international research, a greater increase for girls than for boys. Noteworthy is that girls in primary school had higher scores in 2013. The generational comparison for lower secondary school (ages 13-15) demonstrated higher scores for school competence, relational self-evaluations, and a total higher score in 2013. Interactions between generation and gender were found for total, physical, and psychological well-being evaluation scores, indicating an increase for boys and a decrease for girls in 2013 compared to 1983. The gender comparison for secondary school (ages 16-18, 2013), showed gender differences for physical, psychological well-being, school competence evaluations, and for the total score to the advantage of boys. The study discusses changes in self-evaluation in relation to phenomena such as permissive child-rearing, decreased demands in school, increased self-enhancement behavior through social media, and narrow body ideals in today's society. The study recommends that interventions directed toward groups with low self-evaluation scores should be considered.

Comprehensive geriatric assessment: recognition of identified geriatric conditions by community-dwelling older persons.

OBJECTIVES: to study (i) the prevalence of geriatric conditions in community-dwelling older persons at increased risk of functional decline and (ii) the extent to which older persons recognise comprehensive geriatric assessment (CGA)-identified conditions as relevant problems. METHODS: trained registered nurses conducted a CGA in 934 out of 1209 older persons at increased risk of functional decline participating in the intervention arm of a randomised trial in the Netherlands. After screening for 32 geriatric conditions, participants were asked which of the identified geriatric conditions they recognised as relevant problems. RESULTS: at baseline, the median age of participants was 82.9 years (interquartile range (IQR) 77.3-87.3 years). The median number of identified geriatric conditions per participant was 8 (IQR 6-11). The median number of geriatric conditions that were recognised was 1 (IQR 0-2). Functional dependency and (increased risk of) alcohol and drug dependency were the most commonly identified conditions. Pain was the most widely recognised problem. CONCLUSION: CGA identified many geriatric conditions, of which few were recognised as a problem by the person involved. Further study is needed to better understand how older persons interact with identified geriatric conditions, in terms of perceived relevance. This may yield a more efficient CGA and further improve a patient-centred approach.

5-Aminosalicylic acid inhibits cell cycle progression in a phospholipase D dependent manner in colorectal cancer.

BACKGROUND: 5-Aminosalicylic acid (5-ASA) may protect against the development of inflammation-associated colorectal cancer. In vitro data suggest that, in colorectal cancer cells, 5-ASA induces cell cycle arrest, but the molecular mechanism leading to this arrest remains to be determined. AIM: To dissect the signal transduction events that lead to 5-ASA mediated inhibition of proliferation of colorectal cancer cells, focusing on mammalian target of rapamycin (mTOR), a regulator of cell cycle progression. METHODS: The influence of 5-ASA on mTOR signalling was examined in a panel of colorectal cancer cell lines. The effects of 5-ASA on the pathways that control mTOR activity were studied in detail in two different colorectal cancer cell lines, using western blot, siRNA, a phospholipase D (PLD) activity assay, proliferation assays and cell cycle analysis. The phosphorylation status of mTOR and its downstream target, ribosomal protein S6, was studied in colorectal cancers before and after topical 5-ASA treatment. RESULTS: Treatment of colorectal cancer with 5-ASA inhibited mTOR signalling in vitro and in vivo. 5-ASA had no effect on any of the pathways that regulate the activity of the tuberous sclerosis complex in colorectal cancer cells. Both proliferation and mTOR activity depended on PLD, an enzyme that generates phosphatidic acid (PA). 5-ASA treatment inhibited PLD activity and proliferation; these effects could be rescued with exogenous PA. CONCLUSION: 5-ASA interferes with proliferation of colorectal cancer cells via inhibition of PLD-dependent generation of PA and loss of mTOR signalling.

Resilience to bacterial infection: difference between species could be due to proteins in serum.

Vertebrates vary in resistance and resilience to infectious diseases, and the mechanisms that regulate the trade-off between these often opposing protective processes are not well understood. Variability in the sensitivity of species to the induction of damaging inflammation in response to equivalent pathogen loads (resilience) complicates the use of animal models that reflect human disease. We found that induction of proinflammatory cytokines from macrophages in response to inflammatory stimuli in vitro is regulated by proteins in the sera of species in inverse proportion to their in vivo resilience to lethal doses of bacterial lipopolysaccharide over a range of 10,000-fold. This finding suggests that proteins in serum rather than intrinsic cellular differences may play a role in regulating variations in resilience to microbe-associated molecular patterns between species. The involvement of circulating proteins as key molecules raises hope that the process might be manipulated to create better animal models and potentially new drug targets.