Complementary and Integrative Medicine for Anxiety in Children, Adolescents, and Young Adults.

An integrative approach to treating anxiety in children and adolescents takes a biopsychosocial-spiritual approach. Early life stress may translate into anxiety via epigenetic mechanisms, the adoption of maladaptive coping tendencies (poor eating, sedentary lifestyle, substance use), and dysregulation of central autonomic nervous system function. Each of these mechanisms may increase inflammatory markers. This article will explore the efficacy of CIM interventions that work on these mechanisms through mind-body-medicine, acupuncture, nutrition, and supplements.

Sleep continuity, timing, quality, and disorder are associated with suicidal ideation and suicide attempts among college students.

Objective: To evaluate sleep continuity, timing, quality, and disorder in relation to suicidal ideation and attempts among college students. Participants: Eight hundred eighty-five undergraduates aged 18-25 in the southwestern United States. Methods: Participants completed questionnaires on sleep, suicide risk, mental health, and substance use. Differences in sleep variables were compared by lifetime and recent suicidal ideation and suicide attempts using covariate-adjusted and stepwise regression models. Results: A total of 363 (41.0%) individuals reported lifetime suicidal ideation, of whom 172 (47.4%) reported suicidal ideation in the last 3 months and 97 (26.7%) had attempted suicide in their lifetime. Sleep disturbances were prevalent among those with lifetime suicidal ideation or a lifetime suicide attempt. Insomnia was identified as the best predictor of recent suicidal ideation, but this relationship did not survive adjustment for covariates. Conclusions: Sleep continuity, quality, and sleep disorders are broadly associated with suicidal thoughts and behaviors among college students.

Implementing a Mind-Body Skills Group in Psychiatric Residency Training.

OBJECTIVE: The burnout crisis in healthcare has led to interventions promoting resiliency and wellness among residents. One such intervention is a 10-week Mind-Body Skills Group including didactics and experiential exercises, self-expression, and small-group support. A Mind-Body Skills Group for residents and fellows in the University of Arizona-Tucson Department of Psychiatry aimed to teach skills for self-care and patient care. METHODS: In 2018-2020, 50 University of Arizona-Tucson psychiatric residents and fellows participated in Mind-Body Skills Groups. After finishing the course, 44 participants completed a survey about satisfaction with the course and its content, comfort sharing experiences with the group, use of mind-body skills for participants' own self-care and wellness, use of these skills with patients, and likelihood of recommending the Mind-Body Skills Group to colleagues. RESULTS: Eighty-four percent of survey respondents were satisfied or very satisfied with the Mind-Body Skills Group. Eighty percent used skills learned in the course for their own self-care and 61% used the skills with patients on at least a weekly basis. Eighty-nine percent indicated they were likely or very likely to use mind-body skills with patients in the future. Ninety-five percent of respondents felt safe sharing personal feelings and experiences in the group, and 95% would strongly recommend or likely recommend the course to colleagues. Results for in-person and online groups were not significantly different. CONCLUSIONS: A 10-week Mind-Body Skills Group during psychiatric residency was well received by participants. The course influenced personal health behaviors, which may bolster resiliency and reduce risk for burnout.

Culturally-consistent diet among individuals of Mexican descent at the US-Mexico border is associated with sleep duration and snoring.

BACKGROUND: Existing studies show that consuming food consistent with one's culture reduces cardiometabolic risk. However, few studies have assessed whether these dietary choices influence sleep health. Accordingly, this study assessed how Mexican food consumption by individuals of Mexican descent residing at the US-Mexico border, was associated with various measures of sleep, after accounting for acculturation. METHODS: Data were provided by 100 adults between the ages of 18-60, in the city of Nogales, AZ. Questionnaires were provided in either Spanish or English. Acculturation was assessed with the Acculturation Scale for Mexican-Americans (ARSMA-II), with an additional question, asking how often "my family cooks Mexican foods." Frequency of cooking Mexican food was coded as either "yes" or "no." Sleep was assessed, using validated measures that include the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and sleep duration with the item "how many hours of actual sleep did you get at night?" Regression models estimated the associations between sleep health variables as outcomes and consumption of Mexican food as the independent variable. Covariates included age, sex, and acculturation scores. Parental education level was also included, as an indicator of childhood socioeconomic status and since food culture likely involves parents. RESULT: We found that among individuals who identified as Mexican-Americans who consumed culturally-consistent foods, was associated with, on average, 1.41 more hours of sleep (95% CI 0.19, 2.62; p = 0.024) and were less likely to report snoring (OR: 0.25; 95% CI 0.07, 0.93; p = 0.039). Consuming Mexican food was not associated with sleep quality, insomnia severity or sleepiness. CONCLUSION: Individuals of Mexican descent residing at the US-Mexico border who regularly consumed Mexican food, reported more sleep and less snoring. Mexican acculturation has been shown previously to improve sleep health. This is likely due to consumption of a culturally- consistent diet. Future studies should examine the role of acculturation in sleep health, dietary choices, and subsequent cardiometabolic risk.

Genomic profiling identifies novel mutations and SNPs in ABCD1 gene: a molecular, biochemical and clinical analysis of X-ALD cases in India.

X-linked adrenoleukodystrophy (X-ALD) affects the nervous system white matter and adrenal cortex secondary to mutations in the ABCD1 gene that encode the peroxisomal membrane protein. We conducted a genomic and protein expression study of susceptibility gene with its clinical and biochemical analysis. To the best of our knowledge this is the first preliminary comprehensive study in Indian population that identified novel mutations and SNPs in a relatively large group. We screened 17 Indian indigenous X-linked adrenoleukodystrophy cases and 70 controls for mutations and SNPs in the exonic regions (including flanking regions) of ABCD1 gene by direct sequencing with ABI automated sequencer along with Western blot analysis of its endogenous protein, ALDP, levels in peripheral blood mononuclear cells. Single germ line mutation was identified in each index case in ABCD1 gene. We detected 4 novel mutations (2 missense and 2 deletion/insertion) and 3 novel single nucleotide polymorphisms. We observed a variable protein expression in different patients. These findings were further extended to biochemical and clinical observations as it occurs with great clinical expression variability. This is the first major study in this population that presents a different molecular genetic spectrum as compared to Caucasian population due to geographical distributions of ethnicity of patients. It enhances our knowledge of the causative mutations of X-ALD that grants holistic base to develop effective medicine against X-ALD.

De novo ABCD1 gene mutation in an Indian patient with adrenoleukodystrophy.

A large number of ABCD1 gene mutations have been reported all over the world, but not previously in India. We report on the first known patient with childhood cerebral adrenoleukodystrophy and a de novo 3' splice-site mutation in this gene. Magnetic resonance imaging of the brain revealed large, confluent, hyperintense areas in the bilateral cerebral white matter, predominantly parieto-occipital, with extensions into posterior regions that led to breakdown of the blood-brain barrier. An increased level of very long chain fatty acids was also consistent with the biochemical defect for adrenoleukodystrophy. Sequencing of the ABCD1 gene of this patient identified a 3' splice-site mutation in the intervening sequence 4 (-2a > g). We did not find any mutation in the gene of the proband's mother, which confirms its de novo occurrence.

Phospholipid metabolism and protein kinase C mediated protein phosphorylation in dietary protein deficiency in rat lung.

Nutritional deprivation of proteins decreases the protein kinase C (PKC) activity in rat lung. The activity of (PKC) is influenced by lipid metabolism. Changes in PKC activity may influence phosphorylation of its substrate proteins in the tissues. Therefore, alterations in phospholipid metabolism and PKC mediated protein phosphorylation in dietary protein deficiency in rat lung were envisaged. The study was conducted on rats fed on three different types of diet viz., casein (20% protein), deficient (4% protein, rice flour as source of protein) and supplemented (deficient diet supplemented with L-lysine and DL-threoning). Feeding of protein deficient diet caused reduction in incorporation of [3H] myo-inositol in the total phosphoinositides in lungs and an increase in total inositol phosphate pool. There was a significant reduction in the contents and turnover rate of phosphatidyl inositol and phosphatidyl inositol monophosphate. Supplementation of diet with L-lysine and DL-threonine had a reversing effect on total pool of phosphoinositides and, the metabolism of phosphatidyl inositol bisphosphate and phosphatidyl inositol. In phosphatidyl choline metabolism, the dietary protein deficiency led to a decrease in incorporation of [14C-methyl] choline-chloride in total phospholipids. In contrast, its incorporation increased in phosphatidyl choline pool. The contents of phosphatidyl choline and residue, incorporation of [14C-methyl] choline-chloride in them and their turnover rate also increased. Supplementation of diet had a reversal effect on most of these parameters. Phosphorylation of proteins of 84, 47, 35 and 16 kDa was identified to be mediated by PKC. In dietary protein deficiency, phosphorylation of all these proteins, except that of 47 kDa, increased. Supplementation of diet reversed the pattern except that of 84 kDa. The findings suggest that changes in phospholipid metabolism in dietary protein deficiency may effect the activity of PKC thereby influencing the phosphorylation of its substrate proteins and hence associated functions that may lead to pathophysiology of lung.