Preliminary translation of 'Reducing Disability in Alzheimer's Disease' among individuals with intellectual disabilities and caregiver dyads.

BACKGROUND: The Reducing Disability in Alzheimer's Disease in Kansas City (RDAD-KC) intervention has been shown to improve the health of individuals with dementia and caregiver dyads. This manuscript reports the results of implementing the RDAD among individuals with intellectual disabilities and caregiver dyads. METHODS: Nine community agencies deployed the 12-week intervention. We assessed changes in individuals with intellectual disabilities' behavioural symptom related severity and physical activity, and caregivers' behavioural symptom-related distress, unmet needs, and caregiver strain. RESULTS: Forty-four dyads enrolled, and 23 (~60 years, 48% female) completed ≥75% of the intervention. We observed decreases in behavioural symptom related severity (p = .07) and increases in physical activity (p = .20) among individuals with intellectual disabilities. We also observed decreases in behavioural symptom related distress (p = .14), unmet needs (p = .50), and caregiver strain (p = .50) among caregivers. CONCLUSIONS: The RDAD-KC intervention showed promising, although statistically non-significant, benefits among individuals with intellectual disabilities and their caregivers.

Drive in the Moment: An evaluation of a web-based tool designed to reduce smartphone use among young drivers.

OBJECTIVE: Young drivers are overrepresented in road traffic crashes and fatalities. Distracted driving, including use of a smartphone while driving (SWD), is a major risk factor for crashes for this age group. We evaluated a web-based tool (Drive in the Moment or DITM) designed to reduce SWD among young drivers. METHODS: A pretest-posttest experimental design with a follow-up was used to assess the efficacy of the DITM intervention on SWD intentions and behaviors, and perceived risk (of having a crash and of being apprehended by the police) associated with SWD. One hundred and eighty young drivers (aged 17-25 years old) were randomly assigned to either the DITM intervention or a control group where participants completed an unrelated activity. Self-reported measures of SWD and perceptions of risk were obtained pre-intervention, immediately post-intervention and at a follow-up 25 days after the intervention. RESULTS: Participants who engaged with the DITM showed a significant reduction in the number of times they used their SWD at follow-up compared to their pre-intervention scores. Future intentions to SWD were also reduced from pre-intervention to post-intervention and follow-up. There was also an increase in the perceived risk of SWD following the intervention. CONCLUSIONS: Our evaluation of DITM suggests that the intervention had an impact on reducing SWD among young drivers. Further research is needed to establish which particular elements of the DITM are associated with reductions in SWD and whether similar findings would be identified in other age groups.

Prologue to the special issue on predrinking and drinking game behaviors among adolescents and young adults in the United States and across the globe: Definitions and overview of prevalence rates.

Predrinking and drinking games (DGs) are common risky drinking practices among adolescents and young adults in many different countries around the world. However, most studies on these behaviors have been conducted with university student samples in a limited number of countries. Despite the risks of negative alcohol-related consequences associated with predrinking and DGs, these activities are quite prevalent among young people. In this prologue, we provide definitions for predrinking and DGs and an extensive overview of the known prevalence rates of predrinking and DGs among young people around the world. This special issue addresses known gaps in the literature by including articles which (a) use differing methodologies to examine predrinking or DGs behavior, (b) consider psychosocial and contextual factors that influence these behaviors, and (c) examine young people's perceptions of alcohol policies and interventions. Taken together this Special Issue offers an international view on how and why young people around the world engage in these risky drinking practices, and potential ways to address these behaviors.

"It Breaks the Ice": A Qualitative Examination of Drinking Game Motives, Harms and Protective Behavioral Strategies among University Students in Australia.

Background: Most research on drinking games (DG) behaviors and cognitions has been conducted among university students from the United States. Understanding why DGs are played, consequences and protective behavioral strategies (PBS) to reduce negative consequences is needed among Australian students. Objectives: In Australia, five focus groups (n=3-8) were held with 27 university students (63% female) aged 18-24 years who had played a DG in the past month. The study aimed to identify motives for playing DGs, consequences and adoption of PBS. Results: Four themes were identified: (1) social lubrication and conformity: playing to fit in; (2) community and camaraderie (perceived social benefits of DGs); (3) a means to an end (where getting drunk/predrinking was the goal and avoidance of PBS was prevalent); and (4) it is not a levelled playing field, which highlights that the risks are not equal for everyone. Conclusions: The interplay between DG motives, PBS and associated harms was identified. Expanding measurement of pre-existing DG motives and PBS is recommended, as well as the potential of DG motives to inform proposed interventions.

Examining the Drinking Motives Questionnaire-Revised Short Form among university students in Australia, New Zealand and Argentina.

INTRODUCTION: The Drinking Motives Questionnaire-Revised Short Form (DMQ-R-SF) is widely used among alcohol researchers studying adolescents and young adults. The psychometric properties of the DMQ-R-SF have been examined among university students in many countries, but to our knowledge, not in Australia, New Zealand or Argentina. We sought to examine the reliability and endorsement of the items on the DMQ-R-SF, and test the associations between the DMQ-R-SF subscales and alcohol use, and negative alcohol consequences between university students from Australia, New Zealand and Argentina. METHOD: University students (N = 820) in Australia (n = 315), New Zealand (n = 265) and Argentina (n = 240) completed a confidential online alcohol survey which included the DMQ-R-SF, the Daily Drinking Questionnaire and the Brief Young Adult Alcohol Consequences Questionnaire. RESULTS: Using the alignment method, support for the four-factor model on the DMQ-R-SF emerged and the factor loadings for 11 of the 12 items were invariant across sites. Most items (8 out of 12) on the DMQ-R-SF were fully invariant across all sites, but some small differences in item reliability for one item, and endorsement for three items emerged between the sites. Across the three countries, coping motives were positively correlated with negative alcohol consequences. Enhancement motives were positively associated with both alcohol use and negative alcohol consequences among students from Australia and New Zealand. DISCUSSION AND CONCLUSIONS: Most items on the DMQ-R-SF were comparably reliable among the university students sampled from Australia, New Zealand and Argentina. Our preliminary findings suggest that the DMQ-R-SF can be reliably used with university students from these countries.

Young drivers and smartphone use: The impact of legal and non-legal deterrents.

INTRODUCTION: Young drivers continue to be overrepresented in road crash statistics and smartphone use has been identified as a dangerous form of driver distraction. Previous research has identified factors encouraging drivers to use their mobile phone, with few examining what deters drivers. This study examines the influence of legal and non-legal deterrents on smartphone use while driving (SWD) in a young adult sample. METHOD: An online survey was administered to a sample of 524 Australian drivers aged 17-25 years. Measures included demographic variables, legal deterrents (certainty, severity, and swiftness), and non-legal deterrents: social loss (peers and parents), internal loss (anticipated regret) and physical loss (injury to self/others). Self-reported SWD was the outcome variable, measured separately for initiating SWD and responding SWD behaviors. RESULTS: Responding behaviors were reported more frequently than initiating, and social, internal, and physical loss were perceived as higher for initiating versus responding behaviors. Anticipated action regret and physical loss were significant negative predictors of SWD across both modalities of communication. Anticipated inaction regret was also a significant positive predictor of initiating behaviors. Both legal deterrents and social loss were non-significant predictors for both modalities of SWD. CONCLUSIONS: The results reinforce previous evidence showing that legal deterrence variables are not consistently effective at reducing offending behaviors. Future research should continue to explore the effect of non-legal deterrents across different modalities of SWD. PRACTICAL APPLICATIONS: Road safety interventions aimed at young drivers should evaluate the impact of highlighting anticipated regret and potential injury to self and others associated with risky driving behaviors, such as SWD.

The Brief Young Adult Alcohol Consequences Questionnaire: A cross-country examination among university students in Australia, New Zealand, Canada, Argentina, and the United States.

BACKGROUND: The Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) was designed to measure alcohol consequences and identify at-risk students. It was developed and originally validated among university students in the United States (U.S.), yet it is widely used in both the U.S. and abroad. Using the alignment method, we tested whether the B-YAACQ measures alcohol consequences similarly across university students in several countries where heavy alcohol use and related outcomes are prevalent. METHODS: The sample consisted of 1473 university students (ages 18-30) from five university sites: Australia (n = 315), New Zealand (n = 270), Canada (n = 276), Argentina (n = 232), and the U.S. (n = 380). Participants completed a confidential, online alcohol use survey which included the B-YAACQ. RESULTS: Overall, 12 of the 24 B-YAACQ items had invariant factor loading and threshold parameters, suggesting that these items exhibited similar reliability and difficulty among university students across the five countries. Of the 24 B-YAACQ items, 21 exhibited comparable reliability across the five countries; the remaining 3 items were slightly less reliable indicators of alcohol consequences among U.S. students. Thus, several items on the B-YAACQ may be particularly informative for identifying students who are experiencing high levels of drinking harm across multiple countries. CONCLUSIONS: The present study is an important step toward (a) validating the B-YAACQ among university students in New Zealand and Canada, and (b) furthering our understanding of the psychometric properties of the B-YAACQ among university students in Australia, Argentina, and the U.S.

Participation in Drinking Games and Predrinking Among University Students in Argentina, Australia, Canada, and New Zealand.

AIMS: The limited existing research on drinking games and predrinking among university students in Argentina, Australia, Canada, and New Zealand suggests that participation in these risky drinking practices is relatively widespread among this population. Drinking norms and alcohol use can vary across countries and in different regions of the globe. The measurement of drinking games and predrinking participation between studies also differs, making cross-country comparisons difficult. The present study explored differences in past month participation in drinking games and predrinking among university students from a large public university in Argentina, Australia, Canada, and New Zealand. METHODS: The data analytic sample consisted of 1134 university students (ages 18-25, Mage = 20.2 years; 72.6% women) from Argentina (n = 349), Australia (n = 280), Canada (n = 262), and New Zealand (n = 243) who reported weekly alcohol consumption. Students completed a confidential survey on drinking attitudes and behaviors. RESULTS: Controlling for age, gender, and weekly drink consumption, there were no cross-country differences in past month participation in predrinking. In contrast, university students from Canada and New Zealand were more likely to have played a drinking game in the past month than students from Australia and Argentina. CONCLUSIONS: The present finding suggest that university students from Argentina, Australia, Canada, and New Zealand are equally likely to participate in predrinking regardless of country; however, the likelihood of playing drinking games differs as a function of country site.

Effectiveness of "Reducing Disability in Alzheimer's Disease" Among Dyads With Moderate Dementia.

Replications of evidence-based dementia care receiver-caregiver dyad interventions in the community are scarce. We aimed to assess the effectiveness of the Kansas City implementation of Reducing Disability in Alzheimer's Disease (RDAD) among a convenience sample of dyads with moderate dementia, which addressed needs identified by nine participating community agencies. We hypothesized that dyads' mental health and physical activity outcomes would improve from baseline to end-of-treatment. The final analytic sample included 66 dyads. Outcomes improved (p < .01) from pre- to post-intervention: behavioral symptom severity (range 0-36) decreased from 11.3 to 8.6, physical activity increased from 125.0 to 190.0 min/week, caregiver unmet needs (range 0-34) decreased from 10.6 to 5.6, caregiver behavioral symptom distress (0-60) decreased from 15.5 to 10.4, and caregiver strain (0-26) decreased from 11.1 to 9.7. This adapted implementation of RDAD leads to clinically meaningful improvements and might inform scaling-up.

Impulsivity facets and mobile phone use while driving: Indirect effects via mobile phone involvement.

Mobile phone use while driving (MWD) is a threat to road safety, particularly for younger drivers. Research suggests impulsivity may be a psychological risk factor for MWD, however, the literature is limited. The current study examined the unique contributions of impulsivity facets on different social interactive MWD behaviours, and whether these relationships were influenced by mobile phone involvement. Eight hundred and fifty-three young drivers aged 17-25 years (Mage = 19.89; 74 % female) completed an online questionnaire which included measures of the five-facet model of impulsivity, mobile phone involvement, and MWD (initiating, monitoring/reading, and responding to social communications). Of impulsivity facets, lower premeditation and higher positive urgency significantly predicted each MWD behaviour, while higher sensation seeking significantly predicted responding only, providing some support for differential relationships of impulsivity facets with MWD. Mobile phone involvement was a more robust predictor of MWD. Moreover, there were significant indirect effects of positive and negative urgency via mobile phone involvement for all three MWD behaviours. Findings highlight the importance of mobile phone involvement for explaining MWD which should be addressed in future studies.

Examining drinking game harms as a function of gender and college student status.

Drinking game (DG) participation among young adults is widespread. Because heavy alcohol consumption is commonly associated with playing DGs, this activity presents a health risk for those who play. In the present study, we explored the most common negative DG consequences experienced by young adults and how DG consequences differed by gender and college status. Participants were young adult drinking gamers (N = 1,600; age 18-25; Mage = 22.6; 47% men; 41% noncollege students; 77% White) recruited from Amazon's Mechanical Turk. They completed an online anonymous survey which included items on the Brief Young Adult Alcohol Consequences Questionnaire that were modified to measure DG consequences experienced in the past month. Over half of the participants reported experiencing a hangover, saying/doing embarrassing things, having less energy, and feeling sick as a result of playing DGs. Using IRT analysis, we also found differential item functioning (DIF) on several items across gender and college status. We then created a short-form version of the DG consequences measure that excluded items demonstrating DIF, and based on this modified measure, we examined differences in severity of negative DG consequences as a function of gender and college status. Controlling for age, college status, DG frequency/consumption, and alcohol use on non-DG occasions, we found that men experienced slightly more DG consequences than women. Similar findings emerged for college students compared to noncollege students. This study is an important first step toward understanding who is most at risk for experiencing certain types of negative DG consequences and how researchers/practitioners could measure this construct. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Social anxiety and drinking game behaviors among Australian university students.

INTRODUCTION: The relationship of social anxiety with alcohol use/problems has been examined among college student samples, but the relevance of findings to drinking game (DG) consumption/gaming consequences is not well understood due to a paucity of research. METHODS: A cross-sectional sample of 224 Australian university students aged 18-25 years (Mage = 20.7 years; 63% female) was utilized for analysis. Participants completed an online questionnaire which included measures of social anxiety, DG consumption, DG consequences, and motives for playing drinking games. RESULTS: Social anxiety was positively associated with DG consequences, but not DG consumption. However, after controlling for DG motives, social anxiety was no longer associated with DG consequences. Rather, an indirect effect of social anxiety on DG consequences via conformity DG motives was identified. CONCLUSIONS: Our findings highlight the vulnerability of socially anxious students to experiencing greater drinking game consequences, but the importance of considering motives specific to playing DGs when examining these relationships.

Association between socio-economic status and physical activity is mediated by social support in Brazilian students.

This study evaluated whether the relationship between socioeconomic status (SES) and moderate-to-vigorous physical activity (MVPA) is mediated by social support of peers and parents. A cross-sectional study included students (n = 1182) aged 11 to 18 years who were recruited in 2014 from public schools in Fortaleza, Brazil. Participants completed a questionnaire to assess all variables. Mediation analyses were performed to determine the role of parental support and peer support on the relationship between SES and MVPA. Also, moderated-mediation analyses with estimating of conditional indirect effects were performed in order to identify whether gender is a moderator of the mediating effect. A positive and significant association between SES and MVPA was found among Brazilian students, and social support of parents and peers were significant mediators of this relationship. Conditional indirect effects showed that both parental and peer support had a significant indirect effect among boys; only parental support had a significant indirect effect among girls. These results suggest that improving social support can help reduce the impact of SES on physical activity among Brazilian adolescents.

Examining the factor structure of the Motives for Playing Drinking Games measure among Australian university students.

INTRODUCTION AND AIMS: Given the prevalence of drinking games among university students and the health risks associated with playing drinking games, it is important to consider motivations for participation. The psychometric properties of the Motives for Playing Drinking Games (MPDG) measure have been examined among US college student samples, but mixed findings have been reported regarding the number of factors in the measure. This is the first study to examine the factor structure and applicability of the MPDG measure among a sample of Australian university students. DESIGN AND METHODS: University students (N = 254; aged 18-46 years; 62% female) with prior drinking experience completed an online survey which included questions pertaining to demographics, drinking game frequency and consumption, drinking game consequences and the MPDG measure. RESULTS: Confirmatory factor analyses demonstrated that the originally proposed 8-factors within the MPDG measure were problematic in the current sample and a revised 7-factor solution was preferred. Analyses examining the relations of the revised 7 MPDG factors with drinking game behaviours (e.g. gaming-specific consequences and amount consumed during play) highlighted the importance of some MPDG (enhancement/thrills, conformity and sexual pursuit motives). DISCUSSION AND CONCLUSIONS: While the MPDG measure shows promise for assessing drinking game-specific motives, the need to consider the applicability of MPDG subscales across different samples was apparent.

Drinking game participation and outcomes in a sample of Australian university students.

INTRODUCTION AND AIMS: Most drinking game (DG) research among university students has been conducted among USA college samples. The extent to which demographics and game type (e.g. team and sculling games) are linked to DG behaviours/consequences among non-USA students is not well understood. As such, the current study investigated characteristics of DG participation (and associated outcomes) among a sample of Australian university students. METHODS: University students (N = 252; aged 18-24 years; 67% female) who had consumed alcohol in the prior year completed an online survey. Measures included demographics, DG behaviours (lifetime, frequency and consumption) and gaming-specific consequences. RESULTS: Most of the students reported lifetime DG participation (85%). Among those who played a DG in the prior 6 months (69%), most had experienced a negative gaming-specific consequence. While team games were the most popular DG played, regression analysis demonstrated that participation in games which encouraged consumption (e.g. sculling) were associated with increased alcohol consumption during play. In addition to being older, playing DGs more frequently, and consuming more alcohol while playing, participation in both consumption and dice games (e.g. 7-11, doubles) predicted more negative gaming-specific consequences. DISCUSSION AND CONCLUSIONS: DG participation is common among Australian university students, as it is in other parts of the world. The importance of game type is clear, particularly the risk of consumption games. Findings could help inform interventions to reduce participation in consumption games and identify students who might be especially at-risk for experiencing negative DG consequences.

Sedentary behavior during school-time: Sociodemographic, weight status, physical education class, and school performance correlates in Brazilian schoolchildren.

OBJECTIVES: To investigate whether sedentary behavior during school-time is associated with gender, age, mother's education, having physical education classes, weight status, and academic performance. DESIGN: Cross-sectional study. METHODS: A sample of 571 children (7-12 years old) from five elementary schools in Florianopolis, South Brazil had their height and weight measured, and wore accelerometers during class time. Teachers completed a form to evaluate children's reading and writing skills. Parents provided sociodemographic and educational information. Data was analyzed using multilevel linear regression analyses. RESULTS: Children spent an average of 132min in sedentary behavior during school-time (64% of total school-time). Girls (137.5min), obese children (138.1min), older children (144.2min), and those who did not have physical education classes (140.2min) spent more time engaged in sedentary activities than their peers. Academic performance and mother's education were not associated with sedentary behaviors. CONCLUSIONS: Children spent most of their school-time in sedentary activities, with girls, older students, and obese students being even more sedentary than their peers. Physical education classes were a protective factor against excessive sedentary behavior in school. Interventions for reducing sedentary behavior during school-time could employ additional strategies to benefit the at risk groups. In addition, encouraging student's participation in physical education classes could minimize the time spent in sedentary behavior during school hours.

Accuracy of the vivofit activity tracker.

The purpose of this study was to examine the accuracy of the vivofit activity tracker in assessing energy expenditure and step count. Thirteen participants wore the vivofit activity tracker for five days. Participants were required to independently perform 1 h of self-selected activity each day of the study. On day four, participants came to the lab to undergo BMR and a treadmill-walking task (TWT). On day five, participants completed 1 h of office-type activities. BMR values estimated by the vivofit were not significantly different from the values measured through indirect calorimetry (IC). The vivofit significantly underestimated EE for treadmill walking, but responded to the differences in the inclination. Vivofit underestimated step count for level walking but provided an accurate estimate for incline walking. There was a strong correlation between EE and the exercise intensity. The vivofit activity tracker is on par with similar devices and can be used to track physical activity.

Social anxiety and drinking game participation among university students: the moderating role of drinking to cope.

BACKGROUND: Few studies have examined the relationship of social anxiety with drinking game participation. Drinking games represent a popular form of drinking in university settings. Due to their structure, games may appeal to socially anxious drinkers, particularly among those seeking to fit in or cope with the social setting. OBJECTIVES: To examine the relationship of social anxiety with frequency of drinking game participation among a university undergraduate sample and to investigate if drinking motives moderate this association. METHOD: A total of 227 undergraduate students aged 18-24 years (73% female) who had consumed alcohol in the prior year were included in the current investigation. Hierarchical regression examined the influences of social anxiety and drinking motives on frequency of drinking game participation, as well the interactions of social anxiety with drinking for coping motives and conformity motives. RESULTS: Social anxiety failed to emerge as a significant predictor of frequency of drinking game participation. However, drinking to cope moderated the relationship of social anxiety with frequency of drinking game participation. Socially anxious students who drank to cope were more likely to participate in drinking games on occasions when they consumed alcohol than those who did not endorse this drinking motive. CONCLUSION: Results demonstrated the influence of drinking to cope in the relationship of social anxiety with frequency of drinking game participation. Future work should examine the relationship with other indicators of drinking game activity. Intervention efforts addressing social anxiety and drinking should consider motives for drinking, as well as drinking patterns.

Impact of Nintendo Wii Games on Physical Literacy in Children: Motor Skills, Physical Fitness, Activity Behaviors, and Knowledge.

Physical literacy is the degree of fitness, behaviors, knowledge, and fundamental movement skills (agility, balance, and coordination) a child has to confidently participate in physical activity. Active video games (AVG), like the Nintendo Wii, have emerged as alternatives to traditional physical activity by providing a non-threatening environment to develop physical literacy. This study examined the impact of AVGs on children's (age 6⁻12, N = 15) physical literacy. For six weeks children played one of four pre-selected AVGs (minimum 20 min, twice per week). Pre and post measures of motivation, enjoyment, and physical literacy were completed. Results indicated a near significant improvement in aiming and catching (p = 0.06). Manual dexterity significantly improved in males (p = 0.001), and females felt significantly less pressured to engage in PA (p = 0.008). Overall, there appears to be some positive impact of an AVG intervention on components of physical literacy.

Type III TGF-ß receptor downregulation generates an immunotolerant tumor microenvironment.

Cancers subvert the host immune system to facilitate disease progression. These evolved immunosuppressive mechanisms are also implicated in circumventing immunotherapeutic strategies. Emerging data indicate that local tumor-associated DC populations exhibit tolerogenic features by promoting Treg development; however, the mechanisms by which tumors manipulate DC and Treg function in the tumor microenvironment remain unclear. Type III TGF-ß receptor (TGFBR3) and its shed extracellular domain (sTGFBR3) regulate TGF-ß signaling and maintain epithelial homeostasis, with loss of TGFBR3 expression promoting progression early in breast cancer development. Using murine models of breast cancer and melanoma, we elucidated a tumor immunoevasion mechanism whereby loss of tumor-expressed TGFBR3/sTGFBR3 enhanced TGF-ß signaling within locoregional DC populations and upregulated both the immunoregulatory enzyme indoleamine 2,3-dioxygenase (IDO) in plasmacytoid DCs and the CCL22 chemokine in myeloid DCs. Alterations in these DC populations mediated Treg infiltration and the suppression of antitumor immunity. Our findings provide mechanistic support for using TGF-ß inhibitors to enhance the efficacy of tumor immunotherapy, indicate that sTGFBR3 levels could serve as a predictive immunotherapy biomarker, and expand the mechanisms by which TGFBR3 suppresses cancer progression to include effects on the tumor immune microenvironment.