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Health-Related Quality of Life in Childhood Interstitial Lung Disease
Get PDFBackground:Childhood interstitial lung diseases (chILD) encompass a diverse group of rare, chronic respiratory disorders. While treatment options are limited, evaluating health related quality of life (HrQoL) has become a vital approach for clinical monitoring. This study aims to enhance our understanding of the medical and socio-demographic factors influencing HrQoL in chILD. Methods:This study used prospectively obtained data from the chILD EU Register. Caregivers were handed validated, age-specific HrQoL questionnaires (the chILD specific and generic PedsQL™ 4.0 questionnaire) and the scores calculated. We used exploratory univariate analyses and multivariable ordinary least squares (OLS) regression models on cross-sectional data to investigate the associations between subjects´ clinical features and HrQoL scores.Results:424 patients from 10 European countries and 48 study sites were included in the final analysis. The most relevant factors associated with lower HrQoL scores for the chILD specific questionnaire and the Total Score, as identified in the univariate analysis and confirmed in the multivariable OLS regression model, were “inpatient medical care in the last 3 months” (-13.6; p<0.0001 and -11.4; p<0.0001) and “failure to thrive” (-9.1; p=0.0014 and -12.1; p<0.0001). Among subjects old enough for pulmonary function testing (PFT) (n=162), we observed only a weak correlation between PFT results and different HrQoL scores. Conclusions: Main factors linked to reduced HrQoL scores were prior inpatient treatment and failure to thrive. Further interventional studies should determine whether addressing these factors can enhance HrQoL scores and potentially improve quality of life in chILD.<br/
Chromosome-level genome assembly of a hemiparasitic plant, Scurrula parasitica (Loranthaceae)
Get PDFScurrula parasitica (Loranthaceae) is a widespread aerial hemiparasitic plant in southwest China, recognized for its ecological roles and broad host range. As a representative of mistletoes in Santalales, it serves as a model for studying the genomic basis of aerial hemiparasitism. Here, we present a high-quality chromosome-level genome assembly of S. parasitica using PacBio high-fidelity and Hi-C sequencing. The assembled genome spans 547.41 Mb with a contig N50 of 8.32 Mb, and 97.54% of the sequence is anchored to nine pseudochromosomes. Repetitive sequences account for 64.53% of the genome. We predicted 21,837 protein-coding genes, of which 20,974 (96.05%) received functional annotations.Additionally, we identified 1,271 transcription factor genes and 8,407 non-coding RNAs. This chromosome-level assembly provides a foundational resource for investigating gene family evolution, parasitic adaptation, and genome architecture in S. parasitica. The genome assembly and associated datasets have been deposited in public repositories, enabling future comparative and functional genomic studies in parasitic angiosperms
Psychological resilience and mental wellbeing mitigate the risk of irritable bowel syndrome
No full textObjectives Comorbidities between mental disorders and irritable bowel syndrome (IBS) have been widely reported, yet associations between mental wellbeing and IBS, particularly regarding underlying genetic modification and proteomic signatures, remain underexplored. Methods This prospective cohort study analyzed 75,842 IBS-free participants aiming to investigate the prospective association between mental wellbeing and the risk of IBS in UK Biobank. Mental wellbeing was assessed through life satisfaction, life satisfaction, neuroticism, and depressive/anxiety symptoms. Cox models evaluate the hazard ratio (HR) for mental wellbeing and plasma proteome in relation to incident IBS during follow-up. Proteomic profiling identified mental wellbeing-associated proteins, with pathway enrichment analysis revealing biological mechanisms. Mediation and Mendelian randomization (MR) analyses further examine intermediate pathways and causality. Results With a 12.4-year follow-up period, 1,400 cases of incident IBS were documented. Better mental wellbeing mitigated IBS risk dose-dependently (low risk group: HR, 0.37; 95%CI: 0.31-0.43). Higher life satisfaction (HR, 0.41; 95%CI: 0.30- 0.56) and positive affect (HR, 0.50; 95%CI: 0.41-0.62) were inversely associated with IBS risk, whereas neuroticism (HR, 2.35; 95%CI: 1.92-2.88) and depressive/anxiety symptoms (HR, 3.09; 95%CI: 2.17-4.42) increased the risk. Findings remained consistent in across prevalent IBS and IBS subtypes. Mental wellbeing effects were independent of genetic predisposition. Mediation analyses revealed about 27% of protective effect of mental wellbeing were mediated through reduced depression and anxiety. MR supports causal protective effects of positive mental wellbeing on IBS. Proteomic profiling identified mental wellbeing-associated proteins mainly enriched in cytokine-cytokine receptor interactions. Chromogranin A and gastrin emerged as key protein biomarkers, showing significant associations with both mental wellbeing components and IBS risk. Conclusions Our study demonstrates that enhanced mental wellbeing confers substantial protection against IBS development, highlighting psychological interventions as potential primary prevention strategies
Repetition in action:Søren Kierkegaard and the problem of human agency in the Anthropocene
No full textOne of the most perplexing aspects of life on a climate-changed planet concerns the status of human action. As Donna Haraway observes, we appear to be stuck between a rock and a hard place: on the hand, there is the “position that the game is over, it’s too late, there’s no sense trying to make anything any better” and, on the other side, we encounter “the comic faith in technofixes”. In this paper, my goal is to investigate how we might overcome this persistent stalemate and recover a type of action that is properly adjusted to the exigencies of the climate emergency. Building on Sharon Krause’s re-conceptualization of nonsovereign, normatively inflected agency, I shall demonstrate that a critical turn to Søren Kierkegaard’s discussion of repetition provides valuable resources for precisely such an endeavour. “Repetition” here means, surprisingly, the complete opposite of business as usual. Rather, Kierkegaard’s thoughts reveal a mode of acting that allows us to get the world back at the very moment when all seems lost. Paradoxically, this only becomes an option once an agent forsakes the pretence of control and mastery over their environment. The paper suggests that this complex notion of agency, and the attendant conception of existential attunement (via faith, resignation, hope and anxiety), is best suited for navigating the disconcerting reality of the Anthropocene
Psychological flexibility buffers the effects of intolerance of uncertainty and diminished masculine self-esteem on distress in prostate cancer
No full textObjectivesLiving with prostate cancer presents considerable psychological challenges. Previous research has identified masculinity, intolerance of uncertainty, coping, and psychological flexibility as predictors of psychological adjustment, suggesting an integrative framework. However, the interplay between these factors remains underexplored. This study aims to address this gap by examining how these psychological factors collectively influence distress and well-being in prostate cancer, with a specific focus on the moderated mediation models involving coping and psychological flexibility. Findings will inform the development of tailored interventions and supportive care for men with prostate cancer.MethodsA cross-sectional, correlational survey design was employed. A total of 162 men diagnosed with prostate cancer completed an online survey containing a battery of validated measures and demographic questions. Bivariate correlation, hierarchical regression, and conditional process analyses were conducted to test the proposed relationships.ResultsPsychological flexibility, masculine identity, masculine self-esteem, intolerance of uncertainty, and coping collectively explained 61.9% of the variance in distress and 52.7% in mental well-being. Masculine self-esteem emerged as the strongest predictor of both outcomes. Psychological flexibility explained significant additional variance beyond other psychological predictors and prostate cancer symptoms. Moreover, psychological flexibility moderated the indirect relationship between masculine self-esteem and distress through avoidant coping, as well as the direct effect of intolerance of uncertainty on distress.ConclusionsScreening for difficulties related to masculine self-esteem and intolerance of uncertainty may help identify men at higher risk of poorer psychological adjustment following prostate cancer diagnosis. Interventions such as Acceptance and Commitment Therapy or mindfulness-based approaches may enhance psychological flexibility, improve tolerance of uncertainty, and foster adaptive engagement with masculine identity. Targeted interventions addressing the framing and enactment of masculinity may also prove beneficial
Criminal justice system contacts of young people who were placed in out-of-home care in childhood:A population-based descriptive study of over 79,000 young people in New South Wales, Australia
No full textChildren in out-of-home care are disproportionately represented in the criminal justice system, especially in formal court proceedings and youth custody. Whether this extends to other types of contact, such as police contact as a person of interest, victim, or witness, is unclear. This descriptive study examined a range of criminal justice contacts in adolescence (i.e., police contacts, police cautions, youth justice conferencing, court appearances, and youth custody) among young people who experienced out-of-home care in childhood. Data for >79,000 children were drawn from the New South Wales Child Development Study, with linked administrative records from child protection and criminal justice available from birth to age 17 years. We identified young people placed in out-of-home care before age 10 years (n = 1,715) to determine the prevalence of different criminal justice contacts for these individuals from age 10 to age 17, compared to those who did not experience out-of-home care prior to age 10. Analyses were conducted separately for girls and boys, by placement type (e.g., foster care, family and kinship care), and by number of placements (0, 1, 2, and ≥3). The prevalence of all types of criminal justice contact was significantly higher among those placed in out-of-home care compared to those who were not. Specifically, 62.3% of young people in out-of-home care had any type of contact with the criminal justice system, compared to 22.3% of those with no out-of-home care before age 10. The prevalence of criminal justice contacts was comparable for boys and girls, as well as across out-of-home care placement types and number of placements. While children who experience out-of-home care in childhood are at heightened risk for all types of criminal justice contact, most children who experience out-of-home care did not have a court appearance (88.9%) or experience youth custody (91.5%).</p
The healthy context paradox:a cross-country analysis of the association between bullying victimisation and adolescent mental health
No full textBullying victimisation is an increasing global health problem among adolescents and is associated with short- and long-term adverse mental health outcomes. Investigating whether associations with mental health vary across national contexts and why, can provide insights into mechanisms underlying those associations and inform policy. We used data from 479,685 adolescents participating in the 2018 Program for International Student Assessment (PISA) cross-sectional survey and examined whether the associations between bullying victimisation, psychological distress and life satisfaction vary across 63 countries. We further tested the modifying role of country-level factors – bullying prevalence, income inequality and national wealth, by implementing multilevel cross-country analyses. We found significant associations between bullying victimisation, increased psychological distress (β = 0.181; 95%CI: 0.178, 0.184) and decreased life satisfaction (β = -0.158; 95%CI: -0.162, -0.155). Associations between bullying victimisation, psychological distress and life satisfaction among adolescents were consistent across countries in terms of direction but effect sizes varied substantially. The effects ranged from β = 0.08 in the Philippines to β = 0.40 in South Korea for psychological distress and from β = −0.05 in the Philippines to β = −0.36 in the United Kingdom for life satisfaction. In addition, consistent with the “healthy context paradox” effect, associations between bullying and mental health were larger in countries where the prevalence of bullying was lower, as well as in higher-income countries. Interventions aiming to reduce bullying victimisation should aim to provide additional targeted support for those who still experience bullying after the intervention
Successful treatment of spinal cord drop metastasis from a forebrain oligodendroglioma with radiotherapy
No full textA 7-year-old female neutered French Bulldog presented with left thoracic limb paresis. Twelve months earlier, the dog had been treated with 3D conformal radiotherapy for a right piriform lobe mass (suspected glioma), which had a strong partial response following treatment. Magnetic resonance imaging (MRI) revealed an intramedullary lesion of the cervical spinal cord, suspected to be drop metastasis. This lesion was treated with intensity-modulated radiotherapy (IMRT) (10 fractions of 3.6 Gy, total 36 Gy), with a response documented on MRI, alongside resolution of clinical signs. The dog died of unrelated causes 647 days following IMRT, and the diagnosis was confirmed at post-mortem examination.</p
Evidence based practice for pediatric eating disorders:Perspectives of health professionals
No full textBackgroundEvidence-based practice (EBP) for pediatric eating disorders (EDs), including the strongly recommended family-based treatment (FBT), is not always available to children, adolescents or emerging adults and their families. Our aim was to investigate clinician knowledge and perspectives of EBP, including FBT, and explore barriers and facilitators to its implementation.MethodsClinicians working in Western Canada who were engaged in care for pediatric EDs were invited to participate. A multimethod design was employed using an online survey and subsequent phone interview for data collection. Descriptive data was summarized using means and frequencies. Qualitative data was analysed using a mixed approach encompassing inductive and deductive techniques.ResultsEighty-four clinicians completed the survey and 24 completed the interview. A total of 64% of clinicians providing therapy were offering FBT in their practice. Of these, 12.5% had no formal training in the modality. Clinicians identified a range of barriers and facilitators to EBP, including FBT, such as service-centered reasons (inadequate training, staff beliefs around which professionals should be involved, program mandates, and private practice therapists struggling to get other professionals on the ‘same page’ in FBT), clinician-centered reasons (desire to offer more holistic care, lack of inclusion of dietetics, belief that FBT was better suited to hospital settings), and patient/family-centered reasons (co-occurring conditions in parents or children, lack of financial privilege).ConclusionsThe barriers to delivering EBP, and low rates of formal FBT training indicate a need to improve capacity building efforts for pediatric ED clinicians, including improved access to training and consultation.Plain English summaryChildren, youth and their families can experience challenges with accessing timely evidence-based treatment for eating disorders. Our team engaged with clinicians working in British Columbia and Alberta to understand their knowledge and perspectives of care for pediatric eating disorders, and learn about factors that help and hinder the implementation of treatment approaches that are recommended in Canadian guidelines, such as family-based treatment (FBT). Participants completed an online survey and were also invited to take part in a subsequent phone interview, with 84 clinicians taking part in the survey, and 24 in the interview. Nearly two-thirds of therapists were offering FBT in clinical care; however, some of these therapists reported having no formal training in FBT. Clinicians shared a variety of barriers to using evidence-based practice, including FBT, in their clinical work. This study suggests a need to improve access to training and consultation for clinicians to help make evidence-based treatments for pediatric eating disorders more available
Redesigning mental health research systems from within:The role of peer-led co-production
No full textMomentum is building across mental health research and practice toward collaborative, equity-driven approaches, yet institutional cultures often remain rooted in hierarchy and individual achievement. Co-production has emerged as a framework for redistributing power, fostering reciprocity, and embedding lived experience into research and system design. However, it is typically framed as something that occurs externally with communities, while the internal research dynamics within institutions go unexamined. In this commentary, we argue that peer-led co-production is a vital but under-recognized strategy for transforming mental health systems from within. Drawing on the experience of the Network for Early Career X Trainee Researchers in Youth Mental Health (NExT) in Canada, we examine how early career researchers (ECRs) are modelling alternative ways of working through relational leadership, shared accountability, and collaborative infrastructures. We identify structural barriers that constrain this work, including siloed training pathways, narrow professional evaluation metrics, rigid role definitions, and funding mechanisms that undervalue relational practices. Building on these insights, we outline a roadmap for embedding peer-led co-production within institutions, calling for four shifts: sustained investment in relational infrastructure; training that embeds collaborative competencies; evaluation systems that reward both outcomes and processes; and leadership models that support shared governance. Peer-led networks demonstrate that these shifts are not abstract ideals but viable practices already in motion. Realizing their potential requires institutional commitment to reconfiguring funding, training, evaluation, and leadership so that co-production becomes foundational of mental health research and system change
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