Search

Self-concept develops during adolescence, but little is known about self-concept in adolescents with autism. This behavioral neuroimaging study investigated (1) self-concept positivity across three domains (academic, physical appearance, and prosocial) and (2) from the perspective of self (direct self-concept) and the perceived perspective of peers (reflected self-concept) in 12- to 16-year-old adolescent males with (n = 35) and without autism (n = 34). These behavioral and neural measures of self-concept were additionally related to autism traits and alexithymia traits across groups. Results showed no general group differences, but more autism traits were related to less positive self-concept ratings in the physical appearance and prosocial domains. More autism traits were also associated with less similarity between direct and reflected prosocial self-concept ratings. Lower self-esteem was additionally explained by alexithymia, specifically the difficulty to identify ones feelings. Participants showed medial prefrontal cortex activation in response to evaluating self-traits in both groups. Region-of-interest analyses revealed that medial prefrontal cortex and right temporal-parietal junction activation were differentially related to alexithymia traits. Together, this study provides a comprehensive understanding of self-concept and self-esteem in adolescents with varying levels autism and alexithymia traits.

Background: Health research is increasingly conducted with the active involvement of the people who are the focus of the research. People with intellectual disabilities also participate actively in research; this is called inclusive research. Collaboration in inclusive research teams requires shared decision-making (SDM). Although inclusive studies frequently refer to decision-making as something the research team does together, the decision-making process is still a black box. This study aims to provide more insight into SDM in inclusive research by reflecting on a 3-year collaboration in an inclusive research team. The research questions are: (1) What kinds of decisions were made by the inclusive research team? (2) How were decisions made by the inclusive research team? (3) What impact did the decisions have on the research project? Methods: To answer the research questions, the inclusive research team members reflected on SDM in their project by looking at the documentation of the inclusive research process and by conducting semi-structured interviews with the team members. Findings: In all research steps, the inclusive research team decided together on the content and procedures of the studies and on role division. Reflecting on SDM resulted in an overview of the types of decisions made, the information needed and the processes involved in making shared decisions. Furthermore, the team provided an account of how SDM positively impacted the quality of the studies and empowered people with intellectual disabilities. Conclusions: This study provides insights into types of decisions, SDM processes and their impact on research. The insights give an overview of opportunities and key components of SDM that can foster conceptual clarity of SDM in inclusive research. In practice, inclusive research teams can use these insights to advance successful ways of sharing power in decision making, having an impact on the quality of research and empowering people with intellectual disabilities.

Although the link between self-esteem and psychopathology has been well established, studies on self-esteem in individuals with autism spectrum disorder are lacking. In this study, we aimed to (1) compare explicit and implicit self-esteem of youth with autism spectrum disorder to typically developing peers and to (2) explore relationships of implicit-, explicit-, and discrepant self-esteem measures with co-occurring internalizing and externalizing problems in youth with autism spectrum disorder. For this purpose, 25 individuals with autism spectrum disorder and 24 individuals as age and intelligence quotient--matched controls aged 8-16 years participated in this study. Results showed lower explicit self-esteem in autism spectrum disorder compared to typically developing youth and no differences in implicit self-esteem between groups. In youth with autism spectrum disorder, low explicit self-esteem was related to co-occurring depression symptoms, whereas lower implicit self-esteem was related to externalizing symptoms. These results show that youth with autism spectrum disorder are at risk for developing low explicit self-esteem, which appears to be related to often co-occurring internalizing symptoms. This emphasizes the need to focus more on self-esteem in assessment and treatment of youth with autism spectrum disorder.

Background: People with intellectual disabilities (ID) depend on their environment to live healthily. Asset-based health promotion enhances a settings' health-promoting capacity starting with identifying protective or promotive factors that sustain health. Method: This inclusive mixed-methods study used group sessions to generate and rank ideas on assets supporting healthy nutrition and physical activity in Dutch intellectual disability care settings. Participants included people with moderate intellectual disabilities and family and care professionals of people with severe/profound intellectual disabilities. Results: Fifty-one participants identified 185 assets in group sessions. They include the following: (i) the social network and ways "people" can support, (ii) assets in/around "places," and person-environment fit, and (iii) "preconditions": health care, prevention, budget, and policy. Conclusion: This inclusive research provides a user perspective on assets in the living environment supporting healthy living. This gives insight in contextual factors needed for development and sustainable embedment of health promotion in the systems of intellectual disability support settings.

Background: Inclusive research is studied mainly in short-term collaborations between researchers with and without intellectual disabilities focusing on practicalities. Structural study of long-term collaborations can provide insight into different roles of inclusive researchers, thereby contributing to a collective approach. Method: Interviews with inclusive research team members (n = 3), colleagues (n = 8), and managers (n = 2) and three group discussions within the inclusive research team were held. Data were analysed following membership categorization analysis (MCA) adapted to the needs of the inclusive research team. Results: This MCA provides insight into the complexity of inclusive research, reflected in the multitude of identified roles and activities. Analysis indicates that researchers with and without intellectual disabilities complement each other. Conclusions: The activities identified in this study provide valuable information for discussing roles and responsibilities from the outset, so that dialogue starts at the core of inclusive research: the process between researchers with and without intellectual disabilities.

Using unique payment diary survey data, this paper analyses trust in the Dutch payment system (broad-scope trust) and trust in the payment services of customers' own bank (narrow-scope trust) among several customer groups at risk of being financially excluded due to the ongoing digitalisation. We specifically research people who have low digital skills, face financial challenges, or have a disability. Our results suggest that respondents with low digital skills or those who experience financial difficulties have below-average levels of both broad-scope and narrow-scope trust. Among people who have difficulty walking or are wheelchair-bound we find a significant positive effect on broad-scope trust in the payment system, while blind or visually impaired people and people with limited or no hand function are less likely to have trust in the payment system compared to people who do not belong to one of these groups. Among those who fall in a group at risk due to a physical disability, we only uncover a significant negative effect on narrow-scope trust for people who are blind or with a visual impairment. Respondents with little broad-scope trust report various reasons for their lack of trust, such as dissatisfaction with banks' policies and the cost of bank services, interruptions in the payment system, and the ongoing digitalisation of payment services. Our findings underscore the importance of cultivating an accessible and inclusive payment system to increase financial inclusion from a trust-centred perspective. [ABSTRACT FROM AUTHOR]

The Dietary Approaches to Stop Hypertension (DASH) diet has been shown to effectively reduce blood pressure and body weight, but its effectiveness for reducing (cardiovascular) mortality rates has never been assessed in a clinical trial. Causal effects of dietary interventions are difficult to measure, due to practical limitations of randomized controlled diet trials. Target trial emulation can be used to improve causal inference in observational data. The aim of this study was to emulate a target trial assessing the relationship between compliance with the DASH diet and cardiovascular and all-cause mortality risk in patients with established CVD. Using data from the Alpha Omega Cohort, we emulated a DASH diet trial in patients with a history of myocardial infarction (MI). Inverse probability of treatment weighting (IPTW) was used to balance confounders over DASH-compliant and non-DASH-compliant participants. Hazard ratios (HRs) were estimated with IPT-weighted Cox models. Of 4365 patients (79% male, median age 69 years, >80% treated with lipid- and blood pressure-lowering medication), 598 were classified as DASH-compliant (compliance score ≥5 out of 9). During a median follow-up of 12.4 years, 2035 deaths occurred of which 903 (44%) were of cardiovascular origin. DASH compliance was not associated with all-cause mortality (HR 0.92, 95%CI 0.0.80–1.06) and cardiovascular mortality (HR 0.90, 95%CI 0.72–1.11). In an emulated target trial on the DASH diet in the Alpha Omega cohort no relation was found between DASH compliance and risk of all-cause and cardiovascular mortality in patients with a history of MI. The DASH diet's effects may have been modified in this population by concomitant use of blood pressure-lowering medications. [ABSTRACT FROM AUTHOR]

Population-based studies have shown both beneficial and neutral associations between dairy consumption and kidney function outcomes. We investigated the association between dairy products and kidney function decline in drug-treated post-myocardial infarction (MI) patients. We analysed data of 2169 post–MI patients (aged 60–80 years, 81% male) of the Alpha Omega Cohort. Dietary data were collected at baseline (2002–2006) using a validated 203-item food frequency questionnaire. The 2021 Chronic Kidney Disease Epidemiology (CKD-EPI) equation was used to estimate 40-months change in creatinine-cystatin C based glomerular filtration rate (eGFR cr-cysC , mL/min per 1.73 m2). Beta coefficients and 95% confidence intervals (CIs) for dairy products in relation to annual eGFR cr-cysC change were obtained from multivariable linear regression, adjusted for age, sex, energy intake, and other lifestyle and dietary factors. Baseline energy-adjusted median intakes were 64 g/day for total milk, 20 g/day for hard cheeses, 18 g/day for plain yogurt, and 70 g/day for dairy desserts. Mean ± SD eGFR cr-cysC was 84 ± 20 (13% with CKD), and annual eGFR cr-cysC change was −1.71 ± 3.85. In multivariable models, high vs. low intakes of total milk, cheese, and dairy desserts were not associated with annual eGFR cr-cysC change (β total milk : −0.21 [−0.60; 0.19], β cheese : −0.08 [−0.52; 0.36], β dairy desserts : −0.24 [−0.72; 0.24]). High vs. low intake of yogurt was adversely associated with annual eGFR cr-cysC change (β total yogurt : −0.50 [−0.91;-0.09]), but subsequent spline analyses showed no clear dose–response association. Intakes of milk, cheese or dairy desserts were not associated with a delayed kidney function decline after MI. The observed adverse association for yogurt should be interpreted with caution. Our findings require confirmation in other cohorts of coronary heart disease patients. [ABSTRACT FROM AUTHOR]

Background: The use of eHealth is more challenging for people with intellectual disabilities (IDs) than for the general population because the technologies often do not fit the complex needs and living circumstances of people with IDs. A translational gap exists between the developed technology and users' needs and capabilities. User involvement approaches have been developed to overcome this mismatch during the design, development, and implementation processes of the technology. The effectiveness and use of eHealth have received much scholarly attention, but little is known about user involvement approaches. Objective: In this scoping review, we aimed to identify the inclusive approaches currently used for the design, development, and implementation of eHealth for people with IDs. We reviewed how and in what phases people with IDs and other stakeholders were included in these processes. We used 9 domains identified from the Centre for eHealth Research and Disease management road map and the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability framework to gain insight into these processes. Methods: We identified both scientific and gray literature through systematic searches in PubMed, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, Google Scholar, and (websites of) relevant intermediate (health care) organizations. We included studies published since 1995 that showed the design, development, or implementation processes of eHealth for people with IDs. Data were analyzed along 9 domains: participatory development, iterative process, value specification, value proposition, technological development and design, organization, external context, implementation, and evaluation. Results: The search strategy resulted in 10,639 studies, of which 17 (0.16%) met the inclusion criteria. Various approaches were used to guide user involvement (eg, human or user-centered design and participatory development), most of which applied an iterative process mainly during technological development. The involvement of stakeholders other than end users was described in less detail. The literature focused on the application of eHealth at an individual level and did not consider the organizational context. Inclusive approaches in the design and development phases were well described; however, the implementation phase remained underexposed. Conclusions: The participatory development, iterative process, and technological development and design domains showed inclusive approaches applied at the start of and during the development, whereas only a few approaches involved end users and iterative processes at the end of the process and during implementation. The literature focused primarily on the individual use of the technology, and the external, organizational, and financial contextual preconditions received less attention. However, members of this target group rely on their (social) environment for care and support. More attention is needed for these underrepresented domains, and key stakeholders should be included further on in the process to reduce the translational gap that exists between the developed technologies and user needs, capabilities, and context. [ABSTRACT FROM AUTHOR]

Globally, peatlands have been affected by drainage and peat extraction, with adverse effects on their functioning and services. To restore peat‐forming vegetation, drained bogs are being rewetted on a large scale. Although this practice results in higher groundwater levels, unfortunately it often creates deep lakes in parts where peat was extracted to greater depths than the surroundings. Revegetation of these deeper waters by peat mosses appears to be challenging due to strong abiotic feedbacks that keep these systems in an undesired bare state. In this study, we theoretically explore if a floating peat mat and an open human‐made bog lake can be considered two alternative stable states using a simple model, and experimentally test in the field whether stable states are present, and whether a state shift can be accomplished using floating biodegradable structures that mimic buoyant peat. We transplanted two peat moss species into these structures (pioneer sp. Sphagnum cuspidatum and later‐successional sp. S. palustre) with and without additional organic substrate. Our model suggests that these open human‐made bog lakes and floating peat mats can indeed be regarded as alternative stable states. Natural recovery by spontaneous peat moss growth, i.e., a state shift from open water to floating mats, is only possible when the water table is sufficiently shallow to avoid light limitation (<0.29 m at our site). Our experiment revealed that alternative stable states are present and that the floating structures facilitated the growth of pioneer S. cuspidatum and vascular plants. Organic substrate addition particularly facilitated vascular plant growth, which correlated to higher moss height. The structures remained too wet for the late‐successional species S. palustre. We conclude that open water and floating peat mats in human‐made bog lakes can be considered two alternative stable states, and that temporary floating establishment structures can induce a state shift from the open water state to peat‐forming vegetation state. These findings imply that for successful restoration, there is a clear water depth threshold to enable peat moss growth and there is no need for addition of large amounts of donor‐peat substrate. Correct species selection for restoration is crucial for success. [ABSTRACT FROM AUTHOR]

Insights from developmental neuroscience are not always translated to actionable policy decisions. In this review, we explore the potential of bridging the gap between developmental neuroscience and policy through youth participatory research approaches. As the current generation of adolescents lives in an increasingly complex and rapidly changing society, their lived experiences are crucial for both research and policy. Moreover, their active involvement holds significant promise, given their heightened creativity and need to contribute. We therefore advocate for a transdisciplinary framework that fosters collaboration between developmental scientists, adolescents, and policy makers in addressing complex societal challenges. We highlight the added value of adolescents' lived experiences in relation to two pressing societal issues affecting adolescents' mental health: performance pressure and social inequality. By integrating firsthand lived experiences with insights from developmental neuroscience, we provide a foundation for progress in informed policy decisions. • Actively involving adolescents in research could help informing policy. • Participatory research suits adolescents because of their need to contribute. • Marginalized communities could be reached through participatory research. • Policy could be informed through an iterative transdisciplinary research cycle. [ABSTRACT FROM AUTHOR]

This study examined the role of brain regions involved in academic self-evaluation in relation to problems with study orientation. For this purpose, 48 participants between ages 14–20 years evaluated themselves on academic traits sentences in an fMRI session. In addition, participants completed an orientation to study choice questionnaire, evaluated the importance of academic traits, and completed a reading and shortened IQ test as an index of cognitive performance. Behavioral results showed that academic self-evaluations were a more important predictor for problems with study orientation compared to subjective academic importance or academic performance. On a neural level, we found that individual differences in the positivity of academic self-evaluations were reflected in increased precuneus activity. Moreover, precuneus activity mediated the relation between academic self positivity and problems with study orientation. Together, these findings support the importance of studying academic self-concept and its neural correlates in the educational decision-making process. [ABSTRACT FROM AUTHOR]

Neuroimaging studies in adults showed that cortical midline regions including medial prefrontal cortex (mPFC) and posterior parietal cortex (PPC) are important in self-evaluations. The goals of this study were to investigate the contribution of these regions to self-evaluations in late childhood, adolescence, and early adulthood, and to examine whether these differed per domain (academic, physical and prosocial) and valence (positive versus negative). Also, we tested whether this activation changes across adolescence. For this purpose, participants between ages 11–21-years (N = 150) evaluated themselves on trait sentences in an fMRI session. Behaviorally, adolescents rated their academic traits less positively than children and young adults. The neural analyses showed that evaluating self-traits versus a control condition was associated with increased activity in mPFC (domain-general effect), and positive traits were associated with increased activity in ventral mPFC (valence effect). Self-related mPFC activation increased linearly with age, but only for evaluating physical traits. Furthermore, an adolescent-specific decrease in striatum activation for positive self traits was found. Finally, we found domain-specific neural activity for evaluating traits in physical (dorsolateral PFC, dorsal mPFC) and academic (PPC) domains. Together, these results highlight the importance of domain distinctions when studying self-concept development in late childhood, adolescence, and early adulthood. [ABSTRACT FROM AUTHOR]

Background: Operative management of chronic exertional compartment syndrome of the tibialis anterior muscle compartment (ant-CECS) usually involves the use of a fasciotome. Collateral tissue damage such as hematoma and nerve damage may occur during the procedure. The current report assessed the feasibility and safety of an alternative tool for the operative management of ant-CECS. Methods: The system had a speculum-like hollow tube that was inserted via a 2-cm skin incision and allowed for the protected advancement of a fasciotome. The device was tested in patients with bilateral ant-CECS. Symptoms were prospectively scored before and after surgery using a 5-category verbal rating scale (VRS). Fourteen patients (age 26 ± 10 years) were analyzed. Complications and operative efficacy were determined using physical examination and questionnaires after 21 (range = 16-25) months. Results: Technical operative success rate was 100% (28/28 legs). Operation time was 10 ± 2 minutes per leg (range = 6-14). Perioperative complications were not observed. One superficial wound infection was treated nonoperatively. Significant reductions in pain (–2.2 ± 1.1 on 5-point VRS, P < .001), tightness (–1.9 ± 1.6, P = .01), cramps (–1.4 ± 1.6, P = .009), muscle weakness (–1.6 ± 1.2, P < .001), and altered sensibility (–1.3 ± 1.4, P = .005) were registered 21 months postoperatively. Conclusion: This fasciotome was simple to use and allowed for a safe fasciotomy in patients with leg ant-CECS. A randomized controlled trial comparing the present device with a widely used fasciotome was under way at the time of writing of this study. Level of evidence: Level IV, case series [ABSTRACT FROM AUTHOR]