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The Mobile Application Rating Scale (MARS) provides a reliable method to assess the quality of mobile health (mHealth) apps. However, training and expertise in mHealth and the relevant health field is required to administer it. This study describes the development and reliability testing of an end-user version of the MARS (uMARS). The MARS was simplified and piloted with 13 young people to create the uMARS. The internal consistency and test-retest reliability of the uMARS was then examined in a second sample of 164 young people participating in a randomized controlled trial of a mHealth app. App ratings were collected using the uMARS at 1-, 3,- and 6-month follow up. The uMARS had excellent internal consistency (alpha = .90), with high individual alphas for all subscales. The total score and subscales had good test-retest reliability over both 1-2 months and 3 months. The uMARS is a simple tool that can be reliably used by end-users to assess the quality of mHealth apps.

Restrictive practices on alcohol sales in entertainment districts have been introduced to reduce alcohol-related violence in youth. On 1st July 2016, the Queensland State Government (Australia) imposed a 2-hour reduction in trading hours for alcohol sales in venues within specific night-time entertainment districts (NEDS; from 5am to 3am), a reduction in maximum trading hours for venues outside NEDs (with a maximum 2am closing time), the banning of 'rapid intoxication drinks' (e.g. shots) after 12am, and no new approvals for trading hours beyond 10pm for the sale of takeaway alcohol. No independent study has evaluated general levels of intoxication, crowd numbers, fear of violence, and illicit substance use as people enter and exit NEDS, both before and after the introduction of restrictive legislation. Further, no study has assessed the impact using matched times of the year in a controlled study and also assessed actual assault rates as recorded by the police. We conducted 3 studies-randomly breath-testing patrons for alcohol, as they entered and exited NEDs. Study 1 assessed patrons' (n = 807) breath approximated blood alcohol concentration (BrAC) and predictions of how the legislation would change their drinking habits before the legislation was enacted. Study 2 assessed crime statistics and patrons' BrAC levels and drug taking reports on an equivalent night, one year apart-before (n = 497) and after (n = 406) the new legislation. Study 3 was a test of the generalisation of Study 2 with two months of survey and BrAC data collected as people entered and exited the NEDs over two consecutive years before (n = 652 and n = 155) and one year after (n = 460) the new legislation. In Study 3 we also collected crime statistics and data on people leaving the entertainment district one year before (n = 502) and one year after (n = 514) the legislative change. People predicted that the legislation would lead to them drinking more alcohol before they entered town or make little change to their drinking habits. Baseline data over the 2 years before the legislation (Study 3) demonstrated stable preloading rates and BrAC at entry to the NEDs. However, after the introduction of the legislation patrons entered the NEDs systematically later and increased their alcohol preloading. People were substantially more inebriated as they entered the NEDs after the legislative change, with approximately 50% fewer people not preloading after the new laws. Exit BrAC was less consistent but showed some evidence of an increase. Crime statistics and patrons' self-reported experiences of violence did not change. Legislation that does not specifically adapt to the cultural shift of preloading and take local conditions into account will be unsuccessful in reducing alcohol consumption. Such legislation is unlikely to meaningfully change assault rates in youth.

The use of mobile apps for health and well being promotion has grown exponentially in recent years. Yet, there is currently no app-quality assessment tool beyond \"star\"-ratings. The objective of this study was to develop a reliable, multidimensional measure for trialling, classifying, and rating the quality of mobile health apps. A literature search was conducted to identify articles containing explicit Web or app quality rating criteria published between January 2000 and January 2013. Existing criteria for the assessment of app quality were categorized by an expert panel to develop the new Mobile App Rating Scale (MARS) subscales, items, descriptors, and anchors. There were sixty well being apps that were randomly selected using an iTunes search for MARS rating. There were ten that were used to pilot the rating procedure, and the remaining 50 provided data on interrater reliability. There were 372 explicit criteria for assessing Web or app quality that were extracted from 25 published papers, conference proceedings, and Internet resources. There were five broad categories of criteria that were identified including four objective quality scales: engagement, functionality, aesthetics, and information quality; and one subjective quality scale; which were refined into the 23-item MARS. The MARS demonstrated excellent internal consistency (alpha = .90) and interrater reliability intraclass correlation coefficient (ICC = .79). The MARS is a simple, objective, and reliable tool for classifying and assessing the quality of mobile health apps. It can also be used to provide a checklist for the design and development of new high quality health apps.

There is growing evidence for the positive impact of mindfulness on wellbeing. Mindfulness-based mobile apps may have potential as an alternative delivery medium for training. While there are hundreds of such apps, there is little information on their quality. This study aimed to conduct a systematic review of mindfulness-based iPhone mobile apps and to evaluate their quality using a recently-developed expert rating scale, the Mobile Application Rating Scale (MARS). It also aimed to describe features of selected high-quality mindfulness apps. A search for \"mindfulness\" was conducted in iTunes and Google Apps Marketplace. Apps that provided mindfulness training and education were included. Those containing only reminders, timers or guided meditation tracks were excluded. An expert rater reviewed and rated app quality using the MARS engagement, functionality, visual aesthetics, information quality and subjective quality subscales. A second rater provided MARS ratings on 30% of the apps for inter-rater reliability purposes. The \"mindfulness\" search identified 700 apps. However, 94 were duplicates, 6 were not accessible and 40 were not in English. Of the remaining 560, 23 apps met inclusion criteria and were reviewed. The median MARS score was 3.2 (out of 5.0), which exceeded the minimum acceptable score (3.0). The Headspace app had the highest average score (4.0), followed by Smiling Mind (3.7), iMindfulness (3.5) and Mindfulness Daily (3.5). There was a high level of inter-rater reliability between the two MARS raters. Though many apps claim to be mindfulness-related, most were guided meditation apps, timers, or reminders. Very few had high ratings on the MARS subscales of visual aesthetics, engagement, functionality or information quality. Little evidence is available on the efficacy of the apps in developing mindfulness.

Inherited alleles account for most of the genetic risk for schizophrenia. However, new ( de novo ) mutations, in the form of large chromosomal copy number changes, occur in a small fraction of cases and disproportionally disrupt genes encoding postsynaptic proteins. Here we show that small de novo mutations, affecting one or a few nucleotides, are overrepresented among glutamatergic postsynaptic proteins comprising activity-regulated cytoskeleton-associated protein (ARC) and N -methyl- d -aspartate receptor (NMDAR) complexes. Mutations are additionally enriched in proteins that interact with these complexes to modulate synaptic strength, namely proteins regulating actin filament dynamics and those whose messenger RNAs are targets of fragile X mental retardation protein (FMRP). Genes affected by mutations in schizophrenia overlap those mutated in autism and intellectual disability, as do mutation-enriched synaptic pathways. Aligning our findings with a parallel case–control study, we demonstrate reproducible insights into aetiological mechanisms for schizophrenia and reveal pathophysiology shared with other neurodevelopmental disorders. The authors report the largest family-trio exome sequencing study of schizophrenia to date; mutations are overrepresented in genes for glutamatergic synaptic proteins and also genes mutated in autism and intellectual disability, providing insights into aetiological mechanisms and pathopshyisology shared with other neurodevelopmental disorders. Pathogenic mechanisms in schizophrenia Two major sequencing studies of the exome — the protein-coding portion of the genome — in schizophrenia sufferers and their relatives are published in this issue of Nature . Together they provide strong pointers to specific pathogenic mechanisms that disrupt the glutamatergic synapses in schizophrenia. In particular, mutations that influence the action of the scaffold protein ARC (activity-regulated cytoskeleton-associated protein) are prominently involved, as are mutations in targets of the fragile X mental retardation protein (FMRP). Defects in FMRP have previously been shown to be associated with autism spectrum disorders.

[This corrects the article DOI: 10.1371/journal.pone.0322592.].

Sexual minority young people use licit and illicit substances at disproportionate levels. However, little is known about the perceptions of substance use among members of LGBT communities. This paper reports the results of a content analysis of 45 semi-structured interviews about substance use in LGBT communities with sexual minority young people (n = 31) and community stakeholders (n = 14). Results indicated both sexual minority youth and community stakeholders perceived the use and acceptance of substances to be higher in LGBT communities compared to the general population. Participants identified a range of characteristics potentially leading to higher levels of substance use including peer pressure, high exposure to substance use, and the high concentrations of licensed venues in LGBT communities. Marginalisation, discrimination and mental health were also perceived as important reasons for these disparities. Community stakeholders identified a range of potential interventions including legislation to address discrimination and substance use, increased services and activities, advertising in commercial LGBT venues and social media, and reinvigorating community cohesion.