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Impulsivity refers to a number of conceptually related phenotypes reflecting self‐regulatory capacity that are considered promising endophenotypes for mental and physical health. Measures of impulsivity can be broadly grouped into three domains, namely, impulsive choice, impulsive action, and impulsive personality traits. In a community‐based sample of ancestral Europeans (n = 1534), we conducted genome‐wide association studies (GWASs) of impulsive choice (delay discounting), impulsive action (behavioral inhibition), and impulsive personality traits (UPPS‐P), and evaluated 11 polygenic risk scores (PRSs) of phenotypes previously linked to self‐regulation. Although there were no individual genome‐wide significant hits, the neuroticism PRS was positively associated with negative urgency (adjusted R2 = 1.61%, p = 3.6 × 10−7) and the educational attainment PRS was inversely associated with delay discounting (adjusted R2 = 1.68%, p = 2.2 × 10−7). There was also evidence implicating PRSs of attention‐deficit/hyperactivity disorder, externalizing, risk‐taking, smoking cessation, smoking initiation, and body mass index with one or more impulsivity phenotypes (adjusted R2s: 0.35%–1.07%; FDR adjusted ps = 0.05–0.0006). These significant associations between PRSs and impulsivity phenotypes are consistent with established genetic correlations. The combined PRS explained 0.91%–2.46% of the phenotypic variance for individual impulsivity measures, corresponding to 8.7%–32.5% of their reported single‐nucleotide polymorphism (SNP)‐based heritability, suggesting a non‐negligible portion of the SNP‐based heritability can be recovered by PRSs. These results support the predictive validity and utility of PRSs, even derived from related phenotypes, to inform the genetics of impulsivity phenotypes. This study demonstrates an alternative polygenic approach using polygenic risk scores (PRSs) to understand the out‐of‐sample features of genetic variance and genetic overlaps of impulsivity traits and related self‐regulatory phenotypes. Consistent with established genetic correlations, PRSs of attention‐deficit/hyperactivity disorder, externalizing, risk‐taking, smoking cessation, smoking initiation, and body mass index were associated with at least one impulsivity phenotype. For individual impulsivity measures, the combined PRS covered a non‐negligible portion of the single‐nucleotide polymorphism‐based heritability, supporting the predictive validity and utility of PRSs to inform the genetics of impulsivity phenotypes.

Delay discounting—the extent to which individuals show a preference for smaller immediate rewards over larger delayed rewards—has been proposed as a transdiagnostic neurocognitive process across mental health conditions, but its examination in relation to posttraumatic stress disorder (PTSD) is comparatively recent. To assess the aggregated evidence for elevated delay discounting in relation to posttraumatic stress, we conducted a meta-analysis on existing empirical literature. Bibliographic searches identified 209 candidate articles, of which 13 articles with 14 independent effect sizes were eligible for meta-analysis, reflecting a combined sample size of N = 6897. Individual study designs included case-control (e.g. examination of differences in delay discounting between individuals with and without PTSD) and continuous association studies (e.g. relationship between posttraumatic stress symptom severity and delay discounting). In a combined analysis of all studies, the overall relationship was a small but statistically significant positive association between posttraumatic stress and delay discounting ( r = .135, p < .0001). The same relationship was statistically significant for continuous association studies ( r = .092, p = .027) and case-control designs ( r = .179, p < .001). Evidence of publication bias was minimal. The included studies were limited in that many did not concurrently incorporate other psychiatric conditions in the analyses, leaving the specificity of the relationship to posttraumatic stress less clear. Nonetheless, these findings are broadly consistent with previous meta-analyses of delayed reward discounting in relation to other mental health conditions and provide further evidence for the transdiagnostic utility of this construct.

Purpose of Review Precision medicine prioritizes characterization of individual patient parameters to optimize care and this review evaluates measurement-based care (MBC) as a strategy for doing so in the treatment of substance use disorders (SUD). Measurement-based care refers to the systematic use of validated assessments to inform diagnosis and treatment planning, with varying frequency of assessments. Despite the seemingly obvious grounds for the use of MBC in treating SUD, systematic implementation to date has been limited. Thus, the goal of this review is to evaluate efforts to date and to stimulate greater consideration of MBC models in addictions programs. Recent Findings Data from two published randomized controlled trials and findings from pragmatic clinical research highlight the potential utility of MBC in the SUD treatment settings. Despite these findings, the existing literature indicates the high need for larger-scale clinical trials and quality improvement programs. Potential barriers to the implementation of MBC for SUD are outlined at the patient, provider, organization, and system levels, as well as the challenges associated with the use of MBC programs for clinical research. Critical thinking considerations and risk mitigation strategies are offered toward advancing MBC for SUD beyond the current nascent state. Summary Collectively, the existing data confirm that MBC is a suitable and promising strategy for applying a precision medicine approach in SUD treatment, warranting further implementation efforts and scientific inquiry.

South Asia has the highest rates of malnutrition and the largest number of malnourished women and children in the world. Childhood malnutrition is the main cause of child mortality—one-third of all child deaths are due to the underlying cause of malnutrition. For the children who survive, malnutrition results in lifelong problems by severely reducing a child's ability to learn and to grow to his or her full potential. Malnutrition directly leads to less productive adults and thus to weaker national economic performance. The negative impact of malnutrition on a society's productivity and a nation's long-term development is difficult to underestimate. Malnutrition is a key development priority for the World Bank's South Asia region. The Bank intends to increase its commitment to reducing malnutrition in the region. As a first step, Bank staff are preparing a series of country assessments such as Malnutrition in Afghanistan. These assessments will be useful for governments and development partners committed to scaling up effective, evidence-based interventions to reduce malnutrition in their countries. Conclusive evidence shows that a multisectoral planning approach, followed by actions in the various sectors, is the most successful method to improve a populations' nutrition. Malnutrition in Afghanistan provides the background analysis for the development of a comprehensive nutrition action plan. The timing of this report is propitious. The international communities' interest in the developmental benefits of nutrition programming is high. This analytical report is part of a broader effort by the World Bank South Asia region to increase investments in nutrition, recognizing that good nutrition is important to economic growth and development, and because investing in well-proven nutrition interventions pays high dividends in poverty reduction and national economic development.

In 2005, the Cayuga Indian Nation of New York (CIN) lost a federal land claim that would have allowed it to reclaim the historic reservation that New York State illegally bought at the turn of the 18th century. After losing the case, the nation began to pursue a new strategy to rebuild its reservation: buying land on the open market that one day might be converted to federal trust land. Following these recent purchases, the nation has refused to pay property taxes and to collect sales taxes at its local businesses, much to the chagrin of most local politicians and many town residents. As these politicians and residents denounce the nation for not paying/collecting these taxes, they offer the CIN an either/or choice for belonging in this space: come here as local citizens, or uphold Cayuga sovereignty as a foreign nation moving into “our” territory. Cayuga representatives, in contrast, describe options that sit outside of this binary: the CIN can belong in this space as a sovereign nation, and also as a part of the Seneca Falls community. They call upon fiscal models that depict tribal nations both as sovereign entities and as net contributors to the larger regional economy. This dissertation examines the complex discourses about the CIN’s tax refusals in Seneca Falls to show how dominant notions of tribal sovereignty present a conceptual binary that in effect asks tribal nations to deny their sovereignty to gain a place in the modern world. This dissertation also demonstrates that tribal nations such as the CIN use local fiscal systems to carve out alternative modes of political belonging.

Prevention of transmission of the HIV virus was shown possible with the daily use of a combination drug oral tenofivir (TDF) with emtricitabine (FTC/TDF). The study presented in Rome in 2011 at the international antiviral society (IAS) is known as the partners prep study, which was a phase three randomized double-blind placebo-controlled three armed trial of daily TDF and FTC/TDF (Baeten & Celum, 2011). Other notable studies include HPTN052, a randomized trial evaluating effectiveness of antiretroviral therapy in the primary care setting between discordant couples (Guay, Musoke, & Fleming, 1999), and iPrEX, also known as the Pre-Exposure Prophylaxis Initiative, a randomized controlled trial of PrEP in humans which yielded statistically significant results of up to 96% efficacy in sero discordant couples (Cardo, Culver, & Ciesielski, 1997). In June 2013, a study done in conjunction with the Center for Disease Control (CDC) in Thailand showed that efficacy was established amongst intravenous drug users (IDU) resulting in the Center for disease control( CDC) beginning to promulgate the use of Pre-exposure prophylaxis (PrEP) for IDU. The transmission is preventable but is it achievable in practice? The challenge is to promote adherence. Adherence has been a key issue in treatment with antiretroviral medications.