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We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a waitlist. Following the intervention program, participants who were initially symptomatic reported significantly lower depression and stress scores on the Depression Anxiety Stress Scales in comparison to individuals on the waitlist. There was no significant change in anxiety related symptoms. The benefits were maintained at 3 and 9 month follow-up. Our findings demonstrate the potential of CBT in a small group setting for assisting young people with ASD who have symptoms of depression and stress.

The COVID-19 pandemic presents significant risks to population mental health. Despite evidence of detrimental effects for adults, there has been limited examination of the impact of COVID-19 on parents and children specifically. We aim to examine patterns of parent and child (0–18 years) mental health, parent substance use, couple conflict, parenting practices, and family functioning during COVID-19, compared to pre-pandemic data, and to identify families most at risk of poor outcomes according to pre-existing demographic and individual factors, and COVID-19 stressors. Participants were Australian mothers (81%) and fathers aged 18 years and over who were parents of a child 0–18 years ( N  = 2365). Parents completed an online self-report survey during ‘stage three’ COVID-19 restrictions in April 2020. Data were compared to pre-pandemic data from four Australian population-based cohorts. Compared to pre-pandemic estimates, during the pandemic period parents reported higher rates of parent depression, anxiety, and stress (Cohen’s d  = 0.26–0.81, all p  < 0.001), higher parenting irritability ( d  = 0.17–0.46, all p  < 0.001), lower family positive expressiveness ( d  = − 0.18, p  < 0.001), and higher alcohol consumption (22% vs 12% drinking four or more days per week, p  < 0.001). In multivariable analyses, we consistently found that younger parent age, increased financial deprivation, pre-existing parent and child physical and mental health conditions, COVID-19 psychological and environmental stressors, and housing dissatisfaction were associated with worse parent and child functioning and more strained family relationships. Our data suggest wide-ranging, detrimental family impacts associated with the COVID-19 pandemic; and support policy actions to assist families with financial supports, leave entitlements, and social housing.

IN THE picturesque little village of Domremy, on the left bank of the River Meuse, was born Joan of Arc, the unique peasant girl of grand historic fame. Authors slightly differ as to the year of her birth, but whether born in 1410 or a year or two later makes little account in view of the magnificent achievement of her brief life, with its guerdon of a martyr's crown and the deep applause of posterity. And whether she was French born or a Lorrainer, concerning which some doubt has also been expressed, is likewise of slight import, comparatively.

Autism Spectrum Disorder affects up to 2.5% of children and is associated with harmful health outcomes (e.g. obesity). Low levels of physical activity and high levels of sedentary behaviors may contribute to harmful health outcomes. To systematically review the prevalence and correlates of physical activity and sedentary behaviors in children with Autism Spectrum Disorder, electronic databases (PsycINFO, SPORTDiscus, EMBASE, Medline) were searched from inception to November 2015. The review was registered with PROSPERO (CRD42014013849). Peer-reviewed, English language studies were included. Two reviewers screened potentially relevant articles. Outcomes of interest were physical activity and sedentary behaviour levels and their potential correlates. Data were collected and analysed in 2015. Of 35 included studies, 15 reported physical activity prevalence, 10 reported physical activity correlates, 18 reported sedentary behavior prevalence, and 10 reported sedentary behavior correlates. Estimates of children's physical activity (34-166 mins/day, average 86 mins/day) and sedentary behavior (126-558 mins/day in screen time, average 271 mins/day; 428-750 mins/day in total sedentary behavior, average 479 mins/day) varied across studies. Age was consistently inversely associated, and sex inconsistently associated with physical activity. Age and sex were inconsistently associated with sedentary behavior. Sample sizes were small. All but one of the studies were classified as having high risk of bias. Few correlates have been reported in sufficient studies to provide overall estimates of associations. Potential correlates in the physical environment remain largely unexamined. This review highlights varying levels of physical activity and sedentary behavior in children with Autism Spectrum Disorder. Research is needed to consistently identify the correlates of these behaviors. There is a critical need for interventions to support healthy levels of these behaviors. [Author abstract]

Injectable biomimetic hydrogels have great potential for use in regenerative medicine as cellular delivery vectors. However, they can suffer from issues relating to hypoxia, including poor cell survival, differentiation, and functional integration owing to the lack of an established vascular network. Here we engineer a hybrid myoglobin:peptide hydrogel that can concomitantly deliver stem cells and oxygen to the brain to support engraftment until vascularisation can occur naturally. We show that this hybrid hydrogel can modulate cell fate specification within progenitor cell grafts, resulting in a significant increase in neuronal differentiation. We find that the addition of myoglobin to the hydrogel results in more extensive innervation within the host tissue from the grafted cells, which is essential for neuronal replacement strategies to ensure functional synaptic connectivity. This approach could result in greater functional integration of stem cell-derived grafts for the treatment of neural injuries and diseases affecting the central and peripheral nervous systems. Injectable biomimetic hydrogels hold significant promise for tissue engineering applications. Here, the authors present a hybrid myoglobin:peptide hydrogel to overcome a critical oxygen shortage following neural stem cell transplantation, thus increasing cell survival and integration.

Suicidal ideation is a major risk for a suicide attempt in younger people, such that reducing severity of ideation is an important target for suicide prevention. Smartphone applications present a new opportunity for managing ideation in young adults; however, confirmatory evidence for efficacy from randomized trials is lacking. The objective of this study was to assess whether a therapeutic smartphone application (\"LifeBuoy\") was superior to an attention-matched control application at reducing the severity of suicidal ideation. In this 2-arm parallel, double-blind, randomized controlled trial, 455 young adults from Australia experiencing recent suicidal ideation and aged 18 to 25 years were randomly assigned in a 2:2 ratio to use a smartphone application for 6 weeks in May 2020, with the final follow-up in October 2020. The primary outcome was change in suicidal ideation symptom severity scores from baseline (T0) to postintervention (T1) and 3-month postintervention follow-up (T2), measured using the Suicidal Ideation Attributes Scale (SIDAS). Secondary outcomes were symptom changes in depression (Patient Health Questionnaire-9, PHQ-9), generalized anxiety (Generalized Anxiety Disorder-7, GAD-7), distress (Distress Questionnaire-5, DQ5), and well-being (Short Warwick-Edinburgh Mental Well-Being Scale, SWEMWBS). This trial was conducted online, using a targeted social media recruitment strategy. The intervention groups were provided with a self-guided smartphone application based on dialectical behavior therapy (DBT; \"LifeBuoy\") to improve emotion regulation and distress tolerance. The control group were provided a smartphone application that looked like LifeBuoy (\"LifeBuoy-C\"), but delivered general (nontherapeutic) information on a range of health and lifestyle topics. Among 228 participants randomized to LifeBuoy, 110 did not complete the final survey; among 227 participants randomized to the control condition, 91 did not complete the final survey. All randomized participants were included in the intent-to-treat analysis for the primary and secondary outcomes. There was a significant time × condition effect for suicidal ideation scores in favor of LifeBuoy at T1 (p < 0.001, d = 0.45) and T2 (p = 0.007, d = 0.34). There were no superior intervention effects for LifeBuoy on any secondary mental health outcomes from baseline to T1 or T2 [p-values: 0.069 to 0.896]. No serious adverse events (suicide attempts requiring medical care) were reported. The main limitations of the study are the lack of sample size calculations supporting the study to be powered to detect changes in secondary outcomes and a high attrition rate at T2, which may lead efficacy to be overestimated. LifeBuoy was associated with superior improvements in suicidal ideation severity, but not secondary mental health outcomes, compared to the control application, LifeBuoy-C. Digital therapeutics may need to be purposefully designed to target a specific health outcome to have efficacy. Australian New Zealand Clinical Trials Registry ACTRN12619001671156.

The prevention of bacteria colonization by immobilizing proteins with antimicrobial activity onto cotton fabrics was investigated. Such coatings have potential applications in medical dressing materials used in wound care and healing. Two antimicrobial proteins lysozyme and hydramacin-1 (HM-1) were surface immobilized through two linkers (3-aminopropyl) triethoxysilane (APTES) and citric acid in the presence of the water soluble carbodiimide coupling reagent 1-cyclohexyl-3-(2-morpholinoethyl)carbodiimide metho-p-toluenesulfonate. Surface composition analysis by attenuated total reflection-Fourier transform infrared and X-ray photoelectron spectroscopies confirmed formation of the protein-cellulose conjugates. Antimicrobial activities of the different functionalized surfaces were found to vary between APTES and citric acid directed coatings. Citric acid immobilized lysozyme treated samples demonstrated superior activity against Gram-positive Bacillus subtilis, whereas APTES immobilized HM-1 treated samples demonstrated an advantage in inhibiting the growth of Gram-negative Escherichia coli. The antibacterial activity and stability of citric acid immobilized protein fabrics following sonication, boiling and chemical treatment were noticeably higher than that of the corresponding APTES immobilized protein fabrics. The dual coating of fibers with both antimicrobial proteins afforded efficient antimicrobial activities against both bacterial species. The results suggest that coating cotton fibers with antimicrobial proteins and peptides represents a feasible approach for developing active surfaces that prohibit growth and colonization of bacterial strains and can be potentially used in medical cotton-based fabrics.

Down syndrome (DS), or trisomy 21, is a common disorder associated with several complex clinical phenotypes. Although several hypotheses have been put forward, it is unclear as to whether particular gene loci on chromosome 21 (HSA21) are sufficient to cause DS and its associated features. Here we present a high-resolution genetic map of DS phenotypes based on an analysis of 30 subjects carrying rare segmental trisomies of various regions of HSA21. By using state-of-the-art genomics technologies we mapped segmental trisomies at exon-level resolution and identified discrete regions of 1.8-16.3 Mb likely to be involved in the development of 8 DS phenotypes, 4 of which are congenital malformations, including acute megakaryocytic leukemia, transient myeloproliferative disorder, Hirschsprung disease, duodenal stenosis, imperforate anus, severe mental retardation, DS-Alzheimer Disease, and DS-specific congenital heart disease (DSCHD). Our DS-phenotypic maps located DSCHD to a <2-Mb interval. Furthermore, the map enabled us to present evidence against the necessary involvement of other loci as well as specific hypotheses that have been put forward in relation to the etiology of DS--i.e., the presence of a single DS consensus region and the sufficiency of DSCR1 and DYRK1A, or APP, in causing several severe DS phenotypes. Our study demonstrates the value of combining advanced genomics with cohorts of rare patients for studying DS, a prototype for the role of copy-number variation in complex disease.

Major Depressive Disorder (MDD) is characterized by high stress sensitivity and unsatisfactory response rates to standard treatments. Stress and depression share a bidirectional relationship. We, therefore, conducted a pilot randomized control trial (RCT) to understand if adjunctive stress management and resiliency training tailored for depression(SMART-D), can improve treatment outcomes in patients with MDD, receiving treatment as usual(TAU) with standard treatments (medications and/or psychotherapy), in real-world clinical settings, compared to a group receiving TAU. Participants with MDD, in a current depressive episode, were randomized to adjunctive SMART-D (delivered by video telehealth over 8 weeks), compared to TAU alone. Random assignment, blinding of raters and statistician were utilized. The primary outcome measure was baseline to end point change in depression [Hamilton Rating Scale for Depression (HAM-D] over a 6-month follow-up period using a mixed model regression analysis. 27 participants (mean age 47.9 ± 14 years, female 67%) enrolled in the study (TAU = 14, SMART-D + TAU = 13). Baseline mood ratings were in mild-moderate symptom severity (HAM-D)- SMART-D + TAU = 12.2 ± 6.6, TAU = 13.9 ± 5.7). Linear mixed model analysis showed significant Group*Time interaction for measures of depression (HAM-D) (B = 6.1 (CI = 1.5-10.8, P = .01) and perceived stress (PSS) (B = 5.5(0.5-10.6), p = .03) between the 2 groups at 3 months post follow-up ((HAMD)-SMART-D + TAU = 8.7 ± 4.3 Vs. TAU = 16.1 ± 6.3), but not at 6-months (SMART-D + TAU = 8.1 ± 5.4 Vs. TAU = 12.3 ± 5.5). A RCT of 27 adults with MDD provide initial support that an adjunctive resiliency intervention (SMART-D) for patients with MDD may positively impact symptoms of depression and perceived stress, earlier than standard care. A small sample size limits ability to draw firm conclusions. Further investigation is warranted, using larger samples. Clinical Trials Registration I.D.# NCT04388748.