These findings suggest that recent cohorts of adolescent girls are experiencing increases in internalizing symptoms compared to previous cohorts. Approaches for prevention and early intervention should be explored.
BackgroundEpidemiological research links vitamin D status to various brain-related outcomes. However, few trials examine whether supplementation can improve such outcomes and none have examined effects on cognition. This study examined whether Vitamin D supplementation led to improvements in diverse measures of cognitive and emotional functioning, and hypothesised that supplementation would lead to improvements in these outcomes compared to placebo.Methods/Principal FindingsHealthy young adults were recruited to a parallel-arm, double-blind trial conducted at The University of Queensland. Participants were randomly allocated to receive Vitamin D (one capsule daily, containing 5000 IU cholecalciferol) or identical placebo capsule for six weeks. All participants and outcome assessors were blinded to group assignment. Primary outcome measures assessed at baseline and 6 weeks were working memory, response inhibition and cognitive flexibility. Secondary outcomes were: hallucination-proneness, psychotic-like experiences, and ratings of depression, anxiety and anger. 128 participants were recruited, randomised and included in primary analyses (vitamin D n = 63; placebo n = 65). Despite significant increases in vitamin D status in the active group, no significant changes were observed in working memory (F = 1.09; p = 0.30), response inhibition (F = 0.82; p = 0.37), cognitive flexibility (F = 1.37; p = 0.24) or secondary outcomes. No serious adverse effects were reported.ConclusionsOur findings indicate that vitamin D supplementation does not influence cognitive or emotional functioning in healthy young adults. Future controlled trials in targeted populations of interest are required to determine whether supplementation can improve functioning in these domains.Australian and New Zealand Clinical Trials Registry; ACTRN12610000318088.
IntroductionPoor medication adherence is common in children and adolescents with chronic illness, but there is uncertainty about the best way to enhance medication adherence in this group. The authors conducted a systematic review of controlled trials examining interventions that aim to improve medication adherence. Method A comprehensive literature search was undertaken to locate controlled trials that described specifi c interventions aiming to improve adherence to long-term medication, where participants were aged 18 years and under, medication adherence was reported as an outcome measure, and which could be implemented by individual health practitioners. Studies were reviewed for quality and outcome. Results 17 studies met inclusion criteria: seven studies examined educational strategies, seven studies examined behavioural interventions and three studies examined educational intervention combined with other forms of psychological therapies. Only two of seven studies reported a clear benefi t for education on medication adherence, whereas four of seven trials indicated a benefi t of behavioural approaches on medication adherence. One trial reported that combining education with behavioural management may be more effective than education alone. Studies which combined education with other non-medication specifi c psychological interventions failed to demonstrate a benefi cial effect on medication adherence. Only two studies examined adherencepromoting interventions in young people with established adherence problems. Conclusion These fi ndings suggest that education interventions alone are insuffi cient to promote adherence in children and adolescents, and that incorporating a behavioural component to adherence interventions may increase potential effi cacy. Future research should examine interventions in high-risk groups. INTRODUCTIONAdherence has been defi ned as 'the extent to which a person's behaviour corresponds with agreed recommendations from a healthcare provider'. 1 Medication adherence refers to the degree to which the medications taken refl ect the prescriber's intention. 2 3 Poor medication adherence is common, especially in chronic illness, 1 3 4 and is associated with poorer outcomes. 3 5 6 Interventions to promote adherence may be effective, although benefi ts are not consistently demonstrated across studies. 4 A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness Angela J Dean, 1-3 Julie Walters, 4 Anthony Hall 4,5Most existing reviews of adherence-promoting interventions have focused on adults. However, many young people experience chronic illness 7 8 and poor medication adherence. 9-12 Involvement of families in medication routines, 12 13 and varying developmental capacities of children and adolescents 11 12 14 15 may infl uence medication adherence, reinforcing the need to identify interventions with demonstrated effi cacy in young people rather than translating fi ndings from adult research. 9 11 A review of interven...
Sustainable approaches to water management require broad community acceptance of changes in policy, practice and technology, which in turn, requires an engaged community. A critical first step in building an engaged community is to identify community knowledge about water management, an issue rarely examined in research. To address this, we surveyed a representative sample of Australian adults (n = 5172). Knowledge was assessed using 15 questions about impact of household activities on waterways, the urban water cycle, and water management. This survey also examined demographics, psychosocial characteristics, exposure to water-related information, and water-related behaviors and policy support. Participants correctly answered a mean of 8.0 questions (Range 0–15). Most respondents knew that household actions can reduce water use and influence waterway health, whereas less than one third correctly identified that domestic wastewater is treated prior to entering waterways, urban stormwater is not treated, and that these are carried via different pipes. Higher water knowledge was associated with older age, higher education and living in non-urban areas. Poorer water knowledge was associated with speaking a language other than English in the home. Garden size, experience of water restrictions, satisfaction, waterway use for swimming, and certain information sources were also associated with knowledge. Greater water knowledge was associated with adoption of water-saving and pollution-reduction behaviors, and support for both alternative water sources and raingardens. These findings confirm the importance of community knowledge, and identify potential subgroups who may require additional targeting to build knowledge and support for water management initiatives.
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