Effects of Cannabis on Cardiovascular System: The Good, the Bad, and the Many Unknowns

Cannabis is currently the most consumed illicit substance in the world, and gradual legalization in the USA makes it important to understand the health consequences of the use of this substance. With growing body of evidence that some cannabis ingredients may be beneficial in various aspects of hemostasis, additional research is clearly needed in various clinical areas. In addition to understanding the efficacy, research efforts should also include studies that address any harmful effects of the compounds or administration methods that may result in adverse effects. This review is focused on the cardiometabolic effects of cannabis use. Cardiometabolic diseases are among the leading causes of death in the USA and around the world. The purpose of this review was to provide an overview of the known medicinal benefits of selected cannabis cannabinoids and the known side effects or contraindications. More importantly, we have proposed new questions and signposts in cannabis research to uncover additional medicinal benefits and identify the health hazards with focus on cardiovascular disease.

For happy children with a visual or visual-and-intellectual disability: Efficacy research to promote sensitive caregiving with the Barti-mat

Cycles of miscommunication often occur within the caregiver–child dyad when a child has a visual or visual-and-intellectual disability, influencing sensitive and responsive caregiver behaviour and child happiness. This study aims to examine the efficacy of using interactive technology, the Barti-mat, to promote sensitive and responsive caregiver behaviour, specifically mirroring behaviour, and increase the happiness of children with a visual or visual-and-intellectual disability. The secondary aim is to examine the social validity of the Barti-mat. A mixed-method approach was used, combining quantitative data from a multiple within-series single-case design and qualitative data comparing play-as-usual with play on the Barti-mat. Eleven caregiver–child dyads participated in a home-based study. No significant effects were found for Attunement nor for Valence. Significant improvements were found for Total Mirroring, Happiness, and Arousal. Overall, the caregivers enjoyed using the Bart-mat and were enthusiastic about the development of specialized play material for children with visual impairments. Results of the current study suggest that the Barti-mat can act as catalyst for caregiver mirroring behaviour and improve the happiness of a child with a visual or visual-and-intellectual disability. Caregivers were generally motivated to use and recommend the Barti-mat again. Minor product improvement recommendations were made. The Barti-mat is appropriate for a diverse group of caregivers and children with a visual or visual-and-intellectual disability and would be a good adjunct to preventive attachment-based interventions.

Efficacy of once-weekly teriparatide for primary prevention of glucocorticoid-induced osteoporosis: A post hoc analysis of the TOWER-GO study

ABSTRACT Objectives A post hoc analysis of the Teriparatide Once-Weekly Efficacy Research for Glucocorticoid-induced Osteoporosis (TOWER-GO) study was performed to examine the effect of once-weekly administration of 56.5 μg teriparatide on primary prevention of glucocorticoid-induced osteoporosis (GIOP). Methods Of the subjects of the TOWER-GO study, 73 were included. The percentage changes from baseline in lumbar spine bone mineral density (BMD) and bone turnover markers were evaluated over 72 weeks with once-weekly teriparatide and once-weekly alendronate. Results The percentage change of lumbar spine BMD from baseline at 72 weeks was significantly increased in both groups. Bone formation markers were significantly increased by teriparatide administration, although they were slightly decreased by alendronate administration. Bone resorption markers were gradually decreased by teriparatide, whereas alendronate markedly decreased them within 4 weeks. No major safety concerns arose. Conclusions In this primary prevention study of GIOP, comparable increases in BMD were observed between alendronate and once-weekly teriparatide. More desirable changes in bone markers were observed with teriparatide administration. These data suggest that once-weekly teriparatide is effective in primary prevention of GIOP.

Education of Students with Disabilities, Science, and Randomized Controlled Trials

The purpose of this article is to examine the application of randomized controlled trial (RCT) methodology for determining the efficacy of school-based interventions in general and special education. In education science, RCTs are widely acknowledged as the gold standard of efficacy research, with other methodologies relegated to a lower level of credibility. However, scholars from different disciplines have raised a variety of issues with RCT methodology, such as the utility of random assignment, external validity, and the challenges of applying the methodology for assessing complex service interventions, which are necessary for many students with disabilities. Also, scholars have noted that school-based RCT studies have largely generated low effect sizes, which indicate that the outcomes of the interventions do not differ substantially from services as usual. The criticisms of RCT studies as the primary methodology in school-based intervention research for students with disabilities are offered along with recommendations for extending the acceptability of a broader variety of research approaches.

SARS-CoV-2 Antibodies Detected in Mother’s Milk Post-Vaccination

Background The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic has infected over 127 million people worldwide, with almost 2.8 million deaths at the time of writing. Since no lactating individuals were included in initial trials of vaccine safety and efficacy, research on SARS-CoV-2 vaccination in lactating women and the potential transmission of passive immunity to the infant through mother’s milk is needed to guide patients, clinicians, and policy makers on whether to recommend immunization during the worldwide effort to curb the spread of this virus. Research Aims (1) To determine whether SARS-CoV-2 specific immunoglobins are found in human milk after vaccination, and (2) to characterize the time course and types of immunoglobulins present. Methods A longitudinal cohort study of lactating women ( N = 7) who planned to receive both doses of the Pfizer-BioNTech or Moderna SARS-CoV-2 vaccine between December 2020 and January 2021 provided milk samples. These were collected pre-vaccination and at 11 additional timepoints, with the last sample at 14 days after the second dose of vaccine. Samples were analyzed for levels of SARS-CoV-2 specific immunoglobulins A and G (IgA and IgG). Results We observed significantly elevated levels of SARS-CoV-2 specific IgG and IgA antibodies in human milk beginning approximately 7 days after the initial vaccine dose, with an IgG-dominant response. Conclusions Maternal vaccination results in SARS-CoV-2 specific immunoglobulins in human milk that may be protective for infants.

Tourette and Trichotillomania

This chapter explores the treatment of trichotillomania (TTM; also referred to as hair pulling disorder) and Tourette disorder (TD). TTM and TD exist in separate diagnostic categories but exhibit functional similarities and respond to similar treatments. The chapter reviews the characteristics of each disorder. It then describes habit reversal training (HRT) and function-based interventions, which serve as core therapeutic elements in the treatment of both TTM and TD. The chapter also discusses additional treatment strategies that occur as part of standard protocols for both disorders, before looking at the treatment efficacy research. It considers the key features of the manual-based treatments (behavior therapy protocols), as well as ways these protocols can be flexibly implemented for those with TTM and TD. Finally, consistent with the call for “flexibility within fidelity,” the chapter provides an example of a flexible implementation of these treatments.

General and Gambling-Specific Types of Control: Extending Mental Health Theory and Concepts to Problem Gambling

Rationale: A key factor in our understanding of problem gambling is control: over gambling outcomes (illusion of control) and behaviours (gambling self-efficacy). Research in the gambling field rarely looks beyond these gambling-specific types of control to more general types when identifying predictors of gambling problems. This work begins to integrate control concepts from the mental health and problem gambling fields by examining the importance of a more general type of control from the Stress Process Model: sense of control over life events. Methods: Closed-ended questionnaire and open-ended interview responses from 30 frequent (weekly or more) gamblers were used to examine whether general and gambling-specific types of control are linked as predicted in a conceptual model of control. Results: For some people, beliefs about one type of control are extended to inform beliefs about another type of control. In many cases, understandings of outcomes in life inform beliefs about controlling gambling outcomes and behaviours. Conclusions: Different types of control work together, and general understandings can translate into gambling-specific beliefs. Future work is needed to confirm and specify these relationships and clarify their importance to understanding the development of gambling problems.

Core CBT Components

Chapter 7 presents another core cognitive behavioral therapy (CBT) skill: CBT with exposure and response prevention, a first-line treatment for obsessive-compulsive and anxiety-related disorders. After briefly highlighting the efficacy research for children and adolescents, this chapter describes the technique’s theoretical framework, explains it in detail, addresses common misconceptions, and guides practitioners in developing customized fear hierarchies for students. Next, the chapter carefully describes the technique’s trauma applications, including trauma narratives and in vivo exposures. Differences between treatments for anxiety and trauma are noted, as well as complexities that arise from complex trauma. The chapter concludes with a discussion of trauma-focused CBT in schools and stepped-care models and provides a detailed case study.

A Placebo-Controlled, Pseudo-Randomized, Crossover Trial of Botanical Agents for Gulf War Illness: Reishi Mushroom (Ganoderma lucidum), Stinging Nettle (Urtica dioica), and Epimedium (Epimedium sagittatum)

This report is third in a three-part clinical trial series screening potential treatments for Gulf War Illness (GWI). The goal of the project was to rapidly identify agents to prioritize for further efficacy research. We used a placebo-controlled, pseudo-randomized, crossover design to test the effects of reishi mushroom (Ganoderma lucidum), stinging nettle (Uritca dioica), and epimedium (Epimedium sagittatum) in 29 men with GWI. Participants completed 30 days of symptom reports for baseline, then a botanical line consisting of 30 days of placebo, followed by 30 days each of lower-dose and higher-dose botanical. After completing a botanical line, participants were randomized to complete the protocol with another botanical, until they completed three botanical trials. GWI symptom severity, pain, and fatigue were contrasted between the four conditions (baseline, placebo, lower-dose, higher dose) using linear mixed models. GWI symptom severity was unchanged from placebo in the reishi lower-dose condition (p = 0.603), and was higher in the higher-dose condition (p = 0.012). Symptom severity was not decreased from placebo with lower-dose stinging nettle (p = 0.604), but was significantly decreased with higher-dose stinging nettle (p = 0.048). Epimedium showed no significant decreases of GWI symptoms in the lower (p = 0.936) or higher (p = 0.183) dose conditions. Stinging nettle, especially at higher daily dosages, may help reduce the symptoms of GWI. Epimedium does not appear to beneficially affect GWI symptom severity, and reishi may exaggerate symptoms in some GWI sufferers. These results are in a small sample and are preliminary. Further research is required to determine if stinging nettle is indeed helpful for the treatment of GWI, and what dosage is optimal. This trial was registered on ClinicalTrials.gov (NCT02909686).