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Making virtual exams routine: what health systems need to do
Clinical validation, patient training, reliable data workflows and clear responsibility for follow-up will determine whether remote examinations can scale.
“He’s had a tremendous training camp from a physical …
“He’s had a tremendous training camp from a physical …
IAM Members Hone Skills at Safety & Health Conference
The IAM safety and health conference recently convened at the Winpisinger Education Center in Maryland. Topics and training ranged from CPR refresher courses to active shooter response in the workplace.
Future African Scientist, Two Years On: From Training Scientists to Building Africa's Biotech Companies
Martin Lubowa and Daniel Zhang on how Future African Scientist grew from a research bootcamp into the FAS Biocamp, a program turning Africa’s scientists into founders of real biotech companies. Two years ago, the Ragon had the opportunity to speak with two alumni of MIT’s Evolution of an Epidemic course, Martin Lubowa and Daniel Zhang. […]
When paychecks fall short: America's affordability squeeze
Three US families share how rising housing, health care and everyday costs are straining household budgets and turning affordability into a major political issue ahead of the midterm elections.
“It’s not ideal, but” Arteta defends Arsenal’s training following injuries
Mikel Arteta has defended Arsenal’s training methods, insisting that his players must maintain the highest standards despite concerns over injuries sustained by key players during training. The Gunn...
Spotlight AZ: Sundt
From transportation and water infrastructure to advanced manufacturing facilities, Sundt Construction has helped build Arizona’s economy since 1929. Headquartered in Tempe, the 100% employee-owned company is investing in new facilities, workforce training and technologies to support the state’s next chapter of growth. In this Chamber Business News Spotlight, Sundt’s Alex Charland discusses the company’s new […]
UNA again named among Billboard’s top music business schools
UNA’s music business program returns to Billboard’s 2026 top schools list, with hands-on training and faculty including Grammy winner John
Piero Hincapié and Martin Zubimendi Absent from Arsenal Training
Arsenal have been dealt an injury blow ahead of Tuesday's Champions League clash with Lille, with two first-team players missing from training.
New Doctoral Training Programme will tackle key polar science questions with a reduced carbon footprint
The Net Zero Polar Science (NZPS) Doctoral Training Programme (DTP) has welcomed its first cohort of PhD researchers, marking the launch of a new UK-based...
🎥 All fit at Atleti's final training session before United
Atlético de Madrid head into their next European fixture with the best possible news. Diego Pablo Simeone will have his entire squad available to face Manchester United this Tuesday (9:00 p.m.) in th...
Schoellkopfs expand support for IU Columbus mental health counseling program
More students and residents across South Central Indiana will have access to mental health counseling services and counselor training opportunities at Indiana University Columbus thanks to Tom and Barbara Schoellkopf.
Just 7 Days of Strength Training Starts Shrinking Fat Cells in Mice
Not all improvements are visible.
The science, instinct and hard work behind Roosters’ success
Enter your email address to get each Tribune edition sent to your inbox Subscribe There’s a fair bit of unseen work that goes into winning an NRL premiership, dating back many months - just ask Simon Jones. The Sydney Roosters Head of Performance, who hails from Southland, has been in the thick of it. He played a lead role in guiding the 2026 champions through a marathon campaign that ended with a grand final win over the Newcastle Knights. The Roosters had to navigate the lengthy round-robin competition, including the pre-season, before playing through all four weeks of the finals series. It was a demanding stretch that tested the players and the staff responsible for keeping them on the field. “It is a hell of a beast, mate, to be honest,” Jones told The Roar Podcast. “There’s such a great group of staff there that know what they’re doing, and the boys are pretty professional.” Jones believed the Roosters managed the physical demands well, pointing to the health of the squad throughout the campaign and the decision to rest a significant portion of the playing group in the final round of the regular season. That call, made by head coach Trent Robinson and his coaching staff, proved valuable as the Roosters entered the finals with some energy in reserve. “We did finish the season physically where we needed to be, and we’d sort of had a pretty healthy squad all year,” Jones said. “To the team that do that, mate, mission accomplished, really.” It is the sort of work that often goes unnoticed when the spotlight falls on the players scoring tries and making match-winning plays, but Jones knows the cumulative effect of those decisions can be significant over a long season. After a win over Penrith had helped establish them as premiership favourites, losses to the Wests Tigers and Dolphins were followed by a defeat to the Panthers in the opening week of the finals. Rather than panic, the club refocused to position itself to challenge for the title. “The Tigers’ performance was probably the only one where you’re really quite disappointed because it’s hard to get to the top of the competition,” Jones told The Roar Podcast. “We had proof that we could; we knew what we needed to do. We just had to get back to that.” For Jones, the answer was not necessarily a radical change to the programme. It was about executing the basics consistently, both on the field and in preparation. “We just do the basics better than anybody else,” he said. “Whether that is actually the way you play the game or how you’re preparing, it’s just be really consistent, do the basics really, really well.” Like many professional sports teams, the Roosters are entrenched in sports science and performance data. The club has access to a range of information, including players’ sleep, GPS metrics and neuromuscular scores, helping staff assess how individuals are coping with training and competition. “We are very science-backed, and some people would say data-driven, but it’s people first,” he said. “The reason you collect all this data is to try and be the best for that person.” Jones said the club was also prepared to reconsider testing methods if they were not generating useful discussions or helping staff make better decisions. In an environment where technology is continually evolving, he believes experience and gut instinct remain important. “The data is no good unless you have conversations,” he said. “When you strip it right back, mate, trust the gut still and obviously, you know, just doing the basics really, really well.” The return of halfback Sam Walker provided a further example of the importance of individual determination and the work of the club’s medical team. Walker underwent ankle surgery late in the regular season, with his premiership campaign appearing in doubt. However, he was determined to return for the preliminary final. Jones said Walker was back at the training ground three days after surgery, walking freely enough to surprise those around him. While the surgeon’s work was crucial, Jones credited the halfback’s mindset as a major factor in the remarkable turnaround. “He was quite clear with Robbo after he got the surgery that he was going to make it back for the prelim finals,” Jones said. The Roosters’ performance programme also sits within a wider club culture that Jones believes is central to their success. Each season, players develop their own team mantra through a lengthy process facilitated by Robinson. It provides principles that the squad can connect to its actions on the field. Rather than simply carrying over the previous year’s wording after a successful campaign, the club repeats the process because the players’ ownership of it is what gives it meaning. “When it’s led, player-owned and player-led, mate, it’s really powerful,” Jones said. Get more from Logan Savory in the Substack app Available for iOS and Android Get the app Jones joined the Roosters in 2024 and said the environment had evolved as experienced players departed and younger members of the squad took on greater responsibility. Maintaining continuity in the club’s culture and preparation had helped the group navigate those changes. The premiership was a significant achievement for Jones, who acknowledged how difficult it was to win the NRL’s ultimate prize. However, he is already looking at how the performance programme can improve. “There’s still things within my role and things that I’d like to help improve at the club,” he said. For Jones and his team, the challenge now is to review the season, refine their systems and prepare for another campaign. The celebrations may have followed a memorable title win, but the work behind the scenes never really stops. The Southland Tribune is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
NC's State Health Plan moves to block Atrium program it calls an 'unlawful pricing scheme'
North Carolina's State Health Plan announced Friday it had requested a temporary restraining order in Wake County Superior Court to halt Atrium Health’s new “affordability program.”
How Do Freedivers Cope With So Little Oxygen? Scientists May Have Found a Clue.
A small, unreviewed study linked freediving training to changes in brain connectivity, raising questions about adaptation to low oxygen.
Hope Network awarded federal grant to expand mental health resources
The Hope Network has received a $600,000 federal grant to expand mental health awareness and suicide prevention training across Michigan, helping an additional 5,000 people over the next three years learn how to recognize and respond to…
'A little puppy love': Meridian event highlights dogs' role in mental health
Organizers said events like PAWS for Mental Wellness help showcase the many ways animals can support people, whether through therapy visits, service dog training or simply companionship.
Tuipulotu is called in after Capstick ruled out
EXETER have signed No.8 Carwyn Tuipulotu for the rest of the season. The 25-year-old, who has represented Wales at Under-20 level, played in France last season for Pau and was a free agent. He has most recently been training with Dragons having previously played for Scarlets, and had a spell with Saracens in 2025. “After […] The post Tuipulotu is called in after Capstick ruled out appeared first on The Rugby Paper .
Health expert shares simple ways to help lower inflammation throughout the body
Clinical pharmacist Jim LaValle breaks down how diet, stress, medications, blood sugar, environmental exposures and even overtraining may contribute to inflammation — and why the gut-brain connection matters.
Informanté on Instagram: "Namibia urged to harness growing space science opportunities Staff Reporter NAMIBIA is positioning itself to benefit from the growing space economy through new satellite infrastructure, proposed legislation and expanded education and training opportunities, with young people urged to pursue science, technology, engineering and mathematics (STEM) careers. This was said by Dr Lisho Mundia, Deputy Executive Director for the Department of Higher Education, Training, Research and Innovation, who represented Education Minister Sanet Steenkamp at the official opening of World Space Week Namibia 2026 at the Windhoek High School Stadium on Monday. This year’s World Spac
1 likes, 0 comments - informante_news on October 10, 2026: "Namibia urged to harness growing space science opportunities Staff Reporter NAMIBIA is positioning itself to benefit from the growing space economy through new satellite infrastructure, proposed legislation and expanded education and training opportunities, with young people urged to pursue science, technology, engineering and mathematics (STEM) careers. This was said by Dr Lisho Mundia, Deputy Executive Director for the Department of Higher Education, Training, Research and Innovation, who represented Education Minister Sanet Steenkamp at the official opening of World Space Week Namibia 2026 at the Windhoek High School Stadium on Monday. This year’s World Space Week is being held under the theme “Rocket Revolution”, reflecting the transformation of space technology from the first human-made satellite launched in 1957 to modern spacecraft, satellites, space stations and missions beyond Earth. Full story: https://informante.web.na/?p=401904 Photo: National Commission on Research, Science and Technology - (NCRST)".
Training: Ready for the Reds
View the best images as City complete our final preparations ahead of our trip to Liverpool. Men's Team Maresca: Our players are ready for Anfield test After an extended international break, the retur...
NBA insider reveals potential Warriors' Kristaps Porzingis return timeline for unknown health issue
Kristaps Porzingis has not been to training camp after suffering an undsiclosed health issue. An NBA insider may know when the veteran center will come back.
Andoni Iraola hints at Liverpool striker gamble for Man City
Andoni Iraola has hinted that he may look to Bradley Barcola to act as an auxiliary striker in the absence of Alexander Isak.The Sweden international was missing from the club’s training sessions in...
Tottenham to fly to Marbella for team bonding
Tottenham manager Roberto De Zerbi to take his squad to Marbella for team-bonding training camp after clash against Manchester United
Kenya prepared for Ebola. It still slipped through — a warning of wider cross-border spread
Kenya had spent months preparing for Ebola, one of the world’s deadliest viral diseases, screening hundreds of thousands of travelers and training nearly 5,000 health workers in case it crossed the borders.
OpenAI's math dump rattles researchers who saw programs wiped out
OpenAI's release of hundreds of AI-generated math papers raised questions over its training data and what it would do to the academic norms in math.
Training: Getting ready for a return to action
View the best images from training on Friday... Features Liverpool v City: The Premier League returns! A long-awaited return to action following the international break is moving closer.City head to...
Carpenter’s heart attack after restraining donkey ruled compensable
A New York appeals court on Thursday upheld workers compensation coverage for a carpenter who suffered a heart attack after helping restrain a donkey at his employer’s owner’s residence.
NYC Health + Hospitals/Bellevue Strengthens New York City's Special Pathogen Preparedness through Specialized Hands-On Training
NYC Health + Hospitals/Bellevue today hosted around fifty health care workers from NYC Health + Hospitals/Elmhurst, NYC Health + Hospitals/Harlem, and NYC
OSHA awards $10.2M in safety and health training grants
Training and education will be aimed at small businesses in high-hazard industries.
Employee development shouldn’t stop at promotion
A promotion is only the beginning. For businesses competing to retain top talent, advancing employees into leadership roles can be a powerful investment, but a new title doesn’t automatically make someone an effective manager. As Business Report writes in its Best Places to Work issue, training, mentorship and ongoing support can help newly promoted employees […]
Marshfield Clinic earns $580K grant to address mental health
SAMHSA has awarded Marshfield Clinic a three-year Mental Health Awareness Training Grant of more than half a million dollars in Wisconsin.
Project ECHO helps primary care providers tackle treatment-resistant depression
Project ECHO at Penn State College of Medicine and the National Network of Depression Centers are launching a no-cost, virtual MBC training series to address treatment-resistant depression.
Back on the pitch: preparations ahead of Inter vs. Parma
With the international break now over, Inter returned to training at Appiano Gentile before the league picks up again. The Nerazzurri will take on Parma at San Siro on Saturday 10 October at 18:00 CES...
Training Gallery: Motherwell v Celtic
Club football is back upon us once more following the prolonged international break with the squad getting back to regular numbers as various Celts return from representing their countries.So Lennoxto...
Finding Joy Again: Sarah Adam on Mental Health and High Performance
There is a familiar message in elite sport: Keep going.Push through the hard training. Push through fatigue. Push through doubt. Push through the pressure.For Sarah Adam — the first woman named to the U.S. Wheelchair Rugby Paralympic Team, a silver med...
Why Weight Lifting Is Good for Your Heart
Strength training isn’t just for muscle and bone health — it’s also surprisingly good cardio.
Injury Boost For Newcastle With Will Osula Back In Training
The Denmark international’s return bolsters Matthias Jaissle’s attacking depth, providing a physical, high-intensity threat just as a grueling fixture list across three major competitions looms large.
Whitmer celebrates Michigan educators completing intensive Science of Reading training
LANSING, Mich. — On Wednesday, Governor Gretchen Whitmer announced that 8,019 Michigan educators have now completed Language Essentials for Teaching Reading and Spelling (LETRS) training, a program that helps educators strengthen their literacy instruction and implement proven methods, like phonics and comprehension, to empower kids in the classroom. This milestone comes after Michigan saw record […]
Rochester-area businesses expect boost from under-construction Micron plant near Syracuse
As construction of Micron's massive semiconductor plant gets underway near Syracuse, companies in the Rochester area are now recruiting and training to be a part of the semiconductor supply chain.
ICYMI: New Jersey Expands NJ FamilyCare-Approved Doula Trainings to 29 Programs
New Jersey Expands NJ FamilyCare-Approved Doula Trainings to 29 Programs
Stony Brook Brings AI Expertise to Long Island Small Businesses Through LIA-AI Growth Academy
Artificial intelligence can seem like a big concept for a small business. For 49 Long Island businesses, five months of training with Stony Brook University experts helped turn that concept into a plan. On September 24, the inaugural class of the LIA-AI Growth Academy gathered at Stony Brook’s Center of Excellence in Wireless and Information
Harkin Institute introduces digital accessibility initiative
The Harkin Institute for Public Policy and Citizen Engagement at Drake University has launched Inclusion by Design, a collaboration with Value Inclusion Inc. and Clear Vision LLC aimed at helping municipalities and other organizations improve digital accessibility. The initiative offers accessibility audits, user testing by people with disabilities, strategic planning, staff training and vendor management…
Law firm with Garden City office expands legal team
Moritt Hock & Hamroff is expanding its Garden City office. It has hired seven new associates from the 2026 law school graduating class. The firm emphasizes mentorship and AI training to prepare young lawyers for evolving legal challenges while growing its Long Island presence and maintaining a collaborative environment.
PSV Receive Major Injury Boost Ahead of SC Heerenveen Clash
Lutsharel Geertruida’s return to training bolsters Peter Bosz’s defensive options as the Eredivisie champions navigate a congested schedule and a lengthy absentee list for Friday's home fixture.
Bleav in Wizards Podcast: Anthony Davis Rumors, Wizards Preseason
On the latest episode of the Bleav in Wizards Podcast, we dissect the latest Anthony Davis rumors and break down everything you need to know from Washington Wizards' training camp and ahead of the preseason opener
I’m a personal trainer. This compact dumbbell set is the best addition to my home gym
If you want to step up your strength training at home, snag this compact set at a deal
Raphinha still not training with Barcelona ahead of Getafe clash
The Brazilian looks unlikely to feature on Saturday.
Scott McTominay returns to Napoli training after heart procedure
McTominay was diagnosed with a mild, benign arrhythmia in September
Lyon’s Mohamed Ouédraogo sustains serious knee injury
Olympique Lyonnais’ Mohamed Ouédraogo (23) has sustained a serious knee injury in training and is set to be absent for several months, as per a report from L’Équipe. Ouédraogo joined from Spart...
The radical idea that temperature sets when we sleep
Some scientists think that temperature could be just as important as light at training the body's circadian clocks.
India Research Center marks 10 years of public health impact | Harvard T.H. Chan School of Public Health
The India Research Center has evolved into a platform for research, training, and public health research translation.
Justin Casse passed on the family training business over 4:30 a.m. wake-ups. Now he owns stakes in about 100 racehorses across six countries
Casse built a global business spotting future champions—and learned that even the best judgment can’t guarantee a winning investment.
Bryan Seaver accused of evading service amid Dolly Parton estate lawsuit
After acquiring a restraining order against Dolly Parton's nephew Bryan Seaver, her company is leveling allegations that he implemented evasive measures to avoid being served legal documents in the
Hope Network awarded $600K grant to expand mental health training
Hope Network has been awarded a $600,000 federal grant to expand mental health and suicide prevention training statewide over the next three years.
Hope Network awarded $600K grant to expand mental health training
Hope Network has been awarded a $600,000 federal grant to expand mental health and suicide prevention training statewide over the next three years.
Hope Network awarded $600K grant to expand mental health training
Hope Network has been awarded a $600,000 federal grant to expand mental health and suicide prevention training statewide over the next three years.
Hope Network awarded $600K grant to expand mental health training
Hope Network has been awarded a $600,000 federal grant to expand mental health and suicide prevention training statewide over the next three years.
Hope Network awarded $600K grant to expand mental health training
Hope Network has been awarded a $600,000 federal grant to expand mental health and suicide prevention training statewide over the next three years.
Hope Network awarded $600K grant to expand mental health training
Hope Network has been awarded a $600,000 federal grant to expand mental health and suicide prevention training statewide over the next three years.
Baumgartner Takes Major Step Towards Leipzig Comeback
After 128 days sidelined by surgery, the Austrian playmaker rejoins team training to rescue a struggling attack missing his clinical finishing and veteran leadership from midfield.
Emre Can sidelined until 2027
Borussia Dortmund captain Emre Can has suffered a fresh injury blow. According to Bild, the 32-year-old will unlikely return to team training until after the international break after requiring surger...
Kristaps Porzingis still not around Warriors as he deals with “concerning” health condition
Kristaps Porzingis did not travel with the Warriors to Hawaii for training camp, was not at Tuesday’s preseason game at Chase Center
How combining science and community knowledge could shape coral reef conservation in Indonesia
Coral reefs in Indonesia’s Spermonde Archipelago are under pressure from both natural and anthropogenic activities. Researchers from Hasanuddin University assessed reef conditions across three islands using underwater photography and drone surveys, while also gathering local perspectives on reef conditions and restoration. They found greater live coral cover in clearer waters but limited community readiness to participate in conservation efforts, suggesting that training and institutional support could strengthen local communities’ role in protecting these natural treasures.
Sinclair Community College opens new Fire Science Academy
DAYTON, Ohio (WDTN) – Sinclair Community College is celebrating the grand opening of its new Fire Science Academy. The new Fire Science Academy training facility, which is located on Commerce Park …
Virginia ranked No. 1 for workforce training
Virginia ranks No. 1 for workforce training in Area Development’s 2026 report, while ranking No. 8 among Top States for Doing Business
Julia Stiles says it was ‘very wrong’ to play up dance training for “Save the Last Dance” at the time
The actress is competing on season 35 of “Dancing With the Stars” alongside pro partner Ezra Sosa.
Julia Stiles says it was ‘very wrong’ to play up dance training for ‘Save the Last Dance’ at the time
Julia Stiles said it was ‘very wrong’ of her to play up the dance training she had for ‘Save the Last Dance’ at the time while looking back at a 2000 interview she gave on set of the film.
Mental Health First Aid Training Offered in Lenawee County
Mental Health First Aid Training Offered in Lenawee CountyLenawee Community Mental Health Authority is sponsoring a Mental Health First Aid training on November 3 and November 10, from 4:00 p.m. to 7:
Coby White injury creates major problem for Hornets
A training camp injury for the Hornets' point guard could have ramifications as the regular season arrives.
The Kids in the Arena: Spectrum Business Keeps Florida Esports Facility Connected
With Spectrum Business Internet Gig, Valhallan Esports Training now has reliable high-speed, low-latency connectivity so young gamers have a safe, supportive environment to play their favorite games.
Podcast: Wizards Training Camp, Alex Sarr Update, Preseason Nears
On the latest episode of the DC Roundtable Podcast covering the Washington Wizards, we dive into the training camp storylines, update on Alex Sarr and what to watch in game one of the preseason
Workforce training program earns another No.1 ranking for Virginia
Virginia’s workforce training program has earned another No. 1 national ranking as the commonwealth competes for companies looking for workers trained for specialized jobs.Area Development, a major national trade publication, ranked Virginia first for workforce training programs in its 2026 Top States for Doing Business report. The recognition highlights the Virginia Talent Accelerator Program, which provides customized recruitment and training at no cost to qualifying companies opening or expanding operations in the commonwealth. a
De Roon to start alongside Kone vs Como
Roma returns to training today ahead of the trip to Como, scheduled for Sunday at 12:30. Gian Piero Gasperini will gradually reunite all the players who have been on international duty in recent weeks...
NYC Health + Hospitals/Woodhull Marks Simulation Week with Hospital-Wide Training to Advance Patient Safety and Clinical Readiness
NYC Health + Hospitals/Woodhull celebrated Simulation Week on September 25 with an interdisciplinary simulation event designed to strengthen
Tottenham’s International Returns For Manchester United Preparations
Tottenham’s internationals return in stages before Manchester United, leaving Roberto De Zerbi to balance training, travel and recovery at Hotspur Way.
Spurs employ three-guard lineup during Silver & Black Scrimmage
De'Aaron Fox, Stephon Castle and Dylan Harper played together in what coach Mitch Johnson called "on-the-job training."
Spurs' Harris questionable for regular-season opener after straining left calf
The 6-foot-8 power forward will be reevaluated following the team’s five-game preseason schedule.
Puka Nacua has a "pre-hernia"
With Rams receiver Puka Nacua having "core muscle" issues during training camp and then a hip/groin problem that caused him to miss two games, it began to seem as if Nacua might have a hernia.
Yale School of Medicine On the Science of Childhood Anxiety, Say, Anxiety Disorders Are the Most Common Mental Health Challenges In Youth
Credit: Matt Bradbury October 5, 2026 - By Isabella Backman - Anxiety disorders are the most common mental health challenges in youth. Left untreated, they can disrupt the lives of both children and their families. The good news is that with intervention, most children will overcome these conditions. Across Yale School of Medicine, scientists are working to understand anxiety at every level, from common anxious behaviors to molecular biomarkers in the brain. They are using their findings to develop and disseminate new evidence-based treatments for childhood anxiety. Today, the go-to treatment for childhood anxiety disorders is cognitive behavioral therapy (CBT). This is a form of psychotherapy that teaches children skills for confronting anxious thoughts and helps them practice managing situations that cause anxiety. While it is the gold-standard treatment backed by considerable scientific evidence, up to 50% of children will not see sufficient benefit from CBT alone. Wendy Silverman, PhD, Alfred A. Messer Professor in the Child Study Center, co-directs the Anxiety and Mood Disorders Program alongside Eli Lebowitz, PhD, associate professor in the Child Study Center. One of their main interests is learning how to improve outcomes beyond CBT. “We’re developing cutting-edge, research-based knowledge that can reduce the suffering that anxiety causes children and their families,” says Silverman. Changing parent behavior YSM experts are investigating how to improve CBT outcomes for children by involving the parents. Silverman’s research has uncovered two main components of parent intervention that improve childhood anxiety: not enabling children to completely avoid the things that make them anxious and taking steps to enhance their autonomy. Parents may unintentionally reinforce their child’s anxiety by allowing them to avoid what makes them anxious. They also may unintentionally limit the children’s sense of autonomy by being overly intrusive. “One of the things that we take pride in is that we’ve focused on trying to understand what parents need to do, and to test our ideas and see if changing the parents’ behaviors is enhancing the effects of CBT,” Silverman says. “Our findings thus far suggest that they do." As much as CBT can be helpful, it can also be challenging to get one’s child to do the necessary steps for CBT to work. This is one important reason why Lebowitz created a novel intervention program for parents named Supportive Parenting for Anxious Childhood Emotions (SPACE). Existing intervention programs often teach parents to act as therapists for their child, such as training them on how to practice breathing exercises. “It makes sense, but this doesn’t work very well in practice,” says Lebowitz. “And part of the reason, I think, is that it’s not easy to get your kid to do things, especially if they’re not excited about doing it.” SPACE is unique because it focuses entirely on parent involvement and changing parental behavior—children are not involved in the sessions. For example, parents learn how to use supportive messages that convey confidence that their child can tolerate and manage distress. “It might sound like a parent saying to a child, ‘I get that this is really hard for you, but I know that you can handle it,’” Lebowitz says. The program also works with parents to identify the ways in which they are accommodating anxious behaviors. “We’ll pick one thing that parents are doing that is an accommodation and help them make a detailed plan for how they’re going to change that,” Lebowitz explains. Treating Anxiety in Children and Adolescents Much of the existing research on SPACE has focused on parents of children under age 14. Ongoing studies are now exploring its use with parents of older teens. “Both anxiety and accommodation can interfere with normative developmental shifts during the teen years, including increased autonomy and individuation from parents,” says Rebecca Etkin, PhD, associate research scientist in the Child Study Center. “In this sense, SPACE may be particularly well-suited for anxious teens and their parents. We want to see whether it is effective during this distinct developmental window.” Unfortunately, many families in need of CBT face barriers, including limited availability of services and geographic constraints. One way to improve access is digital interventions. Silverman and her team are developing an evidence-based digitized intervention program for parents that they can access directly from their computer or smart phone. “The work we’re doing will be one of the very few parent interventions that is digitized and importantly tested for effectiveness,” she says. Creating interventions for anxiety-related challenges Silverman and Lebowitz recently received a generous gift to develop and test other interventions that help parents reduce other child anxiety-related behavioral and emotional difficulties, such as restrictive eating and unexplained somatic symptoms. One of these projects in particular focuses on understanding the risks of social media and its potential benefits, including offering a sense of connection. “A lot of research has focused on the idea that social media is harmful and the less of it the better,” says Lebowitz. “But we actually see is that this is not quite right—there are negatives, but there are also positives. So, we’re trying to get a little bit more nuanced of a picture.” The team is working with teens with social anxiety and their parents over an extended period to better understand their social media habits and how their anxiety levels affect engagement with different platforms. The teens will answer questions sent to an app on their phones about mood and social media usage in an effort to capture emotional responses as they unfold. “We hope to develop interventions that can help make the best of social media while protecting against the more problematic effects,” Lebowitz says. The brain’s role in anxiety Researchers are also testing therapies to address anxiety at the neurological and molecular levels. In collaboration with Dylan Gee, PhD, professor of psychology in Yale's Faculty of Arts and Sciences, and Hilary Blumberg, MD, John and Hope Furth Professor of Psychiatric Neuroscience at Yale School of Medicine, Lebowitz and Silverman are using brain imaging to identify changes in a child’s brain before and after parents enroll in SPACE. In one study, children viewed anxiety-inducing images while undergoing magnetic resonance imaging (MRI); the researchers conducted scans with and without the children’s parents nearby. Before SPACE, children’s brains were better able to activate the regulatory circuitry needed to turn off an anxious response when their parents were nearby. But after SPACE, children could activate this circuitry even without the parent around. “As parents work on gradually reducing some of their accommodations, you can see a child get better at regulating their own fear system in the brain,” Lebowitz says. “It’s remarkable.” Research into the molecular underpinnings of anxiety can also inform new childhood anxiety treatments. In a recent study, Lebowitz, Silverman, and Flora Vaccarino, MD, Harris Professor in the Child Study Center, discovered that a protein known as fibroblast growth factor 2 (FGF2) could be protective from the toxic effects of stress. FGF2 levels in children and their parents were linked to the children’s risk of developing anxiety and depression, the study showed. The findings could help explain why some children who are exposed to early life trauma such as poverty or abuse are more prone to developing mental health disorders. And FGF2 could be a target for treatment. “This is very novel because it starts to give a clue to what is the molecular chain that connects those lived experiences to the actual psychological outcomes,” Lebowitz says. New ways to study and treat childhood anxiety Michael Crowley, PhD, associate professor in the Child Study Center, collaborates with Silverman and Lebowitz to study the role that attention plays in development and maintenance of childhood anxiety. There is a large body of research that shows that anxious children, like anxious adults, are prone to focus on threatening stimuli such as angry faces compared with neutral faces. This has led to innovative interventions that involve attention retraining. The idea is that if experts train children to look away from threatening stimuli, it may reduce their anxiety—especially children with social anxiety who are most prone to attend to threats. The researchers have just completed a clinical trial for attention retraining with 10- to 14-year-olds with social anxiety disorders and are currently analyzing the findings. Besides this innovative attention retraining research, as Crowly notes, “I like to design tasks that are engaging to kids,” Crowley says. “My goal is to assess something without the kids knowing what we are assessing.” With this goal in mind, Crowley has created a virtual game, named Boom, to study threat processing in children with anxiety disorders. The game is similar to that of hot potato—the child and three digital players take turns virtually passing a ball to each other’s gloves. At some point, the ball turns into a bomb, and as the bomb lands in each player’s glove, the outline of the glove turns yellow. The goal is to avoid having the bomb go off in your glove. What isn’t obvious is that the game is designed to measure different types of threatening stimuli, both ambiguous and direct. In the game, the direct threat occurs as the bomb is traveling towards your glove. The ambiguous threat is the yellow outlined glove as it is unknown where the bomb will travel next. While children play the game, Crowley’s team measures their brain activity using electroencephalography (EEG). The researchers have discovered that in kids with anxiety, the brain reacts more strongly to ambiguous threats than it does in their peers, but less strongly to direct threats. They believe that the initial abnormally large brain response to not knowing where the bomb is going impairs the brain's ability to properly respond when the threat is actually traveling the child’s way. “The brains of children with anxiety are unable to differentiate between threats you need to do something about and those that are not your problem.” Michael Crowley, PhD, develops innovative games for studying anxiety in children and adolescents.Credit: Matt Bradbury Based on these insights, Crowley hopes to study whether interventions like attention training could restore appropriate threat processing. Crowley’s team is also working on a test called the Balloon Risk Avoidance Task, which evaluates risk-taking and avoidance behaviors. It features a digital balloon that is full of air and about to burst. Kids have six seconds to let air out of the balloon. The more air they let out, the less risk they face that the balloon will pop. But at the same time, the balloon becomes less valuable as it deflates. “The more air you keep in the balloon, the more points you get,” Crowley explains. So far, the researchers have found that when the balloons pop unexpectedly, teens with social anxiety show distinct brain responses. Studying these responses can help psychologists understand the underlying pathways driving the various manifestations of anxiety. The genetics of anxiety When Thomas Fernandez, MD, associate professor in the Child Study Center and of psychiatry, was still in training, there was a lot of excitement about understanding the genetics associated with autism spectrum disorder. Since then, scientists have identified around 250 genes associated with autism. The genetic contribution to anxiety disorders, on the other hand, has historically received less attention. Anxiety is less heritable than autism, but the genetic contribution for anxiety disorders that emerge in childhood may be higher than for anxiety disorders overall. While scientists estimate the heritability of anxiety disorders in general to be around 30% to 50%, some studies suggest higher heritability for certain childhood-onset anxiety presentations. “I saw firsthand how researchers in the field went about finding vulnerability genes for autism,” Fernandez says. “So, we’re using a very similar playbook for childhood anxiety.” “I saw firsthand how researchers in the field went about finding vulnerability genes for autism. So, we’re using a very similar playbook for childhood anxiety.” Thomas Fernandez, MD Associate Professor In the Child Study Center and in Psychiatry Now, Fernandez and Emily Olfson, MD, PhD, assistant professor in the Child Study Center, are studying children and their parents to identify genetic changes that are present in the child but not the parents, known as “de novo mutations.” “All of us have some de novo mutations—maybe about 50 to 100 sprinkled throughout the genome,” Olfson says. “But when they occur within the coding regions of genes, they can be really disruptive.” Previous research shows that people with autism have higher rates of damaging de novo mutations than the general population. In 2022, Olfson, Lebowitz, Silverman, and Fernandez published a study on 68 children and their families that found that children with anxiety had similarly high levels of these mutations. Studying de novo mutations can help point the researchers to where they should be looking for genes associated with anxiety. “The end game is using the genes to steer us toward the right part of biology that we can then target to come up with better treatments,” Fernandez says. Building on those findings, the team is now studying more families to better understand how these de novo mutations, along with other genetic and environmental factors, shape pediatric anxiety disorders. They recently received a National Institutes of Health grant to enroll 750 new families over the next five years. Olfson is the principal investigator, with co-investigators Lebowitz, Fernandez, Silverman, and Shuangge Steven Ma, PhD, department chair and professor of biostatistics at Yale School of Public Health. Neurodevelopment, Risk Genes, and Mental Health Conditions - The Olfson Lab Joel Gelernter, MD, Foundations Fund Professor of Psychiatry, is interested in how different anxiety disorders differ genomically. “We are studying social phobia, panic disorder, and generalized anxiety disorder, working to understand why people differ in their risk to these specific anxiety disorders and evaluating various risk factors,” he says. Gelernter was recently involved in one of the largest studies to date of the genomics underlying anxiety disorder. The study included around 122,000 people with anxiety disorders and around 730,000 without. It found that some genetic differences associated with anxiety were linked to signaling that helps reduce overactivity in the nervous system. Many anxiety medications available today work by targeting this process. “It’s nice when the biology that you get out of a large genome-wide study ratifies things that we already know because that can help increase confidence in further findings from the study,” Gelernter says. Uncovering the neurobiology of psychiatric disorders John Krystal, MD, Robert L. McNeil, Jr. Professor of Translational Research and chair of the Department of Psychiatry, is interested in the neurobiology of psychiatric disorders, including post-traumatic stress disorder (PTSD), of which anxiety is a major symptom. In the late 1980s, Krystal’s team discovered that the drug yohimbine activated symptoms in patients with PTSD. “This was the first time we could link a specific biological mechanism to the symptoms of PTSD,” Krystal says. At the time, he adds, this finding was highly controversial. “A lot of people felt that PTSD was a purely psychological syndrome that didn’t have an underlying biology.” Since then, Krystal has dived deep into understanding the neurobiology of PTSD to learn how to better treat it. His team is evaluating the use of ketamine and psychedelics. These would be among the first treatments to be developed specifically for PTSD. They may also be applicable for other disorders including anxiety disorders, Krystal adds. An important gap in PTSD treatment is the absence of biological tests that inform how to best help patients manage their PTSD symptoms. A doctor doesn’t diagnose cancer based on how they feel. Rather, they use tests of the biology of the cancer to determine the best course of treatment. “And we can’t do that in any psychiatric disorder other than Alzheimer’s disease,” Krystal says. “But now we are building a foundation for this approach to the treatment of anxiety disorders for the first time.” Source: Yale School of Medicine
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