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Minnesota gubernatorial candidates discuss business platforms at Economic Club discussion
Minnesota gubernatorial candidates Sen. Amy Klobuchar (DFL) and Rep. Lisa Demuth (R) faced off Monday afternoon in a forum hosted by the Economic Club of Minnesota. Each candidate took the stage independently to answer questions from a moderator for 30 minutes apiece.
Minnesota gubernatorial candidates discuss business platforms at Economic Club discussion
Minnesota gubernatorial candidates Sen. Amy Klobuchar (DFL) and Rep. Lisa Demuth (R) faced off Monday afternoon in a forum hosted by the Economic Club of Minnesota. Each candidate took the stage independently to answer questions from a moderator for 30 minutes apiece.
Week 7 schedule for Lubbock-area high school football
Here's the complete schedule for Week 7 games involving Lubbock and the South Plains.
Democrats could win majority of governor’s offices for first time in 16 years
As the political prospects for Republicans worsen ahead of November’s midterm elections, the GOP is increasingly playing defense over its yearslong grip on state governments. That’s particularly true for gubernatorial elections, as Democrats could win a majority of governorships for the first time since 2010. Currently, Republicans boast a 26-24 gubernatorial advantage over Democrats. This […]
From ‘feel-good’ to urgent: NC lawmakers move to act on gas taxes
If the legislature suspends the state gas tax, it would save North Carolinians 41 cents per gallon.
Lexington restaurant reopens after health department reinspection. Why it closed
The restaurant was one of three closed by the health department last month. All are now back in business. What happened?
Serie A returns: The biggest games after the international break
Serie A resumes after a three-week international break, and Football Italia looks at the biggest matches coming up in Italy’s top flight.Three teams lead the Serie A table: Inter, Roma and Lazio are...
Countdown now on to proper football returning
When the final whistle blew on the Premier League match at Craven Cottage on Sunday 20 September, we new it was going to be tough, but this tough??? Yes, this absolutely ridiculous three week break for largely meaningless internationals, so many pointless friendlies (including the Nations League nonsense). The Premier League had only kicked off four weeks earlier and then a break of three weeks so early in the season… Please let it make sense.
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...
India's Harmanpreet steps down as captain
India batter Harmanpreet Kaur leaves her role as national team captain across all three formats of international cricket.
Which Premier League players got injured during the international break?
The current international break has stretched well beyond what fans are used to.But the three-week break is set to end now, as football enthusiasts eagerly wait for the Premier League action to resume...
Climate Science Under Political Attack Reaches US Supreme Court
In 2018, local officials in Colorado sued oil companies in state court, charging that pollution from fossil fuels contributed to global warming and harmed
Big-Bank Strength, Local Business Insight
A government subcontractor had a chance to win its own contract — one that could increase revenue up to fivefold. A standard credit line based only on current revenue would […]
'Stop playing politics': Ginther, Council trade barbs over $2.5M Barack Center repairs
A fight over $2.5 million in repairs to a tornado-damaged Southside community center has escalated into a public political clash between Columbus Mayor Andrew G
Hochul, Blakeman campaign in Erie County as governor’s race enters final month
With less than a month until Election Day, the race for New York governor ran through Western New York Monday.
Sacramento’s Aftershock music festival draws record crowd during sweltering weekend
Festival organizers said attendance for the four-day music festival, which concluded Sunday, drew 15,000 more attendees this year.
Columbus Councilmembers say mayor playing politics over damaged rec center
Columbus City Councilmember Nancy Day-Achauer is accusing Mayor Andrew Ginther of using Barack Recreation Center as a "political prop" after it was damaged by a tornado in August.
Sacramento entertainment spot tops list of best escape room in the United States
Three other California escape rooms also made the list by USA Today.
Study: Does earlier menopause onset mean faster cognitive decline?
A new study found that women who experience earlier onset menopause had earlier cognitive decline and were diagnosed with Alzheimer's sooner.
Former SPASH teacher pleads not guilty to possessing child pornography
Daniel Hagstrom, a former science teacher at Stevens Point Area Senior High, pleaded not guilty Oct. 5 to 10 counts of child pornography possession.
U.S. Supreme Court declines request to consider Bellingham COVID-19 vaccine case
The denial means the lower court’s ruling will remain in effect, thereby signaling the end of the case.
Legends Radio spotlights JB Berkow’s lifelong art passion
JB Berkow is the founder of Benzaiten Center for Creative Arts in Lake Worth Beach. LEGENDS RADIO / COURTESY PHOTO This week's Legends Radio Local Artist Spotlight shines on accomplished artist and passionate advocate for the arts, JB Berkow. For more than five decades, JB Berkow has dedicated her life not only to creating art but also to making sure art has a place to thrive. Her work has been exhibited throughout the country in galleries, museums, and universities, and is held in permanent collections, including the Vatican’s Contemporary Art Collection in Italy, Boston University, and Palm Beach International Airport. Her passion for supporting other artists began early. At age 26, Berkow founded Touchstone Gallery in Washington, D.C., which became a highly successful cooperative gallery. She later brought that same entrepreneurial spirit to South Florida, founding Frenchman’s Art Gallery and Studios in Juno Beach in 1995. She opened Rosetta Stone Fine Art Gallery in 2003. In 2015, JB took her commitment to arts education even further by founding the nonprofit Benzaiten Center for Creative Arts. The 15,000-square-foot facility in Lake Worth Beach is home to Florida’s largest publicly accessible glassblowing hot shop and offers instruction in glassblowing, fusing, flameworking, and glass casting. The center also provides free classes to approximately 1,000 underserved children and young adults with disabilities each year. Its “Fragments Reimagined” art therapy program for veterans with PTSD recently received a $100,000 Impact 100 grant. In addition to her work as an artist and advocate, Berkow has authored four books, including Shades of Love and What They Didn’t Teach You in Art School. For JB, art has always been about more than creating something beautiful. It’s about opening doors, inspiring others, and making creativity an important part of life.That is why JB Berkow is in this week’s Legends Radio Local Artist Spotlight.
Danny Ward’s Error Costs Wales
Danny Ward’s error proved decisive in Wales’ defeat to Denmark. We examine his performance, international workload and the Wrexham implications.
Pittsburgh Oktoberfest returns with food, music and Ferris wheel
Pittsburgh's annual Oktoberfest celebration has officially kicked off with German-inspired food, drinks and entertainment in the heart of downtown Pittsburgh through Oct. 11.
Pittsburgh Oktoberfest returns with food, music and Ferris wheel
Pittsburgh's annual Oktoberfest celebration has officially kicked off with German-inspired food, drinks and entertainment in the heart of downtown Pittsburgh through Oct. 11.
McNeese’s College of Business Earns Reaffirmation of Accreditation
The McNeese State University College of Business has earned reaffirmation of its accreditation from AACSB International, The Association to Advance Collegiate
Executive MBA Grad Garners Industry Honors
The Daily Journal of Commerce has recognized Caitlin Powell, MBA '24, as one of its Women of Vision for 2026.
Art, science and climate futures converge through international symposium
What: SCI_ART: After the Data/Cultural Climate Futures Symposium Who: Artists […]
US says foreign financial institutions doing business with Iran may be sanctioned without notice
WASHINGTON, Oct 5 (Reuters) - The US Treasury Department said on Monday it was alerting foreign financial institutions that continue to do business with Iran or its financial sector that they may be sanctioned by Washington without advance notice.
Mass. business confidence rises in September but remains pessimistic
Massachusetts business confidence rose modestly in September after a sharp decline in August.
Is It Smart To Buy Science Applications International Corporation (NASDAQ:SAIC) Before It Goes Ex-Dividend?
Regular readers will know that we love our dividends at Simply Wall St, which is why it's exciting to see Science...
Wall Street Journal Puts Michigan’s Collapse on National Stage
The Wall Street Journal says Michigan is wobbling after the Minnesota loss dropped the Wolverines to 3-2. #GoBlue
Crystal Palace Women Head into International Break: How to Follow
Crystal Palace Women head into international break - who's playing?
'If You Can Keep It': Mental Health And Democracy
A veteran journalist covered the Jan. 6 attacks on the Capitol. That experience got her exploring the connection between stress, trauma, and our political choices.Our mental health might affect our politics. But our politics also definitely affect our mental health.In this edition of “If You Can Keep It,” we examine that intersection.Find more of our programs online. Listen to 1A sponsor-free by signing up for 1A+ at plus.npr.org/the1a.
WBJ seeks nominations of business executives who served in the military
Worcester Business Journal is seeking nominations of notable executives with military experience for the Focus on Veterans in Business edition. WBJ will highlight professionals who served in the country’s active […]
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.
Warner Bros. Executive Gerhard Zeiler to Enter Politics in Austria
Gerhard Zeiler, president of international for Warner Bros. Discovery, has declared his intention to enter politics in Austria.
Your Vote 2026 Maine Calling candidate interview: Bobby Charles, Republican for governor
Maine Calling host Jennifer Rooks interviews Republican gubernatorial candidate Bobby Charles ahead of the November election.
WindRose Health Network Discloses Data Breach Affecting 33K Individuals
Data breaches have been announced by WindRose Health Network and Advantage Home Health Care in Indiana, Camden-on-Gauley Medical Center in West Virginia, WindRose Health Network in Indiana has reported a data breach affecting more than 33,000 individuals. Data breaches have also been reported by Advantage Home Health Care in Indiana, Camden-on-Gauley Medical Center in West Virginia, and Lakes Region Visiting Nursing Association in New Hampshire.
RWJBarnabas Health President and CEO Mark E. Manigan Named 2026 NJBIZ Executive Excellence Honoree
Mark E. Manigan, President and Chief Executive Officer of RWJBarnabas Health, the largest, most comprehensive academic health system in New Jersey, has been named a 2026 Executive Excellence honoree by NJBIZ, recognizing his leadership and impact on New Jersey’s health care landscape. Mr. Manigan and the other honorees will be recognized by NJBIZ at an awards ceremony taking place today.
ASU designs a statewide pipeline for Arizona's anesthesia workforce
Every surgery, C-section, trauma case and cancer operation in Arizona depends on a clinician administering anesthesia and keeping the patient safe while the surgeon works. The state needs more of these clinicians.As of September, the Arizona State Board of Nursing lists 1,759 certified registered nurse anesthetists, or CRNAs, in the state. In 2023, Arizona was short 732 nurse anesthetists, and the shortage is projected to reach 868 by 2033.
Hoptoberfest and Art Walk combined for art, entertainment, and fun
COLDWATER, MI. - Downtown Coldwater was filled with hundreds of visitors Friday evening, Oct. 2, as Hoptoberfest and the annual Art Walk combined to create an evening of art, entertainment, and fun.
Philanthropy: Q+A with Gerun Riley
Gerun Riley is president of the Eli and Edythe Broad Foundation, a role she has held since 2016 after 13 years working for the Broads – who have given
1,800-year-old temple to Mars and statue of Victory unearthed at Roman military fort in Germany
Archaeologists in Germany have found a temple to Mars, the god of war, next to a Roman Empire military encampment.
Philanthropy: Q+A with William Ahmanson
William Ahmanson is the president of the Ahmanson Foundation, which financier Howard F. Ahmanson and his wife, Dorothy Grannis Ahmanson, established in
CT Business Blend: Oct. 5, 2026
Hartford Business Journal’s Greg Bordonaro and WTIC’s Brian Shactman explore the people, companies and trends shaping Connecticut’s business scene every Monday at 8:30 a.m. on WTIC 1080 AM.
58,000 Hoosiers not in compliance with new HIP work rules
The Indiana Family and Social Services Administration shared internal estimates Monday showing 58,000 Hoosiers insured through the Healthy Indiana Plan are not in compliance with federal work requirements set to take effect next year.
RWJBarnabas Health President and CEO Mark E. Manigan Named 2026 NJBIZ Executive Excellence Honoree
Mark E. Manigan, President and Chief Executive Officer of RWJBarnabas Health, the largest, most comprehensive academic health system in New Jersey, has been named a 2026 Executive Excellence honoree by NJBIZ, recognizing his leadership and impact on New Jersey’s health care landscape.
Weaner Pig Breakeven at $22.46, Up $12.25 From Last Week
When you consider that today’s purchased weaner would be sold in March 2027 using April 2027 futures, the weaner breakeven was $22.46, up $12.25 for the week, and $0.57 below the average cash price for the week of $23.03.
3 scientists share Nobel Prize in Physiology and Medicine for work in optogenetics
The Nobel Foundation awarded its prize in physiology and medicine Monday to three scientists who researched how nerve cells affect the brain.
Harold Crocker Attends 50th Annual Ventriloquist Convention In Kentucky
Falmouth’s Harold Crocker was among more than 600 attendees at the 50th Vent Haven International Ventriloquist Convention held in Kentucky in July.
Senate Unanimously Passes the Health Care Cybersecurity and Resiliency Act
A bipartisan bill that seeks to improve healthcare cybersecurity and resilience has been unanimously passed by the U.S. Senate. The bill - The Health Care The U.S. Senate has voted unanimously to advance the Health Care Cybersecurity and Resiliency Act, which requires more robust cybersecurity measures for healthcare organizations and authorizes grants to help rural and under-resourced providers improve cybersecurity.
Chevron elevates CFO to head oil and gas operations
HOUSTON, Oct 5 (Reuters) - Chevron Chief Financial Officer Eimear Bonner will become president of the US oil producer's oil, products and gas business, the company said on Monday.
Top Athletes: J|medical Brings Excellence in Sports Medicine to Allianz Stadium
On 2 and 3 October, Allianz Stadium hosted the second edition of “Top Athletes: Where Excellence Meets Evidence”, the International Congress promoted by J|medical, which brought together in Turi...
Who will rural voters blame for harmful healthcare changes, policies this election?
Inflation and affordability, immigration and international conflicts may be dominating much of the news—and voters' attention—but healthcare, as always, still matters at the ballot box—perhaps even more so for rural voters.
What we learned from Wales' Nations League window
On the back of a demanding four-game international window, BBC Sport Wales assesses the key talking points from Wales' Nations League A campaign so far.
USA vs. Canada: How to watch, stream international friendly
Two of Concacaf's elite teams clash Tuesday evening when the United States host Canada at Allianz Field, home of Minnesota United FC.How to watch & streamUSA: TNT, truTV, HBO Max, Universo, PeacockCan...
2026 Outstanding Women in Business
The 18th annual Outstanding Women in Business awards recognize a dozen well-accomplished professionals from across the region and in many industries who go above and beyond. The committee selected the winners from more than 80 nominations, all of whom were worthy. The criteria evaluated each nominee’s professional achievements, community impact, ability to break the glass ceiling and mentorship of other professionals, particularly women. In addition to profiling these women in the following pages, the Worcester Business Journal will celebrate this year’s Outstanding Women in Business at a special luncheon on Oct. 28 at the College of the Holy Cross. To join the celebration of these exceptional women, visit WBJournal.com and register. – Mark Conti, editor This Year’s Judges Worcester Business Journal considered 54 Central Massachusetts professionals for the 2026 Outstanding Women in Business awards, based on 83 nominations. These nominees were independently evaluated by two volunteer judges, who scored each on their professional achievements, community contribution and mentorship of young professionals. Samantha P. McDonald is a partner at Bowditch. She is an experienced, client-focused real estate lawyer, concentrating on business and real estate property law. She has been recognized as a WBJ Power 100 in the Class of 2026 and a “Top Women of Law” in Massachusetts Lawyers Weekly. Dr. Kavita Babu is chief medical officer and vice president of medical affairs at Heywood Healthcare, where she provides strategic and clinical leadership to advance high-quality, patient-centered care across the organization. She is also a member of the WBJ Outstanding Women in Business Class of 2025.
Conference to Explore Alternatives to Coercive Mental Health Care
The 18th annual Critical Voices Network Ireland (CVNI) conference will take place at University College Cork November 12 and 13, bringing together speakers and participants to explore critical and alternative responses to human distress.
See photos from the final day of Aftershock 2026
See photos from performances by Oleander, Dance Gavin Dance and others during the final day of Aftershock.
Chelsea is leading Arsenal in the race for England international
New England star Alex Scott is one of the most sought-after players in European football, and Arsenal wants to add him to its squad.The Bournemouth midfielder has established himself as an outstanding...
The Science Behind Female-Specific Firefighting PPE
Camilla Callesen, chief designer at VIKING Fire & Rescue, and retired firefighter Kendall Taylor discuss the research, engineering, and field testing behind the VIKING VALKYRIE.
Bruno Guimaraes Details Heavy Brazil Workload Ahead of Arsenal Return
Bruno Guimaraes has revealed the amount of travelling Brazil faced during a demanding international window before his return to Arsenal.
Pope Francis' diaries to be published next month, revealing reflections on Vatican years
Pope Francis' journal entries from his time in the Vatican and years before will be published this fall | WBBM Newsradio 780 AM & 105.9 FM
Pope Francis' diaries to be published next month, revealing reflections on Vatican years
Pope Francis' journal entries from his time in the Vatican and years before will be published this fall | Talk 1370
Pope Francis' diaries to be published next month, revealing reflections on Vatican years
Pope Francis' journal entries from his time in the Vatican and years before will be published this fall.
Heartland Catfish Unveils New Website
Heartland Catfish Company recently launched a new website in celebration of its 30th anniversary. The site has been refreshed to focus on retail and food service partnerships, give a detailed look at the company’s products and processes and emphasize consumer education about the benefits of U.S. Farm-Raised Catfish as a versatile and healthy protein source. […]
Three Japanese regional banks consider business integration
The Japanese lenders concerned are Procrea Holdings, Akita Bank, and Bank of Iwate.
Hunt Marketing Firm in Oxford Receives Accolade
For the third consecutive year, Hunt Marketing in Oxford has earned a place on the Inc. 5000 list of America’s fastest-growing private companies. Hunt ranked No. 4,009 on the 2026 list. “Being named to the Inc. 5000 list for a third time is meaningful because it validates the growth story we’re building,” said CEO and […]
Delta Health Center Receives Funding
Delta Health Center, Inc. has received four awards totaling $4,660,331.59 through the Mississippi Rural Health Transformation Program, a state initiative funded by the Centers for Medicare & Medicaid Services. Governor Tate Reeves announced the four RHTP awards on September 14, as part of 167 awards totaling more than $104 million statewide. The awards announced will […]
Delta Health Center Receives Funding
Delta Health Center, Inc. has received four awards totaling $4,660,331.59 through the Mississippi Rural Health Transformation Program, a state initiative funded by the Centers for Medicare & Medicaid Services. Governor Tate Reeves announced the four RHTP awards on September 14, as part of 167 awards totaling more than $104 million statewide. The awards announced will […]
Science Highlights Six Overlooked Pioneers Who Missed the Nobel Prize in Medicine
The international journal Science has spotlighted six groundbreaking achievements in the life sciences that never received Nobel Prize recognition.…
The Business of Civility
In an ever-coarsening world where even hosts on the bastion of conservative media, Fox News, are now using profanity on a regular basis, there is still one place where civility is demanded—and usually delivered. And that place is the business community. Whether you’re ordering a meal at McDonald’s or interviewing the wealthy CEO of Mississippi’s […]
International Coalition Endorses Kyoto Vision For A Golden Age Of Science
An international coalition of 17 countries have endorsed the Kyoto Vision for a Golden Age of Science. A joint declaration issued at the 23rd Annual Meeting of the Science and Technology in Society Forum held in Kyoto, reflects a shared ambition to renew and strengthen our science ecosystems and usher in a golden age of discovery and prosperity.
Arkansas will receive $10 million for maternal health
Olivia Walton announced her nonprofit will give $10M to Arkansas and $10M to Kentucky.
Huntsville Honored As ‘Secret Sauce Community’ At Heartland Summit
What’s Huntsville’s “secret sauce?”
RBI sees no signs of expropriation of Russian business, CEO says
Raiffeisen Bank International currently sees no signs of an expropriation of its Russian business, CEO Michael Hoellerer said on Monday, after several attempts by the Austrian lender to sell the division have failed.
Jagex responds to use of generative AI in RuneScape trailer made by "trusted external partner"
Developer removes promotional material as it investigates situation, says it highlights "an issue with our own processes which we must address"
The Daily Mauling: 10/5/26
Kansas Jayhawks News It’s official, Melvin Council, Jr is coming back to Kansas Jalon Daniels got his first NFL start this weekend. It didn’t go especially well, but he vows to use the lessons he learned moving forward What did we learn from the 55-0 drubbing of MTSU? The LJW weighs in The Topeka Capitol-Journal […]
25 Years of Business Income Insurance Coverage Claims Since the Attacks of Sept. 11, 2001
The 9/11 attacks reshaped business income insurance, spurring decades of litigation over loss calculations, restoration periods, expert evidence, and terrorism coverage. These disputes continue to influence claims and policyholder protections after major catastrophes.
Jobs in health care. Jobs for women. The US labour market is segmenting. Chernobyl’s radiation and Lenin’s love of literature.
Thank you for opening your Chartbook email. Elmer Bischoff, Two Figures at the Seashore, 1957 The only really dynamic job-creator in the US economy is health care: The largest crunch has come in Federal government, which has shed 2.7 m jobs. Source: tchouvkov on Twitter Tech is struggling. [ Joey Politano 🏳️🌈@JosephPolitano The US tech sector continues bleeding jobs in official data released today—overall, employment decreased by 17k last month and is down 69k over the last year That's nearly as bad as the worst of the 2024 tech-cession, and much worse than the 2022 boom or even pre-2020 norms 12:42 PM · Oct 2, 2026 · 15.2K Views 15 Replies · 47 Reposts · 390 Likes ](https://x.com/JosephPolitano/status/2106001807847940232?s=20) The new jobs are all for women. [ Justin Wolfers@JustinWolfers I'm not sure who saw this coming, but so far nearly all the jobs created during the second Trump administration have gone to women. 1:09 PM · Oct 2, 2026 · 33K Views 70 Replies · 146 Reposts · 644 Likes ](https://x.com/JustinWolfers/status/2106008723533533601?s=20) Meanwhile, real wages are being eaten up by modest over-target inflation. [ Heather Long@byHeatherLong The financial pain is real: Wage growth fell to 3% (y/y) in September. That's the lowest in 5 years. Wage growth: 3% Inflation: ~3.4% Inflation has eaten up all wage gains for the average worker since April. Many people are having to make hard choices about what to buy and what … 1:24 PM · Oct 2, 2026 · 37K Views 24 Replies · 275 Reposts · 533 Likes ](https://x.com/byHeatherLong/status/2106012367712620728?s=20) HEY READERS, THANK YOU for opening the Chartbook email. I hope it brightens your day. I enjoy putting out the newsletter, but tbh, what keeps this flow going is the generosity of those readers who clicked the subscription button. If you are persuaded to click, please consider the annual subscription of $60. It is both better value for you and a much better deal for me, as it involves only one credit card charge. Why feed the payments companies if we don’t have to. Subscribe Elmer Bischoff, Bathers, 1960 Americans are disillusioned with higher ed. For contributing subscribers only. Subscribe Where the Chernobyl radiation went. h/t Simon Kuestenmacher aka simongerman600 How Lenin’s love of literature shaped the Russian Revolution - Tariq Ali This, then, was the intellectual atmosphere in which Lenin came of age. His father, a highly cultured conservative, was the chief inspector of schools in his region and much respected as an educationalist. At home, Shakespeare, Goethe and Pushkin, among others, were read aloud on Sunday afternoons. It was impossible for the Ulyanov family – “Lenin” was a pseudonym adopted to outwit the tsarist secret police – to escape high culture. At high school, Lenin fell in love with Latin. His headteacher had high hopes that he might become a philologist and Latin scholar. History willed otherwise, but Lenin’s passion for Latin, and taste for the classics, never left him. He read Virgil, Ovid, Horace and Juvenal in the original, as well as Roman senatorial orations. He devoured Goethe during his two decades in exile, reading and rereading Faust many times. Lenin put his knowledge of the classics to good use in the time leading up to the October revolution of 1917. In April of that year, he broke with Russian social-democratic orthodoxy and, in a set of radical theses, called for a socialist revolution in Russia. A number of his own close comrades denounced him. In a sharp riposte, Lenin quoted Mephistopheles from Goethe’s masterwork: “Theory, my friend, is grey, but green is the eternal tree of life.” Source: The Guardian Elmer Bischoff, The River, 1953 If you’ve scrolled this far, you know you want to click: Subscribe
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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