Objectives To assess physical activity (PA), mental health and well-being of adults in the UK, Ireland, New Zealand and Australia during the initial stages of National governments’ Coronavirus disease (COVID-19) containment responses. Design Observational, cross-sectional. Methods An online survey was disseminated to adults (n = 8,425; 44.5 ± 14.8y) residing in the UK, Ireland, New Zealand and Australia within the first 2-6 weeks of government-mandated COVID-19 restrictions. Main outcome measures included: Stages of Change scale for exercise behaviour change; International Physical Activity Questionnaire (short-form); World Health Organisation-5 Well-being Index; and the Depression Anxiety and Stress Scale-9. Results Participants who reported a negative change in exercise behaviour between pre-initial COVID-19 restrictions and during initial COVID-19 restrictions demonstrated poorer mental health and well-being compared to those demonstrating either a positive-or no change in their exercise behaviour ( p < 0.001). Whilst women reported more positive changes in exercise behaviour, young people (18-29y) reported more negative changes (both p < 0.001). Individuals who had more positive exercise behaviours reported better mental health and well-being ( p < 0.001). Although there were no differences in PA between countries, individuals in New Zealand reported better mental health and well-being ( p < 0.001). Conclusion The initial COVID-19 restrictions have differentially impacted upon PA habits of individuals based upon their age and sex, and therefore have important implications for international policy and guideline recommendations. Public health interventions that encourage PA should target specific groups (e.g., men, young adults) who are most vulnerable to the negative effects of physical distancing and/or self-isolation.

Breast MRI may be superior to mammography and ultrasound for the screening of women at high risk for hereditary breast cancer.

Objective: To determine whether nutrient intake and academic and psychosocial functioning improve after the start of a universal-free school breakfast program (USBP). Methods: Information was gathered from 97 inner city students prior to the start of a USBP and again after the program had been in place for 6 months. Students who had total energy intakes of <50% of the recommended daily allowance (RDA) and/or 2 or more micronutrients of <50% of RDA were considered to be at nutritional risk. Results: Prior to the USBP, 33% of all study children were classified as being at nutritional risk. Children who were at nutritional risk had significantly poorer attendance, punctuality, and grades at school, more behavior problems, and were less likely to eat breakfast at school than children who were not at nutritional risk. Six months after the start of the free school breakfast programs, students who decreased their nutritional risk showed significantly greater: improvements in attendance and school breakfast participation, decreases in hunger, and improvements in math grades and behavior than children who did not decrease their nutritional risk. Conclusion: Participation in a school breakfast program enhanced daily nutrient intake and improvements in nutrient intake were associated with significant improvements in student academic performance and psychosocial functioning and decreases in hunger.

Children from families that report multiple experiences of food insufficiency and hunger are more likely to show behavioral, emotional, and academic problems on a standardized measure of psychosocial dysfunction than children from the same low-income communities whose families do not report experiences of hunger. Although causality cannot be determined from a cross-sectional design, the strength of these findings suggests the importance of greater awareness on the part of health care providers and public health officials of the role of food insufficiency and hunger in the lives of poor children.

The Pediatric Symptom Checklist-17 (PSC-17) is a widely used, briefer version of the PSC-35, a parent-completed measure of children's psychosocial functioning. Despite the extensive use of the PSC-17 over the past 15 years there has not been a large-scale replication of the original derivation study.

Introducing the BHL into primary care was associated with an apparent change in clinical practice in primary care at the Philadelphia VA Medical Center. Not only were more patients identified, the broad-based approach of the BHL identified significant comorbidity with alcohol misuse, illicit drugs, and suicidal ideation, symptoms likely to have been missed in routine clinical practice. The BHL offers a practical, low-cost method of assessment, monitoring, and treatment planning for patients identified in primary care with MH/SA needs.

The Pediatric Symptom Checklist (PSC) is a brief, well-validated parent-report questionnaire designed to detect psychosocial dysfunction in school-age children during pediatric primary care visits. This study assessed the utility of the PSC when completed by children (PSC-Y) ages 9-14 in a public school when parents are not available (n = 173). The PSC-Y identified 20% of children as having psychosocial problems, a rate similar to other low-income samples. When compared with teacher ratings of attention and behavior problems, the PSC-Y showed a sensitivity of 94% and a specificity of 88%. The PSC-Y correlated significantly with teacher and parent measures of child dysfunction, and with child-reported symptoms of depression and anxiety. Three quarters of the children identified by the PSC-Y were not identified by parents on the PSC. These children had impairment on all other measures, but fewer than one in five had received mental health services, suggesting the PSC-Y identified children with unmet mental health needs. The PSC-Y has the potential to be a rapid, easily administered tool for large-scale mental health screening in schools.Psychosocial dysfunction in children, first recognized twenty years ago as the "new morbidity" in pediatric practice, is now the leading cause of disability in childhood and adolescence (Costello & Pantino, 1987;Costello et al., 1988aCostello et al., , 1988bKelleher & Wolraich, 1995). Epidemiological research indicates that 14 to 20% of American children have one or more psychiatric disorders in the moderate to severe range (Brandenburg, Friedman, & Silver, 1990). Poor and minority children, who are a growing proportion of our population, are at even higher risk (Bird et al., 1988;Costello et al., 1996a; Zahner, Pawelkiewicz, De francesco, & Adnopoz, 1992), and the overall prevalence of children's emotional and behavioral problems is increasing (Achenbach & Howell, 1993). Despite this growing prevalence, it is estimated that only one sixth to one half of the children with psychiatric disorders are identified. Of these, at most one fifth receive mental health services (Burns et al., 1995;Costello et al., 1988b). Numerous studies have shown that untreated mental health problems place children at risk for school failure and serious psychiatric complications, including antisocial and self-injurious behavior (Kessler, Foster, Saunders, & Stang, 1995;Koot & Verhulst, 1992; Rutter, 1991).Traditionally, pediatricians have been seen as primary resources for the recognition of psychosocial problems in children and adolescents (Costello & Pantino, 1987), and screening within pediatric primary care has been shown to improve recognition rates

This article provides an alternative conception of postconventional moral development which fits existing data on late adolescent and adult moral judgment better than Kohlberg’s higher stage descriptions. Moral judgment data from a longitudinal study of 26 undergraduates are scored by Kohlberg’s newly revised manual and replicate his original finding that a significant percentage of subjects appear to regress from adolescence to adulthood. The persistence of relativistic regression in these data suggests the need to revise the theory. The same hypothetical moral dilemmas are also scored according to an alternative coding scheme based on the hypothesis of an adult form of cognitive development. Results indicate that the Kohlberg regressors are progressors when evaluated against a standard of commitment in relativism instead of absolute principles of justice. Real-life data on the same subjects suggest that this progression is related to actual experiences of moral conflict and choice which lead to the restructuring of moral judgment to a more dialectical mode. It is suggested that this alternative notion of postconventional development is necessary for understanding (and scoring) adult moral judgment.