Saturday, April 29, 2023

Modern-day Scottish, Welsh and Northern Irish people have Pictish ancestry


PLOS

The Picts of Scotland who have long intrigued and have been ascribed exotic origins in fact descended from indigenous Iron Age society and were genetically most similar to people living today in Scotland, Wales, North Ireland and Northumbria. Adeline Morez of Liverpool John Moores University and Linus Girdland-Flink of the University of Aberdeen report these findings in a new study published April 27 in the journal PLOS Genetics.

The Picts, who inhabited early medieval Scotland from about 300-900 AD, formed the first documented kingdoms of eastern Scotland, but have often been a subject of mystery due to the lack of historical and archaeological evidence and due to their enigmatic symbol tradition inscribed on stone. In their new study, Morez and Girdland-Flink sampled Pictish burials to extract genomes to explore how the Picts are related to other cultural groups in Britain. They sequenced DNA from two individuals from central and northern Scotland that dated from the fifth to the seventh century AD. They compared the resulting high-quality genomes to more than 8,300 previously published ancient and modern genomes.

The analysis revealed that Picts descended from local Iron Age populations, who lived across Britain before the arrival of mainland Europeans. Additionally, the researchers found genetic similarities between the Picts and present-day people living in western Scotland, Wales, Northern Ireland and Northumbria. Medieval traditions, including from the time of the Picts themselves, had ascribed exotic origins to the Picts including them coming from Thrace (north of the Aegean Sea), Scythia (eastern Europe), or isles north of Britain, but the new research suggests much less sensational origins.

A further analysis of DNA sequenced from seven individuals interred in a Pictish cemetary showed that the individuals did not share a common ancestor on their mother’s side. This finding suggests that females may have married outside their own social group and runs counter to older speculation, such as that mentioned by the great English scholar Bede, that the Picts were matrilineal; that they had had a society based on kinship through the mother’s lineage.

The new findings support current archaeological theories that Picts descended from Iron Age people in Britain. The study also provides novel insights into the genetic relationships that existed amongst Pictish individuals buried in cemeteries together and between ancient Picts and present-day groups in the United Kingdom.

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Author Interview:

PLOS: What first drew you to study paleogenetics?

Dr. Morez: I always have been fascinated by human evolution overall: where are we from? How did we manage to settle worldwide and adapt to the wide diversity of environments? I chose to focus on paleogenetics, the study of ancient DNA, as it is a formidable opportunity to gain direct knowledge of an individual ancestry or a population's genetic diversity, free from inference based on modern genomes. And now, we actually see that the migrations and population mixtures are more numerous and complex than previously hypothesised.

PLOS:  What did you choose to investigate in this study, and why?

Dr. Morez: In this study, I chose to investigate the genetic ancestry of the Picts - people living in Scotland during the early medieval period (here from individuals buried in eastern and northern Scotland). It has never been done and many historical-based hypotheses stated that they were biologically diverse from their neighbours, with possible ties from the Eurasian steppes. Once we realised they were actually genetically very similar to their contemporaries living in the UK, we decided to push the limit in terms of analytical resolution using imputation of genotypes and analyses based on the autosomal haplotype information (chunks of DNA shared from parents to offspring, modify by mutation and recombination). It allows us to study the fine-scale genetic structure between the Picts and ancient and modern individuals from the UK and Europe.

PLOS: What are the key findings from your research on ancient Pictish genetics?

Dr. Morez: The two Picts studied here showed a greater affinity (by haplotype sharing) with present-day populations from western Scotland, Wales, Northern Ireland and Northumbria compared to the populations from southern England, which is important for understanding how present-day diversity formed in the UK.

Thanks to comparison with previously published genomes from Pictish people living in the Orkney islands, we could also show that individuals living in the Orkney and in mainland Scotland, likely gathered under the same cultural unit, were slightly divergent likely because of limited gene flow between the two regions and small population size in Orkney, which is known to speed up genetic divergence.

PLOS: What most surprised or interested you about your findings?

Dr. Morez: I was surprised to find that the two Pictish genomes from eastern and northern Scotland show a slightly higher but noticeable haplotype sharing with present-day people living in western Scotland, rather than with those from the East where Pictish culture is believed to thrive. This was unexpected and may be caused by several reasons; either we are detecting a population movement from the west of Scotland toward the east but which did not leave a long-lasting genetic signature, or later population movements in the East replaced some of the Pictish ancestry. We still don’t know which one is correct.

PLOS: What do you hope your findings might lead to, and what are the next steps for your research?

Dr. Morez: I hope the fascination for the Iron Age and medieval period in the UK will increase and lead to more genomes being discovered and analysed, to get a better understanding of the genetic structure across Scotland. Thanks to these genomes, those already published and the many more yet to come, the UK will soon become the first country where we understand in detail how genetic diversity has formed.

Future research will provide new information on the Pictish lifestyle, thanks to archaeologists from the University of Aberdeen and co-authors of the study. Gordon Noble who is reassessing and excavating new Pictish sites, and Kate Britton who investigates dietary habits and mobility using stable isotopes. Linus Girdland Flink (senior author, University of Aberdeen) is coordinating further research on Pictish DNA. This ongoing project will provide an excellent tool to facilitate interdisciplinary research to connect archaeology, archaeological science, history, and human population genetics.

 

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In your coverage, please use this URL to provide access to the freely available article in PLOS Genetics:

http://journals.plos.org/plosgenetics/article?id=10.1371/journal. pgen.1010360

Citation: Morez A, Britton K, Noble G, Günther T, Götherström A, Rodríguez-Varela R, et al. (2023) Imputed genomes and haplotype-based analyses of the Picts of early medieval Scotland reveal fine-scale relatedness between Iron Age, early medieval and the modern people of the UK. PLoS Genet 19(4): e1010360. https://doi.org/10.1371/journal.pgen.1010360

Author Countries: Germany, Sweden, UK

Funding: AM was supported by ECR strategic support of early career researchers in the faculty of science at LJMU, awarded to LGF. LGF was supported by the School of Geoscience, University of Aberdeen. KB was supported by the Leverhulme Trust (PLP-2019-284) during production of this manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Novel biomarker score could help measure adherence to Mediterranean diet

New evidence suggests Mediterranean diet may reduce type 2 diabetes risk more than previously thought

Peer-Reviewed Publication

PLOS

Novel biomarker score could help measure adherence to Mediterranean diet 

IMAGE: RESEARCHERS DEVELOPED A NEW WAY TO DETECT WHETHER SOMEONE FOLLOWS A MEDITERRANEAN DIET USING A BLOOD TEST AND SHOWED THAT A MEDITERRANEAN DIET IS ASSOCIATED WITH LOWER RISK OF TYPE 2 DIABETES. view more 

CREDIT: GALYAFANASEVA, PIXABAY (CC0, HTTPS://CREATIVECOMMONS.ORG/PUBLICDOMAIN/ZERO/1.0/)

Researchers have developed a novel way to detect whether a person follows a Mediterranean diet using a blood test and, applying this method, have shown that a Mediterranean diet is associated with lower risk of type 2 diabetes. Jakub Sobiecki of the University of Cambridge, UK and colleagues present these findings April 27th in the open access journal PLOS Medicine.

Prior research has shown that people who self-report that they follow a Mediterranean diet have a modestly lower risk of type 2 diabetes. However, the subjectivity of self-reports makes that link uncertain. Until now, the potential link between a Mediterranean diet and type 2 diabetes risk has not been evaluated using objective biological indicators—biomarkers—of adherence to the diet.

Sobiecki and colleagues developed a novel biomarker-based indicator of a Mediterranean diet that incorporates levels of certain molecules in the blood. First, the researchers identified that blood levels of 24 fatty acids and 5 carotenoids could be applied to predict whether participants from a clinical trial of 128 people were assigned to following a Mediterranean diet. Levels of these molecules in a person’s blood were used to calculate a biomarker score, which the researchers used as a measure of the extent to which they followed a Mediterranean diet.

Next, the researchers applied the biomarker score in a study of 340,234 people living in eight European countries, of whom 9,453 developed type 2 diabetes during follow-up and had relevant biomarkers measured. Comparing them with 12,749 participants who remained free of type 2 diabetes, the researchers found that people whose biomarker score indicated greater adherence to a Mediterranean diet were less likely to develop type 2 diabetes.

For comparison, the researchers also asked participants to self-report their diet. They found that using the biomarker score identified a stronger link between the Mediterranean diet and reduced risk of type 2 diabetes than when self-report was used. This finding suggests that previous self-report-based studies may have underestimated the association.

Based on these findings, the researchers argue that even a modest improvement in people’s adherence to a Mediterranean diet could meaningfully reduce the incidence of type 2 diabetes. However, they also point out that additional research will be needed to confirm and extend these new findings since it is currently unknown to what extent the biomarker score is specific for the Mediterranean diet.

Senior author Professor Nita Forouhi said, “Our research combining information from a dietary clinical trial and a large cohort study to identify and apply blood biomarkers for a dietary pattern is exciting and should stimulate development of improved methods to study diet-disease associations which are typically limited by reliance on subjective recall of eating.”

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In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicinehttp://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004221

Citation: Sobiecki JG, Imamura F, Davis CR, Sharp SJ, Koulman A, Hodgson JM, et al. (2023) A nutritional biomarker score of the Mediterranean diet and incident type 2 diabetes: Integrated analysis of data from the MedLey randomised controlled trial and the EPIC-InterAct case-cohort study. PLoS Med 20(4): e1004221. https://doi.org/10.1371/journal.pmed.1004221

Author Countries: United Kingdom, Australia, Spain, Germany, China, Italy, Colombia, France, Sweden, Norway, Denmark, and the Netherlands

Funding: see manuscript

Socio-economic inequalities in access to joint replacement surgery in England

Peer-Reviewed Publication

PLOS

Socio-economic inequalities in access to joint replacement surgery in England 

IMAGE: RESEARCHERS INVESTIGATED INEQUALITIES IN PROVISION OF JOINT REPLACEMENT FOR OSTEOARTHRITIS. view more 

CREDIT: TOWFIQU BARBHUIYA, PEXELS (CC0, HTTPS://CREATIVECOMMONS.ORG/PUBLICDOMAIN/ZERO/1.0/)

The provision of joint replacement surgery in England is subject to socio-economic inequalities, despite a years-long effort to reduce them. A study of hip and knee surgeries over a ten-year period, published April 27th in the open access journal PLOS Medicine, concludes that care providers must take further action to address variation in access to these frequently performed operations.

Joint replacements are cost-effective elective surgeries that are frequently performed in developed settings around the world. As populations age and obesity rises, the need for these surgeries is likely to increase, which will place an increasing public health burden on health systems. People living in the most deprived areas have the greatest need for surgery, and inequalities were reported in the UK over a decade ago. National Health Service (NHS) England has tried to address this, in part by delivering part of its publicly funded orthopedic activities within the private sector. With growing financial strain in the NHS, the current picture is unclear.

Erik Lenguerrand of the University of Bristol, UK, and colleagues merged data from the National Joint Registry and the Office for National Statistics official population statistics to investigate inequalities in provision of joint replacement for osteoarthritis. They identified all primary hip and knee replacements for osteoarthritis between 2007 and 2017 in England (675,342 hip and 834,146 knee replacements overall). Despite an overall improvement in the numbers of operations performed and less geographical variation in rates of surgery, inequalities between the most and least affluent areas remained large, and inequalities between most and least affluent areas have remained fairly constant.

For knee replacement, the social deprivation inequalities were only observed for the privately funded procedures, whereas for hip replacement, evidence of disparities was observed for both publicly and privately funded procedures. These findings could help healthcare commissioners to identify how joint replacement provision should be provided in the NHS to best address these disparities. One limitation was that this study was unable to investigate inequalities by certain important domains, such as ethnicity.

Lenguerrand adds, “Our study has shown that over the last decade socioeconomic inequalities in access to hip and knee replacement surgery remain wide, where those living in the most deprived areas have the least access to this surgery, even though they have the greatest clinical need.”

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In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicinehttp://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004210

Citation: Lenguerrand E, Ben-Shlomo Y, Rangan A, Beswick A, Whitehouse MR, Deere K, et al. (2023) Inequalities in provision of hip and knee replacement surgery for osteoarthritis by age, sex, and social deprivation in England between 2007–2017: A population-based cohort study of the National Joint Registry. PLoS Med 20(4): e1004210. https://doi.org/10.1371/journal.pmed.1004210

Author Countries: United Kingdom

Funding: see manuscript

Study suggests catalyst for human brain evolution

Large structural changes to the genomes of human ancestors could have spurred the smaller changes that set human brains apart from other primates

Peer-Reviewed Publication

GLADSTONE INSTITUTES

Gladstone scientists Kathleen Keough and Katie Pollard 

IMAGE: RESEARCHERS FROM GLADSTONE INSTITUTES KATIE POLLARD (RIGHT) AND KATHLEEN KEOUGH (LEFT) LED A STUDY THAT FOUND LARGE STRUCTURAL CHANGES TO THE GENOMES OF OUR ANCESTORS LIKELY SET OFF A CASCADE OF OTHER RAPID CHANGES IN HUMAN DNA THAT MAY UNDERLIE UNIQUELY HUMAN FEATURES, PARTICULARLY THE BRAIN. view more 

CREDIT: MICHAEL SHORT/GLADSTONE INSTITUTES

SAN FRANCISCO, CA—April 28, 2023—More than a million years ago, large chunks of the human genome were rearranged—a chance event during egg or sperm formation that led to the deletion, duplication, or reversal of sections of DNA. Those structural variants, researchers have now discovered, likely set off a cascade of other rapid changes in human DNA that may underlie uniquely human features, particularly the brain.

The new finding, published today in Science by researchers at Gladstone Institutes, came out of a study analyzing how stretches of DNA called human accelerated regions (HARs) differ between humans and chimpanzees. HARs are nearly identical among all humans, but differ between humans and all other mammals. Researchers have long wondered why these sequences—many of which control brain development—changed so rapidly in early human evolution.

“What we found is that many HARs are in regions of DNA where structural variants caused the genome to fold differently in humans compared to other primates,” says Katie Pollard, PhD, director of the Gladstone Institute of Data Science and Biotechnology and lead author of the new study. “This gave us an idea how HARs could have arisen in the first place.”

Folding like Origami

When comparing human and chimpanzee genomes nearly two decades ago, Pollard discovered regions of DNA—now called HARs—that were stable in mammals for millennia, but suddenly changed in early humans. Her lab has since shown that most HARs are enhancers, short stretches of DNA that regulate the activity of genes related to brain development. But researchers still have many questions about how HARs came about and the role they play in making humans distinct from other primates.

Pollard and her colleagues wondered whether other changes to the DNA surrounding HARs might help explain their origin. In collaboration with The Zoonomia Project, an international collaboration to study mammalian genomes, the researchers analyzed HARs and their surroundings in 241 mammalian genomes. They concluded that HARs tend to be located in areas of the human genome that have large structural differences when compared to other mammals.

So, the scientists next probed whether the structural variations around HARs might have changed the way the DNA folded.

“The way the genome folds up in three-dimensional space like origami is particularly important for enhancers,” explains Pollard, who is also a professor at UC San Francisco and a Chan Zuckerberg Biohub investigator. “That’s because enhancers can impact the activity of any gene that ends up close by, which can vary depending on how DNA is folded.”

To study the relationship between HARs and DNA folding, Pollard’s team used a machine learning model they previously developed to predict DNA folding patterns, and applied it to human and chimpanzee DNA sequences. Then, they identified the regions of the genome that folded differently in humans. The computer predicted that nearly 30 percent of HARs were in areas of the genome that folded differently in humans compared to chimpanzees.

“We realized that these human-specific structural changes may have created the right environment for HARs to evolve fast in the human ancestor, after remaining almost the same over millions of years of mammal evolution,” said Kathleen Keough, PhD, first author of the study and former postdoctoral scholar in the Pollard lab at Gladstone.

Piecing Together the Past

If DNA near HARs folded differently in humans and brought different genes in proximity to HARs, this could have had drastic consequences for our ancestors.

“Imagine you’re an enhancer controlling blood hormone levels, and then the DNA folds in a new way and suddenly, you’re sitting next to a neurotransmitter gene and need to regulate chemical levels in the brain instead of in the blood,” says Pollard. “Your instructions are now out-of-date and need to be changed.”

The predictions from the machine learning model suggested that large structural changes had occurred near HARs, but did not demonstrate which genes had fallen under their control. To address that question, Pollard and her colleagues carried out lab experiments that let them determine, in human and chimpanzee brain cells they derived from stem cells, what stretches of DNA were closest to hundreds of different HARs.

In many cases, they found, the human HARs were close to genes known to play a role in brain development; in some instances, the nearby genes were also associated with neurodevelopmental or psychiatric diseases.

Pollard’s team recently reported that the variations that rapidly appeared in HARs during early human evolution often opposed each other, first turning up the activity of an enhancer and then turning it down, or vice versa. The new results, she says, fit in well with the model proposed in that study.

“Something big happens like this massive change in genome folding, and our cells have to quickly fix it to avoid an evolutionary disadvantage,” said Pollard. “But the fix might kind of overdo it and need to be refined over time.”

While the new paper helps answer how HARs may have emerged in the beginning, Pollard’s team still has questions they plan to follow up on about why the massive structural changes survived the test of time and how HARs impact human brain development.

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About the Study

The paper “Three-dimensional genome re-wiring in loci with Human Accelerated Regions” was published in the journal Science on April 28, 2023.

Other authors are Sean Whalen and Pawel Przytycki of Gladstone; Fumitaka Inoue, Tyler Fair, Chengyu Deng, Marilyn Steyert, Hane Ryu, Tomasz Nowakowski, Nadav Ahituv, and Alex Pollen of UCSF; and Kerstin Lindblad-Toh and Elinor Karlsson of Broad Institute of Harvard and MIT.

The work was supported by a Discovery Fellowship, the National Institutes of Health (GR-01125,  DP2MH122400-01, NHGRI R01HG008742), the National Institute of Mental Health (R01MH109907, U01MH116438), the Schmidt Futures Foundation, the Shurl and Kay Curci Foundation, and a Swedish Research Council Distinguished Professor Award.

About Gladstone Institutes

Gladstone Institutes is an independent, nonprofit life science research organization that uses visionary science and technology to overcome disease. Established in 1979, it is located in the epicenter of biomedical and technological innovation, in the Mission Bay neighborhood of San Francisco. Gladstone has created a research model that disrupts how science is done, funds big ideas, and attracts the brightest minds.

Pulling the plug on viral infections: CRISPR isn’t just about cutting

Study shows how a Cas protein partners with a unique membrane protein to stop viral infection in bacteria


UNIVERSITY OF ROCHESTER MEDICAL CENTER

Membrane Protein Enhances CRISPR Anti-viral Defense 

IMAGE: STUDY IN SCIENCE SHOWS HOW A CAS PROTEIN PARTNERS WITH A UNIQUE MEMBRANE PROTEIN TO STOP VIRAL INFECTION IN BACTERIA. view more 

CREDIT: UNIVERSITY OF ROCHESTER MEDICAL CENTER

CRISPR claimed scientific fame for its ability to quickly and accurately edit genes. But, at the core, CRISPR systems are immune systems that help bacteria protect themselves from viruses by targeting and destroying viral DNA and RNA. A new study published in Science reveals a previously unrecognized player in one such system – a membrane protein that enhances anti-viral defense – simultaneously broadening our understanding of and raising more questions related to the complexities of CRISPR.

Uncovering New Clues about CRISPR

CRISPR systems consist of two major components – a guide RNA that targets a specific viral DNA or RNA sequence and a Cas enzyme that cuts the targeted DNA or RNA, preventing a virus from replicating and spreading. A team at the University of Rochester Center for RNA Biology found that a specific Cas protein (Cas13b) not only cuts viral RNA, but communicates with another protein (Csx28) to augment its anti-viral defense.

In partnership with scientists at Cornell, the team discovered that the Csx28 protein forms a pore-like structure (i.e. it has a big hole in it). When they infected E. coli with a phage (virus that attacks bacteria) and deployed the CRISPR-Cas13 system to target and halt infection, they found that Cas13 signals to Csx28 to affect membrane permeability. Once this happens, Csx28 wreaks havoc in the infected cell, discombobulating membrane potential, crushing metabolism and hindering energy production. A virus can’t replicate under such unhospitable circumstances, leading to the team’s conclusion that Csx28 enhances CRISPR-Cas13b’s phage defense.

“This finding upends the idea that CRISPR systems mount their defense only by degrading RNA and DNA in cells and really broadens our view of how CRISPR systems may be working,” said corresponding author Mitchell O’Connell, PhD, assistant professor of Biochemistry and Biophysics at the University of Rochester Medical Center (URMC) and a member of the UR Center for RNA Biology. “When we think about CRISPR, we see Cas proteins such as Cas9 or Cas13 as the big hammer doing all the damage, but that might not be the case; we found that Cas13 and Csx28 are working together to effectively extinguish a virus.”

“When you read this paper you think to yourself…‘what?’ This is such a weird mechanism and not the way I would have predicted that bacteria would work,” added John Lueck, PhD, assistant professor of Pharmacology and Physiology at URMC. “It is really impressive that the team identified this pore-like protein that doesn’t resemble anything else we’ve seen before, and now that we know that this mechanism exists people will start to look for it in other systems. This is exciting because in science, when you scratch the surface, you often find that there is an entirely new world behind it.”

More Questions than Answers

With the added knowledge of the structure of Csx28 through the use of high-resolution cryo-EM, the team is beginning to probe the function of the protein. Questions abound. If the goal is protection, why is there a giant hole in the membrane? The team found that when Cas13 isn’t around, Csx28 isn’t active. What makes it become active in defense? How long does it stay active and what does it let through the membrane? Understanding the biochemistry behind the opening and closing of the pore will shed light on how CRISPR-Cas13 uses it as part of its defense and provide a jumping off point for the study of membrane proteins across other CRISPR systems.

“This finding is unexpected and raises all kinds of new questions about how bacteria protect themselves and what they are doing to survive infection,” noted Mark Dumont, PhD, a professor of Biochemistry and Biophysics at URMC who has spent his career studying membrane proteins. “It is also a very interesting interface between RNA biology, CRISPR, structural biology and membrane biology. While there is no immediate medical relevance or application, the ideas that boil up from this could be very powerful.”

Lueck adds, “It is very rare for one study to have this many thought-provoking pieces that it brings several different fields together. And because the concepts are brand new, future work won’t be burdened by dogma. Any time people can bring fresh, unfettered ideas to the table it is really good for science.”

In addition to O’Connell, lead study author Arica VanderWal, PhD, a former graduate student in O’Connell’s lab who is now a postdoctoral researcher at UC San Diego, contributed to the research. Graduate students Julia K. Nicosia and Adrian M. Molina Vargas in the O’Connell lab, Bogdan Polevoda, PhD, research assistant professor of Biochemistry and Biophysics at URMC, and Elizabeth Kellogg, PhD, and Jung-Un Park from the department of Molecular Biology and Genetics at Cornell University also supported the research. The study was funded by the National Institutes of Health.

 

Connect, unplug and do good: Wellness tips for substance use and mental health recovery

“Journey to Wellness” is a new 20-page prescription for well-being created in part by a Rutgers wellness expert

Reports and Proceedings

RUTGERS UNIVERSITY

Wellness is big business, and every year millions of people commit to living happier, healthier lives. But for people with substance use and mental health disorders, the concept of wellness isn’t a typical part of recovery.

Margaret Swarbrick, professor and associate director of the Rutgers Center of Alcohol and Substance Use Studies, is working to change that. Her latest contribution, “Journey to Wellness,” is an easy-to-use 20-page guide co-created with people in recovery.

“Typically, people with mental health and substance use challenges are not involved in creating the interventions and tools that can support their recovery,” Swarbrick said. “Journey to Wellness was developed in response to this identified need.”

Many recovery programs are built around steps: Do this first for a prescribed amount of time, then proceed. Swarbrick said she wanted to make something that was more relatable and individual.

“A lot of what’s available to people in recovery is just so boring – impractical advice written by people with no lived experience,” she said. “That’s what makes Journey to Wellness so powerful.”

The guide was developed based on the lived experience of what people said had helped them to pursue and maintain recovery.  The guide is organized into four sections and prioritizes taking positive action. For example, human connections are crucial to recovery; the guide’s first tip is to connect with at least one person every day who supports your wellness.

“You can connect by talking to a friend, neighbor, or co-worker, by smiling at a stranger, or through a heart-to-heart conversation with someone you care about,” the guide suggests.

Another recommendation: Unplug. “This means taking a small break, even a minute or less, to relax. Literally unplug from technology, activities or whatever is happening around you. Taking a few moments for a few deep breaths, closing your eyes or looking out a window can help you disconnect if stress is building.”

Sleep is the third tip. The fourth? Do good – for yourself and others.

These concepts might seem obvious, but for people in recovery, self-healing strategies are easy to overlook, said Swarbrick.

Journey to Wellness was created using a co-production strategy – a process of research, service design and educational materials development where people with lived experience of mental health and/or substance use challenges share decision-making power throughout all stages of the process. The concepts are based on a wellness approach Swarbrick has been developing for decades called the Wellness Model. The process of creating and piloting the guide is detailed in a recent paper published in the Journal of Psychosocial Nursing and Mental Health Services.

The guide has been downloaded thousands of times since it was published, and the potential audience is exponentially larger, said Swarbrick. In 2020, more than 40 million Americans were living with a substance use disorder and 21 percent of adults – about 53 million people – were classified as having a mental illness, according to the Substance Abuse and Mental Health Services Administration. Since then, stress and substance use have increased, attributed in part to the COVID-19 pandemic and its aftermath.

“There’s no perfect formula for wellness, but there are things that everyone can do each day to create their own self-care prescription,” Swarbrick said.

Trauma-informed education could improve outcomes for justice-involved Black adolescents


Rutgers study finds link between childhood trauma, risky sexual behaviors and substance misuse


RUTGERS UNIVERSITY

Sexual and substance use education that incorporates knowledge about trauma could improve developmental outcomes among justice-involved Black youth, according to a Rutgers study published in the journal Children and Youth Services Review.

“For black adolescents in the justice system, childhood trauma greatly influences early life choices, particularly with sex, drugs and alcohol,” said Abigail Williams-Butler, an assistant professor at the Rutgers School of Social Work. “Trauma-informed sexual health education, coupled with substance misuse awareness, can improve wellbeing and might even lower rates of incarceration for these youth.”

To determine how adverse childhood experiences (ACEs) influenced the age of sexual debut (first intercourse), and substance use initiation (first experience with marijuana or alcohol) among incarcerated Black adolescents, Williams-Butler and Tyriesa Howard, an assistant professor of social work in the Brown School at Washington University in St. Louis, examined data from the Northwestern Juvenile Project (NJP).

Launched in 1995, the NJP was created at Northwestern University to assess the mental health needs and outcomes of youth after they entered the juvenile justice system.

A total of 368 Black adolescents (52.7 percent female) between ages 11 and 17 arrested in Cook County, Illinois, were surveyed as part of the NJP. Respondents self-reported history of sexual activity, substance use and adverse childhood experiences – traumas such as emotional, physical or sexual abuse; neglect; and household dysfunction (like an incarcerated relative).

Using this original data, Williams-Butler, Howard and colleagues conducted analyses to determine the effects of adverse childhood experiences on sexual debut, substance use initiation and engagement in sex under the influence.

What the researchers found was shocking: 97 percent of participants reported at least one adverse childhood experience and 82 percent reported a sexual debut before turning 15. More than 10 percent said they used alcohol or cannabis before they turned 11.

The researchers also found having a history of adverse childhood experiences influenced whether respondents had engaged in sex under the influence of drugs or alcohol, suggesting that childhood trauma influences substance use behaviors that contribute to risky sexual behaviors.

“What this data demonstrates is the need to include discussions about trauma in sexual health education,” said Howard. “For this population, sexual health needs to emphasize what people’s lived experiences look like and be intentional and direct about post-traumatic growth.”

While sexuality education curriculum varies widely by state, most programs tend to avoid discussions related to trauma, Williams-Butler said. This oversight is problematic for justice-involved youth, especially those arrested for activities that “may be seen as traumatic within themselves, such as engaging in survival sex …or running away from physical violence in their home caused by childhood victimization,” the researchers wrote.

Bringing a trauma-informed approach to sexuality education “honors their experiences – whether they are good, bad or really ugly – and acknowledges them in the rehabilitation process,” said Howard.

Williams-Butler said she hopes this research will eventually help expand trauma-informed adolescent sexual health programming, which in turn could reduce sexual harm, unplanned and unwanted pregnancies and sexual disease.