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To test the feasibility of a browser extension to estimate the exposure of adolescents to (un)healthy food and beverage advertisements on Facebook and the persuasive techniques used to market these foods and beverages.
A Chrome browser extension (AdHealth) was developed to automatically collect advertisements seen by participants on their personal Facebook accounts. Information was extracted and sent to a web server by parsing the Document Object Model tree representation of Facebook web pages. Key information retrieved included the advertisement type seen and duration of each ad sighting. The WHO-Europe Nutrient Profile Model was used to classify the healthiness of products advertised as permitted (healthy) or not permitted (unhealthy) to be advertised to children.
Auckland, New Zealand.
Thirty-four Facebook users aged 16–18 years.
The browser extension retrieved 4973 advertisements from thirty-four participants, of which 204 (4 %) were food-related, accounting for 1·1 % of the exposure duration. Of those food advertisements, 98 % were classified as not permitted, and 33·7 and 31·9 %, respectively, of those featured promotional characters or premium offers. The mean rate of exposure to not permitted food was 4·8 (sd = 2·5) advertisements per hour spent on Facebook.
Using a Chrome extension to monitor exposure to unhealthy food and beverage advertisements showed that the vast majority of advertisements were for unhealthy products, despite numerous challenges to implementation. Further efforts are needed to develop tools for use across other social media platforms and mobile devices, and policies to protect young people from digital food advertising.
Self-reported measures for body mass index (BMI) are considered a limitation in research design, especially when they are a primary outcome. Studies have found some populations to be quite accurate when self-reporting BMI; however, there is mixed research on the accuracy of self-reported measurements in adolescents. The aim of this study is to examine the accuracy of self-reported BMI by comparing it with measured BMI in a sample of U.S. adolescents and to understand gender differences. This cross-sectional study collected self-reported height and weight measurements of students from five high schools in four states (Tennessee, South Dakota, Kansas and Florida). Trained researchers took height and weight of students for an objective measurement. BMI was calculated from both sources and categorized (underweight, normal, overweight and obese) using the Centers for Disease Control and Prevention's BMI-for-age percentiles. Participants (n 425; 51⋅0 % female) had a mean age of 16⋅3 years old, and the majority were White (47⋅5 %). Limits of agreement (LOA) analysis revealed that BMI and weight were underreported, and height was overreported in the overall sample, in females, and in males. LOA analysis was fair for BMI in all three groups. Overall agreement in BMI categorisation was considered substantial (Κ 0⋅71, P < 0⋅001). As BMI increased, more height and weight inaccuracies led to decreased accuracy in BMI categorisation, and the specificity of obese participants was low (50⋅0 %). This study's findings suggest that using self-reported values to categorize BMI is more accurate than using continuous BMI values when self-reported measures are used in health-related interventions.
OBJECTIVES/GOALS: Access to pediatric subspecialty care varies by sociodemographic factors. Providers for gender diverse youth (GDY) are rare, and GDY face health disparities, stigma, and discrimination. We examined the association between GDY access to medical and mental health care and rurality, race, parental education, and other GDY-specific factors. METHODS/STUDY POPULATION: We surveyed parents of GDY (<18 years old) across the United States. Participants were recruited through online communities and listserves specific to parents of GDY. We determined associations between access to gender-specific medical or mental health providers and rurality, race, parental education, as well as other GDY-specific factors including age, time since telling their parent their gender identity, parent-adolescent communication, parent stress, and gender identity using chi-square or Fisher’s exact tests. We calculated adjusted odds ratios using logistic regression models. RESULTS/ANTICIPATED RESULTS: We surveyed 166 parents and caregivers from 31 states. The majority (73.2%) identified as white, 66.5% had earned a bachelor’s degree or higher, and 7.6% lived in a zip code designated rural by the Federal Office of Rural Health Policy. We found no evidence of association between reported GDY access to medical or mental health care and race, parental education, or rurality. We did find a significant univariate association between access to mental health care and feminine (either female or transfeminine/transfemale) gender identity (p = 0.033, OR 2.60, 95% CI 1.06 – 6.36). After controlling for parent-adolescent communication in a backwards elimination logistic regression model, it was no longer significant (p = 0.137, OR 2.05, 95% CI 0.80 – 5.25). DISCUSSION/SIGNIFICANCE OF IMPACT: Despite rurality, race, and parental education impacting access to pediatric subspecialty care, we failed to find these associations among GDY accessing gender care. There is a need to better understand structural and societal barriers to care for this population including the impact of stigma and discrimination.
To assess changes in body mass and metabolic profiles in patients with first-episode schizophrenia receiving standardised, assured treatment and to identify predictors and moderators of the effects.
We investigated the changes in body mass, fasting blood glucose and lipids in 107 largely antipsychotic naïve, first-episode schizophrenia patients who were treated according to a standard algorithm with long-acting injectable flupenthixol decanoate over 12 months.
Eighty-three (78%) participants completed the 12 months of treatment, and 104 (97%) received 100% of the prescribed injections during their participation. There were significant increases in BMI (P < .0001), waist circumference (P = 0.0006) and triglycerides (P = 0.03) and decrease in HDL (P = 0.005), while systolic (P = 0.7) and diastolic blood pressure (P = 0.8), LDL (P = 0.1), cholesterol (P = 0.3), and glucose (P = 0.9) values did not change over time. The triglyceride: HDL ratio increased by 91%. Change in BMI was only correlated with change in triglycerides (P = .008). The only significant predictor of BMI increase was non-substance abuse (P = .002).
The risks of weight gain and metabolic syndrome associated with antipsychotic treatment in first-episode schizophrenia are not restricted to second generation antipsychotics. This is a global problem, and developing communities may be particularly susceptible.
Memory for speech benefits from linguistic structure. Recall is better for sentences than for random strings of words (the “sentence superiority effect”; SSE), and evidence suggests that ongoing speech may be organized advantageously as clauses in memory (recall by word position shows within-clause U shape). In this study, we examined the SSE and clause-based organization for closed-set speech materials with low semantic predictability and without typical prosody. An overall SSE was observed and accuracy by word position was enhanced at the clause boundaries for these materials. Next, we tested the effects of mental manipulation on the SSE and clause-based organization. Listeners heard word strings that were syntactic, were arranged syntactically then presented backwards, or were random draws. Participants responded to materials as presented or in reversed order, requiring mental manipulation. Clause-level organization was apparent only for materials presented in syntactic order regardless of response order. After accounting for benefits due to reductions in uncertainty for these close-set materials, an SSE was present for syntactic materials regardless of response order, and for the syntactic backwards condition with reverse-order response (yielding a syntactically correct sentence in the response). Thus, the SSE was both resistant to and could be obtained following mental manipulation.
‘It is nationalism which engenders nations, and not the other way round. Admittedly, nationalism uses the pre-existing, historically inherited proliferation of cultures or cultural wealth, though it uses them very selectively, and it most often transforms them radically. Dead languages can be revived, traditions invented, quite fictitious pristine purities restored.’ The late Ernest Gellner's pronouncement on the ficticity of national identities stands at the modernist extreme of an exciting and highly relevant debate about the provenance of nationalism. On the one hand, primordialists point to the historic continuity of ethnic and national groups from medieval, and, sometimes, ancient times: on the other, modernists point to the ways in which during the nineteenth and twentieth centuries the subethnic and highly localist peasantries of eastern Europe and Caucasia were transformed into ethnic nations, not least through the offices of nationalist intellectuals who endowed them with invented national pasts and distinctive written languages.
Despite their scepticism of primordialist claims, modernists recognise the need for compelling stories of ethnogenesis. In answer to the question ‘Do nations have navels?’, Gellner conceded that ‘some nations possessed ancient navels’, but argued that more ‘have navels invented for them by their own nationalist propaganda, and some are altogether navel-less’. By Gellner's lights, Scotland is an anatomical freak, a nation with two navels: one an authentic historic navel representative of a deep continuity from the Middle Ages of a lively Scottish national consciousness, the second involving modern retailoring of some scanty rags bequeathed from the ancient past. Traditionally, the Scots - a historic nation whose consciousness can be clearly documented from at least the turn of the fourteenth century - have traced their ethnogenesis back to the ancient west Highland settlement of Dalriada by Gaelic Scots from Ireland, and beyond. However, the shadowy Picts of Scotland's distant past have offered an alternative navel - ancient, yet also largely fabricated - for disaffected intellectuals. From the early eighteenth century through to the late twentieth century a variety of groups in quest of aboriginal historical legitimation, not only Scottish nationalists, but also Jacobites, celtophobic champions of Lowland Scots, a noted Marx-ist-Diffusionist, and, most recently, Ulster loyalists, have appropriated and reshaped an elusive Pictish antiquity to serve contemporary ideological needs.
This chapter offers a phenomenological analysis of changes in the structure of experience that fundamentally characterise both several main forms of neuropsychiatric illness and the nature of religious commitment. The use of the portmanteau term ‘neuropsychiatric’ acknowledges the fact that many of the conditions discussed in this chapter do not fit neatly within the shifting and unclear professional boundaries of psychiatry and neurology, a problem with which other chapters in this volume engage. In this chapter, in fact, I propose that these conditions are best understood phenomenologically in a way that challenges those professional partitions. Specifically, neuropsychiatric illness and religious commitment both involve distinctive changes to the structure of first-person experience that can be characterised phenomenologically in terms of altered existential feelings – a neglected set of affective states, currently a topic of research by philosophers, psychiatrists and cognitive scientists. Later in the chapter, I go on to make the further, stronger claim that the fundamentally phenomenological character of neuropsychiatric and religious experience assigns investigative and interpretive priority to phenomenology rather than to neuroscience. As a caveat before beginning, my claim is not that neuropsychiatric illness and religious commitment are identical or that religiosity is pathological, though doubtless they can be, and indeed surely are, complexly related in many cases.1 Instead, the claim is that what a person experiences during neuropsychiatric illness and in religious commitment ought to be understood phenomenologically in terms of alterations in their existential feeling.
Infants with CHD often experience growth failure. Ensuring optimal growth before surgery is associated with improved outcomes and has emerged as a significant cause of parental stress. Parents have reported a perceived lack of accessible feeding information for infants with CHD. To address this gap, the aim of this study was to develop feeding information to better support parents.
Materials and methods:
A search for existing material on six electronic databases and an internet search for unpublished (grey) literature on feeding information for infants with CHD were carried out. Following the development of feeding information, semi-structured interview(s) with parents/health-care professionals were completed, focusing on whether the information was easy to understand, relevant, provided sufficient information around feeding/feeding difficulties, and whether there were any information gaps. Iterative changes were made to the information following each interview. The process was completed until thematic saturation was achieved.
A total of 23 unique articles were identified of which 5 studies were included. From the grey literature, four web pages were reviewed. A total of 22 parents and 25 health-care professionals were interviewed. All parents/health-care professionals felt that the feeding information developed provided sufficient information; however, many wanted information on how to introduce complementary food, particularly if weaning was delayed.
This study describes the development of feeding information for infants with CHD. From parent interviews, gaps identified focused on the introduction of complementary foods and uncertainty regarding the feeding journey beyond surgery.
This article argues for a cross-culturally pluralistic conception of spiritual exemplarity. Three main modes of exemplarity are identified, distinguished by their underlying aspirations, which I label ‘allegiance’, ‘enlightened insight’, and ‘emulation’. After challenging some attempts to privilege the modes of exemplarity characteristic of theistic religions, I argue that perhaps the fullest example of the aspiration to emulation is the form of Daoism presented in The Book of Zhuāngzǐ. I conclude that what one finds across different cultures and traditions is a plurality of modes of spiritual exemplarity that should be acknowledge and explored, rather than given more reductive analyses that narrow our sense of the variety of ways of living a spiritual life.
Tombs and cairns present a dating challenge when the human remains are unstratified, incomplete and dispersed. By considering the distribution of time intervals between deaths as a possible a priori condition of multiple burials of select groups, a Bayesian model is suggested that may constrain the uncertainty date range of the group. The method may also address the wide uncertainties seen in radiocarbon calibration on a calibration curve plateau. The mathematical justification for the choice of Log Normal intervals, between death events, is first presented, followed by worked examples that compare the treatment of groups of 22 dates using Phase then Sequence with interval gaps. Finally, scenarios of potential Select Groups are examined, to demonstrate the efficacy of this alternative heuristic model to current model treatments.