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Preventive health is a broad term encompassing screening tests (e.g., for cancer, cardiovascular risk, or geriatric syndromes), healthy lifestyle counseling (e.g., nutrition and physical activity), immunizations, and safety considerations (e.g., falls, driving). These discussions become more important with age as a clinician considers an individual patient's goals and values, prognosis and life expectancy, and whether a patient is likely to benefit. The 4Ms (what Matters, Medications, Mentation, and Mobility) provide a useful framework for thinking about how to frame discussions with older adults in the primary care setting, and the Medicare Annual Wellness Visit provides an opportunity to review screening and prevention with an older adult and to update goals and preferences. The overarching goal should be to follow evidence-based practice, cause no harm to our patients, and align with what matters most to the patient.
Disruptions in neural circuits underlying emotion regulation (ER) may be a mechanism linking child maltreatment with psychopathology. We examined the associations of maltreatment with neural responses during passive viewing of negative emotional stimuli and attempts to modulate emotional responses. We investigated whether the influence of maltreatment on neural activation during ER differed across development and whether alterations in brain function mediated the association between maltreatment and a latent general psychopathology (‘p’) factor.
Youth aged 8–16 years with (n = 79) and without (n = 72) exposure to maltreatment completed an ER task assessing neural responses during passive viewing of negative and neutral images and effortful attempts to regulate emotional responses to negative stimuli. P-factor scores were defined by a bi-factor model encompassing internalizing and externalizing psychopathology.
Maltreated youth had greater activation in left amygdala and salience processing regions and reduced activation in multiple regions involved in cognitive control (bilateral superior frontal gyrus, middle frontal gyrus, and dorsal anterior cingulate cortex) when viewing negative v. neutral images than youth without maltreatment exposure. Reduced neural recruitment in cognitive control regions mediated the association of maltreatment with p-factor in whole-brain analysis. Maltreated youth exhibited increasing recruitment with age in ventrolateral prefrontal cortex during reappraisal while control participants exhibited decreasing recruitment with age. Findings were similar after adjusting for co-occurring neglect.
Child maltreatment influences the development of regions associated with salience processing and cognitive control during ER in ways that contribute to psychopathology.
Entry into graduate programmes is highly competitive. Although careers advisors working within higher education do their best to prepare students for engagement with these programmes; anecdotal reports suggest many graduates remain unsure what it is these employers are seeking, and how it is assessed. Our study examines both selection criteria profiles and practices, drawing comprehensive data from 20 New Zealand firms and finds that regardless of a firm's characteristics, most seek a very similar graduate profile, with the concepts of candidate ‘well roundedness’ and ‘fit’ considered most vital. Selection practices employed are tightly connected to this graduate profile. These findings shed some much needed light for graduates on what is, but also what is not, highly sought after by employers in the recruitment and selection process. They should also be of benefit to universities by assisting them to better prepare their graduates for successful transition into the employment market.
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