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Impairment in reciprocal social behavior (RSB), an essential component of early social competence, clinically defines autism spectrum disorder (ASD). However, the behavioral and genetic architecture of RSB in toddlerhood, when ASD first emerges, has not been fully characterized. We analyzed data from a quantitative video-referenced rating of RSB (vrRSB) in two toddler samples: a community-based volunteer research registry (n = 1,563) and an ethnically diverse, longitudinal twin sample ascertained from two state birth registries (n = 714). Variation in RSB was continuously distributed, temporally stable, significantly associated with ASD risk at age 18 months, and only modestly explained by sociodemographic and medical factors (r2 = 9.4%). Five latent RSB factors were identified and corresponded to aspects of social communication or restricted repetitive behaviors, the two core ASD symptom domains. Quantitative genetic analyses indicated substantial heritability for all factors at age 24 months (h2 ≥ .61). Genetic influences strongly overlapped across all factors, with a social motivation factor showing evidence of newly-emerging genetic influences between the ages of 18 and 24 months. RSB constitutes a heritable, trait-like competency whose factorial and genetic structure is generalized across diverse populations, demonstrating its role as an early, enduring dimension of inherited variation in human social behavior. Substantially overlapping RSB domains, measurable when core ASD features arise and consolidate, may serve as markers of specific pathways to autism and anchors to inform determinants of autism's heterogeneity.
The long-term effects of pediatric concussion on white matter microstructure are poorly understood. This study investigated long-term changes in white matter diffusion properties of the corpus callosum in youth several years after concussion.
Participants were 8–19 years old with a history of concussion (n = 36) or orthopedic injury (OI) (n = 21). Mean time since injury for the sample was 2.6 years (SD = 1.6). Participants underwent diffusion magnetic resonance imaging, completed cognitive testing, and rated their post-concussion symptoms. Measures of diffusivity (fractional anisotropy, mean, axial, and radial diffusivity) were extracted from white matter tracts in the genu, body, and splenium regions of the corpus callosum. The genu and splenium tracts were further subdivided into 21 equally spaced regions along the tract and diffusion values were extracted from each of these smaller regions.
White matter tracts in the genu, body, and splenium did not differ in diffusivity properties between youth with a history of concussion and those with a history of OI. No significant group differences were found in subdivisions of the genu and splenium after correcting for multiple comparisons. Diffusion metrics did not significantly correlate with symptom reports or cognitive performance.
These findings suggest that at approximately 2.5 years post-injury, youth with prior concussion do not have differences in their corpus callosum microstructure compared to youth with OI. Although these results are promising from the perspective of long-term recovery, further research utilizing longitudinal study designs is needed to confirm the long-term effects of pediatric concussion on white matter microstructure.
Pan-Americanism’s promotion of liberal internationalism and pan-Africanism’s appeals to transnational solidarity among African people(s) provided useful frames for critics of non-interference to make it the subject of debate. I argue that the content and political salience of pan-Americanism & pan-Africanism empowered – or even inspired – critics of non-interference in these regions. In this chapter I offer a long-term account of the (uneven) erosion of non-interference at the regional level in the global South, an account centering on the contestedness of this norm within the OAS and OAU compared to ASEAN during the Cold War period. This contestation (at the level of discourse) contributed over time to norm erosion (at the level of law and practice). Pan-Asianism did not serve the same function. Since non-interference was less contested in Southeast Asia (and not on these grounds), it was therefore more robust or resilient over time. Because of the history of norm contestation and erosion, the three regional groupings arrived at the 1980s with different normative priors. This meant that Latin America and Africa were more amenable to the intrusive regionalism trend than was Southeast Asia.
Because of variation in the discursive foundations of regionalism and in the degree and nature of norm contestation and erosion, Latin America, Africa, and Southeast Asia arrived at the end of the Cold War with different normative priors. These normative priors interacted with other key variables during the second wave of regionalism, one of which is regime type. Democratization in Latin America during the 1980s was extensive, and, by the end of this decade, the region boasted a high “density” of democracy. The achievement of this critical mass of democracies contributed to the renewal of the development of intrusive regionalism (especially aimed at democracy promotion) in the region. Neither Africa nor Southeast Asia has achieved this density. Although average democracy scores in these other regions have been on the rise in the last twenty years, they remain in the “anocracy” range. Even though high democratic density was not achieved in these two regions, though, individual states democratized, and emerging democracies with regional leadership aspirations, like South Africa and Indonesia, have been at the forefront of regional reform campaigns.
This conclusion both briefly revisits the causal arguments that make up the book’s general(izable) framework and highlights the role of idiosyncrasy, contingency, and agency in the divergent normative trajectories of regional societies of Latin America, Africa, and Southeast Asia. It then considers the applicability of the book’s theory to a new case – the “Arab” region (defined by membership in the League of Arab States).The last section of the chapter discusses the status of sovereignty in the South today; challenges for intrusive regionalism moving forward; and the normative implications of non-interference and its institutionalized violations.
This chapter examines Third World regional organizations’ discursive foundations, focusing on macronationalism as a movement and discourse, and tracing the development of the OAS, the OAU, and ASEAN. Decolonization produced sovereignty-sensitive states. It also, in some cases, produced regional international societies founded on macronational ideologies, like pan-Americanism and pan-Africanism. And because macronationalism appeals to values and solidarities that transcend the nation state, it holds the potential to challenge strict sovereignty norms. In Latin America and Africa, the establishment of regional organizations in some ways culminated pan-American and pan-African movements, but the formation of ASEAN did not culminate pan-Asianism – the latter had long lost favor in the wider region due to its cooptation by imperial Japan. ASEAN’s discursive foundations served more to reinforce strict sovereignty norms – in the long run – than to create openings for contestation of them. Non-interference did not have to compete with transnational pan-Asian discourses or liberal ideas about human rights and democracy that were more prominent in the African and Latin American cases.
This chapter addresses a puzzle set up in Chapter 5: Why did Africa become so much more intrusive than Southeast Asia in the post–Cold War period, given that neither region experienced widespread democratization? A partial explanation for this variation in outcomes is that Africa’s normative priors were different – by the time these regions arrived at the 1980s, the norm of non-interference had already eroded to a greater extent in Africa than Southeast Asia. In this chapter, I make the case for another more proximate factor – economic performance. Poor economic performance renders states materially and socially vulnerable and creates legitimacy deficits, and these vulnerabilities make states more open to normative and institutional reform. In Africa, reform took the form of more intrusive regional norms and institutions. Southeast Asia’s stellar economic performance prior to the 1997 financial crisis served to reaffirm and reinforce its norm set – including non-interference. The crisis prompted some reform (and some erosion of non-interference) but not to the same degree as in Africa.
This chapter introduces the reader to the repertoire of interference practices that regional communities use to promote democracy, security, and human rights. These include state monitoring (of elections and human rights practices) and crisis response in the form of mediation, sanctions, civilian missions, and military deployments. It also systematically measures variation across time (1960–2009) and space in the strength or status of the non-interference norm. It does so by tracing regional legal regimes relevant to non-interference and by comparing the interference practices of regional actors (using an original dataset). It argues that non-interference has long been weaker in Africa and Latin America than in Southeast Asia, and that this variation became more pronounced from the late-1980s onward, when regional interference converged on multilateral “liberal internationalist” practices. This chapter establishes the variation that the rest of the book seeks to explain.
This chapter introduces the intrusive regionalism trend and explains why it’s puzzling: It’s happening in the global South (where we expect states to be particular “jealous” of their sovereignty) and it’s uneven (it varies across regions in the global South). It then lays out the methodological approach of the book, which is comparative-historical analysis, and presents the book’s explanatory framework, which seeks to account for the uneven rise of intrusive regionalism in the global South. The theory section covers the changing ideational and institutional context at the global level; the role of macronationalism in creating openings for norm contestation and erosion; and two more proximate factors: regime type and economic performance. Chapter 1 concludes by outlining the plan for the book.
As international organisations gain greater power to monitor and manage the domestic affairs of their member states, the relationship between state sovereignty and international intervention becomes increasingly fraught. This book examines international rule-making in the Global South, tracing how the status of state sovereignty has evolved since decolonization. Coe argues that regional organizations flout the former norm of non-interference, becoming involved in the domestic affairs of their member states in Africa, Latin America, and (to a much lesser extent) Southeast Asia. In the name of democracy, human rights, and security, regional organizations increasingly assume jurisdiction over once off-limits domestic matters: they monitor elections and human rights and they respond to intrastate crises with mediation, fact-finding and sanctions. Coe explores the effects of democratization and economic crisis on regional institutions to explain the uneven development of 'intrusive regionalism' across the postcolonial world.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.