We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The psychometric rigor of unsupervised, smartphone-based assessments and factors that impact remote protocol engagement is critical to evaluate prior to the use of such methods in clinical contexts. We evaluated the validity of a high-frequency, smartphone-based cognitive assessment protocol, including examining convergence and divergence with standard cognitive tests, and investigating factors that may impact adherence and performance (i.e., time of day and anticipated receipt of feedback vs. no feedback).
Methods:
Cognitively unimpaired participants (N = 120, Mage = 68.8, 68.3% female, 87% White, Meducation = 16.5 years) completed 8 consecutive days of the Mobile Monitoring of Cognitive Change (M2C2), a mobile app-based testing platform, with brief morning, afternoon, and evening sessions. Tasks included measures of working memory, processing speed, and episodic memory. Traditional neuropsychological assessments included measures from the Preclinical Alzheimer’s Cognitive Composite battery.
Results:
Findings showed overall high compliance (89.3%) across M2C2 sessions. Average compliance by time of day ranged from 90.2% for morning sessions, to 77.9% for afternoon sessions, and 84.4% for evening sessions. There was evidence of faster reaction time and among participants who expected to receive performance feedback. We observed excellent convergent and divergent validity in our comparison of M2C2 tasks and traditional neuropsychological assessments.
Conclusions:
This study supports the validity and reliability of self-administered, high-frequency cognitive assessment via smartphones in older adults. Insights into factors affecting adherence, performance, and protocol implementation are discussed.
Cancer health research relies on large-scale cohorts to derive generalizable results for different populations. While traditional epidemiological cohorts often use costly random sampling or self-motivated, preselected groups, a shift toward health system-based cohorts has emerged. However, such cohorts depend on participants remaining within a single system. Recent consumer engagement models using smartphone-based communication, driving projects, and social media have begun to upend these paradigms.
Methods:
We initiated the Healthy Oregon Project (HOP) to support basic and clinical cancer research. HOP study employs a novel, cost-effective remote recruitment approach to effectively establish a large-scale cohort for population-based studies. The recruitment leverages the unique email account, the HOP website, and social media platforms to direct smartphone users to the study app, which facilitates saliva sample collection and survey administration. Monthly newsletters further facilitate engagement and outreach to broader communities.
Results:
By the end of 2022, the HOP has enrolled approximately 35,000 participants aged 18–100 years (median = 44.2 years), comprising more than 1% of the Oregon adult population. Among those who have app access, ∼87% provided consent to genetic screening. The HOP monthly email newsletters have an average open rate of 38%. Efforts continue to be made to improve survey response rates.
Conclusion:
This study underscores the efficacy of remote recruitment approaches in establishing large-scale cohorts for population-based cancer studies. The implementation of the study facilitates the collection of extensive survey and biological data into a repository that can be broadly shared and supports collaborative clinical and translational research.
Online supermarkets are increasingly used both by consumers and as a source of data on the food environment. We compared product availability, nutritional information, front-of-pack (FOP) labelling, price and price promotions for food and drink products between physical and online supermarkets.
Design:
For physical stores, we collected data on price, price promotions, FOP nutrition labels and nutrition information from a random sample of food and drinks from six UK supermarkets. For online stores, we used foodDB, a research-ready dataset of over 14 million observations of food and drink products available in online supermarkets.
Setting:
Six large supermarket stores located near Oxford, UK.
Participants:
General sample with 295 food and drink products, plus boost samples for both fruit and vegetables, and alcohol.
Results:
In the general sample, 85 % (95 % CI 80, 90 %) of products found in physical stores could be matched with an online product. Nutritional information found in the two settings was almost identical, for example, concordance correlation coefficient for energy = 0·995 (95 % CI 0·993, 0·996). The presence of FOP labelling and price promotions differed between the two settings (Cohen’s kappa = 0·56 (95 % CI 0·45, 0·66) and 0·40 (95 % CI 0·26, 0·55), respectively). Prices were similar between online and physical supermarkets (concordance correlation coefficient > 0·9 for all samples).
Conclusions:
Product availability, nutritional information and prices sourced online for these six retailers are good proxies of those found in physical stores. Price promotions and FOP labelling vary between the two settings. Further research should investigate whether this could impact on health inequalities.
There are concerns that price promotions encourage unhealthy dietary choices. This review aims to answer the following research questions (RQ1) what is the prevalence of price promotions on foods in high-income settings, and (RQ2) are price promotions more likely to be found on unhealthy foods?
Design:
Systematic review of articles published in English, in peer-review journals, after 1 January 2000.
Setting:
Included studies measured the prevalence of price promotions (i.e. percentage of foods carrying a price promotion out of the total number of foods available to purchase) in retail settings, in upper-mid to high-income countries.
Participants:
‘Price promotion’ was defined as a consumer-facing temporary price reduction or discount available to all customers. The control group/comparator was the equivalent products without promotions. The primary outcome for this review was the prevalence of price promotions, and the secondary outcome was the difference between the proportions of price promotions on healthy and unhealthy foods.
Results:
Nine studies (239 344 observations) were included for the meta-analysis for RQ1, the prevalence of price promotions ranged from 6 % (95 % CI 2 %, 15 %) for energy-dense nutrient-poor foods to 15 % (95 % CI 9 %, 25 %) for cereals, grains, breads and other starchy carbohydrates. However, the I-squared statistic was 99 % suggesting a very high level of heterogeneity. Four studies were included for the analysis of RQ2, of which two supported the hypothesis that price promotions were more likely to be found on unhealthy foods.
Conclusions:
The prevalence of price promotions is very context specific, and any proposed regulations should be supported by studies conducted within the proposed setting(s).
Data from the in-school sample of the PROSPER preventive intervention dissemination trial were used to investigate associations between alcohol dehydrogenase genes and alcohol use across adolescence, and whether substance misuse interventions in the 6th and 7th grades (targeting parenting, family functioning, social norms, youth decision making, and peer group affiliations) modified associations between these genes and adolescent use. Primary analyses were run on a sample of 1,885 individuals and included three steps. First, we estimated unconditional growth curve models with separate slopes for alcohol use from 6th to 9th grade and from 9th to 12th grade, as well as the intercept at Grade 9. Second, we used intervention condition and three alcohol dehydrogenase genes, 1B (ADH1B), 1C (ADH1C), and 4 (ADH4) to predict variance in slopes and intercept. Third, we examined whether genetic influences on model slopes and intercepts were moderated by intervention condition. The results indicated that the increase in alcohol use was greater in early adolescence than in middle adolescence; two of the genes, ADH1B and ADH1C, significantly predicted early adolescent slope and Grade 9 intercept, and associations between ADH1C and both early adolescent slope and intercept were significantly different across control and intervention conditions.
Data drawn from the in-home subsample of the PROSPER intervention dissemination trial were used to investigate the moderation of intervention effects on underage alcohol use by maternal involvement and candidate genes. The primary gene examined was dopamine receptor D4 (DRD4). Variation in this gene and maternal involvement were hypothesized to moderate the influence of intervention status on alcohol use. The PROSPER data used were drawn from 28 communities randomly assigned to intervention or comparison conditions. Participating youth were assessed in five in-home interviews from sixth to ninth grades. A main effect of sixth-grade pretest maternal involvement on ninth-grade alcohol use was found. Neither intervention status nor DRD4 variation was unconditionally linked to ninth-grade drinking. However, moderation analyses revealed a significant three-way interaction among DRD4 status, maternal involvement, and intervention condition. Follow-up analyses revealed that prevention reduced drinking risk, but only for youth with at least one DRD4 seven-repeat allele who reported average or greater pretest levels of maternal involvement. To determine if this conditional pattern was limited to the DRD4 gene, we repeated analyses using the serotonin transporter linked polymorphic region site near the serotonin transporter gene. The results for this supplemental analysis revealed a significant three-way interaction similar but not identical to that found for DRD4.
The greenbug, Schizaphis graminum (Rondani), is a major pest of cereals in some parts of the world and is of particular concern because it can be resistant to some insecticides and overcome the resistance of crops. In the UK, it has never been found on crops, but two rather little-known and closely-related species (Schizaphis holci and Schizaphis agrostis) are associated with the wild grasses, Holcus lanatus and Agrostis stolonifera. Since 1987, winged (alate) aphids morphologically resembling the greenbug have been found in increasing numbers in 12.2 m high suction-trap samples of the Rothamsted Insect Survey (RIS); hence, studies were undertaken to establish their identity. Clones (=asexual lineages) established from populations collected from H. lanatus in southern England showed strong preference for Holcus over Agrostis and Hordeum in laboratory tests and produced sexual morphs when transferred to short-day conditions, the males being apterous, as expected for S. holci. Multivariate morphometric comparisons of alatae caught in UK RIS suction traps in 2007 and 2011 with named specimens from museum collections, including S. graminum from many countries, indicated that the suction-trapped alatae were mostly S. agrostis and S. holci. Cytochrome c oxidase subunit I (COI) mtDNA obtained from 62 UK specimens from suction-traps had 95.4–100% sequence identity with US specimens of S. graminum. Two of the UK specimens had identical COI sequence to the US sorghum-adapted form of S. graminum, and these specimens also had 100% identity with a 640 bp fragment of nDNA CytC, indicating that this form of S. graminum may already be present in the UK. Present and future economic implications of these results are discussed.
A new phase Zn3Cu4Sb2O12 was analyzed by X-ray powder diffraction. Its monoclinic unit cell parameters are a=21.0378(19) Å, b=8.7825(7) Å, c=5.5860(4) Å, and β=112.578(7)°, and the space group is either Cc (9) or C2/c (15). From comparison with density measurements, Z=4.
Poor-quality diet, regarded as an important contributor to health inequalities, is linked to adverse health outcomes. We investigated sociodemographic and lifestyle predictors of poor-quality diet in a population sample.
Design
A cross-sectional analysis of the Survey of Lifestyle, Attitudes and Nutrition (SLÁN). Diet was assessed using an FFQ (n 9223, response rate = 89 %), from which a dietary score (the DASH (Dietary Approaches to Stop Hypertension) score) was constructed.
Setting
General population of the Republic of Ireland.
Subjects
The SLÁN survey is a two-stage clustered sample of 10 364 individuals aged 18 years.
Results
Adjusting for age and gender, a number of sociodemographic, lifestyle and health-related variables were associated with poor-quality diet: social class, education, marital status, social support, food poverty (FP), smoking status, alcohol consumption, underweight and self-perceived general health. These associations persisted when adjusted for age, gender and social class. They were not significantly altered in the multivariate analysis, although the association with social support was attenuated and that with FP was borderline significant (OR = 1·2, 95 % CI 1·03, 1·45). A classical U-shaped relationship between alcohol consumption and dietary quality was observed. Dietary quality was associated with social class, educational attainment, FP and related core determinants of health.
Conclusions
The extent to which social inequalities in health can be explained by socially determined differences in dietary intake is probably underestimated. The use of composite dietary quality scores such as the DASH score to address the issue of confounding by diet in the relationship between alcohol consumption and health merits further study.
The bony skeleton of the larynx consists of the hyoid bone superiorly, and the thyroid and cricoid cartilages, from which the trachea is suspended. The thickened edge of the cricovocal membrane forms the cricovocal ligament, which is covered with mucous membrane and thus forms the vocal fold (cord). The vocal cord is responsible not only for phonation, but also for protection of the tracheobronchial tree from food and fluids during deglutition. The nerve supply of the vocal cords is largely by the recurrent laryngeal nerves, which originate from the vagus nerve within the thorax. On the right side the recurrent laryngeal nerve originates in the root of the neck, hooks around the right subclavian artery and ascends to the larynx between the trachea and oesophagus. On the left it originates at the level of the aortic arch in the thorax, hooks around the ligamentum arteriosum, and ascends to the right of the aortic arch, again between the trachea and oesophagus. Thus the left recurrent laryngeal nerve in particular is susceptible to involvement by mediastinal pathology.
The laryngeal prominence (Adam's apple) is formed by the junction of the two laminae of the thyroid cartilage. Below this is the cricoid cartilage, and between the two is the cricothyroid membrane which is the landmark used for emergency cricothyroidotomy or more commonly, the insertion of a minitracheostomy (Figure 19.1).
Insects are a key component of natural biodiversity, providing food for birds, mammals and other invertebrates, and pollinating many natural and cultivated plants. Despite this importance, there is a real lack of long-term data across Britain on the general abundance of most insect orders. An important source of information on aerial insect populations comes from the national network of 12.2 m high suction traps of the Rothamsted Insect Survey, which started operation with the first site in 1965. All aphids have been identified and counted from these samples and, of the 12 longest-running sites, seven show no trends, three increases and two overall declines in total aphid numbers. Recently a small sub-set of stored samples from these traps has been analysed for biomass and added to the aphid biomass to estimate total aerial biomass across all insect orders for four sites in southern Britain. At three of these sites there are no long-term trends, but the total biomass has declined severely at one site, Hereford. A more detailed analysis of the Hereford samples has been done, which indicated that the major component of the biomass decline is in the larger insects, particularly the Diptera (flies). Such declines may have been more widespread before the present sampling system was initiated, and may have had important conservation consequences, particularly for insectivorous birds and mammals.
Originally published in 2006, this authoritative clinical handbook provides a detailed overview of the main disorders encountered by child and adolescent psychiatrists in clinical practice, ranging from eating, sleep and affective disorders to substance abuse, gender identity disorder and sexual abuse. The approach is evidence based and emphasis is on good clinical practice and quality control of patient care. In contrast to other books in the field, the authors' intention is not to cover exhaustively all the relevant science, but rather to present in condensed form any research findings that are significant for clinical practice. For coherence, each chapter is constructed in the same way: introduction, definition and classification, epidemiology, the clinical picture, aetiology, treatment and outcome. The disorders covered are based on the ICD- 10 and DSM-IV classifications, and appendices include documents for assessment of intervention planning and evaluation.
A structured respondent-based version of the SADS-L interview was compared with a semi-structured investigator-based version of the same interview in terms of efficiency in assessing lifetime psychopathology. There was substantial agreement across most Research Diagnostic Criteria (RDC) categories, but there was less agreement on the rating of symptoms. The implications of these similarities and differences between the techniques are discussed.
Overweight and obesity are associated with increased morbidity and mortality, although the range of body weights that is optimal for health is controversial. It is less clear whether weight loss benefits longevity and hence whether weight reduction is justified as a prime goal for all individuals who are overweight (normally defined as BMI>25 kg/m2). The purpose of the present review was to examine the evidence base for recommending weight loss by diet and lifestyle change as a means of prolonging life. An electronic search identified twenty-six eligible prospective studies that monitored subsequent mortality risk following weight loss by lifestyle change, published up to 2008. Data were extracted and further analysed by meta-analysis, giving particular attention to the influence of confounders. Moderator variables such as reason for weight loss (intentional, unintentional), baseline health status (healthy, unhealthy), baseline BMI (normal, overweight, obese), method used to estimate weight loss (measured weight loss, reported weight loss) and whether models adjusted for physical activity (adjusted data, unadjusted data) were used to classify subgroups for separate analysis. Intentional weight loss per se had a neutral effect on all-cause mortality (relative risk (RR) 1·01; P = 0·89), while weight loss which was unintentional or ill-defined was associated with excess risk of 22 to 39 %. Intentional weight loss had a small benefit for individuals classified as unhealthy (with obesity-related risk factors) (RR 0·87 (95 % CI 0·77, 0·99); P = 0·028), especially unhealthy obese (RR 0·84 (95 % CI 0·73, 0·97); P = 0·018), but appeared to be associated with slightly increased mortality for healthy individuals (RR 1·11 (95 % CI 1·00, 1·22); P = 0·05), and for those who were overweight but not obese (RR 1·09 (95 % CI 1·02, 1·17); P = 0·008). There was no evidence for weight loss conferring either benefit or risk among healthy obese. In conclusion, the available evidence does not support solely advising overweight or obese individuals who are otherwise healthy to lose weight as a means of prolonging life. Other aspects of a healthy lifestyle, especially exercise and dietary quality, should be considered. However, well-designed intervention studies are needed clearly to disentangle the influence of physical activity, diet strategy and body composition, in order to define appropriate advice to those populations that might be expected to benefit.