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Frequent use of screen-based devices could be a modifiable risk factor for adolescent depression, but findings have been inconsistent and mostly from cross-sectional studies. We examined prospective associations of video gaming, social media, and internet use with depressive symptoms in adolescents.
A total of 11 341 adolescents from the Millennium Cohort Study, a representative, UK population-based. The main outcome was depressive symptoms from a Moods and Feelings Questionnaire (age 14). Exposures were frequency of video game, social media, and internet use (age 11). Physical activity (effect modifier) was measured by self-report.
The fully adjusted models indicated that boys playing video games most days, at least once a week, and at least once a month at age 11 had lower depression scores at age 14 by 24.2% (IRR = 0.77, 95% CI 0.66–0.91), 25.1% (IRR = 0.75, 95% CI 0.62–0.90), and 31.2% (IRR = 0.69, 95% CI 0.57–0.83), compared with playing less than once a month/never. In girls, compared with less than once a month/never, using social media most days at age 11 was associated with 13% higher depression scores at age 14 (IRR = 1.13, 95% CI 1.05–1.22). We found some evidence of associations between using the internet most days and depressive symptoms compared with less than once a month/never in boys (IRR = 0.86, 95% CI 0.75–1.00). More frequent video game use was consistently associated with fewer depressive symptoms in boys with low physical activity, but not in those with high physical activity.
Different types of screen-time may have contrasting associations with depressive symptoms during adolescence. Initiatives to address adolescents’ screen-time may require targeted approaches.
Geomorphic mapping, landform and sediment analysis, and cosmogenic 10Be and 36Cl ages from erratics, moraine boulders, and glacially polished bedrock help define the timing of the Wisconsinan glaciations in the Chugach Mountains of south-central Alaska. The maximum extent of glaciation in the Chugach Mountains during the last glacial period (marine isotope stages [MIS] 5d through 2) occurred at ~50 ka during MIS 3. In the Williwaw Lakes valley and Thompson Pass areas of the Chugach Mountains, moraines date to ~26.7 ± 2.4, 25.4 ± 2.4, 18.8 ± 1.6, 19.3 ± 1.7, and 17.3 ± 1.5 ka, representing times of glacial retreat. These data suggest that glaciers retreated later in the Chugach Mountain than in other regions of Alaska. Reconstructed equilibrium-line altitude depressions range from 400 to 430 m for late Wisconsinan glacial advances in the Chugach Mountains, representing a possible temperature depression of 2.1–2.3°C. These reconstructed temperature depressions suggest that climate was warmer in this part of Alaska than in many other regions throughout Alaska and elsewhere in the world during the global last glacial maximum.
Simulation training has become a core component in the training of ENT surgeons. It provides the opportunity for the repetitive practice of a surgical technique. Simulators are broadly categorised into low- and high-fidelity simulators. A method using a home microprocessor to enhance a low-fidelity surgical simulator is introduced.
The Yorick tonsil tie trainer was enhanced using an Arduino microcontroller attached to the simulated inferior pole of the tonsil. The Arduino was coded to give a visual stimulus when linear motion exceeded parameters. The prototype simulator was tested to gain information on whether the enhancement could identify differences between novice and expert users.
An enhanced low-fidelity tonsil trainer was produced using a low-cost, simple home microprocessing board. The enhanced simulator gives objective feedback allowing for self-directed learning. Further research is required to evaluate the benefits of these enhancements above non-enhanced simulation training.
While the story of Caribbean literature in English generally focuses on its emergence in relation to Great Britain, Caribbean writers also urgently explored the Caribbean’s relationship to the United States. US imperialism in the region was most explicit with the US presence in Cuba and Puerto Rico after the Spanish-American War, in the occupations of Haiti and the Dominican Republic in the 1910s to 1930s, and in its post-World War II involvement in various territories. Caribbean migration into the US fuelled the alliances that Brent Hayes Edwards describes as ‘the practice of diaspora’. In the 1920s, Caribbean activists and writers such as Hubert Harrison, Claude McKay, and Eric Walrond helped shape the Harlem Renaissance. That movement’s aesthetic experiments and pan-African identifications inspired the development of literature within the region. The United States was also a hub from which some writers travelled to other parts of the world (Russia, France, the UK) and became part of a network of mutual influences. US writers such as Langston Hughes and Zora Neale Hurston travelled to the Caribbean. Later, the ranks of the predominantly male writers in the United States were expanded with the emergence of women writers such as Audre Lorde and Paule Marshall, and growing Caribbean immigration to the US coupled with the rise of US cultural institutions meant that the US location continued to influence Caribbean writing.
Recently developed quantitative models of psychopathology (i.e., Hierarchical Taxonomy of Psychopathology) identify an Antagonistic Externalizing spectrum that captures the psychological disposition toward criminal and antisocial behavior. The purpose of the present study was to examine relations between Antagonistic psychopathology (and associated Five-Factor model Antagonism/Agreeableness) and neural functioning related to social-cognitive Theory of Mind using a large sample (N = 973) collected as part of the Human Connectome Project (Van Essen et al., 2013a). No meaningful relations between Antagonism/Antagonistic Externalizing and Theory of Mind-related neural activity or synchrony were observed (p < .005). We conclude by outlining methodological considerations (e.g., validity of social cognition task and low test–retest reliability of functional biomarkers) that may account for these null results, and present recommendations for future research.
This study aimed to examine the predictors of cognitive performance in patients with pediatric mild traumatic brain injury (pmTBI) and to determine whether group differences in cognitive performance on a computerized test battery could be observed between pmTBI patients and healthy controls (HC) in the sub-acute (SA) and the early chronic (EC) phases of injury.
203 pmTBI patients recruited from emergency settings and 159 age- and sex-matched HC aged 8–18 rated their ongoing post-concussive symptoms (PCS) on the Post-Concussion Symptom Inventory and completed the Cogstate brief battery in the SA (1–11 days) phase of injury. A subset (156 pmTBI patients; 144 HC) completed testing in the EC (∼4 months) phase.
Within the SA phase, a group difference was only observed for the visual learning task (One-Card Learning), with pmTBI patients being less accurate relative to HC. Follow-up analyses indicated higher ongoing PCS and higher 5P clinical risk scores were significant predictors of lower One-Card Learning accuracy within SA phase, while premorbid variables (estimates of intellectual functioning, parental education, and presence of learning disabilities or attention-deficit/hyperactivity disorder) were not.
The absence of group differences at EC phase is supportive of cognitive recovery by 4 months post-injury. While the severity of ongoing PCS and the 5P score were better overall predictors of cognitive performance on the Cogstate at SA relative to premorbid variables, the full regression model explained only 4.1% of the variance, highlighting the need for future work on predictors of cognitive outcomes.
Fungal endocarditis classically involves dense heterogenous vegetations. However, several patients with fungal infections were noted to have myocardial changes ranging from focal brightening to nodular thickening of chordae or papillary muscles. This study evaluates whether these findings are associated with fungal infections.
In a retrospective case–control study, paediatric inpatients with fungal infections (positive blood, urine, or catheter tip culture) in a 5-year period were matched 1:1 to inpatients without positive fungal cultures. Echocardiograms were scored on a 5-point scale by two independent readers for presence of myocardial brightenings, nodular thickenings, and vegetations. Clinical data were compared.
Of 67 fungal cases, positive culture sites included blood (n = 44), vascular catheter tip (n = 7), and urine (n = 29); several had multiple positive sites. “Positive” echo findings (score ≥ 2+) were more frequent in the Fungal Group (33 versus 18%, p = 0.04). Fungal Group patients with “positive” versus “negative” echo findings had similar proportion of bacterial infections. Among fungal cases, those with “positive” echo findings had longer hospital length of stay than cases with “negative” echos (median 58 versus 40 days, p = 0.03) but no difference in intensive care unit admission, extracorporeal membranous oxygenation support, or mortality.
Myocardial and papillary muscle brightening with nodular thickening on echocardiogram appear to be associated with fungal infections. There may be prognostic implications of these findings as patients with “positive” echo have longer length of stay. Further studies are needed to better understand the mechanism and temporal progression of these changes and determine the prognostic value of this scoring system.
This pilot study tested the feasibility, acceptability, and effect-sizes of a multimodal, individual intervention designed to optimize antipsychotic medication use in patients ≥40 years of age with schizophrenia or schizoaffective disorder.
We randomized 40 patients into two groups: usual care (UC) or a nine-session, manualized, antipsychotic adherence intervention (AAI). the AAI attempted to improve adherence by combining three psychosocial techniques:
b. skills training, and
c. alliance building.
Sessions employed a semi-structured format to facilitate open communication. the primary outcome was antipsychotic adherence at study end. We obtained qualitative data regarding patient preferences for the duration and modality for receiving the adherence intervention.
Compared to the UC group, a greater proportion of the AAI group was adherent post-intervention based on medication possession ratio, a commonly used measure of medication adherence (85% vs. 66.6%; OR=2.64), a difference that was statistically not significant. the entire AAI group reported that they intended to take medications, and 75% were satisfied with the intervention.
The AAI was feasible and acceptable. Preliminary data on its effectiveness warrant a larger study. Qualitative data shows that patients prefer brief adherence interventions and accept telephone strategies.
Diversity is key for sustainable weed management and can be achieved via both chemical and nonchemical control tactics. Genetically modified crops with two-way or three-way stacked herbicide-tolerant traits allow use of herbicide mixtures that would otherwise be phytotoxic to the crop. Early weed management (EWM) strategies promote the use of PRE herbicides with residual activity to keep the field free of weeds early in the season for successful crop establishment. To evaluate the respective sustainability and practicality of the two chemical-based management tactics (i.e., stacked traits and EWM), we used a population model of waterhemp, Amaranthus tuberculatus (Moq.) Sauer (syn. rudis), to simulate the evolution of resistance in this key weed species in midwestern U.S. soybean [Glycine max (L.) Merr.] agroecosystems. The model tested scenarios with a varying number of herbicide sites of action (SOAs), application timings (PRE and POST), and preexisting levels of resistance. Results showed that both tactics provided opportunity for controlling resistant A. tuberculatus populations. In general, each pass over the field should include at least two effective herbicide SOAs. Nevertheless, the potential evolution of cross-resistance may void the weed control programs embraced by stacked traits and diverse herbicide SOAs. Economic calculations suggested that the diversified programs could double long-term profitability when compared to the conventional system, because of improved yield and grain quality. Ultimately, the essence of a sustainable herbicide resistance management strategy is to be proactive. Although a herbicide-dominated approach to diversifying weed management has been prevalent, the increasing presence of weed populations with multiple resistance means that finding herbicides to which weed populations are still susceptible is becoming increasingly difficult, and thus the importance of reintroducing cultural and mechanical practices to support herbicides must be recognized.
This chapter introduces the major philosophical concepts, historical interpretations, and political, legal, and economic issues concerning the First Amendment, church-state relations, and religious liberty in the United States. It will address philosophical concepts such as natural religion, the nature of religious exercise, and the special status of religious liberty in the philosophy of law. It will then present historical developments from colonial America to modern Supreme Court cases concerning church establishments, religious toleration, religious dissent and minorities, religious tests, and the historical and jurisprudential meanings of “free exercise” and “establishment.” It will conclude with reflections on natural rights and religious liberty exemptions, originalist constitutional interpretations, corporate religious liberty, the economic origins of religious liberty, the separation of church and state, and contemporary challenges to religious liberty.