Early Adulthood Research Articles

Knowledge, practice, and factors associated with electrocardiography interpretation among nurses working in adult emergency and critical care units at selected governmental hospitals in Addis Ababa, Ethiopia, 2023: a cross-sectional study

BackgroundElectrocardiography (ECG) is a noninvasive diagnostic method used to examine electrical and muscular cardiac activity. It is usually the first-line diagnostic tool for patients with chest pain. Late recognition of electrocardiography abnormalities can cause in-hospital cardiac arrest, further complicate care, increase the cost of health care, and prolong admission. Hence, the objective of this study was to determine the knowledge, practice, and associated factors of nurses regarding the interpretation of electrocardiography.MethodsA cross-sectional study was carried out on 334 nurses working at randomly selected public hospitals from March 06, 2023, to April 05, 2023. Since our study populations were less than the calculated sample size, all nurses who fulfilled the inclusion criteria were included. The collected data were coded and cleaned using EpiData version 4.2 and analysed using Statistical Package for the Social Sciences (SPSS) version 25. Both bivariate and multivariate logistic regression was run to find an association between dependent and independent variables. Odds ratios (ORs) with 95% confidence levels were used to measure the strength of associations.ResultsA total of 334 nurses responded to the survey, yielding a 93% response rate. Only 15.4% and 9% of them had satisfactory knowledge and good practice, respectively. Nurses who had 2–4 years of experience in the current unit were 3.13 times more likely (AOR = 3.13 (1.23, 7.92) to have sufficient knowledge. Nurses working in cardiac care units were 3.45 times more likely to have good practices than those working in intensive care units (AOR = 3.45 (1.02, 13.73)).ConclusionThe study revealed that educational qualifications, in-service training, and current working units were significantly associated with nurses’ knowledge and practice of electrocardiography interpretation. The concerned body must provide continuous on-the-job training related to ECG interpretation to all nurses working in adult emergency and critical care unit.

Real time patient scheduling orchestration for improving key performance indicators in a hospital emergency department

Healthcare systems worldwide are increasingly subject to in-depth analysis. Problems in healthcare systems are of concern to the general public. For example, overcrowding in emergency departments creates several issues including longer waiting times, more frequent medical errors, a longer length of stay and worsened performance indicators. Overcrowding situations reduce the availability of staff and material resources, and therefore deteriorate the quality of care. The main cause of the overcrowding in emergency departments is the permanent interferences between the scheduled patients, unscheduled patients and urgent and unscheduled patients arriving at the emergency department. The objective of the present study is to develop an innovative decision support system that minimizes these interferences, while taking into account the perturbations that can occur throughout the day. The research’s ultimate goal is to improve the performance indicators via two processes: the first is a memetic algorithm based on a four dimensional hypercube genetic algorithm and local search techniques, and the second is based on a multi-agent system which dynamically orchestrates the patient pathway (given by the scheduling algorithm). In order to test and validate our approach, experiments are designed with real data from the adult emergency department at Lille University Medical Center. Simulations showed that with our approach we were able to reduce the waiting time of patients by 28.12%.

Self-Acceptance and Interpersonal Trust with Self Disclosure for Early Adulthood Instagram Users in Estonia

This research is quantitative research using a correlational method, which aims to determine the relationship between self-acceptance and interpersonal trust and self-disclosure of Instagram social media users in early adulthood in Estonia. The data analysis techniques used were bivariate correlation and multivariate correlation. The sampling method in this study is convenience sampling, which is a collection of information from population members who agree to provide information and enter the sample criteria. The research instrument used is the Self-disclosure, Self-acceptance, and Interpersonal Trust Scale based on a Likert scale model. The study result indicates the relationship between self-acceptance and interpersonal trust with self-disclosure in early adulthood, based on Instagram users' research in Estonia.

Environment or behavior: Which childhood nature experiences predict nature relatedness in early adulthood?

Childhood nature experiences have been identified as critical factors of Nature Relatedness (NR) at the individual level. This exploratory study delved into the distinct contribution of different forms of childhood experiences to NR in early adulthood, focusing on the living environment and actual contact with nature, along with nature education and the influence of people around. NR scores and self-reported experiences of Chinese college students (n = 431) were collected using a questionnaire survey. Objective environmental indicators (normalized difference vegetation index, land cover, and nighttime light) in 13 buffers of different sizes were adopted to precisely depict their historical living environments. Based on the results of bivariate correlations and hierarchical linear regressions, the quantity of natural components in the childhood living environment did not predict long-term NR. Nighttime light and impervious surface at large geographic scales had significant but weak negative correlations with NR. Experiences of actual contact with nature, especially the experiences of interactive behaviors rather than merely visiting natural spaces, are better predictors than the objective environment. The interactive behaviors of observing natural processes and cultivating plants had significantly independent contributions to NR, even when other factors were included in the regression models. Nature education could not replace the role of actual contact with nature. This study implies that an urbanized living environment will not necessarily reduce the level of NR of future generations. Rather than simply increasing the quantity of natural components in urban areas, it is more important to support children’s interactive behaviors with nature.

Genotype and X-chromosome inactivation are associated with disease severity in females with X-linked Alport syndrome.

Male patients with X-linked Alport syndrome (XLAS) generally develop end-stage kidney disease in early or middle adulthood and show distinct genotype-phenotype correlations. Female patients, however, show various phenotypes ranging from asymptomatic to severe with no genotype-phenotype correlations. However, the factors affecting the severity of XLAS in female patients are unclear. Since X-chromosome inactivation (XCI) affects the severity of certain female X-linked diseases, we investigated whether genotype and XCI were associated with XLAS severity in female patients in a large Japanese cohort. Among 139 female patients with genetically diagnosed XLAS at our institution, we conducted XCI analysis on peripheral blood leukocytes using the human androgen receptor assay method and analyzed two cohorts. In 74 adult female patients, we evaluated the correlation between kidney function (creatinine-estimated glomerular filtration rate [Cr-eGFR] optimized for Japanese individuals) and genotype/XCI using multivariable linear regression analysis, and in 65 pediatric female patients, we evaluated the correlation between kidney function (Cr-eGFR optimized for Japanese individuals) and genotype/XCI using multivariable linear regression analysis. We also investigated the correlation between the development of proteinuria (urine protein-to-creatinine ratio above normal for the patient's age) and genotype/XCI using multivariable Cox proportional hazard analysis. In adult female patients, XCI pattern was significantly associated with Cr-eGFR (regression coefficient estimate = -0.53, P=0.004), whereas genotype was not (P=0.892). In pediatric female patients, both genotype and XCI pattern were significant independent risk factors for the development of proteinuria (hazard ratio [HR], 3.702; 95% confidence interval [CI], 1.681-8.150; P=0.001 and HR, 1.043; 95% CI, 1.061-1.070; P=0.001, respectively), whereas both genotype and XCI pattern were not associated with Cr-eGFR (P=0.20, P=0.67, respectively). Genotype and XCI are factors associated with the severity in females with XLAS.

Psychological Well-Being, Curiosity and Perfectionism among Filipino Young Professionals with Quarter Life Crisis: Basis for Existential Positive Psychology Wellness Plan

Quarter Life Crisis is a difficult encounter in the life transition from adolescence to early adulthood. This crisis revolves around social comparison, work satisfaction, intimate relationships, career consolidation, preoccupations and fears, struggle from transition, social isolation, and frustration and disappointments. This study examined the psychological well-being, curiosity, and perfectionism among young professionals with a quarter-life crisis. There were 318 participants in this study from two different cities in one province of Region IV-A in the Philippines. The study used a sequential explanatory mixed method design that combines qualitative and quantitative research. Based on the result, the research found that young professionals with quarter-life crises have low psychological well-being, low curiosity, and high perfectionism. The themes, low disposition, poor mindset, and weak personality were extracted from the texts to fully support the respective variables. Furthermore, the research proposed a psychological intervention plan for young professionals experiencing the crisis: the existential positive psychology wellness plan.

The development of aperiodic and periodic resting-state power between early childhood and adulthood: New insights from optically pumped magnetometers

Neurophysiological signals, comprised of both periodic (e.g., oscillatory) and aperiodic (e.g., non-oscillatory) activity, undergo complex developmental changes between childhood and adulthood. With much of the existing literature primarily focused on the periodic features of brain function, our understanding of aperiodic signals is still in its infancy. Here, we are the first to examine age-related changes in periodic (peak frequency and power) and aperiodic (slope and offset) activity using optically pumped magnetometers (OPMs), a new, wearable magnetoencephalography (MEG) technology that is particularly well-suited for studying development. We examined age-related changes in these spectral features in a sample (N=65) of toddlers (1–3 years), children (4–5 years), young adults (20–26 years), and adults (27–38 years). Consistent with the extant literature, we found significant age-related decreases in the aperiodic slope and offset, and changes in peak frequency and power that were frequency-specific; we are the first to show that the effect sizes of these changes also varied across brain regions. This work not only adds to the growing body of work highlighting the advantages of using OPMs, especially for studying development, but also contributes novel information regarding the variation of neurophysiological changes with age across the brain.

The dishonest disposition and everyday economic criminality of the British public

This paper is concerned with the everyday economic crimes of ordinary people. Although dishonesty is a core characteristic of these offences, we are not aware of any prior research that examines the direct, relationship between dishonest attitude and economic crime. Based on a survey of the British public, this article presents insights into this relationship. By profiling the integrity, dishonest disposition and everyday economic criminality of the British public, the study finds a strong relationship between attitudes and harmful dishonest behaviour such that, in a given year, 26 % of adults in the UK commit at least one economic crime. The higher levels of dishonesty in males and younger adults helps to explain their more prolific offending. Both the honesty and age-economic crime curves indicate that the maturation decline in offending is gradual compared to the sharp desistance in early adulthood of the traditional age-crime curve. Whilst this finding also contradicts the conventional view that economic crime is a middle-aged problem, it helps to explain this perception. By comparing the attitude results to a 2011 study, the research further found that the maturation effect is more pronounced due to a decline in integrity of the under 55 y population so that the younger generations now have a steeper moral hill to climb.

The puparium of Cyphomyia wiedemanni Gerstaecker, 1857 (Diptera: Stratiomyidae) found in cassava (Manihot esculenta) roots

The puparium of Cyphomyia wiedemanni Gerstaecker, 1857 is hereby described for the first time, based on 14 puparia from specimens collected buried in soil and feeding off the roots of cassava (Manihot esculenta Crantz) plants in an area of industrial cassava plantation in Distrito Federal (15°35′30″S, 47°42′30″W), Brazil and, reared in controlled lab conditions until the emergence of adults. Unprecedented data on the occurrence of Cyphomyia wiedemanni in Distrito Federal (new record), and the relationship of the larvae with the cassava plants are discussed.

Retrospective analysis of serologic test requests in the diagnosis of viral hepatitis: Inappropriate test requests and cost.

The rational laboratory use and implementation of test ordering procedures aim to reduce unnecessary test requests. This study aimed to determine the financial burden caused by inappropriate serological test requests for viral hepatitis and to investigate physicians' reasons for making unnecessary test requests. We performed a retrospective evaluation of inappropriate requests for hepatitis serology testing and the financial burden they caused at a tertiary care hospital over a 1-year period. The study found 2183 (3.84%) inappropriate test requests, costing $3309.00. Of these, 357 were same-day repeat requests and 1826 were requests not following diagnostic algorithms. In the logistic regression analysis of the factors affecting unnecessary test requests, a statistically significant difference was found between whether the unit was internal or surgical, whether the request came from inpatient services or outpatient clinics, and the professional titles (P < .05). Both types of inappropriate requests were more common among male physicians (P < .05). The highest rates of inappropriate test requesting were in physical therapy and rehabilitation, pediatrics, and adult emergency units. To identify the reasons behind unnecessary test requests, 135 physicians from 23 different departments participated in the survey. The main reasons for requesting tests were identified as protecting against malpractice and fears of misdiagnosis or overlooking a diagnosis. It has been observed that physicians often order tests routinely, without being fully familiar with standard test ordering procedures based on diagnostic algorithms, and lacking knowledge about rational laboratory use. The cost of tests is mostly unknown to clinicians. The study concludes that there are laboratory tests that incur much higher costs. When this assessment is applied to the entire laboratory, it becomes clear how significant a financial burden, unnecessary workload, and loss of time this situation can cause. Identifying the presence of unnecessary test requests is the first step in preventing them. Appropriate measures include highlighting these issues, providing necessary information, and offering in-service training.

Dynamics of Redox Metabolism during Complete Metamorphosis of Insects: Insights from the Sunflower Caterpillar Chlosyne lacinia (Lepidoptera).

Complete insect metamorphosis requires substantial metabolic and physiological adjustments. Although oxidative stress has been implicated in metamorphosis, details on redox metabolism during larva-to-pupa and pupa-to-adult remain scarce. This study explores redox metabolism during metamorphosis of a lepidopteran (Chlosyne lacinia), focusing on core metabolism, antioxidant systems and oxidative stress. The larva-to-pupa transition was characterized by increased lactate dehydrogenase and glutathione peroxidase (GPX) activities, coupled with depletion of reduced glutathione (GSH), high disulfide-to-total-glutathione ratio (GSSG/tGSH), and increased lipid peroxidation. As metamorphosis progressed, metabolic enzyme activities, citrate synthase and glucose 6-phosphate dehydrogenase increased, indicating heightened oxidative metabolism associated with adult development. Concurrently, GSH and GPX levels returned to larval levels and GSSG/tGSH reached its most reduced state right before adult emergence. Adult emergence was marked by a further increase in oxidative metabolism, accompanied by redox imbalance and enhanced antioxidant mechanisms. These findings highlight a fluctuation in redox balance throughout metamorphosis, with periods of oxidative eustress followed by compensatory antioxidant responses. This study is the first to identify concurrent changes in metabolism, antioxidants, redox balance and oxidative stress throughout metamorphosis. Our findings extend knowledge on redox metabolism adjustments and highlight redox adaptations and oxidative stress as natural components of complete insect metamorphosis.

Usefulness of combined pseudo-continuous arterial spin labelling and spectroscopic analysis in schizophrenic Egyptian population sample

BackgroundSchizophrenia is a prevalent psychiatric disorder that affects 1% of the global population. Schizophrenia frequently begins in late adolescence or early adulthood, causing significant educational, social, and economic costs for people and society. Functional neuroimaging research on schizophrenia physiopathology has been beneficial. Arterial spin labelling (ASL) is one of functional magnetic resonance imaging (fMRI) technologies that assess brain function without radiation. ASL uses magnetic resonance (MR) imaging to quantify tissue-level brain perfusion non-invasively. Arterial spin labelling (ASL) is one of the functional magnetic resonance imaging (fMRI) technologies that assess the brain function without radiation hazards. ASL uses magnetic resonance (MR) imaging to quantify tissue-level brain perfusion non-invasively. Many publications were performed on role of different advanced MRI techniques in schizophrenia, but our study insisted on the added value of combined ASL and MRS over the conventional MRI in schizophrenic Egyptian population sample.Aim of the workThe purpose of this work was to evaluate the added value of combined ASL-perfusion MRI and MRS in schizophrenic patients.MethodsThis prospective case–control study was carried out on two groups: First group was 30 patients who were diagnosed clinically as schizophrenic patients, and second group was 20 healthy volunteers as a control group for comparison in the period from August 2021 till July 2022.ResultsThe majority of newly diagnosed cases had significant higher positive symptoms than chronic cases. According to arterial spin labelling (ASL) data, rCBF was noticed to be reduced in anterior cingulate, frontal lobe, and parietal lobe of both patients’ subgroups but more significant in chronically ill patients. Convergent results of decreased rCBF were also found in the parietal lobe and occipital lobe. Magnetic resonance spectroscopic analysis showed that NAA was decreased in the anterior cingulate cortex, thalami and basal ganglia of the newly diagnosed cases more than chronic cases. The ASL-MRI perfusion accurately detected the hypo-perfusion of different brain regions with sensitivity 100%, specificity 66.67%, positive predictive value 96.43%, negative predictive value 100%, and accuracy 96.67%, while MR spectroscopy showed sensitivity 100%, specificity 33.33%, positive predictive value 93.10%, negative predictive value 100%, and accuracy 93.33% in evaluation of changes of brain metabolites.ConclusionASL is a promising functional MRI technique that can produce together with MRS quantitative information about the metabolites of different brain regions. The ASL-MRI appears as a reliable non-invasive technique to measure cerebral blood flow and identify decreased rCBF without any contrast administration, and it could be repeatable which helps in early diagnosis as well as follow-up of the progression of the disease.

Hierarchical tricarboxylic acid cycle regulation by hepatocyte arginase 2 links the urea cycle to oxidative metabolism

Urea cycle impairment and its relationship to obesity and inflammation remained elusive, partly due to the dramatic clinical presentation of classical urea cycle defects. We generated mice with hepatocyte-specific arginase 2 deletion (Arg2LKO) and revealed a mild compensated urea cycle defect. Stable isotope tracing and respirometry revealed hepatocyte urea and TCA cycle flux defects, impaired mitochondrial oxidative metabolism, and glutamine anaplerosis despite normal energy and glucose homeostasis during early adulthood. Yet during middle adulthood, chow- and diet-induced obese Arg2LKO mice develop exaggerated glucose and lipid derangements, which are reversible by replacing the TCA cycle oxidative substrate nicotinamide adenine dinucleotide. Moreover, serum-based hallmarks of urea, TCA cycle, and mitochondrial derangements predict incident fibroinflammatory liver disease in 106,606 patients nearly a decade in advance. The data reveal hierarchical urea-TCA cycle control via ARG2 to drive oxidative metabolism. Moreover, perturbations in this circuit may causally link urea cycle compromise to fibroinflammatory liver disease.

Honey bee larval toxicity study designs: Applicability of the current study protocols and endpoints asa predictor of pesticide hazard for pollinators.

The assessment of pesticide risks to bees in North America currently relies in part on Tier 1 honey bee laboratory toxicity studies to support the registration and registration review processes for crop protection chemicals. For immature stages, the studies follow two standardized test designs recommended by the Organization for Economic Cooperation (OECD), evaluating acute (seven-day single-dose, TG OECD 237) and chronic (22-day repeated-dose, GD OECD 239) toxicity in bee larvae. In this article, we aim to evaluate the current approach for generating and interpreting honey bee larval toxicity data, enhancing pesticide risk assessment for pollinators. First, by considering that the repeated-dose larval study covers all stages of honey bee brood development up to adult emergence, we compared endpoints (larval LD/ED50 and LC/EC50 values) from seven-day acute exposure studies with the 22-day chronic exposure studies. Our goal was to identify the study design offering greater sensitivity in assessing pesticide toxicity to immature bees. Our second objective involved analyzing available weight data from emerged adults and comparing it to survival endpoints (e.g., NOEL and LD50) to determine if the weight after adult emergence would accurately represent a sensitive indicator of pesticide effects on developing honey bees. Our analysis determined that the use of a single 22-day chronic exposure study adequately covers all immature stages and that the toxicity values based on cumulative dose are more accurate and representative measures of exposure for immature bees than using endpoints based on estimated daily doses. Furthermore, our analysis suggests that measuring the weight of emerged adults was a more sensitive indicator than mortality of treatment-related effects in 22% of the compounds included in our analysis. Here we also discuss the importance of standardized protocols for proper collection of weight after emergence and the need for further discussion on the relevance of this parameter at risk assessment scheme. Integr Environ Assess Manag 2024;20:2283-2293. © 2024 Pollinator Research Task Force. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Validation of a checklist to facilitate serious illness conversations in adult emergency in China: a single-centre pilot study

BackgroundAdvances in emergency and critical care have improved outcomes, but gaps in communication and decision-making persist, especially in the emergency department (ED), prompting the development of a checklist to aid in serious illness conversations (SIC) in China.MethodsThis was a single-centre prospective interventional study on the quality improvement of SIC for life-sustaining treatment (LST). The study recruited patients consecutively for both its observational baseline and interventional stages until its conclusion. Eligible participants were adults over 18 years old admitted to the Emergency Intensive Care Unit (EICU) of a tertiary teaching hospital, possessing full decisional capacity or having a legal proxy. Exclusions were made for pregnant women, patients deceased upon arrival, those who refused participation, and individuals with incomplete data for analysis. First, a two-round Delphi process was organized to identify major elements and generate a standard process through a checklist. Subsequently, the efficacy of SIC in adult patients admitted to the EICU was compared using the Decisional Conflict Scale (DCS) score before (baseline group) and after (intervention group) implementing the checklist.ResultsThe study participants presented with the most common comorbidities, such as diabetes, myocardial infarction, cerebrovascular disease, moderate-to-severe renal disease, congestive heart failure, and chronic pulmonary disease. The median Charlson Index did not differ between the baseline and intervention cohorts. The median length of hospital stay was 11.0 days, and 82.9% of patients survived until hospital discharge. The total DCS score was lower in the intervention group than in the baseline group. Three subscales, including the informed, values clarity, and support subscales, demonstrated significant differences between the intervention and baseline groups. Fewer intervention group patients agreed with and changed their minds about cardiopulmonary resuscitation (CPR) compared to the baseline group.ConclusionThe use of a SIC checklist in the EICU reduced the DCS score by increasing medical information disclosure, patient value awareness, and decision-making support.

Comparative Biology of Guava Fruit Fly &lt;i&gt;Bactrocera correcta&lt;/i&gt; (Bezzi)

Fruit flies are polyphagous insect pests, infesting various fruits and vegetables. The host preference and biology of guava fruit fly Bactrocera correcta (Bezzi) were studied on 17 hosts. Biological parameters such as incubation period, maggot and pupal period, maggot and pupal weight, pupal recovery, adult emergence, total fecundity and adult longevity were studied. All biological parameters were significantly influenced by the host fruits. The results showed that the total developmental period was longer on pomegranate (26.7± 2.1 days), ber (26.1± 2.4 days) and custard apple (25.1± 1.5 days); while shorter period was observed on sweet banana (20.1± 1.6 days). Pupal recovery was maximum on sweet banana (93.33%) and lowest on mango (Totapuri) (42%). The adult emergence was also more on sweet banana (90%) and survived for longer period. Sweet banana was preferred for oviposition followed by guava, papaya, and sapota.

Impact of stress during adolescence on general and work-related stress in early adulthood: A prospective cohort study

Impact of stress during adolescence on general and work-related stress in early adulthood: A prospective cohort study

Fitness Cost Associated with Diamide-Resistant Population of Brinjal Shoot and Fruit Borer &lt;i&gt;Leucinodes orbonalis&lt;/i&gt; Guenee

Brinjal shoot and fruit borer, Leucinodes orbonalis is a serious pest of brinjal and has evolved resistance to commonly used diamide insecticides such as flubendiamide and chlorantraniliprole. Lifetable parameters of the field populations of L. orbonalis, collected from brinjal fields of Kullarayanpalayam (Palakkad) (PKD) and Anchal (Kollam) (KLM), Kerala, reported resistance to diamides was studied and compared with that of laboratory-reared susceptible population of L. orbonalis (Lo-S) procured from ICAR- NBAIR, Bengaluru to determine the fitness cost associated with diamide resistance. The results revealed that the PKD population was found to have a significantly longer larval period with 12.7± 0.82 days as compared to the Lo-S population (10.6± 2.71 days), while the KLM population showed a larval period of 11.1± 0.87 days. The pupal duration was significantly longer in both KLM and PKD populations with 10.3± 0.48 and 11.8± 0.63 days respectively; whereas, the Lo-S population showed only 9.6± 0.69 days. The longevity of female adults of PKD population was (3.80± 0.63 days), while KLM and Lo-S populations showed 4.20± 0.63 and 4.40± 0.51 days respectively. The fecundity of KLM (178.9± 6.08 eggs/ female) and PKD (171.40± 5.64 eggs/ female) populations were significantly lower when compared with the Lo-S population (194.1± 4.38 eggs/ female). Only 89.11% eggs hatched in the PKD population while 89.34± 2.73and 91.87± 4.01% of eggs hatched in KLM and Lo-S populations, respectively. However, the fitness parameters like the incubation period, pupation rate, adult emergence rate, female ratio, and male longevity were not significantly different. The PKD and KLM populations showed both negative and positive biological trade-offs exhibiting a relative fitness of 0.74 and 0.82 respectively compared to the Lo-S population (1).

Developing a brief telematic cognitive behavioral therapy for the treatment of social isolation in young adults.

The present study aims to present a novel cognitive-behavioral intervention protocol focused on treating social isolation through telematic interaction, thus overcoming common barriers characteristic of face-to-face interventions. We examined current literature about face-to-face and telematic psychotherapeutic interventions for the treatment of social isolation in early adulthood. Current evidence is mixed, suggesting the need to develop novel interventions focused on patients' cognitive functioning. Moreover, telematic interventions are promising candidates for overcoming common barriers intrinsic to the condition of social isolation. The present 8-session model inspired by cognitive behavioral theoretical models and cognitive interventions currently present in the literature is thought to help socially isolated adult patients reduce clinical symptoms associated with the condition and lead to a reduction in the avoidance of social situations, leading to an improvement of the quality of life. We presented a telematic psychotherapeutic intervention aimed at helping adult patients suffering from social isolation who are unable to seek help from national health systems and face-to-face interventions, thus overcoming barriers intrinsic to social isolation. The present cognitive-behavioral treatment protocol has been developed in the context of a randomized clinical trial ongoing in Italy, aimed at implementing and testing the feasibility and effectiveness of multimodal digital interventions for treating social isolation.

Understanding the relationship between intergenerational mobility and community violence

Violence is a key mechanism in the reproduction of community disadvantage. The existing evidence indicates that violence in a community impacts the intergenerational mobility of its residents. The current study explores the possibility of a reverse relationship. This study provisionally tests the hypothesis that depressed intergenerational mobility in a community may also spark subsequent community violence. We deploy a county measure of intergenerational mobility captured during early adulthood for a cohort of youth born between 1980 and 1986 and raised in low-income families [R. Chetty, N. Hendren, Quart. J. Econom. 133, 1163-1228 (2018)]. We model the relationship between county mobility scores and two county-level outcomes: violent crime and homicide. We find that a county's level of intergenerational mobility as measured by the Chetty-Hendren data is a major predictor of its rate of violent crime and homicide in 2008, when the youth in Chetty's mobility cohort were young adults (the same age the mobility measure was captured). In fact, mobility is a significantly stronger and more consistent predictor of community violent crime and homicide rates than more commonly used factors like poverty, inequality, unemployment, and law enforcement presence.