Sample Age Range Research Articles

A study on the pattern of selfie culture among university students in Bangladesh

This study endeavors to explore the determinants behind the prevalence of selfie culture in the light of self-presentation strategies. It applied Erving Goffman’s (1959) Self-Presentation theory to scrutinize the pattern of selfie culture among university students in Bangladesh. Following a qualitative methodology, semi-structured interviews were conducted among 20 participants as a purposive sample age range from 20 to 25 years old. The results demonstrate that the participants tend to invest considerable attention to take selfies, afterward use filters to maximize the “best version” of the self, and eventually post them in the digital world. Their desire to represent the “best version” of themselves and gain the attention of others reflect the narcissist traits of the participants. Also, their level of self-esteem increases when they feel confident and see their “retouched image” after using photographic filters.

Health and well-being of maturing adults with classic galactosemia.

Long-term outcomes in classic galactosemia (CG) have been studied previously, but all prior studies have relied on cohorts of patients that were small in number, or heavily skewed toward children and young adults, or both. Here, we extend what is known about the health and well-being of maturing adults with CG by analyzing the results of anonymous custom surveys completed by 92 affected individuals, ages 30-78, and 38 unaffected sibling controls, ages 30-79. The median age for patients was 38.5 years and for controls was 41 years. These study participants hailed from 12 different countries predominantly representing Europe and North America. Participants reported on their general life experiences and outcomes in seven different domains including: speech/voice/language, cognition, motor function, cataracts, bone health, psychosocial well-being, and gastrointestinal health. We also queried women about ovarian function. Our results indicated a prevalence of long-term complications across all outcome domains that aligned with levels previously reported in younger cohorts. Given the sample size and age range of participants in this study, these findings strongly suggest that the adverse developmental outcomes commonly linked to CG are not progressive with age for most patients. We also tested four candidate modifiers for possible association with each of the outcomes followed, including: days of neonatal milk exposure, rigor of dietary galactose restriction in early childhood, current age, and home continent. We observed no associations that reached even nominal significance, except for the following: cataracts with neonatal milk exposure (p = 2.347e-04), cataracts with age (p = 0.018), and bone health with home continent (p = 0.03).

Psychometric properties of a scale to measure social entrepreneurship competency in Mexican university students

PurposeThe purposes of this study were to calculate the confirmatory factor analysis in the measurement model using robust measures (McDonald’s omega and Cronbach’s alpha) to ensure the reliability of the proposed scale and to explore the measurement invariance of the scale per the participants’ gender.Design/methodology/approachThe methodological sample had 408 students from a private university in northern Mexico, of which 200 (49%) were male and 208 (51%) were female; the sample age range was 18–58 years (M = 22.4 years, SD = 6.0). The data analysis included descriptive and normality, dimensionality, reliability and measurement invariance.FindingsThe social entrepreneurship competency measurement model showed acceptable adjustment indexes in evaluating the internal structure, reliability and factorial invariance by gender of the study participants.Research limitations/implicationsEven though the contributions of this study are evident, these findings must be taken with caution due to some limitations. First, the proposed measurement model uses a self-reported scale, so it is essential to include other measurement methods with less implicit social desirability. Second, although the sample was intended to be representative, it only drew from a specific geographical area, making it difficult to generalize these findings to culturally diverse areas. Third, this study did not consider other validity measures; for example, concurrent, divergent and predictive, so future studies should consider examining the relationship of social entrepreneurship with other factors.Practical implicationsFrom the practical perspective, this study provides a parsimonious instrument regarding the number of items included in the measurement model. From the theoretical perspective, the present study contributes to delimiting the dimensions of social entrepreneurship competency.Originality/valueThis study contributes to the field of social entrepreneurship, particularly in the area of construct measurement, by offering a measurement model with solid evidence of internal structure validity, reliability and factorial invariance for the perceived achievement of social entrepreneurship competency.

Brain-age prediction: Systematic evaluation of site effects, and sample age range and size.

Structural neuroimaging data have been used to compute an estimate of the biological age of the brain (brain-age) which has been associated with other biologically and behaviorally meaningful measures of brain development and aging. The ongoing research interest in brain-age has highlighted the need for robust and publicly available brain-age models pre-trained on data from large samples of healthy individuals. To address this need we have previously released a developmental brain-age model. Here we expand this work to develop, empirically validate, and disseminate a pre-trained brain-age model to cover most of the human lifespan. To achieve this, we selected the best-performing model after systematically examining the impact of seven site harmonization strategies, age range, and sample size on brain-age prediction in a discovery sample of brain morphometric measures from 35,683 healthy individuals (age range: 5-90 years; 53.59% female). The pre-trained models were tested for cross-dataset generalizability in an independent sample comprising 2101 healthy individuals (age range: 8-80 years; 55.35% female) and for longitudinal consistency in a further sample comprising 377 healthy individuals (age range: 9-25 years; 49.87% female). This empirical examination yielded the following findings: (1) the accuracy of age prediction from morphometry data was higher when no site harmonization was applied; (2) dividing the discovery sample into two age-bins (5-40 and 40-90 years) provided a better balance between model accuracy and explained age variance than other alternatives; (3) model accuracy for brain-age prediction plateaued at a sample size exceeding 1600 participants. These findings have been incorporated into CentileBrain (https://centilebrain.org/#/brainAGE2), an open-science, web-based platform for individualized neuroimaging metrics.

Removing scanner effects with a multivariate latent approach: A RELIEF for the ABCD imaging data?

Abstract Scan site harmonization is a crucial part of any neuroimaging analysis when data have been pooled across different study sites. Zhang and colleagues recently introduced the multivariate harmonization method RELIEF (REmoval of Latent Inter-scanner Effects through Factorization), aiming to remove explicit and latent scan site effects. Their initial validation in an adult sample showed superior performance compared to established methods. We here sought to investigate utility of RELIEF in harmonizing data from the Adolescent Brain and Cognitive Development (ABCD) study, a widely used resource for developmental brain imaging. We benchmarked RELIEF against unharmonized, ComBat, and CovBat harmonized data and investigated the impact of manufacturer type, sample size, and a narrow sample age range on harmonization performance. We found that in cases where sites with sufficiently large samples were harmonized, RELIEF outperformed other techniques, yet in cases where sites with very small samples were included there was substantial performance variation unique to RELIEF. Our results therefore highlight the need for careful quality control when harmonizing data sets with imbalanced samples like the ABCD cohort. Our comment alongside shared scripts may provide guidance for other scholars wanting to integrate best practices in their ABCD related work.

41. Brain-Age Prediction: Systematic Evaluation of Site Effects, and Sample Age Range and Size

41. Brain-Age Prediction: Systematic Evaluation of Site Effects, and Sample Age Range and Size

Vowel quantity/quality redux: Revisiting vowel contrasts in Hakha Lai monophthongs

Previous scholars have documented a phonemic length distinction in the monophthongal vowels of Hakha Lai, a Tibeto-Burman language spoken in Chin State in western Myanmar (Melnik, 1997; Peterson, 2003; Maddieson, 2004). In a previous pilot study of data from two college-aged speakers (the first instrumental acoustic analysis of Hakha Chin vowel quality), our findings revealed stark individual differences: one speaker showed robust quantity and minor quality differences, while for the other, neither duration nor quality played key roles; rather, her system had merged. Maddieson (2004) proposed that the length associated with long vowels in Hakha Lai is mainly realized through lengthening of sonorant codas; we did not find this to be the case for either speaker. However, those pilot data were limited both in terms of sample size and age range. Therefore, to expand on our previous findings, we now present analysis of data from fourteen talkers, including both a group of nine college aged talkers (6 women) and five older talkers (2 women, ages 46 and 77; 3 men, ages 48, 60, and 62). Duration and quality measures are reported for all monophthongs in all possible syllable shapes.

Relative Contributions of Mixed Pathologies to Cognitive and Functional Symptoms in Brain Donors Exposed to Repetitive Head Impacts.

Exposure to repetitive head impacts (RHI) is associated with later-life cognitive symptoms and neuropathologies, including chronic traumatic encephalopathy (CTE). Cognitive decline in community cohorts is often due to multiple pathologies; however, the frequency and contributions of these pathologies to cognitive impairment in people exposed to RHI are unknown. Here, we examined the relative contributions of 13 neuropathologies to cognitive symptoms and dementia in RHI-exposed brain donors. Neuropathologists examined brain tissue from 571 RHI-exposed donors and assessed for the presence of 13 neuropathologies, including CTE, Alzheimer disease (AD), Lewy body disease (LBD), and transactive response DNA-binding protein 43 (TDP-43) inclusions. Cognitive status was assessed by presence of dementia, Functional Activities Questionnaire, and Cognitive Difficulties Scale. Spearman rho was calculated to assess intercorrelation of pathologies. Additionally, frequencies of pathological co-occurrence were compared to a simulated distribution assuming no intercorrelation. Logistic and linear regressions tested associations between neuropathologies and dementia status and cognitive scale scores. The sample age range was 18-97 years (median = 65.0, interquartile range = 46.0-76.0). Of the donors, 77.2% had at least one moderate-severe neurodegenerative or cerebrovascular pathology. Stage III-IV CTE was the most common neurodegenerative disease (43.1%), followed by TDP-43 pathology, AD, and hippocampal sclerosis. Neuropathologies were intercorrelated, and there were fewer unique combinations than expected if pathologies were independent (p < 0.001). The greatest contributors to dementia were AD, neocortical LBD, hippocampal sclerosis, cerebral amyloid angiopathy, and CTE. In this sample of RHI-exposed brain donors with wide-ranging ages, multiple neuropathologies were common and correlated. Mixed neuropathologies, including CTE, underlie cognitive impairment in contact sport athletes. ANN NEUROL 2024;95:314-324.

Are internet users with high risk for internet addiction prone to substance use?

Abstract Background Similar to psychoactive substances, certain internet activities can produce highly rewarding sensations, leading to addictive use. Previous research reported associations between internet addiction (IA) and substance use. Our aim is to identify key differences between internet users with low and high IA risk in terms of which substances they consume (alcohol, tobacco, illicit drugs) and in terms of internet activities they engage in. Methods The National survey on the use of tobacco, alcohol and other drugs was conducted in 2018 in Slovenia on a nationally representative sample (age range: 15-64 years; 62.4% response rate). Among people who used internet at least once per week (N = 7,413), we distinguished between internet users with low IA risk (n = 6,929; 93.6%) and high IA risk (n = 484; 6.4%), based on latent profile analysis of responses on the Internet disorder scale (IDS-15). Results Higher IA scores were associated with lower age (r = - .310), but not with gender. Significantly more users in the high risk group were using internet to access social media (%L = 54.4; %H = 73.1), pornography (%L = 7.8; %H = 18.2), video content (%L = 42.7; %H = 61.0), and videogames (%L = 13.1; %H = 25.8), compared to the low risk group. Higher IA scores were associated with frequency (r = .040) and volume (r = .179) of drinking alcohol, while no associations were found with tobacco smoking measures. Lastly, smoking marihuana (%L = 6.3; %H = 12.7) and using any other illicit drugs (%L=2.2; %H = 5.6) in the past 12 months was significantly more common in the high risk group. Conclusions The present study underlines the addictive potential of four internet content categories (social media, pornography, video content and videogames). People who are sensitive to the rewarding potential of internet content may also be more prone to seeking rewarding sensations associated with consuming psychoactive substances, in particular alcohol, marijuana and illicit drugs, but not tobacco. Key messages • Using internet to access social media, videogames, video content and pornography is significantly more common among individuals with high risk for internet addiction. • High risk for internet addiction is associated with consuming alcohol, marijuana and illicit drugs, but not with tobacco use.

Experiences of Using Digital Mindfulness-Based Interventions: Rapid Scoping Review and Thematic Synthesis.

Digital mindfulness-based interventions (MBIs) are a promising approach to deliver accessible and scalable mindfulness training and have been shown to improve a range of health outcomes. However, the success of digital MBIs is reliant on adequate engagement, which remains a crucial challenge. Understanding people's experiences of using digital MBIs and identifying the core factors that facilitate or act as barriers to engagement is essential to inform intervention development and maximize engagement and outcomes. This study aims to systematically map the literature on people's experiences of using digital MBIs that target psychosocial variables (eg, anxiety, depression, distress, and well-being) and identify key barriers to and facilitators of engagement. We conducted a scoping review to synthesize empirical qualitative research on people's experiences of using digital MBIs. We adopted a streamlined approach to ensure that the evidence could be incorporated into the early stages of intervention development. The search strategy identified articles with at least one keyword related to mindfulness, digital, user experience, and psychosocial variables in their title or abstract. Inclusion criteria specified that articles must have a qualitative component, report on participants' experiences of using a digital MBI designed to improve psychosocial variables, and have a sample age range that at least partially overlapped with 16 to 35 years. Qualitative data on user experience were charted and analyzed using inductive thematic synthesis to generate understandings that go beyond the content of the original studies. We used the Quality of Reporting Tool to critically appraise the included sources of evidence. The search identified 530 studies, 22 (4.2%) of which met the inclusion criteria. Overall, the samples were approximately 78% female and 79% White; participants were aged between 16 and 69 years; and the most used measures in intervention studies were mindfulness, psychological flexibility, and variables related to mental health (including depression, anxiety, stress, and well-being). All studies were judged to be adequately reported. We identified 3 themes characterizing barriers to and facilitators of engagement: responses to own practice (ie, negative reactions to one's own practice are common and can deplete motivation), making mindfulness a habit (ie, creating a consistent training routine is essential yet challenging), and leaning on others (ie, those engaging depend on someone else for support). The themes identified in this review provide crucial insights as to why people frequently stop engaging with digital MBIs. Researchers and developers should consider using person-based coparticipatory methods to improve acceptability of and engagement with digital MBIs, increase their effectiveness, and support their translation to real-world use. Such strategies must be grounded in relevant literature and meet the priorities and needs of the individuals who will use the interventions.

Psychometric properties of inhibitory control measures among youth with Down syndrome.

Inhibitory control measures have been commonly used when assessing individuals with Down syndrome. However, minimal attention has been devoted to evaluating the appropriateness of specific assessments for use in this population, potentially leading to erroneous conclusions. This study aimed to examine the psychometric properties of measures of inhibitory control among youth with Down syndrome. We sought to examine the feasibility, presence of floor or practice effects, test-retest reliability, convergent validity and correlations with broader developmental domains of a set of inhibitory control tasks. A sample of 97 youth with Down syndrome aged 6 to 17years old participated in verbal and visuospatial tasks of inhibitory control including the Cat/dog Stroop, Neuropsychological Assessment Second Edition (NEPSY-II) Statue, National Institutes of Health (NIH) Toolbox Cognition Battery (TCB) Flanker, Leiter-3 Attention Sustained, and the Test of Attentional Performance for Children (KiTAP) Go/No-go and Distractibility subtests. Youth also completed standardised assessments of cognition and language, and caregivers completed rating scales. Psychometric properties on the tasks of inhibitory control were evaluated against a priori criteria. Apart from demonstrating negligible practice effects, adequate psychometric properties were not observed for any inhibitory control measure within the current sample's age range. One task with low working memory demands (NEPSY-II Statue) generally had better psychometric properties than the other tasks assessed. Subgroups of participants with an IQ greater than 30 and age more than 8years were shown to be more likely to be able to complete the inhibition tasks. Findings suggest better feasibility for analogue tasks rather than computerised assessments of inhibitory control. Given the weak psychometrics of several common measures, future studies are required to evaluate other inhibitory control measures, specifically those with reduced working memory demands for youth with Down syndrome. Recommendations for use of the inhibitory control tasks among youth with Down syndrome are provided.

UTILIZATION OF VIRTUAL CARE IN POSTOPERATIVE TOTAL KNEE ARTHROPLASTY: ASSESSMENT OF OUTCOME AND PATIENT CHALLENGES

Virtual physiotherapy has been provided to hundreds of patients at the Holland Centre during the COVID pandemic. As we plan for virtual care to be one part of our care delivery we want to evaluate it and ensure the care delivery is safe and effective.The objectives of this project was two-fold: 1) to examine the outcome of virtual physiotherapy and/ or a hybrid of virtual and in-person care in patients who received post-operative treatment following total knee replacement at the Holland Centre, 2) to explore the challenges of virtual care participation in the joint replacement population.Patients who received either virtual care or a combination of in-person and virtual care (hybrid model) based on the patients’ needs were included. Patient-related outcomes were the Patient Specific Functional Scale (PSFS) and pain scale. Flexion and extension range of motion were measured before and after treatment. A modified Primary Care Patient Experience Virtual Care Survey was used to examine barriers for virtual care.Sixty patients, mean age 68(8), ranging between 45-83 years, 34(57%) females, who received either virtual care or a combination of in-person and virtual care based on the patients’ needs were included. Patients showed improvement in the PSFS and pain scores (p&lt;0.0001). Flexion (p&lt;0.0001) and extension (p=0.02) improved at a statistically significant level. A separate sample (N=54) (age range 50-85 years) completed the patient experience survey.A well-designed post-operative virtual physiotherapy program, initially implemented to maintain continuity of care during the pandemic, continues to be an important part of our model of care as we normalize our activities. Clear understanding of barriers to virtual care and mitigation strategies will help us create virtual care standards, meet our patient needs, optimize our care delivery and potentially increase the use of virtual rehab in the future.

Preservation biases are pervasive in Holocene paleofire records

Fire and its controls span several spatial and temporal scales in the Earth System and sedimentary paleofire archives are the primary means of inferring how fire varies on timescales exceeding observational records. However, our understanding of the biases affecting paleofire records remains limited. We address this gap by assembling a dataset of Holocene paleofire records to test whether preservation biases interfere with paleofire interpretations. The dataset contains 40 records composed of a total of 17,225 charcoal accumulation rate (CHAR) samples. We find that the “Sadler effect,” which is the observation that sedimentation rates decrease systematically when measured over longer timescales due to the incorporation of sedimentary hiatuses, is pervasive in these paleofire records. In the compiled dataset, the age ranges of measurement share a negative power law relationship with both accumulation rate (AR; AR = 0.4018*[sample age range]-1.09) and CHAR (CHAR = 1.118*[sample age range]-0.6655), indicating that longer time spans of measurement are more likely to incorporate longer period hiatuses into sediment records. This biases AR measurements, which subsequently bias CHAR values. Indeed, more than half of the paleofire records (n = 21) are composed of CHAR values which share a statistically significant negative relationship with the sample age range of their measurement. To our knowledge, our results are the first to identify this sedimentary bias in Holocene paleofire records. As a solution, we therefore provide an interpretative framework which outlines necessary steps to identify preservation bias in paleofire records and intervals. Lastly, we explore the implications of these findings for paleofire research.

Translation and Validation of Turnover Intention Scale on a Pakistani Sample

The availability of valid and reliable tool to assess turnover intent in any organization is essential. This study aimed to translate turnover intention scale in Urdu for employees working in diverse organizations (universities, banks, and hospitals). For this purpose, forward and backward translation methods were adopted. After determining cross language validation, factor validity was confirmed through Confirmatory factor analysis. Sample for Confirmatory factor analysis was consisted of 350 employees taken from diverse organizations. Sample age range was 22 to 60 years. The findings of Confirmatory factor analysis supported single factor structure of turnover intention scale with good fit model with Root mean square error .04. The alpha reliability coefficient of the Urdu version turnover intention scale was ?= .87. The findings also showed that turnover intention scale is a promising assessment tool having high validity and reliability.

Comparative Study between Pregnant and Non-Pregnant Women Regarding Variation of Liver Function Tests: Assessment of Health Literacy

&#x0D; &#x0D; &#x0D; Context: Pregnancy is associated with normal physiological adaptive changes. Biochemical parameters reflect these changes and are distinct from the non-pregnant state. Low levels of health literacy have been shown to result in less healthy choices, riskier behavior, poorer health, less self-management, and more hospitalization among that category of adult patients. Aim: The study aimed to examine the effect of pregnancy on liver function tests among pregnant women during various trimesters of pregnancy and compare with non-pregnant and determine the patients' level of health literacy regarding the variation of liver function tests among those patients.&#x0D; Methods: A descriptive cross-sectional design was used to achieve the study aim. A random sample of 65 women was selected from an outpatient clinic in the maternity hospital; 54 out of them were pregnant women. Three tools were used to collect data, socio-demographic and clinical data assessment sheet; assessment of liver function tests by Cobas c 311; and health literacy management scale. Results: The sample's age range was between 20-40 years. This study revealed that; serum albumin levels decreased from the first trimester (3.7-4.7), and this decrease became progressively more accentuated as the pregnancy advanced (3.35-4.36 decreased significantly to 3.19-3.81). There was no significant decrease in serum AST between pregnant and non-pregnant women, but there was a significant decrease in ALT in pregnant women compared with non-pregnant women (11.90 Vs. 8.60 at p 0.017). In the current study, Serum alkaline phosphatase (ALP) was significantly higher (P˂0.0001) during the third trimester (63-171) compared with the second trimester (33-137), and the first trimester (36-129), and with the control group (48-122). Finally, it was found that a significant decrease in total serum bilirubin concentrations during the second (0.11-0.38) and third trimesters (0.12-0.42) compared to control (0.11-1.57) and the first trimester (0.12-0.85). Moreover, most of the studied sample has a low level of health literacy for all subscales and the total scores.&#x0D; Conclusion: During normal pregnancy, most values of liver function tests remain below the normal upper limits compared to non-pregnant women. Any increase in serum ALT and AST activity levels and serum bilirubin should be considered pathologic and prompt for further evaluation. Moreover, most of the studied sample has a low level of health literacy for all subscales and the total scores. The study recommended that the liver function tests should be routinely investigated during pregnancy to outline any pathologic changes. Focusing on the nurse's role, she should emphasize increasing the patient's level of health literacy regarding the variation of liver function tests. So, it is a must for nurses to develop many skills to enable them to function for this category of patients with low health literacy levels. Also, those patients should be equipped with information-seeking behavior, decision-making abilities, and problem-solving approaches along their health and illness continuum.&#x0D; &#x0D; &#x0D;

Projecting Mortality Rates to Extreme Old Age with the CBDX Model

We introduce a simple extension to the CBDX model to project cohort mortality rates to extreme old age. The proposed approach fits a polynomial to a sample of age effects, uses the fitted polynomial to project the age effects to ages beyond the sample age range, then splices the sample and projected age effects, and uses the spliced age effects to obtain mortality rates for the higher ages. The proposed approach can be used to value financial instruments such as life annuities that depend on projections of extreme old age mortality rates.

Toward a biological basis of the FFM Meta-traits: Associations between the Fisher Type Indicator (FTI) temperament construct and the hierarchical Five Factor Model (FFM) of personality

BackgroundThis large-scale (N = 1870) replication effort of Fisher et al. (2015) (N = 190) examines associations between the Fisher Type Indicator (FTI) temperament construct and the hierarchical Big5/Five Factor Model (FFM) of personality. AimThe original and current studies are among contemporary efforts to link biologically related temperament/personality dimensions with socio-cultural and lexical personality traits. In this context, the current study explores possible links between FFM traits and higher-order personality factors such as the ‘Big Two’ (Stability and Plasticity) and the General Factor of Personality (GFP) and their implications. MethodsBoth studies examine possible associations between four broad neural systems—dopamine and related norepinephrine, serotonin, testosterone, and estrogen/oxytocin and Big5/FFM personality traits. The current sample size is ten times larger (1870 vs. 190) and represents a much broader age distribution (13–82 vs. 20–22) than the original study. Similar statistical procedures were employed to ensure accurate methodological replication. Results and conclusionsThe current study replicated most FTI-FFM associations reported in the original study, thereby lending greater validity to the original findings. Given the current study's larger sample and broader age range, it extended into three other domains: 1. Improved understanding of dopamine-serotonin based meta-traits in the FFM construct and beyond; 2. Consolidated and expanded understanding of gender-related temperament differences; 3. Explore developmental aspects concerning how associations between biological-temperament and socio-cultural FFM personality traits change with age.

Motor Performance in Male Youth Soccer Players: A Systematic Review of Longitudinal Studies.

The aim of this systematic review was to identify and synthesize the available information regarding longitudinal data addressing young soccer players’ motor performance changes. Following the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA) statement, literature searches were performed in three databases: PubMed, ISI Web of Science and SCOPUS. The following descriptors were used: football, soccer, youth, young, player, athlete, physical performance, motor performance, longitudinal. The inclusion criteria were original articles in English with longitudinal data of young males (aged 10–18 years), with the aim to investigate motor performance serial changes. The initial search returned 211 records, and the final sample comprised 32 papers. These papers covered the European continent, and used mixed and pure longitudinal design with variation in sample size and age range. The reviewed studies tended to use different tests to assess the motor performance and aimed to identify changes in motor performance in several ways. In general, they indicated motor performance improvements with age, with a marked influence of biological maturity, body composition, and training stimuli. This review highlights the need for coaches and stakeholders to consider players’ motor performance over time whilst considering biological maturation, biological characteristics, and training stimuli.

Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data.

Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population's median 10-year predicted CVD risk, including its variation within countries by socio-demographic characteristics, and (2) the prevalence of self-reported blood pressure (BP) medication use among those with and without an indication for such medication as per World Health Organization (WHO) guidelines. We conducted a cross-sectional analysis of nationally representative household surveys from 45 LMICs carried out between 2005 and 2017, with 32 surveys being WHO Stepwise Approach to Surveillance (STEPS) surveys. Country-specific median 10-year CVD risk was calculated using the 2019 WHO CVD Risk Chart Working Group non-laboratory-based equations. BP medication indications were based on the WHO Package of Essential Noncommunicable Disease Interventions guidelines. Regression models examined associations between CVD risk, BP medication use, and socio-demographic characteristics. Our complete case analysis included 600,484 adults from 45 countries. Median 10-year CVD risk (interquartile range [IQR]) for males and females was 2.7% (2.3%-4.2%) and 1.6% (1.3%-2.1%), respectively, with estimates indicating the lowest risk in sub-Saharan Africa and highest in Europe and the Eastern Mediterranean. Higher educational attainment and current employment were associated with lower CVD risk in most countries. Of those indicated for BP medication, the median (IQR) percentage taking medication was 24.2% (15.4%-37.2%) for males and 41.6% (23.9%-53.8%) for females. Conversely, a median (IQR) 47.1% (36.1%-58.6%) of all people taking a BP medication were not indicated for such based on CVD risk status. There was no association between BP medication use and socio-demographic characteristics in most of the 45 study countries. Study limitations include variation in country survey methods, most notably the sample age range and year of data collection, insufficient data to use the laboratory-based CVD risk equations, and an inability to determine past history of a CVD diagnosis. This study found underuse of guideline-indicated BP medication in people with elevated CVD risk and overuse by people with lower CVD risk. Country-specific targeted policies are needed to help improve the identification and management of those at highest CVD risk.

Examining Criteria for Defining Persistent Post-concussion Symptoms in Children and Adolescents.

Researchers operationalize persistent post-concussion symptoms in children and adolescents using varied definitions. Many pre-existing conditions, personal characteristics, and current health issues can affect symptom endorsement rates in the absence of, or in combination with, a recent concussion, and the use of varied definitions can lead to differences in conclusions about persistent symptoms and recovery across studies. This study examined how endorsement rates varied by 14 different operational definitions of persistent post-concussion symptoms for uninjured boys and girls with and without pre-existing or current health problems. This cross-sectional study included a large sample (age range: 11–18) of girls (n = 21,923) and boys (n = 26,556) without a recent concussion who completed the Post-Concussion Symptom Scale at preseason baseline. Endorsements rates varied substantially by definition, health history, and current health issues. The most lenient definition (i.e., a single mild symptom) was endorsed by most participants (54.5% of boys/65.3% of girls). A large portion of participants with pre-existing mental health problems (42.7% of boys/51.5% of girls), current moderate psychological distress (70.9% of boys/72.4% of girls), and insufficient sleep prior to testing (33.4% of boys/47.6% of girls) endorsed symptoms consistent with mild ICD-10 postconcussional syndrome; whereas participants with no current or prior health problems rarely met this definition (1.6% of boys/1.6% of girls). The results illustrate the tremendous variability in the case definitions of persistent symptoms and the importance of harmonizing definitions across future studies.