Neuropsychological Deficits in Disordered Screen Use Behaviours: A Systematic Review and Meta-analysis.

Over the last few decades, excessive and disordered screen use has become more prevalent, prompting investigations into its associated consequences. The extent to which disordered screen use behaviours impact neuropsychological functioning has been reportedly mixed and at times inconsistent. This review sought to synthesise the literature and estimate the magnitude of overall cognitive impairment across a wide range of disordered screen use behaviours. We also sought to determine the cognitive domains most impacted, and whether the observed impairments were moderated by the classification of screen-related behaviours (i.e., Internet or gaming) or the format of cognitive test administration (i.e., paper-and-pencil or computerised). A systematic search of databases (Embase, PsycINFO, MEDLINE) identified 43 cross-sectional articles that assessed neuropsychological performance in disordered screen use populations, 34 of which were included in the meta-analysis. A random-effects meta-analysis revealed significant small/medium (g = .38) cognitive deficits for individuals with disordered screen use behaviours relative to controls. The most affected cognitive domain with a significant medium effect size (g = .50) was attention and focus followed by a significant reduction in executive functioning (g = .31). The classification of disordered screen use behaviours into Internet or gaming categories or the format of cognitive testing did not moderate these deficits. Additionally, excluding disordered social media use in an exploratory analysis had little effect on the observed outcomes. This study highlights a number of methodological considerations that may have contributed to disparate findings and shows that disordered screen use can significantly impact cognitive performance. Recommendations for future research are also discussed. Data for this study can be found at https://osf.io/upeha/ .

Understanding University Students during COVID-19: A Longitudinal Mixed-Methods Analysis of Their Experiences of Online Learning, Mental Health, Academic Engagement, and Academic Self-Efficacy.

INTRODUCTION: Research has consistently demonstrated that the COVID-19 pandemic, and resulting sudden shift to online learning (OL), had detrimental impacts on the motivation and mental health of university students. To date however this research has been cross-sectional and quantitative. METHOD: This study employed a mixed-methods design to examine the experiences of students at a large national Australian University both at the outset of the pandemic in 2020 (n = 824) and again 6 months later (n = 254) at the conclusion of their academic year. RESULTS: Key findings from this study highlighted that despite quantitative findings suggesting poorer attitudes toward learning during the pandemic, qualitatively students perceived both positives and negatives to studying online. The qualitative results further highlighted that this experience was not the same for all and suggests the need to reconsider the standard approaches to offering support for students. CONCLUSION: Students reported poor mental health in both time points, but outlined avenues which improved not only their mental health but also their motivation for studying such as increased peer engagement and self-care activities. Students reported that OL negatively impacted on both their engagement with studies and their mental health, highlighting the need for universities to prioritize supporting their students' mental health as much as their development of academic skills.

Managing surgical demand when needs outstrip resource: qualitative investigation of colorectal cancer surgery provision in the first wave of the COVID-19 pandemic.

BACKGROUND: At the onset of the COVID-19 pandemic, elective surgical provision was severely affected by the need for hospital reorganization to care for critically ill patients. In response, National Health Service (NHS) England issued national guidance proposing acceptable time intervals for postponing different types of surgical procedure. This study reports healthcare professionals' private accounts of the strategies adopted to manage the imbalance of demand and resource, using colorectal cancer surgery as a case study. METHODS: Twenty-seven semistructured interviews were conducted with healthcare professionals between June and November 2020. A key informant sampling approach was used, followed by snowballing to achieve maximum regional variation across the UK. Data were analysed thematically using the constant comparison approach. RESULTS: In the context of considerable resource constraint, surgical teams overcame challenges to continue elective cancer provision. They achieved this by pursuing a combination of strategies: relocating surgical services; prioritizing patients within and across surgical specialties; adapting patient treatment plans; and introducing changes to surgical team working practices. Despite national guidance, prioritization decisions were framed as complex, and the most challenging of the strategies to implement, both practically and emotionally. CONCLUSION: There is a need to better support surgeons tasked with prioritizing patients when capacity exceeds demand.

Emotion Recognition and Traumatic Brain Injury: a Systematic Review and Meta-Analysis.

Traumatic brain injury (TBI) can lead to impairments in emotion recognition that can present considerable challenges to social communication and the maintenance of interpersonal relationships. This review aimed to estimate the magnitude of emotion recognition impairments in TBI patients overall, and at the emotion category level, and to determine if the magnitude of observed impairments were moderated by modality (e.g., face, voice, multi-modal) of emotional expression, and severity of injury. Searches of PubMed, Scopus, PsycINFO, and Medline databases identified 17 studies which satisfied strict inclusion and exclusion criteria for the systematic review (comparing TBI patients to matched controls). Of these studies, 15 were included in the meta-analysis (NTBI = 474; NControl = 461). Moderate/large average deficits emerged for TBI patients relative to controls (Hedges' g = 0.79, 95% CI: 0.61 - 0.96, p < .001; Q = 22.53, p = .068, τ2 = 0.04, I2 = 37.84; indicating low heterogeneity). TBI patients were impaired across all emotion categories, with moderate/large effect sizes observed for fear and anger, moderate effect sizes for disgust, neutral and sadness, while effect sizes for happiness and surprise were small. The magnitude of impairment for individuals with TBI severity classified as moderate/severe TBI was moderate, whereas severe TBI was large. Moderate/large effect sizes were observed across the different modalities of presentation. This meta-analysis provides evidence for marked global impairments in emotion recognition, with the magnitude of impairment greatest for negative emotions (i.e., anger and fear). This meta-analysis provided no evidence to suggest that the magnitude of impairment is influenced by injury severity or modality of stimulus presentation. Recommendations for future research are discussed.

The myriad of complex demographic responses of terrestrial mammals to climate change and gaps of knowledge: A global analysis.

Approximately 25% of mammals are currently threatened with extinction, a risk that is amplified under climate change. Species persistence under climate change is determined by the combined effects of climatic factors on multiple demographic rates (survival, development and reproduction), and hence, population dynamics. Thus, to quantify which species and regions on Earth are most vulnerable to climate-driven extinction, a global understanding of how different demographic rates respond to climate is urgently needed. Here, we perform a systematic review of literature on demographic responses to climate, focusing on terrestrial mammals, for which extensive demographic data are available. To assess the full spectrum of responses, we synthesize information from studies that quantitatively link climate to multiple demographic rates. We find only 106 such studies, corresponding to 87 mammal species. These 87 species constitute <1% of all terrestrial mammals. Our synthesis reveals a strong mismatch between the locations of demographic studies and the regions and taxa currently recognized as most vulnerable to climate change. Surprisingly, for most mammals and regions sensitive to climate change, holistic demographic responses to climate remain unknown. At the same time, we reveal that filling this knowledge gap is critical as the effects of climate change will operate via complex demographic mechanisms: a vast majority of mammal populations display projected increases in some demographic rates but declines in others, often depending on the specific environmental context, complicating simple projections of population fates. Assessments of population viability under climate change are in critical need to gather data that account for multiple demographic responses, and coordinated actions to assess demography holistically should be prioritized for mammals and other taxa.

Plant traits moderate pollen limitation of introduced and native plants: a phylogenetic meta-analysis of global scale.

The role of pollination in the success of invasive plants needs to be understood because invasives have substantial effects on species interactions and ecosystem functions. Previous research has shown both that reproduction of invasive plants is often pollen limited and that invasive plants can have high seed production, motivating the questions: How do invasive populations maintain reproductive success in spite of pollen limitation? What species traits moderate pollen limitation for invaders? We conducted a phylogenetic meta-analysis with 68 invasive, 50 introduced noninvasive and 1931 native plant populations, across 1249 species. We found that invasive populations with generalist pollination or pollinator dependence were less pollen limited than natives, but invasives and introduced noninvasives did not differ. Invasive species produced 3× fewer ovules/flower and >250× more flowers per plant, compared with their native relatives. While these traits were negatively correlated, consistent with a tradeoff, this did not differ with invasion status. Invasive plants that produce many flowers and have floral generalisation are able to compensate for or avoid pollen limitation, potentially helping to explain the invaders' reproductive successes.

Variation in abundance of nectarivorous birds: does a competitive despot interfere with flower tracking?

Adaptive resource tracking in space and time may be disrupted by the modification of resources and competitors. Major global change drivers (e.g. land-use change) have induced declines in many native species, while facilitating only a few. Given that many resources are predicted to become increasingly scarce under the joint effects of climate and land-use change, disturbance-tolerant species that are able to defend high-value resources may further limit the persistence of disturbance-sensitive species. We sought to determine which nectarivorous birds track variation in flowering and if relationships between nectarivores and flowering are affected by on-transect vegetation structure or the occurrence of a native, hyper-aggressive species, the noisy miner Manorina melanocephala, which has become more prevalent. We measured eucalypt flowering and abundances of nectarivorous birds over the course of a year; we measured vegetation structure on the same forest transects. Nectarivores tracked spatial and some temporal variation in flowering, but this relationship was disrupted by noisy miners. Where present in sufficient numbers, the noisy miner excluded small-bodied nectarivores (<63 g) from fragments, limiting the ability of this numerically dominant component of the avifauna to gain access to flowering resources. Altered patterns of interspecific competition due to vegetation fragmentation and climate-induced degradation may have led to changes in the distribution of small nectarivore species that is a departure from the 'ideal free distribution' model. Interactions between noisy miners and small-bodied nectarivores appear to be best described by the 'ideal despotic distribution' model in which noisy miners exclude smaller competitors and monopolize local resources. Increases in the severity and frequency of extreme climatic events (e.g. long droughts) predicted under climate change may create a boom-bust pattern of availabilities of resources. The apparent insensitivity of noisy miners to such variation in flowering resource availability and the miners' influence on the ability of small nectarivores to access resources may lead to disproportionate declines in smaller-bodied nectarivorous species. Reduced tracking of flowering by nectarivores has the potential to disrupt ecosystem services (e.g. pollination, seed dispersal) and may have long-term consequences for the persistence of fragmented vegetation, adding further pressure on forest-dependent biota.

The efficacy of hazard perception training and education: A systematic review and meta-analysis.

BACKGROUND: Hazard perception (HP) has been argued to improve with experience, with numerous training programs having been developed in an attempt to fast track the development of this critical safety skill. To date, there has been little synthesis of these methods. OBJECTIVE: The present study sought to synthesise the literature for all road users to capture the breadth of methodologies and intervention types, and quantify their efficacy. DATA SOURCES: A systematic review of both peer reviewed and non-peer-reviewed literature was completed. A total of 57 papers were found to have met inclusion criteria. RESULTS: Research into hazard perception has focused primarily on drivers (with 42 studies), with a limited number of studies focusing on vulnerable road users, including motorcyclists (3 studies), cyclists (7 studies) and pedestrians (5 studies). Training was found to have a large significant effect on improving hazard perception skills for drivers (g = 0.78) and cyclists (g = 0.97), a moderate effect for pedestrians (g = 0.64) and small effect for motorcyclists (g = 0.42). There was considerable heterogeneity in the findings, with the efficacy of training varying as a function of the hazard perception skill being measured, the type of training enacted (active, passive or combined) and the number of sessions of training (single or multiple). Active training and single sessions were found to yield more consistent significant improvements in hazard perception. CONCLUSIONS: This study found that HP training improved HP skill across all road user groups with generally moderate to large effects identified. HP training should employ a training method that actively engages the participants in the training task. Preliminary results suggest that a single session of training may be sufficient to improve HP skill however more research is needed into the delivery of these single sessions and long-term retention. Further research is also required to determine whether improvements in early-stage skills translate to improvements in responses on the road, and the long-term retention of the skills developed through training.

Sleep disturbance mediates the link between both self-compassion and self-criticism and psychological distress during prolonged periods of stress.

Poor sleep and subsequent decline in mental health often occur during times of prolonged stress, such as a pandemic. Self-compassion is linked with improved sleep and better mental health, while self-criticism is linked with poorer sleep and psychological distress. Given there is little evidence of the interrelationships of these constructs, we examined whether higher self-compassion or lower levels of self-criticism can reduce psychological distress directly and indirectly via sleep during times of prolonged stress. Structural equation modelling was used to analyse two samples (N = 722, Study 1, and N = 622, Replication Study) of university students during different stages of the pandemic. An aggregate psychological distress construct was calculated using depression, anxiety and stress measures. We created models that showed insomnia symptoms mediated the relationship between self-compassion/self-criticism and psychological distress. Sleep partially mediated both relationships, and this was the strongest effect in both samples. This suggests that improving self-compassion and reducing self-criticism will improve sleep, leading to reduced psychological distress. As our findings are robust and held at two time points, future research should investigate broader demographics and differing stress responses.

The efficacy of training to improve road safety in elderly pedestrians: A systematic review.

Elderly pedestrians are involved in disproportionately more vehicle-pedestrian crashes than younger age groups. Training programs have been found to be effective in training children in pedestrian behaviours that improve their safety, however there is no consensus on whether older adults benefit from training. This systematic review aimed to identify whether training is effective for older adult pedestrians through analysis of training type, modalities, and the lasting effects of training. A systematic search of Medline, PsycINFO, and Scopus was conducted in March 2022 and updated in September 2023. Eight studies met the criteria all of which were high quality. Four distinct training types were found: physical (e.g., training physical strength or balance), behavioural (e.g., training specific pedestrian safety behaviours), cognitive (e.g., training reaction time and executive functioning), and educational (training knowledge about pedestrian safety behaviours). Physical training types were found to be most effective, followed by behavioural, cognitive, and educational respectively. Twelve pedestrian behaviours were measured across the eight studies. Reaction time was the most effectively trained outcome, followed by missed crossing opportunities. Errors of stimuli, median accepted time gap, initiation time and crossing were not effectively trained. The effects of training were maintained at follow-up for missed crossing opportunities only. There was preliminary evidence of potential efficacy of training for specific pedestrian safety behaviours, however, the long-term efficacy of training was not promising. Theory-driven research is needed to better understand why some behaviours are more trainable than others. More research is also needed to determine the real-world generalisability if training is to be recommended for older adult pedestrians.

Plant-pollinator network change across a century in the subarctic.

Animal-mediated pollination is a vital ecosystem service to crops and wild plants, and long-term stability of plant-pollinator interactions is therefore crucial for maintaining plant biodiversity and food security. However, it is unknown how the composition of pollinators and the structure of pollinator interactions have changed across longer time spans relevant to examining responses to human activities such as climate change. We resampled an historical dataset of plant-pollinator interactions across several orders of pollinating insects in a subarctic location in Finland that has already experienced substantial climate warming but little land use change. Our results reveal a dramatic turnover in pollinator species and rewiring of plant-pollinator interactions, with only 7% of the interactions shared across time points. The relative abundance of moth and hoverfly pollinators declined between time points, whereas muscoid flies, a group for which little is known regarding conservation status and responses to climate, became more common. Specialist pollinators disproportionately declined, leading to a decrease in network-level specialization, which could have harmful consequences for pollination services. Our results exemplify the changes in plant-pollinator networks that might be expected in other regions as climate change progresses.

Stability and compatibility of parenteral nutrition solutions; a review of influencing factors.

Both stability and compatibility of parenteral nutrition solutions (PNS) with drug products are major concerns for clinicians and clinical pharmacists, especially when concurrent administration of PNS with intravenous medications (IVM) is unavoidable. Since the same physicochemical principles apply to both adult's and paediatrics' PNS, concerns about stability and compatibility may still apply to both. However, these concerns are relatively more common in paediatrics and neonatal clinical settings, where limited vascular access can be problematic and the coadministration of PNS and drugs is more common. In neonatal and paediatric populations, there have been few experimental studies and comprehensive evaluations looking at medication compatibility with frequently used PNS. This work is part of a larger research project concerned for compatibility of PNS with commonly used intravenous medication in paediatric and neonates. This paper captures and reviews published data on factors influencing stability and compatibility of parenteral nutrition solutions. This information will help clinicians and clinical pharmacists to understand the principals of the stability and compatibility of PNS, furthermore, it will inform better design of future compatibility studies, as it highlights the complexity of PNS and the multiple factors influencing the stability of PNS, and hence its compatibility with IVM. When preparing, prescribing, and administering the PNS, especially when co-administration with IVM is unavoidable, it is important to take into account the physicochemical properties of the PNS components and IVM as well as administration conditions and environmental factors. These factors should also be considered in the design of the compatibility studies of the PNS with the IVM.

Narcissism and Intimate Partner Violence: A Systematic Review and Meta-Analysis.

This review aimed to examine the relationship between intimate partner violence (IPV) perpetration and trait narcissism, and whether the strength of this relationship differs depending on narcissism type (grandiose or vulnerable), the type of violence perpetrated, or the perpetrator's gender. Scopus, Medline, PsycInfo, and Academic Search Complete databases were searched on August 11, 2022. Studies were included if they were in English, measured IPV perpetration and trait narcissism, and examined the relationship between trait narcissism and IPV perpetration. Studies were excluded if they were review papers, conference extracts, book chapters, or if the data was not specific to trait narcissism. The AXIS tool was used to assess the quality and risk of bias of the studies. Twenty-two studies (N = 11,520 participants) were included in the random effects meta-analysis revealing a significant, weak, positive relationship between trait narcissism and IPV perpetration, r = .15. Subgroup analyses revealed physical IPV perpetration was not significantly related to trait narcissism while cyber and psychological IPV perpetration were significantly, positively, weakly related to trait narcissism. No significant difference in the strength of the relationship with IPV perpetration was found between males and females. The relationship between trait narcissism and IPV perpetration was significantly greater for vulnerable narcissism than grandiose narcissism. Overall, the quality of the included studies was high, and risk of bias was low. All measures were self-report and underreporting could be present given both narcissistic traits and IPV perpetration are considered socially undesirable. Future research examining these relationships should specify IPV and narcissism types.

Temperate species underfill their tropical thermal potentials on land.

Understanding how temperature determines the distribution of life is necessary to assess species' sensitivities to contemporary climate change. Here, we test the importance of temperature in limiting the geographic ranges of ectotherms by comparing the temperatures and areas that species occupy to the temperatures and areas species could potentially occupy on the basis of their physiological thermal tolerances. We find that marine species across all latitudes and terrestrial species from the tropics occupy temperatures that closely match their thermal tolerances. However, terrestrial species from temperate and polar latitudes are absent from warm, thermally tolerable areas that they could potentially occupy beyond their equatorward range limits, indicating that extreme temperature is often not the factor limiting their distributions at lower latitudes. This matches predictions from the hypothesis that adaptation to cold environments that facilitates survival in temperate and polar regions is associated with a performance trade-off that reduces species' abilities to contend in the tropics, possibly due to biotic exclusion. Our findings predict more direct responses to climate warming of marine ranges and cool range edges of terrestrial species.

What should be included in case report forms? Development and application of novel methods to inform surgical study design: a mixed methods case study in parastomal hernia prevention.

OBJECTIVES: To describe the development and application of methods to optimise the design of case report forms (CRFs) for clinical studies evaluating surgical procedures, illustrated with an example of abdominal stoma formation. DESIGN: (1) Literature reviews, to identify reported variations in surgical components of stoma formation, were supplemented by (2) intraoperative qualitative research (observations, videos and interviews), to identify unreported variations used in practice to generate (3) a 'long list' of items, which were rationalised using (4) consensus methods, providing a pragmatic list of CRF items to be captured in the Cohort study to Investigate the Prevention of parastomal HERnias (CIPHER) study. SETTING: Two secondary care surgical centres in England. PARTICIPANTS: Patients undergoing stoma formation, surgeons undertaking stoma formation and stoma nurses. OUTCOME MEASURES: Successful identification of key CRF items to be captured in the CIPHER study. RESULTS: 59 data items relating to stoma formation were identified and categorised within six themes: (1) surgical approach to stoma formation; (2) trephine formation; (3) reinforcing the stoma trephine with mesh; (4) use of the stoma as a specimen extraction site; (5) closure of other wounds during the procedure; and (6) spouting the stoma. CONCLUSIONS: This study used multimodal data collection to understand and capture the technical variations in stoma formation and design bespoke CRFs for a multicentre cohort study. The CIPHER study will use the CRFs to examine associations between the technical variations in stoma formation and risks of developing a parastomal hernia. TRIAL REGISTRATION NUMBER: ISRCTN17573805.

Proposed Tool to Compare and Assess the Applicability of Taste Assessment Techniques for Pharmaceuticals.

Palatability is amongst the most important determinants of whether or not a child will take a medicine. In order to increase concordance with treatment regimens it is often necessary to utilise a range of formulation techniques to improve the palatability of medicines. These can include selecting a different molecule or version of a molecule (such as a different polymorph or salt form), various taste masking techniques and/or the inclusion of flavours and sweeteners. In order to be able to understand the taste of the Active Pharmaceutical Ingredient (API) and to validate the formulation approach used, it is necessary to be able to use the most reliable taste evaluation method possible. Multiple in vivo and in vitro methods exist nowadays or are proposed in the literature but are often little understood by the pharmaceutical product development community. In particular, different methods may be more relevant at different stages of product development. The aim of this article is to propose a tool to guide the selection of the most appropriate method for the desired evaluation. A spreadsheet-based tool is proposed that is designed to allow the systematic assessment of the applicability of any taste assessment technique existing or new to the users proposed application. A series of criteria are defined that will allow the user to assess the analytical, usability and availability factors for the technique that is being considered. Such a systematic review will help the user to understand the benefits and risks of using each methodology for that application. The use of the tool is illustrated based on currently available data and literature. As new/existing methods are developed/improved, the outcomes of the tool may change.

Nasogastric tube placement: changing culture.

The Department of Health recognises that feeding through a misplaced nasogastric feeding tube is largely preventable if appropriate steps are taken, and lists it as a never event. After one such never event at a trust, a team of senior clinical staff, senior nursing staff, radiographers, dietitians and medical educational staff were involved in tackling the causes of the problem. This article discusses the steps they took to change trust culture to make placing nasogastric feeding tubes a safer procedure.

The mere presence of a mobile phone: Does it influence driving performance?

The ubiquity of mobile phones has led to a rapid increase in its presence and use in vehicles, especially among young adults (up to 25 years), who are generally the least experienced group of drivers. The potential for phones to draw attention away from the main driving task has significant consequences for road safety. Previous studies have found that the mere presence of a mobile phone can be distracting by impairing attention in experimental non-driving contexts. However, the effect of phone presence, independent to usage, has not yet been examined in the context of driving. As such, the present study examined whether the mere presence of a mobile phone, its proximity to the driver, and power status (on/off) influenced the driving performance of young drivers. Additionally, this study assessed whether the effects of phone presence and proximity were moderated by an individual's level of dependence on, or emotional attachment to, their phone. A sample of 127 undergraduate psychology students (M = 19.76, SD = 1.63) were randomly assigned to one of four conditions: (1) phone absent (control), (2) phone on, in holder, (3) phone off, in holder, and (4) phone on, in pocket. They all completed the same simulated drive, and were measured for degree of phone dependence and phone emotional attachment. Overall, drivers in all the phone present conditions made significantly more driving errors (speeding and collision) compared to those in the phone absent (control) condition, irrespective of proximity to the phone and whether it was on or off. Phone dependence, but not phone emotional attachment, moderated the effect of phone presence on speeding behaviour. These findings suggest that the mere presence of a phone is distracting for drivers, especially so for those who are highly dependent on their phone, which may place them at a greater risk of a distraction induced crash.

Development and optimisation of simulated salivary fluid for biorelevant oral cavity dissolution.

Drug release within the oral cavity can be of paramount importance for formulations that are designed for specific purposes such as taste-masking, faster onset of therapeutic action, localization of treatment or avoidance of first-pass metabolism. Preclinical methods for assessment of dissolution in the oral cavity are necessary for design and development of these formulation but currently there is no consensus on what variables should be defined to achieve biorelevance in these tests. In this study, biorelevant simulated salivary fluids (SSFs) that can be uniformly applied for oral cavity dissolution testing were developed. Unstimulated saliva (US) SSF and stimulated saliva (SS) SSF were separately developed since the two states significantly differ. Physicochemical properties including pH, buffer capacity, surface tension and viscosity were assessed during development and optimised to mimic human saliva (HS). In order to account for the salivary proteins in HS, use of bovine submaxillary mucin (BSM) and porcine gastric mucin (PGM) in SSFs was evaluated. Following optimisation of the SSFs, biorelevance of the developed SSFs to HS was assessed by their comparative physicochemical properties as well as dissolution profiles of three diverse model compounds (sildenafil citrate, efavirenz, and caffeine) which showed comparable profiles between the SSFs and HS. This work addresses the lack of uniformed biorelevant dissolution media for oral cavity dissolution studies and provides a basis for standardised dissolution tests that provide consistency and harmonisation in future oral cavity dissolution studies. We envisage that this will have a positive impact on the development of new medicines that require functionality in the oral cavity.