'More options less time' in the 'hustle culture' of 'generation sensible': Individualization and drinking decline among twenty-first century young adults.

There has been a dramatic decline in alcohol consumption among younger people, including an increase of conscious moderation and abstinence. Change has a generational character, with different cohorts' drinking changing over time from the heavy, embedded pattern among post-war 'boomers' to the more selective habits initiated by 'millennials'. This is a surprising development in historical terms and has been cast as indicating the emergence of a moderating 'generation sensible'. It is also coincident with more negative trends, such as young adults worsening mental health. Informed by the perspective of individualization, we consider the decline in youth drinking in the context of generational changes in the lifecourse. We focus upon how recent generations of young people experience greater choice, pressure and a prolonged adolescence, characterized by more limited autonomy. Explored with conscious young moderators through a survey (N = 517) and focus groups (N = 13), these themes resonated with our sample who appear a self-conscious generation with significant and open-ended focus upon maintaining their wellbeing and control. Further, they appear more disembedded from pressure to conform but under greater pressure to perform. The same forces of individualization encouraging moderate drinking may also weigh down upon young people who feel under pressure not only to transform their own lives but feel a burden of responsibility for a damaged, unjust world. The article's originality lies in applying individualization to both generational change and consumption, suggesting this can be usefully done through a focus upon freedom/choice and pressure/performance. It also considers what is regarded as the positive trend of drinking decline alongside, and as related to, negative trends such as greater loneliness and less autonomy among young adults.

Emergency Department Presentation of Iliopsoas Hematoma in a Severe Hemophiliac.

Severe hemophilia A is defined by factor VIII level of <1%. Limited research and case series show that these patients are at the highest risk for bleeding complications, the most common being hemarthrosis and muscle hematoma, respectively.1 While rare, iliopsoas hematoma carries significant morbidity, mortality, and requires prompt intervention in hemophiliac patients. As such, it is essential the emergency providers evaluate for this condition in this unique patient population. We present the case of 21-year-old male with severe hemophilia A who presented with one day of right groin pain after going without his prophylactic factor VIII infusions for one week, with subsequent diagnosis and initial treatment of iliopsoas hematoma made in the ED.

Risk, ritual and health responsibilisation: Japan's 'safety blanket' of surgical face mask-wearing.

This article begins to develop an understanding of surgical mask-wearing in Japan, now a routine practice against a range of health threats. Their usage and associated meanings are explored through surveys conducted in Tokyo with both mask wearers and non-mask wearers. It contests commonly held cultural views of the practice as a fixed and distinctively Japanese collective courtesy to others. A historical analysis suggests that an originally collective, targeted and science-based response to public health threats has dispersed into a generalised practice lacking a clear end or purpose. Developed as part of the biomedical response to the Spanish flu of 1919, the practice resonated with folk assumptions as making a barrier between purity and pollution. But mask-wearing became socially embedded as a general protective practice only from the 1990s through a combination of commercial, corporate and political pressures that responsibilised individual health protection. These developments are usefully understood amidst the uncertainty created by Japan's 'second modernity' and the fracturing of her post-war order. Mask-wearing is only one form of a wider culture of risk; a self-protective risk ritual rather than a selfless collective practice.

Media, risk, and absence of blame for "acts of God": attenuation of the European volcanic ash cloud of 2010.

This article analyzes the character, extent, and patterns of media coverage of the 2010 volcanic ash cloud, comparing it with coverage of other major natural hazards, such as Deepwater Horizon. It does so drawing upon sociological themes and concludes that the ash cloud was reported largely in its own terms rather than being amplified as a wider, uncertain threat. As well as the absence of major incident and casualties two interrelated factors are highlighted to explain this result. Emphasizing the importance of hazard duration, the unexpected arrival and short-lived character of the ash cloud was one important factor that limited the potential for sustained media amplification. More broadly, this was an "act of God" with no clear responsible agents. This preliminary study suggests that contemporary media risk narrative requires a focus for institutional blame attribution, and without a plausible candidate amplification may not acquire momentum.

Characterization of class II fumarase from Schistosoma mansoni provides the molecular basis for selective inhibition.

Schistosomiasis is a neglected tropical disease that affects more than 250 million people worldwide. The only drug available for its treatment undergoes first-pass hepatic metabolism and is not capable of preventing reinfection, which makes the search of new therapies urgently needed. Due to the essential role of fumarases in metabolism, these enzymes represent potential targets for developing novel schistosomiasis treatments. Here, we evaluate the expression profiles for class I and class II fumarases from Schistosoma mansoni (SmFHI and SmFHII, respectively), and report the complete characterization of SmFHII. The first SmFHII structure in complex with L-malate was determined at 1.85 Å resolution. The significant thermoshift observed for SmFHII in the presence of identified ligands makes the differential scanning fluorimetry an adequate technique for ligand screening. A complete kinetic characterization of SmFHII was performed, and comparison with the human fumarase (HsFH) revealed differences regarding the turnover number (kcat). Structural characterization allowed us to identify differences between SmFHII and HsFH that could be explored to design new selective inhibitors. This work represents the very first step towards validate the fumarases as drug targets to treat schistosomiasis. Our results provide the structural basis to rational search for selective ligands.

An oropharyngeal device for airway management of conscious and semiconscious patients: A randomized clinical trial.

OBJECTIVE: No oropharyngeal devices exist for use in conscious and semiconscious trauma patients during emergency evacuation, transport, or resuscitation. We aimed to test the hypotheses that the ManMaxAirway (MMA) is better tolerated than the standard Guedel-style device in awake volunteers and that it produces a jaw thrust and improves air flow. METHODS: This was a randomized cross-over study of healthy volunteers with either the MMA or standard device. The primary outcome of tolerability was defined as maintaining the device in place for 60 seconds. Secondary outcomes included respiratory system function and jaw thrust. Resistance to airflow through the device lumen was measured in situ and when placed in subjects in the pulmonary laboratory alone. Jaw thrust was quantified as displacement between the mandibular condyle and condylar fossa apex relative to baseline visualized with magnetic resonance imaging (MRI). RESULTS: We enrolled 19 subjects. Of these, a convenience sample of 5 individuals was selected for MRI; the remaining individuals (n = 14) were randomized for the cross-over study. All 14 subjects were able to maintain the MMA for 60 seconds compared with 2/14 (14%) with the standard device (odds ratio, 145; 95% confidence interval, 6.3-3314). Subjects reported that the experimental device was more comfortable and its placement did not trigger the gag reflex. Airway resistance produced by the MMA in an oscillatory flow model was nearly an order of magnitude lower than that of the standard device (experimental vs standard, 8 Hz-0.092 vs 0.786 cmH20·s/L; 15 Hz-0.193 vs 1.321 cmH20·s/L). Rapid induction of the gag reflex precluded further measurements with the standard device. Forced oscillation pulmonary testing in conscious volunteers with and without the MMA demonstrated that the device decreased respiratory system resistance to airflow and reduced respiratory elastance (31% ± 8% and 44% ± 13.4%, respectively; P < 0.05). MRIs of the subjects (n = 5) with the MMA in place showed a significant jaw thrust compared with baseline (7 ± 1 mm). CONCLUSIONS: The MMA proved well tolerated in conscious subjects, resulting in an opening of the anatomic airway and a decreased resistance to airflow.

Inflammation Predicts Decision-Making Characterized by Impulsivity, Present Focus, and an Inability to Delay Gratification.

Here, we propose a novel theoretical model linking present-focused decision-making to the activities of the immune system. We tested our model by examining the relationship between inflammatory activity - in vivo and in vitro - and decision-making characterized by impulsivity, present focus, and an inability to delay gratification. Results support our model, revealing that inflammation predicts these outcomes even after controlling for factors that may contribute to a spurious linkage between them. Moreover, subsequent analyses revealed that our model was a better fit for the data than alternative models using present-focused decision-making and its health-harming behavioural sequelae (e.g., smoking, risky sexual behaviour) to predict inflammation, lending support for the proposed directionality of this relationship. Together, these results suggest that inflammation may contribute to decision-making patterns that can result in undesirable personal and societal outcomes.