Prospective relationships of adolescents' screen-based sedentary behaviour with depressive symptoms: the Millennium Cohort Study.

BACKGROUND: Frequent use of screen-based devices could be a modifiable risk factor for adolescent depression, but findings have been inconsistent and mostly from cross-sectional studies. We examined prospective associations of video gaming, social media, and internet use with depressive symptoms in adolescents. METHODS: A total of 11 341 adolescents from the Millennium Cohort Study, a representative, UK population-based. The main outcome was depressive symptoms from a Moods and Feelings Questionnaire (age 14). Exposures were frequency of video game, social media, and internet use (age 11). Physical activity (effect modifier) was measured by self-report. RESULTS: The fully adjusted models indicated that boys playing video games most days, at least once a week, and at least once a month at age 11 had lower depression scores at age 14 by 24.2% (IRR = 0.77, 95% CI 0.66-0.91), 25.1% (IRR = 0.75, 95% CI 0.62-0.90), and 31.2% (IRR = 0.69, 95% CI 0.57-0.83), compared with playing less than once a month/never. In girls, compared with less than once a month/never, using social media most days at age 11 was associated with 13% higher depression scores at age 14 (IRR = 1.13, 95% CI 1.05-1.22). We found some evidence of associations between using the internet most days and depressive symptoms compared with less than once a month/never in boys (IRR = 0.86, 95% CI 0.75-1.00). More frequent video game use was consistently associated with fewer depressive symptoms in boys with low physical activity, but not in those with high physical activity. CONCLUSIONS: Different types of screen-time may have contrasting associations with depressive symptoms during adolescence. Initiatives to address adolescents' screen-time may require targeted approaches.

Association between physical activity and leisure-time sedentary behavior among 140,808 adolescents aged 12 to 15 from 47 low- and middle-income countries.

OBJECTIVES: Data from high-income countries (HICs) indicate that sedentary behavior is negatively associated with moderate-to-vigorous physical activity (MVPA) in young people. We examined associations between leisure-time sedentary behavior (LTSB) and MVPA in adolescents from 47 low- and middle-income countries (LMICs). STUDY DESIGN: Cross-sectional study. METHODS: Data from the Global school-based Student Health Survey were analyzed in 140,808 adolescents (13.8 ± 1.0 years; 49% girls). Time spent in LTSB was a composite variable assessing time spent sitting and playing computer games, watching TV, talking with friends during a typical day. The PACE + Adolescent Physical Activity Measure assessed MVPA levels. The association between ≥3 h/day of LTSB and adequate physical activity levels (every day last week 60 min MVPA) was explored with multivariable logistic regression analyses. RESULTS: The prevalence of ≥3 h/day of LTSB and 60 min of MVPA/day last week were 26.3% (girls 26.2%; boys 26.5%) and 15.3% (girls 12.1%; boys 18.4%), respectively. LTSB of ≥3 h/day versus <3 h/day was associated with a 35% increased odds for adequate levels of MVPA in boys [OR = 1.35 (95%CI = 1.23-1.48)] and 22% in girls [1.22 (95%CI = 1.10-1.36)]. CONCLUSIONS: Our data indicate that being physically active 60 min per day every day and at moderate-to-vigorous intensity and being sedentary ≥3 h/day during leisure-time might co-exist in adolescents in some LMICs.

Validity of the 12-item version of the General Health Questionnaire in detecting depression in the general population.

OBJECTIVES: The 12-item version of the General Health Questionnaire (GHQ-12) is frequently used to measure common mental disorder in public health surveys, but few population-based validations have been made. We validated the GHQ-12 against structured psychiatric interviews of depression using a population-based cohort in Stockholm, Sweden. METHODS: We used a population-based cohort of 484 individuals in Stockholm, Sweden (participation rate 62%). All completed the GHQ-12 and a semi-structured psychiatric interview. Last month DSM-III-R symptoms were used to classify major and minor depression. Three scoring methods for GHQ-12 were assessed, the Standard, Likert and Corrected method. Discriminatory ability was assessed with area under the receiver operating characteristic (ROC) curve. RESULTS: A total of 9.5% had a major or minor depression. The area under the ROC curve was for the Standard method 0.73 (0.65-0.82), the Likert method 0.80 (0.72-0.87) and the Corrected method 0.80 (0.73-0.87) when using major or minor depression as standard criterion. Adequate sensitivity and specificity for separating those with or without a depressive disorder was reached at ≥12 Likert scored points (80.4 and 69.6%) or ≥6 Corrected GHQ points (78.3 and 73.7%). Sensitivity and specificity was at ≥2 Standard scored points 67.4% and 74.2%. CONCLUSION: When scored using the Likert and Corrected methods, the GHQ-12 performed excellently. When scored using the Standard method, performance was acceptable in detecting depressive disorder in the general population. The GHQ-12 appears to be a good proxy for depressive disorder when used in public health surveys.

Changes in alcohol consumption between 2009 and 2014 assessed with the AUDIT.

BACKGROUND: Alcohol habits in Sweden, assessed as sales and estimates of unrecorded consumption, have changed since joining the EU. Earlier studies using the Alcohol Use Disorders Identification Test (AUDIT) showed that reported consumption is consistent with sales data, which makes it possible to assess consumption according to sex and age. AIMS: This study reports the changes in alcohol habits between 2009 and 2014, a period starting a couple of years after Sweden joined the EU. METHOD: The AUDIT was sent to a random sample of the Swedish population aged between 17 and 80 years old. RESULTS: No statistically significant changes were shown in six age and sex groups. CONCLUSIONS: Alcohol habits have stabilised in Sweden but on a higher consumption level than before.

Relations between psychophysical measures of spatial hearing and self-reported spatial-hearing abilities.

OBJECTIVE: The aim of the present study was to investigate how well the virtual psychophysical measures of spatial hearing from the preliminary auditory profile predict self-reported spatial-hearing abilities. DESIGN: Virtual spatial-hearings tests (conducted unaided, via headphones) and a questionnaire were administered in five centres in Germany, the Netherlands, Sweden, and the UK. Correlations and stepwise linear regression models were calculated among a group of hearing-impaired listeners. STUDY SAMPLE: Thirty normal-hearing listeners aged 19-39 years, and 72 hearing-impaired listeners aged 22-91 years with a broad range of hearing losses, including asymmetrical and mixed hearing losses. RESULTS: Several significant correlations (between 0.24 and 0.54) were found between results of virtual psychophysical spatial-hearing tests and self-reported localization abilities. Stepwise linear regression analyses showed that the minimum audible angle (MAA) test was a significant predictor for self-reported localization abilities (5% extra explained variance), and the spatial speech reception threshold (SRT) benefit test for self-reported listening to speech in spatial situations (6% extra explained variance). CONCLUSIONS: The MAA test and spatial SRT benefit test are indicative measures of everyday binaural functioning. The binaural SRT benefit test was not found to predict self-reported spatial-hearing abilities.

Technology and everyday functioning in people with intellectual disabilities: a Rasch analysis of the Everyday Technology Use Questionnaire (ETUQ).

BACKGROUND: As people with intellectual disabilities (ID) today live integrated in society and use different technological artefacts and services in their everyday life, more in-depth evaluation methods are crucial to detect strengths and limitations of their everyday technology use. The Everyday Technology Use Questionnaire (ETUQ) was originally designed to investigate the extent to which older adults with cognitive limitations can use the everyday technology that is of relevance to them. The purpose of this study was to explore and evaluate evidence of the validity of ETUQ among adult persons with ID. METHODS: The original 93-item ETUQ was used to interview 120 adult participants with ID, recruited from a region in northern Sweden. A Rasch model was used to analyse the psychometric properties of the rating scale, scale validity, person response validity and person separation. RESULTS: The ETUQ rating scale displayed sound psychometric properties when used with this sample. The goodness-of-fit statistics showed that 15 (16%) of the 93 items demonstrated higher values than expected. A step-by-step removal process of items not demonstrating fit to the model resulted in an ETUQ version with 46 items (49%) that met all the criteria for scale validity. Fifteen participants (12%), primarily with mild ID, still demonstrated a higher number of unexpected responses included in ETUQ. CONCLUSIONS: The results of this study indicate that the ETUQ generates a valid measure of perceived difficulty in using everyday technology including adult persons with ID.

Right-hemispheric brain activation correlates to language performance.

Language function in the right-hemispheric homologues of Broca's and Wernicke's areas does not only correlate with left-handedness or pathology, but occurs naturally in right-handed healthy subjects as well. In the current study, two non-invasive methods of assessing language lateralization are correlated with behavioral results in order to link hemispheric dominance to language ability in healthy subjects. Functional magnetic resonance imaging (fMRI) together with a sentence-completion paradigm was used to determine region-specific lateralization indices in the left- and right-sided Broca's and Wernicke's areas, the frontal temporal lobe, the anterior cingulate cortex and the parietal lobe. In addition, dichotic listening results were used to determine overall language lateralization and to strengthen conclusions by correlating with fMRI indices. Results showed that fMRI lateralization in the superior parietal, the posterior temporal, and the anterior cingulate cortices correlated to dichotic listening. A decreased right ear advantage (REA), which indicates less left-hemispheric dominance in language, correlated with higher performance in most administered language tasks, including reading, language ability, fluency, and non-word discrimination. Furthermore, right hemispheric involvement in the posterior temporal lobe and the homologue of Broca's area suggests better performance in behavioral language tasks. This strongly indicates a supportive role of the right-hemispheric counterparts of Broca's and Wernicke's areas in language performance.

Associations of physical activity and depression: Results from the Irish Longitudinal Study on Ageing.

Physical activity (PA) can protect against depression, but few studies have assessed whether meeting PA guidelines is sufficient, or if benefits can be derived from greater volumes of PA. The present study examines cross-sectional and prospective associations between different volumes of moderate-to-vigorous PA (MVPA) and walking, and depressive symptoms and status. Participants (n = 4556; 56.7% female) aged ≥ 50 years completed the International PA Questionnaire (IPAQ) at baseline and the Center for Epidemiological Studies Depression Scale at baseline and two years later. Prevalence and incidence of depression were 9.0% (n = 410) and 5.0% (n = 207), respectively. After full adjustment, odds of prevalent depression were: 40% (OR = 0.60, 95%CI: 0.48-0.76) lower among those meeting PA guidelines; 23% (OR = 0.77, 0.49-1.21) and 43% (OR = 0.57, 0.45-0.73) lower among those in moderate and high categories, respectively; and, 22% (OR = 0.78, 0.61-1.01) and 44.0% (OR = 0.56, 0.42-0.74) lower among those in moderate and high walking tertiles, respectively. Odds of incident depression were: 23% (OR = 0.77, 0.58-1.04) lower among those meeting PA guidelines; 37% (OR = 0.63, 0.32-1.22) and 20.0% (OR = 0.80, 0.59-1.09) lower among those in moderate and high categories, respectively; and, 21% (OR = 0.79, 0.56-1.12) and 25% (OR = 0.75, 0.52-1.07) lower among those in moderate and high walking tertiles, respectively. Moderate and high volumes of MVPA were significantly associated with lower odds of concurrent depression, and significantly and non-significantly associated with reduced odds of incident depression, respectively. Meeting recommended levels of MVPA and walking were associated with significantly lower odds of concurrent depression, and non-significantly reduced odds of the development of depression over two years.

Sedentary behavior and anxiety: Association and influential factors among 42,469 community-dwelling adults in six low- and middle-income countries.

OBJECTIVE: This study investigated the association between sedentary behavior (SB) and anxiety, and explored factors that influence this relationship in six low- and middle-income countries. METHOD: Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. Multivariable linear and logistic regression analyses were conducted to assess the association between anxiety and self-reported SB. Potentially influential factors were examined with mediation analysis. RESULTS: The sample consisted of 42,469 adults aged≥18years (50.1% female; mean age 43.8years). After adjusting for sociodemographics and country, people with anxiety engaged in 24 (95%CI=7-41) more minutes per day of SB than non-anxious individuals; the corresponding figure for the elderly (≥65years) was much higher (55min; 95% CI=29-81). Anxiety was associated with a 2.0 (95%CI=1.5-2.7) times higher odds for high SB (i.e., ≥8h/day). Overall, the largest proportion of the high SB-anxiety relationship was explained by mobility limitations (46.8%), followed by impairments in sleep/energy (44.9%), pain/discomfort (31.7%), disability (27.0%), cognition (13.3%), and physical activity levels (6.3%). CONCLUSIONS: Anxiety was significantly associated with high SB, particularly among older adults. Future longitudinal studies are warranted to disentangle the potentially complex interplay of factors that may influence the anxiety-SB relationship.

Altered expression of CD11b/CD18 and CD62L on human monocytes after cell preparation procedures.

We have investigated the effect of different cell preparation procedures on the surface expression of CD11b/CD18 and CD62L on human monocytes. Both EDTA and heparin anticoagulated blood were used as sources for leukocytes. The monocytes were analysed by flow cytometry in a mixed leukocyte suspensions obtained after ammonium chloride mediated lysis and in mononuclear cell suspension prepared by density gradient centrifugation (Ficoll-Paque) performed both at 4 degrees C and at 20 degrees C. Monocytes from heparinized blood had a higher expression of CD11b/CD18 and a more pronounced inter-individual variation than monocytes from EDTA blood. Monocytes isolated by Ficoll-Paque had a higher degree of ex vivo activation by means of altered expression of CD11b/CD18 and CD62L compared to monocytes prepared by ammonium chloride mediated lysis. This was more pronounced when the isolation procedure was performed at 20 degrees C. Our findings indicate that monocytes prepared by ammonium chloride mediated lysis of EDTA blood and with the cell handling temperature kept at 4 degrees C are exposed to the smallest ex vivo modulation by means of receptor alteration. An awareness of ex vivo modulation by different cell preparation procedures is of importance especially when comparing the expression of functional receptors on leukocytes of disparate origin.

Up-regulation of antigens on alveolar macrophages in quartz exposed rats.

We have analysed the expression of the OX-6 and OX-42 antigens on alveolar macrophages in rats after intratracheal exposure to quartz. Eight female Sprague Dawley rats were included in the study. Four were exposed to physiological saline and four to quartz dust. The rats were sacrificed after 58 +/- 2 weeks and alveolar macrophages were harvested and analysed by flow cytometry. We found a significant higher amount of both antigens on alveolar macrophages harvested from quartz exposed rats. However, we did not find any significant difference in the percentage positive labeled cells between the two groups. We conclude that quartz dust induces up-regulation of functional receptors on alveolar macrophages in rats and that quantitative analysis of these receptors may serve as inflammatory markers in the bronchoalveolar space.

Evaluation of a cognitive test battery in young and elderly normal-hearing and hearing-impaired persons.

A cognitive test battery sensitive to processes important for speech understanding was developed and investigated. Test stimuli are presented as text or in an auditory or audiovisual modality. The tests investigate phonologic processing and verbal information processing. Four subject groups, young/elderly with normal-hearing and young/elderly with hearing impairment, each including 12 subjects, participated in the study. The only significant effect in the text modality was an age effect in the speed of performance, seen also in the auditory and audiovisual modalities. In the auditory and audiovisual modalities, the effects of hearing status and modality were seen in accuracy parameters. Interactions between hearing status and modality, both in accuracy and in reaction times, show that hearing-impaired subjects have difficulties without visual cues. Performing the test battery in noise made the tasks more difficult, especially in the auditory modality and for the elderly, affecting both accuracy and speed. Test-retest measurements showed learning effects and a modality-dependent variability. The test battery has proven useful in assessing the relative contribution of different input signals and the effects of age, hearing impairment, and visual contribution on functions important for speech processing.

A system for recording of auditory evoked responses.

A system for recording of evoked potentials from auditory stimulation was developed. The system consists of a PC equipped with an audio bandwidth board with analog input and output channels. The sound stimulus signal is generated in the computer, D/A converted, and via audio amplifier fed to earphones on the test subject. Auditory evoked potentials in response to sound stimuli are recorded via electrodes, amplified and filtered in an EEG recording system and fed to an A/D converter. The signal is analysed in the PC. The modular design of the program makes it a flexible system where stimulus and recording parameters can easily be modified and new applications can be added to standard clinical measurements. Three applications that are not possible with commercially available systems were developed and evaluated. a) A diagnostic procedure to verify hydrops in patients with Meniere's disease. b) Intraoperative recordings of auditory evoked potentials during neurootological surgery. c) Recording of mismatch negativity (MMN) potentials in evaluation of central auditory functions.

Dichotic speech tests.

When central auditory dysfunction is present, ability to understand speech in difficult listening situations can be affected. To study this phenomenon, dichotic speech tests were performed with test material in the Swedish language. Digits, spondees, sentences and consonant-vowel syllables were used as stimuli and the reporting was free or directed. The test material was recorded on CD. The study includes a normal group of 30 people in three different age categories; 11 years, 23-27 years and 67-70 years. It also includes two different groups of subjects with suspected central auditory lesions; 11 children with reading and writing difficulties and 4 adults earlier exposed to organic solvents. The results from the normal group do not show any differences in performance due to age. The children with reading and writing difficulties show a significant deviation for one test with digits and one test with syllables. Three of the four adults exposed to solvents show a significant deviation from the normal group.

Cognitive effects in dichotic speech testing in elderly persons.

OBJECTIVE: To study the effect of chronologic age on central auditory functions using dichotic speech tests and to study whether and how the age effect in dichotic listening is related to cognitive ability. DESIGN: Dichotic speech tests and cognitive tests were performed on 30 bilaterally hearing-impaired subjects, with a pure-tone average better than 50 dB HL. They were between 42 and 84 yr of age and were divided into an older and a younger group comprising 15 subjects each. The dichotic test material were digits, low-redundancy sentences and consonant-vowel syllables. The subjects reported stimuli heard in both ears (free report) or in one ear (directed report to left or right ear). The cognitive test battery comprised tests focusing on short-term memory, verbal information-processing speed and phonologic processing. RESULTS: A decreased overall performance in all dichotic speech tests was observed in the older group. In the syllable test the older subjects showed poorer results when focusing on the stimuli heard in the left ear, as compared with when focusing on stimuli heard in the right ear, whereas the younger group showed almost equal results for left- and right ear-focusing conditions. An age effect was also seen in reaction times recorded in the cognitive tests and in the scores of the reading span test. These cognitive parameters correlate with the results of the dichotic test when focusing to the left, but not when focusing to the right in the directed report condition. In the free report condition the overall performance showed a high correlation with cognitive test parameters. CONCLUSIONS: Effects of chronologic age in dichotic speech tests in the elderly have been verified. The degree of effect is dependent on test material, way of reporting and focusing condition. The different listening tasks in dichotic tests put different demands on cognitive ability shown by a varying degree of correlations between cognitive function and dichotic test parameters. Also, the results indicate a strong connection between age-related cognitive decline in the elderly and problems to perceive stimuli presented to the left ear.

Monocyte and neutrophil adhesion to matrix proteins is selectively enhanced in the presence of inflammatory mediators.

The authors investigated the time course of monocyte and neutrophil adhesion to fibronectin, vitronectin and albumin precoated culture wells, using mixed leucocyte populations from healthy blood donors. Moreover, the influence of chemotactic agonists on the adhesion properties as well as the quantitative expression of CD29, CD11b/CD18 and CD61 was analysed by flow cytometry. Different chemotactic agonists were used representing a classical chemotactic agonist (fMLP), and agonists with a preferential effect on monocytes (RANTES) and neutrophils (IL-8), respectively. The authors found a gradual increase in monocyte and neutrophil adhesion to all three surfaces, reaching a plateau at 15 min of incubation. Adhesion to fibronectin was significantly higher at all time points (5, 15 and 60 min, respectively) compared with vitronectin and albumin in both monocytes and neutrophils. Neutrophil adhesion to vitronectin was significantly lower at 60 min compared with 15 min. Monocyte adhesion to albumin was increased by fMLP and RANTES and to vitronectin also by IL-8. Neutrophil adhesion to albumin and vitronectin was increased by fMLP and IL-8, but not RANTES. The adhesion to fibronectin was not altered by any of the chemotactic agonists used. The quantitative levels of CD11b/CD18, but not CD29 and CD61, was increased by fMLP, but not RANTES nor IL-8. The authors conclude that the adhesion of human monocytes and neutrophils to vitronectin and albumin, but not fibronectin, is selectively enhanced by chemotactic agonists and may contribute to the selective accumulation of different leucocyte subsets at the inflammatory site.

Preventative mental health care: accessing the target population.

OBJECTIVE: Preventative approaches to mental illness are becoming a focus of clinical and research settings. To date, however, few clinical programs have been established with this primary aim. This descriptive paper summarises patterns of referral to one service providing clinical care for young people known to be at high risk of developing a psychotic illness. METHODS AND RESULTS: A 20-month survey of referrals to the service revealed that most patients had a prolonged and circuitous route to assessment. Additionally, a lengthy time period elapsed between the onset of symptoms and initiation of help seeking. CONCLUSIONS: Information arising from this survey may influence the development of strategies to improve access to this service and others aimed at the prevention of psychosis. Further, this information may affect the development of generalised preventative mental health services for young people.

Chronic smoke exposure alters the phenotype pattern and the metabolic response in human alveolar macrophages.

Smoking induces a chronic inflammatory process in the lower respiratory tract, where the alveolar macrophages (AM) are the main phagocytes. In the present study, the expressions of different membrane glycoproteins (CD11abc, CD71, CD54, CD14 and CD16) were determined by flow cytometry in AM from smokers and non-smokers after quenching of the intracellular autofluorescence. The metabolic activity of the AM was quantified as a functional test. The expressions of CD11a, CD54 and CD71 were higher in non-smokers' AM than in smokers'. The expressions of CD11b and CD16 were similar between the groups, while the CD11c was higher in smokers' AM compared with non-smokers'. The expression of CD14 was weak in both groups, therefore there was no clear-cut difference between the background and positively labelled cell populations. The metabolic response after in vitro stimulation with the phorbol ester phorbol myristate acetate (PMA) was higher in non-smokers' than in smokers' AM. Our results indicate that chronic exposure to tobacco smoke influences both the expression of AM membrane antigens and the metabolic activity. AM from non-smokers express a phenotype more related to cell proliferation and an accessory function. In contrast, receptors reflecting adhesion and phagocytosis were unaltered or even increased in smokers' AM. The findings suggest a functional change in the AM population after chronic smoke exposure.

A study evaluating the efficacy and tolerability of tropisetron in combination with dexamethasone in the prevention of delayed platinum-induced nausea and emesis.

BACKGROUND: Chemotherapy-induced emesis is one of the most disturbing side effects of cancer therapy. Control of acute emesis has improved substantially during recent years, but control of delayed emesis and nausea remains a challenging problem. The role of 5-HT3 receptor antagonists in the treatment of delayed emesis is disputed. METHODS: Tropisetron, a highly specific 5-HT3 receptor antagonist, was compared (as an adjunct to dexamethasone) with placebo in a randomized, double blind, multicenter trial for the prevention of delayed emesis during platinum-containing chemotherapy. Three hundred chemotherapy-naive women with gynecologic malignancies were included. The cisplatin dose was in the range of 50-100 mg/m2. RESULTS: Acute emesis was prevented completely in 87% of patients and acute nausea in 77% of patients in the complete series. During the complete delayed period (Days 2-6), total control of emesis was achieved in 77% of the dexamethasone and tropisetron-treated patients and in 72% of the patients receiving dexamethasone and placebo (P = 0.2473). During the same period nausea was controlled completely in 42% of the dexamethasone and tropisetron group and in 41% of the dexamethasone and placebo group. On Day 3, complete protection from nausea was achieved in 65% of patients receiving tropisetron and in 51% of patients receiving placebo (P = 0.0304). Constipation occurred more frequently in the tropisetron group. CONCLUSIONS: Tropisetron added to dexamethasone improved control of delayed nausea on Day 3 compared with placebo. No significant differences were recorded regarding control of delayed emesis.