Association between impulsivity and cognitive capacity decrease is mediated by smartphone addiction, academic procrastination, bedtime procrastination, sleep insufficiency and daytime fatigue among medical students: a path analysis.

BACKGROUND: Medical students are at high risk for sleep disturbance. One possible cause of their sleeping problem is impulsivity. We aim to investigate the possible mediators between medical students' impulsivity and sleep outcomes. Thus, we developed and investigated a model where the predictors were attentional, non-planning, and motor impulsivity subtraits. In the final model, subjective cognitive capacity decrease was the outcome variable. In light of previous findings, academic procrastination, smartphone addiction, and bedtime procrastination were considered important mediators as well as two variables of poor sleep, sleeping insufficiency, and daytime fatigue. METHODS: Medical students (N = 211; ageM = 22.15 years; ageSD = 3.47 years; 71.6% women) were recruited to complete an online survey comprised of demographics (age, gender), self-administered scales (Abbreviated Impulsiveness Scale, Bedtime Procrastination Scale, Abbreviated Impulsiveness Scale, Academic Procrastination Scale-Short Form) and questions on tiredness, daily fatigue and subjective cognitive capacity decrease. Correlation and path analyses were implemented to examine hypothesized relationships between the variables. RESULTS: Both attentional impulsivity (ß = 0.33, p < .001) and non-planning impulsivity (ß = -0.19, p < .01) had a direct relationship with cognitive capacity decrease. Attentional impulsivity was also associated with decreased cognitive capacity with a serial mediation effect via smartphone addiction, academic procrastination, bedtime procrastination, sleep insufficiency and fatigue (estimate = 0.017, p < .01). The indirect link between non-planning impulsivity and cognitive capacity decrease was mediated by academic procrastination, bedtime procrastination, sleep insufficiency and fatigue (estimate = 0.011, p < .01). CONCLUSIONS: Inability to stay focused and plan tasks effectively (directly and indirectly) predicts poor sleep outcomes. This relationship is mediated by excessive smartphone use, academic procrastination, and bedtime procrastination. Our findings are relevant in light of self-regulatory learning, which is crucial in medical education. This is a recursive cycle of planning, emotion regulation, proper strategy selection and self-monitoring. Future interventions addressing attentional and non-planning impulsivity, problematic smartphone use, academic procrastination, and in turn, bedtime procrastination might make this routine more effective. In the conclusion section, practical implications of the results are discussed.

Relationships Among Depression, Online Self-Disclosure, Social Media Addiction, and Other Psychological Variables Among Hungarian University Students.

ABSTRACT: In the digital age, besides the well-known contributors to depression, more research is needed on certain activities of social media, such as online self-disclosure. Using an online survey, we examine the associations of depression with social media addiction, online self-disclosure, loneliness, and life satisfaction among a sample of Hungarian university students ( N = 301, aged between 18 and 30 years). There were no sex differences in depression scores. Findings showed the following: a) lonely students; b) those less satisfied with their lives; c) those sharing negative information; and d) those that engage in deep self-disclosure are more likely to report depressive symptomatology. Although social media addiction was a correlate of depression in bivariate analyses, it became nonsignificant when online self-disclosure and other psychological variables were introduced to the model. A more careful accounting of these relationships is needed to more wisely use social media when disclosing information about ourselves.

Utility and practice of electrodiagnostic testing in the pediatric population: An AANEM consensus statement.

Nerve conduction studies and needle electromyography, collectively known as electrodiagnostic (EDX) studies, have been available for pediatric patients for decades, but the accessibility of this diagnostic modality and the approach to testing vary significantly depending on the physician and institution. The maturation of molecular diagnostic approaches and other diagnostic technologies such as neuromuscular ultrasound indicate that an analysis of current needs and practices for EDX studies in the pediatric population is warranted. The American Association of Neuromuscular & Electrodiagnostic Medicine convened a consensus panel to perform literature searches, share collective experiences, and develop a consensus statement. The panel found that electrodiagnostic studies continue to have high utility for the diagnosis of numerous childhood neuromuscular disorders, and that standardized approaches along with the use of high-quality reference values are important to maximize the diagnostic yield of these tests in infants, children, and adolescents.

Living in the midst of fear: Depressive symptomatology among US adults during the COVID-19 pandemic.

BACKGROUND: The current study examines interrelationships between social vulnerability, individual stressors, social and psychological resources, and depressive symptomatology among US adults during the current coronavirus disease 2019 (COVID-19) pandemic. METHODS: Using an online survey platform, a poststratified (by age, gender, race, income, and geography), representative sample (n = 10,368 adults) is used in the analysis. RESULTS: On average, sample respondents report Center for Epidemiological Studies Depression (CES-D) Scale symptomatology nearly a point higher than the often used cutoff score for clinical caseness (16+); one-third of respondents had CES-D scores higher than 25. Multiple regression results show elevated levels of depressive symptomatology among the socially vulnerable (women, Hispanic, unmarried, not working). Those persons expressing heightened COVID-19 fear and moderate to high levels of food insecurity report more depressive symptoms than persons with less fear and low or no food insecurity. All three of the resource variables (mastery of fate, strength of ties, and optimism) are significant and in the negative direction. CONCLUSIONS: In a snapshot, the data provide an important point prevalence assessment of adult depressive symptoms during the current public health crisis. Results highlight the significance of vulnerability and individual stressors in the wake of the COVID-19 pandemic. In addition, the analysis affirms the importance of access to social and psychological resources to combat heightened fear and anxiety that persons report during the current pandemic.

Adolescent food insecurity: the special case of Marshallese youth in north-west Arkansas, USA.

OBJECTIVE: Food insecurity is not randomly dispersed throughout the population; rather, there are a number of risk and protective factors shaping both the prevalence and severity of food insecurity across households and sociodemographic populations. The present study examines some of these factors and the role that race and ethnicity among adolescent individuals in north-west Arkansas might play, paying specific attention to a subgroup of Pacific Islanders: the Marshallese. DESIGN: The study uses cross-sectional survey data collected from a self-administered questionnaire of 10th-12th grade students. SETTING: A city in north-west Arkansas, USA. PARTICIPANTS: The number of enrolled students in the selected high school at the time of the survey was 2148. Ten classrooms (116 students) were unable to participate at the time of the survey, making 2032 students eligible to be surveyed. Approximately 22% refused to participate and 105 students were absent from school, yielding a response rate of approximately 78% (n 1493). RESULTS: Marshallese students had a higher prevalence of food insecurity than all other racial and ethnic groups in the study. After controlling for other sociodemographic, risk and protective factors, their odds of food insecurity remained significantly higher than both non-Hispanic White and Hispanic or Latinx students. CONCLUSIONS: Adolescent food insecurity among Marshallese students must be made sense of in relation to structural-level determinants that shape the distribution of vital resources such as food across racial, ethnic and foreign-born lines.

Examining food insecurity among high school students: A risks and resources model.

Food insecurity is associated with several negative health outcomes, many of which can be detrimental to youth during the vulnerable life stage of adolescence. Among a sample of 1493 high school students, the current study utilizes a risks and resources model to examine ways that risks and resources come together to shape the lives and health of youth, making them more vulnerable or shielding them from food insecurity and its related negative health outcomes. A number of factors are proposed as important correlates of food insecurity measured at four perceived levels of aggregation: individual, family, school/peer, and community. These risks and resources are analyzed using a three-step ordinal regression model. Analyses reveal depression, intact family, student risk, and neighborhood risk are positively related to food insecurity, despite significant sociodemographic differences. In addition, self-esteem, eating meals with family, and peer social capital are all significant and negatively related to food insecurity. Collectively, these findings tell an important story about adolescent food insecurity and the relationships that social and psychological circumstances have with varying levels of food insecurity. This study highlights the importance of children and adolescents as reliable respondents and spokespersons of their own experiences with food insecurity.

Adolescents' attitudes towards healthy eating: The role of self-control, motives and self-risk perception.

BACKGROUND: Adolescence is a critical stage in life course development. It is a particularly relevant stage regarding our understanding of eating behaviors since adolescent's evolving, more autonomous food preferences tend to be influenced by peers and media as much if not more than the family. Therefore, exploring adolescent's eating preferences could be an important focus to developing prevention programs. AIMS: To explore the role of psychological variables (namely, self-risk perception, self-control and eating motivations) and their relationships with healthy eating attitudes. METHODS: A sample of adolescents (Szeged, Hungary, N = 274, ages 14-19 years; mean age = 15.95 years, S.D. = 1.17 years; 54% males) was recruited to participate in the study. Data were collected from self-administered/anonymous questionnaires. Besides descriptive statistics, correlations and a path analysis were applied to examine the relationships between self-control, self-risk perception, eating motivations and healthy eating attitudes. RESULTS: Self-control played a decisive role, both directly and indirectly in healthy eating attitudes, while self-risk-perception had a less important mediating role. Eating motives were directly related to eating attitudes but in a different way: health motives were positively associated with healthy eating attitudes, while social and external motives had a negative relationship. CONCLUSIONS: The path analysis suggests that self-control indeed plays an important role in developing healthy attitudes. While health motives play a more decisive role in health-related attitudes than we might expect, self-risk perception plays a limited role perhaps due to the notion that adolescents typically present a feeling of invulnerability. These findings suggest that despite their diminished self-risk perception, adolescents tend to be health conscious in nutrition, particularly when it combines with the underlying impact of self-control and health motives.

Brain abnormalities in children and adolescents with chronic kidney disease.

BACKGROUND: Chronic kidney disease (CKD) is a risk factor for vascular disease and stroke. The spectrum of brain injury and microstructural white matter abnormalities in children with CKD is largely unknown. METHODS: Cross sectional study at two North American pediatric hospitals. A cohort of 49 children, 29 with CKD, including renal transplant (mean age 14.4 ± 2.9 years; range 9-18), and 20 healthy controls (mean age 13.7 ± 3.1 years; range 9-18) had their conventional brain magnetic resonance images (MRIs) reviewed by one neuroradiologist to determine the prevalence of brain injury. Fractional anisotropy (FA) maps calculated from diffusion tensor imaging (DTI) were generated to compare white matter microstructure in CKD compared to controls, using tract-based spatial statistics (TBSS). RESULTS: Focal and multifocal white matter injury was seen on brain MRI in 6 children with CKD (21%). Relative to controls, CKD subjects showed reduced white matter fractional anisotropy and increased mean diffusivity and radial diffusivity in the anterior limb of the internal capsule, suggestive of abnormal myelination. CONCLUSION: Cerebral white matter abnormalities, including white matter injury, are under-recognized in pediatric CKD patients. Brain imaging studies through progression of CKD are needed to determine the timing of white matter injury and any potentially modifiable risk factors.

Youth Problem Drinking: The Role of Parental and Familial Relationships.

BACKGROUND: Alcohol use continues to be an important global public health problem and adolescence seems to be a decisive period of time in the development of drinking patterns into adulthood. While most studies concentrate on frequency and amount of alcohol, fewer studies address "problem drinking." Gathering information on youth's alcohol-related behavioral consequences is especially important. OBJECTIVES: Current research focuses on gathering information on the background of problem drinking behavior with special attention to parental/familial relationships. METHODS: The survey was conducted within the youth health behavior - Makó research project in 2012 (n = 1,981, aged 13-18 years, 50.9% males). Anonymous, self-administered questionnaires contained items on sociodemographics, substance use, and parental/familial relationships (such as parental control and awareness or variables of family environment). RESULTS: Problem drinking (identified in 17.2% of the sample) was more common among males and high school students and those from lower socioeconomic status groups compared to their counterparts. Among the familial/parental variables, negative family interactions, discussion of problems with parents, physical and sexual abuse were positively related to adolescent problem drinking, whereas parental control and awareness, and the positive identification with parents proved to be protective factors. Conclusions/Importance: We conclude that parents and the family were important correlates of adolescents' problem drinking. Our findings suggest that on-going school interventions to prevent the development of problem drinking among youth should include parents and the family.

Do Place and Time Make a Difference? Examining Quality of Life Among Homeless Persons in Northwest Arkansas and Birmingham.

This study examines the role that life chances and choices play in determining quality of life among homeless people. Given the prominent negative impact of homelessness, this paper specifically examines the impact of length of time homeless and location on adverse quality of life. OLS regression examined quality of life among 264 homeless adults living in Northwest Arkansas and Birmingham, Alabama. Analysis shows no significant impact of life choices on quality of life but a significant impact of life chances including strong social ties and mastery of fate, on adverse quality of life. Length of time homeless was related to adverse quality of life, but location was not, indicating that the homeless experience with regards to subjective quality of life did not vary significantly between Birmingham and Northwest Arkansas.

Residual Limb Hyperhidrosis and RimabotulinumtoxinB: A Randomized Placebo-Controlled Study.

OBJECTIVE: To investigate the use of rimabotulinumtoxinB (BoNT/B [Myobloc]) compared with placebo in treating hyperhidrosis in the residual limbs of individuals with amputation. DESIGN: Randomized, double-blind, placebo-controlled pilot study. SETTING: Military medical center. PARTICIPANTS: Male participants (N=9) with 11 major amputations of the lower limbs and who complained of excessive sweating in their residual limbs were enrolled in the study between September 24, 2008 to October 28, 2011. Participants' lower limbs were randomly assigned to receive injections of either BoNT/B (n=7) or placebo (n=4). INTERVENTION: BoNT/B. MAIN OUTCOME MEASURES: The primary efficacy variable was a minimum of 50% reduction in sweat production 4 weeks after the injection as measured via gravimetric sweat analysis after 10 minutes of physical exertion. Secondary analyses were performed on prosthetic function and pain. RESULTS: All volunteers (100%; 7) in the BoNT/B group achieved a minimum of 50% reduction in sweat production as compared with only 50% (2) in the placebo group. The percent reduction was significantly greater for the BoNT/B group than for the placebo group (-72.7%±15.7% vs -32.7%±39.2%; P<.05). Although both groups subjectively self-reported significant sweat reduction and improved prosthetic function (P<.05 for both), objective gravimetric sweat analyses significantly decreased only for the BoNT/B group (2.3±2.3g vs 0.7±1.1g; P<.05). Neither group reported a change in phantom limb pain or residual limb pain (P>.05 for both). CONCLUSIONS: BoNT/B successfully reduces sweat production in individuals with residual limb hyperhidrosis, but does not affect pain. No differences were found in perceived effect on prosthetic use between BoNT/B and placebo groups.

Psychosocial factors as mediators of food insecurity and weight status among middle school students.

Research regarding the association between food insecurity and weight status among youth has produced mixed results. However, few studies on this topic have utilized data that includes survey responses from children themselves regarding their experience with food insecurity. This study was undertaken to examine the association between food insecurity and weight status among youth, as well as the potential mediation by psychosocial factors. A survey of 5th-7th grade students was administered to gather information on food insecurity, social and psychological resources, and health. The primary analysis includes OLS (Ordinary Least Squares) regression conducted using SPSS software and Sobel's test for mediation. Results suggest a positive association between food insecurity and weight status even when controlling for key demographic variables. In addition, we find that this association is mediated by psychosocial factors-namely, perceived social status and depression. Insights from this work highlight the need to consider non-nutritional pathways through which food insecurity impacts health as well the need to continue surveying youth directly when examining their experiences with food insecurity.

Does context matter? Examining the mental health among homeless people.

While much research has focused on the impact community has on health and wellbeing of domiciled populations, limited research has explored the same for homeless people. Using multivariate models, this research explores what factors are related to depressive symptomatology among homeless people living in two distinctly different communities. Results suggest that context matters, but not for every circumstance examined in these models. While some variables exhibit a consistent relationship with depressive symptoms, the role of social capital is noted as particularly important to lowering symptomatology, yet its impact differs significantly by location.

The design and synthesis of novel SGLT2 inhibitors: C-glycosides with benzyltriazolopyridinone and phenylhydantoin as the aglycone moieties.

The sodium glucose co-transporter 2 (SGLT2) has received considerable attention in recent years as a target for the treatment of type 2 diabetes mellitus. This report describes the design, synthesis and structure-activity relationship (SAR) of C-glycosides with benzyltriazolopyridinone and phenylhydantoin as the aglycone moieties as novel SGLT2 inhibitors. Compounds 5p and 33b demonstrated high potency in inhibiting SGLT2 and high selectivity against SGLT1. The in vitro ADMET properties of these compounds will also be discussed.

Socioeconomic inequalities in mental well-being among Hungarian adolescents: a cross-sectional study.

INTRODUCTION: According to several empirical studies, mental well-being is significant in adolescence; adolescent's social network is undergoing radical changes while at the same time depression is increasing. The primary goal of our study is to determine whether socioeconomic status (SES) is associated with mental health status of Hungarian adolescents and the strength and nature of this association. METHODS: Our sample was comprised of three high schools of Debrecen (the second largest city of Hungary). Data were collected in January 2013. In all, 471 students filled out the questionnaire from 22 classes (14-18 years old). 'Absolute' (education and occupational status of the parents, assessed by the adolescent) and 'subjective' (self-assessment of family's social class) SES measures and five mental health indicators (shyness, loneliness, need to belong, psychosomatic symptoms, self-esteem) were involved. Descriptive statistics and binary logistic regression analyses were used to examine the relationships between family SES and mental health indicators. RESULTS: Our results indicate that association between adolescents' 'subjective' SES and mental well-being is not gradient-like. Manual employment and unemployment status of both parents also proved to be significant determinants of mental health status. CONCLUSIONS: According to our results, professionals of school-based mental health programs should consider students whose parents are unemployed or have manual occupational status as a high risk group in terms of mental well-being.

The Froment-Rauber nerve: a case report and review.

INTRODUCTION: The Froment-Rauber nerve is a rarely described anomalous nerve arising from 1 of the terminal branches of the radial nerve that provides innervation to intrinsic hand muscles. We describe a 26-year-old man who had a traumatic radial nerve injury that resulted in first dorsal interosseous muscle wasting. He presented to our clinic 2.5 years post-injury, after having had unnecessarily undergone surgical exploration of the ulnar nerve. METHODS: The patient's history, clinical examination, and multiple electrodiagnostic tests were reviewed. RESULTS: All findings were consistent with a diagnosis of anomalous innervation via a Froment-Rauber nerve. CONCLUSIONS: Understanding this rare phenomenon may aid in diagnosing confusing clinical cases and prevent unnecessary procedures.

Social and psychological resources and COVID-19 related fear, threat and worry.

OBJECTIVES: The current study examines the relationship between social/psychological resources and COVID-related fear, threat, and worry. METHODS: This work is based on data collected in March 23, 2020 from a national sample of 10,368 adults (ages 18 or older) living in the United States. The final sample of 10,368 was post-stratification weighted across gender, age, race, income, and geography (state) to ensure representativeness of the overall population of the United States. RESULTS: Findings suggest some social and psychological resources are related to COVID-specific distress (fear/threat/worry), but depending on the resource, relationships vary in both direction and significance. On the one hand, strength of social ties and mastery of fate play a protective role in perceived distress (fear/threat/worry) related to COVID. On the other hand, community connectedness is significantly related to higher levels of COVID-specific fear, threat, and worry. CONCLUSIONS: The analyses provide some evidence of the nature of the relationships between social and psychological resources and perceived COVID-19 distress that vary by race and ethnicity. These and other relationships are explored and discussed in the context of improving ones well-being with mediating social and psychological resources.

Place Still Matters: Social Vulnerabilities, Place-Level Disadvantage, and Food Insecurity during COVID-19.

COVID-19 variants continue to create public health danger impacting mortality and morbidity across the United States. The spillover effects of COVID-19 on the economy and social institutions pose a significant threat to broader wellbeing, including the food security of millions across the country. We aim to explore whether the context of place matters above and beyond individual and social vulnerabilities for food insecurity. To do so, we employ a multi-level framework using data from a survey of over 10,000 U.S. adults from March 2020 with American Community Survey (ACS) and John Hopkins COVID Dashboard county-level data. We find nearly two in five respondents were food insecure by March of 2020 with disparities across race, nativity, the presence of children in the home, unemployment, and age. Furthermore, we note that individuals living in more disadvantaged communities were more likely to report food insecurity above and beyond individual and social vulnerabilities. Overall, food insecurity is driven by complex, multi-level dynamics that remain a pressing public health concern for the current-but also future-public health crisis.

A sex-stratified multiple regression on Jordanian adolescents' life satisfaction using different elements of school climate.

BACKGROUND: School climate is one of several important factors influencing adolescent well-being and life satisfaction. Although a growing number of studies investigate the role of school climate, they often apply a global scale and only a few of them measure any specific elements. Likewise, most studies are focused on well-being and not life satisfaction. AIM: The purpose of this study is to investigate how different elements of school climate (teacher responsiveness, disruptive behavior, positive mutual bonds, classroom atmosphere, growth) are related to life satisfaction among a sample of Jordanian high school students. METHODS: Using a self-administered and online questionnaire, the sample consists of adolescents from public schools located in northern Jordan (N = 2141, aged 13-18 years). RESULTS: Jordanian high school students' levels of life satisfaction were higher for girls [t(2139) = -8.2, p < .001]. Disruptive behavior correlated negatively with classroom atmosphere (r = -0.50; p < .001 among girls and r = -0.45; p < .001 for boys); teacher responsiveness was positively correlated with growth (r = 0.49; p < .001 for girls and r = 0.61; p < .001 for boys). However, the role of disruptive behavior was different for girls (negative) compared to boys (positive), although these correlations were weak. In multiple regression analyses, teacher responsiveness (ß = 0.22; p < .001) and positive mutual bonds (ß = 0.19; p < .001) were largest contributors to life satisfaction beyond self-assessed socioeconomic status (ß = 0.27; p < .001). Age (ß = -0.08; p < .01) and growth (ß = 0.27; p < .001) were significant only for boys. CONCLUSIONS: These results demonstrate the importance of examining different elements of school climate in an effort to better understand adolescents' life satisfaction. Certain gender differences may highlight differences in social needs across different classroom settings which require further investigation.

Risk of disordered eating in emerging adulthood: media, body and weight-related correlates among Hungarian female university students.

Background: University years often are accompanied by dramatic lifestyle changes resulting in an elevated risk of disordered eating among females. We examined the associations of disordered eating with body image, weight and media-related variables. Methods: Hungarian female university students (n = 261, mean age = 22.0 years; SD = 2.2 years) were the study participants using online data collection. The Eating Attitude Test-26 (EAT-26) was used to assess levels of and risk for disordered eating. Results: Twenty-four percent of the sample displayed disordered eating: students with family's eating disorders (OR = 4.73 [1.34-16.67], p < 0.05), body satisfaction (OR = 0.23 [0.07-0.70], p < 0.01), engagement in sporting (OR = 4.46[1.77-11.27], p < 0.01) and past slimming (OR = 5.63 [2.07-15.27], p < 0.001) were particularly at risk. Multiple linear regression indicated that dieting was associated with a higher score among sporting students (ß = 0.18, p < 0.001) and internalization of media messages (ß = 0.18, p < 0.001). BMI was a predictor of dieting (ß = 0.15, p < 0.01) and oral control (ß = -0.34, p < 0.001); social media addiction for bulimia (ß = 0.17, p < 0.01). Conclusions: Our paper highlights the role of body dissatisfaction, sporting and slimming tendencies, sociocultural attitudes toward appearance, and family's eating pathology in understanding female university students' disordered eating. There is a limited role that social media plays in part, due to possible age-related experiences and skills related to coping with a variety of social pressures.