Social network engagement and subjective well-being: a life-course perspective.

Social networking is a digital phenomenon embraced by billions worldwide. Use of online social platforms has the potential to generate a number of benefits including to well-being from enhanced social connectedness and social capital accumulation, but is also associated with several negative behaviours and impacts. Employing a life-course perspective, this paper explores social networking use and its relationship with measures of subjective well-being. Large-scale UK panel data from wave 3 (2011-12) and 6 (2014-15) of Understanding Society reveals that social network users are on average younger, aged under 25, but that rising use is reported across the life-course including into old age. Probit, multinomial logistic, and ANCOVA and change-score estimations reveal that membership, and greater use, of social networks is associated with higher levels of overall life satisfaction. However, heavy use of social networking sites has negative impacts, reflected in reductions in subjective well-being. Socio-economic disadvantage may drive these impacts among young (in education), unemployed and economically inactive heavy SNS users.

Assessing the efficacy of a resilience training intervention for long-term improvements in well-being and resilience.

This article has two aims: (1) to assess the impacts of a novel training intervention for individual well-being and (2) to measure the trajectory of resilience over the training period dependent on reported significant life events. Using a randomised controlled trial with a diverse German sample with the majority drawn from a student population, we measure the effects of the intervention to provide insight into its impacts and act as a proof of concept for the training. We find that the training intervention boosts resilience and other related well-being measures with a high effect size in comparison with a control group and compared with existing resilience training studies.

Clinical and microbiological features of infection in alcoholic hepatitis: an international cohort study.

BACKGROUND: Previous studies have described the clinical impact of infection in alcoholic hepatitis (AH) but none have comprehensively explored the aetiopathogenesis of infection in this setting. We examined the causes, consequences and treatment of infection in a cohort of patients with AH. METHODS: We undertook a retrospective cohort study of patients with AH admitted between 2009 and 2014 to seven centres in Europe and the USA. Clinical and microbiological data were extracted from medical records. Survival was analysed with Kaplan-Meier analysis and Cox proportional hazards analysis to control the data for competing factors. Propensity score matching was used to examine the efficacy of prophylactic antibiotics administered in the absence of infection. RESULTS: We identified 404 patients with AH. Of these, 199 (49%) showed clinical or culture evidence of infection. Gut commensal bacteria, particularly Escherichia coli and Enterobacter species, were most commonly isolated in culture. Fungal infection was rarely seen. Cultured organisms and antibiotic resistance differed markedly between centres. Infection was an independent risk factor for death (hazard ratio for death at 90 days 2.33, 95% confidence interval 1.63-3.35, p < 0.001). Initiation of antibiotic therapy on admission in the absence of infection did not reduce mortality or alter the incidence of subsequent infections. Corticosteroid use increased the incidence of infection but this did not impact on survival. CONCLUSIONS: In this large real-world cohort of patients with AH, infection was common and was associated with reduced short-term survival. Gram-negative, gut commensal bacteria were the predominant infective organisms, consistent with increased translocation of gut bacteria in AH; however, the characteristics of infection differ between centres. Infection should be actively sought and treated, but we saw no benefits of prophylactic antibiotics.

Primary Sclerosing Cholangitis: Therapeutic Options and Surveillance Management.

Primary sclerosing cholangitis is a chronic immune-mediated liver disease. Though rare, it poses several clinical concerns for the managing physician. There are currently limited therapeutic options in the management of the condition and weak evidence base behind them. Endoscopic intervention is limited to those patients with obstructing stricture-related disease, and even liver transplantation has a risk of disease recurrence. Surveillance for inflammatory bowel disorders, metabolic bone disease, and malignancy is paramount when managing such patients. This article provides an overview of the condition with further focus on current therapeutic options and guidance on surveillance management.