4254 research outputs found
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A Person-Based Web-Based Sleep Intervention Aimed at Adolescents (SleepWise): Randomized Controlled Feasibility Study
No full textBackground: Adolescents are advised to sleep 8-10 hours per night; however, most do not sleep for this recommended amount. Poor adolescent sleep is associated with detrimental health outcomes, including reduced physical activity, risk-taking behaviors, and increased depression and anxiety levels, making this an important public health concern. Existing interventions targeting adolescent sleep are often unsuccessful or their effectiveness unclear, as they are frequently noninteractive, time-consuming, and lack a strong theoretical foundation; highlighting an urgent need for innovative interventions deemed acceptable by adolescents. Objective: The main objective of this study was to determine the acceptability, feasibility, and preliminary impact of a web-based person-based sleep intervention (SleepWise) on adolescent sleep quality. Participant incentivization was also explored to understand its impact on engagement, acceptability, and sleep quality. Methods: A feasibility trial was conducted to test the feasibility, acceptability, and preliminary impact of SleepWise on adolescent sleep quality, developed based on the person-based approach to intervention development. In total, 90 participants (aged 13-17 years) from further education institutions and secondary schools were recruited for two 2-arm randomized controlled trials. One trial (trial 1) was incentivized to understand the impact of incentivization. Acceptability and sleep quality were assessed via questionnaires, and a mixed methods process evaluation was undertaken to assess participant engagement and experience with SleepWise. Engagement was automatically tracked by SleepWise, which collected data on the date and time, pages viewed, and the number of goals and sleep logs completed per participant. Semistructured interviews were carried out to gain participant feedback. Results: Participants in both trials reported high levels of acceptability (trial 1: mean 21.00, SD 2.74; trial 2: mean 20.82, SD 2.48) and demonstrated similar levels of engagement with SleepWise. Participants in trial 1 viewed slightly more pages of the intervention, and those in trial 2 achieved their set goals more frequently. Improvements in sleep quality were found in both trials 1 and 2, with medium (trial 1) and large (trial 2) effect sizes. A larger effect size for improvement in sleep quality was found in the nonincentivized trial (d=0.87), suggesting that incentivization may not impact engagement or sleep quality. Both trials achieved acceptable recruitment (trial 1, N=48; trial 2, N=42), and retention at 5 weeks (trial 1: N=30; trial 2: N=30). Qualitative findings showed that adolescents lead busy lifestyles, which may hinder engagement; however, participants deemed SleepWise acceptable in length and content, and made attempts at behavior change. Conclusions: SleepWise is an acceptable and potentially efficacious web-based sleep intervention aimed at adolescents. Findings from this study showed that incentivization did not greatly impact engagement, acceptability, or sleep quality. Subject to a full trial, SleepWise has the potential to address the urgent need for innovative, personalized, and acceptable sleep interventions for adolescents
Assessment and management of vitamin status in children with CKD stages 2–5, on dialysis and post-transplantation: clinical practice points from the Pediatric Renal Nutrition Taskforce
No full textChildren with chronic kidney disease (CKD) are at risk for vitamin deficiency or excess. Vitamin status can be affected by diet, supplements, kidney function, medications, and dialysis. Little is known about vitamin requirements in CKD, leading to practice variation. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric kidney dietitians and pediatric nephrologists, was established to develop evidence-based clinical practice points (CPPs) to address challenges and to serve as a resource for nutritional care. Questions were formulated using PICO (Patient, Intervention, Comparator, Outcomes), and literature searches undertaken to explore clinical practice from assessment to management of vitamin status in children with CKD stages 2–5, on dialysis and post-transplantation (CKD2-5D&T). The CPPs were developed and finalized using a Delphi consensus approach. We present six CPPs for vitamin management for children with CKD2-5D&T. We address assessment, intervention, and monitoring. We recommend avoiding supplementation of vitamin A and suggest water-soluble vitamin supplementation for those on dialysis. In the absence of evidence, a consistent structured approach to vitamin management that considers assessment and monitoring from dietary, physical, and biochemical viewpoints is needed. Careful consideration of the impact of accumulation, losses, comorbidities, and medications needs to be explored for the individual child and vitamin before supplementation can be considered. When supplementing, care needs to be taken not to over-prescribe. Research recommendations are suggested
Climatic variability in the Armenian Highlands as the backdrop to hominin population dynamics 50-25 ka
No full textThe impact of Late Pleistocene climatic oscillations, volcanism and the diverse terrain of the Armenian Highlands affected hominin population dynamics and movements through the region. To test different scenarios for the period 50–25 ka regarding expansion, adaptive response, intra-population interactions and extinction, we need local on-site paleoclimatic data found in association with hominin occupations. However, this approach has been hampered by the dearth and highly uneven spatiotemporal recovery of paleoclimatic data from prehistoric sites across the region. In this study, we analyze multiple assemblages of fossil micromammals from the Late Middle Paleolithic (LMP) Lusakert-1 rockshelter (two fossil-yielding strata; <55 ka) and Early Upper Paleolithic (EUP) Aghitu-3 Cave (four fossil-yielding strata; ∼39–24 ka) using geometric morphometric-aided taxonomy, to quantify the representation of different species among the abundant and diverse arvicoline genera (Microtus and Chionomys; mean = 58% of assemblages). We combined this approach with quantitative species-level paleoclimatic reconstructions (Bioclimatic Model; 14 rodent taxa) to determine changes in habitat composition as well as temperature and precipitation shifts during the Late Middle–Early Upper Paleolithic. Taphonomic analysis was conducted to establish isotaphonomy among the assemblages. The analysis shows higher than present-day absolute temperatures for the series of occupations at both Lusakert-1 and Aghitu-3, making it unlikely that hominin activity at the sites coincided with extreme cold-climate phases. A multivariate comparison of the taxonomic abundances (genus level) across a wider sample of regional Middle Paleolithic (MP) and Upper Paleolithic (UP) cave sites (Hovk-1, Kudaro-1, Mezmaiskaya, Satsurblia and Dzudzuana) indicates the possibility of cold-period occupation at only two of the sites, Mezmaiskaya Layers 3 and 2 and Kudaro-1 Layer 3. We surmise that the manufacturers of LMP lithic industries in the Caucasus were well adapted to these challenging environments, thus undermining arguments that rapid climate change through the LMP/EUP period could alone have determined the course of population dynamics in this region
Dynamics of value-tracking in financial markets
Get PDFThe efficiency of a modern economy depends on value-tracking: that market prices of key assets broadly track some underlying value. This can be expected if a sufficient weight of market participants are valuation-based traders, buying and selling an asset when its price is, respectively, below and above their well-informed private valuations. Such tracking will never be perfect, and we propose a natural unit of tracking error, the 'deciblack'. We then use a simple discrete-time model to show how large tracking errors can arise if enough market participants are not valuation-based traders, regardless of how much information the valuation-based traders have. Similarly to Lux [17] and others who study subtly different models, we find a threshold above which value-tracking breaks down without any changes in the underlying value of the asset. We propose an estimator of the tracking error and establish its statistical properties. Because financial markets are increasingly dominated by non-valuation-based traders, assessing how much valuation-based investing is required for reasonable value tracking is of urgent practical interest
Fungal Imaginaries: The Reconfiguration of Post-Pandemic Society in Severance (2018) and The Last of Us (2023)
No full textThis chapter considers two texts, Ling Ma’s 2018 novel Severance and the HBO adaptation of Naughty Dog’s The Last of Us (2023) as emblematic of a new relationship to the global situation in our post-pandemic moment. Focusing specifically on rhizomic networks and the fungal nature of various types of connection, it suggests that both works offer us macro and micro-political understandings that showcase the sublime and complex difficulties we face when attempting to integrate into a world that is moving at such great pace. While offering a word of caution about some of these emerging fungal networks in areas like economics and disinformation, it ends with a reflection on the hope we might draw from new possibilities of connection and collaboration that the pandemic has, ultimately, forced upon us
