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The COVID-19 pandemic precipitated numerous changes in daily life, including the cancellation and restriction of sports trainings and competitions globally. Because engagement in sports contributes positively to the physical and psychosocial development of adolescents, restricting these activities may have led to long-term changes in mental health, especially among high school student-athletes that spend a significant amount of time training and competing.
Objectives
We sought to (1) compare overall prevalence rates and symptom severity of depression and anxiety between 2021 and 2022, (2) assess cohort and class-level differences on internalizing measures, and (3) identify demographic and health risk factors for developing depressive and anxiety symptoms in 2022 and compare the composition of these models predicting depression and anxiety with those proposed by Håkansson et al. (Front. sports act. living 2022; 4 943402) on student-athletes in the 2021 sample.
Methods
Using a cross-sectional study design with repeated measures, we measured rates of depression using the Patient Health Questionnaire-2 scale (PHQ-2) and anxiety using the Generalized Anxiety Disorder-2 scale (GAD-2) in student-athletes attending elite sport high schools in Sweden during the second wave of the pandemic (February 2021) and after all restrictions were lifted (February 2022).
Results
As illustrated in Table 1, the overall prevalence of depression among student-athletes declined significantly from 19.8% in 2021 to 17.8% in 2022, whereas the percentage of student-athletes screening for anxiety did not change significantly (17.4% in 2021 to 18.4% in 2022).Table 1
Note. Comparison of psychological health measures across years. P-values adjusted for multiple comparison using Benjamini & Hochberg (1995)36 procedure.
a
Chi-square test of homogeneity
b
independent-samples t-test
Cohort-level analyses revealed older students exhibited decreases in depressive symptoms (Figure 1), while younger cohorts experienced increases in symptoms of anxiety (Image 2) from 2021 to 2022. Logistic regressions revealed that being female, reporting poorer mental health due to COVID-19, and excessive worry over one’s career in sports were significant predictors of both depression and anxiety screenings in the 2022 sample (Image 2).
Image:
Image 2:
Conclusions
In comparison to periods when sports participation was limited in February 2021, the lifting of restrictions in February 2022 was associated with overall reduced levels of depression, but not anxiety.
Disclosure of Interest
M. Andersson: None Declared, G. Kenttä: None Declared, K. Moesch: None Declared, E. Borg: None Declared, E. Claesdotter-Knutsson: None Declared, A. Håkansson Grant / Research support from: AH receives financing from the Swedish state-owned gambling operator, AB Svenska Spel, and the state-owned alcohol monopoly. Neither were involved in the study planning, execution, or decision to publish the current article.
An online training package providing a concise synthesis of the scientific data underpinning EU legislation on enrichment and tail-docking of pigs was produced in seven languages, with the aim of improving consistency of professional judgements regarding legislation compliance on farms. In total, 158 participants who were official inspectors, certification scheme assessors and advisors from 16 EU countries completed an initial test and an online training package. Control group participants completed a second identical test before, and Training group participants after, viewing the training. In Section 1 of the test participants rated the importance of modifying environmental enrichment defined in nine scenarios from 1 (not important) to 10 (very important). Training significantly increased participants’ overall perception of the need for change. Participants then rated nine risk factors for tail-biting from 1 (no risk) to 10 (high risk). After training scores were better correlated with risk rankings already described by scientists. Scenarios relating to tail-docking and management were then described. Training significantly increased the proportion of respondents correctly identifying that a farm without tail lesions should stop tail-docking. Finally, participants rated the importance of modifying enrichment in three further scenarios. Training increased ratings in all three. The pattern of results indicated that participants’ roles influenced scores but overall the training improved: i) recognition of enrichments that, by virtue of their type or use by pigs, may be insufficient to achieve legislation compliance; ii) knowledge on risk factors for tail-biting; and iii) recognition of when routine tail-docking was occurring.
Quetiapine immediate release (quetiapine IR) improves PANSS total, positive, negative and general psychopathology scores in schizophrenia. This study (D1444C00132) evaluated the efficacy of once-daily extended release quetiapine fumarate (quetiapine XR) in patients with acute schizophrenia.
Methods:
This was a 6-week, double-blind, randomised study (n=588) comparing quetiapine XR (400, 600 or 800 mg/day) and quetiapine IR (400 mg/day) with placebo. Efficacy was assessed using ANCOVA analyses of the change from baseline to study endpoint (Day 42) for: PANSS total score; positive, negative and general psychopathology subscale scores; and aggression and depression cluster scores (modified ITT population, LOCF). Changes in individual PANSS item scores were assessed post hoc.
Results:
At Day 42, there were statistically significant reductions (ie two-sided p-value <0.05) versus placebo with all doses of quetiapine XR for the change in PANSS total, positive, general psychopathology and aggression cluster scores. Changes in negative and depression cluster scores were statistically significant versus placebo for quetiapine XR 600 mg/day and 800 mg/day. There was statistically significant separation from placebo with quetiapine XR 600 mg/day and 800 mg/day for the change in 6/7 PANSS positive items, 5/7 negative items, and 12/16 general psychopathology items. For those items with no statistically significant separation from placebo, baseline scores were generally low.
Conclusions:
Once-daily quetiapine XR is effective across a broad range of symptoms in acute schizophrenia, including positive and negative symptoms, as well as symptoms of general psychopathology, aggression and depression.
To evaluate efficacy and tolerability of quetiapine sustained release (SR) in a 6-week study (D1444C00132).
Methods:
588 patients with acute schizophrenia (PANSS total ≥70; CGI-S ≥4) were randomised to fixed-dose quetiapine SR 400, 600 or 800 mg/day (once-daily), quetiapine immediate release (IR) 400 mg/day (200 mg twice-daily; 5-day dose-escalation schedule), or placebo. Quetiapine SR doses: 400, 600 mg reached by Day 2; 800 mg by Day 3. Primary endpoint: change from baseline to Day 42 in PANSS total score (LOCF; ANCOVA). Other assessments: PANSS response rate (% patients with ≥30% reduction in total score from baseline); CGI-I response rate (% patients with rating ≤3); CGI-S; AEs.
Results:
446 patients (76%) completed the study (similar across groups). LS mean change from baseline in PANSS total score at Day 42 showed significant improvement versus placebo (-18.8): -24.8 (p=0.03), -30.9 (p<0.001), and -31.3 (p<0.001), quetiapine SR 400, 600, and 800 mg, respectively; -26.6 (p=0.004), quetiapine IR. Statistical separation from placebo at Day 42 for: change from baseline in CGI-S (quetiapine SR 600 and 800 mg; IR); PANSS and CGI-I response rates (all active treatments). Most common AEs with quetiapine: somnolence and dizziness. There were no unexpected AEs with quetiapine SR. Incidence of EPS-related AEs was similar to placebo. Two quetiapine SR and two IR patients discontinued due to AEs in Week 1.
Conclusions:
Once-daily quetiapine SR (400-800 mg) was effective versus placebo in patients with acute schizophrenia. Rapid dose escalation was well tolerated, with a therapeutically effective dose reached by Day 2.
As the IAU heads towards its second century, many changes have simultaneously transformed Astronomy and the human condition world-wide. Amid the amazing recent discoveries of exoplanets, primeval galaxies, and gravitational radiation, the human condition on Earth has become blazingly interconnected, yet beset with ever-increasing problems of over-population, pollution, and never-ending wars. Fossil-fueled global climate change has begun to yield perilous consequences. And the displacement of people from war-torn nations has reached levels not seen since World War II.
Visual processing problems may be one underlying factor for cognitive impairments related to autism spectrum disorders (ASDs). We examined associations between ASD-traits (Autism-Spectrum Quotient) and visual processing performance (Rey–Osterrieth Complex Figure Test; Block Design task of the Wechsler Adult Intelligence Scale-III) in young adults (mean age=25.0, s.d.=2.1 years) born preterm at very low birth weight (VLBW; <1500 g) (n=101) or at term (n=104). A higher level of ASD-traits was associated with slower global visual processing speed among the preterm VLBW, but not among the term-born group (P<0.04 for interaction). Our findings suggest that the associations between ASD-traits and visual processing may be restricted to individuals born preterm, and related specifically to global, not local visual processing. Our findings point to cumulative social and neurocognitive problems in those born preterm at VLBW.
The incidence of childhood respiratory infections in Greenland is among the highest globally. We performed a population-based study of 352 Greenlandic children aged 0–6 years aiming to describe rates and risk factors for carriage of four key bacteria associated with respiratory infections, their antimicrobial susceptibility and inter-bacterial associations. Nasopharyngeal swabs were tested for Streptococcus pneumoniae grouped by serotypes included (VT) or not included (NVT) in the 13-valent pneumococcal conjugate vaccine, non-typable Haemophilus influenzae (NTHi), Staphylococcus aureus and Moraxella catarrhalis. S. pneumoniae was detected from age 2 weeks with a peak carriage rate of 60% in 2-year-olds. Young age and having siblings attending a daycare institution were associated with pneumococcal carriage. Overall co-colonization with ⩾2 of the studied bacteria was 52%. NTHi showed a positive association with NVT pneumococci and M. catarrhalis, respectively, M. catarrhalis was positively associated with S. pneumoniae, particular VT pneumococci, whereas S. aureus were negatively associated with NTHi and M. catarrhalis. Nasopharyngeal bacterial carriage was present unusually early in life and with frequent co-colonization. Domestic crowding increased odds of carriage. Due to important bacterial associations we suggest future surveillance of pneumococcal conjugate vaccine's impact on carriage in Greenland to also include other pathogens.
Results of adulthood mental health of those born late-preterm (34 + 0–36 + 6 weeks + days of gestation) are mixed and based on national registers. We examined if late-preterm birth was associated with a higher risk for common mental disorders in young adulthood when using a diagnostic interview, and if this risk decreased as gestational age increased.
Method
A total of 800 young adults (mean = 25.3, s.d. = 0.62 years), born 1985–1986, participated in a follow-up of the Arvo Ylppö Longitudinal Study. Common mental disorders (mood, anxiety and substance use disorders) during the past 12 months were defined using the Composite International Diagnostic Interview (Munich version). Gestational age was extracted from hospital birth records and categorized into early-preterm (<34 + 0, n = 37), late-preterm (34 + 0–36 + 6, n = 106), term (37 + 0–41 + 6, n = 617) and post-term (⩾42 + 0, n = 40).
Results
Those born late-preterm and at term were at a similar risk for any common mental disorder [odds ratio (OR) 1.11, 95% confidence interval (CI) 0.67–1.84], for mood (OR 1.11, 95% CI 0.54–2.25), anxiety (OR 1.00, 95% CI 0.40–2.50) and substance use (OR 1.31, 95% CI 0.74–2.32) disorders, and co-morbidity of these disorders (p = 0.38). While the mental disorder risk decreased significantly as gestational age increased, the trend was driven by a higher risk in those born early-preterm.
Conclusions
Using a cohort born during the advanced neonatal and early childhood care, we found that not all individuals born preterm are at risk for common mental disorders in young adulthood – those born late-preterm are not, while those born early-preterm are at a higher risk. Available resources for prevention and intervention should be targeted towards the preterm group born the earliest.
It is well known that web-based interventions can be effective treatments for depression. However, dropout rates in web-based interventions are typically high, especially in self-guided web-based interventions. Rigorous empirical evidence regarding factors influencing dropout in self-guided web-based interventions is lacking due to small study sample sizes. In this paper we examined predictors of dropout in an individual patient data meta-analysis to gain a better understanding of who may benefit from these interventions.
Method
A comprehensive literature search for all randomized controlled trials (RCTs) of psychotherapy for adults with depression from 2006 to January 2013 was conducted. Next, we approached authors to collect the primary data of the selected studies. Predictors of dropout, such as socio-demographic, clinical, and intervention characteristics were examined.
Results
Data from 2705 participants across ten RCTs of self-guided web-based interventions for depression were analysed. The multivariate analysis indicated that male gender [relative risk (RR) 1.08], lower educational level (primary education, RR 1.26) and co-morbid anxiety symptoms (RR 1.18) significantly increased the risk of dropping out, while for every additional 4 years of age, the risk of dropping out significantly decreased (RR 0.94).
Conclusions
Dropout can be predicted by several variables and is not randomly distributed. This knowledge may inform tailoring of online self-help interventions to prevent dropout in identified groups at risk.
The study aimed to determine the effects of red clover (Trifolium pratense) silage with high phyto-oestrogen content on ewe performance during their first breeding season. Red clover silage containing formononetin, biochanin A, genistein, and daidzein was fed to 10 nulliparous ewes of the prolific Finnish Landrace breed before, during and after the breeding season, for a total of 5 months. A control group of 10 ewes was fed with grass silage. The mean numbers of foetuses per pregnancy were 2.1±0.7 and 2.2±0.8 for the red clover and control groups, respectively. The total mass of the uterus with its contents was significantly greater in ewes of the red clover group compared with those of the control group. This difference was mainly explained by the greater volume of foetal fluids. Serum progesterone concentration in the red clover group was significantly lower over the entire period analysed than in the control group. In conclusion, the fecundity of the ewes was not reduced by red clover feed with high phyto-oestrogen concentrations. The volume of foetal fluids increased that could increase the risk for vaginal prolapse before the term.
We studied the seasonal fluctuation of norovirus and other enteric viruses in Cameroon. Two hundred participants aged between 1 and 69 years were prospectively followed up. Each participant provided monthly faecal samples over a 12-month period. A total of 2484 samples were tested using multiplex real-time PCR assay for the detection of norovirus, rotavirus and enterovirus. The effect of weather variables and risk factors were analysed by Pearson correlation and bivariate analysis. Overall, enterovirus was the most commonly detected virus (21·6% of specimens), followed by norovirus (3·9%) and rotavirus (0·4%). Norovirus and enterovirus were detected throughout the year with a peak of norovirus detection at the beginning of the rainy season and a significant alternation of circulation of norovirus genogroups from one month to the next. Age <5 years and consumption of tap water were risk factors for norovirus infection. Better understanding of factors influencing transmission and seasonality may provide insights into the relationship between physical environment and risk of infection for these viruses.
The effects of antidepressants for treating depressive disorders have been overestimated because of selective publication of positive trials. Reanalyses that include unpublished trials have yielded reduced effect sizes. This in turn has led to claims that antidepressants have clinically insignificant advantages over placebo and that psychotherapy is therefore a better alternative. To test this, we conducted a meta-analysis of studies comparing psychotherapy with pill placebo.
Method
Ten 10 studies comparing psychotherapies with pill placebo were identified. In total, 1240 patients were included in these studies. For each study, Hedges’ g was calculated. Characteristics of the studies were extracted for subgroup and meta-regression analyses.
Results
The effect of psychotherapy compared to pill placebo at post-test was g = 0.25 [95% confidence interval (CI) 0.14–0.36, I2 = 0%, 95% CI 0–58]. This effect size corresponds to a number needed to treat (NNT) of 7.14 (95% CI 5.00–12.82). The psychotherapy conditions scored 2.66 points lower on the Hamilton Depression Rating Scale (HAMD) than the placebo conditions, and 3.20 points lower on the Beck Depression Inventory (BDI). Some indications for publication bias were found (two missing studies). We found no significant differences between subgroups of the studies and in meta-regression analyses we found no significant association between baseline severity and effect size.
Conclusions
Although there are differences between the role of placebo in psychotherapy and pharmacotherapy research, psychotherapy has an effect size that is comparable to that of antidepressant medications. Whether these effects should be deemed clinically relevant remains open to debate.
The radiocarbon concentration of different atherosclerotic plaque fragments obtained from 20 patients in Portugal, operated in 2000–2001, has been measured in order to define the year of plaque formation. A difference of 1.8–15 yr was observed, with the mean and median both 9 yr, between the bomb-pulse date estimated with the CALIBomb software and the operation date. Stable isotope (δ13C and δ15N) analysis was also performed and provides insight to the diet of the subjects. The wide range of measured stable isotope values could indicate that the subjects' diet varied, including an abundance of marine foodstuffs. It could also mean a different isotope fractionation process for the different plaque fragments (cap, core, interface to media) and a possible difference in tissues in which the various fragments are formed. Analysis of δ13C and δ15N values of each patient separately revealed subjects considered more influenced by marine foodstuffs consumption.
The European decision support systems ARGOS and RODOS rely on the ECOSYS model for prognoses of ingestion doses. ECOSYS needs an update of various parameter values to provide reliable estimates. This paper reports on some results of a Nordic initiative to derive parameter values that are specific to Nordic conditions, as well as to improve generic parameter values in ECOSYS, taking into account the host of useful measurement data accumulated since ECOSYS was created.
Cratylia argentea (Desv.) O. Kuntze is a drought-tolerant tropical shrub legume that can help to ensure continuity of forage supply in smallholder systems either through direct grazing or as a cut-and-carry plant for fresh foliage or silage. A collection of 38 accessions was characterized agronomically and nutritionally. High diversity was detected between accessions. Time to flowering ranged from 217–329 days after transplanting seedlings to the field and from 129–202 days after cutting. Flowering is probably induced by reduction of day length. Seed production was high but variable. Dry matter production ranged from 190–382 g/plant in the rainy and from 124–262 g/plant in the dry season, content of in vitro digestible dry matter from 589–690 g/kg, crude protein content from 184–237 g/kg and fibre content from 403–528 g/kg (neutral detergent fibre, NDF), 240–335 g/kg (acid detergent fibre, ADF), and 9–13 g/kg (acid detergent fibre-bound nitrogen, N-ADF). Accessions CIAT 18674 and CIAT 22406 were identified as promising for further study. They were superior to the commercial cultivar in terms of dry matter (DM) production, particularly in the dry season. Further research is required to determine the prevailing reproduction strategy of C. argentea and to quantify outcrossing-rates. Multilocational trials with a selected set of accessions should be conducted under different environmental conditions.
Characterisation of genetic diversity in a large number of European pig populations has been undertaken with EC support. The populations sampled included local (rare) breeds, national varieties of the major international breeds, commercial lines and the Chinese Meishan breed. A second phase of the project will sample a further 50 Chinese breeds. Neutral genetic markers (AFLP and microsatellites), with individual or bulk typing, were used and compared.
DNA from 59 European pig populations was extracted on samples of about 50 individuals per population. Individuals were typed for 50 microsatellites and for 148 AFLP bands. A subset of 25 populations was typed for 20 microsatellites on pools of DNA. Allele frequencies were estimated by direct allele counting for the co-dominant markers. Frequencies of AFLP negative alleles (absent bands) were obtained by taking the square root of absent band frequencies. Within-breed variability was summarised using standard statistics: expected and observed heterozygosity, mean observed and effective numbers of alleles, and F statistics. Between-breed diversity analysis was based on a bootstrapped Neighbor-Joining (NJ) tree derived from Reynolds distances (DR). The standard distance of Nei (DS) was also calculated.
The purpose of this study was to evaluate effects of a progressive strength training programme on walking ability in adults with cerebral palsy. Ten individuals with spastic diplegia (seven males, three females; mean age 31, range 23–44 years) participated twice a week over 10 weeks. Seven individuals with spastic diplegia (four males, three females; mean age 33, range 25–47 years) who did not receive strength training served as controls. All individuals were ambulatory but motor ability ranged from functional walkers to individuals who always required walking aids and used a wheelchair regularly. Significant improvements were seen in isometric strength (hip extensors p=0.006, hip abductors p=0.01), and in isokinetic concentric work at 30°/s (knee extensors p=0.02) but not in eccentric work. Results also showed significant improvements in Gross Motor Function Measure (GMFM) dimensions D and E (p=0.005), walking velocity (p=0.005), and Timed Up and Go (p=0.01). There was no increase in spasticity for those who underwent strength training. Individuals in the control group did not show any significant improvement in any measured variable. The groups were small, however, and there was no significant difference between the groups in any measured variable. These findings suggest that a 10-week progressive strength training programme improves muscle strength and walking ability without increasing spasticity.
An outbreak of febrile gastroenteritis affected consumers of on-farm manufactured dairy products from a summer farm in Sweden. Symptoms included diarrhoea, fever, stomach cramps and vomiting in 88, 60, 54 and 21% of cases identified. The median incubation period was 31 h. A cohort study with 33 consumers showed an attack rate of 52% and an association between the total amount of product eaten and illness (P=0·07). Twenty-seven of 32 (84%) stool samples cultured for Listeria monocytogenes tested positive, although there was no association between clinical disease and the isolation of L. monocytogenes. In addition, gene sequences for VTEC and ETEC were detected in 6 and 1 subjects, respectively. Bacteriological analysis of cheese samples revealed heavy contamination with L. monocytogenes and coagulase positive staphylococci in all of them and gene markers for VTEC in one of them. Molecular profiles for L. monocytogenes isolated from dairy products, stool samples and an abscess from 1 patient who developed septic arthritis were identical. Results of both microbiological and epidemiological analyses point to L. monocytogenes as the most likely cause of this outbreak. The finding of markers for VTEC in some humans and cheese samples means that a mixed aetiology at least in some cases cannot be conclusively ruled out.