The course of bipolar disorder in pregnant versus non-pregnant women

Background and rationale Although it has been suggested that pregnancy may influence the course of bipolar disorder (BD), studies show contradictory results. Until now, no studies included a finegrained validated method to report mood symptoms on a daily basis, such as the lifechart method (LCM). The aim of the present study is to investigate the course of BD during pregnancy by comparing LCM scores of pregnant and non-pregnant women. Methods Study design: Comparison of LCM scores of two prospective observational BD cohort studies, a cohort of pregnant women (n = 34) and a cohort of non-pregnant women of childbearing age (n = 52). Main study parameters are: (1) proportions of symptomatic and non-symptomatic days; (2) symptom severity, frequency, and duration of episodes; (3) state sequences, longitudinal variation of symptom severity scores. Results No differences in clinical course variables (symptomatic days, average severity scores, frequency, and duration of episodes in BD were found between pregnant and non-pregnant women. With a combination of State Sequence Analysis (SSA) and cluster analysis on the sequences of daily mood scores three comparable clusters were found in both samples: euthymic, moderately ill and severely ill. The distribution differences between pregnant and non-pregnant women were significant, with a majority of the pregnant women (68%) belonging to the moderately ill cluster and a majority of the non-pregnant women (46%) to the euthymic cluster. In pregnant women the average daily variation in mood symptoms as assessed with Shannon’s entropy was less than in non-pregnant women (respectively 0.43 versus 0.56). Conclusions Although the use of daily mood scores revealed no difference in overall course of BD in pregnant versus non-pregnant women, more pregnant than non-pregnant women belonged to the moderately ill cluster, and during pregnancy the variation in mood state was less than in non-pregnant women. Further research is necessary to clarify these findings.

Risk of Nursing Home Use Among Older Americans: The Impact of Psychiatric History and Trajectories of Cognitive Function

Objectives Mental illness and cognitive functioning may be independently associated with nursing home use. We investigated the strength of the association between baseline (1998) psychiatric history, 8-year cognitive function trajectories, and prospective incidence of nursing home use over a 10-year period while accounting for relevant covariates in U.S. adults aged 65 and older. We hypothesized that self-reported baseline history of psychiatric, emotional, or nervous problems would be associated with a greater risk of nursing home use and that cognition trajectories with the greatest decline would be associated with a subsequent higher risk of nursing home use. Methods We used 8 waves (1998–2016) of Health and Retirement Study data for adults aged 65 years and older. Latent class mixture modeling identified 4 distinct cognitive function trajectory classes (1998–2006): low-declining, medium-declining, medium-stable, and high-declining. Participants from the 1998 wave (N = 5,628) were classified into these 4 classes. Competing risks regression analysis modeled the subhazard ratio of nursing home use between 2006 and 2016 as a function of baseline psychiatric history and cognitive function trajectories. Results Psychiatric history was independently associated with greater risk of nursing home use (subhazard ratio [SHR] 1.26, 95% confidence interval [CI] 1.06–1.51, p < .01), net the effects of life course variables. Furthermore, “low-declining” (SHR 2.255, 95% CI 1.70–2.99, p < .001) and “medium-declining” (2.103, 95% CI 1.69–2.61, p < .001) trajectories predicted increased risk of nursing home use. Discussion Evidence of these associations can be used to educate policymakers and providers about the need for appropriate psychiatric training for staff in community-based and residential long-term care programs.

INVESTIGATION OF ATTITUDES OF STUDENTS STUDYING AT THE FACULTY OF SPORT SCIENCES FIRAT UNIVERSITY TOWARDS SPORT TOURISM

Aim: This research was conducted to examine the attitudes of students studying at Fırat University Faculty of Sport Sciences towards sport tourism. Methods: 1091 students participated in the study. In order to examine the students' attitudes towards sports tourism, the attitude scale towards sports tourism (STYTÖ) developed by Kardaş and Sadık (2018) was used. The data obtained were evaluated in the SPSS 22.0 package program. Frequency, mean, standard deviation, one-wayAnova, independent t-test were used to analyze the data. The significance level of the statistics made was accepted as p <.05. Conclusion: As a result of the study, it was determined that the students' attitudes towards sports tourism were at a positive level and there were signifi-cant differences in terms of some variables (age, class, mother and father education level, branch, department, etc.) according to the sub-dimensions of the scale. It was deter-mined that there was no significant difference in terms of gender, marital status and sports tourism course variables. It is predicted that this research will provide an advantage in determining the attitudes of university students who receive sports education towards sports tourism and evaluating the issue in the sectoral field.

Medical students perceptions of the influence of undergraduate experiences on making a career choice in psychiatry

Purpose Psychiatric recruitment and retention are at an unprecedented low within the UK. The reasons for this shortfall may include public and professional stigma, recent NHS service developments and changes in undergraduate training. The purpose of this study is to explore medical student’s perceptions of the nature and magnitude of these factors on influencing whether or not they would choose a career in psychiatry. Design/methodology/approach This qualitative study was conducted with year four medical students at a single UK University with low levels of recruitment into psychiatry. Two focus groups were asked about their undergraduate experience within the speciality. Thematic analysis of the resulting transcripts enabled the identification of codes and over-arching themes, which formed the focus of this study. Findings Four key themes were identified during analysis and these included: the core subject matter (of psychiatry) viewed as being different; curriculum or course variables; interpersonal factors and; career factors. Placement enjoyment, positive role-modelling and enthusiasm were all important when considering psychiatry as a career. Therapeutic success, career flexibility and pay-banding were also powerful determinants. Practical implications These findings led to the initiation of an apprentice programme for undergraduates on psychiatric placement, designed to enhance the student experience of psychiatry and the perception of the speciality as a career. Originality/value While there are a number of possible solutions to current adverse national trends in psychiatric recruitment, increasing efforts to increase both the variety and quality of undergraduate placements and establishing a clearer sense of team identity is of vital importance if these patterns are to be reversed.

Quantifying Native Speakerism in Second Language (L2) Writing: A Study of Student Evaluations of Teaching

Despite the continually growing number of non-native English-speaking (NNES) teachers in English language teaching, the profession is nonetheless still shaped by native speakerism (Holliday 2005), the idealization of native English speakers (NESs) as linguistically and culturally superior to their NNES counterparts. Such an ideology leads to negative perceptions toward NNES faculty even if they hold equal qualifications to their NES counterparts. This study sought to determine whether multilingual students themselves evaluate instructors differently based on the instructors’ language background. Based on 5,050 Student Evaluation of Teaching (SET) scores compiled over three years (2015–18), independent t-tests and MANCOVA analysis revealed a statistically significant relationship between NNES students’ perceptions of teacher effectiveness and instructor’s language background. Such findings were further compounded by instructor’s gender and course variables, additionally disadvantaging NNES instructors. The broader implications are for institutional stakeholders to be cognizant of the prevalence of native speakerism in L2 writing contexts and use holistic models for teacher assessment to adapt more equitable approaches to assessing underrepresented faculty.

“Generation invisible“. Higher education students’ (non)use of webcams in synchronous online learning

The Spring term 2020 saw a global switch to emergency remote teaching in higher education due to the COVID-19 pandemic. Alongside asynchronous online learning activities, students were called to participate in synchronous videoconferencing sessions, substituting the traditional on-campus face-to-face courses. Given the preponderance of students to avoid using webcams, this study sought to investigate usage behavior, as well as potentially related course variables and individual characteristics. 3,527 students from across all institutional faculties of a comprehensive German university took part in an online survey. Students’ webcam usage behavior was related to personal thoughts and feelings (e.g., privacy), to course characteristics (e.g., group cohesion), and it differed due to specific groups (gender, study degree). Results of this research shed light on a globally present phenomenon and provide a foundation for further investigation.

The association between psychological distress in mid-life and hospital-based multimorbidity

Background Mental ill-health is common with significant impact on individuals and services. Using healthcare records to identify poor mental health missed individuals who do not seek healthcare treatment. A screening questionnaire (General Health Questionnaire (GHQ)) can detect psychological distress. However, before considering implementing such a screening tool, we need to understand if it detects those at high risk of experiencing poorer outcomes. Hospital-based multimorbidity is a rising healthcare challenge. The aim was to assess the prevalence of psychological distress in mid-life and its influence on hospital-based multimorbidity by older age in the Aberdeen Children of the 1950s (ACONF) cohort. Methods Prospective cohort study using ACONF. GHQ-4 was measured in mid-life from questionnaire. Multimorbidity (2 or more co-existing conditions) was measured using linked hospital records in older age (15 years after the questionnaire). The relationship between psychological distress (GHQ-4 score of 1 or more) and multimorbidity was assessed using logistic regression with adjustment for key life-course variables. Results Of 5,839 individuals (48% male, mean age 48), psychological distress prevalence was 20% and was associated with being female, lower childhood cognition, lower educational attainment, lower adult social class, unemployment, higher adult body mass index, smoking and alcohol misuse. In comparison to the asymptomatic reference group, the odds ratio for multimorbidity in older age in those with psychological distress was 2.2 (95% CI 1.8-2.7) in the unadjusted model. In the adjusted model this was 1.4 (95% CI 1.1-1.8). Conclusions 1 in 5 individuals in the general population in mid-life had psychological distress. This was associated with hospital-based multimorbidity by older age. Intervening early could reduce costs to both individuals and healthcare services. The next step is research of the cost-effectiveness of population screening for psychological distress. Key messages Psychological distress in mid-life is associated with hospital-based multimorbidity by older age. Screening for psychological distress early in life should be explored as an intervention to reduce costs to individuals and healthcare services.

When Should We Start Work? Circadian Sociology Analysis of the Conflict Between Biological and Social Time

The average starting time for US workers is 08:00, and many workers experience chronic sleep deprivation. A novel survey was used to determine when workers were at their best in each hour of the 24-hour circadian cycle as well as related life-course variables. Results indicated a 10:00 start would be better for performance and sleep. Analysis by chronotypes demonstrated the Definitely Evening chronotype group showed negative impacts of early US work start times on their education, employment, and subjective health and life satisfaction that were as great as being born into the poorest 25% of US families. Circadian analysis showed synchronizing work to biological timing in each chronotype group was possible with a wide range starting times (07:00 to 16:00), 8 hours for sleep, and optimized performance. Taken together, these circadian patterns revealed possible functional benefits of chronotypes for social groups

Lead Exposure and Oxidative Stress—A Life Course Approach in U.S. Adults

Lead exposure and a marker of oxidative stress (gamma-glutamyl transferase—GGT), and their effects on life course variables (age, country of birth, education levels, gender, ethnicity, income, and occupation) were explored in this cross-sectional study of United States (U.S.) adults’ ≥ 20 years of age via the National Health and Nutrition Examination Survey (NHANES) 2007–2010 datasets. Country of birth, education levels, gender, ethnicity, income, and occupation showed significant differences depending on the degree of lead exposure, with higher levels of exposure resulting in worse outcomes. Age and GGT were significantly associated with lead exposure. More must be done to mitigate sources of lead exposure, to prevent it from altering the life course of at-risk populations.

Effectiveness of Light Emitting Diodes (LED) versus Conventional Phototherapy for Neonatal Jaundice

Background: Phototherapy is crucially an important aspect for the management of most neonatal jaundice. Neonates are prone to develop bilirubin encephalopathy (kernicterus). LED phototherapy is a new option of managing neonatal jaundice. The objective of this study is to compare the efficacy and safety of LEDs with fluorescent phototherapy in the treatment of indirect hyperbilirubinemia.Method: The study was Experimental research design, prospective study. The Study was conducted at Neonatal unit of Shaheed Suhrawardy Medical College Hospital, Dhaka. Total sample size of the study was one hundred neonates. Fifty for conventional phototherapy and fifty for LED phototherapy. Purposive sampling method was used for the study. The data collection tool of the study was pretested structured questionnaire. The modes of presentation, the clinical examination and investigation findings at admission and during daily follow up were recorded for individual patient.Result: The rate of fall of S. bilirubin was more in those neonates who have had LED phototherapy. As a result, duration of phototherapy as well as hospital stay was less in LED group. Furthermore, higher number of neonates developed rashes in LED group than in conventional group with statistically significant difference. Of course, variables regarding other adverse events did not show any statistically significant difference between two groups.Conclusion: Management of neonatal jaundice may be more effective in LED phototherapy than conventional phototherapy. LED device require shorter duration of phototherapy, thus, shorter hospital stay.Bangladesh J Child Health 2018; VOL 42 (2) :62-66