Five Principles for Vertical Merger Enforcement Policy

There seems to be consensus that the Department of Justice’s 1984 Vertical Merger Guidelines do not reflect either modern theoretical and empirical economic analysis or current agency enforcement policy. Yet widely divergent views of preferred enforcement policies have been expressed among agency enforcers and commentators. Based on our review of the relevant economic literature and our experience analyzing vertical mergers, we recommend that the enforcement agencies adopt five principles: (i) The agencies should consider and investigate the full range of potential anticompetitive harms when evaluating vertical mergers; (ii) The agencies should decline to presume that vertical mergers benefit competition on balance in the oligopoly markets that typically prompt agency review, nor set a higher evidentiary standard based on such a presumption; (iii) The agencies should evaluate claimed efficiencies resulting from vertical mergers as carefully and critically as they evaluate claimed efficiencies resulting from horizontal mergers, and require the merging parties to show that the efficiencies are verifiable, merger-specific and sufficient to reverse the potential anticompetitive effects; (iv) The agencies should decline to adopt a safe harbor for vertical mergers, even if rebuttable, except perhaps when both firms compete in unconcentrated markets; (v) The agencies should consider adopting rebuttable anticompetitive presumptions that a vertical merger harms competition when certain factual predicates are satisfied. We do not intend these presumptions to describe all the ways by which vertical mergers can harm competition, so the agencies should continue to investigate vertical mergers that raise concerns about input and customer foreclosure, loss of a disruptive or maverick firm, evasion of rate regulation or other threats to competition, even if the specific factual predicates of the presumptions are not satisfied

Recommendations and Comments on the Draft Vertical Merger Guidelines

These recommendations and comments respond to the request by the Federal Trade Commission and the Department of Justice’s Antitrust Division for public comment on the draft 2020 Vertical Merger Guidelines. We commend the agencies for updating the 1984 non-horizontal merger guidelines by recognizing the substantial advances in economic thinking about vertical mergers in the thirty-five years since those guidelines were issued. Our comments emphasize four issues: (i) the treatment of the elimination of double marginalization (“EDM”), particularly that the draft vertical merger guidelines appear inappropriately to make proof of cognizability part of the agencies burden and that they appear to inappropriately treat the merging firm’s failure to have eliminated double marginalization pre-merger as proof that the merger would lead to EDM and that the post-merger EDM would be merger-specific; (ii) the seemingly arbitrary and inappropriately permissive safe harbor; (iii) the inappropriate (though perhaps unintended) apparent requirement that harms be quantified; and (iv) the inappropriate (though perhaps unintended) apparent requirement that the agencies show that foreclosure would not have been profitable before the merger. We are concerned that these features of the draft Guidelines will lead to under-enforcement and false negatives (including under-deterrence)

Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study

BackgroundDespite the ubiquity of adolescent screen use, there are limited longitudinal studies that examine the prospective relationships between screen time and child behavioral problems in a large, diverse nationwide sample of adolescents in the United States, which was the objective of the current study.MethodsWe analyzed cohort data of 9,538 adolescents (9-10 years at baseline in 2016-2018) with two years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. We used mixed-effects models to analyze associations between baseline self-reported screen time and parent-reported mental health symptoms using the Child Behavior Checklist, with random effects adjusted for age, sex, race/ethnicity, household income, parent education, and study site. We tested for effect modification by sex and race/ethnicity.ResultsThe sample was 48.8% female and racially/ethnically diverse (47.6% racial/ethnic minority). Higher total screen time was associated with all mental health symptoms in adjusted models, and the association was strongest for depressive (B = 0.10, 95% CI 0.06, 0.13, p < 0.001), conduct (B = 0.07, 95% CI 0.03, 0.10, p < 0.001), somatic (B = 0.06, 95% CI 0.01, 0.11, p = 0.026), and attention-deficit/hyperactivity symptoms (B = 0.06, 95% CI 0.01, 0.10, p = 0.013). The specific screen types with the greatest associations with depressive symptoms included video chat, texting, videos, and video games. The association between screen time and depressive, attention-deficit/hyperactivity, and oppositional defiant symptoms was stronger among White compared to Black adolescents. The association between screen time and depressive symptoms was stronger among White compared to Asian adolescents.ConclusionsScreen time is prospectively associated with a range of mental health symptoms, especially depressive symptoms, though effect sizes are small. Video chat, texting, videos, and video games were the screen types with the greatest associations with depressive symptoms. Future research should examine potential mechanisms linking screen use with child behavior problems

A study of older adults’ mental health across 33 countries during the covid-19 pandemic

Despite older adults’ extremely high vulnerability to COVID-19 complications and death, few studies have examined how personal characteristics and the COVID-19 pandemic have impacted the mental health of older adults at the global level. The purpose of this study was to examine the relationships among demographics, COVID-19 life impacts, and depression and anxiety in adults aged 60 and older from 33 countries. A sample of 823 older adults aged 60–94 and residing in 33 countries completed a 10-minute online survey following recruitment from mailing lists and social media. Being separated from and having conflicts with loved ones predicted both anxiety and depression, as did residing in a country with higher income. Getting medical treatment for severe symptoms of COVID-19 and having decreased work responsibilities predicted depression, but adjustment to working from home and younger age predicted both depression and anxiety. Participants from Europe and Central Asia reported higher depression than those from all other regions and higher anxiety than those from Latin America and the Caribbean. The COVID-19 pandemic has had serious deleterious effects on the mental health of older adults worldwide. The current findings have direct implications for mental health services that may be delivered to older adults to help facilitate healthy psychological adjustment

Cyberbullying and Sleep Disturbance Among Early Adolescents in the U.S.

ObjectiveTo determine the association between cyberbullying (victimization and perpetration) and sleep disturbance among a demographically diverse sample of 10-14-year-old early adolescents.MethodsWe analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (Year 2, 2018-2020) of early adolescents (10-14 years) in the US. Modified Poisson regression analyses examined the association between cyberbullying and self-reported and caregiver-reported sleep disturbance measures.ResultsIn a sample of 9,443 adolescents (mean age 12.0 years, 47.9% female, 47.8% white), 5.1% reported cyberbullying victimization, and 0.5% reported cyberbullying perpetration in the past 12 months. Cyberbullying victimization in the past 12 months was associated with adolescent-reported trouble falling/staying asleep (risk ratio [RR] 1.87, 95% confidence interval [CI] 1.57, 2.21) and caregiver-reported overall sleep disturbance of the adolescent (RR: 1.16 95% CI 1.00, 1.33), in models adjusting for sociodemographic factors and screen time. Cyberbullying perpetration in the past 12 months was associated with trouble falling/staying asleep (RR 1.95, 95% CI 1.21, 3.15) and caregiver-reported overall sleep disturbance of the adolescent (RR: 1.49, 95% CI 1.00, 2.22).ConclusionsCyberbullying victimization and perpetration are associated with sleep disturbance in early adolescence. Digital media education and counseling for adolescents, parents, teachers, and clinicians could focus on guidance to prevent cyberbullying and support healthy sleep behavior for early adolescents

Bedtime screen use behaviors and sleep outcomes: Findings from the Adolescent Brain Cognitive Development (ABCD) Study

ObjectivesTo determine associations between bedtime screen time behaviors and sleep outcomes in a national study of early adolescents.MethodsWe analyzed cross-sectional data from 10,280 early adolescents aged 10-14 (48.8% female) in the Adolescent Brain Cognitive Development Study (Year 2, 2018-2020). Regression analyses examined the association between self-reported bedtime screen use and self- and caregiver-reported sleep measures, including sleep disturbance symptoms, controlling for sex, race/ethnicity, household income, parent education, depression, data collection period (pre- vs. during COVID-19 pandemic), and study site.ResultsOverall, 16% of adolescents had at least some trouble falling or staying asleep in the past 2 weeks and 28% had overall sleep disturbance, based on caregiver reports. Adolescents who had a television or an Internet-connected electronic device in the bedroom had a greater risk of having trouble falling or staying asleep (adjusted risk ratio 1.27, 95% CI 1.12-1.44) and overall sleep disturbance (adjusted risk ratio 1.15, 95% CI 1.06-1.25). Adolescents who left their phone ringer activated overnight had more trouble falling/staying asleep and greater overall sleep disturbance compared to those who turned off their cell phones at bedtime. Streaming movies, playing video games, listening to music, talking/texting on the phone, and using social media or chat rooms were all associated with trouble falling/staying asleep and sleep disturbance.ConclusionsSeveral bedtime screen use behaviors are associated with sleep disturbances in early adolescents. The study's findings can inform guidance for specific bedtime screen behaviors among early adolescents

Are deprivation-specific cancer survival patterns similar according to individual- and area-based measures? A cohort study of patients diagnosed with five malignancies in England & Wales, 2008-2016

Objective: To investigate if measured inequalities in cancer survival differ when using individual- (‘person’) compared to area- (‘place’) based measures of deprivation for three socio-economic dimensions: income, deprivation and occupation Design: Cohort studySetting: Data from the Office for National Statistics (ONS) Longitudinal Study of England and Wales, UK, linked to the National Cancer Registration DatabaseParticipants: Patients diagnosed with cancers of the colorectum, breast, prostate, bladder or with Non-Hodgkin Lymphoma (NHL) during the period 2008-2016Primary and secondary outcome measures: Differentials in net survival between groups defined by individual wage, occupation and education compared to those obtained from corresponding area-level metrics using the English and Welsh Indices of Multiple Deprivation (IMD).Results: Survival was negatively associated with area-based deprivation irrespective of the type analysed, although a trend from least to most deprived was not always observed. Socio-economic differences were present according to individually-measured socio-economic groups although there was an absence of a consistent ‘gradient’ in survival. The magnitude of differentials was similar for area-based and individually-derived measures of deprivation, which was unexpected.Conclusion: These unique data suggest that the socio-economic influence of ‘person’ is different to that of ‘place’ with respect to cancer outcomes. This has implications for health policy aimed at reducing inequalities. Further research could further consider the separate and additional influence of area-based deprivation over individual-level characteristics (contextual effects) as well as investigate the geographic, socio-economic and healthcare related characteristics of areas with poor outcomes in order to inform policy intervention

Screen time, problematic screen use, and eating disorder symptoms among early adolescents: findings from the Adolescent Brain Cognitive Development (ABCD) Study

PurposeEmerging research evidence suggests positive relationships between higher screen time and eating disorders. However, few studies have examined the prospective associations between screen use and eating disorder symptoms in early adolescents and how problematic screen use may contribute to symptom development.MethodsWe analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,246, 2016-2020, ages 9-14). Logistic regression analyses were used to estimate the longitudinal associations between baseline self-reported screen time and eating disorder symptoms in year two. Logistic regression analyses were also used to estimate cross-sectional associations between problematic screen use in year two (either problematic social media or mobile phone use) and eating disorder symptoms in year two. Eating disorder symptoms based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) included fear of weight gain, self-worth tied to weight, engaging in compensatory behaviors, binge eating, and distress with binge eating.ResultsEach additional hour of total screen time and social media use was associated with higher odds of fear of weight gain, self-worth tied to weight, compensatory behaviors to prevent weight gain, binge eating, and distress with binge eating two years later (odds ratio [OR] 1.05-1.55). Both problematic social media and mobile phone use were associated with higher odds of all eating disorder symptoms (OR 1.26-1.82).ConclusionsFindings suggest greater total screen time, social media use, and problematic screen use are associated with more eating disorder symptoms in early adolescence. Clinicians should consider assessing for problem screen use and, when high, screen for disordered eating.Level of evidenceLevel III: Evidence obtained from well-designed cohort or case-control analytic studies

Moderate, little, or no improvements in neurobehavioral symptoms among individuals with long COVID: A 34-country retrospective study

(1) Background: Some people with COVID-19 develop a series of symptoms that last for several months after infection, known as Long COVID. Although these symptoms interfere with people’s daily functioning and quality of life, few studies have focused on neurobehavioral symptoms and the risk factors associated with their development; (2) Methods: 1001 adults from 34 countries who had previously tested positive for COVID-19 completed the Neurobehavioral Symptom Inventory reporting the symptoms before their COVID-19 diagnosis, during the COVID-19 infection, and currently; (3) Results: Participants reported large-sized increases before vs. during COVID-19 in all domains. Participants reported a medium-sized improvement (during COVID-19 vs. now) in somatic symptoms, a small-sized improvement in affective symptoms, and very minor/no improvement in cognitive symptoms. The risk factors for increased neurobehavioral symptoms were: being female/trans, unemployed, younger age, low education, having another chronic health condition, greater COVID-19 severity, greater number of days since the COVID-19 diagnosis, not having received oxygen therapy, and having been hospitalized. Additionally, participants from North America, Europe, and Central Asia reported higher levels of symptoms across all domains relative to Latin America and Sub-Saharan Africa; (4) Conclusions: The results highlight the importance of evaluating and treating neurobehavioral symptoms after COVID-19, especially targeting the higher-risk groups identified. General rehabilitation strategies and evidence-based cognitive rehabilitation are needed in both the acute and Long COVID phases.Daniela Ramos Usuga was supported by a predoctoral fellowship from the Basque Government (PRE_2019_1_0164)

Trauma-Related Distress During the COVID-19 Pandemic In 59 Countries

First published online March 11, 2022The COVID-19 pandemic has upended life like few other events in modern history, with differential impacts on varying population groups. This study examined trauma-related distress among 6,882 adults ages 18 to 94 years old in 59 countries during April to May 2020. More than two-thirds of participants reported clinically significant trauma-related distress. Increased distress was associated with unemployment; identifying as transgender, nonbinary, or a cisgender woman; being from a higher income country; current symptoms and positive diagnosis of COVID-19; death of a loved one; restrictive government-imposed isolation; financial difficulties; and food insecurity. Other factors associated with distress included working with potentially infected individuals, care needs at home, a difficult transition to working from home, conflict in the home, separation from loved ones, and event restrictions. Latin American and Caribbean participants reported more trauma-related distress than participants from Europe and Central Asia. Findings inform treatment efforts and highlight the need to address trauma-related distress to avoid long-term mental health consequences.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the European Commission (H2020-MSCA-IF-2018-837228-ENGRAVING). Daniela Ramos-Usuga was supported by a predoctoral fellowship from the Basque Government (PRE_2019_1_0164)