Association between chronic conditions and health-related quality of life: differences by level of urbanization in Peru.

PURPOSE: To evaluate the role of urbanization as an effect modifier for the association between specific chronic conditions and number of conditions with health-related quality of life (QOL). METHODS: We analyzed cross-sectional data from the CRONICAS Cohort Study conducted in Lima (highly urbanized), Tumbes (semi-urban), as well as rural and urban sites in Puno. Exposures of interest were chronic bronchitis, depressive mood, hypertension, type 2 diabetes, and a composite variable aggregating the number of chronic conditions (the four exposures plus heart disease and stroke). QOL outcomes were assessed with EuroQol's EQ-5D visual analogue scale (EQ-VAS). We fitted linear regressions with robust variance to evaluate the associations of interest. Study site was assessed as a potential effect modifier using the likelihood-ratio (LR) test. RESULTS: We evaluated data on 2433 subjects: 51.3% were female, mean age was 57.2 years. Study site was found to be an effect modifier only for the association between depressive mood and EQ-VAS score (LR test p < 0.001). Compared to those without depressive mood, participants with depressive mood scored -13.7 points on the EQ-VAS in Lima, -7.9 in urban Puno, -11.0 in semi-urban Tumbes, and -2.7 in rural Puno. Study site was not found to be an effect modifier for the association between the number of chronic conditions and EQ-VAS (LR test p = 0.64). CONCLUSION: The impact of depressive mood on EQ-VAS was larger in urban than in rural sites, while site was not an effect modifier for the remaining associations

Marine recreational fishing and the implications of climate change

Marine recreational fishing is popular globally and benefits coastal economies and people's well-being. For some species, it represents a large component of fish landings. Climate change is anticipated to affect recreational fishing in many ways, creating opportunities and challenges. Rising temperatures or changes in storms and waves are expected to impact the availability of fish to recreational fishers, through changes in recruitment, growth and survival. Shifts in distribution are also expected, affecting the location that target species can be caught. Climate change also threatens the safety of fishing. Opportunities may be reduced owing to rougher conditions, and costs may be incurred if gear is lost or damaged in bad weather. However, not all effects are expected to be negative. Where weather conditions change favourably, participation rates could increase, and desirable species may become available in new areas. Drawing on examples from the UK and Australia, we synthesize existing knowledge to develop a conceptual model of climate-driven factors that could impact marine recreational fisheries, in terms of operations, participation and motivation. We uncover the complex pathways of drivers that underpin the recreational sector. Climate changes may have global implications on the behaviour of recreational fishers and on catches and local economies

The role of the cerebellum in adaptation: ALE meta‐analyses on sensory feedback error

It is widely accepted that unexpected sensory consequences of self‐action engage the cerebellum. However, we currently lack consensus on where in the cerebellum, we find fine‐grained differentiation to unexpected sensory feedback. This may result from methodological diversity in task‐based human neuroimaging studies that experimentally alter the quality of self‐generated sensory feedback. We gathered existing studies that manipulated sensory feedback using a variety of methodological approaches and performed activation likelihood estimation (ALE) meta‐analyses. Only half of these studies reported cerebellar activation with considerable variation in spatial location. Consequently, ALE analyses did not reveal significantly increased likelihood of activation in the cerebellum despite the broad scientific consensus of the cerebellum's involvement. In light of the high degree of methodological variability in published studies, we tested for statistical dependence between methodological factors that varied across the published studies. Experiments that elicited an adaptive response to continuously altered sensory feedback more frequently reported activation in the cerebellum than those experiments that did not induce adaptation. These findings may explain the surprisingly low rate of significant cerebellar activation across brain imaging studies investigating unexpected sensory feedback. Furthermore, limitations of functional magnetic resonance imaging to probe the cerebellum could play a role as climbing fiber activity associated with feedback error processing may not be captured by it. We provide methodological recommendations that may guide future studies

The contribution of X-linked coding variation to severe developmental disorders

Over 130 X-linked genes have been robustly associated with developmental disorders, and X-linked causes have been hypothesised to underlie the higher developmental disorder rates in males. Here, we evaluate the burden of X-linked coding variation in 11,044 developmental disorder patients, and find a similar rate of X-linked causes in males and females (6.0% and 6.9%, respectively), indicating that such variants do not account for the 1.4-fold male bias. We develop an improved strategy to detect X-linked developmental disorders and identify 23 significant genes, all of which were previously known, consistent with our inference that the vast majority of the X-linked burden is in known developmental disorder-associated genes. Importantly, we estimate that, in male probands, only 13% of inherited rare missense variants in known developmental disorder-associated genes are likely to be pathogenic. Our results demonstrate that statistical analysis of large datasets can refine our understanding of modes of inheritance for individual X-linked disorders

The problematic relationship between knowing how and knowing that in secondary art education

This is a postprint of an article whose final and definitive form has been published in the Oxford Review of Education© 2005 Copyright Taylor & Francis; Oxford Review of Education is available online at http://www.informaworld.comThis article explores and attempts to rectify current conceptual confusion found in secondary art education in the UK between procedural knowledge or 'knowing how' and declarative knowledge or 'knowing that'. The paper argues that current practice confuses procedural knowledge with declarative knowledge. A corollary is that assessment evidence for 'knowing how', which is shown or demonstrated, is confused with assessment evidence for 'knowing that', which requires spoken or written forms of reporting. The confusion is replicated in the national examination, the General Certificate of Secondary Education, taken by students at the age of 16. The article traces this confusion to three dualisms: the Cartesian dualisms of mind and body, an individual mind and the distributed mind of culture, and the more recent mind-in-brain hemisphere dualism. The article advocates a Wittgensteinian embodied, socio-cultural view of mind as a way of solving the current conceptual confusion that prevails in art education in the UK

Multi-trait genome-wide association analysis of blood pressure identifies 45 additional loci

Introduction: Single-trait genome wide association studies (GWAS) have revealed over 1,000 blood pressure (BP) loci. However, these loci only account for less than one third of the BP genetic variation. Multi-trait GWAS is reported to increase discovery power by jointly analysing highly correlated traits. By performing the first large-scale multi-trait BP GWAS, we aimed 1) to compare multi-trait vs single-trait results and 2) identify additional loci. Methods: We apply MTAG to conduct a multi-trait GWAS of systolic BP, diastolic BP and pulse pressure using results from our recent GWAS discovery analysis of ~750k individuals of European ancestry from UK Biobank and the International Consortium of Blood Pressure. To detect additional loci we tested ~7 million imputed genetic variants applying the same combined 1-stage and 2-stage design criteria as in the original GWAS, with replication using MTAG results from the US Million Veteran Program (n~220k). Results: Single-trait GWAS yielded a higher number of significant independent signals genome-wide. Nevertheless, our multi-trait analysis identified 45 new BP loci that were not detected in the equivalent GWAS, of which nine remain novel (based on further BP loci discoveries since 2018). Conclusions: Our multi-trait GWAS discovered additional BP loci. However, our results illustrate that the benefits of MTAG are trait-specific, requiring high pairwise correlation between all pairs of traits, and that more power is gained when MTAG is also used for meta-analysis of traits from different samples. This suggests that future BP genetics discovery projects should focus efforts on larger meta-analyses including new cohorts