Adjusted indices of multiple deprivation to enable comparisons within and between constituent countries of the UK including an illustration using mortality rates

This is the final version of the article. Available from BMJ Publishing Group via the DOI in this record.Objectives Social determinants can have a major impact on health and as a consequence substantial inequalities are seen between and within countries. The study of inequalities between countries relies on having accurate and consistent measures of deprivation across the country borders. However, in the UK most socioeconomic deprivation measures are not comparable between countries. We give a method of adjusting the Indices of Multiple Deprivation (IMD) for use across the UK, describe the deprivation of each UK country, and show the problems introduced by naïvely using country-specific deprivation measures in a UK-wide analysis of mortality rates. Setting/participants 42 148 geographic areas covering the population of the UK. Outcome measures Adjusted IMD scores based on the income and employment domains of country-specific IMD scores, adjusting for the contribution of other domains. The mortality rate among people aged under 75 years standardised to the UK age structure was compared between country-specific and UK-adjusted IMD quintiles. Results Of the constituent countries of the UK, Northern Ireland was the most deprived with 37% of the population living in areas in the most deprived fifth of the UK, followed by Wales with 22% of the population living in the most deprived fifth of the UK. England and Scotland had similar levels of deprivation. Deprivation-specific mortality rates were similar in England and Wales. Northern Ireland had lower mortality rates than England for each deprivation group, with similar differences for each group. Scotland had higher mortality rates than England for each deprivation group, with larger differences for more deprived groups. Conclusions Analyses of between-country and within-country inequalities by socioeconomic position should use consistent measures; failing to use consistent measures may give misleading results. The published adjusted IMD scores we describe allow consistent analysis across the UK

Age-related changes in the impact of valence on self-referential processing in female adolescents and young adults

Adolescence is a period of self-concept development. In the current study, females aged 11–30 years (N = 210) completed two self-referential tasks. In a memory task, participants judged the descriptiveness of words for themselves or a familiar other and their recognition of these words was subsequently measured. In an associative-matching task, participants associated neutral shapes to either themselves or a familiar other and the accuracy of their matching judgements was measured. In the evaluative memory task, participants were more likely to remember self-judged than other-judged words and there was an age-related decrease in the size of this self-reference effect. Negative self-judgements showed a quadratic association with age, peaking around age 19. Participants were more likely to remember positive than negative words and there was an age-related increase in the magnitude of this positivity bias. In the neutral shapes task, there were no age-related changes in the self-reference effect. Overall, adolescent girls showed enhanced processing of self-relevant stimuli when it could be used to inform their self-concept and especially when it was negative

Children are full of optimism, but those rose-tinted glasses are fading-Reduced learning from negative outcomes drives hyperoptimism in children

Believing that good things will happen in life is essential to maintain motivation and achieve highly ambitious goals. This optimism bias, the overestimation of positive outcomes, may be particularly important during childhood when motivation must be maintained in the face of negative outcomes. In a learning task, we have thus studied the mechanisms underlying the development of optimism bias. Investigating children (8 to 9 year-olds), early (12 to 13 year-olds), and late adolescents (16 to 17 year-olds), we find a consistent optimism bias across age groups. However, children were particularly hyperoptimistic, with the optimism bias decreasing with age. Using computational modeling, we show that this was driven by a reduced learning from worse-than-expected outcomes, and this reduced learning explains why children are hyperoptimistic. Our findings thus show that insensitivity to bad outcomes in childhood helps to prevent taking on an overly realistic perspective and maintain motivation. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Postdecision Evidence Integration and Depressive Symptoms

Background: Metacognition, or the ability to reflect on one’s own thoughts, may be important in the development of depressive symptoms. Recent work has reported that depressive symptoms were associated with lower metacognitive bias (overall confidence) during perceptual decision making and a trend toward a positive association with metacognitive sensitivity (the ability to discriminate correct and incorrect decisions). Here, we extended this work, investigating whether confidence judgments are more malleable in individuals experiencing depressive symptoms. We hypothesized that depressive symptoms would be associated with greater adjustment of confidence in light of new evidence presented after a perceptual decision had been made. // Methods: Participants (N = 416) were recruited via Amazon Mechanical Turk. Metacognitive confidence was assessed through two perceptual decision-making tasks. In both tasks, participants made a decision about which of two squares contained more dots. In the first task, participants rated their confidence immediately following the decision, whereas in the second task, participants observed new evidence (always in the same direction as initial evidence) before rating their confidence. Participants also completed questionnaires measuring depressive symptoms and self-esteem. // Analysis: Metacognitive bias was calculated as overall mean confidence, whereas metacognitive sensitivity was calculated using meta-d’ (a response-bias free measure of how closely confidence tracks task performance) in the first task. Postdecision evidence integration (PDEI) was defined as the change in confidence following postdecision evidence on the second task. // Results: Participants with more depressive symptoms made greater confidence adjustments (i.e., greater PDEI) in light of new evidence (β = 0.119, p = 0.045), confirming our main hypothesis. We also observed that lower overall confidence was associated with greater depressive symptoms, although this narrowly missed statistical significance (β = -0.099, p = 0.056), and we did not find an association between metacognitive sensitivity (meta-d’) and depressive symptoms. Notably, self-esteem was robustly associated with overall confidence (β = 0.203, p < 0.001), which remained significant when controlling for depressive symptoms. // Conclusions: We found that individuals with depressive symptoms were more influenced by postdecisional evidence, adjusting their confidence more in light of new evidence. Individuals with low self-esteem were less confident about their initial decisions. This study should be replicated in a clinically depressed sample

Children perform extensive information gathering when it is not costly

Humans often face decisions where little is known about the choice options. Gathering information prior to making a choice is an important strategy to improve decision making under uncertainty. This is of particular importance during childhood and adolescence, when knowledge about the world is still limited. To examine how much information youths gather, we asked 107 children (8-9 years, N = 30), early (12-13 years, N = 41) and late adolescents (16-17 years, N = 36) to perform an information sampling task. We find that children gather significantly more information before making a decision compared to adolescents, but only if it does not come with explicit costs. Using computational modelling, we find that this is because children have reduced subjective costs for gathering information. Our findings thus demonstrate how children overcome their limited knowledge and neurocognitive constraints by deploying excessive information gathering, a developmental feature that could inform aberrant information gathering in psychiatric disorders

Functional diversity of marine ecosystems after the Late Permian mass extinction event

Article can be accessed from http://www.nature.com/ngeo/journal/v7/n3/full/ngeo2079.htmlThe Late Permian mass extinction event was the most severe such crisis of the past 500 million years and occurred during an episode of global warming. It is assumed to have had significant ecological impact, but its effects on marine ecosystem functioning are unknown and the patterns of marine recovery are debated. We analysed the fossil occurrences of all known Permian-Triassic benthic marine genera and assigned each to a functional group based on their inferred life habit. We show that despite the selective extinction of 62-74% of marine genera there was no significant loss of functional diversity at the global scale, and only one novel mode of life originated in the extinction aftermath. Early Triassic marine ecosystems were not as ecologically depauperate as widely assumed, which explains the absence of a Cambrian-style Triassic radiation in higher taxa. Functional diversity was, however, significantly reduced in particular regions and habitats, such as tropical reefs, and at these scales recovery varied spatially and temporally, probably driven by migration of surviving groups. Marine ecosystems did not return to their pre-extinction state, however, and radiation of previously subordinate groups such as motile, epifaunal grazers led to greater functional evenness by the Middle Triassic

Chemotherapy in patients with unresected pancreatic cancer in Australia: A population-based study of uptake and survival

1 Aim Palliative chemotherapy improves symptom control and prolongs survival in patients with unresectable pancreatic cancer, but there is a paucity of data describing its use and effectiveness in everyday practice. We explored patterns of chemotherapy use in patients with unresected pancreatic cancer in Australia and the impact of use on survival. 2 Methods We reviewed the medical records of residents of New South Wales or Queensland, Australia, diagnosed with unresectable pancreatic adenocarcinoma between July 2009 and June 2011. Associations between receipt of chemotherapy and sociodemographic, clinical and health service factors were evaluated using logistic regression. We used Cox proportional hazards models to analyze associations between chemotherapy use and survival. 3 Results Data were collected for 1173 eligible patients. Chemotherapy was received by 44% (n = 184/414) of patients with localized pancreatic cancer and 53% (n = 406/759) of patients with metastases. Chemotherapy receipt depended on clinical factors, such as performance status and comorbidity burden, and nonclinical factors, such as age, place of residence, multidisciplinary team review and the type of specialist first encountered. Consultation with an oncologist mitigated most of the sociodemographic and service‐related disparities in chemotherapy use. The receipt of chemotherapy was associated with prolonged survival in patients with inoperable pancreatic cancer, including after adjusting for common prognostic factors. 4 Conclusions These findings highlight the need to establish referral pathways to ensure that all patients have the opportunity to discuss treatment options with a medical oncologist. This is particularly relevant for health care systems covering areas with a geographically dispersed population

Time spent with cats is never wasted: Lessons learned from feline acromegalic cardiomyopathy, a naturally occurring animal model of the human disease

<div><p>Background</p><p>In humans, acromegaly due to a pituitary somatotrophic adenoma is a recognized cause of increased left ventricular (LV) mass. Acromegalic cardiomyopathy is incompletely understood, and represents a major cause of morbidity and mortality. We describe the clinical, echocardiographic and histopathologic features of naturally occurring feline acromegalic cardiomyopathy, an emerging disease among domestic cats.</p><p>Methods</p><p>Cats with confirmed hypersomatotropism (IGF-1>1000ng/ml and pituitary mass; n = 67) were prospectively recruited, as were two control groups: diabetics (IGF-1<800ng/ml; n = 24) and healthy cats without known endocrinopathy or cardiovascular disease (n = 16). Echocardiography was performed in all cases, including after hypersomatotropism treatment where applicable. Additionally, tissue samples from deceased cats with hypersomatotropism, hypertrophic cardiomyopathy and age-matched controls (n = 21 each) were collected and systematically histopathologically reviewed and compared.</p><p>Results</p><p>By echocardiography, cats with hypersomatotropism had a greater maximum LV wall thickness (6.5mm, 4.1–10.1mm) than diabetic (5.9mm, 4.2–9.1mm; Mann Whitney, p<0.001) or control cats (5.2mm, 4.1–6.5mm; Mann Whitney, p<0.001). Left atrial diameter was also greater in cats with hypersomatotropism (16.6mm, 13.0–29.5mm) than in diabetic (15.4mm, 11.2–20.3mm; Mann Whitney, p<0.001) and control cats (14.0mm, 12.6–17.4mm; Mann Whitney, p<0.001). After hypophysectomy and normalization of IGF-1 concentration (n = 20), echocardiographic changes proved mostly reversible. As in humans, histopathology of the feline acromegalic heart was dominated by myocyte hypertrophy with interstitial fibrosis and minimal myofiber disarray.</p><p>Conclusions</p><p>These results demonstrate cats could be considered a naturally occurring model of acromegalic cardiomyopathy, and as such help elucidate mechanisms driving cardiovascular remodeling in this disease.</p></div

Environmental differences between sites control the diet and nutrition of the carnivorous plant Drosera rotundifolia

Background and aims: Carnivorous plants are sensitive to small changes in resource availability, but few previous studies have examined how differences in nutrient and prey availability affect investment in and the benefit of carnivory. We studied the impact of site-level differences in resource availability on ecophysiological traits of carnivory for Drosera rotundifolia L. Methods: We measured prey availability, investment in carnivory (leaf stickiness), prey capture and diet of plants growing in two bogs with differences in N deposition and plant available N: Cors Fochno (0.62 g m−2 yr.−1, 353 μg l−1), Whixall Moss (1.37 g m−2 yr.−1, 1505 μg l−1). The total N amount per plant and the contributions of prey/root N to the plants’ N budget were calculated using a single isotope natural abundance method. Results: Plants at Whixall Moss invested less in carnivory, were less likely to capture prey, and were less reliant on prey-derived N (25.5% compared with 49.4%). Actual prey capture did not differ between sites. Diet composition differed – Cors Fochno plants captured 62% greater proportions of Diptera. Conclusions: Our results show site-level differences in plant diet and nutrition consistent with differences in resource availability. Similarity in actual prey capture may be explained by differences in leaf stickiness and prey abundance