Producing Sites, Exploring Identities: Youth Online Authorship

Part of the Volume on Youth, Identity, and Digital MediaThis chapter explores why young authors find value in expressing themselves on the Internet. Concentrating on the genres of personal home pages and blogs, in particular, the chapter aims to answer the following questions: What do adolescents see as the rewards of online expression? How do they make choices about the self-presentations they offer? What role do audiences play in their decision-making? How is online expression meaningful, and in what ways is it unfulfilling? Discussion is based in large part on interviews with hundreds of authors ranging in age from 12 to 21 years. The chapter notes how youth authors' sentiments about their online practices reflect their engagement with important developmental tasks associated with adolescence. The goal throughout this chapter is to broaden the terrain of discussion about online youth expression practices so that our public and popular discourse about young people is more meaningful and contextualized

Reactions to the U.S. Surgeon General’s Advisory on Social Media & Youth Mental Health

The United States Surgeon General issued an Advisory on Social Media and Youth Mental Health on May 23 2023. Warnings by the Surgeon General are infrequent, but have the potential to influence the course of history. This survey captures awareness of and reaction to the Advisory. The survey finds that respondents are already convinced that social media influences young people, mostly negatively. The Surgeon General remains a meaningful public health communicator, with substantial reach and some power to influence both beliefs and behaviors. There is widespread agreement that more research is needed to better understand how social media impact youth mental health, and some faith that the Surgeon General’s recommended actions for policymakers, technology companies, parents, youth and researchers could make a difference if they were implemented

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

A Progress Evaluation of National Geographic's Geotourism Program

In response to the deleterious effects of traditional mass tourism, National Geographic launched a Geotourism Program in 1997 in an effort to sustain or enhance the geographical character of a place – its environment, culture, aesthetics, heritage, and the well-being of its residents. A major tenet of Geotourism is establishing an evaluation process for strategies implemented by Geotourism destinations. This study targets one stakeholder group - businesses featured on the Geotourism MapGuide - through an exploratory case study approach to create a methodology and establish baseline data for a participant evaluation system. Data collection instruments determine the social, economic and environmental impacts of the Geotourism Project as perceived by participants in two destinations: Sierra Nevada and Crown of the Continent. Analysis of results yields recommendations for how stakeholder education and involvement, impact measurement, and project positioning can be more effectively integrated into each destination’s strategic plan

Genetic epilepsy with febrile seizures plus: refining the spectrum

Objective: Following our original description of generalized epilepsy with febrile seizures plus (GEFS1) in 1997, we analyze the phenotypic spectrum in 409 affected individuals in 60 families (31 new families) and expand the GEFS1 spectrum. Methods: We performed detailed electroclinical phenotyping on all available affected family members. Genetic analysis of known GEFS1 genes was carried out where possible. We compared our phenotypic and genetic data to those published in the literature over the last 19 years. Results: We identified new phenotypes within the GEFS1 spectrum: focal seizures without preceding febrile seizures (16/409 [4%]), classic genetic generalized epilepsies (22/409 [5%]), and afebrile generalized tonic-clonic seizures (9/409 [2%]). Febrile seizures remains the most frequent phenotype in GEFS1 (178/409 [44%]), followed by febrile seizures plus (111/409 [27%]). One third (50/163 [31%]) of GEFS1 families tested have a pathogenic variant in a known GEFS1 gene. Conclusion: As 37/409 (9%) affected individuals have focal epilepsies, we suggest that GEFS1 be renamed genetic epilepsy with febrile seizures plus rather than generalized epilepsy with febrile seizures plus. The phenotypic overlap between GEFS1 and the classic generalized epilepsies is considerably greater than first thought. The clinical and molecular data suggest that the 2 major groups of generalized epilepsies share genetic determinants.National Health and Medical Research Council of Australia [628952, 1091593, 466671, 1006110, 1104831, 1032603, 1063799]SCI(E)ARTICLE121210-12198