Paige Walton, MD, joined host Frank Clark, MD, on this episode of Psyched Perspectives to discuss disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis, the impact of screen time on ADHD symptoms, and the newly approved medication centanafadine (Simtriyo).
Walton said untreated ADHD can affect a child’s self-esteem and academic performance and, left unaddressed, carries downstream risks in adulthood such as substance misuse, unsafe driving, and impaired employment and financial functioning, making early identification important. Hyperactive, disruptive behavior in boys tends to draw earlier attention in the classroom, while several other groups are frequently missed. Girls with ADHD, she explained, more often present with inattentive, internalizing symptoms and daydreaming rather than overt hyperactivity, and many compensate by working excessively hard to maintain grades before symptoms surface as anxiety or perfectionism.1 “They tend to be quieter, they’re more on the inattentive side—so they’re daydreaming, they might struggle with being disorganized, paying attention,” Walton said. She also described disparities among racial and ethnic minority groups, citing limited access to care, cultural attitudes toward mental health and medication, and clinician bias as contributing factors; Walton cautioned that ADHD in these populations can be mislabeled as conduct disorder or oppositional defiant disorder, which carries different treatment implications.
On screen time, Walton described a bidirectional relationship with ADHD: screens do not cause the disorder, but heavy use can worsen inattention and emotional dysregulation, while children with ADHD are drawn to the novelty of the device and immediate reward and may struggle to disengage.
Walton noted that centanafadine, a norepinephrine-, dopamine-, and serotonin-reuptake inhibitor, was recently approved for ADHD, adding a novel mechanism distinct from traditional stimulants and nonstimulants such as atomoxetine and viloxazine.2
For nonpharmacologic management, Walton emphasized sleep, along with regular exercise, adequate nutrition, and predictable routines using tools such as alarms and visual calendars. On caffeine, Walton advised monitoring intake in patients taking stimulants: “we have to be really careful with monitoring how much caffeine our patients are drinking because it can really impact those side effects, can have some cardiac risks.” She generally recommended no more than 200 mg daily, adjusted to individual tolerance.
Dr Waltonis a double board-certified child and adolescent psychiatrist and adult psychiatrist practicing at Sweetgrass Psychiatry in Mount Pleasant, South Carolina. She also serves as an affiliate assistant professor at the Medical University of South Carolina.
Japan Today Spotlight #72 | Japan’s ‘hikikomori’ shut-ins are getting older — and the clock is ticking
June 18 10:09 pm JST 8 Comments By Jeff W. RichardsTOKYO
Japan is home to an estimated 1.46 million hikikomori — people who withdraw from society and self-isolate, often in their elderly parents’ homes.
Once thought of as a youth problem, the phenomenon has aged significantly. More than 43% of hikikomori are now over 40, and the parents supporting them are in their 60s and 70s. As those parents age and pass away, the question of what happens next has become urgent.
This episode of Japan Today Spotlight looks at the Employment Ice Age generation that gave rise to the crisis, the 8050 problem that defines it, and the individuals and organizations working to help shut-ins find their way back.
Since publication, the episode has drawn more than 1,000 comments on YouTube, with many viewers saying the story felt familiar far beyond Japan — in their families, their countries and their own lives.
Watch the full episode
Discussion question
Mayumi Kikuchi helped bring Fujisato’s 113 hikikomori down to fewer than 10 — one door at a time. With over 1.46 million shut-ins across Japan, can that approach ever scale up?
I suppose when Japan becomes a less stressful society the 1.5 million hikikomori will come out and play. In the meantime, the hikikomori are a huge wasted economic and demographic resource.
The advent of the Internet and living in a wealthy enough nation in which people can live either off the government or their parents has facilitated this phenomenon that. Also, cheap rent has helped cause the hikkikomori phenomenon. It’s much easier to socially withdraw if you get welfare and have access to a 3万 apartment.
Here are the nations in which the phenomenon is most widespread:
If you lose your job in Japan in your 40’s, it seems like it is very difficult to get another job. I know someone that lost a graphic designed job in early 40’s and was never able to find another. Only options were arubeito type jobs.
I’ve been a Hikkikomori for several times, spanning months since graduating college. I’m just burnt out of society’s bovine dung, but there’s no way out of the system but to just survive it long enough. Let me tell you, being a recluse is like getting sick with a terminal illness that gets worse the longer it becomes untreated. I never reached the point of having social anxiety, but I find job hunting and having conversations about career and life goals distressing. Who wants to be a part of a system that treats you like cattle anyway.
Solving this issue in Japan will be tough, especially how Japanese society tends to be very unkind towards people suffering from problems. Gaman suru, Genki ni nare, and Ganbatte ne can only take one so far.
AI is already squeezing some job categories more than others.
On Wednesday, Goldman Sachs published a report showing that AI is starting to press the labor markets of major economies, with industries that have a greater exposure to AI automation seeing a slowdown in job growth over the past four years. The research found that job growth in information and communication services has slowed across all major economies since 2022.
This includes white collar jobs like call centers, software publishing, management consulting and advertising, all of which have fallen far below historical trends, largely as a result of AI, according to the Goldman Sachs research.
For instance, call center employment is down 39% the historical average in the US, 33% down in Canada, and 27% down in Germany. Additionally, entry-level workers are being hit the hardest by AI, especially for those in occupations that are more exposed to AI, such as the ones listed above, the report finds.
This is coupled with data that shows that AI adoption is spreading widely across these economies. Goldman’s research found that adoption rates have increased between 15% and 20% in developed markets, with France, the US, the Netherlands and the UK leading. Adoption is on the rise in emerging markets, too, sitting between 10% and 15%.
“Overall, our analysis confirms that the conclusions from the US hold globally,” wrote Goldman Sachs’ Sarah Dong, macro research analyst, and Joseph Briggs, economist, in the report. “AI-related hiring headwinds are clearly visible in official and unofficial employment data, but impacts are limited to a narrow set of industries and workers.”
Goldman’s data marks the latest addition to a growing pile of evidence that AI is impacting specific segments of the labor market. However, the broader signals are still largely mixed. Some estimates suggest that companies investing in AI have grown their headcount by as much as 10%, with entry-level hiring rising 12%. Other studies estimate that a large percentage of US work hours can already be automated. Further, some research finds that half of those laid off will be rehired for new jobs, and that AI actually increases the scope of work, rather than narrowing it.
Despite the mixed messaging on the efficacy of replacing humans with AI, layoffs are happening either way, especially for white-collar fields. The US made up 82% of the nearly 160,000 tech layoffs in 2026, and almost half of those were tied to companies restructuring around AI and automation, recent data finds. However, the truth is that AI has become a scapegoat for companies that want to trim headcount. In the long run, this is bound to backfire in two ways. For one, the question of AI ROI is ever-present. While layoffs may provide a temporary buffer that appeases stakeholders, those returns won’t last forever. Additionally, blaming layoffs on AI is bound to worsen sentiment around it, both organizationally and publicly, creating resentment among staff that didn’t get laid off and creating friction about internal AI deployments. The bottom line is that companies need to tread very carefully in their messaging about AI and its impact on jobs.
For free and unbiased Medicare help, dial 507-478-7579 to speak with my trusted partner, Chapter, or go to https://askchapter.org/smerconish
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Why has Trump aide Natalie Harp suddenly become one of the most talked-about figures in Washington? Michael Smerconish and Mark Halperin examine Harp’s unusually close access to President Trump, concerns reportedly raised by other Trump aides, and the uproar surrounding Sen. Jon Ossoff’s comments about her. Was Ossoff’s remark sexist or simply careless? Is Harp’s influence inside Trump’s orbit worthy of scrutiny? Or has Washington turned a half-sentence into a controversy that ultimately amounts to “much ado about nothing”? Smerconish and Halperin break down what we actually know — and why the reaction may be more revealing than the original comment.
Mali, Burkina Faso and Niger are building an economic system centered on gold (≈230 tonnes/year, ~$32 billion market value) after exiting ECOWAS, using greater state control of mines, refining and trade to reduce external dependence.
Massive discrepancies between official exports and actual gold flows (hundreds of tonnes of undeclared metal) reveal extensive smuggling, while new state refineries aim to capture more of the value chain.
Control of the “gold pipeline” (mine → refinery → buyer), including links to Russian networks, is turning the commodity into an instrument of political and financial autonomy for the AES juntas.
The collapse of West Africa’s political order last year assumed an oddly bureaucratic tone. The Economic Community of West African States formally confirmed the departure of Mali, Burkina Faso and Niger, even as the bloc preserved a six-month transition for visas, trade and passport recognition. Diplomatic language made the rupture sound manageable, yet the underlying economic break was considerably more consequential.
The three states had already built the machinery of separation. The Alliance of Sahel States, created in September 2023 as a mutual defense pact, acquired a confederal structure a year later, complete with a planned import levy and a proposed regional development bank. By the time the ECOWAS exit became official, the juntas had moved beyond rejecting Western political conditions. They were beginning to assemble an economic system designed to function with less reliance on them.
And gold sits at the center of this transformation.
The three Alliance of Sahel States economies collectively produce about 230 tonnes of gold a year. At a spot price of just over $4,380 per troy ounce, that volume carries a gross market value of about $32.4 billion. A staggering figure representing a little more than half the combined gross domestic product of the three economies, corresponding to the value of gold extracted, not government revenue, export earnings or money available to the juntas.
It is a distinction central to understanding the Sahel’s new political economy.
Gold does not need to make Mali, Burkina Faso or Niger rich to make their governments harder to isolate. A commodity with enormous value relative to its physical weight can finance imports, secure hard currency, attract foreign partners and compensate for weaknesses in conventional financial channels. Every additional point in the chain that governments control can increase the share of that value they retain.
As a result, the overall strategy has already moved in this direction. Mali’s 2023 mining code raised the potential state stake in mining projects from 20 percent to 35 percent. Burkina Faso has created a state mining participation company while increasing royalties on higher-value production. Niger has gone further, nationalizing the Somair uranium operation previously controlled by France’s Orano and revoking licenses held by several Western companies.
Moreover, a parallel monetary system is also being discussed. Alliance of Sahel States officials have floated a common central bank and currency to replace the CFA franc, whose reserve arrangements have long been politically contentious. A functioning gold-backed currency remains difficult to imagine given the bloc’s limited reserve-management and monetary institutions. However, it does signal that gold, bilateral settlement and physical commodities are likely to become alternatives to conventional currency channels.
What’s more, Western and ECOWAS assumptions have another problem. Regional growth can remain respectable while regional integration deteriorates. ECOWAS projected 5 percent growth for 2026 and 7.1 percent for 2027, yet those aggregates say little about who controls the mineral rents being generated inside the bloc’s former Sahelian core. The three departing states remove about 70 million consumers from the customs union while taking major mineral assets outside its institutional framework.
A useful way to read the break, therefore, is vertically rather than horizontally. ECOWAS measures economic integration through trade, markets and formal institutions. The Alliance of Sahel States is increasingly pursuing sovereignty through control of a “gold pipeline” running from mine to tax office to refinery to foreign buyer.
Put simply, the political exit was the announcement — the pipeline is the project.
However, the most revealing part of the Sahel’s commodity story begins where the official export figures stop making sense.
Take Mali, for instance. In 2019, it was reported to have sold nearly 81 tonnes of Malian gold to a single country, but Bamako declared only about half a tonne of this. SWISSAID has estimated that between 30 tonnes and 57 tonnes of Malian gold may be smuggled out each year, representing $1.98 billion to $3.77 billion in undeclared trade. Between 2012 and 2022, the cumulative quantity of undeclared Malian gold was estimated at about 300 tonnes, worth some $13.5 billion.
Elsewhere, Niger’s official gold exports in 2022 amounted to only 235 kg, worth less than €10 million ($11.5 million), but again just one country recorded €457 million in gold imports from Niger. Burkina Faso is estimated to lose about $490 million a year through smuggling and under-declaration. Togo, meanwhile, reported billions of dollars-worth of gold exports in 2024 despite producing little gold itself. The figures do not prove every tonne originated in the Alliance of Sahel States but they expose how poorly national production statistics map onto the bullion actually reaching international markets.
Physical gold makes the problem unusually difficult to police. Couriers reportedly move between 10 kg and 40 kg per trip. A $500 airfare is irrelevant when the passenger is carrying bullion easily worth hundreds of thousands to millions of dollars. The transaction also bears little resemblance to conventional commodity trade: the gold can move through intermediaries, change hands for cash and enter a refining system where its provenance becomes progressively harder to reconstruct.
Domestic refining could change things even further.Burkina Faso launched a national refinery in late 2024 with an annual capacity of 150 tonnes a year. Mali broke ground in June 2025 on a refinery designed to process 200 tonnes, with 62 percent state ownership and the remainder held by Russia’s Yadran Group and a Swiss investor. The Malian facility is designed for 99.5 percent purity and has been explicitly presented as a regional processor capable of handling gold from neighboring Burkina Faso.
This lurch to refining matters because it captures a stage of the value chain that producers have historically outsourced. More importantly, high-purity bullion is highly fungible.Once ore has become standardized bars, the questions shift from where the metal was mined to who is willing to buy it.
Russia enters the system at this point, with Kremlin-associated networks linked to more than $2.5 billion in African gold flows since 2022, while Wagner Group-linked forces reportedly gained access to Mali’s Intahaka artisanal mine and received payment for security services.
A mine, a security contractor, a refinery and an offshore buyer can therefore become parts of one circuit in which gold finances security; security protects access to gold; refining increases the commodity’s portability; and offshore markets convert bullion into currencies, imports or further strategic relationships.
Ultimately, the Alliance of Sahel States juntas’ vertical sovereignty is complete: control over mine, refinery, transport and buyer transforms gold from commodity into instrument of state power. The laundering machine will eventually transcend gold itself — turning into a conversion mechanism in which commodities, illicit flows, nationalization decrees, external security guarantees and political rhetoric are endlessly transmuted into one another, making Western isolation of a sufficiently autonomous political system tolerable.
Hafed Al-Ghwell is senior fellow and program director at the Stimson Center in Washington and senior fellow at the Center for Conflict and Humanitarian Studies. X: @HafedAlGhwell
About Arab News
Arab News is Saudi Arabia’s first English-language newspaper. It was founded in 1975 by Hisham and Mohammed Ali Hafiz. Today, it is one of 29 publications produced by Saudi Research & Publishing Company (SRPC), a subsidiary of Saudi Research & Marketing Group (SRMG).
Published: August 13, 2019Last Updated: February 18, 2025
On or about August 20, 1619, “20 and odd” Angolans, kidnapped by the Portuguese, arrive in the British colony of Virginia and are then bought by English colonists. The exact date is not definitively known (a letter from the time identified the ship’s arrival coming in “the latter part of August”), but this date has been chosen by many to mark the arrival of the enslaved Africans in the New World—beginning two and a half centuries of slavery in North America.
Founded at Jamestown in 1607, the Virginia Colony was home to about 700 people by 1619. The first enslaved Africans to arrive in Virginia disembarked at Point Comfort, in what is today known as Fort Monroe.Most of their names, as well as the exact number who remained at Point Comfort, have been lost to history, but much is known about their journey.
Life Aboard a Slave Ship
Life aboard the ship was agonizing and dangerous; nearly 2 million enslaved Africans would perish on their journey across the Atlantic.
They were originally kidnapped by Portuguese colonial forces, who sent captured members of the native Kongo and Ndongo kingdoms on a forced march to the port of Luanda, the capital of modern-day Angola. From there, they were ordered on the ship San Juan Bautista, which set sail for Veracruz in the colony of New Spain. As was quite common, about 150 of the 350 captives aboard the ship died during the crossing. Then, as it approached its destination, the ship was attacked by two privateer ships, the White Lion and the Treasurer. Crews from the two ships kidnapped up to 60 of the Bautista’s enslaved people. It was the White Lion which docked at Virginia Colony’s Point Comfort and traded some of the prisoners for food on August 20, 1619.
Scholars note that the arrivals were technically sold as indentured servants. Indentured servants agreed, or in many cases were forced, to work with no pay for a set amount of time, often to pay off a debt and could legally expect to become free at the end of the contract. Many Europeans who arrived in the Americas came as indentured servants. Despite this classification—and records which indicate that some of them did eventually obtain their freedom—it is clear that the Africans arriving at Point Comfort in 1619 were forced into servitude and that they fit the Universal Declaration of Human Rights’ definition of enslaved peoples.
The arrival at Point Comfort marked a new chapter in the history of the trans-Atlantic slave trade, which began in the early 1500s and continued into the mid-1800s. The trade uprooted roughly 12 million Africans, depositing roughly 5 million in Brazil and over 3 million in the Caribbean. Though the number of Africans brought to mainland North America was relatively small—roughly 400,000—their labor and that of their descendants was crucial to the economies of the British colonies and, later, the United States.
Two of the Africans who arrived aboard the White Lion, Antonio and Isabella, became “servants” of Captain William Tucker, commander of Point Comfort. Their son William is the first known African child to have been born in America, and under the law of the time he was born a freeman. In the coming decades, however, slavery became codified.
Slavery in America
In 1619, the Dutch introduced the first captured Africans to America, planting the seeds of a slavery system that evolved into a nightmare of abuse and cruelty that would ultimately divide the nation.
Servants of African origin were oftentimes forced to continue working after the end of their contract, and in 1640 a Virginia court sentenced rebellious servant John Punch to a lifetime of slavery. With fewer white indentured servants arriving from England, a racial caste system developed and African servants were increasingly held for life. In 1662, a Virginia court ruled that children born to enslaved mothers were the property of the mother’s owner.
As cash crops like tobacco, cotton and sugar became pillars of the colonial economy, slavery became its engine. Though the slave trade was outlawed in 1807, chattel slavery and the plantation economy it made possible flourished in the South. The 1860 census found that there were 3,953,760 enslaved people in the United States, making up roughly 13 percent of the total population.
The conflict between abolitionists and those who wanted to preserve and spread slavery was a major catalyst in the outbreak of the Civil War. President Abraham Lincoln formally freed enslaved people in the South with the Emancipation Proclamation in 1863, although it was not until the passage of the Thirteenth Amendment in 1865 that slavery was formally abolished in the United States.
In the end, 246 brutal years of slavery had an incalculable effect on American society. It would take another century after the Civil War for racial segregation to be declared unconstitutional, but the end of state-sanctioned racism was by no means the end of racism and discrimination in America. Because it became a crucial part of the culture and economy of early America after its introduction in Jamestown, slavery is often referred to as the nation’s “original sin.”
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Discover more of the major events, famous births, notable deaths and everything else history-making that happened on August 20th
The decline of socialising in modern society has been a steady process, but on many measures of isolation a gap really opened up after the pandemic. The FT’s John Burn-Murdoch examines the data behind the damaging new normal. https://ft.trib.al/0eVZ8bM
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