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Background: There is a marked male preponderance in autism spectrum conditions. The extreme male brain theory and the fetal androgen theory of autism suggest that elevated prenatal testosterone exposure is a key contributor to autistic traits. The current paper reports findings from two separate studies that test this hypothesis. Methods: A parent-report questionnaire, the Childhood Autism Spectrum Test (CAST), was employed to measure autistic traits in both studies. The first study examined autistic traits in young children with congenital adrenal hyperplasia (CAH), a condition causing unusually high concentrations of testosterone prenatally in girls. Eighty one children with CAH (43 girls) and 72 unaffected relatives (41 girls), aged 4–11 years, were assessed. The second study examined autistic traits in relation to amniotic testosterone in 92 typically developing children (48 girls), aged 3–5 years. Results: Findings from neither study supported the association between prenatal androgen (testosterone) exposure and autistic traits. Specifically, young girls with and without CAH did not differ significantly in CAST scores and amniotic testosterone concentrations were not significantly associated with CAST scores in boys, girls, or the whole sample. Conclusions: These studies do not support a relationship between prenatal testosterone exposure and autistic traits. These findings augment prior research suggesting no consistent relationship between early androgen exposure and autistic traits. [ABSTRACT FROM AUTHOR]

Background: Eating self-regulatory capacity can help individuals to cope with the obesogenic environment and achieve, as well as maintain, a healthy weight and diet. At present, there is no comprehensive, reliable and valid questionnaire for assessing this capacity and measuring change in response to self-regulation interventions in adults. This paper reports the development of the Self-regulation of Eating Behaviour Questionnaire (SREBQ) for use in UK adults, and presents evidence for its reliability and construct validity. The development of the SREBQ involved generation of an item pool, followed by two pilot studies (Samples 1 and 2) and a test of the questionnaire's underlying factor structure (Sample 3). The final version of the SREBQ was then assessed for reliability and construct validity (Sample 4). Results: Development of the SREBQ resulted in a 5-item questionnaire. The face validity was satisfactory, as assessed by the pilot studies. The factor structure analysis (Sample 3) suggested that it has a single underlying factor, which was confirmed in a second sample (Sample 4). The SREBQ had strong construct validity, showing a positive correlation with general measures of self-regulation. It was also positively correlated with motivation and behavioural automaticity, and negatively correlated with food responsiveness and emotional over-eating (p < 0.001). It showed good discriminant validity, as it was only weakly associated with satiety responsiveness, food fussiness and slowness in eating. Conclusions: The SREBQ is a reliable and valid measure for assessment of eating self-regulatory capacity in the general UK adult population. [ABSTRACT FROM AUTHOR]

Background Evidence is conflicting regarding the relationship between low maternal alcohol consumption and birth outcomes. This paper aimed to investigate the association between alcohol intake before and during pregnancy with birth weight and gestational age and to examine the effect of timing of exposure. Methods A prospective cohort in Leeds, UK, of 1303 pregnant women aged 18-45 years. Questionnaires assessed alcohol consumption before pregnancy and for the three trimesters separately. Categories of alcohol consumption were divided into ≤2 units/week and ≥2 units/week with a nondrinking category as referent. This was related to size at birth and preterm delivery, adjusting for confounders including salivary cotinine as a biomarker of smoking status. Results Nearly two-thirds of women before pregnancy and over half in the first trimester reported alcohol intakes above the Department of Health (UK) guidelines of ≤2 units/week. Associations with birth outcomes were strongest for intakes ≥2 units/week before pregnancy and in trimesters 1 and 2 compared to non-drinkers. Even women adhering to the guidelines in the first trimester were at significantly higher risk of having babies with lower birth weight, lower birth centile and preterm birth compared to non-drinkers, after adjusting for confounders (p<0.05). Conclusions We found the first trimester to be the period most sensitive to the effect of alcohol on the developing fetus. Women adhering to guidelines in this period were still at increased risk of adverse birth outcomes. Our findings suggest that women should be advised to abstain from alcohol when planning to conceive and throughout pregnancy. [ABSTRACT FROM AUTHOR]

Background: Studies revealed unidirectional associations between frailty and medication‐related problems (MRPs) among older adults. Less is known about the association between frailty and the risk of MRPs. We aimed to assess the bi‐directional association between frailty and the risk of MRPs in community‐dwelling older adults in five European countries. Methods: Participants were 1785 older adults in the population‐based Urban Health Centres Europe project. Repeated assessments were collected at baseline and one‐year follow‐up, including frailty, the risk of MRPs, and covariates. Linear regression analyses were conducted to examine the unidirectional associations. A cross‐lagged panel modeling was used to assess bi‐directional associations. Results: The unidirectional association between frailty at baseline and the risk of MRPs at follow‐up remained statistically significant after adjusting for covariates (β = 0.10, 95%CI:0.08, 0.13). The association between the risk of MRPs at baseline and frailty at follow‐up shows similar trends. The bi‐directional association was comparable with reported unidirectional associations, with a stronger effect from frailty at baseline to the risk of MRPs at follow‐up than reversed path (Wald test for comparing lagged effects: p < 0.05). Conclusion: This longitudinal study suggests that a cycle may exist where older adults with higher frailty levels are more likely to have a higher risk of MRPs, which in turn contributes to developing a higher level of frailty. Further research is needed to validate our findings and explore underlying pathways. [ABSTRACT FROM AUTHOR]

Background Increasing the price of alcohol reduces alcohol consumption and harm. The role of food complementarity, transaction costs and inflation on alcohol demand are determined and discussed in relation to alcohol price policies. Methods UK Biobank (N  = 502,628) was linked by region to retail price quotes for the years 2007 to 2010. The log residual food and alcohol prices, and alcohol availability were regressed onto log daily alcohol consumption. Model standard errors were adjusted for clustering by region. Results Associations with alcohol consumption were found for alcohol price (β  = −0.56, 95% CI, −0.92 to −0.20) and availability (β  = 0.06, 95% CI, 0.04 to 0.07). Introducing, food price reduced the alcohol price consumption association (β  = −0.26, 95% CI, −0.50 to −0.03). Alcohol (B  = 0.001, 95% CI, 0.0004 to 0.001) and food (B  = 0.001, 95% CI, 0.0005 to 0.0006) price increased with time and were associated (ρ  = 0.57, P  < 0.001). Conclusion Alcohol and food are complements, and the price elasticity of alcohol reduces when the effect of food price is accounted for. Transaction costs did not affect the alcohol price consumption relationship. Fixed alcohol price policies are susceptible to inflation. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to investigate primary care use by men with recent onset of lower urinary tract symptoms (LUTS) to identify differences in presentation and investigation that may explain ethnic inequality in prostate cancer outcomes. Methods: This is a multi‐method study of men presenting LUTS to primary care. Two hundred seventy‐four men completed a self‐administered questionnaire, and 23 participated in face‐to‐face interviews. Regression analyses investigated ethnic differences in (a) the period between symptom onset and first primary care presentation (patient interval) and (b) the interval between first primary care presentation and investigation with prostate‐specific antigen (PSA) and digital rectal examination (DRE). Interview data were analysed using thematic analysis. Results: Half (144, 53%) reported a solitary first symptom, although multiple first symptoms were also common, particularly in Asian and Black men. There was no difference between ethnicities in patient interval or time from presentation to investigation. However, Asian men were offered less PSA testing (odds ratio 0.39; 95% confidence interval 0.17–0.92; p = 0.03). Qualitative data revealed ethnic differences in general practitioners' offer of DRE and PSA testing and highlighted limitations in doctor–patient communication and safety netting. Conclusion: Our study showed only small differences in primary care experiences, insufficient to explain ethnic inequalities in prostate cancer outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To explore exercise beliefs and behaviours of individuals with Joint Hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type and to explore patient experiences of physiotherapy. Methods: A cross sectional questionnaire survey design was used to collect quantitative and qualitative data from adult members of the Hypermobility Syndromes Association and Ehlers-Danlos Syndrome Support UK. Descriptive and inferential statistics were used to analyse the data. Qualitative data was analysed thematically. Results: 946 questionnaires were returned and analysed. Participants who received exercise advice from a physiotherapist were 1.75 more likely to report high volumes of weekly exercise (odds ratio [OR] = 1.75, 95% confidence interval [CI] = 1.30-2.36, p < 0.001) than those with no advice. Participants who believed that exercise is important for long-term management were 2.76 times more likely to report a high volume of weekly exercise compared to the participants who did not hold this belief (OR = 2.76, 95% CI = 1.38-5.50, p = 0.004). Three themes emerged regarding experience of physiotherapy; physiotherapist as a partner, communication - knowledge, experience and safety. Conclusion: Pain, fatigue and fear are common barriers to exercise. Advice from a physiotherapist and beliefs about the benefits of exercise influenced the reported exercise behaviours of individuals with Ehlers-Danlos syndrome - hypermobility type in this survey. Implications for rehabilitation: Exercise is a cornerstone of treatment for Ehlers-Danlos syndrome/Ehlers-Danlos syndrome - hypermobility type. Pain, fatigue and fear of injury are frequently reported barriers to exercise. Advice from physiotherapists may significantly influence exercise behaviour. Physiotherapists with condition specific knowledge and good verbal and non-verbal communication facilitate a positive therapeutic experience. [ABSTRACT FROM AUTHOR]

Background Rising use of foodbanks highlights food insecurity in the UK. Adverse life events (e.g. unemployment, benefit delays or sanctions) and financial strains are thought to be the drivers of foodbank use. This research aimed to explore who uses foodbanks, and factors associated with increased food insecurity. Methods We surveyed those seeking help from front line crisis providers from foodbanks (N = 270) and a comparison group from Advice Centres (ACs) (N = 245) in relation to demographics, adverse life events, financial strain and household food security. Results About 55.9% of foodbank users were women and the majority were in receipt of benefits (64.8%). Benefit delays (31.9%), changes (11.1%) and low income (19.6%) were the most common reasons given for referral. Compared to AC users, there were more foodbank users who were single men without children, unemployed, currently homeless, experiencing more financial strain and adverse life events (P = 0.001). Food insecurity was high in both populations, and more severe if they also reported financial strain and adverse life events. Conclusions Benefit-related problems appear to be a key reason for foodbank referral. By comparison with other disadvantaged groups, foodbank users experienced more financial strain, adverse life events, both increased the severity of food insecurity. [ABSTRACT FROM AUTHOR]

Introduction: Higher levels of anxiety and depression have been found to be associated with greater difficulty in stopping smoking. This raises the question as to whether mood disturbance may be associated with exposure to, and use of, quitting support. Aims: This study examined whether General Practitioner (GP) advice and/or offer of support, or stop-smoking service use differed between smokers reporting or not reporting depression/anxiety. Methods: Data came from the Smoking Toolkit Study. Participants were 1,162 English adults who reported currently smoking or having stopped within the past 12 months, aged 40+ years, surveyed between April and September 2012. Anxiety/depression was assessed by the mood disturbance item of the EuroQol five dimensions questionnaire (EQ-5D). This was compared to recall of GP quit advice and/or support, and stop-smoking aid use adjusting for age, gender, and social grade. Results/Findings: Smokers reporting depression/anxiety were more likely to recall being offered advice and support to stop smoking by their GP (OR = 1.50, 95% C.I. = 1.05–2.13). However, there were no significant differences in use of stop-smoking aids during the past year. Conclusions: Smokers reporting depression/anxiety are more likely to be offered stop-smoking support by their GPs, but this does not appear to translate into stop-smoking aid use, despite high motivation to quit. Given higher nicotine dependence in this group, mental health specific support may need to be offered, and more needs to be done to make this offer of aid attractive. [ABSTRACT FROM AUTHOR]

Background: Conduct problems (CP) and attention deficit hyperactivity disorder (ADHD) are often comorbid and have each been linked to 'unhealthy diet'. Early-life diet also associates with DNA methylation of the insulin-like growth factor 2 gene (IGF2), involved in fetal and neural development. We investigated the degree to which prenatal high-fat and -sugar diet might relate to ADHD symptoms via IGF2 DNA methylation for early-onset persistent (EOP) versus low CP youth. Methods: Participants were 164 youth with EOP (n = 83) versus low (n = 81) CP drawn from the Avon Longitudinal Study of Parents and Children. We assessed if the interrelationships between high-fat and -sugar diet (prenatal, postnatal), IGF2 methylation (birth and age 7, collected from blood), and ADHD symptoms (age 7-13) differed for EOP versus low CP youth. Results: Prenatal 'unhealthy diet' was positively associated with IGF2 methylation at birth for both the EOP and low CP youth. For EOP only: (a) higher IGF2 methylation predicted ADHD symptoms; and (b) prenatal 'unhealthy diet' was associated with higher ADHD symptoms indirectly via higher IGF2 methylation. Conclusions: Preventing 'unhealthy diet' in pregnancy might reduce the risk of ADHD symptoms in EOP youth via lower offspring IGF2 methylation. [ABSTRACT FROM AUTHOR]

Background:Evidence suggests that college students are often unclear about how much alcohol is present in different drinks.Objectives:To evaluate the abilities of students to estimate the alcohol contents of drinks, both in relative and absolute terms, and to examine how alcohol strength informs behavior.Methods:For 10 popular drinks that varied by alcohol content, beverage and volume, 209 UK university students rank-ordered the drinks according to total alcohol content and then estimated, for each drink, the number of UK “units” of alcohol contained and its percentage alcohol-by-volume (% ABV). Participants also reported the importance of drink strength as a factor in drink choice, and its influence in different scenarios.Results:There was low but significant concordance between participants’ rank-orderings of drinks by strength, and the correlation of mean ranks with correct ranks was also significant. However, their explicit estimates of the numbers of “units” in the drinks, and their % ABV values, often diverged dramatically from actual values. Participants tended to overestimate the unit contents of spirit-based drinks but underestimated the unit contents of beers and wine; women were consistently less accurate than men, typically making greater underestimates for commonly-consumed drinks. Over one-third of the sample reported that strength influenced drink choice, but its importance ranked below flavor and cost; drink strength might contribute to drink choice depending on the drinking situation.Conclusion/Importance:Young drinkers (women especially) have a poor awareness of the alcohol contents of different drinks, particularly wines and beers, but they make better judgments of relative strength. [ABSTRACT FROM PUBLISHER]

Background Heavy alcohol use during pregnancy can cause considerable developmental problems for children, but effects of light-moderate drinking are uncertain. This study examined possible effects of moderate drinking in pregnancy on children's conduct problems using a Mendelian randomisation design to improve causal inference. Methods A prospective cohort study ( ALSPAC) followed children from their mother's pregnancy to age 13 years. Analyses were based on 3,544 children whose mothers self-reported either not drinking alcohol during pregnancy or drinking up to six units per week without binge drinking. Children's conduct problem trajectories were classified as low risk, childhood-limited, adolescence-onset or early-onset-persistent, using six repeated measures of the Strengths and Difficulties Questionnaire between ages 4-13 years. Variants of alcohol-metabolising genes in children were used to create an instrumental variable for Mendelian randomisation analysis. Results Children's genotype scores were associated with early-onset-persistent conduct problems ( OR = 1.29, 95% CI = 1.04-1.60, p = .020) if mothers drank moderately in pregnancy, but not if mothers abstained from drinking ( OR = 0.94, CI = 0.72-1.25, p = .688). Children's genotype scores did not predict childhood-limited or adolescence-onset conduct problems. Conclusions This quasi-experimental study suggests that moderate alcohol drinking in pregnancy contributes to increased risk for children's early-onset-persistent conduct problems, but not childhood-limited or adolescence-onset conduct problems. [ABSTRACT FROM AUTHOR]

Background: There is increasing policy interest in ensuring that the school environment supports healthy behaviours. We examined the cross-sectional and longitudinal associations between schools' policies, programmes and facilities for physical activity (PA) and adolescents' objectively-measured activity intensity during the school day and lunchtime. Methods: Accelerometer-derived PA (proportion of time spent in sedentary (SED), light PA (LPA) and moderate-tovigorous PA (MVPA)) during school hours and lunchtime from 325 participants in the SPEEDY study were obtained from baseline measurements (primary school, age 9/10 years) and +4y follow-up (secondary school). School environment characteristics were assessed by teacher questionnaire. Multivariable multi-level linear regression analyses accounting for school and adjusted for sex, age, BMI and family socio-economic status assessed cross-sectional associations with lunchtime and school-day SED, LPA and MVPA; effect modification by sex was investigated. The association of changes in school environment with changes in outcomes was examined using multivariable cross-classified linear regression models. Results: There were significant differences between primary and secondary schools for 6/10 school environment characteristics investigated (including secondary schools reporting shorter breaks, more lunchtime PA opportunities, and higher number of sports facilities). Cross-sectional analyses showed that boys attending secondary schools with longer breaks spent significantly less time in SED and more time in MVPA during the school day. Longitudinally, an increase in break-time duration between primary and secondary school was associated with smaller reductions in MVPA during the school day. Moreover, participants who moved from a primary school that did not provide opportunities for PA at lunchtime to a secondary school that did provide such opportunities exhibited smaller increases in SED and smaller reductions in MVPA at lunchtime. Conclusions: Schools should consider the potential negative impact of reducing break time duration on students' MVPA and SED during the school day. School-based interventions that combine longer breaks and more PA opportunities during lunchtime may be a fruitful direction for future research. Further research should also explore other factors in the school environment to explain the school-level clustering observed, and study sex differences in the way that the school environment influences activity intensity for adolescent populations. [ABSTRACT FROM AUTHOR]

Background. The relationship between childhood adversity (CA) and psychotic disorder is well documented. As the adequacy of the current categorical diagnosis of psychosis is being increasingly questioned, we explored independent associations between different types of CA and specific psychotic symptom dimensions in a well-characterized sample of first-episode psychosis (FEP) patients. Method. This study involved 236 FEP cases aged 18-65 years who presented for the first time to psychiatric services in South London, UK. Psychopathology was assessed with the Positive and Negative Syndrome Scale and confirmatory factor analysis was used to evaluate the statistical fit of the Wallwork/Fortgang five-factor model of psychosis. CA prior to 17 years of age (physical abuse, sexual abuse, parental separation, parental death, and being taken into care) was retrospectively assessed using the Childhood Experience of Care and Abuse Questionnaire. Results. Childhood sexual abuse [β = 0.96, 95% confidence interval (CI) 0.40-1.52], childhood physical abuse (β = 0.48, 95% CI 0.03-0.93) and parental separation (β = 0.60, 95% CI 0.10-1.11) showed significant associations with the positive dimension; while being taken into care was associated with the excited dimension (β = 0.36, 95% CI 0.08-0.65), independent of the other types of CA. No significant associations were found between parental death and any of the symptom dimensions. Conclusions. A degree of specificity was found in the relationships between different types of CA and psychosis symptom dimensions in adulthood, suggesting that distinct pathways may be involved in the CA-psychosis association. These potentially different routes to developing psychosis merit further empirical and theoretical exploration. [ABSTRACT FROM AUTHOR]

Background. It is well-established that offspring of depressed mothers are at increased risk for suicidal ideation. However, pathways involved in the transmission of risk for suicidal ideation from depressed mothers to offspring are poorly understood. The aim of this study was to examine the contribution of potential mediators of this association, including maternal suicide attempt, offspring psychiatric disorder and the parent-child relationship. Method. Data were utilized from a population-based birth cohort (ALSPAC). Three distinct classes of maternal depression symptoms across the first 11 years of the child's life had already been identified (minimal, moderate, chronic-severe). Offspring suicidal ideation was assessed at age 16 years. Data were analysed using structural equation modelling. Results. There was evidence for increased risk of suicidal ideation in offspring of mothers with chronic-severe depression symptoms compared to offspring of mothers with minimal symptoms (odds ratio 3.04, 95% confidence interval 2.19- 4.21). The majority of this association was explained through maternal suicide attempt and offspring psychiatric disorder. There was also evidence for an independent indirect effect via the parent-child relationship in middle childhood. There was no longer evidence of a direct effect of maternal depression on offspring suicidal ideation after accounting for all three mediators. The pattern of results was similar when examining mechanisms for maternal moderate depression symptoms. Conclusions. Findings highlight that suicide prevention efforts in offspring of depressed mothers should be particularly targeted at both offspring with a psychiatric disorder and offspring whose mothers have made a suicide attempt. Interventions aimed at improving the parent-child relationship may also be beneficial. [ABSTRACT FROM AUTHOR]

To examine the differences in alcohol consumption and psychosocial antecedents between team and individual sportspeople via secondary data analysis.~Aims~Objective~Questionnaires measured alcohol consumption, athlete identity and subjective happiness from a sample of UK university sportspeople (N = 1785; male = 1048, 58.7%), involved in team (77.9%) and individual sports.~Methods~Methods~Team sports players were more likely to be categorized as hazardous drinkers, and reported significantly greater rates of alcohol consumption, stronger athlete identity and higher levels of happiness than individual sports players. Athlete identity was a significant predictor for alcohol consumption, however there was no significant relationship found between happiness and consumption. Further regression analyses revealed interactions between sport-type and athlete identity on alcohol consumption. For individual sport players, as athlete identity increased alcohol consumption significantly reduced; however, there was a positive association between identity and consumption for team sport players.~Results~Results~Our findings implicate the role of identity as an important factor to consider when addressing the issue of hazardous drinking among sportspeople.~Conclusions~Conclusions [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to examine growth in UK and Croatian women following childbirth and to identify correlates of personal growth after birth, specifically focusing on sociodemographic, obstetric and coping variables.Background:Childbirth is a significant and challenging life event for many women with the potential for both positive and negative psychological changes. Research is increasingly exploring growth in different cultures. No studies have explored growth in Croatian women following childbirth.Methods:UK (N= 193) and Croatian (N= 160) women who had given birth within the last two years completed online questionnaires measuring growth, depression, posttraumatic stress symptoms and coping strategies.Results:Approximately 44% and 35% of UK and Croatian women, respectively, reported a moderate level of growth after childbirth. Hierarchical multiple regression analyses showed that younger women in both countries reported more growth. In the UK sample, coping strategies were related to higher growth. In the Croatian sample, higher posttraumatic stress symptoms and the avoidant coping strategy of denial were associated with higher levels of growth.Conclusion:This study suggests that many women report positive changes as a result of their birth experience. Further research is needed to explore how cultural elements are manifested in the experience of growth. [ABSTRACT FROM PUBLISHER]

Background Retirement is associated with an increase in recreational physical activity but its impact on other domains of activity (at home, for transport) and sedentary behaviour, such as time spent watching television (TV) is unknown. We examined the association between retirement and changes in domain-specific and overall activity and TV viewing. Methods Data were derived from the population-based EPIC (European Prospective Investigation into Cancer)– Norfolk cohort. Physical activity and TV viewing time were self-reported at baseline (1997–2000) and followup 2 (2006–2007) by 3334 participants employed at baseline, of whom 785 (24%) were retired at follow-up 1 (2002–2006). Multivariable regression models were fitted to estimate the association between retirement and changes in physical activity and weekly TV viewing time. Results Compared with continued employment, retirement was associated with a decline in overall activity (men: non-manual, −40.9 MET h/wk; manual, −49.6 MET h/wk; women: non-manual, −26.9 MET h/wk; manual, −31.6 MET h/wk; all p<0.001 (MET, metabolic equivalent of task)). Domain-specific activity declined for transport and occupational (p<0.001) and increased for recreational (p<0.02) and household (p≤0.002) activity. We observed significant interaction between retirement and social class in respect of overall and domain-specific activity apart from household activity. Retirement was associated with a mean increase in TV viewing time, with the largest increase among manual social classes (men: +3.9 h/wk; women: +2.8 h/wk; both p<0.001). Conclusions Interventions should aim to promote household and transport as well as recreational activity. Further research on the impact of retirement on sedentary behaviour is needed. [ABSTRACT FROM AUTHOR]

Background: evidence on the long-term natural history, predictors and outcomes of anxiety after stroke is insufficient to inform effective interventions. This study estimates within 10 years of stroke: (i) the incidence, cumulative incidence, prevalence, and time of onset of anxiety. (ii) Predictors of anxiety and its association with depression. (iii) The association between anxiety 3 months after stroke and mortality, stroke recurrence, disability, cognitive impairment and quality of life (QoL) at follow-up.Methods: data from the South London Stroke Register (1995–2010). Patients were assessed at the time of the stroke, at 3 months, 1 year and then annually for up to 10 years. Baseline data included socio-demographics and stroke severity. Follow-up data included assessments for anxiety and depression (hospital anxiety and depression scale), disability, cognition and QoL. Multivariate regression was used to investigate predictors and associated outcomes of anxiety.Results: incidence of anxiety up to 10 years ranged from 17 to 24%. Cumulative incidence: 57%. Prevalence range: 32–38%. Amongst patients with anxiety, 58% were anxious at 3 months. 57–73% of patients with anxiety had co-morbid depression. Predictors of anxiety included age under 65, female gender, inability to work, depression treatment, smoking and stroke severity. Anxiety at 3 months was associated with lower QoL at follow-up.Conclusions: anxiety is a frequent problem affecting stroke survivors in the long term. Clinicians should pay attention to patients at risk of anxiety since it is associated with lower QoL and depression. [ABSTRACT FROM AUTHOR]

Background and Aims Sexual minority adolescents are more likely to engage in alcohol use than their heterosexual counterparts; however, the underlying reasons remain unclear and longitudinal research is limited. Owing to evidence that this group also experiences greater depressive symptoms than their peers, we aimed to (i) assess to what extent depressed mood explains the increased likelihood of engaging in alcohol use among sexual minority adolescents, and (ii) explore potential gender-specific patterns. Design Structural equation modelling was used to test the indirect relationship between sexual orientation and alcohol use through depressed mood, with heterosexuals as the reference group. Settings and Participants A total of 3710 adolescents (12% sexual minority), from the Avon Longitudinal Study of Parents and Children ( ALSPAC) study, assessed between the ages of 15 and 18 years. Measurements Sexual orientation was assessed at age 15, while alcohol use was measured using the Alcohol Use Disorders Identification Test ( AUDIT) at age 18. Depressed mood was indexed by the Short Mood and Feelings Questionnaire ( SMFQ) at age 16. Findings Sexual minority adolescents were more likely to engage in alcohol problem use compared to their heterosexual counterparts [ Btotal = 0.12, 95%confidence interval ( CI) = 0.04-0.20, P = 0.003]. Depressed mood explained 21% of the link between sexual orientation and alcohol use after adjustment for covariates and earlier measures ( Z = 3.2, P = 0.001). No gender differences were observed. Conclusions A higher prevalence of alcohol problem use in adolescents who are gay, lesbian or bisexual is partly explained by increased rates of depression in this group. [ABSTRACT FROM AUTHOR]

Objectives To estimate the likelihood of recovery at 1, 4 and 12 months post injury and investigate predictors of recovery in injured people attending an emergency department (ED) or admitted to hospital in the UK. Methods Participants completed questionnaires at recruitment and 1, 4 and 12 months post injury or until recovered. Data were collected on injury details, sociodemographic characteristics, general health prior to injury and recovery. We compared three age groups: 5-17, 18-64 and 65 years and above. Modified Poisson regression estimated the relative risk of recovery. Multivariable models were built using backward stepwise regression. Sensitivity analyses assessed the effect of missing data. Results We recruited 1517 participants, 55% (n=836) ED attenders and 44% (n=661) hospital admissions. By 1 month after injury, 28% (285/968) had fully recovered, 54% (440/820) at 4 months and 71% (523/738) at 12 months. Recovery was independently associated with gender, admission status, injury severity, body region injured and place of injury for 5-17 year olds and 18-64 year olds and with gender, admission status, injury severity and long-term illness for those aged 65+. Injury severity and hospital admission were associated with recovery across all age groups, but not at every time point in each age group. Other factors varied between age groups or time points. Results were generally robust to imputing missing data. Conclusions A range of factors was found to predict recovery among injured people. These could be used to identify those at risk of delayed recovery and to inform the design of interventions to maximise recovery. [ABSTRACT FROM AUTHOR]

We tested whether knowing more about an area where a humanitarian disaster happened would increase willingness to donate to its victims. Knowledge was proposed to have a positive impact on donation proclivity, mediated by greater identification with the victims: The more potential donors know about the victims and their environment, the more are they able to identify with the victims. Identification, in turn, was proposed to positively impact on willingness to donate. Results confirmed these predictions in one correlational study ( N= 111), one experimental study ( N= 200), and one quasi-experimental study ( N= 100), focusing on the Asian Tsunami of 2004 and the Chinese earthquake of 2008. Theoretical and applied implications of the research findings are discussed. [ABSTRACT FROM AUTHOR]

Objectives To examine the relationship between number of lifestyle risk factors (out of low physical activity, poor diet, obesity, smoking) and physical function in older community-dwelling men and women. Design Cross-sectional study, Hertfordshire, United Kingdom. Participants Men (n = 1,682) and women (n = 1,540) aged 59 to 73. Measurements Physical activity was assessed using an administered questionnaire with a score from 0 to 100; low activity was defined as a score of 50 or less. Diet was assessed using a food frequency questionnaire; diet quality was assessed according to a score for a principal component analysis-defined 'healthy' dietary pattern. Poor diet was categorized as a dietary pattern score in the lowest quarter of the distribution. Obesity was defined as a body mass index of 30.0 kg/m2 or more. Physical function was assessed according to self-report (SF-36); poor function was defined as a score in lowest quarter of the distribution. A subgroup of participants had objective assessments of physical function (Timed Up-and-Go Test, timed 3-m walk, chair rises, one-legged standing balance). Results There was a graded increase in prevalence of poor self-reported physical function in men and women with increasing number of risk factors (men, adjusted odds ratio ( AOR) for 3 or 4 risk factors vs none = 3.79, 95% confidence interval ( CI) = 2.31-6.21; women, AOR = 5.37, 95% CI = 2.66-10.84). With the exception of balance, the objective assessments also showed graded relationships with number of risk factors, such that more risk factors was associated with poorer physical function. Conclusion These modifiable lifestyle risk factors are linked to marked differences in risk of poorer physical function in older adults. Efforts to encourage healthy lifestyles have the potential to improve physical function and to promote healthier ageing. [ABSTRACT FROM AUTHOR]

anthony d., baggott r., tanner j., jones k., evans h., perkins g. & palmer h. ( 2012) Health, lifestyle, belief and knowledge differences between two ethnic groups with specific reference to tobacco, diet and physical activity. Journal of Advanced Nursing 68(11), 2496-2503. Abstract Aims. To compare physical activity levels, body mass index, habitual diet, tobacco use and prevalence of non-communicable disease between the two ethnic groups and to identify predictors for differences between groups. Background. Tobacco use, poor diet and physical inactivity are major lifestyle risk factors for chronic cardiovascular diseases, certain cancers, diabetes and chronic lung diseases. There are higher risk and incidence of these diseases in some ethnic groups, for example Asians have higher incidence of diabetes. Design. Cross sectional survey. Methods. Cross sectional survey of Asians of Indian descent and white British adults conducted between October-December 2009. Main outcome variables were lifestyle behaviours and BMI. Self-reported disease diagnosis was also collected. In a regression analysis, predictors of outcome variables were demographic variables and beliefs/attitudes/knowledge towards lifestyle behaviours. Results/Findings. Body mass index, tobacco use and non-communicable disease (except diabetes) were lower in Indians. Indians reported lower physical activity levels and greater salt use than Whites. Tobacco use was higher in Whites, but knowledge, attitudes and beliefs were similar between Whites and Indians. Conclusion. Health risk behaviour and morbidity are different between the two ethnic groups. Gender, age, educational level, beliefs, attitudes and knowledge do not explain these differences. Health promotion that aims to improve knowledge will probably not work and innovative methods are needed to improve health in high risk groups. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To assess longer-term outcomes of a drop-in rolling-group model of behavioural support for smoking cessation and the factors that influence cessation outcomes. Design Prospective observational cohort study. Setting Fag Ends NHS Stop Smoking Service in Liverpool and Knowsley, UK. Participants A total of 2585 clients, aged 16 or over, setting a quit date. Measurements Routine monitoring data were collected from Fag Ends service users and were supplemented by survey data on socio-economic circumstances, smoking-related behaviour and self-report and carbon monoxide (CO)-validated smoking status at 52-week follow-up. Findings The CO-validated prolonged abstinence rate at 52 weeks for smokers attending the groups was 5.6%, compared with 30.7% at 4 weeks (a relapse rate of 78.2%). The sample was particularly disadvantaged: 68% resided in the most deprived decile of the English Index of Multiple Deprivation. Higher socio-economic status within the sample was a predictor of quitting. Other predictors of long-term cessation in multivariate analysis included older age, being female, lower levels of nicotine dependence, having a live-in partner, stronger determination to quit and use of varenicline versus other medication. Conclusions A wholly state-reimbursed clinical stop-smoking service providing behavioural support and medication in a region of high economic and social disadvantage has reached a significant proportion of the smoking population. Long-term success rates are lower than are found typically in clinical trials, but higher than would be expected if the smokers were to try and quit unaided. Research is needed into how to improve on the success rates achieved. [ABSTRACT FROM AUTHOR]

The present research compared a distributive fairness model of EU transfer payments (Hartner, Rechberger, Kirchler, & Wenzel, 2011) between three countries: Austria, the Czech Republic, and the UK. The model postulates an interplay between EU-tax compliance, distributive fairness, outcome favorability as well as national and European identification. Results across countries showed that EU-tax compliance was positively related to distributive justice, which was in turn related to outcome favorability and identification. National identifiers perceived EU membership as unfavorable in financial and socio-political terms, and thus considered the transfer payments as less fair. Dual identifiers perceived the socio-political outcomes as more favorable, and thus evaluated the transfer payments as fairer. Although the basic structure of the model was valid across all three countries, two country-specific results were found. First, in the UK individual tax paying behavior was influenced by outcome favorability, whereas in Austria and the Czech Republic this relationship was mediated via distributive fairness. Second, in the Austrian sample, the differentiation between patriots and nationalists proved fruitful since nationalists considered the EU transfer payments as unfair, unlike patriots. In the UK and the Czech Republic the distinction between nationalists and patriots did not add any further information. [ABSTRACT FROM AUTHOR]

Objective: To examine differences in alcohol consumption among Hispanic national groups in the United States [Puerto Ricans, Mexican, Cuban, and Dominican South Central (D/SC) Americans] and identify sociodemographic predictors of drinking and binge drinking (four drinks for women and five for men in a 2-hr period). Method: The study used a household probability sample of adult Hispanics in five metropolitan areas in the United States. Comprehensive data on alcohol consumption were collected. Analyses included bivariate and multivariate regression techniques. Results: Puerto Rican and Mexican American men reported higher drinking rates, weekly consumption, and binge drinking than D/SC and Cuban Americans. Women drank significantly less than men. Mexican American women reported the highest abstention rate (61%); Puerto Rican women drank more per week and binged more frequently compared with their counterparts in other groups. Puerto Rican origin, initiating drinking during high school years (<18), and male gender (US- or foreign-born) were significant predictors of weekly alcohol consumption. Being younger, being single, Puerto Rican or D/SC American origin, initiating drinking at <18 years, being a US- or foreign-born male and being a US-born female were significant predictors of binge drinking. Conclusions: There are considerable differences in drinking behavior across Hispanic national groups as well as between men and women. Results underscore the need to recognize heterogeneity in drinking practices while designing effective prevention interventions in the community. [ABSTRACT FROM AUTHOR]