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Objectives: Over the past decades, China has seen a dramatic epidemic of overweight and obesity. However, the optimal period for interventions to prevent overweight/obesity in adulthood remains unclear, and little is known regarding the joint effect of sociodemographic factors on weight gain. We aimed to investigate the associations of weight gain with sociodemographic factors, including age, sex, educational level, and income. Study design: This was a longitudinal cohort study. Methods: This study included 121,865 participants aged 18–74 years from the Kailuan study who attended health examinations over the period 2006–2019. Multivariate logistic regression and restricted cubic spline were used to evaluate the associations of sociodemographic factors with body mass index (BMI) category transitions over two, six, and 10 years. Results: In the analysis of 10-year BMI changes, the youngest age group had the highest risks of shifting to higher BMI categories, with odds ratio of 2.42 (95% confidence interval 2.12–2.77) for a transition from underweight or normal weight to overweight or obesity and 2.85 (95% confidence interval 2.17–3.75) for a transition from overweight to obesity. Compared with baseline age, education level was less related to these changes, whereas gender and income were not significantly associated with these transitions. Restricted cubic spline analyses suggested reverse J-shaped associations of age with these transitions. Conclusions: The risk of weight gain in Chinese adults is age dependent, and clear public healthcare messaging is needed for young adults who are at the highest risk of weight gain.

Objectives The aims of this study were to estimate the incidence of the post-partum post-traumatic stress disorder (PP-PTSD) in primiparous women, and to determine the profile of women at risk of developing this disorder. Methods We conducted a descriptive, prospective and longitudinal study carried out at the maternity department of the Hedi Chaker Hospital, Sfax-Tunisia over a period of 15 months. At the first stage of the study, the Saint-Antoine pain questionnaire, the peri-traumatic dissociative experiences questionnaire and the peri-traumatic distress inventory were used respectively to assess the pain of delivery, the peri-traumatic dissociation and distress. At the second stage of the study, the questionnaires, perinatal post-traumatic stress disorder (PPQ), hospital anxiety and depression scale and the Edinburgh postnatal depression scale were used respectively for the PP-PTSD screening and the assessment of the post-partum anxious and depressive symptomatology. Results The study population consisted of 183 parturients at the first stage of the study and 150 parturients at the second stage of the study. The incidence of the PP-PTSD was 9.3 %. In the multivariate study, some factors studied were significantly associated with the development of PTSD-PP, including a history of therapeutic termination of pregnancy, a history of miscarriage, exposure to a stressful event during pregnancy, prenatal hospitalization of the mother, instrumental delivery, pain intensity especially in the affective component, peri-traumatic dissociation and avoidance of sexual intercourse for fear of a new pregnancy. However the skin to skin contact with the new-born immediately after delivery was a significant protective factor. Conclusion The psychological consequences associated with the first birth, particularly the PP-PTSD, are common. The Identification of women at risk and a systematic screening of postpartum post-traumatic stress symptoms are desirable.

This study sheds light on the contingent effect that employee human capital may have on the relationship between family involvement and internationalisation via exporting —both in terms of entry mode (how to export) and degree (how much to export). We formulate several hypotheses by drawing mainly on arguments from the resource-based view and stewardship theory. The empirical setting is a large sample of Spanish manufacturing firms (family and non-family) operating between 1991 and 2016. Our results reveal that the positive (negative) relationship between family involvement and export intensity (direct exporting) is boosted (mitigated) at higher levels of employee human capital. Our findings thus provide statistical support for a positive and significant contingent approach to the effect human capital has on the connection between family involvement and internationalisation.

Objective: There is a lack of studies on the natural history of the initial stages of schizophrenia in Colombia. This study aims to assess functionality in the first five years after the diagnosis of schizophrenia. Methods: Naturalistic longitudinal study of 50 patients with early schizophrenia evaluated between 2011 and 2014. Data about demographic background, symptoms, introspection, treatment and adverse reactions were collected in all patients every 3 months for at least 3-5 years. Functionality was measured with the Global Assessment of Functioning (GAF) and Personal and Social Performance (PSP) scales. Results: Patients were followed up for a mean of 174 ± 62.5 weeks and showed moderate difficulties in overall functioning. This functioning was modified by polypharmacy, degree of introspection, changes in antipsychotic regimens, and the number of episodes, relapses and hospitalisations. Conclusions: The results suggest that functional outcomes seem to be related to the use of polypharmacy, degree of insight, changes in antipsychotic regimens, and number of episodes, relapses and hospitalisations during the first years of schizophrenia. RESUMEN Objetivo: Existe una falta de estudios en la historia natural de los estadios iniciales de la esquizofrenia en Colombia. Este estudio apunta a evaluar la funcionalidad en los primeros cinco años después del diagnóstico de esquizofrenia. Método: Estudio longitudinal naturalístico de 50 pacientes con esquizofrenia temprana evaluados entre los anos 2011 y 2014. Loa datos demográficos, síntomas, introspección, tratamiento, y reacciones adversas fueron recolectados en todos los pacientes cada 3 meses por lo menos3a5anos. La funcionalidad se midió mediante la escala global de funcionamiento (GAF), y la escala de funcionamiento personal y social (PSP). Resultados: Los pacientes fueron seguidos por una media de 174 semanas (SD: 62.5) y mostraron dificultades moderadas en su funcionamiento global. Este funcionamiento fue modificado por la presencia de polifarmacia, grado de introspección, cambios en los esquemas antipsicóticos, y el número de episodios, recaídas, y hospitalizaciones. Conclusiones: Los resultados sugieren que los desenlaces en funcionalidad parecen estar relacionados con uso de polifarmacia, grado de introspección, cambios en esquemas antipsicóticos, y numero de episodios, recaídas, y hospitalizaciones durante los primeros años de esquizofrenia.

This paper analyzes the impact that health indicators have upon an individual's trip and mode choices to out-patient care facilities. The study's focus is an out-patient trip to a health care facility and the source of data is the China Health and Retirement Longitudinal Study (CHARLS) for 2011, 2013 and 2015. Based on a random utility framework, the study finds that making a trip to treat an illness or for a check-up increases the likelihood of an out-patient trip by 52 and 31 probability points, respectively. Out-patient visits for which insurance is not relevant, when the individual pays most of the out-of-pocket costs and when the facility is a public facility are also important factors. Diagnosed and other personal health factors have some but much more modest effects on one's trip choice. The analysis also identifies differential modal impacts of health indicators. A series of robustness tests generally confirms the results but also identifies areas for further research. Including a no-trip option, the biannual survey and infrequent out-patient trip-making mitigate endogeneity concerns. The analysis has broad health policy and transportation implications for an ageing population whose share is increasing.

Objective To describe baseline and procedural characteristics and clinical outcomes of isolated striatocapsular infarct (iSCI) after mechanical thrombectomy in patients with large-vessel occlusion of the anterior cerebral circulation and its clinical outcome. Methods We performed a longitudinal study including all patients treated with mechanical thrombectomy at our centre between 2015 and 2017; patients were divided into 2 groups (iSCI and non-iSCI) according to whether they presented iSCI in a control CT scan at 24 hours. Results Of the 83 patients identified, 22.9% developed an iSCI. There were no statically significant differences in baseline characteristics or in reperfusion times. Patients presenting iSCI showed better collateral circulation and better reperfusion rates in the bivariate analysis. No significant difference was observed for mortality at discharge or at 3 months, or for functional prognosis at 3 months. Conclusions Even if successful reperfusion is achieved, iSCI is a common sequela, independently of reperfusion time, especially in patients with good collateral circulation.

Introduction and objectives Childhood obesity trends are plateauing in Spain, but limited information is available about how they differ by region. This study assessed childhood and adolescent the prevalence and incidence of overweight and obesity from 2005 to 2017 across 8 Spanish regions. Methods This longitudinal study used height and weight measurements from 2.5 million children aged 2 to 17 years to calculate overweight and obesity, according to the World Health Organization (WHO) guidelines. Data were obtained from The Base de datos para la Investigacion Farmacoepidemiologica en Atencion Primaria, and the Information System for Research in Primary Care. Prevalence and incidence rates and trends from 2005 to 2017 were calculated and stratified by age, sex, and region. Results The overall obesity prevalence increased in boys and girls from age 2 (0.8%; 95%CI, 0.8-0.9 in both sexes) until peaking at age 7 in girls (17.3%; 95%CI, 17.1-17.5) and age 9 in boys (24.1%; 95%CI 23.9-24.3). The highest and lowest obesity prevalences were observed in Murcia and Navarre. Overall obesity prevalence trends decreased from 2005 to 2017 in all age-sex groups and in most regions. Highest obesity incidence rates were found in children aged 6 to 7 years, (4.5 [4.5-4.5] and 3.5 [3.5-3.5] new obesity cases per 100 person-years in boys and girls, respectively). Boys had higher prevalence and incidence rates than girls across all regions. Overweight/obesity prevalence and incidence rates and their trends were consistently higher than the obesity results, although a similar pattern was observed across sex and age. Conclusions Overweight and obesity prevalence slightly decreased in Spain from 2005 to 2017, but regional, sex, and age differences persisted. Because incidence peaked around the age of 6 years, it may be important to begin health promotion programs at an early age.

Summary Background Bedaquiline improves outcomes of patients with rifampicin-resistant and multidrug-resistant (MDR) tuberculosis; however, emerging resistance threatens this success. We did a cross-sectional and longitudinal analysis evaluating the epidemiology, genetic basis, and treatment outcomes associated with bedaquiline resistance, using data from South Africa (2015–19). Methods Patients with drug-resistant tuberculosis starting bedaquiline-based treatment had surveillance samples submitted at baseline, month 2, and month 6, along with demographic information. Culture-positive baseline and post-baseline isolates had phenotypic resistance determined. Eligible patients were aged 12 years or older with a positive culture sample at baseline or, if the sample was invalid or negative, a sample within 30 days of the baseline sample submitted for bedaquiline drug susceptibility testing. For the longitudinal study, the first surveillance sample had to be phenotypically susceptible to bedaquiline for inclusion. Whole-genome sequencing was done on bedaquiline-resistant isolates and a subset of bedaquiline-susceptible isolates. The National Institute for Communicable Diseases tuberculosis reference laboratory, and national tuberculosis surveillance databases were matched to the Electronic Drug-Resistant Tuberculosis Register. We assessed baseline resistance prevalence, mutations, transmission, cumulative resistance incidence, and odds ratios (ORs) associating risk factors for resistance with patient outcomes. Findings Between Jan 1, 2015, and July 31, 2019, 8041 patients had surveillance samples submitted, of whom 2023 were included in the cross-sectional analysis and 695 in the longitudinal analysis. Baseline bedaquiline resistance prevalence was 3·8% (76 of 2023 patients; 95% CI 2·9–4·6), and it was associated with previous exposure to bedaquiline or clofazimine (OR 7·1, 95% CI 2·3–21·9) and with rifampicin-resistant or MDR tuberculosis with additional resistance to either fluoroquinolones or injectable drugs (pre-extensively-drug resistant [XDR] tuberculosis: 4·2, 1·7–10·5) or to both (XDR tuberculosis: 4·8, 2·0–11·7). Rv0678 mutations were the sole genetic basis of phenotypic resistance. Baseline resistance could be attributed to previous bedaquiline or clofazimine exposure in four (5·3%) of 76 patients and to primary transmission in six (7·9%). Odds of successful treatment outcomes were lower in patients with baseline bedaquiline resistance (0·5, 0·3–1). Resistance during treatment developed in 16 (2·3%) of 695 patients, at a median of 90 days (IQR 62–195), with 12 of these 16 having pre-XDR or XDR. Interpretation Bedaquiline resistance was associated with poorer treatment outcomes. Rapid assessment of bedaquiline resistance, especially when patients were previously exposed to bedaquiline or clofazimine, should be prioritised at baseline or if patients remain culture-positive after 2 months of treatment. Preventing resistance by use of novel combination therapies, current treatment optimisation, and patient support is essential. Funding National Institute for Communicable Diseases of South Africa.

OBJECTIVES Muscle-strengthening activity (MSE e.g. push-ups, sit-ups, use of weight machines) is linked to multiple health benefits for youth, and is part of the global physical activity guidelines for children and adolescents (5-17 years). However, MSE is rarely assessed in youth health surveillance. This study describes the longitudinal trends and predictors of MSE among a cohort of Canadian youths. DESIGN Longitudinal. METHODS Data were drawn from a cohort of 3366 youths who participated in three waves of COMPASS, a longitudinal study of secondary school students across Canada [Wave 1 (T1) 2015/16, Wave 2 (T2) 2016/17, Wave 3 (T3) 2018/19]. The prevalence of the sample meeting the MSE guideline (≥3 days/week) was calculated for each wave. A multivariable logistic regression assessed the odds of meeting the MSE guideline for each wave (T1 and T2 and T3) across sociodemographic/lifestyle characteristics (e.g. sex, race, regionally, Body Mass Index, and aerobic physical activity). RESULTS For the total sample, MSE guideline adherence significantly declined across each study wave (T1 = 57.0%; T2 = 52.0%; T3 = 48.5%; p

Few studies have examined whether maintaining moderate or vigorous physical activity (PA) reduces the risk of low back pain in older people. This study aimed to examine the magnitude of the associations of changes in PA on the risk of low back pain at 4 years of follow-up. We analyzed 4,882 participants in the English Longitudinal Study of Ageing who were initially free from low back pain (mean age, 65.6 ± 8.9 years at baseline). Self-reported PA, which was assessed at wave 6 (2012–2013) and wave 7 (2014–2015), was used as the exposure. The PA of the respondents was categorized into “no PA at all,” “up to moderate PA,” and “up to vigorous PA” groups. Self-reported moderate/severe low back pain assessed at 4 years of follow-up (2016–2017) was used as the outcome. Maintaining moderate (relative risk [RR], 0.59; 95% confidence interval [CI], 0.36–0.99) or vigorous (RR, 0.46; 95% CI, 0.27–0.77) PA at least 1–3 times a month was negatively associated with prevalence of low back pain compared with no PA at all. Interventions for maintaining either moderate or vigorous PA might be beneficial in preventing the incidence of low back pain in the older population. Perspective Perspective: This study examined the magnitude of the association between changes in physical activity over time and the risk of low back pain. The findings suggest that encouraging people to maintain at least moderate physical activity over 2 years is useful for reducing the risk of low back pain at 4 years of follow-up.

Objective The Liver Imaging Reporting and Data System (LI-RADS) has been widely applied to CT and MR liver observations in patients at high-risk for hepatocellular carcinoma (HCC). We investigated the impact of CT vs MR in upgrading LI-RADS 3 to LI-RADS 5 observations using a large cohort of high-risk patients. Methods We performed a retrospective, longitudinal study of CT and MR radiographic reports (June 2013 - February 2017) with an assigned LI-RADS category. A final population of 757 individual scans and 212 high-risk patients had at least one LI-RADS 3 observation. Differences in observation time to progression between modalities were determined using uni- and multivariable analysis. Results Of the 212 patients with a LI-RADS 3 observation, 52 (25%) had progression to LI-RADS 5. Tp ranged from 64 - 818 days (median: 196 days). One hundred and three patients (49%) had MR and 109 patients (51%) had CT as their index study. Twenty-four patients with an MR index exam progressed to LI-RADS 5 during the follow-up interval, with progression rates of 22% (CI:13%-30%) at 1 year and 29% (CI:17%-40%) at 2 years. Twenty-eight patients with a CT index exam progressed to LI-RADS 5 during follow-up, with progression rates of 26% (CI:16%-35%) at 1 year and 31% (CI:19%-41%) at 2 years. Progression rates were not significantly different between patients whose LI-RADS 3 observation was initially diagnosed on MR vs CT (HR: 0.81, P = 0.44). Discussion MR and CT modalities are comparable for demonstrating progression from LI-RADS 3 to 5 for high risk patients.

Research on disproportionality in special education has largely overlooked how students of color with disabilities are less likely to spend time in general education classrooms than White peers with disabilities. Although disparities in general education inclusion for students of color with disabilities raise larger concerns about educational inequality within schools, when these gaps begin to emerge and what factors may explain them remain less understood due to methodological challenges. In leveraging individual-level administrative data from a large school district over a 10-year period, this longitudinal study found general education inclusion declines for all students as they age. However, Black students with disabilities experienced the least inclusion, whereas Asian American and Pacific Islander (AAPI) students with disabilities were included in the general education classroom more than Latinx and White peers with disabilities; this disparity was largely associated with academic test score differences and disability type.

Background A decline in cortical thickness during early life appears to be a normal neuromaturational process. Accelerated cortical thinning has been linked with conversion to psychosis among individuals at clinical high risk for psychosis (CHR-P). Previous research indicates that exposure to life event stress (LES) is associated with exaggerated cortical thinning in both healthy and clinical populations, and LES is also linked with conversion to psychosis in CHR-P. To date, there are no reports on the relationship of LES with cortical thickness in CHR-P. This study examines this relationship and whether LES is linked with cortical thinning to a greater degree in individuals at CHR-P who convert to psychosis compared with individuals at CHR-P who do not convert and healthy control subjects. Methods Controlling for age and gender (364 male, 262 female), this study examined associations between LES and baseline cortical thickness in 436 individuals at CHR-P (375 nonconverters and 61 converters) and 190 comparison subjects in the North American Prodrome Longitudinal Study. Results Findings indicate that prebaseline cumulative LES is associated with reduced baseline cortical thickness in several regions among the CHR-P and control groups. Evidence suggests that LES is a risk factor for thinner cortex to the same extent across diagnostic groups, while CHR-P status is linked with thinner cortex in select regions after accounting for LES. Conclusions This research provides additional evidence to support the role of LES in cortical thinning in both healthy youth and those at CHR-P. Potential underlying mechanisms of the findings and implications for future research are discussed.

BackgroundPrevious studies, in which the data were collected about half a century ago, suggested that elevated low density lipoprotein cholesterol (LDL-C) is not associated with increased risk of cardiovascular disease (CVD) in patients over 70 years old. However, what is the relationship between LDL-C and CVD risk in a contemporary population aged over 70 years has not been well examined in China.MethodsThe China Health and Retirement Longitudinal Study (CHARLS) is an ongoing nationally representative study. In this analysis, participants of CHARLS who did not taking statins and did not have heart disease and stroke at 2011 were include and were followed up to 2018. The outcome of this analysis was occurrence of CVD at follow up, which include heart disease and stroke. Cox regression was used to assess the harmful effect of LDL-C on CVD occurrence. We calculated e-values to quantify the effect of unmeasured confounding on our results.ResultsOf the 9,631 participants, 15.2% (N=1,463) were aged over 70 years and 52.5% (N=5,060) were female. During the 7 years follow-up, 1,437 participants had a first CVD attack. Risk of CVD occurrence increased 8% with each 10 mg/mL elevation in LDL-C in whole participants (adjusted HR, 1.08; 95% CI, 1.06-1.10) and age groups of ≥70 years, 60-69years and ConclusionsIn contemporary society of China, elevated the level of LDL-C also increased the risk of CVD in participants over 70 years old as in the relatively younger participants. These results should strengthen guideline recommendations for the use of lipid lowering therapies in those elderly.

Objectives The present study, building on cross-sectional research showing links between mothers’ sleep, stress, and parenting, used a longitudinal design to consider (1) the temporal direction of links between mothers’ sleep and stress, (2) whether mother sleep deficits predict change in parenting across time, and (3) whether mother sleep deficits mediate the inverse association between stress and positive parenting. Design The study used repeated measures of stress, mother sleep, and positive parenting at toddler ages 30, 36, and 42 months. Setting Data were collected at 2 sites, one in the Midwest and one in the East. Participants Four hundred thirteen mother-toddler pairs were followed. Mothers were mostly married, college educated, and middle class, but there was also considerable variability between families. Measurements Stress was measured via parenting hassles, CHAOS, and role overload scales. Mother sleep was measured via actigraphy. Positive parenting was observed during the bedtime routine and rated using the HOME scale and other items. Results Mother stress and sleep were inextricably linked across toddlerhood, and worse sleep was predictive of less observed positive parenting, even when controlling for prior levels of stress and parenting. Conclusions Improving mothers’ sleep may be important in efforts to improve their parenting.

Individuals exposed to persistent neighborhood violence are at increased risk for developing mental and physical health problems across the lifespan. The biological mechanisms underlying this phenomenon are not well understood. Thus, we examined the relationship between children’s exposure to neighborhood violence and inflammatory activity, a process involved in the pathogenesis of multiple health problems. 236 children from the Chicago area participated in a two-year longitudinal study (mean age at baseline, 13.9 years; 67% female; 39% White, 34% Black, 33% Hispanic). Neighborhood violence was measured as the homicide frequency in a child’s Census block group in the five years before study entry. Fasting blood was drawn at study entry and two years later (in eighth and tenth grade). The blood was used to quantify protein biomarkers of systemic inflammatory activity and perform genome-wide expression profiling of isolated monocytes. Neighborhood violence was associated with higher systemic inflammatory activity at both assessments. It also was associated with a monocyte transcriptional profile indicative of increased signaling along the nuclear factor-kappa B (NF-κB) and activator protein 1 (AP-1) control pathways, which are key orchestrators of pro-inflammatory effector functions. Neighborhood violence also was associated with transcriptional indications of higher beta-adrenergic and lower glucocorticoid signaling, which could function as neuroendocrine conduits linking threatening experiences with inflammatory activity. Neighborhood violence was not associated with two-year changes in protein biomarkers, although it did presage a transcriptional profile indicative of increasing AP-1 and declining glucocorticoid signaling over follow-up. Collectively, these observations highlight cellular and molecular pathways that could underlie health risks associated with neighborhood violence.

Background/Objective Preparing family caregivers, cognitively, emotionally, and behaviorally, for their relative's death is an actionable component of high-quality end-of-life care. We aimed to examine the never-before-examined associations of conjoint cognitive prognostic awareness and emotional preparedness for death with caregiving outcomes and end-of-life care received by cancer patients. Design/Setting/Participants/Main measures For this longitudinal study, associations of death-preparedness states (no-death-preparedness, cognitive-death-preparedness-only, emotional-death-preparedness-only, and sufficient-death-preparedness states) with subjective caregiving burden, depressive symptoms, and quality of life (QOL) and patients’ end-of-life care (chemotherapy and/or immunotherapy, cardiopulmonary resuscitation, intensive care unit care, intubation, mechanical ventilation support, vasopressors, nasogastric tube feeding, and hospice care) were evaluated using multivariate hierarchical linear and logistic regression modeling, respectively, for 377 caregivers in cancer patients’ last 6 months and 1 month, respectively. Key results Caregivers in the cognitive-death-preparedness-only state experienced a higher level of subjective caregiving burden than those in the sufficient-death-preparedness state. Caregivers in the no-death-preparedness and cognitive-death-preparedness-only states reported significantly more depressive symptoms and worse QOL than those in the sufficient-death-preparedness state. Cancer patients with caregivers in the sufficient-death-preparedness state were less likely to receive chemotherapy and/or immunotherapy, intubation, mechanical ventilation, and nasogastric tube feeding than patients with caregivers in other death-preparedness states. However, patients’ receipt of hospice care was not associated with their caregivers’ death-preparedness states. Conclusion Family caregivers’ death-preparedness states were associated with caregiving outcomes and their relative's end-of-life care. Cultivating caregivers’ accurate prognostic awareness and improving their emotional preparedness for their relative's death may facilitate more favorable end-of-life-caregiving outcomes and may limit potentially nonbeneficial end-of-life care.

Study objectives To examine the longitudinal links between maternal and infant nocturnal wakefulness by employing a trajectory-based approach, and to assess whether the strength of these links differs as a function of sleep assessment method (actigraphy vs. self-report) and sleeping arrangements. Methods Maternal and infant nocturnal wakefulness were assessed with actigraphy and sleep diaries at home for 5 nights, at 3 (N = 191), 6 (N = 178), 12 (N = 155), and 18 (N = 135) months postpartum. Outcome measures included the number of night-wakings (NW) and the length of nocturnal wakefulness (WASO). Results Strong associations between maternal and infant nocturnal wakefulness (controlling for nighttime breastfeeding) were found for NW and WASO. Trajectory analyses demonstrated that the strength of these relations decreased linearly from 3 to 18 months. Furthermore, the findings showed that the links between maternal and infant NW and WASO were stronger for maternal reports than for actigraphy. No consistent differences were found in the strength of the relations between maternal and infant NW and WASO as a function of sleeping arrangements (ie, room-sharing vs. solitary-sleeping families). Conclusions The results suggest that infant and maternal sleep are strongly intertwined, especially during the first 6 months. The decline in the synchronization between maternal and infant nocturnal wakefulness through infant development may be attributed to the growing ability of infants to self-soothe during the night. The findings emphasize the need to study sleep within a family context.

The negative impact of the COVID-19 pandemic on the economy is well documented, with widespread furloughs, job loss, and financial insecurity. Concerns have been raised about increases in maladaptive coping behaviours such as gambling, to offset financial losses. Similarly, as individuals spend increased time at home, new populations may initiate or increase the frequency of gambling behaviours. The current study used a large longitudinal study of UK adults (N = 32,559) to examine a range of sociodemographic, stress, and health predictors of (i) gambling during strict lockdown (March to the first week of June 2020), (ii) gambling more frequently during strict lockdown compared to before lockdown, and (iii) continued increased rates of gambling during the relaxing of lockdown restrictions (end of July/early August 2020) compared to earlier in the lockdown (late May/early June 2020). Results from a logistic regression indicated that males, older ages, the employed, those with progressively lower levels of education, who lived in overcrowded accommodation, were highly bored, frequently drank alcohol, smoked or were ex-smokers, and had high risk-taking tendencies were more likely to gamble during strict lockdown. Individuals who were more likely to have increased their frequency of gambling during strict lockdown compared to before the lockdown were highly bored, employed, frequently drank alcohol, and had depression and anxiety, whilst men and current smokers were less likely. As lockdown restrictions eased, individuals of ethnic minority backgrounds, who were current smokers, and with lower education attainment were more likely to continue gambling at heightened rates. This suggests which risk groups should be targeted and provided with more effective coping strategies.

This “Year in review” presents a selection of research themes and individual studies from the clinical osteoarthritis (OA) field (epidemiology and therapy) and includes noteworthy descriptive, analytical-observational, and intervention studies. The electronic database search for the review was conducted in Medline, Embase and medRxiv (15th April 2020 to 1st April 2021). Following study screening, the following OA-related themes emerged: COVID-19; disease burden; occupational risk; prediction models; cartilage loss and pain; stem cell treatments; novel pharmacotherapy trials; therapy for less well researched OA phenotypes; benefits and challenges of Individual Participant Data (IPD) meta-analyses; patient choice- balancing benefits and harms; OA and comorbidity; and inequalities in OA. Headline study findings included: a longitudinal cohort study demonstrating no evidence for a harmful effect of non-steroidal anti-inflammatory drugs (NSAIDs) in terms of COVID-19 related deaths; a Global Burden of Disease study reporting a 102% increase in crude incidence rate of OA in 2017 compared to 1990; a longitudinal study reporting cartilage thickness loss was associated with only a very small degree of worsening in pain over 2 years; an exploratory analysis of a non-OA randomised controlled trial (RCT) finding reduced risk of total joint replacement with an Interleukin -1β inhibitor (canakinumab); a significant relationship between cumulative disadvantage and clinical outcomes of pain and depression mediated by perceived discrimination in a secondary analysis from a RCT; worsening socioeconomic circumstances were associated with future arthritis diagnosis in an innovative natural experiment (with implications for unique research possibilities arising from the COVID-19 pandemic context).

Whether or not schoolchildren exhibit better behavior in the context of wearing uniforms has been a longstanding area of debate in education. Nonetheless, there has been little empirical inquiry into the benefits or drawbacks of school uniform policies. To contribute new insights to the dialog, the present investigation used nationally representative data from the Early Childhood Longitudinal Study Kindergarten Class of 2011 (n = 6,320) to examine students’ social-behavioral and engagement outcomes across the elementary school years as a function of school uniform policies. In general, students in schools that required school uniforms did not demonstrate better social skills, internalizing and externalizing behavior, or school attendance as compared with students in schools without school uniforms. These associations were true across both public and private schools. There was, however, some indication that low-income students in schools that required uniforms demonstrated better school attendance than low-income students in schools that did not.

Background Few studies examining the impact of metabolic syndrome and depressive symptoms on subsequent functional disability are available. Objectives To determine the impact of baseline metabolic syndrome and depressive symptoms on subsequent functional disability. Methods This study used data from the 2011 baseline and 2013, 2015 and 2018 follow-up waves of the China Health and Retirement Longitudinal Study (CHARLS). Functional status was assessed by activities of daily living (ADLs) and instrumental ADLs (IADLs). Analyses were restricted to middle-aged and older adults (≥50 years) free of functional disability at baseline. Metabolic syndrome, depressive symptoms, and covariates were measured at baseline. New-onset ADL and IADL disability were obtained in follow-up measurements. Competitive risks based on survival analysis were conducted to examine the impact of baseline metabolic syndrome and depressive symptoms on subsequent functional disability after covariates were controlled. Results Baseline depressive symptoms significantly predicted functional disability over a 7-year follow-up after adjusting for covariates (Hazard ratio [HR] = 1.54, 95% confidence intervals [CI] = 1.40–1.70 for ADL disability; HR=1.36, 95% CI=1.25–1.48 for IADL disability). Metabolic syndrome significantly predicted ADL disability (HR=1.25, 95% CI=1.14–1.38) but not IADL disability (HR=1.02, 95% CI=0.94–1.10). No significant additive interaction between metabolic syndrome and depressive symptoms on functional disability was found. Conclusion The current study found that baseline depressive symptoms were significantly associated with both ADL and IADL disabilities, while metabolic syndrome significantly predicted ADL disability. In addition, some indications showed that the effect in those with both conditions was greater than the sum of the effects separately.

Objective: SARS-CoV-2 outbreak has a negative psychological impact among general population. Data comparing mental health status before and during the outbreak is needed. The BIOVAL-D-COVID-19 study assess the socio-economic and psychological impact of the COVID-19 pandemic and lockdown in a representative sample of non-institutionalized Spanish adult population, and estimate the incidence of mental health disorders, including suicidal behaviours, and possible related factors. Method: Observational longitudinal study including two online surveys: baseline survey (T0) performed during 2019 and follow-up survey (T1) conducted 12-month later. The latter included nine sections: socio-demographic, health status, mental health, employment conditions and status, material deprivation, use of healthcare services, intimate partner violence and resilience. Four of the nine sections are administered in T0 and T1 assessments. Longitudinal data analyses will estimate adjusted incidence rates of mental health disorders using Poisson regression models. Risk and protective factors will be analysed through multiple logistic regression models. RESUMEN Objetivo: El estudio BIOVAL-D-COVID-19 evaluara el impacto socioeconomico y psicologico de la pandemia de COVID-19 y del confinamiento en una muestra representativa de poblacion espanola adulta no institucionalizada, y estimara la incidencia de trastornos de salud mental, incluida la conducta suicida, y los posibles factores relacionados. Metodo: Estudio longitudinal que incluye dos encuestas online: la encuesta basal (T0) realizada durante 2019 y la encuesta de seguimiento (T1) realizada 12 meses despues. Esta ultima tiene nueve secciones: variables sociodemograficas, estado de salud general, salud mental, condiciones laborales y estatus laboral, privacion material, uso de servicios de salud, violencia de pareja y resiliencia. Cuatro de las nueve secciones se administran en ambas encuestas (T0 y T1). Se utilizaran modelos de regresion de Poisson para el analisis longitudinal de las tasas de incidencia ajustadas de trastornos de salud mental. Los factores de riesgo y de proteccion se analizaran mediante modelos de regresion logistica multiple.

Background Both physical multimorbidity and subclinical depression pose a significant threat to aging population worldwide. The association between these conditions appeared to be in a bidirectional way, however the joint causal relationship yet to be fully understood in elderly Chinese population. Methods A total of 4605 Chinese elders from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2015) were included for the present study. Physical multimorbidity was defined as having two or more self-reported chronic physical conditions. Subclinical depression was defined by ≥ 12 scores assessed using the 10-item Centre for Epidemiological Studies Depression Scale. The bidirectional association between physical multimorbidity and subclinical depression was examined using multivariable logistic regression models, adjusting for covariates. Results During study period, 23.99% of participant reported incident episode of subclinical depression and 21.36% reported physical multimorbidity. In fully adjusted model, those with physical multimorbidity were two times more likely to have subclinical depression (OR = 2.05, 95% CI: 1.71–2.46). Besides that, subclinical depression was associated with physical multimorbidity (OR = 1.84, 95% CI: 1.50–2.46), but in slightly less magnitude. Furthermore, the bidirectional association remains statistically significant across different subgroups. Limitations Chronic conditions were all self-reported and we couldn't adjust for all confounders, which may be subject to measurement error. Conclusions Physical multimorbidity and subclinical depression was associated in a bidirectional way in elderly Chinese population, which highlights the necessary of covering a broad spectrum of aspects of clinical management among adults with physical multimorbidity or subclinical depression.

Objective To examine the combined association of central obesity and depressive symptoms with risk of heart disease in a national prospective cohort study of the Chinese population. Methods Data came from 10,722 community-dwelling adults aged over 45 years, from the China Health and Retirement Longitudinal Study during 2011-2018. Central obesity was assessed with waist circumference (WC) in physical examinations (men with a WC of ≥ 90 cm and women with a WC of ≥ 80 cm). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (score ≥ 10). Participants were assigned to four groups according to central obesity (yes/no) and depressive symptoms (yes/no). Cox proportional hazard regression was used after adjusting for covariates. Results During 7 years of follow-up, we identified 1080 heart disease cases. Compared with people without central obesity and depressive symptoms, the multivariable-adjusted hazard ratios (95% confidence intervals) were 1.39 (1.18, 1.64) for those who had central obesity alone, 1.44 (1.18, 1.77) for those who had depressive symptoms alone, and 1.88 (1.55, 2.30) for those who had both central obesity and depressive symptoms. The combined association in men was more evident than that in women. Conclusions Our study provided evidence that the coexistence of central obesity and depressive symptoms were associated with a substantially increased risk of heart disease compared to those without these two conditions.

Early low socioeconomic status (SES) is associated with poor outcomes in childhood, many of which endure into adulthood. It is critical to determine how early low SES relates to trajectories of brain development and whether these mediate relationships to poor outcomes. We use data from a unique 17-year longitudinal study with five waves of structural brain imaging to prospectively examine relationships between preschool SES and cognitive, social, academic, and psychiatric outcomes in early adulthood.Children (n = 216, 50% female, 47.2% non-White) were recruited from a study of early onset depression and followed approximately annually. Family income-to-needs ratios (SES) were assessed when children were ages 3 to 5 years. Volumes of cortical gray and white matter and subcortical gray matter collected across five scan waves were processed using the FreeSurfer Longitudinal pipeline. When youth were ages 16+ years, cognitive function was assessed using the NIH Toolbox, and psychiatric diagnoses, high-risk behaviors, educational function, and social function were assessed using clinician administered and parent/youth report measures.Lower preschool SES related to worse cognitive, high-risk, educational, and social outcomes (|standardized B| = 0.20-0.31, p values.003). Lower SES was associated with overall lower cortical (standardized B = 0.12, p.0001) and subcortical gray matter (standardized B = 0.17, p.0001) volumes, as well as a shallower slope of subcortical gray matter growth over time (standardized B = 0.04, p = .012). Subcortical gray matter mediated the relationship of preschool SES to cognition and high-risk behaviors.These novel longitudinal data underscore the key role of brain development in understanding the long-lasting relations of early low SES to outcomes in children.

Phenotypic traits in humans are under selection pressure and are still evolving, but the relative importance of these traits remains to be investigated. We therefore analyzed jointly phenotypic traits associated with number of children and having ever been married. This provides insights into the relative contribution of each trait and indicates the potential selection pressure induced by a specific trait relative to others. To shed light on potential selection on the genome level, all analyses include a multivariate polygenic risk score of general cognitive ability. We used the data from the Wisconsin Longitudinal Study (WLS), a dataset consisting of 4991 men and 5326 women almost all whites, educated at least at A-level. The focus was on the association between age, education level, wages, religious intensity, fathers' age at child's birth, ratings of facial attractiveness, number of siblings of the respondent, as well as the polygenic risk score of general cognitive ability on the following dependent variables: i) number of children, ii) ever being married, and iii) age at first birth. For each factor we additionally examined the relative contribution to the overall variance explained of the dependent variable. Having been married and, thus, mate selection, is the most important determinant for the number of children for both men and women. Wages explain most of the total variance for “ever married”, yet in different directions for men and women, as is also the case for the association between wages and number of children. In both women and men, education explains most of the variance in age at first birth, and the effect is postponing. Furthermore, although the phenotype education is negatively associated with the number of children in both sexes, this holds true for the polygenic risk score for cognitive ability only in men. In addition, in men, the polygenic risk score for cognitive ability also has a positive effect on reproduction due to its positive interaction with wages. Anyhow, with the exception of having ever been married, all other variables explain only a small proportion of the variation in fertility outcomes. Although our results are consistent with the hypothesis that there is selection pressure for rather recently arising traits as education and income, on the basis of our results we are not able to draw any final conclusion on selection.

Early intervention in obsessive-compulsive disorder has recently gained traction. However, to address obsessive-compulsive (OC) symptoms before they progress to clinical levels, it is important to investigate potential processes involved in driving OC symptoms, as well as the processes driving the lower quality of life, impairments in functioning, and increased comorbidities that are already present in the subthreshold phase of the disorder. This study aimed to investigate the role of 12 psychological flexibility and inflexibility processes in predicting quality of life, disability, and OC symptoms over six months while controlling for psychological distress. An online community sample of 766 individuals from Amazon Mechanical Turk was evaluated at baseline and again at 6-month follow-up with a survey battery assessing OC symptom dimensions, psychological in/flexibility processes, psychological distress, and sociodemographic information. Results revealed that greater self-as-content was associated with more severe mental contamination and unacceptable thoughts at baseline. No other psychological inflexibility processes were associated with OC symptom severity or disability cross-sectionally or longitudinally. The study did not provide support for psychological flexibility processes being associated with quality of life at any time point. These findings suggest that self-as-content may be related to OC symptom severity, and potentially more so than other inflexibility processes. With this knowledge, self-as-content requires more research attention in relation to OC symptoms, as well as research on processes that have the potential to improve important non-psychiatric outcomes.

Infant-parent attachment has been theoretically proposed to serve a key regulatory function for children's emotion, cognition, and behavior, with secure attachment leading to more favorable outcomes, but much of the research supporting this claim has been conducted solely on infant-mother dyads. While research on infant-father attachment has gained traction, studies including fathers often examine their contributions as independent from mothers, which may overlook the interacting influence of multiple attachment relationships on child development. Here, we use a new approach in which we consider infant attachment to both mothers and fathers as a configuration. This study examined whether infant attachment configurations to both mothers and fathers predicted effortful control, compliance, and defiance during toddlerhood. Using data from a longitudinal study on socio-emotional development, 117 infants participated in the Strange Situation, first with their mothers at 12 months, and then again with their fathers at 14 months to assess attachment. When toddlers were 20 months of age, mothers completed a questionnaire assessing toddlers’ effortful control, and toddlers were video recorded with their mothers and fathers in a gratification delay and clean-up task during a laboratory visit. Toddlers’ compliance and defiance towards parents were coded. Using linear mixed models, attachment configuration in infancy significantly distinguished effortful control, compliance, and defiance in toddlerhood. Infants with a secure attachment only to fathers had significantly lower effortful control and higher defiance at 20 months than the other 3 attachment configurations. In contrast, infants with a secure attachment to mothers were significantly more compliant than infants without a secure attachment to mothers. Our findings provide evidence that when analyzed from a family systems perspective, attachment security (and insecurity) to mothers and fathers may be functionally distinct for children's developing socio-emotional competence.

This study aimed to evaluate the longitudinal treatment effect on depression measured by Hamilton Depression Rating Scale (HAM-D) score in a randomized clinical trial for the treatment of opioid use disorder (OUD).We conducted a secondary data analysis of data from the National Institute on Drug Abuse's Clinical Trials Network Protocol-0051. Patients with OUD (N = 570) were randomized to receive buprenorphine/naloxone (BUP-NX, n = 287) or extended-release naltrexone injection (XR-NTX, n = 283). The HAM-D score was completed at baseline and follow-up visit up to 36 weeks. A linear mixed model analysis was performed for log transformed HAM-D score and a generalized linear mixed model analysis was conducted for depression status.Compared with BUP-NX, subjects randomized to XR-NTX had higher HAM-D scores at weeks 1 and 3 (p0.05). There were significant interactions between treatment and visit on HAM-D score and depression status during the first four weeks of treatments in individuals without lifetime major depressive disorder (MDD). Past year cocaine use was associated with HAM-D score and depression status just in individuals without MDD, whereas past year cannabis use was associated with HAM-D score and depression status just in individuals with MDD. Past year amphetamine use was associated with HAM-D score just in individuals without MDD, however, lifetime anxiety was associated with HAM-D scores regardless of MDD.When prescribing XR-NTX, particularly in the first month of treatment, it is essential to monitor for depressive symptoms. Screening for depression and multiple substance abuse may help clinicians identify appropriate treatment.

Longitudinal studies are essential to understand healthy and pathological neurocognitive aging such as Alzheimer's Disease, but longitudinal designs are rare in both humans and non-human primate models of aging because of the difficulty of tracking cognitive change in long-lived primates. Common marmosets (Callithrix jacchus) are uniquely suited for aging studies due to their naturally short lifespan (10–12 years), sophisticated cognitive and social abilities and Alzheimer Disease-like neuropathology. We report the first longitudinal study of cognitive aging in marmosets (N = 28) as they transitioned from middle- (∼5 years) to old age (∼9 years). We characterized aging trajectories using reversal learning with different stimuli each year. Marmosets initially improved on cognitive performance due to practice, but worsened in the final year, suggesting the onset of age-related decline. Cognitive impairment emerged earlier in females than males and was more prominent for discrimination than for reversal learning. Sex differences in cognitive aging could not be explained by differences in motivation or motor abilities, which improved or remained stable across aging. Likewise, males and females did not differ in aging trajectories of overall behavior or reactivity to a social stressor, with the exception of a progressive decline in the initiation of social behavior in females. Patterns of cognitive aging were highly variable across marmosets of both sexes, suggesting the potential for pathological aging for some individuals. Future work will link individual cognitive trajectories to neuropathology in order to better understand the relationships between neuropathologic burden and vulnerability to age-related cognitive decline in each sex.

Purpose Amidst the on-going SARS-CoV-2 pandemic, healthcare workers have been at a greater risk of disease exposure as they are working in environments chiefly involved in the COVID-19 patient care since March 2020. SARS-CoV-2 antibody testing can prove to be a valuable tool for better understanding of prevalence of disease exposure in this population. Therefore, we conducted this study to grasp the sero-prevalence of COVID-19 antibodies in our hospital to better comprehend the duration of IgG response. Materials & methods This was a longitudinal study involving 305 healthcare workers at Rajiv Gandhi Super Speciality Hospital spanning over a period of four months starting from October 2020 to January 2021. Serum samples were obtained from the study group taken as Day 0 of the study and were screened for the presence of SARS-CoV-2 IgG antibodies using semi-quantitive enzyme linked immunoassay technology from ERBAlisa (India). The Antibody Index was determined. Those showing reactive in the screening test were further followed up on a monthly basis till January 2021 for serial antibody testing. Result The overall seroprevalence for IgG response among the workers was found to be 21.96%. Seropositivity rate was observed to be significantly higher in those having a history of RT-PCR confirmed COVID-19 infection (45.09%) CONCLUSION: Our study demonstrated that healthcare workers have a higher sero-prevalence. Our study also demonstrated that the antibodies developed following COVID-19 infection had a waning effect of protective response following infection.

This paper examines the effects of adverse childhood experiences (ACEs) on adult entrepreneurial behaviors. By adopting the data from China Health and Retirement Longitudinal Study (CHARLS), we exploited the instrumental variable (IV) methods and found that the shadow of ACEs is significantly detrimental to entrepreneurship in adulthood, and this result proved robust across several methods. Mechanism tests indicated that the negative impacts of ACEs on entrepreneurship can be explained by losses in human capital, physical capital, and social capital, and developing a risk-averse personality. Further, heterogeneity results showed that the negative impact of ACEs from parents is greater, and the negative effect of ACEs on entrepreneurship is only valid for young and female and rural residents. This study enriches the discussion on ACEs and entrepreneurial behaviors in adulthood via better causal identification, and it provides important insights for other developing countries.

Background and objectives Although a large body of research has examined the relationship between social support and psychological health of family carers of frail older people, the exact nature and direction of this relationship is not well understood with most research to date being cross-sectional. This longitudinal study explored the relationship between perceived social support and psychological distress in carers of older relatives. Methods We used data from two longitudinal cohorts which included a total of 332 family carers of frail older people. We used cross-lagged panel analysis to investigate the longitudinal association between perceived social support and carer psychological distress controlling for a number of covariates over time. Results Fully-adjusted Generalised Estimating Equations (GEE) and cross-lagged models indicated that higher social support was significantly associated with lower carer psychological distress over time (regression coefficient [B] = -0.178, standard error [SE] = 0.028), with levels of perceived social support exerting an effect on psychological distress rather than vice versa (β = 0.03, p = 0.32). Limitations All observations were based on self-report data, and there may be other variables that may explain the results that we did not account for. Discussion and implications Our study finds that the directionality of the relationship appears to be from perceived social support to carer psychological distress suggesting that social support directly affects carer psychological health but not vice versa. This finding has important implications for the provision of social support interventions for carers of frail older people at risk of experiencing psychological distress.

Growing research shows that parent‒child relationships are reliable predictors of child executive functioning (EF), a set of cognitive skills of key importance for learning and school adjustment. However, few EF studies have considered fathers and even fewer have examined paternal mind-mindedness, an aspect of parental behavior that is gaining attention in developmental research. Accordingly, the aim of this longitudinal study (N = 108) was to investigate the role of paternal mind-mindedness in the prediction of individual differences in child EF as manifested at school. Paternal mind-mindedness was assessed during a 10-min father–toddler free play sequence when children were aged 18 months, and child EF problems were reported by teachers in kindergarten. The findings indicated that toddlers who were exposed to more paternal mind-mindedness were later considered by their teachers to present fewer EF problems in everyday school settings. The results held after controlling for other documented predictors of EF, namely mother–toddler attachment security, paternal socioeconomic status, and prenatal risk. This study underscores the relevance of parental mind-mindedness for child cognitive development and adds to growing research on fathers and their importance for child EF. Futures studies should adopt a systemic approach, including both parents and their children, to enhance the understanding of the parental and family antecedents of child EF.

Purpose This study examines the differences in parent-perceived and patient-reported quality of life (QoL) among young adult burn patients three years after injury and the factors affecting these differences. Method The sample comprised 35 burn patients from the Formosa Fun Coast Water Park dust explosion and their parents. The study was conducted from June 2016 to August 2018. We used self-report questionnaires to collect socio-demographic data, the adapted Chinese version of the Burn Specific Health Scale-Brief, and the Impact of Events Scale for Burn. Results The analysis indicated that simple abilities recovered the fastest, while body image recovered the slowest. The variation trends of these factors were similar but parents’ scores were lower than patients’ scores. Parents’ post-traumatic stress disorder (PTSD) scores were higher than that of patients, but were not statistically significant. Parents’ gender and PTSD levels and patients’ burn area affected differences in parent-perceived QoL among patients. PTSD levels were significantly higher among mothers. Conclusions For parents, PTSD is a common response to their children experiencing burn injuries. Parents’ observations of warning signs enable early medical intervention. Establishing a family-centered care plan, providing psychological support for both parents and patients, and forming a continuous care system with efficient communication can support patients’ return to society.

Housing is an important social determinant of health. We investigated effects of changes in housing tenure and affordability on depressive symptoms.Data of 9,956 individuals aged20 years from the Korea Welfare Panel Study (2015-2020) were analyzed. Housing tenure was categorized as homeowners or tenants. Individuals with housing-related expenditures exceeding 30% of household income were defined as having housing unaffordability. Analyses using generalized estimating equations were conducted to evaluate the relationship between changes in housing tenure and affordability on depressive symptoms measured with the Center for Epidemiologic Studies Depression Scale.Individuals who became tenants (β = 0.326, p = 0.027) or were persistent tenants (β = 0.542, p0.001) demonstrated significantly more severe depressive symptoms than persistent homeowners. Individuals with new (β = 0.562, p0.001) or consistent housing unaffordability (β = 1.032, p = 0.036) showed increased depressive symptoms compared with those with persistent housing affordability. Depressive symptoms were reduced in new homeowners and those who left housing unaffordability status (β = -0.807, p = 0.031). The interaction between housing tenure and affordability on depressive symptoms differed by age and household composition. Housing tenure at post-retirement age and single-person households were associated with a decrease in depressive symptoms, respectively.All housing-related factors, especially different domains of housing insecurity including unstable neighborhoods or reasons for moving, have not been identified.Changes in housing tenure, affordability, and the two combined were significantly associated with depressive symptoms. Furthermore, the degree of interactive effect varied among age groups and household composition. Housing welfare policies that can stabilize housing tenure and affordability might help prevent depression.

Background: The COVID-19 pandemic has had a huge impact on people’s lives and may influence mental health in the general population. In a unique representative Danish longitudinal study, we examined mental well-being measured just before and during the COVID-19 pandemic. Methods: The Danish Health and Wellbeing Survey is the Danish contribution to the European Health Interview Survey. In this study, we included the wave from autumn 2019, which we re-invited in the autumn 2020. The study population consisted of 4,234 persons. The main outcome was the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Linear and logistic regression models were conducted to evaluate change in SWEMWBS between 2019 and 2020. Outcomes: The SWEMWBS distribution was similar in 2019 and 2020, although the distribution moved to lower scores in 2020 compared to 2019. Mean SWEMWBS decreased significantly from 25·5 in 2019 to 24·6 in 2020 corresponding to a mean change of -1·0 (95%CI, -1·1. to -0·8). The proportion with low SWEMWBS increased from 16·5% in 2019 to 20·1% in 2020 (p

Background Trajectories of postpartum depressive symptoms up to 1 year after childbirth and the related risk factors remain unclear. Accordingly, this study aimed to examine the 1-year trajectories of postpartum depressive symptoms and their associated risk factors. Methods A total of 22,493 pregnant women were recruited between July 2013 and September 2016 in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Among them, 11,668 women with no missing data were included in the analyses. Depressive symptoms were assessed at 1 month and 1 year postpartum using the Edinburgh Postnatal Depression Scale. Multinominal logistic regression analysis was conducted after adjusting for covariates. Results The prevalence of depression was 13.9% at 1 month and 12.9% at 1 year postpartum. We identified four depression trajectories, i.e., “persistent (depressed throughout the 1 year postpartum)” (6.0%), “recovered (depressed at 1 month postpartum and recovered within a year)” (7.9%), “late-onset (became depressed after 1 month postpartum)” (6.8%), and “resilient (not depressed throughout 1 year postpartum)” (79.2%). Psychological distress during pregnancy was significantly associated with all trajectories (persistent: odds ratio [OR]=10.24, 95% confidence interval (CI)=8.40-12.48; recovered: OR=3.78, 95%CI=3.28-4.36; and late-onset: OR=3.96, 95%CI=3.40-4.62). Limitations Postpartum depression was evaluated only by a self-administered questionnaire and the dropout rate was not neglectable. Conclusions This study highlighted the high prevalence of depressive symptoms at 1 year postpartum and found that half of the depressive symptoms at 1 year were late-onset. The findings suggest the necessity of long-term follow-up (up to 1 year) for perinatal mental health.

Purpose School attainment has increased and gender gaps narrowed in many settings without commensurate declines in child marriage and with persistent gender gaps in work. This paper investigates whether child marriage changes young people’s ability to translate education into paid work in rural Malawi. Methods Using data from a longitudinal study of adolescents in rural Malawi followed through young adulthood, individual-level fixed-effects regressions that account for time-invariant factors were used to investigate differences in child marriage status on the extent to which grade attainment, reading, and numeracy skills lead to higher participation in paid work and reduce participation in unpaid work. Gender differences in these relationships were explored. Results Prevalence of child marriage is high for young women (53% vs. 6% for men), and participation in paid work low (7% vs. 42% for men). Attainment of six grades among young married women and nine grades among young married men was associated with paid work irrespective of child marriage. Reading with comprehension in two languages was associated with paid work for young men married as adults (coefficient = .27, p ≤ .01). Numeracy was associated with paid work among unmarried young women (coefficient = .04, p ≤ .01). Negative associations between grade attainment and unpaid work were found for young women married at ages 16–17 and unmarried, while positive associations were found for young unmarried men. Conclusions The relationship between education and work among young people in Malawi is compromised by related challenges of poor learning and continued high levels of child and young adult marriage.

Background The outbreak of COVID-19 and the physical isolation measures taken by the governments to reduce its propagation might have negative psychological consequences on the population. In this study, we aimed to explore, for the first time, how mental health status fluctuated along the weeks of the emergency state in Portugal, and to identify which factors may shape these changes in mental health outcomes. Methods To this end, we conducted an online survey to evaluate demographic, lifestyle and mental health variables (DASS-21 and quality of life) in the Portuguese population at three different time-points. 748 participants (mean age = 39.52, % females = 79.95) provided data at all time-points. Results We observed that depression, anxiety and stress symptoms seemed to improve as the weeks passed during the state of emergency, while the perception of quality of life and sleep got worse. In particular, being female, younger, actively working, and extroverted appear to be protective factors of mental health adaptability during this particular period. On the contrary, having a psychiatric diagnosis or physical illness, and higher neuroticism seem to be risk factors for mental health worsening. Limitations The lack of a more diverse sample could limit the generalizability of our results, and other factors that were not considered in our analysis might also have a significant impact on mental health. Conclusions Our results provide relevant and novel insights about the course of mental health changes and its predictors during the outbreak of COVID-19, which may help identify potential vulnerability groups.

Longitudinal associations between eating disorders (EDs) and comorbid psychiatric disorders are poorly understood but important to examine as comorbidities are common and can impede ED recovery. We examined two common comorbidities, major depressive disorder (MDD) and substance use disorder (SUD), in adult women with intake diagnoses of anorexia nervosa (AN) and bulimia nervosa (BN) who participated in a longitudinal study. To test the longitudinal reciprocal relations among ED, MDD, and SUD, we conducted a multi-group autoregressive cross-lagged path analysis. We tested whether ED, MDD, and SUD in a given three-month period (t – 1) each predicted ED, MDD, and SUD during the subsequent three-month period (t) over 5 years. We examined the moderating effect of intake diagnosis (AN vs. BN). Among AN (but not BN) participants, having MDD at t – 1 predicted having an ED at time t, OR = 1.98, B = .68, z = 2.49, p = .01. Among BN (but not AN) participants, having a SUD at t – 1 predicted having an ED at time t, OR = 5.16, B = 1.64, z = 2.34, p = .01. In contrast, having an ED at t – 1 did not predict MDD or SUD at time t for AN or BN participants. These results suggest for individuals with AN and MDD, treating MDD may facilitate ED recovery. For individuals with BN and SUD, treating SUD may facilitate ED recovery. These identified temporal associations between ED and comorbid disorders may guide cognitive behavioral researchers and therapists in prioritizing treatment targets given the high rate of comorbidity in EDs.

BACKGROUND: Altered functional brain connectivity has been proposed as an intermediate phenotype between genetic risk loci and clinical expression of schizophrenia. Genetic high-risk groups of healthy subjects are particularly suited for the investigation of this proposition because they can be tested in the absence of medication or other secondary effects of schizophrenia. METHODS: Here, we applied dynamic functional connectivity analysis to functional magnetic resonance imaging data to reveal the reconfiguration of brain networks during a cognitive task. We recruited healthy carriers of common risk variants using the recall-by-genotype design. We assessed 197 individuals: 99 individuals (52 female, 47 male) with low polygenic risk scores (schizophrenia risk profile scores [SCZ-PRSs]) and 98 individuals (52 female, 46 male) with high SCZ-PRSs from both tails of the SCZ-PRS distribution from a genotyped population cohort, the Avon Longitudinal Study of Parents and Children (N = 8169). We compared groups both on conventional brain activation profiles, using the general linear model of the experiment, and on the neural flexibility index, which quantifies how frequent a brain region's community affiliation changes over experimental time. RESULTS: Behavioral performance and standard brain activation profiles did not differ significantly between groups. High SCZ-PRS was associated with reduced flexibility index and network modularity across n-back levels. The whole-brain flexibility index and that of the frontoparietal working memory network was associated with n-back performance. We identified a dynamic network phenotype related to high SCZ-PRS. CONCLUSIONS: Such neurophysiological markers can become important for the elucidation of biological mechanisms of schizophrenia and, particularly, the associated cognitive deficit.

Background Graduated compression garments (CG) are a standard form of management of post-thrombotic syndrome (PTS) in adults, but data in children are lacking. We aimed to study the attitudes toward CG and change in PTS severity score in children who were prescribed CG for PTS management. Methods Children with PTS were enrolled in this longitudinal prospective study at the time of CG prescription. PTS severity was measured at baseline and follow-up using CAPTSure© ; attitude toward CG was registered at follow-up. Results Forty-five patients were enrolled (median age 13 years, 25th -75th percentile 7-15 years; 53% male patients); 71% were prescribed socks and 29% sleeves; pressure was 15-20 mmHg in 84% of CG. Median baseline PTS CAPTSure© score was 31 points (25th -75th percentile 21-45 points). At follow-up, 49% of patients found CG helpful, 27% found CG not helpful, and 16% did not buy or wear the CG. Eight percent of enrolled patients did not return for study follow-up. Ninety-five percent of the children who found CG helpful wore them for ≥3 days/week. Hours of CG wear at the time of follow-up were associated with lower PTS scores at follow-up in a non-linear manner (e.g., wearing 12 vs 0 hours/day was associated with a 16-point reduction in PTS scores at follow-up, 95% CI -29 to -2 points). Conclusion Nearly half the patients who were prescribed CG found them helpful. We observed non-linear improvement in PTS severity with the use of low-pressure CG for 8-12 hours/day and ≥3 days/week, providing guidance in their prescription.

Background Neurobiological measures may inform our understanding of individual differences in adolescents’ general risk for and resilience to depressive symptoms, including during the COVID-19 pandemic. We tested a developmental model linking variation in amygdala–subgenual anterior cingulate cortex (sgACC) resting-state connectivity to perceived parenting experiences earlier in adolescence, to concurrent depressive symptoms before the pandemic, and to subsequent depressive symptoms during the pandemic. Methods We used data from a longitudinal study that included three waves (N = 214 adolescents; ages 9–15 years at time 1 [T1], 11–17 years at T2, and 12–19 years during the pandemic at T3). We assessed positive parenting (warm and supportive) (T1), depressive symptoms (T1 to T3), and functional connectivity between the sgACC and basolateral (BLA) and centromedial amygdala (T1 and T2). We modeled associations among earlier positive parenting, amygdala–sgACC connectivity, and depressive symptoms before and during the pandemic. Results Less positive parenting at T1 was associated prospectively with stronger BLA–sgACC connectivity at T2 (β = −0.22) over and above the effect of BLA–sgACC connectivity at T1. Stronger BLA–sgACC connectivity, in turn, was associated with heightened depressive symptoms, both before the pandemic (r = 0.21) and during the pandemic (β = 0.19; independent of the effect of pre-pandemic symptoms). Conclusions Adolescents who experience less positive parenting may develop a pattern of BLA–sgACC connectivity that increases their risk for mental health problems. BLA–sgACC connectivity may be associated with depressive symptoms in general, including during periods of heightened risk for adolescents, such as the pandemic.

This paper estimates the wellbeing effects of the 2009 Black Saturday Bushfires, the deadliest wildfire event in Australia’s known history. Using subjective wellbeing data from a nationally representative longitudinal study and adopting an individual fixed-effects approach, our results identify a significant reduction in life satisfaction for individuals residing in close proximity of the wildfires. The negative wellbeing effect is valued at A$52,300. This corresponds to 80% of the average annual income of a full-time employed adult in the state of Victoria. The satisfaction domain most negatively affected is how safe the person feels, and the group most affected are people with low social support. A delayed adverse mental health effect is also identified.

Background Light has powerful effects on mood, sleep, and the circadian system. Humans evolved in an environment with a clear distinction between day and night, but our modern environments have blurred this distinction. Negative effects of light exposure at night have been well characterized. The importance of daytime light exposure has been less well characterized. Here we examine the cross-sectional and longitudinal associations of time spent in daytime outdoor light with mood, sleep, and circadian-related outcomes. Methods Participants were drawn from the UK Biobank cohort, a large study of UK adults (n = 502,000; 37–73 years old; 54% women). Results UK Biobank participants reported spending a median of 2.5 daylight hours (IQR = 1.5–3.5 h) outdoors per day. Each additional hour spent outdoors during the day was associated with lower odds of lifetime major depressive disorder (95% CI OR:0.92–0.98), antidepressant usage (OR:0.92–0.98), less frequent anhedonia (OR:0.93–0.96) and low mood (OR:0.87–0.90), greater happiness (OR:1.41–1.48) and lower neuroticism (incident rate ratio, IRR:0.95–0.96), independent of demographic, lifestyle, and employment covariates. In addition, each hour of daytime light was associated with greater ease of getting up (OR:1.46–1.49), less frequent tiredness (OR:0.80–0.82), fewer insomnia symptoms (OR:0.94–0.97), and earlier chronotype (adjusted odds ratio; OR:0.75–0.77). Auto-Regressive Cross-Lagged (ARCL) models were used to examine the longitudinal association of time spent in outdoor light at baseline with later mood-, sleep- and circadian-related outcomes reported at time point 2. Overall, longitudinal associations support cross-sectional findings, though generally with smaller effect sizes. Limitations Future studies that examine the intensity of daytime light exposure at the ocular level are needed. Conclusions Our findings suggest that low daytime light exposure is an important environmental risk factor for mood, sleep, and circadian-related outcomes.

Introduction Infants with medical complexity have multiple complex chronic conditions and require specialized intensive care. One important factor in optimizing infant health and development is parenting self-efficacy (PSE). The purpose of this study was to examine parental self-efficacy in fathers over time. Methods A longitudinal survey study was conducted with fathers of medically complex infants. We used the validated Karitane Parent Confidence Scale to assess PSE and multivariable linear regression examined the associations between father and infant characteristics on PSE. Results Fathers (n = 27) were white (74%), married (85%), high school educated (37%), with incomes ≥ $US50,000 (66%). Father's mean PSE score was 39.28 (±3.9). Hispanic ethnicity and total number of chronic conditions were significant predictors of lower PSE in fathers. Conclusions Fathers of medically complex infants reported low PSE. More strategic interventions need to focus on self-efficacy and creating opportunities for connection between fathers and infants.