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Purpose: Cow's milk is the primary source of iodine in the UK, but consumption of plant-based milk alternatives (PBMA) is increasing and these products are often not fortified with iodine. We evaluated the impact that replacing current milk consumption with PBMA would have on iodine intake. Methods: We used data from the National Diet and Nutrition Survey (2016–2019) for children (1.5–10 years), girls 11–18 years, and women of reproductive age (WRA). We used a dietary modelling approach with scenarios using brand-level iodine-fortification data (0, 13, 22.5, 27.4 and 45 µg/100 mL). Relative to usual diet, we calculated change in iodine intake, and the proportion with intake below the Lower Reference Nutrient Intake (LRNI) or above the upper limit. Results: For all groups, replacement with PBMA, either unfortified or fortified at the lowest concentration, resulted in a meaningful decrease in iodine intake, and increased the proportion with intake < LRNI; compared to usual diet, iodine intake reduced by 58% in children 1.5–3 years (127 vs. 53 µg/day) and the proportion with intake < LRNI increased in girls (11–18 years; 20% to 48%) and WRA (13% to 33%) if an unfortified PBMA was used. Replacement of milk with PBMA fortified at 27.4 µg/100 mL had the lowest impact. Conclusion: Replacing milk with commercially available PBMAs has potential to reduce population iodine intake, depending on the fortification level. PBMAs fortified with ≥ 22.5 and < 45 µg iodine/100 mL would be required to minimize the impact on iodine intake. Research is needed on the impact of total dairy replacement. [ABSTRACT FROM AUTHOR]

Personality disorder occurs in up to one-quarter of people attending primary care, usually co-occurring with other mental and physical health needs. Evidence-based practical support is first-line treatment, with referral of patients for more specialised treatments only when needed. [ABSTRACT FROM AUTHOR]

Purpose: The perceived benefits and risks associated with seed oil intake remain controversial, with a limited number of studies investigating the impact of intake on a range of compounds used as cardiometabolic markers. This study aimed to explore the proteomic and cardiometabolic effects of commonly consumed seed oils in the UK, with different fatty acid profiles. Methods: In a parallel randomised control design, healthy adults (n = 84), aged 25–72 with overweight or obesity were randomised to one of three groups: control (habitual diet, CON); 20 mL rapeseed oil per day (RO), or 20 mL sunflower oil per day (SO). Blood, spot urine and anthropometric measures were obtained at 0, 6 and 12 weeks. Proteomic biomarkers analysis was conducted for coronary arterial disease (CAD) and chronic kidney disease (CKD) using capillary electrophoresis coupled to mass spectrometry (CE-MS). Blood lipids, fasting blood glucose, glycative/oxidative stress and inflammatory markers were also analysed. Results: No differences in change between time points were observed between groups for CAD or CKD peptide fingerprint scores. No change was detected within groups for CAD or CKD scores. No detectable differences were observed between groups at week 6 or 12 for the secondary outcomes, except median 8-isoprostane, ~ 50% higher in the SO group after 12-weeks compared to RO and CON groups (p = 0.03). Conclusion: The replacement of habitual fat with either RO or SO for 12 weeks does not lead to an improvement or worsening in cardiovascular health markers in people with overweight or obesity. Trial registration: Trial registration clinicaltrials.gov NCT04867629, retrospectively registered 30/04/2021. [ABSTRACT FROM AUTHOR]

Abstract: We investigated the relationship between borderline personality disorder (BPD) and childhood adversity using photographs of emotional faces. We found that those with BPD were less able to correctly identify emotional facial expressions, particularly disgust, and that this deficit in BPD correlated significantly with a measure of childhood trauma (CTQ). [Copyright &y& Elsevier]

One in five young people with first-episode psychosis (FEP) also presents with borderline personality disorder (BPD) features. Among people diagnosed with BPD, auditory verbal hallucinations occur in 29–50 % and delusions in 10–100 %. Co-occurrence of psychotic symptoms and BPD is associated with greater clinical severity and greater difficulty accessing evidence based FEP care. This study aimed to investigate psychotic symptoms and psychosocial functioning among young people presenting to an early intervention mental health service. According to the presence or absence of either FEP or BPD, 141 participants, aged 15–25 years, were assigned to one of four groups: FEP, BPD, combined FEP + BPD, or clinical comparison (CC) participants with neither FEP nor BPD. Participants completed semi-structured diagnostic interviews and interviewer and self-report measures of psychopathology and psychosocial functioning. The FEP + BPD group had significantly more severe psychopathology and poorer psychosocial functioning than the FEP group on every measure, apart from intensity of hallucinations. Comparing the FEP or BPD groups, the BPD group had greater psychopathology, apart from intensity of psychotic symptoms, which was significantly greater in the FEP group. These two groups did not significantly differ in their overall psychosocial functioning. Compared with CC young people, both the FEP + BPD and BPD groups differed significantly on every measure, with medium to large effect sizes. Young people with co-occurring FEP and BPD experience more severe difficulties than young people with either diagnosis alone. This combination of psychosis and severe personality pathology has been longitudinally associated with poorer outcomes among adults and requires specific clinical attention. [ABSTRACT FROM AUTHOR]

This study aimed to investigate predictors of vocational disengagement (referred to as Not in Employment, Education, or Training [NEET]) in young people with borderline personality disorder (BPD). The sample comprised 112 outpatients with a BPD diagnosis, aged 15–25 years, who participated in a randomized controlled trial (ANZCTR12610000100099). The proportion of participants who were NEET (39.3%) at study entry did not improve after 18 months and NEET status frequently changed. Therefore, multinomial regression analyses were used to study three groups: Non-NEET, NEET, and Unstable NEET status. NEET status was predicted by not achieving expected age-appropriate educational milestones, greater instability in identity, and emptiness. Greater instability in interpersonal relationships and identity predicted Unstable NEET status. The findings suggest that specific vocational interventions, that also incorporate a focus on interpersonal functioning, emptiness, and identity disturbance, are needed to improve functioning in youth with BPD, especially when educational milestones are not achieved. [ABSTRACT FROM AUTHOR]

Background: The clinical onset of borderline personality disorder (BPD) usually occurs in young people (aged 12-25 years) and commonly leads to difficulty achieving and maintaining vocational (education and/or employment) engagement. While current psychosocial interventions lead to improvements in psychopathology, they have little effect upon functioning. Individual Placement and Support (IPS) is a client-driven model that assists individuals with severe mental illness to engage with education and/or employment appropriate to their personal goals, and that provides ongoing support to maintain this engagement. The objective of the INdividual Vocational and Educational Support Trial (INVEST) is to evaluate the effectiveness of adding IPS to an evidence-based early intervention programme for BPD, with the aim of improving vocational outcomes.Methods/design: INVEST is a single-blind, parallel-groups, randomised controlled trial (RCT). The randomisation is stratified by gender and age and uses random permuted blocks. The interventions are 39 weeks of either IPS, or 'usual vocational services' (UVS). Participants will comprise 108 help-seeking young people (aged 15-25 years) with three or more DSM-5 BPD features and a desire to study or work, recruited from the Helping Young People Early (HYPE) early intervention programme for BPD at Orygen, in Melbourne, Australia. All participants will receive the HYPE intervention. After baseline assessment, staff who are blind to the intervention group allocation will conduct assessments at 13, 26, 39 and 52 weeks. At the 52-week primary endpoint, the primary outcome is the number of days in mainstream education/employment since baseline. Secondary outcomes include the cost-effectiveness of the intervention, quality of life, and BPD severity.Discussion: Current treatments for BPD have little impact on vocational outcomes and enduring functional impairment is prevalent among this patient group. IPS is a targeted functional intervention, which has proven effective in improving vocational outcomes for adults and young people with psychotic disorders. This trial will investigate whether IPS is effective for improving vocational (employment and educational) outcomes among young people with subthreshold or full-syndrome BPD.Trial Registration: Australian New Zealand Clinical Trials Registry, ID: ACTRN12619001220156 . 13 September 2019. [ABSTRACT FROM AUTHOR]

Background:Borderline personality disorder (BPD) is a common and serious mental illness, associated with a high risk of suicide and self harm. Those with a diagnosis of BPD often display difficulties with social interaction and struggle to form and maintain interpersonal relationships. Here we investigated the ability of participants with BPD to make social inferences from faces. Method:20 participants with BPD and 21 healthy controls were shown a series of faces and asked to judge these according to one of six characteristics (age, distinctiveness, attractiveness, intelligence, approachability, trustworthiness). The number and direction of errors made (compared to population norms) were recorded for analysis. Results:Participants with a diagnosis of BPD displayed significant impairments in making judgements from faces. In particular, the BPD Group judged faces as less approachable and less trustworthy than controls. Furthermore, within the BPD Group there was a correlation between scores on the Childhood Trauma Questionnaire (CTQ) and bias towards judging faces as unapproachable. Conclusion:Individuals with a diagnosis of BPD have difficulty making appropriate social judgements about others from their faces. Judging more faces as unapproachable and untrustworthy indicates that this group may have a heightened sensitivity to perceiving potential threat, and this should be considered in clinical management and treatment. [ABSTRACT FROM AUTHOR]

Summary: Characterising sleep in young people (aged 15–25 years) with borderline personality disorder (BPD) features is crucial given the association between BPD features and sleep disturbance, negative consequences of poor sleep, and normative developmental sleep changes that occur in this age group. The present study aimed to characterise the sleep profile of young people with BPD to determine whether this profile is non‐normative and specific to BPD. Participants were 96 young people (40 with BPD features, 38 healthy individuals, and 18 young people seeking help for mental health difficulties without BPD). Sleep was measured subjectively (self‐report questionnaires) and objectively (10 days of actigraphy). Young people with BPD features reported poorer subjective sleep quality, greater insomnia symptoms and later chronotype than same‐age healthy and clinical comparison groups. Young people with BPD features also displayed irregular sleep timing, later rise times, greater time in bed and longer sleep durations than healthy young people. Those with BPD features had superior sleep quality (greater sleep efficiency, less wake after sleep onset) and longer sleep durations than the clinical comparison group. Sleep profiles were similar across young people with BPD features with and without co‐occurring depression. Overall, the findings revealed a subjective–objective sleep discrepancy and suggest that sleep‐improvement interventions might be beneficial to improve subjective sleep in young people with BPD features. [ABSTRACT FROM AUTHOR]

People’s affective or emotional state can alter their cognitive processing, biasing interpretation of ambiguous stimuli. Those in a more positive state interpret such stimuli in a more optimistic manner than those in a negative state. Recently this research has extended to animals, and has shown that manipulations associated with negative affect cause animals to interpret ambiguous stimuli more pessimistically. We investigated whether exposure to environmental enrichment engenders optimistic responses to ambiguous stimuli. Rats, Rattus norvegicus, were trained on a novel conditional discrimination task whereby they learned the correct response necessary to obtain a food reward given the stimulus present during approach (rough or smooth sandpaper). One stimulus was associated with a higher-value reward than the other. Once the rats were trained, cognitive bias was probed by exploring their responses to an ambiguous stimulus (intermediate grade of sandpaper); a rat was defined as optimistic if it chose the response appropriate to the stimulus associated with the better reward. Animals transferred from unenriched to enriched cages showed more optimistic responses following the change. A control group maintained in unenriched cages showed pessimistic responses throughout. These results demonstrate for the first time that environmental enrichment can induce an optimistic cognitive bias in rats previously housed in standard caging, possibly indicative of a more positive affective state. These results add support to the suggestion that measuring cognitive biases can give an insight into animal emotional states; this has implications for animal welfare and preclinical testing of potential therapeutics for mood disorders. [Copyright &y& Elsevier]