Search

Background Adolescent antisocial behavior (AB) is a public health concern due to the high financial and social costs of AB on victims and perpetrators. Neural systems involved in reward and loss processing are thought to contribute to AB. However, investigations into these processes are limited: few have considered anticipatory and consummatory components of reward, response to loss, nor whether associations with AB may vary by level of callous-unemotional (CU) traits. Methods A population-based community sample of 128 predominantly low-income youth (mean age = 15.9 years; 42% male) completed a monetary incentive delay task during fMRI. A multi-informant, multi-method latent variable approach was used to test associations between AB and neural response to reward and loss anticipation and outcome and whether CU traits moderated these associations. Results AB was not associated with neural response to reward but was associated with reduced frontoparietal activity during loss outcomes. This association was moderated by CU traits such that individuals with higher levels of AB and CU traits had the largest reductions in frontoparietal activity. Co-occurring AB and CU traits were also associated with increased precuneus response during loss anticipation. Conclusions Findings indicate that AB is associated with reduced activity in brain regions involved in cognitive control, attention, and behavior modification during negative outcomes. Moreover, these reductions are most pronounced in youth with co-occurring CU traits. These findings have implications for understanding why adolescents involved in AB continue these behaviors despite severe negative consequences (e.g. incarceration).

Background Studies have shown a link between food insecurity and housing problems, including trouble paying rent. Additional research is needed to test the longitudinal effect of food insecurity on housing insecurity in a socio-demographically diverse, population-based sample. We tested whether food insecurity transitions predicted housing insecurity using a housing insecurity index consisting of housing and neighborhood factors. We also tested whether social cohesion or social support mediated the food/housing insecurity relationship. Method Data were analyzed from a sample of 2868 mothers of young children residing in California at two time points: the baseline Maternal and Infant Health Assessment (2003–2007) and follow-up Geographic Research on Wellbeing survey (2012–2013). Women were categorized as food insecure both times; became food insecure; became food secure; and food secure both times. We constructed linear regression models for housing insecurity: models regressing each variable separately; a model regressing sociodemographic covariates and food insecurity status; mediation models adding social cohesion or social support; and mediation models for each racial/ethnic group. Results Food insecurity transitions were associated with housing insecurity in a gradient pattern. Compared to women who were food secure both times, housing insecurity was highest among women who were food insecure both times, followed by those who became food insecure, and then those who transitioned out of food insecurity (became food secure). Food insecurity remained a significant risk factor for housing insecurity even after adjusting sociodemographic covariates. While social support and social cohesion were negatively associated with housing insecurity, there was limited evidence that social support/cohesion mediated the food insecurity/housing insecurity relationships. Conclusions The lack of substantial mediation suggests that factors beyond social ties may explain the food and housing insecurity relationship. Efforts to reduce material hardship should consist of streamlined policy efforts that offer tangible supports for women and their families.

Objectives: We described the burden of illness and health-related quality of life (HRQoL) in adults with spondyloarthritis (SpA) using a nationally representative sample. Materials and Methods: We ...

Ability-grouping has been studied extensively in relation to children's academic, but not emotional and behavioral outcomes. The sample comprised 7259 U.K. children (50% male) with data on between-class and within-class ability-grouping at age 7. Peer, emotional, hyperactivity, and conduct problems were measured at ages 7, 11, and 14 years. Children in low within-class ability groups showed more hyperactivity and emotional problems across the study period compared to non-grouped children, after adjustments for the different types of ability grouping and confounding. Additionally, children in the middle within-class ability groups showed more, and those in the top within-class groups less, hyperactivity compared to non-grouped children, after adjustment. Children in lower within-class groups should be monitored closely to ensure that their well-being is not compromised.

Purpose: This study aimed to identify the associations between social isolation, social contextual factors, and behavioral and psychological health during emerging adulthood. Methods: Participants (n = 1,568) were drawn from EAT 2018 (mean age = 22.1 ± 2.0). Logistic regressions tested the associations between social isolation, contextual factors, and behavioral and psychological health. Results: Approximately 16% of the sample reported social isolation. Emerging adults with socially marginalized identities (e.g., racial/ethnic, socioeconomic), who were unemployed, and/or lived alone had higher odds of experiencing social isolation. Social isolation was associated with more risky health behaviors and lower self-esteem. Discussion: Emerging adults who were socially disadvantaged (e.g., unemployed) had greater risk of social isolation. Findings suggest that social isolation is more strongly linked with behavioral health than psychological health. Generally, findings suggest that access to community resources and areas wherein social connections can be formed may to be important for behavioral health in emerging adulthood.

OBJECTIVE: Meditation practice and meditation-based psychotherapies have become increasingly popular. Although psychological benefits associated with meditation are well-documented, potential risks are unclear. METHOD: We conducted a population-based survey to evaluate the occurrence of a broad range of meditation-related adverse effects (MRAE). RESULTS: 953 participants completed our screening survey, 470 endorsed lifetime exposure to meditation practice, and 434 completed a follow-up survey assessing MRAE (92.3% response rate). A higher proportion than hypothesized reported occurrence of MRAE (general item = 32.3%, 1+ specific item = 50.0%) and MRAE duration ≥1 month (10.4%). Anxiety, traumatic re-experiencing, and emotional sensitivity were the most common MRAE. Some degree of functional impairment was reported by 10.6% of participants, with impairment lasting ≥1 month for 1.2%. Childhood adversity was associated with elevated risk for MRAE. Participants reporting MRAE were equally glad to have practiced meditation as those not reporting MRAE. Additional correlates of MRAE were identified in exploratory analyses. CONCLUSION: MRAE are common, even in a sample with relatively modest amounts of experience. Identifying individuals at elevated risk for MRAE, being transparent and realistic about the possible range of effects, and increasing trauma-sensitivity are warranted to maximize benefits and minimize risks of meditation.

Fatigue is one of the most common and distressing symptoms experienced by cancer survivors. Understanding fatigue trajectories from pre- to post-diagnosis could inform fatigue prevention and management strategies. We used the Surveillance, Epidemiology and End Results Medicare Health Outcomes Survey (SEER-MHOS) linked data resource to characterize fatigue trajectories and their predictors 1214 older adult survivors of breast, colorectal, or prostate cancer. Fatigue was measured prior to the cancer diagnosis (T0) and at two timepoints after diagnosis (T1: mean = 20 months and T2: mean = 39 months post-diagnosis). Latent growth curve modeling and mixed effects models for repeated measurements were used to investigate fatigue experiences before and after a cancer diagnosis. Overall, mean fatigue T-scores declined (T0 = 50, T1 = 46, and T2 = 45) indicating worsening fatigue over time. Four latent trajectory subgroups were identified: severe fatigue worsening over time (8.2% of sample), severe fatigue persisting over time (14.4%), no fatigue pre-diagnosis and mild fatigue post-diagnosis (44.4%), and not fatigued (33%). Age, cancer stage, comorbidities, and depressed mood predicted membership in the two trajectory groups experiencing severe fatigue that persisted or that worsened post-diagnosis. Older age, advanced cancer stage at diagnosis, and depressed mood were significantly associated with worsening fatigue from T1 to T2 (all p

Supa Pengpid,1,2 Karl Peltzer3 1ASEAN Institute for Health Development, Mahidol University, Salaya, Nakhon Pathom, Thailand; 2Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa; 3Department of Psychology, University of the Free State, Bloemfontein, South AfricaCorrespondence: Karl PeltzerDepartment of Psychology, University of the Free State, Bloemfontein, South AfricaEmail kfpeltzer@gmail.comBackground: This study aimed to determine the prevalence and correlates of self-reported cardiovascular diseases (SRCVDs) among adults in Ecuador.Methods: National cross-sectional survey data of 4638 persons aged 18– 69 years in Ecuador were analysed. Research data were collected with an interview-administered questionnaire, physical and biochemical measurements.Results: The prevalence of SRCVDs was 8.7%, 8.5% among men and 8.9% among women. In adjusted logistic regression analysis, being Montubio (adjusted odds ratio-AOR: 1.66, 95% confidence interval-CI: 1.10– 2.50), family alcohol problems (AOR: 1.78, 95% CI: 1.19– 2.65), past smoking tobacco (AOR: 1.36, 95% CI: 1.02– 1.81), and poor oral health status (AOR: 1.74, 95% CI: 1.19– 2.54) were associated with SRCVD. In addition, in unadjusted analysis, older age, alcohol dependence, obesity, and having hypertension were associated with SRCVD.Conclusion: Almost one in ten persons aged 18– 69 years had SRCVD in Ecuador. Several associated factors, including Montubio by ethnicity, family alcohol problems, past smoking, and poor oral health status, were identified, which can be targeted in public health interventions.Keywords: chronic conditions, lifestyle factors, cardiovascular disease, adults, Ecuador

Introduction This study evaluated the diagnostic accuracy of the Cogstate Brief Battery (CBB) for mild cognitive impairment (MCI) and prodromal Alzheimer's disease (AD) in a population-based sample. Methods Participants included adults ages 50+ classified as cognitively unimpaired (CU, n = 2866) or MCI (n = 226), and a subset with amyloid (A) and tau (T) positron emission tomography who were AD biomarker negative (A-T-) or had prodromal AD (A+T+). Results Diagnostic accuracy of the Learning/Working Memory Composite (Lrn/WM) for discriminating all CU and MCI was moderate (area under the curve [AUC] = 0.75), but improved when discriminating CU A-T- and MCI A+T+ (AUC = 0.93) and when differentiating MCI participants without AD biomarkers from those with prodromal AD (AUC = 0.86). Conventional cut-offs yielded lower than expected sensitivity for both MCI (38%) and prodromal AD (73%). Discussion Clinical utility of the CBB for detecting MCI in a population-based sample is lower than expected. Caution is needed when using currently available CBB normative data for clinical interpretation.

Purpose Fragile X syndrome (FXS), the most prevalent inherited cause of intellectual disability, remains underdiagnosed in the general population. Clinical studies have shown that individuals with FXS have a complex health profile leading to unique clinical needs. However, the full impact of this X-linked disorder on the health of affected individuals is unclear and the prevalence of co-occurring conditions is unknown. Methods We mined the longitudinal electronic health records from more than one million individuals to investigate the health characteristics of patients who have been clinically diagnosed with FXS. Additionally, using machine-learning approaches, we created predictive models to identify individuals with FXS in the general population. Results Our discovery-oriented approach identified the associations of FXS with a wide range of medical conditions including circulatory, endocrine, digestive, and genitourinary, in addition to mental and neurological disorders. We successfully created predictive models to identify cases five years prior to clinical diagnosis of FXS without relying on any genetic or familial data. Conclusion Although FXS is often thought of primarily as a neurological disorder, it is in fact a multisystem syndrome involving many co-occurring conditions, some primary and some secondary, and they are associated with a considerable burden on patients and their families.

Psychological distress is an undersearched cause of major burden of disease in the Pacific island countries. The study aimed to investigate the prevalence and associated factors of psychological di...

BackgroundAlthough research has shown that exposure to potentially traumatic and morally injurious events is associated with psychological symptoms among veterans, knowledge regarding functioning impacts remains limited.MethodsA population-based sample of post-9/11 veterans completed measures of intimate relationship, health, and work functioning at approximately 9, 15, 21, and 27 months after leaving service. Moral injury, posttraumatic stress, and depression were assessed at ~9 months post-separation. We used Latent Growth Mixture Models to identify discrete classes characterized by unique trajectories of change in functioning over time and to examine predictors of class membership.ResultsVeterans were assigned to one of four functioning trajectories: high and stable, high and decreasing, moderate and increasing, and moderate and stable. Whereas posttraumatic stress, depression, and moral injury associated with perpetration and betrayal predicted worse outcomes at baseline across multiple functioning domains, moral injury associated with perpetration and depression most reliably predicted assignment to trajectories characterized by relatively poor or declining functioning.ConclusionsMoral injury contributes to functional problems beyond what is explained by posttraumatic stress and depression, and moral injury due to perpetration and depression most reliably predicted assignment to trajectories characterized by functional impairment over time.

Introduction:Although survival rates are highest among prostate cancer survivors compared to any other forms of cancer, nearly 60% suffer from mental distress. Here we examine urinary funct...

Zusammenfassung Ziel der Studie Zusammenhangsanalyse von wahrgenommenen Alltagsbelastungen während der COVID-19-Krise und Persönlichkeitsaspekten mit dem aktuellen psychischen Befinden in der Bevölkerung sowie Vergleich der psychischen Symptomatik mit einem Survey von 2018. Methodik Zufallsstichprobe aus der Bevölkerung (n = 721), die zu coronabezogenen Einschätzungen, Persönlichkeitsaspekten und aktuellem psychischen Befinden (WHO-5, PHQ-D) schriftlich befragt wurde. Ergebnisse Angst um die Gesundheit Nahestehender, Belastungen durch Ausgangsbeschränkungen und vermehrter Substanzkonsum sowie psychische Risiko- und Resilienzfaktoren trugen im statistischen Modell unabhängig zur Vorhersage des psychischen Befindens bei. Ausprägungen und Häufigkeiten psychischer Symptomatik unterschieden sich nicht zwischen 2018 und 2020. Schlussfolgerung Dies ist eine erste Studie in Deutschland, die Ergebnisse aus einer bevölkerungsbezogenen Zufallsstichprobe zu Determinanten psychischen Befindens während der COVID-19-Krise und einen Vergleich der psychischen Symptomatik mit einer präpandemischen Referenzstichprobe vorlegt.

OBJECTIVE: The objectives of this study were to: 1) Determine the association between subjective cognitive decline (SCD) and life satisfaction; and 2) Assess the gendered racial/ethnic disparities in the association between SCD and life satisfaction. METHOD: Data were obtained from 3,795 participants from the Behavioral Risk Factor Surveillance System survey. SCD was operationalized by “During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse?” Life satisfaction was operationalized by the question “In general how satisfied are you with your life?” Interaction terms of SCD*sex, SCD*race/ethnicity, and SCD*sex*race/ethnicity were used to determine potential effect measure modification. Crude and adjusted linear regression models, controlling for age, education, income and employment, were used to assess the association between SCD and life satisfaction by sex, race, and by gendered racial/ethnic groups: Black women, White women, Hispanic women, Other women; and Black men, White men, Hispanic men and Other men. RESULTS: SCD was negatively associated with life satisfaction in the overall sample (β: −0.55; 95% CI: −0.66, −0.43). However, the negative associations seen across gender, race/ethnicity, and gendered racial/ethnic groups were statistically similar (p for interaction terms>0.05). The highest effect estimate was seen for Other men (β: −1.22; 95% CI: −1.37, −1.09). CONCLUSION: Interventions geared towards improving cognition may improve life satisfaction for all groups, irrespective of gender and/or race/ethnicity. Future research may include longitudinal studies to determine the temporal sequence between SCD and life satisfaction.

Objective: We aimed to investigate the prevalence of ADHD and its comorbidities and some associated demographic factors in a large sample population-based study. Method: As part of a population-based survey among 30,532 children and adolescents between 6 and 18 years, we used K-SADS-PL to screen and detect ADHD and its comorbidities. Results: The prevalence of ADHD was 4%, with more prevalence among boys (5.2% vs. 2.7%), younger participants, urban residents, and offspring of mothers who had a history of psychiatric hospitalization. Anxiety disorders (37.9%) and behavioral disorders (31%) are the most prevalent group of comorbidities, and oppositional defiant disorder (ODD) is the most prevalent comorbid disorder (26.1%). Mood disorders and anxiety disorders are more common among girls, but conduct disorder has a higher rate among boys. Conclusion: ADHD is a common neurodevelopmental disorder which is accompanied by several comorbid conditions. The high rate of comorbidities makes it complicated and difficult to manage.

The prevalence of Mycoplasma genitalium among women aged 21 to 24 years was similar to that of Chlamydia trachomatis, for which women are screened regularly in the United States., In this population-based US study, the overall prevalence of Mycoplasma genitalium was 1.95% (95% confidence interval [CI], 1.62%–2.34%), declining from 6.12% (95% CI, 4.72%–7.92%) in women aged 21 to 24 years to 0.48% (95% CI, 0.25%–0.94%) in women aged 40 to 64 years. The prevalence of coinfections with Chlamydia trachomatis and Trichomonas vaginalis was low.

Objectives: The study aimed was to investigate the relationship between physical activity (PA) levels and muscle markers in healthy children and adolescents. Methods: This cross-sectional study was conducted in 2020 among school students from Isfahan, Iran. Using cluster sampling, 159 students aged 7 to 18 years were selected. In addition to the physical examination, the PA level was assessed using a valid questionnaire. The serum levels of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and alanine aminotransferase (ALT) were measured. Statistical analysis was performed using the Pearson correlation test. Results: The samples included 79 girls and 80 boys with a mean age (standard deviation) of 12.72 (3.06) years and a mean body mass index of 18.30 (3.70) kg/m2. The mean AST and CPK were significantly higher in boys than in girls (P < 0.05). Participants with higher PA levels had significantly lower LDH and ALT than other participants (-0.20, P = 0.003, and 0.044 P = 0.295, respectively). There was no significant relationship between PA level and muscle enzyme levels. Conclusions: The findings of this study indicated that higher PA level was associated with lower serum muscle markers other than LDH. This suggests that the best types of PA for children and adolescents are those activities with rest sets to prevent muscle damage.

Introduction Cardiovascular diseases (CVD) are the most serious public health problem, remaining the leading cause of death in the adult population. A great number of CVD risk scales are successfully used in clinics, yet they are tuned to work the best for patients of older age and often are population specific. Methods We used the data from a longitudinal epidemiologic study of 4,750 individuals aged 25–64 years from European part of Russia recruited in 2012–2013 to predict the 10-year risk of cardiovascular events in Russian population and evaluate performance for common clinical risk scales. The cohort was divided into two groups: “cases” – individuals with a cardiovascular event registered during the follow up period (2013–2019) as a study group (N=106) and “controls” – individuals with no cardiovascular events registered during follow up as a control group (N=4,644). All individuals with previous history of CVD (ischemic heart disease, stroke or heart attack) prior to 2012 were assigned high risk in all scales. The case and control groups were split by age: below and above 40 to reflect the properties of cardiovascular risk scales to work best for age over 40. We assessed CVD risk scores using Framingham 2008 [1], ASCVD 2013, both were calculated with mean parameters values calculated from our cohort and from the original study [2], SCORE 2003, 2017 and 2019 [3] and MOSP - the recalibrated for Russian population scale of the SCORE 2017 [4] Results For patients over 40 years old, cardiovascular risk scales showed similar performance, with ASCVD normalized to the original study's mean parameter values returning the best prediction scores. Expectedly, for the younger group of patients, cardiac risk scales do not have notable predictive power. Further, we thought to identify additional factors discriminating young individuals at higher risk of CVD. We downsampled the control cohort to include only samples with age, weight, height, LDL, total cholesterol and systolic blood pressure matching those in a case cohort ( 186 phenotypic features were tested and 4 out of top 10 (p Conclusions We identified depression and anxiety screening questionnaires as a valuable predictor for cardiovascular events in the younger population improving the quality of predictions of traditional clinical scales. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Science and Higher Education of the Russian Federation Table 1. ROC analysis

Little is known about advance care planning among young adults with congenital heart defects (CHD). Congenital Heart Survey to Recognize Outcomes, Needs, and well-beinG (CH STRONG) participants were born with CHD between 1980 and 1997, identified using active, population-based birth defects surveillance systems in Arkansas, Arizona and Atlanta, and Georgia, and surveyed during 2016–2019. We estimated the percent having an advance care directive standardized to the site, year of birth, sex, maternal race, and CHD severity of the 9312 CH STRONG-eligible individuals. We calculated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for characteristics associated with having advance care directives. Of 1541 respondents, 34.1% had severe CHD, 54.1% were female, and 69.6% were non-Hispanic white. After standardization, 7.3% had an advance care directive (range: 2.5% among non-Hispanic blacks to 17.4% among individuals with “poor” perceived health). Individuals with severe CHD (10.5%, aOR = 1.6, 95% CI: 1.1–2.3), with public insurance (13.1%, aOR = 1.7, 95% CI: 1.1–2.7), with non-cardiac congenital anomalies (11.1%, aOR = 1.9, 95% CI: 1.3–2.7), and who were hospitalized in the past year (13.3%, aOR = 1.8, 95% CI: 1.1–2.8) were more likely than their counterparts to have advance care directives. Individuals aged 19–24 years (6.6%, aOR = 0.4, 95% CI: 0.3–0.7) and 25–30 years (7.6%, aOR = 0.5, 95% CI: 0.3–0.8), compared to 31–38 years (14.3%), and non-Hispanic blacks (2.5%), compared to non-Hispanic whites (9.5%, aOR = 0.2, 95% CI: 0.1–0.6), were less likely to have advance care directives. Few young adults with CHD had advance care directives. Disparities in advance care planning may exist.

Развитие молекулярно-генетических исследований позволило определить мутации в генах BRCA1 и BRCA2, приводящие к возникновению наследственных форм рака молочной железы (РМЖ) и рака яичников (РЯ). Проведение генетического тестирования открывает возможности осуществления ранней диагностики и направленной профилактики. Цель: сравнить распространенность патогенных вариантов в гене BRCA1 и BRCA2 у больных с верифицированным РМЖ/РЯ и в популяционной выборке женщин без онкологических заболеваний. Было включено 156 больных с диагнозом РМЖ/РЯ и 359 женщин без онкологических заболеваний из популяционной выборки ЭССЕ-Вологда. Для генетического анализа использована диагностическая панель, разработанная в ФГБУ «НМИЦ ТПМ», позволяющая выявлять варианты генов BRCA1 и BRCA2. Среди обследованных больных выявлено 5 носителей (3,21%) мутаций в гене BRCA1 (у 4 человек - rs80357906, 2,56%; у 1 человека - rs80357711, 0,64%) и 1 носитель (0,64%) rs80359550 в гене BRCA2. В выборке женщин без онкологических заболеваний носителей не выявлено. При наличии вариантов BRCA1 (rs80357906, rs80357711) или BRCA2 (rs80359550) риск развития РМЖ/РЯ повышен как минимум в 2,63 раза (р=0,0009). Выявление патогенных вариантов генов BRCA1 и BRCA2 может способствовать ранней диагностике и своевременной профилактике РМЖ и РЯ. Progress in genetics and molecular research enabled discovery of mutations in BRCA1 and BRCA2, leading to the development of hereditary breast (BC) and ovarian (OC) cancer. Genetic testing contributes to early diagnosis and targeted prevention of these cancers. Objective: To investigate the prevalence of pathogenic variants in BRCA1 and BRCA2 genes in patients with BC/OC and in a population-based sample without oncological diseases. Methods: 156 patients with diagnosed BC/OC were included in the study consecutively. In addition to it, 359 women from a population-based sample ESSE-Vologda were recruited in the study. Variants of BRCA1 and BRCA2 were detected using a custom panel. Results: Among cancer patients there were 5 carriers (3.21%) of mutations in BRCA1 (4 - rs80357906, 2.56%; 1 - rs80357711, 0.64%) and 1 carrier (0.64%) of rs80359550 in BRCA2. In a population-based sample no mutations were identified. The presence of BRCA1 (rs80357906, rs80357711) or BRCA2 (rs80359550) variants increases the risk of BC/OC at least 2.63 times (р=0.0009). Conclusion: Detection of pathogenic variants in BRCA1 and BRCA2 could facilitate early diagnosis and timely prevention of BC and OC.

Objective This study aimed to examine the relationship between proximity to healthy and unhealthy food outlets around children's homes and their weight outcomes. Methods A total of 3,507,542 student-year observations of height and weight data from the 2009-2013 annual FitnessGram assessment of New York City public school students were used. BMI z scores were calculated, student obesity or obesity/overweight was determined using Centers for Disease Control and Prevention growth charts, and these data were combined with the locations of four food outlet types (fast-food restaurants, wait-service restaurants, corner stores, and supermarkets) to calculate distance to the nearest outlet. Associations between weight status outcomes and distance to these food outlet types were examined using neighborhood (census tract) fixed effects. Results Living farther than 0.025 mile (about half of a city block) from the nearest fast-food restaurant was associated with lower obesity and obesity/overweight risk and lower BMI z scores. Results ranged from 2.5% to 4.4% decreased obesity. Beyond this distance, there were generally no impacts of the food environment and little to no impact of other food outlet types. Conclusions Proximity to fast-food restaurants was inversely related to childhood obesity, but no relationships beyond that were seen. These findings can help better inform policies focused on food access, which could, in turn, reduce childhood obesity.

Background: Young women are disadvantaged with respect to their ability to access contraception, which puts them at especially high risk of repeat induced abortion. This study aims to esti...

BACKGROUND: Prescription opioid use (POU) among young adults is increasing. This represents a major public health concern due to the increased risks of opioid use misuse and opioid-related overdose. Limited research has examined the POU among young black men who have sex with men (YBMSM), a diverse group experiencing continued increases in HIV incidence over the past decade. OBJECTIVE: The current study aims to examine the prevalence and both the individual and network characteristics of POU among YBMSM. METHODS: Data come from a longitudinal cohort study of 16–29 year old YBMSM (N =514) between 2013 and 2016 in Chicago. Bivariate and multivariable associations were estimated using general estimating equations (GEE). RESULTS: Approximately 4.2% of YBMSM reported POU in the past 12 months with a cumulative incidence rate of 4.1% over the 18-month follow-up period. YBMSM having criminal justice involvements, experiencing violence, or using any illicit drug other than marijuana in the past 12 months were more likely to report POU in the past 12 months. The presence of a mother figure, however, was associated with a decreased risk of POU in the past 12 months, while engaging in condomless anal sex with their named sexual partners was associated with an increased risk of POU in the past 12 months. CONCLUSIONS: This is one of the first studies to describe POU among a population-based sample of YBMSM. The high incidence rate of POU among YBMSM is alarming, and it underscores the need for further analysis on POU among this key population.

BackgroundBronchiolitis is the most common cause of respiratory hospitalisation in children aged MethodsWe searched for national and international CPGs relating to management of bronchiolitis in children and identified 16 recommendations which were formatted into 40 medical record audit indicator questions. A retrospective medical record review assessing compliance with the CPGs was conducted across three types of healthcare setting: hospital inpatient admissions, emergency department (ED) presentations and general practice (GP) consultations in three Australian states for children aged ResultsPurpose-trained surveyors conducted 13 979 eligible indicator assessments across 796 visits for bronchiolitis at 119 sites. Guideline adherence for management of bronchiolitis was 77.3% (95% CI 72.6 to 81.5) for children attending EDs, 81.6% (95% CI 78.0 to 84.9) for inpatients and 52.3% (95% CI 44.8 to 59.7) for children attending GP consultations. While adherence to some individual indicators was high, overall adherence to documentation of 10 indicators relating to history taking and examination was poorest and estimated at 2.7% (95% CI 1.5 to 4.4).ConclusionsThe study is the first to assess guideline-adherence in both hospital (ED and inpatient) and GP settings. Our study demonstrated that while the quality of care for bronchiolitis was generally adherent to CPG indicators, specific aspects of management were deficient, especially documentation of history taking.

Background: Ideal cardiovascular health (ICH) measures four ideal health behaviours (non-smoking, body mass index

BACKGROUND: Brain maturation is reflected in the sleep electroencephalogram (EEG) by a decline in non-rapid eye movement (NREM) slow wave activity (SWA) throughout adolescence and a related decrease in sleep depth. However, this trajectory and its sex and pubertal differences lack replication in population-based samples. We tested age-related changes in SWA (0.4-4 Hz) power and odds ratio product (ORP), a standardized measure of sleep depth. METHODS: We analyzed the sleep EEG of 572 subjects aged 6-21y (48% female, 26% racial/ethnic minority) and 332 subjects 5-12y followed-up at 12-22y. Multivariable-adjusted analyses tested age-related cross-sectional and longitudinal trajectories of SWA and ORP. RESULTS: SWA remained stable from age 6 to 10, decreased between ages 11 and 17, and plateaued from age 18 to 21 (p-cubic

The objectives of this study are:1)To identify temporal trends in the age-sex-race/ethnicity adjusted prevalence of vision impairment among Americans aged 65+ from 2008-2017; To determine if these temporal trends in vision impairment differ by 2)gender and age cohort, and 3)race/ethnicity, and; 4)To investigate if improvements in cohort educational attainment partially attenuate these trends.Secondary analysis of 10 years of annual nationally-representative data from the American Community Survey with 5.4 million community-dwelling and institutionalized older adults aged 65+. The question on vision impairment was "Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?".The prevalence of serious vision impairment in the US population aged 65+ declined from 8.3% to 6.6% between 2008 and 2017. There would have been an additional 848,000 older Americans with serious vision impairment in 2017 if rates had remained at the 2008 level. After age, sex and race/ethnicity were controlled, women had a 2.1% per year decline in the odds of vision impairment (OR = 0.979; CI = 0.977, 0.980), which represents a 21% decline over the decade, and men had a 9% decline over the decade (OR = 0.991; CI = 0.989, 0.993). Adjusting for education attenuated the decade decline among women, reducing it to 13%, and completely attenuated the decline among men. Most of the decline was among those aged 75+. Racial/ethnic disparities narrowed over the decade.Between 2008 and 2017, the prevalence of serious vision impairment among older Americans declined significantly, with steeper declines among African Americans and Hispanic Americans than among non-Hispanic White Americans.

Intuitive eating has been associated with markers of better health in cross-sectional studies, but less is known about long-term associations between intuitive eating and subsequent eating and weight-related behaviors. This study assessed how intuitive eating in early adulthood is related to weight status, dieting, healthy and unhealthy weight control behaviors, and binge eating with loss of control five years later. Young adults (N = 1660) were asked about intuitive eating as part of the 2008–2009 third wave of the Project EAT (Eating and Activity in Teens and Young Adults) longitudinal cohort study. Weight status, dieting, healthy and unhealthy weight control behaviors, and binge eating with loss of control were assessed during both the third (EAT-III: mean age 25.3 ± 1.5) and fourth (EAT-IV mean age 31.1 ± 1.5) waves. In analyses adjusted for sociodemographic characteristics, both male and female intuitive eaters had a lower prevalence of high weight status and lower engagement in dieting, unhealthy weight control behaviors, and binge eating at the 5-year follow-up, compared to non-intuitive eaters. Among women, after additional adjustment for EAT-III values for the respective outcome measures, intuitive eating was unrelated to any of the behaviors studied at 5-year follow-up. Among men, intuitive eating predicted a lower likelihood of engaging in unhealthy weight control behaviors (intuitive eaters: 30.0% vs. non-intuitive: 41.9%, p = 0.002) and binge eating (intuitive eaters: 0.9% vs. non-intuitive: 1.5%, p = 0.046) independent of participating in these behaviors at EAT-III. In a population-based sample of young adults, intuitive eating was associated with better markers of eating and weight-related behaviors five years later, suggesting intuitive eating may have potential long-term benefits.

Background Previous research demonstrated a relationship between ON and disordered eating symptoms (eating concern, restraint, cognitive preoccupations about body shape and weight) and disordered eating attitudes (DEA). Since screening for orthorexia nervosa is now part of clinical practice, the measurement instruments to be used must be clinically significant, reliable, valid and sensitive to our target population. The main objective of the present study was to confirm the factor structure of the Arabic version of the ORTO-R using a first sample of Lebanese adults and confirm those results on another sample. The secondary objective was to assess sex differences in terms of ON and DEA, as well as to examine whether symptoms of ON were related to DEA in Lebanese adults. Methods A total of 783 Lebanese adults was selected to participate in this cross-sectional study (January-May 2018) using a proportionate random sample from all Lebanese governorates. Results The mean age of the total sample was 27.78 ± 11.60 years (Min. 18 –Max. 84) (33.5% females) and their mean BMI was 24.36 ± 5.31 kg/m2. All items of the ORTO-R were extracted during the factor analysis and yielded a two-factor solution with Eigenvalues > 1 (variance explained = 50.07%; KMO = 0.570; Bartlett’s sphericity test pCronbach = 0.755). This factor structure was confirmed by a confirmatory factor analysis; the Maximum Likelihood Chi-Square = 26.894 and Degrees of Freedom = 8, which gave a χ2/df = 3.36. The Tucker Lewis Index (TLI) value was 0.914, whereas the standardized root mean square residual (SRMR) value was 0.032. The root mean square error of approximation (RMSEA) value was 0.077 [95% CI 0.046–0.111] (pclose = 0.07) and comparative fit index (CFI) value was 0.967 respectively, indicating a good fit of the model. There was also no measurement invariance between genders. Female gender was significantly associated with lower ORTO-R scores (more orthorexia nervosa) compared to males (B = -0.65; p = 0.026, 95% CI -1.22- -0.08; ɳ2 = 0.006). However, no significant difference was found between genders in terms of EAT-26 scores (B = 0.23; p = 0.813, 95% CI -1.66–2.12; ɳ2 = 0.0001). Higher ORTO-R scores (lower/ less pathological ON tendencies and behaviors) were significantly related to higher EAT-26 total scores (higher levels of DEA) as well as higher dieting, bulimia and oral control scores in both females (from a weak to a moderate positive correlation) and males (a weak positive correlation). Conclusion This cross-sectional population-based study confirmed the factor structure of the Arabic version of the ORTO-R, demonstrated an association between ON and DEA and revealed more ON among females compared to males.

BackgroundPerformance of three automated commercial serological IgG-based assays was investigated for assessing SARS-CoV-2 ever (past or current) infection in a population-based sample in a high exposure setting.MethodsPCR and serological testing was performed on 394 individuals.ResultsSARS-CoV-2-IgG seroprevalence was 42.9% (95% CI 38.1%-47.8%), 40.6% (95% CI 35.9%-45.5%), and 42.4% (95% CI 37.6%-47.3%) using the CL-900i, VidasIII, and Elecsys assays, respectively. Between the three assays, overall, positive, and negative percent agreements ranged between 93.2%-95.7%, 89.3%-92.8%, and 93.8%-97.8%, respectively; Cohen kappa statistic ranged from 0.86-0.91; and 35 specimens (8.9%) showed discordant results. Among all individuals, 12.5% (95% CI 9.6%-16.1%) had current infection, as assessed by PCR. Of these, only 34.7% (95% CI 22.9%-48.7%) were seropositive by at least one assay. A total of 216 individuals (54.8%; 95% CI 49.9%-59.7%) had evidence of ever infection using antibody testing and/or PCR during or prior to this study. Of these, only 78.2%, 74.1%, and 77.3% were seropositive in the CL-900i, VidasIII, and Elecsys assays, respectively.ConclusionsAll three assays had comparable performance and excellent agreement, but missed at least 20% of individuals with past or current infection. Commercial antibody assays can substantially underestimate ever infection, more so when infection rates are high.

Background: Psychological distress is an undersearched cause of poorer health in the Pacific island countries. Aims: The study aimed to investigate the prevalence and associated factors of psychological distress in a population-based survey among 18–69 year-old persons in Solomon Islands. Method: Cross-sectional nationally representative data of 2,533 18–69 year-old persons (38 years were the median age) from the 2015 Solomon Islands STEPS survey were analysed. Results: The results indicate that 18.9% of participants had psychological distress (⩾20 scores), 13.4% had mild (20–24 scores), 4.3% moderate (25–29 scores) and 1.1% severe (30–50 scores) psychological distress. In adjusted logistic regression analysis, being divorced, separated, or widowed (AOR: 2.76, 95% CI: 1.60–4.78), having had a heart attack or stroke (AOR: 3.34, 95% CI: 2.23–4.99), alcohol dependence (AOR: 1.72, 95% CI: 1.04–2.84), and sedentary behaviour (AOR: 1.90, 95% CI: 1.28–2.84), were positively and the consumption of 3–4 servings of fruit and vegetables (AOR: 0.62, 95% CI: 0.42–0.92), were negatively associated with psychological distress (⩾20 scores). In addition, in a sex stratified adjusted logistic regression analysis among men, current smokeless tobacco use (AOR: 4.95, 95% CI: 1.66–14.75), was associated with psychological distress. Furthermore, in the overall unadjusted analysis, stop smoking attempts in the past 12 months and consumption of too much salt was associated with psychological distress. Conclusion: Almost one in five participants were reported psychological distress and several factors were detected which could be targeted in intervention activities.

Objective Associations of eveningness with health hazards benefit from analyzing to what extent the polygenic score for morningness correlates with the assessments of the behavioral trait of morningness-eveningness and chronotype. Methods With a population-based sample of 17,243 Finnish adults, aged 25–74 years, this study examines the associations of four feasible assessment methods of chronotype, a) biological the genetic liability based on the polygenic score for morningness (PGSmorn), b) the widely-used single item for self-assessed morningness/eveningness (MEQi19) of the original Morningness-Eveningness Questionnaire (MEQ), c) the behavioral trait of morningness-eveningness as assessed with the score on the shortened version (sMEQ) of the original MEQ, and d) the phase of entrainment as assessed with the habitual midpoint of sleep based on the self-reported sleep-wake schedule during weekend (Sleepmid-wknd) as well as the sleep debt corrected midpoint of sleep (Sleepmid-corr). Results All self-report measures correlated with each other, but very weakly with the PGSmorn, which explained 1–2% of the variation in diurnal preference or habitual sleep-wake schedule. The influence of age was greater on Sleepmid-wknd and Sleepmid-corr than on the sMEQ or MEQi19, indicating that the diurnal preference might be a more stable indicator for morningness-eveningness than the sleep-wake schedule. Analyses of the discrepancies between sMEQ and MEQi19 indicated that eveningness can be over-estimated when relying on only the single-item self-assessment. Conclusions The current polygenic score for morningness explains only a small proportion of the variation in diurnal preference or habitual sleep-wake schedule. The molecular genetic basis for morningness-eveningness needs further elucidation.

BackgroundObesity is a growing public health problem worldwide. Over the past few decades, the prevalence of obesity has increased significantly in Saudi Arabia, putting population health at an increased risk of mortality and morbidity. Because of the wide variation in previous local estimates, this study used electronic records of a population-based sample to estimate the prevalence of obesity and its association with diabetes and hypertension.MethodsThis study used records from five hospitals in the National Guard Health Affairs, which provides medical service to about a million beneficiaries. We included individuals aged 17 years or older who visited any outpatient clinic in the past four years (2016-2019). Body mass index (BMI) was measured before the doctor’s encounter. Patients were classified as diabetic or hypertensive if they had any visit during the four years, where the primary diagnosis was one of those conditions or if the patient was taking medications. The associations between obesity (BMI>30) and diabetes and hypertension were evaluated using a multiple logistic regression model adjusting for age, gender, nationality, and region.ResultsA total of 616,092 individuals were included. Of them, 55.0% were females, and the majority were Saudi nationals (93.1%). Approximately 68% of the population were either obese (38.9%) or overweight (29.30%). Obesity was more prevalent among Saudi nationals (39.8% vs. 26.7%, pConclusionsThe prevalence of obesity in the study population was high, and more pronounced among women. Our findings call for efforts to intensify preventive measures to reduce obesity and associated conditions. Using electronic records to examine the impact of interventions to reduce obesity and chronic conditions may help monitor and improve population health.

AIM: Factors associated with verified post-colonoscopy colorectal cancers (PCCRC) have not been well defined and survival for these patients is not well described. We aimed to assess the association of patient, tumour and endoscopist characteristics with PCCRC. METHODS: Using population-based data, we identified individuals diagnosed with CRC from 1 January 2000 to 31 December 2005 who underwent a colonoscopy within 3 years prior to diagnosis. Detected cancers were those diagnosed ≤6 months following colonoscopy; PCCRC were diagnosed >6 months to ≤3 years following colonoscopy. Post-colonoscopy and detected cancers were verified through chart review using a hospital-based simple random sampling frame. We used multivariable conditional logistic regression to determine the association of patient, tumour and endoscopist factors with PCCRC and compared overall survival using Cox proportional hazard models. RESULTS: Using the random sampling frame, we identified 498 patients with PCCRC and 498 with detected CRC; we obtained records and confirmed 367 patients with PCCRC and 412 with detected cancers. In multivariable analysis, patient age (OR 1.01; 95% CI 1.00-1.03) and tumour location (distal vs. proximal OR 0.36; 95% CI 0.25-0.53) were associated with PCCRC; endoscopist quality measures were not significantly associated with PCCRC. We did not find significant differences in overall survival between PCCRC and detected cancers (hazard ratio 1.12; 95% CI 0.92-1.32). CONCLUSION: Although endoscopic quality measures are important for CRC prevention, endoscopist factors were not associated with PCCRC. This study highlights the need for further research into the role of tumour biology in PCCRC development.

Background Informal caregiving refers to providing unpaid assistance to a relative or friend who has a disease or a disability. The assumption that providing informal care leads to deleterious health outcomes is widespread and commonly accepted. However, several comments have been made about the need to question this belief. Methods To put this assumption to test, the Belgian National Health Survey from 2013 was used. In this nationwide sample, the association between informal care and mental health was investigated through the GHQ-12 and the SCL (depression, anxiety, and sleep subscales). Three complementary comparison were performed: (1) between informal caregivers and non-caregivers; (2) between informal caregivers at home, outside of home, and non-caregivers; (3) between informal caregivers providing care for more than 20 hours a week, those providing between 1 and 20 hours a week, and non-caregivers. Statistically significant differences were controlled afterwards for gender, age, and perceived quality of social support. Results Overall, the results show that, with a population-based point of view, informal caregivers are not particularly at risk. Few comparisons were statically different, and when they were, the effect sizes remained low. Conclusions Far from settling this debate, these results rather suggest that the key point might lie elsewhere, as informal caregivers represents a diverse population in itself. Therefore, the focus should probably not be on the sole investigation of the differences between informal caregivers and the general population, but rather on how and why some caregivers differ from other caregivers and how such difference can represent a risk for them. Key messages Informal caregiving is often seen as a risk factor for mental health, but our results point to non-significant and little differences. By questioning this assumption, we call for a better understanding of what could be at risk in informal care.

In this cross-sectional study, the prevalences of tooth loss, prosthetic dental restorations, and probing pocket depths (PPDs) of ≥4 mm, and their relationship to sociodemographic factors, were investigated in older Swiss adults. There were up to 1,673 participants aged ≥55 yr in the fourth survey of the Swiss Cohort Study on Air Pollution And Lung And Heart Disease In Adults (SAPALDIA4). Missing teeth, prosthetic dental restorations, and PPDs ≥4 mm were recorded in clinical examinations conducted by field workers and compared with self-reported information from questionnaires. Examination data showed that participants were missing five teeth on average, 74.8% had a prosthetic dental restoration, and 21.1% had PPDs of ≥4 mm. The mean number of missing teeth and the prevalences of tooth loss, fixed dental prostheses, and removable dental prostheses were associated with age, education level, smoking status, and time since last visit to a dentist. Comparison of data obtained by field workers and that from self-reports show a high level of agreement for the number of missing teeth and the prevalence of removable dental prostheses, but a lower level of agreement for self-reports of fixed dental prostheses and periodontitis.

Analysis of associations between perceived daily life strain during the COVID-19-crisis and personality aspects with current psychological wellbeing in the general population and comparison of mental health indicators with those from a previous survey in 2018.Written survey in a random sample from the general population (n = 721) on Corona-related assessments, personality aspects and current mental health (WHO-5, PHQ-D).Fear for the health of close persons, strain regarding going out restrictions, increased substance use and psychological risk- and resilience factors were independently related to current mental health. Extent and frequencies of mental health symptomatology did not differ between 2018 and 2020.This is a first study in Germany reporting results from a population-based random sample on determinants of mental health during the COVID-19-crisis and a comparison of mental health symptomatology with prepandemic data from the same population.Zusammenhangsanalyse von wahrgenommenen Alltagsbelastungen während der COVID-19-Krise und Persönlichkeitsaspekten mit dem aktuellen psychischen Befinden in der Bevölkerung sowie Vergleich der psychischen Symptomatik mit einem Survey von 2018.Zufallsstichprobe aus der Bevölkerung (n = 721), die zu coronabezogenen Einschätzungen, Persönlichkeitsaspekten und aktuellem psychischen Befinden (WHO-5, PHQ-D) schriftlich befragt wurde.Angst um die Gesundheit Nahestehender, Belastungen durch Ausgangsbeschränkungen und vermehrter Substanzkonsum sowie psychische Risiko- und Resilienzfaktoren trugen im statistischen Modell unabhängig zur Vorhersage des psychischen Befindens bei. Ausprägungen und Häufigkeiten psychischer Symptomatik unterschieden sich nicht zwischen 2018 und 2020.Dies ist eine erste Studie in Deutschland, die Ergebnisse aus einer bevölkerungsbezogenen Zufallsstichprobe zu Determinanten psychischen Befindens während der COVID-19-Krise und einen Vergleich der psychischen Symptomatik mit einer präpandemischen Referenzstichprobe vorlegt.

Objective: Chronic daily pain is experienced by 11.2% of United States adults and psychosocial factors have significant impact on self-reported pain. Most research in this area has focused on pain-related conditions, not the general population. This study sought to understand the associations between clinically significant chronic pain and multiple dimensions of social relationship quality in a general population. Methods: A cross-sectional survey was deployed and adjusted logistic regression models were constructed for chronic pain against independent social support domains. The moderating effect of self-rated health on social support quality was explored. Results: Of all, 26.1% of surveys were completed (3920/15 000) and 18.8% reported clinically significant chronic pain. Patients with chronic pain had lower friendship quality (aOR = 0.78; 0.64-0.94) and higher perceived rejection (aOR = 1.26; 1.04-1.53) and perceived hostility (aOR = 1.26; 1.05-1.52). Within our moderation analysis, chronic pain patients with low self-rated health had higher odds of low friendship quality, high loneliness, and high perceived rejection. Conclusions: Chronic pain patients experience social relationships differently than those without, and self-rated health differentially impacts these perceptions.

Background : The term arterial stiffness (ArSt) describes structural changes in arterial wall related to the loss of elasticity and is known as an independent predictor of cardiovascular diseases (CVD). The evidence relating to ArSt and triglycerides (TG) shows contradictory results. This paper means to survey the association between high TG and ArSt, utilizing the cardio-ankle vascular index (CAVI). Methods : Subjects aged between 25 and 64 years from a random population-based sample were evaluated between 2013-2016. Data from questionnaires, blood pressure, anthropometric measures, and blood samples were collected and analyzed. CAVI was measured using VaSera VS-1500N devise. Subjects with a history of CVD or chronic renal disease were excluded. Results : 1934 participants, 44.7 % of males, were included. The median age was 48 (Interquartile Range [IQR] 19) years, TG levels were 1.05 (0.793) mmol/L, and CAVI 7.24 (1.43) points. Prevalence of high CAVI was 10.0 % (14.5 % in males and 6.4 % in females; P < 0.001) and prevalence of hypertriglyceridemia was 20.2 % (29.2 % in males and 13 % in females; P