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Consuming diets of low diversity may lead to micronutrient deficiencies and non-communicable diseases (NCDs). Dietary diversity (DD) has become a popular indicator to assess the quality of diets as well as nutrient adequacy of food intake among adults and children. With the high prevalence of malnutrition in the Northwest Region (NWR) of Cameroon, the objective of this study was to determine the DD of the diet and nutritional status of adults (18-65 years) and children (1-5 years) in four selected rural (Mankon and Mendakwe) and urban (Mankon and Nkwen) communities. Cross-sectional study design was used with multistage sampling technique to select the participants and study sites. The study sample consisted of a total of 1248 participants. Nutritional status of adults was determined using body mass index (BMI) and waist circumference (WC), while weight-for-age, weight-for-height, height-for-age and mid-upper arm circumference (MUAC) were used for children. Dietary diversity (DD) of adults and children was determined using individual DD questionnaire. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 25. A significant number of adults from Nkwen (urban) were either overweight (n=74; 47.4%) or obese (n=44; 28.2%) with 43.6% (n=68) from urban Mankon. A significant number of adults from rural Mankon were normal weight (49.4%; n=77), while 2.6% (n=4) from Mendakwe (rural) were underweight and 64.1% (n=100) were normal weight. Children in the rural areas were severely underweight (n=45; 14.4%), while children in the urban areas were either normal (n=158; 50.6%) or overweight (n=43; 13.8%). Mid-upper arm circumference (MUAC) values indicated that most children in both urban and rural areas were not acutely malnourished. The food groups that were consumed most across all age groups in all areas were grains, roots and tubers, fats and oils. The least consumed were fruit and vegetables, including vitamin A-rich plant foods as well as milk and milk products. There was a significant relationship between poor DD and weight-for-height (MAM) among 1-3 year old children in urban Nkwen (p=0.03) and urban Mankon (p=0.04). Although there was no significant association between DD, BMI and WC across all areas, most of the adults who had good DD were either of normal weight, overweight or obese. Overweight and obesity were more prevalent in the urban areas compared to the rural areas. There is a need to investigate the association between overall dietary intake and nutritional status and not specifically DD. Key words: Malnutrition, nutritional status, dietary diversity, association, obesity, rural, urban, Cameroon, INTRODUCTION Macro- and micro-nutrient deficiencies due to the consumption of diets high in refined starch, few meats or meat alternatives and few fruits and vegetables have been a public health [...]

Background: This study aimed to develop, validate and compare the performance of models predicting post-treatment outcomes for depressed adults based on pre-treatment data. Methods: Individual patient data from all six eligible randomised controlled trials were used to develop (k = 3, n = 1722) and test (k = 3, n = 918) nine models. Predictors included depressive and anxiety symptoms, social support, life events and alcohol use. Weighted sum scores were developed using coefficient weights derived from network centrality statistics (models 1–3) and factor loadings from a confirmatory factor analysis (model 4). Unweighted sum score models were tested using elastic net regularised (ENR) and ordinary least squares (OLS) regression (models 5 and 6). Individual items were then included in ENR and OLS (models 7 and 8). All models were compared to one another and to a null model (mean post-baseline Beck Depression Inventory Second Edition (BDI-II) score in the training data: model 9). Primary outcome: BDI-II scores at 3–4 months. Results: Models 1–7 all outperformed the null model and model 8. Model performance was very similar across models 1–6, meaning that differential weights applied to the baseline sum scores had little impact. Conclusions: Any of the modelling techniques (models 1–7) could be used to inform prognostic predictions for depressed adults with differences in the proportions of patients reaching remission based on the predicted severity of depressive symptoms post-treatment. However, the majority of variance in prognosis remained unexplained. It may be necessary to include a broader range of biopsychosocial variables to better adjudicate between competing models, and to derive models with greater clinical utility for treatment-seeking adults with depression. [ABSTRACT FROM AUTHOR]

Background: Self-administered questionnaires, such as the Patient Health Questionnaire (PHQ-9), are regularly used in clinical practice to guide prescribing or to measure recovery and response to treatment. There are concerns that patients are not all interpreting the questionnaire items in the same way. Cognitive interviewing is a research technique that identifies 'interpretative measurement error' (IME). IME is distinct from traditional components of measurement error, such as not reading the question as worded, or recording answers inaccurately.Aim: To use cognitive interviewing techniques to explore patterns in answer mapping and comprehension of the PHQ-9 questionnaire to ascertain whether the measure captures meaningful symptoms of low mood.Design and Setting: Qualitative study using cognitive interviewing techniques and card sorting in six GP practices in Bristol.Method: The study recruited 18 participants at the point of entry to a longitudinal primary care depression cohort study, PANDA (the indications for Prescribing ANtiDepressants that will leAd to a clinical benefit). Participants were interviewed 2, 4, and 6 weeks after their baseline visit. Cognitive interviews were digitally recorded. Analysis used the digital audio file, rather than verbatim transcripts, as it retained important features needed for analyses.Results: Cognitive interviewing revealed that items on the PHQ-9 are interpreted in a range of ways, that patients often cannot 'fit' their experience into the response options, and therefore often feel the questionnaire is misrepresenting their experience of meaningful symptoms of low mood.Conclusion: The PHQ-9 may be missing the presence and/or intensity of certain symptoms that are meaningful to patients. Clinicians should adopt caution when using it. [ABSTRACT FROM AUTHOR]