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Psychiatric disorders are associated with increased risk of ischaemic heart disease (IHD) and stroke, but it is not known whether the associations or the role of sociodemographic factors have changed over time.
To investigate the association between psychiatric disorders and IHD and stroke, by time period and sociodemographic factors.
We used Scottish population-based records from 1991 to 2015 to create retrospective cohorts with a hospital record for psychiatric disorders of interest (schizophrenia, bipolar disorder or depression) or no record of hospital admission for mental illness. We estimated incidence and relative risks of IHD and stroke in people with versus without psychiatric disorders by calendar year, age, gender and area-based deprivation level.
In all cohorts, incidence of IHD (645 393 events) and stroke (276 073 events) decreased over time, but relative risks decreased for depression only. In 2015, at the mean age at event onset, relative risks were 2- to 2.5-fold higher in people with versus without a psychiatric disorder. Age at incidence of outcome differed by cohort, gender and socioeconomic status. Relative but not absolute risks were generally higher in women than men. Increasing deprivation conveys a greater absolute risk of IHD for people with bipolar disorder or depression.
Despite declines in absolute rates of IHD and stroke, relative risks remain high in those with versus without psychiatric disorders. Cardiovascular disease monitoring and prevention approaches may need to be tailored by psychiatric disorder and cardiovascular outcome, and be targeted, for example, by age and deprivation level.
BACTOT, Quebec’s healthcare-associated bloodstream infection (HABSI) surveillance program has been operating since 2007. In this study, we evaluated the changes in HABSI rates across 10 years of BACTOT surveillance under a Bayesian framework.
A retrospective, cohort study of eligible hospitals having participated in BACTOT for at least 3 years, regardless of their entry date. Multilevel Poisson regressions were fitted independently for cases of HABSI, catheter-associated bloodstream infections (CA-BSIs), non–catheter-associated primary BSIs (NCA-BSIs), and BSIs secondary to urinary tract infections (BSI-UTIs) as the outcome and log of patient days as the offset. The log of the mean Poisson rate was decomposed as the sum of a surveillance year effect, period effect, and hospital effect. The main estimate of interest was the cohort-level rate in years 2–10 of surveillance relative to year 1.
Overall, 17,479 cases and 33,029,870 patient days were recorded for the cohort of 77 hospitals. The pooled 10-year HABSI rate was 5.20 per 10,000 patient days (95% CI, 5.12–5.28). For HABSI, CA-BSI, and BSI-UTI, there was no difference between the estimated posterior rates of years 2–10 compared to year 1. The posterior means of the NCA-BSI rate ratios increased from the seventh year until the tenth year, when the rate was 29% (95% confidence interval, 1%–89%) higher than the first year rate.
HABSI rates and those of the most frequent subtypes remained stable over the surveillance period. To achieve reductions in incidence, we recommend that more effort be expended in active interventions against HABSI alongside surveillance.
In this article, we outline the key principles of education for sustainability (EfS) that enable us to question the enthusiastic and uncritical promotion of STEM (science, mathematics, engineering and technology) and its offshoot, STEM education, as key contributors to an environmentally sustainable future. We examine the framing of STEM and STEM education as situated in an unproblematised, neoliberal growthist paradigm, in contrast to the more critical ecological paradigm of EfS. We conclude that STEM, and hence STEM education, need to include critical reflection and futures perspectives if they are to align themselves with a flourishing economic, social and environmental future. We provide examples for the classroom that illustrate our contention.
Healthcare-associated bloodstream infections (HABSI) are a significant cause of morbidity and mortality worldwide. In Québec, Canada, HABSI arising from acute-care hospitals have been monitored since April 2007 through the Surveillance des bactériémies nosocomiales panhospitalières (BACTOT) program, but this is the first detailed description of HABSI epidemiology.
This retrospective, descriptive study was conducted using BACTOT surveillance data from hospitals that participated continuously between April 1, 2007, and March 31, 2017. HABSI cases and rates were stratified by hospital type and/or infection source. Temporal trends of rates were analyzed by fitting generalized estimating equation Poisson models, and they were stratified by infection source.
For 40 hospitals, 13,024 HABSI cases and 23,313,959 patient days were recorded, for an overall rate of 5.59 per 10,000 patient days (95% CI, 5.54–5.63). The most common infection sources were catheter-associated BSIs (23.0%), BSIs secondary to a urinary focus (21.5%), and non–catheter-associated primary BSIs (18.1%). Teaching hospitals and nonteaching hospitals with ICUs often had rates higher than nonteaching hospitals without ICUs. Annual HABSI rates did not exhibit statistically significant changes from year to year. Non–catheter-associated primary BSIs were the only HABSI type that exhibited a sustained change across the 10 years, increasing from 0.69 per 10,000 patient days (95% CI, 0.59–0.80) in 2007–2008 to 1.42 per 10,000 patient days (95% CI, 1.27–1.58) in 2016–2017.
Despite ongoing surveillance, overall HABSI rates have not decreased. The effect of BACTOT participation should be more closely investigated, and targeted interventions along alternative surveillance modalities should be considered, prioritizing high-burden and potentially preventable BSI types.
There is a broad set of human beliefs, attitudes and behaviours around the issue of magical animals, referring to both mythical animals not recognized by science and extant animals that are recognized by science but have magical properties. This is a broad issue ranging from spiritual beliefs around mythical animals living in Malagasy forests, to cultural heritage associated with the Loch Ness Monster in Scotland. Beliefs and behaviours around magical animals can have positive and negative impacts on biodiversity conservation goals. Yet, so far, the discipline of conservation biology has not adequately considered magical animals, neglecting to account for the broader knowledge from outside the natural sciences on this issue, and taking a narrow, utilitarian approach to how magical animals should be managed, without necessarily considering the broader impacts on conservation goals or ethics. Here we explore how magical animals can influence conservation goals, how conservation biology and practice has thought about magical animals, and some of the limitations of current approaches, particularly the failure to consider magical animals as part of wider systems of belief and culture. We argue that magical animals and their implications for conservation merit wider consideration.
Early-onset conduct problems (CP) are a key predictor of adult criminality and poor mental health. While previous studies suggest that both genetic and environmental risks play an important role in the development of early-onset CP, little is known about potential biological processes underlying these associations. In this study, we examined prospective associations between DNA methylation (cord blood at birth) and trajectories of CP (4–13 years), using data drawn from the Avon Longitudinal Study of Parents and Children. Methylomic variation at seven loci across the genome (false discovery rate < 0.05) differentiated children who go on to develop early-onset (n = 174) versus low (n = 86) CP, including sites in the vicinity of the monoglyceride lipase (MGLL) gene (involved in endocannabinoid signaling and pain perception). Subthreshold associations in the vicinity of three candidate genes for CP (monoamine oxidase A [MAOA], brain-derived neurotrophic factor [BDNF], and FK506 binding protein 5 [FKBP5]) were also identified. Within the early-onset CP group, methylation levels of the identified sites did not distinguish children who will go on to persist versus desist in CP behavior over time. Overall, we found that several of the identified sites correlated with prenatal exposures, and none were linked to known genetic methylation quantitative trait loci. Findings contribute to a better understanding of epigenetic patterns associated with early-onset CP.
Validation-study data were analysed to investigate retention interval (RI) and prompt effects on the accuracy of fourth-grade children’s reports of school-breakfast and school-lunch (in 24-h recalls), and the accuracy of school-breakfast reports by breakfast location (classroom; cafeteria). Randomly selected fourth-grade children at ten schools in four districts were observed eating school-provided breakfast and lunch, and were interviewed under one of eight conditions created by crossing two RIs (‘short’ – prior-24-hour recall obtained in the afternoon and ‘long’ – previous-day recall obtained in the morning) with four prompts (‘forward’ – distant to recent, ‘meal name’ – breakfast, etc., ‘open’ – no instructions, and ‘reverse’ – recent to distant). Each condition had sixty children (half were girls). Of 480 children, 355 and 409 reported meals satisfying criteria for reports of school-breakfast and school-lunch, respectively. For breakfast and lunch separately, a conventional measure – report rate – and reporting-error-sensitive measures – correspondence rate and inflation ratio – were calculated for energy per meal-reporting child. Correspondence rate and inflation ratio – but not report rate – showed better accuracy for school-breakfast and school-lunch reports with the short RI than with the long RI; this pattern was not found for some prompts for each sex. Correspondence rate and inflation ratio showed better school-breakfast report accuracy for the classroom than for cafeteria location for each prompt, but report rate showed the opposite. For each RI, correspondence rate and inflation ratio showed better accuracy for lunch than for breakfast, but report rate showed the opposite. When choosing RI and prompts for recalls, researchers and practitioners should select a short RI to maximise accuracy. Recommendations for prompt selections are less clear. As report rates distort validation-study accuracy conclusions, reporting-error-sensitive measures are recommended.
Non-invasive survey in the Stonehenge ‘Triangle’, Amesbury, Wiltshire, has highlighted a number of features that have a significant bearing on the interpretation of the site. Geophysical anomalies may signal the position of buried stones adding to the possibility of former stone arrangements, while laser scanning has provided detail on the manner in which the stones have been dressed; some subsequently carved with axe and dagger symbols. The probability that a lintelled bluestone trilithon formed an entrance in the north-east is signposted. This work has added detail that allows discussion on the question of whether the sarsen circle was a completed structure, although it is by no means conclusive in this respect. Instead, it is suggested that it was built as a façade, with other parts of the circuit added and with an entrance in the south.
Integrated non-invasive survey in the Stonehenge ‘triangle’, Amesbury, Wiltshire, has highlighted a number of features that have a significant bearing on the interpretation of the site. Among them are periglacial and natural topographical structures, including a chalk mound that may have influenced site development. Some geophysical anomalies are similar to the post-holes in the car park of known Mesolithic date, while others beneath the barrows to the west may point to activity contemporary with Stonehenge itself. Evidence that the ‘North Barrow’ may be earlier in the accepted sequence is presented and the difference between the eastern and western parts of the enclosure ditch highlighted, while new data relating to the Y and Z Holes and to the presence of internal banks that mirror their respective circuits is also outlined.
SCFA resulting from the microbial fermentation of carbohydrates have been linked to increased glucagon-like peptide-1 (GLP-1) secretion from the gastrointestinal tract in cell and animal models; however, there is little direct evidence in human subjects to confirm this. The present study was designed to investigate whether endogenous plasma GLP-1 concentrations increase following acute consumption of 48 g dietary fibre (as resistant starch (RS) from high-amylose maize type 2 RS (HAM-RS2)) compared with a matched placebo. A total of thirty healthy males participated in the present randomised cross-over study where HAM-RS2 or placebo was consumed as part of standardised breakfast and lunch meals. Changes to GLP-1, glucose, insulin and C-peptide were assessed half hourly for 7 h. Following the breakfast meal, plasma GLP-1 concentrations were lower with HAM-RS2 compared with the placebo (P =0·025). However, there was no significant difference between the supplements following the lunch meal. Plasma insulin concentrations were significantly lower following the lunch meal (P =0·034) with HAM-RS2 than with the placebo, but were not different after breakfast. Plasma glucose and C-peptide concentrations did not differ at any point. These results suggest that increased dietary fibre intake, in the form of HAM-RS2, does not acutely increase endogenous GLP-1 concentrations in human subjects. Further fibre feeding studies are required to determine whether GLP-1 concentrations may increase following longer-term consumption.