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Ethnic minority groups in Western countries face an increased risk of psychotic disorders. Causes of this long-standing public health inequality remain poorly understood. We investigated whether social disadvantage, linguistic distance and discrimination contributed to these patterns.
We used case–control data from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study, carried out in 16 centres in six countries. We recruited 1130 cases and 1497 population-based controls. Our main outcome measure was first-episode ICD-10 psychotic disorder (F20–F33), and exposures were ethnicity (white majority, black, mixed, Asian, North-African, white minority and other), generational status, social disadvantage, linguistic distance and discrimination. Age, sex, paternal age, cannabis use, childhood trauma and parental history of psychosis were included as a priori confounders. Exposures and confounders were added sequentially to multivariable logistic models, following multiple imputation for missing data.
Participants from any ethnic minority background had crude excess odds of psychosis [odds ratio (OR) 2.03, 95% confidence interval (CI) 1.69–2.43], which remained after adjustment for confounders (OR 1.61, 95% CI 1.31–1.98). This was progressively attenuated following further adjustment for social disadvantage (OR 1.52, 95% CI 1.22–1.89) and linguistic distance (OR 1.22, 95% CI 0.95–1.57), a pattern mirrored in several specific ethnic groups. Linguistic distance and social disadvantage had stronger effects for first- and later-generation groups, respectively.
Social disadvantage and linguistic distance, two potential markers of sociocultural exclusion, were associated with increased odds of psychotic disorder, and adjusting for these led to equivocal risk between several ethnic minority groups and the white majority.
While scholarship has investigated how to provide more healthy food options in choice pantry environments, research has just begun to investigate how pantry users go about making decisions regarding food items when the ability to choose is present. The present analysis sought to investigate the factors prohibiting and inhibiting food decision making in choice pantries from the perspective of frequent pantry users.
Six focus group interviews were conducted with visitors to choice food pantries, to discuss the decision-making process involved in food selection during choice pantry visits. Each was provided a $US 15 remuneration for taking part.
A school-based choice food pantry in Anderson, Indiana, USA, a small Midwestern community.
Thirty-one men and women, largely aged 45–64 years, who made use of choice food pantries at least once monthly to meet their family’s food needs.
Choice pantry visitors indicated that the motivation to select healthy food items was impacted by both individual and situational influences, similar to retail environments. Just as moment-of-purchase and place-of-purchase factors influence the purchasing of food items in retail environments, situational factors, such as food availability and the ‘price’ of food items in point values, impacted healthy food selection at choice pantries. However, the stigmatization experienced by those who visit pantries differs quite dramatically from the standard shopping experience.
Choice pantries would benefit from learning more about the psychosocial factors in their own pantries and adapting the environment to the desires of their users, rather than adopting widely disseminated strategies that encourage healthy food choices with little consideration of their unique clientele.
OBJECTIVES/SPECIFIC AIMS: To translate a behavioral theory–informed, evidence-based, face-to-face health education program into an mHealth lifestyle intervention for African-Americans (AAs). METHODS/STUDY POPULATION: This mixed methods study consisted of 4 phases, using an iterative development process to intervention design with the AA community. In Phase 1, we held focus groups with AA community members and church partners (n=23) to gain insight regarding the needs and preferences of potential app end users. In Phase 2, the interdisciplinary research team synthesized input from Phase 1 for preliminary app design and content development. Phase 3 consisted of a sequential 3-meeting series with the church partners (n=13) for iterative app prototyping (assessment, cultural tailoring, final review). Phase 4 was a single group pilot study among AA church congregants (n=50) to assess app acceptability, usability, and satisfaction. RESULTS/ANTICIPATED RESULTS: Phase 1 focus groups indicated preferences for general and health related apps: multifunctional; high-quality graphics/visuals; evidence-based, yet simple health information; and social networking capability. Phase 2 integrated these preferences into the preliminary app prototype. Feedback from Phase 3 was used to refine the FAITH! App prototype for pilot testing. Phase 4 pilot testing indicated high acceptability, usability, and satisfaction of the FAITH! App. DISCUSSION/SIGNIFICANCE OF IMPACT: This study illustrates the process of using formative and CBPR approaches to design a culturally relevant, mHealth lifestyle intervention to address CV health disparities within the AA community. Given the positive perceptions of the app, our study supports the use of an iterative development process by others interested in implementing an mHealth lifestyle intervention for racial/ethnic minority communities.
Building on the recent advances in next-generation sequencing, the integration of genomics, proteomics, metabolomics, and other approaches hold tremendous promise for precision medicine. The approval and adoption of these rapidly advancing technologies and methods presents several regulatory science considerations that need to be addressed. To better understand and address these regulatory science issues, a Clinical and Translational Science Award Working Group convened the Regulatory Science to Advance Precision Medicine Forum. The Forum identified an initial set of regulatory science gaps. The final set of key findings and recommendations provided here address issues related to the lack of standardization of complex tests, preclinical issues, establishing clinical validity and utility, pharmacogenomics considerations, and knowledge gaps.
Current policy emphasises the importance of ‘living well’ with dementia, but there has been no comprehensive synthesis of the factors related to quality of life (QoL), subjective well-being or life satisfaction in people with dementia. We examined the available evidence in a systematic review and meta-analysis. We searched electronic databases until 7 January 2016 for observational studies investigating factors associated with QoL, well-being and life satisfaction in people with dementia. Articles had to provide quantitative data and include ⩾75% people with dementia of any type or severity. We included 198 QoL studies taken from 272 articles in the meta-analysis. The analysis focused on 43 factors with sufficient data, relating to 37639 people with dementia. Generally, these factors were significantly associated with QoL, but effect sizes were often small (0.1–0.29) or negligible (<0.09). Factors reflecting relationships, social engagement and functional ability were associated with better QoL. Factors indicative of poorer physical and mental health (including depression and other neuropsychiatric symptoms) and poorer carer well-being were associated with poorer QoL. Longitudinal evidence about predictors of QoL was limited. There was a considerable between-study heterogeneity. The pattern of numerous predominantly small associations with QoL suggests a need to reconsider approaches to understanding and assessing living well with dementia.
Schizophrenia is associated with impaired neurodevelopment as indexed by lower premorbid IQ. We examined associations between erythrocyte sedimentation rate (ESR), a marker of low-grade systemic inflammation, IQ, and subsequent schizophrenia and other non-affective psychoses (ONAP) to elucidate the role of neurodevelopment and inflammation in the pathogenesis of psychosis.
Population-based data on ESR and IQ from 638 213 Swedish men assessed during military conscription between 1969 and 1983 were linked to National Hospital Discharge Register for hospitalisation with schizophrenia and ONAP. The associations of ESR with IQ (cross-sectional) and psychoses (longitudinal) were investigated using linear and Cox-regression. The co-relative analysis was used to examine effects of shared familial confounding. We examined mediation and moderation of effect between ESR and IQ on psychosis risk.
Baseline IQ was associated with subsequent risk of schizophrenia (adjusted HR per 1-point increase in IQ = 0.961; 95% confidence interval (CI) 0.960–0.963) and ONAP (adjusted HR = 0.973; 95% CI 0.971–0.975). Higher ESR was associated with lower IQ in a dose-response fashion. High ESR was associated with increased risk for schizophrenia (adjusted HR = 1.14; 95% CI 1.01–1.28) and decreased risk for ONAP (adjusted HR = 0.85; 95% CI 0.74–0.96), although these effects were specific to one ESR band (7–10 mm/hr). Familial confounding explained ESR-IQ but not ESR-psychoses associations. IQ partly mediated the ESR-psychosis relationships.
Lower IQ is associated with low-grade systemic inflammation and with an increased risk of schizophrenia and ONAP in adulthood. Low-grade inflammation may influence schizophrenia risk by affecting neurodevelopment. Future studies should explore the differential effects of inflammation on different types of psychosis.
The Taipan galaxy survey (hereafter simply ‘Taipan’) is a multi-object spectroscopic survey starting in 2017 that will cover 2π steradians over the southern sky (δ ≲ 10°, |b| ≳ 10°), and obtain optical spectra for about two million galaxies out to z < 0.4. Taipan will use the newly refurbished 1.2-m UK Schmidt Telescope at Siding Spring Observatory with the new TAIPAN instrument, which includes an innovative ‘Starbugs’ positioning system capable of rapidly and simultaneously deploying up to 150 spectroscopic fibres (and up to 300 with a proposed upgrade) over the 6° diameter focal plane, and a purpose-built spectrograph operating in the range from 370 to 870 nm with resolving power R ≳ 2000. The main scientific goals of Taipan are (i) to measure the distance scale of the Universe (primarily governed by the local expansion rate, H0) to 1% precision, and the growth rate of structure to 5%; (ii) to make the most extensive map yet constructed of the total mass distribution and motions in the local Universe, using peculiar velocities based on improved Fundamental Plane distances, which will enable sensitive tests of gravitational physics; and (iii) to deliver a legacy sample of low-redshift galaxies as a unique laboratory for studying galaxy evolution as a function of dark matter halo and stellar mass and environment. The final survey, which will be completed within 5 yrs, will consist of a complete magnitude-limited sample (i ⩽ 17) of about 1.2 × 106 galaxies supplemented by an extension to higher redshifts and fainter magnitudes (i ⩽ 18.1) of a luminous red galaxy sample of about 0.8 × 106 galaxies. Observations and data processing will be carried out remotely and in a fully automated way, using a purpose-built automated ‘virtual observer’ software and an automated data reduction pipeline. The Taipan survey is deliberately designed to maximise its legacy value by complementing and enhancing current and planned surveys of the southern sky at wavelengths from the optical to the radio; it will become the primary redshift and optical spectroscopic reference catalogue for the local extragalactic Universe in the southern sky for the coming decade.
This paper reports on the findings from a qualitative study exploring the experiences of teenage mothers using a nurse-led, home-based contraceptive service designed to prevent repeat unplanned pregnancies. The aim was to understand if, and how the service was effective in equipping teenage mothers to make informed choices about contraception, thus preventing a second pregnancy.
Unplanned teenage pregnancy remains a significant focus of health and social policy in the United Kingdom (UK). Despite the long-term pattern of declining conception rates, the UK continues to report higher rates than comparable countries elsewhere in Europe. Current estimates suggest that approximately one fifth of births amongst under 18’s are repeat pregnancies (Teenage Pregnancy Independent Advisory Group, 2009). Services that are designed to reduce second unplanned pregnancies are an important element in promoting teenage sexual health. However, there has been no UK research that explores this kind of service and the experiences of service users.
We conducted a qualitative interview study. From 2013–2014 we interviewed 40 teenage mothers who had engaged with the nurse-led, home-based contraceptive service.
The data demonstrates that the service was effective in preventing repeat pregnancies in a number of cases. Among the aspects of the service which were found to contribute to its effectiveness were privacy, convenience, flexibility, appropriately timed access, the non-judgemental attitude of staff and ongoing support.
While recent years have seen rapid growth in the number of galaxy peculiar velocity measurements, disagreements remain about the extent to which the peculiar velocity field - a tracer of the large-scale distribution of mass - agrees with both ΛCDM expectations and with velocity field models derived from redshift surveys. The 6dF Galaxy Survey includes peculiar velocities for nearly 9 000 early-type galaxies (6dFGSv), making it the largest and most homogeneous galaxy peculiar velocity sample to date. We have used the 6dFGS velocity field to determine the amplitude and scale of large-scale cosmic flows in the local universe and test standard cosmological models. We also compare the galaxy density and peculiar velocity fields to establish the distribution of dark and luminous matter and better constrain key cosmological parameters such as the redshift-space distortion parameter.
Astrometric CCD observations have been made of wide (∼3 to 60 arcsec) southern double stars selected from the Washington Double Star catalogue (WDS). Southern double stars have not been well studied in the past; typically they had not been measured since about 1930, and ∼50% of them have been observed only once before our observations. Of the pairs measured ∼80% show no evidence of motion since the last observation. This is Paper II in which we present the observations of 290 WDS stars in the approximate RA range 17h 13m to 07h 30m and in the declination range −70° to −60°. We suggest 412 companions for these 290 stars and list 29 (10%) pairs that have shown significant motion.
We develop a robust Bayesian model to derive peculiar velocities and Fundamental Plane (FP) distances for a subsample of 9000 galaxies from the 6dF Galaxy Survey (6dFGS). These galaxies form the basis of 6dFGSv, the largest and most uniform galaxy peculiar-velocity sample to date. We perform a Bayesian analysis of the data set as a whole, determining cosmological parameters from the peculiar-velocity field (e.g., fitting β and the bulk flow), by comparing to the field predicted from the redshift survey and assuming that the galaxy distribution traces the matter distribution.
The 6dF Galaxy Survey (6dFGS) is an all-southern-sky galaxy survey, including 125,000 redshifts and a Fundamental Plane (FP) subsample of 10,000 peculiar velocities. This makes 6dFGS the largest peculiar-velocity sample to date. We have fitted the FP with a tri-variate Gaussian model using a maximum-likelihood approach, and derive the Bayesian probability distribution of the peculiar velocity for each of the 10,000 galaxies. We fit models of the velocity field, including comparisons to the field predicted from the redshift-survey density field, to derive the values of the redshift-space distortion parameter β, the bulk flow and the residual bulk flow in excess of that predicted from the density field. We compare these results to those derived by other authors and discuss the cosmological implications.
We have measured Fundamental Plane (FP) parameters in the 2MASS J, H and K passbands for 10,000 ellipticals, lenticulars and early-type spiral bulges in the 6dF Galaxy Survey (6dFGS) – a spectroscopic survey of the southern sky with |b| > 10° (Jones et al. 2009). 6dFGS provides a large near-infrared-selected sample of galaxies for accurately determining the NIR FP and investigating the trends in the FP with stellar population, morphology and environment.
This article is concerned with business strategies of political risk management during the twentieth century. It focuses especially on Beiersdorf, a pharmaceutical and skin care company in Germany. During World War I, the expropriation of its brands and trademarks revealed its vulnerability to political risk. Following the advent of the Nazi regime in 1933, the largely Jewish owned and managed company faced a uniquely challenging combination of home and host country political risk. This article reviews the company's responses to these adverse circumstances, challenging the prevailing literature that interprets so-called “cloaking” activities as one element of businesses' cooperation with the Nazis. We also depart from the previous literature in assessing the outcomes of the company's strategies after 1945 and examine the challenges and costs faced by the company in recovering the ownership of its brands. While the management of distance became much easier over the course of the twentieth century because of communications improvements, this article shows that the management of governments and political risk grew sharply.