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The Developmental Origins of Health and Disease (DOHaD), also termed developmental programming, refers to adaptations during development that predispose an individual or a population towards later life noncommunicable disease (NCD) conditions or chronic diseases. The developmental trajectory of an individual is determined broadly by the interaction between that individual’s genes and the environment. “Environment” in this sense may include maternal or paternal factors, influences such as nutritional status before or during pregnancy, stress and exposure to contaminants, drugs or alcohol; and maternal diseases of pregnancy that influence transport of substrates and nutrients across the placenta (e.g., preeclampsia, placental insufficiency); and pre-term birth; factors that occur before or around the time of conception, during gestation or in the period after birth; the so-called First 1,000 Days. The interactions between genes and environment determine not only the developmental processes of the fetus and placenta leading to short term morbidity (low birth weight) and mortality, but also long term morbidity of multiple systems including neurodevelopmental disorders such as learning difficulties, poor developmental trajectories and cognitive development, mental health and behavioral disorders in children, and metabolic disorders such as obesity and diabetes. In later life, developmental programming contributes to heart disease such as hypertension and coronary heart disease, type II diabetes, obesity, immune, behavioral, and neurological disorders.
The mechanisms underlying developmental programming can result from structural changes in tissues or organs, effects on germ cells or stem cells, alterations in the microbiome, or in core inflammatory and immunological processes. There are clear sex differences in these responses, strong intergenerational effects, and variable vulnerability across the life course. Many adjustments occur as adaptive fetal responses to adversity or stress, such as hypoxemia or inappropriate nutrient supply, to ensure survival. The placenta plays a critical role in developmental programming, both in regulating the impact of maternal influences on the fetus, and through its direct impact on fetal development.
Co-occurring psychiatric disorders are common in autism, with previous studies suggesting 54–94% of autistic individuals develop a mental health condition in their lifetime. Most studies have looked at clinically-recruited cohorts, or paediatric cohorts followed into adulthood, with less known about the autistic community at a population level. We therefore studied the prevalence of co-occurring psychiatric and neurological conditions in autistic individuals in a national sample.
This retrospective case-control study utilised the SAIL Databank to examine anonymised whole population electronic health record data from 2001 to 2016 in Wales, UK (N = 3.6 million). We investigated the prevalence of co-occurring psychiatric and selected neurological diagnoses in autistic adults' records during the study period using International Classification of Diseases-10 and Read v2 clinical codes compared to general population controls matched for age, sex and deprivation
All psychiatric conditions examined were more common amongst adults with autism after adjusting for age, sex and deprivation. Prevalence of attention-deficit hyperactivity disorder (7.00%), bipolar disorder (2.50%), obsessive-compulsive disorder (3.02%), psychosis (18.30%) and schizophrenia (5.20%) were markedly elevated in those with autism, with corresponding odds ratios 8.24–10.74 times the general population. Depression (25.90%) and anxiety (22.40%) were also more prevalent, with epilepsy 9.21 times more common in autism.
We found that a range of psychiatric conditions were more frequently recorded in autistic individuals. We add to understanding of under-reporting and diagnostic overshadowing in autism. With increasing awareness of autism, services should be cognisant of the psychiatric conditions that frequently co-occur in this population.
Debris-covered glaciers are an important component of the mountain cryosphere and influence the hydrological contribution of glacierized basins to downstream rivers. This study examines the potential to make estimates of debris thickness, a critical variable to calculate the sub-debris melt, using ground-based thermal infrared radiometry (TIR) images. Over four days in August 2019, a ground-based, time-lapse TIR digital imaging radiometer recorded sequential thermal imagery of a debris-covered region of Peyto Glacier, Canadian Rockies, in conjunction with 44 manual excavations of debris thickness ranging from 10 to 110 cm, and concurrent meteorological observations. Inferring the correlation between measured debris thickness and TIR surface temperature as a base, the effectiveness of linear and exponential regression models for debris thickness estimation from surface temperature was explored. Optimal model performance (R2 of 0.7, RMSE of 10.3 cm) was obtained with a linear model applied to measurements taken on clear nights just before sunrise, but strong model performances were also obtained under complete cloud cover during daytime or nighttime with an exponential model. This work presents insights into the use of surface temperature and TIR observations to estimate debris thickness and gain knowledge of the state of debris-covered glacial ice and its potential hydrological contribution.
Evidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.
To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.
A comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool.
Fifty-one studies were included: 57% (29/51) were rated as ‘low’ quality, 31% (16/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six rated as high-moderate quality, which reported reductions of 17–56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls.
Sustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups.
To determine the association between after-hours consultations and the likelihood of antibiotic prescribing for self-limiting upper respiratory tract infections (URTIs) in primary care practices.
A cross-sectional analysis using Australian national primary-care practice data (MedicineInsight) between February 1, 2016 and January 31, 2019.
Nationwide primary-care practices across Australia.
Adult and pediatric patients who visited primary care practices for first-time URTIs.
We estimated the proportion of first-time URTI episodes for which antibiotic prescribing occurred on the same day (immediate prescribing) using diagnoses and prescription records in the electronic primary-care database. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the likelihood of antibiotic prescribing by the time of primary care visits were calculated using generalized estimating equations.
Among 357,287 URTI episodes, antibiotics were prescribed in 172,605 episodes (48.3%). After adjusting for patients’ demographics, practice characteristics, and seasons, we detected a higher likelihood of antibiotic prescribing on weekends compared to weekdays (OR, 1.42; 95% CI, 1.39–1.45) and on national public holidays compared to nonholidays (OR, 1.23; 95% CI, 1.17–1.29). When we controlled for patient presentation and diagnosis, the association between antibiotic prescribing and after-hours consultations remained significant: weekend versus weekdays (OR, 1.37; 95% CI, 1.33–1.41) and holidays versus nonholidays (OR, 1.10; 95% CI, 1.03–1.18).
Primary-care consultations on weekends and public holidays were associated with a higher likelihood of immediate antibiotic prescribing for self-limiting URTIs in primary care. This finding might be attributed to lower resourcing in after-hours health care.
Dithiopyr and dinitroanilines are preemergence-applied, mitotic-inhibiting herbicides used to control goosegrass [Eleusine indica (L.) Gaertn.] in turfgrass. A suspected resistant E. indica population was collected from a golf course putting green and was evaluated for possible resistance to dithiopyr and prodiamine. After dose–response evaluation, the α-tubulin gene was sequenced for known target-site mutations that have been reported to confer resistance to mitotic-inhibiting herbicides. A mutation was discovered that resulted in an amino acid substitution at position 136 from leucine to phenylalanine (Leu-136-Phe). Previous research has indicated that Leu-136-Phe does confer resistance to dinitroaniline herbicides. The level of resistance indicated by regression models and I50 values indicates that there is 54.1-, 4.7-, >100-, and >100-fold resistance to dithiopyr, prodiamine, pendimethalin, and oryzalin, respectively, when compared with the susceptible population based on seedling emergence response and 88.4-, 7.8-, >100-, and >100-fold resistance to dithiopyr, prodiamine, pendimethalin, and oryzalin, respectively, when compared with the susceptible population based on biomass reduction response. This is the first report of less resistance to prodiamine compared with pendimethalin or oryzalin due to a target-site α-tubulin mutation and the first report of a target-site α-tubulin mutation associated with dithiopyr resistance.
The rise in social inequality and the emergence of the new nationalism place us in a new world. The postwar system of social cohesion is gone; the potential for new disruptions to capitalism has grown. So we write this chapter with a good deal of fear and trembling for two reasons. First, the capacities of many advanced capitalist states to effectively manage their economies continue to diminish.
Adam Smith died in 1790, just before the French Revolutionary and Napoleonic wars. The long peace of the nineteenth century that followed rested on an implicit geopolitical deal. For decades after the Congress of Vienna of 1815 had established a framework for peace, no one wanted to challenge Britain, in part because they were exhausted from war but also because doing so might upset the balance of power in Europe and strengthen one’s rivals. Furthermore, the world’s leading economies subscribed to the gold standard – fixing their currencies to the price of gold – thereby ensuring a stable international payments system that steadied capitalism. The hope was that trade would now replace military conquest, and that peace and prosperity would be assured. The first half of the twentieth century crushed that hope. It was a time of war and economic catastrophe.
As sociologists, we view capitalism and its optimal needs differently from conventional economists. Ironically, however, our own perspective draws on the work of well-known early economists – sociologically astute, but often misunderstood or neglected in economics today. Those earlier economists provide us with most of the important building blocks for our argument. They also remind us that the foundations of economics are fundamentally different from the widespread contemporary belief that markets work best when political and social forces do not interfere with them. The historical perspective suggests that this contemporary view is wrong and that putting it into practice has caused serious economic damage.
Let us recall three events that challenged the political status quo in the early part of this century. The first took place in 2000, when Danes were asked in a national referendum whether they wished to join the European Monetary Union, abandoning Denmark’s national currency, the krone, for the euro. Every element of the political elite – both left and right – as well as most intellectuals and the media were in favor of a “yes” vote. But the vote failed, beaten by a vote of “no” most common among less-educated Danish men living outside metropolitan Copenhagen. This was a harbinger of things to come. The second event saw protestors commandeer Zuccotti Park in lower Manhattan’s financial district on a crisp fall day in 2011, setting up a makeshift tent city to protest economic inequality in the United States.
Storm clouds began to threaten the postwar political economy rather quickly. By the late 1960s, war-torn countries had made great strides in revitalizing their economies, while competition was heating up in world markets, challenging the United States’ economic primacy. Then, the price of oil skyrocketed in the 1970s, driving production costs higher. These years came to be dominated by stagflation – a toxic mix of inflation, sluggish economic growth, and high unemployment. On top of that, thanks to dramatic improvements in telecommunications and transportation, consumer demands began to change rapidly, and manufacturers raced to keep up. In 1909, Henry Ford had promised his customers that they could buy a Model T in any color so long as it was black; by 1973, the Ford Mustang came in three body styles, with five engine options, a choice of three transmissions, and more than a dozen colors.
We began this book by presenting the ideas of great economists that have been unduly neglected. Smith recognized that capitalism works best when people seek to catch those above them on the societal escalator. That requires a sense that they are at least on the escalator – something stressed too by Polanyi, who was well aware of the dangers that could follow if people were to feel themselves to be left out altogether. Keynes wanted the state to smooth out capitalism’s instabilities – notably, persistent unemployment – which often stemmed from the creative destruction that Schumpeter described. Hirschman understood that another way of ensuring that capitalism worked for everyone was to provide voice to all of its stakeholders.