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Food insecurity has been shown to be associated with fast-food consumption. However, to date, studies on this specific topic are scarce. Therefore, the aim of the present study was to investigate the association between food insecurity and fast-food consumption in adolescents aged 12-15 years from 68 countries (7 low-income, 27 lower middle-income, 20 upper middle-income, 14 high-income countries). Cross-sectional, school-based data from the Global School-based Student Health Survey were analyzed. Data on past 30-day food insecurity (hunger) and fast-food consumption in the past 7 days were collected. Multivariable logistic regression and meta-analysis were conducted to assess associations. Models were adjusted for age, sex, and body mass index. There were 180,164 adolescents aged 12-15 years [mean (SD) age 13.8 (1.0) years; 50.8% boys] included in the analysis. Overall, severe food insecurity (i.e., hungry because there was not enough food in home most of the time or always) was associated with 1.17 (95%CI=1.08-1.26) times higher odds for fast-food consumption. The estimates pooled by country-income levels were significant in low-income countries (adjusted odds ratio [aOR]=1.30; 95%CI=1.05-1.60), lower middle-income countries (aOR=1.15; 95%CI=1.02-1.29), and upper middle-income countries (aOR=1.26; 95%CI=1.07-1.49), but not in high-income countries (aOR=1.04; 95%CI=0.88-1.23). The mere co-occurrence of food insecurity and fast-food consumption is of public health importance. To tackle this issue, a strong governmental and societal approach is required to utilize effective methods as demonstrated in some high-income countries such as the implementation of food banks and the adoption of free school meals.
Only a few studies have analyzed the effects of physical and psychiatric conditions on the risk of chronic fatigue syndrome (CFS). Therefore, the goal of this exploratory case-control study was to investigate the associations of physical and psychiatric conditions with CFS in almost 19 800 adults from Germany.
This study included patients diagnosed for the first time with CFS in one of 1238 general practices in Germany between 2010 and 2017 (index date). Controls without CFS were matched (1:1) to cases with CFS by sex, age, index year, and practice. Physical and psychiatric conditions diagnosed in the year prior to the index date were included if they were present in at least 3% of patients with CFS. Associations between physical and psychiatric conditions (33 potential independent variables) and CFS (dependent variable) were analyzed in an adjusted conditional logistic regression model, and physical and psychiatric disorders were included in the model using forward stepwise selection.
This study included 9896 cases with CFS and 9896 controls without CFS [65.1% women; mean (standard deviation) age 49.5 (18.3) years]. Seven conditions were associated with CFS in the adjusted regression model. The disorders displaying the strongest relationship with CFS were cancer [odds ratio (OR) = 2.57, 95% confidence interval (CI) = 2.24–2.95], sleep disorders (OR = 1.88, 95% CI = 1.66–2.12) and depression (OR = 1.77, 95% CI = 1.61–1.95).
Cancer, sleep disorders, and depression were strongly and positively associated with CFS. Additional studies are needed to gain a better understanding of the mechanisms underlying these relationships.
Perceived discrimination has been linked to psychotic experiences (PEs). However, as yet, information is lacking on the relationship between different forms of discrimination and PEs. This study examined this association in the English general population.
Nationally representative, cross-sectional data were analyzed from 7363 adults aged 16 and above that came from the Adult Psychiatric Morbidity Survey, 2007. Self-reported information was obtained on six forms of discrimination (ethnicity, sex, religious beliefs, age, physical health problems/disability, sexual orientation), while PEs were assessed with the Psychosis Screening Questionnaire (PSQ). Multivariable logistic regression analysis was used to assess associations.
In a fully adjusted logistic regression analysis, any discrimination was significantly associated with PEs (odds ratio [OR]: 2.47, 95% confidence interval [CI]: 1.75–3.48). All individual forms of discrimination were significantly associated with PEs except sexual orientation. Multiple forms of discrimination were associated with higher odds for PEs in a monotonic fashion with those experiencing ≥ 3 forms of discrimination having over 5 times higher odds for any PE. In addition, experiencing any discrimination was associated with significantly increased odds for all individual forms of PE with ORs ranging from 2.16 (95%CI: 1.40–3.35) for strange experience to 3.36 (95%CI: 1.47–7.76) for auditory hallucination.
Different forms of discrimination are associated with PEs in the general population. As discrimination is common at the societal level, this highlights the importance of public policy and evidence-based interventions to reduce discrimination and improve population mental health.
Non-heterosexual individuals are at high risk for a variety of factors associated with the emergence of psychotic experiences (PEs) (e.g. common mental disorders, substance use, and stress). However, there is a scarcity of data on the association between sexual orientation and PEs. Therefore, the aim of this study was to examine the sexual orientation-PE relationship, and to identify potential mediators in this relationship.
This study used nationally representative cross-sectional data from the 2007 Adult Psychiatric Morbidity Survey. Sexual orientation was dichotomized into heterosexual and non-heterosexual. Past 12-month PE was assessed with the Psychosis Screening Questionnaire. Regression and mediation analyses were conducted to analyze the association between sexual orientation and PEs, and to identify potential mediators involved in this relationship.
The final sample consisted of 7275 individuals aged ⩾16 years. The prevalence of non-heterosexual orientation and any PE was 7.1% and 5.5%, respectively. After adjusting for sex, age, and ethnicity, non-heterosexual orientation was positively associated with any PE (odds ratio 1.99, 95% confidence interval 1.34–2.93). The strongest mediators involved in this relationship were borderline personality disorder (BPD) traits (mediated percentage = 33.5%), loneliness (29.1%), and stressful life events (25.4%).
These findings suggest that there is a positive relationship between sexual orientation and PEs in the general population in England, and that underlying mechanisms may involve BPD traits, loneliness, and stressful life events. Future studies with a longitudinal design are warranted to shed more light on how these factors are implicated in the association between sexual orientation and PEs.
Data on the relationship between intelligence quotient (IQ) and violence perpetration are scarce and nationally representative data from the UK adult population is lacking. Therefore, our goal was to examine the relationship between IQ and violence perpetration using nationally representative community-based data from the UK.
We analyzed cross-sectional data from the 2007 Adult Psychiatric Morbidity Survey. IQ was estimated using the National Adult Reading Test (NART). Violence perpetration referred to being in a physical fight or having deliberately hit anyone in the past 5 years. We conducted logistic regression analysis to assess the association between IQ (exposure variable) and violence perpetration (outcome variable).
There were 6872 participants aged ⩾16 years included in this study. The prevalence of violence perpetration decreased linearly with increasing IQ [16.3% (IQ 70–79) v. 2.9% (IQ 120–129)]. After adjusting for demographic and behavioral factors, childhood adversity, and psychiatric morbidity, compared with those with IQ 120–129, IQ scores of 110–119, 100–109, 90–99, 80–89, and 70–79 were associated with 1.07 [95% confidence interval (CI) 0.63–1.84], 1.90 (95% CI 1.12–3.22), 1.80 (95% CI 1.05–3.13), 2.36 (95% CI 1.32–4.22), and 2.25 (95% CI 1.26–4.01) times higher odds for violence perpetration, respectively.
Lower IQ was associated with violence perpetration in the UK general population. Further studies are warranted to assess how low IQ can lead to violence perpetration, and whether interventions are possible for this high-risk group.
An internationally approved and globally used classification scheme for the diagnosis of CHD has long been sought. The International Paediatric and Congenital Cardiac Code (IPCCC), which was produced and has been maintained by the International Society for Nomenclature of Paediatric and Congenital Heart Disease (the International Nomenclature Society), is used widely, but has spawned many “short list” versions that differ in content depending on the user. Thus, efforts to have a uniform identification of patients with CHD using a single up-to-date and coordinated nomenclature system continue to be thwarted, even if a common nomenclature has been used as a basis for composing various “short lists”. In an attempt to solve this problem, the International Nomenclature Society has linked its efforts with those of the World Health Organization to obtain a globally accepted nomenclature tree for CHD within the 11th iteration of the International Classification of Diseases (ICD-11). The International Nomenclature Society has submitted a hierarchical nomenclature tree for CHD to the World Health Organization that is expected to serve increasingly as the “short list” for all communities interested in coding for congenital cardiology. This article reviews the history of the International Classification of Diseases and of the IPCCC, and outlines the process used in developing the ICD-11 congenital cardiac disease diagnostic list and the definitions for each term on the list. An overview of the content of the congenital heart anomaly section of the Foundation Component of ICD-11, published herein in its entirety, is also included. Future plans for the International Nomenclature Society include linking again with the World Health Organization to tackle procedural nomenclature as it relates to cardiac malformations. By doing so, the Society will continue its role in standardising nomenclature for CHD across the globe, thereby promoting research and better outcomes for fetuses, children, and adults with congenital heart anomalies.
Across the globe, the implementation of quality improvement science and collaborative learning has positively affected the care and outcomes for children born with CHD. These efforts have advanced the collective expertise and performance of inter-professional healthcare teams. In this review, we highlight selected quality improvement initiatives and strategies impacting the field of cardiovascular care and describe implications for future practice and research. The continued leveraging of technology, commitment to data transparency, focus on team-based practice, and recognition of cultural norms and preferences ensure the success of sustainable models of global collaboration.
Dementia is a psychiatric condition the development of which is associated with numerous aspects of life. Our aim was to estimate dementia risk factors in German primary care patients.
The case-control study included primary care patients (70–90 years) with first diagnosis of dementia (all-cause) during the index period (01/2010-12/2014) (Disease Analyzer, Germany), and controls without dementia matched (1:1) to cases on the basis of age, sex, type of health insurance, and physician.
Practice visit records were used to verify that there had been 10 years of continuous follow-up prior to the index date. Multivariate logistic regression models were fitted with dementia as a dependent variable and the potential predictors.
The mean age for the 11,956 cases and the 11,956 controls was 80.4 (SD: 5.3) years. 39.0% of them were male and 1.9% had private health insurance. In the multivariate regression model, the following variables were linked to a significant extent with an increased risk of dementia: diabetes (OR: 1.17; 95% CI: 1.10–1.24), lipid metabolism (1.07; 1.00–1.14), stroke incl. TIA (1.68; 1.57–1.80), Parkinson's disease (PD) (1.89; 1.64–2.19), intracranial injury (1.30; 1.00–1.70), coronary heart disease (1.06; 1.00–1.13), mild cognitive impairment (MCI) (2.12; 1.82–2.48), mental and behavioral disorders due to alcohol use (1.96; 1.50–2.57). The use of statins (OR: 0.94; 0.90–0.99), proton-pump inhibitors (PPI) (0.93; 0.90–0.97), and antihypertensive drugs (0.96, 0.94–0.99) were associated with a decreased risk of developing dementia.
Risk factors for dementia found in this study are consistent with the literature. Nevertheless, the associations between statin, PPI and antihypertensive drug use, and decreased risk of dementia need further investigations.
Understanding the ecological function of large frugivores in tropical forests is important considering their central position in seed-dispersal networks. This study illustrates the seed-dispersal effectiveness of a western lowland gorilla (Gorilla gorilla gorilla) population in Cameroon by looking at the interaction of seed quantity, species regeneration traits and the environmental characteristics of the deposition sites (sleeping sites vs. feeding trails) in order to discuss the role of gorillas within the ecosystem. The analysis of 1030 faecal samples collected over a 3-y period (September 2009–August 2012) showed that gorillas dispersed a diverse array of species (58 spp. identified), with an average of 289 intact seeds (>5 mm) d−1 per individual. Seed damage during mouth and gut processing occurred for 12 spp., generally accounting for <5% of specific seed load. Germination trials suggested that germination success of passed seeds remained unchanged (N = 6 spp.) or improved (N = 5 spp.) after gut passage compared with hand-cleaned seeds, with one exception. Indicator species identification (IndVal method) and General Discriminant Analysis suggested that sleeping sites (N = 36), as a main type of seed deposition site, correspond to regenerating microhabitats and correspondingly degree of canopy openness is one variable discriminating significantly this type of deposition site with random locations in the forest (N = 36) used as a proxy for non-directed seed deposition on feeding trails. With a mean canopy openness of 19–27%, sleeping sites offer optimal light conditions for the seedling recruitment of non-pioneer light-demanding species, the seeds of which encompass 47.4% of the total seed load dispersed over the 3-y period. From this study, it is hypothesized that the gorilla performed directed-dispersal of some light-demanding plant species at sleeping sites, and hence, by being actively implicated in gap-phase dynamics, fulfils a valuable ecological function within its ecosystem.
Developmental risk refers to conditions, characteristics, experiences, or situations with potentially deleterious effects that lead to outcomes later in life that do not meet societal expectations. While risk is typically framed as the statistical probability of a problematic outcome in relation to the general population, the converse notion of well-being is considered in relation to the level of functioning at a given developmental stage. The contributors to this volume provide insight into developmental well-being by examining the ways that culture and context affect outcomes associated with various types of risk, such as those related to oppression, academic performance, family background, life history, physical health, and psychiatric conditions. Even though certain outcomes may seem inevitable in cases involving harmful environments, diseases, and disorders, they are virtually all influenced by complex interactions among individuals, their families, communities, and societies.