This study aimed to identify perinatal and early-life factors associated with trajectories of psychopathic traits across childhood.

Participants were 1631 children (51.5% girls) from the Quebec Longitudinal Study of Child Development. A wide range of perinatal and early-life factors were assessed from pregnancy to age 2.5 years using medical files and mothers’ reports. Psychopathic traits were assessed via teachers’ reports at ages 6, 7, 8, 10, and 12 years. Latent class growth analyses and multinomial logistic regressions controlling for child sex were conducted. Two-way interaction effects between perinatal/early-life factors and child sex were explored.

Four trajectories of psychopathic traits were identified: High-stable (4.48%), Increasing (8.77%), Decreasing (11.46%), and Low-stable (75.29%). A few perinatal factors and most child-level and family-level early-life factors significantly increased the odds of following the High-stable v. the Low-stable trajectory. Higher levels of psychotropic exposures during pregnancy, socioeconomic adversity, child's physical aggression, child's opposition, mother's depressive symptoms, and hostile parenting increased the likelihood of following the Increasing instead of the Low-stable trajectory. Higher socioeconomic adversity, mother's depressive symptoms, and inconsistent parenting were associated with membership to the High-stable instead of the Decreasing trajectory. Most associations were not moderated by child sex.

These results shed light on the perinatal and early-life factors that are associated with specific pathways of psychopathic traits during childhood and suggest that different factors could be targeted to prevent the exacerbation (v. low and stable levels) or the stability at high levels (v. attenuation) of these traits.

New dietary recommendations focus on a plant-based diet. As dietary habits are formed during adolescence, knowledge on determinants of this food choice in this age-group can help prevention campaigns. Since an unbalanced choice in plant-based food might lead to nutrient deficiencies, it is also crucial to detect its association with nutrient intake and nutrient status.

In 2330 adolescents from the European HELENA study in 2006, a healthy plant-based diet index (hPDI) was calculated based on two 24 h recalls. In Belgium, 69 of them were remeasured in 2016 as young adults. The psychosocial determinants nutritional knowledge, advantages, awareness, social support, social norm, self-efficacy, barriers, availability and intention were tested by multiple linear regression. Nutrient status was determined by 16 markers in fasting blood. Linear regressions with hPDI as predictor and nutrient intake/status as outcome were adjusted for age, sex, socio-economic status, BMI, waist circumference, energy-intake, physical activity and smoking.

There was a strong correlation in hPDI after 10 years (Spearman = 0.56, p < 0.001). Determinants for adolescents’ plant-based diet were in descending order being a girl(β = 0.245;p < 0.001), a higher BMI(β = 0.140;p < 0.001), knowing the advantages(β = 0.104;p < 0.001), having availability over healthy food(β = 0.100;p < 0.001), high self-efficacy(β = 0.087;p < 0.001), health awareness(β = 0.072,p = 0.004), younger age(β = -0.048;p = 0.015) and better nutritional knowledge(β = 0.046;p = 0.020). In adolescents, hPDI was associated with lower energy intake, especially less overall fat, cholesterol, saturated fatty acids, mono-unsaturated fatty acids, proteins and mono/di-saccharides but more fibre. In micronutrients, higher intake of calcium, iron, magnesium, potassium, zinc, copper, vitamin A, C, E, K but less vitamin B12 and D were detected. Concerning nutrient status, hPDI was related to higher low-density cholesterol, vitamin D, vitamin C and beta-carotene levels. In adults, hPDI was associated with lower energy intake, especially less overall fat, cholesterol, saturated fatty acids and mono-unsaturated fatty acids but more carbohydrates and fibre, magnesium and vitamin C; while not with nutrient status. Longitudinally, we confirmed the link with intake of more fiber, potassium and less cholesterol. Additionally, a longitudinal positive association with poly-unsaturated fat intake was seen.

Tracking of hPDI over 10 years proved the importance of targeting these determinants in adolescents. The hPDI was indeed generally linked to a healthier dietary intake, especially more fiber, a healthier fat choice and higher vitamin intake except for lower vitamin B12 and D. Nevertheless, the latter two were not reflected in more deficiencies and nutrient status differences were limited.

Psychosocial stressors deriving from socioeconomic disadvantages in adolescents can result in higher metabolic syndrome (MetS) risk. We aimed to examine whether socioeconomic disadvantages were associated with MetS independent of lifestyle and whether there was a dose response relationship between the number of cumulated socioeconomic disadvantages and the risk of MetS.

The present study included 1,037 European adolescents (aged 12.5–17.5) of the 3,528 total HELENA participants. Sociodemographic variables and lifestyle were assessed through self-reported questionnaires. Disadvantaged groups included adolescents with low educated parents, low family affluence, migrant origin, unemployed parents, and from non-traditional families. MetS score was calculated as the sum of sex- and age-specific z-scores of waist circumference, HOMA-IR index, mean of z-scores of diastolic and systolic blood pressure and mean of z-score of HDL-C multiplied by -1 and z-score of TG. A higher score indicates poor metabolic health. Linear mixed-effects models were used to study the association between social disadvantages and MetS risk score. Models were adjusted for sex, age, pubertal status (Tanner stage) and lifestyle (diet quality, physical activity, alcohol consumption and smoking status).

Adolescents with low educated mothers showed a higher MetS score (0.54 [0.09–0.98]; β [99% confidence interval]) compared to high-educated mothers. Adolescents who accumulated more than three disadvantages (0.69 [0.08–1.31]) or with missing information on disadvantages (0.72 [0.04–1.40]) had a higher MetS risk compared to non-socioeconomically disadvantaged groups. Stronger associations between socioeconomic disadvantages and MetS were found in male in comparison with female adolescents.

Out of the studied socioeconomic disadvantages, maternal education is the most important determinant of adolescent's MetS risk independently of sex, age, Tanner stage, smoking status, alcohol consumption, diet quality and physical activity. Social vulnerabilities (migrant background, unemployment status and belonging to a non-traditional family) were not associated with a higher MetS risk in European adolescents. However, we found a dose-response relationship between the number of factors related to social disadvantage and adolescents’ MetS risk with adolescents accumulating three or more socioeconomic disadvantages showing the highest risk. Stronger associations between socioeconomic disadvantages and MetS were found in male compared to female adolescents. Policy makers should focus on low educated families to tackle health disparities.

To investigate whether adherence to the adapted Mediterranean Diet Score for Adolescents (MDS_A) and the adapted Mediterranean Diet Quality Index for Adolescents (KIDMED_A) is associated with better food/nutrient intakes and nutritional biomarkers.

The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional study aiming to obtain comparable data on a variety of nutritional and health-related parameters in European adolescents aged 12·5–17·5 years.

Nine European countries.

European adolescents (n 2330) recruited to the HELENA study. Dietary intake was obtained with 24 h dietary recalls, an FFQ and a Food Choices and Preferences questionnaire. MDS_A was calculated as a categorical variable using cut-offs (MDS_A), as a continuous variable (zMDS_A) and with energy adjustments (zEnMDS_A). The KIDMED_A score was also calculated.

Multilevel linear regression analysis showed positive associations for zMDS_A and KIDMED_A with serum levels of vitamin D, vitamin C, plasma folate, holo-transcobalamin, β-carotene and n-3 fatty acids, while negative associations were observed with trans-fatty acid serum levels. For categorical indices, blood biomarkers showed few significant results. zMDS_A and KIDMED_A showed positive associations with vegetables and fruits intake, and negative associations with energy-dense and low-nutritious foods. zMDS_A and KIDMED_A were positively associated with all macronutrients, vitamins and minerals (all P < 0·0001), except with monosaccharides and PUFA for KIDMED_A and cholesterol for both indices (P < 0·05).

zMDS_A and KIDMED_A have shown the strongest associations with the dietary indicators and biomarkers that have been associated with the Mediterranean diet before, and are therefore considered the most appropriate and valid Mediterranean diet scores for European adolescents.

Stakeholders from the innovation field in Québec (Canada) have collectively stressed the need to formalize the process for evaluating innovative technologies in the province. In the context of innovation, and more so for non-pharmaceutical technologies where the pace of development is rapid and the lifecycle short, evidence supporting the added value can be limited and uncertainties are common. Therefore, pragmatic approaches are needed to guide recommendations and to assure that the process is rigorous, transparent and fair.

Inspired by international experiences, the Institut national d'excellence en santé et services sociaux (INESSS) has developed a novel framework, where four types of recommendations are possible (introduction, refusal, limited or conditional introduction). The starting point is an evaluation of the technology's added value, for the patient, the population and the healthcare system, and the identification of uncertainties. The value of addressing uncertainty with further research is assessed, based on the value-of-information theory, and the distinct characteristics of medical devices are taken into account (e.g. learning curve effect, irrecoverable costs and incremental innovation). Those elements interact to support the formulation of recommendations by INESSS’ advisory committee.

The development of the framework was an iterative process supported by the use of the preliminary framework for the assessment of several innovative technologies. Challenges with its use were identified, and led to methodological and operational improvements. So far, the experience with the framework is positive and stakeholders confirm its relevance to support fair and reasonable recommendations for innovations.

In the rapidly changing landscape of innovation, HTA has to adapt to the challenges of assessing technologies in a context of promise and uncertainties. The framework developed by INESSS is a tool for supporting timely and fair value-based decision-making, which will benefit the healthcare system, and the patients and population it serves.

To analyse the Nutritional Knowledge Test (NKT) using Item Response Theory (ITR) analysis and to assess the construct validity of the Nutritional Knowledge Scale (NKTS) and its associations with adolescent food group consumption and nutritional biomarkers.

Cross-sectional study.

Multicentre investigation conducted in ten European cities.

Adolescents aged 12·5–17·5 years (n 3215) who completed over 75 % of the NKT.

Factor analysis indicated that the NKT can be analysed with a one-dimensional model. Eleven out of twenty-three items from the NKT presented adequate parameters and were selected to be included in the NKTS. Nutrition knowledge was positively associated with consumption of fruits, cereals, dairy products, pulses, meat and eggs, and fish, as well as with blood concentrations of vitamin C, β-carotene, n-3 fatty acids, holo-transcobalamin, cobalamin and folate; nutrition knowledge was negatively associated with intake of olives and avocado, alcohol and savoury snacks.

The NKTS assessed nutritional knowledge adequately and it is proposed as a new tool to investigate this subject in future studies.

Major depressive disorder (MDD) is underdiagnosed and undertreated in schizophrenia, and has been strongly associated with impaired quality of life.

To determine the prevalence and associated factors of MDD and unremitted MDD in schizophrenia, to compare treated and non-treated MDD.

Participants were included in the FondaMental Expert Centers for Schizophrenia and received a thorough clinical assessment. MDD was defined by a Calgary score ≥6. Non-remitted MDD was defined by current antidepressant treatment (unchanged for >8 weeks) and current Calgary score ≥6.

613 patients were included and 175 (28.5%) were identified with current MDD. MDD has been significantly associated with respectively paranoid delusion (odds ratio 1.8; P = 0.01), avolition (odds ratio 1.8; P = 0.02), blunted affect (odds ratio 1.7; P = 0.04) and benzodiazepine consumption (odds ratio 1.8; P = 0.02). Antidepressants were associated with lower depressive symptoms score (5.4 v. 9.5; P < 0.0001); however, 44.1% of treated patients remained in non-remittance MDD. Nonremitters were found to have more paranoid delusion (odds ratio 2.3; P = 0.009) and more current alcohol misuse disorder (odds ratio 4.8; P = 0.04). No antidepressant class or specific antipsychotic were associated with higher or lower response to antidepressant treatment. MDD was associated with Metabolic syndrome (31.4 v. 20.2%; P = 0.006) but not with increased C-reactive protein.

Antidepressant administration is associated with lower depressive symptom level in patients with schizophrenia and MDD. Paranoid delusions and alcohol misuse disorder should be specifically explored and treated in cases of non-remission under treatment. MetS may play a role in MDD onset and/or maintenance in patients with schizophrenia.

None.

Memory strategies help seniors remember information that is essential for the performance of their daily activities and contribute to their independence in the context of declining memory skills. This study aimed to analyze the categories, the diversity, and relevance of memory strategies known by seniors, and to identify individual characteristics that correlated with these variables.

The sample consisted of 294 participants aged 60 and over who decided to take part in a cognitive vitality promotion program. An adapted version of the memory situation questionnaire (Troyer, 2001) was administered to identify the memory strategies that seniors would use in five daily life situations. A scoring grid, also adapted from the questionnaire's original version (Troyer, 2001), was used to quantify the relevance of the strategies that were reported by participants.

All participants mentioned at least once that they would use a strategy from the physical category of memory strategies. Out of a possible range of 26 strategies, participants answered an average of 6.14 (SD = 1.7) different answers across the five situations. Based on expert consensus, 67.7% of the mentioned memory strategies were relevant. Diversity and relevance were significantly higher when trying to remember appointments, things to bring or phone numbers (p ≤ 0.05). The level of education, cognitive skills, and participation in leisure activities were related to diversity and relevance of reported strategies.

Seniors know various and relevant memory strategies to perform daily activities. The advantages of integrating strategies that they already know in cognitive health promotion programs should be considered in further studies.

To describe dietary patterns by applying cluster analysis and to describe the cluster memberships of European children over time and their association with body composition changes.

The analyses included k-means clustering based on the similarities between the relative frequencies of consumption of forty-three food items and regression models were fitted to assess the association between dietary patterns and body composition changes.

Primary schools and pre-schools of selected regions in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain.

Participants (n 8341) in the baseline (2–9 years old) and follow-up (4–11 years old) surveys of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) study.

Three persistent clusters were obtained at baseline and follow-up. Children consistently allocated to the ‘processed’ cluster presented increased BMI (β=0·050; 95 % CI 0·006, 0·093), increased waist circumference (β=0·071; 95 % CI 0·001, 0·141) and increased fat mass gain (β=0·052; 95 % CI 0·014, 0·090) over time v. children allocated to the ‘healthy’ cluster. Being in the ‘processed’–‘sweet’ cluster combination was also linked to increased BMI (β=0·079; 95 % CI 0·015, 0·143), increased waist circumference (β=0·172; 95 % CI 0·069, 0·275) and increased fat mass gain (β=0·076; 95 % CI 0·019, 0·133) over time v. the ‘healthy’ cluster.

Children consistently showing a processed dietary pattern or changing from a processed pattern to a sweet pattern presented the most unfavourable changes in fat mass and abdominal fat. These findings support the need to promote overall healthy dietary habits in obesity prevention and health promotion programmes targeting children.