Influence of maternal and paternal IQ on offspring health and health behaviours: Evidence for some trans-generational associations using the 1958 British birth cohort study

PurposeIndividuals scoring poorly on tests of intelligence (IQ) have been reported as having increased risk of morbidity, premature mortality, and risk factors such as obesity, high blood pressure, poor diet, alcohol and cigarette consumption. Very little is known about the impact of parental IQ on the health and health behaviours of their offspring.MethodsWe explored associations of maternal and paternal IQ scores with offspring television viewing, injuries, hospitalisations, long standing illness, height and BMI at ages 4 to 18 using data from the National Child Development Study (1958 birth cohort).ResultsData were available for 1446 mother-offspring and 822 father-offspring pairs. After adjusting for potential confounding/mediating factors, the children of higher IQ parents were less likely to watch TV (odds ratio (95% confidence interval) for watching 3+ vs. less than 3 hours per week associated with a standard deviation increase in maternal or paternal IQ: 0.75 (0.64, 0.88) or 0.78 (0.64, 0.95) respectively) and less likely to have one or more injuries requiring hospitalisation (0.77 (0.66, 0.90) or 0.72 (0.56, 0.91) respectively for maternal or paternal IQ).ConclusionsChildren whose parents have low IQ scores may have poorer selected health and health behaviours. Health education might usefully be targeted at these families.     

Estimation of bisphenol A (BPA) concentrations in pregnant women,fetuses and nonpregnant women in Eastern Townships of Canada

We determined bisphenol A (BPA) concentrations of 61 pregnant women (PW), their fetuses and 26 nonpregnant women (NPW) in Eastern Townships of Canada; and evaluated potential correlations between maternal and fetal blood, and between peripheral blood and peritoneal fluid. In PW, BPA levels were ranged from non-detected to 4.46 ng/ml and from non-detected to 4.60 ng/ml for maternal and fetal serum, respectively. In NPW, BPA levels were ranged from 1.30 to 8.17 ng/ml and from 0.19 to 13.45 ng/ml for serum and peritoneal fluid, respectively. Positive correlation was found between maternal and fetal serum, and between serum and peritoneal fluid. In conclusion, our findings highlight a continuous distribution of BPA between the mother and its fetus and reveal a role of pregnancy in underestimating the actual levels of blood BPA. Our study also provides a temporal-spatial reference on BPA exposure, which is a useful tool in monitoring, comparing and correcting.     

Food environment,walkability, and public open spaces are associated with incident development of cardio-metabolic risk factors in a biomedical cohort

We investigated whether residential environment characteristics related to food (unhealthful/healthful food sources ratio), walkability and public open spaces (POS; number, median size, greenness and type) were associated with incidence of four cardio-metabolic risk factors (pre-diabetes/diabetes, hypertension, dyslipidaemia, abdominal obesity) in a biomedical cohort (n=3205). Results revealed that the risk of developing pre-diabetes/diabetes was lower for participants in areas with larger POS and greater walkability. Incident abdominal obesity was positively associated with the unhealthful food environment index. No associations were found with hypertension or dyslipidaemia. Results provide new evidence for specific, prospective associations between the built environment and cardio-metabolic risk factors.     

Eating and drinking-related care for persons with advanced dementia in long-term care

BackgroundAdvanced dementia is a life-limiting illness that requires a palliative approach to care. Decline in eating/drinking represents a milestone in progression that warrants decision-making and planning of care. In long-term care (LTC), this is best conducted via family case conferences.AimTo explore decision-making and planning regarding eating/drinking-related care in case conferences for persons with advanced dementia in LTC to inform future practice.MethodsA qualitative approach was taken, using observation of audio-recorded case conferences. Case conferences were conducted in 6 LTC facilities within the intervention arm of a cluster randomized controlled trial. Participants were LTC personnel, doctors, and families of persons with advanced dementia. Content was analysed for eating/drinking-related goals of care and the degree to which decision-making was shared.FindingsThirty-two case conferences considered eating/drinking-related care. The goals included nutrition, hydration, weight gain and maintenance, food enjoyment, social interaction, and independence. Key considerations included secondary health issues impacting comfort, and tensions between food enjoyment versus nutrition and risk of aspiration. While families contributed essential information about eating/drinking history, sometimes decision-making was dominated by professionals and overlooked overall goals of care.DiscussionShared decision-making regarding eating/drinking-related care for persons with advanced dementia in LTC should start with consensus on overall goals of care and include contributions to quality of life as well as risks. Family involvement should be supported beyond information-giving.ConclusionFuture studies are needed to identify the most sensitive and understandable ways for families of discussing eating/drinking-related decline in dementia.     

Vanadium exposure-induced neurobehavioral alterations among Chinese workers

Vanadium-containing products are manufactured and widely used in the modern industry. Yet the neurobehavioral toxicity due to occupational exposure to vanadium remained elusive. This cross-sectional study was designed to examine the neurotoxic effects of occupational vanadium exposure. A total of 463 vanadium-exposed workers (exposed group) and 251 non-exposed workers (control group) were recruited from a Steel and Iron Group in Sichuan, China. A WHO-recommended neurobehavioral core test battery (NCTB) and event-related auditory evoked potentials test (P300) were used to assess the neurobehavioral functions of all study subjects. A general linear model was used to compare outcome scores between the two groups while controlling for possible confounders. The exposed group showed a statistically significant neurobehavioral alteration more than the control group in the NCTB tests. The exposed workers also exhibited an increased anger-hostility, depression-dejection and fatigue-inertia on the profile of mood states (p < 0.05). Performances in the simple reaction time, digit span, benton visual retention and pursuit aiming were also poorer among exposed workers as compared to unexposed control workers (p < 0.05). Some of these poor performances in tests were also significantly related to workers’ exposure duration. P300 latencies were longer in the exposed group than in the control (p < 0.05). Longer mean reaction times and more counting errors were also found in the exposed workers (p < 0.05). Given the findings of our study and the limitations of neurobehavioral workplace testing, we found evidence of altered neurobehavioral outcomes by occupational exposure to vanadium.     

防御性医疗行为现状及测量方法综述

在我国医患关系较为紧张的宏观环境下,防御性医疗成为医疗费用上涨的重要原因。本研究综述了防御性医疗行为的国内外现状及测量方法,为我国防御性医疗行为研究的开展提供借鉴。研究指出,目前我国医生中存在防御性医疗行为的比例较高,且国内相关实证研究较为缺乏,研究范围较小,测量指标不够全面。防御性医疗行为的测量方法主要包括医生自评、基于诊疗规范的客观评判、临床情景调查以及基于真实世界数据的分析,可根据实际情况选择适宜方法或将其结合运用。