Current evidence linking nutrition with brain health in ageing

Cognitive dysfunction and depression are significant problems of ageing with major health and socio‐economic impacts; therefore, preventing or delaying the onset of these disorders should be a public health priority. In particular, there is a need to identify modifiable factors that could be targeted to promote better brain health in ageing. Epidemiological studies indicate a protective role for certain dietary patterns, in particular the Mediterranean diet, and for specific nutrients, including n‐3 polyunsaturated fatty acids, polyphenols and B vitamins. Although, the evidence to date from randomised controlled trials is generally inconsistent, there is clearer evidence to support a role for folate and related B vitamins in slowing the progression of cognitive decline and possibly reducing the risk of depression in ageing. Future studies incorporating new technologies offer much promise for the development of effective nutrition strategies that could reduce the risk of cognitive and mental disorders and improve quality of life in our ageing population.     

Knowledge and risk perception of HIV/AIDS: a profile of the Brazilian people in 1998

This paper focuses on cognitive aspects related to HIV/AIDS by presenting distinct subgroups of the Brazilian population. Four subgroups were created according to their different levels of knowledge regarding HIV/AIDS and risk perception: subgroup 1 (no awareness and no risk perception); subgroup 2 (no awareness, with some risk perception); subgroup 3 (some awareness and no risk perception); and subgroup 4 (some awareness and some risk perception). The data come from the National Survey on Sexual Behavior and HIV/AIDS Risk Perception in the Brazilian Population, conducted by CEBRAP (the Brazilian Analysis and Planning Agency) together with the Ministry of Health, in 1998. The study highlights that in 1998, slightly over half of the Brazilian population were minimally aware of HIV transmission processes. Analysis of demographic and socioeconomic characteristics associated with protective behavior against HIV/AIDS showed that approximately 23% of the study population belonged to subgroup 1 - with no awareness and no risk perception - and were thus highly vulnerable to infection.     

898 名新兵睡眠状况与心理健康状况研究

目的了解新兵睡眠状况和心理健康水平,研究其相关性。方法选用野战心理防护方舱上的军人心理测查软件系统中的人口学问卷、症状自评量表（SCL-90）和睡眠状况自评量表等心理测量工具,对某军区2012年底入伍898名空军和陆军新兵施测,结果软件自动分析处理。结果新兵睡眠状况和心理健康状况总体良好,且两者间存在显著正相关,军兵种、对军营生活满意度是影响新兵心理健康和睡眠状况的因素。结论要采取积极干预措施,增强新兵对军人职业的荣誉感和对军营生活的认同感,改善他们的睡眠状况,维护和促进新兵心理健康。同时,野战心理防护方舱的实用性功能得到验证。     

The Influence of Environmental Factors on the Development of Ultra‐Orthodox Preschool Boys in Israel

The study objectives were: (a) to compare the prevalence of children at risk and/or with developmental delay (at risk/delayed) among the Ultra‐Orthodox community with the prevalence reported in the literature and (b) to compare the performance of Ultra‐Orthodox children in kindergarten versus that of children in preschool. To this end, motor, visual–motor integration and cognitive performance of 203 Ultra‐Orthodox boys from low socio‐economic status were assessed. We found a higher percentage of children who were at risk/delayed in gross motor and motor–cognitive skills as compared with the percentage reported in the literature. However, as opposed to expected, the results did not show that there was a higher percent of at‐risk/delayed children among the kindergarten group as compared with those among the preschool group. Our findings are consistent with the research literature suggesting that children's cultural background and economic constraints can affect their motor and cognitive development. Thus, occupational therapists and other health professionals should be more culturally competent and more aware of the specific values and practices of families of children with whom they work, which can impact their development. However, in this study, it is difficult to distinguish between the influence of the cultural factors and the influence of socio‐economic factors. Therefore, it is recommended to repeat this study among children from either low socio‐economic status or other cultural backgrounds. Copyright © 2011 John Wiley & Sons, Ltd.     

HIV/AIDS患者生活质量的影响因素研究

目的了解杭州市HIV/AIDS患者生活质量的影响因素,为完善HIV/AIDS患者心理卫生服务体系,进一步提高其心理健康水平及生活质量提供依据。方法对杭州市226例HIV/AIDS患者进行问卷调查。内容包括基本情况、认知评价、医学应对方式和生活质量。结果年龄增长、认知评价的"威胁"因子分和应对方式的"屈服"因子分对HIV/AIDS患者的生活质量有负性影响,有工作、应对方式的"面对"因子分对生活质量存在正性影响。结论认知评价和应对方式是HIV/AIDS患者生活质量的影响因素。帮助患者改变认知,建立正确的应对方式可以提高其生活质量。     

Factors influencing health-related quality of life of thalassaemic Jordanian children

Purpose To assess the health‐related quality of life (HRQoL) of Jordanian children with thalassaemia, identify differences in HRQoL according to socio‐demographic and clinical characteristics of participants, and identify factors influencing HRQoL of thalassaemic children in Jordan. Methods The Pediatric Quality of Life Inventory and socio‐demographic and clinical data forms were used to collect data from a convenience sample of 128 thalassaemic children and 83 healthy children between the ages of 8 to 18 years. Thalassaemic children were recruited from two thalassaemia units during their blood transfusion and treatment visits. Healthy children were recruited from four public schools. Results Thalassaemic children had significantly lower HRQoL mean scores in all dimensions compared with their healthy counterparts. The lowest mean scores for thalassaemic children were reported for the school functioning and the physical functioning domains (46.71 ± 21.14 and 54.19 ± 15.10), respectively. Regression analysis showed that disease complications and family history of thalassaemia explained 8.5% of the variance in the total HRQoL. Conclusion This study highlights the negative impact of thalassaemia on the quality of life of children, especially in terms of physical well‐being and school achievement. Healthcare providers, counsellors and school teachers have very important roles in helping these children to overcome these problems and enhance their quality of life.     

Is parental coping associated with the level of function in children with physical disabilities?1

Objectives The objectives of this study are: (1) to describe parental coping in a cohort of children with physical disabilities (PDs); (2) to determine whether the child's level of function is associated with parental coping; and (3) to explore whether socio‐demographic factors such as child's age, maternal education and family structure are associated with parental coping. Methods Parents of 150 children with PDs were interviewed after being referred to community rehabilitation services. They answered the following: the Coping Health Inventory for Parents, the Functional Independence Measure for children (WeeFIM) and a study questionnaire that addressed socio‐demographic characteristics. Multiple linear regression models were used to determine the association between level of function and other factors and parental coping. Results Mean (SD) age of the children was 40.9 (15.2) months and 64.7% were male. Parental coping scores, measured by the Coping Health Inventory for Parents, indicated that the parents in our study found seeking out social support from community resources useful. Parents of children with moderate to severe dysfunction in mobility (WeeFIM) found coping behaviours related to communicating with the healthcare professionals regarding their child's condition useful (β coefficient, 2.07; 95% CI, 0.37, 3.78). Greater perceived usefulness of maintaining social support through community resources was associated with lower maternal education, working parents and two‐parent families. Conclusion These findings underscore the importance of helping parents of children with PDs maintain social support. It is important to help parents understand their child's medical situation, especially those whose children have more severe mobility dysfunction.     

Informal caregivers of people with an intellectual disability in England: health,quality of life and impact of caring

There is wide variation in reported impact of caring on caregiver well‐being, and often a negative appraisal of caregiving. Researchers are beginning to question the robustness of the evidence base on which negative appraisals are based. The present study aimed to draw on data from a population‐representative sample to describe the health, quality of life and impact of caring of informal caregivers of people with an intellectual disability. Informal carers of people with intellectual disability (N = 260) were identified among 2199 carers in the English Survey of Carers in Households 2009/10. Generalised estimating equations explored the association between socio‐demographic and caring profile with quality of life, physical health status, and impact on psychological health and personal life. Compared to other caregivers, providing care to a person with intellectual disability was not associated with reduced quality of life. There was an 82% increased risk of reporting poorer health status, even though poorer health was not likely to be attributed to care‐giving. A higher risk of negative impact on personal life was seen in comparison with the wider group of caregivers, but not in comparison with more similar‐sized caregiver groups (mental health or dementia). Carers of people with intellectual disability were more likely to be struggling financially and have a high caring load. These factors were systematically related to lower well‐being. A uniformly negative appraisal of caring for people with intellectual disability was not supported by these English population‐representative data. Poverty and long care‐giving hours may make caregivers more susceptible to negative well‐being. Support for caregivers of people with intellectual disability should focus on alleviating those two factors.     

Trajectories of risk behaviors and exiting homelessness among newly homeless adolescents

Using cluster analysis techniques, we identified two distinct clusters of newly homeless adolescents in Los Angeles (n = 261): those who are protected and doing relatively well while out of home with more protective than risk factors, and those who are risky with more risk than protective factors. The objective of this study was to examine the trajectories of human immunodeficiency virus (HIV) risk behaviors and exiting homelessness among protected newly homeless adolescents, compared to those who are classified as risky. HIV risk behavior included unprotected sex, having multiple sex partners and hard drug use. Logistic regression mixed-effects models were used to evaluate the trajectories of HIV risk behaviors and exiting homelessness over time. The adolescents in the protected group reported significantly less unprotected sex ( p = 0.0156), being abstinent or monogamous ( p < 0.0001) and less hard drug use ( p < 0.0001) compared to the adolescents in the risky group. In addition, the protected group reported more "exiting homelessness", compared to the risky group ( p = 0.0007). However, the differences in the level of unprotected sex between the protected and risky groups decreased over time. Our findings confirm the notion that newly homeless adolescents are indeed heterogeneous. Given that the risk behavior profiles of protected group merges to the risky group over time, our findings underscore the need to mount tailored interventions to be designed for the protected group early in the process.     

Evaluation of the ability of neurobiological, neurodevelopmental and socio-economic variables to predict cognitive outcome in premature infants

Background When developed in the 1990s, the Neurobiologic Risk Score (NBRS) and Neurodevelopmental Risk Exam (NRE) correlated well with developmental outcomes in premature infants. Given recent advances in neonatology, we assessed their present ability to predict cognitive outcome, alone and combined with socio‐economic factors. Methods One hundred and twenty‐nine neonates <32 weeks gestational age were assessed at 6, 12 and/or 24 months corrected age with the Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS). Indices of socio‐economic status included maternal education and marital status. Results At 24 months corrected age (n= 67), the NBRS (r=?0.5), maternal education (r= 0.46) and marital status (r= 0.37) correlated with the CAT/CLAMS. These correlations increased when NBRS and maternal education were combined (r= 0.63) and when specific NBRS components (intraventricular haemorrhage, periventricular leukomalacia, seizures) and maternal education were combined (r= 0.66). Conclusions In the contemporary neonatal intensive care unit, measures used to predict cognitive outcome should incorporate both neurobiological risk factors and socio‐economic variables.     

Protective and risk factors for depressive mood and anxiety against occupational stress: examining temperament character and coping strategy among civil servants

Abstract

This study investigated protective and risk factors for depressive mood and anxiety against occupational stress, including temperament character and coping strategy, among civil servants. We administered a questionnaire that included demographic factors and psychological scales to 1197 Korean civil servants. High levels of occupational stress, temperaments of novelty seeking and harm avoidance, a character of cooperativeness, and using emotion-focused coping were risk factors for depressive mood, while living with a partner, having a character of self-directedness, and using problem-focused strategies were protective factors. Additionally, female gender, high level of occupational stress, and temperaments of novelty seeking and harm avoidance were risk factors for anxiety, while having a character of self-directedness was a protective factor. Assessment of temperament character and training on effective coping strategies may help address depressive mood and anxiety for civil servants.     

Parenting stress in US families: implications for paediatric healthcare utilization

Objective According to family stress models, parental responses to stress disrupt interactions between parent and child and may lead to parental inability to seek timely medical care for their child. The objective of this study was to quantitatively assess the relationship between high parenting stress and child healthcare utilization. Methods We used the 2003–2004 National Survey of Children's Health to determine the prevalence of parenting stress in US families and associated socio‐demographic variables. We used weighted logistic regression to investigate associations between parenting stress and healthcare utilization, controlling for other parental psychosocial and socio‐demographic variables. The primary independent variables were parenting stress, parental mental health, parental coping and social support. The main dependent variables were emergency care, sick visits to primary care and preventive care in the past 12 months. Results Nationally, 13% of children lived in households with at least one parent experiencing high parenting stress. Socio‐demographic variables associated with the highest odds of parenting stress included Black race, special needs status and non‐English primary language. Parents with high parenting stress had a higher odds (adjusted odds ratio 1.24, 95% confidence interval 1.10–1.41) of seeking emergency care for their children compared with parents with low parenting stress, controlling for other parental psychosocial factors and socio‐demographic variables. Conclusions Having a parent who is experiencing high parenting stress is associated with greater utilization of paediatric emergency care. Interventions targeted at parenting stress may provide families with needed support and reduce unnecessary emergency care utilization.     

Trajectories of risk behaviors and exiting homelessness among newly homeless adolescents

Using cluster analysis techniques, we identified two distinct clusters of newly homeless adolescents in Los Angeles (n = 261): those who are protected and doing relatively well while out of home with more protective than risk factors, and those who are risky with more risk than protective factors. The objective of this study was to examine the trajectories of human immunodeficiency virus (HIV) risk behaviors and exiting homelessness among protected newly homeless adolescents, compared to those who are classified as risky. HIV risk behavior included unprotected sex, having multiple sex partners and hard drug use. Logistic regression mixed-effects models were used to evaluate the trajectories of HIV risk behaviors and exiting homelessness over time. The adolescents in the protected group reported significantly less unprotected sex ( p = 0.0156), being abstinent or monogamous ( p < 0.0001) and less hard drug use ( p < 0.0001) compared to the adolescents in the risky group. In addition, the protected group reported more “exiting homelessness”, compared to the risky group ( p = 0.0007). However, the differences in the level of unprotected sex between the protected and risky groups decreased over time. Our findings confirm the notion that newly homeless adolescents are indeed heterogeneous. Given that the risk behavior profiles of protected group merges to the risky group over time, our findings underscore the need to mount tailored interventions to be designed for the protected group early in the process.     

Joint modeling of repeated multivariate cognitive measures and competing risks of dementia and death: a latent process and latent class approach

Joint models initially dedicated to a single longitudinal marker and a single time‐to‐event need to be extended to account for the rich longitudinal data of cohort studies. Multiple causes of clinical progression are indeed usually observed, and multiple longitudinal markers are collected when the true latent trait of interest is hard to capture (e.g., quality of life, functional dependency, and cognitive level). These multivariate and longitudinal data also usually have nonstandard distributions (discrete, asymmetric, bounded, etc.). We propose a joint model based on a latent process and latent classes to analyze simultaneously such multiple longitudinal markers of different natures, and multiple causes of progression. A latent process model describes the latent trait of interest and links it to the observed longitudinal outcomes using flexible measurement models adapted to different types of data, and a latent class structure links the longitudinal and cause‐specific survival models. The joint model is estimated in the maximum likelihood framework. A score test is developed to evaluate the assumption of conditional independence of the longitudinal markers and each cause of progression given the latent classes. In addition, individual dynamic cumulative incidences of each cause of progression based on the repeated marker data are derived. The methodology is validated in a simulation study and applied on real data about cognitive aging obtained from a large population‐based study. The aim is to predict the risk of dementia by accounting for the competing death according to the profiles of semantic memory measured by two asymmetric psychometric tests. Copyright © 2015 John Wiley & Sons, Ltd.     

A geographic comparison of the prevalence and risk factors for postnatal depression in an Australian population

Objective: This study sought to compare the contribution of demographic and psychosocial variables on the prevalence of, and risk for, PND in urban and rural women. Methods: Demographic, psychosocial risk factor and mental health data was collected from urban (n=908) and rural (n=1,058) women attending perinatal health services in Victoria, Australia. Initial analyses determined similarities and significant differences between demographic and psychosocial variables. The association between these variables and PND case/non‐case was evaluated using logistic regression analysis. Results: There were a number of significant differences between the two cohorts in terms of socio‐economic status (SES), age, marital status and past history of psychopathology Antenatal depression was more common in the urban group compared to the rural group (8.5% vs 3.4%, p=0.006); there was no significant difference in the prevalence of PND (6.6% vs 8.5%, p=0.165). For urban mothers, antenatal EPDS score was the best predictor of PND. For rural mothers antenatal EPDS score, SES and psychiatric history had a significant influence on postnatal mood. Conclusions: Findings confirm the contribution of established risk factors such as past psychopathology, antenatal EPDS score and SES on the development of PND and reiterate the need for procedures to identify and assess psychosocial risk factors for depression in the perinatal period. Other predictors such as efficacy of social support and perceived financial burden may strengthen statistical models used to predict PND for women living in a rural setting.     

中国精神分裂症患者自杀风险影响因素的Meta分析

目的 系统分析我国精神分裂症患者自杀风险的影响因素,为预防自杀行为提供循证依据。方法 计算机检索PubMed、Embase、Web of Science、Cochrane图书馆、中国知网、万方数据知识服务平台、维普数据库,中国生物医学文献服务系统,搜集建库至2022年9月发表的有关中国精神分裂症患者自杀风险影响因素相关的文献,由两名研究者根据纳入和排除标准独立完成文献筛选、资料提取和质量评价,并采用Stata17.0软件进行统计学分析。结果 共纳入文献22篇,累积样本量13 266例,纳入研究质量均为中等以上。Meta分析结果显示,女性（OR=2.63,95%CI:1.88～3.66)、照顾者对疾病知识了解程度低（OR=5.46,95%CI:1.58～18.84)、饮酒（OR=2.30,95%CI:1.58～3.34)、吸烟（OR=2.45,95%CI:1.66～3.63)、自杀未遂史（OR=5.77,95%CI:4.16～7.46)、家族自杀史（OR=3.89,95%CI:1.64～9.24)、服药依从性低（OR=3.18,95%CI:1.71～5.19)、自知力缺乏（OR=3.49...     

Deaths of children occurring at home in six European countries

Objectives Until now there have been no population‐based European data available regarding place of death of children. This study aimed to compare proportions of home death for all children and for children dying from complex chronic conditions (CCC) in six European countries and to investigate related socio‐demographic and clinical factors. Methods Data were collected from the death certificates of all deceased children aged 1–17 years in Belgium, the Netherlands, Norway, England, Wales (2003) and Italy (2002). Gender, cause and place of death (home vs. outside home) and socio‐demographic factors (socio‐economic status, degree of urbanization and number of hospital beds in the area) were included in the analyses. Data were analysed using frequencies and multivariate logistic regression. Results In total 3328 deaths were included in the analyses; 1037 (31.2%) related to CCC. The proportion of home deaths varied between 19.6% in Italy and 28.6% in the Netherlands and was higher for children dying from CCC in all the countries studied, varying between 21.7% in Italy and 50% in the Netherlands. Among children dying from CCC, home death was more likely for cancer patients and those aged over 10 years. After controlling for potentially related clinical and socio‐demographic factors, differences in the proportion of home deaths between countries remained significant, with higher proportions in Belgium and the Netherlands as compared with Italy. Conclusions Although home deaths comprise a substantial proportion of all deaths of children with CCCs, variation among disease categories and across countries suggest that considerable potential still exists for further improvements in facilitating end‐of‐life care in the home for those children and families who desire to be in this location.     

Psychological distress among Ugandan adolescents living with HIV: Examining stressors and the buffering role of general and religious coping strategies

HIV infection increases the risk of psychological distress among adolescents living with HIV (ALHIV), which, in turn, increases risky behaviours such as medication non-adherence, substance use, and sexual risk-taking. The majority of studies on psychological distress among ALHIV have been conducted in high-income countries; data on the prevalence and correlates of psychological distress among ALHIV in sub-Saharan Africa (SSA) are scarce, yet over two-thirds of the global population of ALHIV resides in SSA. The purpose of this study was to identify the contextually relevant correlates of psychological distress among Ugandan ALHIV. Utilizing the stress and coping framework, we explored the risk and protective factors for psychological distress in cross-sectional sample of 464 ALHIV (aged 12–19; 53% female) at a large HIV treatment centre in Kampala, Uganda. The stressors associated with psychological distress included daily hassles, major negative life events, HIV-related quality of life, and stigma. Protective factors included psychosocial resources such as religious coping, satisfaction with social support, and general coping style and behaviours. Social support and optimism were significantly associated with psychological distress. Findings underscore the need for mental health services for ALHIV in Uganda and other resource-limited settings.     

Ethnic and Gender Differences in Psychosocial Risk,Protection, and Adolescent Alcohol Use

Theoretical models suggest that many diverse psychosocial factors contribute to the etiology of substance use among youth. It has been suggested that substance use is a function of the total number of etiologic factors, rather than a specific type or set of factors. This study examined whether cumulative psychosocial risk and protection measured in the 7th grade predicted alcohol use in the 9th grade across ethnically diverse samples of adolescents. Participants consisted of black (n = 775) and Hispanic (n = 467) inner-city youth and white suburban youth (n = 708). Prevalence rates for alcohol use and risk/protection varied more widely based on ethnic group compared to gender. Black youth reported the fewest risk factors and lowest levels of alcohol use, white youth reported the most risk factors and highest levels of alcohol use, and Hispanic youth reported the fewest protective factors and intermediate levels of alcohol use. Despite these differences, structural equation modeling indicated that a latent factor consisting of cumulative risk, protection, and their interaction significantly predicted later alcohol use for the combined sample as well as for each ethnic/gender subgroup. However, the proportion of variance explained in alcohol use varied across subgroups, and moderator analyses indicated that protection significantly buffered the effects of risk differentially across subgroups. The strongest protective effects were observed among black inner-city youth. Findings suggest that prevention approaches should focus on enhancing protection in addition to reducing risk, particularly among youth with lower levels of psychosocial protection.