What accounts for depressive symptoms among mothers? The impact of socioeconomic status,family structure and psychosocial stress

Objectives  

Based on a cross-sectional population survey of 3,129 women with minor children, it was analyzed how socioeconomic status, family structure and perceived psychosocial stress are linked and how they contributed to women’s self-reported depressive symptoms.     

Is age a better predictor of weight loss one year after gastric bypass than symptoms of disordered eating,depression, adult ADHD and alcohol consumption?

IntroductionFindings regarding psychological risk factors for low weight loss after bariatric surgery have been inconsistent. The association between gender and weight outcome is unclear while younger age has been consistently shown to be associated with better weight outcome. The aim of this study was to analyze the interactions between gender and age on the one hand and symptoms of disordered eating, depression, adult ADHD and alcohol consumption on the other hand in regard to weight loss after gastric bypass.MethodsBariatric surgery patients were recruited and asked to fill out self-report questionnaires regarding behavioral risk factors before and twelve months after surgery. Data from one hundred and twenty-nine patients were analyzed.ResultsAfter controlling for age, no psychological variable measured prior to surgery could predict weight loss after twelve months. After surgery, there was an interaction effect between age, gender and specific eating disorder symptoms. Specifically, loss of control over eating was a risk factor for low weight loss among older, but not among younger, female participants. Symptoms of adult ADHD were associated with elevated alcohol consumption after surgery.DiscussionThese results indicate that age and gender may moderate the effects of potential risk factors for inferior weight outcome. This interaction could potentially be one of the reasons behind the mixed findings in this field. Thus, there are important gender differences in the bariatric population that should be considered. The present study is the first to show that symptoms of adult ADHD may not be a risk factor for inferior weight loss but for alcohol risk consumption after gastric bypass.     

The effect of stress on the onset and progression of Creutzfeldt–Jakob disease: Results of a German pilot case–control study

The association between Creutzfeldt–Jakob disease (CJD) and stressful life events was examined in a pilot case–control study in Germany. The study sample consisted of 37 CJD cases and 37 controls, both groups were frequency-matched for age and sex. In standardised interviews of close relatives of the cases and the controls, all stressful life events were assessed and subsequently grouped into one of the following three subgroups: psychosocial stress events, medical operations with hospitalisation, and other serious medical examinations. A significantly higher proportion of CJD cases experienced stressful life events during the last six months before disease onset than controls (65% vs. 32%, p=0.01), yielding an odds ratio (OR) of 3.85 (95% confidence interval (CI): 1.33–11.30). We found the clearest distinction between cases and controls for the subgroup of medical operations where an OR of 6.97 (95% CI: 0.76–329.20) was observed. Further data indicated that stressful events seem to influence not only the onset of CJD but also the progression of the disease. Although based on a rather small study sample, this pilot case–control investigation suggests evidence that stressful life events in the last six months before disease onset may influence CJD occurrence and may modify the course of disease. This stress hypothesis, which is in line with findings from other epidemiological and experimental studies in CJD, is thus a promising direction for future CJD research as it could enlighten the pathophysiological mechanisms and point towards strategies for the prevention and therapy of CJD.     

Does quality of life among breast cancer survivors one year after diagnosis differ depending on urban and non-urban residence? A comparative study

Background  

This study examined the quality of life (QOL), measured by the Functional Assessment of Cancer Therapy (FACT) questionnaire, among urban (n = 277) and non-urban (n = 323) breast cancer survivors and women from the general population (n = 1140) in Queensland, Australia.     

The relationship between health-related quality of life,pain, and coping strategies in juvenile arthritis – A one year prospective study

The aim of this 12-month prospective study was to compare reports describing the health-related quality of life (HRQL) of children with Juvenile idiopathic arthritis (JIA) obtained from parents and children, to investigate the extent to which the children’s HRQL changed over a 12-month period, and to describe the relationship between children’s HRQL, and their experience of pain and use of pain coping strategies. Fifty-four children aged 8–18 years with JIA and their parents completed standard questionnaires assessing children’s HRQL, pain intensity, and pain coping strategies at baseline, 6 months, and 12 months. In general, children reported that their HRQL was better than was reported by parents. Both informants described children’s HRQL as being very stable over the 12 months of the study. Consistent with the Biobehavioural Model of Pain, there was a significant negative relationship between children’s HRQL and their experience of pain. However, there was little evidence that pain coping strategies mediated the relationship between children’s experience of pain and their HRQL.     

The 2005 World Health Organization re-evaluation of TEFs for dioxins and dioxin-like compounds — What are the consequences for German human background levels?

In 2005 the World Health Organization (WHO) re-evaluated toxicity equivalency factors (TEFs) for dioxins and dioxin-like compounds. WHO 2005 toxicity equivalent (TEq) levels were calculated based on our data on German background levels of polychlorinated dibenzo-p-dioxins (PCDD), dibenzofurans (PCDF) and polychlorinated biphenyls (PCB) in human blood and milk of the Duisburg birth cohort study. Levels of WHO 2005 TEq (PCDD/F+PCB) were in the range of 3.77-63.6 pg/g(lipid base) (n=226, median: 19.38, arithmetic mean: 20.86) for blood, or 2.62-59.2 pg/g(lipid base) (n=176, median: 19.78, arithmetic mean: 20.57) for milk, respectively. Compared to WHO 1998 TEq values WHO 2005 TEq levels were about 25% lower in both matrices. The shares of PCB (31% blood, 43% milk), especially of mono-ortho-substituted PCB (4% blood and milk), on total WHO 2005 TEq has become lower. If similar congener patterns can be assumed for certain matrices, appropriate multiplication factors can be used to convert TEq values of other TEF models sufficiently to WHO 2005 TEq values.     

The relationship between antibiotic therapy in early childhood and the symptoms of allergy in children aged 6–8 years — the questionnaire study results

Introduction

Studies based on the ISAAC questionnaire suggest a correlation between the use of antibiotics and the prevalence of asthma and allergy in children aged 6–7 years. The number of courses of antibiotic therapy is an important factor.

Objectives

To investigate the relationship between the use of antibiotics during the first years of life and the prevalence of allergy and asthma among children (aged 6–8 years) in the urban population of Poland.

Materials and Methods

A survey-based study with a self-completed questionnaire. The respondents were parents of children aged 6-8 years living in Warszawa, Poland. 1461 completed questionnaires were collected.

Results

Asthma was declared in 4.3% of the children. Wheezing and/or sibilant rhonchi within 12 months before the study was observed in 13.5% of the cases. Asthma medication was taken by 21.8% of the children. Allergic rhinitis was declared in 18.7% of the children. Problems with sneezing, rhinorrhea, and nasal congestion not associated with cold or fever were observed in 40.7% of the children. The analysis of the odds ratios between the use of antibiotics and the symptoms of allergic diseases revealed a clear correlation. The highest odds ratio was observed between the completion of over three courses of antibiotic therapy prior to the age of 12 months and the declaration of one of the following: asthma (OR = 5.59, 95% CI: 2.6–12.01), wheezing and/or sibilant rhonchi (OR = 4.68, 95% CI: 3.01–7.27) and taking medicines for breathlessness (OR = 5.12, 95% CI: 3.42–7.68).

Conclusions

There is a direct relationship between antibiotic use in the first 3 years of life and asthma and allergy symptoms in children aged 6–8 years old.     

The M-OVIN study: does switching treatment to FSH and / or IUI lead to higher pregnancy rates in a subset of women with world health organization type II anovulation not conceiving after six ovulatory cycles with clomiphene citrate – a randomised controlled trial

Background

Clomiphene citrate (CC) is first line treatment in women with World Health Organization (WHO) type II anovulation and polycystic ovary syndrome (PCOS). Whereas 60% to 85% of these women will ovulate on CC, only about one half will have conceived after six cycles. If women do not conceive, treatment can be continued with gonadotropins or intra-uterine insemination (IUI). At present, it is unclear for how many cycles ovulation induction with CC should be repeated, and when to switch to ovulation induction with gonadotropins and/or IUI.

Methods/Design

We started a multicenter randomised controlled trial in the Netherlands comparing six cycles of CC plus intercourse or six cycles of gonadotrophins plus intercourse or six cycles of CC plus IUI or six cycles of gonadotrophins plus IUI.Women with WHO type II anovulation who ovulate but did not conceive after six ovulatory cycles of CC with a maximum of 150 mg daily for five days will be included.Our primary outcome is birth of a healthy child resulting from a pregnancy that was established in the first eight months after randomisation. Secondary outcomes are clinical pregnancy, miscarriage, multiple pregnancy and treatment costs. The analysis will be performed according to the intention to treat principle. Two comparisons will be made, one in which CC is compared to gonadotrophins and one in which the addition of IUI is compared to ovulation induction only. Assuming a live birth rate of 40% after CC, 55% after addition of IUI and 55% after ovulation induction with gonadotrophins, with an alpha of 5% and a power of 80%, we need to recruit 200 women per arm (800 women in total).An independent Data and Safety Monitoring Committee has criticized the data of the first 150 women and concluded that a sample size re-estimation should be performed after including 320 patients (i.e. 80 per arm).

Discussion

The trial will provide evidence on the most effective, safest and most cost effective treatment in women with WHO type II anovulation who do not conceive after six ovulatory cycles with CC with a maximum of 150 mg daily for five days. This evidence could imply the need for changing our guidelines, which may cause a shift in large practice variation to evidence based primary treatment for these women.

Trial registration number

Netherlands Trial register NTR1449