Long-term survivors following autologous haematopoetic stem cell transplantation have significant defects in their humoral immunity against vaccine preventable diseases,years on from transplant

Current international guidelines recommend routinely vaccinating haematopoetic stem cell transplant (HSCT) recipients. Despite significant infection-related mortality following autologous HSCT, routine vaccination programmes (RVP) completion is poor. For recovered HSCT recipients, it is uncertain whether catch-up vaccination remains worthwhile years later.To determine potential susceptibility to vaccine preventable infections, we measured antibody titres in 56 patients, a median of 7 years (range 0–29) following autologous HSCT, who had not completed RVP. We found that almost all participants had inadequate titres against diphtheria (98.2%) and pneumococcal infection (100%), and a significant proportion had inadequate titres against measles (34.5%). Of those subsequently vaccinated according to available guidelines, many mounted adequate serological responses.These data suggest a pragmatic catch-up approach for autologous HSCT recipients who have not completed RVP is advisable, with universal vaccination against some pathogens (e.g. Streptococcus pneumoniae and diphtheria) and serologically-guided approaches for others (e.g. measles and varicella zoster virus).     

Onset of loneliness in older adults: results of a 28?year prospective study

The goal of this research is to test whether often observed correlates of loneliness in older age are related to onset of loneliness longitudinally. Despite the increasing number of longitudinal studies, the investigation of factors that are related to onset of loneliness is still limited. Analyses are based on data of the TamELSA study, which is a population-based prospective study in Tampere, Finland and started in 1979. For the present study 469 older adults aged between 60 and 86 years at baseline, who were not lonely at baseline, were selected and followed-up in 1989, 1999 and 2006. During the 28 years of follow-up approximately one third (N = 178) of the study population developed feelings of loneliness. Logistic regression analyses indicated that losing a partner, reduced social activities, increased physical disabilities, increased feelings of low mood, uselessness and nervousness, rather than baseline characteristics, are related to enhanced feelings of loneliness at follow-up. The higher incidence of loneliness among women can be fully explained by the unequal distribution of risk factors among men and women (e.g., women more often become widowed). Our results are in line with the cognitive approach that conceptualizes loneliness as an unpleasant feeling due to a perceived discrepancy between the desired and the achieved level of social and personal resources.     

Delayed sleep–wake phase disorder in young adults: prevalence and correlates from a national survey of Norwegian university students

BackgroundDelayed sleep–wake phase disorder (DSWPD) during adolescence has been linked to impaired health and poor functioning. However there is a dearth of knowledge about DSWPD in young adulthood. We seek to contribute knowledge on the prevalence and correlates of DSWPD in this age group.MethodsData were drawn from a 2018 national survey of students in higher education in Norway (the SHoT-study). All 162,512 fulltime students in Norway were invited to participate and 50,054 students (69.1% women) aged 18–35 years were included (response rate = 30.8%). DSWPD was assessed by self-report, and was operationalized according to the criteria for DSWPD in the most recent edition of the International Classification of Sleep Disorders. Correlates of DSWPD were examined by validated self-report instruments covering a wide range of demographic and health domains.ResultsThe overall prevalence of DSWPD was 3.3%, and significantly higher in male (4.7%) than female (2.7%) students. DSWPD was associated with being single, having financial difficulties, having divorced parents, being overweight/obese, and physical inactivity. Students with DSWPD had more sleep problems during weekdays, and higher levels of somatic and mental health problems. Students with DSWPD also had an elevated risk of self-harm-related thoughts and behaviors as well as suicidality.ConclusionDSWPD remains a significant problem among young adults, and the high symptom load across health domains indicates that suggests a need for existing evidence-based approaches to be scaled for college students who present with DSWPD.     

The Global Activity Limitation Index mainly measured functional disability,whereas self-rated health measured physical morbidity

ObjectivesAs the Global Activity Limitation Index (GALI) has only recently been created and it is not yet known whether it adds any additional information to self-rated health (SRH), two hypotheses were tested: (1) GALI is primarily correlated with functional disability and secondarily with morbidity and (2) SRH is primarily correlated with morbidity and secondarily with functional disability.MethodsThe data source used was a subsample of the 2006 Spanish National Health Survey comprising people aged more than 64 years (N = 7,835). Age, sex, social class, physical and mental morbidities, and functional disability were selected as predictors in multinomial logistic regression models, in which GALI and SRH were the outcome variables. Fractional polynomials were used to handle the continuous predictors.ResultsThe results supported, generally, both hypotheses: functional disability was the main correlate of GALI and physical morbidity, rather than mental morbidity, was the main correlate of SRH. Furthermore, mental morbidity was as strong a correlate of GALI as SRH, but physical morbidity was notably less strong a correlate for GALI than for SRH.ConclusionIn older people, GALI mainly measured functional disability, whereas SRH mainly measured physical morbidity.     

Association between common genetic risk variants and depression in Parkinson's disease: A dPD study in Chinese

IntroductionPrediction of depression in patients with Parkinson's disease (PD) remains challenging. We investigated whether the common susceptible genetic variants for PD are associated with the risk and improves prediction of development of depression in PD (dPD).Methods1134 individuals with a primary diagnosis of PD were recruited. Demographic information, Unified Parkinson's Disease Rating Scale (UPDRS), and 17-item Hamilton Rating Scale for Depression (HAMD) were obtained. Nine variants located in six susceptible genes for PD were determined in all subjects. Logistic regression analyses were used to identify the study genetic variants that individually and collectively best predicted the presence of depressive disorder (HAMD ≥14).ResultsDepression occurred in 19.8% of patients with PD. The GBA L444P variant was associated with an increased risk of depression (odds ratio [OR] = 2.69, 95% confidence interval [CI] = 1.31–5.53, P = 0.007) and SNCA-Rep1 (CA)12/12 showed a decreased risk for the presence of depression (OR = 0.54, 95% CI = 0.29–0.99, P = 0.049) in the PD population after adjusted for demographic and clinical factors. Stepwise logistic regression model found that female sex, UPDRS part II score, motor fluctuation, GBA L1444P and SNCA Rep-1 variants collectively best predict depression in PD.ConclusionsBesides non PD-specific and PD-specific clinical correlates, we showed that GBA L444P and SNCA Rep-1 were also associated with dPD. Our findings highlight the crucial role of genetic variants for the prediction of dPD in clinical practice and may shed light on the future development of better therapeutic targets for dPD.     

Trajectories of delinquent behaviour in adolescence and their covariates: relations with initial and time-averaged factors

This longitudinal study examined individual, family, and peer covariates of distinctive trajectories of juvenile delinquency, using data from a community sample of 318 German adolescents (mean age at the first wave was 11.45 years). Latent growth mixture modelling analysis revealed four trajectory groups: high-level offenders, medium-level offenders, low-level offenders, and rare offenders. The trajectory groups were discriminated better by time-averaged covariates than by initial status covariates. High peer tolerance of deviance and low parental empathy were consistently linked to varying offending trajectories, whereas gender, low academic achievement, and low parental monitoring appeared to be trajectory-specific covariates.     

Risk factors and correlates of deliberate self-harm behavior: A systematic review

Objective

Deliberate self-harm behavior—without suicidal intent—is a serious health problem and may be studied as a clinical phenomenon in its own right. Empirical studies of sociodemographic and psychological correlates and risk factors are systematically reviewed.

Methods

We searched Medline, PsycINFO, PSYNDEX (German psychological literature), and reference lists. We targeted self-induced bodily harm without conscious suicidal intent. Studies on suicidal behavior or self-poisoning were only included if they also assessed nonsuicidal self-harm.

Results

Fifty-nine original studies met the criteria. Deliberate self-harm may occur at all ages, yet adolescents and young adults are at a higher risk. Evidence on gender is complex. Only 5 studies realize a prospective design (6 months to 10 years) and test predictors. The majority use cross-sectional and retrospective methods. No longitudinal study (separately) examines new incidence. Evidence of correlates encompasses distal/proximal, person/environment, and state/trait factors. Many studies report associations between current self-harm behavior and a history of childhood sexual abuse. Adolescent and adult self-harmers experience more frequent and more negative emotions, such as anxiety, depression, and aggressiveness, than persons who do not self-harm. Two studies yield specific interactions between childhood trauma and current traits and states such as low emotional expressivity, low self-esteem, and dissociation with respect to a vulnerability to self-harm.

Conclusion

Evidence of distal, biographical stressors is fairly strong. Proximal stressors have rarely been investigated; protective factors, hardly at all. Despite many findings of correlates, the data do not yet justify terming them risk factors. Longitudinal studies are needed.     

The epidemiology of insomnia: Associations with physical and mental health.: The HUNT-2 study

Objective

The aim of the present study was to examine the association of insomnia symptoms with demographic and physical and mental conditions in a large population-based study.

Methods

Cross-sectional data on insomnia and comorbid conditions were gathered from 47,700 individuals aged 20-89 in Norway. Comorbid conditions included anxiety and depression and the following physical conditions: asthma, allergy, cancer, hypertension, diabetes, migraine, headache, osteoporosis, fibromyalgia rheumatoid arthritis, arthrosis, Bechterew's disease, musculoskeletal disorders, and obesity (body mass index >30).

Results

Insomnia symptoms were found in 13.5% of the population and were more prevalent among women, older adults, and in individuals with less education. Reporting insomnia symptoms significantly increased the associations with a range of conditions, especially mental conditions, pain conditions with uncertain etiology and, to a lesser extent, chronic pain conditions. These findings remained significant also when adjusting for a range of potential confounders, whereas the association between insomnia and somatic conditions was largely reduced to a nonsignificant level in the fully adjusted analyses.

Conclusion

This study demonstrates that insomnia symptoms are associated with a range of different conditions. The findings suggest that the independent contribution of insomnia is strongest on conditions characterized by some level of psychological or psychosomatic properties.     

Prevalence and correlates of domestic violence by husbands against wives in Bangladesh: evidence from a national survey

Background

The aim of this study was to determine the prevalence of domestic violence by husbands against wives (DVHW) and its correlates using the data of ever married men from a national survey.

Methods

This subset of ever married men (equal to 2823 if weighted and 3165 if unweighted) was extracted from 4297 men (including single) aged 14-54 years, who were interviewed during the Bangladesh Demographic and Health Survey (BDHS) in 2004. The BDHS 2004 applied a pre-tested structured questionnaire for men to collect much information including socio-demographic, life-style, violence (physical and sexual) against wives and reasons for violence. SPSS version 10 was used to perform all of the analyses.

Results

The prevalence of physical, sexual and overall DVHW was 68%, 27% and 72%, respectively within the year preceding the survey. Slapping/twisting (61%) and pushing/shaking/throwing something (40%) were the most common forms of physical DVHW. Age, place of residence, education, religion and number of children showed significant associations (by odds ratio) with at least one form of violence using multiple logistic regression analysis. Both cross-tabs analysis and logistic regression analysis (adjusted for age, place of residence, education, religion and number of children) indicated a significantly higher prevalence and higher odds ratio of DVHW among those husbands who: did not watch television everyday, had experience of pre-marital and post-marital sex, smoked cigarettes/bidi, chewed tobacco and took illicit drugs. The estimates of the lifestyle variables sharply attenuated when all of the variables were included in the same model, although the significance levels were changed for only some of them.

Conclusion

The high prevalence of DVHW deserves immediate attention and intervention in Bangladesh. For effective intervention, the significant correlates of DVHW, especially the lifestyle-related factors, must be taken into consideration to reduce the prevalence and consequences of DVHW in Bangladesh.