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Child maltreatment and metabolic syndrome: a systematic review
Get PDFBackground: Evidence suggests that child maltreatment (CM) is associated with an elevated risk of adult diseases in later life. Emerging evidence shows that CM in childhood is associated with metabolic syndrome (MetS) in adulthood. However, no study has systematically examined the evidence. Hence, this review aims to synthesise the evidence on the association between forms of CM and MetS in adulthood. Methods: Electronic databases of CINAHL, Medline, PsychInfo, SOCINDEX, and Scopus were systematically searched using predefined key terms to identify relevant published studies on the association between CM and MetS from the beginning of indexing to 1st January 2024. Studies were included if they met the selection criteria. The quality of studies was appraised using suitable criteria for cross-sectional and prospective studies. Results: The search revealed a total of 2411 studies. Five studies met the inclusion criteria and were included in the review. The findings revealed that there was an association between physical abuse and MetS in women across two studies and one study in men. In addition, one study reported an association between emotional abuse and the risk of MetS in men, while two studies revealed increased odds with CM. However, no significant associations were reported between MetS and childhood sexual abuse and neglect, respectively. Conclusion: These findings suggest that some forms of CM may increase a person’s risk of having MetS. However, there is a need for methodological improvements due to heterogeneity in studies, mainly on the assessment and definition of CM. Further research is needed on forms of CM and MetS to understand the underlying mechanisms of the associations found and to identify targeted strategies to prevent the impact of CM on MetS and subsequent future health.</p
Energetic activity for depression in young people aged 13-17 years: the READY feasibility RCT
Get PDFBackground: Prevalence of depression is increasing in young people (YP). Behaviour change interventions providing benefits equal to or greater than talking therapies or pharmacological alternatives are needed. Exercise could be beneficial for YP with depression, but we lack robust, trials of effectiveness. Objective(s): Test whether an exercise intervention targeting YP with depression is feasible, including recruitment and retention of YP, recruitment and training of exercise professionals and intervention delivery. Design: Three-arm cluster feasibility Randomised Controlled Trial (RCT) with embedded process evaluation and health economic data collection. Setting: Local community venues in Hertfordshire, Bedfordshire, and Norfolk. Participants: Young people aged 13-17 years experiencing mild to moderate low mood or depression (indicated by scoring 17-36 on the Child Depression Inventory version 2 (CDI 2)) identified by mental health services, schools or by self-referral. Interventions: Participants were randomised to one of three groups: high intensity exercise, low intensity exercise, or a social activity control. Group sessions ran twice weekly for 12 weeks delivered by registered exercise professionals (REP), supported by mental health support workers (MHSW). Main outcome measures: Referral, recruitment, and retention rates; attendance at group sessions; adherence to and ability to reach intensity during exercise sessions, proportions of missing data, and adverse events measured at baseline, 3, and 6 months; resource use; reach and representativeness. Results: Of 321 referrals to the study, 173 were assessed for eligibility and of the target sample size of 81, 15 were recruited and 14 randomised (1 withdrawal). Retention rate was 71.4% and attendance at intervention sessions was >67%; data completeness was >80% for baseline assessments. Follow up completion rate at 14 weeks was >80% for most outcomes, with 50% for accelerometer data in the low intensity group. Trial processes and the intervention were acceptable to YP. Barriers and facilitators to intervention delivery were identified. Limitations: Findings highlighted challenges around recruitment, delivery of exercise interventions and informed ways of addressing barriers to recruitment for future studies. The study was conducted between October 2020 and August 2022 and consequently COVID-19 had a disruptive impact on implementation. Conclusions: A large, randomised trial of the effectiveness of the intervention is not feasible using the current study design, but issues relating to recruitment could be addressed with further work. Future work: Developing appropriate recruitment strategies via triage services, GP practices, schools and social media and early engagement with local CRN (Clinical Research Network) to support the recruitment into the study would address significant shortfalls identified. YP who are deemed unsuitable for mental health services should be followed up to offer participation in such interventions. Collaborations between the NHS services and sports delivery partners should consider in-person contact with YP rather than remote consultations. Recruiting through GP practices is effective and relatively inexpensive. The role of community engagement (social-media, public health agencies, community groups) needs to be further explored. Strong PPI (Public and Patient Involvement) and engagement via YP Advisory Groups is important to ensure that research is relevant to YP
Effects of continuous cropping of Codonopsis pilosula on rhizosphere soil microbial community structure and metabolomics
Get PDFCodonopsis pilosula is an important medicinal plant in China. Continuous cropping of C. pilosula affects crop quality and yield. However, comprehensive research on the impacts of continuous cropping on soil properties, microbial community structures, and soil metabolites is lacking. This study involved collecting rhizosphere soil samples from C. pilosula monocropped for 1 to 4 years to analyze variations in soil properties, microbial community structure, and metabolites across different continuous-cropping years (CCYs) through metabolomic and microbiomic analyses. Significant variations in the soil properties were observed; total phosphorus (TP) and available potassium (AK) in the rhizosphere soil increased with the number of CCYs, and pH declined. The microbial community structure significantly changed with continuous cropping. Overall, the soil bacterial diversity decreased with increasing CCY. The abundances of Proteobacteria and Firmicutes significantly decreased with increasing CCY, whereas the abundance of Acidobacteria significantly increased. The fungal diversity tended to decrease, with an increase in the abundance of beneficial Basidiomycota and an increase in potentially pathogenic Rozellomycota. Metabolomic analysis revealed 101 metabolites and significant changes in lipid compounds, organic acids, phenols, and carbohydrates. Notably, autotoxic substances such as 2,6-di-tert-butylphenol accumulated with increasing CCY. The results indicated that the main factors causing continuous-cropping obstacles in C. pilosula were soil nutrient imbalance and autotoxic substance accumulation. Continuous cropping of C. pilosula significantly altered the microbial community structure and metabolomic profile of rhizosphere soils. Effective management practices are needed to mitigate soil acidification, nutrient imbalances, and autotoxic substance accumulation during continuous cropping. Future research should focus on integrated soil management strategies to maintain soil health and crop productivity in C. pilosula continuous-cropping systems
The PHEM-B toolbox of methods for incorporating the influences on behaviour into public health economic models
Get PDFBackground: It is challenging to predict long-term outcomes of interventions without understanding how they work. Health economic models of public health interventions often do not incorporate the many determinants of individual and population behaviours that influence long term effectiveness. The aim of this paper is to draw on psychology, sociology, behavioural economics, complexity science and health economics to: (a) develop a toolbox of methods for incorporating the influences on behaviour into public health economic models (PHEM-B); and (b) set out a research agenda for health economic modellers and behavioural/ social scientists to further advance methods to better inform public health policy decisions. Methods: A core multidisciplinary group developed a preliminary toolbox from a published review of the literature and tested this conceptually using a case study of a diabetes prevention simulation. The core group was augmented by a much wider group that covered a broader range of multidisciplinary expertise. We used a consensus method to gain agreement of the PHEM-B toolbox. This included a one-day workshop and subsequent reviews of the toolbox. Results: The PHEM-B toolbox sets out 12 methods which can be used in different combinations to incorporate influences on behaviours into public health economic models: collaborations between modellers and behavioural scientists, literature reviewing, application of the Behaviour Change Intervention Ontology, systems mapping, agent-based modelling, differential equation modelling, social network analysis, geographical information systems, discrete event simulation, theory-informed statistical and econometric analyses, expert elicitation, and qualitative research/process tracing. For each method, we provide a description with key references, an expert consensus on the circumstances when they could be used, and the resources required. Conclusions: This is the first attempt to rigorously and coherently propose methods to incorporate the influences on behaviour into health economic models of public health interventions. It may not always be feasible or necessary to model the influences on behaviour explicitly, but it is essential to develop an understanding of the key influences. Changing behaviour and maintaining that behaviour change could have different influences; thus, there could be benefits in modelling these separately. Future research is needed to develop, collaboratively with behavioural scientists, a suite of more robust health economic models of health-related behaviours, reported transparently, including coding, which would allow model reuse and adaptation
Synthetic brain images: bridging the gap in brain mapping with generative adversarial model
Get PDFMagnetic Resonance Imaging (MRI) is a vital modality for gaining precise anatomical information, and it plays a significant role in medical imaging for diagnosis and therapy planning. Image synthesis problems have seen a revolution in recent years due to the introduction of deep learning techniques, specifically Generative Adversarial Networks (GANs). This work investigates the use of Deep Convolutional Generative Adversarial Networks (DCGAN) for producing high-fidelity and realistic MRI image slices. The suggested approach uses a dataset with a variety of brain MRI scans to train a DCGAN architecture. While the discriminator network discerns between created and real slices, the generator network learns to synthesise realistic MRI image slices. The generator refines its capacity to generate slices that closely mimic real MRI data through an adversarial training approach. The outcomes demonstrate that the DCGAN promise for a range of uses in medical imaging research, since they show that it can effectively produce MRI image slices if we train them for a consequent number of epochs. This work adds to the expanding corpus of research on the application of deep learning techniques for medical image synthesis. The slices that are could be produced possess the capability to enhance datasets, provide data augmentation in the training of deep learning models, as well as a number of functions are made available to make MRI data cleaning easier, and a three ready to use and clean dataset on the major anatomical plans
Less talk, more action? exploring proficiency scores and embodied resources in online L2 interactions
Get PDFThis mixed-methods study explores Embodied Resources (ERs) in an online, triadic task involving 52 candidates within the Common European Framework of Reference for Languages (CEFR) B2˗C1 range of language proficiency. Mean comparisons and correlations were used to explore the relationship between ER use and proficiency level. An applied Conversation Analysis approach was used to explicate specific sequences of conversational repair where ERs were evident. Findings suggest no significant correlation between proficiency and ER frequency but support the view that ERs are co-ordinated with verbal resources. This raises questions as to how language testers might approach the interplay of ERs and interactional practices
Mandela's legacy of leadership, old traditions, new trends: a Black British perspective on Gambia's youth landscape
Get PDFPolitical uncertainty in public-private partnership projects (PPPs): a flexible risk mitigation framework for Jordan's challenging landscape
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