Obesity increases the risk of depression in children and adolescents: Results from a systematic review and meta-analysis

BACKGROUND

Clinical depression (including major depression, dysthymia, and unspecified depression) is common in children and adolescents with obesity and overweight. The objective of this systematic review and meta-analysis was to examine prevalence of clinical depression among overweight and obese children.

METHODS

PubMed, EMBASE, Web of Science, Medline, Cochrane library, and PsycINFO databases were systematically and independently searched by three researchers from the inception dates to April 01, 2019. The fixed-effects model was used to perform meta-analysis. Data analyses were performed with STATA Version 12.0.

RESULTS

Eleven studies with 69,893 subjects were included; 5 studies examined major depressive disorder (MDD), while the remaining 6 studies examined other types of clinical depression. In the overweight and obese group, the prevalence of clinical depression ranged from 1.7% to 26.7% in obese subjects and from 4.0% to 16.9% in overweight subjects. In studies on MDD, prevalence ranged from 10.1% to 26.7% in obese subjects and from 9.0% to 16.9% in overweight subjects. The odd ratios (ORs) of clinical depression ranged from 0.92 to 4.39 between obese subjects and healthy controls (i.e., normal-weight controls), and ranged from 0.96 to 1.67 between overweight subjects and controls. Compared to healthy controls, obese (OR = 1.851, 95% CI: 1.410-2.429) but not overweight (OR = 1.068, 95% CI: 0.889-1.283) children and adolescents were more likely to have MDD.

CONCLUSION

Obese children and adolescents had a significantly higher risk for MDD compared with healthy controls. Considering the negative health outcomes of depression, regular screening and effective treatments should be implemented for obese children and adolescents.

The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations

The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η² = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.

Prevalence and Socio-Demographic Correlates of Poor Mental Health Among Older Adults in Agricultural Areas of China

Objective: Poor mental health is associated with impaired social functioning, lower quality of life, and increased risk of suicide and mortality. This study examined the prevalence of poor general mental health among older adults (aged 65 years and above) and its sociodemographic correlates in Hebei province, which is a predominantly agricultural area of China. Methods: This epidemiological survey was conducted from April to August 2016. General mental health status was assessed using the 12-item General Health Questionnaire (GHQ-12). Results: A total of 3,911 participants were included. The prevalence of poor mental health (defined as GHQ-12 total score ≥ 4) was 9.31% [95% confidence interval (CI): 8.4-10.2%]. Multivariable logistic regression analyses found that female gender [P < 0.001, odds ratio (OR) = 1.63, 95% CI: 1.29-2.07], lower education level (P = 0.048, OR = 1.33, 95% CI: 1.00-1.75), lower annual household income (P = 0.005, OR = 1.72, 95% CI: 1.17-2.51), presence of major medical conditions (P < 0.001, OR = 2.95, 95% CI: 2.19-3.96) and family history of psychiatric disorders (P < 0.001, OR = 3.53, 95% CI: 2.02-6.17) were significantly associated with poor mental health. Conclusion: The prevalence of poor mental health among older adults in a predominantly agricultural area was lower than findings from many other countries and areas in China. However, continued surveillance of mental health status among older adults in China is still needed.

Rappaport-Vassiliadis Medium for Recovery of Salmonellaspp. from Low Microbial Load Foods: Collaborative Study

Twenty-three laboratories participated in a collaborative study to compare the relative effectiveness of Rappaport-Vassiliadis (RV) medium incubated at 42°C, selenite cystine (SC) broth (35°C), and tetrathionate (TT) broth (35 and 43°C) for recovery of Salmonella from the following foods with a low microbial load: dried egg yolk, dry active yeast, ground black pepper, guar gum, and instant nonfat dry milk. For dry active yeast, lauryl tryptose (LT) broth, incubated at 35°C, was used instead of SC broth. All of the foods were artificially inoculated with single Salmonella serovars, that had been lyophilized before inoculation, at high and low target levels of 0.4 and 0.04 colony forming units/g food, respectively. For analysis of 870 test portions, representing all of the foods except yeast, 249 Salmonella-positive test portions were detected by RV medium, 265 by TT broth (43°C), 268 by TT broth (35°C), and 269 by SC broth (35°C). For analysis of 225 test portions of yeast, 79 Salmonella-positive test portions were detected by RV medium, 79 by TT broth (43°C), 84 by TT broth (35°C), and 68 by LT broth (35°C). RV medium was comparable to, or even more effective than, the other selective enrichments for recovery of Salmonella from all of the foods except guar gum. It is recommended that RV (42°C) and TT (35°C) be used with foods that have a low microbial load, except for guar gum for which SC (35°C) and TT (35°C) are recommended.

Interaction Effect of Sex and Body Mass Index on Gray Matter Volume

Objective: Few studies have investigated sex differences in brain structure associated with body mass index (BMI), and the related findings are inconsistent. In this study, we aimed to investigate the effect of sex × BMI interactions on gray matter volume (GMV), and to determine the implications of any structural differences.

Methods: The final sample comprised 653 participants (449 women) who were assessed using voxel-based morphology analysis of T1-weighted magnetic resonance images. We used the voxel-based morphometry (VBM) to build a multiple regression model to explore the association between BMI and GMV, and used analysis of variance (ANOVA) to explore the BMI × sex interaction on GMV. A subset of 410 participants (291 women) underwent whole brain resting-state functional connectivity (rsFC) analysis to investigate sex differences in the seed (interaction) region. The cluster with a significant effect in the previous ANOVA analysis was used as a seed.

Results: A significant BMI × sex interaction was observed in the left anterior cingulate cortex (ACC), while GMV was negatively correlated with BMI in men but not in women. The rsFC between the left ACC and the caudate was lower in men than in women. Within the entire sample, the insula, caudate, and medial frontal cortex activities were negatively correlated with BMI while the cerebellum and postcentral gyrus activities were positively correlated with BMI.

Conclusions: Our findings address the interaction effect of BMI and sex on GM alterations. We found that the GMV in men seemed to be more likely to change with BMI than women, and the left ACC may be the reason for the increase in BMI of men, but not women.

Identifying At-Risk Subgroups for Acute Postsurgical Pain: A Classification Tree Analysis

Objective

Acute postsurgical pain is common and has potentially negative long-term consequences for patients. In this study, we evaluated effects of presurgery sociodemographics, pain experiences, psychological influences, and surgery-related variables on acute postsurgical pain using logistic regression vs classification tree analysis (CTA).

Design

The study design was prospective.

Setting

This study was carried out at Chongqing No. 9 hospital, Chongqing, China.

Subjects

Patients (175 women, 84 men) completed a self-report battery 24 hours before surgery (T1) and pain intensity ratings 48-72 hours after surgery (T2).

Results

An initial logistic regression analysis identified pain self-efficacy as the only presurgery predictor of postoperative pain intensity. Subsequently, a classification tree analysis (CTA) indicated that lower vs higher acute postoperative pain intensity levels were predicted not only by pain self-efficacy but also by its interaction with disease onset, pain catastrophizing, and body mass index. CTA results were replicated within a revised logistic regression model.

Conclusions

Together, these findings underscored the potential utility of CTA as a means of identifying patient subgroups with higher and lower risk for severe acute postoperative pain based on interacting characteristics.

Arthritis self-efficacy beliefs and functioning among osteoarthritis and rheumatoid arthritis patients: a meta-analytic review

Objectives

The Arthritis Self-Efficacy Scale (ASES) is a widely used self-report measure of beliefs reflecting confidence in one’s capacity to function despite pain and control pain or other symptoms of arthritis. Despite evidence linking higher ASES scores to lower levels of impairment, pain and emotional distress, numerous modest, non-significant associations have also been observed. In this meta-analysis, we evaluated overall associations between ASES scores and adjustment in RA and OA samples as well as potential moderators that may explain the heterogeneity in these associations.

Method

Data from 48 samples that met all 10 inclusion criteria (N = 9222 patients) were subject to analyses.

Results

ASES scores had significant medium average effect sizes with functional impairment, pain severity and emotional distress but substantial heterogeneity was evident for each association. ASES–impairment associations were moderated by the diagnosis, ASES version and ASES subscale content: significantly larger effect sizes were found for studies that included RA patients, used the original 20-item ASES and assessed subscale content reflecting the pursuit of daily activities despite pain (i.e. functional self-efficacy) than for studies based exclusively on OA patients, the eight-item ASES and ASES pain control and other symptom subscales. Relations of ASES scores with pain severity and emotional distress were moderated by ASES version and subscale content, respectively.

Conclusion

The ASES has significant overall associations with key areas of functioning. Moderator analyses of the measure provide empirically grounded suggestions for optimal use of the ASES within OA and RA patient samples.

Differential effect with septal and apical RV pacing on ventricular activation in patients with left bundle branch block assessed by non-invasive electrical imaging and in silico modelling

Purpose

It is uncertain whether right ventricular (RV) lead position in cardiac resynchronization therapy impacts response. There has been little detailed analysis of the activation patterns in RV septal pacing (RVSP), especially in the CRT population. We compare left bundle branch block (LBBB) activation patterns with RV pacing (RVP) within the same patients with further comparison between RV apical pacing (RVAP) and RVSP.

Methods

Body surface mapping was undertaken in 14 LBBB patients after CRT implantation. Nine patients had RVAP, 5 patients had RVSP. Activation parameters included left ventricular total activation time (LVtat), biventricular total activation time (VVtat), interventricular electrical synchronicity (VVsync), and dispersion of left ventricular activation times (LVdisp). The direction of activation wave front was also compared in each patient (wave front angle (WFA)). In silico computer modelling was applied to assess the effect of RVAP and RVSP in order to validate the clinical results.

Results

Patients were aged 64.6 ± 12.2 years, 12 were male, 8 were ischemic. Baseline QRS durations were 157 ± 18 ms. There was no difference in VVtat between RVP and LBBB but a longer LVtat in RVP (102.8 ± 19.6 vs. 87.4 ± 21.1 ms, p = 0.046). VVsync was significantly greater in LBBB (45.1 ± 20.2 vs. 35.9 ± 17.1 ms, p = 0.01) but LVdisp was greater in RVP (33.4 ± 5.9 vs. 27.6 ± 6.9 ms, p = 0.025). WFA did rotate clockwise with RVP vs. LBBB (82.5 ± 25.2 vs. 62.1 ± 31.7 ^op = 0.026). None of the measurements were different to LBBB with RVSP; however, the differences were preserved with RVAP for VVsync, LVdisp, and WFA. In silico modelling corroborated these results.

Conclusions

RVAP activation differs from LBBB where RVSP appears similar.

Trial registration

(ClinicalTrials.gov identifier: NCT01831518)

Electronic supplementary material

The online version of this article (10.1007/s10840-019-00567-2) contains supplementary material, which is available to authorized users.

Effects of Palatable Food Versus Thin Figure Conflicts on Responses of Young Dieting Women

Many young women use dieting to achieve a thinner figure yet most tend to fail as a result of heightened responsiveness to palatable food environments and increases in hedonic cravings. In this preliminary study, we developed a novel palatable food vs. thin figure conflict task to assess conflicting motives associated with eating among young women. Forty young dieting women [mean body mass index (BMI) = 22.98 kg/m², SD = 3.81] completed a food vs. figure conflict task within a 2 (distractor image: food vs. figure) × 2 (word-image congruence: congruent vs. incongruent) within-subjects design. Results supported the view that this new task could effectively capture conflict costs. Dieting young women displayed stronger food conflicts than figure conflicts based on having longer response delays and higher error rates in the food conflict condition than the figure conflict condition. Although young women often proclaimed "dieting" to achieve or maintain a good figure, dieters appeared to exhibit stronger preferences for palatable food cues relative to thin figure cues. These results provide important information for understanding automatic processing biases toward palatable foods and underscore the need for research extensions in other cultural contexts to determine whether such biases are universal in nature.

An architectural understanding of natural sway frequencies in trees

The relationship between form and function in trees is the subject of a longstanding debate in forest ecology and provides the basis for theories concerning forest ecosystem structure and metabolism. Trees interact with the wind in a dynamic manner and exhibit natural sway frequencies and damping processes that are important in understanding wind damage. Tree-wind dynamics are related to tree architecture, but this relationship is not well understood. We present a comprehensive view of natural sway frequencies in trees by compiling a dataset of field measurement spanning conifers and broadleaves, tropical and temperate forests. The field data show that a cantilever beam approximation adequately predicts the fundamental frequency of conifers, but not that of broadleaf trees. We also use structurally detailed tree dynamics simulations to test fundamental assumptions underpinning models of natural frequencies in trees. We model the dynamic properties of greater than 1000 trees using a finite-element approach based on accurate three-dimensional model trees derived from terrestrial laser scanning data. We show that (1) residual variation, the variation not explained by the cantilever beam approximation, in fundamental frequencies of broadleaf trees is driven by their architecture; (2) slender trees behave like a simple pendulum, with a single natural frequency dominating their motion, which makes them vulnerable to wind damage and (3) the presence of leaves decreases both the fundamental frequency and the damping ratio. These findings demonstrate the value of new three-dimensional measurements for understanding wind impacts on trees and suggest new directions for improving our understanding of tree dynamics from conifer plantations to natural forests.

Causal effects of challenge and threat appraisals on pain self-efficacy, pain coping, and tolerance for laboratory pain: An experimental path analysis study

Background

Primary appraisals of pain as a potential threat influence pain perception and coping but comparatively less is known about related effects of challenge appraisals or causal effects of primary appraisals on secondary appraisals of perceived pain coping capacities (e.g., pain self-efficacy).

Methods

To address these gaps, young Chinese women (N = 147) and men (N = 88) were randomly assigned to one of three appraisal conditions prior to engaging in a cold pressor test (CPT): (1) a higher threat appraisal condition featuring task orienting information describing symptoms and consequences of frostbite, (2) a lower threat appraisal condition featuring orienting information about safety of the CPT, or (3) a challenge appraisal condition featuring orienting information describing benefits of persistence despite discomfort for future life satisfaction.

Results

Compared to peers in the higher threat condition, challenge condition cohorts experienced smaller decreases in task-related self-efficacy, more cognitive coping, and less catastrophizing as well as more overall pain tolerance. A path analysis indicated that self-efficacy changes, cognitive coping and catastrophizing fully mediated links of subjective challenge and threat appraisals with pain tolerance.

Conclusions

Initial appraisals about the nature of pain influence, not only pain tolerance and coping, but also perceived coping capacities.

Perspective

Through examining particular theory-based pain appraisal and coping processes, this experiment is the first to identify both perceived coping capacities (pain self-efficacy) and coping responses as factors that explain why appraisals of pain as a challenge or threat have differential effects on pain tolerance.

Fear of pain and event-related potentials during exposure to image-cued somatosensory stimulation

Numerous behavior studies have assessed links of pain-related fear with biases in attention towards pain stimuli but considerably less is known about neural processes underlying such biases. To address this gap, event-related potentials (ERPs) were examined as 39 high pain-fearful (Hi-FOP) and 36 low pain-fearful (Lo-FOP) adults (1) viewed non-painful versus painful images and (2) subsequently received non-painful versus possibly painful somatosensory stimulation, respectively. The Hi-FOP group judged both non-painful and painful somatosensory stimulation to be more intense than Lo-FOP group members did. Hi-FOP group members also displayed smaller N1 amplitudes than Lo-FOP group members did during image presentations, regardless of image type. Finally, Lo-FOP group members exhibited larger P3 amplitudes when processing potentially painful somatosensory stimulation compared to non-painful stimulation while no such difference was observed in Hi-FOP group members. Overall results suggested that the pain-fearful tended to exaggerate the subjective intensity of potentially painful somatosensory stimuli but allocated comparatively fewer cognitive resources to processing such stimulation; arguably, this pattern perpetuates high fear of pain levels.

Results of an international comparison of activity measurements of 68Ge

An international key comparison, identifier CCRI(II)-K2.Ge-68, has been performed. The National Institute of Standards and Technology (NIST) served as the pilot laboratory, distributing aliquots of a 68Ge/68Ga solution. Results for the activity concentration, CA, of 68Ge at a reference date of 12h00 UTC 14 November 2014 were submitted by 17 laboratories, encompassing many variants of coincidence methods and liquid-scintillation counting methods. The first use of 4π(Cherenkov)β-γ coincidence and anticoincidence methods in an international comparison is reported. One participant reported results by secondary methods only. Two results, both utilizing pure liquid-scintillation methods, were identified as outliers. Evaluation using the Power-Moderated Mean method results in a proposed Comparison Reference Value (CRV) of 621.7(11)kBqg-1, based on 14 results. The degrees of equivalence and their associated uncertainties are evaluated for each participant. Several participants submitted 3.6mL ampoules to the BIPM to link the comparison to the International Reference System (SIR) which may lead to the evaluation of a Key Comparison Reference Value and associated degrees of equivalence.