Large Population-based Sample Research Articles

Childhood exposure to green space – A novel risk-decreasing mechanism for schizophrenia?

Schizophrenia risk has been linked to urbanization, but the underlying mechanism remains unknown. Green space is hypothesized to positively influence mental health and might mediate risk of schizophrenia by mitigating noise and particle pollution exposure, stress relief, or other unknown mechanisms. The objectives for this study were to determine if green space are associated with schizophrenia risk, and if different measures of green space associate differently with risk. We used satellite data from the Landsat program to quantify green space in a new data set for Denmark at 30×30m resolution for the years 1985–2013. The effect of green space at different ages and within different distances from each person's place of residence on schizophrenia risk was estimated using Cox regression on a very large longitudinal population-based sample of the Danish population (943,027 persons). Living at the lowest amount of green space was associated with a 1.52-fold increased risk of developing schizophrenia compared to persons living at the highest level of green space. This association remained after adjusting for known risk factors for schizophrenia: urbanization, age, sex, and socioeconomic status. The strongest protective association was observed during the earliest childhood years and closest to place of residence. This is the first nationwide population-based study to demonstrate a protective association between green space during childhood and schizophrenia risk; suggesting limited green space as a novel environmental risk factor for schizophrenia. This study supports findings from other studies highlighting positive effects of exposure to natural environments for human health.

A Twin Study of Normative Personality and DSM-IV Personality Disorder Criterion Counts: Evidence for Separate Genetic Influences.

Both normative personality and DSM-IV personality disorders have been found to be heritable. However, there is limited knowledge about the extent to which the genetic and environmental influences underlying DSM personality disorders are shared with those of normative personality. The aims of this study were to assess the phenotypic similarity between normative and pathological personality and to investigate the extent to which genetic and environmental influences underlying individual differences in normative personality account for symptom variance across DSM-IV personality disorders. A large population-based sample of adult twins was assessed for DSM-IV personality disorder criteria with structured interviews at two waves spanning a 10-year interval. At the second assessment, participants also completed the Big Five Inventory, a self-report instrument assessing the five-factor normative personality model. The proportion of genetic and environmental liabilities unique to the individual personality disorder measures, and hence not shared with the five Big Five Inventory domains, were estimated by means of multivariate Cholesky twin decompositions. The median percentage of genetic liability to the 10 DSM-IV personality disorders assessed at wave 1 that was not shared with the Big Five domains was 64%, whereas for the six personality disorders that were assessed concurrently at wave 2, the median was 39%. Conversely, the median proportions of unique environmental liability in the personality disorders for wave 1 and wave 2 were 97% and 96%, respectively. The results indicate that a moderate-to-sizable proportion of the genetic influence underlying DSM-IV personality disorders is not shared with the domain constructs of the Big Five model of normative personality. Caution should be exercised in assuming that normative personality measures can serve as proxies for DSM personality disorders when investigating the etiology of these disorders.

Psychometric properties of the Sexual Excitation/Sexual Inhibition Inventory for Women and Men (SESII-W/M) and the Sexual Excitation Scales/Sexual Inhibition Scales short form (SIS/SES-SF) in a population-based sample in Germany.

The Sexual Excitation Sexual/Inhibition Inventory for Women and Men (SESII-W/M) and the Sexual Excitation Scales/Sexual Inhibition Scales short form (SIS/SES-SF) are two self-report questionnaires for assessing sexual excitation (SE) and sexual inhibition (SI). According to the dual control model of sexual response, SE and SI differ between individuals and influence the occurrence of sexual arousal in given situations. Extreme levels of SE and SI are postulated to be associated with sexual difficulties or risky sexual behaviors. The present study was designed to assess the psychometric properties of the German versions of both questionnaires utilizing a large population-based sample of 2,708 participants (Mage = 51.19, SD = 14.03). Overall, psychometric evaluation of the two instruments yielded good convergent and discriminant validity and mediocre to good internal consistency. The original 30-item version of the SESII-W/M did not show a sufficient model fit. For a 24-item version of the SESII-W/M partial strong measurement invariance across gender, and strong measurement invariance across relationship status, age, and educational levels were established. The original structure (14 items, 3 factors) of the SIS/SES-SF was not replicated. However, a 4-factor model including 13 items showed a good model fit and strong measurement invariance across the before-mentioned participant groups. For both questionnaires, partial strong measurement invariance with the original American versions of the scales was found. As some factors showed unsatisfactory internal consistency and the factor structure of the original scales could not be replicated, scores on several SE- and SI-factors should be interpreted with caution. However, most analyses indicated sufficient psychometric quality of the German SESII-W/M and SIS/SES-SF and their use can be recommended in German-speaking samples. More research with diverse samples (i.e., different sexual orientations, individuals with sexual difficulties) is needed to ensure the replicability of the factor solutions presented in this study.

Genetic polymorphisms of NOS2 and predisposition to fracture non-union: A case control study based on Han Chinese population.

A non-union, especially atrophic non-unions, is a permanent failure of healing following a fracture and can be difficult to treat. Approximately 5–10% of fractures will result in a non-union during the healing process. non-unions can be classified into two types: atrophic non-union which is often due to impaired bone healing with a potential biological mechanism, and hypertrophic non-union which is due to inadequate fixation after fracture. Genetic variations also play an important role in the fracture healing response. Previous studies based on animal models have indicated that NOS2 might be greatly involved in the bone fracture healing process. In this case-control study, 346 nonunion patients were compared to 883 patients with normal fracture healing to investigate the potential genetic association between NOS2 and the fracture healing process using study subjects of Chinese Han ancestry. Twenty-seven single nucleotide polymorphisms (SNPs) covering NOS2 were genotyped in our study subjects and analyzed. In addition to the single marker-based analysis, we performed a gene-by-environment analysis to examine the potential interactions between genetic polymorphisms and some environmental factors. SNP rs2297514 showed significant association with the fracture healing process after adjusting for age and gender (OR = 1.38, P = 0.0005). Our results indicated that the T allele of rs2297514 significantly increased the risk of a non-union during the fracture healing process by 38% compared to the C allele. Further stratification analyses conducted for this SNP using data from subgroups classified by different sites of fracture indicated that significance could only be observed in the tibial diaphysis subgroup (N = 428, OR = 1.77, P = 0.0007) but not other groups including femur diaphysis, humeral shaft, ulnar shaft, and femur neck. Gene-by-environment interaction analyses of the three environmental factors showed no significant results. In this study, rs2297514 was significantly associated with the non-union status of fracture healing using a large Chinese population-based study sample. Our findings replicated those of a previous preliminary study and offered strong evidence linking NOS2 and fracture healing.

Community treatment orders increase community care and delay readmission while in force: Results from a large population-based study.

There is debate about the effectiveness of community treatment orders in the management of people with a severe mental illness. While some case-control studies suggest community treatment orders reduce hospital readmissions, three randomised controlled trials find no effects. These randomised controlled trials measure outcomes over a longer period than the community treatment order duration and assess the combined effectiveness of community treatment orders both during and after the intervention. This study examines the effectiveness of community treatment orders in a large population-based sample, restricting observation to the period under a community treatment order. All persons ( n = 5548) receiving a community treatment order in New South Wales, Australia, over the period 2004-2009 were identified. Controls were matched using a propensity score based on demographic, clinical and prior care variables. A baseline period equal to each case's duration of treatment was constructed. Treatment effects were compared using zero-inflated negative binomial regression, adjusting for demographics, clinical characteristics and pre-community treatment order care. Compared to matched controls, people on community treatment orders were less likely to be readmitted (odds ratio = 0.90, 95% confidence interval = [0.84, 0.97]) and had a significantly longer time to their first readmission (incidence rate ratio = 1.47, 95% confidence interval = [1.36, 1.58]), fewer hospital admissions (incidence rate ratio = 0.90, 95% confidence interval = [0.84, 0.96]) and more days of community care (incidence rate ratio = 1.55, 95% confidence interval = [1.51, 1.59]). Increased community care and delayed first admission were found for all durations of community treatment order care. Reduced odds of readmission were limited to people with 6 months or less of community treatment order care, and reduced number of admissions and days in hospital to people with prolonged (>24 months) community treatment order care. In this large population-based study, community treatment orders increase community care and delay rehospitalisation while they are in operation. Some negative findings in this field may reflect the use of observation periods longer than the period of active intervention.

Mortality in single fathers compared with single mothers and partnered parents: a population-based cohort study

Single parent families, including families headed by single fathers, are becoming increasingly common around the world. Previous evidence suggests that single parenthood is associated with adverse health outcomes and increased mortality; however, most studies have focused on single mothers, with little known about the health of single fathers. This study aimed to examine mortality in a large population-based sample of Canadian single fathers compared with single mothers and partnered fathers and mothers. We used a representative sample of 871 single fathers, 4590 single mothers, 16 341 partnered fathers, and 18 688 partnered mothers from the Canadian Community Health Survey (cycles 2001-12; earliest survey date: Sept 5, 2000; latest survey date: Dec 24, 2012). We anonymously linked survey participants to health administrative database records to ascertain health status at baseline and mortality from survey date up to Oct 28, 2016. We included individuals who were aged 15 years or older, living in a household with one or more biological or adopted child younger than 25 years, and living in Ontario, and we excluded those who left Ontario during the study period or had data discrepancies. Single parents were defined as those who were divorced, separated, widowed, or single, never-married, and non-cohabitating, and partnered parents were defined as those who were married or common-law partners. We investigated differences in mortality using Cox proportional hazards models with adjustment for sociodemographic, lifestyle, and clinical factors. Median follow-up was 11·10 years (IQR 7·36-13·54). Mortality in single fathers (5·8 per 1000 person-years) was three-times higher than rates in single mothers (1·74 per 1000 person-years) and partnered fathers (1·94 per 1000 person-years). Single fathers had a significantly higher adjusted risk of dying than both single mothers (hazard ratio [HR] 2·49, 95% CI 1·20-5·15; p=0·01) and partnered fathers (2·06, 1·11-3·83; p=0·02). In this first head-to-head comparison of mortality across single and partnered parent groups, we found that single fathers had the least favourable risk factor profile and greatest risk of mortality. Social histories might help physicians identify these high-risk patients. Further work is needed to understand the causes of this high mortality risk and how clinical and public health interventions can improve lifestyle and behavioural risk factors. Ontario Ministry of Health and Long-Term Care.

Trends in the prevalence of congenital hydrocephalus in 14 cities in Liaoning province, China from 2006 to 2015 in a population-based birth defect registry from the Liaoning Women and Children's Health Hospital.

The aim of this study was to assess the prevalence and trends of congenital hydrocephalus (CH) using a large population-based sample with cases retrieved from the Liaoning Birth Defects Registry, which included 14 cities, over a 10-year period. CH prevalence, percent change, average change, and contribution rates of each city were calculated. Statistical analysis was performed using a Poisson regression model. There was a total of 3008 CH cases among 3,248,954 live births during the observational period (9.26 cases/10,000 live births). On average, the prevalence of CH had significantly decreased by 11.84% each year (P < 0.01). The three leading cities with the highest prevalence of CH were Chaoyang (13.73/10,000), Huludao (13.18/10,000), and Fuxin (12.71/10,000), while Yingkou (6.06/10,000), Dalian (6.27/10,000), and Anshan (6.56/10,000) had the lowest prevalence. Notably, significantly decreasing trends were observed in 10 (71.4%) of these 14 cities. In addition, the cities of Fushun, Shenyang, and Dalian had contributed to more than one-third of the decreasing trend in Liaoning province. In conclusion, this study provides evidence of the decreasing prevalence of CH over a 10-year period (2006–2015) in Liaoning province. Preventative efforts should be strengthened to further reduce the risk of CH in these high prevalence areas.

Prevalence, Mortality, and Spatial Distribution of Gastroschisis in Mexico.

To explore the prevalence, mortality, and spatial distribution of gastroschisis using a large population-based sample with cases identified according to birth and death certificates (ICD-10 diagnosis code Q79.3, gastroschisis) through the General Directorate of Health Information of the Secretary Health of Mexico, over the course of a 15-year period. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A descriptive study examining 10,287 cases of gastroschisis was performed from 2000-2014 using public natality data for denominators (more than 25 million live births). Gastroschisis prevalence and mortality was calculated for each of year, state, maternal, and newborn characteristics. Spatial distribution was analyzed according to gastroschisis prevalence in the 32 states of Mexico. Gastroschisis prevalence was 4.01 per 10,000 live births (annual trend 2.09-6.85). Mortality associated with gastroschisis was 1.28 per 10,000 live births. Women younger than 20years old, primiparae, and preterm infants had the highest gastroschisis-related prevalence (13.12, 5.83, and 7.51 per 10,000 live births, respectively). Gastroschisis prevalence and mortality did not differ according to newborn sex. A negative binomial distribution, variance (82,391.87) greater than the mean (321.47) was identified. Our findings show an increasing temporal trend for gastroschisis since 2000 in Mexico. Additionally, gastroschisis might follow in future instances a positive binomial or Poisson distribution. Therefore, improving surveillance of risk factors and supporting research for gastroschisis is warranted among maternal age younger than 25, particularly, younger than 20years of age.

Adherence to colonoscopy at 1 year following resection of localized colon cancer: a retrospective cohort study.

Background:For patients with stages I-III colon cancer who have undergone surgical resection, guidelines recommend surveillance colonoscopy at 1 year. However, limited data exist on adherence and associated factors. We aimed to determine the rate of adherence to surveillance colonoscopy at 1 year among nonmetastatic colon cancer patients who underwent resection and factors associated with adherence.Methods:In this population-based retrospective cohort study, the Surveillance, Epidemiology, and End Results (SEER)–Medicare database was used. We identified patients with stages I-III colon cancer who underwent surgical resection and survived >3 years without recurrence (no chemotherapy after 8 months) from 2002–2011. Our primary outcome was a colonoscopy claim 10–15 months after resection. We used multivariable regression analysis to assess associations between sociodemographic and clinical factors and receipt of timely colonoscopy.Results:Among 28,732 patients who survived >3 years without recurrence, 7967 (28%) did not undergo colonoscopy; 12,033 (42%) had it at one year, with 3159 (11%) before 10 months and 5573 (19%) after 15 months. Decreased adherence was associated with older age; being male versus female; being black or Hispanic versus white; higher tumor stage; left-sided tumors versus right sided; and increased comorbidities. Chemotherapy receipt was associated with increased adherence (odds ratio 2.06; 95% confidence interval 1.88–2.24).Conclusions:In a large population-based sample of individuals aged ⩾ 65 years, only 42% of colon cancer survivors underwent 1-year surveillance colonoscopy. Demographic and clinical factors were associated with adherence.

Application of latent class analysis in assessing the competency of physicians in China

BackgroundThe physicians’ competency is an important public health issue around the world. Several international organizations have taken the lead in examining the competencies required to be a physician. The purpose of this study is to identify subgroups of physicians’ competency based upon the importance results of competency evaluation and provide a scientific basis for the qualitative research of the competency of physicians.MethodsA cross-sectional study was conducted on a large population-based sample in 31 provinces, autonomous regions and municipalities directly under the central government in China. The latent class analysis was performed to identify patterns of physicians’ competency using M-plus software.ResultsIn this study, the latent class analysis was adopted to identify the appropriate number of distinct latent classes of physicians’ competency based on eight competency dimensions, and a four-class model best fit the data, which are excellent competency group, lack of professionalism competency group, individual competency driven group, and lack of competency cognitive group. Therefore, 6247 physicians can be divided into four latent classes based on the importance results of competency evaluation, and the number of each class is 5684, 284, 215 and 64, respectively.ConclusionThese findings suggested that latent class analysis can be used to study the competency of physicians, and four distinct subgroups were identified. Therefore, we can effectively understand the patterns of physicians’ competency, and the health administrative departments could utilize more specific measures according to their different competency subgroups, and providing individualized training schemes in the future training and management of physicians.

APOBEC3A/B deletion polymorphism and cancer risk.

Activity of the apolipoprotein B mRNA editing enzyme, catalytic-polypeptide-like (APOBEC) enzymes has been linked to specific mutational processes in human cancer genomes. A germline APOBEC3A/B deletion polymorphism is associated with APOBEC-dependent mutational signatures, and the deletion allele has been reported to confer an elevated risk of some cancers in Asian populations, while the results in European populations, so far, have been conflicting. We genotyped the APOBEC3A/B deletion polymorphism in a large population-based sample consisting of 11 106 Caucasian (Norwegian) individuals, including 7279 incident cancer cases (1769 breast, 1360 lung, 1585 colon, and 2565 prostate cancer) and a control group of 3827 matched individuals without cancer (1918 females and 1909 males) from the same population. Overall, the APOBEC3A/B deletion polymorphism was not associated with risk of any of the four cancer types. However, in subgroup analyses stratified by age, we found that the deletion allele was associated with increased risk for lung cancer among individuals <50 years of age (OR 2.17, CI 1.19-3.97), and that the association was gradually reduced with increasing age (P = 0.01). A similar but weaker pattern was observed for prostate cancer. In support of these findings, the APOBEC3A/B deletion was associated with young age at diagnosis among the cancer cases for both cancer forms (lung cancer: P = 0.02; dominant model and prostate cancer: P = 0.03; recessive model). No such associations were observed for breast or colon cancer.

Sexual assault incidents among college undergraduates: Prevalence and factors associated with risk.

Sexual assault on college campuses is a public health issue. However varying research methodologies (e.g., different sexual assault definitions, measures, assessment timeframes) and low response rates hamper efforts to define the scope of the problem. To illuminate the complexity of campus sexual assault, we collected survey data from a large population-based random sample of undergraduate students from Columbia University and Barnard College in New York City, using evidence based methods to maximize response rates and sample representativeness, and behaviorally specific measures of sexual assault to accurately capture victimization rates. This paper focuses on student experiences of different types of sexual assault victimization, as well as sociodemographic, social, and risk environment correlates. Descriptive statistics, chi-square tests, and logistic regression were used to estimate prevalences and test associations. Since college entry, 22% of students reported experiencing at least one incident of sexual assault (defined as sexualized touching, attempted penetration [oral, anal, vaginal, other], or completed penetration). Women and gender nonconforming students reported the highest rates (28% and 38%, respectively), although men also reported sexual assault (12.5%). Across types of assault and gender groups, incapacitation due to alcohol and drug use and/or other factors was the perpetration method reported most frequently (> 50%); physical force (particularly for completed penetration in women) and verbal coercion were also commonly reported. Factors associated with increased risk for sexual assault included non-heterosexual identity, difficulty paying for basic necessities, fraternity/sorority membership, participation in more casual sexual encounters (“hook ups”) vs. exclusive/monogamous or no sexual relationships, binge drinking, and experiencing sexual assault before college. High rates of re-victimization during college were reported across gender groups. Our study is consistent with prevalence findings previously reported. Variation in types of assault and methods of perpetration experienced across gender groups highlight the need to develop prevention strategies tailored to specific risk groups.

Cognitive functioning in the general population: Factor structure and association with mental disorders-The neuropsychological test battery of the mental health module of the German Health Interview and Examination Survey for Adults (DEGS1-MH).

The objective of this study is to obtain population level data about cognitive functions and their association with mental disorders. We here report factor analytic and psychometric findings of a neuropsychological test battery and examine the association of current and past mental disorders with cognitive function in a large nationwide population-based sample of 18- to 79-year-old adults in Germany (n=3,667) participating in the mental health module of the German Health Interview and Examination Survey for Adults 2008-2011. Confirmatory factor analysis confirmed verbal memory and executive function factors. Older age was strongly associated with lower verbal memory and executive function and with higher vocabulary scores. After adjustment for age, sex, and education, rather modest decrements were found for verbal memory (β=-.118, p=.002) and executive functions (β=-.191, p<.001) in participants with any current mental disorder (n=442) compared to those without (n=3,201). Small decrements in memory (β=-.064, p=.031) and executive function (β=-.111, p<.001) were found in participants with any mental disorder in the last 12months but not in those with past (fully or partially remitted) mental disorders, compared to participants without a history of mental disorder. More fine-grained analyses of these data will investigate the complex interplay between cognition, health behaviors, and specific mental and somatic diseases.

Children’s disclosures of sexual abuse in a population-based sample

Most previous studies on disclosing child sexual abuse (CSA) have either been retrospective or focused on children who already have disclosed. The present study aimed to explore the overall CSA disclosure rate and factors associated with disclosing to adults in a large population-based sample. A representative sample of 11,364 sixth and ninth graders participated in the Finnish Child Victim Survey concerning experiences of violence, including CSA. CSA was defined as having sexual experiences with a person at least five years older at the time of the experience. Within this sample, the CSA prevalence was 2.4%. Children reporting CSA experiences also answered questions regarding disclosure, the disclosure recipient, and potential reasons for not disclosing. The results indicate that most of the children (80%) had disclosed to someone, usually a friend (48%). However, only 26% had disclosed to adults, and even fewer had reported their experiences to authorities (12%). The most common reason for non-disclosing was that the experience was not considered serious enough for reporting (41%), and half of the children having CSA experiences did not self-label their experiences as sexual abuse. Relatively few children reported lacking the courage to disclose (14%). Logistic regression analyses showed that the perpetrator’s age, the age of the victim at the time of abuse, and having no experiences of emotional abuse by the mother were associated with disclosing to an adult. The results contribute to understanding the factors underlying children’s disclosure patterns in a population-based sample and highlight the need for age-appropriate safety education for children and adolescents.

Clinical significance of periodic limb movements during sleep: the HypnoLaus study

ObjectivePeriodic limb movements during sleep (PLMS) are prevalent in the general population, but their impact on sleep and association with cardiometabolic disorders are a matter of debate. MethodsData from 2162 participants (51.2% women, mean age 58.4 ± 11.1 years) of the population-based HypnoLaus study (Lausanne, Switzerland) were collected. Subjective sleep complaints and habits were assessed using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale (ESS). Participants underwent a full polysomnography (PSG) at home and were evaluated for the presence of hypertension, diabetes, and metabolic syndrome. ResultsParticipants with a PLMS index (PLMSI) > 15/h (28.6% of the sample) had longer subjective sleep latency (18.6 ± 17.2 vs. 16.1 ± 14.3 min, p = 0.014) and duration (7.1 ± 1.2 vs. 6.9 ± 1.1 h, p < 0.001) than participants with PLMSI ≤ 15/h. At the PSG, they spent more time in stage N2 sleep (49.0 ± 11.2 vs. 45.5 ± 9.8%, p < 0.001), less in stage N3 (17.6 ± 8.2 vs. 20.6 ± 8.4%, p < 0.001) and in REM sleep (20.3 ± 6.4 vs. 22.4 ± 6.0%, p < 0.001), and exhibited longer REM latency (104.2 ± 70.2 vs. 91.7 ± 58.6 min, p < 0.001) and higher arousal index (26.5 ± 12.3 vs. 19.2 ± 9.7 n/h, p < 0.001). Participants with a PLMSI > 15/h had a lower ESS scores and higher prevalence of hypertension, diabetes, and metabolic syndrome. Multivariate analysis adjusting for confounding factors confirmed the independent association of PLMSI > 15/h with subjective sleep latency and duration, and with objective sleep structure disturbances. However, the associations with sleepiness and cardiovascular risk factors disappeared. ConclusionsIn our large middle-age European population-based sample, PLMSI > 15/h was associated with subjective and objective sleep disturbances but not with sleepiness, hypertension, diabetes, or metabolic syndrome.

A longitudinal test of the predictions of the interpersonal-psychological theory of suicidal behaviour for passive and active suicidal ideation in a large community-based cohort

BackgroundThe Interpersonal-Psychological Theory of Suicide (IPTS) aims to elucidate the key antecedents of suicide deaths. Limited research has tested the IPTS in a community setting, and very little longitudinal research has been conducted. The current study longitudinally tested the predictions of the IPTS for suicidal ideation in a large population-based sample. MethodsThe PATH through Life study assesses three age cohorts (20's, 40's, 60's) every four years. Two interpersonal factors were estimated at the third wave of assessment: thwarted belongingness (TB) and perceived burdensomeness (PB). The roles of these factors in suicide ideation (active and passive) four years later were estimated using logistic regression models (n = 4545). ResultsA one SD increase in TB was associated with increased odds of 37% for passive ideation and 24% for active ideation. For PB, odds were increased 2.5-fold for passive ideation and 2.4-fold for active ideation. A significant negative PB × TB interaction was found for passive but not active ideation. Effects were not consistent by age group or gender. LimitationsProxy measures were used to assess the constructs. The extended timeframe and low prevalence of suicidal ideation limited power to find effects within subgroups. ConclusionsAlthough TB and PB were individually associated with suicidal thoughts, little evidence was found for the key predictions of the IPTS longitudinally. Further investigation of the dynamic interplay between interpersonal factors over time is needed.

The Impact of Sexual Abuse, Family Violence/Conflict, Spirituality, and Religion on Anger and Depressed Mood Among Adolescents.

Stressful life experiences, such as sexual abuse and family violence/conflict, relate to an increased risk of mental health problems. Religion and spirituality may prevent this negative impact, but religion and spirituality are lower among survivors of stressful life experiences. To explore this effect, we examined the relationship between childhood sexual abuse and family violence/conflict on anger and depressed mood. Survey data were collected from a large population-based sample of Icelandic adolescents (N = 7,365) on their stressful life experiences, religion, spirituality, and mental health. Survivors of stressful life experiences (sexual abuse or family violence/conflict) were significantly lower on religion and spirituality than others. A hierarchical linear regression showed that stressful life experiences contributed uniquely to higher levels of anger and depressed mood. Spirituality was associated with decreased anger and depressed mood. The religion of parents and peers was also associated with decreased anger. Religious participation, on the contrary, did not have a relationship with mental health outcomes. In addition, the negative association between spirituality and anger was stronger among survivors of sexual abuse than nonabused individuals. These results confirm previous research, indicating that survivors of stressful life experiences may experience less religion and spirituality. The results also extend existing knowledge by showing that spirituality may be even more beneficial among sexual abuse survivors, as a protective factor against anger. These findings can help in the minimization of the negative mental health impact of stressful life experiences.

Prevalence of retinal nerve fiber layer defects: The Korea National Health and Nutrition Examination Survey 2008-2012.

PurposeTo investigate the prevalence and associated factors of retinal nerve fiber layer defects (RNFLDs) in a Korean population.MethodsThe Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based study using a complex, stratified, multistage, probability-cluster survey. We performed a review of 2008–2012 data from the KNHANES. Two masked ophthalmologists evaluated fundus photography to detect RNFLDs. All participants underwent ocular and systemic evaluations.ResultsA total of 28,637 subjects aged ≥ 19 years with at least one evaluable fundus photograph were enrolled. The estimated prevalence of RNFLDs in this Korean population was 4.8% (95% confidence interval, 4.4%–5.3%). The estimated percentages of glaucomatous RNFLD and non-glaucomatous RNFLD subjects were 34.4% and 65.6%, respectively. In a multivariate analysis, the prevalence of RNFLDs was significantly associated with older age (P < 0.001), male gender (P = 0.047), glycosylated hemoglobin (P = 0.048), disc hemorrhage (P = 0.016), ISNT rule (P < 0.001), and vertical cup to disc ratio (P < 0.001).ConclusionsThe prevalence of RNFLDs in a large Korean population-based sample with a minimum age of 19 years was 4.8%. RNFLD prevalence was associated with old age, male gender, glycosylated hemoglobin, disc hemorrhage, and glaucomatous optic disc.

Exposure to teasing on popular television shows and associations with adolescent body satisfaction

ObjectiveThis study uses a novel mixed methods design to examine the relationship between incidents of teasing in popular television shows and body satisfaction of adolescent viewers. MethodsSurvey data were used to identify 25 favorite television shows in a large population-based sample of Minnesota adolescents (N=2793, age=14.4years). Data from content analysis of teasing incidents in popular shows were linked to adolescent survey data. Linear regression models examined associations between exposure to on-screen teasing in adolescents' own favorite shows and their body satisfaction. Effect modification by adolescent weight status was tested using interaction terms. ResultsTeasing on TV was common, with 3.3 incidents per episode; over one-quarter of teasing was weight/shape-related. Exposure to weight/shape-related teasing (β=−0.43, p=0.008) and teasing with overweight targets (β=−0.03, p=0.02) was inversely associated with girls' body satisfaction; no associations were found for boys. Findings were similar regardless of the adolescent viewer's weight status. ConclusionsFamilies, health care providers, media literacy programs and the entertainment industry are encouraged to consider the negative effects exposure to weight stigmatization can have on adolescent girls.

Exploring parental mentalization in postnatal phase with a self-report questionnaire (PRFQ): Factor structure, gender differences and association with sociodemographic factors. The Finn Brain Birth Cohort Study

The objective was to explore the preliminary functioning of a self-report questionnaire designed to assess parental reflective functioning (PRFQ, Luyten et al., 2009, unpublished manual) during early postnatal phase and with a large population-based sample. Parental reflective functioning (PRF) refers to parental capacity to focus on experience and feelings, within self, in the child and underlying observed reactions. Individual differences in PRF reportedly affect child attachment and socio-emotional development. Cost-effective tools to assess key areas of early parenting are needed for both research and clinical purposes. The factor structure of a 36-item version suitable for early postnatal phase was explored using population-based data from the Finn Brain Birth Cohort Study (425 mothers and 237 fathers). Exploratory and confirmatory factor analysis resulted in a 14-item version comprising four factors capturing relevant aspects of early PRF. The factor structure was further tested with separate participants from the cohort (1030 mothers and 422 fathers). Mothers tended to score higher than fathers in PRF. Among mothers, parity, age, and financial situation were associated with postnatal mentalization. Level of education was associated with postnatal mentalization in both genders. The 14-item PRFQ-Fi has potential to serve as a new screening tool for very early parenting.