Intimate partner violence and sexual assault among women with serious mental illness: A review of prevalence and risk factors

As compared with the general population, women with serious mental illness experience higher rates of intimate partner violence, sexual assault, and are at a greater risk of future victimization, post-traumatic stress disorder, exacerbated symptoms of mental illness, and other negative health outcomes. Despite substantial research, the field lacks clear, consistent guidance for intervention development. To this end, this review aims to move the field beyond its focus on prevalence by providing a comprehensive and concise summary that compares and assesses the findings, quality, and scope of 10 systematic reviews (reviewing 168 studies) pertaining to prevalence and risk factors of intimate partner violence and/or sexual assault among women with serious mental illness

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

A Comparison of the Australian Dietary Guidelines to the NOVA Classification System in Classifying Foods to Predict Energy Intakes and Body Mass Index

NOVA classification distinguishes foods by level of processing, with evidence suggesting that a high intake of ultra-processed foods (UPFs, NOVA category 4) leads to obesity. The Australian Dietary Guidelines, in contrast, discourage excess consumption of “discretionary foods” (DFs), defined according to their composition. Here, we (i) compare the classification of Australian foods under the two systems, (ii) evaluate their performance in predicting energy intakes and body mass index (BMI) in free-living Australians, and (iii) relate these outcomes to the protein leverage hypothesis of obesity. Secondary analysis of the Australian National Nutrition and Physical Activity Survey was conducted. Non-protein energy intake increased by 2.1 MJ (p p p = 0.0001) and UPFs (−1.1, p = 0.0001) consumption, with no difference in strength of association. For both classifications, macronutrient and energy intakes conformed closely to the predictions of protein leverage. We account for the similarities and differences in performance of the two systems in an analysis of Australian foods

Age and Growth of Gray Triggerfish (\u3ci\u3eBalistes capriscus\u3c/i\u3e) From a North-Central Gulf of Mexico Artifical Reef Zone

The overexploitation of many traditionally targeted reef fishes such as red snapper (Lutjanus campechanus, Poey 1860), alongside the implementation of increasingly restrictive management measures on those species, has led to increased targeting of conventionally discarded Gulf of Mexico gray triggerfish (Balistes capriscus, Gmelin 1789) commercially and recreationally. The goal of this study was to assess age and growth of gray triggerfish from the Alabama Artificial Reef Zone in the north-central Gulf of Mexico. Gray triggerfish (n = 1135) were collected predominantly from artificial habitat during 1999 – 2017. Specimens were sexed macroscopically and ages were assigned by counting translucent increments in sections of the first dorsal spine. Fish ranged in size from 22 – 617 mm fork length. The oldest female was assigned an age of nine years; the oldest male, 10 years. A suite of growth models was tested to develop combined and sex-specific models. The von Bertalanffy growth function best fit the combined data with parameters (+/- SE) L∞ = 488.63 (5.19), k = 0.57 (0.02), and t0 = -0.27 (0.03). Mean size-at-age differed between sexes for six of the eight ages which possessed sample sizes large enough to make comparisons. Growth differed between sexes (P \u3c 0.01), and the best-fitting version of the von Bertalanffy growth function permitted L∞ to vary by sex (female L∞ = 480.26 (7.99); male L∞ = 532.89 (8.95); k = 0.44 (0.04); t0 = -0.78 (0.16)). These findings enhance our knowledge of the age and growth of Gulf of Mexico gray triggerfish

Measuring symptoms in community-dwelling older adults: the psychometric properties of a brief symptom screen.

BackgroundWith aging, the probability of experiencing multiple chronic conditions has increased, along with symptoms associated with these conditions. Symptoms form a central component of illness burden, and distress. To date, most symptom measures have focused on a particular disease population.ObjectiveWe aimed to develop and evaluate a simple symptom screen using data obtained from a representative sample of community-dwelling older adults.MethodsPsychometric analyses were conducted on 10 self-reported dichotomous symptom indicators collected during in-person interviews from a sample of 1000 community-dwelling older adults. Symptoms included shortness of breath, feeling tired or fatigued, problems with balance or dizziness, perceived weakness in legs, constipation, daily pain, stiffness, poor appetite, anxiety, and anhedonia.ResultsOver one third of the individuals (37.4%) had 5 or more concurrent symptoms. Stiffness and feeling tired were the most common symptoms. Confirmatory factor analyses were performed on the 10 symptoms for single factor and bifactor (physical and affective) models of symptom reporting. Goodness-of-fit indices indicated better fit for the bifactor model (χdf=10=89.6; P<0.001), but the practical significance of the improvement in fit was negligible. Differential item functioning analyses showed some differences of relatively high magnitude in location parameters by race; however, because the differential item functioning was in different directions, the impact on the overall measure was most likely lessened.ConclusionsAmong community-dwelling older adults, a large proportion experienced multiple co-occurring symptoms. This Brief Symptom Screen can be used to quickly measure the overall symptom load in older adult populations, including those with multiple chronic conditions

Symptom burden predicts hospitalization independent of comorbidity in community-dwelling older adults.

ObjectivesTo determine whether cumulative symptom burden predicts hospitalization or emergency department (ED) visits in a cohort of older adults.DesignProspective, observational study with a baseline in-home assessment of symptom burden.SettingCentral Alabama.ParticipantsNine hundred eighty community-dwelling adults aged 65 and older (mean 75.3 ± 6.7) recruited from a random sample of Medicare beneficiaries stratified according to sex, race, and urban/rural residence.MeasurementsSymptom burden score (range 0-10). One point was given for each symptom reported: shortness of breath, tiredness or fatigue, problems with balance or dizziness, leg weakness, poor appetite, pain, stiffness, constipation, anxiety, and loss of interest in activities. Dependent variables were hospitalizations and ED visits, assessed every 6 months during the 8.5-year follow-up period. Using Cox proportional hazards models, time from the baseline in-home assessment to the first hospitalization and first hospitalization or ED visit was determined.ResultsDuring the 8.5-year follow-up period, 545 (55.6%) participants were hospitalized or had an ED visit. Participants with greater symptom burden had higher risk of hospitalization (hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.05-1.14) and hospitalization or ED visit (HR = 1.10, 95% CI = 1.06-1.14) than those with lower scores. Participants living in rural areas had significantly lower risk of hospitalization (HR = 0.83, 95% CI = 0.69-0.99) and hospitalization or ED visit (HR = 0.80, 95% CI = 0.70-0.95) than individuals in urban areas, independent of symptom burden and comorbidity.ConclusionGreater symptom burden was associated with higher risk of hospitalization and ED visits in community-dwelling older adults. Healthcare providers treating older adults should consider symptom burden to be an additional risk factor for subsequent hospital utilization

Intimate partner violence and sexual assault among women with serious mental illness: A review of prevalence and risk factors

As compared with the general population, women with serious mental illness experience higher rates of intimate partner violence, sexual assault, and are at a greater risk of future victimization, post-traumatic stress disorder, exacerbated symptoms of mental illness, and other negative health outcomes. Despite substantial research, the field lacks clear, consistent guidance for intervention development. To this end, this review aims to move the field beyond its focus on prevalence by providing a comprehensive and concise summary that compares and assesses the findings, quality, and scope of 10 systematic reviews (reviewing 168 studies) pertaining to prevalence and risk factors of intimate partner violence and/or sexual assault among women with serious mental illness