Cross-cohort change in adolescent outcomes for children with mental health problems

Background Child mental health problems are common. Previous studies have examined secular changes in their prevalence but have not assessed whether later outcomes have changed. We therefore aimed to test whether outcomes of child mental health problems have changed over a 40-year period. Methods Three cohorts were utilised: the National Child Development Study (NCDS: N = 14544, aged 7 in 1965), the Avon Longitudinal Study of Parents and Children (ALSPAC: N = 8188, aged 7 in 1998), and the Millennium Cohort Study (MCS: N = 13192, aged 7 in 2008). Mental health problems at age 7 were identified using the parent-reported Rutter A scale (NCDS) and Strengths and Difficulties Questionnaire (ALSPAC and MCS). Associated outcomes were compared across cohorts: age 11 social functioning, age 16 exam attainment and age 16 mental health. Results Child mental health problems were common in each cohort (boys: 7.0%-9.7%; girls: 5.4%-8.4%). Child mental health problems became more strongly associated with social functioning problems (boys: NCDS OR = 1.95 (1.50, 2.53), MCS OR = 3.77 (2.89, 4.92); interaction p < .001; girls: NCDS OR = 1.69 (1.22, 2.33), MCS OR = 3.99 (3.04, 5.25), interaction p < .001), lower academic attainment for boys (NCDS OR = 0.49 (0.31, 0.78), ALSPAC OR = 0.30 (0.22, 0.41), interaction p = .009), and age 16 mental health problems (boys: NCDS d’ = 0.55 (0.38, 0.72), ALSAPC d’ = 0.95 (0.73, 1.16); interaction p = .004; girls: NCDS d’ = 0.50 (0.34, 0.65), ALSPAC d’ = 0.99 (0.78, 1.20); interaction p < .001). Conclusions Child mental health problems have become more strongly associated with negative social, educational and mental health outcomes in recent generations

Using a cross-cohort comparison design to test the role of maternal smoking in pregnancy in child mental health and learning: evidence from two UK cohorts born four decades apart

Background: Maternal smoking in pregnancy is associated with low birth weight (LBW), child conduct problems, hyperactivity and lower cognitive attainment, but associations may reflect measured and unmeasured confounding. Cross-cohort designs can aid causal inference through comparison of associations across populations with different confounding structures. We compared associations between maternal smoking in pregnancy and child conduct and hyperactivity problems, cognition and LBW across two cohorts born four decades apart. Methods: Two national UK cohorts born 1958 (N = 12415) and 2000/1 (N = 11800) were compared. Maternal smoking in pregnancy and child birth weight was assessed at or shortly after birth. Parents rated children’s conduct problems and hyperactivity, and children completed standardized tests of reading and mathematics. Results: Maternal smoking in pregnancy was less common and more strongly associated with social disadvantage in 2001/1 compared to 1958 (interactions p<.001). Maternal smoking in pregnancy was robustly and equivalently associated with infant LBW in both cohorts (interactions boys OR = 1.01 [.89, 1.16], p=.838; girls OR = 1.01 [.91, 1.17], p=0.633). Maternal smoking was more strongly associated with conduct problems, hyperactivity and reading in 2000/1 cohort (interactions p<.001). Conclusions: Marked cross-cohort change in associations between maternal smoking and child conduct problems, hyperactivity and reading highlights the likely role of confounding factors. In contrast, association with LBW was unaffected by change in prevalence of maternal smoking and patterns of confounding. The study highlights the utility of cross-cohort designs in helping triangulate conclusions about the role of putative causal risk factors in observational epidemiology

Synthesis of cyclic alpha-diazo-beta-keto sulfoxides in batch and continuous flow

Diazo transfer to beta–keto sulfoxides to form stable isolable alpha-diazo-beta-keto sulfoxides has been achieved for the first time. Both monocyclic and benzofused ketone derived beta-keto sulfoxides were successfully explored as substrates for diazo transfer. Use of continuous flow leads to isolation of the desired compounds in enhanced yields relative to standard batch conditions, with short reaction times, increased safety profile and potential to scale up

Genetische Beratung: Konzepte, Missverständnisse, Perspektiven

Genetische Beratung Die Medizinische Genetik hat sich von einem Randgebiet zu einer zentralen klinischen Disziplin in der Medizin entwickelt. Der enorme Wissenszuwachs der letzten Jahre zu Phänotypen und Genotypen, zu Ätiologie und Verlauf seltener und häufiger Krankheiten wirkt sich auf alle Fachbereiche der klinischen Medizin aus. Viele haben jedoch nur eine vage Vorstellung, was eine genetische Beratung beinhaltet. = Génétique Bien que marginale à ses débuts, la médecine génétique s’est développée en une discipline clinique essentielle. L’énorme croissance des connaissances de ces dernières années en ce qui concerne les phénotypes et génotypes ainsi que l’étiologie et l’évolution de maladies rares et fréquentes entraîne des répercussions sur toutes les spécialités de la médecine. Cependant, beaucoup n’ont qu’une vague idée de ce que devrait contenir un conseil génétique

Collecting genetic samples and linked mental health data from adolescents in schools:Protocol co-production and a mixed-methods pilot of feasibility and acceptability

OBJECTIVES: To coproduce a school-based protocol and examine acceptability and feasibility of collecting saliva samples for genetic studies from secondary/high school students for the purpose of mental health research. DESIGN: Protocol coproduction and mixed-methods feasibility pilot. SETTING: Secondary schools in Wales, UK. PARTICIPANTS: Students aged 11–13 years. PRIMARY AND SECONDARY OUTCOME MEASURES: Coproduced research protocol including an interactive science workshop delivered in schools; school, parental and student recruitment rates; adherence to protocol and adverse events; ability to extract and genotype saliva samples; student enjoyment of the science workshop and qualitative analysis of teacher focus groups on acceptability and feasibility. RESULTS: Five secondary schools participated in the coproduction phase, and three of these took part in the research study (eligible sample n=868 students). Four further schools were subsequently approached, but none participated. Parental opt-in consent was received from 98 parents (11.3% eligible sample), three parents (0.3%) actively refused and responses were not received for 767 (88.4%) parents. We obtained saliva samples plus consent for data linkage for 79 students. Only one sample was of insufficient quality to be genotyped. The science workshop received positive feedback from students. Feedback from teachers showed that undertaking research like this in schools is viewed as acceptable in principle, potentially feasible, but that there are important procedural barriers to be overcome. Key recommendations include establishing close working relationships between the research team and school classroom staff, together with improved methods for communicating with and engaging parents. CONCLUSIONS: There are major challenges to undertaking large-scale genetic mental health research in secondary schools. Such research may be acceptable in principle, and in practice DNA collected from saliva in classrooms is of sufficient quality. However, key challenges that must be overcome include ensuring representative recruitment of schools and sufficient parental engagement where opt-in parental consent is required

Entwicklung der genetischen und genomischen Medizin in der Schweiz

Mit den rasanten technologischen Entwicklungen im medizinisch-genomischen Bereich und dem damit verbundenen exponentiellen Kenntniszuwachs hat der Bedarf an genetischer Expertise in praktisch allen medizinischen Disziplinen zugenommen. Die Schweizerische Gesellschaft für Medizinische Genetik (SGMG) sieht sich als Fachgesellschaft und Vertreterin einer transversalen medizinischen Disziplin besonders geeignet, die gegebene Situation zu evaluieren und zukünftige Konzepte zu entwickeln und zu begleiten

Uncertain effectiveness of Miscanthus bioenergy expansion for climate change mitigation explored using land surface, agronomic and integrated assessment models

Large-scale bioenergy plays a key role in climate change mitigation scenarios, but its efficacy is uncertain. This study aims to quantify that uncertainty by contrasting the results of three different types of models under the same mitigation scenario (RCP2.6-SSP2), consistent with a 2°C temperature target. This analysis focuses on a single bioenergy feedstock, Miscanthus × giganteus, and contrasts projections for its yields and environmental effects from an integrated assessment model (IMAGE), a land surface and dynamic global vegetation model tailored to Miscanthus bioenergy (JULES) and a bioenergy crop model (MiscanFor). Under the present climate, JULES, IMAGE and MiscanFor capture the observed magnitude and variability in Miscanthus yields across Europe; yet in the tropics JULES and IMAGE predict high yields, whereas MiscanFor predicts widespread drought-related diebacks. 2040–2049 projections show there is a rapid scale up of over 200 Mha bioenergy cropping area in the tropics. Resulting biomass yield ranges from 12 (MiscanFor) to 39 (JULES) Gt dry matter over that decade. Change in soil carbon ranges from +0.7 Pg C (MiscanFor) to −2.8 Pg C (JULES), depending on preceding land cover and soil carbon.2090–99 projections show large-scale biomass energy with carbon capture and storage (BECCS) is projected in Europe. The models agree that <2°C global warming will increase yields in the higher latitudes, but drought stress in the Mediterranean region could produce low yields (MiscanFor), and significant losses of soil carbon (JULES and IMAGE). These results highlight the uncertainty in rapidly scaling-up biomass energy supply, especially in dry tropical climates and in regions where future climate change could result in drier conditions. This has important policy implications—because prominently used scenarios to limit warming to ‘well below 2°C’ (including the one explored here) depend upon its effectiveness

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Protecting 30% of the planet for nature: costs, benefits and economic implications

A. Waldron, K. Nakamura, J. Sze, T. Vilela, A. Escobedo, P. Negret Torres, R. Button, K. Swinnerton, A. Toledo, P. Madgwick, N. Mukherjee were supported by National Geographic and the Resources Legacy Fund. V. Christensen was supported by NSERC Discovery Grant RGPIN-2019-04901. M. Coll and J. Steenbeek were supported by EU Horizon 2020 research and innovation programme under grant agreement No 817578 (TRIATLAS). D. Leclere was supported by TradeHub UKRI CGRF project. R. Heneghan was supported by Spanish Ministry of Science, Innovation and Universities, Acciones de Programacion Conjunta Internacional (PCIN-2017-115). M. di Marco was supported by MIUR Rita Levi Montalcini programme. A. Fernandez-Llamazares was supported by Academy of Finland (grant nr. 31176). S. Fujimori and T. Hawegawa were supported by The Environment Research and Technology Development Fund (2-2002) of the Environmental Restoration and Conservation Agency of Japan and the Sumitomo Foundation. V. Heikinheimo was supported by Kone Foundation, Social Media for Conservation project. K. Scherrer was supported by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme under grant agreement No 682602. U. Rashid Sumaila acknowledges the OceanCanada Partnership, which funded by the Social Sciences and Humanities Research Council of Canada (SSHRC). T. Toivonen was supported by Osk. Huttunen Foundation & Clare Hall college, Cambridge. W. Wu was supported by The Environment Research and Technology Development Fund (2-2002) of the Environmental Restoration and Conservation Agency of Japan. Z. Yuchen was supported by a Ministry of Education of Singapore Research Scholarship Block (RSB) Research Fellowship