Child mental health differences amongst ethnic groups in Britain: a systematic review

BACKGROUND: Inter-ethnic differences have been reported for many mental health outcomes in the UK, but no systematic review on child mental health has been published. The aim of this review is to compare the population-based prevalence of child mental disorders between ethnic groups in Britain, and relate these findings to ethnic differences in mental health service use. METHODS: A systematic search of bibliographic databases for population-based and clinic-based studies of children aged 0-19, including all ethnic groups and the main child mental disorders. We synthesised findings by comparing each minority group to the White British study sample. RESULTS: 31 population-based and 18 clinic-based studies met the inclusion criteria. Children in the main minority groups have similar or better mental health than White British children for common disorders, but may have higher rates for some less common conditions. The causes of these differences are unclear. There may be unmet need for services among Pakistani and Bangladeshi children. CONCLUSION: Inter-ethnic differences exist but are largely unexplained. Future studies should address the challenges of cross-cultural psychiatry and investigate reasons for inter-ethnic differences

Remote meta-C-H Cyanation of Arenes Enabled by a Pyrimidine-Based Auxiliary

An easily removable pyrimidine-based auxiliary has been employed for the remote meta-C-H cyanation of arenes. The scope of this Pd-catalyzed cyanation reaction using copper(I) cyanide as the cyanating agent was demonstrated with benzylsilanes, benzylsulfonates, benzylphophonates, phenethylsulfonates, and phenethyl ether derivatives. The method was utilized for the synthesis of pharmaceutically valuable precursors

The importance of enteral nutrition

Many neurological diseases are followed by a disturbance of nutritional intake to some extent and thus constitute the most common indication for nutritional support and enteral access. Several studies have shown that malnutrition is a common condition, with as many as 40% of admitted patients being identified as undernourished and 78% of these further found to be deteriorated in their nutritional status during hospital stay (McWirtrer and Pennington, BMJ 308:945–948, 1994). Malnutrition, being a preventable disorder, is thus of great importance to identify patients at risk of malnutrition and prevent impairment of nutritional status. With adequate nutritional care, improved healing is augmented, resulting in better care and quality of life, lowered costs due to reduced length of hospital stay, fewer complications, and decreased mortality. Gut starvation hampers the immunological response. Even small amounts of enteral nutrition maintain gastrointestinal mucosal integrity and improve barrier function, thus minimizing immunological complications and enhancing clinical recovery

Clinical and Seasonal Variations of Nutritional Risk Screening in Patients Scheduled for Rehabilitation after Heart Surgery

Background: Current knowledge on the pervasiveness of increased nutritional risk in cardiovascular diseases is limited. Our aim was to analyze the characteristics of nutritional risk screening in patients scheduled for rehabilitation after heart surgery. Prevalence and extent of nutritional risk were studied in connection with patients' characteristics and seasonal climate effects on weight loss dynamics. Methods: The cohort included 65 consecutive patients with an age range of 25-84 years, 2-6 months after surgical treatment for ischemic or valvular heart disease. Nutritional risk screening was appraised using a standardized NRS-2002 questionnaire. Groups were analyzed according to a timeline of rehabilitation according to the "cold" and "warm" seasons of the moderate Mediterranean climate in Opatija, Croatia. Results: Increased nutritional risk scores (NRS-2002) of >3 were found in 96% of studied patients. Mean NRS-2002 of patients was 5.0 +/- 1.0, with a percentage weight loss history of 11.7% +/- 2.2% (4.6-19.0). Risk was found to be more pronounced during the warmer season, with NRS-2002 scores of 5.3 +/- 0.7 versus 4.8 +/- 1.1 (P = 0.136) and greater loss of weight of 13.0% +/- 3.2% versus 10.6% +/- 3% (P = 0.005), respectively. Increased nutritional risk correlated significantly with creatinine concentrations (rho = 0.359; P = 0.034 versus 0.584; P = 0.001, respectively). Significant discordance in correlations was found between NRS-2002 and the decrease in left ventricle systolic function (rho correlation coefficient [rho-cc] = -0.428; P = 0.009), the increase in glucose concentrations (cc = 0.600; P < 0.001), and the decrease in erythrocyte counts (cc = -0.520; P = 0.001) during the colder season. Conclusion: Increased nutritional risk was found to be frequently expressed in the course of rehabilitation after heart surgery. Although seasonal climate effects influenced the weight loss dynamics, the impact on reproducibility of NRS-2002 was clinically less important. Further studies on the connection of nutritional risk with composited end points might offer improvements in overall quality of treatment