Monitoring and prevalence rates of metabolic syndrome in military veterans with serious mental illness

Background: Cardiovascular disease is the leading cause of mortality among patients with serious mental illness (SMI) and the prevalence of metabolic syndrome-a constellation of cardiovascular risk factors-is significantly higher in these patients than in the general population. Metabolic monitoring among patients using second generation antipsychotics (SGAs)-a risk factor for metabolic syndrome-has been shown to be inadequate despite the release of several guidelines. However, patients with SMI have several factors independent of medication use that predispose them to a higher prevalence of metabolic syndrome. Our study therefore examines monitoring and prevalence of metabolic syndrome in patients with SMI, including those not using SGAs. Methods and Findings: We retrospectively identified all patients treated at a Veterans Affairs Medical Center with diagnoses of schizophrenia, schizoaffective disorder or bipolar disorder during 2005-2006 and obtained demographic and clinical data. Incomplete monitoring of metabolic syndrome was defined as being unable to determine the status of at least one of the syndrome components. Of the 1,401 patients included (bipolar disorder: 822; schizophrenia: 222; and schizoaffective disorder: 357), 21.4% were incompletely monitored. Only 54.8% of patients who were not prescribed SGAs and did not have previous diagnoses of hypertension or hypercholesterolemia were monitored for all metabolic syndrome components compared to 92.4% of patients who had all three of these characteristics. Among patients monitored for metabolic syndrome completely, age-adjusted prevalence of the syndrome was 48.4%, with no significant difference between the three psychiatric groups. Conclusions: Only one half of patients with SMI not using SGAs or previously diagnosed with hypertension and hypercholesterolemia were completely monitored for metabolic syndrome components compared to greater than 90% of those with these characteristics. With the high prevalence of metabolic syndrome seen in this population, there appears to be a need to intensify efforts to reduce this monitoring gap

Five insights from the Global Burden of Disease Study 2019

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3.5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.Peer reviewe

metabolic bone disease and osteoporosis in children

To understand the basics of pediatric bone metabolism and mechanisms underlying osteoporosi

Emotionale Aspekte der beruflichen Entwicklung in der Kindheit: Bedeutung und künftige Agenda

Childhood is a central period for career and social-emotional development. However, the literature covering childhood career development and the role of emotions in careers is scarce. In this article, we advocate for the consideration of emotions in childhood career development. Emotional aspects of children’s career exploration, key-figures and interests, as well as of childhood antecedents of lifelong career processes are presented. Relations between childhood emotion, behavior, functioning and learning are also presented. Conclusions center on a call for focused study of the role of emotion in childhood career development and how such an agenda will advance the literature.L’enfance est une période centrale pour le développement socio-émotionnel et de carrière. Cependant, la littérature couvrant le développement de carrière dans l’enfance et le rôle des émotions dans les carrières est rare. Dans cet article, nous défendons la prise en considération des émotions dans le développement de carrière dans l’enfance. Les aspects émotionnels de l’exploration de carrière des enfants, les figures-clés et les intérêts, ainsi que les antécédents des processus de carrière dans l’enfance sont présentés. Les relations entre les émotions dans l’enfance, le comportement, le fonctionnement et l’apprentissage sont également présentées. La pertinence de tenir compte des émotions pour faire progresser la littérature et la pratique du développement de carrière dans l’enfance est présentée.La infancia es un periodo fundamental a considerar en la carrera y el desarrollo socioemocional. Sin embargo, la literatura existente basada en el desarrollo de la carrera en la niñez y el papel de las emociones en ella es escasa. En el presente artículo, abogamos por considerar el papel de las emociones en el desarrollo profesional durante la infancia. Para ello, se presentan los aspectos emocionales de la exploración de la carrera de los niños, figuras clave e intereses, así como los antecedentes de los procesos de carrera más tardíos en la vida. Se presentan también las relaciones existentes entre emoción, comportamiento, funcionamiento y el aprendizaje en esta etapa. Se discute la importancia de considerar la emoción con el propósito de producir avances en la literatura y en la práctica del desarrollo de la carrera infantil.Die Kindheit ist ein zentraler Zeitraum für die berufliche sowie sozial-emotionale Entwicklung. Allerdings ist die Literatur, die, die berufliche Entwicklung in der Kindheit und die Rolle der Emotionen in der Karriere abdeckt, knapp. In diesem Artikel setzen wir uns für die Berücksichtigung von Emotionen in der beruflichen Entwicklung in der Kindheit ein. Es werden emotionale Aspekte der Erforschung der Karriere von Kindern, deren Schlüsselzahlen und Interessen vorgestellt, sowie, der Einfluss, von Karriereprozessen in der Kindheit, im späteren Leben. Die Beziehungen zwischen den Emotionen der Kindheit, dem Verhalten, dem Fungieren und dem Lernen werden ebenfalls vorgestellt. Es wird desweiteren, die Relevanz der Emotion um die Literatur und die Praxis der beruflichen Entwicklung in der Kindheit voranzutreiben, diskutiert.The Portuguese Foundation for Science and Technology supported POPH/FSE and European Union funded this work through a Doctoral Grant (SFRH/BD/84162/2012