Preventing depression in low-income mothers

It is well-established that women in low-income households have an increased risk of developing mental health problems, in particular depression | The Mental Elf

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Studies have found that these women are around twice as likely to develop the disorder compared with those from higher-income households (Hobfoll et al, 1995). Low-income women are also less likely to seek and receive appropriate treatment, in part because of the associated costs (Lennon et al, 2001).

For women who are mothers, this is especially consequential: parental depression has been linked with developmental, emotional and mental health problems in children (McDaniel et al., 2013). In the United States this has been highlighted as a public health concern, and it is increasingly being recognised that community-based services offer valuable opportunities to reach those for whom help is less accessible.

Head Start is a US government-funded service aimed at families at or below the federal poverty level with young children under five. They use a case-management structure to establish a healthy family environment in order to look after the child’s development and wellbeing. Depression affects almost half of the mothers at Head Start. A recent study by Silverstein et al. (2017) examines the efficacy of embedding a depression prevention strategy in the Head Start program.

Nutrition advice aimed at children also improves parents’ diets

Nutrition advice aimed at children also improves parents’ diets, according to research published today in the European Journal of Preventive Cardiology | ScienceDaily

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For the current study, parental dietary intake was assessed by a one-day food record biennially from the child’s age of nine to 19 years. Weight, height, blood pressure, serum lipids, glucose and insulin of the parents were measured repeatedly from the child’s age of seven months until 20 years.

The investigators found that the child-oriented dietary counselling increased the intake of polyunsaturated and monounsaturated fats and decreased the saturated fat intake of intervention mothers and fathers compared to control parents between the child’s ages of nine and 19 years.

In addition, the child-oriented dietary counselling tended to decrease serum total and LDL concentrations in intervention mothers compared to control mothers. There was a similar trend in fathers but it was not statistically significant.

Podcast: What’s going on with life expectancy?

The increase in life expectancy in England has almost “ground to a halt” since 2010 and austerity measures are likely to be a significant contributor | BMJ Talk Medicine

In this podcast Michael Marmot, director at University College London’s Institute of Health Equity, joins us to discuss what might be causing that drop off, and why a decrease in early life chances is particularly problematic.

Read more about the report here

Mild Cognitive Impairment and Driving Cessation

Driving cessation is associated with significant morbidity in older people. People with mild cognitive impairment (MCI) may be at particular risk of this | Dementia and Geriatric Cognitive Disorders

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Very little research has examined driving in this population. Given this, we sought to identify predictors of driving cessation in people with MCI.

One hundred and eighty-five people with MCI were recruited from 9 memory clinics around Australia. People with MCI and their carers reported their driving status and completed measures of cognition, function, neuropsychiatric symptoms, and medication use at regular intervals over a 3-year period.

Of the 144 people still driving at baseline, 50 (27.0%) stopped driving during the study. Older age, greater cognitive and functional impairment, and greater decline in cognition and function at 6 months predicted subsequent driving cessation. Twenty-nine of the 50 people (58%) who stopped driving were diagnosed with dementia during the study; all except one of whom ceased driving after their dementia diagnosis.

A significant proportion of people diagnosed with MCI stop driving over the following 3 years. This cannot be entirely attributed to developing dementia. Easily assessable characteristics – such as age, cognition, and function – and changes in these measures over 6 months predict driving cessation.

Full reference: Connors, M.H. et al. (2017) Mild Cognitive Impairment and Driving Cessation: A 3-Year Longitudinal Study. Dementia and Geriatric Cognitive Disorders. Vol. 44 (no. 1-2) pp. 63-70

Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester

There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services | BMJ Open

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Results: Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive and Sleepio  groups. Promising improvements in mental health scores were found within all three groups, as were significant reductions in numbers of service users reaching clinical threshold scores for mental health difficulties. Number of days of engagement was not related to change from baseline for the Living Life to the Full or Sleepio programmes but was associated with degree of change for Breaking Free Online.

Conclusion: Data presented provide evidence for feasibility of this eTherapy delivery model in supporting service users with a range of mental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services.

Full reference: Elison, S. et al. (2017) Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of ‘Living Life to the Full Interactive’, ‘Sleepio’ and ‘Breaking Free Online’ at ‘Self Help Services’. BMJ Open. 7:e016392

Factors influencing eating behaviours in overweight and obese South Asian men living in the UK

It is widely recognised that South Asian men living in the UK are more likely to develop type 2 diabetes mellitus (T2DM) than their white British counterparts | BMJ Open

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Despite this, limited data have been published quantifying current dietary intake patterns and qualitatively exploring eating behaviours in this population. The objectives of this study were to (1) assess diet, (2) explore perceptions of T2DM, (3) investigate factors influencing eating behaviours in overweight/obese South Asian men and (4) determine the suitability of the UK Diet and Diabetes Questionnaire (UKDDQ) for use in this population.

Many of the areas of dietary improvement and factors affecting eating behaviours identified in this study are similar to those observed in the general UK population. Consumption of sugar-sweetened beverages in particular was high; given the association between their consumption and the risk of T2DM, this should be an area of primary focus for healthcare professionals. Nevertheless, there are sociocultural factors unique to this population that need to be considered when designing culturally specific programs to reduce the development of T2DM in this high-risk population.

Full reference: Emadian, A. et al. (2017) Dietary intake and factors influencing eating behaviours in overweight and obese South Asian men living in the UK: mixed method study. BMJ Open. 7:e016919

Deaths linked to Aids have halved in a decade

A report by the Joint United Nations Programme on HIV/Aids (UNAids) showed deaths had fallen from a peak of 1.9 million in 2005 to 1 million last year | BBC News

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Image source: UNAIDS

The condition, which is caused by HIV, used to be one of the top 10 causes of death worldwide. It said the “scales have tipped”, with more than half of people getting drug treatment for the first time. An HIV infection cannot be cured – it can only be contained with daily doses of antiretroviral therapy.

Unchecked, it destroys the immune system, causing Aids. At this point people tend to die from other “opportunistic infections” such as tuberculosis. Worldwide, 36.7 million are living with HIV and 53% of them are getting the therapy that gives a near-normal life expectancy.