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Allostatic load is a multiple biomarker measure of physiological ‘wear and tear’ that has shown some promise as marker of overall physiological health, but its power as a risk predictor for mortality and morbidity is less well known. This study has used data from the 2003 Scottish Health Survey (SHeS) (nationally representative sample of Scottish population) linked to mortality records to assess how well allostatic load predicts all-cause and cause-specific mortality. From the sample, data from 4,488 men and women were available with mortality status at 5 and 9.5 (rounded to 10) years after sampling in 2003. Cox proportional hazard models estimated the risk of death (all-cause and the five major causes of death in the population) according to allostatic load score. Multiple imputation was used to address missing values in the dataset. Analyses were also adjusted for potential confounders (sex, age and deprivation). There were 258 and 618 deaths over the 5-year and 10-year follow-up period, respectively. In the fully-adjusted model, higher allostatic load (poorer physiological ‘health’) was not associated with an increased risk of all-cause mortality after 5 years (HR = 1.07, 95% CI 0.94 to 1.22; p = 0.269), but it was after 10 years (HR = 1.08, 95% CI 1.01 to 1.16; p = 0.026). Allostatic load was not associated with specific causes of death over the same follow-up period. In conclusions, greater physiological wear and tear across multiple physiological systems, as measured by allostatic load, is associated with an increased risk of death, but may not be as useful as a predictor for specific causes of death. [ABSTRACT FROM AUTHOR]

Background: Conflicting findings were observed in recent studies assessing the association between patients’ area-level socio-economic status and the received number of computed tomography (CT) examinations in children. The aim was to investigate the association between area-level socio-economic status and variation in CT examination practice for pediatric patients in Germany. Methods: Data from Radiology Information Systems for children aged 0 to < 15 years without cancer who had at least one CT examination between 2001 and 2010 were extracted in 20 hospitals across Germany. The small-area German Index of Multiple Deprivation (GIMD) was used to assess regional deprivation. The GIMD scores were classified into least, medium and most deprived areas and linked with the patient’s last known postal code. A multinomial logistic regression model was used to assess the association between patients’ CT numbers and regional deprivation adjusting for age, sex, and location of residence (urban/rural). Results: A total of 37,810 pediatric patients received 59,571 CT scans during the study period. 27,287 (72%) children received only one CT, while n = 885 (2.3%) received six or more. Increasing numbers of CT examinations in non-cancer patients were significantly associated with higher regional deprivation, which increased, although CI overlap, for higher CT categories: ‘2–3 CT’ odds ratio (OR) = 1.45, 95%CI: 1.40–1.50; ‘4–5 CT’ OR = 1.48, 95%CI: 1.38–1.59; ‘6+CT’ OR = 1.54, 95%CI: 1.41–1.69. In addition, male sex, higher age categories, and specific body regions were positively associated with increased numbers of CT examinations. Conclusion: We observed a positive association between regional deprivation and CT numbers in non-cancer pediatric patients. Limitations of the ecological approach and the lack of differentiation of CT details have to be acknowledged. More information on CT indications is necessary for a full assessment of this finding. In addition, further work on ways to assess socio-economic status more accurately may be required. [ABSTRACT FROM AUTHOR]

Deprivation of one modality can lead to the improvement of other intact modalities. We have previously reported that visual deprivation drives AMPA receptors into synapses from layer4 to 2/3 in the barrel cortex and sharpens functional whisker-barrel map at layer2/3 2 days after the beginning of visual deprivation. Enhanced excitatory synaptic transmission at layer4-2/3 synapses is transient and returns to the base line level a week after the beginning of visual deprivation. Here we found that sharpened whisker-barrel function is maintained at least for a week in visually deprived animals. While increased AMPA receptor-mediated synaptic transmission at layer4-2/3 synapses dropped to the base line a week after the beginning of visual deprivation, lateral inhibitory synaptic transmission onto the neighboring barrel was kept strengthened for a week of visually deprived animals. Thus, transient strengthening of excitatory synapses at layer4-2/3 in the barrel cortex could trigger the enhancement of inhibitory inputs to neighboring barrel, and sustained lateral inhibition can maintain the sharpening of whisker-barrel map in visually deprived animals. [ABSTRACT FROM AUTHOR]

Introduction: In September 2009, middle and secondary schools in England were required to comply with food and nutrient-based standards for school food. We examined the impact of this policy change on children’s lunchtime and total dietary intake. Methods: We undertook repeat cross-sectional surveys in six Northumberland middle schools in 1999–2000 and 2009–10. Dietary data were collected from 11–12 y olds (n = 298 in 1999–2000; n = 215 in 2009–10). Children completed two consecutive 3-day food diaries, each followed by an interview. Linear mixed effect models examined the effect of year, lunch type and level of socio-economic deprivation on children’s mean total dietary intake. Results: We found both before and after the introduction of the food and nutrient-based standards children consuming a school lunch, had a lower per cent energy from saturated fat (−0.5%; p = 0.02), and a lower intake of sodium (−143 mg; p = 0.02), and calcium (−81 mg; p = 0.001) in their total diet, compared with children consuming a home-packed lunch. We found no evidence that lunch type was associated with mean energy, or absolute amounts of NSP, vitamin C and iron intake. There was marginal evidence of an association between lunch type and per cent energy NMES (p = 0.06). In 1999–2000, children consuming a school lunch had a higher per cent energy from fat in their total diet compared with children consuming a home-packed lunch (2.8%), whereas by 2009–10, they had slightly less (−0.2%) (year by lunch type interaction p<0.001; change in mean differences −3%). Conclusions: We found limited evidence of an impact of the school food and nutrient-based standards on total diet among 11–12 year olds. Such policies may need to be supported by additional measures, including guidance on individual food choice, and the development of wider supportive environments in school and beyond the school gates. [ABSTRACT FROM AUTHOR]

Background: Research conducted in high-income countries has investigated influences of socioeconomic inequalities on drinking outcomes such as alcohol use disorders (AUD), however, associations between area-level neighborhood social deprivation (NSD) and individual socioeconomic status with these outcomes have not been explored in Brazil. Thus, we investigated the role of these factors on drink-related outcomes in a Brazilian population, attending to male-female variations. Methods: A multi-stage area probability sample of adult household residents in the São Paulo Metropolitan Area was assessed using the WHO Composite International Diagnostic Interview (WMH-CIDI) (n = 5,037). Estimation focused on prevalence and correlates of past-year alcohol disturbances [heavy drinking of lower frequency (HDLF), heavy drinking of higher frequency (HDHF), abuse, dependence, and DMS-5 AUD] among regular users (RU); odds ratio (OR) were obtained. Results: Higher NSD, measured as an area-level variable with individual level variables held constant, showed an excess odds for most alcohol disturbances analyzed. Prevalence estimates for HDLF and HDHF among RU were 9% and 20%, respectively, with excess odds in higher NSD areas; schooling (inverse association) and low income were associated with male HDLF. The only individual-level association with female HDLF involved employment status. Prevalence estimates for abuse, dependence, and DSM-5 AUD among RU were 8%, 4%, and 8%, respectively, with excess odds of: dependence in higher NSD areas for males; abuse and AUD for females. Among RU, AUD was associated with unemployment, and low education with dependence and AUD. Conclusions: Regular alcohol users with alcohol-related disturbances are more likely to be found where area-level neighborhood characteristics reflect social disadvantage. Although we cannot draw inferences about causal influence, the associations are strong enough to warrant future longitudinal alcohol studies to explore causal mechanisms related to the heterogeneous patterns of association and male-female variations observed herein. Hopefully, these findings may help guide future directions for public health. [ABSTRACT FROM AUTHOR]

Objective: Depression is the second most common mental disorder in older adults (OA) worldwide. The ways in which depression is influenced by the social determinants of health – specifically, by socioeconomic deprivation, income inequality and social capital - have been analyzed with only partially conclusive results thus far. The objective of our study was to estimate the association of income inequality and socioeconomic deprivation at the locality, municipal and state levels with the prevalence of depressive symptoms among OA in Mexico. Methods: Cross-sectional study based on a nationally representative sample of 8,874 OA aged 60 and over. We applied the brief seven-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to determine the presence of depressive symptoms. Additionally, to select the principal context variables, we used the Deprivation Index of the National Population Council of Mexico at the locality, municipal and state levels, and the Gini Index at the municipal and state levels. Finally, we estimated the association of income inequality and socioeconomic deprivation with the presence of depressive symptoms using a multilevel logistic regression model. Results: Socioeconomic deprivation at the locality (OR = 1.28; p<0.10) and municipal levels (OR = 1.16; p<0.01) correlated significantly with the presence of depressive symptoms, while income inequality did not. Conclusions: The results of our study confirm that the social determinants of health are relevant to the mental health of OA. Further research is required, however, to identify which are the specific socioeconomic deprivation components at the locality and municipal levels that correlate with depression in this population group. [ABSTRACT FROM AUTHOR]

The article discusses the associations between social deprivation, depression, and psychotic symptoms such as paranoia, hallucinations, and mania using the 2007 Adult Psychiatric Morbidity Survey dataset. Topics include the mediating roles of stress, discrimination, trust, and social support; the relationship between paranoid ideation and participants' index of multiple deprivation (IMD); and investigations of the role of social inequalities in psychopathology.