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Mental health and behavioural problems are common among students commencing university. University life can be stressful and problems often exacerbate during their course of study, while others develop disorders for the first time. The WHO World Mental Health Surveys International College Student Project aims to conduct longitudinal research to examine and monitor student mental health and wellbeing. The Ulster University Student Wellbeing study, which commenced in September 2015 in Northern Ireland (NI), was conducted as part of this initiative (wave 1, n = 739), using the WMH-CIDI to examine psychopathology. Baseline prevalence rates of lifetime and 12-month mental health and substance disorders, ADHD and suicidality were high, with more than half of new undergraduate students reporting any lifetime disorder. Co-morbidity was common with 19.1% of students experiencing three or more disorders. Logistic regression models revealed that females, those over 21, non-heterosexual students, and those from a lower SES background were more likely to have a range of mental health and behavioural problems. Overall, 10% of new entry students received treatment for emotional problems in the previous year. However, 22.3% of students with problems said they would not seek help. The study provides important information for universities, policy makers and practice, on mental health and wellbeing in young people generally but particularly for students commencing university. The findings will assist in the development and implementation of protection and prevention strategies in the university setting and beyond.

Background Cross-sectional studies have linked adolescent food choices to health-related quality of life (HRQoL). This research sought to determine the degree to which adolescent food choices are linked to HRQoL longitudinally. Methods Data were collected in the UK as part of the Wellbeing in Schools (WiSe) survey. Adolescents ( N  = 2241) (49% female, n  = 1112) were surveyed at age 11–12 (2014); 13–14 (2016); and 15–16 years (2018). HRQoL was assessed using the Kidscreen10 and food intake using a 17-item short food frequency questionnaire (sFFQ). Confirmatory factor analysis of FFQ responses indicated five food factors (junk food; fruit and vegetables; bread and dairy; meat; protein). Using a bidirectional strategy the five food factors and HRQoL were examined at three points in time over a period of six years. This cross-lagged model was examined using a multigroup strategy to assess the stability of responses over time in boys and girls, thus accounting for temporal stability of the different constructs. Results Boys reported higher HRQoL than girls at age 13–14 and 15–16 years. Boys consumed ‘protein’ and ‘meat intake’ more frequently at all time-points. Girls reported more frequent consumption of ‘fruit and vegetables’ at all time points, while boys’ intake decreased progressively at ages 13–14 and 15–16 years. Cross-lagged panel modelling indicated that more frequent intake of ‘fruit and vegetables’, and ‘protein’ was associated with lower HRQoL scores at baseline (age 11–12 years) and that this association strengthened through ages 13–14 and 15–16 years. Lower HRQoL scores at baseline were associated with more frequent ‘bread and dairy’ intake at age 13–14 years but not at 15–16 years. No associations were observed over time between HRQoL and ‘junk food’ or ‘meat intake’. Conclusions These findings imply the importance of diet to quality of life during adolescence. Further research is required to understand why certain dietary factors were associated with lower HRQOL over the course of adolescence. Meanwhile, intervention to enhance HRQoL should target girls while efforts to enhance ‘fruit and vegetable’ intake should target boys.

Background Understanding how health-related quality of life (HRQoL) is related to lifestyle factors during adolescence is crucial to effective health promotion. The aim of this analysis was to identify associations between HRQoL and lifestyle and to determine the degree to which they are mediated by food choices in adolescents. Methods The Wellbeing in Schools (NI) survey (N = 1609; 13–14 years) assessed HRQoL using the Kidscreen52. Food choice was assessed by Food Frequency Questionnaire (FFQ) and physical activity was assessed using the Physical Activity Questionnaire for Adolescents (PAQ-A). Social media and alcohol abstinence were self-reported. Results Path analysis indicated that fruit and vegetable intake was associated with higher HRQoL on dimensions of moods and emotions, parent relations and home life, financial resources, and social support and peers. Bread and diary intake was related to higher physical wellbeing. Protein was associated with higher psychological wellbeing, moods and emotions, self-perception, parent relations and home life, financial resources, and lower social support and peers. Junk food was related to lower moods and emotions. Males had higher psychological wellbeing, moods and emotions, parental relations and home life. Females had higher self-perception, autonomy, and social support and peers. Greater physical activity explained higher HRQoL on all dimensions. Less social media was associated with higher psychological wellbeing, moods and emotions, self-perception, parent relations and home life, and school environment. Alcohol abstinence was associated with higher physical wellbeing, psychological wellbeing, moods and emotions, self-perception, parent relations and home life, and school environment dimensions. Conclusion Intervention to promote HRQoL in adolescents should consider food choices whilst encouraging physical activity, discouraging social media and deterring alcohol, and targeting boys and girls separately.

Citizens play a crucial role in attaining the United Nations 2030 sustainable development goals (SDGs). There is growing awareness of the importance of understanding citizen perspectives on environmental issues, in relation to developing and maintaining sustainable lifestyles, and in addressing perceived threats to protection and restoration of ecosystems and biodiversity. This analysis sought to understand people’s attitudes towards environmental conservation, how they relate to perceived threats to the countryside, and to determine how attitudes and perceived threats vary demographically and between countries. A survey was administered to citizens (quota sampled on age, gender, education, and split between rural and urban residency) across five countries representative of differing biogeographical regions (N = 3,190): Czech Republic (n = 649) (Continental); Spain (Mediterranean) (n = 623); Sweden (Boreal) (n = 645); Switzerland (Alpine) (n = 641); United Kingdom (UK) (Atlantic) (n = 632). Attitudes were measured using the Environmental Attitudes Inventory (EAI-24) on 2 factors (utilization; preservation) and perceived threat to the countryside on 1-factor (15 items). Multigroup regression analysis indicated that preservationist attitudes were associated with greater perceived threat to the countryside in all five countries. Higher perceived threat was associated with activities linked to environmental degradation, socio-economic uncertainty and risks in agri-food supply chains in all countries. The “bad behaviour of visitors” was the greatest perceived threat in the Czech Republic, Switzerland and the UK, while “lack of young farmers taking over farming” was the greatest perceived threat in Spain and Sweden. To promote pro-environmental attitudes and obtain greater public support for policies and interventions targeting environmental conservation, communication about environmental threats is needed, together with threat mitigation measures. Raising peoples’ awareness of threats to the countryside through targeted communications could promote pro-environment attitudes and potentially result in pro-environmental behaviours.

We evaluated a simulation-based training curriculum with quantitatively defined performance benchmarks for utility workers location and excavation of utility services. Damaging buried utilities is associated with considerable safety risks to workers and substantial cost to employers. In a prospective, randomized and blinded study we assessed the impact of Proficiency Based Progression (PBP) simulation training on the location and excavation of utility services work. PBP simulation training reduced performance errors (33%, p = 0.006) in comparison a standard trained group. When implemented across all workers in the same division there was a 35-61% reduction in utility strikes (p = 0.028) and an estimated cost saving of £116,000 -£2,175,000 in the 12 months (47,000 work hours) studied. The magnitude of the training benefit of PBP simulation training in the utilities sector appears to be the same as it is in surgery, cardiology and procedure-based medicine. Quality-assured utility worker simulation training significantly reduces utility damage and associated costs.

Background The economic and moral implications of family burden are well recognised. What is less understood is whether or how family health and family burden relate to personal mental health. This study examines family health and perceived family burden as predictors of personal mental health, taking personal and sociodemographic factors into consideration. Methods Data used was from the National Comorbidity Study Replication (NCS-R), namely the random 30% of participants (N = 3192) to whom the family burden interview was administered. Measures of family burden and mental health were considered for analysis. Results Binary logistic regressions were used as means of analyses. Perception of family burden was associated with an increased vulnerability to personal mental health problems, as was the presence of mental health difficulties within the family health profile. Which member of the family (kinship) was ill bore no relation to prediction of personal mental health. Personal and socio-demographic factors of sex, age, marital status, education and household income were all predictive of increased vulnerability to mental health problems over the last 12 months. Conclusions Certain elements of family health profile and its perceived burden on the individuals themselves appears related to risk of personal incidence of mental health problems within the individuals themselves. For moral and economic reasons, further research to understand the dynamics of these relationships is essential to aid developing initiatives to protect and support the mental health and wellbeing of relatives of ill individuals.

Background Congenital Heart Defects (CHD) is the most commonly occurring congenital anomaly in Europe and a major paediatric health care concern. Investigations are needed to enable identification of CHD risk factors as studies have given conflicting results. This study aim was to identify maternal sociodemographic characteristics, behaviours, and birth outcomes as risk factors for CHD. This was a population based, data linkage cohort study using anonymised data from Northern Ireland (NI) covering the period 2010-2014. The study cohort composed of 94,067 live births with an outcome of 1162 cases of CHD using the International Statistical Classification of Diseases and Related Health Problems (ICD)-10 codes and based on the European Surveillance of Congenital Anomalies (EUROCAT) grouping system for CHD. CHD cases were obtained from the HeartSuite database (HSD) at the Royal Belfast Hospital for Sick Children (RBHSC), maternal data were extracted from the Northern Ireland Maternity System (NIMATS), and medication data were extracted from the Enhanced Prescribing Database (EPD). STATA version 14 was used for the statistical analysis in this study, Odds Ratio (OR), 95% Confident intervals (CI), P value, and logistic regression were used in the analysis. Ethical approval was granted from the National Health Service (NHS) Research Ethics Committee. Result In this study, a number of potential risk factors were assessed for statistically significant association with CHD, however only certain risk factors demonstrated a statistically significant association with CHD which included: gestational age at first booking (AOR = 1.21; 95% CI = 1.04-1.41; P < 0.05), family history of CHD or congenital abnormalities and syndromes (AOR = 4.14; 95% CI = 2.47-6.96; P < 0.05), woman’s smoking in pregnancy (AOR = 1.22; 95% CI = 1.04-1.43; P < 0.05), preterm birth (AOR = 3.01; 95% CI = 2.44-3.01; P < 0.05), multiple births (AOR = 1.89; 95% CI = 1.58-2.60; P < 0.05), history of abortion (AOR = 1.12; 95% CI = 1.03-1.28; P < 0.05), small for gestational age (SGA) (AOR = 1.44; 95% CI = 1.22-1.78; P < 0.05), and low birth weight (LBW) (AOR = 3.10; 95% CI = 2.22-3.55; P < 0.05). Prescriptions and redemptions of antidiabetic (AOR = 2.68; 95% CI = 1.85-3.98; P < 0.05), antiepileptic (AOR = 1.77; 95% CI = 1.10-2.81; P < 0.05), and dihydrofolate reductase inhibitors (DHFRI) (AOR = 2.13; 95% CI = 1.17-5.85; P < 0.05) in early pregnancy also showed evidence of statistically significant association with CHD. Conclusion The results of this study suggested that there are certain maternal sociodemographic characteristics, behaviours and birth outcomes that are statistically significantly associated with higher risk of CHD. Appropriate prevention policy to target groups with higher risk for CHD may help to reduce CHD prevalence. These results are important for policy makers, obstetricians, cardiologists, paediatricians, midwives and the public.

We investigated the role of maternal environmental factors in the aetiology of congenital heart disease (CHD). A population-based case-control study (242 CHD cases, 966 controls) was conducted using an iPad questionnaire for mother with linkage to maternity and first trimester prescription records. Risk of CHD was associated with low maternal education (OR adjusted for confounders 1.59; 95% confidence interval [CI], 1.02-2.49), pregestational diabetes (OR 4.04; 95% CI 1.00-16.28), self-reported maternal clotting disorders (adjOR 8.55, 95%CI 1.51-48.44), prescriptions for the anticlotting medication enoxaparin (adjOR 3.22, 95%CI 1.01-10.22) and self-reported vaginal infections (adjOR 1.69, 95%CI 1.01-2.80). There was no strong support for the hypothesis that periconceptional folic acid supplements have a protective effect, but there was a protective effect of frequent consumption of folate rich fruits (adjOR 0.64, 95%CI 0.47-0.89). Compared to the most common pre-pregnancy dietary pattern, CHD risk was associated with a poor diet low in fruit and vegetables (adjOR 1.56, 95%CI 1.05-2.34). Mothers of cases reported more pregnancy related stress (adjOR 1.69; 95% CI 1.22-2.34) and multiple stressors (adjOR 1.94, 95%CI 0.83-4.53). We found no supportive evidence for CHD risk being associated with obesity, smoking, depression or antidepressant use in this population. Our findings add to the previous evidence base to show potential for public health approaches to help prevent CHD in future by modifying environmental factors. Independent confirmation should be sought regarding elevated CHD risk associated with maternal blood clotting disorders and their treatment, since we are the first to report this.

Objective: The present study explored associations between food choice motives, attitudes towards and intention to adopt personalised nutrition, to inform communication strategies based on consumer priorities and concerns. Design/Setting: A survey was administered online which included the Food Choice Questionnaire (FCQ) and items assessing attitudes towards and intention to adopt personalised nutrition. Subjects: Nationally representative samples were recruited in nine EU countries (n 9381). Results: Structural equation modelling indicated that the food choice motives weight control, mood, health and ethical concern had a positive association and price had a negative association with attitude towards, and intention to adopt, personalised nutrition. Health was positively associated and familiarity negatively associated with attitude towards personalised nutrition. The effects of weight control, ethical concern, mood and price on intention to adopt personalised nutrition were partially mediated by attitude. The effects of health and familiarity were fully mediated by attitude. Sensory appeal was negatively and directly associated with intention to adopt personalised nutrition. Conclusions: Personalised nutrition providers may benefit from taking into consideration the importance of underlying determinants of food choice in potential users, particularly weight control, mood and price, when promoting services and in tailoring communications that are motivationally relevant. Copyright (c) The Authors 2018

AimsFall prevention is an important health consideration for older adults. The benefits of moderate-to-vigorous intensity physical activity (MVPA) for fall prevention are well established. Few studies have explored the association between low intensity physical activity (LPA) and fall risk in older adults over time.MethodsSix waves of data from the English Longitudinal Study of Ageing (ELSA) were analysed. The measures of physical activity (PA) intensity were developed using latent class analysis (LCA). Then, the association between PA intensity and gait speed was analysed using a latent growth model (LGM).ResultsLatent class analysis identified three classes of PA—inactive, low intensity, and moderate-vigorous intensity PA. LGM analysis showed that MVPA (Est 1.12, SE 0.05) was associated with a faster gait speed and slower rate of decline over time. LPA (Est 0.96; SE 0.12) was more beneficial than being inactive. Age was found to influence gait speed where MVPA was associated with better gait speed in adults aged ≤ 70 years, and LPA was associated with better gait speed for adults aged ≥ 70 years.DiscussionModerate-to-vigorous intensity physical activity maybe more beneficial for older adults and current policy supports this. However, LPA is associated with better gait speed in older adults aged ≥ 70 years and also maybe more achievable for older adults.ConclusionTherefore, future fall prevention interventions should also include recommendations for LPA for old-older adults (≥ 70 years).