Public Mental Health Approaches to Online Radicalisation: An Empty Systematic Review.

This systematic review seeks to position online radicalisation within whole system frameworks incorporating individual, family, community and wider structural influences whilst reporting evidence of public mental health approaches for individuals engaging in radical online content. METHODS: the authors searched Medline (via Ovid), PsycInfo (via Ebscohost) and Web of Science (Core Collection) with the use of Boolean operators across "extremism", "online content" and "intervention". RESULTS: Following full-text assessments, all retrieved papers were excluded. No publications fulfilled the primary objective of reporting public mental health interventions specifically addressing online radicalisation. However, six publications fulfilled the secondary objective of identifying theoretical and conceptual relationships amongst elements in the three inclusion criteria (online extremism, psychological outcomes and intervention strategy) that could inform interventions within public mental health frameworks. These publications were quality assessed and discussed following the Cochrane Effective Practice and Organisation of Care guide for reporting empty reviews. CONCLUSIONS: there is an immediate need for further research in this field given the increase in different factions of radicalised beliefs resulting from online, particularly social media, usage.

Drinking alcohol in moderation is associated with lower rate of all-cause mortality in individuals with higher rather than lower educational level: findings from the MORGAM project.

The association between socioeconomic status (SES) and alcohol-related diseases has been widely explored. Less is known, however, on whether the association of moderate drinking with all-cause mortality is modified by educational level (EL). Using harmonized data from 16 cohorts in the MORGAM Project (N = 142,066) the association of pattern of alcohol intake with hazard of all-cause mortality across EL (lower = primary-school; middle = secondary-school; higher = university/college degree) was assessed using multivariable Cox-regression and spline curves. A total of 16,695 deaths occurred in 11.8 years (median). In comparison with life-long abstainers, participants drinking 0.1-10 g/d of ethanol had 13% (HR = 0.87; 95%CI: 0.74-1.02), 11% (HR = 0.89; 0.84-0.95) and 5% (HR = 0.95; 0.89-1.02) lower rate of death in higher, middle and lower EL, respectively. Conversely, drinkers > 20 g/d had 1% (HR = 1.01; 0.82-1.25), 10% (HR = 1.10; 1.02-1.19) and 17% (HR = 1.17; 1.09-1.26) higher rate of death. The association of alcohol consumption with all-cause mortality was nonlinear, with a different J-shape by EL levels. It was consistent across both sexes and in various approaches of measuring alcohol consumption, including combining quantity and frequency and it was more evident when the beverage of preference was wine. We observed that drinking in moderation (≤ 10 g/d) is associated with lower mortality rate more evidently in individuals with higher EL than in people with lower EL, while heavy drinking is associated with higher mortality rate more evidently in individuals with lower EL than in people with higher EL, suggesting that advice on reducing alcohol intake should especially target individuals of low EL.

Genetically Determined Reproductive Aging and Coronary Heart Disease: A Bidirectional 2-sample Mendelian Randomization.

BACKGROUND: Accelerated reproductive aging, in women indicated by early natural menopause, is associated with increased coronary heart disease (CHD) risk in observational studies. Conversely, an adverse CHD risk profile has been suggested to accelerate menopause. OBJECTIVES: To study the direction and evidence for causality of the relationship between reproductive aging and (non-)fatal CHD and CHD risk factors in a bidirectional Mendelian randomization (MR) approach, using age at natural menopause (ANM) genetic variants as a measure for genetically determined reproductive aging in women. We also studied the association of these variants with CHD risk (factors) in men. DESIGN: Two-sample MR, using both cohort data as well as summary statistics, with 4 methods: simple and weighted median-based, standard inverse-variance weighted (IVW) regression, and MR-Egger regression. PARTICIPANTS: Data from EPIC-CVD and summary statistics from UK Biobank and publicly available genome-wide association studies were pooled for the different analyses. MAIN OUTCOME MEASURES: CHD, CHD risk factors, and ANM. RESULTS: Across different methods of MR, no association was found between genetically determined reproductive aging and CHD risk in women (relative risk estimateIVW = 0.99; 95% confidence interval (CI), 0.97-1.01), or any of the CHD risk factors. Similarly, no associations were found in men. Neither did the reversed analyses show evidence for an association between CHD (risk factors) and reproductive aging. CONCLUSION: Genetically determined reproductive aging is not causally associated with CHD risk (factors) in women, nor were the genetic variants associated in men. We found no evidence for a reverse association in a combined sample of women and men.

Reducing occupational sitting time in adults with type 2 diabetes: Qualitative experiences of an office-adapted mHealth intervention.

AIM: Understanding barriers and facilitators for limiting occupational sitting and what impact it has on health on those with type 2 diabetes is essential for future trials and intervention development in primary healthcare settings. This study aimed to explore the feasibility and acceptability of an intervention using mobile health (mHealth) technology, together with counselling by a diabetes specialist nurse, to reduce occupational sitting in adults with type 2 diabetes. METHODS: Individual semi-structured interviews were conducted in 15 participants with type 2 diabetes who completed a 3-month intervention including mHealth; activity tracker (Garmin Vivofit3) and SMS reminders, one initial face-to-face patient-centred counselling session and three telephone follow-up calls by a diabetes specialist nurse within the primary healthcare system in Sweden. The interviews were recorded, transcribed verbatim and analysed using qualitative content analysis. RESULTS: Two themes were identified: (1) 'From baby steps to milestones' reflecting three categories; 'Small changes make it easier to reduce sitting', 'Encouraged by trustworthy coaching', 'Physical and mental rewards matter' and (2) 'Tailoring strategies that fit me and my workplace' reflecting four categories; 'It's up to me', 'Taking advantage of the support', 'Using creativity to find practical solutions for interrupting sitting' and 'Living up to expectations'. CONCLUSION: The intervention was perceived as feasible and acceptable in different office workplaces, and led to increased awareness of sedentary behaviour in adults with type 2 diabetes. Stepwise goal setting together with personalization of the mHealth intervention should be emphasized in individual type 2 diabetes programmes aiming to reduce workplace sitting.

Association of menopausal characteristics and risk of coronary heart disease: a pan-European case-cohort analysis.

BACKGROUND: Earlier age at menopause has been associated with increased risk of coronary heart disease (CHD), but the shape of association and role of established cardiovascular risk factors remain unclear. Therefore, we examined the associations between menopausal characteristics and CHD risk; the shape of the association between age at menopause and CHD risk; and the extent to which these associations are explained by established cardiovascular risk factors. METHODS: We used data from EPIC-CVD, a case-cohort study, which includes data from 23 centres from 10 European countries. We included only women, of whom 10 880 comprise the randomly selected sub-cohort, supplemented with 4522 cases outside the sub-cohort. We conducted Prentice-weighted Cox proportional hazards regressions with age as the underlying time scale, stratified by country and adjusted for relevant confounders. RESULTS: After confounder and intermediate adjustment, post-menopausal women were not at higher CHD risk compared with pre-menopausal women. Among post-menopausal women, earlier menopause was linearly associated with higher CHD risk [HRconfounder and intermediate adjusted per-year decrease = 1.02, 95% confidence interval (CI) = 1.01-1.03, p = 0.001]. Women with a surgical menopause were at higher risk of CHD compared with those with natural menopause (HRconfounder-adjusted = 1.25, 95% CI = 1.10-1.42, p < 0.001), but this attenuated after additional adjustment for age at menopause and intermediates (HR = 1.12, 95% CI = 0.96-1.29, p = 0.15). A proportion of the association was explained by cardiovascular risk factors. CONCLUSIONS: Earlier and surgical menopause were associated with higher CHD risk. These associations could partially be explained by differences in conventional cardiovascular risk factors. These women might benefit from close monitoring of cardiovascular risk factors and disease.