Few studies have examined the prevalence of mental illness in young people over time within the same jurisdiction. In the current study, we compared data from three large surveys of youth in custody in New South Wales, conducted in 2003, 2009 and 2015. We examined rates of mental illness, self-harm and suicidal behaviours, substance use and childhood trauma and found little consistent change over time, though some fluctuations were observed regarding certain mental illnesses and substance use. We also descriptively compared findings with observed rates for the general population and found that young people in custody showed higher levels of all examined variables. In sum, these data suggest little improvement in the well-being of young people in custody in New South Wales over time. Better identification and treatment of these issues are vital if young people are to be prevented from becoming enmeshed in the criminal justice system.

BACKGROUND: In 2016, the SSO and ABIM released a Choosing Wisely® guideline stating SLNB can be safely omitted in women ≥70 with HR ​+ ​HER-invasive breast cancer. No study evaluating concordance of care with this guideline has been performed within a comprehensive cancer center.
METHODS: From 2005 to 2020, there were 382 patients with cT1-2N0 invasive carcinoma ER+/PR+ and HER2-identified as having undergone SLNB. These patients were then separated into two groups; those in the pre-guideline concordance cohort (2005-2015) and those in the post-guideline concordance (2016-2020) cohort. Axillary management concordance was trended over time.
RESULTS: 382 patients from 2005 to 2020 with HR ​+ ​HER- IBC were identified. No difference was seen in SLNB pre-versus post-guidelines (p ​= ​0.35). Increased concordance was noted as age increased (p ​= ​0.0068) and adjuvant radiation therapy exclusion (p ​< ​0.0001) post-guideline release. Concordance improved over the years post-guideline release (R2 ​= ​0.45).
CONCLUSIONS: Surgical guideline adoption occurs over time but may also be affected by outside decisions and factors. Further study into patterns of guideline adoption may facilitate improving adherence to guidelines.

Harmful alcohol consumption is one of the five essential risk factors for disease, impairments and premature death around the world. It is considered to be a contributory cause for more than 200 diseases and is co-responsible for causing many intentional and unintentional injuries. In order to reduce harmful alcohol consumption, the health target \"Reduce alcohol consumption\" has been currently elaborated in Germany and focuses on a policy mix of behavioural and situational preventive measures to include as far as possible all relevant players for the development of overarching objectives. The data from the recurrent health surveys by the Robert Koch Institute (RKI) allow an evaluation of trends of harmful alcohol consumption in the population aged 25 to 69 between 1990/1992, 1997/1999, and 2008/2011. Harmful alcohol consumption is defined as a daily consumption of pure alcohol of more than 10g for women and more than 20g for men. For the years 2008-2011 harmful alcohol consumption for the age group 18 to 79 years is calculated based on the \"German Health Interview and Examination Survey for Adults\" (DEGS1) and examined in connection with socio-demographic and health-related factors. The results of DEGS1 show that 13.1% of women and 18.5% of men consume alcohol in harmful quantities. For men harmful alcohol consumption rises with the age; for women the lowest prevalence is found in those aged 30-39 years and the highest in the age group 50-59 years. Women with a high socio-economic status drink a harmful quantity of alcohol to a higher extent than women from medium or low status groups. For men there are no corresponding differences. Mainly smoking is associated with harmful alcohol consumption. Between 1990 and 1992 as well as between 2008 and 2011 harmful alcohol consumption has strongly declined, for women from 50.9% to 13.6%, for men from 52.6% to 18.3% (age group 25 to 69 years). Even if harmful alcohol consumption in the population has strongly declined, the per capita consumption of pure alcohol is above the average of the EU Member States in Germany. For that reason, preventive measures for specific target groups are required.

Background Few studies have examined age and sex differences in the receipt of cardiac diagnostic and interventional procedures in patients hospitalized with acute myocardial infarction and trends in these possible differences during recent years. Methods and Results Data from patients hospitalized with a first acute myocardial infarction at the major medical centers in the Worcester, Massachusetts, metropolitan area were utilized for this study. Logistic regression analysis was used to examine age (<55, 55-64, 65-74, and ≥75 years) and sex differences in the receipt of echocardiography, exercise stress testing, coronary angiography, percutaneous coronary interventions, and coronary artery bypass graft surgery, and trends in the use of those procedures during patients\' acute hospitalization, between 2005 and 2018, while adjusting for important confounding factors. The study population consisted of 1681 men and 1154 women with an initial acute myocardial infarction who were hospitalized on an approximate biennial basis between 2005 and 2018. A smaller proportion of women underwent cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft surgery, while there were no sex differences in the receipt of echocardiography and exercise stress testing. Patients aged ≥75 years were less likely to undergo cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft surgery, but were more likely to receive echocardiography compared with younger patients. Between 2005 and 2018, the use of echocardiography and coronary artery bypass graft surgery nonsignificantly increased among all age groups and both sexes, while the use of cardiac catheterization and percutaneous coronary intervention increased nonsignificantly faster in women and older patients. Conclusions We observed a continued lower receipt of invasive cardiac procedures in women and patients aged ≥75 years with acute myocardial infarction, but age and sex gaps associated with these procedures have narrowed during recent years.

UNASSIGNED: Chronic social and health inequities faced by indigenous peoples in Brazil foretell the detrimental impact of COVID-19.
UNASSIGNED: We use de-identified, publicly available data from the Ministry of Health from March/2020 - December/2021 to describe vaccination coverage, cumulative incidence, and cumulative mortality rates due to COVID-19 among indigenous peoples. We also compare vaccination coverage among indigenous peoples with that reported for older adults, who were simultaneously included as a priority group in the vaccination strategy. Finally, we compared COVID-19 incidence and mortality rates in the indigenous population with that reported for the general Brazilian population.
UNASSIGNED: We found important heterogeneities in vaccination coverage across the 34 indigenous districts, and a lower overall coverage among indigenous peoples compared to older adults. We observed higher COVID-19 cumulative incidence rates among indigenous populations compared to the general Brazilian population. Although mortality rates were seemingly lower, data should be interpreted with caution due to a younger age structure and more frequent underreporting of cases and deaths among indigenous populations. After the beginning of COVID-19 vaccination program, we observed a decrease in both incidence and mortality rates among indigenous peoples in all Brazilian regions.
UNASSIGNED: The COVID-19 pandemic has had a heavy toll on vulnerable populations. Although social and geographic isolation challenges the implementation of any vaccination program for indigenous populations, prior experience suggests that the COVID-19 vaccination strategy lacked effectiveness. The absence of a coordinated strategy to reinforce the importance of the vaccine and other prevention methods, to guarantee the access to trustworthy information, and to respond with the necessary resources in extreme situations, resulted in lower COVID-19 vaccination coverage, higher incidence rates, and preventable deaths due to COVID-19 among indigenous peoples in Brazil.
UNASSIGNED: This work was not supported by specific funding.

Numerous findings are known to exist between dietary habits, physical activity, and child and adolescent health. Here, we will use data from the most recent Health Behaviour in School-aged Children (HBSC) study to describe dietary habits and patterns of physical activity. Using the survey data for 11-, 13- and 15-year-old students from across Germany, we report findings for key indicators of diet and physical activity for the 2017/18 cycle. By comparing these findings with data from the 2009/10 and 2013/14 survey cycles, we also consider current trends. Results from the most recent cycle show that 10.0% of girls and 16.9% of boys meet the World Health Organization\'s (WHO) physical activity recommendations. Across all HBSC cycles, this is the lowest figure so far. Concerning dietary habits, 50.6% of girls and 59.0% of boys reported having breakfast every morning. Data for daily fruit, vegetable and soft drink consumption emphasises the need to promote a healthy diet among adolescents. For all indicators of physical activity and diet, differences between girls and boys are apparent. Girls\' intake of fruit and vegetables is higher and they consume fewer soft drinks, yet boys are more physically active and have breakfast more regularly. For the majority of indicators of dietary habits and physical activity, considerable inequalities relating to family affluence are observed. An important implication of the study results for dietary habits and physical activity of older children and adolescents is the need to foster settings-based approaches to promote physical activity and a healthy diet that integrate a gender-sensitive perspective.

The extent to which rising atmospheric CO2 concentration has already influenced food production and quality is uncertain. Here, we analyzed annual field trials of autumn-planted common wheat in California from 1985 to 2019, a period during which the global atmospheric CO2 concentration increased 19%. Even after accounting for other major factors (cultivar, location, degree-days, soil temperature, total water applied, nitrogen fertilization, and pathogen infestation), wheat grain yield and protein yield declined 13% over this period, but grain protein content did not change. These results suggest that exposure to gradual CO2 enrichment over the past 35 years has adversely affected wheat grain and protein yield, but not grain protein content.

BACKGROUND: Although the number of patients with end-stage kidney disease is growing, the number of patients who perform dialysis at home has decreased during the past two decades. The aim of this study was to explore time trends in the use of home dialysis in the Netherlands.
METHODS: Dialysis episodes of patients who started dialysis treatment were studied using Dutch registry data (RENINE). The uptake of home dialysis between 1997 through 2016 was evaluated in time periods of 5 years. Home dialysis was defined as start with peritoneal dialysis or home haemodialysis, or transfer to either within 2 years of dialysis initiation. All analyses were stratified for age categories. Mixed model logistic regression analysis was used to adjust for clustering at patient level.
RESULTS: A total of 33 340 dialysis episodes in 31 569 patients were evaluated. Mean age at dialysis initiation increased from 62.5 ± 14.0 to 65.5 ± 14.5 years in in-centre haemodialysis patients, whereas it increased from 51.9 ± 15.1 to 62.5 ± 14.6 years in home dialysis patients. In patients <65 years, the uptake of home dialysis was significantly lower during each 5-year period compared with the previous period, whereas kidney transplantation occurred more often. In patients ≥65 years, the incidence of home dialysis remained constant, whereas mortality decreased.
CONCLUSIONS: In patients <65 years, the overall use of home dialysis declined consistently over the past 20 years. The age of home dialysis patients increased more rapidly than that of in-centre dialysis patients. These developments have a significant impact on the organization of home dialysis.

OBJECTIVE: To map patterns and prevalence of daily smoking among employed Australians over time.
METHODS: Data from four waves of the triennial National Drug Strategy Household Survey (2007, 2010, 2013 and 2016) were used to assess daily smoking. Frequency analyses and significance testing examined smoking prevalence by sex, age, state, remoteness, Indigeneity, socioeconomic status (SES) and psychological distress. Logistic regression models estimated adjusted effects of demographics on smoking prevalence.
RESULTS: Workers\' daily smoking prevalence reduced by 32% between 2007 and 2016. The adjusted model showed the lowest smoking reductions among men and non-metropolitan workers. Other interaction effects showed the highest daily smoking rates for: male workers aged 14-39 years; low SES non-metropolitan workers; and low SES workers aged 40-59 years.
CONCLUSIONS: Specific workplace policies, prevention and intervention strategies are warranted for male workers, especially those aged 14-39; non-metropolitan workers, especially low SES rural workers; and low SES workers especially 40-59-year-olds. Implications for public health: In spite of significant smoking reductions among workers over time, reductions were unevenly distributed. Tailored, innovative workplace prevention and intervention strategies that apply principles of proportionate universalism and address individual, workplace settings and cultural factors are warranted to reduce smoking disparities among male, rural and low SES workers.

OBJECTIVE: Preterm birth clinics provide dedicated obstetric care to women at high risk of spontaneous preterm birth (SPTB). There remains a lack of conclusive evidence to support the overall utility of such clinics, attributable to a paucity and heterogeneity of primary data. This study audits Australia\'s largest and oldest dedicated preterm birth clinic with the aim to add primary data to the area and offer opportunities for similar clinics to align practice.
METHODS: A retrospective audit of referrals to the Preterm Labour Clinic at the Royal Women\'s Hospital, Melbourne, Australia, between 2004 and 2018 was conducted. 1,405 singleton pregnancies met inclusion criteria. The clinic\'s key outcomes, demographics, predictive tests and interventions were analysed. The primary outcomes were SPTB before 37, 34 and 30 weeks\' gestation.
RESULTS: The overall incidence of SPTB in the clinic was 21.2% (n=294). Linear regression showed reductions in the adjusted rates of overall SPTB and pre-viable SPTB (delivery <24 weeks) from 2004 (108%; 8%) to 2018 (65%; 2% respectively). Neonatal morbidity and post-delivery intensive care admission concurrently declined (p=0.02; 0.006 respectively). Rates of short cervix (cervical length <25 mm) increased over time (2018: 30.9%) with greater uptake of vaginal progesterone for treatment. Fetal fibronectin, mid-trimester short cervix, and serum alkaline phosphatase were associated with SPTB on logistic regression.
CONCLUSIONS: Dedicated preterm birth clinics can reduce rates of SPTB, particularly deliveries before 24 weeks\' gestation, and improve short-term neonatal outcomes in pregnant women at risk of preterm birth.