Brittmorin1628

BACKGROUND Cities across the world are undertaking ambitious projects to expand tree canopy by increasing the number of trees planted throughout public and private spaces. In epidemiological studies, greenspaces in urban environments have been associated with physical and mental health benefits for city dwellers. Greenworks Philadelphia is a plan to increase tree cover across Philadelphia (PA, USA) by the year 2025. We aimed to assess whether an increase in tree canopy or greenspace in Philadelphia could decrease mortality. METHODS We did a greenspace health impact assessment to estimate the annual premature mortality burden for adult residents associated with projected changes in tree canopy cover in Philadelphia between 2014 and 2025. Using up-to-date exposure-response functions, we calculated the number of preventable annual premature deaths city-wide, and for areas of lower versus higher socioeconomic status, for each of three tree canopy scenarios low, moderate and ambitious. The ambitious scenario reflected the city's goal of 30% tree canopy cover in each of the city's neighbourhoods; and low and moderate scenarios were based on the varying levels of plantable space across neighbourhoods. FINDINGS We estimated that 403 (95% interval 298-618) premature deaths overall, including 244 (180-373) premature deaths in areas of lower socioeconomic status, could be prevented annually in Philadelphia if the city were able to meet its goal of increasing tree canopy cover to 30%. INTERPRETATION Bringing all of Philadelphia, and particularly its poorer neighbourhoods, up to the 30% goal of tree canopy cover is not without challenge. Nevertheless, policies are warranted that value urban greening efforts as health-promoting and cost-saving measures. FUNDING Spanish Ministry of Science, Innovation and Universities, and Generalitat de Catalunya. BACKGROUND Little is known about the influence of toxic exposures on reduced life expectancy in First Nations people in Canada. The Grassy Narrows First Nation community have lived with the consequences of one of the worst environmental disasters in Canadian history. In the early 1960s, 10 000 kg of mercury (Hg) was released into their aquatic ecosystem. Although Hg concentration in fish, their dietary staple, decreased over time, it remains high. We aimed to examine whether elevated Hg exposure over time contributes to premature mortality (younger than 60 years) in this community. METHODS We did longitudinal and case-control analyses with data for individuals of the Grassy Narrows First Nation community. In 2019, the community obtained their historical Hg biomarker data from a government surveillance programme, which was then shared with the authors. A matched-pair approach allowed us to compare longitudinal hair Hg concentration between cases (individuals who died aged younger than 60 years) and controls (i Hg concentration. Analyses of 36 matched pairs showed that hair Hg concentration of those who died aged younger than 60 years was 4·7 times higher (3·4-5·9) than controls. INTERPRETATION The consistent findings between our different analyses support an association between long-term Hg exposure from freshwater fish consumption and premature mortality in this First Nation community. There is a need to do risk-benefit analyses of freshwater fish consumption in environmentally contaminated regions. FUNDING Canadian Institutes of Health Research. BACKGROUND Evidence exists that maternal depression in the perinatal period has an adverse effect on a range of early childhood outcomes and increases the risk of offspring depression during adolescence. However, the association between maternal depression during the perinatal period and offspring psychotic experiences has not been investigated. We aimed to investigate whether there is an association between maternal antenatal or postnatal depression and offspring psychotic experiences at 18 years of age. METHODS This longitudinal study used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort, which recruited 14 541 pregnant women with an estimated delivery date between April 1, 1991, and Dec 31, 1992. Perinatal depression was measured using the Edinburgh Postnatal Depression Scale (EPDS); offspring psychotic experiences at 18 years of age were measured using the Psychosis-Like Symptom Interview. Offspring of mothers with complete data on maternal perinatal depreriences at the age of 18 years (n=2830, OR for a 5-point increase in EPDS score 1·32 [95% CI 1·16-1·51], p less then 0·0001) and offspring depression at 18 years (OR for a 5-point increase in EPDS score 1·18 [1·03-1·34], p=0·016). From joint modelling, there was no evidence that the association between maternal antenatal depression and offspring psychotic experiences differed in strength compared with offspring depression (p=0·19). INTERPRETATION The offspring of mothers who experience depression in the perinatal period are more likely to report psychotic experiences at 18 years of age. If the association is found to be causal, it would strengthen the case for identifying and treating maternal depression during and after pregnancy. see more FUNDING UK Medical Research Council and the Wellcome Trust. BACKGROUND Multisystemic therapy is a manualised treatment programme for young people aged 11-17 years who exhibit antisocial behaviour. To our knowledge, the Systemic Therapy for At Risk Teens (START) trial is the first large-scale randomised controlled trial of multisystemic therapy in the UK. Previous findings reported to 18 months after baseline (START-I study) did not indicate superiority of multisystemic therapy compared with management as usual. Here, we report outcomes of the trial to 60 months (START-II study). METHODS In this pragmatic, randomised, controlled, superiority trial, young people (aged 11-17 years) with moderate-to-severe antisocial behaviour were recruited from social services, youth offending teams, schools, child and adolescent mental health services, and voluntary services across England, UK. Participants were eligible if they had at least three severity criteria indicating past difficulties across several settings and one of five general inclusion criteria for antisocial behaviour. Eligible families were randomly assigned (11), using stochastic minimisation and stratifying for treatment centre, sex, age at enrolment, and age at onset of antisocial behaviour, to management as usual or 3-5 months of multisystemic therapy followed by management as usual.