Objective 
We aimed to collect and meta-analyse the existing evidence regarding the performance of the Center for Epidemiologic Studies Depression (CES-D) for detecting depression in general population and primary care settings.
Method 
Systematic literature search in PubMed and PsychINFO. Eligible studies were: a) validation studies of screening questionnaires with information on the accuracy of the CES-D; b) samples from general populations or primary care settings; c) standardized diagnostic interviews following standard classification systems used as gold standard; and d) English or Spanish language of publication. Pooled sensitivity, specificity, likelihood ratios and diagnostic odds ratio were estimated for several cut-off points using bivariate mixed effects models for each threshold. The summary receiver operating characteristic curve was estimated with Rutter and Gatsonis mixed effects models; area under the curve was calculated. Quality of the studies was assessed with the QUADAS tool. Causes of heterogeneity were evaluated with the Rutter and Gatsonis mixed effects model including each covariate at a time.
Results 
28 studies (10,617 participants) met eligibility criteria. The median prevalence of Major Depression was 8.8% (IQ range from 3.8% to 12.6%). The overall area under the curve was 0.87. At the cut-off 16, sensitivity was 0.87 (95% CI: 0.82–0.92), specificity 0.70 (95% CI: 0.65–0.75), and DOR 16.2 (95% CI: 10.49–25.10). Better trade-offs between sensitivity and specificity were observed (Sensitivity = 0.83, Specificity = 0.78, diagnostic odds ratio = 16.64) for cut-off 20. None of the variables assessed as possible sources of heterogeneity was found to be statistically significant.
Conclusion 
The CES-D has acceptable screening accuracy in the general population or primary care settings, but it should not be used as an isolated diagnostic measure of depression. Depending on the test objectives, the cut-off 20 may be more adequate than the value of 16, which is typically recommended.

/pdf/screening-for-depression-in-the-general-population-with-the-11z3pqte9g.pdf

Screening for Depression in the General Population with the Center for Epidemiologic Studies Depression (CES-D): A Systematic Review with Meta-Analysis.

Importance Knowledge of whether serious adverse pregnancy outcomes are associated with increasingly widespread effects of climate change in the US would be crucial for the obstetrical medical community and for women and families across the country Objective To investigate prenatal exposure to fine particulate matter (PM25), ozone, and heat, and the association of these factors with preterm birth, low birth weight, and stillbirth Evidence Review This systematic review involved a comprehensive search for primary literature in Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, PubMed, ClinicalTrialsgov website, and MEDLINE Qualifying primary research studies included human participants in US populations that were published in English between January 1, 2007, and April 30, 2019 Included articles analyzed the associations between air pollutants or heat and obstetrical outcomes Comparative observational cohort studies and cross-sectional studies with comparators were included, without minimum sample size Additional articles found through reference review were also considered Articles analyzing other obstetrical outcomes, non-US populations, and reviews were excluded Two reviewers independently determined study eligibility The Arskey and O’Malley scoping review framework was used Data extraction was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline Findings Of the 1851 articles identified, 68 met the inclusion criteria Overall, 32 798 152 births were analyzed, with a mean (SD) of 565 485 (783 278) births per study A total of 57 studies (48 of 58 [84%] on air pollutants; 9 of 10 [90%] on heat) showed a significant association of air pollutant and heat exposure with birth outcomes Positive associations were found across all US geographic regions Exposure to PM25or ozone was associated with increased risk of preterm birth in 19 of 24 studies (79%) and low birth weight in 25 of 29 studies (86%) The subpopulations at highest risk were persons with asthma and minority groups, especially black mothers Accurate comparisons of risk were limited by differences in study design, exposure measurement, population demographics, and seasonality Conclusions and Relevance This review suggests that increasingly common environmental exposures exacerbated by climate change are significantly associated with serious adverse pregnancy outcomes across the US

/pdf/association-of-air-pollution-and-heat-exposure-with-preterm-1q1bgwkbg4.pdf

Association of Air Pollution and Heat Exposure With Preterm Birth, Low Birth Weight, and Stillbirth in the US: A Systematic Review.

Background: In the United States, one in six children are affected by neurodevelopmental disorders, and polybrominated diphenyl ethers (PBDEs) in flame-retardant chemicals are measured ubiquitously...

/pdf/developmental-pbde-exposure-and-iq-adhd-in-childhood-a-2mdyb500si.pdf

Developmental PBDE Exposure and IQ/ADHD in Childhood: A Systematic Review and Meta-analysis

Phthalates are a huge class of chemicals with a wide spectrum of industrial uses, from the manufacture of plastics to food contact applications, children’s toys, and medical devices. People and animals can be exposed through different routes (i.e., ingestion, inhalation, dermal, or iatrogenic exposure), as these compounds can be easily released from plastics to water, food, soil, air, making them ubiquitous environmental contaminants. In the last decades, phthalates and their metabolites have proven to be of concern, particularly in products for pregnant women or children. Moreover, many authors reported high concentrations of phthalates in soft drinks, mineral waters, wine, oil, ready-to-eat meals, and other products, as a possible consequence of their accumulation along the food production chain and their accidental release from packaging materials. However, due to their different physical and chemical properties, phthalates do not have the same human and environmental impacts and their association to several human diseases is still under debate. In this review we provide an overview of phthalate toxicity, pointing out the health and legal issues related to their occurrence in several types of food and beverage.

https://www.mdpi.com/1660-4601/17/16/5655/pdf

Critical Review on the Presence of Phthalates in Food and Evidence of Their Biological Impact.

The United States of America (USA), European Union (EU), Brazil and China are four of the largest agricultural producers and users of agricultural pesticides in the world. Comparing the inclination and ability of different regulatory agencies to ban or eliminate pesticides that have the most potential for harm to humans and the environment can provide a glimpse into the effectiveness of each nation’s pesticide regulatory laws and oversight. The approval status of more than 500 agricultural pesticides was identified in the USA, EU, Brazil and China and compared between nations. The amount of pesticides that were used in the USA and banned in these other nations was compiled and linear regression was used to identify trends in use. There are 72, 17, and 11 pesticides approved for outdoor agricultural applications in the USA that are banned or in the process of complete phase out in the EU, Brazil, and China, respectively. Of the pesticides used in USA agriculture in 2016, 322 million pounds were of pesticides banned in the EU, 26 million pounds were of pesticides banned in Brazil and 40 million pounds were of pesticides banned in China. Pesticides banned in the EU account for more than a quarter of all agricultural pesticide use in the USA. The majority of pesticides banned in at least two of these three nations have not appreciably decreased in the USA over the last 25 years and almost all have stayed constant or increased over the last 10 years. Many pesticides still widely used in the USA, at the level of tens to hundreds of millions of pounds annually, have been banned or are being phased out in the EU, China and Brazil. Of the pesticides banned in at least two of these nations, many have been implicated in acute pesticide poisonings in the USA and some are further restricted by individual states. The United States Environmental Protection Agency (US EPA) has all but abandoned its use of non-voluntary cancellations in recent years, making pesticide cancellation in the USA largely an exercise that requires consent by the regulated industry.

/pdf/the-usa-lags-behind-other-agricultural-nations-in-banning-53nta2d0t6.pdf

The USA lags behind other agricultural nations in banning harmful pesticides.

Summary: Children in America today are at an unacceptably high risk of developing neurodevelopmental disorders that affect the brain and nervous system including autism, attention deficit hyperacti...

/pdf/project-tendr-targeting-environmental-neuro-developmental-346xosi6jg.pdf

Project TENDR: targeting environmental neuro-developmental risks. The TENDR consensus statement.

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Project TENDR: targeting environmental neuro-developmental risks. The TENDR consensus statement.