Objective: To examine whether social media and online behaviours are associated with unhealthy food and beverage consumption in children.Design: A cross-sectional online survey was used to assess Internet and social media use, including engagement with food and beverage brand content, and frequency of consumption of unhealthy foods and beverages. Linear regression models were used to examine associations between online behaviours, including engagement with food and beverage brand content, and consumption of unhealthy foods and beverages, adjusting for age, sex and socio-economic status.Setting: New South Wales, Australia, in 2014.Subjects: Children aged 10–16 years (n417).Results: Watching food brand video content on YouTube, purchasing food online and seeing favourite food brands advertised online were significantly associated with higher frequency of consumption of unhealthy foods and drinks after adjustment for age, sex and socio-economic status.Conclusions: Children who have higher online engagement with food brands and content, particularly through online video, are more likely to consume unhealthy foods and drinks. Our findings highlight the need to include social media in regulations and policies designed to limit children’s exposure to unhealthy food marketing. Social media companies have a greater role to play in protecting children from advertising.

Anthropogenic disturbances and the subsequent loss of biodiversity are altering species abundances and communities. Since species vary in their pathogen competence, spatio-temporal changes in host assemblages may lead to changes in disease dynamics. We explore how longitudinal changes in bat species assemblages affect the disease dynamics of coronaviruses (CoVs) in more than 2300 cave-dwelling bats captured over two years from five caves in Ghana. This reveals uneven CoV infection patterns between closely related species, with the alpha-CoV 229E-like and SARS-related beta-CoV 2b emerging as multi-host pathogens. Prevalence and infection likelihood for both phylogenetically distinct CoVs is influenced by the abundance of competent species and naïve subadults. Broadly, bat species vary in CoV competence, and highly competent species are more common in less diverse communities, leading to increased CoV prevalence in less diverse bat assemblages. In line with the One Health framework, our work supports the notion that biodiversity conservation may be the most proactive measure to prevent the spread of pathogens with zoonotic potential.

OBJECTIVE: To investigate subsequent birth rates, maternal and neonatal outcomes for women with a history of placenta accreta spectrum (placenta accreta, increta, and percreta). METHODS: A population-based record linkage study of women who had a first, second, or third birth in New South Wales from 2003 to 2016 was conducted. Data were obtained from birth and hospital records and death registrations. Women with a history of placenta accreta spectrum were matched to women without, on propensity score and parity, to compare outcomes with women who had similar risk profiles. Modified Poisson regression models were used to calculate adjusted relative risk (aRR) for a range of maternal and neonatal outcomes. RESULTS: We identified recurrent placenta accreta spectrum in 27/570 (4.7%, 95% CI 3.0–6.5%) of second and 9/119 (7.6%, 95% CI 2.8–12.3%) of third pregnancies after placenta accreta spectrum in the preceding birth, with an overall recurrence rate of 38/689 (5.5%, 95% CI 3.9–7.5%, compared with the population prevalence of 25.5/10,000 births (95% CI 24.6–26.4). Subsequent births after placenta accreta spectrum had higher risk of postpartum hemorrhage (aRR 1.51, 95% CI 1.19–1.92), transfusion (aRR 2.13, 95% CI 1.17–3.90), cesarean delivery (aRR 1.19, 95% CI 1.02–1.37), manual removal of placenta (aRR 6.92, 95% CI 3.81–12.55), and preterm birth (aRR 1.43, 95% CI 1.03–1.98), with lower risk of small for gestational age (aRR 0.64, 95% CI 0.43–0.96), compared with similar-risk births. CONCLUSION: Women with a history of placenta accreta spectrum have increased risk of maternal morbidity, preterm birth, and placenta accreta spectrum in the subsequent pregnancy compared with similar-risk women with no previous placenta accreta spectrum, although the absolute risks are generally low. These findings may be used to inform counseling of women on the risks of future pregnancies.

Understanding the immunogenetic basis of coronavirus (CoV) susceptibility in major pathogen reservoirs, such as bats, is central to inferring their zoonotic potential. Members of the crypticHipposiderosbat species complex differ in CoV susceptibility, but the underlying mechanisms remain unclear. The genes of the major histocompatibility complex (MHC) are the best understood genetic basis of pathogen resistance, and differences in MHC diversity are one possible reason for asymmetrical infection patterns among closely related species. Here, we aimed to link asymmetries in observed CoV (CoV‐229E, CoV‐2B and CoV‐2Bbasal) susceptibility to immunogenetic differences amongst fourHipposiderosbat species. From the 2072 bats assigned to their respective species using the mtDNAcytochrome bgene, members of the most numerous and ubiquitous species,Hipposideros caffer D, were most infected with CoV‐229E and SARS‐related CoV‐2B. Using a subset of 569 bats, we determined that much of the existent allelic and functional (i.e. supertype) MHC DRB class II diversity originated from common ancestry. One MHC supertype shared amongst all species, ST12, was consistently linked to susceptibility with CoV‐229E, which is closely related to the common cold agent HCoV‐229E, and infected bats and those carrying ST12 had a lower body condition. The same MHC supertype was connected to resistance to CoV‐2B, and bats with ST12 were less likely be co‐infected with CoV‐229E and CoV‐2B. Our work suggests a role of immunogenetics in determining CoV susceptibility in bats. We advocate for the preservation of functional genetic and species diversity in reservoirs as a means of mitigating the risk of disease spillover.

Protecting children’s mental health is important and studies have shown that diet and exercise can have a positive impact. There are limited data available, however, from representative populations of children on the relationship between regular healthy lifestyle behaviours and psychological health. Data were obtained from the New South Wales Child Population Health Survey, 2013–2014. Parents were asked about diet, physical activity and screen time behaviours and completed the Strengths and Difficulties Questionnaire (SDQ) for one child aged 5–15. Higher SDQ scores indicate poorer psychological health and risk for mental health problems. Multivariable linear and logistic regression examined the relationships among dietary consumption, physical activity, screen time and SDQ scores, adjusting for potential confounding. Meeting screen time recommendations was most strongly associated with a lower SDQ total difficulties score (5–10 years: −1.56 (−2.68, −0.44); 11–15 years: −2.12 (−3.11, −1.12)). Children and adolescents who met screen time recommendations were also significantly less likely to have any score in the at-risk range. Children and adolescents meeting vegetable intake guidelines had significantly lower total difficulties scores (5–10 years: −1.54 (−3.03, −0.05); 11–15 years: −1.19 (−3.60, −0.39)), as did adolescents meeting discretionary food guidelines (−1.16 (−2.14, −0.18)) and children consuming the recommended fruit intake (−1.26 (−2.42, −0.10)). Our findings indicate that more effective interventions to increase the proportion of young Australians who meet the guidelines for diet and screen time would contribute to protecting their mental health.