The macro-social and environmental conditions in which people live, such as the level of a country’s development or inequality, are associated with brain-related disorders. However, the relationship between these systemic environmental factors and the brain remains unclear. We aimed to determine the association between the level of development and inequality of a country and the brain structure of healthy adults.

We conducted a cross-sectional study pooling brain imaging (T1-based) data from 145 magnetic resonance imaging (MRI) studies in 7,962 healthy adults (4,110 women) in 29 different countries. We used a meta-regression approach to relate the brain structure to the country’s level of development and inequality.

Higher human development was consistently associated with larger hippocampi and more expanded global cortical surface area, particularly in frontal areas. Increased inequality was most consistently associated with smaller hippocampal volume and thinner cortical thickness across the brain.

Our results suggest that the macro-economic conditions of a country are reflected in its inhabitants’ brains and may explain the different incidence of brain disorders across the world. The observed variability of brain structure in health across countries should be considered when developing tools in the field of personalized or precision medicine that are intended to be used across the world.

Identify essential components of a curriculum on antimicrobial stewardship (AS) for pediatric residents.

Survey.

Academic tertiary care children’s hospital.

Pediatric residents and infectious diseases (ID)/AS content experts (CE), including pediatric ID faculty, fellows, nurse practitioners, and pharmacists.

Residents were surveyed to assess prior AS experiences and usefulness of education in different AS domains (e.g., antimicrobial resistance [AMR]). CE was surveyed to identify content to include in an AS curriculum. A specific topic (e.g., resistance in Staphylococcus aureus) achieved consensus if ≥80% of CE identified the topic as “very” or “extremely” important.

Thirty-three of 110 pediatric residents responded to the resident survey (response rate 30%). Spectrum of activity (97%), empiric therapy (94%), and duration of therapy (94%) were the domains identified by the most residents as “very” or “extremely” useful. All CE responded to the CE survey (n=26). Thirty-nine of 105 topics (37%) met the consensus threshold. The domains with most topics achieving consensus were empiric therapy (11/13 topics, 85%) and duration of therapy (5/8 topics, 63%). Only one topic was identified within the domains of antibiotic allergies, diagnostics, and AMR, reflecting 18%, 14%, and 6% of the potential topics within each domain, respectively.

A pediatric AS curriculum focused on empiric therapy and duration of therapy is likely to meet the needs of both learners and CEs.

The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally.

This study evaluated whether the psychometric properties of a short-form version, DISC-Ultra Short (DISCUS) (11-item), could be replicated in a sample of people with a wide range of mental disorders from 21 sites in 15 countries/territories, across six global regions. The frequency of experienced discrimination was reported. Scaling assumptions (confirmatory factor analysis, inter-item and item-total correlations), reliability (internal consistency) and validity (convergent validity, known groups method) were investigated in each region, and by diagnosis group.

1195 people participated. The most frequently reported experiences of discrimination were being shunned or avoided at work (48.7%) and discrimination in making or keeping friends (47.2%). Confirmatory factor analysis supported a unidimensional model across all six regions and five diagnosis groups. Convergent validity was confirmed in the total sample and within all regions [ Internalised Stigma of Mental Illness (ISMI-10): 0.28–0.67, stopping self: 0.54–0.72, stigma consciousness: −0.32–0.57], as was internal consistency reliability (α = 0.74–0.84). Known groups validity was established in the global sample with levels of experienced discrimination significantly higher for those experiencing higher depression [Patient Health Questionnaire (PHQ)-2: p < 0.001], lower mental wellbeing [Warwick-Edinburgh Well-being Scale (WEMWBS): p < 0.001], higher suicidal ideation [Beck Hopelessness Scale (BHS)-4: p < 0.001] and higher risk of suicidal behaviour [Suicidal Ideation Attributes Scale (SIDAS): p < 0.001].

The DISCUS is a reliable and valid unidimensional measure of experienced discrimination for use in global settings with similar properties to the longer DISC. It offers a brief assessment of experienced discrimination for use in clinical and research settings.