Understanding country-level nutrition intake is crucial to global nutritional policies that aim to reduce disparities and relevant disease burdens. Still, there are limited numbers of studies using clustering techniques to analyse the recent Global Dietary Database. This study aims to extend an existing multivariate time-series clustering algorithm to allow for greater customisability and to provide the first cluster analysis of the Global Dietary Database to explore temporal trends in country-level nutrition profiles (1990-2018).

Trends in sugar-sweetened beverage intake and nutritional deficiency were explored using the newly developed program ‘MTSclust’. Time-series clustering algorithms are different from simple clustering approaches in their ability to appreciate temporal elements.

Nutritional and demographical data from 176 countries were analysed from the Global Dietary Database.

Population representative samples of the 176 in the Global Dietary Database.

In a 3-class test specific to the domain, the MTSclust program achieved a mean accuracy of 71.5% (Adjusted Rand Index [ARI]=0.381) while the mean accuracy of a popular algorithm, DTWclust, was 58% (ARI=0.224). The clustering of nutritional deficiency and sugar-sweetened beverage intake identified several common trends among countries and found that these did not change by demographics. Multivariate time-series clustering demonstrated a global convergence towards a Western diet.

While global nutrition trends are associated with geography, demographic variables such as sex and age, are less influential to the trends of certain nutrition intake. The literature could be further supplemented by applying outcome-guided methods to explore how these trends link to disease burdens.

The relationship between the subtypes of psychotic experiences (PEs) and common mental health symptoms remains unclear. The current study aims to establish the 12-month prevalence of PEs in a representative sample of community-dwelling Chinese population in Hong Kong and explore the relationship of types of PEs and common mental health symptoms.

This is a population-based two-phase household survey of Chinese population in Hong Kong aged 16–75 (N = 5719) conducted between 2010 and 2013 and a 2-year follow-up study of PEs positive subjects (N = 152). PEs were measured with Psychosis Screening Questionnaire (PSQ) and subjects who endorsed any item on the PSQ without a clinical diagnosis of psychotic disorder were considered as PE-positive. Types of PEs were characterized using a number of PEs (single v. multiple) and latent class analysis. All PE-positive subjects were assessed with common mental health symptoms and suicidal ideations at baseline and 2-year follow-up. PE status was also assessed at 2-year follow-up.

The 12-month prevalence of PEs in Hong Kong was 2.7% with 21.1% had multiple PEs. Three latent classes of PEs were identified: hallucination, paranoia and mixed. Multiple PEs and hallucination latent class of PEs were associated with higher levels of common mental health symptoms. PE persistent rate at 2-year follow-up was 15.1%. Multiple PEs was associated with poorer mental health at 2-year follow-up.

Results highlighted the transient and heterogeneous nature of PEs, and that multiple PEs and hallucination subtype of PEs may be specific indices of poorer common mental health.

Little is known about long-term employment outcomes for patients with first-episode schizophrenia-spectrum (FES) disorders who received early intervention services.

We compared the 10-year employment trajectory of patients with FES who received early intervention services with those who received standard care. Factors differentiating the employment trajectories were explored.

Patients with FES (N = 145) who received early intervention services in Hong Kong between 1 July 2001 and 30 June 2002 were matched with those who entered standard care 1 year previously. We used hierarchical clustering analysis to explore the 10-year employment clusters for both groups. We used the mixed model test to compare cluster memberships and piecewise regression analysis to compare the employment trajectories of the two groups.

There were significantly more patients who received the early intervention service in the good employment cluster (early intervention: N = 98 [67.6%]; standard care: N = 76 [52.4%]; P = 0.009). In the poor employment cluster, there was a significant difference in the longitudinal pattern between early intervention and standard care for years 1–5 (P < 0.0001). The number of relapses during the first 3 years, months of full-time employment during the first year and years of education were significant in differentiating the clusters of the early intervention group.

Results suggest there was an overall long-term benefit of early intervention services on employment. However, the benefit was not sustained for all patients. Personalisation of the duration of the early intervention service with a focus on relapse prevention and early vocational reintegration should be considered for service enhancement.