Reduction in mental distress among substance users receiving inpatient treatment

<p>Abstract</p> <p>Background</p> <p>Substance users being admitted to inpatient treatment experience a high level of mental distress. In this study we explored changes in mental distress during treatment.</p> <p>Methods</p> <p>Mental distress, as measured by the HSCL-10, was registered at admission and at discharge among 164 substance users in inpatient treatment in Northern Norway. Predictors of reduction in mental distress were examined utilizing hierarchical regression analysis.</p> <p>Results</p> <p>We found a significant reduction in mental distress in the sample, but the number of patients scoring above cut-off on the HSCL-10 at discharge was still much higher than in the general population. A more severe use of substances as measured by the AUDIT and the DUDIT, and being female, predicted a higher level of mental distress at admission to treatment as well as greater reduction in mental distress during treatment. Holding no education beyond 10 year compulsory school only predicted a reduction in mental distress.</p> <p>Conclusions</p> <p>The toxic and withdrawal effects of substances, level of education as well as gender, contributed to the differences in change in mental distress during treatment. Regression to the mean may in part explain some of the findings.</p

Transposition of the apophysis of the greater trochanter for reconstruction of the femoral head after septic hip arthritis in children: 4 children followed for more than 15 years

Background and purpose Total necrosis of the femoral head after infection in children during their first months of life gives a dislocated hip with severe leg shortening. A new femoral head can be achieved with subtrochanteric osteotomy and transposition of the apophysis of the greater trochanter into the acetabulum. Previous reports have dealt with short-term results (up to 12 years). Here I present some results of this procedure 15–24 years after operation. Patients and methods 4 children aged 1–6 years with complete necrosis of the femoral head were operated on with transposition of the greater trochanter. Secondary shelf plasty was performed later in 1 child, distal femoral epiphysiodesis in another, and femoral bone lengthening in 1 child. The mean follow-up period was 19 (15–24) years. Results A new femoral head developed in all hips. 2 of them had a spherical head with a good acetabular cover, and without any osteoarthritis except for slight reduction of cartilage height. These hips were painless, with a mobility that allowed good walking function after 16 and 24 years, respectively. In the other 2 patients, in which there was a severe acetabular dysplasia at the primary operation, the new femoral head was somewhat flattened; painful osteoarthritis led to hip replacement 15 and 21 years after trochanter arthroplasty. Even these patients had a relatively good walking function until the last couple of years before hip replacement. Maximum leg length discrepancy was 7 cm. Interpretation Trochanter arthroplasty with subtrochanteric osteotomy in total femoral head necrosis after septic arthritis in children may give satisfactory long-term results provided adequate acetabular cover is obtained. Although the method cannot provide a normal hip, it can contribute to less length discrepancy, less pain, improved gait, and more favorable conditions for later hip replacement

Mellom taushet og fare: Om kulturelle fortolkninger av psykiske problemer og forsøk på å skape ny mening

Artikkelen beskriver en forstdelse av psykiske problemer som inkluderer kunnskap om maktforhold mellom kjønnene. Psykiskesymptomer blir sett som kilde til informasjon om tabubelagte interessekonflikter og erfaringer med maktmisbruk. Terapeutiskforandring beskrives somforsøk på skape ny mening i den gamle historien, der målsettingen blir å skape verdighet for kvinnen.Dette innebærer å bekjempe sykeliggjørende fortolkninger av kvinners reaksjoner.The article describes an understanding of psychological problems that include the knowledge of power structures in the gender system. Psychological symptoms are seen as a source of information to tabooed conflicts of interest and experiences withpower abuse. Therapeutical change implies the creation of new meaning based on dignity by fighting the process of making women's reactions pathological

The Importance of Viscoplastic Strain Rate in the Formation of Center Cracks during the Start-Up Phase of Direct-Chill Cast Aluminum Extrusion Ingots

A comparison of experimental observations and computer simulations shows that trends in the occurrence and severity of center cracks in direct-chill (DC) cast ingots due to different initial casting speed histories may best be explained by the changes in viscoplastic strain rate close to the center of the base of the ingot. The thermomechanical histories of five ingots were simulated and correlations between stresses, strains, strain rates, and liquid pressure drops due to feeding restrictions were considered

Mental health, pain and tiredness in adults born very preterm or with very low birthweight

Aim: Adults born preterm have increased risk of mental health problems and other neurodevelopmental conditions. We aimed to investigate associations of mental health with pain and tiredness in adults born very preterm (VP; <32 weeks) or very low birthweight (VLBW; <1500 g) and at term, and whether these associations are influenced by physical activity. Methods: As part of an EU Horizon 2020 project, individual participant data from six prospective cohort studies were harmonised for 617 VP/VLBW and 1122 term‐born participants. Mental health was assessed by the Achenbach System of Empirically Based Assessment Adult Self‐Report. Pain and tiredness were harmonised based on specific items from self‐reported questionnaires. Associations between mental health and pain or tiredness were explored by linear regression. Results: An increase in the mental health scales internalising, externalising and total problems was associated with increased pain and tiredness in the preterm and term group alike. Results were maintained when adjusting for physical activity. Conclusion: The findings indicate that associations between mental health, pain and tiredness in adults are independent of gestation or birthweight. Future research should explore other potential mechanisms that may underlie the increased risk of mental health problems in the preterm population