Recent physical conditions and health service utilization in people with common mental disorders and severe mental illness in England: Comparative cross-sectional data from a nationally representative sample

BACKGROUND.: Policies addressing the physical health of people with mental disorders have historically focused on those with severe mental illness (SMI), giving less prominence to the more prevalent common mental disorders (CMDs). Little is known about the comparative physical health outcomes of these patient groups. We aimed to first compare the: (a) number of past-year chronic physical conditions and (b) recent physical health service utilization between CMDs vs. SMI, and secondly compare these outcomes between people with CMDs vs. people without mental disorders. METHODS.: We analyzed cross-sectional data from the third Adult Psychiatric Morbidity Survey, a representative sample of the English population. We determined the presence of physical conditions and health service utilization by self-report and performed logistic regression models to examine associations of these outcomes between participant groups. RESULTS.: Past-year physical conditions were reported by the majority of participants (CMDs, n = 815, 62.1%; SMI = 27, 63.1%) with no variation in the adjusted odds of at least one physical condition between diagnoses (odds ratio [OR] = 0.96, 95% confidence intervals [CI] 0.42-1.98, p = 0.784). People with CMDs were significantly more likely to be recently hospitalized relative to with those with SMI (OR = 6.33, 95% CI 5.50-9.01, p < 0.05). Having a CMD was associated with significantly higher odds of past-year physical conditions and recent health service utilization (all p < 0.001) compared with the general population. CONCLUSIONS.: People with CMDs experience excess physical health morbidities in a similar pattern to those found among people with SMI, while their somatic hospitalization rates are even more elevated. Findings highlight the importance of recalibrating existing public health strategies to bring equity to the physical health needs of this patient group

An analysis of gender differences in self-reported heaith, use of medicines and access to information sources about medicines among adolescents

Adolescence is a key period in the emergence of gender differences in health that persist into adulthood. Knowledge about health-related gender differences among adolescents could be instrumental in informing policy and practice to effect health improvement among this age group. The main objectives of this study were lherefore to investigate gender differences in self-reported health complaints and use of medicines during the preceding 3 months and access to information sources about medicines among adolescents in Malta. A self-administered questionnaire was distributed among adolescents attending secondary schools in Malta. A stratified :-andom sample design generated a sample size of 514 students. Common health complaints, use of medicines, and sources of information about medicines were investigated by means of author-designed checklists. The analytical sample was formed from 474 usable questionnaires collected from students aged 14-16 years, of which .8% were females. In general, a femaie excess emerged for health complaints and use of medicines except for sport injuries and use of vitamins. Gender differences were statistically significant for a female excess in the retrieval of information from the package insert (p < .001 ), parents or adult relatives (p < .01) and friends or schoolmates (p < .05). The findings of this study underscore the need for awareness of gender differences in the health o:f adolescents among health care providers, policy makers, and educators. An important implication of the findings is lhat the health needs of adolescents could be more equitably addressed by adopting a holistic patient-oriented approach particular to the health needs of each individual.peer-reviewe

Health complaints and use of medicines among adolescents in Malta

Objective: To investigate self-reported health complaints and the use of medicines among adolescents in Malta. Methods: A self-administered questionnaire was used to survey self-reported health complaints, the use and the sources of medicines that had been accessed, during the preceding 3 months among adolescents attending secondary schools in Malta. A stratified random sample design generated a sample size of 514 students. The health complaints and use of medicines that were investigated included ear problems/hay fever/cold/cough, headache, skin problems, sport injuries, indigestion/diarrhoea/constipation, eye problems and menstrual pain (for girls). The use of vitamins and antibiotics was also investigated. Results: A total of 477 students participated in the final data collection. Correct information was submitted by 474 students, (aged 14-16 years), who formed the analytical sample, of which 53.8% were girls. The students reported a mean number of 2.70 (SD = 1.39) out of a total of 7 health complaints and 90.3% reported using at least 1 medicine during the preceding 3 months. The community pharmacy was cited as the most commonly accessed source for most of the medicines that were investigated. A proportion of 24.3% of the students had taken at least 1 medicine without adult guidance during the preceding 3 months. Almost 10% of those who had taken antibiotics, had accessed them from the home medicine cabinet. Conclusion: A high proportion of adolescents in Malta reported the use of medicines to alleviate the symptoms of common health complaints. This result is concordant with previous research carried out in the United Kingdom, Germany, Slovakia and Kuwait. A considerable proportion of students in this study had obtained medicines without adult guidance and accessed antibiotics from the home medicine cabinet. This highlights the importance of carefully designed education programs for adolescents that will integrate information about the proper use of medicines.peer-reviewe

Knowledge and sources of information about medicines among adolescents in Malta

Objective: To investigate knowledge of medicines and sources of information about medicines among adolescents in Malta. Methods: A self-administered questionnaire was used to survey knowledge of medicines and information sources among adolescents attending secondary schools in Malta. A random stratified sample design generated a sample size of 514 students. Knowledge of medicines was investigated by questions that included topics about the efficacy of medicines, proper communication during a medical consultation, the safety of medicines, antibiotic use and pictograms. Results: The analytical sample, of which 53.8% were girls, was made up of 474 students, aged 14- 16 years. The students obtained a mean score of 22.92 points (SD = 4.31) out of a maximum of 32 points for medicine knowledge. More than 30.0% of the respondents did not mark the correct answer for 40.6% of the questions that investigated knowledge of medicines. The family physician, community pharmacist and parents were the sources of information that were mostly cited. A proportion of 4.4% had obtained information from the teacher. A quarter of the respondents (24.7%) had obtained information from friends/schoolmates, young relatives or the media, generally television (17.3%). Conclusion: Although the level of knowledge about medicines among this study sample of Maltese students was good, there appeared to be particular misconceptions with regard to important aspects associated with the proper use of medicines. These findings highlight the need to educate adolescents about the proper use of medicines. The most important information providers about medicines appeared to be the physician, pharmacist and parents. It is being suggested that education campaigns should be organized in order to help parents guide adolescents on how to use medicines appropriately. In addition, adolescents would benefit if more information about the proper use of medicines would be disseminated by means of television programs and school-based health education curricula.peer-reviewe

The Lattice and Simplex Structure of States on Pseudo Effect Algebras

We study states, measures, and signed measures on pseudo effect algebras with some kind of the Riesz Decomposition Property, (RDP). We show that the set of all Jordan signed measures is always an Abelian Dedekind complete $\ell$-group. Therefore, the state space of the pseudo effect algebra with (RDP) is either empty or a nonempty Choquet simplex or even a Bauer simplex. This will allow represent states on pseudo effect algebras by standard integrals

Pre‑operative pain sensitivity : a prediction of post‑operative outcome in the obstetric population

Context: Experimental assessments can determine pain threshold and tolerance, which mirror sensitivity to pain. This, in turn, influences the post‑operative experience. Aims: The study intended to evaluate whether the pre‑operative pressure and electrical pain tests can predict pain and opioid requirement following cesarean delivery. Settings and Design: Research was conducted on females scheduled for cesarean section at a tertiary care hospital of the state. Twenty women were enrolled, after obtaining written informed consent. Materials and Methods: Pain assessment was performed on the eve of cesarean sections using three devices: PainMatcher® determined electrical pain threshold while the algometers PainTest™ FPN100 (manual) and PainTest™ FPX 25 (digital) evaluated pressure pain threshold and tolerance. Post‑operative pain relief included intravenous morphine administered by patient‑controlled analgesia, diclofenac (100 mg, every 12 h, rectally, enforced) and paracetamol (1000 mg, every 4‑6 h, orally, on patient request). Pain scores were reported on numerical rating scales at specified time intervals. Statistical Analysis Used: Correlational and regression statistics were computed using IBM SPSS Statistics 21 software (IBM Corporation, USA). Results: A significant correlation was observed between morphine requirement and: (1) electrical pain threshold (r = –0.45, P = 0.025), (2) pressure pain threshold (r = –0.41 P = 0.036) and (3) pressure pain tolerance (r = –0.44, P = 0.026) measured by the digital algometer. The parsimonious regression model for morphine requirement consisted of electrical pain threshold (r2 = 0.20, P = 0.049). The dose of morphine consumed within 48 h of surgery decreases by 0.9 mg for every unit increment in electrical pain threshold. Conclusions: The predictive power of pain sensitivity assessments, particularly electrical pain threshold, may portend post‑cesarean outcomes, including opioid requirements.peer-reviewe

Survey of Cochlear Implant User Satisfaction with the Neptune™ Waterproof Sound Processor

A multi-center self-assessment survey was conducted to evaluate patient satisfaction with the Advanced Bionics Neptune™ waterproof sound processor used with the AquaMic™ totally submersible microphone. Subjective satisfaction with the different Neptune™ wearing options, comfort, ease of use, sound quality and use of the processor in a range of active and water related situations were assessed for 23 adults and 73 children, using an online and paper based questionnaire. Upgraded subjects compared their previous processor to the Neptune™. The Neptune™ was most popular for use in general sports and in the pool. Subjects were satisfied with the sound quality of the sound processor outside and under water and following submersion. Seventy-eight percent of subjects rated waterproofness as being very useful and 83% of the newly implanted subjects selected waterproofness as one of the reasons why they chose the Neptune™ processor. Providing a waterproof sound processor is considered by cochlear implant recipients to be useful and important and is a factor in their processor choice. Subjects reported that they were satisfied with the Neptune™ sound quality, ease of use and different wearing options

Smearing of Observables and Spectral Measures on Quantum Structures

An observable on a quantum structure is any $\sigma$-homomorphism of quantum structures from the Borel $\sigma$-algebra of the real line into the quantum structure which is in our case a monotone $\sigma$-complete effect algebras with the Riesz Decomposition Property. We show that every observable is a smearing of a sharp observable which takes values from a Boolean $\sigma$-subalgebra of the effect algebra, and we prove that for every element of the effect algebra there is its spectral measure

On the lattice structure of probability spaces in quantum mechanics

Let C be the set of all possible quantum states. We study the convex subsets of C with attention focused on the lattice theoretical structure of these convex subsets and, as a result, find a framework capable of unifying several aspects of quantum mechanics, including entanglement and Jaynes' Max-Ent principle. We also encounter links with entanglement witnesses, which leads to a new separability criteria expressed in lattice language. We also provide an extension of a separability criteria based on convex polytopes to the infinite dimensional case and show that it reveals interesting facets concerning the geometrical structure of the convex subsets. It is seen that the above mentioned framework is also capable of generalization to any statistical theory via the so-called convex operational models' approach. In particular, we show how to extend the geometrical structure underlying entanglement to any statistical model, an extension which may be useful for studying correlations in different generalizations of quantum mechanics.Comment: arXiv admin note: substantial text overlap with arXiv:1008.416

Impact of the Covid-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19): protocol for an international prospective cohort study

Background: Corona Virus Disease 19 (COVID-19) is a new pandemic, declared a public health emergency by the World Health Organization, which could have negative consequences for pregnant and postpartum women. The scarce evidence published to date suggests that perinatal mental health has deteriorated since the COVID-19 outbreak. However, the few studies published so far have some limitations, such as a cross-sectional design and the omission of important factors for the understanding of perinatal mental health, including governmental restriction measures and healthcare practices implemented at the maternity hospitals. Within the Riseup-PPD COST Action, a study is underway to assess the impact of COVID-19 in perinatal mental health. The primary objectives are to (1) evaluate changes in perinatal mental health outcomes; and (2) determine the risk and protective factors for perinatal mental health during the COVID-19 pandemic. Additionally, we will compare the results between the countries participating in the study. Methods: This is an international prospective cohort study, with a baseline and three follow-up assessments over a six-month period. It is being carried out in 11 European countries (Albania, Bulgaria, Cyprus, France, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom), Argentina, Brazil and Chile. The sample consists of adult pregnant and postpartum women (with infants up to 6 months of age). The assessment includes measures on COVID-19 epidemiology and public health measures (Oxford COVID-19 Government Response Tracker dataset), Coronavirus Perinatal Experiences (COPE questionnaires), psychological distress (BSI-18), depression (EPDS), anxiety (GAD-7) and post-traumatic stress symptoms (PTSD checklist for DSM-V). Discussion: This study will provide important information for understanding the impact of the COVID-19 pandemic on perinatal mental health and well-being, including the identification of potential risk and protective factors by implementing predictive models using machine learning techniques. The findings will help policymakers develop suitable guidelines and prevention strategies for perinatal mental health and contribute to designing tailored mental health interventions. Trial registration: ClinicalTrials.gov Identifier: NCT04595123.The project is part of the COST Action Riseup-PPD CA 18138 and was supported by COST under COST Action Riseup-PPD CA18138; also, by the Spanish Ministry of Health, the Institute of Health Carlos III, and the European Regional Development Fund «Una manera de hacer Europa» by the Prevention and Health Promotion Research Network ‘redIAPP’ (RD16/0007). Raquel Costa is supported by the FSE and FCT under an individual Post-Doctoral Grant SFRH/BPD/117597/2016. Rena Bina and Drorit Levy received funding from the Bar-Ilan Dangoor Centre for Personalized Medicine, Israel. Ana Mesquita is supported from the Portuguese Foundation for Science and Technology (FCT) and from EU through the European Social Fund and from the Human Potential Operational Program - IF/00750/2015. Ana Osório received financial support from CAPES/Proex no. 0653/2018 and CAPES/PrInt grant no. 88887.310343/2018-00.The funders of the study had no role in the study design or the writing the protocol. The corresponding author had final responsibility for the decision to submit for publication