Measuring quality of life in mental health: Are we asking the right questions?

Measuring quality-adjusted-life years using generic preference-based quality of life measures is common practice when evaluating health interventions. However, there are concerns that measures in common use, such as the EQ-5D and SF-6D, focus overly on physical health and therefore may not be appropriate for measuring quality of life for people with mental health problems. The aim of this research was to identify the domains of quality of life that are important to people with mental health problems in order to assess the content validity of these generic measures. Qualitative semi-structured interviews were conducted with 19 people, recruited from UK mental health services, with a broad range of mental health problems at varying levels of severity. This complemented a previous systematic review and thematic synthesis of qualitative studies on the same topic. Seven domains important to quality of life for people with mental health problems were identified: well-being and ill-being; relationships and a sense of belonging; activity; self-perception; autonomy, hope and hopelessness; and physical health. These were consistent with the systematic review, with the addition of physical health as a domain, and revealed a differing emphasis on the positive and negative aspects of quality of life according to the severity of the mental health problems. We conclude that the content of existing generic preference-based measures of health do not cover this domain space well. Additionally, because people may experience substantial improvements in their quality of life without registering on the positive end of a quality of life scale, it is important that the full spectrum of negative through to positive aspects of each domain are included in any quality of life measure

Environmental Geotechnics: Challenges and Opportunities in the Post COVID-19 World

The outbreak of the COVID-19 pandemic not only created a health crisis across the world but is expected to negatively impact the global economy and societies at a scale that maybe larger than the 2008 financial crisis. Simultaneously, it has inevitably exerted many negative consequences on the geoenvironment upon which human beings depend. The current article articulates the role of environmental geotechnics to elucidate and mitigate the effects of the current pandemic. It is the belief of all authors that the COVID-19 pandemic presents significant challenges, but also opportunities for the development of our field. Our discipline should make full use of our professional skills and expertise to look for development opportunities from this crisis, to highlight our discipline’s irreplaceable position in the global fight against pandemics, and to contribute to the health and prosperity of our communities, so as to better serve humankind. In order to reach this goal, while taking into account the specificity of the SARS-CoV-2 and the uncertainty of its environmental effects, it is believed that more emphasis should be placed on the following research directions: pathogen-soil interactions, isolation and remediation technologies for pathogen-contaminated sites, new materials for pathogen-contaminated soil, recycling and safe disposal of medical wastes, quantification of uncertainty in geoenvironmental and epidemiological problems, emerging technologies and adaptation strategies in civil, geotechnical, and geoenvironmental infrastructure, pandemic-induced environmental risk management, and model pathogen transport and fate in geoenvironment, among others. Moreover, COVID-19 has made it clear to the environmental geotechnics community the importance of urgent international cooperation and of multidisciplinary research actions that must extend to a broad range of scientific fields, including medical and public health disciplines, in order to meet the complexities posed by the COVID-19 pandemic

Diagnostic and prognostic assessment of suspected drug‐induced liver injury in clinical practice

Idiosyncratic drug-induced liver injury (DILI) is a challenging liver disorder because it can present with a range of phenotypes, mimicking almost every other hepatic disease, and lacks specific biomarkers for its diagnosis. Hence, a confident DILI diagnosis is seldom possible as it relies on the precise establishment of a temporal sequence between the exposure to a given prescription drug or sometimes hidden herbal product/over the counter medication as well as the exclusion of other aetiologies of liver disease. However, an accurate diagnosis is of most importance, as prompt withdrawal of the causative agent is essential in DILI management. Indeed, DILI can be severe and even fatal or in a fraction of cases evolve to chronic damage, but specific biomarkers for predicting mortality/liver transplantation or a chronic outcome in the very early phases of DILI are not yet available. In this article, we discuss the best diagnostic and prognostic approach of a DILI suspicion by judiciously choosing and interpreting the standard tests currently used in clinical practice