The Life Situation of People with Persistent Mental Illness Visiting Day Centers: a Comparative Study.

This study compared the life situation of visitors of day centers (DC) for people with mental illness (N = 93) with a comparison group (N = 82) in respect of sociodemographic and clinical characteristics, care consumption, well-being and everyday activities. The response rate was 49%, and those who declined are believed to be those with the most severe psychiatric disabilities. Most individuals were single (81%/78%) and few had children (12%/18%). The DC group had less education than the comparison group but had a friend more often. Although having their need for daily activities met, the DC group had greater unmet needs in respect of daily living in general. They less frequently reported having a psychosis and had fewer negative and more depressive symptoms. They got more housing support and general outpatient care, while the comparison group used specialized psychiatric care more frequently. The samples were equally satisfied with their care, health and well-being and found their everyday activities equally meaningful. The DC visitors formed a vulnerable group, by living single, having a low level of education and having unmet needs, and were at risk of not getting specialized psychiatric care

A numerical investigation of the steady states of the spherically symmetric Einstein-Vlasov-Maxwell system

We construct, by numerical means, static solutions of the spherically symmetric Einstein-Vlasov-Maxwell system and investigate various features of the solutions. This extends a previous investigation \cite{AR1} of the chargeless case. We study the possible shapes of the energy density profile as a function of the area radius when the electric charge of an individual particle is varied as a parameter. We find profiles which are multi-peaked, where the peaks are separated either by vacuum or a thin atmosphere, and we find that for a sufficiently large charge parameter there are no physically meaningful solutions. Furthermore, we investigate if the inequality \sqrt{M}\leq \frac{\sqrt{R}}{3}+\sqrt{\frac{R}{9}+\frac{Q^2}{3R}}, derived in \cite{An2}, is sharp within the class of solutions to the Einstein-Vlasov-Maxwell system. Here M is the ADM mass, Q the charge, and R the area radius of the boundary of the static object. We find two classes of solutions with this property, while there is only one in the chargeless case. In particular we find numerical evidence for the existence of arbitrarily thin shell solutions to the Einstein-Vlasov-Maxwell system. Finally, we consider one parameter families of steady states, and we find spirals in the mass-radius diagram for all examples of the microscopic equation of state which we consider.Comment: 25 pages, 16 figure

Effectiveness of an intervention to improve day centre services for people with psychiatric disabilities.

Day centres for people with psychiatric disabilities need to be evaluated for effectiveness in order to provide the best possible support. This study aimed at investigating the effectiveness of a tailor-made intervention to improve day centre services for people with psychiatric disabilities

Measuring perceived meaningfulness in day centres for persons with mental illness

Rationale: As support in leading a meaningful and active life, a person with mental illness is often given the opportunity to attend a day centre. However, few studies have investigated the meaningfulness perceived by the person visiting a day centre. For such a purpose, a self-report instrument was developed. Aims: To explore whether perceived meaningfulness, as expressed in the recently developed instrument Evaluation of Perceived Meaning in Day Centers (EPM-DC), could be viewed as one dimension and also to investigate the psychometric properties of this instrument. Methods: Persons with mental illness attending five day centres in Sweden participated and completed the questionnaire. The data were analysed by Rasch analysis. Major findings: The study showed that the concept captured in the instrument could be viewed as unidimensional and the result gave preliminary evidence for sound psychometric properties. Principal conclusion: The results indicate promising signs of validity and reliability, but the suitability of self-reporting may be questioned

Using Visual Analytics of Heart Rate Variation to Aid in Diagnostics

We present an interactive visualization tool for exploring RR interval data (the time between consecutive heart beats) to support diagnostics. An RR interval sequence diagram allows us to reduce hours of data into a general overview opposed to using short term ECG strips. A simple moving average is applied to the sequence diagram to smooth out short-term variance and highlight long-term trends. The moving average is surrounded by standard deviation bands which allow us to see the fluctuations in variance. After a brief training period using these tools coupled with RR interval and RR interval difference histograms, non- expert participants (undergraduate students) were able to differentiate between normal, atrial fibrillation, and congestive heart failure

Freedom of choice or cost efficiency? The implementation of a free-choice market system in community mental health services in Sweden

This case study investigates the implementation of a free-choice market system in community mental health services using the example of day centres for people with psychiatric disabilities. It was conducted in a major city that was about to implement a free-choice market system due to a new legislation that made it feasible. Eighteen semi-structured interviews were conducted. Agents situated in different parts of the organization were interviewed one year before and two years after the free-choice system was launched in 2010. Data showed a top–down political process. A majority of the intentions of the legislation advocated individual autonomy as the market system's main purpose; only one concerned organizational efficiency. Data reflected, however, that financial efficiency dominated the agents' experiences of the implemented system. The twofold market purpose was clearly reflected in the interviews. Front-line staff hoped for improvements mainly for the users, whereas managers mainly focused on the market as a resource allocator

Associations of breast cancer risk prediction tools with tumor characteristics and metastasis

Purpose: The association between established risk factors for breast cancer and subtypes or prognosis of the disease is not well known. We analyzed whether the Tyrer-Cuzick–predicted 10-year breast cancer risk score (TCRS), mammographic density (MD), and a 77-single nucleotide polymorphism polygenic risk score (PRS) were associated with breast cancer tumor prognosticators and risk of distant metastasis. Patients and Methods: We used a case-only design in a population-based cohort of 5,500 Swedish patients with breast cancer. Logistic and multinomial logistic regression of outcomes, estrogen receptor (ER) status, lymph node involvement, tumor size, and grade was performed with TCRS, PRS, and percent MD as exposures. Cox proportional hazard models were used to estimate hazard ratios (HRs) of distant metastasis. Results: Women at high risk for breast cancer based on PRS and/or TCRS were significantly more likely to be diagnosed with favorable prognosticators, such as ER-positive and low-grade tumors. In contrast, PRS weighted on ER-negative disease was associated with ER-negative tumors. When stratifying by age, the associations of TCRS with favorable prognosticators were restricted to women younger than age 50. Women scoring high in both TCRS and PRS had a lower risk of distant metastasis (HR, 0.69; 95% CI, 0.49 to 0.98). MD was not associated with any of the examined prognosticators. Conclusion: Women at high risk for breast cancer based on genetic and lifestyle factors were significantly more likely to be diagnosed with breast cancers with a favorable prognosis. Better knowledge of subtype- specific risk factors could be vital for the success of prevention programs aimed at lowering mortality.Swedish Research CouncilSwedish Cancer SocietyCancer Society in StockholmCancer Risk Prediction Center (CRisP)Linneus Centre - Swedish Research CouncilPublishe