Treatment received and treatment adequacy of depressive disorders among young adults in Finland

Peer reviewe

Safe Distance for Machinery Actuators: Is After-reach Speed a Constant?

A common setup for industrial machines is to install a pair of actuator buttons a safe distance from the point of operation. Safety codes specify that minimum distance by assuming a constant hand speed of 1.6 m/s. The specific purpose of this paper is to address an important initial question: Is after-reach speed a constant or a variable? If after-reach speed is a constant, then it should be the same: (a) for a waist-level and a face-level placement, and (b) for varying distances within each placement. To examine the adequacy of that value, a simulated power press with a moving ram was set up for measuring actual hand speed for three placements of the buttons. For each placement, a randomized complete block experiment with nine students provided after-reach hand speed data. Results indicated that after-reach hand speed is not a constant because it varies both with placement of the buttons and distance within placement. The authors conclude that setting up a press using mean after-reach speed is a flawed concept. If a normal distribution applies to after-reach speeds of press operators, then half will exceed the mean. It would be more appropriate to use, instead of mean speed, a speed suitable to protect a larger proportion of press operators. The subjects in this study and in prior studies by NIOSH had substantial portions of their after-reach speeds exceed the 1.6 m/s value

Suicide and suicide attempts in people with severe mental disorders in Butajira, Ethiopia:10 year follow-up of a population-based cohort

Background: People with severe mental disorders (SMD) are at higher risk of suicide. However, research into suicide attempts and completed suicide in people with SMD in low-and middle-income countries is mostly limited to patients attending psychiatric facilities where selection bias is likely to be high. Methods: A population-based cohort of 919 people with SMD from rural Ethiopia (who received standardized clinician diagnoses of schizophrenia (n = 358) major depressive disorder (n = 216) and bipolar I disorder (n = 345)) were followed up annually for an average of 10 years. The Longitudinal Interval Follow-up Evaluation chart was administered by psychiatrists and used to evaluate systematically suicidal behavior and risk factors, which may be amenable to intervention. Results: Over the follow-up period, the cumulative risk of suicide attempt was 26.3% for major depression, 23.8% for bipolar I disorder and 13.1% for schizophrenia, (p < 0.001). The overall incidence of completed suicide was 200.2/100,000 person-years (CI = 120.6, 312.5). Hanging was the most frequent method used (71.5%) for both attempters and completers. Most people who completed suicide were successful on the first attempt (84.2%), but the case-fatality rate for suicide attempt was 9.7%. In the adjusted logistic regression model, being currently married (Adjusted OR) =2.17, 95% CI = 1.21, 3.91), and having a diagnosis of bipolar I disorder (Adjusted OR = 2.59, 95% CI = 1.57, 4.26) or major depression (Adjusted OR = 2.71, 95% CI = 1.60, 4.58) were associated significantly with increased risk of suicide attempts. Conclusion: In this sample of people with SMD from a rural setting, the rate of suicide was high. Initiatives to integrate mental health service into primary care need to focus on limiting access to suicide methods in people with SMD in addition to expanding access to mental health care

Does Combined Antipsychotic Treatment Provide Better Control on Symptoms in Patients with Schizophrenia than the Monotherapy?

Objective: Combined antipsychotic treatment is frequently used in clinical practice either to improve the symptom control or to reduce the severity of side effects. The expected benefits by combining different antipsychotics include active cross-titration and co-utilization of different administration routes of the therapeutic agents. However, except the add-on therapies to clozapine, there is no objective evidence implying the superiority of combined therapy over monotherapy. Furthermore, there are a number of published case reports of significant side effects accompanying combined antipsychotic usage such as extrapyramidal and metabolic symptoms, seizures, and electrocardiographic abnormalities. It is also argued that switching into a new therapeutic agent might be more beneficial than augmenting the ongoing medication by polypharmacy. Here, we studied on a group of hospitalized schizophrenia patients in a training and research hospital in Turkey whether the Positive and Negative Symptom Scale (PANSS) scores differ between the patients under monotherapy and combined therapy