Twelve-month utilization rates and adequacy of treatment for mental health and substance use disorders in Argentina

OBJECTIVE: To estimate the 12-month prevalence of mental health services utilization (overall and by type of service sector), the adequacy of treatment provided, and sociodemographic correlates in the Argentinean Study of Mental Health Epidemiology (ASMHE). METHODS: The ASMHE is a multistage probability household sample representative of adults in urban areas of Argentina. The World Health Organization World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to evaluate psychiatric diagnosis and service utilization. RESULTS: Among those with a disorder, 27.6% received any treatment in the prior 12 months. Of these, 78.3% received minimally adequate treatment using a broad definition and only 43.6% using a stringent definition. For individuals with a disorder, more services were provided by mental health professionals (17.7%) than by general medical professionals (11.5%) or non-healthcare sectors (2.6%). Younger individuals with low education and income were less likely to receive treatment; those never married and those with an anxiety or mood disorder were more likely to receive treatment. Among those in treatment, treatment was least adequate among younger individuals with low education and low income. CONCLUSIONS: Policies to increase access to services for mental health disorders in Argentina are needed, as is training for primary care practitioners in the early detection and treatment of psychiatric disorders.Fil: Cia, Alfredo H.. Centro de Investigaciones Médicas En Ansiedad; ArgentinaFil: Stagnaro, Juan C.. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Aguilar Gaxiola, Sergio. University of California; Estados UnidosFil: Sustas, Sebastián Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Serfaty, Edith. Centro de Estudios Epidemiológicos; ArgentinaFil: Nemirovsky, Martin. Proyecto SUMA; ArgentinaFil: Kessler, Ronald C.. Harvard Medical School; Estados UnidosFil: Benjet, Corina. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz; Méxic

High refractive index inverse vulcanized polymers for organic photonic crystals

Photonic technologies are nowadays dominated by highly performing inorganic structures that are commonly fabricated via lithography or epitaxial growths. Unfortunately, the fabrication of these systems is costly, time consuming, and does not allow for the growth of large photonic structures. All-polymer photonic crystals could overcome this limitation thanks to easy solubility and melt processing. On the other hand, macromolecules often do not offer a dielectric contrast large enough to approach the performances of their inorganic counterparts. In this work, we demonstrate a new approach to achieve high dielectric contrast distributed Bragg reflectors with a photonic band gap that is tunable in a very broad spectral region. A highly transparent medium was developed through a blend of a commercial polymer with a high refractive index inverse vulcanized polymer that is rich in sulfur, where the large polarizability of the S–S bond provides refractive index values that are unconceivable with common non-conjugated polymers. This approach paves the way to the recycling of sulfur byproducts for new high added-value nanostructures

Localizing the cross-links distribution in elastomeric composites by tailoring the morphology of the curing activator

The localization of the rubber vulcanization reaction close to the silica filler surface was investigated in isoprene rubber composites (IR NCs): the main goal was to highlight the role of curing agents’ dispersion and filler surface features on the spatial propagation of the rubber cross-links and the resulting mechanical behavior of the material. The study was realized by tailoring the morphology of the curing activator, i.e. by vulcanizing IR NCs with Zn@SiO2 double function filler, composed of Zn(II) single sites anchored on SiO2 filler, in comparison to silica filled IR NCs vulcanized with microcrystalline ZnO (m-ZnO). The microscopic cross-links distribution was measured by Transmission Electron Microscopy for network visualization (NVTEM) and Time Domain Nuclear Magnetic Resonance (TD-NMR). Besides the NCs mechanical behavior was characterized both at small strain and at fracture. In the presence of Zn@SiO2, higher cross-link density in proximity to SiO2 particles was evidenced, which gradually spreads from the filler surface to the bulk, induced by localization of the Zn(II) centers. IR NCs with Zn@SiO2 resulted stiffer (+45%) and with a lower fracture toughness (less than one third), compared to m-ZnO based NCs, which shows a quite homogeneous structure of the rubber cross-links network. The results highlighted the correlation between the composites structural features and their macroscopic behavior, paving the way to modulating the mechanical properties of elastomeric materials by tuning the nature of the curing agents

Quantifying and Mitigating Wind‐Induced Undercatch in Rainfall Measurements

Despite the apparent simplicity, it is notoriously difficult to measure rainfall accurately because of the challenging environment within which it is measured. Systematic bias caused by wind is inherent in rainfall measurement and introduces an inconvenient unknown into hydrological science that is generally ignored. This paper examines the role of rain gauge shape and mounting height on catch efficiency (CE), where CE is defined as the ratio between nonreference and reference rainfall measurements. Using a pit gauge as a reference, we have demonstrated that rainfall measurements from an exposed upland site, recorded by an adjacent conventional cylinder rain gauge mounted at 0.5 m, were underestimated by more than 23% on average. At an exposed lowland site, with lower wind speeds on average, the equivalent mean undercatch was 9.4% for an equivalent gauge pairing. An improved-aerodynamic gauge shape enhanced CE when compared to a conventional cylinder gauge shape. For an improved-aerodynamic gauge mounted at 0.5 m above the ground, the mean undercatch was 11.2% at the upland site and 3.4% at the lowland site. The mounting height of a rain gauge above the ground also affected CE due to the vertical wind gradient near to the ground. Identical rain gauges mounted at 0.5 and 1.5 m were compared at an upland site, resulting in a mean undercatch of 11.2% and 17.5%, respectively. By selecting three large rainfall events and splitting them into shorter-duration intervals, a relationship explaining 81% of the variance was established between CE and wind speed

ps8 161 the disease burden in patients with longstanding systemic lupus erythematosus focus on health resource use and costs

Introduction As a consequence of increased SLE patients survival, patients with long disease duration represent a significant proportion of our cohorts. This study aims to evaluate health resource use and the 6 months costs in patients with SLE with long disease duration. Methods The economic evaluation was performed in terms of cost-of-illness analysis as part of a larger study enrolling SLE patients with at least 15 years of disease duration regularly followed at our unit. At enrollment, the following information were collected: disease activity (SLEDAI), organ damage (SLICC-DI score), comorbidities, treatment patterns; in addition to clinical data, patients were required to complete an ad-hoc questionnaire for the collection of facts relevant for the estimation of the economic dimension and covering the previous six-months. Such a time frame was considered to be appropriate as recall period. Direct health (drugs, hospitalizations, emergency visits, specialists visits, laboratory tests and instrumental examination) and non-health costs (transportation and accommodation) as well as indirect costs because of productivity loss were estimated. Results 51 adult patients with long disease duration were recruited (98% female, mean age 49±11 years, median disease duration 17 years, IQR 15–23). Median (IQR) SLEDAI score was 2 (0–4), median SLICC-DI was 1 (0–2). The median (IQR) direct health costs per patients over the previous 6 months resulted 410€ (201–1687); indirect costs because of productivity lost were 130€ (0–356). The median overall cost to the Society was 473€ (327–2148); the presence of comorbid conditions resulted associated with higher overall cost for the Society (552€ [327–1807] vs 264€ [94–1164] p=0.046); disease activity and damage at enrollment were not associated with costs increase in this cohort. Conclusions This cohort of patients with long lasting disease is characterised by low disease activity and mild organ damage; in this setting, the disease burden on the single patient and family is significant and the costs to the Society are influenced by the presence of comorbidities

LDPE-based blends and films stabilized with nonreleasing polymeric antioxidants for safer food packaging

Several novel random copolymers of ethylene and 1-olefin counits bearing a highly efficient phenolic antioxidant moiety placed at different distances from the polymerizable double bond were prepared in the presence of a metallocene catalyst. These copolymers were melt-blended with an antioxidant-free LDPE in an internal batch mixer to obtain innovative materials containing nonreleasing polymeric antioxidants suitable for safer food packaging applications. Blends and films, obtained by compression molding, were tested for their thermal and thermo-oxidative stability by thermogravimetric analysis both in dynamic and isothermal conditions. Films containing the macromolecular antioxidants showed a longer induction time before O2 uptake starts and, consequently, a higher degradation temperature than neat LDPE or LDPE containing a low molecular weight commercial additive. Aging tests demonstrated that the new polymeric antioxidants also exert a valid protection against photo-oxidation. Eventually, migration tests demonstrated the absence of any trace of products containing the antioxidant moiety when the films were kept in contact with a food simulant

Associations between neighborhood-level violence and individual mental disorders: results from the World Mental Health surveys in five Latin American cities

Rapidly urbanizing areas of Latin America experience elevated but unevenly distributed levels of violence. Extensive research suggests that individual exposure to violence is associated with higher odds of both internalizing (anxiety and mood) and externalizing (substance and intermittent explosive) mental disorders. Less research, however, has focused on how neighborhood-level violence, as an indicator of broader neighborhood contexts, might relate to the mental health of residents, independently of an individual’s personal exposure. We used multilevel analyses to examine associations of neighborhood-level violence with individual-level past-year mental disorders, controlling for individual-level violence exposure. We used data from 7,251 adults nested in 83 neighborhoods within five large Latin American cities as part of the WHO World Mental Health Surveys. Accounting for individual-level violence exposure, living in neighborhoods with more violence was associated with significantly elevated odds of individual-level internalizing disorders, but not externalizing disorders. Caution should be exercised when making causal inferences regarding the effects of neighborhood-level violence in the absence of experimental interventions. Nevertheless, neighborhood context, including violence, should be considered in the study of mental disorders. These findings are particularly relevant for rapidly urbanizing areas with high levels of violence, such as Latin America