1,621 research outputs found

    Longitudinal association between different levels of alcohol consumption and a new onset of depression and generalized anxiety disorder: Results from an international study in primary care

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    BACKGROUND: Several studies that have examined the full range of alcohol consumption have pointed to a possible non-linear association between alcohol use and the common mental disorders. Most of these studies are cross sectional and assessed psychiatric morbidity using non-specific instruments. Our aim was to investigate the longitudinal association between varying levels of alcohol consumption at baseline and the new-onset of depression and generalized anxiety disorder (GAD), in a large international primary care sample. METHODS: The sample consisted of 3201 primary care attenders from 14 countries in the context of WHO Collaborative Study of Psychological Problems in General Health Care. Alcohol use at baseline was assessed using AUDIT and the mental disorders were assessed with the Composite International Diagnostic Interview. RESULTS: Light to moderate alcohol consumption at baseline was associated with a lower incidence of depression and GAD compared to abstinence while excessive alcohol consumption was associated with a higher incidence of depression but not GAD. This non-linear association was not substantially affected after adjustment for a range of possible confounding variables. CONCLUSION: Any causal interpretation of this association is difficult in the context of an observational study and further combined and consistent evidence from different sources is needed

    Changes in the mean echogenicity and area of the puborectalis muscle during pregnancy and postpartum

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    INTRODUCTION AND HYPOTHESIS: Three-dimensional (3D) and four-dimensional (4D) volume transperineal ultrasound imaging is increasingly used to assess changes in the dimensions of the pelvic floor during pregnancy and after delivery. Little is known with regard to the area of the puborectalis muscle and its structural changes. Echogenicity measurement, a parameter that provides information on the structure of muscles, is increasingly used in orthopaedics and neuromuscular disease evaluation. This study is aimed at assessing the changes in the mean echogenicity of the puborectalis muscle (MEP) and the puborectalis muscle area (PMA) during first pregnancy and after childbirth. METHODS: The MEP and PMA of 254 women during first pregnancy were measured at 12 and 36 weeks’ gestation and 6 months postpartum. To determine the effect of child-birth on MEP and PMA, the results at 6 months postpartum were separately analysed for vaginal deliveries, operative vaginal deliveries (ventouse) and caesarean section deliveries. Mean differences in MEP and PMA were analysed using ANOVA statistics. RESULTS: The MEP at 6 months postpartum was, independent of manoeuvre, significantly (p < 0.001) lower than MEP values during pregnancy. After caesarean delivery, the PMA was significantly smaller at maximum pelvic floor contraction than PMA after vaginal delivery (p = 0.003) or operative vaginal delivery (p = 0.002). CONCLUSION: Our study indicates that structural changes in the puborectalis muscle during and after pregnancy, as measured by MEP, occur and can be analysed. In addition, the mode of delivery affects the area of the puborectalis during contraction after delivery. For true volume analysis, as part of an assessment of contractility of the puborectalis muscle we will need 3D volume analysis

    Measuring echogenicity and area of the puborectalis muscle:method and reliability

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    OBJECTIVES: To develop a semi-automated method to assess puborectalis muscle echogenicity on three-dimensional/four-dimensional (3D/4D) volume transperineal ultrasound images using 4D View and MatlabÂź software and evaluate its intra- and interobserver reliability. METHOD: The data of 23 women in their first trimester were included. 3D/4D volume datasets were obtained at rest. Two inexperienced observers were trained by an experienced observer to construct tomographic ultrasound images (TUI) from the original data and to delineate all structures. Puborectalis muscle area (PMA) and the mean echogenicity of the puborectalis muscle (MEP) were calculated offline. Intra- and interobserver reliability were determined by intraclass correlation coefficients (ICC) and their 95% CIs. RESULTS: The development of a semi-automated method to calculate puborectalis area and echogenicity is described in detail. PMA and MEP measurements in pregnant women demonstrated almost perfect intraobserver reliability for both inexperienced observers, with ICC values ranging from 0.88 to 0.99. The interobserver reliability showed ICCs of 0.63 for PMA and almost perfect ICC values, of 0.96-0.98, for echogenicity. The majority of intraobserver mismatch between two delineations of PMA occurred near the borders. CONCLUSIONS: Matlab software can be used to provide reliable measurements of the area and echogenicity of the puborectalis muscle. As the latter can be used to assess structural changes in the puborectalis muscle, it appears a promising new tool for studying pelvic floor structural anatomy

    Paedophiles in the community: inter-agency conflict, news leaks and the local press

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    This article explores the leaking of confidential information about secret Home Office plans to house convicted paedophiles within a local community (albeit inside a prison). It argues that a politics of paedophilia has emerged in which inter-agency consensus on the issue of ‘what to do’ with high-profile sex offenders has broken down. Accordingly, the article situates newspaper ‘outing’ of paedophiles in the community in relation to vigilante journalism and leaked information from official agencies. The article then presents research findings from a case study of news events set in train following a whistle-blowing reaction by Prison Officers’ Association officials to Home Office plans. Drawing from a corpus of 10 interviews with journalists and key protagonists in the story, the article discusses both the dynamics of whistle blowing about paedophiles and also what happens after the whistle has blown
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