Health-related quality of life of primary care patients with depressive disorders

Background: Depressive disorders are known to impair health-related quality of life (HRQoL) both in the short and long term. However, the determinants of long-term HRQoL outcomes in primary care patients with depressive disorders remain unclear. Methods: In a primary care cohort study of patients with depressive disorders, 82% of 137 patients were prospectively followed up for five years. Psychiatric disorders were diagnosed with SCID-I/P and SCID-II interviews; clinical, psychosocial and socio-economic factors were investigated by rating scales and questionnaires plus medical and psychiatric records. HRQoL was measured with the generic 15D instrument at baseline and five years, and compared with an age-standardized general population sample (n = 3707) at five years. Results: Depression affected the 15D total score and almost all dimensions at both time points. At the end of follow-up, HRQoL of patients in major depressive episode (MDE) was particularly low, and the association between severity of depression (Beck Depression Inventory [BDI]) and HRQoL was very strong (r = -0.804). The most significant predictors for change in HRQoL were changes in BDI and Beck Anxiety Inventory (BAI) scores. The mean 15D score of depressive primary care patients at five years was much worse than in the age-standardized general population, reaching normal range only among patients who were in clinical remission and had virtually no symptoms. Conclusions: Among depressive primary care patients, presence of current depressive symptoms markedly reduces HRQoL, with symptoms of concurrent anxiety also having a marked impact. For HRQoL to normalize, current depressive and anxiety symptoms must be virtually absent. (C) 2016 Elsevier Masson SAS. All rights reserved.Peer reviewe

Ultra-High-Resolution Monitoring of the Catchment Response to Changing Weather Conditions Using Online Sediment Trapping

The purpose of this study was to identify relationships between meteorological and hydrological observations and sediment flux rate changes, in order to better understand catchment dynamics. The meteorological and hydrological observations included local air temperature, wind speed, water temperature, and ice cover, while the sediment flux rate was observed in the lake basin using a modified sediment trap technique. This study demonstrates the advantages of a new online methodology applied in conventional sediment trapping to obtain flux rate information with daily resolution. A prototype of a high-resolution online sediment trap was tested in Savilahti Bay, Lake Kallavesi, eastern Finland, during the period from 22 October 2017 to 6 October 2018. The daily resolutions of meteorological, hydrological, and sediment flux rate data were analyzed using statistical methods. The results indicate relationships between temperature, precipitation, wind speed, and sediment flux rate, but the urban site also showed erosional changes due to anthropogenic land use. Sediment flux ceased during winter season and spring floods were recorded as pronounced peaks in sediment flux, while the growing season showed generally higher sediment accumulation rates. This research also provides valuable information on the catchment response to short-term weather events. The influence of a storm led to larger sediment flux for several days. The importance of wind speed and frost formation on sedimentation, which has been difficult to address due to trap deployment times of typically several months, is now supported. Used together with varved sediment archives, online sediment trapping will facilitate the interpretation of paleoclimatic proxy records and modeling of detailed weather and erosion conditions that are related to climate change.</p

How size matters: exploring the association between quality of mental health services and catchment area size

Background: The diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities are responsible for organizing the services needed, but the real extent and roles of private and third sector service providers are not known. Our previous study showed that the catchment area population size was strongly associated with diversity of mental health services. It is not known whether this was due to some types of services or some provider types being more sensitive to the size effect than others.The aim of this study was to investigate the association between area population size and diversity of mental health services, i.e. which types of services and which service providers' contributions are sensitive to population size.Methods: To map and classify services, we used the ESMS-R. The diversity of services was defined as the count of main types of care. Providers were classified as public, private or third sectors.Results: The diversity of outpatient, residential and voluntary services correlated positively with catchment area population size. The strongest positive correlation between the size of population and services available was found in third sector activities followed by public providers, but no correlation was found for diversity of private services. The third sector and public corporations each provided 44 % of the service units.Third sector providers produced all self-help services and most of the day care services. Third sector and private companies provided a significant part (59 %) of the residential care service units.Conclusions: Significant positive correlations were found between size of catchment area population and diversity of residential, outpatient and voluntary services, indicating that these services concentrate on areas with larger population bases. The third sector seems to significantly complement the public sector in providing different services. Thus the third sector be needs to be functionally integrated with other MHS services to achieve a diversified and integrated service system

Varve Distribution Reveals Spatiotemporal Hypolimnetic Hypoxia Oscillations During the Past 200 Years in Lake Lehmilampi, Eastern Finland

We investigated 34 sediment cores to reconstruct spatiotemporal variations in hypolimnetic hypoxia for the past 200 years in Lehmilampi, a small lake in Eastern Finland. As hypoxia is essential for varve preservation, spatiotemporal changes in varve distribution were used as an indicator for hypolimnetic hypoxia oscillations. The hypoxic water volume was used as a variable reflecting hypolimnetic hypoxia and determined for each year by estimating the water volume beneath the water depth where shallowest varves were preserved. As a result, seven hypoxia periods, highlighting the variations in hypolimnetic hypoxia, are established. These periods may be influenced by bioturbation, lake infill, and lake level changes. Furthermore, we evaluated the relationship between hypolimnetic hypoxia oscillations and climatic factors. Diatom assemblage changes were also analyzed to estimate whether the hypoxia periods could be related to anthropogenic eutrophication. The diatom analyses suggest relatively stable nutrient conditions for the past 200 years in Lake Lehmilampi. Climate, on the other hand, seems to be an important driver of hypoxia oscillations based on correlation analysis. The role of individual forcing factors and their interaction with hypolimnetic hypoxia would benefit from further investigations. Understanding climatic and anthropogenic forcing behind hypolimnetic hypoxia oscillations is essential when assessing the fate of boreal lakes in a multi-stressor world.</p

Physical activity and health related quality of life

Copyright @ 2012 Anokye et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been made available through the Brunel Open Access Publishing Fund.BACKGROUND: Research on the relationship between Health Related Quality of Life (HRQoL) and physical activity (PA), to date, have rarely investigated how this relationship differ across objective and subjective measures of PA. The aim of this paper is to explore the relationship between HRQoL and PA, and examine how this relationship differs across objective and subjective measures of PA, within the context of a large representative national survey from England. METHODS: Using a sample of 5,537 adults (40–60 years) from a representative national survey in England (Health Survey for England 2008), Tobit regressions with upper censoring was employed to model the association between HRQoL and objective, and subjective measures of PA controlling for potential confounders. We tested the robustness of this relationship across specific types of PA. HRQoL was assessed using the summary measure of health state utility value derived from the EuroQol-5 Dimensions (EQ-5D) whilst PA was assessed via subjective measure (questionnaire) and objective measure (accelerometer- actigraph model GT1M). The actigraph was worn (at the waist) for 7 days (during waking hours) by a randomly selected sub-sample of the HSE 2008 respondents (4,507 adults – 16 plus years), with a valid day constituting 10 hours. Analysis was conducted in 2010. RESULTS: Findings suggest that higher levels of PA are associated with better HRQoL (regression coefficient: 0.026 to 0.072). This relationship is consistent across different measures and types of PA although differences in the magnitude of HRQoL benefit associated with objective and subjective (regression coefficient: 0.047) measures of PA are noticeable, with the former measure being associated with a relatively better HRQoL (regression coefficient: 0.072). CONCLUSION: Higher levels of PA are associated with better HRQoL. Using an objective measure of PA compared with subjective shows a relatively better HRQoL.This project was funded by the NIHR Health Technology Assessment programme (project number 08/72/01)

Children’s depressive symptoms and their regulation of negative affect in response to vignette-depicted emotion-eliciting events

The present study examined the relationship between sub-clinical depressive symptoms and children's anticipated cognitive and behavioral reactions to two written vignettes depicting emotion-eliciting stressors (i.e., fight with one's best friend and failure at a roller blade contest). Participants (N = 244) ranging in age between 10 and 13 were presented each vignette and then asked to rate their anticipated utilization of each of seven emotion-regulation strategies (ERs), along with the anticipated mood enhancement effects of each strategy. In addition, ratings of participants' perceived coping efficacy to manage the stressful situation were collected. Results indicated that participants were more likely to endorse ERs for which they have greater confidence in their mood enhancement effects. Moreover, marked differences were observed between ratings for conceptually distinct cognitive ERs. Consistent with expectations, results revealed that participants displaying higher levels of depressive symptoms were more likely to endorse cognitive and behavioral ERs that are negative, passive, and/or avoidant in nature. Children's ratings of the anticipated mood enhancement effects of several ERs were inversely related to their level of depressive symptoms, as was their perceived self-efficacy to manage the stressor. © 2007 The International Society for the Study of Behavioural Development