Patients’ Opinions about Knowing Their Risk for Depression and What to Do about It. The PredictD-Qualitative Study

[Background] The predictD study developed and validated a risk algorithm for predicting the onset of major depression in primary care. We aimed to explore the opinion of patients about knowing their risk for depression and the values and criteria upon which these opinions are based. [Methods] A maximum variation sample of patients was taken, stratified by city, age, gender, immigrant status, socio-economic status and lifetime depression. The study participants were 52 patients belonging to 13 urban health centres in seven different cities around Spain. Seven Focus Groups (FGs) were given held with primary care patients, one for each of the seven participating cities. [Results] The results showed that patients generally welcomed knowing their risk for depression. Furthermore, in light of available evidence several patients proposed potential changes in their lifestyles to prevent depression. Patients generally preferred to ask their General Practitioners (GPs) for advice, though mental health specialists were also mentioned. They suggested that GPs undertake interventions tailored to each patient, from a “patient-centred” approach, with certain communication skills, and giving advice to help patients cope with the knowledge that they are at risk of becoming depressed. [Conclusions] Patients are pleased to be informed about their risk for depression. We detected certain beliefs, attitudes, values, expectations and behaviour among the patients that were potentially useful for future primary prevention programmes on depression.This work was supported by grants from the Andalusian Council of Health [grant reference: 2008/0195][www.juntadeandalucia.es/fundacionprogres​oysalud]; the Department of Health of the Basque Government [grant reference: 2008/111021][www.osakidetza.euskadi.net]; the Spanish Network of Primary Care Research “redIAPP” (RD06/0018), the “Aragón group” (RD06/0018/0020), the “Sant Joan de Deu group” (RD07/0018/0017), “Bizkaya group” (RD07/0018/0018), “Castilla-León group” (RD07/0018/0027) and the “SAMSERAP group” (RD06/0018/0039 and CTS-587) [www.rediapp.org]

Predicting the onset and persistence of episodes of depression in primary health care. The predictD-Spain study: Methodology

Background: The effects of putative risk factors on the onset and/or persistence of depression remain unclear. We aim to develop comprehensive models to predict the onset and persistence of episodes of depression in primary care. Here we explain the general methodology of the predictD-Spain study and evaluate the reliability of the questionnaires used. Methods: This is a prospective cohort study. A systematic random sample of general practice attendees aged 18 to 75 has been recruited in seven Spanish provinces. Depression is being measured with the CIDI at baseline, and at 6, 12, 24 and 36 months. A set of individual, environmental, genetic, professional and organizational risk factors are to be assessed at each follow-up point. In a separate reliability study, a proportional random sample of 401 participants completed the test-retest (251 researcher-administered and 150 self-administered) between October 2005 and February 2006. We have also checked 118,398 items for data entry from a random sample of 480 patients stratified by province. Results: All items and questionnaires had good test-retest reliability for both methods of administration, except for the use of recreational drugs over the previous six months. Cronbach's alphas were good and their factorial analyses coherent for the three scales evaluated (social support from family and friends, dissatisfaction with paid work, and dissatisfaction with unpaid work). There were 191 (0.16%) data entry errors. Conclusion: The items and questionnaires were reliable and data quality control was excellent. When we eventually obtain our risk index for the onset and persistence of depression, we will be able to determine the individual risk of each patient evaluated in primary health care.The research in Spain was funded by grants from the Spanish Ministry of Health (grant FIS references: PI04/1980, PI0/41771, PI04/2450, and PI06/1442), Andalusian Council of Health (grant references: 05/403, 06/278 and 08/0194), and the Spanish Ministry of Education and Science (grant reference SAF 2006/07192). The Malaga sample, as part of the predictD-International study, was also funded by a grant from The European Commission (reference QL4-CT2002-00683)

Tenderización post-mortem de la carne de los distin- tos biotipos amparados por la igp ternera asturiana

Tenderization and μ-calpain activity were studied along post-mortem maduration (2 h to 21 d) on beef from different biotypes included in the Protected Geographical Indication (PGI) Ternera Asturiana attending to breed (Asturiana de los Valles, AV and Asturiana de la Montaña, AM) and genotype for myostatine mutation causing muscu- lar hypertrophy (mh/mh, mh/+ and +/+). This mutation produced significant differences in meat quality, promoting a faster pH decline and earlier activation of calpains, which resulted in faster proteolysis in AV(mh/mh and mh/+) biotypes, that showed earlier tenderization rate than normal (+/+) biotypes of both breeds. The results showed that differences among biotypes in pH and μ- calpain activity paralleled the tenderization process.Se estudió la actividad de la μ-calpaína y la tenderización a lo largo de la maduración post- mortem (de 2 h a 21 d) en carne procedente de distintos biotipos amparados por la Indicación Geográfica Protegida (IGP) Ternera Asturiana, según la raza (Asturiana de los Valles, AV y Asturiana de la Montaña, AM) y el genotipo para la mutación en el gen de la miostatina causante de la hipertrofia muscular (mh/mh, mh/+, +/+). Esta mutación produjo diferencias significativas en la evolución post-mortem de la calidad de la carne promoviendo un descenso más rápido del pH y una activación más temprana de las calpaínas y por tanto de la proteolisis en los biotipos AV (mh/mh y mh/+) que mostraron un ritmo de tenderización más temprano que la carne de los biotipos norma- les (+/+) de ambas razas. Los resultados indican que las diferencias encontradas entre biotipos en pH y actividad de μ-calpaína muestran un parale- lismo con el proceso de tenderización

Characteristics of the participants in the focus groups.

<p>Young: 18–34 years; Middle-aged: 35–60 years; Mature: 61–75 years.</p

Topic guide for the focus groups.

<p>Topic guide for the focus groups.</p

Practical implications to bear in mind when designing a primary prevention programme for depression based on the patients’ understanding of their level and profile of risk.

<p>Practical implications to bear in mind when designing a primary prevention programme for depression based on the patients’ understanding of their level and profile of risk.</p