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To assess community mental health in suburban Dublin in 2018, 5 years after Ireland’s economic recession ended.
A cross-sectional, face-to-face, household survey was conducted in a random cluster sample of 351 households in Tallaght, a deprived suburb of Dublin.
A majority of respondents (61.3%) reported stress over the previous 12 months, with a higher rate in areas of high (66.9%) compared to lower deprivation (55.5%). Deprivation was not related to rates of loneliness (20.2%), feeling depressed (20.2%), loss of interest (19.7%) or anxiety (22.5%). Mean score for positive mental health (59.3/100, with a higher score indicating better mental health) was lower than that reported in a national sample in 2007 (68/100); positive mental health was associated with not living with a person with chronic illness, self-identifying as ‘non-Irish’ and greater age. Mean score for psychological distress (76.7/100, with a higher score indicating less distress) was also lower than that in 2007 (82/100); less psychological distress was associated with not living with a person with chronic illness or disability, greater age and identifying as non-Irish. The rate of ‘probable mental illness’ over the previous 4 weeks (13.1%) was higher than in 2007 (7%).
Our findings emphasise the high prevalence of stress, especially in deprived suburban areas; the centrality of carer burden in determining mental wellbeing; and associations between positive mental health on the one hand and greater age and identifying as non-Irish on the other.
We present the case of a 68-year-old lady with a background diagnosis of bipolar disorder, who developed significant episodes of intractable delirium during each of her last three inpatient psychiatric admissions, where she was admitted with mania and psychosis. The case demonstrates diagnostic and management difficulties secondary to this delirium. We discuss the probable cause of this delirium and the various management strategies utilised in an effort to ameliorate her condition.
Study of illness characteristics and symptoms in a young population with psychosis can assist for understanding of their needs, and can inform service planning strategies. The aims of the current study were to describe illness characteristics and symptoms of a first episode psychosis (FEP) sample aged 25 years and under, and compare with a sample aged over 25 years.
Interviews were conducted for 437 individuals aged 16–65 years presenting with suspected psychosis between 2005 and 2012 in a defined catchment area (population of 390 000) using the Structured Clinical Interview for DSM IV to determine the presence of a psychosis diagnosis. Individuals with confirmed psychosis were assessed using standardised instruments to determine illness characteristics at first presentation.
Among the 25 years, and under FEP sample, 23.9% had their first onset of symptoms (prodromal or psychotic) before 18 years of age. After controlling for confounders, the sample aged 25 years and under had a significantly shorter log transformed duration of untreated psychosis (p=0.002), more negative symptoms (p=0.045) and greater frequency of comorbid cannabis abuse diagnosis (p=0.027).
Symptom onset in a youth FEP sample frequently occurs before age 18 years. Certain illness characteristics differed across the age categories, such as greater negative symptoms and cannabis abuse in the youth sample. Overall, the findings support the provision of adequate strategies for management of negative symptom deficits and substance abuse across all ages in FEP.
We explored the use of galvanostatic electrochemical deposition of Pt for cost-effective fabrication of interconnects in flexible implantable bio-medical devices. Initial studies were done on coupons diced from 200 mm Si wafers coated with PVD TiN. Based on the physical and chemical properties of the electrodeposited Pt films, optimal conditions were chosen for through-mask plating of centimeters long Pt lines on flexible, medical grade, releasable polyimide layers. Possibility for further up-scaling was considered with special emphasis on high throughput manufacturing of Pt interconnects with good adhesion to TiN/flexible substrates, low impurity content and resistivity, and acceptable roughness and uniformity.
Brewers’ spent grain (BSG) is a low-value co-product of the brewing industry produced in large quantities annually. This paper reviews the existing evidence regarding the phenolic component of BSG, focusing on composition, extraction and biofunctions such as antioxidant, anti-atherogenic, anti-inflammatory and anti-carcinogenic activities. Furthermore, the incorporation of BSG in foodstuffs will be discussed, including the use of BSG as an animal feed supplement and the potential of BSG to be incorporated into foods for human consumption. BSG contains hydroxycinnamic acids including ferulic acid, p-coumaric acid and caffeic acid; which have shown bioactivity in the pure form (antioxidant, anti-inflammatory, anti-atherogenic and anti-cancer). Phenolic extracts from BSG have also shown antioxidant potential, by protecting against oxidant-induced DNA damage, possibly by Fe chelation. Studies show that BSG has many benefits when used as a supplement in animal feed, such as increasing milk yield, milkfat content and in providing essential dietary amino acids. The incorporation of BSG in human foods such as cookies and ready-to-eat snacks has resulted in increased protein and fibre contents of the products, where the changes in organoleptic properties are controllable. It can be concluded that the phenolic component of BSG has potential bioactive effects, which are worth pursuing given that the inclusion of BSG into human foodstuffs is viable and beneficial.
This paper uses meta-analysis of published data and a deterministic mathematical model of hepatitis B virus (HBV) transmission to describe the patterns of HBV infection in high endemicity areas. We describe the association between the prevalence of carriers and a simple measure of the rate of infection, the age at which half the population have been infected (A50), and assess the contribution of horizontal and perinatal transmission to this association. We found that the two main hyper-endemic areas of sub-Saharan Africa and east Asia have similar prevalences of carriers and values of A50, and that there is a negative nonlinear relationship between A50 and the prevalence of carriers in high endemicity areas (Spearman's Rank, P = 0·0086). We quantified the risk of perinatal transmission and the age-dependent rate of infection to allow a comparison between the main hyper-endemic areas. East Asia was found to have higher prevalences of HBeAg positive mothers and a greater risk of perinatal transmission from HBeAg positive mothers than sub-Saharan Africa, though the differences were not statistically significant. However, the two areas have similar magnitudes and age-dependent rates of horizontal transmission. Results of a simple compartmental model suggest that similar rates of horizontal transmission are sufficient to generate the similar patterns between A50 and the prevalences of carriers. Interrupting horizontal transmission by mass immunization is expected to have a significant, nonlinear impact on the rate of acquisition of new carriers.
The outcome of schizophrenia appears to be more favourable than once thought. However, methodological issues, including the reliance on diagnosis at first presentation have limited the validity of outcome studies to date.
We conducted a first-episode follow-up study of 97 patients with DSM-IV schizophrenia over the first 4 years of illness. First presentation and follow-up assessments were compared using paired t tests and a forced-entry regression analysis was used to determine prognostic variables.
There were significant improvements in positive and negative symptoms and global assessment of functioning between first presentation and follow-up. At first presentation, fewer negative symptoms (t=−3.40, p<0.01), more years spent in education (t=3.25, p<0.01), and a shorter duration of untreated psychosis (DUP) (t=−2.77, p<0.01) significantly predicted a better outcome at follow-up.
The outcome of schizophrenia may not be as pessimistic as once thought and most patients did not display a downward deteriorating course of illness. This study supports the relationship between DUP and outcome beyond the early stages of illness.
Fitness of tick-borne pathogens may be determined by the degree to which their infection dynamics in vertebrate hosts permits transmission cycles if infective and uninfected tick stages are active at different times of the year. To investigate this hypothesis we developed a simulation model that integrates the transmission pattern imposed by seasonally asynchronous nymphal and larval Ixodes scapularis ticks in northeastern North America, with a model of infection in white-footed mice (Peromyscus leucopus) reservoir hosts, using the bacteria Borrelia burgdorferi and Anaplasma phagocytophilum as examples. In simulations, survival of microparasites, their sensitivity to reduced rodent and tick abundance, and to ‘dilution’ by a reservoir-incompetent host depended on traits that allowed (i) highly efficient transmission from acutely-infected hosts, (ii) long-lived acute or ‘carrier’ host infections, and/or (iii) transmission amongst co-feeding ticks. Minimum values for transmission efficiency to ticks, and duration of host infectivity, necessary for microparasite persistence, were always higher when nymphal and larval ticks were seasonally asynchronous than when these instars were synchronous. Thus, traits influencing duration of host infectivity, transmission efficiency to ticks and co-feeding transmission are likely to be dominant determinants of fitness in I. scapularis-borne microparasites in northeastern North America due to abiotic forcings influencing I. scapularis seasonality.