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This study builds on existing research on the prevalence and consequences of mental illness discrimination by investigating and quantifying the relationships between experienced discrimination and costs of healthcare and leisure activities/social participation among secondary mental health service users in England.
We use data from the Mental Illness-Related Investigations on Discrimination (MIRIAD) study (n = 202) and a subsample of the Viewpoint study (n = 190). We examine experiences of discrimination due to mental illness in the domains of personal relationships, community activities, and health care, and how such experienced discrimination relates to patterns of service use and engagement in leisure activities.
Our findings show that the cost of health services used for individuals who reported previous experiences of discrimination in a healthcare setting was almost twice as high as for those who did not report any discrimination during the last 12 months (Relative Risk: 1.73; 95% Confidence Interval (CI): 1.39, 2.17) and this was maintained after controlling for symptoms and functioning. Experienced discrimination in healthcare (Relative Risk: 0.83; 95% CI: 0.81, 0.84) or in relationships (Relative Risk: 0.89; 95% CI: 0.87, 0.91), however, was associated with lower participation in, and hence lower costs of, leisure activities. Individuals who reported any discrimination in a healthcare setting had, on average, £434 higher costs associated with health service use while reported discrimination in the community was associated with increased leisure costs of £32.
These findings make an important initial step towards understanding the magnitude of the costs of mental health-related discrimination.
Previous pathological reports have indicated that swollen and
vacuolated motoneuron cell bodies are the
most predominant feature characterising Wobbler mouse motoneuron disease,
but there has been little
supportive evidence using area measurements. The present study focuses
the possible role of changes in
neuronal nuclear and perikaryal volumes in the cervical spinal cord
ventral horn, using new and traditional
stereological probes which provide unbiased estimates of volume. Semithin
sections from the ventral horn of
Wobbler mice and age and sex-matched phenotypically normal littermates
were examined at 2 ages (young
and old). The young Wobbler group had significantly larger volume
weighted mean perikaryal volumes
compared with age-matched controls, reflecting the presence of large
swollen cells characteristic of this
group; this situation was reversed in the control group. Number-weighted
perikaryal volume estimates in the
old Wobbler group were smaller than in age-matched controls. The
variation in perikaryal volume was
greatest in the young Wobbler group in which the coefficient of
variation was 127%. The mean number
weighted and volume weighted mean nuclear volumes were significantly
smaller in the old Wobbler group
compared with age-matched controls and young Wobbler groups. The application
of new stereological
probes has enabled us to document more precisely these changes in
neuronal structure in the Wobbler mutant mouse.
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