scholarly journals A Comparative Case Control Study between Innovations Team Malta and Innovations Project UK Working with Hard to Reach Young People with Complex Mental Disorders

2020 ◽  
Author(s):  
Andrea Saliba ◽  
Nigel Camilleri

Abstract BackgroundHard-to-reach young people (HTRYP) can be defined as YP at risk, disadvantaged, marginalised, who slip through the healthcare system and are unwilling to engage with services. MethodThis case control study compared the outcomes from two HTRYP services, Innovations Team Malta (IT Malta) and Innovations Project UK (IP UK) and a matched control from a UK based Community Mental Health Team (CMHT) over a 12 month period. IT Malta included HTRYP 13-25 years and IP UK 15-25 years. An in-depth MDT assessment was carried out together with the Health of the Nation Outcome Scales for Child and Adolescent Mental Health (HoNOSCA) and Children’s Global Assessment Scale (CGAS) at assessment and discharge. HTRYP meeting criteria were offered intensive individual tailored therapy. Results38 YP were referred to IT Malta, 34 (89.5%) assessed and 22 (57.9%) treated in 2018. 40 referrals to IP UK, 36 (90%) assessed, 31 (86%) met criteria and 15(48%) were treated. The HoNOSCA for IT Malta and IP UK were similar, at baseline (20.65, 19.32) and discharge (16.65, 16.53) respectively, but higher when compared to CMHT (11.19, 8.03) (p <0.001). The mean baseline CGAS for IT Malta (46.0) elucidates more impairment compared to IP UK (51.1) and CMHT (58.9). The total mean contact time (hours) per YP were; IT Malta (24.5), IP UK (18.2) and CMHT (8.6). ConclusionIT Malta and IP UK identified, engaged and treated YP with multiple complex mental disorders whose needs were not being met by other mental health services. HTRYP may benefit from a flexible YP oriented service, including outreach capability and a focus on engagement. Despite improvement, HTRYP’s mental and social functioning remained clinically worse than CMHT.

2016 ◽  
Vol 33 (S1) ◽  
pp. S176-S176
Author(s):  
C. Miranda ◽  
L. Santos ◽  
C.S. Paula ◽  
W. Ribeiro ◽  
T. Florencio

IntroductionIn deprived environments, mental health problems for both the mother and her stunted child may be related.ObjectiveTo verify possible association between a child's nutritional and mental health status with common maternal mental disorders (and associated impairment).AimsTo contribute to management of malnutrition and mental health in low-income populations.MethodsCase-control study in which 48 malnourished children (aged 48 to 72 months) were compared with 50 eutrophic children. The child's nutritional status, the children's mental health, the maternal mental health, and the associated disability were evaluated by using the WHO criteria, the “Strengths and Difficulties Questionnaire” (SDQ), the “Self-Report Questionnaire”-20 (SRQ-20), and the “Sheehan Disability Scale” (SDS), respectively. In addition, selected socio-economic aspects were considered.ResultsVariables with significant odds ratio (OR) in the univariate analysis were: maternal education (OR: 2.96, 95% CI: 1.30–6.75), number of residents in the household (OR: 0.32, 95% CI: 0.14–0.74), number of children in the household (OR: 0.25, 95% CI: 0.10–0.61), and social class (OR: 2.30, 95% CI: 1.02–5.18). The only SDQ dimension that tended to be associated with malnutrition was conduct problems (P = 0.08). The disability associated with probable common maternal mental disorders (CMD) also showed statistically significant association (P = 0.02). In the logistic regression, child malnutrition remained associated with child conduct problems and disability associated with probable CMD.ConclusionsConduct problems in stunted children are positively associated with CMD and related disability. Longitudinal studies are necessary to confirm these hypotheses.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Vol 5 ◽  
pp. 262
Author(s):  
Madhumitha Balaji ◽  
Lakshmi Vijayakumar ◽  
Michael Phillips ◽  
Smita Panse ◽  
Manjeet Santre ◽  
...  

Suicide is the second leading cause of death among young people in India. Over 40% of all suicides occur in people between 15 and 29 years of age. Suicide attempts are estimated to be 15 times more common than suicides and substantially increase the risk of subsequent death. However, there has been little systematic study of the determinants for suicide attempts in young people, which makes it difficult to design contextually appropriate and comprehensive suicide prevention strategies for this population. The proposed case-control study seeks to address this knowledge gap by studying a range of risk and protective factors for suicide attempts in young people in India. Field work will be in Yashwantrao Chavan Memorial Hospital (YCMH) hospital, in Pimpri-Chinchwad, Pune, India. Cases will be 15-29-year-old individuals admitted to the hospital with self-inflicted non-lethal injuries and poisoning. They will be matched for age and gender with those presenting at the General Medicine outpatient department with other health complaints. In each group, 150 persons will be recruited from YCMH from October 2019 to September 2022 and will undergo a comprehensive semi-structured interview. The primary exposure variable is negative life events over the past 12 months. Secondary exposure variables considered include: demographic characteristics, psychological factors, addictive behaviours, personal resources, adverse experiences over their lifetime, social support, suicidal behaviours in the family and social environment, and exposure to suicide-related information. Data will be analysed using conditional logistic regression. Following completion of the study, workshops will be held with young people, mental health professionals and policy makers to develop a theory of change that will be used to promote suicide prevention. Results will be disseminated via peer-reviewed publications, reports to young people and mental health organisations, and news articles. The study was approved by the Institutional Review Board at Sangath.


2018 ◽  
Vol 15 (1) ◽  
pp. 74-78
Author(s):  
Mohammadali Nazarinia ◽  
Asghar Zare ◽  
Mohammad javad Fallahi ◽  
Mesbah Shams

Background:Systemic sclerosis is a disorder of connective tissue with unknown cause, affecting the skin and internal organs, characterized by fibrotic changes.Objective:To determine the correlation between serum homocysteine level and interstitial lung involvement in systemic sclerosis. </P><P> Materials and Methods: In this case – control study, 59 patients who fulfilled the ACR/EULAR classification criteria for systemic sclerosis and were referred to Hafez Hospital of Shiraz, Iran, were included as the case group. Fifty nine healthy subjects were involved as the control group. Patients were divided into two groups based on interstitial lung involvement and two subtypes, diffuse and limited type. Serum homocysteine, vitamin B12, and folate levels compared between the controls, and cases groups.Results:Of 59 case and control group, 53 (%89.8) were female and the mean age did not differ in both groups (P=0.929). Thirty five (%59.3) patients had interstitial lung involvement and 38(%64.4) had diffuse cutaneous systemic sclerosis. The mean serum homocysteine level was 13.9±6.3 µmol/L in the case and 13.7±9.2 µmol/L in the control group (P=0.86). The mean serum homocysteine level did not differ between the patients with and without interstitial lung involvement (P=0.52). The patients with lung involvement was older than those without lung involvement (P=0.004). Lung disease was more common in diffuse type (P=0.014).Conclusion:In our study, serum homocysteine level did not differ between the patients and healthy subjects. Also, there was no correlation between serum homocysteine level and lung involvement, but lung involvement was more common in older patients and also diffuse subtype.


Author(s):  
Bakhtiar Piroozi ◽  
Cyrus Alinia ◽  
Hossein Safari ◽  
Ali Kazemi-Karyani ◽  
Ghobad Moradi ◽  
...  

2021 ◽  
Vol 10 (13) ◽  
pp. 2897
Author(s):  
Yu Ri Woo ◽  
Minah Cho ◽  
Hyun Jeong Ju ◽  
Jung Min Bae ◽  
Sang Hyun Cho ◽  
...  

Rosacea is a facial inflammatory dermatosis that is linked with various systemic illnesses. With regards to the eye, rosacea patients have been described to manifest ocular surface changes, such as blepharitis and conjunctivitis. However, studies that examine the association of rosacea with a wider array of ocular diseases are limited. Thus, our aim was to identify the range of ocular comorbidities in the Korean patient population and create a reference data set. A multi-institutional, case-control study was conducted, where 12,936 rosacea patients and an equal number of sex- and age-matched control subjects were extracted over a 12-year period. We were able to discover a notable association between rosacea and blepharitis (adjusted odds ratio (aOR) 3.44; 95% confidence interval, 2.71–4.36, p < 0.001), conjunctivitis (aOR 1.65; 95% CI, 1.50–1.82, p < 0.001), glaucoma (aOR 1.93; 95% CI, 1.70–2.20, p < 0.001), dry eye syndrome (aOR 1.89; 95% CI, 1.70–2.09, p < 0.001), and chalazion (aOR 3.26; 95% CI, 1.41–7.57, p = 0.006) from logistic regression analysis. Female subjects and individuals younger than 50 exclusively showed higher odds for chalazion. Our study suggests that ocular comorbidities (i.e., glaucoma, dry eye syndrome, and chalazion as well as blepharitis and conjunctivitis) are more prevalent among Koreans with rosacea. Clinicians should proactively check ocular symptoms in rosacea and employ joint care with an ophthalmologist in cases of need.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thang Nguyen-Tien ◽  
Duy Cuong Do ◽  
Xuan Luat Le ◽  
Thi Hai Dinh ◽  
Mats Lindeborg ◽  
...  

Abstract Background Dengue is a mosquito-borne flavivirus present in many metropolitan cities of tropical countries. Methods During and after the dengue season (September 2018 to January 2019), we conducted a case-control study in order to determine the risk factors for dengue fever in Hanoi city, Vietnam. 98 dengue patients and 99 patients with other acute infections, such as Hepatitis B virus infection, were recruited at Department of Infectious Disease of Bach Mai national hospital in Hanoi. Patients were interviewed using a structured questionnaire covering demographic, housing, environmental factors and knowledge, attitude, and practice on dengue prevention and control. Univariate analysis and multivariable logistic regression were used to determine the risk factors of dengue status. Results The mean score of knowledge items and practice items was only 7.9 out of total 19 points and 3.9 out of total 17 points, respectively. While the mean score of attitude items was 4.8 out of total 6 points. Multivariable logistic regression indicated that older patients had lesser risk of getting dengue infection as compared to younger adults aged 16–30, and patients living in peri-urban districts were less likely to suffer of dengue fever than patients living in central urban districts (OR = 0.31; 95% CI 0.13–0.75). This study could not find any association with occupation, water storage habit, knowledge, attitude, or practice on dengue prevention. Conclusions All patients had a relatively low level of knowledge and practice on dengue prevention and control. However, the attitude of the participants was good. We found that age group and living district were the risk factors correlated with the dengue status. Communication programs on raising dengue awareness should be repeated all year round and target particular groups of adolescents, younger adults, landlords and migrants from other provinces to improve their knowledge and encourage them to implement preventive measures against dengue fever.


2021 ◽  
Vol 36 ◽  
pp. 153331752110065
Author(s):  
Hyo Geun Choi ◽  
Bum Jung Park ◽  
Jae Sung Lim ◽  
Song Yong Sim ◽  
Yoon Jung Jung ◽  
...  

Objective: This study was conducted to evaluate the association between neurodegenerative dementia and herpes zoster infection (HZI) using a national sample cohort. Methods: From the national cohort study conducted by the Korean National Health Insurance Service, we extracted data for patients with neurodegenerative dementia and for 1:4 matched control participants and searched the patient histories for HZI. Results: The adjusted odds ratio (OR) for HZI was 0.90 (95% CI = 0.84-0.97) in the dementia group. According to the subgroup analysis, the adjusted OR for HZI was 0.91 (95% confidence interval [CI] = 0.83 -1.00) in the < 80 years old group, 0.88 (95% CI = 0.78 -1.00) in the ≥ 80 years old group, 0.77 (95% CI = 0.66-0.89) in men and 0.96 (95% CI = 0.88 -1.05) in women. Conclusions: We concluded that HZI does not increase the risk of neurodegenerative dementia in individuals of any age or of either sex.


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