Quality of life in caregivers of a family member with serious mental illness: Evidence from China

Purpose

To evaluate the quality of life (QoL) and social support among family caregivers of a family member with a mental illness and to identify factors associated with the QoL.

基于真实世界数据挖掘探索新型冠状病毒肺炎危重型患者的证素分布和组方规律＊

目的 基于真实世界临床数据探索新型冠状病毒肺炎危重型患者中医证素分布特点及中药组方规律。方法 系统收集2019年12月至2020年3月武汉市中西医结合医院收治住院的新型冠状病毒肺炎危重型患者的住院数据，采用专业数据收集工具建立数据库，采用IBM SPSS Modeler 14.1 Premium 软件对中医证素信息和处方用药信息进行统计分析。结果 共纳入40例患者193次的中医诊疗信息，方剂193首，中草药种类为181味；其中病位证素信息10个，前3位分别是肺（33.81%）、脾（33.09%）、肾（12.23%）；病性证素信息12个，前5位的分别是湿（24.27%）、痰（14.81%）、阴虚（14.08%）、气虚（12.86%）、阳虚（9.22%）；用药频次最多的前5位分别是甘草（60.52%）、茯苓（44.04%）、白术（33.68%）、半夏（29.02%）、厚朴（25.91%）；中草药关联分析前5名分别是茯苓—黄芪—半夏、厚朴—草果仁、厚朴—槟榔、黄芪—党参—半夏、茯苓—党参—半夏；核心处方挖掘中所获得的4个处方分别是藿香—党参—五味子—陈皮—草果仁、藿香—附子—半夏、茯苓—半夏、黄芪-干姜。结论 新型冠状病毒肺炎危重型患者的病位多位于肺、脾、肾三脏，而病性多以湿、痰、阴虚、气虚、阳虚为主，中药治疗中健脾、祛湿、化痰是治疗危重型患者的基本用药原则，医师需根据临床表现配伍益气、养阴、温阳、行气等药物。     

Patterns and Predictors of Reincarceration among Prisoners with Serious Mental Illness: A Cohort Study: Modèles et prédicteurs de réincarcération chez les prisonniers souffrant de maladie mentale grave : Une étude de cohorte

Background:A small proportion of people who have serious mental illness and rapid and frequent incarcerations account for a disproportionate amount of overall service use and cost. It is important to describe such individuals, so that services can respond more effectively.Methods:We investigated a cohort of 4,704 incarcerated men and women who were discharged from a correctional mental health service and followed for a median of 535 days. We investigated social, clinical, demographic, and offense characteristics as predictors of return to the service using Cox survival analyses. Secondly, we characterized individuals as high-frequency service users as those who had 3 or more incarcerations during a 1-year period and investigated their characteristics.Results:We found that a higher rate of return to custody was associated with schizophrenia spectrum/bipolar affective disorder (BPAD), personality disorder traits, crack cocaine and methamphetamine use, and unstable housing. Charges of theft/robbery and breach of probation were also positively associated, and sex assault was negatively associated with return to custody. Within a 1-year time period, we found 7.2% of individuals were high-frequency service users, which accounted for 19.5% of all reincarcerations.Conclusion:Identification of the characteristics of those with mental illness in custody, especially those who have high-frequency returns to custody, may provide opportunity to target resources more effectively. The primary targets of intervention would be to treat those with schizophrenia/BPAD and substance use problems, particularly those using stimulants, and addressing homelessness. This could reduce the problem of repeated criminalization of the mentally ill and reduce the overall incarceration rate.     

Clinical outcomes of bypass-first versus endovascular-first strategy in patients with chronic limb-threatening ischemia due to infrageniculate arterial disease

Background

Chronic limb-threatening ischemia (CLTI), defined as ischemic rest pain or tissue loss secondary to arterial insufficiency, is caused by multilevel arterial disease with frequent, severe infrageniculate disease. The rise in CLTI is in part the result of increasing worldwide prevalence of diabetes, renal insufficiency, and advanced aging of the population. The aim of this study was to compare a bypass-first with an endovascular-first revascularization strategy in patients with CLTI due to infrageniculate arterial disease.