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991.
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Objective

To describe the characteristics of primary care attendees with depressive symptoms who use mental health websites.

Methods

789 individuals with depressive symptoms recruited and followed up annually for nine years. Self-reported written surveys included mental health, professional and self-help use, e-mental health interventions or therapeutic websites. Marginal logistic regression examined association between mental health website (MHW) use and patient’s mental health, health services use, anti-depressant use and self-help strategies.

Results

36% of participants used an MHW at least once. MHW users were more likely to be female, younger, highly educated and employed. MHW use increased with depressive symptom severity; reported in 16% of assessments when minimal symptoms were present and 28% when severe symptoms were present. MHW use was associated with: GP mental health visits, psychologist and psychiatrist visits and other self-help strategies including self-help books and telephone helplines.

Conclusion(s)

Mental health websites were more likely to be used by those with severe depressive symptoms rather than those with mild depression as recommended in current guidelines.

Practice implication(s)

Whilst mental health websites offer potential to support the high volume of people with mild depression new strategies may be required to ensure uptake.  相似文献   
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目的 采用血管内超声弹性成像技术评价斑块负荷(PB)与面积应变(AS)的关系。方法 对40只雄性纯种新西兰兔全程高脂饲料喂养。第2周末行腹主动脉球囊拉伤术。第12周末行腹主动脉血管内超声检查,对每只动物选择两个等回声斑块,采集不少于3个心动周期的原位血管内超声图像,选择舒张末期连续2帧原位图像,构建血管内超声弹性图。测量并计算血管外弹力膜面积(EEMarea)、血管腔面积(Lumenarea)、斑块面积(PA)、PB、血管外弹力膜体积(EEMvolume)、血管腔体积(Lumenvolume)、斑块体积(PV)、斑块体积负荷(PVB)、斑块最大厚度(Tmax)、斑块最小厚度(Tmin)、斑块偏心指数(EI)、血管重构指数(RI)及AS。根据PB不同,将斑块分为低负荷斑块组(PB≤40%)和高负荷斑块组(PB>40%),并对两组间以上参数的差异、斑块形态学和力学参数的关系等进行统计学分析。结果 两组的PA、PV、PB、PVB、Tmin、Tmax、Lumenarea、Lumenvolume、EI差异均有统计学意义(P均<0.01)。经逐步多元线性回归分析,回归方程为:Ŷ=-6.921+10.430X1+12.207X2Ŷ:AS;X1:EI;X2:PB;R2=0.272,P<0.001)。在矫正偏心指数对AS的影响后,低负荷斑块组的AS明显小于高负荷斑块组(P=0.010)。结论 动脉粥样硬化斑块的负荷对斑块力学稳定性有影响。高负荷斑块较低负荷斑块更易受损。  相似文献   
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Tissue axial strain estimation with ultrasound elastography has become a hot field in recent years. However, for keypoints tracking–based elastography algorithms, locating extrema in multimodal ultrasonic radiofrequency signals is still a challenging problem. In this paper, a new method is proposed to locate the local maxima and minima of the RF signals directly without derivation operation. This algorithm can accurately locate extrema even if disturbed peaks resulting from different noise exist. Furthermore, the new algorithm can speed up approximately 79% of the implementation process as compared with the standard cross‐correlation method on the same computing platform. In addition, the elastographic signal‐to‐noise ratio and the contrast‐to‐noise ratio are also significantly improved with this new method.  相似文献   
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利用斑点追踪技术得出的纵向应变可发现射血分数下降之前的心肌功能损伤,在预测主动脉瓣狭窄术后患者的死亡率及症状发展方面具有重要的临床应用价值。本文对目前应用纵向应变评估主动脉瓣狭窄置换术后患者心肌功能的现状作一综述。  相似文献   
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OBJECTIVE: The purpose of this study was to evaluate the technical feasibility of ultrasound-based elastography as a tool for assessing the size and shape of the coagulation necrosis caused by radio frequency ablation (RFA) probes using expandable electrodes ex vivo as well as in a patient with a liver metastasis. METHODS: A commercially available expandable RFA probe was used to create a 3-cm ablation in a piece of bovine liver. The ablation probe was used in situ to induce tissue deformation for elastography before and after ablation. Ultrasonic radio frequency data were processed to generate elasticity strain images. The appearance of the ablation zone was compared with magnetic resonance imaging and a gross section specimen. One patient with malignant metastatic disease to the liver and a clinical indication for RFA was investigated for the feasibility of percutaneous elastography of RFA using the same technique. Sonographic strain images were compared with the appearance of the nonenhancing ablation zone on contrast-enhanced computed tomography. RESULTS: Ex vivo, the ablation zone on ultrasound-based elastography was represented by an area of increased stiffness and was well demarcated from the nonablated surrounding tissue. The size and shape of the ablated zone on the strain image correlated well with the gross specimen and the magnetic resonance imaging appearance. Strain images obtained from the patient showed results similar to those of the ex vivo experiment and correlated well with the nonenhancing area of ablation on contrast-enhanced computed tomography. CONCLUSIONS: Ultrasound-based elastography may be a promising tool for displaying the ablation zone created by expandable RFA probes.  相似文献   
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