Perceptions of positive treatment and discrimination towards people with mental health problems:findings from the 2017 Attitudes to Mental Illness survey

Anti-stigma programme evaluations primarily measure knowledge and attitudes, and rarely assess behaviour. This study describes perceived and self-reported avoidance, discrimination and positive treatment using data from the 2017 Attitudes to Mental Illness survey. A nationally representative quota sample of 1720 English participants were interviewed about mental health-related knowledge and attitudes, reported and intended contact with people with mental health problems, awareness of the Time to Change anti-stigma programme and knowledge of anyone with a mental health problem. Participants who knew someone were asked how they thought the person was treated in different life areas, and whether they had avoided the person, treated them unfairly or treated them more positively. 30.1% of respondents knew someone with a mental health problem. Most believed the person had been treated fairly across various life domains. 5.1% of participants reported avoiding the person, 2.1% reported unfair treatment, and 58.1% reported positive treatment. Less stigmatising attitudes were associated with reduced avoidance and discrimination. Greater knowledge and reported contact were associated with positive treatment. Anti-stigma campaigns can reduce discrimination or increase positive treatment by targeting knowledge, attitudes and awareness of people with mental health problems. Evaluations should measure discrimination and positive treatment to fully assess behavioural change.</p

The successes and challenges of harmonising juvenile idiopathic arthritis (JIA) datasets to create a large-scale JIA data resource

Background CLUSTER is a UK consortium focussed on precision medicine research in JIA/JIA-Uveitis. As part of this programme, a large-scale JIA data resource was created by harmonizing and pooling existing real-world studies. Here we present challenges and progress towards creation of this unique large JIA dataset. Methods Four real-world studies contributed data; two clinical datasets of JIA patients starting first-line methotrexate (MTX) or tumour necrosis factor inhibitors (TNFi) were created. Variables were selected based on a previously developed core dataset, and encrypted NHS numbers were used to identify children contributing similar data across multiple studies. Results Of 7013 records (from 5435 individuals), 2882 (1304 individuals) represented the same child across studies. The final datasets contain 2899 (MTX) and 2401 (TNFi) unique patients; 1018 are in both datasets. Missingness ranged from 10 to 60% and was not improved through harmonisation. Conclusions Combining data across studies has achieved dataset sizes rarely seen in JIA, invaluable to progressing research. Losing variable specificity and missingness, and their impact on future analyses requires further consideration

Genetic correlates of phenotypic heterogeneity in autism

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Improved antibody breadth with an extended primary dose interval of COVID-19 vaccine is overcome by boosters

IntroductionDuring rollout of mRNA-based COVID-19 vaccines, several jurisdictions extended the interval between the first and second doses to prioritize wider population access to limited vaccine supply. This study evaluated the effects of an extended dose interval on development of antibody and cell-mediated responses following the primary dose series and a subsequent booster dose.MethodsBlood samples were collected from mRNA COVID-19 vaccine recipients at baseline and longitudinally after each dose. Samples were analyzed for SARS-CoV-2-specific antibody titers, neutralizing antibodies and memory T cell responses.ResultsAn extended dose interval was associated with improved breadth of neutralizing antibody responses against both ancestral and early SARS-CoV-2 variants, but not Omicron variants. Dose interval had no impact on the development of antigen-specific memory T cell responses, the memory or T helper phenotypes of responding T cells or cytokine production. The effects of the primary dose interval on immune outcomes were no longer evident after a third dose of mRNA vaccine.DiscussionAn extended primary dose interval resulted in short-term benefits to humoral immunity but these were transient in the context of subsequent exposures. However, in addition to the public health benefits of wider population access to vaccines, the short-term immunological benefits of extending the dose interval may have been sustained in the absence of boosters. These findings underscore the importance of evaluating dosing intervals during the development of future vaccine candidates

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Validation and Establishment of the SARS-CoV-2 Lentivirus Surrogate Neutralization Assay as a Prescreening Tool for the Plaque Reduction Neutralization Test

Neutralization studies play an important role in providing guidance and justification for vaccine administration and helping prevent the spread of diseases. The neutralization data generated in our laboratory have been included in the decision-making process of the National Advisory Committee on Immunization (NACI) in Canada.</jats:p