The epidemiology of excess mortality in people with mental illness

Objective: To investigate the burden of excess mortality among people with mental illness in developed countries, how it is distributed, and whether it has changed over time. Method: We conducted a systematic search of MEDLINE, restricting our attention to peer-reviewed studies and reviews published in English relating to mortality and mental illness. Because of the large number of studies that have been undertaken during the last 30 years, we have selected a representative cross-section of studies for inclusion in our review. Results: There is substantial excess mortality in people with mental illness for almost all psychiatric disorders and all main causes of death. Consistently elevated rates have been observed across settings and over time. The highest numbers of excess deaths are due to cardiovascular and respiratory diseases. With life expectancy increasing in the general population, the disparity in mortality outcomes for people with mental illness is increasing. Conclusions: Without the development of alternative approaches to promoting and treating the physical health of people with mental illness, it is possible that the disparity in mortality outcomes will persist

The Harish-Chandra isomorphism for reductive symmetric superpairs

We consider symmetric pairs of Lie superalgebras which are strongly reductive and of even type, and introduce a graded Harish-Chandra homomorphism. We prove that its image is a certain explicit filtered subalgebra of the Weyl invariants on a Cartan subspace whose associated graded is the image of Chevalley's restriction map on symmetric invariants. This generalises results of Harish-Chandra and V. Kac, M. Gorelik.Comment: 43 pages; v2: substantially improved versio

Action-angle variables for dihedral systems on the circle

A nonrelativistic particle on a circle and subject to a cos^{-2}(k phi) potential is related to the two-dimensional (dihedral) Coxeter system I_2(k), for k in N. For such `dihedral systems' we construct the action-angle variables and establish a local equivalence with a free particle on the circle. We perform the quantization of these systems in the action-angle variables and discuss the supersymmetric extension of this procedure. By allowing radial motion one obtains related two-dimensional systems, including A_2, BC_2 and G_2 three-particle rational Calogero models on R, which we also analyze.Comment: 8 pages; v2: references added, typos fixed, version for PL

All Stable Characteristic Classes of Homological Vector Fields

An odd vector field $Q$ on a supermanifold $M$ is called homological, if $Q^2=0$. The operator of Lie derivative $L_Q$ makes the algebra of smooth tensor fields on $M$ into a differential tensor algebra. In this paper, we give a complete classification of certain invariants of homological vector fields called characteristic classes. These take values in the cohomology of the operator $L_Q$ and are represented by $Q$-invariant tensors made up of the homological vector field and a symmetric connection on $M$ by means of tensor operations.Comment: 17 pages, references and comments adde

Even and odd symplectic and K\"ahlerian structures on projective superspaces

Supergeneralization of \DC P(N) provided by even and odd K\"ahlerian structures from Hamiltonian reduction are construct.Operator $\Delta$ which used in Batalin-- Vilkovisky quantization formalism and mechanics which are bi-Hamiltonian under corresponding even and odd Poisson brackets are considered.Comment: 19 page

Patient blood management in Europe

Preoperative anaemia is common in patients undergoing orthopaedic and other major surgery. Anaemia is associated with increased risks of postoperative mortality and morbidity, infectious complications, prolonged hospitalization, and a greater likelihood of allogeneic red blood cell (RBC) transfusion. Evidence of the clinical and economic disadvantages of RBC transfusion in treating perioperative anaemia has prompted recommendations for its restriction and a growing interest in approaches that rely on patients' own (rather than donor) blood. These approaches are collectively termed ‘patient blood management' (PBM). PBM involves the use of multidisciplinary, multimodal, individualized strategies to minimize RBC transfusion with the ultimate goal of improving patient outcomes. PBM relies on approaches (pillars) that detect and treat perioperative anaemia and reduce surgical blood loss and perioperative coagulopathy to harness and optimize physiological tolerance of anaemia. After the recent resolution 63.12 of the World Health Assembly, the implementation of PBM is encouraged in all WHO member states. This new standard of care is now established in some centres in the USA and Austria, in Western Australia, and nationally in the Netherlands. However, there is a pressing need for European healthcare providers to integrate PBM strategies into routine care for patients undergoing orthopaedic and other types of surgery in order to reduce the use of unnecessary transfusions and improve the quality of care. After reviewing current PBM practices in Europe, this article offers recommendations supporting its wider implementation, focusing on anaemia management, the first of the three pillars of PB

Patient Blood Management Bundles to Facilitate Implementation.

More than 30% of the world's population are anemic with serious economic consequences including reduced work capacity and other obstacles to national welfare and development. Red blood cell transfusion is the mainstay to correct anemia, but it is also 1 of the top 5 overused procedures. Patient blood management (PBM) is a proactive, patient-centered, and multidisciplinary approach to manage anemia, optimize hemostasis, minimize iatrogenic blood loss, and harness tolerance to anemia. Although the World Health Organization has endorsed PBM in 2010, many hospitals still seek guidance with the implementation of PBM in clinical routine. Given the use of proven change management principles, we propose simple, cost-effective measures enabling any hospital to reduce both anemia and red blood cell transfusions in surgical and medical patients. This article provides comprehensive bundles of PBM components encompassing 107 different PBM measures, divided into 6 bundle blocks acting as a working template to develop institutions' individual PBM practices for hospitals beginning a program or trying to improve an already existing program. A stepwise selection of the most feasible measures will facilitate the implementation of PBM. In this manner, PBM represents a new quality and safety standard

College Student Athletes and Psychological Well-being in Retirement

The purpose of this study was to investigate college student athletes' psychological health and well-being in the months immediately following graduation/retirement, which has been indicated as a critical time period. Participants consisted of collegiate athletes (N = 166; women = 138, men = 28; Mage = 21.84 years, SD = 0.86) who were surveyed at the end of their competitive seasons when they were graduating and retiring from their sports (Time 1) and 3 to 4 months later (Time 2). Athletes completed measures of readiness to graduate/retire, depression, body satisfaction, and satisfaction with life at Time 1; they completed the measures of psychological well-being at Time 2. Bivariate correlations revealed six dimensions of retirement readiness related to outcomes at Time 2: seeing self as more than an athlete, maintaining social support, neglecting other areas of life, achieving sport goals, utilizing sport career services and developing a new focus after retirement. Through a series of hierarchical regression analyses, one of reach psychological well-being outcome, I entered the Time 1 measure and gender in Step 1 and then the correlated dimensions for that outcome at Step 2. For body satisfaction, F(5, 160) = 27.281, p < .000, adj. R2 = .443, only Time 1 Body Satisfaction was a significant predictor (β = .639). For depressive symptoms, F(5, 160) = 17.110, p < .000, adj. R2 = .328, Time 1 depression (β = .462) predicted higher levels whereas developing a new focus upon ending career their sport career predicted less depression at Time 2 (β = -.161). Finally, for satisfaction with life, F(7, 158) = 18.336, p < .000, adj. R2 = .424, being male (β = -.165), being more satisfied with one's life at Time 1 (β = .436), maintaining social support networks (β = .199), and having a new focus upon ending sport careers (β = .140) predicted more life satisfaction at Time 2. Although no dimensions were significantly related to higher body satisfaction, a new focus after retirement and social support were essential in understanding the athletes' satisfaction with life and depressive symptoms three to four months post retirement. Future research may continue to apply longitudinal methods to follow the retirement process up to six months to a year, explore gender, race, and NCAA Division differences, identify what is incorporated in an athlete's new focus or examine other dimensions of body image that may better represent it during retirement. Universities may look to implement career assistance programs focusing on these psychosocial factors to prepare athletes for their retirement experiences