Facilitators and Challenges of Integrating Experts by Experience Activity in Mental Health Services: Experiences from Finland.

This qualitative study examines the facilitators and challenges of integrating Experts by Experience (EbyE) activity in mental health services in the public sector from the perspective of mental health professionals and trained EbyE. The research data consist of four focus group interviews conducted in one hospital district in Finland. In the hospital district, EbyE activity is an established working model in mental health services. The professional focus groups had 9, and the EbyE focus groups had 13 participants. The data were analysed using abductive content analysis. The experiences of professionals and EbyE emphasised the successful integration of EbyE activity. The identified facilitators of integration included an organisational culture that values EbyE activity, facilitating operating structures, and extensive implementation and utilization of EbyE activities. Despite successful integration, certain challenges were described with regard to actors and practices. The findings indicate that the hospital district has overcome many of the obstacles to the integration identified in previous studies. The findings highlight the role of effectively implemented, organised EbyE activity.

Mortality and causes of death among people suspected of driving under the influence and testing positive for multiple substances.

Aims: Understanding the mortality of drug users using multiple substances is helpful in preventing the harmful effects of polydrug use. We examined overall and cause-specific mortality and differences in mortality based on social background among people suspected of driving under the influence and testing positive for multiple substances (DUIMS) compared with the general Finnish population. Methods: Register data from 785 DUIMS during 2003-2006 were studied, with a reference population (n = 25,381) drawn from the general Finnish population. The effect of DUIMS on all-cause and cause-specific mortality was estimated using a Poisson regression model. Results: DUIMS had an increased risk of death compared with the general population (MRR 5.3, 95% CI 4.2-6.6). The most common causes of death in DUIMS were poisonings (37.9%) and suicides (13.6%), whereas in the reference population these were cardiovascular diseases (30.8%) and cancer (26.6%). The cause-specific risk of death among DUIMS was higher in all observed causes of death, except for cancer. The effect of DUIMS on mortality was modified by age, employment status and marital status; DUIMS was associated with an elevated risk of death especially in younger age groups and in singles. Conclusions: DUIMS indicates higher mortality, and DUIMS' profiles in causes of death differ from the general population. Elevated risk for, for instance, suicidal, accidental and violent death among those using multiple substances highlights the need to also pay attention to causes of death other than poisoning/overdose.

Combining Alcohol with Benzodiazepines or Psychostimulants. Metaphoric Meanings and the Concept of Control in the Online Talk of Polydrug Use.

The co-administration of different substances is a widespread practice in the context of hard drug use. Among others, alcohol combined with certain substances produces potentially dangerous interactions. This article explores how people who combine alcohol with benzodiazepines or psychostimulants perceive these practices and how they share their perceptions in Finnish and Swedish online discussions. This is carried out by analyzing discussants' use of metaphoric expressions. We found that the metaphors given to the use of these substance combinations reflect their pharmacological characteristics. Through that, the metaphors and meanings were different depending on the substance alcohol was combined with. Moreover, we found that, in the realities the metaphors create, the control of use was differently conceptualized. The different aspects of control could be divided into three categories that, however, were not related to any specific substances but overarched all metaphors: 1) controlling pharmacological risks, 2) controlling social appearance and 3) ignoring control. As our findings bring out, often the actual health dangers and risks of the studied substance combinations were bypassed, and the control was rather understood either as a form of socially appropriate behavior or wholly ignored.

Liquid chromatography-dopant-assisted atmospheric pressure photoionization-mass spectrometry: Application to the analysis of aldehydes in atmospheric aerosol particles.

A complete methodology based on LC-anisole-toluene dopant-assisted atmospheric pressure photoionization-IT-MS was developed for the determination of aldehydes in atmospheric aerosol particles. For the derivatization, ultrasound was used to accelerate the reaction between the target analytes and 2,4-dinitrophenylhydrazine. The developed methodology was validated for three different samples, gas phase, ultrafine (Dp = 30 ± 4 nm; where Dp stands for particle diameter) and all-sized particles, collected on Teflon filters. The method quantitation limits ranged from 5 to 227 pg. The accuracy and the potential matrix effects were evaluated using standard addition methodology. Recoveries ranged between 91.7 and 109.9%, and the repeatability and the reproducibility of the method developed between 0.5 and 8.0% and between 2.9 and 11.1%, respectively. The results obtained by the developed methodology compared to those provided by the previously validated method revealed no statistical differences. The method developed was applied to the determination of aldehydes in 16 atmospheric aerosol samples (30 nm and all-sized samples) collected at the Station for Measuring Forest Ecosystem-Atmosphere Relations II during spring 2011. The mean concentrations of aldehydes, and oxidation products of terpenes were between 0.05 and 82.70 ng/m(3).

Aliphatic and aromatic amines in atmospheric aerosol particles: comparison of three ionization techniques in liquid chromatography-mass spectrometry and method development.

A complete methodology was developed for the determination of ten aliphatic and nine aromatic amines in atmospheric aerosol particles. Before the liquid chromatography - tandem mass spectrometric separation and determination, the derivatization reaction of the analytes using dansyl chloride was accelerated by ultrasounds. From three different ionization techniques studied electrospray ionization was superior in terms of sensitivity, linearity, repeatability and reproducibility over atmospheric pressure chemical ionization and photoionization for the target analytes. The method developed was validated for the gas phase, 30 nm and total suspended atmospheric aerosol particles. The method quantification limits ranged between 1.8 and 71.7 pg. The accuracy and the potential matrix effects were evaluated using a standard addition methodology. Recoveries from 92.1% to 109.1%, the repeatability from 0.6% to 8.4% and the reproducibility from 2.3% to 9.8% were obtained. The reliability of the methodology was proved by the statistical evaluation. Finally, the developed methodology was applied to the determination of the target analytes in eight size separated ultrafine particulate (Dp=30±4 nm) samples and in eight total suspended particulate samples collected at the SMEAR II station. The mean concentrations for aliphatic amines were between 0.01 and 42.67 ng m(-3) and for aromatic amines between 0.02 and 1.70 ng m(-3). Thirteen amines were quantified for the first time in 30 nm aerosol particles.