bluuebunny/crossref_metadata_2025 huggingface dataset:
In-Situ Observation of Transition Between Surface Relief and Wrinkling in Thin Film Shape Memory Alloys
Authors: Fu Y. Q. , Sanjabi S. , Barber Z. H. , Huang W. M. , Cai M. , Zhang S. , Luo J. K. , Flewitt A. J. , Milne W. I.
Published: May 2008

Significant surface morphology evolution between relief and wrinkling was observed on a 3.5 μm thick TiNiCu film sputter-deposited on a silicon substrate. At room temperature, variation in surface relief morphology (from separated martensite crystals embedded in amorphous
matrix to fully inter-weaved martensite plates) was observed with slight change in film composition. The phenomenon was attributed to variations in crystallization temperatures of as-deposited amorphous films during annealing because of the compositional difference. During thermal cycling
between room temperature and 100 °C, reversible surface morphology changes can be observed between surface relief and wrinkling patterns. The formation of the surface wrinkling is attributed to the large compressive stress in the film during high temperature post-annealing and crystallization,
whereas surface relief is caused by the martensitic transformation to relieve the large tensile stress in the film. Compositional effect on this surface morphology evolution is discussed. Results also indicate that there is a critical dimension for the wrinkling to occur, and a small circular
island can only relax by in-plane expansion.
Genomic imprinting of IGF2 in marsupials is methylation dependent
Authors: Lawton Betty R , Carone Benjamin R , Obergfell Craig J , Ferreri Gianni C , Gondolphi Christina M , VandeBerg John L , Imumorin Ikhide , O'Neill Rachel J , O'Neill Michael J
Published: May 2008

Background-

Parent-specific methylation of specific CpG residues is critical to imprinting in eutherian mammals, but its importance to imprinting in marsupials and, thus, the evolutionary origins of the imprinting mechanism have been the subject of controversy. This has been particularly true for the imprinted Insulin-like Growth Factor II (IGF2), a key regulator of embryonic growth in vertebrates and a focal point of the selective forces leading to genomic imprinting. The presence of the essential imprinting effector, DNMT3L, in marsupial genomes and the demonstration of a differentially methylated region (DMR) in the retrotransposon-derived imprinted gene, PEG10, in tammar wallaby argue for a role for methylation in imprinting, but several studies have found no evidence of parent-specific methylation at other imprinted loci in marsupials.

Results-

We performed the most extensive search to date for allele-specific patterns of CpG methylation within CpG isochores or CpG enriched segments across a 22 kilobase region surrounding the IGF2 gene in the South American opossum Monodelphis domestica. We identified a previously unknown 5'-untranslated exon for opossum IGF2, which is flanked by sequences defining a putative neonatal promoter, a DMR and an active Matrix Attachment Region (MAR). Demethylation of this DMR in opossum neonatal fibroblasts results in abherrant biallelic expression of IGF2.

Conclusion-

The demonstration of a DMR and an active MAR in the 5' flank of opossum IGF2 mirrors the regulatory features of the 5' flank of Igf2 in mice. However, demethylation induced activation of the maternal allele of IGF2 in opossum differs from the demethylation induced repression of the paternal Igf2 allele in mice. While it can now be concluded that parent-specific DNA methylation is an epigentic mark common to Marsupialia and Eutheria, the molecular mechanisms of transcriptional silencing at imprinted loci have clearly evolved along independent trajectories.
Characterization of CD4+CD25+ natural regulatory T cells in the inflammatory infiltrate of human chronic periodontitis
Authors: Cardoso Cristina Ribeiro , Garlet Gustavo Pompermaier , Moreira Ana Paula , Júnior Wálter Martins , Rossi Marcos Antônio , Silva João Santana
Published: May 2008

Periodontitis is an infectious disease, where putative periodontopathogens trigger chronic inflammatory and immune responses against periodontal structures, in which an unbalanced host response is also determinant to the disease outcome. It is reasonable to assume that patient susceptibility to periodontal tissue destruction could be determined by the balance between the response against periodontopathogens and regulatory mechanisms of these events mediated by suppressive T cells. In the present study, we identified and characterized natural regulatory T cells (Tregs) in the inflammatory infiltrate of human chronic periodontitis (CP) with emphasis on phenotypic analyses that were carried out to address the participation of Tregs in CP. Results showed that patients with CP presented increased frequency of T lymphocytes and CD4+CD25+ T cells in the inflammatory infiltrate of gingival tissues. These cells exhibited the phenotypic markers of Tregs such as forkhead box p3 (Foxp3), CTLA-4, glucocorticoid-inducible TNFR, CD103, and CD45RO and seemed to be attracted to the inflammation site by the chemokines CCL17 and CCL22, as their expression and its receptor CCR4 were increased in CP patients. Moreover, besides the increased detection of Foxp3 mRNA, diseased tissues presented high expression of the regulatory cytokines IL-10 and TGF-β. In addition, the inflammatory infiltrate in CP biopsies was composed of CD25+Foxp3+ and CD25+TGF-β+ cells, thus corroborating the hypothesis of the involvement of Tregs in the pathogenesis of CP. Finally, these results indicate that Tregs are found in the chronic lesions and must be involved in the modulation of local immune response in CP patients.
Human recombinant heat shock protein 70 affects the maturation pathways of dendritic cells in vitro and has an in vivo adjuvant activity
Authors: Valentinis Barbara , Capobianco Annalisa , Esposito Francesca , Bianchi Alessandro , Rovere-Querini Patrizia , Manfredi Angelo A , Traversari Catia
Published: May 2008

Heat shock proteins (HSPs) are potent inducers of an antigen-specific immunological response. A role of chaperon of immunogenic peptides and a direct effect on APC activation and function have been described. However, the signal transduction events involved in the activation of human APCs are poorly characterized. We investigated, using human monocyte-derived dendritic cells (DCs), the signal transduction pathways activated by a human recombinant HSP70 (r)HSP70 purified from eukaryotic cells. rHSP70 effectively induced a partial maturation of DCs in vitro and a significant increase in the titers of antigen-specific IgG when used as a vaccine adjuvant in vivo. rHSP70 did not desensitize human DCs to LPS stimulation and retained its adjuvant properties in C3H/HeJ mice, which are LPS-resistant as a result of a mutation in TLR-4, ruling out the potential interference of LPS contamination. Effects on DC maturation and in vivo functions correlate to the ability of rHSP70 to activate IκB-α/NF-κB and ERK1/2 pathways in human DCs. No activation of p38 was induced in the same experimental conditions. Our data suggest that the IκB-α/NF-κB pathway has a critical role in the partial maturation of DCs induced by rHSP70.
Using HEM surveys to evaluate disposal of by-product water from CBNG development in the Powder River Basin, Wyoming
Authors: Lipinski Brian A. , Sams James I. , Smith Bruce D. , Harbert William
Published: May 2008

Production of methane from thick, extensive coal beds in the Powder River Basin of Wyoming has created water management issues. Since development began in 1997, more than 650 billion liters of water have been produced from approximately 22,000 wells. Infiltration impoundments are used widely to dispose of by-product water from coal bed natural gas (CBNG) production, but their hydrogeologic effects are poorly understood. Helicopter electromagnetic surveys (HEM) were completed in July 2003 and July 2004 to characterize the hydrogeology of an alluvial aquifer along the Powder River. The aquifer is receiving CBNG produced water discharge from infiltration impoundments. HEM data were subjected to Occam’s inversion algorithms to determine the aquifer bulk conductivity, which was then correlated towater salinity using site-specific sampling results. The HEM data provided high-resolution images of salinity levels in the aquifer, a result not attainable using traditional sampling methods. Interpretation of these images reveals clearly the produced water influence on aquifer water quality. Potential shortfalls to this method occur where there is no significant contrast in aquifer salinity and infiltrating produced water salinity and where there might be significant changes in aquifer lithology. Despite these limitations, airborne geophysical methods can provide a broadscale (watershed-scale) tool to evaluate CBNG water disposal, especially in areas where field-based investigations are logistically prohibitive. This research has implications for design and location strategies of future CBNG water surface disposal facilities within the Powder River Basin.
Incorporating topography into 2D resistivity modeling using finite-element and finite-difference approaches
Authors: Erdoğan Erhan , Demirci Ismail , Candansayar Mehmet Emin
Published: May 2008

We incorporate topography into the 2D resistivity forward solution by using the finite-difference (FD) and finite-element (FE) numerical-solution methods. To achieve this, we develop a new algorithm that solves Poisson’s equation using the FE and FD approaches. We simulate topographic effects in the modeling algorithm using three FE approaches and two alternative FD approaches in which the air portion of the mesh is represented by very resistive cells. In both methods, we use rectangular and triangular discretization. Furthermore, we account for topographic effects by distorting the FE mesh with respect to the topography. We compare all methods for accuracy and calculation time on models with varying surface geometry and resistivity distributions. Comparisons show that model responses are similar when high-resistivity values are assigned to the top half of the rectangular cells at the air/earth boundary with the FE and FD methods and when the FE mesh is distorted. This result supports the idea that topographic effects can be incorporated into the forward solution by using the FD method; in some cases, this method also shortens calculation times. Additionally, this study shows that an FD solution with triangular discretization can be used successfully to calculate 2D DC-resistivity forward solutions.
Recognition of Psychiatric Tutors and others Concerned with the Provision of Postgraduate Psychiatric Education and Training
Authors: Rawnsley Ken , Smith E. B. O.
Published: May 2008

In response to a widespread demand within the College, Council has approved a scheme for granting formal recognition to individuals appointed as Psychiatric Tutors, Specialty Tutors and Organizers in the field of postgraduate education. The College is not concerned in the creation of such posts or in the appointment of individuals to them but in making the tutors' position more formal by providing criteria for their recognition and establishing standards by which they are chosen, and in doing this in a way that will be both acceptable to and welcomed by Universities, Postgraduate Committees, Health Authorities and other appointing bodies.
Reflections On Training in Psychotherapy: A Personal View
Authors: Malcolm Margaret R.
Published: May 2008

The object of this paper is to set out some of the difficulties experienced in early training in Psychotherapy.
How Anorexics See Themselves
Authors: Button Eric
Published: May 2008

The tendency of anorexic patients to overestimate their own body size was one element of Bruch's (1962) concept of body image disorder. The first experimental validation of this tendency was reported by Slade and Russell (1973), who also demonstrated that overestimation was directly related to a poor prognosis and that patients tended to become more accurate with therapeutically induced weight gain.
Acute Psychotic Reactions in Immigrants
Authors: Littlewood Roland , Lipsedge Maurice
Published: May 2008

Studies of West Indian and West African immigrants have consistently shown high rates of diagnosed schizophrenia, although they differ in the extent to which the illness is seen as atypical. A retrospective examination of hospital notes at an East London Psychiatric Unit showed that although total admissions were similar in different ethnic groups there was an excess of schizophrenia in Caribbean and West African migrants similar to that found previously. These patients also showed an increase in two pathoplastic features, religious and paranoid flavour and an increased proportion of women, formal admissions and short admissions.
The Eeg in Antisocial Behaviour: A Study of Borstal Boys
Authors: Fenton G. W. , Fenwick P. B. C. , Dollimore J. , Foggitt R. , Nichol R.
Published: May 2008

A sample of borstal boys was selected (56). All had an assessment of mental state and ratings of sociopathy and aggressiveness performed, using structured interview techniques. A group of RAMC apprentices matched for age, sex and social class, was also examined (56). Eight-channel bipolar scalp EEG recordings were taken, 4 channels (T4–T6, P4–O2, T3–T5, P3–O1) being recorded on analogue tape. The tape-recorded signals were filtered off line through a low pass filter, multiplexed and digitized on to magnetic tape. Power spectral analysis was carried out on this data, using the University of London CDC 60 600 computer. Three 30-second epochs were analysed: eyes closed, eyes open, and eyes closed. No significant EEG differences were found between the borstal boys and the control sample. Neither visual inspection nor power spectral analysis revealed any EEG differences between the borstal boys and controls. Correlation coefficients between the power at each frequency from all four channels, the violence and sociopathy ratings and the time spent in institutional care in months for each boy were computed. These showed that violence contributes not more than 1 per cent and sociopathy not more than 5 per cent to the variance of the EEG power. Duration of stay in the institution accounted for as much as 20 per cent of the variance of the EEG power with significant correlations at 7 Hz (positive) and 11 Hz (negative). Duration of stay is thus a variable that must be controlled for during the investigation of subjects in penal institutions and long-stay hospitals.
An English Psychiatrist in Ontario
Authors: Crammer J. L.
Published: May 2008

After 30 years of psychiatry in England I've just had a cold plunge through Canadian psychiatry as a staffman in an Ontario general hospital. Because science is international and a good many British psychiatrists work in Canada I expected clinical practice to be the same: but psychiatry is different on the two sides of the Atlantic. Before my raw, insistent perceptions of these differences fade, as they do so quickly when one adapts to a new life, I will write some of them down. However faulty they form a rough mirror in which we can all examine our own professional faces.
The Role of the Consultant Psychiatrist in Mental Handicap: A Personal View
Authors: Marriott Caroline
Published: May 2008

Since taking the decision to pursue a career in mental handicap, I have been increasingly aware of the debate surrounding the role of the consultant psychiatrist in this field. Nowhere else in medicine does there seem to be such uncertainty about the continued need for an already established specialty. I believe that one of the major reasons for the continued difficulty in attracting trainees into mental handicap is precisely this uncertainty about its future, which is in no way ameliorated by the College's view that a full time specialist appointment in the psychiatry of mental handicap is not superior to a joint appointment either with adult or child psychiatry.1
Psychiatry in Contemporary Iran: a Survey of Views and Practices of a Group of Iranian Psychiatrists
Authors: Mehryar A. H. , Muharreri M. R. , Nouri K. , Khajavi F.
Published: May 2008

Psychiatry has a long past but a short history in Iran. References to causes and treatment of mental disorders can be found in parts of the Avesta, the holy book of pre-Islamic Iranians. Early muslim physicians like Tabari, Majusi, Razi and Ibn Sina, who were mostly born and brought up in Iran, have devoted long sections of their books to a discussion of mental disorders under the general title of ‘the diseases of the head and the brain’. In fact, the oldest medical textbook in modern Persian—which was completed around 970 A.D.—was written by a practising physician who claims to have been known as a ‘doctor of the insane’ by his contemporaries.
The Sheffield Cognitive Psychotherapy Training Course
Authors: Macaskill N. D.
Published: May 2008

This paper describes a basic training course in cognitive therapy for trainee psychiatrists on the Sheffield rotational scheme. Cognitive therapy, as represented by the work of Beck and Ellis, has emerged over the past decade as a potent therapeutic tool, particularly in the treatment of depression. It is a structured, directive, short-term therapy aimed at eliciting and modifying the dysfunctional cognitions which are hypothesised to play a central role in initiating and maintaining emotional disorders.
The Premenstrual Syndrome
Authors: Sampson Gwyneth A.
Published: May 2008

A conference on the premenstrual syndrome (PMS) was held in September 1984 in Philadelphia, USA, jointly supported by the Ethics and Values in Science and Technology (EVIST) Section of the National Science Foundation, and by a grant from the National Endowment for the Humanities (USA). Twenty-two international research workers in the area of PMS met for a week's closed workshop discussing the scientific, legal and ethical issues raised by the present attention being given to the syndrome. PMS is now popular in the USA, with many private clinics and programmes being developed. Ten of the twenty-two invited participants were from medicine (six of these were psychiatrists, two general practitioners and four gynaecologists); the remainder were sociologists, anthropologists, lawyers, physiologists, philosophers, behavioural geneticists, psychologists, social workers, criminologists and bioethicists—an indicator of the diversity of the effects of and research into premenstrual syndrome. There were three UK participants—a general practitioner, a gynaecologist, and a psychiatrist. As the UK psychiatrist I felt that two in particular of the concensus opinions reached by such a diverse group would be of interest to readers of the Bulletin.
Who Wears the Chains Now
Authors: Thomas Chris
Published: May 2008

In 1793 Pinel started the move towards modern psychiatry by removing the chains from patients at the Bicetre Psychiatric Asylum. In 1986 the Mental Health Commission through their draft Code of Practice (COP) are metaphorically attempting to place those chains upon the professionals whose job it is to treat psychiatric disorder. Psychiatry will not benefit by having either the patients or the carers chained. I feel that if the COP in its current form is accepted, then it is likely in the long-term to lead to a deterioration of services for the mentally ill and we should ensure through the Royal College that we are not forced into accepting proposals from people who are in a worse position than ourselves to determine what is best for our patients.
Practical Management: Impotence
Authors: Goodman Raymond E.
Published: May 2008

At the initial interview the doctor should assess just what the patient means by ‘impotence’. If present, its speed of onset, its duration and whether or not the patient has libido are important factors to consider. Do morning erections occur? Is ejaculation normal? It may be retrograde, premature or retarded. The presence of chronic disease, e.g. rheumatoid arthritis, hypertension, diabetes or depressive illness, may adversely affect potency, as may the drugs used in the treatment of these conditions.
A Counselling Centre and a Psychiatric Out-patient Clinic
Authors: Caccia Jennifer , Watson J. P.
Published: May 2008

This paper gives information about people attending a counselling centre and a psychiatric out-patient clinic in London. Data were collected in order to clarify the extent to which the counselling centre deals with people with significant psychiatric morbidity, rather than people with distress and life problems not amounting to illness; and also to define groups in society currently using the counselling services, by systematically recording socio-demographic information about them.
Institutional Care for Patients with Huntington's Chorea
Authors: Barczak Paul , Pedler Ann , Hunter Sarah , Betts Tim
Published: May 2008

Despite recent advances in the understanding of Huntington's Chorea, treatment remains, at best, symptomatic and many sufferers end their days in institutional care. A recent survey established the prevalence of Huntington's Chorea in South Wales as 7·65 per 100,000. From this figure, 4,000 or more sufferers of this condition are living in the United Kingdom at present of whom 20% are in hospital or other institutional care. Although some studies have looked in passing at the degree of disability of Huntington's Chorea sufferers in hospital and found it to be considerable, staff and relatives often feel that long stay psychiatric wards are inappropriate or unnecessarily restrictive settings for these patients. This study looks at the disability of Huntington's Chorea sufferers in hospital and other institutions in order to determine the suitability of their placement and to see whether their physical and psychological needs are being met.
Course in Psychiatry for Family Doctors
Authors: Creed Francis
Published: May 2008

This course was organised so that future general practitioners might learn those aspects of psychiatry which are relevant to their future work. It has been recognised that six months working in a mental hospital is only helpful to the future GP in terms of assessment and treatment of severe psychiatric illness of which the general practitioner sees relatively little. The vast majority of psychiatric illness seen by a general practitioner in his day-to-day work is not represented at all in an in-patient psychiatric unit.
Jack Morrison White, formerly Consultant Psychiatrist, Stanley Royd Hospital, Wakefield
Authors: JSH
Published: May 2008

Dr J. M. White, for many years consultant psychiatrist at Stanley Royd Hospital, Wakefield, and St James's Hospital, Leeds, died recently.
The Freud Museum
Authors: Fahy Thomas
Published: May 2008

Sigmund Freud spent the last year of his life at 20 Maresfield Gardens, an impressive redbrick Hampstead residence. The house was bought by his friends after the penniless psychoanalyst and his family fled from Vienna in 1938. His personal assets had been extorted from him by the authorities following the Anschluss of Austria to the Third Reich. When the family took up residence, Freud's daughter, Anna, organised his new study to resemble his Viennese consulting rooms. Before her own death in 1982, Anna arranged for the house to become a museum in honour of her father. Once again the study was refashioned to Freud's original specifications. This time capsule was opened to the public in July 1986.
How should you organise an exam workshop?
Authors: Lynch S. P. J.
Published: May 2008

For several years members of the University Department of Psychiatry and post-membership trainees have organised an informal exam workshop for the final part of the Membership examination of the Royal College of Psychiatrists. This is in addition to existing postgraduate courses in the Region. The workshop concentrates on examination technique rather than on teaching the basic knowledge required. Trainees from within the Mersey Region due to sit the June or November sittings of the final MRCPsych are invited to attend by formal and informal means and the workshop is currently held on a weekly basis over six weeks. According to guidelines laid down by the College, the majority of trainees have access to postgraduate training at a university department of psychiatry; usually by day-release courses. However, these vary widely in their immediate relevance to the Membership examination; and the amount of experience in examination technique. Consequently, several residential pre-examination training courses and workshops that give this experience have flourished.
Today's conviction – tomorrow's fiction
Authors: Harrington John
Published: May 2008

Trying to put one's career into perspective is like selecting those eight records for the Desert Island; what should one choose? My recollections are more of people than events. A few individuals have had a lasting influence on me, many more have enriched my life, only rarely have I met somebody I would not care to meet again. People of all types have always fascinated me, and this is perhaps why I have greatly enjoyed my time in psychiatry. My career lacked any master plan, things happened, opportunities arose but my path was determined as much by chance as anything else.
ECT custom and practice
Authors: Pippard John
Published: May 2008

The 50th anniversary of the first ECT provides an opportunity to look back and reconsider whether we are using this important treatment as well as we might.
Community-initiated research: a study of psychiatrists' conceptualisations of ‘cannabis psychosis’
Authors: Littlewood Roland
Published: May 2008

Concern among black and ethnic minorities with current research in ‘transcultural psychiatry’ entails future work taking into account their collaboration to minimise the possibility that it is prejudicial to their interests. An instance is given of a project initiated by black community groups which looks at psychiatric conceptualisations of a diagnosis commonly used locally in inner-city Birmingham: cannabis psychosis. Responsibility remains with the researcher.
Chemical castration and consent to treatment
Authors: Hamilton John R.
Published: May 2008

A funny thing happened to Mr Kenneth Clarke on his way to the House of Commons in October 1982. It was the last day of debate on the Mental Health (Amendment) Bill and for some peculiar reason the then Minister of Health decided to reject the advice he had just been given by DHSS officials and instead accepted at the last minute an amendment proposed by the Opposition which extended the consent to treatment provisions for psychosurgery and certain other (then undefined) treatments to voluntary patients.
The Oxford Service for the Young Adult Chronically Mentally Ill
Authors: Pullen G. P.
Published: May 2008

The final page of this manuscript was inadvertently omitted and the full Comment section is printed below. We regret this omission.
John Conolly (1794–1866): the Return of the Wanderer
Authors: Rollin Henry R.
Published: May 2008

The name of John Conolly, writes his obituarist in the Journal of Mental Science [12 (1866): 146] “liveth for ever more.” As a reformer he will go down in history as one of the most distinguished men of his age, to be mentioned in the same breath, say, as John Howard, Thomas Clarkson and Lord Shaftesbury. As a psychiatrist he will be identified for all time with the non-restraint system after its translation from France to England. “There is no asylum in the world,” he opined, “in which all mechanical restraints may not be abolished not only with safety, but with incalculable advantage.”
New Directions in Mental Health Care Evaluation
Authors: Marks Isaac , Connolly Joseph , Muijen Matthijs
Published: May 2008

Mental health care evaluation is a priority area as mental health care services are changing rapidly, more than are most other medical services. Budgets are finite, and there is concern for value for money in meeting the needs of patients and families. A one-day workshop brought together leading figures in the USA and Europe to discuss how a unit and consortium might be established to give cohesion and catalyse evaluative research in this fragmented field in the UK. Sound scientific data are available which have not yet been widely disseminated or used in policy making. There are rich opportunities for cross-national projects. The USA has intriguing innovations in evaluative research in mental health, some on a large scale, and these are relevant to the UK.
Getting your papers published
Authors: Prins Herschel
Published: May 2008

During the past three years it has been my task and privilege to act as an assessor for The British Journal of Psychiatry. In this time I have assessed, and in some cases reassessed, over 30 papers. Having looked back on my comments on these papers a number of common criticisms emerge. I thought intending contributors to the Journal might find it helpful if I commented upon some of these. I hope I do so with a sense of humility, since it is always easy to criticise the work of others and appear to be patronising. However, I have the impression that if intending authors paid heed to some of my suggestions (which are certainly not original) they would save themselves a great deal of disappointment and save the assessors and the Editors of the Journal a degree of frustration and occasional irritation.
Work at Netherne — A service responding to change
Authors: Ekdawi Mounir
Published: May 2008

Work activities were systematically introduced by R. K. Freudenberg at Netherne Hospital, in the 1950s, as a component of a rehabilitation programme for severely disabled in-patients. At about the same time, Douglas Bennett utilised the psychological, vocational and economic benefits of work in preparing long-stay Netherne patients for resettlement in the community. The value of work as a principal rehabilitative medium in a wide spectrum of disability was periodically reported.
Consultant manpower in child psychiatry
Authors: Black Dora
Published: May 2008

This paper has been prepared by the North East Thames Child and Adolescent Psychiatric Advisory Sub-Committee (NETCAP) in order to draw the attention of the Region to deficiencies in consultant child psychiatric services in the Region. It sets out below the population of each district and the current consultant manpower. These figures have been obtained from the district general managers and in some cases corrected by the local consultants.
Benzodiazepine addiction and child sexual abuse
Authors: Haeger Bisa
Published: May 2008

There is now an extensive literature on benzodiazepines (over 18,400 publications since 1966), particularly regarding their addictive potential (Feely, 1988). The importance of this finding lies in prescribing as well as in the treatment of existing addiction. However, psychological factors are also important in the maintenance of addictive behaviour and one should not assume that all are recognised. For example, it is known that drugs are used to reward children employed by the pornographic industry and that sexually abused children can develop drug addiction (Burgess et al., 1984). There are now over 300 publications on child sexual abuse but none linking it with benzodiazepine addiction specifically. This is the first one.
Training for an uncertain future
Authors: Haigh Rex , Wear Alan
Published: May 2008

Although psychiatry's future looks less and less likely to be in large psychiatric hospitals, trainees at SHO/registrar level still spend nearly all their time in them. Although the White Paper looks set to dismember comprehensive provision as we know it, few psychiatrists have experienced self-employment, and most are untrained in practical management skills. Although our consumers – as we must now view them – are getting more discerning about what services we offer, psychiatrists only see them after they become ill, and less able to decide for themselves.
Psychiatric day hospital discharge summaries
Authors: Shamash Kim , Ikkos George , Wanigaratne Shamil , Greenberg Maurice
Published: May 2008

With the increasing emphasis on community care (Turner, 1986) the psychiatric day hospital has been seen as an alternative (Tantam, 1985) or as a complement (Tyrer, 1985) to in-patient care. Associated with this is the development of new styles of working with patients such as the ‘multidisciplinary team’ with those looking after individual patients being referred to as ‘key workers’ (Watts & Bennett, 1983). In our day hospital the keyworker has considerable responsibility for history-taking, organising a treatment programme and communicating with other professionals, including writing the discharge summary.
The work of the Somali Counselling Project in the UK
Authors: Dihour Omar E. , Pelosi Anthony J.
Published: May 2008

The Somali Counselling Project was established in London's East End in December 1986 with the support of a grant from the City Parochial Foundation. It offers social support and psychosocial counselling to Somalis and other culturally related peoples from the Horn of Africa who are living in the United Kingdom. Its aims are: to advise on social, administrative and financial problems; to help clients make effective use of mainstream health services; to prevent and treat emotional disorder; and to provide administrative and emotional assistance to those with uncertain immigration status.
Psychiatric presentations to an accident and emergency department
Authors: Dunn John , Fernando Renuka
Published: May 2008

The nature, management and disposal of patients who present to casualty departments and receive psychiatric diagnoses by the assessing doctor are areas that have received scant attention by psychiatric researchers. The aim of this study was to analyse the records of such patients to see how they had been managed, in particular to document the degree of psychiatric intervention provided or offered, and to see what follow-up arrangements, if any, had been made.
Adventures in Attica — a personal view of the VIIIth World Congress of Psychiatry
Authors: Guthrie Elspeth , Black Dawn
Published: May 2008

Little did we know, as fledgling conference attenders, what lay in store for us when we learnt that our papers had been accepted for the VIIIth World Congress of Psychiatry in Athens, October 1989.
Speech therapy for psychogeriatric services
Authors: Griffiths Helen , Baldwin Bob
Published: May 2008

A psychogeriatrician was recently given the opportunity of five sessions of speech therapy for his service. His response was that he had no need of a speech therapist as he was perfectly well able to do his own assessment of dysphasia. This attitude is perhaps understandable since there has been so little exposure to the skills of speech therapists within this clinical field. In 1985 a full-time speech therapist was appointed by Central Manchester Health Authority to be part of the multidisciplinary team working in old age psychiatry. At the time this was, to our knowledge, the first full-time position of its kind. This article reviews progress thus far and outlines the contribution of speech therapy skills to the management of the elderly mentally ill.
Child psychiatry in a new medical school in Hong Kong
Authors: Wong C. K.
Published: May 2008

There are two medical schools in Hong Kong, that of the University of Hong Kong and that of the Chinese University of Hong Kong. The former has a history of more than 100 years whereas the latter admitted its first batch of students only in 1981. Both use English as the teaching medium and both are recognised by the GMC. I received my undergraduate medical education in the former but have been teaching in the latter for seven years.
Mental health education for primary health care
Authors: Hollander D. , Checkley S. , Appleby L.
Published: May 2008

The Alma Ata Primary Health Care Conference in 1978 marked a watershed in global health care policy and specifically a fundamental milestone for mental health. Not only was mental health defined as a right and an integral part of health generally, but also its promotion was a major recommendation of the conference.
Clinical decisions about patients
Authors: Cockburn J. J.
Published: May 2008

The structure of mental illness services is changing rapidly. Large hospitals are closing or preparing to close and the service will be provided in other ways, partly by smaller units, partly by increased care in the community outside hospital and partly by amalgamations of two or more large hospitals. Smaller units allow closer working relationships with GPs, social workers and other professionals.
Participating in primary care
Authors: Mitchell A. R. K.
Published: May 2008

Traditionally, general practitioners and psychiatrists relate to one another through a system of cross referrals, from primary care to secondary care and back again, the referral being initiated by the GP through a request for a domiciliary visit or more usually for an out-patient assessment of the clinical problem. However, in the mid-1960s, individual psychiatrists began to report a new way of working, which consisted of the psychiatrist going by invitation into GPs' surgeries or health centres to work directly with the general practitioners and with other members of the primary health care team. A survey undertaken by Strathdee & Williams of the General Practice Research Unit of the Institute of Psychiatry, showed that by 1984 in England and Wales, one psychiatric consultant in five, sometimes with, sometimes without, junior staff, spent some time in a general practice setting. At the College meeting in Cambridge (April 1988), Pullen reported that in Scotland a similar survey showed that as many as 40 to 50% of psychiatric consultants spent some time in primary care settings.
Courses in psychotherapy
Authors: Lund C. A.
Published: May 2008

With the rapid expansion in the number and variety of psychotherapy courses in this country, it is perhaps timely to review some of the issues influencing these courses. One purpose of this paper is intended to draw attention to the fact that not only are there interesting conflicts in establishing such courses but also establishments whose power relationships affect the educational effectiveness of these complex teaching ventures. These issues will be discussed with reference to the trainees, trainers, patients, and host organisations.
Night sedation in the admission wards of a psychiatric hospital
Authors: Fry Richard P. W.
Published: May 2008

Since their introduction in the 1960s, benzodiazepine drugs have been widely prescribed for anxiety states and insomnia. Despite the initial hopes for these drugs being non-addictive and not producing tolerance, recent work has shown that there is a well defined withdrawal syndrome (Hallstrom & Lader, 1981; Petursson & Lader, 1981; Tyrer et al, 1981; Tyrer et al, 1983) and that tolerance has also been shown to occur (Aranko et al, 1983; Aranko et al, 1985). There has been widespread concern about these effects. The British National Formulary advocates that “used as hypnotics routine prescribing especially in hospitals is undesirable, and ideally they should be reserved for short courses of treatment in the acutely distressed” and that they should be discontinued as soon as possible. Indeed the Royal College of Psychiatrists' statement on benzodiazepine prescribing and the Committee on Safety of Medicines have recommended that their use as hypnotics should be considered only when the condition is severe, disabling or subjecting the individual to extreme distress. Tyrer & Murphy (1987) have recommended that these drugs are best used for no longer than two weeks in regular dosage.
Audit in psychiatry
Authors: Garden Gillian , Oyebode Femi , Cumella Stuart
Published: May 2008

Medical audit has been defined as the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient (DOH, 1989). The White Paper Working for Patients states that the Government proposes that every consultant should participate in a form of medical audit agreed between management and the profession locally. It also states that management should be able to initiate an independent professional audit.
Medical audit in psychiatry or Fear and loathing on the White Paper trail
Authors: Holman Christopher
Published: May 2008

The Government White Paper, Working for Patients (1989), although presented as a discussion document, should be seen as a position paper. It is clear that the government intends to implement the major proposals, and will be able through its control of general management, enhanced by a stream-lined management structure (Working for Patients para 2.3–2.11), to put pressure on health authorities to take action accordingly.
The pre-menstrual syndrome
Authors: Browne R. V. , Ellis N. C. , Hird J. A.
Published: May 2008

Since its clinical delineation, the premenstrual syndrome has enjoyed a wide repertoire of descriptive labels commensurate with the enormity of its symptomatology and the diversity of its postulated aetiologies, none of which has attained pre-eminence, although some (e.g. progesterone deficiency) have been of more enduring interest, due perhaps as much to the enthusiasm of their authors as to the presence of any compelling scientific premise. The entity thus remains of syndromal status constituting as it does an enigmatic curiosity for some and a fellowship of controversy for others, with little agreement as to its exact nature, time of occurrence or even its existence.
Occupational therapy – the forgotten speciality within the community mental health team?
Authors: Coia Denise , Joice Anne
Published: May 2008

From the plethora of articles examining the role of individual disciplines within the community mental health team, one discipline appears almost conspicious by its absence. How has occupational therapy become the forgotten speciality?
On consultation
Authors: Nelki Julia
Published: May 2008

Consultation is a term that can have many different meanings. In this paper, it is used in the sense that Caplan (1964) defines as mental health consultation, to describe the interaction between a consultee and consultant who meet to facilitate some area of mental health work in which the consultee is involved. By working with workers instead of directly with clients, the consultant aims to offer a service to a greater number of people than would otherwise be possible and to have a preventive role with earlier detection and management of mental health problems.
Suicidal patients — the effect on staff
Authors: Rossiter J. C.
Published: May 2008

Although psychiatric hospitals contain a population at risk of suicidal behaviour compared to the community at large, suicide in hospital in-patients and recently discharged patients is relatively rare. It has been suggested that hospital admission itself reduces the risk of suicide (Tenrocheet al, 1984). Factors considered important are a calm ward routine carried out by staff confident in the immediate future, and the opportunities for social contract offered by the ward environment.
The psychiatrist in the community mental health team
Authors: Montague Linda
Published: May 2008

It was with a feeling of taking a step into only vaguely charted territory that in May 19881 agreed to be the psychiatric member of a pilot multidisciplinary community mental health team to be set up in the South-West sector of Cardiff.
Brief encounters in general practice: liaison in general practice psychiatry clinics
Authors: Darling Claire , Tyrer Peter
Published: May 2008

Liaison psychiatry in general practice has been recognised as an increasingly important part of the development of community psychiatry. Collaborative working between general practitioners (GPs) and psychiatrists has become commonplace in most parts of the country (Strathdee & Williams, 1984). Different models of liaison have been proposed and a variety of advantages claimed for such work (Mitchell, 1985).
John as a utility and ‘utility’
Authors: Nadesalingam K.
Published: May 2008

John is a 30-year-old man suffering from severe mental handicap (IQ:30) and epilepsy, without other physical deformities or illness. He is sociable, would initiate social interaction (physical), enjoys a cuddle and going out on trips. He has no communication skills but is able to understand basic commands like ‘open your mouth’, ‘sit down’ and so on. He has been a long-term in-patient in a mental handicap hospital for the past 15 years. He is from an affluent family and had been admitted because of his family's inability to cope. He has visits from his mother once a month, and from his father less frequently. A few months ago his mother left a verbal instruction to the ward staff to make arrangements to donate his organs and to ask me, as responsible medical officer, to leave written instructions to inform the local Organ Transplant Team before his death, whenever it becomes imminent, so that the Organ Transplant Team can remove the necessary organs on his death.
Suicide and life insurance
Authors: O'Grady T. J. , Naik R. , Butterworth E.
Published: May 2008

In the study of suicide little attention has been paid to the role of life insurance. One might suppose that ‘deliberately accelerating the event insured against’ by homicide or suicide would void a policy. One might also predict that changes in attitude towards suicide, so that it is increasingly regarded as a medico-social problem rather than a criminal act, would be reflected in a softening of attitude among insurers. On the other hand, recent epidemiological changes, such as the increased suicide rate among young males, could make companies reluctant to relax their policy conditions.
Future child and adolescent psychiatrists: a further survey of senior registrar training
Authors: Bools Christopher , Cottrell David
Published: May 2008

Child and adolescent psychiatry is a growing speciality. Significant increases in workload, the reasons for which have been described elsewhere (Black, 1989), have led to an expansion in consultant posts across the UK. Recently the Joint Planning and Advisory Committee (JPAC) reviewed senior registrar numbers and recommended an increase in the establishment by 38 whole-time equivalents in England and Wales, a rise of 38%, to meet the expected shortfall. How existing senior registrars, as well as this large number of new recruits, are trained is clearly a matter of some importance.
Audit of psychiatric discharge summaries
Authors: Craddock Nick , Craddock Bridget
Published: May 2008

Improving discharge procedures is a topical subject and audit of discharge summaries is an important part of this procedure. In many hospitals the summary compiled following a patient's discharge is used for two purposes: a copy is sent to the general practitioner to provide details of the patient's illness and management, and a copy is filed in the hospital notes as a record of the admission. Discharge summaries often fail to meet the needs of either psychiatrist or GP. Using a questionnaire study, we have recently demonstrated that GPs and psychiatrists have different requirements from discharge summaries (Craddock & Craddock, 1989). The present study, which examines the content of a sample of discharge summaries from a large psychiatric hospital, was conducted to identify potentially important items of information which are consistently poorly covered in psychiatric summaries.
Mother and baby admissions: survey of resources
Authors: Cassell Diana M. C. , Coleman Rosalyn M.
Published: May 2008

Units to admit psychiatrically ill mothers with their babies to psychiatric hospitals were pioneered follow ing Main's description (1958) of the treatment of mothers with their children at the Cassel Hospital. Particular interest in puerperal psychosis and dis orders of bonding and attachment led to units usually providing for babies below six or 12months. Suggesting older infants should also be admitted, Main referred to the benefits in admitting parents to paediatric wards with ill children, and described how toddlers had been admitted with their mothers at the Cassel. Another early unit at Banstead Hospital cared for schizophrenic mothers with their babies and found that joint admissions lead to faster recovery, lower relapse rates and more babies continuing to live with their mothers (Baker et al, 1961).