bluuebunny/crossref_metadata_2025 huggingface dataset:
Mitteleuropa, Zentraleuropa, Mittelosteuropa
Authors: Le Rider Jacques
Published: May 2008

The German term `Mitteleuropa' was coined to designate Central Europe at the time when the Habsburg monarchy exercised its domination over the Danube area and when the Eastern borders of the Reich proclaimed in 1871 were formed, thus from the end of the eighteenth century to the end of the First World War. Mitteleuropa constitutes an ambivalent `lieu de mémoire', a notion in which Central Europe has invested its memory of the past and its identity: such a notion is negative when it brings to mind the mental map of German imperialism both exploited and perverted in the Third Reich; it is positive when it is interpreted as a federative idea, opening supranational perspectives associating the countries of German culture with Slavic peoples — the Hungarians, the Romanians — and with the Jews. Since the formation of the `Habsburg myth' as a retrospective utopia of a defunct harmony of nationalities in the `third Europe' situated between Western Europe and the Russian world, the Austrian tradition has become the focus of the new notion of `Zentraleuropa', prefiguring Central European union.
Does occupational social class predict coronary heart disease after retirement? A 12-year follow-up study in Sweden
Authors: Sundquist Kristina , Johansson Sven-Erik , Qvist Jan , Sundquist Jan
Published: May 2008

Aims: To examine whether socioeconomic status and coronary heart disease (CHD) risk factors remain significant predictors of CHD among people aged ≥65 years. Previous studies in this age group are few and inconsistent. Methods: Follow-up study of a simple random sample of Swedish women and men aged ≥65 years interviewed in a national survey 1988—89 and followed up until 31 December 2000, for CHD incidence rates. Cox regression was used to study the association between socioeconomic status (occupation) and CHD, after adjustment for age, sex, physical activity, smoking, BMI, diabetes, and hypertension. Participants with CHD hospitalization two years before the start of the study and those who rated their general health as poor were excluded. Results: Among manual workers and lower-level employees the risk of CHD was significantly higher than among middle-level employees and professionals (49% and 50%, respectively), after adjustment for age and sex. The association between low socioeconomic status and increased CHD risk disappeared after adjustment for the CHD risk factors, which were more prevalent among those with low socioeconomic status. All the CHD risk factors (with the exception of BMI) were associated with increased CHD incidence rates. Conclusions: Low socioeconomic status remains a significant predictor of CHD among people aged ≥65 years. Healthcare policies among elderly patients should encourage physical activity and smoking cessation in all socioeconomic groups.
Using data effectively to prevent and control infection
Authors: Curran Evonne , Wilson Jennie
Published: May 2008

Data is an essential tool for convincing healthcare workers to accept that problems exist, inspire them to better performance, or demonstrate that their performance is improving. Infection control professionals have access to a wealth of data on healthcare associated infections. Using simple graphical examples this paper illustrates how data can be analysed and presented in accessible ways that will help infection control practitioners to better understand infection problems and to use the information to influence practice.
Toward a Cultural Contingency Model of Leadership
Authors: Muczyk Jan P. , Holt Daniel T.
Published: May 2008

To succeed in today's economy, multinational and transnational organizations must have strong leaders who are versed in global leadership principles. Unfortunately, 85% of Fortune 500 executives report that their firms lack enough competent global leaders. Relying on leadership theories based solely on North American experiences will unlikely ameliorate this shortfall. Accordingly, the authors integrate the Project GLOBE cultural imperatives with mainstream leadership dimensions to produce global leadership prescriptions. Examples of regional leadership styles based on regional cultural determinants are also provided. This prospective framework serves as a springboard to help guide and develop leaders who wish to transcend geographical boundaries and effectively lead in a culturally diverse, global context.
Scaphoid Fracture Due to Rigid Handcuffs
Authors: BALL L. , FERRAN N. A. , BARTON C. R.
Published: May 2008

Rigid handcuffs have been designed to allow ease of application and to allow better control of violent suspects by the police. This paper reports a case of scaphoid fracture sustained during inappropriate use of these handcuffs. The mechanism of injury described has been simulated for demonstration. Law enforcement officers and clinicians need to be aware of the risks of inappropriate use of these handcuffs.
Osteolineage niche cells initiate hematopoietic stem cell mobilization
Authors: Mayack Shane R. , Wagers Amy J.
Published: May 2008

Recent studies have implicated bone-lining osteoblasts as important regulators of hematopoietic stem cell (HSC) self-renewal and differentiation; however, because much of the evidence supporting this notion derives from indirect in vivo experiments, which are unavoidably complicated by the presence of other cell types within the complex bone marrow milieu, the sufficiency of osteoblasts in modulating HSC activity has remained controversial. To address this, we prospectively isolated mouse osteoblasts, using a novel flow cytometry–based approach, and directly tested their activity as HSC niche cells and their role in cyclophosphamide/granulocyte colony-stimulating factor (G-CSF)–induced HSC proliferation and mobilization. We found that osteoblasts expand rapidly after cyclophosphamide/G-CSF treatment and exhibit phenotypic and functional changes that directly influence HSC proliferation and maintenance of reconstituting potential. Effects of mobilization on osteoblast number and function depend on the function of ataxia telangiectasia mutated (ATM), the product of the Atm gene, demonstrating a new role for ATM in stem cell niche activity. These studies demonstrate that signals from osteoblasts can directly initiate and modulate HSC proliferation in the context of mobilization. This work also establishes that direct interaction with osteolineage niche cells, in the absence of additional environmental inputs, is sufficient to modulate stem cell activity.
Precision-mapping and statistical validation of quantitative trait loci by machine learning
Authors: Bedo Justin , Wenzl Peter , Kowalczyk Adam , Kilian Andrzej
Published: May 2008

Background

We introduce a QTL-mapping algorithm based on Statistical Machine Learning (SML) that is conceptually quite different to existing methods as there is a strong focus on generalisation ability. Our approach combines ridge regression, recursive feature elimination, and estimation of generalisation performance and marker effects using bootstrap resampling. Model performance and marker effects are determined using independent testing samples (individuals), thus providing better estimates. We compare the performance of SML against Composite Interval Mapping (CIM), Bayesian Interval Mapping (BIM) and single Marker Regression (MR) on synthetic datasets and a multi-trait and multi-environment dataset of the progeny for a cross between two barley cultivars.

Results

In an analysis of the synthetic datasets, SML accurately predicted the number of QTL underlying a trait while BIM tended to underestimate the number of QTL. The QTL identified by SML for the barley dataset broadly coincided with known QTL locations. SML reported approximately half of the QTL reported by either CIM or MR, not unexpected given that neither CIM nor MR incorporates independent testing. The latter makes these two methods susceptible to producing overly optimistic estimates of QTL effects, as we demonstrate for MR. The QTL resolution (peak definition) afforded by SML was consistently superior to MR, CIM and BIM, with QTL detection power similar to BIM. The precision of SML was underscored by repeatedly identifying, at ≤ 1-cM precision, three QTL for four partially related traits (heading date, plant height, lodging and yield). The set of QTL obtained using a 'raw' and a 'curated' version of the same genotypic dataset were more similar to each other for SML than for CIM or MR.

Conclusion

The SML algorithm produces better estimates of QTL effects because it eliminates the optimistic bias in the predictive performance of other QTL methods. It produces narrower peaks than other methods (except BIM) and hence identifies QTL with greater precision. It is more robust to genotyping and linkage mapping errors, and identifies markers linked to QTL in the absence of a genetic map.
Circadian genomics of the chick pineal gland in vitro
Authors: Karaganis Stephen P , Kumar Vinod , Beremand Phillip D , Bailey Michael J , Thomas Terry L , Cassone Vincent M
Published: May 2008

Background

Chick pinealocytes exhibit all the characteristics of a complete circadian system, comprising photoreceptive inputs, molecular clockworks and an easily measured rhythmic output, melatonin biosynthesis. These properties make the in vitro pineal a particularly useful model for exploring circadian control of gene transcription in a pacemaker tissue, as well as regulation of the transcriptome by primary inputs to the clock (both photic and noradrenergic).

Results

We used microarray analysis to investigate the expression of approximately 8000 genes within cultured pinealocytes subjected to both LD and DD. We report that a reduced subset of genes was rhythmically expressed in vitro compared to those previously published in vivo, and that gene expression rhythms were lower in amplitude, although the functional distribution of the rhythmic transcriptome was largely similar. We also investigated the effects of 6-hour pulses of light or of norepinephrine on gene expression in free-running cultures during both subjective day and night. As expected, both light and norepinephrine inhibited melatonin production; however, the two treatments differentially enhanced or suppressed specific sets of genes in a fashion that was dependent upon time of day.

Conclusion

Our combined approach of utilizing a temporal, photic and pharmacological microarray experiment allowed us to identify novel genes linking clock input to clock function within the pineal. We identified approximately 30 rhythmic, light-responsive, NE-insensitive genes with no previously known clock function, which may play a role in circadian regulation of the pineal. These are candidates for future functional genomics experiments to elucidate their potential role in circadian physiology. Further, we hypothesize that the pineal circadian transcriptome is reduced but functionally conserved in vitro, and supports an endogenous role for the pineal in regulating local rhythms in metabolism, immune function, and other conserved pathways.
Complex permittivity and clay mineralogy of grain-size fractions in a wet silt soil
Authors: Arcone Steven , Grant Steven , Boitnott Ginger , Bostick Benjamin
Published: May 2008

We determined the complex permittivity and clay mineralogy of grain-size fractions in a wet silt soil. We used one clay-size fraction and three silt-size fractions, measured permittivity with low error from [Formula: see text] with time-domain spectroscopy, and estimated mineral weight percentages using X-ray diffraction (XRD). The volumetric water contents were near 30%, and the temperature was [Formula: see text]. For the whole soil, standard fractionation procedures yielded 2.4% clay-size particles by weight, but XRD showed that the phyllosilicate clay minerals kaolinite, illite, and smectite made up 17% and were significantly present in all fractions. Above approximately [Formula: see text], all real parts were similar. Below approximately [Formula: see text], the real and imaginary permittivities increased with decreasing grain size as frequency decreased, and the imaginary parts became dominated by direct-current conduction. Similarly, below approximately [Formula: see text], the measured permittivity of montmorillonite, a common smectite, dominated that of the other clay minerals. Total clay mineral and smectite mass fractions consistently increased with decreasing grain size. Below [Formula: see text], a model with progressively increasing amounts of water and parameters characteristic of montmorillonite matches the data well for all fractions, predicts permittivities characteristic of free water in smectite structural galleries, and shows that the similar real parts above [Formula: see text] are caused by a small suppression of the high-frequency static value of water permittivity by the smectite. We conclude that the clay mineral content, particularly smectite, appears to be responsible for permittivity variations between grain-size fractions. Small model mismatches in real permittivity near the low-frequency end and the greater fractions of kaolinite and illite suggest that the total clay mineral content might have been important for the coarser fractions.
Five Years of Nurse-Therapy: Development of a Clinical Nursing Specialty
Authors: Marks Isaac
Published: May 2008

The Royal College of Nursing recently published a book in their research series entitled Nursing in Behavioural Psychotherapy (Marks et al., 1977) which reviewed developments in the field. Operational research into nurse-therapy began in 1972 at the Maudsley Hospital. Out of this a national course was formalized in 1975 by the Joint Board of Clinical Nursing Studies for England and Wales (Course No. 650). Although the formal course lasts 18 months, it is now possible to shorten the training period to one year, followed by six months of lightly supervised practice working in settings away from the training centre. Currently there are two recognized training centres, at the Bethlem/Maudsley and Graylingwell Hospitals, and moves are afoot to start a third programme elsewhere.
Self-Induced Vomiting: II. Methods of Behaviour Therapy
Authors: Slade Peter
Published: May 2008

When confronted with patients who indulge in frequent self-induced vomiting one has to ask oneself the question ‘why do they do it?’ At the simplest level the answer to this question is that there are clear advantages to the patient from this behaviour. Patients can indulge their cravings for food to excess while at the same time avoiding the consequences in terms of weight gain. They can literally ‘have their cake and eat it’. The first therapeutic requirement is therefore to convince the patient that the disadvantages of self-induced vomiting, in terms of effects on physical health, far outweigh these benefits. Let us assume that we have been successful in this respect; the next step is to undertake a behavioural analysis.
Psychogeriatric Liaison: A Service to a District General Hospital
Authors: Fraser R. M. , Healy Rosemary
Published: May 2008

Liaison psychiatry has been an influential element in hospital psychiatric practice for over a decade now. It is concerned with the ‘diagnosis, treatment, study, and prevention of psychiatric disorders among patients in non-psychiatric health care institutions, especially in general hospitals’. This paper describes and evaluates a project in which the principles of liaison psychiatry were incorporated into a psychogeriatric service.
A Psychiatric Emergency Clinic
Authors: Smithies J. M. A.
Published: May 2008

Provision for dealing effectively with psychiatric emergencies has never been more important than now, with the current increasing emphasis on community care. There follows a description of the psychiatric emergency clinic in Southampton and the changes in its organisation and practice which have taken place over the last few years. It is hoped that this will stimulate discussion on the best methods of providing emergency psychiatric care.
The Effect of Community Care on Long-Stay Patients at Knowle Hospital
Authors: Shawcross Charles R. , Davies Huw , Taylor Susan
Published: May 2008

It was in 1961 at the Annual Conference of MIND that Enoch Powell first announced that the traditional mental hospitals were to be run down. Since then it has been government policy to emphasise the value of a transfer of care from hospital to the community. Concern was soon being widely expressed at the growing gap between statements of proposed government policy and their realisation. It has long been the intention to close Knowle Hospital, which originally served the city of Southampton, and over the last ten years there has been a gradual transfer of some of the services away from the main hospital site. A major problem in successfully implementing the closure of any mental hospital is the appropriate relocation of the long-stay population. The problems this involves have been much debated recently.
Contribution of Telephone Conferences to Continuing Medical Education for Consultant Psychiatrists
Authors: Seager C. P.
Published: May 2008

It is increasingly recognised that neither general medical nor specialist qualification marks the cessation of the need for continuing reinforcement and renewal of the well-known tripod of education, namely knowledge, skills and attitudes. It can be argued that experience is the great teacher and the day-to-day work of the graduate ensures a continuing updating. This is only partially correct since new knowledge and practices, together with changes in working relationships, may pass by the educationally isolated, leaving a person hidebound, prejudiced and reactionary on an island surrounded by a speeding torrent of change. Unthinking response to these pressures may not be the way to deal with the situation but an awareness of these changes, so that the choice of response is made from strength rather than weakness, is an essential aspect.
A Psychiatric Clinic in General Practice
Authors: Browning Sally M. , Ford Michael F. , Goddard Cait A. , Brown Alexander C.
Published: May 2008

Only a minority suffering from mental illness are treated by the specialist psychiatric service. The majority of psychiatrically ill patients seen in general practice suffer from minor neuroses, personality disorders and situational reactions and can be appropriately treated by the primary care team. However, a significant degree of morbidity, some of it severe, fails to be identified in general practice and the identification and treatment of psychiatric disorder varies according to the GP's interest and attitudes.
In Someone Else's Shoes
Authors: McCune Noel
Published: May 2008

The relatively rigid structures of the medical and nursing professions hamper the development of an adequate mutual understanding of the experiences and contributions of each in the care of patients. It is not uncommon for medical staff in psychiatric institutions to be patronising in their attitudes to work done by nurses; and vice versa. McGuire, in her submission to the Report of the Royal Commission on the NHS (1979) commented that “decisions made by nurses may go unrecognised by doctors and even by nurses themselves”.1 Such failure to recognise decisions is symptomatic of an underestimation of the role of nurses in general.
Asylum for the mentally ill in historical perspective
Authors: Li Parry-Jones William
Published: May 2008

At a time of increasing emphasis on community care for the mentally ill and of mounting concern about its adequacy, questions arise about the necessity for asylum and its optional provision. The term ‘asylum’ was first used in relation to institutions for the insane in the late 18th century and it became the ‘in’ word in 19th century lunacy terminology. It took over from ‘madhouse’, which a contemporary observer called “an opprobious epithet, only suited to the horrible ideas formerly deservedly associated with such places”. In turn, it was superseded officially by ‘mental hospital’ under the 1930 Mental Treatment Act, in an attempt to jettison the negative connotations of ‘lunatic asylum’, and to suggest a parallel curative function with general hospitals.
A community treatment service for sex offenders
Authors: Mendelson Eric F. , Quinn Michael , Dutton Sue , Seewonarain Kishore
Published: May 2008

If you have been referred a sex offender recently, you will probably still be conscious of how difficult it is on an individual basis to provide a comprehensive treatment approach. Indeed, in our area, as in nearly all areas, there has been little therapeutic help available for sex offenders outside the special hospital system, and certainly little for those in the community.
Psychiatrists' use of investigations
Authors: White Anthony
Published: May 2008

Many westernised countries have introduced Quality Assurance (QA) into their process of health care. The UK has lagged behind other countries and psychiatry has lagged behind other specialities.
Observations of mental health care programmes for schizophrenic patients in Toronto
Authors: Kemp Marion M.
Published: May 2008

Toronto is a large multicultural society with a metropolitan population of several million people. It is mainly English-speaking, although it contains Portuguese, Chinese, Italian and other communities. Although similar in population to the larger industrial cities of the United Kingdom, and despite a common language, there are important cultural differences which are relevant when assessing treatment programmes. In particular, in contrast to the urban decay, high unemployment rates, and increasing number of elderly residents prevalent in UK cities, Toronto is a young, thriving city with a low unemployment rate and affluent population. There is a low crime rate, little evidence of vandalism, but ample evidence of an advanced structure, e.g. public transport, play schemes etc. Accommodation is, however, expensive and mainly in private ownership.
Part-time senior registrar training in psychiatry
Authors: Livingston Hilary M. , Ogelthorpe Dorothy , Robertson Sarah
Published: May 2008

One of the topics discussed at the recent Trainees Day of Thames Health Authority, Southern Division, was part-time training. Trainees were concerned about difficulties experienced by those wishing to train on a part-time basis.
Foreign Report: Psychiatry in Zambia
Authors: Haworth Alan
Published: May 2008

That a hospital in an African country has just celebrated 25 years of its existence may not seem a particularly newsworthy event but I hope that the story I have to tell will prove to be interesting and maybe even instructive for many more colleagues than those having a special interest in Africa. My own qualification for recounting the story is that I have worked at Chainama Hills Hospital since September 1964, just 15 months after it was opened.
Trainees' Forum: Conflict and Consensus in the Multi-disciplinary Team
Authors: Coghlan Cherrie A.
Published: May 2008

During my training I have had the relatively unusual experience of two placements in community psychiatry—one at registrar, the other at senior registrar level. These placements were in many respects quite different. One was in an Emergency Psychiatric Service based in a London teaching hospital and the other was in a domiciliary-based Crisis Intervention Service in a district general hospital. A feature shared by both services was a multi-disciplinary team. The move towards community psychiatry is going hand in hand with the multi-disciplinary approach, and this leads inevitably to some re-evaluation of the role of the psychiatrist as other disciplines contribute more to clinical assessment and management. From my own experience as a member of these teams I have noted the relevance of two overlapping issues; these concern attitudes to the practice of psychiatry and the distribution of responsibility within the team.
Detention – the grey area
Authors: Daly Oscar E.
Published: May 2008

In September 1978 the Government published a review of the Mental Health Act (1959). This review was prompted to a large degree by an increasing awareness of the rights of the mentally ill and by an awareness among psychiatrists of the limits of their management procedures. The proposals of this review were largely incorporated into the Mental Health Act (1983). Among the proposals so incorporated was one that persons could not be detained in hospital against their will for assessment or treatment “by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs”.
Assessors reports on Advisory Appointments Committees Changes since 1974
Authors: Brook Peter
Published: May 2008

From the time of its foundation the College has been represented on Advisory Appointments Committees for consultant posts. One of the College nominated assessors' responsibilities is to supply confidential information on applicants, and those interviewed, to the Registrar by completing a form containing information on the number of applicants, numbers interviewed and their quality together with any deficiencies in qualifications and experience in those seen and those appointed. Prior to 1979 the assessors gave their opinion on qualifications and experience on all applicants but the form then in use did not allow for any quantitative analysis. Since the introduction of a new form in that year, such an analysis has been possible. A summary of assessors reports from 1974 to 1977 was published in the Bulletin.
Integration into the working world
Authors: Grove Bob
Published: May 2008

The Richmond Fellowship has for almost 30 years been a leading mental health organisation delivering half way house care and rehabilitation to people needing to overcome the secondary social effects of mental breakdown. It has developed the half way house therapeutic community principally as a short term institution with a programme which stresses social relations and self management, and as such has been beneficial to many thousands of people who have quickly re-established themselves into their families and communities.
Health authority patterns of hospital discharge rates for poisonings in the RHAs of England and the DHAs of Yorkshire, and their relationship to social deprivation
Authors: Renvoize E. B. , Clayden A. D. , Beveridge A. W.
Published: May 2008

Currently, resources for acute mental illness services are allocated on the basis of the age, sex and marital status profiles of the catchment population. However, it has been argued (Hirsch, 1988) that mental illness budgets and bed provision should also be weighted according to the socio-demographic characteristics of the local population.
The Burdens — pioneers in mental health
Authors: Jancar J.
Published: May 2008

Rarely in a lifetime do three people contribute to society in so many ways as the Burdens in Bristol. Here are some of their major achievements.

The Reverend Burden and his wifw Katharine opened ‘The Royal Victoria Home’, near Horfield Prison, for the care of inebriate women and girls in moral danger in 1895.
Training in psychiatry in less developed countries
Authors: Holden Neil L.
Published: May 2008

The declared aim of the World Health Organization, based on the Alma Ata declaration (1978), is to promote health care for all by the year 2000. It is recognised that this can be achieved only by the channelling of efforts into the development of primary health care, with medical care greatly augmented by the utilisation of non-medical carers, traditional healers and public health measures. As in more developed countries, where psychiatry struggles to maintain its share of national health resources against the ever increasing demand of technical advances in physical health care, so the mental health services of the less developed countries constantly are in danger of losing out to physical health in the battle against illness and natural disasters. To redress this balance and to meet the needs for mental health by the year 2000, the less developed world needs more psychiatrists (who are currently estimated to relate to the population at a rate of approximately only one per million) and these psychiatrists need to be appropriately trained to meet the challenges. How can the more developed nations help in this training of trainees from the less developed world? Can a partnership be formed between nations that ensures that trainees in psychiatry, in whichever country, are equipped as well as possible for the needs of their home country?
Guidelines on the clinical management of suicidal patients in psychiatric units
Authors: Gardner R.
Published: May 2008

Views differ as to whether it is feasible – or indeed desirable – to agree on a Code of Practice with respect to the clinical management of suicidal patients in psychiatric units (Morgan, 1988). At Fulbourn Hospital (Gardner, 1988) we have developed some guidelines which might, if suitably modified, be used elsewhere; they are appended below.
Psychotherapy within general psychiatry
Authors: Freeman Thomas
Published: May 2008

This paper focuses on issues relating to the place of psychotherapy within general psychiatry rather than describing details of psychotherapeutic methods and their range of application in psychiatric practice.
All patients great and small
Authors: Simpson C. J.
Published: May 2008

Having trained in London and Manchester, I found psychiatry in the Yorkshire Dales a little different. Most senior registrar training is done within cities. Most consultant posts are old posts. Moving into a newly created consultant post with hardly any psychiatric service, miles from any city, was a new challenge with clear benefits professionally and personally. James Heriot, our famous local vet, gives the impression of being self-sufficient and isolated when providing his services. Though the countryside is the same, surely the opposite must be true for developing a mental health service.
Developing family-based care for schizophrenia: a training project
Authors: Falloon Ian R. H. , Hole Victor , Shanahan William , Laporta Marc , Krekorian Haroutyon
Published: May 2008

In recognition of the fact that schizophrenia disorders remain a major public health problem presenting a severe limitation to the success of community-based approaches to mental health care, a programme was started in 1985 with the goal of developing family care of schizophrenia within the NHS.
Rational Emotive Therapy Workshop
Authors: Freeman Hugh
Published: May 2008

Last year, I was very fortunate to be able to attend a workshop at Sheffield University on Rational Emotive Therapy – fortunate because Dr Albert Ellis of New York, who conducted it and who founded RET, is surely one of the most remarkable figures on the international scene in psychiatry. His presentation is frankly dramatic, but he insists that far from being undesirable, this quality may be essential in transmitting a therapeutic message to the patient.
The history of the Maudsley Hospital Junior Common Room: The Complaints Book (28 January 1959–26 July 1964)
Authors: Wilkinson Greg
Published: May 2008

The Maudsley Hospital Junior Common Room (JCR) Complaints Book was opened on 28 January 1959 by the secretary of the JCR, Dr R. H. Cawley (RHC). Complaints were to be entered on the left-hand page only leaving the right “for replies thereto”.
Who uses a day hospital and for how long?
Authors: Conway M. , Davidson I. A. , Dewey M. E.
Published: May 2008

The dichotomy caused by the National Health Service Act, Section 28, which split the responsibility for the mentally disordered between the Minister of Health and local authorities has remained with us. Along with a separate GP service this dichotomy has caused inconsistencies, confusion and overlap in day care facilities. Although psychiatric day care has now become accepted as an essential element in the comprehensive psychiatric care of the mentally ill, its development has been unplanned and there is a great regional variation (Vaughan, 1983).
A staff group in a burns unit
Authors: Antebi D. , Ambler N. R.
Published: May 2008

The issue of the relationship between physical illness and psychological disorder has a long and chequered history. It is therefore difficult to derive practice implications. However, there are associations between methods of patient care and long-term psychological and physical functioning which have provided some guiding principles (Nichols, 1984). This paper describes how these principles have been applied in a regional burns unit.
Consent and the mentally handicapped
Authors: Kanjilal G. C.
Published: May 2008

Consent to a transaction has three basic components. These are: the transaction – its nature; understanding; and response, i.e. the consent itself.
Psychiatric education in Yorkshire
Authors: Spencer D. A.
Published: May 2008

The Yorkshire Regional Psychiatric Association is a group of psychiatrists, general practitioners, psychologists, nurses, social workers, occupational therapists, chaplains, health managers and others working in the field of mental health. Its main functions are to promote vocational, academic and social discourse between members of the professions with an interest in mental health and handicap. It has about 300 members. The Association was founded in January 1949 as the Leeds Regional Psychiatric Association. This became the Yorkshire Regional Psychiatric Association in 1982. In 1989 the Association reaches its 40th anniversary. The Association can claim the distinction of being the first multi-professional society of workers in mental health to be established in the United Kingdom.
A novel approach to tackling the ‘benzodiazepine problem’ in general practice
Authors: O'leary Maureen
Published: May 2008

With growing concern – both professional and lay (Ashton, 1986; Lacey & Woodward, 1985) – about the adverse effects of long-term benzodiazepine use, many GPs are wondering how best to tackle the problem. In this paper, I describe a strategy adopted by a GP, CPN and psychiatrist (the author). This strategy centred around a meeting of all patients who had been taking benzodiazepines for over six months.
London hotels
Authors: Boyd W. D.
Published: May 2008

Members have requested information about hotel accommodation near the College. Within the immediate area, most hotels are either excessively expensive or of poor quality. However, members may apply to the Finance Officer for the names of two hotels providing adequate accommodation at a reasonable price, and details of the BMA's London Hotels Priority Registration Services.
A district benzodiazepine policy in practice
Authors: Ramster D. G. , Barber A. J.
Published: May 2008

It was decided to plan the introduction of a benzodiazepine policy in North East Essex when the result of a health authority survey of all local general practitioners in 1986 revealed a substantial dependence problem among patients in the area.
Working for psychiatric patients?
Authors: Peck Edward
Published: May 2008

Working for Patients and the subsequent Working Papers mention psychiatric services explicitly only twice. The proposals have been formulated for patients requiring tests and treatment for elective surgical conditions. They are the conditions which are believed to be predictable and therefore the most receptive to contractual specification and pricing. The health care contract is to be central to the new NHS. It is the device by which the Department of Health hopes to produce a fundamental change in attitude by both doctors and managers. Kenneth Clarke seems much more concerned with this attitudinal shift than with the detail of what the NHS might resemble a decade from now. This omission of overt consideration of psychiatric services does not allow us to ignore the White Paper. I intend to focus on the potential implications of the proposed themes for psychiatric services, particularly in the context of what they might indicate about the Government response to Community Care: Agenda for Action.
Disorders of mental handicap institutions
Authors: Read Stephen
Published: May 2008

In each of three mental handicap hospitals I have observed an institutional disorder. From consideration of these I have suggested a classification. I have analysed the aetiology and pathogenesis of some of these disorders and discuss the treatment and prognosis.
Relative support group of long-stay psychiatric patients
Authors: Leung Grace M. , Rastogi S. C. , Woods J.
Published: May 2008

It is now widely recognised that families represent a hidden and largely unacknowledged resource to the NHS in the day to day management of long-term disabilities, particularly severe mental problems like schizophrenia. It is most likely that 50–60% of first admission schizophrenic patients will return to some type of family environment and a significant number will remain with the family for a considerable time. The current trend towards community management of mental illness, hampered by the lack of community provision, almost inevitably means discharge to families and is likely to continue and increase further.
The working of the 1983 Mental Health Act: the experience of patients, relatives, psychiatrists, general practitioners and social workers involved in compulsory admission
Authors: Webster Lynne , Dean Christine
Published: May 2008

The 1983 Mental Health Act was introduced to increase the safeguards of the civil liberties of patients. One of the new provisions is that it is now the statutory responsibility of hospital managers to inform detained patients of their rights; this is done by giving them a leaflet explaining the appeal procedures. Doubt has been expressed (Dunlop, 1979) about whether this is an efficient means of conveying information to acutely ill patients.
Managing mentally abnormal offenders
Authors: Hajioff Jack
Published: May 2008

Psychiatric patients often break society's rules and find themselves before the courts. Sometimes an offence is the first sign of mental illness. The coincidence of mental disorder and an offence complicates both assessment and management, but particularly the latter.
The trainee's guide to research methodology
Authors: Freeman Chris , Tyrer Peter
Published: May 2008

This short paper is an aperitif that touches on the main issues involved in research methodology for the psychiatric trainee but which understandably cannot explore any of them in depth. It accompanies publication of a book published simultaneously by the College (Freeman & Tyrer, 1989), the orientation of which has been affected greatly by experience gathered during a series of courses in research methodology organised under the auspices of the Research Committee. These courses have demonstrated the need for a basic text on research methodology that is sensitive to the aims and resources available to trainees and also a guide that helps to avoid the pitfalls in research that often are discovered too late to be overcome.
Diagnosis-related groups: implications for psychiatry
Authors: Oyebode Femi , Cumella Stuart , Garden Gillian , Binyon Sharon
Published: May 2008

The escalating cost of medical care in most industrial countries has given impetus to several different strategies designed to impose limitations on cost and introduce efficiency into health care systems. In the United States of America, legislation was passed in 1983 to introduce a system of prospective payment for Medicare hospital expenditures. This change was a departure from the previous cost based reimbursement method and was based upon a categorisation of medical conditions into discrete groups termed diagnosis-related groups (DRGs). The intention of the American Congress in passing the legislation was to encourage hospitals to reduce cost without sacrificing quality of care.
Leadership development for mental health: an educational workshop in Africa
Authors: Checkoway Barry , Orley John
Published: May 2008

Community leadership for mental health is of increasing importance in developing areas of the world. As changes such as urbanisation and indus trialisation affect these areas, their mental health problems are becoming more apparent. These include conditions requiring either curative or cus todial care in an often distant hospital, but probably most others are more appropriately managed by inte grating mental health into primary health care, closer to patients' homes (Giel & Harding, 1976; Harding, 1980; WHO, 1984a).
The role of the psychotherapist as consultant to in-patient psychiatric units
Authors: Hobbs Mike
Published: May 2008

The psychotherapist as consultant to in-patient psychiatric units may undertake any one of a number of specific tasks. Central to, and common to these, is his support of the effective work of the psychiatric unit's staff. The consultant's contribution is directed primarily towards enabling the staff to utilise themselves, i.e. their selves, to the full in their treatment of the patients.
What should community mental health workers do? Experience in an inner city support team
Authors: Turner T. H. , Lovett A. , Ness M.
Published: May 2008

In 1979 a survey of Hackney's psychiatric in-patients revealed that many were resident simply because there was nowhere else for them to go. (Lomas, 1979). As a response to this, the Community Psychiatry Research Unit (CPRU) was set up, and a team of support workers appointed (from nursing, social work and occupational therapy backgrounds) to assist in re-housing and to provide continuing care. Developing projects have meant that the role and job description of this support team have constantly changed. To review their present role, we decided to assess the day-to-day activities of three workers so as to improve our understanding of their function, training needs and work load. Details of the assessment criteria for taking on patients have been outlined by Rich et al (1989).
Psychiatric in-patient audit – the patient's perspective
Authors: Ballard C. G. , McDowell A. W. T.
Published: May 2008

Consumer attitudes are of the utmost importance in achieving adequate care of a psychiatric population and may directly influence compliance with drug treatment, attendance at out-patient appointments and willingness to accept admission to a psychiatric unit. It is therefore surprising that despite the original Griffiths Report (1987) highlighting the need for consumer input into the psychiatric audit process, little research has been undertaken in this area and knowledge into the quality of inpatient care is especially sparse.
The costs of hospital closure: reproviding services for the residents of Darenth Park Hospital
Authors: Glennerster Howard
Published: May 2008

There has been little economic evaluation of the costs of closing long-stay institutions. Studies that have been undertaken have rarely had the opportunity to study the before and after effects of complete closure. Most attention has focused on the mentally ill not the mentally handicapped. This study followed a sample of residents leaving Darenth Park Hospital which was closed in 1988.
Improving initial attendance to a child and family psychiatric clinic
Authors: Mathai J. , Markantonakis A.
Published: May 2008

Recent papers regarding failure to keep appointments at child psychiatry clinics (Plunkett, 1984; Gould et al, 1985; Cottrell et al, 1988) suggest from 15% to 50% failing to keep their first appointments. Benson, Novick & Rembar (1981) calculated an attrition rate of 85.4%, obtained by considering cases of non-agreed termination of treatment at any stage of the referral/treatment-uptake process.
The Horton Malaria Laboratory
Authors: Rollin Henry R.
Published: May 2008

Horton Hospital, Epsom, has many claims to fame; but none so worthy of communication than the unique contribution towards the relief of suffering made by the Horton Laboratory, the name by which it became universally known.
Reprosecution of patients found unfit to plead: a report of anomalies in procedure in Scotland
Authors: Chiswick Derek , Shubsachs Alexander P. W. , Novosel Steven
Published: May 2008

A legal finding of unfitness to plead results in automatic committal of the accused to a mental hospital. In Scotland, if criminal proceedings are under solemn jurisdiction, there is a mandatory order restricting discharge without limit of time and the hospital must be a state hospital unless for special reasons an alternative hospital is appropriate (Section 174 of the Criminal Procedure [Scotland] Act 1975). The mental condition of a person found unfit to plead may subsequently improve such that he may become fit to be tried in the normal way. In England and Wales the Home Secretary has power, under Section 5(4) of the Criminal Procedure (Insanity) Act 1964, to remit to prison for trial a person found unfit to plead who subsequently recovers. On arrival of such a person in prison the hospital and restriction orders cease to have effect. The Criminal Procedure (Insanity) Act 1964 does not apply to Scotland; authority to reprosecute unfit defendants in sheriff courts and the High Court rests exclusively with procurators fiscal and the Crown Office respectively. The status of the original hospital and restriction orders in reprosecuted cases is unclear.
Training and appointment of consultants in behavioural psychotherapy
Authors: Veale David
Published: May 2008

This article argues for a new initiative in the training and appointment of consultants in behavioural psychotherapy or with a special interest in behavioural psychotherapy.
The Institute of Psychiatry cognitive behaviour therapy course
Authors: Moorey Stirling , Williams Ruth , Cobb John
Published: May 2008

Cognitive behaviour therapy is now widely accepted clinically as a treatment for depression and anxiety, and there is increasing research evidence to confirm its efficacy (Rush et al, 1977; Blackburn et al, 1981; Murphy et al, 1984; Butler et al, 1987; Beck, 1988). Of the various short term psychotherapies currently available, it is probably the most widely known and best researched. Despite this, and the recommendation of the Royal College of Psychiatrists (1986) that trainees receive training in cognitive therapy, there is little opportunity to gain a formal training in this psychotherapy. Short workshops are often available through the British Association for Behavioural Psychotherapy and from other sources, and ad hoc supervision from interested psychologists and psychiatrists may be available in some centres. Scott et al (1985) described a workshop and peer supervision training scheme in Newcastle. Macaskill (1986) reported a course for psychiatrists in training in Sheffield which extended over 20 weeks and combined Beck's cognitive therapy and Ellis' Rational Emotive Therapy.
The legacy of Dutch psychiatry
Authors: Neeleman Jan
Published: May 2008

The library of the Institute of Psychiatry is undoubtedly internationally oriented; it stocks writings in languages ranging from German to Chinese. As a foreigner one is bound to be on the look-out for texts in one's own language. In my case this search has until now been unsuccessful. After the librarian asked me whether the Dutch write about psychiatry at all, I have actually given up but at the same time I decided that it was my task to increase awareness of Dutch psychiatry among my colleagues. Although it is true that the Dutch have accepted English as the international scientific language more than any other members of the European Community, Flemish and Dutch psychiatrists do continue to publish in their native language by means of the Tijdschrift voor Psychiatrie, a journal which differs from, for example, its British counterpart by the emphasis it puts on case studies, psychotherapy and philosophical/historical issues rather than on research in the internationally accepted format.
Beyond mental hospital sites
Authors: Tannahill Mabel , Wilkinson Greg , Higson Peter
Published: May 2008

Professor R. G. Priest and Dr K. A. Day have prepared a discussion document on the future of mental hospital sites on behalf of the Public Policy Committee (Psychiatric Bulletin, April 1990, 14, 245–248), and may be complimented for stating their views in such detail.