bluuebunny/crossref_metadata_2025 huggingface dataset:
SIRT3, a pivotal actor in mitochondrial functions: metabolism, cell death and aging
Authors: Giralt Albert , Villarroya Francesc
Published: April 2012

SIRT3 is a member of the sirtuin family of protein deacetylases that is preferentially localized to mitochondria. Prominent among the proteins targeted by SIRT3 are enzymes involved in energy metabolism processes, including the respiratory chain, tricarboxylic acid cycle, fatty acid β-oxidation and ketogenesis. Through these actions, SIRT3 controls the flow of mitochondrial oxidative pathways and, consequently, the rate of production of reactive oxygen species. In addition, SIRT3-mediated deacetylation activates enzymes responsible for quenching reactive oxygen species, and thereby exerts a profound protective action against oxidative stress-dependent pathologies, such as cardiac hypertrophy and neural degeneration. SIRT3 also plays a role in multiple additional metabolic processes, from acetate metabolism to brown adipose tissue thermogenesis, often by controlling mitochondrial pathways through the deacetylation of target enzymes. In general, SIRT3 activity and subsequent control of enzymes involved in energy metabolism is consistent with an overall role of protecting against age-related diseases. In fact, experimental and genetic evidence has linked SIRT3 activity with increased lifespan. In the coming years, the identification of drugs and nutrients capable of increasing SIRT3 expression or modulating SIRT3 activity can be expected to provide promising strategies for ameliorating the metabolic syndrome and other oxidative stress-related diseases that appear preferentially with aging, such as cancer, cardiac dysfunction and neural degeneration.
Gibberellin biosynthesis and its regulation
Authors: Hedden Peter , Thomas Stephen G.
Published: April 2012

The GAs (gibberellins) comprise a large group of diterpenoid carboxylic acids that are ubiquitous in higher plants, in which certain members function as endogenous growth regulators, promoting organ expansion and developmental changes. These compounds are also produced by some species of lower plants, fungi and bacteria, although, in contrast to higher plants, the function of GAs in these organisms has only recently been investigated and is still unclear. In higher plants, GAs are synthesized by the action of terpene cyclases, cytochrome P450 mono-oxygenases and 2-oxoglutarate-dependent dioxygenases localized, respectively, in plastids, the endomembrane system and the cytosol. The concentration of biologically active GAs at their sites of action is tightly regulated and is moderated by numerous developmental and environmental cues. Recent research has focused on regulatory mechanisms, acting primarily on expression of the genes that encode the dioxygenases involved in biosynthesis and deactivation. The present review discusses the current state of knowledge on GA metabolism with particular emphasis on regulation, including the complex mechanisms for the maintenance of GA homoeostasis.
A moving-frame boundary-integral method for particle transport in microchannels of complex shape
Authors: Zinchenko Alexander Z. , Ashley John F. , Davis Robert H.
Published: April 2012

A new, three-dimensional algorithm is developed to accurately simulate low-Reynolds number, flow-driven motion of a neutrally buoyant spherical particle in plane-parallel microchannels of complex shape. The channel profile may consist of an arbitrary number of straight line segments with sharp corners in an arbitrary configuration. This geometry provides a suitable model for particle transport in many microfluidic devices with multiple branch bifurcations. The particle may be comparable with the narrowest channel dimensions, but is typically much smaller than the overall channel domain, which creates difficulties with a standard boundary-integral approach. To make simulations feasible, the 3D problem is solved locally in a computational cell that is smaller than the full domain and is dynamically constructed around the particle as it moves through the channel; the outer boundary conditions are provided by the 2D flow that would exist in the channel in the absence of the particle. Difficulties with particle-corner close interactions are alleviated using special iterative techniques, (near-) singularity subtractions and corner-fitted, gap-adaptive discretizations of the cell boundary. The algorithm is applied to simulate “pinched-flow fractionation” and predict how particle interactions with a narrow pinch region and sharp corners result in particle focusing and separation in the outlet according to their size. As another application, the particle motion through a T-bifurcation with sharp corners is simulated, with calculation of the particle flux partition ratio for a broad range of parameters. It is demonstrated how the particle-corner interactions can make the side branch inaccessible to particles, even for relatively strong fluid suction through this branch.
On the existence of a natural common gauge-origin for the calculation of magnetic properties of atoms and molecules via gaugeless basis sets
Authors: Pelloni Stefano , Lazzeretti Paolo
Published: April 2012

It is proven that, within the conventional approach using a common origin and gaugeless basis sets for the calculation of atomic magnetizability and Larmor current density induced by an external magnetic field, the natural gauge origin coincides with the nucleus. Recipes for defining an optimal gauge origin for the calculation of magnetizability and magnetic shielding at the nuclei of a molecule are given. Within the common origin approach, the paramagnetic contributions to the components of magnetic tensors of a molecule are represented by a minimum number of non-vanishing parameters if the gauge origin is chosen at a point characterized by the total molecular symmetry, e.g., the center of electronic charge for magnetizabilities. It is shown that total values of diagonal components of the magnetic shielding tensor \documentclass[12pt]{minimal}\begin{document}${\bm \sigma}^I$\end{document}σI at a nucleus I in a molecule, as well as separate diamagnetic \documentclass[12pt]{minimal}\begin{document}${\bm \sigma}^{{\rm d} I }$\end{document}σdI and paramagnetic \documentclass[12pt]{minimal}\begin{document}${\bm \sigma}^{{\rm p} I }$\end{document}σpI contributions, calculated via the common origin method, are origin independent for a number of local point group symmetries.The diagonal components (and the average value) of \documentclass[12pt]{minimal}\begin{document}${\bm \sigma}^I$\end{document}σI depend on the gauge origin only for nuclear site symmetries C1, Cs, Cn, Cnv, n = 2, 3…. Group-theoretical methods show interesting features, e.g., for S4 local symmetry, in a coordinate transformation, the paramagnetic contribution to the zz component and to the trace of the shielding tensor is origin independent, whereas the xx and yy components mix into one another, in such a way that their sum remains constant.
Probing and modelling the localized self-mixing in a GaN/AlGaN field-effect terahertz detector
Authors: Sun J. D. , Qin H. , Lewis R. A. , Sun Y. F. , Zhang X. Y. , Cai Y. , Wu D. M. , Zhang B. S.
Published: April 2012

In our previous work [Sun et al., Appl. Phys. Lett. 100, 013506 (2012)], we inferred the existence of localized self-mixing in an antenna-coupled field-effect terahertz detector. In this Letter, we report a quasistatic self-mixing model taking into account the localized terahertz fields and its verification by comparing the simulated results with the experimental data in a two-dimensional space of the gate voltage and the drain/source bias. The model well describes the detector characteristics: not only the magnitude, but also the polarity, of the photocurrent can be tuned. The existence of strongly localized self-mixing in such detectors is confirmed.
Nucleation on active centers in confined volumes
Authors: Kožíšek Zdeněk , Hikosaka Masamichi , Okada Kiyoka , Demo Pavel
Published: April 2012

Kinetic equations describing nucleation on active centers are solved numerically to determine the number of supercritical nuclei, nucleation rate, and the number density of nuclei for formation both of droplets from vapor and also crystalline phase from vapor, solution, and melt. Our approach follows standard nucleation model, when the exhaustion of active centers is taken into account via the boundary condition, and thus no additional equation (expressing exhaustion of active centers) is needed. Moreover, we have included into our model lowering of supersaturation of a mother phase as a consequence of the phase transition process within a confined volume. It is shown that the standard model of nucleation on active centers (Avrami approach) gives faster exhaustion of active centers as compared with our model in all systems under consideration. Nucleation rate (in difference to standard approach based on Avrami model) is equal to the time derivative of the total number of nuclei and reaches some maximum with time. At lower nucleation barrier (corresponding to higher initial supersaturation or lower wetting angle of nucleus on the surface of active center) the exhaustion of active centers is faster. Decrease in supersaturation of the mother phase is faster at higher number of active centers.
Electronic properties of individual diarylethene molecules studied using scanning tunneling spectroscopy
Authors: Arramel  , Pijper T. C. , Kudernac T. , Katsonis N. , van der Maas M. , Feringa B. L. , van Wees B. J.
Published: April 2012

The investigation of the electronic conduction through monosulfurdiarylethene (1S-DE) immobilized in an insulating dodecanethiol matrix on a gold surface was addressed. Scanning tunneling spectroscopy allows to probe spatially the frontier molecular orbitals of 1S-DE at 77 K. We locally extracted the electronic highest occupied molecular orbital-lowest unoccupied molecular orbital gap of 1S-DE with the value of 1.56 eV. This attempt reveals the importance of scanning tunneling spectroscopy as a tool to measure the charge transport properties of diarylethene towards the realization of a switching-based molecular device.
Integrated high frequency aluminum nitride optomechanical resonators
Authors: Xiong Chi , Sun Xiankai , Fong King Y. , Tang Hong X.
Published: April 2012

Aluminum nitride (AlN) has been widely used in microeletromechanical resonators for its excellent electromechanical properties. Here, we demonstrate the use of AlN as an optomechanical material that simultaneously offers low optical and mechanical loss. Integrated AlN microring resonators in the shape of suspended rings exhibit high optical quality factor (Q) with loaded Q up to 125 000. Optomechanical transduction of the Brownian motion of a GHz contour mode yields a displacement sensitivity of 6.2 × 10−18 m/Hz1/2 in ambient air.
Metal-insulator transition with multiple micro-scaled avalanches in VO2 thin film on TiO2(001) substrates
Authors: Kawatani Kenichi , Takami Hidefumi , Kanki Teruo , Tanaka Hidekazu
Published: April 2012

We observed micro-scale phase separation in VO2 thin films on TiO2(001) substrates and investigated the relationship between the appearance of metallic domains and the abrupt resistive changes around the phase transition. The resistive changes are interpreted using a combined resistance model of the two phases, and the conductance evaluated from the visualized domain behavior was consistent with the electronic properties. These results indicate the importance of modifying conductive behavior spatially using a partial phase transition.
Local structure around Fe ions on multiferroic Pb(Fe1/2Nb1/2)O3 ceramics probed by x-ray absorption spectroscopy
Authors: Mesquita A. , Fraygola B. M. , Mastelaro V. R. , Eiras J. A.
Published: April 2012

Local structure around Fe ions on Pb(Fe1/2Nb1/2)O3 ceramics was probed by x-ray absorption spectroscopy in order to settle the controversies about its structure. It is observed that the shell structure around Fe atoms exhibits a monoclinic local symmetry at 130 and 230 K, tetragonal local symmetry at room temperature, and cubic local symmetry at 410 K. Independently of the coordination, temperature, or symmetry, Fe-O mean bond-length does not vary significantly.
The Mark–Houwink–Sakurada Relation for Poly(Methyl Methacrylate)
Authors: Wagner Herman L.
Published: April 2012

In this third review of a series, the literature values for the viscosity-molecular weight relationship (Mark–Houwink–Sakurada) for poly(methyl methacrylate) have been critically evaluated. Although most of the studies have been concerned with conventionally produced poly(methyl methacrylate), some work has also been done with the isotactic polymer. The Mark–Houwink relations for the following solvents are discussed: benzene, toluene, acetone, chloroform, 2-butanone, and tetrahydrofuran, as well as for several other infrequently used solvents. The values of the coefficient K in the relation [η]=KM0.5 for several theta solvents are also reported.
The Viscosity of Carbon Dioxide, Methane, and Sulfur Hexafluoride in the Limit of Zero Density
Authors: Trengove R. D. , Wakeham W. A.
Published: April 2012

The paper contains accurate representations for the viscosity of the three polyatomic gases, carbon dioxide, methane, and sulfur hexafluoride, in the limit of zero density. These gases were studied because they possess permanent multipole moments of increasing order 4, 6, and 8, respectively. The correlations have associated uncertainties of ±0.3% around room temperature rising to ±1.5% at the low-temperature extreme and to a maximum of ±2.0% at the high-temperature extreme. The correlating equation for carbon dioxide is valid for the temperature range 200–1500 K, that for methane from 110–1050 K and that for sulfur hexafluoride from 220–900 K. It is shown that a two-parameter law of corresponding states is inadequate for the representation of the data over these wide ranges of temperature.
The Viscosity of Normal Deuterium in the Limit of Zero Density
Authors: Assael M. J. , Mixafendi S. , Wakeham W. A.
Published: April 2012

This paper contains a new representation of the viscosity of normal deuterium in the limit of zero density as a function of temperature. The correlation is based upon the semiclassical kinetic theory of polyatomic gases and a body of critically evaluated experimental data. The similarity of the intermolecular pair potentials of normal hydrogen and normal deuterium is employed to extrapolate the correlation for deuterium beyond the range of the experimental data. In the temperature range 250–350 K the accuracy of the representation of the viscosity is estimated to be ±1%, which deteriorates to ±2% at the lowest temperatures and to ±4% at the highest temperatures.
Standard Chemical Thermodynamic Properties of Alkanethiol Isomer Groups
Authors: Alberty Robert A. , Burmenko Ellen , Kang Tae H. , Chung Michael B.
Published: April 2012

The chemical thermodynamic properties of alkanethiol (RSH where R is an alkyl group) isomer groups from CH4S to C4H10S in the ideal gas phase have been calculated from 298.15 to 1000 K from tables of Stull, Westrum, and Sinke. In the absence of literature data on all isomers of higher isomer groups, the properties of isomers of C5H12S to C8H18S have been estimated using Benson group values. Equilibrium mole fractions within isomer groups have been calculated for the ideal gas state from 298.15 to 1000 K. For isomer group properties, increments per carbon atom have been calculated to show the extent to which thermodynamic properties of higher isomer groups may be obtained by linear extrapolation. Values of C○P, S°, ΔfH°, and ΔfG° are given for all species of alkanethiols from CH4S to C8H18S in SI units for a standard state pressure of 1 bar.
Evaluation of Binary Excess Volume Data for the Methanol+Hydrocarbon Systems
Authors: Srivastava R. , Smith B. D.
Published: April 2012

The volume change of mixing data for the methanol+hydrocarbon binary mixtures have been compiled and the best sets of data identified. The needs for new experimental data have been defined.
Evaluation of Binary Excess Enthalpy Data for the Methanol+Hydrocarbon Systems
Authors: Srivastava R. , Smith B. D.
Published: April 2012

The heat of mixing data for the methanol+hydrocarbon binary mixtures have been compiled and the best sets of data identified. The needs for new experimental data have been defined.
Extinction Coefficients of Triplet–Triplet Absorption Spectra of Organic Molecules in Condensed Phases: A Least-Squares Analysis
Authors: Carmichael Ian , Helman W. P. , Hug G. L.
Published: April 2012

A global least-squares technique is developed to assist in the critical evaluation of data consisting of large sets of measurements. The technique is particularly designed to handle sets of data where many of the measurements are relative measurements. A linearization procedure is used to reduce the inherently nonlinear problem to a traditional multivariate linear regression. The technique developed here is used to evaluate extinction coefficients, ε’s, of triplet–triplet absorption (TTA) spectra of organic molecules in condensed phases. A previous assumption, that there are no solvent effects on the TTA spectra, is investigated and modified so that a group of compounds measured in benzene is treated separately. The set of 445 ε’s obtained from the global least-squares fit, including these solvent effects, is presented in the accompanying tables. How these least-squares results can be used in a hierarchy of TTA ε standards is discussed. Further solvent effects such as the separation of polar and nonpolar media and the influence of temperature are probed.
Evaluated Chemical Kinetic Data for the Reactions of Atomic Oxygen O(3P) with Unsaturated Hydrocarbons
Authors: Cvetanović R. J.
Published: April 2012

Chemical kinetic data for reactions of O(3P) atoms with unsaturated hydrocarbons are compiled and critically evaluated. Specifically, the reactions considered include the interactions of the ground electronic state of oxygen atoms, O(3P), with alkenes, cycloalkenes, halogen substituted alkenes and ketenes, alkynes, halogen substituted alkynes, aromatic hydrocarbons, halogen substituted aromatic hydrocarbons and pyridine. All kinetic data considered were restricted to gas phase reactions. ‘‘Recommended’’ values of the rate parameters have been assessed and conservative uncertainty limits assigned to them.
Spectral Data for Molybdenum Ions, Mo VI–Mo XLII
Authors: Shirai Toshizo , Nakai Yohta , Ozawa Kunio , Ishii Keishi , Sugar Jack , Mori Kazuo
Published: April 2012

Wavelengths, intensities, and classifications for the molybdenum ions Mo VI to Mo XLII are compiled. A short review of the work on each stage of ionization is included. The data are critically evaluated and the best results, in our judgement, are quoted.
Thermodynamic Properties of Selected Binary Aluminum Alloy Systems
Authors: Desai P. D.
Published: April 2012

This work reviews the data and information available through March 1985 on the various thermodynamic properties of five binary aluminum alloy systems: Al–Fe, Al–Mn, Al–Ni, Al–Si, and Al–Ti. The thermodynamic properties covered in this work are heat capacity, Gibbs energy, enthalpy, and entropy of formation. Existing data have been evaluated and analyzed. The values for heat capacity and room-temperature enthalpy of formation for a large number of alloys have been generated. For each of the binary alloy systems, the recommended values for integral Gibbs energy, enthalpy, and entropy of formation as well as the partial quantities, activity, and activity coefficients for each component covering the entire composition range have been reported. These values are reported for both solid and liquid alloys.
1
3C Chemical Shieldings in Solids
Authors: Duncan T. M.
Published: April 2012

Analogous to the importance of 13C isotropic shieldings for chemical analysis of liquids with nuclear magnetic resonance spectroscopy, 13C chemical shielding anisotropies are proving to be valuable in the characterization of solids. Specifically, molecular geometry is revealed by the full shielding anisotropy and molecular motion may be characterized by changes in the powder pattern. In particular, the principal components of the shielding reveal differences in bonding geometry which may not be correlated to monotonic changes in the isotropic shift. This report is a comprehensive, critical compilation of 13C chemical shieldings in solids, organized by carbon functionality. From these data, representative shieldings of common carbon functionalities are calculated.
Thermochemical Data on Gas Phase Compounds of Sulfur, Fluorine, Oxygen, and Hydrogen Related to Pyrolysis and Oxidation of Sulfur Hexafluoride
Authors: Herron John T.
Published: April 2012

Thermochemical data on selected gas phase compounds containing sulfur, fluorine, oxygen, and hydrogen are evaluated. These are of particular relevance to plasma chemistry and SF6 dielectric breakdown. Values of the enthalpies of formation and the entropy are provided at 298 K. Where no experimental data are available, methods for estimation have been developed for deriving the enthalpy of formation. Data are tabulated for 36 substances.
Standard Thermodynamic Functions of Gaseous Polyatomic Ions at 100–1000 K
Authors: Loewenschuss Aharon , Marcus Yitzhak
Published: April 2012

The standard thermodynamic functions—heat capacity at constant pressure C○p, its ratio to that at constant volume, the entropy S○, the enthalpy minus that at absolute zero (H○−H○0), and the Gibbs energy function (G○−H○0)/T were calculated for 131 gaseous ions in the temperature interval 100–1000 K, and are presented in tables. The input data included structural information (bond lengths and angles), vibrational spectroscopic information (vibrational frequencies and degeneracies), and electronic level occupation and degeneracies for ions having unpaired electrons. These were taken mainly from a recent review by the authors, and supplemented by further data from the literature, updated to the end of 1985.
The Thermochemical Measurements on Rubidium Compounds: A Comparison of Measured Values with Those Predicted from the NBS Tables of Chemical and Thermodynamic Properties
Authors: Parker V. B. , Evans W. H. , Nuttall R. L.
Published: April 2012

This report presents the assessed thermochemical measurements on rubidium compounds upon which the property values, Δf H0, Δf G0, S0, C0p, and H0(T)−H0(0) at 298.15 K and Δf H0(0 K) recommended in the ‘‘NBS Tables of Chemical Thermodynamic Properties’’ are based. Included in this set of thermochemical measurements, or thermochemical reaction catalog, is a comparison of the observed values for the processes in question with those predicted (calculated) from the recommended property values in the forementioned tables. The evaluator’s initially assigned uncertainties on the experimental measurements and final estimated reliabilities on the recommended process values are given. This paper illustrates the evaluation procedure used in preparing the full set of recommended data in the ‘‘NBS Tables of Chemical Thermodynamic Properties’’.
Thermodynamic Properties of Manganese and Molybdenum
Authors: Desai P. D.
Published: April 2012

This work reviews and discusses the data on the various thermodynamic properties of manganese and molybdenum available through March 1985. These include heat capacity, enthalpy, enthalpy of transitions and melting, vapor pressure, and enthalpy of vaporization. The existing data have been critically evaluated and analyzed. The recommended values for the heat capacity, enthalpy, entropy, and Gibbs energy function from 0.5 to 2400 K for manganese and from 0.4 to 5000 K for molybdenum have been generated, as have heat capacity values for supercooled β-Mn and for γ-Mn below 298.15 K. The recommended values for vapor pressure cover the temperature range from 298.15 to 2400 K for manganese and from 298.15 to 5000 K for molybdenum. These values are referred to temperatures based on IPTS-1968. The uncertainties in the recommended values of the heat capacity range from ±3% to ±5% for manganese and from ±1.5% to ±3% for molybdenum.
The governance of formal university–industry interactions: understanding the rationales for alternative models
Authors: Bodas Freitas Isabel
                      M. , Geuna Aldo , Rossi Federica
Published: April 2012

This article develops a conceptual framework to explain the economic rationale underpinning the choice of different modes of governance of formal university–industry interactions: personal contractual interactions, where the contract regulating the collaboration involves a firm and an individual academic researcher, and institutional interactions, where the relationship between the firm and the academic is mediated by the university. Although institutional interactions, for numerous reasons, have become more important, both governance modes are currently being implemented. We would argue that they have some important specificities that need to be understood if university–industry knowledge transfer is to be managed effectively and efficiently.
Prospective Observational Study of Imatinib Therapy in Japanese Patients with Advanced Gastrointestinal Stromal Tumors: Long-term Follow-up and Second Malignancy
Authors: Kanda Tatsuo , Ishikawa Takashi , Hirota Seiichi , Yajima Kazuhito , Kosugi Shin-ichi , Ohashi Manabu , Suzuki Satoshi , Mashima Yasuoki , Ajioka Yoichi , Hatakeyama Katsuyoshi
Published: April 2012

Objective

Limited data are available concerning long-term results of imatinib therapy in patients with advanced gastrointestinal stromal tumors. We aimed to clarify the long-term outcomes of imatinib therapy in Japanese patients with advanced gastrointestinal stromal tumors.

Methods

A prospective, observational study of imatinib therapy for unresectable and metastatic gastrointestinal stromal tumors was conducted in our institution. Imatinib was initiated at a dose of 400 mg daily and continued until disease progression. Safety, efficacy and long-term tolerability and survival were evaluated in an intent-to-treat population. The median follow-up period in this study was 68 months.

Results

Seventy patients were enrolled between December 2001 and December 2009. Treatment-related Grade 3/4 adverse events occurred in 49 patients (70.0%). Although 14 patients required adverse effect management with hospitalization, only 5 patients (7.1%) withdrew from the treatment owing to imatinib intolerance. The tumor response and clinical benefit rates were 61.4 and 85.7%, respectively. Thirty-seven patients (52.9%) maintained the treatment at 400 mg daily imatinib, whereas 33 patients (47.1%) had their dose reduced to 300 mg daily or less. The overall survival rate at 5 years was 60.9% and the median survival time was 70 months. The median progression-free survival time of all the 70 enrolled patients was 30 months. Seven patients (10.0%) suffered from second malignancies, including three patients with genitourinary carcinomas.

Conclusions

Despite the need for dose reduction, the long-term results of imatinib therapy for advanced gastrointestinal stromal tumors were good in Japanese patients. Physicians should pay attention to the occurrence of second malignancies during imatinib therapy for gastrointestinal stromal tumor patients.
Recovery as an integrative paradigm in mental health
Authors: Slade Mike , Davidson Larry
Published: April 2012

The term ‘recovery’ is at the heart of a debate about the core purpose of mental health services. It is a contested term, with at least two meanings. We call these two meanings recovery from mental illness, or ‘clinical recovery’, on the one hand, and being in recovery with a mental illness, or ‘personal recovery’, on the other (Davidson and Roe, 2007). Each meaning is underpinned by a set of values, and creates role expectations for mental health professionals. We begin by differentiating these two meanings.
Treated and untreated prevalence of mental disorders: results from the World Health Organization World Mental Health (WMH) surveys
Authors: Wang Philip S. , Sergio Aguilar-Gaxiola , AlHamzawi Ali Obaid , Alonso Jordi , Andrade Laura Helena , Angermeyer Matthias C. , Borges Guilherme , Bromet Evelyn J. , Bruffaerts Ronny , Bunting Brendan , Caldas de Almeida José Miguel , Florescu Silvia , Girolamo Giovanni de , Graaf Ron de , Gureje Oye , Haro Josep Maria , Hinkov Hristo Ruskov , Hu Chi-yi , Karam Elie G. , Kovess Viviane , Lee Sing , Levinson Daphna , Ono Yutaka , Petukhova Maria , Posada-Villa José , Sagar Rajesh , Seedat Soraya , Wells J. Elisabeth , Kessler Ronald C.
Published: April 2012

Neuropsychiatric disorders are leading causes of disability worldwide, accounting for 37 % of all healthy life years lost from disease (Lopez et al., 2006). They are among the most disabling conditions even in low-income countries, where detection of emotional problems and access to treatment are lowest. Although efficacious and tolerable treatments for these disorders are increasingly available, even economically-advantaged societies experience competing priorities and budgetary constraints (Tasman et al., 2003). Knowing how to provide effective treatment is consequently a worldwide imperative (Hu, 2003). Unfortunately, most countries suffer from a lack of data to guide decisions, absent or competing visions for resources, and near constant pressures to cut insurance and entitlements (Mechanic, 1994).

How can countries redesign their mental health care systems and optimally allocate resources? A first step is to document the services currently being used as well as the extent and nature of unmet needs for treatment. A second step may be to conduct cross-national comparisons of service use and unmet needs in countries with different mental health care systems. Such comparisons have the potential to help uncover optimal financing, national policies, and delivery systems for the care of mental disorders. Unfortunately, few cross-national studies of such differences are available (Bijl et al., 2003; Kessler et al., 1997).

For these reasons, WHO established the WMH Survey Initiative in 1998 (Demyttenaere et al., 2004 ). Coordinated surveys of the prevalence of mental disorders, their severity, impairments, and treatments have been implemented and analysed in 24 developing and developed countries. The current report describes the levels, types, and adequacy of mental health service use in these countries. We also examine unmet needs for treatment among strata defined by the seriousness of mental disorders. Finally, we identify sociodemographic correlates of unmet needs for treatment to guide the design and targeting of future resources, policies, and interventions.
The global burden of mental disorder
Authors: Prince Martin
Published: April 2012

The World Health Organization’s global burden of disease (GBD) estimates provide evidence on the relative impact of health problems worldwide (Murray and Lopez, 1996; World Health Organization, 2006). Patterns of morbidity seem to be globalizing with non-communicable diseases rapidly becoming the dominant causes of ill health in all developing regions except Sub-Saharan Africa. Within this wider health transition, the GBD report showed for the first time the true scale of the contribution of mental disorders, this revelation attributed to the use of the disability-adjusted life year (DALY), the sum of years lived with disability (YLD), and years of life lost (YLL) as a single integrated measure of disease burden. Neuropsychiatric conditions (comprising, in descending order of DALY contribution: mental disorders, substance and alcohol use disorders, other neuropsychiatric disorders, dementia, mental retardation, migraine, epilepsy, Parkinson’s disease, and multiple sclerosis) account for 14 % of all DALYs and 28 % of all DALYs attributed to non-communicable disease (Murray and Lopez, 1996; World Health Organization, 2006). They are the chief contributor to burden among the non-communicable diseases, more than either cardiovascular disease (22 % of non-communicable disease DALYs) or cancer (11 %). Proportionately, mental disorders account for just 9 % of the burden in low-income countries, compared with 18 % in middle-income and 27 % in high-income countries. This is because the burden of communicable, perinatal, and maternal conditions remains high in many low- and low–middle-income countries, swelling the denominator. However, the absolute burden of mental disorder as indicated by per capita DALYs does not vary much between world regions.
Crisis and emergency services
Authors: Johnson Sonia , Totman Jonathan , Hobbs Lorna
Published: April 2012

Our primary focus in this chapter is people with significant mental illnesses who are experiencing an exacerbation of their mental health or social problems of such severity that they reach the threshold for inpatient admission, or else seem likely very soon to reach this threshold unless pre-emptive action is taken. This is a relatively restrictive definition, excluding, for example, many crisis intervention services that have aimed to optimize the psychological adjustment of people experiencing difficult transitions in their lives. However, a focus on acute care at the threshold of admission is readily justified in economic, pragmatic, and policy terms. From the perspective of service users and carers, easy and prompt access to helpful and acceptable crisis services to help them at the times when they are most distressed is consistently rated as very important, with avoiding inpatient admission whenever possible also often identified as an important priority (Rose, 2001). From an economic and policy point of view, acute care, especially in hospital, consumes a large share of the mental health budget in most countries (Holloway and Sederer, Chapter 19, this volume), making it very desirable that optimal outcomes are achieved as efficiently as possible.

Given these major reasons for regarding acute care as a priority, the evidence base is surprisingly weak. For example, none of the 2009 recommendations of the Schizophrenia Patient Outcomes

Research Team (PORT) (Dixon et al., 2010) related to models of acute care delivery, and the National Institute of Health and Clinical Excellence (NICE) guidelines on schizophrenia and bipolar disorder make in relation to acute care only the general recommendations that crisis resolution and home treatment teams should be available. Despite this lack of robust evidence, mental health crises and, in particular, models aimed at diverting people from hospital admission, have been the focus of considerable innovative service development in the past few decades. In this chapter we complement Holloway and Sederer’s discussion of inpatient care by reviewing four other main types of care: two aimed mostly at initial triage of people experiencing crises (stand-alone emergency services and emergency department services in the general hospital), one combining assessment and provision of a community alternative to acute admission (crisis resolution and home treatment teams), and one mainly aimed at providing an alternative (community residential crisis services).

Acute day care is also excluded from our discussion as it is covered elsewhere, but, as the final section suggests, it should also be seen as a potentially important element in integrated care pathways.
Case management and assertive community treatment
Authors: Killaspy Helen , Rosen Alan
Published: April 2012

Recent decades have seen the relocation of psychiatric care from hospital-based settings to community-based services. The initial phases of deinstitutionalization led to a replication of the general hospital outpatient clinic model for review of community patients by psychiatrists, but gradually services began to expand the support available to people with more severe mental health problems. Over time, the addition of nurses, psychologists, occupational therapists, and social workers led to the establishment of community mental health teams. As community health and social care provision expanded, it became an increasingly complex system to navigate. Case management was developed to address this by assigning individual staff to assess service users’ needs and coordinate their treatment and care. Contemporary mental health services use a variety of models of case management of which assertive community treatment (ACT) is the most intensive and clearly defined form. This chapter explores these models of community mental health care, the evidence for them, and the possible explanations for the discrepancies in their effectiveness reported in the international literature.
Psychiatric outpatient clinics
Authors: Becker Thomas , Koesters Markus
Published: April 2012

Specialist psychiatric outpatient services have not, in recent years, been a priority of either the conceptual development or the study of community mental health care. General (or psychiatric) hospitals or community mental health team bases — at all of which outpatient clinics are held — can be considered community based as they are all located ‘in the community’. However, there may have been an implicit assumption that services should be considered community based only if conceptually they have moved away from hospitals or other institutions. Also, the outpatient clinic model, in its traditional form, has been ‘single-handed’. As such, outpatient clinics lack multidisciplinary input. A recent review of the community-based United Kingdom mental health care system, however, suggests that outpatient clinics are reported by more than two-thirds of so-called local implementation teams (Glover, 2007). There may also be a current trend towards specialized clinics for subgroups of patients, e.g. people with affective disorders, mentally disordered offenders, young adults, new mothers, patients with neuroses and eating disorders. Also, there may be a degree of under-reporting of outpatient clinics in surveys of local mental health services (Glover, 2007). Historically, these services have been a core element in the provision of psychiatric treatment, and it is likely that outpatient care continues to be a service element meeting important clinical needs in a large number of people with mental disorders.
Individual placement and support: the evidence-based practice of supported employment.
Authors: Becker Deborah R. , Bond Gary R. , Drake Robert E.
Published: April 2012

In most societies, employment is a major avenue to social inclusion (Grove et al., 2005). The benefits of working include increasing one’s financial resources, being productive and contributing to society, utilizing one’s skills and talents, enhancing self-esteem, improving self-image, meeting other people, and structuring one’s time. People with severe mental illness benefit from employment in these same ways. In addition, work enables many to recover from the disabling effects of mental illness.

Expectations for people with severe mental illness have changed drastically in the last two decades. Clients who once were relegated to day treatment 5 days a week are now working competitively.

The most successful employment practice to assist people develop a working life is a form of supported employment called individual placement and support (IPS). IPS has been standardized, tested, and implemented in several countries, especially the United States.
Inpatient treatment
Authors: Holloway Frank , Sederer Lloyd, I.
Published: April 2012

‘Inpatient care is, from the research perspective, the Cinderella of contemporary mental health services’ (Szmukler and Holloway, 2001). Research on the day-to-day practice of inpatient care remains a step-child of psychiatry and a policy vacuum on the role of inpatient treatment characterizes our field today. In the majority of advanced mental health economies large mental hospitals and institutional care has been vanquished by deinstitutionalization that has produced vast numbers of inpatient bed reductions.

Deinstitutionalization was driven by many forces: empirical evidence about the harmful effects of large institutions on patients (Wing and Brown, 1970); a general social movement that emphasized the ‘community’ as a positive resource for helping people (Hawks, 1975); scandals surrounding institutional care (Martin, 1984); cost containment (Kluiter, 1997); concerns about the importance of patients’ liberties and quality of life (Peele and Chodoff, 1999); and improvements in treatment technologies, which included medication, rehabilitation, assertive community treatment, psychological treatments, and crisis care (Ramsay and Holloway, 2007). A consensus developed amongst user groups, government and policy makers, service managers, and practitioners that inpatient treatment represented if not a failure then a barrier to an evolving paradigm of comprehensive community care. However, carers, clinicians in inpatient services, and community mental health staff who recognize the limits of community care however well it is done remain sceptical of such an antihospital proposition.
Residential care
Authors: Shepherd Geoff , Macpherson Rob
Published: April 2012

We all need somewhere to live where we feel safe and comfortable. Given this simple fact, it is unfortunate that for far too long, housing has been seen as at the periphery of the concerns of most mental health professionals, service providers, and researchers. While the importance of adequate housing may be recognized in principle, little research has been done to identify staffing and management practices associated with high quality care, or to improve outcomes. Meanwhile, people with severe mental health problems continue to live in substandard accommodation and struggle to gain access to decent and affordable housing (Kirby and Keon, 2006). This chapter explores these issues. We will describe the historical and policy background, review current issues, and bring together the available research to make practical, evidence-based suggestions for improving the quality of residential care. The context is the ‘mixed economy’ of care that now characterizes housing provision for people with mental health problems in the United Kingdom and in most of northern Europe, Australasia, and North America. This has grown up as we have moved away from long-term care in hospital. The ‘total institution’ has thus disappeared, but we now have many smaller ‘institutions’, with different management authorities, cultures, and values. How have we arrived at this point?
Medication treatment for anxiety, depression, schizophrenia, and bipolar disorder in the community setting
Authors: Shaywitz Jonathan , Marder Stephen
Published: April 2012

In the community setting, four of the most common mental health syndromes affecting individuals include anxiety, depression, psychosis, and bipolar disorder. While the disorders can be quite debilitating, fortunately recent advances in both behavioural therapy as well as pharmacotherapy have helped improve the lives of countless individuals. In this chapter we will focus our discussion on pharmacotherapy with an emphasis on providing practical information that will be particularly useful to the community psychiatrist in selecting the most optimal therapeutic agents for his/her patient. Specifically, we first briefly introduce each clinical syndrome, and the classes of medications used in treatment; then we go on to discuss in detail each disorder within the general syndrome with the current pharmacological treatments variable for each entity, including both their short term and long term efficacy and then discuss the current pharmacological treatments available for each entity, including both their short-term and long-term efficacy. The potential adverse (side) effects associated with each of these medications will also be discussed. Our goal is for this chapter to serve as a clinical tool box providing the reader with a practical and effective approach to these very common psychiatric disorders.
Ethical framework for community mental health
Authors: Rudnick Abraham , Forchuk Cheryl , Szmukler George
Published: April 2012

Community mental health services have been developing in the last few decades and in the process a number of ethical issues have arisen. Some of these deserve special attention as they are relatively distinct from ethical issues related to hospital mental health services. Application of established ethical approaches in the context of community mental health services may require revision of these approaches or alternatives to them. The aim of this chapter is to review key ethics concepts, to discuss ethical issues in community mental health services, and to provide a basis for an ethical framework for community mental health.

We will present definitions and central theories in ethics, an overview of bioethics, ethical issues related to community mental health services, addressing generic as well as distinctive problems. We will consider conservative and radical approaches (the latter partly based on community psychology research and practice), and challenges arising from an ethics of community mental health services (such as the view that social justice as in ‘social inclusion’ goes beyond fair resource allocation).
International human rights and community mental health
Authors: Lewis Oliver , Bartlett Peter
Published: April 2012

This chapter concerns human rights relating to people with mental health problems living in the community. It seeks to explain how international human rights law can work in a variety of ways to foster a person’s equal right to live in the community on an equal basis, with choices equal to others.

Each individual country may have legislation and policy to underpin community living. These may include social security payments and personal budgets to help people live independently, housing arrangements, provision of personal assistance and other supports, as well as non-discrimination provisions relating to vocational training and employment, and more widely to the provision of all goods and services. Such legislation and policy are essential in setting and regulating standards of human rights at the domestic level. These arrangements differ widely between countries, and for practical reasons a comparative analysis lies outside the scope of this chapter.

Instead, this chapter concerns the layers of international law and standards that sit above domestic law, directing and influencing domestic law and policy in order to bring about positive changes to the lived experiences of persons with mental health problems living in the community. The second section of the chapter (‘International human rights law’) is a primer on the treaties, how they are monitored, and how they apply to people with mental health problems living in the community. The third section (‘The dawn of a new era?’) introduces elements of the United Nations Convention on the Rights of Persons with Disabilities (hereinafter ‘CRPD’), and examines its philosophical underpinnings, the obligations on the State to implement it, and sets out its innovative features at the domestic level to coordinate policy action and to monitor implementation. It also outlines the Optional Protocol to the CRPD and the international mechanism established to monitor State compliance. The fourth section (‘Human rights underpinning community mental health’) explains some of the CRPD rights which impact upon community mental health, and the next three sections (‘Right to health’, ‘Right to live in the community’, and ‘Right to legal capacity’) provide an analysis of three of these rights in more depth. The conclusion in the final section suggests actions which community mental health practitioners could take in order to ensure that the State respects, protects, and fulfils the rights of people with mental health problems in the community.