bluuebunny/crossref_metadata_2025 huggingface dataset:
Local and remote controls on observed Arctic warming
Authors: Screen J. A. , Deser C. , Simmonds I.
Published: April 2012

The Arctic is warming two to four times faster than the global average. Debate continues on the relative roles of local factors, such as sea ice reductions, versus remote factors in driving, or amplifying, Arctic warming. This study examines the vertical profile and seasonality of observed tropospheric warming, and addresses its causes using atmospheric general circulation model simulations. The simulations enable the isolation and quantification of the role of three controlling factors of Arctic warming: 1) observed Arctic sea ice concentration (SIC) and sea surface temperature (SST) changes; 2) observed remote SST changes; and 3) direct radiative forcing (DRF) due to observed changes in greenhouse gases, ozone, aerosols, and solar output. Local SIC and SST changes explain a large portion of the observed Arctic near‐surface warming, whereas remote SST changes explain the majority of observed warming aloft. DRF has primarily contributed to Arctic tropospheric warming in summer.
Climatic impacts of stochastic fluctuations in air–sea fluxes
Authors: Williams Paul D.
Published: April 2012

Air–sea fluxes vary partly on scales that are too small or fast to be resolved explicitly by global climate models. This paper proposes a nonlinear physical mechanism by which stochastic fluctuations in the air–sea buoyancy flux may modify the mean climate. The paper then demonstrates the mechanism in climate simulations with a comprehensive coupled general circulation model. Significant changes are detected in the time‐mean oceanic mixed‐layer depth, sea‐surface temperature, atmospheric Hadley circulation, and net upward water flux at the sea surface. Also, El Niño Southern Oscillation (ENSO) variability is significantly increased. The findings demonstrate that noise‐induced drift and noise‐enhanced variability, which are familiar concepts from simple climate models, continue to apply in comprehensive climate models with millions of degrees of freedom. The findings also suggest that the lack of representation of sub‐grid variability in air–sea fluxes may contribute to some of the biases exhibited by contemporary climate models.
Methane retrievals from Greenhouse Gases Observing Satellite (GOSAT) shortwave infrared measurements: Performance comparison of proxy and physics retrieval algorithms
Authors: Schepers D. , Guerlet S. , Butz A. , Landgraf J. , Frankenberg C. , Hasekamp O. , Blavier J.‐F. , Deutscher N. M. , Griffith D. W. T. , Hase F. , Kyro E. , Morino I. , Sherlock V. , Sussmann R. , Aben I.
Published: April 2012

We compare two conceptually different methods for determining methane column‐averaged mixing ratios from Greenhouse Gases Observing Satellite (GOSAT) shortwave infrared (SWIR) measurements. These methods account differently for light scattering by aerosol and cirrus. The proxy method retrieves a CO2 column which, in conjunction with prior knowledge on CO2acts as a proxy for scattering effects. The physics‐based method accounts for scattering by retrieving three effective parameters of a scattering layer. Both retrievals are validated on a 19‐month data set using ground‐based at 12 stations of the Total Carbon Column Observing Network (TCCON), showing comparable performance: for the proxy retrieval we find station‐dependent retrieval biases from −0.312% to 0.421% of a standard deviation of 0.22% and a typical precision of 17 ppb. The physics method shows biases between −0.836% and −0.081% with a standard deviation of 0.24% and a precision similar to the proxy method. Complementing this validation we compared both retrievals with simulated methane fields from a global chemistry‐transport model. This identified shortcomings of both retrievals causing biases of up to 1ings and provide a satisfying validation of any methane retrieval from space‐borne SWIR measurements, in our opinion it is essential to further expand the network of TCCON stations.
Diversity patterns and activity of uncultured marine heterotrophic flagellates unveiled with pyrosequencing
Authors: Logares Ramiro , Audic Stephane , Santini Sebastien , Pernice Massimo C , de Vargas Colomban , Massana Ramon
Published: April 2012

Flagellated heterotrophic microeukaryotes have key roles for the functioning of marine ecosystems as they channel large amounts of organic carbon to the upper trophic levels and control the population sizes of bacteria and archaea. Still, we know very little on the diversity patterns of most groups constituting this evolutionary heterogeneous assemblage. Here, we investigate 11 groups of uncultured flagellates known as MArine STramenopiles (MASTs). MASTs are ecologically very important and branch at the base of stramenopiles. We explored the diversity patterns of MASTs using pyrosequencing (18S rDNA) in coastal European waters. We found that MAST groups range from highly to lowly diversified. Pyrosequencing (hereafter ‘454’) allowed us to approach to the limits of taxonomic diversity for all MAST groups, which varied in one order of magnitude (tens to hundreds) in terms of operational taxonomic units (98% similarity). We did not evidence large differences in activity, as indicated by ratios of DNA:RNA-reads. Most groups were strictly planktonic, although we found some groups that were active in sediments and even in anoxic waters. The proportion of reads per size fraction indicated that most groups were composed of very small cells (∼2–5 μm). In addition, phylogenetically different assemblages appeared to be present in different size fractions, depths and geographic zones. Thus, MAST diversity seems to be highly partitioned in spatial scales. Altogether, our results shed light on these ecologically very important but poorly known groups of uncultured marine flagellates.
Building a better sphingosine kinase-1 inhibitor
Authors: Lynch Kevin R.
Published: April 2012

Sphingosine 1-phosphate (S1P) is currently one of the most intensely studied lipid mediators. Interest in S1P has been propelled by the development of fingolimod, an S1P receptor agonist prodrug, which revealed both a theretofore unsuspected role of S1P in lymphocyte trafficking and that such modulation of the immune system achieves therapeutic benefit in multiple sclerosis patients. S1P is synthesized from sphingosine by two SphKs (sphingosine kinases) (SphK1 and SphK2). Manipulation of SphK levels using molecular biology and mouse genetic tools has implicated these enzymes, particularly SphK1, in a variety of pathological processes such as fibrosis, inflammation and cancer progression. The results of such studies have spurred interest in SphK1 as a drug target. In this issue of the Biochemical Journal, Schnute et al. describe a small molecule inhibitor of SphK1 that is both potent and selective. Such chemical tools are essential to learn whether targeting S1P signalling at the level of synthesis is a viable therapeutic strategy.
Fast and spectrally accurate Ewald summation for 2-periodic electrostatic systems
Authors: Lindbo Dag , Tornberg Anna-Karin
Published: April 2012

A new method for Ewald summation in planar/slablike geometry, i.e., systems where periodicity applies in two dimensions and the last dimension is “free” (2P), is presented. We employ a spectral representation in terms of both Fourier series and integrals. This allows us to concisely derive both the 2P Ewald sum and a fast particle mesh Ewald (PME)-type method suitable for large-scale computations. The primary results are: (i) close and illuminating connections between the 2P problem and the standard Ewald sum and associated fast methods for full periodicity; (ii) a fast, O(N log N), and spectrally accurate PME-type method for the 2P k-space Ewald sum that uses vastly less memory than traditional PME methods; (iii) errors that decouple, such that parameter selection is simplified. We give analytical and numerical results to support this.
Bond-order potentials with split-charge equilibration: Application to C-, H-, and O-containing systems
Authors: Knippenberg M. Todd , Mikulski Paul T. , Ryan Kathleen E. , Stuart Steven J. , Gao Guangtu , Harrison Judith A.
Published: April 2012

A method for extending charge transfer to bond-order potentials, known as the bond-order potential/split-charge equilibration (BOP/SQE) method [P. T. Mikulski, M. T. Knippenberg, and J. A. Harrison, J. Chem. Phys. 131, 241105 (2009)]10.1063/1.3271798, is integrated into a new bond-order potential for interactions between oxygen, carbon, and hydrogen. This reactive potential utilizes the formalism of the adaptive intermolecular reactive empirical bond-order potential [S. J. Stuart, A. B. Tutein, and J. A. Harrison, J. Chem. Phys. 112, 6472 (2000)]10.1063/1.481208 with additional terms for oxygen and charge interactions. This implementation of the reactive potential is able to model chemical reactions where partial charges change in gas- and condensed-phase systems containing oxygen, carbon, and hydrogen. The BOP/SQE method prevents the unrestricted growth of charges, often observed in charge equilibration methods, without adding significant computational time, because it makes use of a quantity which is calculated as part of the underlying covalent portion of the potential, namely, the bond order. The implementation of this method with the qAIREBO potential is designed to provide a tool that can be used to model dynamics in a wide range of systems without significant computational cost. To demonstrate the usefulness and flexibility of this potential, heats of formation for isolated molecules, radial distribution functions of liquids, and energies of oxygenated diamond surfaces are calculated.
Spectral contaminant identifier for off-axis integrated cavity output spectroscopy measurements of liquid water isotopes
Authors: Brian Leen J. , Berman Elena S. F. , Liebson Lindsay , Gupta Manish
Published: April 2012

Developments in cavity-enhanced absorption spectrometry have made it possible to measure water isotopes using faster, more cost-effective field-deployable instrumentation. Several groups have attempted to extend this technology to measure water extracted from plants and found that other extracted organics absorb light at frequencies similar to that absorbed by the water isotopomers, leading to δ2H and δ18O measurement errors (Δδ2H and Δδ18O). In this note, the off-axis integrated cavity output spectroscopy (ICOS) spectra of stable isotopes in liquid water is analyzed to determine the presence of interfering absorbers that lead to erroneous isotope measurements. The baseline offset of the spectra is used to calculate a broadband spectral metric, mBB, and the mean subtracted fit residuals in two regions of interest are used to determine a narrowband metric, mNB. These metrics are used to correct for Δδ2H and Δδ18O. The method was tested on 14 instruments and Δδ18O was found to scale linearly with contaminant concentration for both narrowband (e.g., methanol) and broadband (e.g., ethanol) absorbers, while Δδ2H scaled linearly with narrowband and as a polynomial with broadband absorbers. Additionally, the isotope errors scaled logarithmically with mNB. Using the isotope error versus mNB and mBB curves, Δδ2H and Δδ18O resulting from methanol contamination were corrected to a maximum mean absolute error of 0.93 ‰ and 0.25 ‰ respectively, while Δδ2H and Δδ18O from ethanol contamination were corrected to a maximum mean absolute error of 1.22 ‰ and 0.22 ‰. Large variation between instruments indicates that the sensitivities must be calibrated for each individual isotope analyzer. These results suggest that the properly calibrated interference metrics can be used to correct for polluted samples and extend off-axis ICOS measurements of liquid water to include plant waters, soil extracts, wastewater, and alcoholic beverages. The general technique may also be extended to other laser-based analyzers including methane and carbon dioxide isotope sensors.
Uncertainty inequalities among frequency moments and radial expectation values: Applications to atomic systems
Authors: Angulo J. C. , Bouvrie P. A. , Antolín J.
Published: April 2012

Rigorous and universal bounds on frequency moments of one-particle densities in terms of radial expectation values in the conjugate space are obtained. The results, valid for any d-dimensional quantum-mechanical system, are derived by using Rényi-like position-momentum inequalities in an information-theoretical framework. Especially interesting are the upper bounds on the Dirac exchange and Thomas-Fermi kinetic energies, as well as the disequilibrium or self-similarity of both position and momentum distributions. A variety of bounds for these functionals in a given space are known, but most usually in terms of quantities defined within the same space. Very few results including a density functional on one space, and expectation values on the conjugate one, are found in the literature. A pioneering bound on the disequilibrium in terms of the kinetic energy is improved in this work. A numerical study of the aforementioned relationships is carried out for atomic systems in their ground state. Some results are given in terms of relevant physical quantities, including the kinetic and electron-nucleus attraction energies, the diamagnetic susceptibility and the height of the peak of the Compton profile, among others.
Dissociative electron attachment resonances in ammonia: A velocity slice imaging based study
Authors: Ram N. Bhargava , Krishnakumar E.
Published: April 2012

Negative ion resonance states of ammonia are accessed upon capture of electrons with energy 5.5 eV and 10.5 eV, respectively. These resonance states dissociate to produce H− and \documentclass[12pt]{minimal}\begin{document}${\rm NH}_2^-$\end{document} NH 2− fragment anions via different fragmentation channels. Using the velocity slice imaging technique, we measured the angular and kinetic energy distribution of the fragment H− and \documentclass[12pt]{minimal}\begin{document}${\rm NH}_2^-$\end{document} NH 2− anions with full 0–2π angular coverage across the two resonances. The scattered H− ions at both resonances show variation in their angular distribution as a function of the kinetic energy indicating geometric rearrangement of \documentclass[12pt]{minimal}\begin{document}${\rm NH}_3^{-*}$\end{document} NH 3−* ion due to internal excitations and differ from the equilibrium geometry of the neutral molecule. The second resonance at 10.5 eV shows strong forward-backward asymmetry in the scattering of H− and \documentclass[12pt]{minimal}\begin{document}${\rm NH}_2^-$\end{document} NH 2− fragment ions. Based on the angular distributions of the H− ions, the symmetry of the resonances at 5.5 eV and 10 .5 eV are determined to be A1 and E, respectively, within C3v geometry.
Molecular dynamics simulation study on heat transport in monolayer graphene sheet with various geometries
Authors: Cao Ajing
Published: April 2012

Using non-equilibrium molecular dynamics (MD) simulations, we study heat transport in monolayer graphene sheet. We show that the thermal transport in monolayer graphene sheet exhibits a strong length dependence on thermal conductivity, reaching 2360 W/mK at 2.8 μm. By modeling a two-dimensional heat spread type of heat conduction mimicking the experimental probing using the excitation laser light focused on a graphene, the isotropic nature of heat flow in graphene is revealed, which is in support of recent experimental probing. The T−1 dependence of thermal conductivity is observed at temperatures above room temperature. A peak value at 300 K is observed with further decreasing T, in good agreement with that of carbon nanotubes reported experimentally. Thermal conductivity of graphene nanoribbons (GNRs) strongly depends on the ribbon width, which is attributed to arise from the surface phonon scattering. Furthermore, the nonlinear temperature profile is revealed for asymmetric GNRs. A fitting approach for the MD obtained temperature profile based upon the analytic solution is proposed to obtain the thermal conductivity of GNRs of asymmetric geometry. These findings shed light on tuning thermal properties of GNRs with geometry optimizations.
Communication: Adjusting charge transfer state energies for configuration interaction singles: Without any parameterization and with minimal cost
Authors: Liu Xinle , Fatehi Shervin , Shao Yihan , Veldkamp Brad S. , Subotnik Joseph E.
Published: April 2012

In a recent article, we showed that configuration interaction singles (CIS) has a systematic bias against charge-transfer (CT) states: CT vertical excitation energies are consistently too high (by 1-2 eV) as compared with non-CT energies [J. E. Subotnik, J. Chem. Phys. 137, 071104 (2011)]. We now show that this CIS error can be corrected approximately by performing a single Newton-Raphson step to reoptimize orbitals, thus establishing a new set of orbitals which better balances ground and excited state energies. The computational cost of this correction is exactly that of one coupled-perturbed Hartree-Fock calculation, which is effectively the cost of the CIS calculation itself. In other words, for twice the computational cost of a standard CIS calculation, or roughly the same cost as a linear-response time-dependent Hartree-Fock calculation, one can achieve a balanced, size-consistent description of CT versus non-CT energies, ideally with the accuracy of a much more expensive doubles CIS(D) calculation.
Structure stabilities and transitions in polyhedral metal nanocrystals: An atomic-bond-relaxation approach
Authors: Zhang Ai , Zhu Ziming , He Yan , Ouyang Gang
Published: April 2012

We present an atomic-bond-relaxation (ABR) method to illustrate a deeper insight on structure stabilities and transitions of metal nanocrystals with polyhedral structure based on the thermodynamic consideration. It has been found that the end effects in polyhedral nanocrystals induced by the atoms located at edges, side facets, and vertexes play the dominant roles for their structure performances. The theoretical predictions are well consistent with the experimental measurements and simulations, which suggest the ABR model can be an effective method to understand solid-solid phase transition of polyhedral metal nanocrystals.
High sensitivity low field magnetically gated resistive switching in CoFe2O4/La0.66Sr0.34MnO3 heterostructure
Authors: Thakare Vishal , Xing Guozhong , Peng Haiyang , Rana Abhimanyu , Game Onkar , Anil Kumar P. , Banpurkar Arun , Kolekar Yesappa , Ghosh Kartik , Wu Tom , Sarma D. D. , Ogale Satishchandra B.
Published: April 2012

The phenomenon of resistive switching (RS) has been demonstrated in several non-magnetic and some magnetic oxide systems, however the “magnetic” aspect of magnetic oxides has not been emphasized especially in terms of low field tunability. In our work, we examined the CoFe2O4/La0.66Sr0.34MnO3 all-magnetic oxide interface system for RS and discovered a very sharp (bipolar) transition at room temperature that can be gated with high sensitivity by low magnetic fields (∼0–100 mT). By using a number of characterizations, we show that this is an interface effect, which may open up interesting directions for manipulation of the RS phenomenon.
Gold nanoring as a sensitive plasmonic biosensor for on-chip DNA detection
Authors: Huang Chengjun , Ye Jian , Wang Shuo , Stakenborg Tim , Lagae Liesbet
Published: April 2012

We report an on-chip nanosensor based on the localized surface plasmon resonance (LSPR) property of gold nanorings. The fabricated nanorings using nanosphere lithography showed highly tunable optical properties and were optimized to boost LSPR-based biosensing. The LSPR extinction spectra of the nanosensor agreed well with the theoretical calculations using a finite-difference time-domain model. Such an on-chip nanoring-based biosensor showed a refractive index sensitivity of 350 nm/refractive index unit with a figure of merit of 3.1 and was utilized to detect DNA in a real-time and label-free manner.
A correction factor for ablation algorithms assuming deviations of Lambert-Beer’s law with a Gaussian-profile beam
Authors: Rodríguez-Marín Francisco , Anera Rosario G. , Alarcón Aixa , Hita E. , Jiménez J. R.
Published: April 2012

In this work, we propose an adjustment factor to be considered in ablation algorithms used in refractive surgery. This adjustment factor takes into account potential deviations of Lambert-Beer’s law and the characteristics of a Gaussian-profile beam. To check whether the adjustment factor deduced is significant for visual function, we applied it to the paraxial Munnerlyn formula and found that it significantly influences the post-surgical corneal radius and p-factor. The use of the adjustment factor can help reduce the discrepancies in corneal shape between the real data and corneal shape expected when applying laser ablation algorithms.
Note: Self-characterizing ultrafast pulse shaper for rapid pulse switching
Authors: Pearson Brett J. , Weinacht Thomas C.
Published: April 2012

We use a high-efficiency acousto-optic modulator at the input to a two-dimensional Fourier-domain pulse shaper to achieve built-in characterization of the shaped output pulses. The acousto-optic modulator directs the beam to different vertical positions on a two-dimensional spatial light modulator, each of which can contain a different pulse shape. The undiffracted portion of the light serves as a reference beam for characterizing the shaped pulse via spectral interferometry. Pulse switching rates of 100 kHz can be achieved, making the device especially useful for quantum-control spectroscopy.
DISCOURSES ON ANTISEMITISM AND ISLAMOPHOBIA IN ARAB MEDIA
Authors: Webman Esther
Published: April 2012

This paper discusses the relationship between antisemitism and Islamophobia, focusing on debates in Arab newspapers in the wake of the Second Intifada and 9/11 and then in response to two issues of contention for Muslim communities in Europe, the Danish cartoon crisis in 2006 and the Swiss referendum on building minarets in 2009. The paper relates these debates to major UN and EU resolutions for combating racism, Islamophobia and antisemitism. The aim of this paper is to explore how far discussion of antisemitism and Islamophobia in the Arab world is dominated by those who see Islamophobia as the real danger in today's Europe and antisemitism as a Zionist ploy, and how far antisemitism and Islamophobia have become two competing terms relating to two communities that perceive themselves as victims of prejudice and racism and also of each other. The paper seeks to qualify this image. It acknowledges that the entanglement of the Israeli–Palestinian conflict adds a political aspect to the discussion of the two terms, intensifies competition between them for recognition as unique forms of racism and discrimination, and curtails the creation of positive ground for dialogue. However, it also demonstrates the presence of other voices which are more open to addressing both forms of exclusion.
The PROTECT in‐hospital risk model: 7‐day outcome in patients hospitalized with acute heart failure and renal dysfunction
Authors: O'Connor Christopher M. , Mentz Robert J. , Cotter Gad , Metra Marco , Cleland John G. , Davison Beth A. , Givertz Michael M. , Mansoor George A. , Ponikowski Piotr , Teerlink John R. , Voors Adriaan A. , Fiuzat Mona , Wojdyla Daniel , Chiswell Karen , Massie Barry M.
Published: April 2012

Aims

In patients with acute heart failure (AHF), early worsening heart failure (WHF) predicts a significant proportion of post‐discharge readmissions and mortality. We aimed to identify the predictors of 7‐day heart failure events or death in patients hospitalized with AHF.

Methods and results

A predictive model and risk score for the short‐term primary composite endpoint of 7‐day death, HF rehospitalization, or WHF was created using variables collected within 24 h of admission from patients with complete data (n = 2015) enrolled in the PROTECT trial of AHF patients. The 7‐day composite was experienced by 294 patients (14.6%), with a mortality rate of 1.8% (n = 37), HF rehospitalization rate of 0.5% (n = 9), and WHF rate of 13.1% (n = 264). In multivariable analyses, the strongest predictor of short‐term morbidity and mortality was higher blood urea nitrogen (BUN) concentration. Additional independent predictors of a worse outcome were lower serum albumin, cholesterol, and systolic blood pressure, as well as higher heart rate and respiratory rate. Model coefficients were converted to an additive risk score for predicting the 7‐day composite endpoint with a total point range of 0–100. The risk score allowed discrimination of a wide spectrum of risk (4.8% risk with score ≤35, to 28.7% risk with score >55).

Conclusions

Using the PROTECT 7‐day risk model and score, the main determinants of an adverse outcome for AHF patients included impaired metabolic status, neurohormonal activation, and reduced cardiac performance, gauged by BUN, serum albumin and cholesterol levels, systolic blood pressure, heart rate, and respiratory rate.
Historical changes in mental health practice
Authors: Rose Nikolas
Published: April 2012

However we define ‘community psychiatry’, it is clear that, in contemporary societies, practices addressed to the mental troubles of individuals have proliferated across everyday life. Psychiatric interventions occur in mental hospitals, psychiatric wards in general hospitals, special hospitals, medium secure units, day hospitals, outpatient clinics, child guidance clinics, prisons, children’s homes, sheltered housing, drop-in centres, community mental health centres, domiciliary care by community psychiatric nurses, multiple forms of psychological therapies, and, of course, in the general practitioner’s surgery, not least through the increasing prescription of psychiatric drugs. No phase of life is unknown to these practices: infertility, pregnancy, birth and the postpartum period; infancy; childhood at home and at school; sexual normality, perversion, impotence, and pleasure; family life, marriage and divorce, employment and unemployment, mid-life crises, and failures to achieve; old age, terminal illness, and bereavement.

Wherever problems arise — in our homes, on the streets, in factories, schools, hospitals, the army, courtroom, or prison — experts with specialist knowledge of the nature, causes, and remedies for mental distress are on hand to provide its diagnoses and propose remedial action. And, of course, there is a wider penetration of psychiatry, broadly defined, into popular culture, as psychiatrists, mental hospitals, those with mentally illness, and the problems of mental health feature daily in political and social debates, in our newspapers, in television documentaries, exposés, talk shows, and soap operas. The languages that have been disseminated have given us new vocabularies in which to think and talk about our problems — stress, trauma, depression, neuroses, compulsions, phobias. They have also provided us with new ways of explaining, judging, and accounting for our personal miseries, of distinguishing the normal and the abnormal, identifying what is illness, when to seek assistance and from whom. It would not, therefore, be too much of an exaggeration to say that we lived in a ‘psychiatric society’. ‘Community psychiatry’, then, is one dimension of the ‘psychiatric societies’ that has taken shape over the course of the 20th century. There have been many international variations in the historical paths followed in different national contexts, but the rationalities and practices that have taken shape are remarkably similar across the Western world. In this chapter, focusing upon the United Kingdom, I want to sketch out some of the key moments in this history.
Mental health policy in modern America
Authors: Grob Gerald N.
Published: April 2012

In the United States a variety of factors have shaped and continuously modified mental health policy: the changing composition of the population with severe mental disorders; concepts of the aetiology and nature of mental illnesses; shifting diagnostic systems; the organization and ideology of psychiatry; funding mechanisms; and existing popular, political, social, and professional attitudes and values. Equally significant has been the structure of the American political system, which divides authority between local, state, and national government.
The application of epidemiology to mental disorders
Authors: Lewis Glyn H. , Errazuriz Antonia , Thomas Hollie V. , Cannon Mary , Jones Peter B.
Published: April 2012

In this chapter we shall present the main tools used by epidemiologists to measure the occurence and aetiology of disease in populations, and we shall summarize the results of epidemiological studies when applied to mental disorders.
The mental health challenges of immigration
Authors: Mollica Richard F. , Kirschner Kathia E. , Ngo-Metzger Quyen
Published: April 2012

In 2007 it was estimated that there were 38.1 million foreign-born people living in the United States (U.S. Census Bureau, 2007). Since 1975, the United States has resettled approximately 2.6 million refugees (Office of Refugee Resettlement, 2008). Most immigrants and refugees come to escape poverty, mass violence, and/or political/religious oppression. Since 1960 there has been a continuous increase in immigrants coming from Latin America (from 9.4 % in 1960 to 53.6 % in 2007) and Asia (from 5.1 % in 1960 to 26.8 % in 2007). In Europe a similar trend is taking place: the European Union (EU) estimates that 28.8 immigrants currently live in the EU. By the end of 2008, the United Nations High Commissioner for Refugees (UNHCR; 2008 ) estimated that there were more than 10 million refugees under its mandate and about 26 million conflict- induced displaced persons worldwide. According to the UNHCR, ‘The year 2008 saw the mass movement of people within and beyond their borders, uprooted by conflict, calamity or searching for opportunity’ (UNHCR, 2008). Patterns of both conflict and human displacement are becoming increasingly more complex. The increase in diversity of immigrant/refugee population from developing countries to the so-called developed countries has increased and poses new challenges to the field of community health and mental health care.

In this chapter we will focus on describing the barriers encountered by highly traumatized immigrants and refugees from culturally diverse backgrounds and provide a model that addresses this population’s specific health and mental health problems and barriers to care.
Early interventions for people with psychotic disorders
Authors: Power Paddy , McGorry Pat
Published: April 2012

Early intervention (EI) in psychosis has established itself as a cornerstone of service provision in psychosis over the last two decades. It is the latest in a line of key developments in the management of psychotic disorders over the last 60 years, following the introduction of antipsychotic medication, de-institutionalization, community care, and more effective psychosocial interventions. It borrows from principles that have emerged over the last few decades in other areas of medicine, social care, and education. Its focus is on early detection, prevention, and intervention in young people with emerging first-episode psychosis. It has become a social movement in its own right, developing its own national and international associations (e.g. the International Early Psychosis Association) World Health Organization-endorsed principles (Bertolote and McGorry, 2005), and attracting considerable political, media, and community support.

This explosion of interest in EI over the past two decades has prompted governments in many developed countries to adopt the EI model, with some promoting it as a top priority for mental health service planning (Appleby, 2009). Countries such as United Kingdom, Canada, Australia, and New Zealand have committed to national roll-outs of these services. This has been further supported by recent economic evaluations highlighting the substantial health savings involved (McCrone et al., 2008; Mihalopoulos et al., 2009).

The field is now moving into other forms of serious mental illness, not only in conditions typically affecting young people but even into old age psychiatry (Naismith et al., 2009). However, questions remain regarding the long-term benefits of a focus on early intervention (Bertelsen et al., 2008; Craig, 2003; Gafoor et al., 2010; Pelosi, 2009) and there is much to discover about the true extent of its merits. There is still uncertainty about the ideal model. EI services wrestle with the dilemma of whether they are for all age groups or specifically for young people, whether they are extensions of child and adolescent mental health services, or young adult services, or both, whether they are limited to non-affective psychoses or all forms of serious mental illness, and whether they are best provided independently of generic services or embedded as subcomponents of these services.
Day hospital and partial hospitalization programmes
Authors: Schene Aart H.
Published: April 2012

Partial hospitalization (PH) as a treatment modality for psychiatric disorders has evolved over more than 60 years now. PH fills the wide gap between inpatient or full-time hospitalization (FTH) on the one hand and outpatient or community mental health care on the other. For patients, carers, and professional staff, PH has the potential to offer more than low-frequency outpatient visits while at the same time it prevents the disadvantages of a hospital admission.

In this chapter I discuss some of the main issues regarding the current status and the future development of PH: history, development, conceptual issues and definition, different types of PH programmes, (cost-) effectiveness of PH in comparison with FTH and outpatient treatment, selection criteria, treatment models, and therapeutic factors. In the last section I review the place of this component in the total of psychiatric services.
Programmes to support family members and caregivers
Authors: Drapalski Amy L. , Dixon Lisa B.
Published: April 2012

Most individuals with schizophrenia or other serious mental illnesses have regular contact with family members and these family members often provide substantial support and assistance to their ill relative (Chien et al., 2006; Hackman and Dixon, 2008; Resnick et al., 2005). Although providing support to a relative with mental illness is often rewarding on many levels, caring for a relative with a mental illness can also be extremely demanding and can lead to feeling of being overwhelmed, frustrated, worried, and depressed. Oftentimes, limited knowledge of mental illness, mental health treatments, and the mental health service system coupled with the increased demands associated with taking on a caregiver role can contribute to significant family stress, distress, and burden. In turn, this increased burden may impede a family’s ability to continue to provide the support and assistance that their ill relative may need to help effectively manage an illness and achieve recovery goals. Several programmes have been developed in an effort to address the varying needs and preferences of family members and caregivers of individuals with serious mental illness. This chapter aims to discuss the potential impact of mental illness on the family and its relationship to family needs, to highlight the basic tenets or principles of effective family programmes, and to describe several prominent family interventions and outline the evidence for their effectiveness.
Managing co-occurring physical disorders in mental health care
Authors: Cimpean Delia , Drake Bob
Published: April 2012

Individuals with serious mental illness (SMI) have increased rates of medical comorbidity. The most common serious medical conditions in this population include cardiovascular disease, cardiovascular risk conditions (obesity, hyperlipidaemia, type 2 diabetes), and blood-borne viral infections. The cluster of cardiovascular risk factors that includes high body-mass index (BMI), high blood pressure, high blood sugar and cholesterol, sometimes called metabolic syndrome, is found in 35 % to 63 % of people with schizophrenia and is associated with a fivefold increase in risk of diabetes and twofold increased cardiovascular risk.

As consequences of high rates of medical comorbidity, people with SMI have greatly reduced physical functioning, are vulnerable to early institutionalization in nursing homes, experience worse mental health outcomes, and ultimately, high levels of early mortality, especially cardiovascular mortality. Indeed, on average, people with SMI have 30-year shorter lifespans compared to people of the same age without mental illness (Dickey et al., 2002; Miller et al., 2006).

Morbidity, disability, and early mortality observed in people with SMI are outcomes that resemble that of people 20 years older in the general population. In other populations with premature aging or ‘weathering’, chronic pervasive socioeconomic stress was associated with increased allostatic load, measured by several cardiovascular, metabolic, and inflammatory biomarkers (Bird et al., 2010; Geronimus et al., 2006). Similarly, people with SMI are subjected to pervasive stress, such as poverty, unemployment, homelessness, and overt or subtle chronic stigma and discrimination. Over the course of a lifetime, psychological and physiological response to pervasive stress and the high effort required for coping, produce premature aging of people with SMI. This underlines the importance of coupling socioeconomic measures to the health improvement programmes to address the high medical burden and early mortality of people with SMI.
Treatment pressures, coercion, and compulsion
Authors: Szmukler George , Appelbaum Paul S.
Published: April 2012

In the last half of the 20th century and beginning of the 21st century, psychiatrists and other mental health clinicians became increasingly sensitive to the effects and implications of treatment that was not fully consensual. The number of psychiatric inpatients declined by more than two-thirds during that period. Many countries have tightened their procedures and standards for involuntary commitment (Appelbaum, 1997; Dressing and Salize, 2004). Mental health systems have worked harder to protect patients’ liberty interests, and to avoid circumstances in which non-consensual treatment occurs.

Nonetheless, the nature of mental illness — with patients frequently manifesting denial of their disorder or of a need for care — and the public’s concerns about the propensity of mentally ill persons to injure others or themselves, will probably make it impossible for non-consensual treatment ever to be abandoned completely. Indeed, with the movement to community care, new mechanisms for exerting pressures on patients have developed in services such as Assertive Community Treatment (ACT) (Stein and Santos, 1998). A major focus of ACT — usually targeted at persons with chronic mental illness who are thought likely to drift away from care — is to prevent defaulting from treatment, since loss of contact is likely to lead to relapse and readmission to hospital. Treatment is brought assertively to the patient making disengagement difficult. ‘Compliance’ or ‘adherence’ with medication is often a central issue. In the background also remains the possibility of compulsory admission to hospital.

This chapter has three aims:

To outline a spectrum of treatment pressures in contemporary practice, drawing ethically relevant distinctions between them

To consider when the exercise of such treatment pressures can be justified

To suggest approaches aimed at reducing the need for treatment pressures in community mental health services.
Public attitudes towards people with mental illness
Authors: Link Bruce , Angermeyer Matthias C. , Phelan Jo
Published: April 2012

The increase in research about public knowledge, attitudes, and beliefs concerning mental illnesses is a prominent fact. From just a small number of path-breaking studies in the 1950s and 1960s (Cohen and Struening, 1962; Cumming and Cumming, 1957; Nunnally, 1961; Star, 1955) the field has grown to become an enormous literature that has used multiple measures and multiple methods in studies conducted in a vast array of populations (Link et al., 2004; Thornicroft 2006; Thornicroft et al., 2009). We seek to capture the essence of this body of work by reviewing the core questions it has assessed. We follow this brief review by posing two questions. The first asks why it is important to study knowledge, attitudes, and beliefs (KABs) and turns our attention to KABs as representations of cultural conceptions of mental illness. We argue that KABs are elements of a cultural context that influences how people think about and respond to mental illnesses and that this influence expands beyond the narrow individually-based model that asks whether individual attitudes are good predictors of individual behaviours. To exemplify this point we highlight the importance of cultural conceptions for modified labelling theory and for the creation and sustenance of structural stigma. The second question asks how we can capture changes in KABs towards mental illnesses and leads us to consider the importance of studies that monitor trends in KABs over time.
Reducing stigma and discrimination
Authors: Thornicroft Graham , Mehta Nisha
Published: April 2012

The term stigma (plural stigmata) was originally used to refer to an indelible dot left on the skin after stinging with a sharp instrument, sometimes used to identify vagabonds or slaves. The resulting mark led to the metaphorical use of ‘stigma’ to refer to stained or soiled individuals who were in some way morally diminished. In modern times stigma has come to mean ‘any attribute, trait or disorder that marks an individual as being unacceptably different from the “normal” people with whom he or she routinely interacts, and that elicits some form of community sanction’ (Goffman, 1963 ).

There is now a voluminous literature on stigma (Corrigan, 2005; Link et al., 1999 ; Mason, 2001 ; Sartorius and Schulze, 2005 ). The stigma of mental illness is the subject of many hundreds of scientific papers (Pickenhagen and Sartorius, 2002). The most complete model of the component processes of stigmatization has four key components (Link and Phelan, 2001 ): 1) labelling, in which personal characteristics are signalled or noticed as conveying an important difference; 2) stereotyping, which is the linkage of these differences to undesirable characteristics; 3) separating, the categorical distinction between the mainstream/normal group and the labelled group as in some respects fundamentally different; 4) status loss and discrimination: devaluing, rejecting, and excluding the labelled group. Interestingly, more recently the authors of this model have added a revision to include the emotional reactions which may accompany each of these stages (Link et al., 2004 ).

We shall consider later what needs to be done to allow people with mental illnesses a full opportunity for social participation. First of all we need to have a clear map to know where we are and where we want to go.

Stigma theories have not been enough to understand the feelings and experiences of people with mental illness, nor to know what practical steps are needed to reverse social exclusion (Social Exclusion Unit, 2004). Rather stigma can be seen as an overarching term that contains three important elements:

◆ Problems of knowledge (ignorance)

◆ Problems of attitudes (prejudice), and

◆ Problems of behaviour (discrimination).

In terms of social psychology, these are referred to as the cognitive, affective, and behavioural domains (Dovidio et al., 2000), and each will now be discussed.
Funding of mental health services
Authors: Chisholm Dan , Knapp Martin
Published: April 2012

Whether it is a case of setting out to develop, reorientate, or just maintain existing levels of community-based mental health services, policy-makers and planners will run up against the inconvenient but inescapable question of resource constraints. How much money will it take, for example, to build up service coverage and capacity, to introduce effective new intervention strategies, to overhaul prevailing modes of service delivery, or to cater for the changing needs of the population? Decisions made at this strategic level of mental health policy and planning exert a powerful influence over the extent to which those people in need of services will actually be able to access and use them, as well as shape the way in which provision is organized and paid for.

Mental health financing is a far-reaching topic that not only addresses the specific question of what services to purchase and how, but also more normative questions around how much should be allocated to (say) community mental health care (e.g. what can be afforded, given the extent of mental health and broader other health needs in the population?), as well as equity issues (e.g. are funding arrangements fair, in the sense that people in need are not prevented from accessing services on financial grounds?). Indeed, alongside meeting the reasonable expectations of service users and actualizing mental health improvements in the population, fair financing does or should represent a key goal of a mental health system (WHO, 2006). In this chapter, we endeavour to cover these diverse questions under a number of central financing themes— resource generation and revenue collection, risk pooling and financial protection, plus resource allocation and purchasing — to highlight key funding issues that need to be considered when planning, implementing, or evaluating community mental health services.
Qualitative research methods in mental health
Authors: Whitley Rob
Published: April 2012

In this chapter I set out to introduce the reader to qualitative research in mental health. I describe its main methods of inquiry, and its underpinning foundational and philosophical principles. I give numerous examples of where qualitative research has been fruitfully employed in community psychiatry. I then describe criteria of rigour which can be used to assess the strength and contribution of any qualitative study in mental health. I believe qualitative research continues to offer interesting insights into the prevention, diagnosis, phenomenology, treatment, management, and understanding of psychiatric disorder. It may also assist resolution of current policy imperatives, such as calls for person-centred care, and more thorough evaluations of service effectiveness.
Understanding and using systematic literature reviews
Authors: Cipriani Andrea , Barbui Corrado
Published: April 2012

Making rapid decisions is a key component of everyday clinical practice. Informed decision-making such as this requires physicians to combine their own clinical expertise and training with high-quality scientific evidence (Guyatt et al., 2000). New scientific knowledge is emerging all the time and all health workers need to update their knowledge continuously. Most busy practising clinicians simply do not have sufficient time to read all the important primary research reports. Over two million articles are published every year in 20,000 biomedical journals (Mulrow, 1994) and even if a clinician restricts his/her reading to high-yield clinical psychiatry journals, he/she would need to read over 5000 articles a year (Geddes et al., 1999). The clinician therefore needs a reliable system of knowledge management, that is, systematic reviews and meta-analyses. In this chapter, we will outline the main features and limitations of systematic reviews and will suggest ways in which further syntheses of primary trial data may yield clinically useful information.