bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Ammonia on the Growth of Carbon Nanotubes
Authors: Lin Szu-Hsien , Mishra Dillip Kumar , Ting Jyh-Ming
Published: May 2008

Carbon nanotubes were grown on hydrogen-treated Fe catalyst at 700 °C using a thermal chemical vapor deposition method. During the growth, acetylene was used as the carbon source, which is balanced by hydrogen and/or ammonia. Raman analysis shows that the introduction of ammonia
to the gaseous carbon source can lead to defect structures in the carbon nanotubes due to the incorporation of nitrogen atoms into the carbon nanotubes. Furthermore, the growth rate of carbon nanotubes was also affected by the introduction of ammonia into the gaseous carbon source. We show
that the dependence of the growth rate on the gaseous source composition is better described in terms of the ratio of ammonia to acetylene than the overall ammonia concentration. It is proposed that there is a competition between the ammonia and the acetylene during the growth of CNTs. At
low ammonia/acetylene ratios the growth increases with ammonia concentration; while at high ammonia/acetylene ratios the growth decreases with the ammonia concentration. A critical ammonia/acetylene ratio of 4.4, at which the growth peaks, was found and discussed.
The Integration Solution of Copper Barrier Deposition for Nanometer Interconnect Process
Authors: Chen Kei-Wei , Wang Ying-Lang , Tsao Jung-Chih , Lo Kuang-Yao
Published: May 2008

As the dimensions of devices are shrunk quickly, the requirements of metallization become more critical. For VIA barrier and seeding layer filling and deposition, the process was mostly applied with the copper physical vapor deposition methodology in the back-end of line flow of the
interconnection metallization. The criteria for barrier and seeding layer deposition are the metal continuity inside the VIA feature and grain size and orientation control for film diffusion barrier and qualities. Besides, while the interconnection size shrunk to nano-scale, the barrier thickness
would be very thinner to maintain the VIA resistance; however, it would face the film conformity and continuity consistence within the wafer and different features. The integration solution would be developed and studied with the re-sputter process step adding into the convectional physical
vapor deposition process. The resputter process step could not only improve the film conformity and continuity in the VIA's sidewall; but also reduce the resistance of VIA feature over 20%. The improvement of the resputter method adding into the deposition process would be contributed to the
standard barrier deposition in the nano-scale feature of the interconnect. Besides, we also discussed the effect of the film properties after the resputter process introduced into the barrier deposition.
Mitteleuropa in East-Central Europe
Authors: Franzinetti Guido
Published: May 2008

The aim of this article is to provide a description, an analysis and an explanation of Mitteleuropa and of other closely related concepts, such as East-Central Europe. The first section briefly addresses the broad historiographical issues. The second addresses the more strictly political and intellectual history of the concept in the period between 1975 and 1989 while the third section will describe the evolution of the concept after the end of the Cold War. The final part outlines the future directions in which the concept will change.
ATF4-dependent transcription is a key mechanism in VEGF up-regulation by oxidized phospholipids: critical role of oxidized sn-2 residues in activation of unfolded protein response
Authors: Oskolkova Olga V. , Afonyushkin Taras , Leitner Alexander , von Schlieffen Elena , Gargalovic Peter S. , Lusis Aldons J. , Binder Bernd R. , Bochkov Valery N.
Published: May 2008

We have shown previously that oxidized phospholipids (OxPLs), known to accumulate in atherosclerotic vessels, stimulate angiogenesis via induction of autocrine mediators, such as vascular endothelial growth factor (VEGF). We now address the pathways mediating up-regulation of VEGF in human endothelial cells treated with OxPLs. Analysis of structure-function relationship using individual species of OxPLs demonstrated a close relation between induction of VEGF and activation of the unfolded protein response (UPR). Inducers of UPR up-regulated VEGF, whereas inhibition of UPR by chemical chaperones or knock-down of cochaperone HTJ-1 inhibited elevation of VEGF mRNA induced by OxPLs. OxPLs induced protein expression of activating transcription factor-4 (ATF4), an important effector of UPR. Expression levels of VEGF in OxPL-treated cells strongly correlated with induction of the ATF4 target genes ATF3 and TRB3. Knocking down ATF4 was paralleled by loss of VEGF induction by OxPLs. Chromatin immunoprecipitation demonstrated that OxPLs stimulated binding of ATF4 to a regulatory site in the VEGFA gene. Taken together, these data characterize UPR and more specifically its ATF4 branch as an important mechanism mediating up-regulation of VEGF by OxPLs, and allow hypothesizing that the UPR cascade might play a role in pathologic angiogenesis in atherosclerotic plaques.
IL-2 triggers specific signaling pathways in human NKT cells leading to the production of pro- and anti-inflammatory cytokines
Authors: Bessoles Stéphanie , Fouret Frédéric , Dudal Sherri , Besra Gurdyal S , Sanchez Françoise , Lafont Virginie
Published: May 2008

NKT cells belong to a conserved T lymphocyte subgroup that has been implicated in the regulation of various immune responses, including responses to viruses, bacteria, and parasites. They express a semi-invariant TCR that recognizes glycolipids presented by the nonpolymorphic MHC class I-like molecule CD1d, and upon activation, they produce various pro- and anti-inflammatory cytokines. Recent studies have shed light on the nature of glycolipids and the environmental signals that may influence the production of cytokines by NKT cells and thus, modulate the immune response. To better understand the regulation mechanisms of NKT cells, we explored their behavior following activation by IL-2 and investigated the signaling pathways and biological responses triggered. We demonstrated that IL-2 activates not only STAT3 and -5 and the PI-3K and ERK-2 pathways as in all IL-2 responder cells but also STAT4 as in NK cells and the p38 MAPK pathway as in αβ T cells. We also showed that STAT6 is activated by IL-2 in NKT cells. Moreover, IL-2 induces the production of IFN-γ and IL-4. The ability of IL-2 to induce pro- and anti-inflammatory cytokine production, in addition to proliferation, could open new therapeutic approaches for use in combination with molecules that activate NKT cells through TCR activation.
Mother-Baby Units in Psychiatric Hospitals
Authors: Protheroe Colin
Published: May 2008

Middlewood Psychiatric Hospital, Sheffield, has recently provided facilities for the admission of babies with mothers suffering from psychiatric illness. The venture was sufficiently novel and noteworthy to receive mention in national newspapers, and one gathers that medical and nursing staff are pleased and encouraged by their experiences with their first few mother-infant pairs.
Self-induced Vomiting: I. An Ominous Variant of Anorexia Nervosa
Authors: Russell Gerald
Published: May 2008

The findings in this paper are based on 13 patients (12 female and 1 male) under my personal care who all satisfied the criteria for the diagnosis of anorexia nervosa (Russell, 1970). In addition, they had persistently made themselves vomit after most meals, over the course of several years (mean of 5.4 years). There were also episodes of over-eating that culminated in vomiting. The vomiting was done in private and achieved by stimulating the throat with fingers or a toothbrush, drinking large amounts of fluids or bending over, or a combination of these devices.
Teaching Liaison Psychiatry to Medical Students
Authors: Simpson Michael A.
Published: May 2008

Consultation-liaison psychiatry has emerged as a significant area of special interest within clinical psychiatry in recent years. It seeks to enhance the quality of psycho-social care of medically ill patients and of their psychological reactions to illness; to provide effective consultations not only with regard to patient management, but also to the complex problems arising where serious medical and psychiatric illness overlap, and to deal with the personal difficulties arising in members of the clinical team caring for the patient. It has an essential contribution to make to the actual practice of holistic, comprehensive health care; rather than just to the airy rhetoric by which whole-person medicine exists in the medical school's prospectus and objectives but not in its wards. We do not teach mere vapid sympathy, but competent psycho-physiological understanding of the patient, and sound communication skills.
Development of the Waltham Forest Local Mental Health Case Register
Authors: Fagin Leonard , Pursher Harry
Published: May 2008

608 is a Community Mental Health Centre (CMHC) in Waltham Forest Health District which came into service in February 1983. It serves a catchment area in North East London of approximately 95,000, and caters primarily for the 16 to 65 age group. It is linked with the services provided by a large psychiatric hospital—Claybury—which has been scheduled for closure by 1993. Planning is now under way to provide alternative services in each of the five districts covered by the hospital.
Developing a Microcomputer Based Automated Testing System for use with Psychogeriatric Patients
Authors: Carr A. C. , Woods R. T. , Moore B. J.
Published: May 2008

Microcomputers are increasingly being used in psychiatry for a variety of purposes. When used in computer-patient ‘interviews’ they have generally proved acceptable—indeed popular—with psychiatric patients. Automated psychological assessment is one form of computer-patient interview that is attracting much interest. Some of the early applications were with elderly patients. Kendrick has expressed doubts regarding this application with the current generation of elderly people, suggesting that their relative unfamiliarity with computers and video games might cause difficulties.
Thanatology in a Liaison Psychiatry Setting
Authors: Shelley R. K.
Published: May 2008

There has been increasing interest in recent years in the care of the terminally ill. Much of what has been written has been focussed on medical management and centred in hospices. The psychological dimension often appears neglected. The objective of this article is to outline the evolution, practice and problems of a liaison psychiatry input to the care of patients with terminal illness treated in a general hospital.
Liaison Psychiatry in a Burns Unit
Authors: Olivieri S.
Published: May 2008

Liaison psychiatry is in a developmental stage in the UK and the opportunity to be trained in this special area at Senior Registrar level is rare. The Wessex Rotation for Senior Registrars is therefore privileged to be able to offer an attachment to Odstock Hospital, Salisbury, where the Spinal and Plastic Regional Units are based. The local psychiatric service offers consultations to both Units, the senior registrar having opted for one session a week with the Burns Unit. He is supervised by the consultant psychiatrist who spends two weekly sessions in liaison with the special Unit.
The Role of Psychiatric Tutors: Report from the Third Collegiate Trainees Committee Working Party
Authors: Hampson Michele , Shapiro Colin , Thompson Chris
Published: May 2008

The working party was set up by the Third Collegiate Trainees Committee because dissatisfaction had often been expressed about psychiatric tutors at trainees' days around the country. It met regularly between September 1983 and April 1985. The aims were to survey trainees' satisfaction with their tutors, to invite tutors to comment on the difficulties of the job, to examine the structure of the system and to recommend changes if necessary.
The Role of the Health Advisory Service in Psychiatry
Authors: Horrocks Peter
Published: May 2008

The climate in 1969, in which the HAS was created, was one of increasing anxiety and embarrassment about the quality of long term care being offered to elderly, mentally ill and mentally handicapped patients in England and Wales. The need for a body to advise the Secretary of State, independently of the Department of Health and Social Security, was recognised and, with the wise guidance of Dr Alex Baker, the concept of multidisciplinary review by professional colleagues was established. Both these important principles have been maintained and stoutly defended by subsequent Directors, including myself.
Planning for Bed Needs and Resource Requirements in Acute Psychiatry: Key points from the Report of the Royal College of Psychiatrists Working Party on Psychiatric Beds and Resources, 1986
Authors: Hirsch Steven R.
Published: May 2008

In 1978 the Section for Social and Community Psychiatry of the Royal College of Psychiatrists set up a working party to reconsider the DHSS guideline of 0.5 beds per 1,000 population for acute psychiatric units and to develop a new approach which would enable planners to adopt an appropriate bed provision figure according to the needs of different district psychiatric services. This followed the realisation that Health Authorities were beginning to set arbitrarily their own norms for bed provision, often based on one or two examples within their region, despite the fact that there is a two to three fold variation between districts in the number of beds provided for acute psychiatry. For example, in 1981 Worcester used 0.19 acute beds per 1,000 population and Camberwell used 0.76.
The Psychiatrist on the Parole Board
Authors: McGrath Patrick G.
Published: May 2008

It is some years since Dr Henry Rollin published, in thePrison Medical Journal, an address he gave to prison doctors on the Role of The Psychiatrist on the Parole Board. Since then, there have been changes in policy and practice, and it may be opportune now to bring the work up to date, and to the notice of a generation of psychiatrists who might some day have the privilege and pleasure of serving on the Board.
A Regional Survey of the Training of Junior Psychiatrists in Behavioural Psychotherapy
Authors: Drummond Lynne M. , Bhat Ashok V.
Published: May 2008

It is 16 years since the Royal College of Psychiatrists published its recommendations for the training of psychiatrists. The guidelines for the training of general psychiatrists in psychotherapy have recently been reviewed and, once again, experience in behavioural psychotherapy was an integral part of such training.
Therapy, Battery and Informed Consent
Authors: Ormrod Roger
Published: May 2008

In its present state the law has little to contribute towards the solution of the problems arising from the medical treatment of mentally incapable, but informal patients. This is because there are no relevant rules; there is no legislation governing the situation because Parliament has not acted; and there are no Common (i.e. judge-made) Law rules because these problems have never come before a judge for decision.
A service for patients with Wilson's disease
Authors: Dening T. R. , Berrios G. E. , Seymour C. A.
Published: May 2008

Wilson's disease (WD) is an autosomal recessive disorder of copper metabolism with an incidence of about 30 per million (i.e. fewer than 2,000 in the UK). Nevertheless, it is important for two main reasons: its manifestations are protean and may lead it to present to a range of specialists; and its otherwise lethal course can be halted by treatment with chelating agents such as penicillamine and trientine. Published cases and systematic study have shown that neuropsychiatric symptomatology is important in a high proportion. In fact, about one-fifth either present psychiatrically or are at least seen by a psychiatrist before WD is diagnosed.
Developments in Chinese psychiatry
Authors: McClure G. M. G.
Published: May 2008

During a recent visit to China, which included meetings with psychiatrists in Beijing, Shanghai, Xian and Hohot, I noted that many of the political constraints of the Cultural Revolution on psychiatry had been removed. Clearly, Chinese society was still strongly influenced by Marxist doctrine, but there was greater academic and clinical freedom for the reinstated professionals who had previously been considered ‘elitist’. Western textbooks and journals were available, and the very fact that Chinese psychiatrists were able to communicate freely with me was in sharp contrast to the enforced isolation of the previous decade.
The Squibb Travelling Fellowship
Authors: Fitzpatrick Carol
Published: May 2008

In 1986 I was awarded the Squibb Travelling Fellowship by the Royal College of Psychiatrists. The funding this provided, combined with funding provided by the Henry Hutchinson Stewart Scholarship in Psychiatry awarded by Trinity College, Dublin, enabled me to spend a three month period in the summer of 1987 at the Children's Hospital Medical Center, Boston, doing research in the area of emotional adjustment in adolescents with chronic physical illnesses. The research will be the subject of a future paper. The purpose of this communication is to outline some of the steps en route between winning the Fellowship and starting on the project at Children's Hospital. The amount of paperwork involved was time consuming, confusing and, at times, overwhelming, and I hope that other doctors planning to travel to the United States to carry out research will benefit from my expeience.
The developmental history of mental disorder in old age
Authors: Robinson John R.
Published: May 2008

A worldwide demographic shift towards old age is being accompanied by a corresponding increase in the number of old people presenting with psychiatric disorders, and traditional systems are unable to cope with the problem.
Sexuality and Mental Illness: A small group approach
Authors: Medley Ian , Douglas Anne R.
Published: May 2008

The issue of sexuality and the mentally ill provokes an uneasy reaction in many people. The lay person possesses inaccurate notions, for instance, about the level of sex drive or the expression thereof. Public interest and anxiety was recently fuelled by the case of Jeanette, the mentally handicapped woman for whom sterilisation was requested. Less understandable is the reaction of the more informed carers of the mentally ill. Being in such a position of responsibility raises a challenge, though the usual attitudes are of either ambivalence or denial. It was not then without some reservations that we organised a group for young people with psychotic conditions, with the aim of tackling sexual issues in relationships.
Training Implications of the Shift to Community-Orientated Psychiatric Services. Collegiate Trainees' Committee Working Party Report
Authors: Scott Jan , Webb Tim
Published: May 2008

Freeman pointed out that in 1968 the Royal Commission on Medical Education suggested that “every psychiatrist should be familiar with the conduct of community psychiatry”. In 1987, we still seem to be no nearer achieving this recommendation despite the fact that 60,000 patients have since been discharged into the community, most mental hospitals are being reduced in size and 32% are due to be closed. Whilst doubts have been expressed about the wisdom of these changes, it is unlikely that the process will be reversed. Progress towards adequate training in community psychiatry has been both sluggish and sporadic.
Mental health in primary care
Authors: Famuyiwa O. O.
Published: May 2008

The expression primary health care (PHC) gives the impression of an ensemble of control of communicable diseases, infant care, avoidance of insanitary personal habits and curbing environmental pollution. These indeed constitute the main elements of the scheme but are not exclusive to it. An integral but often ignored aspect is the community dimension of mental health whose importance is underscored by the fact that a significant majority of people in the third world live in rural areas with minimal or no access to formal psychiatric facilities. In this paper, I shall review the conceptual framework and practicality of primary health care with special reference to community mental health, highlight some notable limitations to policy execution and finally propose an organisational model structure for the community mental health services within the primary health care system.
The current situation in Soviet psychiatry regarding political abuses
Authors: Reddaway Peter
Published: May 2008

The current situation in Soviet psychiatry needs a surrealist of Kafka's skill to describe it. On the one hand, an increasing range of Soviet journals have, since last November, been forthrightly saying what Soviet dissidents and Western observers have said for 20 years. This is that politically motivated abuse of psychiatry has taken place in the USSR on a large scale for decades, causing enormous human suffering. Second, some of these journals point out that abuses, though much reduced in scale, continue to occur today.
Psychiatry in the German Democratic Republic
Authors: Cooling N. J.
Published: May 2008

The London-Berlin (GDR) Committee was established in June 1986, with the aim of encouraging cultural exchanges between Britain and the German Democratic Republic. This Committee organised a study tour of East Berlin for British health care workers in October 1988. This was the first exchange of this kind since the Second World War and the subsequent foundation of the modern Republic of East Germany.
Meanwood Park Hospital, Leeds
Authors: Spencer Douglas A.
Published: May 2008

In August 1989 Meanwood Park Hospital, Leeds, the biggest hospital for mental handicap in the Yorkshire Health Region, reached the seventieth anniversary of its foundation. Like other hospitals for mental handicap. Meanwood Park is coming to the end of an era. The parkland of 134 acres, which has been the hospital's estate, and has existed for over 200 years, is to be sold in phases for housing schemes. Now is an opportune time to record the history of this hospital.
Psychiatry in the USA
Authors: Loebel J. Pierre
Published: May 2008

In a rash moment of bonhomie, having offered to one of the editors to write a personal view of psychiatry in the USA today, and with his encouragement to proceed, I find myself a long time later reflecting as to why the task seems to have been so daunting. Interpretations regarding my DSM-III-Axis II disorder apart, the numbers involved perhaps provide some of the reasons. There are 38,276 psychiatrists in this country, mostly paying dues ($300.00 per year) to the American Psychiatric Association, which has 76 district branches across the country, with between a few dozen and a few thousand members each; $428 billion spent on total personal health care in 1988, approximately two-thirds of which was covered by Federal Government programmes, of which $351 million went to the mental health sector; 150,000 patients treated for longer than one year in the long-term care psychiatric hospitals in this postdeinstitutionalisation era; and 6.5 million persons resident in nursing homes (at an estimated cost of $46 billion) of whom more than 50% are estimated to suffer from Alzheimer's disease. From such an array it is difficult to distill the essentials with much confidence as to their reliability or significance. What follows is therefore selective and impressionistic.
Casting out demons?
Authors: Thompson A. E. , Mahoney P. F.
Published: May 2008

A one day conference on possession and religious psychosis drew clergymen, doctors and other health care workers from across England and Scotland. It was organised by Sunderland Health Authority and papers were presented by churchmen and by psychiatrists, under the chairmanship of John Cox, Professor of Psychiatry at Keele University.
An inner city home treatment service for acute psychiatric patients
Authors: Dean Christine , Gadd Elaine
Published: May 2008

Over the last ten years it has been shown that it is possible to treat the majority of patients with acute psychiatric illness in their own homes. Home treatment has been shown to produce a superior outcome to hospital care on measures of symptomatology, subsequent independent living and employment status (Hoult, 1986) self-esteem (Stein & Test, 1980) and may decrease the need for re-admission. Additionally, home treatment decreases the burden felt by the relatives (Pai & Kapur, 1982) and may enable them to cope better with the patient after the acute episode.
The life of a group on a locked ward
Authors: Lovett Lisetta M.
Published: May 2008

Group therapy in an out-patient setting has been well established for over 40 years. Today, most acute wards offer some in-patient group therapy experience. Duration of in-patient stay (Yalom, 1983), the type of group therapy offered (Cox, 1976; Kanas, 1980) and patient psychopathology, can all alter efficacy of in-patient group therapy. However, in-patient units do appear to benefit from group therapy programmes, although some approaches are more effective than others and psychotic patients may suffer from the traditional group therapy approach (Cox, 1983).
Are homoeopathic patients conspicuously neurotic?
Authors: Amor Timothy , Todd John
Published: May 2008

There appears to be a growing public interest in “holistic” and alternative medicine which can be seen as a reaction to the scientific–medical role (Mechanic, 1978) of a conventional medicine which often fails when confronted by emotional or psychosomatic problems, and to fears, by the public, about the side-effects of therapeutic drugs.
In defence of the depot clinic
Authors: Anderson David , Leadbetter Angela , Williams Bernie
Published: May 2008

The depot clinic has long been part of the traditional British psychiatric service. With moves towards care in the community many of the traditional, particularly hospital based, methods of service delivery are becoming unfashionable. The depot clinic has been criticised (Beveridge, 1987) for being out of date, not geared to the needs of the patient, inaccessible and unable to provide personalised care, especially regarding the family factors recognised to be important in the management of chronic psychosis, and is portrayed as a facility designed for the convenience of the staff not the patient. This has led to suggestions for alternative methods of administering treatment to these patients, e.g. at home, from GP, health centre based.
Pattern of hospital admission before and following the Mental Health Act 1983
Authors: Durani S. K. , Ford R.
Published: May 2008

The Mental Health Act brought a number of signficant changes to psychiatric practice. Among the most important were changes in the process of compulsory admissions. Other notable alterations have been a change in the definition of the nearest relative; a reduction in duration of treatment section by a half; a right to appeal against their detention by all patients; the observation section becoming an assessment and treatment section; the introduction of nurses holding power; the removal of age limits for admission of patients with psychopathic disorder and mental impairment, and the introduction of the treatability clause. These and other important differences could be expected to interact with social work and psychiatric practice to influence the number of compulsory admissions. Previous correspondence has examined this question, to which we add our findings.
Good Practices in Mental Health
Authors: Renshaw Judy
Published: May 2008

Good Practices in Mental Health (GPMH) is a national charity set up to disseminate information about local mental health services which are found to work well. Its general aim is to promote and assist the development of good mental health services. By providing an exchange of information about effective services in both hospitals and the community, GPMH encourages others to build on what is already proving successful. GPMH developed from a survey of mental health in big cities carried out by the International Hospital Federation (IHF) and was set up in 1977 with the support of the IHF, MIND and the King's Fund. It has the backing of all the major professional organisations concerned with mental health in the United Kingdom, the World Health Organization and the World Federation for Mental Health internationally. It is now funded mainly by the DHSS; some funding comes from the London Boroughs Grants Committee and charitable sources. There are three units within the organisation: information, development and evaluation.
Befriending: cost-effective community care
Authors: Kingdon D. G. , Turkington D. , Collis J. , Judd M.
Published: May 2008

In a survey of district plans for Mental Health services (Kingdon, 1988) befriending schemes, where volunteers are recruited to visit isolated and lonely users of psychiatric services, were planned or in existence in 14 of the 127 districts who responded. However, lists of the components of a comprehensive community service (MIND, 1983) and Hirsch (1988) surprisingly do not include references to such schemes, although Griffiths (1988) alludes to them in his recent report. There are moreover no reports in the psychiatric literature of such enterprises. The scheme established by MIND in Bassetlaw (population (103,000) is therefore described.
The evolution of mental handicap services in the Yorkshire Region and the Association of Yorkshire Regional Consultants in Mental Handicap
Authors: Spencer Douglas A.
Published: May 2008

At the present time, changes in the NHS provision for people with mental handicaps mark the end of one era and the beginning of another. The Yorkshire Region is seeing a far-reaching change from a previously regionally organised hospital system to district-based services. It is a time to take stock of what has existed before it is altered completely.
Huntington's disease — the experiences of voluntary organisations
Authors: O'Shea Brian
Published: May 2008

Huntington's disease is associated with a considerable psychiatric morbidity and mortality. These risks are not confined to the sufferer. The relations of victims, both biological and legal, are also at high risk for significant psychosocial dysfunction (O'Shea & Falvey, 1988). Despite recent advances in genetic research, there is still no cure for this chronic choreodementia syndrome. Medical management is confined to palliation of symptoms. The doctor and the patient's family, in the face of this unpleasant disease, are wont to exercise a variety of psychological defences which may hinder the delivery and receipt of adequate support (Martindale, 1987).
The University of Leicester new MRCPsych academic programme
Authors: Nasser Mervat , Brugha Traolach
Published: May 2008

Since the establishment of a separate Royal College of Psychiatrists and membership examination, psychiatry has been progressively acquiring a special identity of its own that bridges the social and biological sciences. The University of Leicester Psychiatric Training Scheme has responded to the recently revised Membership Examination by developing a two year modular academic programme, which complements the traditional medical (diagnostic) organisation of teaching by incorporating social and psychological views of the subject, which reflect the lessons of modern psychiatric research. It is hoped that the development of a more eclectic approach to the subject and its practice will complement the multidisciplinary and growing community orientation of the profession. We describe here our first attempts to provide an academic programme that responds sympathetically to these important developments.
The group at work
Authors: Fish David , Fuller Graham , Handy Sumi , Ing Richard , Kerr Meg , Rusca Roberto , Shaw Ian , Silveira Raza
Published: May 2008

Experience in group therapy is recommended by The Royal College of Psychiatrists (1986) as an important aspect of training in psychiatry. However direct experience is unusual. It was reported in the Bulletin that a group formed by trainees in psychiatry to study the group process found a demand for personal therapy for its members (Whewell, 1987). In this paper a group is described which attempted to meet both needs.
Therapy for adult victims of childhood sexual abuse in a district setting
Authors: Fountain Diana M. , Moore Brenda
Published: May 2008

Sexual abuse of children by family members varies in its incidence depending on the reports used but its presentation among the adult population has largely been under-reported and unrecognised by mental health workers. Since 1984 we have become increasingly aware of survivors of childhood sexual abuse within our own district service presenting initially as psychiatric cases and more recently seeking help directly for the distress which their childhood experiences have caused them. Gradually we have come to recognise the persistent negative effects of this trauma and have attempted to evolve a model for therapy which deals with this and is suitable for use within a district psychiatric service. The pattern of therapy follows the usual psychotherapeutic rules in that it is on a one-to-one basis at the same time and same place each week. It differs, however, in that the therapist is active and when necessary, directive. Our experience has taught us that each patient will present with certain common basic issues that need to be worked through. We have recognised that to do this work sensitively and efficiently it is important that all the relevant questions are asked and feelings explored. We have evolved a list of themes which we expect each therapist to cover during the contracted sessions. We believe that this ensures work is carried through to resolution. If any of the points on the list are omitted then a patient's ability to be free from the past might be impaired. The majority of our patients have been dealt with as out-patients or in a community setting, but a number may already be within the in-patient unit or day hospital setting, and, for a few, attendance at the day hospital is arranged whilst undertaking individual therapy.
John Conolly and the treatment of mental illness in early Victorian England
Authors: Haw Camilla M.
Published: May 2008

This year, 1989, marks the 150th anniversary of the abolition of mechanical restraints at the Hanwell Asylum. It was, of course, John Conolly who carried out this large-scale experiment in the application of non-restraint at Hanwell. He was in charge of the diagnosis and treatment of the 800-odd pauper lunatics in this, the largest of the county asylums. Most of his patients had been insane for many years before their admission to Hanwell from the parish workhouses. The prospects of curing them were slim: Hanwell had the second lowest cure rate among the county asylums, a meagre 6% for the period 1835–1845 (Conolly, 1847).
Self-referrals to a community psychiatric clinic
Authors: Boardman A. P. , Bouras N.
Published: May 2008

Over recent years a number of non-hospital based services have been developed that can be subsumed under the title of Community Mental Health Centres (CMHCs). Conferences held by the King's Fund (McAusland, 1985) and the National Unit for psychiatric Research and Development (Sayce, 1987) have highlighted the importance of CMHC-like services in health authorities' plans to develop community based psychiatric services. There is no single view of CMHCs in the United Kingdom and, while many such centres already exist, they are diverse in nature and their activities have been sparsely documented.
Quality of life in a residential setting
Authors: Leonard Ian
Published: May 2008

The David Lewis Centre for Epilepsy has approximately 300 adult residents. All have epilepsy, which is often only partly alleviated by available treatments; many have mental handicap or psychiatric illness, adding to their total disability. The Centre's explicit aim of understanding and caring for people with epilepsy implies concern not just for clinical measures such as seizure frequency, but for our residents' quality of life.
The Canadian experience
Authors: Ferguson Brian
Published: May 2008

A previous article in the Bulletin describes the ‘BTC’ (Been to Canada) scheme sponsored by the Nova Scotia Department of Health to bring psychiatric trainees to Canada in order to undertake a year's clinical work in addition to ongoing medical education under the auspices of the Department of Psychiatry at Dalhousie University. Over the years the scheme has attracted a number of graduates, some of whom have been prompted to stay on and develop rewarding careers. The original article by Munro and colleagues (1987) describes the programme from the sponsor's perspective and might well be complemented by this account from a BTC graduate who has now returned to the National Health Service.
The Cardiff Liaison Psychiatry Study Group
Authors: Jenkins Peter L.
Published: May 2008

We decided to evaluate the recommended reading for US consultation liaison fellowships (Mohl & Cohen Cole, 1985). Our group was open to interested doctors who had either passed Part I or who had relevant previous experience. The seminar group met in the evenings every two weeks for six months and all members shared the synopsis and presentation.
Useful or useless architecture? A dimension of the relationship between the Georgian schizophrenic James Tilly Matthews and his doctor, John Haslam
Authors: Howard Robert
Published: May 2008

James Tilly Matthews, a paranoid schizophrenic admitted to Bethlem on 28 January 1797, was to become the most colourful and controversial inmate of the hospital in the years up to his death in 1815. Influential relatives and friends campaigned for his release and attempted to demonstrate his sanity, on two occasions, in 1797 and 1809, having him examined before high court judges. The hospital medical staff, in particular John Haslam, the apothecary (in post 1795–1816), were obliged to demonstrate repeatedly Matthews' continued insanity, and to this end his case was published (Haslam, 1810). Bethlem was under political pressure to continue Matthews' detention. His admission followed an attempt to disrupt a sitting of the House of Commons in December 1796, which occurred as the climax of a campaign of deluded lobbying during which he had made threats against the safety of senior politicians, including Lord Liverpool, the Home Secretary (Matthews, 1796). Under in-patient care, Matthews continued to express threats against the lives of the Royal Family, politicians, and the staff of Bethlem (Matthews, 1804). Transferred to the incurable ward in 1798, his continued detention was at the specific request of the Home Secretary, a fact revealed by Haslam at the 1809 hearing (Haslam, 1809). In May 1813, Matthews, having developed a spinal abscess, was transferred to a private madhouse in Hoxton, where it was felt country air might improve his medical condition. He died there in January 1815.
Teaching English to psychiatrists from overseas
Authors: Appleby Louis , Beaton Fran
Published: May 2008

The Institute of Psychiatry accepts approximately 30 postgraduate students each year from overseas countries. The composition varies, largely as a result of international economic changes, and since 1977 students from 60 countries have attended (Appleby & Araya, 1990). Knowledge of English also varies and can influence the training of a student in many ways. Difficulties in understanding and communicating with patients, colleagues and teachers can adversely affect study, clinical practice and examination performance. MRCPsych results are poorer for non-UK than for UK doctors (Cawley, 1986): one reason may be poor communication.
Drugs for Alzheimer's disease
Authors: Procter Andrew W.
Published: May 2008

The view (Anon, 1990) that “drugs for Alzheimer's Disease (AD) are generally ineffective” is a reasonable conclusion to draw from the results of treatment studies to date. However in recent years there has been a rapid expansion of knowledge of both basic neurobiology and the pathology of AD. Future advances may be expected to arise from this, so when the authors ofDrugs and Therapeutics Bulletinnext review this subject they may well be able to draw a more optimistic conclusion.
A look at the psychodynamics of ‘being on-call’
Authors: Morris Mark G. A.
Published: May 2008

Experience of being resident on-call is common to all practitioners who have worked through the training grades. Other professions have their lean years while in training, for example the apprentice years in the law profession or the junior financial executive's commitment to his company, but being resident on-call in a place of work, ready to deal with any emergency for a significant fraction of one's waking and sleeping life, is peculiar to the junior grades in the medical profession. Judging by the opinions expressed by my colleagues, all registered practitioners are united in having experience of being on-call and finding it to some extent irksome. Part of the problem lies in having to do long periods of overtime for reduced rates of pay, often in delapidated surroundings when one could be more enjoyably occupied elsewhere. Most people decide that the benefits of serving the prescribed training period in the junior grades to become vocationally trained general practitioners or members of one of the Royal Colleges outweighs the short-term discomfort. In this paper I examine the experience of ‘being on-call’, working through the different aspects. I argue that the irksomeness of the experience may derive in part from the echoing of unconscious conflicts.
Changing practices in mental health care: a lesson from America
Authors: Butler Tom , Thomas Philip
Published: May 2008

Health and social care in Britain is undergoing the most profound changes in its structure and organisation since its inception (Griffiths, 1988); indeed, some would argue that it is about to change beyond recognition. The purpose of this article is to describe contemporary developments in the delivery of such services in the USA. Given that many of the political changes here have been directly influenced by thinking and practice in that country, it is argued that there are two important lessons to be learnt. The first concerns the coordination of service delivery between different agencies, the second involves an emphasis on the delivery of acute and rehabilitation services in the community. In short the traditional distinctions between the two would be blurred.
L-tryptophan and the eosinophilia-myalgia syndrome
Authors: Cowen Philip J.
Published: May 2008

Eosinophilia-myalgia syndrome (EMS) is an alarming illness, occasionally fatal, which is characterised by severe myalgia, arthralgia, fatigue and, it now appears, ingestion of L-tryptophan (Hertzman et al, 1990). At first sight this appears rather surprising because tryptophan is, of course, present in the normal diet, albeit in smaller quantities (about 750 mg daily), than that usually prescribed for the treatment of depression (about 3 g daily). Furthermore, L-tryptophan has been available in the UK for the treatment of depression for over 20 years without previous cases of EMS coming to light, despite the dramatic nature of the symptomatology. All this suggests that a contaminant in the preparation of synthetic L-tryptophan could be responsible for the development of EMS, a view strengthened by the resemblance of EMS to the toxic oil syndrome which was caused by contaminated olive oil.
Psychiatric out-patient non-attenders: a cause for relief or concern?
Authors: Smyth Marcellino , Vostanis Panos , Dean Christine
Published: May 2008

In daily clinical practice, out-patient non-attendances are, unfortunately, regular occurrences. With the current trend towards community based care, out-patient facilities have become increasingly important, and the failure of patients to attend is both disruptive and worrying for professionals in this area. It is difficult to predict which of the non-attenders will progress to join the ranks of those “lost to follow-up”. This study was conceived in an attempt to clarify this question, in the setting of adult general psychiatric out-patient services.
Child psychiatry in Thailand
Authors: Bartlet L. B.
Published: May 2008

Thailand, unlike many Asian countries, never experienced colonial or imperial subjection and thus lacked the portal through which psychiatric services usually gained entry. As a result, progress in this field was initially slow. The first mental hospital was established in 1889, a century later than in India. The country has been fortunate inasmuch as it has been spared involvement in the wars, revolutions, and other social upheavals that have plagued Asia in the 20th century. Recent national stability and impressive economic growth have provided a sound base for the development of health services, and progress has been rapid in comparison with many neighbouring countries. Due attention has been paid to family planning, maternity and child welfare services. The provision of comprehensive primary health care in urban and rural areas is improving all the time. The education of children is universally regarded as important. Schooling is compulsory and attendance satisfactory.
Day care and a hostel – a cost effective approach
Authors: McLoughlin Maire
Published: May 2008

In order to plan a comprehensive psychiatric service for County Clare, it was necessary to divide the county into four sectors, North, East, South and West. The area I am discussing is the West Sector, which covers 800 square kilometres and has a population of 20, 000. Kilrush town is the capital of the West Sector situated 50 kilometres from the main hospital in Ennis. Psychiatric morbidity was noted to be high in this rural area. Prior to opening a Day Hospital in Kilrush (May 1986) we were using 15 beds in the acute unit. Now we are using, on average, five beds at any given time.
Computers in Psychiatry Special Interest Group — 2nd Annual General Meeting
Authors: Wood Stephen , Sinclair Michael
Published: May 2008

If three psychiatrists are needed to change a light bulb — one to change the bulb and two to interpret the experience — how many does it need to operate a computer? Judging by the attendance at the 1989 CIPG meeting, held at Keele University in October, the answer is about 54.
The Early Intervention Service: the first 18 months of an Inner London demonstration project
Authors: Onyett Steve , Tyrer Peter , Connolly Jayne , Malone Steve , Rennison Jane , Parslow Shanti , Shia Nessie , Davey Tom , Lynch Sean , Merson Steve
Published: May 2008

Rigorous studies of community alternatives to hospitalisation show that they are feasible and effective but have spawned considerable debate about their methodology, replicability, and appropriateness for normal clinical practice. In Britain, many demonstration projects have been centrally funded and evaluated initially by the Personal Social Services Research Unit at the University of Kent and latterly by Good Practices in Mental Health (Renshaw et al, 1988). Such community-based projects have attempted to avoid the problems of community mental health centres in the United States which have, with some important exceptions, failed to offer a comprehensive service that would allow closure or a significant drop in bed numbers at state hospitals (Dowell & Ciarlo, 1983). In practice, the design of community services is very dependent on local circumstances, including the demography of the population, existing service provision and attitudes. For this reason, planners and practitioners need to be aware of many practical options for service delivery.
Mind/body in sexuality and reproduction
Authors: Ramsay Rosalind
Published: May 2008

It is a common assumption throughout the world that people may be put in one of two categories, male or female, and that members of each group share common attitudes, beliefs and behaviours. However, variations in how male and female behaviour are defined in the different groups may be numerous.