bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations Between Collateral Status and Thrombus Characteristics and Their Impact in Anterior Circulation Stroke
Authors: Alves Heitor C. , Treurniet Kilian M. , Dutra Bruna G. , Jansen Ivo G. H. , Boers Anna M.M. , Santos Emilie M.M. , Berkhemer Olvert A. , Dippel Diederik W.J. , van der Lugt Aad , van Zwam Wim H. , van Oostenbrugge Robert J. , Lingsma Hester F. , Roos Yvo B.W.E.M. , Yoo Albert J. , Marquering Henk A. , Majoie Charles B.L.M.
Published: January 2018

Background and Purpose—

Thrombus characteristics and collateral score are associated with functional outcome in patients with acute ischemic stroke. It has been suggested that they affect each other. The aim of this study is to evaluate the association between clot burden score, thrombus perviousness, and collateral score and to determine whether collateral score influences the association of thrombus characteristics with functional outcome.

Methods—

Patients with baseline thin-slice noncontrast computed tomography and computed tomographic angiography images from the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands) were included (n=195). Collateral score and clot burden scores were determined on baseline computed tomographic angiography. Thrombus attenuation increase was determined by comparing thrombus density on noncontrast computed tomography and computed tomographic angiography using a semiautomated method. The association of collateral score with clot burden score and thrombus attenuation increase was evaluated with linear regression. Mediation and effect modification analyses were used to assess the influence of collateral score on the association of clot burden score and thrombus attenuation increase with functional outcome.

Results—

A higher clot burden score (B=0.063; 95% confidence interval, 0.008–0.118) and a higher thrombus attenuation increase (B=0.014; 95% confidence interval, 0.003–0.026) were associated with higher collateral score. Collateral score mediated the association of clot burden score with functional outcome. The association between thrombus attenuation increase and functional outcome was modified by the collateral score, and this association was stronger in patients with moderate and good collaterals.

Conclusions—

Patients with lower thrombus burden and higher thrombus perviousness scores had higher collateral score. The positive effect of thrombus perviousness on clinical outcome was only present in patients with moderate and high collateral scores.

Clinical Trial Registration—

URL:
http://www.trialregister.nl
. Unique identifier: NTR1804 and URL:
http://www.controlled-trials.com
Unique identifier: ISRCTN10888758.
An Architect Draws Sound and Light: New Perspectives on Iannis Xenakis's Diatope and La Légende d'Eer (1978)
Authors: Kiourtsoglou Elisavet
Published: January 2018

This article examines the creative process of Diatope, a multimedia project created by Iannis Xenakis in 1978 for the inauguration of the Centre Pompidou in Paris, utilizing analytical research of sources found in several archives. By interpreting Xenakis's sketches and plans, the article elucidates for the first time the spatialization of La Légende d'Eer, the music featured in the Diatope. The findings of the research underline the importance of graphic and geometric representation for understanding Xenakis's thinking, and they highlight the continuity and evolution of his theory and practice over time. Furthermore, the research findings present the means by which this key work of electroacoustic music might be spatialized today, now that the original space of the Diatope no longer exists.
Maternal provisioning by foam-nesting frogs of the genus Physalaemus (Anura, Leptodactylidae) in contrasting environments
Authors: Pupin Nadya C. , Haddad Célio F.B. , Prado Cynthia P.A.
Published: January 2018

In some environments prevailing conditions are unpredictable, thus anuran species use bet-hedging strategies and produce eggs of varied sizes. We investigated whether four species of Physalaemus (two from open, two from forest habitats) exhibit bet-hedging strategies, and if intra-clutch variation in egg size is greater for species that breed in the more unpredictable ponds of open habitats. All species studied adopted the bet-hedging strategy, with intra-clutch variation in egg size regardless of the environment; however, we found greater intra-clutch variation in the two species from open areas. The lower variation in egg-size found within forest habitats may be explained by the more stable environments that forest ponds provide for anuran eggs/embryos. Future studies in a phylogenetic context are needed to confirm the patterns detected here.
A new dagger nematode, Xiphinema poasense n. sp. (Nematoda: Longidoridae), from Costa Rica
Authors: Varela-Benavides Ingrid , Peraza-Padilla Walter , Cantalapiedra-Navarrete Carolina , Palomares-Rius Juan E. , Castillo Pablo , Archidona-Yuste Antonio
Published: January 2018

A new dagger nematode,Xiphinema poasensen. sp., is described and illustrated from three populations extracted from soil associated with a combined plantation ofEucalyptussp.,Cupressussp. andPennisetumsp. and wild plants from a tropical pre-montane forest in Costa Rica. The new dagger nematode is characterised by a moderate body size 2612 (2416-3042) μm long, a rounded lip region 15.0 (13.5-16.5) μm broad, separated from the body contour by a shallow depression, amphidial fovea large, stirrup-shaped, a very long odontostyle (175 (164-188) μm), stylet guiding ring located 167 (136-181) μm from anterior end, vulva situated anterior to mid-body (36-40%), anterior genital branch complete but strongly reduced, without uterine differentiation, female tail short, hemispherical to convex-conoid with a c′ ratio = 0.7 (0.6-0.8) and bearing two pairs of caudal pores, and male absent. Integrative diagnosis was completed with molecular data using D2-D3 expansion segments of 28S rRNA, ITS1 region, partial 18S-rRNA and the partial mitochondrial gene cytochrome c oxidase subunit 1 (coxI). The phylogenetic relationships based on D2-D3 segments of this species with otherXiphinemaspp. of theX.non-americanumgroup indicated thatX. poasensen. sp. clustered with other species with a reduced anterior genital branch from the morphospecies Group 2,viz.,X. costaricenseandX. krugi. However, the phylogeny ofcoxIand partial 18S rRNA gene revealed that the new species did not cluster withXiphinemaspecies having the anterior genital branch absent or reduced (i.e., morphospecies Groups 1 and 2, respectively).
Empirical evidence on scalar implicature processing at the behavioural and neural levels
Authors: Alatawi Haifa
Published: January 2018

The Default hypothesis on implicature processing suggests that a rapid, automatic mechanism is used to process utterances such as “some of his family are attending the wedding” to infer that “not all of them are attending”, an inference subject to cancellation if additional contextual information is provided (e.g. “actually, they are all attending”). In contrast, the Relevance hypothesis suggests that only context-dependent inferences are computed and this process is cognitively effortful. This article reviews findings on behavioural and neural processing of scalar implicatures to clarify the cognitive effort involved.
What’s really going on with the ham sandwich?
Authors: Bowerman Josephine
Published: January 2018

Working within the framework of Relevance Theory, I investigate the nature of referential metonymy (specifically, metonymically-used definite descriptions), aiming to elucidate (i) the pragmatic mechanisms involved in referential metonymy comprehension, and (ii) the contribution of a metonymically-used definite description to the explicitly communicated content of an utterance. I propose that, while the interpretation of referential metonymy is properly inferential in nature, it cannot be explained in terms of ‘meaning modulation’ (narrowing and broadening); rather, the literal meaning of a metonymically-used referring expression remains intact, and is used as evidence of the speaker’s target referent. In addition, I argue that the referential/attributive distinction proposed by Donnellan (1966) for literally-used definite descriptions also applies to metonymically-used definite descriptions. Thus, the contribution of a metonymically-used definite description to explicit utterance content differs according to whether the definite description is used ‘referentially’ or ‘attributively’.
Counselling Muslim Selves on Islamic Websites: Walking a Tightrope Between Secular and Religious Counselling Ideals?
Authors: Abdel-Fadil Mona
Published: January 2018

This article focuses on the interactive counselling service Problems and Answers (PS), an Arabic language and Islamic online counselling service, which draws on global therapeutic counselling trends. For over a decade, PS was run and hosted by www.IslamOnline.net (IOL). Based on ethnographic fieldwork, this article aims to provide a layered, contextualized understanding of online Islamic counselling, through addressing the ‘invisible’, ‘behind the screens’ aspects of PS counselling and the meaning making activities that inform the online output. In particular, I examine: 1. The multiple ways in which ‘religion’ shapes the PS counsellors' counselling output, and 2. The extent to which secular and religious counselling ideals clash, in PS counselling. Drawing on a mixed methods approach, I demonstrate instances in which offline data nuance and generate new understandings of online data. The findings demonstrate the multivocality and variations in the PS counsellors' perspectives on both religion and counselling psychology, and shed light on possible tensions between professed ideals and actual online practices.
Giant among dwarfs: Meganannus lewisi, gen. n. and sp. n., a new genus and species of minute litter bugs from Costa Rica (Hemiptera: Schizopteridae)
Authors: WEIRAUCH CHRISTIANE , WHORRALL KYLE , KNYSHOV ALEXANDER , HOEY-CHAMBERLAIN ROCHELLE
Published: January 2018

The Neotropical biodiversity of the cryptic and tiny minute litter bugs in the family Schizopteridae—although thought to be the best documented tropical fauna of Schizopteridae—is still poorly known. Sixteen species of Schizopteridae have been described from Costa Rica, 13 of which during the past few years, and the last new genus of Schizopteridae from that country was described more than half a century ago. We here describe and document a new monotypic genus of Schizopteridae from Costa Rica, Meganannus n. gen. The new genus belongs to the “Ogeriinae” + Schizopterinae lineage of Schizopteridae and stands out among other litter bugs by the large body size, among other features. We provide habitus photographs and document morphological details using scanning electron, confocal, and light compound microscopic images. A map and measurements are also produced. An illustrated identification key to genus groups and/or genera of Neotropical Schizopteridae including this new genus is presented.
New records of oribatid mites (Acari: Oribatida) from Argentina
Authors: RUIZ E.V. , RIZZUTO S. , MARTINEZ P.A.
Published: January 2018

A taxonomic inventory of oribatid mites from lenga forests in Patagonia Argentina was carried out to assess the taxonomic diversity and to increase the knowledge of their distribution. Nine new records of soil oribatid mites from Argentina are reported. Those species were collected in Chubut province and Tierra del Fuego province. The new registered species belong to the genera Lamellozetes, Hermannia (Phyllhermannia), Crotonia, Kokoppia, Acutoppia, Lanceoppia (Baioppia), Loboppia, Membranoppia(Membranoppia) and Graptoppia (Stenoppia).
Structural Property Losses from Tornadoes in Florida
Authors: Elsner James B. , Ryan Emily , Strode Georgianna
Published: January 2018

Property losses from tornadoes in Florida are estimated by combining a 1-km spatial grid of structural values from the Department of Revenue’s 2014 cadastral database with historical tornado events since 1950. There are 91 180 grid cells in the state with at least some structural value. Total and residential structural values total $942 billion and $619 billion, respectively. Over the period 1950 through 2015 there were 3233 individual tornado reports in the state with a peak frequency during June. The property value exposed to tornadoes is estimated using a geometric model for the path. Annual statewide total and residential structural property exposure to tornadoes is estimated at $171 million and $103 million, respectively. Property exposure to tornadoes peaks in February. A regression model quantifies the relationship between actual losses since 2007 and exposures. A doubling of the residential exposure increases actual recorded losses by 26% since 2007, and a doubling of nonresidential exposure increases losses by 21%, controlling for changes over time. Randomization of the historical tornado paths provides alternative exposure scenarios that are used to determine the probability of extreme loss years. Results from the Monte Carlo algorithm indicate a 1% chance that the annual loss will exceed $430 million and a 0.1% chance that it will exceed $1 billion. These findings, and the procedure to obtain them, should help property insurance and reinsurance companies gauge their risk of losses and prioritize their management actions.
Alcohol use and addiction services in Ukraine
Authors: Samokhvalov Andriy V. , Pidkorytov Valerii S. , Linskiy Igor V. , Minko Oleksandr I. , Minko Oleksii O. , Rehm Jürgen , Popova Svetlana
Published: January 2018

Ukraine, with a population of 46.2 million, is the second largest country in Europe, with an area of 603 700 km2. It is still recovering from the collapse of the Soviet Union in 1991, following the Soviet stagnation era (since the mid-1960s) and perestroika (from 1986), as well as the 1998 Russian financial crisis and Ukraine's 2004 Orange Revolution. These events have resulted in high levels of socio-economic disparity, political instability and a degraded healthcare infrastructure. These issues, in addition to traditionally high levels of alcohol consumption, have made binge drinking and alcoholism, among other addictions, major problems in Ukrainian society (Voloshin et al, 2003).
Psychiatric services in Bahrain: past, present and future
Authors: Al-Haddad M. K. , Al-Offi Adel
Published: January 2018

The Kingdom of Bahrain is an archipelago of 33 islands, located in the Arabian Gulf, covering 2400 km2. The main island, Manama, is the nation's capital. The total population stands at 742 562, 62.3% of whom are local Bahrainis and the remaining 37.7% expatriates (Central Statistics Organisation Directorate, 1991). Bahrain first entered the historical stage around 3000 BC, and for almost 2000 years was the centre of the old Dilmun civilisation (Bibby, 1969). Dilmun was perceived as a sacred land by the Sumerians and Babylonians; it was a burial ground for their dead, and Bahrain has over 100 000 burial mounds each containing 200-250 bodies. In the old Babylonian epic of Gilgamesh, which antedates Homer's Iliad, Dilmun is described as a paradise where the worthy enjoy eternal life (Clarke, 1981).
Sudan's national mental health programme and burden of mental illness
Authors: Sorketti Ehab Ali
Published: January 2018

Sudan occupies 2 500 000 km2in East Africa. It has borders with nine countries, two of which are Arab: Egypt, Libya, Kenya, Uganda, Congo, Chad, the Central African Republic, Ethiopia and Eritrea. Sudan is the largest country in Africa. The heart of the country, in terms of population, lies at the confluence of the Blue and White Niles. The complex of the ‘three towns', comprising the three largest cities, Khartoum, Khartoum North and Omdurman, is situated there and contains almost 20% of the population. The total population of Sudan is about 35.4 million (projected from the 2005 census). The urban population was estimated at 33% of the total. About 2.2 million are still entirely nomadic. Sudan's peoples are as diverse as its geography. There are 19 major ethnic groups and 597 subgroups.
The high cost of poverty: mental health perspectives from the Caribbean Diaspora
Authors: Hickling Frederick W.
Published: January 2018

‘Globalization is an objective reality - underlying the fact that we are all passengers on the same vessel - the planet where we all live.’ (Fidel Castro, 2000, p. vii)

A Caribbean Diaspora has emerged worldwide after 500 years of European colonial exploitation of the Caribbean geopolitical region. This exploitation has a two-tiered social legacy: the ‘haves'; and the ‘have-nots', characterised by poor educational achievement, underdevelopment and unemployability of the many. The Caribbean Diaspora is a product of ever-increasing fantasies of escape from poverty by migration to greener ‘First World’ pastures. The complex, contradictory Caribbean society generates a crucible of misery and violence amid opulent wealth and luxury, which requires a burgeoning private and public police and military apparatus for its containment, and an ever-increasing health, mental health and penal correctional system to buttress the casualties of this conflict that is spiralling out of organisational and economic control. This two-tiered society was inherited from the hierarchical legacy of European colonialism. The colonisers existed in a system of high productivity and order, which imposed its will on the colonised, who lived in relative disorganisation and need. The resultant vector of this unequal yoke is the virtual anarchy of present-day Jamaica and other Caribbean territories, characterised by a subculture of violence and increasingly violent crime. The physical, psychological and economic costs of this seeming conundrum are bewildering and unaffordable.
Inequity and poverty: everyday emotional disturbances and mental disorders in the Mexican urban population
Authors: Berenzon Shoshana , Lara Maria Asunción , Medina-Mora Maria Elena
Published: January 2018

Recent decades have seen renewed interest in the study of poverty and its repercussions on various health problems, including mental disorder (Patel, 2007). There are various ways of measuring poverty; some approaches define it in economic terms, whereby health is included only as an asset that must be given to those defined as poor (Damián & Boltvinik, 2003). Other conceptions propose definitions based on the capacity of the poor to improve their standard of living, and consider health and education as essential elements in this process. This is the case of the Human Development Index (HDI), which, in addition to the economic dimension, measures other social indicators such as life expectancy, literacy and school enrolment and drop-out rates, among others (United Nations Development Programme, 2000). On the basis of the HDI, Mexico ranks 52 out of 177 countries. According to its percentage of gross domestic product invested in health, it is regarded as a country with a medium/high income level.
Fairness, liberty and psychiatry
Authors: Ikkos George
Published: January 2018

According to Beauchamp & Childress (2001) the fundamental principles of biomedical ethics include ‘justice'. But how do we approach ‘justice'? Justice may be thought of in relation to an individual or society. An individual may be just or unjust. Justice in society may be thought of as ‘retributive justice’ (fair punishment), ‘civil justice’ (fair recompense), ‘distributive justice’ (fair shares) or ‘social justice’ (a fair social contract for citizens of a society).
Compulsory treatment in the community: considerations for legislation in Europe
Authors: Strachan James G.
Published: January 2018

In late 2008, the Regional Office for Europe of the World Health Organization (WHO, 2008) issued a report based on a survey of the policies and practices for mental health within its area of operation. Forty-two European states were examined and a great diversity in practice was recorded. Almost everywhere, the report suggested, policy making and legislative initiatives were seen; since 2005, some 57% of the countries studied had adopted new mental health policies and 48% had introduced new legislation. Many countries were reported to be closing mental hospital beds and replacing them with community-based services. In some countries, however, the report suggested, desks in ministries were collapsing under the weight of policies that had never been implemented, and compliance with legislation by planners and psychiatrists was distinctly variable. The WHO felt that even the role that general practitioners played in treating people with mental illness was limited in many European states and that the availability of home treatment options, assertive outreach for people with complex mental health needs and community-based early intervention was not only variable but often severely limited. Given the wide discrepancies of procedure and practice, it was difficult for the WHO to gain any clear perspective on such legislative matters as arrangements for compulsory care in the community.
Egyptian legislation on the compulsory treatment of persons with psychiatric disorders: the old and the new
Authors: Zaky Moody Magdy
Published: January 2018

Compulsory admission to and treatment in psychiatric facilities have recently been brought into the spotlight by both psychiatrists and the media in Egypt. Interventions of this kind have always inherently involved deprivations of liberty and infringements on privacy. The debate around this issue acquired considerable heat after it was joined by the legislatures during the discussion of a Bill in Parliament. The Parliamentary Committee for Constitutional and Legislative Affairs questioned the constitutionality of the process of compulsory detention and requested more robust safeguards to protect the rights of persons with mental illness. The new Bill was passed by the Egyptian Parliament on 26 April 2009 and was due to come into force once ratified by the President and published in the Egyptian Gazette, expected in May.
Community treatment orders in New Zealand
Authors: Dawson John
Published: January 2018

Many legal mechanisms can be used to authorise compulsory community mental healthcare: leave or conditional discharge for compulsory in-patients; adult guardianship (or incapacity) legislation; treatment as a condition of a community-based criminal sentence, like probation, or of parole from imprisonment; or a full-fledged community treatment order (CTO) scheme. It is the specific mix of mechanisms employed in a particular jurisdiction that will characterise how that legal system manages the delivery of compulsory (or quasi-consensual) community psychiatric care.
Mental health in Armenia
Authors: Soghoyan Armen , Hakobyan Arega , Davtyan Harutyun , Khurshudyan Marietta , Gasparyan Khachatur
Published: January 2018

Armenia is a landlocked mountainous country between the Black Sea and the Caspian Sea, in the southern Caucasus. It shares borders with Turkey to the west, Georgia to the north, Azerbaijan to the east, and Iran and the Nakhchivan exclave of Azerbaijan to the south. Its total area is 29 743 km2. A former republic of the Soviet Union, Armenia is a unitary, multi-party, democratic nation state with an ancient cultural heritage. Armenia prides itself on being the first nation formally to adopt Christianity (in the early 4th century).
Investigating the quality of psychotropic drug prescriptions at Accra Psychiatric Hospital
Authors: Sanati Abdi
Published: January 2018

Quality of prescribing is an important aspect of clinical practice. In a study of the effect of electronic prescriptions on prescription quality in the UK, Donyai et al (2008) found errors in 3.8% of their sample before the introduction of electronic prescription. In a psychiatric setting in Leeds in the UK, Nirodi & Mitchell (2002) found that 16.1% of prescriptions written for a cohort of elderly patients were illegible, and a third lacked information on dose, frequency or indication of use of medications. They found that only 18% were legible and free of all errors.
A month at the Hôtel-Dieu: a reversal of perspectives
Authors: Zahedi Sohrab , Kipman Amelie , Dantchev Nicolas , Bozzuto James
Published: January 2018

International medical graduates (IMGs) account for more than 30% of the first-year positions filled in US psychiatric residencies (Nation Residency Match Program, 2007). At the time of writing, the first author was 4 months away from finishing his residency at the University of Connecticut (UCONN) when the opportunity arose to turn the tables and use his fluency in French to complete a month-long elective in France. During this period, he spent time as an observer in the psychiatric service of a Parisian hospital, l'Hôtel-Dieu. The realisation of this elective was helped by the fourth author, who knew various members of World Psychiatric Association. This paper presents some comparative observations of the clinical milieus at UCONN and the Hôtel-Dieu.
Reproductive risk and its role in maternal mental health - perspectives from Pakistan
Authors: Rahman Atif , Sikander Siham
Published: January 2018

There is now an increased awareness of the high rates of depression among women with young children in impoverished communities. Poor maternal mental health affects the home environment, family life, child care and parenting. This paper summarises some of the issues related to the determinants, consequences and management of maternal mental health during and after pregnancy in Pakistan, a low-income country.
Reproductive mental health risk in Nigeria: myths, facts and challenges
Authors: Adewuya Abiodun O. , Aloba Olutayo O.
Published: January 2018

It is widely known that Africans and especially Nigerians place much emphasis on childbearing. It has been said that the effect of childbirth relates to the society and culture's response to parenthood and the existing family structure. Many rituals exist in African societies to signify the changes in women's identity, roles and status during pregnancy and following childbirth. Earlier studies have suggested that perinatal emotional distress is rare among women in sub-Saharan Africa, with the supposed intact family structure in the region acting as a protective factor.
Challenging times for mental health services
Authors: Muijen Matt
Published: January 2018

We are living in significant and challenging times for mental health services across the world. On the one hand, many countries are in the middle of comprehensive reforms of their mental health systems, and these require funding (WHO Europe, 2008). On the other, they are affected by the global financial crisis as regional and national economic recessions threaten to herald a social crisis in many countries. Governments have had to come up with multi-billion-dollar rescue packages. At an individual level, debt status is already high in many countries, owing to falling house prices and high consumption levels, combined with rising commodity prices during the past few years, before the onset of the recession. At a public level, countries will be forced to make stringent cuts in public sector expenditure.
Integrating mental health into primary care: the policy maker's perspective and experience in China
Authors: Xin Yu , Jin Liu , Hong Ma
Published: January 2018

In China, ‘community’ was an alien word. Many people used to live in dormitories (Danwei), to which they were assigned by government according to their work units. ‘Dormitory form’ community was closely linked to where people worked, and thus administration and supervision were simple, as was the provision of health services. In each Danwei, a clinic provided basic healthcare not only for its employees but also for the other residents of the dormitory. The old primary care service was based on this. In fact, the ‘golden age’ of community mental healthcare was at that time, when psychiatric hospitals extended their service to communities via the Danwei's clinics in the cities and via ‘barefoot doctors’ in the rural areas. Home beds, occupational therapy stations and shelter factories were set up in some cities and mobile mental health teams played important roles in the villages. Although this did not really represent the ‘integration’ of mental health into primary care, it was a good example of maximising the utilisation of the very limited mental health resources by stretching the psychiatric service, using administrative power, and mobilising family members (Shen et al, 1990; Zhang & Yan, 1990; Zhang, 1999).
Mental healthcare in Serbia
Authors: Tosevski Dusica Lecic , Gajic Saveta Draganic , Milovancevic Milica Pejovic
Published: January 2018

Serbia is located on the Balkan peninsula, which served for centuries as a vulnerable crossroads between the East and the West. At the beginning of the 1990s, some of the republics of the former Yugoslavia, including Serbia, were involved in disastrous civil conflicts. In 2006 Serbia became a sovereign republic. At the 2002 census, its population was 7 498 000.
Suicide trends and characteristics in Brazil
Authors: de Mello-Santos Carolina , Bertolote José Manoel , Wang Yuan-Pang
Published: January 2018

Brazil is the largest and most populous country in South America (in 2002 the population was approximately 175 million). Although life expectancy in Brazil has increased, suicide and other forms of injury-related mortality, such as homicide and accident, have increased as a proportion of overall mortality (Oswaldo Cruz Foundation, 1984; Brazil Ministry of Health, 2001). The suicide rate in Brazil (3.0–4.0 per 100 000 inhabitants) is not considered high in global terms (World Health Organization, 1999). Nevertheless, it has followed the world tendency towards growth: during 1980–2000, the suicide rate in Brazil increased by 21%. Elderly people present the highest suicide rates in absolute numbers, but the alarming finding in the Brazilian data is that the youth population is increasingly dying by suicide (Mello-Santos et al, 2005). This statistic partially confirms a forecast by Diekstra & Guilbinat (1993) that the number of deaths by suicide would dramatically increase over the next decades, mainly in developing countries, including Latin America. In these regions, socio-economic factors (such as an increase in divorce and unemployment and a decrease in religiosity) increase the risk of self-harm. We discuss the reasons for the low suicide rate in Brazil and highlight the socio-economic factors affecting its increase among the youth population in particular.
Psychiatry in Ukraine
Authors: Gluzman Semyon , Kostyuchenko Stanislav
Published: January 2018

Ukraine, at 603 700 km2, has the second largest landmass in Europe. It has a population of about 47.4 million. Ukraine is a lower-middle-income country with a gross national income per capita of US$1260 (World Bank, 2002).
The teaching and training of psychiatry in Thailand
Authors: Udomratn Pichet
Published: January 2018

In Thailand, we have only two programmes for residency training in psychiatry: one is general or adult psychiatry, which takes 3 years to complete; the other is child and adolescent psychiatry, which takes 4 years. There are nine institutes that offer residency training but only three medical schools have the capacity to offer training in both general and child psychiatry (Table 1).
Mental health legislation in contemporary India: a critical review
Authors: Kala Kunal , Kala A. K.
Published: January 2018

After 20 years of experience with the legislation, it is now a good time to assess the Mental Health Act 1987 of India. How useful has it been to consumers, carers and the mental health profession? It has been perceived as isolationist because it deals only with psychiatric hospitals and excludes a large number of general hospital psychiatric units from its purview. It is also un-implementable in some parts of the country because of the shortage of resources. From a human rights perspective, it is deficient in two important ways: it failed to establish independent review bodies for involuntary admissions; and it lacks provision for research with people who have a mental illness.
Slovenia
Authors: Ziherl Slavko , Plesnicar Blanka Kores
Published: January 2018

Slovenia, with an area of 20 000 km2 and a population of 2 million, is one of the smallest members of the European Union. It gained its independence from Yugoslavia in 1991. The country has a gross domestic product (GDP) of US$27 300 per capita. (Largely because of its historical links with Western Europe, Slovenia has a higher GPD compared with other countries in transition in Central Europe.) The health budget represents 8.4% of GDP. Slovenia has a low birth rate and an ageing population. It is divided into 210 municipalities; however, the re organisation of government into several separate regions with more administrative and economic autonomy is in progress. The prevalence of mental illness is comparable to that in other European countries, although there are high levels of alcoholism and suicide.
Comparison of risperidone, olanzapine and quetiapine: effects on body weight, serum blood glucose and prolactin
Authors: Chaudhry Haroon Rashid , Arshad Nadia , Niaz Saima , Suleman Tahir , Mufti Khalid A.
Published: January 2018

Schizophrenia is a chronic illness with a lifetime prevalence of 1% and with serious physical, social and economic consequences. Over the past decade, atypical antipsychotic medications have become the first-line treatment for schizophrenia (Breieret al, 2005).
Ethno-Psychopharmacology
Authors: Hapangama A. , Kuruppuarachchi K. A. L. A.
Published: January 2018

Sir: We read the article by Pi & Zhu (2007) with interest, as this topic is particularly important to psychiatrists practising in countries like Sri Lanka, where, because of the lack of local prescribing guidelines, the dosing of medication is generally determined by guidelines developed for patients in the West, such as those from the National Institute for Health and Clinical Excellence (NICE) and the British National Formulary.
Competency-Based Training Schemes in Psychiatry
Authors: Soosay Ian
Published: January 2018

Sir: At its 2006 annual forum in Riga, the European Federation for Psychiatric Trainees (EFPT) issued its first statement on competency-based training and assessment in psychiatry. The EFPT, which represents national associations of psychiatric trainees from across Europe, is broadly in favour of competency-based training if it improves the standard of psychiatric education and is not overly bureaucratic.
Association of European Psychiatrists (AEP)
Authors: Calliess Iris , Treichel Kai , Bowers Alexis
Published: January 2018

Sir: Your readers may be interested to know that the Association of European Psychiatrists (AEP) held its 16th Annual Congress in Nice, France, 5-9 April 2008. There were almost 3000 delegates from 57 countries. The theme was ‘Pathways to Integrative Care.’
Child and adolescent psychiatry services in low- and middle-income countries
Authors: Skuse David
Published: January 2018

The theme in this issue concerns the interface between child psychiatric services in low- and middle-income countries and the availability of such services in higher-income countries. In neither context are such services ideal, and resources are relatively slim when compared with demand. The key issues are discussed in three terms: first, of the need for nations to have a general statement of child and adolescent mental health policy (Shatkin et al); second, of the need to establish inter national child and mental health research networks to foster research in low- and middle-income countries (Erlich & Plener); and third, of the circumstances that exist for providing such support to children in one such country, Pakistan (Khan et al).
Child and adolescent mental health services in Pakistan: current situation, future directions and possible solutions
Authors: Khan Faria , Shehzad R. K. , Chaudhry Haroon R.
Published: January 2018

Worldwide, mental disorders are on the increase (Gadit, 2007) and an estimated 10-20% of children have one or more mental or behavioural problems (Park, 2002). There is an urgent and serious need to pay attention to the mental health needs of children in low- and middle-income countries (Rahman et al, 2000). The initial survey for the World Health Organization's Atlas project (Sherer, 2002) showed that 41% of countries surveyed had no mental health policy and 28% had no separate budget for mental health.
Introducing competency-based training in Europe: an Anglo-Dutch perspective
Authors: Oakley Clare , Malik Amit , Kamphuis Femke
Published: January 2018

There are striking and significant differences in psychiatric training across Europe and procedures for the assessment of trainees vary widely (Strachan, 2007). The introduction of competency-based training represents a major shift in medical education and a challenge to harmonising psychiatric training in Europe. This paper discusses the development and implementation of competency-based training in the Netherlands and the UK and focuses on its effects on trainees.
Global Challenges Facing Psychiatric Training
Authors: Simmons Meinou
Published: January 2018

Sir: At the annual meeting of the Royal College in July, British psychiatrists were treated to a taste of the trainee's lot in France, the Czech Republic and the USA. It was reassuring to hear that UK training often compares favourably with that overseas.
Intellectual disability in India: the evolving patterns of care
Authors: Girimaji Satish Chandra
Published: January 2018

Intellectual disability was recognised in ancient Indian literature, but organised services have a history of just five decades. India shares many features of low- and middle-income (LAMI) countries regarding intellectual disability. There is a low level of awareness about its nature, causes and interventions. One can come across many superstitions, myths and misconceptions about intellectual disability. In general, services are inadequate, being concentrated in big cities and urban areas. There is generally limited access to support services and few government benefits, and these, in any case, are often of little value (World Health Organization, 2007). Locally and nationally, there are few relevant and reliable epidemiological data on the prevalence of intellectual disability. However, there have been some positive developments within the past three decades, and they are the focus of this paper.
Psychiatry in the UK: an overview
Authors: Banks Vicky , Searle Geoff , Jenkins Rachel
Published: January 2018

The National Health Service (NHS) serves the UK through four devolved organisations for England, Scotland, Wales and Northern Ireland. It is one of the largest public healthcare systems in the world, universal and free at the point of delivery. Its key challenge is to maintain this approach within tight financial constraints, while embracing new technologies, treatments and styles of service delivery, as well as meeting the health needs of an ageing population.
Psychiatry in paradise – the Solomon Islands
Authors: Singh Ashok N. , Orotaloa Paul
Published: January 2018

The Solomon Islands is situated in the South Pacific Ocean and is a low-income country. It comprises nearly 1000 islands with a total land area of 304 000 km2 spread over a sea area of about 1 500 000 km2, making communications, travel and service delivery difficult and creating inequities in access. The population of the Solomon Islands was estimated to be just over 580 000 in 2008, and is young, with 42% aged under 15 years (Solomon Islands Ministry of Health, 2006). The majority of the people are Melanesian (93%) and 98% of the population belong to a Christian church. The population is, though, extremely diverse, with 91 indigenous languages and dialects being spoken, in addition to the Solomon Islands pijin (the most common language) and English (the official national language). Over 83% of the population live in rural areas, where subsistence agriculture, fishing and food gathering are the main sources of income. There is no substantial tourist industry. The gross domestic product (GDP) is US$1.5 billion and annual per capita income is approximately US$2800 (International Monetary Fund, 2009). Total expenditure on health represented 5.6% of GDP but only 1% of the total health budget is allocated to mental health (World Health Organization, 2005).
Mental health in Botswana
Authors: Sidandi Paul , Opondo Philip , Tidimane Sebonetse
Published: January 2018

Botswana is a landlocked country located in southern Africa. More than two-thirds of it (70%) is covered by the Kalahari Desert, known locally as the Kgalagadi. The majority (82%) of the nearly 2 million population live in the eastern part, along the railway line from Lobatse in the south-east to Francistown in the north-east, and the rest in the central part, including the Okavango River delta.
The influence of war and terrorism on posttraumatic distress among Israeli children
Authors: Brom Danny , Pat-Horenczyk Ruth , Baum Naomi L.
Published: January 2018

The Middle East has been in conflict for many decades and wars have become the ‘normative reality’ of children residing in the area. Questions have been raised about children's vulnerability to the stresses that come with living in a war area. Are children more resilient because they are more flexible in their ways of coping? Or are children more vulnerable because their psychological development is influenced by the environment?
Post-traumatic stress disorder and attention-deficit hyperactivity disorder in Palestinian children affected by the war on Gaza
Authors: Thabet Abdel Aziz , Tawahina Abu , El Sarraj Eyad , Henely David , Pelleick Henrick , Vostanis Panos
Published: January 2018

The Gaza Strip has been badly affected by war and conflict over the past four decades. Palestinians are exposed to repeated incursions of the border areas, with many resulting casualties. At the end of December 2008, more than 230 Palestinians were killed and at least 770 were injured, including 100 in critical condition, after an Israeli airstrike. This was followed by a military operation that continued for 23 days, in which 1420 Palestinians, including 446 children, were killed. At least 4000 houses were totally destroyed and 16000 partially damaged (Palestinian Red Crescent, 2008).
Being monolingual, bilingual or multilingual: pros and cons in patients with dementia
Authors: Khan Farooq
Published: January 2018

This article looks at the advantages and disadvantages of being monolingual or multilingual, with particular reference to dementia patients who belong to ethnic minorities. There has been some progress in understanding the field of cultural diversity and the variations between different ethnic groups in relation to their specific difficulties when suffering from dementia (Hendrie et al, 2001). However, research has largely been targeted towards cultural variations and dementia, while the language aspects have not been properly researched.
Mental health and the World Health Organization: translating strategy into practice
Authors: Skuse David
Published: January 2018

We asked the programme managers for mental health at the World Health Organization's Regional Offices for Europe, the Eastern Mediterranean and South-East Asia to provide an account of developments in the provision of mental health services within their regions.

We are very fortunate that these busy and influential individuals were able to set aside the time to prepare articles that shed a fascinating light on strategic thinking within the World Health Organization.
Judicial involuntary admission under the Mental Health Act in Goa, India: profile, outcome and implications
Authors: Rane Anil , Nadkarni Abhijit , Waikar Shilpa , Borker H. A.
Published: January 2018

Reception order (RO) by a magistrate is a mode of involuntary admission provided under the Indian Mental Health Act of 1987. To the best of our knowledge there has been no evaluation of this provision in clinical practice. The present paper is a descriptive study through retrospective case-note review of patients admitted by way of RO to a tertiary care hospital in Goa. Compared with those admitted voluntarily, those admitted by RO tended to be single, middle aged (40–60 years old) and non-Goan; on average they had a significantly longer hospital stay than voluntarily admitted patients. Non-affective psychosis and substance use disorders were the more common diagnoses. While admissions by RO serve a useful role in bringing patients who are not under proper care into the mental healthcare system, they do not address the issue of aftercare.
Sources of anxiety about (and among) sexual minorities in Africa
Authors: Epprecht Marc
Published: January 2018

There is a perceived increase in incidents of rhetoric, legislation and vigilantism against sexual minorities and their allies across Africa. This ‘African homophobia’ is counter to human rights conventions, public health best practices and sound economic development. The paper reviews areas of progress as well as the broad economic and cultural contexts for the experiences of African sexual minorities.
Pathways to mental healthcare in high-income and low-income countries
Authors: Sorketti E. A. , Zuraida N. Z. , Habil M. H.
Published: January 2018

Understanding the way in which people seek care for mental disorders is important for planning services, training and referral mechanisms. Pathways to care fall broadly into three categories: via primary care physicians; via native healers; and via patient choice (patients can have direct access to mental health professionals). The pattern and nature of access to service in low-income countries are different from those in high-income countries. In many societies, deep-seated cultural beliefs on the part of patients and families about the causes of mental disorders are a major barrier to the receipt of modern psychiatric care.
Impact of religion and culture on mental disorders among Egyptians
Authors: Gadelkarim Wafaa , El-Maraghy Manal , Sule Akeem
Published: January 2018

This review looks at the long-established customs and religious beliefs, as well as social and family structures, affecting the symptoms of psychiatric disorders among Egyptian people. It considers reactions to emotional distress and dysfunctionality. Some light is also shed on the healthcare system.
Together to make a difference in mental health in the Western Pacific Region
Authors: Wang Xiangdong
Published: January 2018

Mental disorders are among the leading causes of disease burden in the Western Pacific Region of the World Health Organization (WHO). Networking and partnership have been identified as the major components of key strategies to address challenges in meeting mental health needs in the region. This article provides a brief review of relevant initiatives collaboratively developed by the WHO, member states in the region and other partners.
Mental health law in Greece
Authors: Douzenis A. , Tsopelas C. , Lykouras L.
Published: January 2018

Like all European countries, Greece has developed its national legislation based on the principles of equality and the right of representation, but there is no separate, specific mental health law in Greece. This paper describes the law for involuntary psychiatric admission. The law concerning criminal and civil responsibility and the law relating to individuals with addictions committing drug-related crimes are also outlined.
What psychiatrists should know about environmental sustainability and what they should be doing about it
Authors: Maughan Daniel , Berry Helen , Davison Phil
Published: January 2018

The 2013 report from the Intergovernmental Panel on Climate Change has caused renewed concern among both clinicians and health policy makers. Climate change is continuing at an increasing rate. This guest editorial describes how climate change might affect global mental health and proposes three things that psychiatrists from every country could implement to respond appropriately to this urgent and severe global threat. These responses are mitigation and adaptation strategies for mental health services, and the integration of sustainability into training.