bluuebunny/crossref_metadata_2025 huggingface dataset:
Myocardial iron overload
Authors: Carpenter John P , Wood John C , Pennell Dudley J
Published: October 2018

The heart is the target lethal organ in thalassaemia major. Cardiovascular magnetic resonance (CMR) measures iron using the magnetic relaxation time T2*. This allows comparison with the left ventricular function and conventional iron measurements such as liver iron and serum ferritin. The single breath-hold cardiac-gated CMR acquisition takes only 15 seconds, making it cost-efficient and relevant to developing countries. Myocardial T2* of <20 ms (increased iron) correlates with reduced left ventricular ejection fraction, but poor correlation exists with ferritin and liver iron, indicating poor capability to assess future risk. Myocardial T2* of <10 ms is present in >90% of thalassaemia patients developing heart failure, and approximately 50% of patients with T2* of <6 ms will develop heart failure within 1 year without intensified treatment. The technique is validated and calibrated against human heart iron concentration. The treatment for iron overload is iron chelation, and three major trials have been performed for the heart. The first trial showed deferiprone was superior to deferoxamine in removing cardiac iron. The second trial showed a combination therapy of deferiprone with deferoxamine was more effective than deferoxamine monotherapy. The third trial showed that deferasirox was non-inferior to deferoxamine in removing cardiac iron. Each drug in suitable doses can be used to remove cardiac iron, but their use depends on clinical circumstances. Other combination regimes are also being evaluated. Use of T2*, intensification of chelation treatment, and use of deferiprone are associated with reduced mortality (a reduction in deaths by 71% has been shown in the United Kingdom). The use of T2* and iron chelators in the heart has been summarized in recent American Heart Association guidelines.
CMR approach in cardiac tumours
Authors: Basso Cristina , Buser Peter T , Rizzo Stefania , Lombardi Massimo , Thiene Gaetano
Published: October 2018

Cardiovascular magnetic resonance (CMR) imaging of cardiac masses provides a multplicity of information, e.g. on localization, extension, dimensions, infiltration of cardiac and/or peri-/para-cardiac tissue, influence on cardiac function and flow, vascularization of the mass, and most importantly tissue characterization. However, since time to investigate a patient within the magnetic resonance scanner is limited, it is recommended to follow published CMR protocols in order to perform highly efficient CMR examinations and nevertheless receive optimized information per unit of investigational time. Furthermore, some criteria may allow differentiation of benign from malignant tumours.
Metastatic tumours
Authors: Basso Cristina , Buser Peter T , Rizzo Stefania , Lombardi Massimo , Thiene Gaetano
Published: October 2018

At autopsy, the incidence of metastasis to the heart seems to be higher than clinically observed. In two-thirds of cases, the pericardium is involved, in about one-third of cases the epicardium and the myocardium, and in 5% of cases the endocardium. On cardiovascular magnetic resonance imaging, cardiac metastases present with features of malignant masses, variable signal characteristics, and generally (60%) enhance after contrast application.
Cardiac thrombi
Authors: Basso Cristina , Buser Peter T , Rizzo Stefania , Lombardi Massimo , Thiene Gaetano
Published: October 2018

Thrombi are the most common intracardiac masses, located within atrial cavities, ventricular cavities, or both. Cardiac thrombi vary considerably in size, morphology, and mobility. On cardiovascular magnetic resonance (CMR), signal intensities on different CMR sequences allow a highly accurate diagnosis of thrombi.
The pulmonary circulation: assessing pulmonary arteries and pulmonary veins
Authors: Yim Deane , Grosse-Wortmann Lars
Published: October 2018

The pulmonary arteries and pulmonary veins can be challenging to image comprehensively with echocardiography. As a result, patients with suspected pulmonary arterial or venous abnormalities are often referred for cross-sectional imaging with cardiac magnetic resonance (CMR). In addition to providing detailed anatomic information, CMR also offers important information regarding flow distribution and flow patterns within the vessel. The haemodynamic and morphological data derived from CMR are important in decision-making and provide a roadmap for planning surgical or interventional approaches. This chapter focuses on the anatomy, pathophysiology, and imaging considerations of congenital or acquired pulmonary arterial and venous abnormalities that are commonly encountered in clinical practice.
Congenital aortic disease
Authors: Pluchinotta Francesca R , Muthurangu Vivek
Published: October 2018

Supravalvar aortic stenosis, aortic arch anomalies, and coarctation of the aorta are lesions involving the ascending and descending aortas, which can cause obstruction to left ventricular forward flow. In some cases, they can be associated with an anomalous borderline left ventricle. Obstructive lesions impose an increased afterload on the left ventricle and, if severe and untreated, result in hypertrophy and eventual dilatation and failure of the left ventricle. In addition, clinical manifestations of double aortic arches and other vascular rings include swallowing or respiratory symptoms due to extrinsic compression. In most cases, the anatomical diagnosis can be made from two-dimensional echocardiography. Common indications for performing cardiovascular magnetic resonance (CMR) are to refine an echocardiographic diagnosis before selecting a management plan or during follow-up to depict post-operative changes after surgical correction or catheter intervention. The goals of CMR in the assessment of patients with left-sided heart lesions are anatomical evaluation of the location, functional assessment of the haemodynamic burden, and identification of associated anomalies.
Extra-cardiac findings
Authors: Rodrigues Jonathan Carl Luis , Secchi Francesco , Lombardi Massimo , Bucciarelli-Ducci Chiara , Pugliese Francesca
Published: October 2018

Cardiovascular magnetic resonance (CMR) is an established, non-invasive technique to comprehensively assess cardiovascular structure and function in a variety of acquired and inherited cardiac conditions. In the process of acquiring CMR images, the inferior neck, entire thorax, and upper abdomen are routinely imaged, particularly in the initial multi-slice axial and coronal images. Identifying and reporting extra-cardiac findings at the time of CMR has ethical, financial, and medicolegal implications. Not all extra-cardiac findings are incidental, and occasionally they may contribute to the interpretation of the primary cardiac pathology, as some cardiac conditions have multi-systemic extra-cardiac involvement. However, the majority of extra-cardiac findings are incidental but may still be clinically important and may alter clinical management. Given that several of the cardiovascular risk factors for atherosclerosis are also risk factors for malignancy, certain patient groups undergoing CMR are at potential risk for important extra-cardiac findings. This chapter aims to provide a systematic overview of the type of extra-cardiac findings that may be detected on CMR, subdivided by anatomical location. Focus is placed on normal variant anatomy that may be confused for pathology, common extra-cardiac findings, and important imaging signs that help distinguish important pathology from benign entities. A framework to the approach and potential further diagnostic workup of incidental extra-cardiac findings discovered at the time of CMR is provided.
Introduction: general considerations on the future of CMR
Authors: Neubauer Stefan
Published: October 2018

Cardiovascular magnetic resonance (CMR) has become one of the great pillars of cardiac imaging. Modern CMR, as we now practise it, is the result of an enormous method and application development effort that occurred over the past 25 years and has taken CMR from its humble beginnings of anatomical T1- and T2-weighted imaging to the extremely versatile, accurate, and robust technique it is now. The main developments over this time, building on the anatomical imaging, were the establishment of cine imaging for assessment of cardiac function, first-pass perfusion imaging for measurement of perfusion reserve, as well as myocardial blood flow (in millilitre per minute and gram), late gadolinium enhancement for imaging of scar and patchy fibrosis, and two-dimensional flow velocity imaging for the assessment of valve and shunt lesions. This chapter aims to address the question of what the game changers for CMR are in the next 10-20 years.
Magnetic resonance spectroscopy
Authors: Tyler Damian
Published: October 2018

Magnetic resonance spectroscopy (MRS) allows for the chemical nature of tissue to be investigated, opening up a novel window on the changes in metabolism and energetics that occur in the diseased heart. However, MRS suffers from a lack of sensitivity when it is compared with magnetic resonance imaging, which means that scan times are long and clinical application is limited. This chapter explores the information available from the application of proton, phosphorus, and carbon MRS in the heart and looks at the recent developments, such as ultra-high field strength MR systems and hyperpolarization methods, that are providing improved sensitivity and a new lease of life for this valuable technique.
Molecular and cellular imaging in cardiovascular disease
Authors: Sosnovik David
Published: October 2018

Molecular imaging has traditionally been performed with nuclear or optical imaging techniques due to their extremely high sensitivity. However, over the last 1-2 decades, molecular magnetic resonance imaging (MRI) has emerged as a highly feasible and accurate alternative. Many molecular targets of interest in the cardiovascular system are abundantly expressed and can be imaged using conventional gadolinium chelates. More sparsely expressed targets can be imaged with targeted nanoparticles, which have far higher magnetic relaxivities. The use of 19-fluorine to label cells can be performed, in conjunction with proton MRI, on conventional magnetic resonance scanners. In addition, recently developed manganese-based probes may provide an alternative to gadolinium, and chemical exchange saturation transfer (CEST) imaging may allow molecular targeting to be performed without any exogenous contrast agents. The combination of therapeutic and diagnostic effects (theranostics) is an area of intense interest and is being actively explored in the cardiovascular arena.
Interventional CMR (MRI catheterization)
Authors: Lederman Robert
Published: October 2018

Real-time magnetic resonance imaging (MRI) is currently suitable to guide diagnostic MRI cardiovascular catheterization in patients. This approach is attractive to characterize haemodynamics and function concurrently, especially in the evaluation of cardiomyopathy and pulmonary artery hypertension. Safe clinical guidewires are entering commercial distribution and, combined with passive catheters, allow successful MRI catheterization in adults and children. This chapter briefly describes suitable instrumentation and approaches.
Career Reflections of a 1970s Feminist
Authors: Rands Gianetta
Published: October 2018

This chapter describes, via personal reflection and experience, some changes for women in psychiatry in the late twentieth century. Examples include progress in higher education, changes in National Health Service structures, and changes in professional recruitment, training, and exams. Evidence is used to illustrate gender inequality, then and now, and the context of some new laws is outlined, particularly Safeguarding Vulnerable Groups Act (2006), the Mental Capacity Act (2005), and the Equality Act (2010). The General Medical Council’s Duties of a Doctor are cited and their use covered. There are examples of how formal inquiries can influence the development of services and standards. Throughout, the emphasis is on women’s roles and experiences. Examples of sexual harassment, in public and at work, are described as are examples and evidence of inequality in pay, job opportunities, and career progression. Some anonymized clinical cases are used to illustrate situations and medical dilemmas.
The Entry of Women into Psychiatry
Authors: Subotsky Fiona
Published: October 2018

This chapter looks at how Elizabeth Garrett Anderson combatted the views of the eminent psychiatrist Henry Maudsley on the higher education of women and their entry into the profession of medicine, and how they were finally overcome. The speciality of psychiatry in the late nineteenth century was largely reflected by participation in the Medico-Psychological Association (MPA) (now the Royal College of Psychiatrists), and the arguments over the admission of women were well documented in the Journal of Mental Science (JMS). Eventually, the persistence of the women and their male sympathizers was successful, while Maudsley’s influence waned. The first woman to gain the Certificate in Psychological Medicine (MPC) was Jane Waterston in 1888, and the first woman formally elected to membership of the MPA was Eleonora Fleury in 1894.
Whose Life is it Anyway? Life and Death in the Court of Protection
Authors: Maddock Clementine
Published: October 2018

Psychiatrists are entering a brave new world. Following the introduction of the Mental Capacity Act, there has been an increase in the number of decisions regarding refusal of life sustaining treatment being heard in the Court of Protection. Many of these cases involve patients with mental health problems. Although in some cases, such as those with anorexia, treatment can be given against a patient’s will under the Mental Health Act, the question has become whether we should continue to give treatment to a patient who is actively refusing and who has not benefited from treatment for this condition over the last 10 to 15 years. In other cases, patients are refusing life-sustaining treatment for conditions unrelated to a mental disorder, who are deemed to lack capacity to make that decision. This essay will consider how the courts are interpreting the ‘best interests’ doctrine in these life or death cases.
Women in Psychiatric Training
Authors: Fozard Georgina , Greenfield Philippa
Published: October 2018

Training in psychiatry involves a fascinating and rewarding journey, and is a wonderful career for women. This chapter explores what it means to be a female psychiatric trainee. The authors discuss the recruitment crisis within psychiatry and the way that stigma and financial pressures upon the NHS compound this. They discuss their own experiences as medical students interested in psychiatry, particularly with regard to overcoming prejudices within the wider medical profession. There are certain challenges that are particular to training in psychiatry that women trainees face, including everyday sexism and how it impacts on self-esteem, as well as exposure to violence and stalking, and the effect of social media on medical practice. The authors discuss their own experiences in facing these challenges, what more could be done to support trainees, and they consider the importance of self-care and the way in which training as a psychiatrist can give trainees particular skills of self-reflection and insights into group dynamics that can be invaluable in developing as medical leaders.
Women as Trainers in Psychiatry
Authors: Fosker Hannah , Boyle Ann
Published: October 2018

Despite increasing numbers of women entering the medical profession, women remain under-represented in positions of leadership. In this chapter, Dr Hannah Fosker and Dr Ann Boyle explore this phenomenon. They outline ways in which this disparity is being challenged, and highlight the importance of continuing to pursue this aim. The pertinence of this to psychiatry is discussed, including the importance of women as role models within the specialty, as well as the important skills they offer to mental health services. Training in psychiatry is discussed, and a personal perspective offered on being a woman trainer in psychiatry gives an insight into this important role.
How to Succeed in Psychiatry Without Really Trying: One Woman’s Accidental Pathway to the Top of Her Profession
Authors: Burn Wendy
Published: October 2018

‘How to succeed in Psychiatry without really trying: One woman’s accidental pathway to the top of her profession’ describes Wendy Burn’s childhood, schooldays, and her time at Southampton University Medical School, including how she failed the first year exams and nearly lost her place there. It covers her first year as a doctor and her training in Psychiatry in Southampton and Leeds. Her early years as a consultant are described together with how her involvement in the postgraduate training of other doctors began. Her progress through the training hierarchy is documented, which culminated in her becoming first the Dean and then the President of the Royal College of Psychiatrists.
A life course approach to understanding the association between depression and type 2 diabetes
Authors: Ismail Khalida , Moulton Calum D. , Danese Andrea , Penninx Brenda W.
Published: October 2018

The relationship between depression and type 2 diabetes is bidirectional and poorly explained by behavioural factors alone. Chronic activation of the innate immune system provides a promising mechanism by which both conditions could develop concurrently across the life course. Genetically, overlap between depression and type 2 diabetes has been reported by twin studies, although not yet at the genome-wide significance level. In utero, activation of inflammatory processes may impact on neurodevelopment of appetite and mood regulation. In early childhood, prolonged adversity is associated with subsequent elevated inflammation, depression, and obesity, which may be amplified by unhealthy lifestyle choices in adolescence. Finally, prolonged low socioeconomic status into adulthood is associated with chronically elevated inflammation and incident type 2 diabetes. In sum, a lifespan approach to the comorbidity of depression and type 2 diabetes offers novel opportunities for timely intervention and even for the primary prevention of type 2 diabetes.
Diabetes distress
Authors: Hermanns Norbert , Bremmer Marijke A. , Snoek Frank J.
Published: October 2018

Diabetes distress is a common emotional response in people with diabetes. It is associated with depression and has a negative impact on quality of life and diabetes control. This chapter reviews current concepts of diabetes-specific distress. Diabetes-related distress is defined as an emotional response to stressors, fears, and worries associated with the burden of living with and managing the chronic disease diabetes mellitus. Evidence to date on point prevalence, persistence of diabetes distress, and incidence in people with type 1 and type 2 diabetes are reviewed as well as the associations between diabetes distress and depression. Conceptual and clinical implications for the assessment and management of diabetes distress are discussed.
Metabolic surgery and depression
Authors: Gissey Lidia Castagneto , Mariolo James R. Casella , Mingrone Geltrude , Rubino Francesco
Published: October 2018

The incidence of obesity is rising worldwide and so are its comorbidities: type-2 diabetes mellitus (T2DM), dyslipidaemia, hypertension, cardiovascular disease, sleep apnoea, and depression. Bariatric/metabolic surgery has established itself over the past several years as an effective treatment not only for morbid obesity but also for its associated morbidities. The effects of bariatric/metabolic surgery on depression are controversial, with some studies showing improvement and others demonstrating a worsening. However, a major drawback of these studies is that they do not compare patients with the same baseline psychiatric disorders. In fact, mild to severe depressive symptoms are observed in most candidates for bariatric/metabolic surgery. Preoperative evaluation of the patient’s mental state would enable identification of the appropriate interventions, enhancing long-term compliance and weight maintenance. It could also leverage psychological support in case the patient’s disorder relapses postoperatively. Preoperative evaluation should detect potential psychological contraindications to surgery, such as severe eating disorders.
Current and emerging psychological models
Authors: Garrett Christopher
Published: October 2018

This chapter critiques the current psychological and social interventions used in addressing type 2 diabetes control and depression, suggesting an alternative approach using a lifespan perspective, drawing on attachment theory and personality research. It evaluates the psychological and social interactions of the two conditions and describes how current interventions such as cognitive behavioural therapy approach these difficulties and the limitations suggested in the current evidence base. It goes on to discuss the association of attachment theory and personality traits on both type 2 diabetes control and depression and proposes how this evidence might be harnessed in future interventions to improve outcomes in both conditions.
Social inequalities and mental health
Authors: Bell Ruth , Marmot Michael
Published: October 2018

This chapter discusses evidence linking social inequalities, across social, economic, and environmental dimensions to inequalities in mental health. A framework for thinking about the lifetime causes of inequalities in mental health is presented and used to discuss how experiences and conditions affect mental health across the life course. The chapter focuses particularly on factors that affect child development because of the importance of child developmental outcomes for future mental and physical health, and on life chances. Finally, the need for more attention to be focused on addressing the causes of social inequalities in mental health through multiple types of policies and interventions is discussed.
Economic costs of mental illness
Authors: Patel Anita
Published: October 2018

The economic costs of mental illness are substantial and extend far beyond those related to mental health care. This chapter describes contributors to these costs and uses well-known cost-of-illness studies as illustrative examples. It discusses uses and limitations of such studies. It highlights the care needed when producing and interpreting such information and points to key literature on methodological practice and issues. It also explains why knowledge of costs is not helpful by itself. Difficult decisions about allocating scarce resources between alternative possibilities require consideration of broader consequences of alternative care options. It describes how considering both cost and outcome information together can more informatively provide estimates of relative value (i.e. efficiency). It outlines the economic evaluation frameworks commonly used for such purposes. It notes key areas within mental health care that have been evaluated using such approaches and potential challenges associated with producing such evidence.
The global burden of mental and substance use disorders
Authors: Ferrari Alize J. , Erskine Holly E. , Charlson Fiona J. , Santomauro Damian F. , Leung Janni , Whiteford Harvey A.
Published: October 2018

The Global Burden of Disease Study (GBD) uses a scientific framework to quantify health loss due to diseases, injuries, and risk factors by location, age, sex, and year. This work has been central in revealing the global health impacts of mental and substance use disorders. In this chapter, the global burden of mental and substance use disorders, based on findings from the Global Burden of Disease Study 2015 (GBD 2015), is presented. The methods used to estimate the burden of mental and substance use disorders and how that has evolved over time; the key analytical considerations for the accurate interpretation of burden findings; the accessibility of GBD data; and the applicability of GBD data in other areas of public health are summarized.
Models of causation of mental illness
Authors: McKenzie Kwame
Published: October 2018

Models of causation of mental illness are complex. But applying new knowledge from research may help us to better understand the mechanisms through which people develop problems. A prerequisite is to consider how diagnoses are made and what a mental illness actually is. After that, this chapter discusses the history of causation research before applying lessons learned to the tension between biological and social theories of mental illness. Using schizophrenia and other psychoses as a lens to think through aetiology, this chapter explores what is known about different mechanism through which mental illness may be caused. The four dimensions of causation—individual, ecological, interactions, and time—are offered as a simple framework for organizing complex aetiological theories.
Genetic influences across the age span
Authors: Shaw Edward , Smith Daniel J.
Published: October 2018

Most psychiatric disorders have a genetic component. Mental illness tends to occur as a consequence of the dynamic interaction between genetic vulnerabilities and environmental risk factors. Future advances in public mental health should bear in mind the important role of genetics in determining mental health and well-being. Genetic research raises important ethical considerations. The challenges of discovering genetic risk factors for psychiatric disorders are outlined, along with examples of recent discoveries from large-scale genetic epidemiological research. The focus is on an age span perspective, with consideration of the role of epigenetic processes during development. Discoveries in childhood (attention deficit hyperactivity disorder), adulthood (schizophrenia and bipolar disorder) and older-age (Alzheimer’s disease) are summarized. The public health significance of psychiatric genetics is considered within the context of ongoing global efforts to understand the causes of mental illness and how this might lead to new approaches to diagnosis, classification, and treatment.
Public mental health and anthropology
Authors: Moses Joshua , Whitley Rob
Published: October 2018

This chapter charts the contributions of anthropology to public mental health. It examines three main traditions in anthropological practice: (i) individual-level approaches, investigating mental health beliefs, behaviours, and illness narratives; (ii) meso-level approaches, assessing the provision, nature, and practice of mental health care systems; and (iii) macro-level approaches, examining the mental health impact of societal structures, including political and economic structures. It emphasizes the importance of moving among different levels of analysis. The chapter also provides case study material on suicide in the Arctic. The chapter concludes by discussing climate change and other emerging public mental health challenges, suggesting a multi-scale, interdisciplinary ecological approach.
Occupational epidemiology
Authors: d’Errico Angelo , Costa Giuseppe
Published: October 2018

Occupational epidemiology has investigated extensively during the last decades the potential impact on mental health of several aspects of work organization, testing the effect of psychosocial exposures derived from theoretical constructs of work stress grown in its own field and in other disciplines (psychology, sociology, ergonomics). The two most important theoretical models are the demand–control–support model and the effort–reward imbalance model, whose effects have been evaluated in hundreds of studies. Other psychosocial dimensions strongly suspected for their association with mental health are emotional demand, organizational justice, work–family conflicts, job insecurity, and working time (long working hours and shift work). For these exposures, moderate-to-good evidence of a causal association with mental disorders has been demonstrated in several epidemiological studies characterized by good methodological quality, pointing to the need to reduce workers’ exposure to these occupational hazards.
Policy challenges
Authors: Huppert Felicia A. , Ruggeri Kai
Published: October 2018

Taking a whole-population perspective, the chapter argues that improved well-being is the most important outcome of policy. Despite growing awareness of its importance, accepting the primacy of well-being has been a challenge within public mental health because there has been no uniform definition or measure, nor consensus on how to apply such a subjective concept across diverse populations. Confusion created by using terms such as happiness, or the continuing tendency to equate mental well-being with lack of mental illness, have created barriers to gaining widespread agreement on the importance of well-being in policy. In this chapter, historical approaches to defining well-being, issues of measurement, and evidence underpinning well-being interventions are explored. The chapter closes with a proposal on how best to consider well-being as an outcome, making use of the evidence in driving public mental health policy.
Unemployment and mental health
Authors: Bartley Mel
Published: October 2018

The effect of mass unemployment on an Austrian community was one of the first examples of the practice of public mental health. In the 86 years and three more recessions that have followed, the study of the relationship between unemployment and mental health has been revolutionized. From community studies to studies of individuals to research taking account of the whole of the life course, we are now rediscovering the importance of social and economic context. It has become clear that full employment of men, including those with more adversity in early life and fewer educational credentials, was a temporary phenomenon of the mid-twentieth century. But advances in theory, method, and data availability mean that public mental health practitioners are in a strong position to carry out the classical role of mitigating the harms of social change.
The social determinants of mental health
Authors: Bhui Kamaldeep
Published: October 2018

The social determinants include poverty; material deprivation; unemployment; poor housing, including exposure to hazardous or noisy or unsafe homes; gender disadvantage, poor educational opportunities, violence, social and cultural inequalities in opportunities; and exposures to adversity, including discrimination, stigma, and prejudice. Health-risk behaviours have been the traditional targets of intervention. Interventions need to be situated within broader policy action on multiple disadvantages that are especially troublesome, operating at the structural level in society, influencing institutions and patterning interpersonal and inter-group relations. Action on social determinants needs cross-sector agreement and commitment to operate in harmony, flexibly, tenaciously, and retaining the capacity to adapt to new contexts and sources of disadvantage. Applying such interventions early in the life course, in youth, and to parents will prevent the intergenerational transmission of disadvantage. Structural sources of poor health must be tackled, hence the importance of action to militate against the social determinants of poor health.
Environmental contaminants and mental health
Authors: Amarante Paulo , Torre Eduardo
Published: October 2018

This chapter discusses the problem of the effects of environmental contaminants and agrochemicals on mental health, relating this discussion to the issue of the right to health and the critique of the paradigm of chemicalization of life. Many studies have demonstrated a necessary criticism of the vicious circle linking infringement of rights, food insecurity, and institutionalized intoxication, with deep and severe social, health, and environmental consequences. Several kinds of physical and mental illnesses have been investigated as widely related to chemical-dependent agriculture, the industrial food model, and the predatory and exclusionary development model that produces intensive exploitation of labour and nature and multiple environmental contaminations. The consequences of the paradigm of chemicalization of life include intoxication of the population, environmental injustice, and human rights violations, and strengthen the renewal of interests of the ‘disease industry’ and the medicalization processes.
Family, marriage, and mental health
Authors: Sidheek Fasli , Satyanarayana Veena A. , Desai Geetha
Published: October 2018

Families provide the bedrock for the development of interpersonal relationships. It grooms a young member’s entry into a web of societal relationships and contributes to one’s mental health and well-being. Couples and families transition through a set of stages, known as family life-cycle stages, with each stage unique in its tasks and goals. In addition to introducing the key tenets of family systems theory, the chapter details contemporary topics in marriage and family, including extramarital involvement, violence, divorce, and same-sex marriages. It discusses important theoretical and therapeutic approaches to marriage and family therapy, including behavioural, dynamic, systemic, and experiential formats of family therapy. It also reviews process and outcome research in the area of marriage and family therapy.
Children and adolescents
Authors: Plauché Jessica L. , Leventhal Bennett L.
Published: October 2018

Child and adolescent mental health has become a pressing, international public health crisis. However, the field of child and adolescent psychiatry has advanced in remarkable ways over the last few decades. Increasing evidence indicates that child and adolescent mental disorders are highly prevalent and impactful conditions that often go unrecognized and untreated, resulting in a tremendous adverse impact on youth, families, and communities. It is critical that future research, public policy, and training programmes continue to identify and support factors that mitigate the risk for developmental psychopathology and foster well-being and healthy development. This chapter focuses on five principal features: developmental epidemiology, healthy development and well-being, access to care, the effects of adverse childhood experiences, and paediatric psychopharmacology. Concluding remarks include strategies to promote healthy child and adolescent development, as well as for the prevention, early identification, and early intervention for child and adolescent mental disorders.
Recognizing mental health problems in the ageing community
Authors: Lam Linda Chiu Wa , Chan Wai Chi
Published: October 2018

With an increase in life expectancy worldwide, the ageing population has been expanding in the last few decades. Advanced age is associated with a high prevalence of physical morbidity. Dementia, the commonest type of mental disorder in later life, has been widely recognized as a public health priority. However, it is important to realize that other mental health problems are also common in old age. Depression and anxiety disorders are affecting a significant proportion of older adults, and may be associated with cognitive decline. This chapter will draw on current research related to key mental health problems in old age, and explore their public health significance through exploration of major prospective, large-scale, long-term cohort studies that shed light on the risk and protective factors that may influence the manifestations of mental health problems and associated disorders from a life course perspective.
Lifestyle
Authors: Zhang Dexing , Wong Samuel Y. S.
Published: October 2018

Plenty of evidence supports the benefits of healthy lifestyles on physical health and disease prevention. However, less attention has been paid to the significant impact of healthy lifestyles on mental health. This chapter gives an overview of the impact of four main lifestyle factors (physical activity, diet, substance use, and social network) on mental health. Other lifestyle behaviours (sleeping habits, nature and leisure activities, pet ownership, religion and spirituality, mindfulness practice, and contribution and services to others), which have close relationships with mental health, are also briefly mentioned. Lifestyles are important for improving mental health status and preventing mental health problems, which can result in significant public health gains at the population level.
Implications of the global mental health and the HIV syndemic on HIV prevention and care
Authors: Lau Joseph T. F. , Li Jinghua , She Rui , Kim Yoo Na
Published: October 2018

HIV is known as a ‘social disease’, as its transmission is attributable to risk behaviours which are influenced by cultural and psychosocial environments. It is important to consider the HIV syndemic, defined here as the co-occurrence of HIV and other illness/health conditions (e.g. mental health problems, substance use). Mental health problems are prevalent both among key populations for HIV prevention and people living with HIV (PLWH), and can influence HIV-related risk behaviours, interact synergistically, and compromise the effectiveness of HIV prevention, treatment, and care. Structural, interpersonal, and individual factors associated with mental health problems among PLWH, and the impact of such problems on HIV prevention, are discussed. Promising approaches, such as positive psychology interventions, are explored. Finally, gaps in current mental health interventions, services, and personnel are highlighted, to suggest areas for improvement. Mental health improvement in affected populations is a prerequisite of controlling the global HIV epidemic.
Anti-stigma interventions
Authors: Gronholm Petra C. , Henderson Claire , Deb Tanya , Thornicroft Graham
Published: October 2018

There is a rich literature on the nature of mental health-related stigma and the processes by which it severely affects the life chances of people with mental health problems. Applying this knowledge to deliver and evaluate interventions to reduce stigma in a lasting way is, however, a complex and long-term challenge. This chapter outlines how mental health-related stigma and discrimination have been defined; describes the negative impact they have on people with mental illness; summarizes anti-stigma strategies and the evidence regarding their effectiveness; and makes suggestions for future intervention development and evaluation. It seems likely that short-term interventions may only have a short-term impact, with the implication being the need to study longer-term interventions and to use interim process and outcome data to improve interventions along the way.
Managing stress
Authors: Fletcher Susan L. , Davidson Sandra K. , Gunn Jane M.
Published: October 2018

Stress is an inevitable part of life. When we experience a stressful event our nervous system is automatically activated and we release hormones that help us to respond to the challenge we are facing. We need a certain level of stress to function effectively; however, when stress is severe or unrelenting it can have a harmful impact on our physical, psychological, and social well-being. This chapter examines the nature of stress and describes the models that have been developed to explain how and why we react when faced with a stressful event. The chapter also describes the prevalence of stress in the community and highlights some of the causes, effects, and risk factors for stress. In the concluding section of this chapter, the evidence in regard to specific strategies for preventing and managing stress is summarized.
Diet, environment, and mental health
Authors: Werneke Ursula , Bergdahl Ingvar A.
Published: October 2018

This chapter reviews dietary and environmental factors that may affect mental health. It takes a public health angle but examines the individual patient perspective where relevant. In the first part, the chapter looks at the impact of various nutritional constituents on mental health, including omega-3 fatty acids, vitamins, and minerals. Then, it reviews the evidence for diets and ‘superfoods’, which people might try to improve their mental health. Here, the focus is on neurodevelopmental disorders, depression, and psychosis. Potential interactions between foodstuffs and psychotropic medicines are also explored. The final part concerns environmental toxins that populations may be exposed to that may affect mental health, including lead, methylmercury, and various organic compounds.
Intimate partner violence
Authors: Wong Carmen , Ng Wai Ching , Zhong Hua , Scully-Hill Anne
Published: October 2018

Intimate partner violence (IPV) refers to any action that causes physical, sexual, and psychological harm by intimate partners, which includes domestic violence. This chapter gives a brief overview and details the prevalence, current theories, research, and evidence, including patriarchy and gender issues. IPV is complex, with internal and external factors relating to the victim, perpetrator, family, and the community. The long-term impacts on physical and mental health are reviewed. Recent direction by the World Health Organization describes a multi-level integrated approach, which is discussed topically in terms of individual, relational, and community prevention and intervention and its challenges. Finally, policies and laws relating to IPV are reviewed. This chapter has been written collaboratively by a multidisciplinary team of medical, social, and legal professionals.
Innovations in the area of social media
Authors: Lee Annisa , Stiller Stephan Hyeonjun
Published: October 2018

An estimated 2.62 billion people use social networking sites worldwide. Only recently have studies been carried out to explore the impact of social media in terms of creating new conditions such as cyberbullying, Internet addictions, and suicide contagion, among many other forms of mental health concerns. However, social media can play a role in education and public mental health interventions. Different types of social media include computerized self-help strategies, online psychotherapy and support groups, websites with medical information, forums, blogs, web applications, mobile apps, games, and networking platforms like Facebook, Instagram, Google+, Snapchat, Twitter, Flickr, YouTube, Pinterest, and Reddit. There are generational differences in the degree of familiarity and use of social media for gathering information and seeking education. The challenge for clinicians and public health educators is to try and use social media for betterment of society.
Policy and public mental health in low- and middle-income countries
Authors: Shields Laura , Pathare Soumitra , Karnatak Pallavi , Desiraju Keshav
Published: October 2018

Low- and middle-income countries (LAMICs) often struggle with the development and implementation of mental health policy. Mental health policy is a complex concept affected by social, political and economic factors, and influenced by the third sector, patient and family organisations. A challenge is ensuring regular review of policies to reflect changing demographics and contextual factors. Many non-governmental organizations, researchers, implementation specialists, and advocates contributed and supported the development, implementation, customization, and evaluation of mental health policy documents in LAMICs. These developments keep public mental health and prevention of mental disorders central to the policy-making process. The development of a good mental health policy requires (a) defining goals and specific targets, (b) establishing an inclusive policy process which involves all stakeholders involved in or affected directly or indirectly by mental ill-health (c) setting a time frame for the implementation of policies and also for review and renewal.
Tuning fork tests
Authors: Whiteside Olivia
Published: October 2018

This chapter discusses Stankiewicz and Mowry’s 1979 paper on the clinical accuracy of tuning fork tests including the design of the study (outcome measures, results, conclusions, and a critique).
Audiological aspects of presbyacusis
Authors: Keaton Casie
Published: October 2018

This chapter discusses Gates, Cooper, Kannel, Miller’s 1990 paper on hearing in the elderly including the design of the study (outcome measures, results, conclusions, and a critique).
Surgical management of Bell’s palsy
Authors: Kutz Walter
Published: October 2018

This chapter discusses Gantz, Rubinstein, Gidley, and Woodworth’s 1999 paper on the surgical management of Bell’s palsy including the design of the study (outcome measures, results, conclusions, and a critique).
The anatomical location of tinnitus
Authors: McFerran Don
Published: October 2018

This chapter discusses Baguley, Jones, Wilkins, Axon, and Moffat’s 2005 paper on the anatomical location of tinnitus including the design of the study (outcome measures, results, conclusions, and a critique).
Benign paroxysmal positional vertigo
Authors: Murdin Louisa
Published: October 2018

This chapter discusses Epley’s 1992 paper on benign paroxysmal positional vertigo including the design of the study (outcome measures, results, conclusions, and a critique).
Conservative management of vestibular schwannoma
Authors: Rompaey Vincent Van
Published: October 2018

This chapter discusses Stangerup, Caye-Thomasen, Tos, and Thomsen’s paper on conservative management of vestibular schwannoma including the design of the study (outcome measures, results, conclusions, and a critique).
Guidelines for the management of rhinosinusitis
Authors: Hopkins Claire
Published: October 2018

This chapter discusses Fokken et al’s paper on the guidelines for the management of rhinosinusitis including the design of the study (outcome measures, results, conclusions, and a critique).
Nasal polyposis
Authors: Bhalla Rajiv
Published: October 2018

This chapter discusses Rimmer, Fokkens, Chong, and Hopkins’s paper on surgical versus medical interventions for chronic rhinosinusitis with nasal polyps including the design of the study (outcome measures, results, conclusions, and a critique).
Allergic rhinitis and asthma
Authors: Saleh Hesham , Ahmed Jahangir
Published: October 2018

This chapter discusses Bousquet, Khaltaev, Cruz, Denburg, Fokkens, and Togias, et al.’s paper on allergic rhinitis and its impact on asthma including the design of the study (outcome measures, results, conclusions, and a critique).
Epistaxis
Authors: Field Rebecca
Published: October 2018

This chapter discusses Sulsenti, Yanez, and Kadiri’s paper on recurrent epistaxis including the design of the study (outcome measures, results, conclusions, and a critique).
Granulomatosis with polyangiitis
Authors: Reid Luke
Published: October 2018

This chapter discusses Srouji, Andrews, Edwards, and Lund’s paper on granulomatosis with polyangiitis including the design of the study (outcome measures, results, conclusions, and a critique).
Radiological assessment of thyroid nodules
Authors: Paleri Vinidh , Fox Hannah
Published: October 2018

This chapter discusses Moon, Jung, and Lee et al.’s paper on the radiological assessment of thyroid nodules including the design of the study (outcome measures, results, conclusions, and a critique).
Radioiodine for thyroid cancer
Authors: Paleri Vinidh , Fox Hannah
Published: October 2018

This chapter discusses Mallick et al.’s paper on predicting outcome in thyroid cancer including the design of the study (outcome measures, results, conclusions, and a critique).
Sleep nasendoscopy
Authors: Vanderveken Olivier
Published: October 2018

This chapter discusses Croft’s paper on sleep nasendoscopy including the design of the study (outcome measures, results, conclusions, and a critique).
Snoring surgery
Authors: Vanderveken Olivier
Published: October 2018

This chapter discusses Fujita, Conway, Zorick, Sicklesteel, Roehrs, and Wittig, et al.’s paper on snoring surgery including the design of the study (outcome measures, results, conclusions, and a critique).
Ventilation tubes
Authors: Kennedy Veronica
Published: October 2018

This chapter discusses Armstrong’s paper on ventilation tubes including the design of the study (outcome measures, results, conclusions, and a critique).