bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients formerly prescribed triazolam: a study in general practice
Authors: Holden John D
Published: March 2016

Objective: To discover whether patients who had formerly been prescribed triazolam continued to take psychotropic medication after its withdrawal.Method: 11 general practitioners provided details of the psychotropic medication of their patients who had previously been prescribed triazolam, 12 month after its withdrawal from Britain.Results: 70 of 91 patients (77%) were still taking regular hypnotics twelve months after the drug was withdrawn. Success at withdrawal was linked to lower doses of triazolam but did not depend upon age or sex.Conclusions: The withdrawal of triazolam resulted in a proportion of patients stopping hypnotics that is comparable with other interventions to reduce psychotropic consumption in general practice. Most patients continued to take hypnotics, which suggests that the withdrawal of a drug will usually lead to the substitution of a similar one when one is available.
Post-traumatic stress disorder in women who were victims of childhood sexual abuse
Authors: O'Neill Kevin , Gupta Kamal
Published: March 2016

Twenty-six women who had been sexually abused in childhood were assessed by means of structured interviews as to the nature of the abusive experience and subsequent psychiatric disorder. Nineteen (73.1%) fulfilled the criteria of Post Traumatic Stress Disorder and a comparison was made between PTSD and non-PTSD groups with regard to quantitative abuse variables. The phenomenon of latency or delay in onset in PTSD symptomatology was investigated. The possible implications of those findings were discussed.
Motivation towards learning and behaviour deviance in eight to eleven year old children attending an urban primary school
Authors: O'Regan Sylvia , Fitzgerald Michael , Kinsella Anthony
Published: March 2016

Motivation towards learning was assessed in a class of 3rd, 4th and 5th standard, using a self report scale. Results for children identified as behaviourally deviant were compared with those of their non-disturbed peers. The findings show no significant difference on motivational scores between both groups; behaviourally deviant children differing from their non-disturbed peers only on an informational subscale of judgment.
Wernicke
Authors: Breathnach Caoimhghin S
Published: March 2016

Carl Wernicke [1848-1905] gave the first description of sensory aphasia [1874] and of ophthalmoplegic encephalopathy [1881]. In addition, his notion of ‘Sejunction’ [1894] foreshadowed Bleuler's ‘schizophrenia [1908], and he may be justly said to have been the first successful organic neuropsychiatrist.
Positron emission tomography in the study of neuropsychiatric disorders – its uses and potential
Authors: Dolan Raymond J
Published: March 2016

PET represents the most powerful tool available for the measurement of in-vivo brain function. The basic principles of the technique and its application to the study of brain energy metabolism and neuroreceptor function are described by reference to findings from clinical studies of cerebral metabolism in neurological and psychiatric disorders. The extension of such resting state investigations by the application of activation paradigms in dynamic studies is discussed. The potential of PET as a tool to investigate neuroreceptor function is outlined in the context of preliminary findings from studies of dopaminergic function in schizophrenic patients.
Caffeine use by psychiatric patients
Authors: Dalby J. Thomas , Williams Richard
Published: March 2016

Caffeine remains the most widely used psychoactive drug and psychiatric populations tend to ingest more caffeine than the general community. It is important to assess caffeine intake in psychiatric patients as it may distort diagnostic signs and is known to interact with psychotropic medications. A blanket condemnation of caffeine use by psychiatric patients is, however, unwarrranted for while it may exacerbate some conditions (eg. anxiety disorders) it may prove beneficial to others (eg. schizophrenics) when used in moderate quantities. A scale for the estimation of caffeine intake is provided.
Deaths in the Central Mental Hospital
Authors: Stokes Marjorie , O'Connor Art
Published: March 2016

All deaths occurring in the in-patient population of the Central Mental Hospital during the period 1963 to 1987 inclusive were examined. The death rate during the total period was 11.7 per 1,000 admissions. The suicide rate during the total period was 3.9 per 1,000 admissions – there had been no suicides during the most recent five year period. Although the admission rate has been rising since the mid-1970s, the death rate over the last fifteen years has remained stable.

Many of the deaths prior to 1970 were in elderly long stay patients who died from natural causes. Five deaths in young patients are described separately – in two of these anticholinergic side effects of medication may have contibuted to the deaths. Seven suicides occcuring during the study period are described separately – four of these occurred in the months soon after admission.
Validation of Language Localisation by Computer Assisted Tomographic and Topographic Techniques
Authors: Breathnach C. S.
Published: March 2016

Computerized tomographic procedures have been used extensively since their introduction to examine specific language disabilities in aphasic patients and to correlate anatomical and clinical changes. The resulting overwhelming evidence in favour of lateralisation and localisation has been confirmed by regional blood flow studies and punctate electrical stimulation as well as by the topographic maps provided by neurometries. That specific lexical functions are localised within the peri-Sylvian cortex in the left cerebral hemisphere is now generally accepted, but the macroscopic mapping, which largely ignores the contribution of the ipsilateral thalamus and possibly of the basal nuclei, must not be mistaken for the language encoding processes in the parallel pathways which have been identified.
Telephone consultancy in adolescent psychiatry: an audit
Authors: Sheerin Declan Finnian
Published: March 2016

Objective: An audit was carried out to evaluate the performance of a telephone consultancy service in adolescent psychiatry. Its objective was to answer the following questions: What does a telephone consultancy service actually do? Is it worth having? If so, how can we improve it? Method: Proforma data sheets on 69 consecutive calls to the Telephone Consultancy Service over a 16-month period were analysed. Results: Seventy-seven percent of enquirers used the service to request a referral or to ask about the appropriateness of referral but only 46% of enquiries were responded to in this way. Twenty-two percent of enquiries were given counselling or advice on how to proceed with the cases themselves. Almost 50% of calls came from the social work department and they enquired principally about conduct problems (27% of their calls) and sexual abuse victims (18% of their calls). General practitioners infrequently used the service (7 calls over a 16-month period). Conclusions: These findings appear to indicate that a telephone consultancy service can provide a counselling service and highlight community resources that may be overlooked by other agencies. However, infrequent use of the service by general practitioners suggests that there has been poor dissemination of information about the service – therefore it is important to bolster awareness of the service itself on a periodic basis amongst potential users.
Monosymptomatic hypochondriacal psychosis treated with paroxetine: a case report
Authors: Brophy J Justin
Published: March 2016

A case of Monosymptomatic hypochondriacal psychosis responding to paroxetine is described. Conventional treatments had failed.
Suicide in schizophrenia
Authors: Cannon Mary , Buckley Peter , Larkin Conall
Published: March 2016

Suicide is recognised as the most devastating possible outcome of a schizophrenic illness. This study examined the characteristics of 15 schizophrenic patients who committed suicide. These patients were older and less socially isolated than noted in other research. Drowning was the commonest method of suicide and overall, the methods chosen were comparable to those reported among the general Irish population. A past history of deliberate self harm was common although no temporal relationship between such behaviour and suicide emerged. The findings are discussed in the light of the existing literature on this topic.
Time series regression results of suicide rates by social correlates for the USA and Northen Ireland
Authors: Lester David , Curran Peter S , Yang Bijou
Published: March 2016

A time series analysis of suicide in Northen Ireland and the USA for 1960 to 1984 revealed different correlates. Whereas divorce rates predicted national suicide rates in the USA, birth and marriage rates predicted suicide rates in Northern Ireland.

The major sociological theory proposed for understanding variations in national suicide rates was that of Durkheim. Durkheim proposed that two broad social characteristics were in large part responsible for the appearance of suicidal behaviour: social integration, the degree to which the people in a society were interconnected through social relationships, and social regulation, the degree to which the emotions and desires of people in the society were controlled and channeled by the social norms and customs.

Durkheim argued that suicide would be common when social integration was very strong (altruistic suicide) or very weak (egoistic suicide) and when social regulation was very strong (fatalistic suicide) or very weak (anomic suicide). Later theorists have argued that Durkheim placed more emphasis than was warranted on very strong social integration and regulation. Johnson argued, for example, that suicide would be more common when social integration and regulation were weak.
Cerebral lupus: a pleomorphic presentation
Authors: Watts Darryl , Hunter Euphan
Published: March 2016

A case of cerebral lupus is described over a three year period. The association of chronic brain syndrome, symptoms of derealisation and a suicide bid has not been reported previously. A hypothesis integrating organic and functional symptoms is suggested.
St. Clare's and St. Louise's child sexual abuse assessment units: an analysis of their origin, function and work practices
Authors: Ryan Imelda , Fitzpatrick Carol
Published: March 2016

St. Clare's Unit, in the Children's Hospital, Temple Street, and St. Louise's Unit, in Our Lady's Hospital for Sick Children, Crumlin, were set up by the Department of Health in Dublin in 1987 to carry out child sexual abuse assessments. Each unit is staffed by multidisciplinary teams and works closely with Community Care teams, the Gardaí, and treatment agencies. Assessment involves gathering information from referrers, the parents and the child at interview, and from physical examination. The information obtained is interpreted in context, and conclusions are based on the composite picture.

Analysis of the first two years' work shows that sexual abuse was confirmed in approximately half the cases seen, the abuser being known to the child and within the child's family or community network in the majority of cases.

As more professionals become trained in child sexual abuse assessment it is envisaged that more cases will be managed at local level, with perhaps more complex cases being referred to the units. This will enable unit staff to further develop a role in consultation, education, training and research.
Male prison transfers to the Central Mental Hospital, a special hospital (1983–1988)
Authors: O'Connor Art , O'Neill Helen
Published: March 2016

During the course of imprisonment, whether on remand or when serving a sentence, people sometimes need to be transferred to a psychiatric hospital. In Ireland the only psychiatric hospital a person can be transferred to is the Central Mental Hospital (CMH).

We describe 627 prison transfers to the CMH between 1983 and 1988. The number each year varied from 99 in 1983 to 127 in 1988. The percentage on remand varied from 49% in 1984 to 31% in 1987 and 1986. The average age of sentenced prisoners was 28 years and 35 years in the case of those on remand. The diagnostic categories were as follows: Schizophrenia (31%), Reactive Depression (23%), Personality Disorder (25%), Mania (5%), Drug and Alcohol (8%) and Mental Handicap (4%). The longest average stay in the hospital was seven weeks for Mania and the shortest was three weeks for Reactive Depression. The largest proportion on remand was for Mania (79%) followed by Schizophrenia (58%). We make recommendations about legislation and the role of the catchment area psychiatric hospital.
The North Dublin Old Age Psychiatry service — survey of patients referred in the first six months
Authors: Wrigley Margo M. , Gannon Miriam A.
Published: March 2016

In Ireland, the demographic pressure of greater numbers of elderly people surviving longer with an attendant increase in the prevalence of dementia and depression compounded by the running down of old mental hospitals and the closure of smaller general hospitals has provoked debate on the need for Old Age Psychiatry (Psychogeriatric) Services.

The first Old Age Psychiatry service in the Republic of Ireland started in North Dublin in January 1989. Detailed information on all referrals (173) assessed in the first six months of operation was collected and is presented. The findings are discussed in the context of the stated government policy of caring for the elderly within the community setting.
The Buckingham Project — the description of a home based mental health service
Authors: Shanahan William J. , Falloon Ian RH , Laporta Marc , Krekorian Haroutyon AW
Published: March 2016

A service based on the principle that the comprehensive mental health needs of a community can be more efficiently met by supporting the existing primary care services has been developed in the North Aylesbury Vale, Buckinghamshire, England. The Buckingham Project is a home-based mental health service and caters for a rapidly expanding rural community of approximately thirty five thousand people between the ages of 16 and 65 years. Professional support is provided to the services and care already provided by primary health care teams, social agencies and above all, by families. Specially trained nurses work as specialists within the primary care teams in the area. Initial consultation is provided on the day of referral, often in the patient's home. Cost effective management approaches are employed throughout. The emphasis is on early detection of major mental illness and immediate intensive treatment using cognitive/behavioural treatment methods, and targeted low dose medication where necessary. The approach differs from the traditional hospital-based specialist services.
The impact of hospital experiences during training on GP referral rates
Authors: McGee Hannah M , Fitzgerald Michael
Published: March 2016

Findings of the influence of hospital training experience in a particular medical speciality on subsequent GP referral patterns to that speciality are outlined. Specialist training appears to sensitise doctors and increase the referral rate to a given speciality. The nature of this sensitisation in medical education is discussed.
Sexual and marital dysfunction and polypartnerism in sexually transmitted diseases (STD) clinic attenders
Authors: O'Gorman Ethna C , Bownes Ian T. , Dinsmore Wallace W.
Published: March 2016

Sexual dysfunctions are common in S.T.D. (Sexually Transmitted Diseases) Clinic attenders. Marital/relationship dysfunctions frequently follow specific sexual dysfunctions such as erectile, impotence and premature ejaculation. In addition concomitant marital therapy has been shown to enhance treatment for sexual dysfunction. Polypartnerism or multiple or serial sexual partners is also a common feature of S.T.D. clinic attenders. To date, no study has fully evaluated the social, psychological and medical determinants of this behaviour.

The study examined the relationship between sexual dysfunction, marital difficulties and polypartnerism in 50 heterosexual STD clinic attenders. Thirty-one per cent of the sample had pathological scores on the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Forty-two per cent of the sample has pathological scores on the Golombok-Rust Inventory of Marital Satisfaction (GRIMS). There was a significant relationship between sexual dysfunction and marital dysfunction. Polypartnerism was also correlated with sexual and relationship dysfunction. It was felt that by offering treatment for specific sexual dysfunctions identified at STD clinics, marital/relationship difficulties could be averted. Subsequently polypartnerism could be reduced. By altering polypartnerism in this way, an important opportunity to influence vector spread of STD, including HIV infection is afforded.
Resettlement of mentally handicapped trainees from two psychiatric hospitals
Authors: MacCarthy Patricia A. C.
Published: March 2016

Thirty two trainees with mental handicap were resettled from two psychiatric hospitals into a centre for people with mental handicap. The progress and problems encountered are described. Recommendations are made for future resettlement programmes.
Some thoughts about obsessional phenomena
Authors: Freedman David A.
Published: March 2016

The author proposes that the propensity to develop obsessional modes of reaction is virtually ubiquitous and, for most people, highly adaptive. As for other parameters of functioning (e.g. blood pressure, blood glucose etc.) there is a range of “obsessionality” which is essential for survival. From the standpoint of the clinician the following questions need to be addressed: (1) Is there a pattern of developmental experiences which can be correlated with the emergence of obsessional phenomena? (2) Are there defineable life circumstances which can be related both to the failure to develop appropriate levels of obsessionality and to the development of a level of obsessionality which is maladaptive? (3) How to distinguish the obsessional character from the individual suffering from an obsessional neurosis? and (4) What therapeutic interventions are likely to be effective in the managment of the obsessional individual?
Methadone Treatment in Irish General Practice: Voices of Service Users
Authors: Latham Linda
Published: March 2016

This study sets out to make a meaningful and useful contribution to the discussion surrounding the treatment of heroin addiction in Ireland. The study took place in nine urban general practices in Dublin city. Twenty five service users were interviewed in-depth. A phenomenological approach drawing on the psychological research methods of Colazzi for data analysis informed this study. Four themes emerged from the data: Service users' the significance of methadone for the service user; service users' understanding of the Methadone Treatment Protocol and the experience of addiction and its effect on families.

This paper reports on the experiences of service users receiving methadone treatment in urban general practice in Dublin and in so doing highlights the influence of the GP in supporting recovery. It explores the theme - Service User's Experience of attending general practice for methadone treatment. These accounts provide insight into the harm reduction policy of methadone maintenance and highlight how - from the service users' experience - the implementation is falling short.
Analysis of Episodes of Involuntary Re-admission in Ireland (2007-2010)
Authors: Cunningham Gerry
Published: March 2016

Objectives: Initial examination of data held by the Mental Health Commission indicated a number of patients having repeated involuntary readmissions (defined as patients having three or more involuntary episodes in a calendar year). The Commission sought more empirical analysis of the data relating to these patients, to determine if there were any trends or commonality regarding their demographic characteristics, length of episode, and diagnoses.

Methods: From 1 November 2006 the Mental Health Commission has been notified of all involuntary admissions in Ireland under the Mental Health Act (2001). From this national database information on patients who have had three or more involuntary admissions per year was analysed.

Results: In the period studied there has been an overall reduction in the number of voluntary and involuntary admissions to Irish psychiatric hospitals and units. However, the use of involuntary admission remains constant at around 10% of all admissions. Seven percent (n=569) of involuntary admission orders in this four year period relate to two percent (n=121) of all involuntary patients. Patients who have experienced repeated involuntary admissions are predominantly male (59%), often have a diagnosis of schizophrenia, or schizotypal and delusional disorders (57%), or mania (20%), are in the age band 22-64 (80%) and more often live in rural counties.

Conclusions: Potential appears to exist to significantly reduce the number of involuntary admissions by focusing on the care given to patients who are repeatedly re-admitted. More analysis is needed of voluntary and involuntary re-admissions if inpatient facilities are to be effectively configured.
Suicide on the Isle of Wight: A Case-study of 35 Suicides among Mental Health Service Users Between 2006 and 2008
Authors: Shahpesandy Homayun , van Heeswijk Ad
Published: March 2016

Aims: To identify the sociodemographic, clinical and service delivery risk factors for suicide in psychiatric patients in a limited geographic area.

Method: A retrospective case study of 35 patients who died as a result of suicide between January 2006 and December 2008.

Results: Male gender, unemployment, living alone, basic education and significant life events were identified as sociodemographic factors. A history of previous psychiatric admission, previous suicide attempt, suffering from depression, co-morbidity of another psychiatric disorder (mainly stress-related symptoms and alcoholism), and contacting the services prior to suicide were found as typical clinical factors. Hanging was the most common method of suicide in both men and women. Most men died in spring and summer, while the majority of females died in autumn.

Clinical implications: As in similar studies, mental disorders could be identified as the strongest risk factor for suicide. Almost 70% of suicides were conducted by people suffering from a mental disorder. Treating mental disorders and identifying certain sociodemographic and clinical characteristics of people suffering from mental disorders and addressing them is the key in suicide prevention strategies.
Patients' Satisfaction with a Psychiatric Day Hospital in the West Galway Catchments Area
Authors: Ul-haq Inam
Published: March 2016

Aim: To evaluate patients' satisfaction with a psychiatric day hospital in the West Galway Catchments area.

Study design: This is a cross-sectional study. Methods: This study was undertaken by using a 33-items questionnaire for 44 patients who attended the day hospital. SPSS version-12 was used for collecting and applying tests to the data, Fisher's exact test was used to analyse the data as sample size is small and P<0.05 was considered statistically significant. Results are also presented in the form of descriptive analysis including percentages and frequencies.

Results: Only 37 out of the 44 patients returned the questionnaires. Among the participants were 61% (n=22) male and 38% (n=15) female. The patients were mostly satisfied with the services available at the day hospital, except the waiting period for a first appointment. There was no significant (P=0.11) gender difference in terms of patients' satisfaction with the day hospital service. The age group, 45 years and above, were less satisfied (P=0.02) with the availability of a comfortable room for counselling, as compared to the younger age group. The patients did not like to tell others that they were attending the day hospital. The results were comparable with previous published patient satisfaction surveys using the same questionnaire by the Health Research Board, except that the patients in the present survey were more satisfied with the waiting area and availability of counselling.

Conclusions: Patients are mostly satisfied with the West Galway day hospital services.

The older patients (45 years and above) are not satisfied with the counselling room, and therefore further investigations are needed to ascertain their requirements for a counselling room. Patients are more satisfied with the waiting area and availability of counselling compared to the findings of other similar studies conducted in Ireland. Resources are needed to be allocated to the day hospital services.
Decreased Verbal Learning but not Recognition Performance in Alcohol-dependent Individuals During Early Abstinence
Authors: Daig Isolde , Mahlberg Richard , Stethin Julia , Schroeder Franziska , Wrase Jana , Knoll Nina , Bschor Tom , Esser Guenter , Heinz Andreas , Kienast Thorsten
Published: March 2016

Objective:Alcoholism ultimately leads to impairment of memory and other cognitive functions. This can interfere with treatment, if cognitively impaired alcohol-dependent individuals have difficulties recalling and implementing skills acquired during therapy. We investigate if alcohol-dependent individuals without clinically apparent withdrawal symptoms may still be impaired in higher-order cognitive functions.

Methods:Thirty-four alcohol-dependent patients and 20 matched healthy controls were tested with the Verbal Learning and Memory Test which includes seven measurement points. The test comprises free recall, free recall after distraction and after 30 minute delay, and a word recognition task. Testing was performed between day seven and day 10 after the beginning of abstinence, when clinical withdrawal symptoms had ceased.

Results:Compared to healthy controls, alcohol-dependent patients performed worse in free recall after delay, but not in word recognition. Healthy controls showed a more linear progression of improvement in verbal memory performance. Overall, alcohol-dependent individuals showed reduced verbal learning efficiency. The extent of impaired recall after distraction was positively associated (one-tailed test) with history of delirium (r=0.34, p=0.04), seizures (r=0.46, p=0.01), and years since diagnosis for alcohol dependency (r=0.39, p=0.01).

Conclusions:Our results provide evidence that unmedicated alcohol-dependent patients without obvious withdrawal symptoms had impaired verbal recall, but normal recognition performance, at seven to 10 days after onset of abstinence. This deficit may deteriorate treatment outcomes due to poorer implementation of skills newly-learned during this time period.
Post-Traumatic Stress Disorder (PTSD) Symptoms in Adults with Psychiatric Disorders
Authors: Khalily Muhammad Tahir , Wota Anna Paulina , Hallahan Brian
Published: March 2016

Objective: This study explores unrecognised symptoms related to post-traumatic stress disorder (PTSD) in individuals with a range of psychiatric disorders in the absence of traumatic events. We also examine the association between PTSD symptoms, social interaction with peers and therapeutic alliance with mental health professionals.

Method: A purposive sample of 120 adults consecutively referred to the psychology department from September 2008 to September 2010 was included in this study. We used the Minnesota Multiphasic Personality Inventory 2 (MMPI-2) to ascertain the presence of PTSD symptoms, social interaction levels and treatment alliance with health professionals.

Results: Individuals previously undiagnosed with PTSD, referred without any noted traumatic event had high levels of symptoms related to PTSD, as measured by the PK scale of the MMPI-2. The PK scale was significantly correlated with several MMPI-2 clinical scales, the Social Introversion Scale (Si) and the Treatment Alliance Scale (TRT) (p < 0.001).

Conclusion: This study demonstrated the presence of symptoms related to PTSD in individuals with a range of psychiatric disorders despite the absence of reported trauma. The presence of symptoms related to PTSD may be associated with an indirect negative impact on social contacts and a poorer therapeutic alliance with mental health professionals. Investigating symptoms of PTSD during a psychological assessment even when trauma is not the presenting complaint is merited in most cases.
Knowledge and Attitude of Basic Psychiatric Trainees in Ireland to the Clinical Indemnity Scheme
Authors: Nkire Nnamdi , Akinsola Oluwatosin , Kavanagh Annette
Published: March 2016

Objectives: To assess the knowledge of basic psychiatric trainees in Ireland of the Clinical Indemnity Scheme (CIS) and to ascertain how many basic specialist trainees in psychiatry had obtained additional medical indemnity cover and reasons for obtaining additional cover.

Method: A structured questionnaire was distributed by post to 300 basic specialist trainees in psychiatric training schemes in Ireland. The questionnaire enquired about demographic details and examined the level of trainees' knowledge of the clinical indemnity scheme. Results were compiled and analysed using descriptive statistics and SPSS version 14.

Results: The response rate was 49%. The bulk of respondents were male (65.5%), aged between 30-35 years of age (44.6%). The majority of the respondents were aware of the CIS, with approximately half of the respondents having acquired additional medical indemnity cover. The level of awareness of the CIS was proportionately more amongst male respondents (69.1%), compared with females (58.5%). However, more females (61.5%) had additional medical indemnity cover compared with males (45.5%). Irish national trainees were more aware (72.9%) and had additional medical indemnity (80%), compared with non-Irish national trainees of whom approximately 61% were aware of the CIS and only 40% had an additional cover. The level of knowledge regarding details of what the CIS provided coverage for was quite poor. Respondents who had obtained additional indemnity were unsure what cover their additional indemnity provided. Only 10 respondents had been involved in medico-legal cases and of these, five had medical indemnity at the time of the case, stating that the legal advice and support was helpful.

Conclusion: Our survey has highlighted that a considerable number of basic specialist trainees in psychiatry in Ireland had no detailed knowledge of what the CIS indemnifies them for and what situations were not covered by the scheme. Additionally, it revealed a clear split in favour of Irish national trainees in comparison to non-Irish national trainees in terms of awareness of the CIS and the procurement of additional medical indemnity. There needs to be an educational drive to provide more information to psychiatric trainees regarding the CIS and other medical insurance schemes. Furthermore, it would be important to examine factors that influence trainees in obtaining/not obtaining additional cover.
Experience of an Inter-regional Research Symposium for Higher Psychiatric Trainees in Scotland
Authors: Duthie Ashleigh C , Shand Allen J , Anderson Seonaid M , Hamilton Ross J
Published: March 2016

Objectives: We present our experience of an annual research symposium for psychiatric trainees in Scotland. This paper aimed to consider trainees' involvement in research by examining firstly rates of publication and secondly the views of trainees.

Methods: A list of all presentations to the Senior Trainees' Annual Research Symposium (STARS) meetings 2007-2009 was compiled and a detailed search made of major research databases. A questionnaire survey examined the views of attendees at the 2009 meeting.

Results: Fifty percent of presented work achieved publication. Feedback from symposia attendees was almost universally positive.

Conclusions: At a time of debate on the value of research sessions as part of higher training and a recent reduction in time allocated to research in the UK, we report on a thriving annual meeting. Research symposia for higher trainees were valued by participants and may be one useful means of encouraging trainee research.
Threshold Concepts and Teaching Psychiatry: Key to the Kingdom or Emperor's New Clothes?
Authors: Suibhne Seamus Mac
Published: March 2016

Psychiatry, more than most medical specialties, must engage with undergraduate medical education to prevent the further marginalisation of mental health within medicine. There is an urgency to the need for psychiatrists and educationalists to communicate, and for psychiatrists to be aware of developments in educational theory. The idea of ‘threshold concepts’ is currently widely discussed by educationalists. Threshold concepts are described as areas of knowledge without which the learner cannot progress, and which, when grasped, lead to a transformation in the learner's perspective and understanding. Threshold concepts have been criticised on conceptual grounds, and there is a lack of clarity as to how to identify them empirically. While they may represent a fruitful approach to the task of engaging medical students in psychiatry teaching, it is suggested that further development of the idea is required before it could be usefully applied. However empirical studies in other disciplines suggest that there may be associated benefits to the teaching of the discipline from trying to identify threshold knowledge.
Study of Presentations for Involuntary Admission to a Cork Approved Centre
Authors: Dunne Elaine , Moloney Eamonn
Published: March 2016

Objectives: To describe the characteristics of patients who present to an approved centre with Mental Health Act 2001 forms, and secondly, to compare those who were subsequently detained to those who were not detained.

Methods: Specific data on patients who presented to South Lee Mental Health Unit with application and recommendation forms for Involuntary Admission over a 22 month period was gathered from a retrospective case note review. Information on both groups was compared statistically using Graph Pad Prism software.

Results: 71% (n=121) of patients presenting for involuntary admission did so outside of normal working hours. Those who were not subsequently detained were more likely to have had their application made by the Gardai and their recommendation made by someone other than their own General Practitioner (GP). GPs were more likely than Consultant Psychiatrists to cite risk to self or others as the reason for involuntary admission.

Conclusion: Although involuntary admissions most often occur in emergency situations, every effort should be made to ensure that those who are known to the patient are involved in the process of application and recommendation. In addition, there is a need for ongoing training and education of those most commonly involved, such as the Gardai and General Practitioners, as well as feedback to these groups when a patient presents who does not require involuntary admission.
Psychiatrists in their eyes: Children's drawings of what a psychiatrist looks like
Authors: Omer Sami , O'Connor Niamh , Sweeney Gavin , McCarthy Geraldine
Published: March 2016

Drawings can be used as an important tool to measure children's perception and emotions. Using a qualitative design, we asked a group of 24 school children (10 boys and 14 girls) aged 11-12 to draw their impressions of psychiatrists. In the majority of drawings, psychiatrists were portrayed as a friendly or kind figure. The art work was analysed by the coordinator of the Arts Initiative in Mental Health, Niamh O'Connor. Psychiatrists were portrayed positively by this group of young people. This reflects a strong influence of the media on children's perception.
Foreword
Authors: HAGGH-HUGLO BARBARA
Published: March 2016

This special issue of Plainsong and Medieval Music honours the memory of Michel Huglo (1921–2012) with four articles that resulted from two sessions of papers held on 11 May 2013 at the 48th International Congress on Medieval Studies at the University of Western Michigan. Titled ‘Chant and Liturgy: Papers in Memory of Michel Huglo’, the sessions were organised by Anna Grau, Cathy Elias and Daniel DiCenso, with papers given by Terence Bailey, Frank Lawrence, Rebecca Maloy (in collaboration with Emma Hornby), William P. Mahrt, Nils Holger Petersen and Michael Norton. Also included is a bibliography of Michel Huglo's articles and unpublished papers to 2012, complementing earlier bibliographies. Obituaries are also cited. Each article in this volume advances research on subjects that occupied Michel Huglo fully at different times in his life.
Regional functional synchronizations in dementia with Lewy bodies and Alzheimer's disease
Authors: Peraza Luis R. , Colloby Sean J. , Deboys Liam , O'Brien John T. , Kaiser Marcus , Taylor John-Paul
Published: March 2016

Background:

Dementia with Lewy bodies (DLB) is a common cause of dementia in the elderly population after Alzheimer's disease (AD), and at early stages differential diagnosis between DLB and AD might be difficult due to their symptomatic overlap, e.g. cognitive and memory impairments. We aimed to investigate functional brain differences between both diseases in patients recently diagnosed.

Methods:

We investigated regional functional synchronizations using regional homogeneity (ReHo) in patients clinically diagnosed with DLB (n = 19) and AD (n = 18), and for comparisons we also included healthy controls (HC, n = 16). Patient groups were matched by age, education, and by the level of cognitive impairment (MMSE p-value = 0.36). Additionally, correlations between ReHo values and clinical scores were investigated.

Results:

The DLB group showed lower ReHo in sensory-motor cortices and higher ReHo in left middle temporal gyrus when compared with HCs (p-value < 0.001 uncorrected). The AD group demonstrated lower ReHo in the cerebellum and higher ReHo in the left/right lingual gyri, precuneus cortex, and other occipital and parietal regions (p-value < 0.001 uncorrected).

Conclusions:

Our results agree with previous ReHo investigations in Parkinson's disease (PD), suggesting that functional alterations in motor-related regions might be a characteristic of the Lewy body disease spectrum. However, our results in AD contradict previously reported findings for this disease and ReHo, which we speculate are a reflection of compensatory brain responses at early disease stages. ReHo differences between patient groups were at regions related to the default mode and sensory-motor resting state networks which might reflect the aetiological divergences in the underlying disease processes between AD and DLB.
TRIB2 regulates normal and stress-induced thymocyte proliferation
Authors: Liang Kai Ling , O’Connor Caitriona , Veiga J Pedro , McCarthy Tommie V , Keeshan Karen
Published: March 2016

TRIB2, a serine/threonine pseudokinase identified as an oncogene, is expressed at high levels in the T-cell compartment of hematopoiesis. The proliferation of developing thymocytes is tightly controlled to prevent leukemic transformation of T cells. Here we examine Trib2 loss in murine hematopoiesis under steady state and proliferative stress conditions, including genotoxic and oncogenic stress. Trib2−/− developing thymocytes show increased proliferation, and Trib2−/− mice have significantly higher thymic cellularity at steady state. During stress hematopoiesis, Trib2−/− developing thymocytes undergo accelerated proliferation and demonstrate hypersensitivity to 5-fluorouracil (5-FU)-induced cell death. Despite the increased cell death post 5-FU-induced proliferative stress, Trib2−/− mice exhibit accelerated thymopoietic recovery post treatment due to increased cell division kinetics of developing thymocytes. The increased proliferation in Trib2−/− thymocytes was exacerbated under oncogenic stress. In an experimental murine T-cell acute lymphoblastic leukemia (T-ALL) model, Trib2−/− mice had reduced latency in vivo, which associated with impaired MAP kinase (MAPK) activation. High and low expression levels of Trib2 correlate with immature and mature subtypes of human T-ALL, respectively, and associate with MAPK. Thus, TRIB2 emerges as a novel regulator of thymocyte cellular proliferation, important for the thymopoietic response to genotoxic and oncogenic stress, and possessing tumor suppressor function.
Cutting‐edge single‐cell genomics and modelling in immunology
Authors: Proserpio Valentina , Lönnberg Tapio
Published: March 2016

The March 2016 issue contains a Special Feature on Cutting‐edge single‐cell genomics and modelling in immunology. The recent advent of single‐cell genomics has offered unprecedented possibilities for hypothesis‐independent characterization of cellular heterogeneity and regulatory states. At the same time, the vast datasets produced by these techniques have highlighted the need for new bioinformatics tools to utilize the contained information to the fullest. In this Special Feature, both the experimental methods for producing such data as well as selected modelling approaches are reviewed, with focus on the applications on the study of the immune system. Immunology and Cell Biology thanks the coordinators of this Special Feature ‐ Tapio Lönnberg and Valentina Proserpio ‐ for their planning and input.
Understanding congested travel in urban areas
Authors: Çolak Serdar , Lima Antonio , González Marta C.
Published: March 2016

Rapid urbanization and increasing demand for transportation burdens urban road infrastructures. The interplay of number of vehicles and available road capacity on their routes determines the level of congestion. Although approaches to modify demand and capacity exist, the possible limits of congestion alleviation by only modifying route choices have not been systematically studied. Here we couple the road networks of five diverse cities with the travel demand profiles in the morning peak hour obtained from billions of mobile phone traces to comprehensively analyse urban traffic. We present that a dimensionless ratio of the road supply to the travel demand explains the percentage of time lost in congestion. Finally, we examine congestion relief under a centralized routing scheme with varying levels of awareness of social good and quantify the benefits to show that moderate levels are enough to achieve significant collective travel time savings.
G6PD protects from oxidative damage and improves healthspan in mice
Authors: Nóbrega-Pereira Sandrina , Fernandez-Marcos Pablo J. , Brioche Thomas , Gomez-Cabrera Mari Carmen , Salvador-Pascual Andrea , Flores Juana M. , Viña Jose , Serrano Manuel
Published: March 2016

Reactive oxygen species (ROS) are constantly generated by cells and ROS-derived damage contributes to ageing. Protection against oxidative damage largely relies on the reductive power of NAPDH, whose levels are mostly determined by the enzyme glucose-6-phosphate dehydrogenase (G6PD). Here, we report a transgenic mouse model with moderate overexpression of human G6PD under its endogenous promoter. Importantly, G6PD-Tg mice have higher levels of NADPH, lower levels of ROS-derived damage, and better protection from ageing-associated functional decline, including extended median lifespan in females. The G6PD transgene has no effect on tumour development, even after combining with various tumour-prone genetic alterations. We conclude that a modest increase in G6PD activity is beneficial for healthspan through increased NADPH levels and protection from the deleterious effects of ROS.
Integrative analyses reveal a long noncoding RNA-mediated sponge regulatory network in prostate cancer
Authors: Du Zhou , Sun Tong , Hacisuleyman Ezgi , Fei Teng , Wang Xiaodong , Brown Myles , Rinn John L. , Lee Mary Gwo-Shu , Chen Yiwen , Kantoff Philip W. , Liu X. Shirley
Published: March 2016

Mounting evidence suggests that long noncoding RNAs (lncRNAs) can function as microRNA sponges and compete for microRNA binding to protein-coding transcripts. However, the prevalence, functional significance and targets of lncRNA-mediated sponge regulation of cancer are mostly unknown. Here we identify a lncRNA-mediated sponge regulatory network that affects the expression of many protein-coding prostate cancer driver genes, by integrating analysis of sequence features and gene expression profiles of both lncRNAs and protein-coding genes in tumours. We confirm the tumour-suppressive function of two lncRNAs (TUG1 and CTB-89H12.4) and their regulation of PTEN expression in prostate cancer. Surprisingly, one of the two lncRNAs, TUG1, was previously known for its function in polycomb repressive complex 2 (PRC2)-mediated transcriptional regulation, suggesting its sub-cellular localization-dependent function. Our findings not only suggest an important role of lncRNA-mediated sponge regulation in cancer, but also underscore the critical influence of cytoplasmic localization on the efficacy of a sponge lncRNA.
Type 1 diabetes vaccine candidates promote human Foxp3+Treg induction in humanized mice
Authors: Serr Isabelle , Fürst Rainer W. , Achenbach Peter , Scherm Martin G. , Gökmen Füsun , Haupt Florian , Sedlmeier Eva-Maria , Knopff Annette , Shultz Leonard , Willis Richard A. , Ziegler Anette-Gabriele , Daniel Carolin
Published: March 2016

Immune tolerance is executed partly by Foxp3+regulatory T (Treg) cells, which suppress autoreactive T cells. In autoimmune type 1 diabetes (T1D) impaired tolerance promotes destruction of insulin-producing β-cells. The development of autoantigen-specific vaccination strategies for Foxp3+Treg-induction and prevention of islet autoimmunity in patients is still in its infancy. Here, using human haematopoietic stem cell-engrafted NSG-HLA-DQ8 transgenic mice, we provide direct evidence for human autoantigen-specific Foxp3+Treg-induction in vivo. We identify HLA-DQ8-restricted insulin-specific CD4+T cells and demonstrate efficient human insulin-specific Foxp3+Treg-induction upon subimmunogenic vaccination with strong agonistic insulin mimetopes in vivo. Induced human Tregs are stable, show increased expression of Treg signature genes such as Foxp3, CTLA4, IL-2Rα and TIGIT and can efficiently suppress effector T cells. Such Foxp3+Treg-induction does not trigger any effector T cells. These T1D vaccine candidates could therefore represent an expedient improvement in the challenge to induce human Foxp3+Tregs and to develop novel precision medicines for prevention of islet autoimmunity in children at risk of T1D.
Therapeutic targeting and rapid mobilization of endosteal HSC using a small molecule integrin antagonist
Authors: Cao Benjamin , Zhang Zhen , Grassinger Jochen , Williams Brenda , Heazlewood Chad K. , Churches Quentin I. , James Simon A. , Li Songhui , Papayannopoulou Thalia , Nilsson Susan K.
Published: March 2016

The inherent disadvantages of using granulocyte colony-stimulating factor (G-CSF) for hematopoietic stem cell (HSC) mobilization have driven efforts to identify alternate strategies based on single doses of small molecules. Here, we show targeting α9β1/α4β1 integrins with a single dose of a small molecule antagonist (BOP (N-(benzenesulfonyl)-L-prolyl-L-O-(1-pyrrolidinylcarbonyl)tyrosine)) rapidly mobilizes long-term multi-lineage reconstituting HSC. Synergistic engraftment augmentation is observed when BOP is co-administered with AMD3100. Impressively, HSC in equal volumes of peripheral blood (PB) mobilized with this combination effectively out-competes PB mobilized with G-CSF. The enhanced mobilization observed using BOP and AMD3100 is recapitulated in a humanized NODSCIDIL2Rγ−/− model, demonstrated by a significant increase in PB CD34+ cells. Using a related fluorescent analogue of BOP (R-BC154), we show that this class of antagonists preferentially bind human and mouse HSC and progenitors via endogenously primed/activated α9β1/α4β1 within the endosteal niche. These results support using dual α9β1/α4β1 inhibitors as effective, rapid and transient mobilization agents with promising clinical applications.