bluuebunny/crossref_metadata_2025 huggingface dataset:
Graph prolongation convolutional networks: explicitly multiscale machine learning on graphs with applications to modeling of cytoskeleton
Authors: Scott Cory B , Mjolsness Eric
Published: September 2020

We define a novel type of ensemble graph convolutional network (GCN) model. Using optimized linear projection operators to map between spatial scales of graph, this ensemble model learns to aggregate information from each scale for its final prediction. We calculate these linear projection operators as the infima of an objective function relating the structure matrices used for each GCN. Equipped with these projections, our model (a Graph Prolongation-Convolutional Network) outperforms other GCN ensemble models at predicting the potential energy of monomer subunits in a coarse-grained mechanochemical simulation of microtubule bending. We demonstrate these performance gains by measuring an estimate of the Floating Point OPerations spent to train each model, as well as wall-clock time. Because our model learns at multiple scales, it is possible to train at each scale according to a predetermined schedule of coarse vs. fine training. We examine several such schedules adapted from the algebraic multigrid literature, and quantify the computational benefit of each. We also compare this model to another model which features an optimized coarsening of the input graph. Finally, we derive backpropagation rules for the input of our network model with respect to its output, and discuss how our method may be extended to very large graphs.
Love is an Emergency Savings Fund: Suze Orman’s Advice as Affective Discipline
Authors: Cormany Diane L
Published: September 2020

After retiring from The Suze Orman Show, Suze Orman remained highly visible across media. Recently, she returned with her revised bestseller Women and Money (2018a) and a weekly podcast timed to coincide with #metoo. Across media, Orman has utilized the affect associated with feminine media genres, including self-help and makeover shows, to promote a lifestyle based on proper financial self-management. Her advice to women about marriage, motherhood, and filial duty makes it clear that such discipline is particularly gendered. Orman both uses and chafes against feminist discourses to frame finance as another problem to be managed for women. I understand Orman’s advice as affective through her use of fear, shame, and pride to promote individualized financialization at the expense of interpersonal relationships. My unique approach brings affect theory to financial media through analysis of Orman’s media texts.
The United States, China and the WTO after Coronavirus
Authors: Stokes Doug , Williamson Martin
Published: September 2020

A hegemon can destroy its international regimes, but what happens when it does not possess the capacity to reconstitute a regime to its liking? Drawing on structural power theory, our article examines President Nixon’s historic attacks on the Bretton Woods international monetary regime to help illuminate President Trump’s attacks on the World Trade Organisation (WTO). In both cases regime destruction was driven to a large extent by a desire to contain rivals: Europe for Nixon, China for Trump. Drawing on original archival material, our case study analysis shows that while the United States possessed sufficient negative structural power to derail Bretton Woods, it lacked sufficient positive structural power to create the new monetary structure Nixon wanted. Trump faces a similar dilemma: he can block the WTO regime, but cannot necessarily replace it with one to the United States’ liking. China is too powerful and possesses too much structural power of its own to give up its WTO privileges without a fight. After the Coronavirus pandemic, it is unlikely that China can prevent the United States from wrecking the WTO trade regime, but very likely it can block US attempts to create a successor regime tailored exclusively to US requirements.
Thoracic endovascular aortic repair in management of aorto-oesophageal fistulas: a case series
Authors: Vijayvergiya Rajesh , Kasinadhuni Ganesh , Sinha Saroj Kant , Yadav Thakur Deen , Singh Harkant , Savlania Ajay , Lal Anupam , Kanabar Kewal
Published: September 2020

Background 

Aorto-oesophageal fistula (AOF) is a rare, catastrophic disease with an extremely poor prognosis. A ruptured thoracic aortic aneurysm is a common aetiology for AOF. The clinical presentation is usually massive haematemesis and collapse. Timely diagnosis and appropriate treatment are crucial in managing AOF.

Case summary 

We hereby report two cases of AOF, who underwent successful emergency thoracic endovascular aortic repair (TEVAR) to control active bleed and exsanguination. Case 1, an elderly lady with atherosclerotic aneurysm had TEVAR followed by open surgery for oesophageal rent and necrosed left main bronchus. Case 2 had mycotic tubercular aneurysm who later had infected graft-stent following TEVAR.

Discussion 

Open surgery is the conventional treatment for AOF; however, TEVAR can be an alternative and less invasive approach in selected high-risk patients. Various management issues related to TEVAR with AOF have been discussed in the article.
Adolescent Kawasaki disease shock syndrome with inflammatory cell infiltration into the myocardium: a case report
Authors: Sugiura Yuki , Okumura Takahiro , Kondo Toru , Murohara Toyoaki
Published: September 2020

Background

Kawasaki disease (KD) is a self-limiting form of systemic vasculitis. KD usually occurs in infants and young children and is rarely seen in adolescents. On rare occasions, KD is accompanied with reduced organ perfusion due to systolic hypotension, a condition known as Kawasaki disease shock syndrome (KDSS). The multifactorial causes of KDSS may include intensive vasculitis with capillary leak, myocardial dysfunction, and release of proinflammatory cytokines. However, the mechanisms underlying the pathophysiology of KDSS have not been fully elucidated.

Case summary

A febrile 17-year-old male with cervical lymphadenopathy developed extreme shock with rapid cardiac dysfunction and reduced organ perfusion. Electrocardiogram revealed ST elevation in the precordial leads and increased serum levels of cardiac enzyme levels. Endomyocardial biopsy at the acute phase revealed CD3+, CD4+ or CD8+, and CD20− lymphocytes and CD68+ macrophages within infiltrates in the myocardium with mild interstitial fibrosis. He was treated with intravenous immunoglobulin (IVIG) and followed by glucocorticoids with mechanical circulatory support. His cardiac function recovered rapidly with no apparent adverse effects.

Discussion

Our results suggest that KDSS may be a form of myocarditis, a condition in which inflammatory cells infiltrate the myocardium. Early immunosuppressive therapy, including IVIG and glucocorticoid therapy, may limit the severity of disease and improve the prognosis. As shown by this case, an accurate diagnosis of KD and KDSS will lead to early intervention and improved prognosis even among those in an older cohort.
Cause-specific death and risk factors of 1-year mortality after implantable cardioverter-defibrillator implantation: a nationwide study
Authors: Alhakak Amna , Østergaard Lauge , Butt Jawad H , Vinther Michael , Philbert Berit T , Jacobsen Peter K , Yafasova Adelina , Torp-Pedersen Christian , Køber Lars , Fosbøl Emil L , Mogensen Ulrik M , Weeke Peter E
Published: September 2020

Aims

Current treatment guidelines recommend implantable cardioverter-defibrillators (ICDs) in eligible patients with an estimated survival beyond 1 year. There is still an unmet need to identify patients who are unlikely to benefit from an ICD. We determined cause-specific 1-year mortality after ICD implantation and identified associated risk factors.

Methods and results

Using Danish nationwide registries (2000–2017), we identified 14 516 patients undergoing first-time ICD implantation for primary or secondary prevention. Risk factors associated with 1-year mortality were evaluated using multivariable logistic regression. The median age was 66 years, 81.3% were male, and 50.3% received an ICD for secondary prevention. The 1-year mortality rate was 4.8% (694/14 516). ICD recipients who died within 1 year were older and more comorbid compared to those who survived (72 vs. 66 years, P < 0.001). Risk factors associated with increased 1-year mortality included dialysis [odds ratio (OR): 3.26, confidence interval (CI): 2.37–4.49], chronic renal disease (OR: 2.14, CI: 1.66–2.76), cancer (OR: 1.51, CI: 1.15–1.99), age 70–79 years (OR: 1.65, CI: 1.36–2.01), and age ≥80 years (OR: 2.84, CI: 2.15–3.77). The 1-year mortality rates for the specific risk factors were: dialysis (13.8%), chronic renal disease (13.1%), cancer (8.5%), age 70–79 years (6.9%), and age ≥80 years (11.0%). Overall, the most common causes of mortality were related to cardiovascular diseases (62.5%), cancer (10.1%), and endocrine disorders (5.0%). However, the most common cause of death among patients with cancer was cancer-related (45.7%).

Conclusion

Among ICD recipients, mortality rates were low and could be indicative of relevant patient selection. Important risk factors of increased 1-year mortality included dialysis, chronic renal disease, cancer, and advanced age.
The Link between Relative Pay and Job Satisfaction Revisited
Authors: Collischon Matthias , Eberl Andreas
Published: September 2020

This paper investigates the connection between job satisfaction and comparison pay (defined as a person’s rank within a reference group) with SOEP Data. Based on work values and social networks, we argue that the existing literature neglects heterogeneities in individual job satisfaction as well as wage trajectories along the career path. Thus, previous studies based on survey data likely overestimate the connection between job satisfaction and comparison pay. We use fixed-effects individual slopes models to account for heterogeneous time trends between individuals. We find no statistically significant correlation between comparison pay and job satisfaction. We conclude that previous estimates were biased by not accounting for idiosyncratic trends in job satisfaction due to unobserved heterogeneity, which led to an omitted variable bias.
Direction, ontogeny, and mechanism of the temperature-size rule operating in a large marine crab, Chionoecetes opilio
Authors: Sainte-Marie Bernard , Ouellet Jean-François , Dionne Hélène
Published: September 2020

The classic temperature-size rule (TSR) states that ectotherms mature smaller in warmer than in colder conditions; the reverse TSR is the opposite response. We combined field observations with laboratory experiments and published information to synthesise the response of snow crab (Chionoecetes opilio), a marine brachyuran with determinate growth, to temperature. Size at onset of physiological maturation/maturity and after terminal moult (TM) were positively related to temperature, thus indicating the reverse TSR. Moult increment varied little with temperature, but crabs were larger at instar in colder than in warmer water due to an initial difference in settlement size that propagated to higher instars, suggesting classic TSR prior to settlement. The pattern of increasing TM size with temperature was caused by crabs moulting more times before TM in warmer than in colder water. Intermoult period (IP) declined exponentially with temperature, and lower instars were more temperature sensitive than higher instars. Temperature effects on IP were strong enough to explain changes in size and instar number at TM under a possible time-invariant maturation schedule. Skip moulting was observed in the smallest crabs reared in the laboratory and resulted in high mortality. The reverse TSR in snow crab seems to be adaptive to coping with ectotherm predation.
Seabird bycatch in a sardine purse seine fishery
Authors: Norriss Jeffrey V , Fisher Emily A , Denham Ainslie M
Published: September 2020

Limited understanding of seabird bycatch in purse seine fisheries has been highlighted as a key information gap in assessments of seabird bycatch in fisheries globally. This study documents the bycatch of breeding flesh-footed shearwaters (Ardenna carneipes) in a sardine purse seine fishery on the southern coast of Western Australia. Fishery-dependent bycatch records from 2009/2010 to 2017/2018 showed a strong peak in the mortality rate per fishing trip during March and April, closely associated with the final stage of chick rearing. Observers during those peak months in 2007, 2008, 2017, and 2018 recorded 171 mortalities during 222 trips at per trip rates (±95% confidence limits) ranging from 0.59 (0.25–1.17) in 2017 to 1.10 (0.56–1.96) in 2007. Zero mortalities were recorded on at least 70% of trips in any year, suggesting infrequent formation of net folds that can trap birds. Total annual mortalities estimated for 2016/2017 and 2017/2018 were 123 (52–251) and 172 (91–302), respectively. Although within a sustainable anthropogenic limit of 495 (369–660) estimated from conservative application of the potential biological removal method, the extent of other anthropogenic mortalities is unknown. Further research on the effect of distance of breeding colonies from fishing operations is required.
Joint preoperative transthoracic and intraoperative transoesophageal echocardiographic assessment of functional mitral regurgitation severity provides better association with long-term mortality
Authors: Asher Shyamal R , Malzberg Gregory W , Ong Chin Siang , Malapero Raymond J , Wang Huan , Shekar Prem , Kaneko Tsuyoshi , Pelletier Marc P , Mallidi Hari , Heydarpour Mahyar , Shook Douglas C , Shernan Stanton K , Fox John A , Muehlschlegel J. Daniel , Xu Xinling , Nguyen Thy B , Sundt Thoralf M , Body Simon C
Published: September 2020

OBJECTIVES

Functional mitral regurgitation (MR) is observed with ischaemic heart disease or aortic valve disease. Assessing the value of mitral valve repair or replacement (MVR/P) is complicated by frequent discordance between preoperative transthoracic echocardiographic (pTTE) and intraoperative transoesophageal echocardiographic (iTOE) assessment of MR severity. We examined the association of pTTE and iTOE with postoperative mortality in patients with or without MR, at the time of coronary artery bypass grafting (CABG) and/or aortic valve replacement without MVR/P.

METHODS

Medical records of 6629 patients undergoing CABG and/or aortic valve replacement surgery with or without functional MR and who did not undergo MVR/P were reviewed. MR severity assessed by pTTE and iTOE were examined for association with postoperative mortality using proportional hazards regression while accounting for patient and operative characteristics.

RESULTS

In 72% of 709 patients with clinically significant (moderate or greater) functional MR detected by pTTE, iTOE performed after induction of anaesthesia demonstrated a reduction in MR severity, while 2% of patients had increased severity of MR by iTOE. iTOE assessment of MR was better associated with long-term postoperative mortality than pTTE in patients with moderate MR [hazard ratio (HR) 1.31 (1.11–1.55) vs 1.02 (0.89–1.17), P-value for comparison of HR 0.025] but was not different for more than moderate MR [1.43 (0.96–2.14) vs 1.27 (0.80–2.02)].

CONCLUSIONS

In patients undergoing CABG and/or aortic valve replacement without MVR/P, these findings support intraoperative reassessment of MR severity by iTOE as an adjunct to pTTE in the prediction of mortality. Alone, these findings do not yet provide evidence for an operative strategy.
Reduced left ventricular contractility, increased diastolic operant stiffness and high energetic expenditure in patients with severe aortic regurgitation without indication for surgery
Authors: Reil Jan-Christian , Reil Gert-Hinrich , Hecker Nora , Sequeira Vasco , Borer Jeffrey S. , Stierle Ulrich , Lavall Daniel , Marquetand Christoph , Busch Claudia , Patzelt Johannes , Heringlake Matthias , Schäfers Hans-Joachim , Sievers Hans-Hinrich , Ensminger Stephan , Aboud Anas
Published: September 2020

OBJECTIVES

Recent mortality studies showed worse prognosis in patients (ARNS) with severe aortic regurgitation and preserved ejection fraction (EF) not fulfilling the criteria of current guidelines for surgery. The aim of our study was to analyse left ventricular (LV) systolic and diastolic function and mechanical energetics to find haemodynamic explanations for the reduced prognosis of these patients and to seek a new concept for surgery.

METHODS

Global longitudinal strain (GLS) and echo-based single-beat pressure–volume analyses were performed in patients with ARNS (LV end-diastolic diameter <70 mm, EF >50%, GLS > −19% n = 41), with indication for surgery (ARS; n = 19) and in mild hypertensive controls (C; n = 20). Additionally, end-systolic elastance (LV contractility), stroke work and total energy (pressure–volume area) were calculated.

RESULTS

ARNS demonstrated significantly depressed LV contractility versus C: end-systolic elastance (1.58 ± 0.7 vs 2.54 ± 0.8 mmHg/ml; P < 0.001), despite identical EF (EF: 59 ± 6% vs 59 ± 7%). Accordingly, GLS was decreased [−15.7 ± 2.7% (n = 31) vs −21.2 ± 2.4%; P < 0.001], end-diastolic volume (236 ± 90 vs 136 ± 30 ml; P < 0.001) and diastolic operant stiffness were markedly enlarged, as were pressure–volume area and stroke work, indicating waste of energy. The correlation of GLS versus end-systolic elastance was good (r = −0.66; P < 0.001). ARNS and ARS patients demonstrated similar haemodynamic disorders, whereas only GLS was worse in ARS.

CONCLUSIONS

ARNS patients almost matched the ARS patients in their haemodynamic and energetic deterioration, thereby explaining poor prognosis reported in literature. GLS has been shown to be a reliable surrogate for LV contractility, possibly overestimating contractility due to exhausted preload reserve in aortic regurgitation patients. GLS may outperform conventional echo parameters to predict more precisely the timing of surgery.
Homogenization and hypocoercivity for Fokker–Planck equations driven by weakly compressible shear flows
Authors: Coti Zelati Michele , Pavliotis Grigorios A
Published: September 2020

We study the long-time dynamics of 2D linear Fokker–Planck equations driven by a drift that can be decomposed in the sum of a large shear component and the gradient of a regular potential depending on one spatial variable. The problem can be interpreted as that of a passive scalar advected by a slightly compressible shear flow, and undergoing small diffusion. For the corresponding stochastic differential equation, we give explicit homogenization rates in terms of a family of time-scales depending on the parameter measuring the strength of the incompressible perturbation. This is achieved by exploiting an auxiliary Poisson problem, and by computing the related effective diffusion coefficients. Regarding the long-time behavior of the solution of the Fokker–Planck equation, we provide explicit decay rates to the unique invariant measure by employing a quantitative version of the classical hypocoercivity scheme. From a fluid mechanics perspective, this turns out to be equivalent to quantifying the phenomenon of enhanced diffusion for slightly compressible shear flows.
A proposal for shoring up Federal Trade Commission protections for electronic health record–connected consumer apps under 21st Century Cures
Authors: Sayeed Raheel , Jones James , Gottlieb Daniel , Mandel Joshua C , Mandl Kenneth D
Published: September 2020

Under the 21st Century Cures Act and the Office of the National Coordinator for Health Information Technology (ONC) rule implementing its interoperability provisions, a patient’s rights to easily request and obtain digital access to portions of their medical records are now supported by both technology and policy. Data, once directed by a patient to leave a Health Insurance Portability and Accountability Act–covered health entity and enter a consumer app, will usually fall under Federal Trade Commission oversight. Because the statutory authority of the ONC does not extend to health data protection, there is not yet regulation to specifically address privacy protections for consumer apps. A technologically feasible workflow that could be widely adopted and permissible under ONC’s rule, involves using the SMART on FHIR OAuth authorization routine to present standardized information about app behavior. This approach would not bias the patient in a way that triggers penalties under information blocking provisions of the rule.
‘The only delight of my life’: the collection of Pablo Bosch (1841–1915) and its bequest to the Museo del Prado
Authors: Martínez Plaza Pedro J
Published: September 2020

The collection of Pablo Bosch, bequeathed to the Museo del Prado in 1915, was one of the most prestigious in early twentieth-century Spain. To date, no detailed study of it has been undertaken. Documentary sources allow for a reconstruction of Bosch’s life and his network of contacts, revealing his artistic preferences and notably his taste for early Flemish painting. Information provided by his correspondence also supports a reconstruction of his two principal collections (paintings, and coins and medals) and new data on many of the works that he owned is published here. An analysis of legal documents and the minutes of the meetings of the museum’s board of trustees provides more detailed information on the Prado’s management of the bequest from 1915 and permits some suggestions to be formulated regarding the decisions taken by Bosch in his several wills.
The Partner Caregiver
Authors: Wittenberg Elaine , Goldsmith Joy V. , Ragan Sandra L. , Parnell Terri Ann
Published: September 2020

A LOW/WARM conformity pattern coupled with a HIGH and WARM conversation pattern produces positive family learning for the Partner caregiver, with family members working on their own to adapt, cooperate with each other, and engage in emotions associated with caregiving. Partner caregivers present to others as supporter of the experiences of the care recipient. Caregiving is an emotionally intense experience for the Partner caregiver, who becomes entrenched in the adjustment process of chronic illness. Partner caregivers perceive their role to involve (a) support care recipient decision-making by trusting doctors and honoring his or her decisions; (b) advocating on behalf of care recipient in communication with doctors and the healthcare team, including asking questions and finding out more information about prognosis and future; and (c) emphasizing family harmony through collaborative efforts that involve taking time to converse as a family.
Nicotine and Tobacco
Authors: Nahvi Shadi , Rastegar Darius A.
Published: September 2020

Nicotine is responsible for the psychoactive and habit-forming effects of tobacco. Approximately 30% of Americans use tobacco products; half of them are nicotine-dependent. Nicotine has mild stimulant effects. Overdose is rare in experienced users. Some may develop nausea, vomiting, weakness, and dizziness. Withdrawal symptoms include craving, irritability, anxiety, restlessness, and increased appetite. Smokers have elevated exhaled carbon monoxide and serum carboxyhemoglobin levels. Cotinine, a metabolite of nicotine, can be detected in blood and urine. Many medical conditions are associated with tobacco use (particularly smoking), including cardiovascular disease, chronic lung disease, and a variety of malignancies. A number of interventions can help increase smoking cessation rates, including physician advice, counseling, nicotine replacement, varenicline, and bupropion. Electronic cigarettes may help smokers quit or reduce their smoking.
Cannabinoids
Authors: Pytell Jarratt , Rastegar Darius A.
Published: September 2020

Tetrahydrocannabinol (THC) is the main psychoactive agent in the leaves of cannabis (marijuana) plants. Many synthetic cannabinoids have been recently developed. Cannabis is the most commonly used illicit drug in the United States; almost 20 million Americans currently consume cannabis. People who use cannabis may experience relaxation, euphoria, and mild hallucinogenic effects. Some may experience nausea and vomiting after use. Synthetic cannabinoids have been associated with more serious complications. Cessation after regular use may result in drug craving, insomnia, anorexia, and restlessness. Metabolites of THC can be detected in the urine up to 1 month after last use; some medications can cause false-positive tests. Serious medical complications of cannabis use are uncommon; the most concerning are neuropsychological problems among adolescent users and acute cognitive and motor impairment. Synthetic cannabinoid use is associated with significant neuropsychological effects. Psychosocial modalities appear to help those who wish to stop or reduce use. There are no medications that have been shown to be effective.
Introduction
Authors: Ansari Arash , Osser David N.
Published: September 2020

This introductory chapter notes the development and increased use of psychiatric medications over the past 70 years. It introduces the reader to the topics that are discussed in the subsequent chapters of this book. It reviews the differences between efficacy studies and effectiveness studies and how evidence gained from these studies can inform clinical knowledge. The availability of practice guidelines and algorithms are noted as well. This chapter also lists clinical variables that need to be taken into account before selecting any psychiatric medicine. Finally, it notes the importance of learning about the use of psychotropic medications in women of childbearing potential and during breastfeeding.
Mood Stabilizers
Authors: Ansari Arash , Osser David N.
Published: September 2020

The chapter on mood stabilizers discusses and reviews the use of available treatments for bipolar disorder, including lithium, selected anticonvulsants (such as valproate, carbamazepine, oxcarbazepine, and lamotrigine) and second-generation antipsychotics. It reviews each medication’s mechanism of action, clinical characteristics, potential medication interactions, and adverse effects. The chapter also reviews emerging pharmacotherapies such as the use of ketamine. It also briefly discusses complementary and alternative pharmacotherapies and the use of omega-3 fatty acids. The chapter includes an in-depth review of the clinical use of the previously listed medications for bipolar depression, mania, mixed episodes, and bipolar maintenance. It also reviews the risks of using antidepressants for bipolar depression. It also discusses the use of mood stabilizers in women of childbearing age, notably for pregnancy and breastfeeding considerations. Finally, the chapter includes a table of mood stabilizers that includes each medication’s generic and brand names, usual adult doses, pertinent clinical comments, black box warnings and Food and Drug Administration indications.
Functional neuroimaging in neuropsychiatry
Authors: Hurley Robin A. , Masters Shane C. , Taber Katherine H.
Published: September 2020

Neuroimaging is making increasing contributions to multiple aspect of clinical neuropsychiatry, including differential diagnosis, prognosis, clinical management, and development of new interventions. Functional neuroimaging techniques provide measures that are directly or indirectly related to brain activity. Functional neuroimaging is particularly useful for areas that are dysfunctional but look normal on structural neuroimaging. Evaluation of the resting state also has shown potential for prediction of treatment response in some conditions. In this chapter, the functional imaging techniques available for clinical use are reviewed with respect to their underlying technical details and the advantages and the limitations of each technique. Classic functional imaging findings in the most frequently occurring neuropsychiatric conditions are discussed, as well as examples provided. Future advances in techniques and their possible application to the practice of neuropsychiatry are also summarized.
Infections of the central nervous system
Authors: Adan Guleed , Nightingale Sam , Burness Christine , Solomon Tom
Published: September 2020

Central nervous system (CNS) infections, caused by various pathogens, can lead to a wide range of neuropsychiatric sequelae, including acute psychosis, mood disorders, and chronic dementias. Early recognition is critical as brain infections are often treatable and possible neuropsychiatric illness can be reversed if the diagnosis is timely. In addition to psychiatric symptoms, CNS infections may also present with other signs such as fever, meningism, cranial nerve deficit, and seizures. Although the presence of these additional features can often provide a clue to an underlying CNS infection, they are not always present; hence CNS infections should be considered in the differential diagnosis of psychiatric patients in certain situations. In this chapter, CNS infections that have psychiatric manifestations or have psychiatric sequelae are discussed, in particular HIV, neurosyphilis, meningitis, and encephalitis.
Neuropsychiatry of neurometabolic, neuroendocrine, and mitochondrial disorders
Authors: Walterfang Mark , Mocellin Ramon , Velakoulis Dennis
Published: September 2020

This chapter examines the role of neurometabolic, neuroendocrine, and mitochondrial disorders in causing neuropsychiatric syndromes. It examines how disorders of cellular metabolic processes, particularly those that affect the brain, can result in major psychiatric syndromes and the over-representation of some neurometabolic disorders in psychiatric illness. It also discusses a range of endocrine disorders, particularly disorders of increased or reduced endocrine function and endocrine tumours, in producing psychiatric syndromes. The chapter also reviews the role of mitochondrial disorders in disrupting central nervous system processes and metabolism, and how some mitochondrial disorders result in psychiatric illness.
Drug use and associated neuropsychiatric conditions
Authors: Venkataraman Ashwin , Turton Sam , Lingford-Hughes Anne
Published: September 2020

Recreational drug use is a well-recognized problem of everyday society. Consumption seems to be driven and maintained for desired effects on cognitive or emotional states. ‘Drug use’ in some situations is seen as socially acceptable such as getting a caffeine ‘hit’ from a morning cup of coffee to ‘get going’ or drinking alcohol as part of a social occasion. However, for some individuals and for some substances, drug use risks adverse consequences for brain function and possible enduring harm. This chapter will focus on how brain function may be altered as a consequence of drug use and describe the current understanding of the neurobiology of drugs of abuse and how this may be related to neuropsychiatric consequences. Drugs can produce neuropsychiatric effects acutely during intoxication or withdrawal, and also after chronic exposure, with effects which may or may not be enduring with abstinence.
Child and adolescent neuropsychiatry
Authors: Furlong Yulia , Chen Wai
Published: September 2020

Child neuropsychiatry encompasses childhood and adolescent psychiatric syndromes of neurobiological origins. It is an evolving discipline without consensus on its exact boundary. Given the inconsistencies, this chapter provides a historical perspective through which different conceptualizations of child neuropsychiatry can be understood and reconciled within the coherent whole. Four specific contrasting conditions are selected in this chapter to illustrate some key principles: attention-deficit/hyperactivity disorder (ADHD) as ‘a diffuse brain disorder’; childhood cranial tumours as ‘a localized brain disorder’; fetal alcohol spectrum disorders (FASD) as ‘a disorder of a specific cause’ represented by toxin exposure; and epilepsy as ‘a disorder of complex aetiology’. ADHD and cranial tumours represent the extremes of the polar divide between ‘a childhood neuropsychiatric disorder’ and ‘the neuropsychiatric manifestation of a childhood neurological disorder’. In contrast, FASD and epilepsy illustrate how specific and complex aetiology can present with a wide spectrum of psychiatric disorders. Atypical presentations of psychiatric symptoms, idiosyncratic treatment response, and ‘diagnostic overshadowing’ are also considered. The chapter emphasizes that child neuropsychiatric conditions are not fixed entities, despite conforming to diagnostic criteria stipulated by authoritative taxonomic systems. Rather, they are the results of the dynamic interplay between environmental factors, developmental maturity, mitigating factors, aberrant neural networks, and innate disease liability.
Impulsivity in humans: neurobiology and pathology
Authors: Voon Valerie
Published: September 2020

Impulsivity refers to premature behaviours and rash, poorly considered decisions which are made in spite of negative consequences. It is not a singular entity, consisting of a number of sub-categories under the two broad headings of motor and decisional impulsivity. The subtypes of motor impulsivity are laid out first, discussing waiting impulsivity, also known as premature responding, which can be a predictor of addiction, and response inhibition impulsivity, which is the capacity to inhibit pre-potent response. The chapter then explores the forms of decisional impulsivity, such as delay discounting and reflection impulsivity, along with their relation to attention-deficit/hyperactivity disorder. Finally, the prevalence of impulsivity across disorders as wide-ranging as obsessive–compulsive disorder and Huntington’s disease is discussed, and a case study of Parkinson’s-related impulsivity is presented.
Psychopharmacotherapy in the neuropsychiatric patient
Authors: Cooper Joseph J. , Bonakdarpour Borna , Ovsiew Fred
Published: September 2020

While in some cases, as with certain inflammatory brain diseases, the neuropsychiatrist can relieve the underlying pathology of a condition and alter its course through pharmaceutical intervention, this chapter is focused predominantly on the symptomatic treatment side of psychopharmacotherapy. After laying out a series of tenets on the responsible application of pharmaceuticals, pharmaceutical intervention is discussed with regard to a number of conditions such as cognitive impairment, apathy, and psychosis. The potential side effects are also discussed, such as psychotoxicity arising from the application of antipsychotics to patients suffering from Parkinson’s disease and the correlation between antiepileptic drug use and suicidal thoughts in patients.
Neuropsychiatric services in Australia and New Zealand
Authors: Finucane Greg , Mohan Adith , Sachdev Perminder S.
Published: September 2020

In New Zealand and Australia, until recently, neuropsychiatric patients with disorders like Parkinson’s disease, epilepsy, or Huntington’s disease were generally treated in state institutions, and there has been an axiomatic shift to short-stay inpatient units and community management, often with insufficient resources. This chapter explores the provision of adult neuropsychiatric services in the Australasian public health sectors and the current inadequacies in its planning frameworks. Divided by region, the facets of the main neuropsychiatric bodies in each are explored such as the Neuropsychiatric Institute (NPI) in New South Wales and the Royal Melbourne Hospital (RMH) Neuropsychiatry Unit. While there are a number of centres in Australasia that satisfy the ‘hub’ requirement of the ‘hub and spoke’ model recommended for the implementation of neuropsychiatric services, the ‘spokes’ are inconsistently developed, leading to patchy provision across the countries.
Neuropsychiatry service provision in India and South Asia
Authors: Krishnamoorthy Ennapadam S. , Misra Vivek
Published: September 2020

Neuropsychiatry as a medical specialty is significantly underrepresented in India, with neurology and psychiatry giving each other a wide berth in many of the country’s regions. This chapter reviews the state of neuropsychiatric services in India and South Asia, before moving on to explore what constitutes a Comprehensive Neuropsychiatry Programme (CNP). This encompasses education and research into neuropsychiatric outcomes, advocacy at a governmental level, and community-engendered activities, all with a view to attaining optimal levels of participation in activities of daily living (ADLs), health-related quality of life (HRQoL), and various social and educational milestones. The model employed by a multidisciplinary team for use in developing nations is then described, along with a case study to demonstrate best practice.
Neuropsychiatric services in South America
Authors: Brofman Gilberto Slud , Brusco Luis Ignacio
Published: September 2020

This chapter examines the historical evolution of neuropsychiatry in Brazil and Argentina, with a view to understanding what the future may hold for the field in South America. A brief historical context is given, before the limitations of neuropsychiatric services in Brazil are discussed, with reference to the lack of attention afforded in education and training and the absence of long-established links between the psychiatric and neurological communities. Meanwhile, although neuropsychiatry only gained official recognition and accreditation in Argentina in 2007, there is a precedent of neuropsychiatric study in the country dating back to Charcot’s theories in the nineteenth century, carried forward by expatriate psychiatrists such as Edmundo Fischer in the twentieth. The future development of neuropsychiatry in South America remains uncertain due to the unscientific distinction between psychiatry and neurology, leading to simplistic diagnoses such as classifying Parkinson’s disease as simply a ‘movement disorder’ or schizophrenia as purely ‘psychotic’.
Priorities and ethics in population-based healthcare
Authors: Griffiths Sian M. , Phipps Emily , McManners Joe
Published: September 2020

As a result of reading this chapter you will be able to: understand the language of ethics and the role ethics play in public; health practice; understand the principles of priority-setting for health and healthcare; systems within a constrained budget; appreciate how an ethical framework guides choices for population; health and health policy-making, including making choices to reduce health inequalities
Monitoring disease and risk factors: surveillance
Authors: Hopkins Richard , Kite-Powell Aaron
Published: September 2020

Public health surveillance is ‘the ongoing, systematic collection, analysis, interpretation, and dissemination of data about a health-related event for use in public health action to reduce morbidity and mortality and to improve health. Data disseminated by a public health surveillance system can be used for immediate public health action, program planning and evaluation, and formulating research hypotheses. This chapter discusses purposes for surveillance, surveillance opportunities, surveillance system design, public health informatics, evaluating a surveillance system, and general principles for effective surveillance systems.
Environmental health risks and assessment
Authors: Heiger-Bernays Wendy , Crawford Kathryn
Published: September 2020

This chapter will help you appreciate: environmental health in the rapidly changing context of health protection; the utility of having a framework for environmental health risk assessment; the process for conducting an environmental health risk assessment; the major strengths and limitations of risk assessment; the process of identifying, evaluating, and planning a response to an environmental health threat.
Health communication
Authors: McCloud Rachel , Bekalu Mesfin , Viswanath Kasisomayajula
Published: September 2020

After reading this chapter, you will be able to: understand why health communication is important in health promotion and disease prevention; explain how communication messages are produced by different organizations; identify different types of communication content and genres, such as entertainment, news and advertising; understand the effects of exposure to communication messages on health outcomes.
Translating evidence to policy
Authors: Smith Lauren , Kawachi Ichiro
Published: September 2020

As a result of reading this chapter, you will be able to: identify the challenges that arise in translating research findings to public policy; understand the frequently cited barriers to evidence-based public health policy making from the perspective of legislators; take steps to bridge the gap between evidence and policy formation.
Health, sustainability, and climate change
Authors: Pencheon David , Roschnik Sonia , Cosford Paul
Published: September 2020

This chapter will help you understand the importance of, and the relationships between, health, health and care systems, sustainable development, and climate change, and to do so locally and globally. The specific objectives of the chapter are to help you: make the case for action by understanding how science, law, policies, and values can be framed and translated into specific and system wide actions; translate what is known and what protects and creates health into policy and practice, and help address barriers to implementation and quality improvement in health and care systems; engage a wide range of stakeholders to ensure appropriate cross-system action involving a diverse group of people, skills, and influences across the health and care system.
Sustainability of healthcare systems
Authors: Azzolini Elena , Harney Mary , Ricciardi Walter
Published: September 2020

Having read this chapter, you should be able to: define the term ‘health sustainability’; understand the importance of health sustainability to public health; recognize opportunities and actions needed to obtain a sustainable healthcare system.
Healthcare process and patient experience
Authors: Delnoij Diana , Milne Ruairidh , Stevens Andrew
Published: September 2020

This chapter provides hands-on guidance with respect to the development and implementation of surveys measuring patient experiences. However, keep in mind that this is only a first step in the quality cycle. The results of such a survey give you a ‘diagnosis’ of the quality of care from the patients’ perspective. It does not really tell you what you should do to improve patient experiences, however. To find effective remedies for negative experiences, often you will have to do additional research. You will learn: how to measure quality of care from the patient’s perspective (i.e. how to construct patient questionnaires or where to find pre-existing ones); how to interpret the findings in the context of the objective of your measurement (e.g. quality improvement, patient choice, pay-for-performance); how to take action based on the results
Improving equity
Authors: Friel Sharon , Melzer David
Published: September 2020

After reading this chapter you will: be familiar with the concept and extent of health inequity in high- and middle- income countries; understand how the healthcare system can be both a cause of health inequities and a mechanism by which to improve health equity; recognize how to address the social determinants of health inequity; begin to systematically apply an equity lens to your daily professional practice.
Developing leadership skills
Authors: Sim Fiona
Published: September 2020

This chapter should help you to acquire the leadership competencies that are necessary to turn excellent public health technical practice into effective public health practice.
Effective writing
Authors: Jessop Edmund
Published: September 2020

This chapter will help you to make your writing more enjoyable to read. As a result, it will be more effective in initiating and sustaining appropriate change in others. Writing has three stages: before, during, and after. The most important stage is before. The most important thing to remember when you write is that no one has to read what you write. Never think that because what you write is important people will read it: they won’t. Consider for a moment how much material you have not read in the past two weeks. If what you write is difficult to read, people will simply give up. So you must do everything in your power to make reading easy for your readers. You can’t force people to read: you have to tempt them. This chapter focuses on corporate rather than academic writing.
Programme planning and project management
Authors: Fien John
Published: September 2020

Programme management, the coordinated development, implementation, and evaluation of a series of related sub-programmes or projects, is central to the efficient delivery of all public health services. This chapter draws from the project management and programme and project evaluation fields to provide a practitioner’s guide to programme planning and project management. This chapter covers: the relationship between programmes and projects; the components of effective programme and project planning; how to develop a programme theory and logic model for a project and how to implement it; ways of developing an evaluation strategy; managing projects as part of a programme; how to be an effective programme planner and project manager.
Working in teams in public health
Authors: Sibbald Shannon L. , Kothari Anita , Steinberg Malcolm , Bryant Beverley
Published: September 2020

This chapter will help you: define types, characteristics, and roles of teams in the context of public health; identify common challenges experienced by teams; consider strategies to foster high-performing teams; Suggest methods to assess, evaluate, and improve team effectiveness.
Workforce
Authors: Greaves Felix , Guest Charles
Published: September 2020

The objectives of this chapter are; To understand the internal and external influences on the public health workforce; To help you identify practical steps you can take to improve the public health workforce in your area.
Evidence for cardiac rehabilitation in the modern era
Authors: Davos Constantinos H. , Rauch Bernhard
Published: September 2020

Management of cardiovascular disease (CVD) has rapidly improved during recent decades and is still changing with the introduction of novel medication and advanced invasive procedures and devices. Notwithstanding these developments, cardiac rehabilitation (CR) is still a cornerstone of secondary prevention. Its effectiveness in improving the physical condition of chronic coronary syndrome (CCS) patients is beyond doubt, but its effectiveness on extending life expectancy is still a matter of debate. This chapter provides insights into the latest evidence (mainly presented in a recent meta-analysis of randomized controlled trials (RCTs) or controlled cohort studies) on the role of CR on morbidity and mortality in patients after an acute coronary event.