bluuebunny/crossref_metadata_2025 huggingface dataset:
Article
Authors: Gunnlaugsson Helgi
Published: January 2018

Helgi Gunnlaugsson: Drug use, attitudes and control policies in Iceland. A comparison with the other Nordic countries

Studies on the use of alcohol, tobacco and other drugs have frequently been conducted in Iceland in the past few years. These studies have mostly involved use among youth, so trends in the adult population have not yet been mapped out to the same extent. In this presentation, findings from the first ever general population survey on drug use in Iceland will be presented. Prompted by the Nordic Drug Survey, in which Iceland did not take part, a few questions from that survey were adopted in a survey conducted in Iceland in late 1997.

Based on the Nordic comparative figures, it appears that Iceland is in some respects not very different from the other Nordic nations. Yet lifetime prevalence of cannabis use was found to be significantly higher in Iceland than in the other Nordic nations, except for Denmark, which clearly is in a league of its own. However, if the use in the last 6 months is analysed, Iceland is very similar to the other Nordic nations. The consumption pattern, in terms of age and gender, seems also to follow the general pattern found in the other Nordic nations. As for attitudes toward different control measures, it is apparent that the public in all of the Nordic countries seems to be in favour of adopting unconventional control methods in the fight against drugs.
Can i buy you a drink?: Alcohol as symbolic communication in erotic encounters
Authors: Træen Bente , Hovland Arild , Ødegård Guro
Published: January 2018

The purpose of the study is to clarify the status of alcohol as a form of symbolic communication in the process of erotic contact seeking among members of three social categories of the urban Norwegian population. In 1995, a field observation/depth interview study on alcohol and sexuality was undertaken among patrons of three clubs designed to attract people from different social categories in Oslo. 33 persons (25–52 years) visiting the three clubs were interviewed. The informants were classified on the basis of background and lifestyle as belonging to three different social categories: ‘the chosen ones‘, ‘the traditionals' and ‘the unconventionals’. In all three clubs it seemed to be common for men to offer to buy women drinks. The traditional gender role pattern was evident in all social categories. However, there were also differences among them in this respect. Men of the ‘the chosen ones' category might be described as acting like ‘gentlemen' when offering to buy drinks for women whom they did not know. In contrast, ‘traditional' men acted more like the traditional ‘provider‘, and ‘unconventional' men behaved more like the women's ‘pals’. There are thus consequences for both men's and women's motives for, and reactions to, offering somebody a drink.
Changes in municipal alcohol policies
Authors: Andersen Jan
Published: January 2018

Municipalities have an important role in enacting alcohol policy in Norway. The task of the local authorities is to implement the national goals and form a locally adapted practice, mainly by controlling the availability of alcohol to the public. The local politicians experience this as an issue where they are exposed to a cross-pressure between sociopolitical concerns on the one hand and business interests on the other hand.

This paper focuses on alcohol policies in municipalities which give priority to business development, especially tourism. It is based on case studies of two Norwegian municipalities. The paper first looks at the actual changes in the alcohol policy in the two municipalities, and secondly, at the decision-making process leading up to these changes. Four approaches for studying decision-making processes, inspired by a model by Jo-han P. Olsen, are used: rationality, legitimacy, power and necessity.

The study found a liberalization with regard to the availability of alcoholic beverages in the two municipalities. This can be explained by changes in external conditions, changes in influential positions between different actors, and changes in public attitudes towards alcohol and interpretations of the local authorities’ ability to control the consumption of alcohol in the population.

At the same time the local authorities have strengthened efforts to control licensees. This can be seen as a result of demands from the national authorities, and of the fact that this activity can be financed by a tax on the licensees. The combination of the liberalization of the license policy and the strengthening of the control of the licensees can also be seen as a compromise between different political attitudes, but where the business interests are more important than the sociopolitical concerns.

The local politicians also underlined the importance of information activity aiming at influencing attitudes towards alcohol. This last mean is characterized by a legitimating function and almost restricted to rhetorics. It seems that this is more a symbolic politics.

Generally the study emphasizes mechanisms indicating that the consequence of a decentralization of power to local authorities will be a more uniform liberal politics rather than more locally based differences.
A Nationwide Study of Norwegian Drug Abusers in Treatment: Methods and findings
Authors: Lauritzen Grethe , Waal Helge , Amundsen Arvid , Arner Oddvar
Published: January 2018

The National Institute for Alcohol and Drug Research (SIFA) has completed the first nationwide survey of drug abusers in treatment in Norway. Experiences from the study have contributed to the creation and initial implementation of a monitoring system for treatment demands and treatment measures in the country. This article presents the approach and methods used in the SIFA study. It provides an overview of the material and focusses on describing clients from long-term residential and outpatient treatment modalities. The results are presented within seven areas: socio-demographics, substance abuse, mental health and significant problems, risk behaviour, social functioning, social network, and biographical data on childhood/adolescence. These areas are analysed by the variables of gender, age, urban Oslo/outside Oslo clients, and client populations from residential/outpatient treatment. The authors reflect upon the prospects opened by such comprehensive documentation concerning preventive strategies, planning of treatment, and further research in Norway.
Beyond Everyday Order; Breaking Away with Alcohol
Authors: Lalander Philip
Published: January 2018

Based on an ethnographical study of a group of young Swedish politicians, the author carries out a discussion concerning two major questions: How can one understand and interpret orgiastic behavior at parties? In what way does the use of alcohol make orgiastic behavior legitimate at parties? The author claims that the use of alcohol in different types of rituals may be seen as a way to travel beyond the structures of everyday life into another reality, in which certain interaction and self-presentation norms become less important and less used. Alcohol is thus used as a symbol in a rite of passage. Using the anthropologist Turner's words, this other reality can be seen as liminal. The individual who enters this reality can do things which she would otherwise find taboo or inconvenient. The body is central in this liminal and carnevalistic reality and the individuals can play with different forms of taboos. The party may thus be seen as an escape zone for people who discipline themselves in their everyday life. The group is of major importance in the transgression. Through rituals in the group, the transgression becomes legitimate. The group also helps the individual to come back to everyday life.
Denileukin Diftitox and Valrubicin
Authors: Solimando Dominic A. , Waddell J. Aubrey
Published: January 2018

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column reviews various issues related to the preparation, dispensing, and administration of cancer chemotherapy, both commercially available and investigational.
Thrombocytopenia Caused by Heparin Flushes When are Drug-Induced Rises in Plasma Creatinine Not a Problem? Procainamide-Induced Psychosis Valproate and Hyperammonemia
Authors: Shuster Joel
Published: January 2018

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medWatch program (1-800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
How to Explain Vaccines to Children and other Inquisitive People
Authors: Grabenstein John D.
Published: January 2018

With the rapid pace of immunologic research, it is more important than ever for readers to understand rational immunodiagnosis, immunopro-phylaxis, and immunotherapy. This column is intended to help you ensure proper immunologic drug use in your practice.
Levobupivacaine
Authors: Cada Dennis J. , Baker Danial E. , Levien Terri
Published: January 2018

Each month, subscribers to The Formulary® Monograph Service receive five to six researched monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. The monographs are published in printed Form and on diskettes that allow customization. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board called The Formulary InFormation Exchange (The F.I.X). All topics pertinent to clinical pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The November 1999 Formulary monographs are on rapacuronium, rabeprazole, zaleplon, alosetron, and ganirelix acetate. The DUE is on zaleplon.
Inverting the Facing-the-Viewer Bias for Biological Motion Stimuli
Authors: Weech Séamas , Troje Nikolaus F.
Published: January 2018

Depth-ambiguous point-light walkers are most frequently seen as facing-the-viewer (FTV). It has been argued that the FTV bias depends on recognising the stimulus as a person. Accordingly, reducing the social relevance of biological motion by presenting stimuli upside down has been shown to reduce FTV bias. Here, we replicated the experiment that reported this finding and added stick figure walkers to the task in order to assess the effect of explicit shape information on facing bias for inverted figures. We measured the FTV bias for upright and inverted stick figure walkers and point-light walkers presented in different azimuth orientations. Inversion of the stimuli did not reduce facing direction judgements to chance levels. In fact, we observed a significant facing away bias in the inverted stimulus conditions. In addition, we found no difference in the pattern of data between stick figure and point-light walkers. Although the results are broadly consistent with previous findings, we do not conclude that inverting biological motion simply negates the FTV bias; rather, inversion causes stimuli to be seen facing away from the viewer more often than not. The results support the interpretation that primarily low-level visual processes are responsible for the biases produced by both upright and inverted stimuli.
A long-term cohort study of surgery for recurrent prolapse comparing mesh augmented anterior repairs to anterior colporrhaphy
Authors: Curtiss Natasha , Duckett Jonathan
Published: January 2018

Background

There are safety concerns regarding the use of mesh in vaginal surgery with a call for long-term follow-up data. This study was designed to evaluate the long-term safety and efficacy of vaginal repairs performed for recurrent cystocele using Perigee (non-absorbable trans-obturator) mesh.

Methods

A retrospective consecutive cohort of 48 women who underwent surgery for recurrent prolapse between March 2007 and December 2011 in a single centre was reviewed. Satisfaction was assessed using the patient global impression of improvement (PGI-I). Symptoms were assessed with the pelvic floor distress inventory (PFDI). Women were questioned regarding pain, sexual activity and pelvic floor surgery performed since the original procedure and examined for erosion. Women were compared to 25 controls from a consecutive cohort of repeat anterior colporrhapies.

Results

The mean length of follow-up was 6.5 years (78 months; range 48–106). Significantly more women in the mesh group reported that they were “much better” or “very much better” (69 vs 40% p = 0.02). The rate of mesh erosion at follow-up was 11.6%. Two women in the mesh group required surgical excision of eroded mesh in the operating room (4%). The reoperation rate for a combination of de novo stress incontinence, recurrent prolapse and mesh exposure was similar in each group (33% mesh vs 32% native tissue).

Conclusions

A vaginal mesh repair using a non-absorbable trans-obturator mesh has improved satisfaction compared to an anterior colporrhaphy.
Do employers in Myanmar prefer workers who accumulated skills in more advanced countries? Evidence from a field experiment
Authors: Wah Saw Htay
Published: January 2018

I conducted an audit study in Yangon, Myanmar, to examine the effects of foreign labor market experience on employment outcomes in the Myanmar labor market focusing on three skilled occupation groups—software developer, accountant, and engineer—which combined account for more than 80% of all professional and technical job openings. I find heterogeneous effects by employer type (local, foreigner), occupation (software developer, accountant, engineer), and foreign country where such experience was accumulated (Singapore, Malaysia). In particular, I find a large and significant effect for software developers who accumulated experience in Singapore and no significant effect for the same experience accumulated in Malaysia; the Singapore effect is mainly due to foreign employers operating in Myanmar. In contrast, I find no significant effects of foreign experience for accountants and engineers. This is true for both the Singapore and Malaysia experiences, as well as for local and foreign employers.

JEL Classification:O15, J01, F22
Estimation of porosity and water saturation in dual-porosity pyroclastic deposits from joint analysis of compression, shear, and electromagnetic velocities
Authors: Gase Andrew C. , Bradford John H. , Brand Brittany D.
Published: January 2018

In situ measurements of porosity and water saturation of pyroclastic deposits have the potential to improve interpretations of geology and hydrology in volcanic regions, and to provide more accurate estimates of dense rock equivalent for volcanic eruptions. However, rock-property models must consider the dual-porosity structure of pyroclastic deposits (i.e., vesicles within pumices and intergranular pores). Vesicularity, intergranular porosity, and water saturation all affect the density, elasticity, and dielectric properties of pyroclastic materials, which control seismic and electromagnetic velocities. The data from active seismic and ground-penetrating radar (GPR) techniques may improve porosity and water saturation estimation if the responses of seismic and electromagnetic velocities to porosity and water saturation variations are complementary in pyroclastic deposits. We developed a dual-porosity petrophysical model to calculate seismic and electromagnetic velocities of pyroclastic deposits with known intergranular porosity, vesicularity, and water saturation, and we tested our ability to estimate porosity and water saturation from field measurements of seismic and electromagnetic velocities in pyroclastic deposits at Mount St. Helens, Washington, USA. Our petrophysical model demonstrates that seismic velocities are more sensitive to intergranular porosity and less sensitive to vesicularity; electromagnetic velocity is primarily controlled by volumetric water content. In a multioffset GPR and active seismic case study, seismic first-arrival traveltime tomography and multichannel analysis of surface waves can resolve high-velocity anomalies caused by porosity reduction. Joint petrophysical inversion of electromagnetic and seismic velocities indicates that although intergranular porosity and water saturation are well-constrained (i.e., standard deviations of approximately 0.05), quantitative estimates of vesicularity remain less certain (i.e., standard deviation of approximately 0.21), due to weak sensitivity.
Psychiatry and mental health in Portugal
Authors: Marques-Teixeira João , Fradique Elisabete
Published: January 2018

Portugal is in the south-west of Europe; its territory includes the Azores and Madeira islands, giving it an area of 91 900 km2. The total resident population of Portugal was 10 579 000 in 2006. The population density was 115 per km2. The birth rate has been declining, from 20.0 per 1000 population in 1970 to 10.4 in 2004. Life expectancy at birth in 2006 was 75 for males and 82 years for females. Healthy life expectancy at birth in 2003 was 67 and 72 years, respectively. The infant mortality rate decreased from 10.8 per 1000 in 1991 to 3.5 per 1000 in 2005. The median age of the population has been steadily rising.
Suicide in Akita Prefecture, Japan
Authors: Fushimi Masahito , Sugawara Junya , Shimizu Tetsuo
Published: January 2018

In recent years, the number of suicides in Japan has increased dramatically, particularly among middle-aged men. According to the Brief Report on Suicides in 2001 by the National Police Agency of Japan (NPA, 2002), the number of suicides in Japan was 31 042, and the national suicide rate was 24.4/100 000. Akita is an agricultural prefecture with a population of approximately 1 200 000. According to the Akita Prefectural Police (APP), the number of suicides in Akita Prefecture was 457 (299 males, 158 females) in 2001. Akita Prefecture currently has the highest rate of suicide in Japan. The identification of strategies for suicide prevention is therefore imperative.
Mental health in Finland
Authors: Lahtinen Eero
Published: January 2018

The prevalence of mental illnesses in Finland generally reflects global trends, with a clear increase in the occurrence of depression and anxiety. At any time, between 4% and 9% of the population of 5.2 million suffer from major depressive disorders. Some 10–20% of the population experience depression during their lifetime. Bipolar depressive disorders affect 1–2% and schizophrenia 0.5–1.5% of the population. The prevalence of alcoholism is 4–8%.
Earthquake in Pakistan and Kashmir: suggested plan for psychological trauma relief work
Authors: Makhdum M. Akmal , Javed Afzal
Published: January 2018

On the morning of 8 October 2005, Pakistan and Pakistani-controlled Kashmir were hit by an earthquake that measured 7.6 on the Richter scale. Within 5 seconds, almost all buildings in two major cities of the north were destroyed: the capital of Pakistani-controlled Kashmir, Muzaffarabad, and Balakot, a picturesque mountain city. This was about 9 a.m. Children were in classrooms and mothers were doing household chores. Many men were in the fields. Therefore, when houses and buildings collapsed, thousands of young children and women were killed, as a result of falling roofs and walls. All government buildings, universities and colleges were destroyed and thousands of students died. In one town there were no children left alive: a generation had been wiped out. In two schools alone people were trying to retrieve 600 bodies of young girls. The earthquake hit hardest in difficult mountainous terrain. Even under normal conditions, four-wheel-drive vehicles are required to travel in this area; after the earthquake, landslides had blocked access to large villages. Many small villages were buried.
Senior Volunteers Programme: a visit to Zambia
Authors: Sims Andrew , Sims Ruth
Published: January 2018

The Board of International Affairs of the Royal College of Psychiatrists initiated the Senior Volunteers Programme in 2004 following discussion at the Board and planning in a subgroup over the preceding year. The aim was to match requests from other countries for specific psychiatric teaching with the services of senior psychiatrists in Britain. The College has acted as intermediary, inviting requests from countries, Members and Fellows overseas, and setting up a database of psychiatrists offering a range of skills. The concept is simple but all the skill and hard work lies in the detail!
The role movies play in alcohol consumption by youths
Authors: Stern Susannah R.
Published: January 2018

Alcohol use and misuse among young people continue to be a major public health concern, despite decades of initiatives aimed at educating young people about the hazards of alcohol. Yet where do young people learn about alcohol use? How do they form attitudes about the effects and risks of drinking? Increasing evidence suggests that young people learn not only from real people (e.g. peers and parents) in their everyday lives but also from characters whose lives they witness through the media. In fact, the mass media have been recognised as significant sources of information about substance use that can influence young people's beliefs and expectations (Bahk, 2001; Sargent et al, 2002).
Mental healthcare services in Mauritius
Authors: Naga Mridula S.
Published: January 2018

The Republic of Mauritius is a group of islands in the south-west of the Indian Ocean, consisting of the main island of Mauritius, Rodrigues and several outer islands, situated 900 km to the east of Madagascar. It has a total land area of 2040 km2 and a population of around 1.2 million. Mauritius has a multiracial population whose origins can be traced mainly to Asia, Africa and Europe. English is the official language but French remains the most widely spoken, along with the local dialect, Creole, which is derived from French. Mauritius is classified as an upper middle income country in sub-Saharan Africa by the World Bank. It has a per capita gross domestic product (GDP) of US$13 200.
Research into the psychological well-being of young refugees
Authors: Lau Winnie , Thomas Trang
Published: January 2018

Interest in the psychological well-being of refugees and asylum seekers has steadily grown in recent years. Latest estimates indicate there are 32.9 million people of concern to the United Nations High Commissioner for Refugees (2006). A refugee is defined as being in that position because of a well-founded fear of persecution due to race, religion, nationality, social group or political opinion, and who is consequently outside and unable to return to his or her country. The status of ‘refugee’ is contrasted with that of a person seeking asylum, whose experiences may be similar but who is not formally determined in the same way.
Use of herbal medications among out-patients in a psychiatry clinic in Sri Lanka
Authors: Kuruppuarachchi K. A. L. A. , Hapangama A.
Published: January 2018

The use of complementary and alternative medicine is increasing among psychiatric populations. Herbal medications are a form of alternative and complementary medicine whose use has increased over the last decade. Two studies done among Western out-patient groups have reported rates of use of herbal medicine at 15% (‘current use’; Matthews et al, 2003) and 24% (Knaudt et al, 1999).
Services for adults with intellectual disability in Mexico: opinions and experiences of service users
Authors: Allen-Leigh Betania , Katz Gregorio , Lazcano-Ponce Eduardo
Published: January 2018

We have conducted a qualitative study to collect information about services for adults and older adolescents with intellectual disability in Mexico, as part of ongoing research on intellectual disability from a public health and rights-oriented perspective. Our focus is on existing services and outstanding needs. One of our main goals is to provide an opportunity for people with intellectual disability to convey their experiences and express their opinions about the additional services they require. Three types of service are included: those supporting autonomy or independence (personal and economic); those enhancing community inclusion; and those providing vocational opportunities.
Working conditions and job satisfaction of Argentinian psychiatrists: initial results of a comprehensive survey
Authors: Wolfberg Elsa , Moldavsky Daniel
Published: January 2018

Working in psychiatry is generally rewarding. However, it can also lack job satisfaction and be detrimental to personal life. Research findings indicate high rates of burnout (Kumar et al, 2007), impaired health status of practitioners (Korkeila et al, 2003), negative effects of violence in the workplace (Inoue et al, 2006) and lack of job satisfaction (Fischer et al, 2007; Bressi et al, 2009).
Criteria for compulsory admission in some European countries
Authors: Carballedo A. , Doyle M.
Published: January 2018

Compulsory admission to mental health facilities is a controversial topic, as it impinges on personal liberty and the right to choose, and it carries the risk of abuse for political, social and other reasons (Gostin, 2000). However, involuntary admission can prevent harm to self and others, and assist people in attaining their right to health, which, due to their mental disorder, they are unable to manage voluntarily. Since the 1950s and 1960s, the delivery of mental health has shifted from a paternalistic emphasis on the need to treat those who are not able to look after themselves, to the rights of patients who have a mental illness. The Principles for the Protection of Persons with Mental Illness (‘the MI Principles’) adopted by the United Nations in 1991 play an important role in raising awareness about the human rights of people with mental health problems. They provide guidance on areas such as the procedures for involuntary admission to mental health facilities and standards of care (Knapp et al, 2007). Legal frameworks for involuntary placement of those who are mentally ill have been reformed in many European countries. Most regulate compulsory admission and treatment by special mental health laws. Only Greece, Spain, Italy and those member states of the European Union (EU) that joined in 2004 and 2007 have no separate laws (Dressing & Salize, 2004).
Mental health law in Denmark
Authors: Brandt-Christensen Mette
Published: January 2018

In Denmark, the parliament passed the first Mental Health Act (MHA) in 1938. A new Act was passed in 1989, based on a thorough report from the Ministry of Justice. The 1989 Act emphasised the protection of citizens' legal rights in relation to compulsory admission, detention and treatment in psychiatric hospitals. That Act is still in operation, although it has been amended several times. In 2006 the definition of ‘compulsion’ was changed, and a 2010 amendment introduced compulsory treatment in the community for a trial period of 4 years.
Mental health law in Finland
Authors: Seppänen Allan , Eronen Markku
Published: January 2018

A tradition of Romano-Germanic or civil law defines the legal system in Finland. Laws of relevance to psychiatry are the 1990 Mental Health Act and, insofar as it pertains to forensic psychiatry, the Criminal Law (1889) and the Law on State Mental Hospitals (1987, revised 1997). These are outlined in the present paper.
Gender differences in mental health in the Middle East
Authors: Ghuloum Suhaila
Published: January 2018

We are now seeing in clinical practice a generation of young women who are referred for psychiatric treatment by their parents because they are rebelling against society's cultural norms but it is often apparent that women fear their families finding out that they are seeking psychiatric help. Despite improvements in the cultural understanding of women's right to equality, there remain deeply rooted practices and cultural norms that continue to adversely affect women's mental health and well-being. Physical abuse, for instance, is rarely reported, for fear of shaming the family, or of retaliation with further abuse. Mental health services in many countries in the Middle East are undergoing reform, but little research has been done into gender differences in service delivery or needs.
The legacy – or not – of Dr Thomas Szasz (1920–2012)
Authors: Turner Trevor
Published: January 2018

Dr Trevor Turner was asked to provide a commentary on the preceding paper in this issue, ‘“Freedom is more important than health”: Thomas Szasz and the problem of paternalism’, by Joanna Moncrieff.
The mental health needs of immigrant workers in Gulf countries
Authors: Zahid Muhammad Ajmal , Alsuwaidan Mohammad
Published: January 2018

The oil-rich member states of the Gulf Cooperation Council (GCC) attract large numbers of migrant workers. The reported rates of psychiatric morbidity among these migrant workers are higher than among nationals, while the mental health services in the GCC countries remain inadequate in terms of both staff and service delivery. The multi-ethnic origin of migrants poses considerable challenges in this respect. The development of mental illness in migrants, especially when many of them remain untreated or inadequately treated, results in their premature repatriation, and the mentally ill migrant ends up facing the same economic hardships which led to migration in the first place. The availability of trained interpreters and transcultural psychiatrists, psychologists and social workers should make psychiatric diagnoses more accurate. Suitable rehabilitation services are also needed.
Psychiatry in Bangladesh
Authors: Karim M. Rezaul , Shaheed Fakhruzzaman , Paul Siddhartha
Published: January 2018

The People's Republic of Bangladesh is located in South Asia. The total land area of Bangladesh is 147570 km2. Its total population in 2001 was about 123 million. The population growth rate is 1.47%; of the total population, 75% live in rural areas and 25% in urban areas (Bangladesh Bureau of Statistics, 2000).
Mental health services in Iraq: past, present and future
Authors: Sadik Sabah , Al-Jadiry Abdul-Monaf
Published: January 2018

Iraq is known to be the cradle of civilisation — a country with a rich history. Present-day Iraq occupies the greater part of the ancient land of Mesopotamia, the plain between the Euphrates and Tigris rivers. Some of the world's greatest ancient civilisations arose in this area, and Iraq possesses a huge number of historical monuments and archaeological sites.
Doctors' values, resilience and professionalism
Authors: Williams Richard
Published: January 2018

In 2001, Richard Smith, then editor of the BMJ, asked why doctors were so unhappy. He provoked a huge international response. The suggested reasons included: changes in the social structures of work; the demographic shift and difficulties in the recruitment and retention of staff; the replacement of trust with accountability; changes in relationships with people and bodies that are responsible for policy and practice; and negative media reporting.
Psychiatric morbidity among patients on haemodialysis in the Mosul district of Iraq
Authors: Najim Hellme , Al-Badrani Emad , Sultan Khalid Omar
Published: January 2018

Patients on chronic haemodialysis experience a wide range of physical and psychological stresses. The specific sources of stress include: loss or threatened loss of possessions; relationship problems (e.g. staff–patient relationships, changed roles within the family); restrictions related to physical health status and the dialysis regimen; loss of body function and impaired body image; increased dependency and aggression; the threat of death; impairment of vocational function and financial security; and decreased participation in leisure, social and community activities (Phipps & Turkington, 2001). A review of psychological maladjustment in patients on haemodialysis found that about 55% exhibited significant emotional distress, a prevalence three to five times that found in the general population (Aghanwa & Morakinyo, 1997). The present study aimed to ascertain the prevalence of psychiatric morbidity among patients attending a renal dialysis unit in Mosul, Iraq.
Mental healthcare in Poland
Authors: Bomba Jacek
Published: January 2018

Modern mental healthcare in Poland has its foundations in the 19th century, when the country was subject to three different organisational and legal systems — of the Austrian, Prussian and Russian Empires. These differences prevailed even after the First World War. Professionals lobbying for a mental health act had no success. The Second World War left mental healthcare with significant losses among its professional groups. More than half of all Polish psychiatrists lost their lives; some of them were exterminated as Jews, some as prisoners of the Soviets. The Nazi occupation in Poland had dramatic consequences for people with a mental disturbance, as Action T4 turned into genocide on the Polish territory. The majority of psychiatric in-patients were killed. After the Second World War, the mental health system had to be rebuilt, almost from scratch. Major political changes in the country across the second part of the 20th century and revolutionary changes in mental healthcare around the world influenced psychiatric services. The purpose of this paper is to describe mental healthcare in Poland today.
Elderly people with mental illness in South-East Asia: rethinking a model of care
Authors: Heok Kua Ee
Published: January 2018

The report World Population Ageing 1950–2050 (United Nations, 2002) estimated that in 2005 there were 37.3 million elderly people (i.e. aged 65 years or more) in South-East Asia (a region incorporating Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Vietnam). There are only a few epidemiological studies on mental disorders among elderly people in this region and the published data are mainly from Singapore, Malaysia and Thailand. Using Singapore's prevalence rate of 3% for dementia and 5.7% for depression, the numbers of elderly people with dementia in this region would be 1.2 million and with depression 2.12 million (Kua, 1992; Kua & Ko, 1995). However, even in Singapore, we have identified only 10% of all potential cases of dementia and depression — meaning that the large majority of elderly people with mental disorders are not detected, although they may be known, for other reasons, to the health services.
Four principles of mental health research and psychosocial intervention for child soldiers: lessons learned in Nepal
Authors: Kohrt Brandon A. , Jordans Mark J. D. , Morley Christopher A.
Published: January 2018

Child soldiers represent a challenging population for mental health and psychosocial support (MHPSS), as we have little evidence regarding their needs or the efficacy of interventions. Despite an increasing breadth of MHPSS interventions for children affected by war, very few are supported by evidence (Jordans et al, 2009). In a recent decade-long conflict, Maoists and the government of Nepal conscripted thousands of children to serve as soldiers, sentries, spies, cooks and porters. After the war ended in 2006, we began a project incorporating research into the development of interventions for former child soldiers. Through this work, conducted with Transcultural Psychosocial Organization (TPO) Nepal, we identified four key principles to guide research and intervention with child soldiers (Fig. 1). We present these principles as location- and context-specific examples of the growing effort to develop guidelines and recommendations for research and intervention in acute post-conflict settings (Inter-Agency Standing Committee, 2007; Allden et al, 2009).
Mental health in Hong Kong: transition from hospital-based service to personalised care
Authors: Cheung Eric F. C. , Lam Linda C. W. , Hung Se-fong
Published: January 2018

Hong Kong was a UK colony before 1997 but has since been a Special Administrative Region of the People's Republic of China. It is located in southern China and has an area of 1104 km2. Approximately 95% of Hong Kong's population is ethnic Chinese. Hong Kong is a developed capitalist economy, with a gross domestic product of US$301.6 billion (2009 estimate), of which about 5.5% is spent on healthcare and about 0.24% on mental health (World Health Organization, 2005). Despite the relatively low level of spending on healthcare, Hong Kong nevertheless has one of the longest life expectancies in the world (79.2 years for men; 84.8 years for women) and a very low infant mortality rate (2.93 per 1000 live births) (Central Intelligence Agency, 2010).
The effects of trauma on children: working to define roles for mental health professionals
Authors: Pine Daniel S.
Published: January 2018

Interest concerning the effects of trauma on the mental health of children has grown markedly during the past few years. At least three factors contribute to this growing concern.
Mental health services in Sri Lanka
Authors: Mendis Nalaka
Published: January 2018

Relative to its economic indicators, Sri Lanka has a high health status. The life expectancy in the year 2001 was 70.7 years for males and 75.4 years for females. Maternal and infant mortality rates have shown a downward trend over the past half century and now are around 2.3 per 10 000 live births and 16 per 1000 live births, respectively. These trends are mainly due to the high literacy rate and comparatively large investments made in health and social welfare.
Psychiatric response to the AIDS epidemic in the United States
Authors: Satriano James
Published: January 2018

In the early 1980s, when the first cases of AIDS were being reported in the gay population and among intravenous drug users, epidemiological research indicated that the disease was both blood-borne and sexually transmitted. Mental health care workers had little concern about infection among people with serious and persistent mental illness, because this population was felt to be too disabled to engage in the sexual or needle-sharing behaviours that put one at risk. Yet the first case of AIDS in a US state psychiatric facility was diagnosed in 1983, when a woman in her mid-20s, who had been hospitalised for several months, developed Pneumocystis carinii pneumonia (Cournos et al, 1989). This case was quite shocking to the treatment team, for two reasons: first, AIDS had unexpectedly entered the psychiatric population; and second, the person infected was a woman, when the disease was being reported almost exclusively in men in the United States.
The World Health Organization's Mental Health and Substance Abuse Programme
Authors: Saraceno Benedetto
Published: January 2018

There has been a rapid rise in the number of people with mental disorders. These disorders represent a major challenge to global development. The burden will be higher in developing countries, which have the least resources to respond. World-wide, 450 million people are affected at any given time. No group is immune to mental disorders but the risk is higher among: the poor; children and adolescents; abused women; the unemployed; persons with little education; neglected elderly people; victims of violence; migrants and refugees; and indigenous populations.
Can we – and should we – have a ‘Europsychiatry’ for children and adolescents? The work of the UEMS Section and Board for Child and Adolescent Psychiatry/Psychotherapy
Authors: Hill Peter , Rothenberger Aribert
Published: January 2018

Since 1994, child and adolescent psychiatry has been a distinct specialty, separate from psychiatry, within the Union of European Medical Specialists (UEMS). It has a slightly curious title, of which more later. It has proved a successful arena for promoting training, and this in turn has led to a developing European view of what exactly child and adolescent psychiatry is, and how it can be practised. This article tries to reflect this.
Ethical international recruitment – a response
Authors: Sartorius Norman
Published: January 2018

This note is written for two reasons: the first is to thank Drs Ndetei, Karim and Mubbashar for their fine article (Ndetei et al, 2004) and for reminding the readers of International Psychiatry of the problems arising from the ‘brain drain’; and the second is to comment on the astonishing argument presented in the paper written in reply by Catherine Jenkins, of the UK Department of Health (Jenkins, 2004).
Psychosocial and cultural motivations for self-inflicted burns among Iranian women
Authors: Rastegar Lari Abdolaziz , Alaghehbandan Reza , Taghi Joghataei Mohammad
Published: January 2018

When the world of public health considers the health of women, one tendency is first and foremost to link the well-being of women to that of children and the family, and, legitimately, to the health of society overall. Epidemiological data point to sex differences in the patterns and clusters of psychiatric disorders and psychological distress. The origins of much of the pain and suffering particular to women can be traced to their social circumstances. Depression, hopelessness, exhaustion, anger and fear grow out of hunger, overwork, domestic and civil violence, entrapment and economic dependence. Understanding the sources of women's ill health demands awareness of how cultural and economic forces interact to undermine their social status. This article highlights aspects of social suffering among women in Iran. Self-inflicted burns, a significant indicator of mental health among Iranian women, are discussed in order to increase awareness of the phenomenon among the international community, as a first step towards initiating an improvement in the health of women in Iran.
Mental health in Lithuania
Authors: Puras Dainius
Published: January 2018

Lithuania is a country with an approximate area of 65 000 km2. Its population is 3.422 million, and the gender ratio (expressed as men per 100 women) is 87. The proportion of the population under the age of 15 years is 18%, and the proportion above the age of 60 years is 20%. The literacy rate is 99.6% for both men and women. The country is in the higher middle-income group (by World Bank 2004 criteria).
Terrorism, human-made and natural disasters as a professional and ethical challenge to psychiatry
Authors: de Jong Joop , Komproe Ivan , Van Ommeren Mark
Published: January 2018

The consequences of terrorism, wars and natural disasters are a challenge to the psychiatric profession. The large numbers of people estimated to have mental health problems surpass the capacities of existing mental health services, whether modern or traditional. The bulk of the 35 million refugees and internally displaced people worldwide reside in countries that, on average, have less than one psychiatrist or psychologist per 100 000 people (WHO, 2001). Even the 500 000 people estimated to need some form of psychological support after the attack in New York on 11 September 2001 exceeded the service capacity, despite the fact that New York has the highest density of mental health professionals in the world (Herman & Susser, this issue, pp. 2–4). Elsewhere, many survivors of various types of disaster reside in peripheral areas of countries and are not covered by modern mental health services.
Development of mental health services in Pakistan
Authors: Mubbashar Malik Hussain
Published: January 2018

Pakistan is a country comprising four provinces: Punjab, Sind, Northwest Frontier Province and Baluchistan, in addition to the federally administered tribal areas and the federal capital territory of Islamabad. It is bordered by China, Afghanistan, Iran and India. It has a population of 152 million (excluding an estimated 3–4 million Afghan and Bangladeshi immigrants) and an area of 796 095 km2.
Reducing non-attendance rates in community psychiatry: a case for sustainable development?
Authors: Maughan Daniel L. , Pearce Michael
Published: January 2018

Non-attendance at mental health clinics is an international problem. A survey was conducted in the UK investigating communication methods used by staff to inform and remind patients about appointments. Increased number of communication methods used was associated with a reduced non-attendance rate. A care modelling analysis is provided that explores the healthcare use of three hypothetical patients following clinic non-attendance. The financial and environmental costs of each are then calculated and results discussed. Reducing non-attendance is achievable through the use of multiple communication methods. This small change can improve the sustainability of mental healthcare in different countries by improving quality of care and reducing financial and environmental costs.
Psychosocial rehabilitation for severe mental illnesses in general hospital psychiatric settings in South Asia
Authors: Sood Mamta , Chadda Rakesh K.
Published: January 2018

In South Asia, general hospital psychiatric units (GHPUs) have developed as an alternative to mental hospitals for the provision of comprehensive mental health services, training and research. GHPUs provide clinical care for all types of patients, including those with severe mental illnesses (SMIs). However, psychosocial rehabilitation is often neglected in GHPUs, partly because of the predominance of the medical model in routine clinical care and a lack of resources. This paper discusses the challenges in the management of SMIs in GHPUs and proposes a model of psychosocial rehabilitation which could be used in such settings.
Development of mental health law in Iran: work in progress
Authors: Esfahani Mehdi Nasr , Mirsepassi Gholamreza , Atef-Vahid Mohammad-Kazem
Published: January 2018

A brief account of the three stages of development of a new mental health law in Iran is given. At each stage, the expert opinions of mental health professionals and lawyers interested in the rights of psychiatric patients were obtained. The final draft of the law consists of six sections and 50 articles. It has been submitted for ratification by Parliament.
Mental health and psychosocial support for children in areas of armed conflict: call for a systems approach
Authors: Jordans M. J. D. , Tol W. A.
Published: January 2018

This paper focuses on the question of whether separate attention to children who have faced specific conflict-related events is justified, or whether the scarce resources for mental health should be spent on the development of services for children more broadly in low- and middle-income countries (where most contemporary armed conflicts are taking place). It is argued that a systems approach to mental health and psychosocial support for children is warranted.
Social sciences and medical humanities: the new focus of psychiatry
Authors: Bhugra Dinesh , Ventriglio Antonio
Published: January 2018

The clinical practice of psychiatry should incorporate a biopsychosocial model of illness, acknowledging both cultural and social influences on the patient's experience. Medical humanities include a number of academic disciplines that complement the clinical practice of psychiatry. The medical profession, including psychiatry, has a social responsibility to study the psychosocial context within which people become ill and have to be treated. Although the biopsychosocial model of illness has strong theoretical foundations, its application in clinical practice is limited. A new approach would be to restructure medical student teaching to include medical humanities in the first year, and to share such education with other professions.