bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Manual Cuff Palpation to Confirm Proper Endotracheal Tube Depth
Authors: Ledrick David , Plewa Michael , Casey Kevin , Taylor Jay , Buderer Nancy 
Published: April 2019

AbstractIntroduction: In the prehospital setting, optimal endotracheal tube (ETT) depth may be approximated using the patient's sex or height, and assessed by auscultation. Even when using these methods, the ETTs still may be placed at inappropriate depths.Problem: This study assessed the inter-rater reliability and accuracy of manual cuff palpation (ballottement) at excluding an improperly placed ETT depth in adult patients.Methods: This is a prospective, observational, pilot study in a convenience sample of adults recently intubated in the prehospital, medical floor, intensive care unit, or emergency department settings of an urban, teaching hospital. Two physician participants separately performed ballottement on each intubated subject and rated the ballottement as none, weak, or strong prior to assessment of appropriate depth using a chest radiograph (CXR). Results were compared for simple agreement and compared to the CXR to estimate accuracy.Results: Of 163 patients, 27 (17%) had an inappropriate ETT depth. Physician assessments of ballottement agreed in 79% of patients (95% CI = 72-85%). Chest radiograph assessment found the ETT in the “strong” ballottement group properly placed in 93%, as compared to 77% in the “weak”, and 42% in the “none” groups. Combining “weak” and “strong” ballottement, the sensitivity was 96% (95% CI = 93–100%), specificity was 26% (95% CI = 9–43%), and accuracy was 85% (95% CI = 79–90%).Conclusions: Manual cuff palpation is a simple and reproducible technique that is sensitive, but nonspecific, in identifying intubations of appropriate depth.
A cognitive behavioural perspective on the relationship between childhood trauma and psychosis
Authors: Morrison Anthony P. 
Published: April 2019

AbstractThis editorial reviews the relationship between childhood trauma and the development of psychosis in adulthood. There are numerous studies, including large, prospective studies, which clearly support a link between childhood adversity and experience of psychosis later in life. There is also evidence that there is a dose response relationship, and that childhood trauma is particularly associated with the experience of hallucinations and delusional ideas. It is possible that psychosis is a relatively understandable response to the experience of severe trauma, and recent cognitive models of psychosis can help to explain the underlying mechanisms in such a causal relationship. There are obvious treatment implications, which include the need to assess histories of childhood trauma in people with psychosis, the incorporation of trauma in shared understandings of psychosis with service users, the incorporation of change strategies in cognitive behaviour therapy for psychosis that are derived from evidence-based approaches to the treatment of trauma and PTSD, and the prevention of traumatisation by mental health services.Declaration of Interest: None.
Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms
Authors: Read John , Bentall Richard P. , Fosse Roar 
Published: April 2019

AbstractMental health services and research have been dominated for several decades by a rather simplistic, reductionistic focus on biological phenomena, with minimal consideration of the social context within which genes and brains inevitably operate. This ‘medical model’ ideology, enthusiastically supported by the pharmaceutical industry, has been particularly powerful in the field of psychosis, where it has led to unjustified and damaging pessimism about recovery. The failure to find robust evidence of a genetic predisposition for psychosis in general, or ‘schizophrenia’ in particular, can be understood in terms of recently developed knowledge about how epigenetic processes turn gene transcription on and off through mechanisms that are highly influenced by the individual's socio-environmental experiences. To understand the emerging evidence of the relationship between adverse childhood events and subsequent psychosis, it is necessary to integrate these epigenetic processes, especially those involving the stress regulating functions of the HPA axis, with research about the psychological mechanisms by which specific types of childhood trauma can lead to specific types of psychotic experiences. The implications, for research, mental health services and primary prevention, are profound.Declaration of Interest: None of the authors have any conflicts of interest in relation to this paper.
Problems in psychiatric care of ‘difficult patients’: a Delphi-study
Authors: Koekkoek Bauke , Meijel Berno Van , Schene Aart , Hutschemaekers Giel 
Published: April 2019

SUMMARYAims– ‘difficult patients’ may evoke strong feelings in health professionals. The ambivalent attitude of, especially, non-psychotic chronic patients towards psychiatric care may be frustrating and burdensome to professionals. Many of these patients are cared for in non-specialized services, where professionals are often more used to working with psychotic patients. Specific problems with ‘difficult’ non-psychotic patients may occur, and hamper the quality of care offered. The aim of this research is to determine precisely what problems psychiatric professionals perceive in contact with non-psychotic chronic patients in order to identify starting points for alternative or improved care in non-specialized services.Methods– a modified five-phase Delphi study with three groups of eight participants from was used to identify and prioritize experts' judgments.Results– 46 problems were identified of which some were relevant to one or two subgroups and some were relevant to the entire group.Conclusions– a program that combines a coherent view at services level, with support and increased communication at the interprofessional level (e.g. through regular supervision, sharing of case-loads) may be highly beneficial to non-specialized services.Declaration of Interest: None for any author. Funding for this study was provided by ZonMW ‘Geestkracht’ (Grant 100–002–031), Altrecht Mental Health Care and Gelderse Roos Mental Health Care.
Diet, smoking and cardiovascular risk in schizophrenia in high and low care supported housing
Authors: Gupta Avirup , Craig Tom K. J. 
Published: April 2019

SUMMARYBackground – People suffering from schizophrenia have markedly increased physical morbidity and mortality. A poor diet and sedentary lifestyle make a significant contribution to this ill health. Healthcare professionals need to include assessments of diet and to promote a ‘healthy living’ lifestyle. Aims – To describe the dietary habits and cardiovascular risk factors of people with chronic schizophrenia living in supported accommodation and to audit the provision of cardiovascular health screening in this population. Method – The dietary habits of 69 people with chronic schizophrenia living in community settings were assessed. Tobacco smoking, body mass indices and waist circumference were also measured. The dietary behaviour of patients living in high care settings with care staff present every day was compared with those in low care settings. Results – Residents in both levels of care made poor dietary choices. Patients in high care were consuming more fast food than those in low care. The dietary habits of men and women in both levels of care were worse than reported by surveys of the general population in England. All patients had seen their GP in the previous year though only 3 had received diabetes screening and fewer than half had lipid profiles. Conclusions – People with schizophrenia do not improve their diet just by the provision of healthy food as was the case in high care settings. Secondary care services must address physical health monitoring as well as mental health if the increased mortality of patients with schizophrenia is to be addressed effectively. More effective interventions are necessary to improve and sustain a healthy diet.Declaration of Interest: Nothing to declare.
Strange bedfellows: economics, happiness and mental disorder
Authors: Cooper Brian 
Published: April 2019

SUMMARYAim – The high economic and social costs associated with the ‘common mental disorders’, and the need to scale up appropriate care services, are now widely recognized, but responses vary from country to country. In Britain, a current government initiative to promote psychological therapy is driven both by economic pressures and by research on the factors of happiness, or life-satisfaction. This article provides a short critical review of the project. Method – A health policy analysis, with regard to problem definition; objectives; sources of information; criteria for evaluation; impact on existing services, and comparison with alternative strategies. Results – The new programme, Improving Access to Psychological Therapies (IAPT), aims to expand treatment services by training 3,600 ‘psychological therapists’ in cognitive behavioural therapy (CBT), which they will then apply in the wider community. This service, with an initial budget of £173 million, will provide treatment for depression and chronic anxiety from local centres across the country. The programme is intended to pay for itself by reducing incapacity costs. Closer examination, however, raises questions concerning the project’s theoretical basis, logistics and research methodology, and casts doubt on its advantages over alternative approaches. Conclusions – The IAPT project is ill-designed to achieve its objectives and unsuitable as a model for treatment and care of the common mental disorders in other countries. An alternative strategy, based on closer integration of community mental health and primary health care, should be tested and on previous experience seems likely to prove more cost-effective.Declaration of Interest: None.
Patterns of benzodiazepine use in a Canadian population sample
Authors: Esposito Eleonora , Barbui Corrado , Patten Scott B. 
Published: April 2019

SUMMARYAim – The objective of this study was to identify clinical and demographic factors that may be associated with benzodiazepine treatment, to describe the reported reasons for use of these medications and to appraise the pattern of use in relation to standard guidelines in a general population sample. Methods – Telephone survey methods were employed to select a sample of 3345 people between the ages of 18 and 64. A computer assisted telephone interview, including the Mini Neuropsychiatric Diagnostic Interview (MINI), was administered. Estimates were weighted for design features and population demographics. Results – The overall prevalence of benzodiazepines use was 3.3% (95% confidence interval [CI] 2.6 to 4.1%). There was a higher frequency of medication use in women than men, among respondents who were widowed, separated or divorced, and those with lower levels of education. In relation to MINI diagnosis, diagnoses of Panic Disorder and Major Depression increased the probability of taking benzodiazepines. The reported main reason for use was “Sleep disorders” (68.9%), “Anxiety” (35.8%), “Depression” (27.8%) and “Pain management” (21.2%). More than 80% of subjects were taking benzodiazepines for more than one year. Conclusions – When compared to previous estimates, the lower frequency of benzodiazepines use suggests that there has been improvement in their evidence-based use at a population level. However our results once more confirm the difficulty stopping the use of these medications once they have been started. Further randomized control studies may help clinicians in having a better practical approach to rational benzodiazepine use.Declaration of Interest: None.
Family burden in bipolar disorders: Results from the Italian Mood Disorders Study (IMDS)
Authors: Magliano Lorenza , Orrico Ada , Fiorillo Andrea , Vecchio Heidegret Del , Castiello Giuseppina , Malangone Claudio , De Rosa Corrado , Capuano Vittorio , Maj Mario ,   The Imds Working Group
Published: April 2019

SummaryAims – To explore: a) the burden of care, and the professional and social support in relatives of patients with bipolar disorders; b) the psychosocial interventions provided to patients and their families by Italian mental health centres. Methods – 342 outpatients with a bipolar disorder and their key-relatives were randomly recruited in 26 Italian mental health centres, randomly selected and stratified by geographical area and population density. Family burden was explored in relation to: a) patient's clinical status and disability; b) relatives’ social and professional support; c) interventions received by patients and their families; d) geographical area. Results – In the previous two months, global functioning was moderately impaired in 36% of the patients, and severely impaired in 34% of them. Twenty-one percent of patients attended a rehabilitative programme, and 3% of their families received a psychoeducational intervention. Burden was higher when patient's symptoms and disability were more severe, the relatives had poorer psychological support and help in emergencies by the social network, and the family lived in Southern Italy. Differences in family burden in relation to geographical area disappeared when psychosocial interventions were provided. Conclusion – This study highlights the need to increase the availability of rehabilitative interventions for patients with bipolar disorders and of psychological support for their families, especially in Southern Italy.
The implementation of mental health information systems in developing countries: Challenges and opportunities
Authors: Ndetei David M. , Jenkins Rachel 
Published: April 2019

AbstractThe aims are to examine the challenges and opportunities in the implementation of mental health information systems (MHIS) in developing countries as suggested by the World Health Organization (WHO) and explored by Gulbinat et al. (2008). Special recommendations for developing countries are: 1) MHIS should be linked to the general medical information system; 2) there is need for adoption, adaptation and validation of preferably self-administered instruments that are appropriate for different levels within the health care system; 3) developing countries must adopt innovative and “unconventional” approaches through utilization of community members, traditional doctors/healers and mid-cadre health workers, in addition to general doctors, for the delivery of mental health services.
What people with schizophrenia think about the causes of their disorder
Authors: Magliano Lorenza , Fiorillo Andrea , Vecchio Heidegret Del , Malangone Claudio , Rosa Corrado De , Bachelet Carla , Truglia Elisabetta , D'ambrogio Rosa , Pizzale Fabrizia , Veltro Franco , Zanus Paola , Pioli Rosaria , Maj Mario 
Published: April 2019

SummaryAims – To describe what users with schizophrenia think about the causes of their disorder. Methods – In each of the 10 participating Italian mental health centres, 25 users with schizophrenia were consecutively recruited and asked to complete the Users' Opinions Questionnaire (UOQ). Results – 150 out of 198 respondents mentioned at least one social cause for their mental disorder, and 114 reported exclusively social causes. Family conflicts were the most frequently reported social cause (21%), followed by traumas (20%), work and study difficulties (17%), and psychological disturbances (17%). Ten percent of the respondents mentioned biological causes. Biological causes were more frequently reported by users who were aware of their diagnosis of schizophrenia, whereas social causes by those who just knew they suffered from a psychosis. Difficulties in social relationships were more frequently pointed out by respondents with an earlier onset of the illness and a higher number of compulsory admissions in the previous 12 months. These users expressed more scepticism about the usefulness of the treatments they received, and perceived a greater social distance. Conclusions – Users' beliefs about the causes of their disorder should be taken into account by psychiatrists in order to improve their working alliance with them.Declaration of Interest: None of the authors has had any interest or he/she has received any form of support, including that from drug companies and honoraria for lectures and consultancies, potentially in conflict with this scientific work. None of the authors has received any form of fee for his/her participation in this study. This study was supported by a grant received from the “M. Lugli” Foundation (grant no. 2–18–8).
So what shall we do about assertive community treatment?
Authors: Johnson Sonia 
Published: April 2019

AbstractThe usefulness of Assertive Community Treatment (ACT) in European countries with well-developed community care systems has been disputed, despite considerable relevant literature. This paper aims to assess reasons for and against implementing ACT in such countries. ACT may not be useful where generic community mental health teams are not yet well-developed, where admission rates are already low, or where an alternative model based on close integration of a full range of types of care is in place. Good reasons for introducing ACT include listening to patients' preferences, being able to monitor a high risk group of patients more successfully, good staff satisfaction, and the potential for using ACT teams as a platform for delivering interventions for difficult to treat psychosis. The ACT model is more likely to thrive in future if a recovery orientation can be adopted.
The Outcome Questionnaire 45.2. Italian validation of an instrument for the assessment of phychological treatments
Authors: Chiappelli Marco , Coco Gianluca Lo , Gullo Salvatore , Bensi Luca , Prestano Claudia 
Published: April 2019

SummaryAims– The Outcome Questionnaire (OQ-45.2; Lambertet al., 2004) was designed to measure important areas of functioning (symptoms, interpersonal problems and social role functioning) that are of central interest in mental health. The crosscultural validity of the OQ-45.2 in the Italian population has been examined by comparing the psychometric properties and equivalence in factor structure and normative scores of the Italian OQ with the original American version.Method– Data were collected at university (N=461), in community (N=61) and in three mental health care organisations (N=301).Results– Results showed that the psychometric properties of the Italian OQ were adequate and similar to the original instrument. The CFA supported the multidimentional construct system of the instrument. Furthermore, normative scores were different for the Italian and American samples and this resulted in different cutoff scores for estimating clinically significant change in the Italian population.Conclusions– The Italian version of the OQ-45.2 appears promising as a measure of general psychological distress, and it could be used to measure the psychotherapy outcome in routine clinical practice.Declaration of Interest:
TH YAU NUMBER OF ISOLATED HYPERSURFACE SINGULARITIES AND AN INEQUALITY CONJECTURE
Authors: HUSSAIN NAVEED , YAU STEPHEN S.-T. , ZUO HUAIQING 
Published: April 2019

AbstractLet $V$ be a hypersurface with an isolated singularity at the origin defined by the holomorphic function $f:(\mathbb{C}^{n},0)\rightarrow (\mathbb{C},0)$. The Yau algebra $L(V)$ is defined to be the Lie algebra of derivations of the moduli algebra $A(V):={\mathcal{O}}_{n}/(f,\unicode[STIX]{x2202}f/\unicode[STIX]{x2202}x_{1},\ldots ,\unicode[STIX]{x2202}f/\unicode[STIX]{x2202}x_{n})$, that is, $L(V)=\text{Der}(A(V),A(V))$. It is known that $L(V)$ is finite dimensional and its dimension $\unicode[STIX]{x1D706}(V)$ is called the Yau number. We introduce a new series of Lie algebras, that is, $k$th Yau algebras $L^{k}(V)$, $k\geq 0$, which are a generalization of the Yau algebra. The algebra $L^{k}(V)$ is defined to be the Lie algebra of derivations of the $k$th moduli algebra $A^{k}(V):={\mathcal{O}}_{n}/(f,m^{k}J(f)),k\geq 0$, that is, $L^{k}(V)=\text{Der}(A^{k}(V),A^{k}(V))$, where $m$ is the maximal ideal of ${\mathcal{O}}_{n}$. The $k$th Yau number is the dimension of $L^{k}(V)$, which we denote by $\unicode[STIX]{x1D706}^{k}(V)$. In particular, $L^{0}(V)$ is exactly the Yau algebra, that is, $L^{0}(V)=L(V),\unicode[STIX]{x1D706}^{0}(V)=\unicode[STIX]{x1D706}(V)$. These numbers $\unicode[STIX]{x1D706}^{k}(V)$ are new numerical analytic invariants of singularities. In this paper we formulate a conjecture that $\unicode[STIX]{x1D706}^{(k+1)}(V)>\unicode[STIX]{x1D706}^{k}(V),k\geq 0.$ We prove this conjecture for a large class of singularities.
A review of applications of principles of quantum physics in oncology: do quantum physics principles have any role in oncology research and applications?
Authors: Raghunandan Renata , Voll Meaghan , Osei Ernest , Darko Johnson , Laflamme Raymond 
Published: April 2019

AbstractBackground:Research in the applications of the principles of quantum physics in oncology has progressed significantly over the past decades; and several research groups with professionals from diverse scientific background, including electrical engineers, mathematicians, biologists, atomic physicists, computer programmers, and biochemists, are working collaboratively in an unprecedented and pioneering economic, organisational and human effort searching for a wider and more effective, potentially definitive, understanding of the cancers. It is hypothesised that the principles of quantum physics could open new and broader understanding of the cancers and the development of new effective, targeted, accurate, personalised and possibly definitive cancer treatment.Materials and methods:This paper reports on a review of recent studies in the field of the applications of the principles of quantum physics in biology, chemistry, biochemistry and quantum physics in cancer research, including quantum physics principles and cancer, quantum modelling techniques, quantum dots and its applications in oncology, quantum cascade laser histopathology and quantum computing applications.Conclusions:The applications of the principles of quantum physics in oncology, chemistry and biology are providing new perspectives and greater insights into a long-studied disease, which could result in a greater understanding of the cancers and the potential for personalised and definitive treatment methods.
Spanish Musical Responses to Moroccan Immigration and the Cultural Memory of al-Andalus
Authors: MACHIN-AUTENRIETH MATTHEW 
Published: April 2019

AbstractThe notion of a shared history across the Mediterranean is central to a number of Spanish-Moroccan musical collaborations, which draw on the notion ofconvivencia: the alleged peaceful coexistence between Christians, Jews, and Muslims in medieval Spain. In this article, I explore the relationship between a ‘musical’convivenciaand Moroccan immigration in Spain, focusing on two prominent case studies:Macama jonda(1983) andInmigración(2003). Spanning a twenty-year period, I argue that these two productions illustrate shifting responses to Moroccan immigration at distinct historical moments: the post-Franco era and post-9/11. These two productions illustrate the malleability of theconvivenciamyth, employing it for distinct social and political purposes. I argue thatMacama jondaandInmigraciónshould be read as products of shifting political and cultural relations between Spain and Morocco, and Spain's negotiation of its Muslim past.