bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teleconsultation Program for Deployed Soldiers and Healthcare Professionals in Remote and Austere Environments
Authors: McManus John , Salinas Jose , Morton Melinda , Lappan Charles , Poropatich Ron 
Published: April 2019

AbstractBackground: In April 2004, the US Army Medical Department approved the use of the Army Knowledge Online (AKO) electronic e-mail system as a teleconsultation service for remote teledermatology consultations from healthcare providers in Iraq, Kuwait, and Afghanistan to medical subspecialists in the United States. The success of the system has resulted in expansion of the telemedicine program to include 11 additional clinical specialty services: (1) burn-trauma; (2) cardiology; (3) dermatology; (4) infectious disease; (5) nephrology; (6) ophthalmology; (7) pediatric intensive care; (8) preventive and occupational medicine; (9) neurology; (10) rheumatology; and (11) toxicology. The goal of the program is to provide a mechanism for enhanced diagnosis of remote cases resulting in a better evacuation system (i.e., only evacuation of appropriate cases). The service provides a standard practice for managing acute and emergent care requests between remote medical providers in austere environments and rear-based specialists in a timely and consistent manner.Methods: Consults are generated using the AKO e-mail system routed through a contact group composed of volunteer, on-call consults. The project manager receives and monitors all teleconsultations to ensure Health Insurance Portability and Accountability Act compliance and consultant's recommendations are transmitted within a 24-hour mandated time period. A subspecialty “clinical champion” is responsible for recruiting consultants to answer teleconsultations and developing a call schedule for each specialty. Subspecialties may have individual consultants on call for specific days (e.g., dermatology and toxicology) or place entire groups on-call for a designated period of time (e.g., ophthalmology).Results: As of May 2007, 2,337 consults were performed during 36 months, with an average reply time of five hours from receipt of the teleconsultation until a recommendation was sent to the referring physician. Most consultations have been for dermatology (66%), followed by infectious disease (10%). A total of 51 known evacuations were prevented from use of the program, while 63 known evacuations have resulted following receipt of the consultants' recommendation. A total of 313 teleconsultations also have been performed for non-US patients.Conclusions: The teleconsultation program has proven to be a valuable resource for physicians deployed in austere and remote locations. Furthermore, use of such a system for physicians in austere environments may prevent unnecessary evacuations or result in appropriate evacuations for patients who initially may have been “underdiagnosed.”
Survey of Bam Earthquake Survivors' Opinions on Medical and Health Systems Services
Authors: Nia Masoud Saghafi , Nafissi Nahid , Moharamzad Yashar 
Published: April 2019

AbstractIntroduction: On 26 December 2003, a catastrophic earthquake measuring 6.6 on the Richter scale devastated large areas of the city of Bam in south-eastern Iran. More than 40,000 people died, tens of thousands were injured, and almost 20,000 homes were destroyed.Many national and international search-and-rescue teams were dispatched to the area to provide medical and health services and assist in the evacuation of survivors to undamaged areas.Problem: The purpose of the study was to evaluate the opinions of survivors about medical responses provided, and the process of reconstruction of health infrastructures.Methods: This was a descriptive study performed two years after the earthquake. Stratified, two-stage area sampling was used to enroll 211 survivors into the survey. A designed questionnaire was applied to evaluate the respondents' opinions about medical and health responses. The respondents were asked to score their satisfaction on a variety of services on a five-point scale, with 1 being “very poor” and 5 being “very good”.Results: Family members and relatives comprised the majority of first responders for those injured or trapped (127, 60.2%). Field hospitals deployed by the Red Crescent, international relief teams, and military forces were the first medical facilities for 98 (46.4%) of the casualties. As denoted by the mean values for the satisfaction scores, transportation by aircraft to the backup hospitals received the highest score (4.2), followed by international assistance (4.1), first medical care (3.5), search and rescue (3.3), primary transportation (3.1), and reconstruction and the quality of access to the infrastructures of the city (2.6). Two years after the earthquake, 151 (71.5%) respondents still were living in connexes (temporary accommodations or shelters for victims to live in; resemble a small hotel), only 33 (15.6%) had access to safe drinking water, and 44 (20.9%) did not have sufficient supplies of sanitary food.Conclusions: In addition to reinforcing the medical and health infrastructures of a society in accordance with geographical and architectural characteristics, effective air evacuation and relief missions carried out by experienced international relief teams can play an important role in the appropriate management of approximately 30,000 casualties after a catastrophic event, such as experience with the Bam Earthquake.
The SIEP-DIRECT's Project on the discrepancy between routine practice and evidence in the treatment of schizophrenia. The design, the indicators, and the methodology of the study
Authors: Semisa Domenico , Lora Antonio , Morosini Pierluigi , Ruggeri Mirella 
Published: April 2019

SUMMARYAims– The aims of the SIEP-DIRECT'S Project (DIscrepancy betweenRoutine practice andEvidence in psychiatricCommunityTreatments onSchizophrenia) are: 1) To evaluate the appropriateness of the NICE guidelines for schizophrenia in Italian Departments of Mental Health; 2) to develop and to test a set of SIEP indicators, based on the NICE recommendations, useful to evaluate their real application in mental health services.Methods– Based on the NICE recommendations, 103 indicators have been developed, some of them qualitative and the rest quantitative. These indicators investigate five different areas: 14 indicators concern the common elements in all phases of mental health care; 11 the treatment of first episode; 24 the crisis treatment; 41 the recovery promotion; 13 the urgency, including management of violent behaviours and fast soothing. After a pilot study conducted in 2 community mental health services, the indicators were tested in 19 Italian Departments of Mental Health, to obtain a self-evaluation of the quality of care and to verify the application of NICE recommendations in the clinical routine of these Services. Data for the self-evaluation have been obtained from the DSM'ls psychiatric informative system and from the Direction of the local health authorities or of the DSM. Moreover, for some indicators, information has been gathered from the clinical records, and by means of questionnaires administered to a sample of patients and relatives. Finally, “multidisciplinary” (i.e. involving different types of professionals) or “specialized” (i.e. involving only psychiatrists) focus groups have assessed the degree of similarity between practice and recommendation for 33 indicators. Finally, the focus group methodology has been applied in all services with the aim to judge the appropriateness of each NICE recommendation in the context of the Italian Departments of Mental Health.Results and Conclusions– Most NICE recommendations have been considered useful and appropriated to measure quality of care in the context of the Italian services. The SIEP indicators have been easily used by the services participating in the DIRECT's Project. The self-evaluation process has provided several data of great relevance to improve the quality of care for schizophrenia and implement clinical guidelines in Italy.Declaration of Interest: None.
Language disturbances in schizophrenia
Authors: Bellani Marcella , Perlini Cinzia , Brambilla Paolo 
Published: April 2019

AbstractLanguage disturbances represent a core feature of schizophrenia, affecting social interactions and quality of life. Here we summarize linguistic and pragmatic deficits and illustrate the role of brain imaging studies in delineating the neural substrates of language deficits in patients with schizophrenia.
Seasonal affective disorder and latitude of living
Authors: Brancaleoni Greta , Nikitenkova Elena , Grassi Luigi , Hansen Vidje 
Published: April 2019

SUMMARYAim – Since the importance of latitude of living for the prevalence of Seasonal Affective Disorder (SAD) is unclear, the study aims to test the latitude hypothesis by comparing SAD in two rather similar groups of students living at latitudes far apart. Methods – Two groups of students, 199 in Tromsø, Norway (690 N) and 188 in Ferrara, Italy (440 N) were asked to fill in the Seasonal Pattern Assessment Questionnaire. Results – Global Seasonality score (GS-score) was significantly higher in Italian than in Norwegian students, in females and in students with sleeping-problems. Norwegian students had significantly higher SAD prevalence in winter and in spring. Most people in both countries felt worst in October and November, and the prevalence of Autumn SAD was not significantly different between the two countries. Conclusions – The hypothesis that SAD is linked to amount of environmental light and latitude of living was not supported.Declaration of Interest: The study was fully financed by the University of Tromsø and the University Hospital North Norway, and there are no conflicts of interests.
The contribution of epidemiology to defining the most appropriate approach to genetic research on schizophrenia
Authors: Tosato Sarah , Lasalvia Antonio 
Published: April 2019

AbstractPsychosis is thought to have a strong genetic component, but many efforts to discover the underlying putative schizophrenia genes have yielded disappointing results. In fact, no strong associations emerged in the first genome-wide association studies in psychiatry and weakly observed associations were not related to the candidate genes identified in previous studies. These partially successful findings may be explained by the fact that genetic research in psychiatry suffers from confounding issues related to phenotype definition, the considerable degree of phenotypic variability and diagnostic uncertainty, absence of specific neuropathological features and environmental influences. To make progress it is first necessary to deconstruct psychosis based on symptomatology, and then to correlate particular phenotypes with genetic variants. Moreover, it is time to conduct studies that define persistent aspects of the schizophrenic profile that are more likely to represent an underlying biological pathogenesis, as opposed to fluctuating symptoms that are possibly environmentally mediated. In fact, progress in understanding the etiology of schizophrenia will depend upon the availability of good measures of genetic liability as well as relevant environmental exposures during critical periods of an individual's life. If environmental and/or genetic factors are not precisely measured, it is impossible to study their independent effects or interactions.
Dissecting the many genetic faces of schizophrenia
Authors: Rujescu Dan , Collier David A. 
Published: April 2019

AbstractRecent genome-wide association studies in schizophrenia have provided strongest evidence for association and this strengthened when the affected phenotype included bipolar disorder suggesting that genes may not always associate with operationalised diagnostic entities. Several further large Genome Wide Association (GWA) studies on schizophrenia are under way and identified and replicated further loci in well-powered cohorts. The last 2 years have also witnessed an explosion of interest in human Copy Number Variants (CNVs). Deletions recently identified in schizophrenia (1q21.1; 2p16.3; 15q11.2; 15q13.3) have also been most recently found in further neurodevelopmental diseases. Thus, a significant fraction of individuals with neurodevelopmental diseases including schizophrenia carry CNVs and many will be defined as “genomic disorders” in the coming years. These findings could represent a decisive step towards understanding the causes of this severe mental disorder as well as developing new potential treatments. There is new hope that these new avenues will help understanding the neurobiology of schizophrenia in more depth leading to the development of new innovative diagnostic tools and therapies as was the case after the discovery of rare APP and presenilin 1 and 2 mutations in Alzheimer's disease.
Drug attitude and subjective well-being in antipsychotic treatment monotherapy in real-world settings
Authors: Balestrieri Matteo , Sciascio Guido Di , Isola Miriam , Lomonaco Emanuele , Maso Elisa , Merli Roberto , Calò Salvatore , Bellantuono Cesario 
Published: April 2019

SummaryAims– To assess using two well-know scales (DAI-30 and SWN) the drug attitude and subjective well-being of patients treated with haloperidol or second-generation antipsychotics (SGA) in four different Italian communities.Methods– The sample included 145 patients taking five different antipsychotics (APs) in mono-therapy: haloperidol, clozapine, olanzapine, risperidone, quetiapine. A stepwise multiple regression analysis (SMRA) was used to analyse the contribution of different AP treatments and of other predictors to SWN and DAI-30 scores. Results – Univariate analyses showed no differences in DAI-30 and SWN scores across treatments. The SMRA showed that SWN scores were negatively correlated with the severity of the psychoses (BPRS scores), while the DAI-30 scores were negatively correlated with the severity of the psychoses and positively correlated both with the length of drug treatment and with the use of olanzapine. Conclusions – Our study does not confirm a better drug attitude in patients treated with SGA with respect to haloperidol. The only partial exception is the better performance of olanzapine over haloperidol on DAI-30, which could be due to the lower use of anticholinergic drugs during olanzapine treatment. The differences between the SWN and DAI-30 may give good reason for the use of both instruments during AP treatments.Declarationof Interest: No grants have been received for this study. In the last two years: Matteo Balestrieri has received grants from AstraZeneca, Eli Lilly, BMS, Janssen-Cilag, Boehringer-Ingelheim, Innova-Pharma, Pfizer, Bristol, Abbott, Lundbeck; Guido Di Sciascio has received grants from AstraZeneca, Eli Lilly, BMS, Janssen-Cilag, Sanofi-Aventis, Wyeth, Boehringer- Ingelheim; Elisa Maso has received grants from Pfizer; Cesario Bellantuono has received grants from Eli Lilly, BMS, Boehringer- Ingelheim, Innova-Pharma, Italfarmaco; The other authors have not received any grants in the last two years.
Per una storia dell'affidamento dei malati psichiatrici alle famiglie: Towards a history of the family care of psychiatric patients
Authors: Guarnieri Patrizia 
Published: April 2019

SummaryInserting adults with psychic problems into families has recently been practiced in various European countries and also in Italy, where some mental health departments support such families. Beyond the well known story of Gheel, the etero and omofamily care of psychiatric patients has a forgotten history. Methods – On the basis of unexplored and exceptionally rich sources from the archives of the asylums in Florence, as well as of the Province di Florence, which funded assistance to the mentally ill – this research focuses on the subsidized “domestic custody” of hundreds of psychiatric patients, who had already been institutionalized. Beginning in 1866, outboarding was supported by the provincial administration in Florence with the collaboration of the asylum medical direction. Results – In the late 19th C. and in the early 20th C. prestigious psychiatrists sought alternatives to the institutionalisation. These alternatives involved varied participants in a community (the patients and their families, the administrators and the medical specialists, the neighborhood and the police). The families played a special role that historians of the psychiatry exclusively dedicated to the insane asylums have not really seen. Conclusions – The role of the families in the interaction with the psychiatric staff is not, even on a historiographical level, simply an additional and marginal chapter of the practices and of the culture of the mental health. These archival evidence contradicts some common places on the past of the Italian psychiatry before 1978, and provokes new reflections of possible relevance to the present.
Developing mental health services in response to research evidence
Authors: Killaspy Helen , Johnson Sonia , King Michael , Bebbington Paul 
Published: April 2019

AbstractOver the last thirty to forty years, psychiatric care in England has relocated from hospital-based settings to community mental health teams (CMHTs) and supported accommodation. Since the 1980s, two forms of intensive home based treatment have evolved in addition to CMHTS, assertive community treatment (ACT) and crisis resolution teams (CRTs). On the basis of evidence for their efficacy in the US and other countries, they have been implemented across England through the Government's National Service Framework for Mental Health. This paper describes this evidence and the first UK studies that were carried out to evaluate these newly implemented services.Methods– Descriptions of the evaluations of ACT and CRTs in the inner London boroughs of Camden and Islington.Results– The implementation of CRTs in North London were associated with reduced use of inpatient services, but the ACT teams were not. Both types of team were associated with greater patient satisfaction with services and the ACTs were better able to engage patients than CMHTs.Conclusions– The authors comment on the implications of the findings for service planners in terms of the difficulties in implementing innovative approaches based on the best available evidence when it originates outside the local context.Declaration of Interest:These studies were funded by Camden and Islington Health Authority, the King's Fund and the Department of Health.
Loss to follow-up in longitudinal psychiatric research
Authors: Eichler Tilly , Schützwohl Matthias , Priebe Stefan , Wright Donna , Adamowski Tomasz , Rymaszewska Joanna , Nawka Petr , Ocvár Ladislav , Kitzlerova Eva , Raboch Jiri , Kallert Thomas W. 
Published: April 2019

SummaryAims – To analyse factors that differentiate patients who attend follow-up assessments versus those who do not, and to identify predictors for drop-out within the context of the European Day Hospital Evaluation Study (EDEN-Study). Methods – The EDEN-Study, a multi-center RCT comparing acute psychiatric day care with inpatient care, required re-assessment of patients at discharge, 3 and 12 months after discharge. Follow-up rates varied between 54.0% and 99.5%. Socio-demographic and clinical characteristics of patients who did and did not attend follow-up were analysed using uni- and multivariate statistical methods. Results – Univariate analyses showed differences between patients regarding study site, treatment setting, living situation, employment, age, psychopathological symptoms and treatment satisfaction. They were not confirmed in multivariate analyses thus meaningful predictors of drop-out could not be identified. Conclusions – Results emphasize the general need to compare patients re-assessed and not re-assessed in terms of their most relevant socio-demographic and clinical variables to assess the generalizability of results.Declaration of Interest: EDEN (Psychiatric day hospital treatment: An alternative to inpatient treatment, being cost-effective and minimizing post-treatment needs for care? An evaluative study in European countries with different care systems) was funded by the European Commission (Quality of Life and Management of Living Resources Programme: QLG4-CT-2000-01700). Additional national grants supporting the project were provided by Roland-Ernst-Stiftung für Gesundheitswesen and the Faculty of Medicine at the Dresden University of Technology, the National Health Service Executive Organization and Management Programme, the Polish National Committee of Scientific Affairs, and the Slovak Ministry of Education. Pfizer Pharmaceutical Company supported travel and accommodation for EDEN project meetings.
What Next? Shostakovich's Sixth Symphony as Sequel and Prequel
Authors: MORRISON SIMON 
Published: April 2019

AbstractFor Dmitri Shostakovich, reaching the heights of the Soviet musical establishment proved easier than staying there. He triumphed with his Fifth Symphony of 1937, which marked the composer's return to official favour after the denunciation of his second opera and third ballet. Following that success, Shostakovich faced the problem of the sequel: whether or not, in the Sixth Symphony, to repeat, refute, or re-inscribe. I propose Shostakovich first thought about going big with his new project, composing a grand text-based score about Lenin, and then considered going small, grounding the first movement in folk fare and mixing light genres in the others. But in the end, he chose a more experimental approach. The Sixth Symphony collapses boundaries, both semantic and syntactic, pulling them back from a fixed state into a play of possibilities.
Global Isotope Hydrogeology―Review
Authors: Jasechko Scott 
Published: April 2019

AbstractGroundwater 18O/16O, 2H/1H, 13C/12C, 3H, and 14C data can help quantify molecular movements and chemical reactions governing groundwater recharge, quality, storage, flow, and discharge. Here, commonly applied approaches to isotopic data analysis are reviewed, involving groundwater recharge seasonality, recharge elevations, groundwater ages, paleoclimate conditions, and groundwater discharge. Reviewed works confirm and quantify long held tenets: (i) that recharge derives disproportionately from wet season and winter precipitation; (ii) that modern groundwaters comprise little global groundwater; (iii) that “fossil” (>12,000‐year‐old) groundwaters dominate global aquifer storage; (iv) that fossil groundwaters capture late‐Pleistocene climate conditions; (v) that surface‐borne contaminants are more common in younger groundwaters; and (vi) that groundwater discharges generate substantial streamflow. Groundwater isotope data are disproportionately common to midlatitudes and sedimentary basins equipped for irrigated agriculture, but less plentiful across high latitudes, hyperarid deserts, and equatorial rainforests. Some of these underexplored aquifer systems may be suitable targets for future field testing.