bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bayesian real options control chart
Authors: Moltchanova Elena 
Published: June 2017

AbstractIn this paper, we present the concept of a novel control chart, which uses economic considerations within the real options–inspired framework together with the principles of Bayesian statistics to produce a continuously updated estimate of the parameters of the actual process, and thus to decide whether to continue running the process or to recalibrate it instead. Bayesian estimate allows the decision maker to combine prior information about the process with the continuously incoming data in a natural flexible manner. In the real options framework, at any given moment, we compare the cost of recalibrating the process to the cost of postponing the (optimal) decision for later. The decision is thus based on cost‐benefit analysis rather than statistically significant deviations from the in‐control process. To have a clear focus on the conceptual representation of the novel methodology, we consider a continuously sampled binary process. We derive the algorithm for the control chart, which can also, in this discrete setting, be represented as a table, a matrix, or a tree. We also investigate the performance of the method in different settings with particular attention being paid to the role of Bayesian prior. Being flexible in prior beliefs leads to better results anywhere outside of the in‐control process. Together, Bayesian paradigm and dynamic decision‐making approach create a realistic representation of a real‐life decision‐making process.
Das Überlesen von Nonsense-Mutationen
Authors: Wiechers Lisa , Samanta Ananya , Nagel-Wolfrum Kerstin 
Published: June 2017

Zusammenfassung
Nonsense-Mutationen weisen eine Inzidenz von etwa 12 % bezogen auf alle krankheitsverursachenden Mutationen auf. Eine ähnliche Rate gilt für Netzhauterkrankungen. Ein speziell auf diesen Mutationstyp ausgerichteter Therapieansatz könnte somit praktikabel und ökonomisch im Sinne einer Therapie „eine für viele“ sein. Nonsense-Mutationen führen zu vorzeitigen Terminationscodons (PTCs), wodurch die Degradation der mRNA über den „nonsense-mediated decay“ (NMD) induziert werden kann oder die Translation am PTC endet und ein verkürztes, zumeist nicht mehr funktionelles Protein synthetisiert wird. Ein pharmakogenetischer Ansatz induziert das Überlesen („read-through“) von PTCs und erlaubt somit die Synthese von vollständigen Proteinen. Die hierbei eingesetzten Wirkstoffe werden als TRIDs („translational read-through inducing drugs“) bezeichnet. Die ersten identifizierten TRIDs gehören zur Klasse der Aminoglykosidantibiotika. Modernere TRIDs sind Amlexanox, Ataluren und Derivate von Aminoglykosidantibiotika. Während Aminoglykoside eine hohe Oto‑, Nephro- und Retinotoxizität aufweisen, zeichnen sich die modernen TRIDs durch eine verbesserte Verträglichkeit aus. Eine Vielzahl von präklinischen Studien belegt die Überlese-Effizienz von TRIDs bei Nonsense-Mutationen und zeigt die Funktionalität der wiederhergestellten Proteine in Zellkultur, Tiermodellen und patientenspezifischen Zellen. Für die Therapie von Netzhauterkrankungen werden systemische und lokale Applikationen evaluiert. Patientenspezifische Zellen stellen ein personalisiertes Screeningmodell für die Identifizierung eines wirksamen TRID dar. Der pharmakogenetische Überlese-Ansatz könnte in Zukunft für jeden Patienten, dessen Netzhauterkrankung durch eine Nonsense-Mutation verursacht wird, eine personalisierte Therapie erlauben.
Identifying and Managing Mental Health Needs of Homeless Individuals
Authors: Bhugra D. 
Published: June 2017

The economic downturn worldwide since 2008 has raised many issues, including an increase in homelessness. Individuals who are homeless are visible across the globe. Definitions of homelessness also vary. Living on the streets in all kinds of inclement weather, brings a different set of issues and problems including physical and mental illnesses. Here homelessness is defined as a lack of customary regular access to a conventional dwelling unit. It has been shown in several studies that nearly half were either depressed or had substance use disorders and half had traumatic brain injury. Homelessness is a social issue and the role of the psychiatrist in reaching these vulnerable individuals is a matter of critical importance. In the UK health services are geographically delineated making it more difficult for ‘out of area’ individuals to get help. The responsibility for looking after people who are homeless, have mental illness or physical co-morbidity, lies with policymakers as well. As clinicians we must advocate for vulnerable patients and psychiatry care needs to be in a joined-up manner. Early interventions and home treatments where and if available are suitable and can be effective but are often linked with secure addresses. Policies must take into account huge variations across cultures and societies and the contributions that unemployment and poverty can play in increasing homelessness. Whether psychiatric disorders lead to homelessness and whether homelessness leads to mental illness is a circular argument and this vicious downward spiral needs to be broken by adequate care and policy support.Disclosure of interestThe author has not supplied his declaration of competing interest.
The Current Status of Women in Psychiatry in Europe
Authors: Frangou S. 
Published: June 2017

For more than two decades, psychiatry has retained its position amongst the medical specialties with the highest proportion of women entering residency programs. The percentage of women in junior academic positions in psychiatry is also high and consistently higher than that of men. However, the number of women in positions of leadership remains disproportionally low at around 5% with no evidence of improvement over time. The phenomenon of female under-representation is not unique to psychiatry or academia. Women are under-represented in all fields of leadership and this is a matter of wider societal concern. In this presentation, I will discuss external and internal barriers that women face and detail positive actions that can help women succeed in their careers.Disclosure of interestThe author has edited and co-authored a book on “Women in Academic Psychiatry: A mind to Succeed”
Forensic Care in Italy: Changes, Illusions and Realities
Authors: De Girolamo G. , Bulgari V. 
Published: June 2017

Violence and the risk of violence posed by patients with severe mental illness is a major public health problem for many reasons. Firstly there is the obvious harm to victims, secondly the counter-therapeutic effect on patients of the violence itself, thirdly the restrictive measures typically deployed by services to manage the violence, and finally the significant additional financial cost of these specialist services. Within mental health services the sometimes inaccurate estimate of risk of violence posed by patients can lead to the frequent use of a variety of coercive measures including involuntary hospitalization, enforced medication, restraint and seclusion. These restrictive and costly interventions are almost unanimously perceived as traumatic by the patients and can, in turn, trigger frustration, therapeutic resistance and even aggression instead of treatment adherence and cooperation.Services for the treatment of psychiatric patients who pose a risk of violence are developing and maturing across Europe. New models of care for this extremely complicated multiple needs clinical population exist. However across Europe intervention strategies and service organization and delivery for these patients are very different, and have never been comparatively evaluated. The lack of reliable comparative data has prevented many European countries benefiting from innovative strategies already tested in those countries which have made the greatest efforts in research and service innovation. In this workshop we will compare the organization and functioning of forensic mental health services in different countries; in particular this presentation will inform about the recent changes in forensic mental health services occurred in Italy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Comorbidity of Depression and Diabetes: Questions Recently Answered and Raised
Authors: Sartorius N. 
Published: June 2017

This paper will present information about a multicentric international collaborative study, which explored the frequency of depressive disorders in people with diabetes Type 2. The study was carried out in 14 countries–5 in Asia (Bangladesh, China, India, Pakistan and Thailand), two in Africa (Kenya and Uganda), two in Latin America (Argentina and Mexico) and five in Europe (Germany, Poland, Russia, Serbia and Ukraine). The study found that depressive disorders and sub threshold depression are frequent in people with diabetes: one tenth of all the nearly 3000 patients examined had major depression and another 15% sub threshold depressive disorders. Depression was only rarely recognized by the physicians dealing with diabetes and those few who were recognized were not provided treatment of their depressive disorders. The presentation will draw attention to the need to improve skills of diagnosis and treatment of psychiatric disorders of physicians who are not psychiatrists.Disclosure of interestThe author has not supplied his declaration of competing interest.
Suicidal behavior among Portuguese psychiatry trainees: Comparison with the European situation
Authors: Marques J. Gama 
Published: June 2017

IntroductionThe aim of this paper was to assess the prevalence of suicide ideation and attempts in Portuguese psychiatry trainees (adult, child and adolescence), and compare the data with the general population and other European countries.Material and MethodsA structured and anonymous questionnaire was sent by email to 159 Portuguese trainees of adult psychiatry, child and adolescence psychiatry with questions about personal history of suicidal ideation and suicide attempts, as well as family history of suicide attempts and completed suicides. This is part of the BoSS Study (Burnout Syndrome Study) performed in 21 countries worldwide. Data was analyzed in SPSS v.19.ResultsFrom the inquired population, 62 trainees (40.3%) partially responded, and 46 (29%) were complete responders - these entered the final analysis. There was a ratio of 2:1 (female: male) and a mean age of 29 years. The suicidal ideation was present in passive form in 44% and in active form in 33%; also, 4.3% of respondents had previous suicide attempts. In first-degree relatives, 22% had attempted suicide and 13% completed suicide.DiscussionThe results are worrying and may be associated with some factors to which this population is exposed.ConclusionIt is necessary further research to better understand this phenomenon, its causes and potential modifiers.Disclosure of interestThe author has not supplied his declaration of competing interest.
Maternal Mental Illness and Early Parenting Interventions
Authors: Sutter-Dallay A.L. 
Published: June 2017

The importance of the “1001 critical days” (conception to age 2) underlies the need to act early in life to enhance children's developmental outcomes. Lack of intervention is likely to affect the children of today but also the generations to come. For adults, transition to parenthood is a major stressful life event. The strong emotional load of this experience can make this transitional period much more challenging for adults with psychological, social and economic vulnerabilities, and lead to unadjusted interactions.Then, applying the “transactional model of development” (Sameroff, 2009) to the early perinatal period helps us to understand how the needs of infants can easily affect a parent's mental state and induce inadequate parenting behaviors. These in turn make the infant's interactions more difficult and the infant's development more likely to be impaired. Perinatal mental health is thus an important public health challenge for it is essential to provide services to enhance maternal and infant emotional well-being at a moment that is simultaneously when the mother's social and emotional vulnerabilities are at their height and a critical time in the child's development.Perinatal mental health policies, including joint care of parents and infants, must provide positive support for the potential virtuous circle between the skills and vulnerabilities of the infant and the parents.This presentation will explore the different types of joined perinatal care for parents and infants that cover a range of services, from parent-infant psychotherapies to joint mother-baby hospitalizations.Disclosure of interestThe author has not supplied his declaration of competing interest.
Psychiatric Trainees’ Experience of their Training in Perinatal Mental Health
Authors: Sönmez E. , Dias M. Casanova , Costa M. Pinto Da 
Published: June 2017

IntroductionApproaching and offering treatment to a patient in perinatal period might be complicated. Often, it is regarded as one of the most difficult aspects in psychiatry. Given the increasing trends in the number of female patients of childbearing age consulting to psychiatric services, it has become an issue that specialists of today and tomorrow need to be well aware of.ObjectivesTo better understand the impact of perinatal mental health training on psychiatric trainees from different countries in Europe who receive such training.MethodsThe European Federation of Psychiatric Trainees conducts annual surveys, directing questions to national trainee representatives, to assess the situation of psychiatric training. EFPT representatives of the countries where perinatal mental health training was reported to be included in psychiatry and/or child and adolescent psychiatry training programmes, namely Germany, France, Malta, Finland and Ireland, were contacted. Qualitative interviews focusing on the confidence (or in confidence) trainees feel when a patient who is planning pregnancy, pregnant or breastfeeding consults to them and the impact of training in perinatal mental health on their attitudes as clinicians were explored.ResultsAlthough theoretical training in perinatal mental health is considered as an important aspect of psychiatry training in general, practical training or rotations are not found as essential. However, being able to benefit to more than one generation was perceived as a source of motivation.ConclusionsPerinatal mental health is appreciated as a critical part of theoretical education by trainees and in countries where a clinical rotation is available, it enhances making more use of resources and consultation possibilities.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Identifying Service and Care Needs from the Users’ Perspective in Treatment-Resistant Schizophrenia
Authors: Rubinstein K. 
Published: June 2017

Exploring service and care needs of patients with treatment-resistant schizophrenia is necessary for a better understanding of their psychosocial functioning, in order to develop rehabilitation goals as well as to provide them with better care.m-RESIST is an innovative project aimed to empower patients with resistant schizophrenia, to personalize treatment by integrating pharmacological and psycho-social approaches, and to develop knowledge related to the illness using predictive models designed to exploit historical and real-time data, based on environmental factors and treatment outcomes.m-RESIST is a system based on computer and cellular applications and wearable computing devices. The system will serve patients, caregivers and clinicians, and include the following functions: Information, Assessment, Monitoring, Communication, and Intervention.The first step in the development process included definition of the end user needs and preferences, in order to involve users in the design of the system. Outpatients with treatment-resistant schizophrenia, informal carers (relatives), and clinicians were included in the sample. There were a total of 9 focus groups, 3 in each pilot country. Each group was composed of one of the participant profiles. Additionally, 35 individual interviews were performed, which were unevenly distributed throughout the 3 institutions.The current workshop section will present the outcomes of this process: perceived advantages and disadvantages of the technological solution, as well as conclusions for further development. In addition, methodological issues, future challenges, relevant for the evolution of the m-RESIST project, in particular, as well as technological developments in the field of mental health, in general, will be discussed.1Disclosure of interestThe author has not supplied his declaration of competing interest.
Elucidating the Neural Circuitry Underlying Individual Differences in Response to Reward-associated Cues
Authors: Flagel S. 
Published: June 2017

Stimuli in the environment that have been associated with reward can gain control over behavior and, in some cases, lead to maladaptive behavior. Reward cues acquire inordinate control when they are attributed with incentive salience or transformed into “motivational magnets” (i.e. incentive stimuli). Individuals vary considerably in the extent to which they attribute incentive motivational value to reward cues, and we can capture this individual variation using an animal model. When rats are exposed to a Pavlovian conditioning paradigm, in which the presentation of a lever-cue is immediately followed by the delivery of a food reward, some rats preferentially approach the lever (sign-trackers, STs) while others approach the food cup (goal-trackers, GTs). Importantly, while the lever is a predictor for both STs and GTs, only for STs does it become an incentive stimulus. Thus, this model allows us to parse the neurobiological mechanisms underlying predictive vs. incentive learning processes. Using this model, we have demonstrated that dopamine is critical for incentive, but not predictive, learning and that the cortico-thalamic-striatal “motive circuit” is engaged only by incentive stimuli. In addition, we have identified the paraventricular nucleus of the thalamus (PVT) as a central node that differentially regulates sign- and goal-tracking behaviors. We have begun to utilize a chemogenetic approach (i.e. DREADDs) in combination with in vivo microdialysis to further elucidate the neural circuitry underlying individual variation in cue-motivated behaviors. Findings suggesting that STs rely primarily on subcortical mechanisms, whereas GTs utilize more “top-down” cortical processes will be presented and discussed.Disclosure of interestThe author has not supplied his declaration of competing interest.
Age at the Onset of a First Episode of Psychotic Mania: Does it Have an Impact on Outcome?
Authors: Conus P. , Cotton S.M. , McGorry P.D. 
Published: June 2017

PurposeStudies conducted in child psychiatry suggest that patients with earlier onset of psychosis have poorer outcome. Similar findings have been published regarding onset of bipolar disorder. However, few studies have been conducted in youth mental health program where these patients may actually receive treatment. Identification of subgroups with distinct need and outcome among first episode mania patients would facilitate the development of specific treatment strategies better suited to the actual needs of patients.MethodsSixty-seven patients with a first episode of psychotic mania were followed up over 12 months after recovery from this initial episode. Syndromic and symptomatic outcome were determined with the brief psychiatric rating scale, functional outcome with the quality of life scale and premorbid adjustment scale sub items.ResultsWhile 90% of patients achieved syndromic recovery (disappearance of manic syndrome) at 6 and 12 months, 40% had not recovered symptomatically, still presenting with depression and anxiety. Return to previous level of functioning was achieved only by 34% of patients at 6 months and 39% at 12 months. Age at the time of first manic episode with psychotic features was a significant predictor of recovery of functional level.ConclusionsWhile manic symptoms reduce quickly in most patients after a first episode of psychotic mania, an important number of patients still display symptoms of depression and anxiety after 12 months and 2/3 do not reach functional recovery. Younger age at first episode predicts risk of poorer functional outcome.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Epidemiological Study Between Greek People and Immigrants with Regard to Diagnosis in a Greek Hospital in Athens
Authors: Lyrakos G. , Menti D. , Dimitriou A. , Spyropoulos I. , Spinaris V. 
Published: June 2017

IntroductionDifferences between the most frequently reported diagnoses of Greek people and immigrants in Greece are expected due to the different underlying factors which are associated with mental health issues.ObjectivesExamine differences in diagnoses between Greek people and immigrants.AimsTo investigate whether Greek people and immigrants had significant differences with regard to reported diagnoses in a Greek hospital.MethodsThe patients who participated in this study are 5551, among them 2760 (49.7%) were males and 2791 (50.3%) were females. The mean age of the sample was 45.54. The sample consisted of 455 (8.3%) immigrants and 5,042 (91.7%) Greek people. Convenience sampling method was used and the sample was collected at the General Hospital of Nikaia, “Ag. Panteleimon” in Athens, Greece, between 01/01/2012 and 31/12/2015.ResultsThere were significant differences between Greek people and immigrant with regard to diagnosis as χ2 (20): 136.875, P < 0.001. More specifically, among Greek people, the most frequently reported diagnosis was psychotic disorder (26.2%), followed by depression (24.7%), general anxiety disorder (9.9%) and substance abuse (8.4%). Among immigrants, the most frequently reported diagnosis was psychotic disorder (22.9%), followed by substance abuse (21.3%), depression (17.4%) and general anxiety disorder (12.1%).ConclusionsThe differences between Greek people and immigrants with regard to diagnoses showcase the different needs between the two populations with regard to mental health. Especially, the higher prevalence of anxiety disorders and substance abuse problems among immigrants highlight the need for protective measures to improve their well-being and reduce their risk of mental health issues.Disclosure of interestThe authors have not supplied their declaration of competing interest.