bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel research on transition from child to adult mental health services in Europe: The MILESTONE project
Authors: Tuomainen H. , Singh S.P. ,   The MILESTONE Consortium
Published: May 2016

IntroductionCurrent service configuration of distinct Child and Adolescent Mental Health (CAMHS) and Adult Mental Health Services (AMHS) is considered the weakest link where the care pathway should be most robust. Transition-related discontinuity of care is a major health, socioeconomic and societal challenge for the EU.ObjectivesThe overall objective of the MILESTONE project is to improve transition from CAMHS to AMHS in diverse healthcare settings in Europe.AimsTo improve the understanding of current transition-related service characteristics, and processes, outcomes and experiences of transition from CAMHS to AMHS using a bespoke suite of measures; to explore the ethical challenges of providing appropriate care to young people as they move to adulthood; to test a model of managed transition in a cluster randomized controlled trial (cRCT) for improving health, social outcomes and transition to adult roles; and to develop training modules for clinicians and policy guidelines.MethodsData will be collected via systematic literature reviews; bespoke surveys to CAMHS professionals, experts and other stakeholders; focus groups with service providers and users and members of youth and mental health advocacy groups; and a longitudinal cohort study with a nested cRCT in eight EU countries (Belgium, Croatia, France, Germany, Ireland, Italy, Netherlands, UK) involving over 1000 CAMHS service users, their parents/carers, and clinicians, with assessments at baseline, 9, 18 and 27 months.ResultsFirst results are expected in 2016 with further major findings following in 2019.ConclusionsThe MILESTONE project will provide unprecedented information on the nature and magnitude of problems at the CAMHS-AMHS interface, and potential solutions to overcome these.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychotherapeutic interventions in consultation-liaison psychiatry implications for psychiatric trainees
Authors: Koelkebeck K. 
Published: May 2016

In clinical reality, psychiatric trainees working in consultation and liaison psychiatry (CLP) face a lot of obstacles to gain satisfactory results from their work on somatic wards. Specifically, the deliverance of psychotherapeutic interventions in every-day CLP is a topic of discussion. The talk will present a case of a young anorectic patient that will exemplify the difficulties in delivering psychotherapeutic treatment in every-day clinical work and will outline common difficulties, specifically in relation to interactions with staff of somatic units. The presentation will be wrapped-up by suggestions on how to deal with the most common problems.Disclosure of interestThe author has not supplied his declaration of competing interest.
The new neuroscience based nomenclature of neuropsychotropic drugs: A chance for a better understanding and teaching of clinical psychopharmacology
Authors: Möller H.J. 
Published: May 2016

Traditional psychopharmacological terminology is based on historical grounds and under different aspects not systematic and rational. It even tends to confuse patients by prescribing a drug that does not reflect their identified diagnosis, prescribing “antipsychotics” to depression. Four major colleges of neuropsychopharmacology (ECNP, ACNP, Asian CNP, an CINP) proposed a new multi-axial pharmacologically-driven nomenclature. The template has five axes: 1- class (primary pharmacological target and relevant mechanism); 2- family (reflecting the relevant neurotransmitter and mechanism); 3- neurobiological activities; 4- efficacy and major side effects; and 5- approved indications. The results of the surveys suggest that the clinicians found the available indication-based nomenclature system dissatisfactory, non-intuitive, confusing, and doubt-inducing for them and the patients. The proposed five-axis template seeks to upend current usage bay placing pharmacology rather than indication as the primary axes. With the proposed nomenclature relating primarily to Axis 1 – the class, and usage of the other axes would largely depend the extent to which the clinician seeks to deepen the scientific and clinical base of his involvement.Disclosure of interestThe author has not supplied his declaration of competing interest.
The negative image of psychiatry in the medical community
Authors: van der Gaag R.J. 
Published: May 2016

It is a very unfortunate matter of fact that mental problems and diseases are matter to societal stigmatization. In the slipstream psychiatry has a negative image in the public eye. Fighting stigma should be at the core of all professionals involved in mental health care. Self-reflection should be a primary reaction of any psychiatrist when confronted with a sensitive issue like stigmatization and negative image. It is painful to realize that the negative image of psychiatry is also present to the community to which psychiatrists belong, namely the medical community. This is strange and hurting. Psychiatrists (then closely linked to neurology) have, worldwide strongly contributed to the birth and strengthening of medical associations. Yet psychiatrists have estranged themselves from the medical community, thus, in my view, contributing themselves to stigma on patients with mental conditions and the negative image of psychiatry. So time for action, starting by self-awareness of psychiatrists that they are medical specialist, urging oneself as a psychiatrist to behave as a medical specialist by relating to colleagues in a helpful way and keeping one's own medical knowledge and skills up to standards. Psychiatrists have so much to offer in helping their colleagues in somatic medicine.Disclosure of interestThe author has not supplied his declaration of competing interest.
Training in old age psychiatry: The 30 countries’ perspective
Authors: Orrell M. 
Published: May 2016

To improve the care of older people with mental health problems it is necessary to have a highly skilled workforce who is very well-trained in the diagnosis and management of the range of the psychiatric problems affecting older people including the dementias. Key to this is the need to have an adequate number of specialists in geriatric psychiatry and a wider recognition of geriatric psychiatry training across Europe including a broad agreement on training requirements. In 2012 the European Association of Geriatric Psychiatry (Toot et al.) published the results of a Europe wide survey on geriatric psychiatry training to scope current practice and develop recommendations to begin a debate on harmonization. Representatives from 30 out of 38 (79%) representatives responded including many from countries where old age psychiatry was not formally a specialty. Training programs and duration varied between countries. Eleven countries reported that they had geriatric psychiatry training programs and most of these required geriatric psychiatry trainees to complete mandatory training for two years within old age psychiatry. Representatives from ten countries reported having specific Continuing Professional Development (CPD) for old age psychiatrists at consultant level.The recognition of geriatric psychiatry as a specialist discipline in Europe is on the rise. The training procedures and processes in place vary considerably between and sometimes within countries. There are several options for harmonizing old age psychiatry training across Europe with advantages to each. However, support is required from national old age psychiatry bodies across Europe and an agreement needs to be reached on a training strategy that encompasses supervision, development, and appraisal of the knowledge and skills sets of old age psychiatrists. This workshop will look at options for harmonization and take first steps towards a consensus.Disclosure of interestThe author has not supplied his declaration of competing interest.
Old and new reasons for specialization
Authors: Stoppe G. 
Published: May 2016

Mental illness is one of the largest areas of activity in the health service, with mental disorders of the elderly an important part of it. This substantial ageing of the population is a new phenomenon, occurring over the last century. It has given prominence to mental illness in old age. There is a growing interest in making decisions about how many and which services to provide to the older community.The expertise of old age psychiatry services lies in the care and treatment of people with complex mixtures of psychological, cognitive, functional, behavioral, physical and social problems usually relating to ageing. Current evidence suggests specialist old age services are best equipped to diagnose and treat mental illness in our ageing population. However, the specialists should be integrated optimally into a service system to the benefit of the elderly. It will be crucial to improve access of older patients to the services. The service system and the partners in the system differ to those for younger adult psychiatric patients. Thus, not only knowledge and skills underline the necessity of specialization but also the increasingly complex health service structures of modern societies.Disclosure of interestThe author has not supplied his declaration of competing interest.
21st century house call home tele-behavioral medicine
Authors: Schwagar H.A. 
Published: May 2016

ObjectiveThis presentation will focus on and demonstrate the effective, secure, cost effective delivery of Tele-Behavioral Medicine services to patients in the privacy or their own home.MethodToday's use of internet technology brings with it “cost effectiveness” for Tele-behavioral medicine applications. Today, with a relatively current laptop computer, a web-cam or iPad, broadband connectivity (256 kB or faster), and a downloadable, free, secure video conference application, makes this technology available literally and virtually everywhere, anywhere, in the world at any time.ResultsMedical History clearly supports the value of the “house call” as a means of getting to “see the entire picture”. Chronically ill patients are frequently visited by home health nurses and or “in home” medical monitoring programs. Psychiatrically ill patients may now receive their medication management and behavioral intervention and assessment right in the privacy of their own home. Psychiatrists and psychologists merely schedule “in home” appointments with their patients in the same manner as they would if the patient were being seen in their office.ConclusionChronically ill patients favored treatment rendered in “their private space” as well as providers tended to learn much more about their patients when the provider is the “guest” in the patients home versus the patient as the “customer” in the providers office. The convenience and cost savings for both provider and patient is significant. Availability of spouses, parents etc. was a valuable addition to the Tele-Home-Behavioral Medicine model.Disclosure of interestThe author has not supplied his declaration of competing interest.
The effects of integrated treatment with atypical antipsychotics and social cognition training on functional outcome
Authors: Sachs G. , Winklbaur B. , Erfurth A. 
Published: May 2016

Social cognition is impaired in patients with schizophrenia [1]. This impairment is one of the core features of the illness and has a clear impact on functional outcome.While conventional antipsychotics might have a worsening effect on social cognition, e.g. on amygdala attenuation in fMRI studies on facial recognition [2], atypical antipsychotics might not show this effect [3].Social cognitive training [4] – such as the training of affect recognition [5] – is a promising approach in the treatment of schizophrenia.Holistic strategies including both treatment with atypical antipsychotics and social cognitive training can improve functional outcome in patients with schizophrenia [6].Disclosure of interestThe author has not supplied his declaration of competing interest.
HIV pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP): What mental health providers should know
Authors: Hall T. 
Published: May 2016

Pharmacologic methods of treating and preventing HIV have advanced tremendously in recent years. Understandings of HIV risk and recommendations for risk-reduction strategies have also changed substantially. A majority of new cases of HIV in many developed countries are now acquired through sex with long-term partners who are unaware of their HIV-positive status, rather than from casual or anonymous sexual encounters. Persons with bipolar disorder and substance use disorders are at particularly high risk. Mental health providers who work with LGBT persons and other populations at higher risk for HIV need to understand strategies their patients are using for HIV risk reduction, and to refer appropriate patients for consideration for pre-exposure prophylaxis (PrEP). PrEP is the daily use of an antiretroviral (ARV) medication for prevention of HIV infection in higher-risk individuals. The United States approved tenofovir + emtracitabine for PrEP in 2012; this is under review in several European countries, Canada, and Australia, and is already prescribed off-label in many. Additionally, studies have shown that treatment with ARV medications to an “undetectable viral load” greatly reduces the risk of further transmission by persons already infected with HIV, called “treatment as prevention” (TasP). As of September 2015, WHO recommends early ARV treatment for all persons with HIV, and consideration of PrEP for men who have sex with men. This paper reviews findings from the PrEP studies (especially iPrEx, iPrEx Ole, IPERGAY, and PROUD) and TasP, and looks at their impact on LGBT and HIV+ communities, with relevance for mental health providers.Disclosure of interestThe author has not supplied his declaration of competing interest.
Continuous monitoring of caspase‐3 activation induced by propofol in developing mouse brain
Authors: Konno Ayumi , Nishimura Akiko , Nakamura Shiro , Mochizuki Ayako , Yamada Atsushi , Kamijo Ryutaro , Inoue Tomio , Iijima Takehiko 
Published: May 2016

AbstractThe neurotoxicity of anesthetics on the developing brain has drawn the attention of anesthesiologists. Several studies have shown that apoptosis is enhanced by exposure to anesthesia during brain development. Although apoptosis is a physiological developmental step occurring before the maturation of neural networks and the integration of brain function, pathological damage also involves apoptosis. Previous studies have shown that prolonged exposure to anesthetics causes apoptosis. Exactly when the apoptotic cascade starts in the brain remains uncertain. If it starts during the early stage of anesthesia, even short‐term anesthesia could harm the brain. Therefore, apoptogenesis should be continuously monitored to elucidate when the apoptotic cascade is triggered by anesthesia. Here, we describe the development of a continuous monitoring system to detect caspase‐3 activation using an in vivo model. Brain slices from postnatal days 0–4 SCAT3 transgenic mice with a heterozygous genotype (n = 20) were used for the monitoring of caspase‐3 cleavage. SCAT3 is a fusion protein of ECFP and Venus connected by a caspase‐3 cleavable peptide, DEVD. A specimen from the hippocampal CA1 sector was mounted on a confocal laser microscope and was continuously superfused with artificial cerebrospinal fluid, propofol (2,6‐diisopropylphenol, 1 μM or 10 μM), and dimethyl sulfoxide. Images were obtained every hour for five hours. A pixel analysis of the ECFP/Venus ratio images was performed using a histogram showing the number of pixels with each ratio. In the histogram of the ECFP/Venus ratio, an area with a ratio > 1 indicated the number of pixels from caspase‐3‐activated CA1 neurons. We observed a shift in the histogram toward the right over time, indicating caspase‐3 activation. This right‐ward shift dramatically changed at five hours in the propofol 1 μM and 10 μM groups and was obviously different from that in the control group. Thus, real‐time fluorescence energy transfer (FRET) imaging was capable of identifying the onset of apoptosis triggered by propofol in neonatal brain slices. This model may be a useful tool for monitoring apoptogenesis in the developing brain.
Developmental changes in the hypothalamic mRNA expression levels of PACAP and its receptor PAC1 and their sensitivity to fasting in male and female rats
Authors: Iwasa Takeshi , Matsuzaki Toshiya , Tungalagsuvd Altankhuu , Munkhzaya Munkhsaikhan , Yiliyasi Maira , Kato Takeshi , Kuwahara Akira , Irahara Minoru 
Published: May 2016

AbstractThe actions and responses of hypothalamic appetite regulatory and factors change markedly during the neonatal to pre‐pubertal period. Pituitary adenylate cyclase‐activating polypeptide (PACAP) has been found to play pivotal roles in the regulation of metabolic and nutritional status through its specific receptor PAC1. PACAP/PAC1 have anorectic roles, and their functions are regulated by leptin in adulthood. In the present study, we showed that hypothalamic PACAP mRNA expression decreases during the neonatal to pre‐pubertal period (from postnatal day 10–30) in both male and female rats. During this period, hypothalamic PACAP mRNA expression was not affected by 24 h fasting in either sex, while the serum leptin levels (leptin is a positive regulator of hypothalamic PACAP expression in adulthood) of both sexes were decreased by fasting. On the other hand, hypothalamic PAC1 mRNA expression did not change during the neonatal to pre‐pubertal period in either sex; however, its levels were consistently higher in males than in females. Hypothalamic PAC1 mRNA expression was decreased by 24 h fasting in males, but no such changes were observed in females. These results indicate while hypothalamic PACAP expression is sensitive to a negative energy state and the serum leptin level in adulthood, no such relationships are seen in the pre‐pubertal period. In addition, we speculate that differences in the gonadal steroidal milieu might induce sexual dimorphism in the basal hypothalamic PAC1 mRNA level and its response to fasting. The mechanisms responsible for and the physiological effects of such changes in hypothalamic PACAP and PAC1 expression during the developmental period remain to be clarified.
Dosing‐time contributes to chronotoxicity of clofarabine in mice via means other than pharmacokinetics
Authors: Luan Jia‐Jie , Zhang Yu‐Shan , Liu Xiao‐Yun , Wang Ya‐Qin , Zuo Jian , Song Jian‐Guo , Zhang Wen , Wang Wu‐San 
Published: May 2016

AbstractTo evaluate the time‐ and dose‐dependent toxicity of clofarabine in mice and to further define the chronotherapy strategy of it in leukemia, we compared the mortality rates, LD50s, biochemical parameters, histological changes and organ indexes of mice treated with clofarabine at various doses and time points. Plasma clofarabine levels and pharmacokinetic parameters were monitored continuously for up to 8 hours after the single intravenous administration of 20 mg/kg at 12:00 noon and 12:00 midnight by high performance liquid chromatography (HPLC)‐UV method. Clofarabine toxicity in all groups fluctuated in accordance with circadian rhythms in vivo. The toxicity of clofarabine in mice in the rest phase was more severe than the active one, indicated by more severe liver damage, immunodepression, higher mortality rate, and lower LD50. No significant pharmacokinetic parameter changes were observed between the night and daytime treatment groups. These findings suggest the dosing‐time dependent toxicity of clofarabine synchronizes with the circadian rhythm of mice, which might provide new therapeutic strategies in further clinical application.
The economic recession and subjective well-being in older adults in the Republic of Ireland
Authors: Duffy R. M. , Mullin K. , O’Dwyer S. , Wrigley M. , Kelly B. D. 
Published: May 2016

ObjectiveSubjective well-being in older people is strongly associated with emotional, physical and mental health. This study investigates subjective well-being in older adults in Ireland before and after the economic recession that commenced in 2008.MethodsCross-sectional data from the biennial European Social Survey (2002–2012) were analysed for two separate groups of older adults: one sampled before the recession and one after. Stratification and linear regression modelling were used to analyse the association between subjective well-being, the recession and multiple potential confounders and effect modifiers.ResultsData were analysed on 2013 individuals. Overall, subjective well-being among older adults was 1.30 points lower after the recession compared with before the recession (s.e. 0.16; 95% confidence interval 1.00–1.61; p<0.001) [pre-recession: 16.1, out of a possible 20 (s.d. 3.24); post-recession:14.8 (s.d. 3.72)]. Among these older adults, the pre- and post-recession difference was especially marked in women, those with poor health and those living in urban areas.ConclusionsSubjective well-being was significantly lower in older adults after the recession compared with before the recession, especially in women with poor health in urban areas. Policy-makers need proactively to protect these vulnerable cohorts in future health and social policy. Future research could usefully focus on older people on fixed incomes whose diminished ability to alter their economic situation might make them more vulnerable to reduced subjective well-being during a recession.
Dual Fuel Turbocharged Engine Operated with Exhaust Gas Recirculation
Authors: Wu H.-W. , Hsu T.-Z. , Lai W.-H. 
Published: May 2016

AbstractWith good combustion characteristics, hydrogen has been developing as a clean alternative fuel of engines. This study is to develop a diesel/hydrogen dual fuel engine. The hydrogen was added at inlet port in a 4-cylinder direct injection turbocharged diesel engine with an EGR (Exhaust Gas Recirculation) system to investigate engine performance and exhaust pollutant. The measured items are composed of the gas pressure of cylinder, crank angle, consumption rate of diesel, consumption rate of hydrogen, air flow rate, emissions (HC, CO2, NOX, and Smoke), and so on. The authors analyze how the addition of hydrogen with EGR system influences the engine performance and emissions. The diesel/hydrogen dual fuel turbocharged engine can increase the brake thermal efficiency with a greater decrease in emissions compared with the turbocharged diesel engine. Furthermore, the authors little altered the engine structure to get the positive effect of energy saving and pollutant decreasing.