bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental capacity assessment and ‘best interests’ decision-making in clinical practice: a case illustration
Authors: Biswas Asit B. , Hiremath Avinash 
Published: October 2010

SummaryMental capacity refers to a person's ability to make decisions, which may include consenting to medical treatment. People are presumed to have this capacity. Individuals may lack capacity because of an impairment or disturbance that affects the way their mind or brain works. Legal frameworks are in place for acting and making decisions on behalf of individuals who lack the mental capacity to do so for themselves, in their best interests. A case illustration is used to outline the principles involved under the Mental Capacity Act 2005 for England and Wales. We describe in detail the assessment of capacity to consent to treatment in this case and good practice in making best interests decisions in everyday clinical practice.
Interface between the Mental Health Act and Mental Capacity Act: deprivation of liberty safeguards
Authors: Brindle Nick , Branton Tim 
Published: October 2010

SummaryThe deprivation of liberty safeguards were introduced into the Mental Capacity Act in 2008 to enhance the protection of adults in residential homes or hospitals who lack capacity in relation to their care arrangements and who are or may be deprived of their liberty. Deprivation of liberty itself is an imprecise concept and there may be difficulty in applying the appropriate authority where there is a choice between the Mental Capacity Act 2005 and the Mental Health Act 1983. Therefore, this article explains the evolution of mental capacity legislation and the concept of deprivation of liberty, how it may be recognised, prevented and authorised by deprivation of liberty safeguards, along with some of the interface issues with the Mental Health Act 1983.
Advance statements in adult mental health
Authors: Jankovic Jelena , Richards Felicity , Priebe Stefan 
Published: October 2010

SummaryThis article reviews the literature on advance statements, including current mental health law and guidance in England and Wales, ethical and practical advantages, disadvantages and barriers to implementation. The idea of planning psychiatric treatment for a time when mental capacity may be impaired is not new. Yet there has been a renewed interest following the introduction of the Mental Capacity Act's 2005 provision of legally binding advance decisions to refuse treatment. In addition to information on treatment refusals, advance statements provide information on treatment preferences and personal care instructions which, although not legally binding, should inform treatment decisions. Advance statements are not yet widely used, but existing limited evidence suggests that they could reduce coercion and improve service users' satisfaction with treatment.
Mental health v. mental illness: Commentary on … Ethics and Economics
Authors: Coia Denise 
Published: October 2010

SummaryThis commentary focuses principally on the semantics of using the term ‘mental health’ rather than ‘mental illness’ and the effect this has in creating a paradigm shift in psychiatry in relation to other medical specialties. The consequences, intended or unintended, are demonstrated and the relationship between ethics and economics in mental health is discussed. The view that economic evaluation is methodologically unsound in ‘mental health’, that it is a special case because of its complexity, does not acknowledge the significant paradigm shift that has occurred. Casual acceptance of the term ‘mental health’ in a serious economic debate about resources for people with mental illnesses is worrying and further diminishes the medical specialty of psychiatry that deals with mental diseases.
Letter from America: how will health reform affect psychiatric care?
Authors: Sharfstein Steven S. 
Published: October 2010

SummaryHealth reform in America will lead to major changes in medical care in the USA, with opportunities for improved access to care, especially for psychiatric patients. Combined with recently enacted ‘parity’ legislation, health reform will expand public and private insurance coverage to an additional 33 million Americans, leading to increased pressure on the psychiatrists who are willing to practise with the insured population and on opportunities for subspecialisation within the field. Some essential non-medical tasks will not be funded by insurance, and these must be given due consideration. A major emphasis of health reform is to integrate general health and mental health services. The reform will have an impact on the use of the hospital and emergency room as well. A major concern is the cost of care and how it will be controlled.
Guidelines for the management of depression: NICE work?
Authors: Kendrick Tony , Peveler Robert 
Published: October 2010

SummaryThe National Institute for Health and Clinical Excellence (NICE) recently updated its guidance on managing depression, adding specific guidance for depression in people with physical illness. The guidance should help improve the targeting of treatments, although implementation of the guidance on depression in physical illness is challenging in the National Health Service (NHS) context of separate primary and secondary care services.
Reflections on PTSD's future in DSM–V
Authors: Rosen Gerald M. , Lilienfeld Scott O. , Frueh B. Christopher , McHugh Paul R. , Spitzer Robert L. 
Published: October 2010

SummaryResearch findings have fuelled debate on the construct validity of post-traumatic stress disorder (PTSD). Accompanying these issues are competing suggestions to redefine PTSD's criteria, including a recent proposal by DSM–V committee members. We review various approaches to revising the PTSD diagnosis and conclude that proposed changes should be placed in the appendix that the DSM has used for experimental criteria sets.
Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys
Authors: Kessler Ronald C. , McLaughlin Katie A. , Green Jennifer Greif , Gruber Michael J. , Sampson Nancy A. , Zaslavsky Alan M. , Aguilar-Gaxiola Sergio , Alhamzawi Ali Obaid , Alonso Jordi , Angermeyer Matthias , Benjet Corina , Bromet Evelyn , Chatterji Somnath , de Girolamo Giovanni , Demyttenaere Koen , Fayyad John , Florescu Silvia , Gal Gilad , Gureje Oye , Haro Josep Maria , Hu Chi-yi , Karam Elie G. , Kawakami Norito , Lee Sing , Lépine Jean-Pierre , Ormel Johan , Posada-Villa José , Sagar Rajesh , Tsang Adley , Üstün T. Bedirhan , Vassilev Svetlozar , Viana Maria Carmen , Williams David R. 
Published: October 2010

BackgroundAlthough significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders.AimsTo examine joint associations of 12 childhood adversities with first onset of 20 DSM–IV disorders in World Mental Health (WMH) Surveys in 21 countries.MethodNationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM–IV disorders with the WHO Composite International Diagnostic Interview (CIDI).ResultsChildhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries.ConclusionsChildhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.
Economic costs and preference-based health-related quality of life outcomes associated with childhood psychiatric disorders
Authors: Petrou Stavros , Johnson Samantha , Wolke Dieter , Hollis Chris , Kochhar Puja , Marlow Neil 
Published: October 2010

BackgroundChildhood psychiatric disorders may have deleterious consequences through childhood and into adulthood.AimsTo estimate costs and preference-based health-related quality of life outcomes (health utilities) associated with a broad range of childhood psychiatric disorders during the eleventh year of life.MethodParticipants in a whole-population study of extremely preterm children and term-born controls (EPICure) undertook psychiatric assessment using the Development and Well Being Assessment (DAWBA) and the Kaufman–Assessment Battery for Children. Questionnaires completed by parents and teachers described the children's utilisation of health, social and education services during the eleventh year of life. Parents also described their child's health status using the Health Utilities Index Mark 2 and Mark 3 health status classification systems. Descriptive and multiple regression techniques were used to explore the association between psychiatric disorders and economic outcomes.ResultsThe study presents detailed costs and health utilities associated with psychiatric disorders for the preterm population, term-born population and pooled study population, following appropriate controls.ConclusionsThe results of this study should be used to inform future economic evaluations of interventions aimed at preventing childhood psychiatric disorders or alleviating their effects. Further research is required that identifies, measures and values the longer-term economic impacts of these disorders in a valid and reliable manner.
Is the EQ–5D fit for purpose in mental health?
Authors: Brazier John 
Published: October 2010

SummaryThe EQ–5D is a widely used questionnaire for calculating quality-adjusted life-years (QALYs) for assessing cost-effectiveness in healthcare. It reflects the impact of common mental health conditions such as mild to moderate depression but seems to be more problematic for use in people with psychotic and severe and complex nonpsychotic disorders.
A patient satisfaction rating scale for psychiatric service
users
Authors: Hansen Lars K. , Vincent Selvaraj , Harris Scott , David Emily , Surafudheen Sheeba , Kingdon David 
Published: October 2010

Aims and methodThe patient's experience of the clinician is an increasingly important
area in time of ‘consumer choice’ and appraisal of the individual
practitioner. Validated, easy-to-use scales are scarce. The aim was to
validate a user-friendly, brief scale measuring patient satisfaction
(PatSat scale). Over three phases, patients were involved in developing
and validating the scale against the Verona satisfaction subscale.ResultsA highly significant correlation was found between the two scales
(Spearman's correlation coefficient 0.97, two-tailed P
<0.001).Clinical implicationsThe PatSat is a new patient satisfaction scale validated in a psychiatric
out-patient population. It appeared popular with patients and took less
than 1 minute to fill in. The use of validated scales measuring patient
satisfaction is a pivotal part of mental health delivery and advancing
overall quality of care.
Domestic violence among female psychiatric patients:
cross-sectional survey
Authors: Morgan John F. , Zolese Gabriella , McNulty Jane , Gebhardt Sharon 
Published: October 2010

Aims and methodTo establish prevalence of domestic violence among female psychiatric
patients, including risk factors, health professional attention and
acceptability of routine enquiry. Participants were 70 adult women in an
inner-city community mental health team who received questionnaire and
case-note review. Main outcome measures were: lifetime/point prevalence
of domestic violence; attitudes to routine enquiry; past disclosure and
recording in psychiatric records; clinical and demographic risk
factors.ResultsLifetime prevalence was 60% for physical violence from partners, 27%
during pregnancy and 40% receiving injuries. Point prevalence was not
reported, as an insufficient number of participants were currently in a
relationship. As many as 82% regarded routine enquiry as acceptable, but
only 24% had ever been questioned. Logistic regression analysis showed
prediction by presence of children, previous overdose, and experience of
sexual abuse.Clinical implicationsDomestic violence in female psychiatric patients is common but
undetected. Enquiry should be routine, but would require staff
training.
Prevalence of catatonic signs in acute psychiatric patients in
Scotland
Authors: Al Sayegh Amal , Reid David 
Published: October 2010

Aims and methodConcerns have been raised that catatonia is underdiagnosed. Prevalence
varies (1.3-32%) depending on diagnostic criteria. We used the Modified
Rogers Scale to rate catatonic signs in patients consecutively admitted
to three psychiatric wards over a 10-month period.ResultsThe prevalence of patients demonstrating any catatonic signs was at least
7.9-19.1%. The most common catatonic signs were marked underactivity (not
sedated), echolalia/palilalia, marked overactivity (not restlessness) and
gegenhalten. In those with catatonic signs, the most common diagnoses
were schizophrenia, schizoaffective disorder and dementia.Clinical implicationsMost of the most common catatonic signs in our sample were motor signs.
Antipsychotic-induced motor signs reflect interaction between drug and
disease. Catatonic signs are not anchored in any one diagnosis and are on
a spectrum of severity and quantity. Prevalence of these signs is higher
than often presumed.
Specialist community perinatal screening clinic: service evaluation
Authors: Magon Rakesh , White Ruth 
Published: October 2010

Aims and methodTo identify the outcomes of patients in the obstetric screening clinic. In 2 years, 180 women were referred by midwives to a clinic run by specialist community perinatal team. ‘Ultra-high risk’ patients were identified. There were four outcome measures predicated on level of care.ResultsOf those referred, 69 women were managed in primary care/generic community mental health teams, 90 by specialist perinatal team and 21 did not attend; 23 women were ultra-high risk. The majority of the ultra-high risk patients required treatment with specialist teams.Clinical implicationsSpecialist community perinatal screening clinics are successful at identifying those at high risk of developing mental health problems. Ultra-high risk women needed a higher level of service. High morbidity in women who fail to attend the services demands more assertive follow-up. Cumulative personal and family history is an important risk factor.
Conceptualisation of recovery from psychosis: a service-user
perspective
Authors: Wood Lisa , Price Jason , Morrison Anthony , Haddock Gillian 
Published: October 2010

Aims and methodThere has been much uncertainty about the concept of recovery in
psychosis. The aim of this paper is to conceptualise recovery, through
service users' descriptions of their recovery stories. A qualitative
approach (interpretive phenomenological analysis) was used to guide
interviews and analysis of data.ResultsEight service users were interviewed about their recovery from psychosis.
Data analysis revealed four superordinate themes: ‘impacts on mental
health’, ‘self-change and adaptation’, ‘social redefinition’ and
‘individualised coping mechanisms’.Clinical implicationsData indicates that multiple dimensions of recovery are all important to
individuals when considering their subjective experiences of recovery
from psychosis. Recovery can only be conceptualised by the person making
the recovery journey and treatment outcome measures must reflect this
individuality.
Monitoring electrocardiograms of service users on high-dose
methadone substitution therapy: an audit
Authors: Ghosh Soumya , Kodagalli Anil , Bhatti Faiz , Bradbeer Timothy 
Published: October 2010

Aims and methodTo explore the extent to which 2007 Department of Health guidelines on
monitoring of high-dose (⩾100 mg) methadone were followed, the reasons
for non-adherence to these and the prevalence of QTc prolongation. We
developed a simple tool for collecting data from case notes.ResultsOut of 25 service users, 11 had had an electrocardiogram (ECG) and 7 had
evidence of requests sent to general practitioners. After implementation
of our recommendations, ten more service users had ECGs within 1 month.
All but one ECG was normal. Methadone prescribing in favour of lower
doses has been observed. QTc interval prolongation was not common.Clinical implicationsEffective communication between primary and secondary care services is
important in identifying cases and arranging ECGs.
Integrated course in psychiatry and literature during
preclinical years and medical students' grades in the general psychiatry
curriculum
Authors: Fan Angela Pei-Chen , Kosik Russell Oliver , Su Tung-Ping , Tsai Thomas C. , Syu Wan-Jr , Chen Chen-Huan , Lee Chen-Hsen 
Published: October 2010

Aims and methodTo examine the effect of taking an elective psychiatry and literature
course during the first year of medical school on performance in the
later mandatory general psychiatry curriculum. Class members were
surveyed for baseline characteristics at the time of their admission to
medical school. Following completion of their fourth year, average grades
in psychiatry were calculated and results compared for those who did and
those who did not take the course. Multiple regression analysis was used
to assess the effects of baseline characteristics that were significantly
different between the groups.ResultsStudents who took the course had statistically significant
(t = −3.34, P <0.001) higher
grades in fourth year psychiatry. They had lower admission interview
scores (t = −2.15, P <0.05) and
reported less academic stress (t = −9.55,
P <0.01) before taking the course.Clinical implicationsLiterature is an effective medium through which to teach medical students
psychiatry as it can lead to a greater understanding of the topic.
The flow fields involved in hydrodynamic imaging by blind Mexican cave fish (Astyanax fasciatus). Part II: gliding parallel to a wall
Authors: Windsor Shane P. , Norris Stuart E. , Cameron Stuart M. , Mallinson Gordon D. , Montgomery John C. 
Published: October 2010

SUMMARY
Blind Mexican cave fish (Astyanax fasciatus) are able to sense detailed information about objects by gliding alongside them and sensing changes in the flow field around their body using their lateral line sensory system. Hence the fish are able to build hydrodynamic images of their surroundings. This study measured the flow fields around blind cave fish using particle image velocimetry (PIV) as they swam parallel to a wall. Computational fluid dynamics models were also used to calculate the flow fields and the stimuli to the lateral line sensory system. Our results showed that characteristic changes in the form of the flow field occurred when the fish were within approximately 0.20 body lengths (BL) of a wall. The magnitude of these changes increased steadily as the distance between the fish and the wall was reduced. When the fish were within 0.02 BL of the wall there was a change in the form of the flow field owing to the merging of the boundary layers on the body of the fish and the wall. The stimuli to the lateral line appears to be sufficient for fish to detect walls when they are 0.10 BL away (the mean distance at which they normally swim from a wall), but insufficient for the fish to detect a wall when 0.25 BL away. This suggests that the nature of the flow fields surrounding the fish are such that hydrodynamic imaging can only be used by fish to detect surfaces at short range.
Temperature effects in articular cartilage biomechanics
Authors: June Ronald K. , Fyhrie David P. 
Published: October 2010

SUMMARYArticular cartilage is the soft tissue that covers contacting surfaces of bones in synovial joints. Cartilage is composed of chondrocytes and an extracellular matrix containing numerous biopolymers, cations and water. Healthy cartilage functions biomechanically to provide smooth and stable joint movement. Degenerative joint diseases such as osteoarthritis involve cartilage deterioration, resulting in painful and cumbersome joint motion. Temperature is a fundamental quantity in mechanics, yet the effects of temperature on cartilage mechanical behavior are unknown. This study addressed the questions of whether cartilage stiffness and stress relaxation change with temperature. Samples of middle-zone bovine calf patellofemoral cartilage were tested in unconfined compression first at 24°C and then again after heating to 60°C. The data reveal that when temperature increases: (1) both peak and equilibrium stiffness increase by 150 and 8%, respectively, and (2) stress relaxation is faster at higher temperature, as shown by a 60% decrease in the time constant. The increases in temperature-dependent stiffness are consistent with polymeric mechanisms of matrix viscoelasticity but not with interstitial fluid flow. The changes in the time constant are consistent with a combination of both fluid flow and matrix viscoelasticity. Furthermore, we discovered a novel phenomenon: at stress-relaxation equilibrium, compressive stress increased with temperature. These data demonstrate a rich area of cartilage mechanics that has previously been unexplored and emphasize the role of polymer dynamics in cartilage viscoelasticity. Further studies of cartilage polymer dynamics may yield additional insight into mechanisms of cartilage material behavior that could improve treatments for cartilage degeneration.
Why do colder mothers produce larger eggs? An optimality approach
Authors: Bownds Celeste , Wilson Robbie , Marshall Dustin J. 
Published: October 2010

SUMMARY
One of the more common patterns of offspring size variation is that mothers tend to produce larger offspring at lower temperatures. Whether such variation is adaptive remains unclear. Determining whether optimal offspring size differs between thermal environments provides a direct way of assessing the adaptive significance of temperature-driven variation in egg size. Here, we examined the relationship between offspring size and performance at three temperatures for several important fitness components in the zebra fish, Danio rerio. The effects of egg size on performance were highly variable among life-history stages (i.e. pre- and post-hatching) and dependent on the thermal environment; offspring size positively affected performance at some temperatures but negatively affected performance at others. When we used these data to generate a simple optimality model, the model predicted that mothers should produce the largest size offspring at the lowest temperature, offspring of intermediate size at the highest temperature and the smallest offspring at the intermediate temperature. An experimental test of these predictions showed that the rank order of observed offspring sizes produced by mothers matched our predictions. Our results suggest that mothers adaptively manipulate the size of their offspring in response to thermally driven changes in offspring performance and highlight the utility of optimality approaches for understanding offspring size variation.