bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pivotal Advance: Expansion of small sputum macrophages in CF: failure to express MARCO and mannose receptors
Authors: Wright Adam K A , Rao Satish , Range Simon , Eder Christiane , Hofer Thomas P J , Frankenberger Marion , Kobzik Lester , Brightling Chris , Grigg Jonathan , Ziegler–Heitbrock Loems 
Published: April 2009

Abstract
In the airways of classical CF cases there is a high number of newly immigrated small macrophages, which are disabled with respect to scavenger receptor–mediated phagocytosis.
Macrophages in the airways form an important element of immune defense and inflammation. We analyzed induced sputum from airways of patients with CF for the types of macrophages present, their receptor expression, and phagocytic function. In samples from patients and age–matched controls, macrophages were analyzed by multicolor flow cytometry, scavenger receptor expression was studied at the protein and mRNA level, and receptor function was investigated using fluorescent particles. In adult patients with CF, we discovered a pronounced expansion of the small CD14+ DR+ CD68weak+ macrophages to 73 ± 18% compared with 16 ± 8% in healthy controls. Expression of the MARCO and CD206 (mannose receptor) was strongly reduced at the mRNA and protein level in sputum macrophages. Antibody–blocking studies showed that MARCO mediates phagocytosis of unopsonized particles. In line with reduced MARCO expression, sputum macrophages in CF showed a deficient uptake of particles (23±9% of cells) compared with healthy controls (71±15%). The deficiency of MARCO expression in the predominant small sputum macrophages in CF may lead to impaired clearance of inhaled particles with increased inflammation and damage to the CF lung.
Zinc transporter ZIP8 (SLC39A8) and zinc influence IFN-γ expression in activated human T cells
Authors: Aydemir Tolunay B , Liuzzi Juan P , McClellan Steve , Cousins Robert J 
Published: April 2009

Abstract
Dietary zinc supplement increases production of the tumor/infection-fighting cytokine IFN-γ in T cells by increasing zinc transport from the lysosomes to the cell cytoplasm.
The zinc transporter ZIP8 is highly expressed in T cells derived from human subjects. T cell ZIP8 expression was markedly up-regulated upon in vitro activation. T cells collected from human subjects who had received oral zinc supplementation (15 mg/day) had higher expression of the activation marker IFN-γ upon in vitro activation, indicating a potentiating effect of zinc on T cell activation. Similarly, in vitro zinc treatment of T cells along with activation resulted in increased IFN-γ expression with a maximum effect at 3.1 μM. Knockdown of ZIP8 in T cells by siRNA decreased ZIP8 levels in nonactivated and activated cells and concomitantly reduced secretion of IFN-γ and perforin, both signatures of activation. Overexpression of ZIP8 by transient transfection caused T cells to exhibit enhanced activation. Confocal microscopy established that ZIP8 is localized to the lysosome where ZIP8 abundance is increased upon activation. Loss of lysosomal labile zinc in response to activation was measured by flow cytometry using a zinc fluorophore. Zinc between 0.8 and 3.1 μM reduced CN phosphatase activity. CN was also inhibited by the CN inhibitor FK506 and ZIP8 overexpression. The results suggest that zinc at low concentrations, through inhibition of CN, sustains phosphorylation of the transcription factor CREB, yielding greater IFN-γ expression in T cells. ZIP8, through control of zinc transport from the lysosome, may provide a secondary level of IFN-γ regulation in T cells.
Government policy and the National Service Framework for Mental Health: modelling and costing services in England
Authors: Boardman Jed , Parsonage Michael 
Published: April 2009

SummaryThe National Service Framework for Mental Health (NSF–MH), published by the Department of Health in 1999, set an ambitious 10-year agenda for improving mental healthcare for working-age adults in England, based on seven quality standards covering all major services. The NSF–MH was supported by a series of other policy documents published by the government. This article illustrates a means of modelling the government's policy for adult mental health services to produce figures for the necessary services, staffing and financial resources required to meet the policy objectives. The findings of a report recently published by the Sainsbury Centre for Mental Health, which undertook a detailed assessment of what needs to be done to deliver these standards in terms of service provision, staffing and funding, is summarised and its implications examined.
Hyperthermia syndromes in psychiatry
Authors: Ahuja Niraj , Cole Andrew J. 
Published: April 2009

SummaryPresence of fever in psychiatric patients may signify a number of potentially fatal conditions. Several of these are related to treatments (e.g. neuroleptic malignant syndrome with antipsychotics, serotonin syndrome with serotonergic antidepressants, and malignant hyperpyrexia with anaesthesia used for administration of electroconvulsive therapy) or exacerbated by them (e.g. malignant catatonia with antipsychotics). New classes of drug treatment may be changing the epidemiology of these disorders. We suggest that an initial diagnosis of hyperthermia syndrome is clinically useful as there are some important commonalities in treatment. We outline a systematic approach to identify a particular subtype of hyperthermia syndrome and the indications for more specific treatments where available.
The humanities in postgraduate medical education
Authors: Oyebode Femi 
Published: April 2009

SummaryThis article discusses the value of the medical humanities within the medical curriculum. It explores the place of the humanities in postgraduate psychiatric training, what a curriculum might look like and which texts it might be useful to include in courses. It also briefly discusses teaching methods that may be appropriate in a postgraduate setting. Many of the proposed ideas are potentially relevant to CPD courses.
Minimal – no, minimise – yes
Authors: Feeney Larkin 
Published: April 2009

SummaryThis commentary questions evidence put forward in support of minimal-medication approaches to the treatment of schizophrenia. Psychiatrists should indeed seek to minimise the amount of medication that they use in order to reduce the incidence of side-effects. However, there is strong evidence that antipsychotic medications do help people with psychosis towards recovery. In practice, psychiatrists do not rigidly follow guidelines recommending medication, but rather work with and support individuals in a broad-based way to make informed choices about their mental healthcare.
Changing the balance of psychosis treatment
Authors: Moncrieff Joanna 
Published: April 2009

SummaryAntipsychotic medication is the primary form of treatment offered to people diagnosed with schizophrenia or psychosis, but it is associated with severe adverse effects, it is often experienced as unpleasant and its benefits may have been overstated. Therefore, it is important to evaluate research into approaches that aim to minimise the use of this medication. Existing studies suggest that such approaches can be successful and result in avoidance of antipsychotics in a high proportion of clients.
Family relationships in childhood and common psychiatric disorders in later life: systematic review of prospective studies
Authors: Weich Scott , Patterson Jacoby , Shaw Richard , Stewart-Brown Sarah 
Published: April 2009

BackgroundMost evidence for associations between childhood adversity and adult mental illness is retrospective.AimsTo evaluate prospective evidence of associations between poor parent–child relationships and common psychiatric disorders in later life.MethodSystematic review of studies published between 1970 and 2008 including: (a) more than 100 participants; (b) measures of relationships in the home during childhood; (c) at least 10 years between assessment of exposures; and (d) measures of anxiety, depression, suicide, suicidal ideation or post-traumatic stress disorder (PTSD). Analysis was by narrative synthesis.ResultsTwenty-three papers were identified reporting data from 16 cohorts. Abusive relationships predicted depression, anxiety and PTSD. Maternal emotional unavailability in early life predicted suicide attempts in adolescence. Results of studies investigating less severe relationship problems were suggestive but not conclusive of causal association, due partly to methodological heterogeneity.ConclusionsGiven the prevalence and disabling nature of common psychiatric problems, these studies highlight the need to minimise harm associated with dysfunctional parent–child relationships.
Screening for depression in high-risk groups: prospective cohort study in general practice
Authors: Baas Kim D. , Wittkampf Karin A. , van Weert Henk C. , Lucassen Peter , Huyser Jochanan , van den Hoogen Henk , van de Lisdonk Eloy , Bindels Patrick E. , Bockting Claudi L. , Ruhé Henricus G. , Schene Aart H. 
Published: April 2009

BackgroundCurrently only about half of the people who have major depressive disorder are detected during regular health care. Screening in high-risk groups might be a possible solution.AimsTo evaluate the effectiveness of selective screening for major depressive disorder in three high-risk groups in primary care: people with mental health problems, people with unexplained somatic complaints and people who frequently attend their general practitioner.MethodProspective cohort study among 2005 people in high-risk groups in three health centres in The Netherlands.ResultsOf the 2005 people identified, 1687 were invited for screening and of these 780 participated. Screening disclosed 71 people with major depressive disorder: 36 (50.7%) already received treatment, 14 (19.7%) refused treatment and 4 individuals did not show up for an appointment. As a final result of the screening, 17 individuals (1% of 1687) started treatment for major depressive disorder.ConclusionsScreening for depression in high-risk populations does not seem to be effective, mainly because of the low rates of treatment initiation, even if treatment is freely and easily accessible.
In-patient and residential alternatives to standard acute psychiatric wards in England
Authors: Johnson Sonia , Gilburt Helen , Lloyd-Evans Brynmor , Osborn David P. J. , Boardman Jed , Leese Morven , Shepherd Geoff , Thornicroft Graham , Slade Mike 
Published: April 2009

BackgroundAcute psychiatric wards have been the focus of widespread dissatisfaction. Residential alternatives have attracted much interest, but little research, over the past 50 years.AimsOur aims were to identify all in-patient and residential alternatives to standard acute psychiatric wards in England, to develop a typology of such services and to describe their distribution and clinical populations.MethodNational cross-sectional survey of alternatives to standard acute in-patient care.ResultsWe found 131 services intended as alternatives. Most were hospital-based and situated in deprived areas, and about half were established after 2000. Several clusters with distinctive characteristics were identified, ranging from general acute wards applying innovative therapeutic models, through clinical crisis houses that are highly integrated with local health systems, to more radical voluntary sector alternatives. Most people using the alternatives had a previous history of admission, but only a few community-based services accepted compulsory admissions.ConclusionsAlternatives to standard acute psychiatric wards represent an important, but previously undocumented and unevaluated, sector of the mental health economy. Further evidence is needed to assess whether they can improve the quality of acute in-patient care.
Metabolic profile of antipsychotic-naive individuals with non-affective psychosis
Authors: Fernandez-Egea Emilio , Bernardo Miguel , Donner Thomas , Conget Ignacio , Parellada Eduard , Justicia Azucena , Esmatjes Enric , Garcia-Rizo Clemente , Kirkpatrick Brian 
Published: April 2009

BackgroundSome studies suggest individuals with schizophrenia have an increased risk of diabetes prior to antipsychotic use. Small sample sizes and the potential for confounding by hypercortisolaemia have decreased confidence in those results.AimsTo examine diabetes-related factors in newly diagnosed, antipsychotic-naive people with non-affective psychosis.MethodParticipants with psychosis (the psychosis group;n= 50) and matched controls (the control group;n= 50) were given a 2 h oral glucose tolerance test. Fasting concentrations were also determined for adiponectin, interleukin-6 and C-reactive protein.ResultsCompared with the control group, the psychosis group had significant increases in 2 h glucose and interleukin-6 concentrations, and in the prevalence of abnormal glucose tolerance (16% of psychosis groupv.0% of control group). Adiponectin and C-reactive protein concentrations did not differ significantly between the two groups. These findings could not be attributed to differences in cortisol concentrations, smoking, gender, neighbourhood of residence, body mass index, aerobic conditioning, ethnicity, socioeconomic status or age.ConclusionsIndividuals with non-affective psychosis appear to have an increased prevalence of abnormal glucose tolerance prior to antipsychotic treatment, as well as abnormalities in a related inflammatory molecule. These underlying problems may contribute to the metabolic side-effects of antipsychotic medications.
Development and implementation of early intervention services for young people with psychosis: case study
Authors: Lester Helen , Birchwood Max , Bryan Stirling , England Elizabeth , Rogers Helen , Sirvastava Namita 
Published: April 2009

BackgroundThe development of early intervention services for young people with first-episode psychosis is a priority internationally.AimsTo evaluate the development, implementation and impact of existing and newly formed early intervention services in England.MethodMultiple-case study involving staff, users, carers and commissioners of 14 early intervention services.ResultsService numbers increased in response to national policy directives. They were still actively working with 90.6% of service users 12 months after inception. They were highly valued by users and carers as providing a personal service that contrasted with previous experiences of care. Tensions between providing a quality service and meeting case-load targets linked to future funding led teams to adopt a series of survival strategies with some unintended consequences.ConclusionsEarly intervention services are highly valued by consumers and engage users effectively after 12 months. Implementation of these services is threatened unless sufficient consistent funding is made available.
Stalking among juveniles
Authors: Purcell Rosemary , Moller Bridget , Flower Teresa , Mullen Paul E. 
Published: April 2009

BackgroundThere is an almost total lack of empirical research on stalking among juveniles.AimsTo examine the characteristics, nature and impacts of stalking by juveniles.MethodAnalysis of consecutive court applications for a restraining order against a juvenile because of stalking behaviours.ResultsA total of 299 juvenile stalkers were identified. The majority were male (64%) and their victims predominantly female (69%). Most pursued a previously known victim (98%), favouring direct means of contact via unwanted approaches (76%) and telephone calls or text messaging (67%). Threats (75%) and physical and sexual assaults (54%) were common. The contexts for juvenile stalking involved an extension of bullying (28%), retaliation for a perceived harm (22%), a reaction to rejection (22%), sexual predation (5%) and infatuation (2%).ConclusionsJuvenile stalking is characterised by direct, intense, overtly threatening and all too often violent forms of pursuit. The seriousness that is afforded to adult forms of stalking should similarly apply to this behaviour among juveniles given the even greater rates of disruption to the victim's life and risks of being attacked.
Mental disorders and termination of education in high-income and low- and middle-income countries: epidemiological study
Authors: Lee S. , Tsang A. , Breslau J. , Aguilar-Gaxiola S. , Angermeyer M. , Borges G. , Bromet E. , Bruffaerts R. , de Girolamo G. , Fayyad J. , Gureje O. , Haro J. M. , Kawakami N. , Levinson D. , Browne M. A. Oakley , Ormel J. , Posada-Villa J. , Williams D. R. , Kessler R. C. 
Published: April 2009

BackgroundStudies of the impact of mental disorders on educational attainment are rare in both high-income and low- and middle-income (LAMI) countries.AimsTo examine the association between early-onset mental disorder and subsequent termination of education.MethodSixteen countries taking part in the World Health Organization World Mental Health Survey Initiative were surveyed with the Composite International Diagnostic Interview (n=41 688). Survival models were used to estimate associations between DSM–IV mental disorders and subsequent non-attainment of educational milestones.ResultsIn high-income countries, prior substance use disorders were associated with non-completion at all stages of education (OR 1.4–15.2). Anxiety disorders (OR=1.3), mood disorders (OR=1.4) and impulse control disorders (OR=2.2) were associated with early termination of secondary education. In LAMI countries, impulse control disorders (OR=1.3) and substance use disorders (OR=1.5) were associated with early termination of secondary education.ConclusionsOnset of mental disorder and subsequent non-completion of education are consistently associated in both high-income and LAMI countries.
Invited commentary on … Lithium levels in drinking water and risk of suicide
Authors: Young Allan H. 
Published: April 2009

SummaryLithium is a well-established treatment in psychiatry. The possibility that lithium from the environment may affect mental health has received little study. However, a recent study and an older report both suggest that higher levels of lithium in drinking water are associated with lower suicide rates. These intriguing data should provoke further research, which ultimately may benefit community mental health.
Multidisciplinary activities in a community mental health service: relationship to Health of the Nation Outcome Scale scores and diagnosis
Authors: Meagher David , O'Brien Sinead , Pullela Ananth , Oshun Anthony , Brosnan Pat 
Published: April 2009

Aims and MethodMultidisciplinary activities of community mental health teams in Ireland are understudied. We explored symptom profile and multidisciplinary team contacts in a complete sector population (n= 504).ResultsThe frequency of attendance was greater in individuals with severe mental illness (P<0.001) and correlated with total Health of the Nation Outcome Scale (HoNOS) scores (P<0.001) and with the sub-scales for social disability (P<0.001) and symptoms (P<0.01). Sixty-two per cent of individuals were receiving shared care and were more likely to have severe mental illness (P<0.001) and higher total HoNOS scores (P<0.001). Frequency of attendance correlated with total HoNOS scores and subscale scores for social impairment and symptoms.Clinical ImplicationsFrequency of service attendance and activities of multidisciplinary team members vary with symptom profile of service attenders but are focused towards individuals with more severe illness and greater problems identified by the HoNOS.
Psychological therapies, older people and human rights
Authors: Hilton Claire 
Published: April 2009

SummaryAdditional funding has recently been made available by the government for the treatment of anxiety and depression. However, this is targeted towards people of working age, to reduce expenditure on incapacity benefit. That older people with the same mental illnesses do not receive equitable access to psychological therapies contradicts other recent government recommendations. Economic data appears to hugely influence provision of services for this group of users, but is this appropriate and humane? the Human Rights Act 1998 (Chapter 42) has been largely ignored in the provision of mental health services for older people, and the centrality of this legislation needs further consideration.
Developing a child and adolescent mental health service in a low-income country: a global partnership model
Authors: Tareen Amina , Mirza Ilyas , Minhas Ayesha , Minhas Fareed , Rahman Atif 
Published: April 2009

Aims and MethodTo develop a child and adolescent mental health service in a low-income country. This was a collaborative effort involving governmental and non-governmental organisations in the UK and Pakistan, where a training clinic was established.ResultsWe assessed and treated 169 children and adolescents. A team of mental health professionals was trained, including one consultant psychiatrist; the consultant psychiatrist is now leading the clinic. Links were further developed with healthcare, social care and educational organisations, as well as efforts made to engage the public in relation to child and adolescent mental health.Clinical ImplicationsOur development highlights a model of research collaboration and service development which may be sustainable in low-income settings. Such initiatives need support from a variety of organisations. There is a need to consider whether there should be a formal funding mechanism to support the Royal College of Psychiatrists Senior Volunteer Programme.
The Mental Health Act 1983 and incapacity: what general hospital doctors know
Authors: Richards Felicity , Dale Jenny 
Published: April 2009

Aims and MethodA questionnaire survey of general hospital doctors was conducted before and after a 1h training intervention. Baseline levels of knowledge and confidence regarding the use of section 5(2) of the Mental Health Act 1983 and assessment and management of incapacitated patients were determined. Following a training intervention, improvements in these areas were established.ResultsEighteen doctors participated. Confidence in assessing capacity and the knowledge of treatment under common law and section 5(2) were low at baseline. Improvements were seen following the training intervention, with four knowledge items relating to section 5(2) achieving statistically significant improvements.Clinical ImplicationsSimple training interventions delivered by psychiatrists may be an effective way of improving the knowledge and confidence of general hospital doctors.
Effect of the 2004 tsunami on suicide rates in Sri Lanka
Authors: Rodrigo Asiri , McQuillin Andrew , Pimm Jonathan 
Published: April 2009

Aims and MethodTo investigate the effect of the 2004 tsunami on suicide rates in Sri Lanka. the number of suicides in the 2 years prior to and 1 year after the tsunami were considered for the study. Data from districts affected by the tsunami were compared with those from unaffected districts.ResultsNo significant differences were found between the number of suicides before and following the disaster or between areas affected and unaffected by the tsunami.Clinical ImplicationsWorldwise, the impact of disasters upon suicide rates is variable. It is possible that the tsunami failed to have any profound effect on societal forces affecting suicide rates in Sri Lanka.