bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing integrated mental health services for adults with ADHD
Authors: Crimlisk Helen 
Published: November 2011

SummaryThe article discusses the issues and challenges for mental health services in providing care for adults with attention-deficit hyperactivity disorder (ADHD). Based on work developed in Sheffield (UK), it describes the contribution that services integrated into community mental health teams may be able to provide. Given the likely increase in numbers of referrals of adults with ADHD (both ‘graduates’ from children's services and adults seeking diagnosis) and the pressures on resources, it is unlikely that current specialist services will be able to address the growing demand. A local service that can link with other mental health services and that has close links to primary care is most likely to provide a sustainable service model, but there are still considerable training needs for this model to be put into practice.
Pharmacotherapy for obsessive—compulsive disorder
Authors: Fineberg Naomi , Brown Angus 
Published: November 2011

SummaryWe present a narrative review of evidence-based treatment for obsessive–compulsive disorder (OCD), covering first-line pharmacological treatment, augmentation strategies, approaches for treatment-refractory OCD and the management of OCD in special populations (children and adolescents, pregnant and breast-feeding women, and elderly people).
Short-term management of repeated self-harm in secure institutions
Authors: Sarkar Jaydip 
Published: November 2011

SummaryThe challenge of managing repeated self-harm and the high risk of morbidity and mortality are compounded in forensic patients, where there are additional risks of harm to others, absconding and security breaches. There is an urgent need for clinically sound, practice-based and theoretically grounded strategies for managing these associated risks. This is essential as available UK guidelines appear inadequate for this group of patients. This article promotes a pragmatic approach to assessing the risk of self-harm clinically to arrive at hierarchical risk judgements. It further suggests an algorithmic approach to managing these risks and provides testable strategies that can be adapted for use in various secure institutions.
Empathy, the song and the singer: a legacy of Robert Schumann
Authors: Cox John 
Published: November 2011

SummaryIn this article it is suggested that empathy is a core component of musical appreciation and particularly of the relationship between the singer and the audience. The brain pathways activated in musical appreciation are outlined and the nature of the empathic process considered with reference to Robert Schumann's songs and his experience of severe mental disorder. The article suggests that listening to Schumann's song cycleDichterliebe (Poet's Love), or to other great music, is a useful component of continuing professional development and that such experience enhances therapeutic effectiveness and empathy, as well as increasing the understanding of the relationship between creativity and mental health.
Bewilderment and conviction: the portrayal of madness in Ondaatje's Coming Through Slaughter
Authors: Polnay Adam 
Published: November 2011

SummaryThe scraps of historical data that exist about Buddy Bolden – a cornet player from New Orleans who influenced early jazz – have evoked curiosity in a wide range of writers, including psychiatrists. The latter are interested because Bolden ‘went berserk in a parade’ at the age of 29 and spent the rest of his life in an asylum. This article is about the novel Coming Through Slaughter by Michael Ondaatje, which is based on Bolden's life. I discuss how the form of the text – including its refusal to comment on where sense is lost – conveys to readers the bewilderment and conviction of Bolden's experience and allows them to share something of this.
Early intervention in psychosis: clinical aspects of treatment
Authors: Murphy Brendan P. , Brewer Warrick J. 
Published: November 2011

SummaryEngaging patients in first-episode psychosis services is critical in maximising the effect of early intervention and establishing a framework for longer-term treatment. Biopsychosocial assessments determine a working diagnosis and inform evidence-based treatment. Atypical antipsychotics should be used at doses that maximise therapeutic benefit and adherence while minimising side-effects. Patients are helped to construct a narrative of their illness, including a shared understanding of the contribution of biological and environmental risks, and early warning signs. Common comorbid conditions, including depression, suicidal ideation, substance misuse and anxiety, should be addressed. Management of comorbid borderline and antisocial personality disorders is difficult; their nexus with psychosis is discussed. Cognitive–behavioural therapy is a mainstay of treatment, with specific interventions developed for problems typical in first-episode presentations. Core psychosocial interventions include psychoeducation, vocational and educational support, family interventions and multimodal group programmes.
Persistent distress after psychological exposure to the Nagasaki atomic bomb explosion
Authors: Kim Yoshiharu , Tsutsumi Atsuro , Izutsu Takashi , Kawamura Noriyuki , Miyazaki Takao , Kikkawa Takehiko 
Published: November 2011

BackgroundAlthough there is speculation that individuals living in the vicinity of nuclear disasters have persistent mental health deterioration due to psychological stress, few attempts have been made to examine this issue.AimsTo determine whether having been in the vicinity of the Nagasaki atomic bomb explosion in the absence of substantial exposure to radiation affected the mental health of local inhabitants more than half a century later.MethodParticipants were randomly recruited from individuals who lived in the vicinity of the atomic bomb explosion in uncontaminated suburbs of Nagasaki. This sample (n = 347) was stratified by gender, age, perception of the explosion and current district of residence. Controls (n = 288) were recruited from among individuals who had moved into the area from outside Nagasaki 5–15 years after the bombing, matched for gender, age and district of residence. The primary outcome measure was the proportion of those at high risk of mental disorder based on the 28-item version of the General Health Questionnaire, with a cut-off point of 5/6. Other parameters related to individual perception of the explosion, health status, life events and habits were also assessed.ResultsHaving been in the vicinity of the explosion was the most significant factor (OR = 5.26, 95% CI 2.56–11.11) contributing to poorer mental health; erroneous knowledge of radiological hazard showed a mild association. In the sample group, anxiety after learning of the potential radiological hazard was significantly correlated with poor mental health (P<0.05), whereas anxiety about the explosion, or the degree of perception of it, was not; 74.5% of the sample group believed erroneously that the flash of the explosion was synonymous with radiation.ConclusionsHaving been in the vicinity of the atomic bomb explosion without radiological exposure continued to be associated with poorer mental health more than half a century after the event. Fear on learning about the potential radiological hazard and lack of knowledge about radiological risk are responsible for this association.
Biogenetic explanations and public acceptance of mental illness: Systematic review of population studies
Authors: Angermeyer Matthias C. , Holzinger Anita , Carta Mauro G. , Schomerus Georg 
Published: November 2011

BackgroundBiological or genetic models of mental illness are commonly expected to increase tolerance towards people with mental illness, by reducing notions of responsibility and blame.AimsTo investigate whether biogenetic causal attributions of mental illness among the general public are associated with more tolerant attitudes, whether such attributions are related to lower perceptions of guilt and responsibility, to what extent notions of responsibility are associated with rejection of people who are mentally ill, and how prevalent notions of responsibility are among the general public with regard to different mental disorders.MethodA systematic review was conducted of representative population studies examining attitudes towards people with mental illness and beliefs about such disorders.ResultsWe identified 33 studies relevant to this review. Generally, biogenetic causal attributions were not associated with more tolerant attitudes; they were related to stronger rejection in most studies examining schizophrenia. No published study reported on associations of biogenetic causal attributions and perceived responsibility. The stereotype of self-responsibility was unrelated to rejection in most studies. Public images of mental disorder are generally dominated by the stereotypes of unpredictability and dangerousness, whereas responsibility is less relevant.ConclusionsBiogenetic causal models are an inappropriate means of reducing rejection of people with mental illness.
Predicting the development of schizophrenia in high-risk populations: Systematic review of the predictive validity of prodromal criteria
Authors: Chuma Jefter , Mahadun Prem 
Published: November 2011

BackgroundThere is a great deal of debate on the usefulness and accuracy of prodromal criteria in predicting schizophrenia. The risk of treating people who screen false positive with medication is considerable. Yet intervening during the prodromal stage of illness may reduce the burden caused by schizophrenia.AimsTo draw together the evidence base for the predictive validity of prodromal criteria in identifying individuals at high risk of developing schizophrenia.MethodWe conducted a systematic review of prospective studies investigating the predictive validity of prodromal criteria in schizophrenia.ResultsOur study found two main criteria, ultra-high-risk criteria and basic-symptoms criteria, used in studies investigating the predictive validity of prodromal symptoms. The sensitivity and specificity of ultra-high-risk criteria was 0.81 (95% CI 0.76–0.85) and 0.67 (95% CI 0.64–0.70) respectively and for basic-symptoms criteria sensitivity and specificity was 0.97 (95% CI 0.91–1.00) and 0.59 (95% CI 0.48–0.70) respectively.ConclusionsBoth ultra-high-risk criteria and basic-symptoms criteria are useful in predicting the development of schizophrenia among high-risk populations.
Great wits and madness: More near allied?
Authors: Jamison Kay Redfield 
Published: November 2011

SummaryA purported association between creativity and psychopathology is ancient, persistent and controversial. Biographical research, studies of living artists and writers, and investigations into the cognitive and temperamental factors linked to both creativity and mood disorders suggest a more specific link to bipolar illness. A new, large and well-designed population-based study adds further support to this connection.
Shame and acute psychiatric in-patient care
Authors: Crossley David Richard , Jones Alun Charles 
Published: November 2011

Aims and methodTo investigate the complementarities of staff and service users' experiences of shame in psychiatric in-patient settings. Qualitative methods were used by means of focus group interviews in two compositions – staff and service users. Data were transcribed and thematically analysed.ResultsService user group transcripts revealed four prominent themes: ‘loss of value’, ‘loss of adulthood and autonomy’, ‘loss of subjectivity’ and ‘shaming or blaming of others’. Staff group transcripts also revealed two themes one of which overlapped with service users (‘shaming or blaming of others’) and one of which was distinct (‘entrapment’).Clinical implicationsShame processes may be elicited by caregiving and impede treatment. Staff find themselves in the predicament of provoking the problems they intend to address. Suggestions are made as to how to respond to this dilemma and practically improve aspects of the in-patient care process to reduce shame.
Systematic review of workplace-based assessments in psychiatry: surgical dissection and recommendations for improvement
Authors: Sugand Kanchan , Palod Swapnil , Olua Kalu , Saha Satyajit , Naeem Asim , Matin Samina , Howlett Mary 
Published: November 2011

SummaryRecent surveys have highlighted widespread criticisms of the use of workplace-based assessments (WPBAs) in psychiatric training. We describe our systematic review of psychiatric WPBAs, including a ‘surgical dissection’ of their format and process. From our review, we identified seven overarching WPBA themes, and have drawn on these to make further recommendations to strengthen the wider acceptability of WPBAs in psychiatric settings. We hope this will encourage further debate on ways of improving these tools, rather than them becoming side-lined as ‘top-down’ tick-box exercises.
‘From glorious to infamous’: the life span of (addiction) specialists in psychiatry
Authors: Swatkins Sandra , Gaston Romina Lopez , Hashmi Mahnaz , Thomas David 
Published: November 2011

SummaryIn this editorial we look at the implications of organisational changes to the National Health Service and financial constraints on addiction psychiatrists, and how creativity and adaptability could be the key to fostering survival and sustainability of subspecialties in danger of extinction.
Risk-Adapted Treatment in Clinical Stage I Testicular Seminoma: The Third Spanish Germ Cell Cancer Group Study
Authors: Aparicio Jorge , Maroto Pablo , del Muro Xavier García , Gumà Josep , Sánchez-Muñoz Alfonso , Margelí Mireia , Doménech Montserrat , Bastús Romá , Fernández Antonio , López-Brea Marta , Terrassa Josefa , Meana Andrés , del Prado Purificación Martínez , Sastre Javier , Satrústegui Juan J. , Gironés Regina , Robert Lidia , Germà José R. 
Published: November 2011

Purpose To confirm the efficacy of a risk-adapted treatment approach for patients with clinical stage I seminoma. The aim was to reduce both the risk of relapse and the proportion of patients receiving adjuvant chemotherapy while maintaining a high cure rate. Patients and Methods From 2004 to 2008, 227 patients were included after orchiectomy in a multicenter study. Eighty-four patients (37%) presented no local risk factors, 44 patients (19%) had tumors larger than 4 cm, 25 patients (11%) had rete testis involvement, and 74 patients (33%) had both criteria. Only the latter group received two courses of adjuvant carboplatin, whereas the rest were managed by surveillance. Results After a median follow-up time of 34 months, 16 relapses (7%) have been documented (15 [9.8%] among patients on surveillance and one [1.4%] among those treated with carboplatin). All relapses occurred in retroperitoneal lymph nodes, except for one case in pelvic nodes. Median node size was 25 mm, and median time to recurrence was 14 months. All patients were rendered disease-free with chemotherapy. The actuarial 3-year disease-free survival rate was 88.1% (95% CI, 82.3% to 93.9%) for patients on surveillance and 98.0% (95% CI, 94.0% to 100%) for those treated with adjuvant chemotherapy. Overall 3-year survival was 100%. Conclusion With the limitations of the short follow-up duration, we confirm that a risk-adapted approach is effective for stage I seminoma. Adjuvant carboplatin seems adequate treatment for patients with 2 risk criteria, as is active surveillance for those with 0 to one risk factors. More reliable predictive factors are needed to improve the applicability of this model.
Sequential Versus Concurrent Trastuzumab in Adjuvant Chemotherapy for Breast Cancer
Authors: Perez Edith A. , Suman Vera J. , Davidson Nancy E. , Gralow Julie R. , Kaufman Peter A. , Visscher Daniel W. , Chen Beiyun , Ingle James N. , Dakhil Shaker R. , Zujewski JoAnne , Moreno-Aspitia Alvaro , Pisansky Thomas M. , Jenkins Robert B. 
Published: November 2011

Purpose NCCTG (North Central Cancer Treatment Group) N9831 is the only randomized phase III trial evaluating trastuzumab added sequentially or used concurrently with chemotherapy in resected stages I to III invasive human epidermal growth factor receptor 2–positive breast cancer. Patients and Methods Patients received doxorubicin and cyclophosphamide every 3 weeks for four cycles, followed by paclitaxel weekly for 12 weeks (arm A), paclitaxel plus sequential trastuzumab weekly for 52 weeks (arm B), or paclitaxel plus concurrent trastuzumab for 12 weeks followed by trastuzumab for 40 weeks (arm C). The primary end point was disease-free survival (DFS). Results Comparison of arm A (n = 1,087) and arm B (n = 1,097), with 6-year median follow-up and 390 events, revealed 5-year DFS rates of 71.8% and 80.1%, respectively. DFS was significantly increased with trastuzumab added sequentially to paclitaxel (log-rank P < .001; arm B/arm A hazard ratio [HR], 0.69; 95% CI, 0.57 to 0.85). Comparison of arm B (n = 954) and arm C (n = 949), with 6-year median follow-up and 313 events, revealed 5-year DFS rates of 80.1% and 84.4%, respectively. There was an increase in DFS with concurrent trastuzumab and paclitaxel relative to sequential administration (arm C/arm B HR, 0.77; 99.9% CI, 0.53 to 1.11), but the P value (.02) did not cross the prespecified O'Brien-Fleming boundary (.00116) for the interim analysis. Conclusion DFS was significantly improved with 52 weeks of trastuzumab added to adjuvant chemotherapy. On the basis of a positive risk-benefit ratio, we recommend that trastuzumab be incorporated into a concurrent regimen with taxane chemotherapy as an important standard-of-care treatment alternative to a sequential regimen.
Microstome–macrostome transformation in the polymorphic ciliateTetrahymena voraxleads to mechanosensitivity associated with prey-capture behaviour
Authors: Grønlien Heidi K. , Hagen Bjarne , Sand Olav 
Published: November 2011

SUMMARYCiliates feed by phagocytosis. Some ciliate species, such as Tetrahymena vorax, are polymorphic, a strategy that provides more flexible food utilization. Cells of the microstomal morph of T. vorax feed on bacteria, organic particles and organic solutes in a non-selective manner, whereas macrostome cells are predators that consume specific prey ciliates. In the present study, we investigated a possible correlation between phagocytosis and mechanosensitivity in macrostome T. vorax. Microstome cells seem to be insensitive to mechanical stimulation whereas macrostome cells depolarise in response to mechanical stimulation of the anterior part of the cell. The amplitude of the receptor potential induced by either a prey ciliate or a 5 μm push by a glass needle was sufficient to elicit a regenerative Ca2+ spike. The difference in mechanosensitivity of the two forms correlates with the swimming behaviour when hitting an obstacle; microstome cells swim alongside the obstacle whereas macrostome cells swim backwards, turn and resume forward swimming. Macrostome cells prevented from backward swimming and the subsequent turn failed to capture prey cells in their pouch. Macrostome cells consumed heterospecific prey ciliates preferentially over conspecific microstome cells. This selectivity is not due to electrical membrane responses elicited by physical contact. Both microstome and macrostome cells accumulated in an area containing putative substances released from heterospecific prey ciliates, but the substances did not elicit any electrophysiological membrane responses. We conclude that the mechanosensitivity of macrostome cells is associated with the prey-capture behaviour, whereas the selective phagocytosis is probably due to chemo-attraction to heterospecific prey ciliates.
Comparison of virtual bronchoscopy with fiberoptic bronchoscopy findings in patients exposed to sulfur mustard gas
Authors: Akhlaghpoor Shahram , Ahari Alireza Aziz , Shabestari Abbas Arjmand , Ghanei Mostafa , Ali Hamideh Ale , Shakiba Madjid 
Published: November 2011

Background Fiberoptic bronchoscopy (FB) is the best modality for evaluation of tracheobronchial endoluminal lesions. Virtual bronchoscopy (VB) with the aid of computed tomography (CT) makes it possible to reconstruct endoscopic-like visualization of major airways. Sulfur mustard (SM) used during the Iraq–Iran war affects respiratory tracts and can lead to tracheobronchial stenosis. Purpose To compare VB with FB in SM-exposed patients suspected for airway stenosis. Material and Methods Thirty-one patients were evaluated with CT and bronchoscopic studies about 15 years after chemical attacks. The median age of patients was 40 years. Spiral CT scans were obtained and data were transferred to a workstation to generate VB images of major airways. Less than one week after CT scan, FB was performed. Results For the tracheal pathologies seen in FB, the sensitivity, specificity, and accuracy of VB was 90.9%, 95%, and 93.5% for tracheal stenosis, 40%, 96.2%, and 87.1% for vocal cord problems, 100%, 100%, and 100% for postoperative changes, and 100%, 96.7%, and 96.8% for intratracheal nodule. The inflammation of mucosal surface could not be assessed by VB. The bronchial pathologies seen in FB included eight cases of stenosis, and one case of nodule. Sensitivity, specificity, and accuracy of VB for detection of bronchial stenosis was 62.5%, 97.8% and 92.6%, respectively. Overall sensitivity, specificity and accuracy of VB in detecting tracheobronchial stenosis were 78.9%, 97.0%, and 92.9%, respectively. Conclusion Our study indicates that VB is an accurate method for evaluating stenoses, endoluminal nodules, and poststenotic areas within the tracheobronchial tree of SM-exposed victims. This complementary method could be helpful in revealing hidden post-stenotic lesions and also better depict the long tracheal strictures and their actual length.
Factors affecting compliance in faecal occult blood testing: a cluster randomized study of the faecal immunochemical test versus the guaiac faecal occult test
Authors: Birkenfeld Shlomo , Belfer Rachel Gingold , Chared Miri , Vilkin Alex , Barchana Micha , Lifshitz Irena , Fruchter Dana , Aronski Dina , Balicer Ran , Niv Yaron , Levi Zohar 
Published: November 2011

Objective To compare the uptake of faecal immunochemical occult blood test (FIT) with guaiac faecal occult blood test (gFOBT) in a screening programme, with specific attention to the demographic and socioeconomic factors that might affect test uptake. Setting The Clalit Health Service screening programme, Israel. Methods Average-risk individuals aged 50–75 years were randomized into a FIT arm or gFOBT arm using a programme based on the socioeconomic status (SES) of their primary care clinics. G-FOBT was performed with Hemoccult SENSA™ (3 evacuations) and FIT with the OC- MICRO™ (3 evacuations, refrigerating mandated). The GLIMMIX model was used. Results There were 5,464 and 10,668 eligible participants in the FIT and gFOBT arms respectively. Compliance in taking the kits was better (but not statistically significantly better) with gFOBT (37.8% vs. 29.3%; odds ratio [OR] 1.43 [95% CI 0.73–2.80]; P = 0.227). Kit return was higher in the FIT arm (65.0% vs. 78.9%; OR 0.45 [95% CI 0.24–0.83], P = 0.021). Overall test uptake was affected by age, gender, being immigrant and SES (determined by whether or not the participant paid national insurance tax, and the SES of the primary care clinic). The overall uptake of gFOBT and FIT was comparable (OR 0.996 [95% CI 0.46–2.17], P = 0.99). Conclusions Overall compliance for test uptake was comparable between the two methods despite the more demanding procedure in the FIT arm. Sociodemographic parameters were the major determinants of compliance. An educational programme, with emphasis on the sociodemographic characteristics of the target population, should be instigated.