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This paper explores the nature and scale of inter-regional and inter-urban inequalities in the UK in the context of international comparisons and our aim is to identify the extent to which such inequalities are associated with strong national economic performance. In order to do this, we first discuss the evolution of UK interregional inequalities relative to comparator European economies over more than a century. We then focus specifically on comparisons between the UK and the reunified Germany. These two exercises demonstrate that the experience of the UK has been rather different to other countries. We further explore UK inter-urban inequalities in the light of international evidence and then explain why observations of cities only tell us a partial story about the nature of interregional inequalities, especially in the case of the UK. Finally, we move onto an OECD-wide analysis of the relationships between economic growth and interregional inequality. What we observe is that any such relationships are very weak, and the only real evidence of a positive relationship is in the post-2008 crisis period, a result which points to differentials in regional resilience rather than inequality-led growth. Moreover, once former transition economies are removed from the sample, the relationship disappears, or if anything becomes slightly negative. As such, the international evidence suggests that the UK’s very high spatial inequalities have hampered, rather than facilitated, national economic growth.
As cash increasingly becomes an essential part of humanitarian assistance, it is critical that practitioners are aware of, and work to mitigate, exposure to protection risks among the most vulnerable recipients. This article presents findings from qualitative research exploring protection risks and barriers that arise in cash programming for internally displaced persons at high risk of violence and exploitation in Cameroon and Afghanistan. The authors conclude with recommendations for mainstreaming global protection principles into cash programmes, as well as key considerations for designing and implementing cash programmes in ways that minimize existing risks of harm and avoid creating new ones.
Brain-derived neurotrophic factor (BDNF) is involved in neurogenesis and in the protection against oxidative damage and neuronal apoptosis. After exercise, there is an increased expression of this myokine, especially in skeletal muscle and brain. Low BDNF levels have been described in neurodegenerative diseases. Alcoholics show both muscle atrophy and brain atrophy. Thus, this study was performed in order to analyze serum BDNF levels among alcoholics and their associations with brain atrophy and muscle strength.
Serum BDNF values were determined to 82 male alcoholics and 27 age-matched controls, and compared with handgrip strength, with the presence of brain atrophy, assessed by computed tomography, and with the intensity of alcoholism and liver function derangement.
BDNF levels and handgrip strength were significantly lower among patients. Handgrip strength was correlated with BDNF values, both in the whole population and in alcoholics, especially in patients over 59 years of age. BDNF was poorly related to liver dysfunction but showed no relationship with brain atrophy or age.
Chronic alcoholics show decreased BDNF serum levels that are related to muscle function impairment rather than to age, brain atrophy, liver dysfunction, or the amount of ethanol consumed.
Although learning second language phonology is a difficult task, orthographic input may support the learning of difficult sound contrasts through a process known as orthographic facilitation. We extended this research by examining the effects of orthographic input together with individual differences in three different phonological learning processes, namely, the production of, perception of, and memorization of words containing three Marathi phonemic contrasts (i.e., [k-kh], , and ) by native English speakers. Moreover, because the  and  contrasts were particularly challenging in previous auditory training studies (e.g., Polka, 1991), we used cross-modal training in order to enhance learning by pairing auditory perception tasks with visual orthographic information, the amplification of relevant acoustic cues, and proprioceptive descriptions to the articulation of target phonemes. Results showed significant learning from the pre- to the posttest across tasks and contrasts, supporting the effectiveness of cross-modal training. Furthermore, incongruent orthographic input could inhibit perception, and orthographic input generally supported memory for word pronunciations. Moreover, individual differences regarding phonological skills and nonspeech auditory discrimination predicted participants’ success in different phonological learning processes. These results provide a detailed picture of the complexity between different aspects of second language phonological learning and cross-modal training.
Describe Attention Deficit Hyperactive Disorder's (ADHD) prevalence in Bipolar Disorders (BD) and relatives.
78 admissions for Bipolar Disorder (DSM-IV) in Impatient Psychiatric Unit, in Hospital Clínico Universitario of Valladolid (Spain). Only 36/78 patients participate in study. Demographic, social and clinical information were registered. ADHD symptomatology was evaluated from patient and descendant (Conners short version).
ADHD symptomatology suggestive in childhood/adolescence were detected in 13,9% (5/36). Conners score were negative (below 15) in all case.
ADHD symptomatology suggestive in their children were detected in 6,25% (n=3). Conner score were positive in 2,1%. Family psychiatry history in 72,2% (n=26), affective disorder in 60,52% (n=23). No family history with ADHD diagnosis. Only one case (2,8%) with symptomatology suggestive of ADHD in relatives.
The ADHD prevalence in our sample of BD and relatives weren’t higher than general population.
- Frontiers Between Attention Deficit Hyperactivity Disorder and Bipolar Disorder. Cathryn A. Galanter, MDa, Ellen Leibenluft, MD. Child Adolesc Psychiatric Clin N Am 17 (2008) 325-346.
- Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children.
Suicide is one of the most frequent causes of death. In 1993, Bleuler emphasized its importance in his “Suicidal behavior is the most serious symptom of schizophrenia”. Since then, various studies have confirmed importance of suicide in schizophrenia, and today it's clear that his research and knowledge is one of the great challenges of psychiatry.
- Establish clinical-socio-demographic profile and risk factors for psychotic people with autolytic behaviors.
- Determine frequency of suicides in psychotic disorders in our area of care.
Material and methods
Retrospective study(3 years evolution) that includes psychotic patients(diagnosed according DSM IV-TR) admitted to the HCU of Valladolid. With data provided by hospital medical records, analyzed socio-demographic variables and clinics. Study consists of two groups:group of cases(those patients who have suicidal behavior) and control group (those that haven't autolytic gesture during the study period). Statistical evaluation was performed with SPSS.
- The sample includes 191 patients:41(21%) have attempted suicide.
- Of them:73% are males;88% singles;51% have basic studies;61% we re unemployed;37% were 31-40 aged;54% started disease 21-30 aged and 63.5% are schizophrenic.
- Considering statistical study we find that suicidal patient profile is male(p = 0.039),diagnosed with schizophrenia(p = 0.033),with previous suicide attempts(p = 0.009)and lack of social support(p = 0.007).
- 21% of hospitalized psychotic patients have presented some autolytic attempt.
- Profile of suicidal psychotic patient is a male, single, 21-40 aged, primary education, unemployed, with a primary diagnosis of schizophrenia, particularly paranoid, with ten years evolution,without acceptable social support, number of revenues higher than non-suicidal psychotic and a personal history of previous autolytic attempts.
Present study shows the socio-demographic and clinical profile of patients with severe mental illness in Mancha Centro health area. Furthermore, it is a descriptive approach to the current state of clinical assistance in the area.
Socio-demographic and clinical variables were collected in a sample of 55 patients, 37 men and 18 women with severe mental illness, treated at the Mancha Centro Mental Health Centre. Using SPSS.15, analysis of qualitative and quantitative variables was made.
Average age was 39, 25 years +/− 8, 82; 72, 7% lived with their families and 85, 5% had the support of relatives. Main diagnosis were: psychotic disorder (81,2%) with high proportion of schizoaffective disorder; mood disorders (9,1%), personality disorders (5,5%) and OCD (3,6%). In the last two years, 25, 5% was admitted in a medium-stay psychiatric unit, 15% in a short- time stay psychiatric unit and, in the last six months, 4% came to emergency service. Patients with higher number of admissions and emergency consultations were those with schizophrenia and schizoaffective disorder. The average time of follow up was 10 years (+/− 6, 84), every 49, 45 days (+/− 19,1). 80% receive group therapy, 85,5% family intervention and 54,5% cognitive rehabilitation.
We found a profile of young man with significant family support, low number of admissions and emergency consultations. Results could be in relation to: geographical dispersion, emergency access difficulties and protective socio-cultural factors. Better knowledge about needs would allow a better assistance in the future.
UPD is a regional referral hospital psychiatric care unit, endowed with multidisciplinary equipment. It provides care to people with light/moderate/severe intellectual incapacity coexisting with mental disease and/or severe behavioral disorders. It offers attention to patients who need a protected therapeutical environment for correcting behavior disorders. It was opened in September 2008.
Description of:therapeutic goals, inclusion/exclusion criteria, admission protocol and psychotherapeutic/pharmacological interventions.
Analysis of inpatients's sociodemographic/clinical characteristics and preliminary assessment of therapy goals.
Retrospective study(13-month) of patients admitted to UPD of Leon Hospital from its inception to date. Data are collected from medical histories.
47 referrals have been received,5 of them have been rejected not to fulfill criteria. We’ve 16 patients on waiting list.32 incomes have been realized and 22 discharges have occurred.
19 of the incomes correspond to Mild,6 to Moderate,6 to Severe and 1 to Profound mental Retardation.
Regarding co-morbidity:22 patients presented serious behavioral disorder. From this group, 2 met criteria for autistic disorder, 5 had schizophrenia or unspecific psychotic disorders, 5 presented Personality Disorder and one ADHD.
10 patients did’nt present any important behavioral disturbance. From this group 2 were diagnosed with OCD,3 presented problems due to Alcohol and Substance-related Disorders,3 had Psychotic Disorders, one met criteria for Impulse Control Disorder and one presented Mood Disorder.
Before admission, 12 patients resided in specific handicappeds center, 5 intermittently at selected centers and in family, and 15 lived with family.
Psychotherapeutic intervention and treatment were useful in most cases. It was particularly helpful in treatment of behavioral disturbances. Now we must determine effectiveness in maintenance of improvement when they return to their community.
Alexithymia is a term to describe a state of deficiency in understanding, processing, or describing emotions. It expresses the cognitive-emotional state of vulnerable subjects who prone to suffer from psychosomatic illnesses. It’s characterized by difficulties in relationship and emptiness of feelings. It has been incriminated in genesis and maintenance of various psychosomatic pathologies, included psoriasis. Psychological stress is important in onset and exacerbation of psoriasis. We assume hypothesis that emotions that cannot be expressed through the appropriate symbolic language will be expressed through a symbolic somatic symptom.
A case study of psoriasis in a woman of 27 years without a previous psychiatric history. She was treated jointly by the service of psychiatry and dermatology. Methodology: We performed a detailed history in the course of the disease, summarizing vital changes and outstanding events of her lifetime in the different vital areas (family, work, school and sex life).
From the comprehensive revision of the ailments and pathobiography we can establish a clear relationship between physical-psychological symptoms.
Skin is an envelope that represents the boundary line between body-psyche. Skin and psyche interact in many ways. The skin reacts to feelings and perceptions. Psychosomatic patients feel extreme anxiety when they have to cope with separation and merger situations. They experience these situations as if they were to lose their physical limit. Broadly speaking, because of their alexithymia, they cannot process a painful emotion properly, and though they will express it through somatisation disorders and the development of diseases. In the case of our patient, the skin verbalizes her emotional silence.
The high prevalence of those called “revolving-door patients” continue supposing a high sanitary cost. The aim of this study was to identify factors associated with multiple admissions in a psychiatric unit.
The sample included all patients hospitalized in a psychiatric unit at the hospital “Virgen de las Nieves” in the city of Granada (southern Spain), during the time period between 1998 and 2006 (n=1873). There is no consensus in the literature with regard to the definition of the “revolving-door phenomenon”. Basing on prior studies (Woogh, 1990; Thornicroft et al., 1992), we defined "revolving-door patients” as those who had been hospitalized eight or more times in an eight-year period (an average of at least an admission per year).
The prevalence of revolving-door patients was 10% (186/1873). The condition of revolving-door patients was associated with male sex (OR=1.5; IC 95%: 1.1-2.1), with a marital status different from the married one (OR=1.8; IC 95%: 1.3-2.6), and with the diagnoses of schizophrenia (OR=3.3; IC 95%: 2.4-4.6), schizoaffective disorder (OR=3.8; IC 95%: 2.3-6.5), bipolar disorder (OR=2.1; IC 95%: 1.4-3.2) and personality disorder (OR=2.2; IC 95%: 1.3-3.5).
Male sex, marital status different from the married one and the diagnoses of schizoaffective disorder or schizophrenia may be a risk factor of readmission in a psychiatric unit. A better comprehension about the characteristics of these patients may help to establish more effective strategies to board the psychiatric community.
A higher prevalence of toxic substances consumption is considered to be under schizophrenia states.These patients are also considered to have a higher possibility than general population of developing different disorders due to the use of substances being the risk above 3 regarding alcohol,5 for cannabis, 6 for opiates, and 13 for cocaine.Two hypotheses were used for explaining this comorbidity: for alleviating its symptomatology and the adverse effects of the antipsychotic treatment, and on the other hand, the use of toxic substances as causal and predisposing effect of psychotic episodes in patients with personal vulnerability.
Sociodemographic description of patients diagnosed as having psychotic disorders with abuse of toxic substances. Establishment of connections between the toxic substance consumption and development of his/her mental disorder.
Methodology: Open retrospective study of two years in which patients diagnosed as having schizophrenia admitted into the University Hospital in Valladolid, Spain: consumers/no consumers.Scales (SAPS, SANS).Hospital Reports(sociodemographic and clinical data).
Preliminary results show the prevalence of the schizophrenic patients with toxic abuse.Predominance of young males that had their first admissions into hospital at very early ages and a higher frequency of hospital readmissions. Likewise in this group positive symptomatology shows a higher predominance and a higher connection with affective disorders. These patients show a better premorbid adaptation, a higher frequency of violent and impulsive behaviours, treatment guidelines with higher doses and higher frequency of resistance to treatment.The order consumption of toxics is tobacco, alcohol, cannabis, cocaine, stimulants, and opiates.However it is not rare to find consumption of multiple drugs.
Attention Deficit Hyperactivity Disorder (ADHD)presents high levels of life-long comorbidity. Several studies demonstrate an elevated coocurrence between ADHD and Substance Use Disorder (SUD) as well as personality disorders.
The objective of this poster is to demonstrate differential characteristics between ADHD with SUD patients versus ADHD without SUD, in relation to Axis II comorbidity, ADHD symptoms severity and childhood behavioural disorders (conduct disorder and oppositional defiant disorder).
Another objective is to identify differences in the prevalence of SUD relative to gender and ADHD subtype (Inattentive, Hyperactive/Impulsive and Combined).
This will be done using a comparative-descriptive study that was carried out with a sample of 125 adults diagnosed with ADHD using the CAADID in the Adult ADHD Integral Programme (PIDAA) of Vall d'Hebron Universitari Hospital; 53 subjects presented associated SUD (DSM-IV). All the subjects were evaluated with ADHD Rating Scale, SCID-I, SCID-II and K-SADS.
Relative to ADHD group, subjects ADHD with SUD subjects showed higher comorbidity with Axis–II Disorders, especially with antisocial, schizoid and paranoid personality disorders, as well as major prevalence of conductual disorder and oppositional defiant disorder in childhood. There were no significant differences respect to ADHD symptoms severity nor ADHD subtype between both groups. A major proportion of men were observed in ADHD with SUD group compared to ADHD patients.
The use of Internet-based communication tools has spread to multiple areas of life. E-mail is a fast and easy tool that can be used by the health care system to facilitate doctor-patient communication.
To assess the use and value of the e-mail for communication between physician and patient, from patients’ perspective.
To evaluate the use of e-mail as a potential therapeutic tool in patients with alcohol dependence.
The sample included patients who reported to have an e-mail account at their first visit in Alcohol Unit (n = 44 of 238 patients seen during one year). 23 patients were given the contact e-mail of the Alcohol Unit, and were instructed to contact their physician, if needed, by e-mail. The rest of the sample (n = 21) could contact their physician only by phone. Six months later, the whole sample received an electronic survey measuring their satisfaction of the communication with the physician.
57% patients who received the contact e-mail of the Alcohol Unit answered the survey (n = 13). Of those, 54% used e-mail to contact their physician. 71% found e-mail easy-to-use; 86% reported being satisfied with e-mail communication.
E-mail contact with physician was considered useful by most patients, although they report using also other contact methods, such as phone call.
To establish the main sociodemographic and clinical characteristics of a sample of inpatients admitted at the Brief Hospitalization Psychiatry Unit from the University Hospital of Valladolid, Spain during 2005.
Descriptive study of a sample of inpatients (n=160) admitted in 2005 by means of the discharge report. Sociodemographic variables include age, sex, civil status and both socioeconomic and education levels; clinical variables include diagnosis according ICD and DSM-IV criteria, substance use, duration of admission and pharmacological treatment.
The type patient is a male between 31 and 40 years or a woman between 51 and 60 years, single, with a middle socioeconomic and education levels. Substance use is frequently found in male patients, mainly concerning several substances. Mean duration of admission was about 13 days. Women usually are diagnosed of affective disorders and men of adaptive disorders associated with substance use; schizophrenia also appears more frequently in men.
The characteristic patient admitted at the Brief Hospitalization Psychiatry Unit from the University Hospital of Valladolid, Spain in 2005 is either a male between 31 and 40 years suffering from adaptive disorders and substance use, or schizophrenia, or a woman between 51 and 60 years diagnosed of affective disorders.
Alcoholism is one of the most common chronic disorders in the western world that causes and aggravates a whole range of diseases and disorders. The purpose of this study was to determine the prevalence of cases of erectile dysfunction (ED) among the alcoholics attending a detoxification unit.
100 male alcoholic patients were selected from all consecutive visits to an alcohol outpatient unit. The diagnosis of ED was determined using the SQUED questionnaire for ED (score <= 12). All the patients were questioned about their use of alcohol and other drugs, the organic diseases they were suffering from and the pharmacological treatment they were receiving.
One hundred patients recruited had a mean age of 47.2 ± 9.8 years. The mean daily amount of alcohol consumed was 14.4 ± 7.6 standard drink units, the mean frequency being 6.5 +- 1.4 days a week. The abstinence time over the last six months was 14.2 ± 9.8 weeks. 83% of patients were smokers and 29% consumed hypnotics-sedatives. 73% of patients were on pharmacological treatment (57% for alcoholic detoxification, 33% with antidepressants). According to the SQUED questionnaire, 26% of patients presented ED and 20% had had no sexual relationship during the last 6 months.
The prevalence of ED in alcoholic patients was high (26-46%). The diagnosis and treatment of ED should be an aspect to be taken into account in this type of patients to reduce their anxiety and so aid in preventing possible relapses of their alcoholism.