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Dans le cadre du développement de la classification internationale des maladies (CIM-11), les groupes de travail ont développé des propositions avec pour objectif d’améliorer l’utilité clinique de la classification. Ces propositions sont testées via la plateforme internet « Réseau Mondial de Pratique Clinique (RMPC) » permettant de conduire à des études cliniques électroniques dans les langues officielles de l’OMS, dont le français. Cette étude s’intéresse aux catégories diagnostiques des troubles de l’alimentation et des conduites alimentaires (TCA). Des nouveaux diagnostics ont été proposés tels que le trouble d’hyperphagie et le trouble d’évitement et de restriction de l’apport alimentaire.
– évaluer l’impact des changements spécifiques des TCA entre la CIM-10 et la CIM-11 auprès des membres francophones du RMPC ;
– évaluer la validité, l’utilité clinique des nouvelles propositions et l’accord inter-juges des participants.
Étude mixte, internationale, conduite par internet auprès des membres francophones du RMPC.
Membres du RMPC maîtrisant le français (environ 1000 professionnels) et exerçant une activité clinique.
La population cible recevra un email d’invitation. Les participants seront amenés à lire deux vignettes puis à poser des diagnostics et à répondre à des questions complémentaires, en se basant sur la CIM-10 ou la CIM-11 qu’ils auront reçu de façon aléatoire.
Les vignettes représenteront des cas cliniques réels et reflèteront les changements spécifiques entre la CIM-10 et la CIM-11. Elles seront ainsi présentées par pair (8 pairs possibles).
– interparticipants portant sur l’utilisation du système diagnostique (10 ou 11) et l’attribution du diagnostic en fonction des changements spécifiques ;
– intra-participant sur l’évaluation des pairs de vignettes.
Cette étude doit permettre d’évaluer les nouvelles propositions CIM en français, en tenant compte des spécificités culturelles et linguistiques de la francophonie.
Stigma against mental illness and the mentally ill is well known. However, stigma against psychiatrists and mental health professionals is known but not discussed widely. Public attitudes and also those of other professionals affect recruitment into psychiatry and mental health services. The reasons for this discriminatory attitude are many and often not dissimilar to those held against mentally ill individuals. In this Guidance paper we present some of the factors affecting the image of psychiatry and psychiatrists which is perceived by the public at large. We look at the portrayal of psychiatry, psychiatrists in the media and literature which may affect attitudes. We also explore potential causes and explanations and propose some strategies in dealing with negative attitudes. Reduction in negative attitudes will improve recruitment and retention in psychiatry. We recommend that national psychiatric societies and other stakeholders, including patients, their families and carers, have a major and significant role to play in dealing with stigma, discrimination and prejudice against psychiatry and psychiatrists.
The Time to Change (TTC) anti-stigma campaign, launched in January 2009 in England, intends to make fundamental improvements across England in: public knowledge, attitudes and discriminatory behaviour in relation to people with mental illness. To be effective and valid the campaign must reach a wide range of diverse audiences. This study explores attitudes of people from ethnic minority communities in relation to mental health.
The study investigates:
1) General attitudes and perceptions about mental illness in ethnic minority communities
2) How we might increase awareness about mental wellbeing and decrease stigma in ethnic minority communities.
Ten focus groups with members of ethnic minority groups were conducted. Five groups consisted of service users and five were composed of non-service users. Two groups comprised participants from an Indian origin, two Somali origin, two Afro-Caribbean origin and the other groups were mixed.
We will present findings regarding the ways in which traditional perceptions of mental health and personal experiences of ethnic minority service users affect their perceptions of sources of support such as family, friends, medical staff and religion and how this feedback could inform ant-stigma interventions.
The study suggests that in order to maximise the impact of anti-stigma campaigns, attention should be given to sources of discrimination and traditional perceptions of mental illness which are emphasised by ethnic minority groups. When planning anti-stigma campaigns it is important to incorporate experiences and perceptions from a wide range of audiences.
Social contact is one of the most effective strategies for improving inter-group relations and is supported by decades of positive evidence. Several studies specifically support social contact interventions as a way of reducing stigma against people with mental health problems. Despite the effectiveness of this approach, some social groups have few opportunities for social contact in the real world.
Using the England Time to Change anti-stigma campaign as an example, we investigate the feasibility and effectiveness of delivering social contact interventions at the mass population level to reduce stigma and discrimination against people with mental health problems.
To investigate: (i) the feasibility of scaling up social contact interventions to reduce stigma and discrimination against people with mental health problems and (ii) the effectiveness of mass population social contact interventions to: improve intended stigmatising behaviour, increase willingness to disclose mental health problems and to promote engagement in antistigma activities.
Two types of mass participation social contact programmes within England's Time to Change campaign were evaluated via self-report questionnaire. Participants at social contact events were asked about the occurrence and quality of contact, attitudes, readiness to discuss mental health, and intended behaviour towards people with mental health problems.
Findings on feasibility and effectiveness of social contact programmes will be presented.
This study suggests that social contact interventions can be used by anti-stigma campaigns to reduce stigma and discrimination against people with mental health problems. Further investigation is needed regarding the maintenance of these changes
Stigma and social exclusion related to mental health are of substantial public health importance for Europe. As part of ROAMER (ROAdmap for MEntal health Research in Europe), we used systematic mapping techniques to describe the current state of research on stigma and social exclusion across Europe. Findings demonstrate growing interest in this field between 2007 and 2012. Most studies were descriptive (60%), focused on adults of working age (60%) and were performed in Northwest Europe—primarily in the UK (32%), Finland (8%), Sweden (8%) and Germany (7%). In terms of mental health characteristics, the largest proportion of studies investigated general mental health (20%), common mental disorders (16%), schizophrenia (16%) or depression (14%). There is a paucity of research looking at mechanisms to reduce stigma and promote social inclusion, or at factors that might promote resilience or protect against stigma/social exclusion across the life course. Evidence is also limited in relation to evaluations of interventions. Increasing incentives for cross-country research collaborations, especially with new EU Member States and collaboration across European professional organizations and disciplines, could improve understanding of the range of underpinning social and cultural factors which promote inclusion or contribute toward lower levels of stigma, especially during times of hardship.
The unprecedented growth, availability and accessibility of sophisticated image analysis algorithms and powerful computational resources led to the idea of developing web-based computational infrastructures that could meet users’ new requirements. On the other hand the gap between the pace of data generation and the capability to extract clinically or scientifically relevant information is rapidly widening.
Integration of the power of sophisticated mathematical models, efficient computational algorithms and advanced hardware infrastructure provides the necessary sensitivity to detect, extract and analyze subtle, dynamic and distributed patterns distinguishing one brain from another, and a diseased brain from a normal brain.
neuGRID is the leading e-Infrastructure where neuroscientists can find core services and resources for brain image analysis. The neuGRID platform makes use of grid services and computing, and was developed with the final aim of overcoming the hurdles that the average scientist meets when trying to set up advanced experiments in computational neuroimaging, thereby empowering a larger base of scientists. Although originally built for neuroscientists working in the field of AD, the infrastructure is designed to be expandable to services from other medical fields (e.g. multiple sclerosis, psychiatric conditions).
“neuGRID for Users” will provide an e-Science environment by further developing and deploying the neuGRID infrastructure to deliver a Virtual Laboratory offering neuroscientists access to a wide range of datasets and algorithm pipelines, access to computational resources, services, and support. Information from this abstract is intended to make aware researchers working with neuroimaging of all possibilities when it comes to resources.
The new channels of communication as social media (e.g. Facebook and Twitter) and the social marketing campaign (i.e. campaign focused on enabling, encouraging and supporting behavioural changes among target audiences) can represent useful strategies to challenge stigma attached to mental disorders.
To evaluate the efficacy of the social marketing campaign of the time to change (SMC-TTC) anti-stigma programme on the target population in England during 2009–2014.
To assess the impact of the SMC-TTC anti-stigma programme in terms of:
– use of the social media channels;
– levels of awareness of the SMC-TTC;
– changes in knowledge, attitude, and behaviour related to mental disorders.
Participants completed the mental health knowledge schedule (MAKS), the community attitudes toward mental illness (CAMI) and the reported and intended behaviour scale (RIBS), together with an ad-hoc schedule on socio-demographic characteristics.
In total, 10526 people were interviewed, it was found a growing usage of the SMC-TTC media channels and of the level of awareness of the campaign (P < 0.001). Being aware of the SMC-TTC was found to be associated with higher score at MAKS (OR = .95, CI = .68 to 1.21; P < .001), at “tolerance and support” CAMI subscale (OR = .12, CI = .09 to .16; P < .001) and RIBS (OR = .71, CI = .51 to .92; P < .001), controlling for confounders.
In the general population, SMC-TTC has been found to be effective in improving attitudes and behaviours towards people with mental disorders.
Considering these promising results obtained in England, social media can represent the possible way forward for challenging stigma. The future on-going evaluation of the SMC-TTC may further shed light on the essential role of social media in reducing of stigma and discrimination.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Reducing public stigma could improve patients’ access to care, recovery and social integration. The aim of the study was to evaluate a mass media intervention, which aimed to reduce the mental health, related stigma among the general population in Catalonia (Spain). We conducted a cross-sectional population-based survey of a representative sample of the Catalan non-institutionalized adult population (n = 1019). We assessed campaign awareness, attitudes to people with mental illness (CAMI) and intended behaviour (RIBS). To evaluate the association between campaign awareness and stigma, multivariable regression models were used. Over 20% of respondents recognized the campaign when prompted, and 11% when unprompted. Campaign aware individuals had better attitudes on the benevolence subscale of the CAMI than unaware individuals (P = 0.009). No significant differences in authoritarianism and support for community mental health care attitudes subscales were observed. The campaign aware group had better intended behaviour than the unaware group (P < 0.01). The OBERTAMENT anti-stigma campaign had a positive impact to improve the attitudes and intended behaviour towards people with mental illness of the Catalan population. The impact on stigma was limited to attitudes related to benevolence. A wider range of anti-stigma messages could produce a stronger impact on attitudes and intended behaviour.
In England, during 2009–2014 the ‘Time to Change’ anti-stigma programme has included a social marketing campaign (SMC) using mass media channels, social media and social contact events but the efficacy of such approach has not been evaluated yet.
The target population included people aged between mid-twenties/mid-forties, from middle-income groups. Participants were recruited through an online market research panel, before and after each burst of the campaign (with a mean number of unique participants per each burst: 956.9 ± 170.2). Participants completed an online questionnaire evaluating knowledge [Mental Health Knowledge Schedule (MAKS)]; attitudes [Community Attitudes toward Mental Illness (CAMI)]; and behaviours [Reported and Intended Behaviour Scale (RIBS)]. Socio-demographic data and level of awareness of the SMC were also collected.
A total of 10,526 people were interviewed. An increasing usage of the SMC-media channels as well as of the level of awareness of SMC was found (P < 0.001). Being aware of the SMC was found to be associated with higher score at MAKS (OR = 0.95, CI = 0.68 to 1.21; P < 0.001), at ‘tolerance and support’ CAMI subscale (OR = 0.12, CI = 0.09 to 0.16; P < 0.001), and at RIBS (OR = 0.71, CI = 0.51 to 0.92; P < 0.001), controlling for confounders.
The SMC represents an important way to effectively reduce stigma. Taking into account these positive findings, further population-based campaigns using social media may represent an effective strategy to challenge stigma.
Total laryngectomy is often utilised to manage squamous cell carcinoma of the larynx or hypopharynx. This study reports on surgical trends and outcomes over a 10-year period.
A retrospective review of patients undergoing total laryngectomy for squamous cell carcinoma was performed (n = 173), dividing patients into primary and salvage total laryngectomy cohorts.
A shift towards organ-sparing management was observed. Primary total laryngectomy was performed for locoregionally advanced disease and utilised reconstruction less than salvage total laryngectomy. Overall, 11 per cent of patients developed pharyngocutaneous fistulae (primary: 6 per cent; salvage: 20 per cent) and 11 per cent neopharyngeal stenosis (primary: 9 per cent; salvage: 15 per cent). Pharyngocutaneous fistulae rates were higher in the reconstructed primary total laryngectomy group (24 per cent; 4 of 17), compared with primary closure (3 per cent; 3 of 90) (p = 0.02). Patients were significantly more likely to develop neopharyngeal stenosis following pharyngocutaneous fistulae in salvage total laryngectomy (p = 0.01) and reconstruction in primary total laryngectomy (p = 0.02). Pre-operative haemoglobin level and adjuvant treatment failed to predict pharyngocutaneous fistulae development.
Complications remain hard to predict and there are continuing causes of morbidity. Additionally, prior treatment continues to affect surgical outcomes.
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
Experiments were initiated to characterize a waterhemp population (CHR) discovered in a central Illinois corn field after it was not controlled by the 4-hydroxyphenylpyruvate dioxygenase (HPPD) inhibitor topramezone. Field experiments conducted during 2014–2015 indicated that acetolactate synthase (ALS)-, protoporphyrinogen oxidase (PPO)-, photosystem II (PSII)-, and HPPD-inhibiting herbicides and the synthetic auxin 2,4-D did not control the CHR population. Laboratory experiments confirmed target site–based resistance mechanisms to ALS- and PPO-inhibiting herbicides. Herbicide doses required to reduce dry biomass 50% (GR50) were determined in greenhouse dose–response experiments, and indicated 16-fold resistance to the HPPD inhibitor mesotrione, 9.5-fold resistance to the synthetic auxin 2,4-D, and 252-fold resistance to the PSII inhibitor atrazine. Complementary results from field, laboratory, and greenhouse investigations indicate that the CHR population has evolved resistance to herbicides from five sites of action (SOAs): ALS-, PPO-, PSII-, and HPPD-inhibiting herbicides and 2,4-D. Herbicide use history for the field in which CHR was discovered indicates no previous use of 2,4-D.
Modern baleen whales (Mysticeti), the largest animals on Earth, arose from small ancestors around 36.4 million years ago (Ma). True gigantism is thought to have arisen late in mysticete history, with species exceeding 10 m unknown prior to 8 Ma. This view is challenged by new fossils from Seymour Island (Isla Marambio), Antarctica, which suggest that enormous whales once roamed the Southern Ocean during the Late Eocene (c. 34 Ma). The new material hints at an unknown species of the archaic mysticete Llanocetus with a total body length of up to 12 m. The latter is comparable to that of extant Omura's whales (Balaenoptera omurai Wada et al. 2003), and suggests that gigantism has been a re-occurring feature of mysticetes since their very origin. Functional analysis including sharpness and dental wear implies an at least partly raptorial feeding strategy, starkly contrasting with the filtering habit of living whales. The new material markedly expands the size range of archaic mysticetes, and demonstrates that whales achieved considerable disparity shortly after their origin.
Increasing the number of quantum bits while preserving precise control of their quantum electronic properties is a significant challenge in materials design for the development of semiconductor quantum computing devices. Semiconductor heterostructures can host multiple quantum dots that are electrostatically defined by voltages applied to an array of metallic nanoelectrodes. The structural distortion of multiple-quantum-dot devices due to elastic stress associated with the electrodes has been difficult to predict because of the large micrometer-scale overall sizes of the devices, the complex spatial arrangement of the electrodes, and the sensitive dependence of the magnitude and spatial variation of the stress on processing conditions. Synchrotron X-ray nanobeam Bragg diffraction studies of a GaAs/AlGaAs heterostructure reveal the magnitude and nanoscale variation of these distortions. Investigations of individual linear electrodes reveal lattice tilts consistent with a 28-MPa compressive residual stress in the electrodes. The angular magnitude of the tilts varies by up to 20% over distances of less than 200 nm along the length of the electrodes, consistent with heterogeneity in the metal residual stress. A similar variation of the crystal tilt is observed in multiple-quantum-dot devices, due to a combination of the variation of the stress and the complex electrode arrangement. The heterogeneity in particular can lead to significant challenges in the scaling of multiple-quantum-dot devices due to differences between the charging energies of dots and uncertainty in the potential energy landscape. Alternatively, if incorporated in design, stress presents a new degree of freedom in device fabrication.
A small fauna of vertebrates is recorded from the Insect Limestone, Bembridge Marls Member, Bouldnor Formation, late Priabonian, latest Eocene, of the Isle of Wight, UK. The taxa represented are unidentified teleost fishes, lizards including a scincoid, unidentified birds and the theridomyid rodent Isoptychus. The scincoid represents the youngest record of the group in the UK. Of particular note is the taphonomic interpretation based on the preservation of anatomical parts of land-based tetrapods that would have been most likely transported to the site of deposition by wind, namely bird feathers and pieces of shed lizard skin. These comprise the majority of the specimens and suggest that the dominant transport mechanism was wind.
GravityCam is a new concept of ground-based imaging instrument capable of delivering significantly sharper images from the ground than is normally possible without adaptive optics. Advances in optical and near-infrared imaging technologies allow images to be acquired at high speed without significant noise penalty. Aligning these images before they are combined can yield a 2.5–3-fold improvement in image resolution. By using arrays of such detectors, survey fields may be as wide as the telescope optics allows. Consequently, GravityCam enables both wide-field high-resolution imaging and high-speed photometry. We describe the instrument and detail its application to provide demographics of planets and satellites down to Lunar mass (or even below) across the Milky Way. GravityCam is also suited to improve the quality of weak shear studies of dark matter distribution in distant clusters of galaxies and multiwavelength follow-ups of background sources that are strongly lensed by galaxy clusters. The photometric data arising from an extensive microlensing survey will also be useful for asteroseismology studies, while GravityCam can be used to monitor fast multiwavelength flaring in accreting compact objects and promises to generate a unique data set on the population of the Kuiper belt and possibly the Oort cloud.
Important Bird and Biodiversity Areas (IBAs) are sites identified as being globally important for the conservation of bird populations on the basis of an internationally agreed set of criteria. We present the first review of the development and spread of the IBA concept since it was launched by BirdLife International (then ICBP) in 1979 and examine some of the characteristics of the resulting inventory. Over 13,000 global and regional IBAs have so far been identified and documented in terrestrial, freshwater and marine ecosystems in almost all of the world’s countries and territories, making this the largest global network of sites of significance for biodiversity. IBAs have been identified using standardised, data-driven criteria that have been developed and applied at global and regional levels. These criteria capture multiple dimensions of a site’s significance for avian biodiversity and relate to populations of globally threatened species (68.6% of the 10,746 IBAs that meet global criteria), restricted-range species (25.4%), biome-restricted species (27.5%) and congregatory species (50.3%); many global IBAs (52.7%) trigger two or more of these criteria. IBAs range in size from < 1 km2 to over 300,000 km2 and have an approximately log-normal size distribution (median = 125.0 km2, mean = 1,202.6 km2). They cover approximately 6.7% of the terrestrial, 1.6% of the marine and 3.1% of the total surface area of the Earth. The launch in 2016 of the KBA Global Standard, which aims to identify, document and conserve sites that contribute to the global persistence of wider biodiversity, and whose criteria for site identification build on those developed for IBAs, is a logical evolution of the IBA concept. The role of IBAs in conservation planning, policy and practice is reviewed elsewhere. Future technical priorities for the IBA initiative include completion of the global inventory, particularly in the marine environment, keeping the dataset up to date, and improving the systematic monitoring of these sites.
Star formation takes place in the dense gas phase, and therefore a simple dense gas and star formation rate relation has been proposed. With the advent of multi-beam receivers, new observations show that the deviation from linear relations is possible. In addition, different dense gas tracers might also change significantly the measurement of dense gas mass and subsequently the relation between star formation rate and dense gas mass. We report the preliminary results the DEnse GAs in MAssive star-forming regions in the Milky Way (DEGAMA) survey that observed the dense gas toward a suite of well-characterized massive star-forming regions in the Milky Way. Using the resulting maps of HCO+ 1–0, HCN 1–0, CS 2–1, we discuss the current understanding of the dense gas phase where star formation takes place.