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Social capital (SC) is highlighted as an important factor for post-crisis mental health outcomes. However, the heterogeneous nature of the construct makes it difficult to get a clear picture of the evidence concerning the association between SC indices and mental health. This review examines how SC is conceptualized and measured, and the relationships with other variables in quantitative empirical studies investigating the associations between SC and mental health in post-disaster and post-conflict contexts. It includes primary data studies focusing on this association in civilian populations. Studies were identified by searching electronic databases, bibliographic mining, cited reference searching, and personal contact with experts. In total, 15 studies were included: 12 in post-natural disaster contexts and 3 in conflict-affected settings. Findings suggested that individual cognitive SC had an inverse association with post-traumatic stress disorder, anxiety, and depression, and that ecological cognitive SC was positively associated with mental well-being. Individual structural SC (in the form of community networks) may be psychologically protective. However, most of the evidence was cross-sectional, limiting conclusions about causal relationships. More clarity and consistency is needed in the conceptualization and measurement of SC in order to inform post-crisis mental health interventions. (Disaster Med Public Health Preparedness. 2018;12:791-802)
In spring 2014, an interdisciplinary media project titled “Troubled Waters: Tracing Waste in the Delaware River” was organized at Haverford College. This project brought together more than 50 students from four courses comprising introductory political science, chemistry, and documentary film students, as well as a community media artist and community partners. The aim was to explore the causes, impacts, and meanings of different types of waste that are polluting the Delaware River. Chemistry students collected samples to determine the presence of chemicals from various waste products, political science students traced the waste to globalized production processes, and documentary students explored diverse ways of representing the theme of waste on screen. This article describes the project and how it might serve as a pedagogical model for multicourse interdisciplinary collaboration and community engagement.
Over the past decade there have been significant efforts to scale-up mental
health services in resource-poor countries. A number of cost-effective
innovations have emerged as a result. At the same time, there is increasing
concern in resource-rich countries about efficacy, efficiency and
acceptability of mental health services. We consider two specific
innovations used widely in low- and middle-income countries, task-sharing
and a development model of mental healthcare, that we believe have the
potential to address some of the current challenges facing mental health
services in high-income countries.
The World Health Organization has made concerted efforts to scale up mental health services in low- and middle-income countries through the Mental Health Gap Action Programme (mhGAP) initiative. However, an overreliance on scaling up services based on those used in high-income countries may risk causing more harm than good.
Clozapine is used in the management of treatment-resistant schizophrenia and is effective in reducing aggression; however a subgroup of patients is poorly responsive. For violent patients in this group, there is limited literature on the use of strategies to augment clozapine with other agents. Here we present a case series of 6 schizophrenia patients, within a high-security hospital, who have a history of serious violence and who were treated with clozapine augmented with amisulpride.
We reviewed case notes and health records for evidence of violence/aggression and positive factors such as engagement in activities, and Clinical Global Impression (CGI) scores were formulated. We also examined metabolic parameters before and after augmentation.
All 6 of the patients showed clinical improvement in symptoms and a reduction in their risk of violence to others. Five patients had a reduction in number of violent/aggressive incidents, and all patients showed improvement in engagement in occupational, vocational, and/or psychological work. Metabolic parameters were largely unchanged except for 1 patient whose Body Mass Index (BMI) increased. Five patients reported side effects as unchanged or improved.
These schizophrenia patients with a history of violence showed clinical improvement and reduced aggression and violence with amisulpride augmentation of clozapine. To our knowledge, this is the first report of an antiaggressive benefit of this combination in forensic psychiatric patients. Further studies are warranted to establish the efficacy and anti-aggressive effects of amisulpride augmentation of clozapine.
Materials that offer the ability to influence tissue regeneration are of vital importance to the field of Tissue Engineering. Because valid 3-dimensional scaffolds for nerve tissue are still in development, advances with 2-dimensional surfaces in vitro are necessary to provide a complete understanding of controlling regeneration. Here we present a method for controlling nerve cell growth on Au electrodes using Atomic Force Microscopy -aided protein assembly. After coating a gold surface in a self-assembling monolayer of alkanethiols, the Atomic Force Microscope tip can be used to remove regions of the self-assembling monolayer in order to produce well-defined patterns. If this process is then followed by submersion of the sample into a solution containing neuro-compatible proteins, they will self assemble on these exposed regions of gold, creating well-specified regions for promoted neuron growth.
In a previous paper auditing individual therapy in the STEPS team, we demonstrated a significant problem with attrition for both CBT and person-centred therapy. We argued that a root-and-branch change to the referral process was needed. This paper looks at the system which replaced it. ‘Callback’ allows self-referral with service users able to leave a phone message at any time. Clinicians call back and carry out a protocol-driven assessment, arranging, where appropriate, services at the end of the call. Reporting on the first 2500 calls, 92% of callers were successfully called back. Individuals were, on average, called back in 8.4 hours. Eighty-six percent of callers were offered an intervention within the STEPS service. They entered these STEPS services, on average, 9.4 days after the initial phone call. Of all callers 15.6% were offered individual therapy. Of these, 93% attended the first appointment and 82% completed a course of treatment. The results suggest that Callback is a significant improvement on the GP-referral system it replaced and provide evidence supporting the utility of ‘multi-level, multi-purpose’ services in primary care.
Piriformis Syndrome (PS) is an uncommon, controversial neuromuscular disorder that is presumed to be a compression neuropathy of the sciatic nerve at the level of the piriformis muscle (PM). The diagnosis is hampered by a lack of agreed upon clinical criteria and a lack of definitive investigations such as imaging or electrodiagnostic testing. Treatment has focused on stretching, physical therapies, local injections, including botulinum toxin, and surgical management. This article explores the various sources of controversy surrounding piriformis syndrome including diagnosis, investigation and management. We conclude with a proposal for diagnostic criteria which include signs and symptoms, imaging, and response to therapeutic injections.
Echinoderms are well represented in nearshore hard-bottom (< 100 m depth) habitats along the Antarctic Peninsula where they are presumably important contributors to benthic production, carbon flow, and determinants of community structure. The present study assesses the densities of echinoderms at shallow depths (2–15 m) at five sampling sites within three kilometres of Anvers Island on the central western Antarctic Peninsula. The asteroids Odontaster validus, Granaster nutrix, Lysasterias perrieri and Adelasterias papillosa, two ophiuroids in the Amphiuridae, the holothuroids Psolicrux coatsi and Psolus carolineae and one representative of the Cucumaridae, and the regular echinoid Sterechinus neumayeri were enumerated. Mean total echinoderm densities were high (34.9 individuals m-2) and ranged from 21.9 individuals m-2 for asteroids to 2.7 individuals m-2 for holothuroids. With the exception of a positive relationship between the abundance of the regular echinoid Sterechinus neumayeri and the biomass of the brown alga Himanthothallus grandifolius, no significant relationships were found between the abundance of asteroids, ophiuroids, or holothuroids and two species of brown algae or three algal ecotypes. The present study indicates nearshore hard-bottom echinoderms are important in the carbon cycle and their inherent vulnerability to ocean acidification may have community-level impacts.
Background: Individuals experiencing psychosis can present with elevated levels of depression and anxiety. Research suggests that aspects of depression and anxiety may serve an avoidant function by limiting the processing of more distressing material. Acceptance and Commitment Therapy suggests that avoidance of aversive mental experiences contributes to psychological inflexibility. Depression and anxiety occurring in the context of psychosis have a limiting effect on quality of life. No research to date has investigated how levels of psychological flexibility and mindfulness are associated with depression and anxiety occurring following psychosis. Aims: This study investigated associations psychological flexibility and mindfulness had with depression and anxiety following psychosis. Method: Thirty participants with psychosis were recruited by consecutive referral on the basis that they were experiencing emotional dysfunction following psychosis. The Hospital Anxiety and Depression Scale (HADS), Positive and Negative Syndrome Scale (PANSS), Acceptance and Action Questionnaire (AAQ-II) and the Kentucky Inventory of Mindfulness Skills (KIMS) were used. A cross-sectional correlational design was used. Results: The depression and anxiety subscales of the HADS both had significant correlations with psychological flexibility (as assessed by the AAQ-II) and aspects of mindfulness (as assessed by the KIMS). Hierarchical regression analyses indicated that psychological flexibility, but not mindfulness, contributed significantly to models predicting 46% of variance in both depression and anxiety scores. Conclusions: Although aspects of mindfulness are associated with depression and anxiety following an episode of psychosis, psychological flexibility appears to account for a larger proportion of variance in depression and anxiety scores in this population.
Nanoindentation and nanoscratching experiments have been performed to assess the mechanical and tribological behavior of three thin film materials with potential application as wear resistant coatings for magnetic disk storage: (1) hydrogenated-carbon (CHx); (2) nitrogenated-carbon (CNx); and (3) boron suboxide (BOx). The hardness and elastic modulus were measured using nanoindentation. Ultra-low load nanoscratching tests were performed to assess the relative scratch resistance of the films and measure their friction coefficients. The mechanical and tribological performance of the three materials are discussed and compared.
A technique has been developed for characterizing the disorder present in thin films through the measurement of their low temperature internal friction. The technique utilizes a substrate, in the form of a double paddle oscillator etched from a high purity silicon wafer, onto which the thin film of interest can be deposited. The oscillator possesses an internal friction of 3 × 10−8 at 4 K which is reproducible to within 1% upon thermally cycling to room temperature. This extremely small substrate internal friction coupled with the excellent reproducibility permits measurements of the internal friction of very thin amorphous films, with a 2 tun silica film producing a change in the internal friction of 4 × 10−9. By performing low temperature internal friction measurements on thin silica films with thicknesses ranging from 2 nm to 1000 nm, we have investigated the role of interacting defects in determining the universal nature of the anomalous low temperature thermal and elastic properties of amorphous solids. We have found no evidence for strong interactions between these tunneling defects. Other applications of the oscillator include monitoring of the crystallization of amorphous films through changes in the low temperature internal friction, internal friction measurements and vapor pressure measurements of quenched condensed rare gas solids and amorphous water ice, and internal friction studies of amorphous solids which can only be produced in thin film form.
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