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Refugees have high rates of mental health morbidity as a result of conflict. However, their needs for mental healthcare and psychosocial support are often unmet, despite the efforts of professional and humanitarian organisations. The war refugee crisis is a global challenge that needs a global solution. We call on all governments, regional and international organisations to take responsible humanitarian actions to intervene and support people affected by these disasters and for all humanity to unite against the forces of injustice and degradation. The thematic papers in this issue report on the Syrian crisis from a variety of perspectives.
The recent influx of refugees and immigrants to Greece has coincided with the ongoing and deteriorating financial crisis. This situation does not allow the Greek authorities to provide help to the desired extent. Yet, the church, local communities, medical societies and non-governmental organisations are offering good psychosocial support. In parallel with support for refugees it is important to provide support for the citizens of the host country. The rich countries of northern Europe should help the poorer countries of southern Europe cope with the refugees. A number of important declarations on refugee mental health and related issues have been produced recently, including the Anti-war Declaration of Athens.
This article provides a brief outline of mental health services in Qatar, historical notes on the use of informal traditional conventions under common law for the care under compulsory conditions of people who are mentally ill and information on the ongoing development of the Mental Health Law and its key provisions in the context of the new National Mental Health Strategy.
The mechanisms involved in the formation of titanium (Ti) nanoclusters produced by sputtering and inert gas condensation were investigated experimentally and numerically. Ti nanoclusters were generated inside an ultrahigh vacuum compatible system under different source parameters, i.e., inert gas flow rate (fAr), length of the aggregation region (L), and sputtering discharge power (P). Nanocluster size and yield were measured using a quadrupole mass filter (QMF). The variation of the above source parameters enabled fine-tuning of the nanocluster size and yield. Herein, Ti nanoclusters were produced within the size range 3.0–10.0 nm. The combination between the nanocluster size and yield as a function of source parameters enabled understanding Ti nanocluster formation mechanisms, i.e., three-body and two-body collisions. The results show that two-body collisions dominate nanocluster production at low fAr while the three-body collisions dominate at high fAr. In addition, nanocluster size increases as L increases due to the increase in nanocluster nucleation and growth times. The maximum nanocluster yield was obtained at fAr that maximize the probability of three-body and two-body collisions. Nanoclusters could be produced within an optimum range of the sputtering discharge power wherein the nanocluster size and yield increase with increasing the discharge power as a result of increasing the amount of sputtered material. The experimental results were compared with a theoretical model of nanocluster formation via three-body collision. Detailed understanding of the evolution of size and yield of Ti (and Ti-oxide) nanoclusters is essential for producing nanoclusters that can be utilized for environmental applications such as conversion of carbon dioxide and water vapor into hydrocarbons.
Copper–tin (CuxSn1−x) nanocluster is a promising system for gas sensing applications, mainly because of its sensitivity and selectivity for H2S. In this work, pure Sn and Cu as well as composite CuxSn1−x nanoclusters were synthesized using the dc magnetron sputtering gas condensation technique. Nanoclusters with different Sn to Cu ratios were produced by changing the ratio of Sn and Cu in the target. The dependence of Sn, Cu, and CuxSn1−x nanoclusters’ size distribution on various source parameters, such as the inert gas flow rate and aggregation length, has been investigated in detail. The results show that as the inert gas flow rate increases, the mean nanocluster size increases for Sn, decreases for Cu, while increases and then decreases for CuxSn1−x. The results could be understood in terms of the contribution percentage of the nanocluster formation mechanism. Furthermore, this work demonstrates the ability of tuning the CuxSn1−x nanoclusters’ size and composition by a proper optimization of the source operation conditions.
Pre-irradiated thermodynamic and microstructural properties of nuclear fuels form the necessary set of data against which to gauge fuel performance and irradiation damage evolution. This paper summarizes recent efforts in mixed-oxide and minor actinide-bearing mixed-oxide ceramic fuels fabrication and characterization at Los Alamos National Laboratory. Ceramic fuels (U1-x-y-zPuxAmyNpz)O2 fabricated in the compositional ranges of 0.19≤x≤0.3 Pu, 0≤y≤0.05 Am, and 0≤z≤0.03 Np exhibited a uniform crystalline face-centered cubic phase with an average grain size of 14μm; however, electron microprobe analysis revealed segregation of NpO2 in minor actinide-bearing fuels. Immersion density and porosity analysis demonstrated an average density of 92.4% theoretical for mixed-oxide fuels and an average density of 89.5% theoretical density for minor actinide-bearing mixed-oxide fuels. Examined fuels exhibited mean thermal expansion value of 12.56×10−6/°C-1 for temperature range (100°C<T<1500°C) and ambient temperature Young's modulus and Poisson's ratio of 169 GPa and of 0.327, respectively. Internal dissipation as determined from mechanical resonances of these ceramic fuels has shown promise as a tool to gauge microstructural integrity and to interrogate fundamental properties.
The objective of the present study was to research the effect of feeding laying hens fish oil-supplemented diets to produce n-3-enriched eggs on their ovarian follicular development, serum lipid peroxidation, antioxidative status and immune response. A total of 105 white Bovens hens at 24 weeks of age were housed in cages in an open-sided building under a 16 h light : 8 h dark lighting schedule. Birds were randomly divided into five treatments and were fed, ad libitum, diets containing 0% (control), 1.25%, 2.5%, 3.5% or 5.0% fish oil from 24 to 36 weeks of age. Egg production and weight were recorded. By weeks 35 and 36 of age 15 eggs were taken at random from each treatment to determine the yolk lipid profile and cholesterol content. At the end of the experimental period, 10 females from each treatment were randomly chosen, anaesthetised and killed by decapitation. Ovary and oviduct samples were immediately weighted and ovarian follicles were classified. Serum thiobarbituric acid-reactive substance (TBARS), hepatic TBARS and hepatic glutathione peroxidase (GSH-Px) activity were measured. No clear trend was observed concerning egg production and egg yolk cholesterol. As dietary fish oil levels increased, n-3-polyunsaturated fatty acids (n-3 PUFA) increased, whereas n-6 PUFA tended to decrease in yolk lipids. No negative effects were detected in ovary and oviduct weights, expressed in both absolute terms and relative to body weight. The numbers and total weights of large yellow follicles (LYF) in the ovary were not significantly affected by fish oil supplementation. Low levels (1.25% to 2.5%) of fish oil reduced both plasma and hepatic TBARS and enhanced GSH-Px activity. It is also interesting to note that inclusion of 2.5% fish oil in laying hen diets enhanced the antibody titre in laying hens. Therefore, it could be concluded that inclusion of fish oil in laying hen diets at moderate levels increased the n-3 fatty acids content in eggs, improved antioxidative status, enhanced the antibody response and did not have a negative influence on the different reproductive morphology parameters in laying hens.
Summary Recent developments in UK government policy have highlighted the unmet needs of people with dual diagnosis (comorbidity of substance misuse and psychiatric disorder, particularly severe mental illness). Advances in assessment techniques and diagnostic practice have informed the treatment of comorbidity and improved its outcome. There is growing evidence for the effectiveness of psychosocial interventions such as motivational interviewing and cognitive– behavioural therapy, mostly from US studies. However, within the secondary care provided by addiction and general psychiatric services there are serious implementation barriers related to service organisation, staffing levels, training and – most importantly – the difficulties of engaging people with severe mental illness and comorbid substance misuse in treatment. The evidence for the effectiveness of psychosocial treatments and models of service is reviewed and challenges for optimal practice in the UK are highlighted.
The co-occurrence of substance misuse with other psychiatric disorders is increasingly recognised as a major public health problem. The term ‘dual diagnosis’ has been introduced to describe this phenomenon, but ‘comorbidity’ might be a better term. Community-based surveys in the USA and the UK have reported high rates of comorbidity, particularly in people with serious mental illness (Harrison & Abou-Saleh, 2002). Farrell et al (2001), in a national household survey, reported prevalence rates of psychiatric disorder of 22% in nicotine dependence, 30% in alcohol dependence and 45% in drug dependence, compared with 12% prevalence in the non-dependent population.
The pattern of this comorbidity varies between comorbid mood, anxiety and personality disorders in patients accessing addiction services, and comorbid alcohol, cannabis and cocaine misuse in patients accessing general psychiatric services (Abou-Saleh, 2000). Comorbidity is associated with increased risk of violence, suicide and worse clinical and social outcomes. The National Confidential Inquiry into Suicide and Homicide has reported substance misuse as a factor in over half of homicides and suicides by people with serious mental illness (Department of Health, 2001). Moreover, people with comorbidity have high rates of criminality and blood-borne infections, including HIV infection and hepatitis B and C.
The severity of this morbidity also varies between these specialist settings: severe psychiatric disorder is associated with non-dependent use of substances (problematic substance misuse), whereas severe addiction is associated with personality disorder with or without minor psychiatric disorder.
The low-cycle fatigue behavior of a cobalt-based superalloy was studied in situ using neutron–diffraction experiments. The alloy exhibited stress-induced formation of a hexagonal-close-packed (hcp) phase within its parent face-centered-cubic (fcc) phase at ambient temperature under strain-controlled fatigue conditions with a total strain range, Δε=2.5%. The (101) hcp peak was first observed during the 12th fatigue cycle under the given conditions following a period during which no hcp phase was detected. Subsequently, the intensity of the hcp peaks increased as fatigue progressed. Furthermore, within a single fatigue cycle, the intensity of the (101) hcp peak decreased during the compression half-cycle and increased again when the specimen was subjected to a subsequent tensile strain. The result suggests that the fcc to hcp transformation is partially reversible within one fatigue cycle.
Recent developments in UK government policy have highlighted the unmet needs of people with dual diagnosis (comorbidity of substance misuse and psychiatric disorder, particularly severe mental illness). Advances in assessment techniques and diagnostic practice have informed the treatment of comorbidity and improved its outcome. There is growing evidence for the effectiveness of psychosocial interventions such as motivational interviewing and cognitive–behavioural therapy, mostly from US studies. However, within the secondary care provided by addiction and general psychiatric services there are serious implementation barriers related to service organisation, staffing levels, training and – most importantly – the difficulties of engaging people with severe mental illness and comorbid substance misuse in treatment. The evidence for the effectiveness of psychosocial treatments and models of service is reviewed and challenges for optimal practice in the UK are highlighted.
The common co-occurrence of substance misuse and other psychiatric disorders and their intricate relationships have led to major community-based epidemiological studies in the US which showed high rates of current and lifetime comorbidity. Moreover, studies of clinical populations conducted in North America, Europe and Australia, showed even higher rates of comorbidity. The aetology of this comorbidity has also been investigated and important models have emerged with findings that inform its assessment and treatment. Future epidemiological studies should focus on the study of concurrent conditions rather than lifetime ones using research diagnostic instruments with high reliability providing information on a number of key outcomes.
The co-occurrence of substance misuse and other psychiatric disorder (dual diagnosis) has been increasingly recognized in the UK. Clinical studies of patients with severe mental disorders showed high rates of substance misuse with poor clinical and social outcome. These patients often fall ‘between the cracks’ of the separate general psychiatric and addiction services. This has necessitated the development of a national policy advocating the provision of integrated care within mainstream psychiatric services. There are emergent models of good practice that require evaluation of effectiveness and cost effectiveness.
The common occurrence of comorbid substance misuse and other psychiatric disorders has challenged the diagnostic and therapeutic skills of professionals concerned with the care of patients with these dual disorders. Combined pharmacological and psychological treatment approaches have evolved empirically drawing upon standard treatments with emphasis on psychosocial approaches to substance misuse for psychotic disorders and pharmacological approaches for mood disorders. Advances in the biology of both disorders have started to inform their psychopharmacology. The specific role of atypical antipscychotics is highlighted. Further studies of the biology of comorbidity will impact the use of effective pharmaceuticals such as clozapine with dual effects on schizophrenia and substance misuse.