This study directly assessed, for the first time, whether, as expected under the membrane phospholipid hypothesis of schizophrenia, there was a change in brain cell motion-restricted membrane phospholipids in vivo in male forensic patients with schizophrenia who had seriously and violently offended (homicide, attempted murder, or wounding with intent to cause grievous bodily harm) while psychotic, by quantification of the broadband resonance signal from 31-phosphorus neurospectroscopy scans.

Cerebral 31-phosphorus magnetic resonance spectroscopy was carried out in 15 male patients with schizophrenia who had seriously and violently offended (homicide, attempted murder, or wounding with intent to cause grievous bodily harm) while psychotic and in 12 age- and sex-matched normal control subjects. Data were obtained using a 1.5 T Marconi Eclipse system with a birdcage quadrature head coil dual-tuned to proton (64 MHz) and 31P (26 MHz). T1-weighted magnetic resonance images were acquired for spectral localization. Spectra were obtained using an image-selected in vivo spectroscopy sequence (TR = 10 s; 64 signal averages) localized on a 70 x 70 x 70 mm3 voxel.

There was no significant difference in the broad resonances between the two groups, with the mean (standard error) percentage broadband signal for the patients being 57.8 (5.6) and that for the control subjects 57.7 (6.0). The phosphomonoesters and phosphodiesters narrow signals also did not differ between the groups.

Our data suggest that the membrane phospholipid hypothesis of schizophrenia may not apply to the subgroup of schizophrenia patients who have seriously and violently offended.

To ascertain the level of compliance of present documentation of PRN medication with national and local standards of good practice.

To inform changes to current practice where room for improvement is identified.

Data collection form was designed based upon the standards found in the local prescribing policy

Audit was carried out on all inpatients on Chafron and Marlborough House

3 month time period August to October 2006

The medication records of 19 patients were viewed

All PRN medication was included in the audit.

Results against standards:

Not more than 1 medicine from any BNF therapeutic category should be prescribed as a PRN at any one time: 2 patients did not meet this standard

100% Compliance to standards

The following 7 standards achieved 100% compliance:

Legible prescription

Written in black ink

Dose recorded

Method recorded

Signature recorded

Start date recorded

Time given recorded, where applicable.

Reccomendations

Increased prescribing practice training for medical staff (doctors). This is covered by pharmacist staff at induction.

Re-audit in 6 months.

The media coverage of a few homicides committed by psychotic obviously raises questions about the dangerous and violent nature of the mentally ill. Firmly rooted in the collective consciousness is the popular idea that someone who kills an unknown person in the street is mentally ill. On the contrary the epidemiological data are reassuring; only 15% of such murders are committed by the seriously mentally ill (schizophrenia, paranoia, melancholia).

Typing and comparison of murders committed by schizophrenic, paranoiac and melancholic persons.

We consulted and analysed 268 expertises from two psychiatrists. This retrospective study shows several types of pathological murder (schizophrenia, paranoiac delirious disorder, affective disorder: melancholia and hypomania).

From these 268 cases of homicide examined, 27 murderers were psychotic.

Ten of these were young, single, jobless, male paranoid schizophrenics: they drank little alcohol. Most of them have criminal history. They knew their victim (family, friends).

Nine others were paranoiac, for the most part male, older, married, family men, without psychiatric or criminal record. They murdered their wife or husband or neighbour. Alcoholic consumption is often involved. Schizophrenic and paranoiac murderers often have an emotional temper.

On the contrary, melancholic murderers are mostly female, aged around 30, married, family women, drinking little alcohol. Two third of them have psychiatric depressive record and had bipolar troubles and attempted suicide. Their murders are more often premeditated. They know the victim: child or partner. Suicide often follows the murder.

Compliance has been mainly researched in the context of custodial interrogation and peer pressure to commit offences. In the present study compliance was studied in relation to adult romantic attachment. It was hypothesized that the relationship between compliance and romantic attachment would be strongest with maladaptive attachment and lowest with secure attachment.

377 pregnant women attending clinics for pregnant women at Primary Health Care Centres completed the Gudjonsson Compliance Scale (GCS), the Depression Anxiety Stress Scales (DASS), the Rosenberg Self-Esteem Scale, and the Multi-item measure of adult Romantic Attachment consisting of Anxious and Avoidant dimensions (and additional quadrant framework consisting of Secure, Preoccupied, Dismissing, and Fearful attachment types).

Compliance was significantly related to both Anxious and Avoidant attachment after controlling for self-esteem, anxiety and depression. A further analysis showed that compliance was highest among the Fearful type and lowest among the Secure type.

The findings suggest that compliance is an important factor in relation to maladaptive adult romantic attachment.

The Criteria of diminished responsibility still are not defined. The aim of research is determination of the factor “Situation” for specification of the criteria of diminished responsibility.

Cohort of 300 patients were studied by clinical psychopathological methods.

So, all kinds of mental disorders of non-psychotic level can be considered as a medical criterion of diminished responsibility, especially in the cases when the role of the factor “Situation” is minimal. For impartial point of view we offer to use an estimation of social adaptation.

Even if the role of the factor “Situation” is minimal, we have to analyze it especially in the cases of group crimes of mentally retarded and infantile patients because of such their characteristics as suggestiveness and striving for self-affirmation in referent group.

When patient commit a crime during traumatic situation, his psychic disorders become a basis of various pathological mental states which can influence on ability of voluntary regulation of behavior. Among these states are various affective disorders from depressions to dysphoria, emotional instability, acute affective outbreaks in a patients with personality disorders in frameworks of mental retardation, organic disease, remission of schizophrenia.

The gravity of antisocial behaviour in women (ABW), can be associate with different psychosocial and psychopathological factors.The aim of our study is to determine such specific associations in a sample of Romanian female offenders.

This is an ongoing study concerning women incarcerated in four Romanian prisons. We are collecting data about their psycho-socio-familial and educational environment, and also about their general psychopathology. The collection of data will be finished in December 2007.We are going to correlate the infractions with this factors and to publish the results and conclusions in March –April 2008.

The customers' satisfaction of health services are priority in Health systems. The purpose of such services is to supply the realized needs of the customers.The Purpose of this study is to explore the original concepts of satisfaction, to determine guidance and final strategies for Child and Adolescent Guidance Clinic.

This is a Qualitative study by triangulation method in three phases: First phase is phenomenology research; second phase is focus group; and third phase is Delphi technique. Clients, including children and their parents referred to Isfahan Child and Adolescent Guidance Clinic and its staff were study sample .

The findings from interview with 24 participants and focus group discussion were recorded. Overall, 834 concept codes were worked out. Then, They were classified in 130 Concept structures. These concept structures were set in 30 groups according to Common characteristics in third level. Finally they were classified in 7 categories: a-factors related to different units of clinic, b- patient, c- factors related to drugs and treatment, d- clinic management, e- clinic, f- recovery, g- needs and recommendation. The suggested guidance from focus group and strategy for satisfaction in 18 items are presented.

It collected the 18 final strategies of satisfaction promotion for child and Adolescent Guidance Clinic . Some of these strategies, include: data collection committee, continuous non drugs treatment program, internal clinic protocol, Guidance clinics development, parent training classes, daily program arranging, team work attendance and patient rights regard .

A growing body of scientific literature suggests that HIV seroprevalence among people with serious mental illness has increased substantially in recent years. In the Italian context, specialized services (mental health or infectious disease) more and more are requested for combined management of dual diagnosis. Consequently health care workers (HCW) have to face difficulties due to new situations of care. To fill these gaps, the core purpose of this study is to analyze HCW experiences from their own perspectives in order to understand their difficulties and create good practices in health care.

A qualitative study was conducted in public services Mental Health and HIV/AIDS workers, in Lazio region, Italy.

HCW were asked in anonymous way about their experiences. The interviews, consisting of one open_question, were audio taped and integrally transcribed and the texts were analysed through software T-Lab (cluster and correspondence analysis).

91 HCW were interviewed. We identified, trough cluster analysis, six cultural models about dual diagnosis: Disease as personal experience, Fear of contagion, Training as support to work, Service as integration function, Families as object of the intervention, Disease as scientific knowledge

In conclusion, this study examines for the first time the constructions of dual diagnosis in the Italian context through text and language of HCW. It reveal that we need further elaboration because of sociocultural meanings of dual diagnosis are not fixed but are ongoingly co-constructed by the various participants of health context.

As demand is increasing, French Mental Health ambulatory settings (CMPs) face an increasing pressure and feel difficulties to achieve their missions (prevention, screening, diagnosis, care and rehabilitation). With the support of a national agency, 8 of them have conducted an 18 month quality improvement project, from April 2006.

In order to have a better understanding of the problems, the first objective was to define what was concretely awaited from them. Based on a study of the literature, operational objectives have been set. Among which, the most notable are: To offer an appointment within 72 hours after the first contact; To offer to all patients leaving the in-patients department, a follow-up consultation within 7 days; To decrease the amount of non attendance…

That definition of objectives made it possible to set up a measurement, to analyse organisational patterns and to launch actions for improvement, such as empowering nurses to allow them to realize the first appointments, reorganizing team working and “institutional times”, defining a strategy to contact non attendant patients…

The use of routine measurement allowed us to evaluate the impact of the project. Actions launched allowed to obtain improvements quickly on some dimensions (for exemple, delay before an appointment with a psychiatrist falling from more than 50 to less than 20 days). Nevertheless other improvements seem longer to achieve (decrease of non attendances).

This report stresses the interest of health services research in achieving significant improvements, regardless of the ideological controversies at stake.

Polydrug using persons pose particular challenges in mental health practice that result from the complexity of cumulative intertwined effects of the addictive course on their cognitive, affective and neurobiological functioning.

To respond to this challenge, this paper presents systematized evidence-based tools developed as part of the multi-site FACE© program (Facilitating Adjustment of Cognitions and Emotions) and analyses how the organization of structured multidimensional assessments impacts on the diagnostic and treatment phases with a series of polydrug and alcohol abusing persons.

At a diagnostic level, practice systematization using a thorough, multidimensional, evidence-based anamnestic protocol appears mandatory to provide the internationally recommended assessment data relevant to designing informed care pathways (cf. World Health Organization, France's ‘Haute Autorité de Santé’, Belgium's ‘Conseil Supérieur de la Santé’). At a treatment level, this protocol reveals beneficial to the practitioner–client relationship, facilitating initiation of a therapeutic contract. Further “assessment to treatment” tools, including monitoring of polydrug use through structured observational agendas and time-line analyses, respond to multiple care challenges by providing both diagnostic and follow-up data. Early treatment course application of psycho-education sessions into self-observational “homework” strategies further benefits comprehension and control of the addiction course by clients.

Evidence-based, structured “assessment to treatment” tools appear to provide valuable insights regarding polydrug use severity, dynamics and contingencies, relevant to initial multidisciplinary assessment and treatment course evaluation. Significantly, these are also found to ameliorate addiction insight along with facilitating cognitive-emotional regulation by the client. Further research and practice implications are advocated.

Breast cancer is one the the most causes of death among Iranian womens. Recently, quality of life (QOL) has been in focus of reseaches. The diagnosis and treatment of breast cancer are, two aspects of QOL . This study assess the impact of breast cancer on Body Image and, which has been not in focus of attention in Iran.

The self-administrated questionnaire, which it's validity and reliability were assessed in local population .Eighty three patients with breast cancer were participated in this survey in Kerman/Iran in the year 2007.. The patients divided to three groups(based on kinds of treatment), and asked to complete demographic data and questionnaire.Statistical comparisons were made using the standard tests.

The mean age of participants was 49.9±11.8.We found relationship between the age of patients and the Body Image (p<0.0003), Sexual desire (p<0.001) and sexual activity(p<0.001).

Body Image, Sexual desire and sexual activity had strong relationship with marital status, education of patients and her partner. Number of children had correlation with Body Image. A significant negative correlation was found between stage of cancer with Body Image, Sexual desire and sexual activity.

Sexual desire and sexual activity had relations with kind of treatment(P1<0.000, p2<0.003).

Body image and sexuality after cancer diagnosis or treatment deserves much more attention. Health care providers need to explore in much more detail in the influence of cancer on Body Image and sexuality (in the cultural background).

There is a need to address vulnerable carers in schizophrenia and severe mental illness, although research has not yet defined feasible risk assessment routines. Caregiver needs must be sought and targeted instead of blindly delivering previously defined programs. In Portugal, where psychoeducational family work has been scarcely implemented/evaluated, the Families of Psychotic Patients(FAPS) Project is now running in Lisbon. It consists of a prospective study of caregivers, which will be followed in time by a group intervention study for a defined sub-sample.

Caregivers' assessments (baseline) include the Involvement Evaluation Questionnaire, the GHQ, the Social Network Questionnaire and a schedule including questions on intervention needs/adherence). Patients are given the BPRS, WHO-DAS II and GAF. We present preliminary data concerning baseline assessments of a first cohort of the prospective survey (n=70). A convenience sample of primary caregivers to patients with schizophrenia, schizo-affective or delusional disorders (ICD-10) was considered.

Key-relatives (age 59.4±13.1 yrs) were mostly female (87%). Burden was evident (especially IEQ worrying 18.9±5.4). 31,4 % scored GHQ+, while needs for family work were not invariably expressed, in discrepancy with interviewers's expectations.

Caregiver burden and psychological distress do not imply adherence to family interventions (either in relative groups or behaviour family therapy format). Moreover, some of the most distressed carers seem to be the hardest to recruit.

These considerations must be checked at follow-up with the whole sample and warrant further research. Apparently, one should tailor family intervention programs to each family according to prior detailed assessments.