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Many people think that people with mental disorders might be dangerous or unpredictable. These patients face various sources of disadvantages and experience discrimination in job interviews, in education, and housing. Mental health-related stigma occurs not only within the public community, it is a growing issue among professionals as well. Our study is the first that investigates the stigmatising attitude of psychiatrists across Europe.
We designed a cross-sectional, observational, multi-centre, international study of 33 European countries to investigate the attitude towards patients among medical specialists and trainees in the field of general adult and child and adolescent psychiatry.
An internet-based, anonymous survey will measure the stigmatising attitude by using the local version of the Opening Minds Stigma Scale for Health Care Providers. Data gathering started in July this year and will continue until December 2020.
This study will be the first to describe the stigmatising attitude of psychiatric practitioners across Europe from their perspectives.
The study will contribute to knowledge of gaps in stigmatising attitude towards people with mental health problems and will provide with new directions in anti-stigma interventions.
Systemic ventricular end-diastolic pressure is important in patients with single ventricle heart disease. Predictors of an elevated systemic ventricular end-diastolic pressure prior to bidirectional Glenn operation have been incompletely identified.
All patients who underwent bidirectional Glenn operation operation at our centre between January 2007 and March 2017 were retrospectively identified and patient variables were extracted. For patients who had undergone Fontan operation at the time of this study, post-Fontan patient variables were also extracted.
One-hundred patients were included with a median age at pre-bidirectional Glenn operation catheterisation of 4.5 months. In total, 71 (71%) patients had a systemic right ventricle. At the pre-bidirectional Glenn operation catheterisation, the mean systemic ventricular end-diastolic pressure was higher amongst those with systemic right ventricle compared to left ventricle (9.1 mmHg ± 2.1 versus 7.7 ± 2.7 mmHg, p < 0.01). On univariate analysis, pre-bidirectional Glenn operation systemic ventricular end-diastolic pressure was positively associated with the presence of a systemic right ventricle (p < 0.01), history of recoarctation (p = 0.03), history of Norwood operation (p = 0.04), and ventricular systolic pressure (p < 0.01). On multivariate analysis, systemic ventricular end-diastolic pressure was positively associated with the presence of a systemic right ventricle (p < 0.01) and ventricular systolic pressure (p < 0.01). Amongst those who had undergone Fontan operation at the time of study (n = 49), those with a higher pre-bidirectional Glenn operation systemic ventricular end-diastolic pressure were more likely to have experienced death, transplantation, or listed for transplantation (p = 0.02) and more likely to have had heart failure symptoms (p = 0.04) at a mean time from Fontan of 5.2 years ± 1.3.
In patients undergoing bidirectional Glenn operation operation, the volume-loaded, pre-bidirectional Glenn operation state may expose diastolic dysfunction that has prognostic value.
To explore the phenomenology of auditory verbal hallucinations (AVHs) in a clinical sample of young people who have a ‘non-psychotic’ diagnosis.
Ten participants aged 17–31 years with presentation of emotionally unstable personality disorder or post-traumatic stress disorder and frequent AVHs were recruited and participated in a qualitative study exploring their subjective experience of hearing voices. Photo-elicitation and ethnographic diaries were used to stimulate discussion in an otherwise unstructured walking interview.
‘Non-psychotic’ voices comprised auditory qualities such as volume and clarity. Participants commonly personified their voices, viewing them as distinct characters with which they could interact and form relationships. There appeared to be an intimate and unstable relationship between participant and voice, whereby voices changed according to the participants’ mood, insecurities, distress and circumstance. Equally, participants reacted to provocation by the voice, leading to changes in mood and circumstance through emotional and physical disturbances. In contrast to our previous qualitative work in psychosis, voice hearing was not experienced with a sense of imposition or control.
This phenomenological research yielded in-depth and novel accounts of ‘non-psychotic’ voices which were intimately linked to emotional experience. In contrast to standard reports of voices in disorders such as schizophrenia, participants described a complex and bi-directional relationship with their voices. Many other features were in common with voice hearing in psychosis. Knowledge of the phenomenology of hallucinations in non-psychotic disorders has the potential to inform future more successful management strategies. This report gives preliminary evidence for future research.
A unique gold finger ring, dated stylistically to c.ad 580–650, was discovered by metal-detecting in Essex in 2011. The ‘northwest Essex Anglo-Saxon ring’ is highly decorated with Style II art and shows a distinctive juxtaposition of ‘pagan’ and ‘Christian’ imagery including birds of prey and an anthropomorphic figure holding a long cross in the right hand, a raptor in the left. In this article, I consider the possibility that the object provides further evidence that falconry was practised in early Anglo-Saxon England. I begin by examining the finger ring itself and the imagery upon it, situating this within an Anglo-Saxon and broader Continental context. I then explore the possible social context of the ring, focusing on the ‘ideology of predation’ within which falconry, as a high-status hunting pursuit, may have been performed. Evaluating the hybrid ‘pagan’ and ‘Christian’ elements of the imagery, I suggest that falconry, and the ring itself as a high-status and possibly royal object, may have played important roles in the dynamics of pagan–Christian ‘discursive space’.
We present a revised chronology for the Kolomoki site (9ER1) in Georgia, occupied primarily during the Middle and Late Woodland periods (ca. 200 BC to AD 1050). The considerable extent of the site has been noted for more than a century but came into sharper focus with the archaeological investigations by Sears (1956) and Pluckhahn (2003). The site includes at least nine mounds, a large central plaza, and a discontinuous habitation area nearly a kilometer in diameter. Previous interpretations assumed gradual and incremental changes in the community plan. We present a greatly revised chronology, based on new investigations in some of the lesser-known portions of the site and a doubling of the number of absolute dates. Bayesian modeling of these and previous dates reveals that, far from the gradualist assumption of previous work, the community at Kolomoki was dynamically transformed several times in its history, reaching its greatest spatial extent and formal complexity in two relatively short-lived phases. In these intervals, the village incorporated permanent residents and visitors into a single community in which daily face-to-face interactions were minimized even as communal identity was celebrated.
We describe the development of an open-access database for Swift Creek Complicated Stamped ceramics, a type of pottery common to Georgia, eastern Alabama, and northern Florida in the Middle and Late Woodland periods between ca. cal A.D. 100 and 800. The characteristic stamped designs on Swift Creek pottery, created by impressing a carved paddle into a clay vessel before firing, provide unique signatures that enable archaeologists to identify paddle matches—multiple vessels, sometimes hundreds of kilometers apart, stamped with a single paddle. These paddle matches potentially allow archaeologists to trace social interactions across hundreds of kilometers with high spatial and temporal resolution. To date, however, this potential has been hindered by the limited accessibility and fragmented nature of the dataset of reconstructed designs. The database we describe integrates paddle designs with other pertinent data for identifying paddle matches and their context, including the results of sourcing and technofunctional analyses and absolute dating. We view this database not only as a critical component of our own research, but also as a platform for collaboration among researchers that will facilitate broad syntheses of the region.
We describe the curation and use of clay samples as part of the ceramic ecology program at the Florida Museum of Natural History's Ceramic Technology Laboratory (FLMNH-CTL). We outline the history of the comparative clay sample collection at the FLMNH-CTL and detail the standard operating procedure by which samples are processed, analyzed, and curated. We also provide examples of how the clay samples have been used in research projects as well as some of the challenges inherent to studies using such samples. Our collection of processed clays and associated thin sections, which is curated in perpetuity, represents a valuable resource for ongoing and future lab endeavors and is available to other researchers focusing on Florida and adjacent regions.
Silicified beyrichiocopid and podocopid ostracods from limestone nodules derived from the middle part of the Ichinotani Formation within the Hida Gaien Terrane of central Honshu Island, Japan, are associated with fusulinid foraminifera that indicate strata of the middle Moscovian (Pennsylvanian, Carboniferous). This is a rare record of ostracods from the Palaeozoic of Japan and the first systematic description of ostracods from the Carboniferous of the Hida Gaien Terrane. The fauna comprises six ostracod species (two new) assigned to the genera Amphissites, Kirkbya, Bairdia, Aechmina and Healdia, and additional material of possible cavellinids. The numerical dominance of ornamented beyrichiocopids such as Kirkbya and Amphissites, along with smaller numbers of smooth podocopids such as Bairdia, indicates an ‘Eifelian mega-assemblage’ ecotype (sensu G. Becker), that is typical of mid Palaeozoic shallow marine, high-energy environments in a fore-reef ecosystem.
In the lower American Southeast, regional scale social interactions burgeoned alongside the growth of nucleated villages, widespread mound-building projects, and conspicuous mortuary ceremonialism during the Middle and Late Woodland periods (ca. A.D. 100–800). A premier material for understanding the scale and significance of social interactions across the southern landscape comes from Swift Creek Complicated Stamped pottery, a ubiquitous class of material culture that provides direct evidence of connections between specific sites at a multitude of scales and in myriad contexts. By combining design data and determinations of vessel provenance through Neutron Activation Analysis of a total of 825 sherds and 130 clay samples, this research ascertains types of social interaction and their predominant directions and levels of intensity across multiple ecological, social, and cultural contexts. The results indicate two main patterns: first, that vessels were frequently transported from habitation sites and civic-ceremonial centers to distant burial mounds; and second, that people traveled to ceremonial centers from outlying villages for events that included the exchange of wooden paddles. These patterns reveal a high level of social coordination within integrated networks that were inextricable from the region-wide trends toward population aggregation and heightened monumentality and rituality.
This study integrates disparate geographical areas of the American Southeast to show how studies of Early Mississippian (A.D. 900-1250) interactions can benefit from a multiscalar approach. Rather than focus on contact and exchanges between farming communities, as is the case with most Mississippian interaction studies, we turn our attention to social relations between village-dwelling St. Johns II fisher-hunter-gatherers of northeastern Florida and more mobile Ocmulgee foragers of southern-central Georgia; non-neighboring groups situated beyond and within the southeastern edge of the Mississippian world, respectively. We draw upon neutron activation analysis data to document the presence of both imported and locally produced Ocmulgee Cordmarked wares in St. Johns II domestic and ritual contexts. Establishing social relations with Ocmulgee households or kin groups through exchange and perhaps marriage would have facilitated St. Johns II access into the Early Mississippian world and enabled them to acquire the exotic copper, stone, and other minerals found in St. Johns mortuary mounds. This study underscores the multiscalarity of past societies and the importance of situating local histories in broader geographical contexts.
Interactions with the bodies of hunted animals often follow prescriptions pertaining to social relationships among human and non-human persons. Despite this, deposits of archaeological food remains are seldom considered in terms of deliberate placement, instead serving primarily as reflections of preparation and consumption activities. The residues of feasts, in particular, are often highlighted as indexes of special consumption events, although such salient occasions might also be expected to highlight ritualized depositional practices as well. This study reconsiders the archaeological residues of feasts through the vantage of a fauna-filled pit in late Pre-Columbian Florida. Most of the contents of the feature correlate with a large feast, but the structure of the deposit and inclusion of specific elements reflects scrupulous emplacement. Drawing on North American relational ontologies, we explore the idea that this pit feature was created as a deliberate bundle, the result of an intentional act of interment that was concerned with positioning its contents in ways that manifested and shaped various relationships.
Anorexia nervosa (AN) is a serious disorder incurring high costs due to hospitalization. International treatments vary, with prolonged hospitalizations in Europe and shorter hospitalizations in the USA. Uncontrolled studies suggest that longer initial hospitalizations that normalize weight produce better outcomes and fewer admissions than shorter hospitalizations with lower discharge weights. This study aimed to compare the effectiveness of hospitalization for weight restoration (WR) to medical stabilization (MS) in adolescent AN.
We performed a randomized controlled trial (RCT) with 82 adolescents, aged 12–18 years, with a DSM-IV diagnosis of AN and medical instability, admitted to two pediatric units in Australia. Participants were randomized to shorter hospitalization for MS or longer hospitalization for WR to 90% expected body weight (EBW) for gender, age and height, both followed by 20 sessions of out-patient, manualized family-based treatment (FBT).
The primary outcome was the number of hospital days, following initial admission, at the 12-month follow-up. Secondary outcomes were the total number of hospital days used up to 12 months and full remission, defined as healthy weight (>95% EBW) and a global Eating Disorder Examination (EDE) score within 1 standard deviation (s.d.) of published means. There was no significant difference between groups in hospital days following initial admission. There were significantly more total hospital days used and post-protocol FBT sessions in the WR group. There were no moderators of primary outcome but participants with higher eating psychopathology and compulsive features reported better clinical outcomes in the MS group.
Outcomes are similar with hospitalizations for MS or WR when combined with FBT. Cost savings would result from combining shorter hospitalization with FBT.
The polished stone objects known as ‘wrist-guards’ found in Early Bronze Age graves in Britain and Continental Europe have proved difficult to interpret. Are they connected with archery, as has long been supposed, or were they instead associated with falconry? Using trained birds of prey for hunting is an elite practice in many historical and ethnographic contexts, and would be consistent with the appearance of exotic materials in these graves. Detailed consideration of the wrist-guards and associated objects from a falconer's perspective, however, demonstrates that the argument is unconvincing.
Archaeological examinations of symbolic meaning often have been hampered by the Saussurean concept of signs as coded messages of preexisting meanings. The arbitrary and imprecise manner by which meaning is represented in material culture according to Saussure tends to stymie archaeological investigations of symbolism. As an alternative, archaeologists recently have drawn on Peirce’s semiotic to investigate how materiality is bound to the creation of meanings through the process of signification. This study examines how the symbolism expressed in pottery of the Middle Woodland period southeastern United States, Swift Creek Complicated Stamped and Weeden Island effigy vessels, might be better explained as icons and indexes that were enlisted to have particular social effects. Examining the semiotic potentials of these objects helps explain their apparent uses and the significance of alternative representations of the same subjects.
A small, early-Bronze Age timber monument, from c.2050 BCE, was discovered near Holme-next-the-Sea in Norfolk in 1998. It quickly became the focus of controversy concerning spirituality and locality. Threatened by sea erosion, the site was excavated in 1999. Pagan protestors tried to stop the dig, believing that ‘Seahenge’ (or ‘Holme I’) belonged in situ. Some argued that the site was destined to be eroded, others that its alleged situation on a ley line meant that its meaning was dependent on its relationship to place. Pagan approaches to the past are diverse but sites from the iconic Stonehenge to the less famous Seahenge are increasingly being seen by them as ‘sacred’. These sacred sites range from the well-known ‘honey-pot’ monuments to those that are local and less well known. In their site-based rituals, Pagans honour ‘ancestors’, celebrate rites of passage and the passing of the seasons, and engage with deities, spirits and other beings held to inhabit the landscape. Pilgrimage extends to museums and other collections where excavated artefacts are held. Such ‘visits’ to the Sutton Hoo displays at the British Museum or to the recent redisplay of Lindow Man at the Manchester Museum, for instance, may comprise ritual acts in themselves. The artefacts are perceived by some Pagans as more than objects, possessing their own agency and personhood.