45 results
Investigating the effect of COVID-19 dissemination on symptoms of anxiety and depression among university students
- Part of
- Daniel Vigo, Laura Jones, Richard Munthali, Julia Pei, Jean Westenberg, Lonna Munro, Carolina Judkowicz, Angel Y. Wang, Brianna Van den Adel, Joshun Dulai, Michael Krausz, Randy P. Auerbach, Ronny Bruffaerts, Lakshmi Yatham, Anne Gadermann, Brian Rush, Hui Xie, Krishna Pendakur, Chris Richardson
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- Journal:
- BJPsych Open / Volume 7 / Issue 2 / March 2021
- Published online by Cambridge University Press:
- 19 March 2021, e69
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Background
Evidence about the impact of the COVID-19 pandemic on the mental health of specific subpopulations, such as university students, is needed as communities prepare for future waves.
AimsTo study the association of proximity of COVID-19 with symptoms of anxiety and depression in university students.
MethodThis trend study analysed weekly cross-sectional surveys of probabilistic samples of students from the University of British Columbia for 13 weeks, through the first wave of COVID-19. The main variable assessed was propinquity of COVID-19, defined as ‘knowing someone who tested positive for COVID-19’, which was specified at different levels: knowing someone anywhere globally, in Canada, in Vancouver, in their course or at home. Proximity was included in multivariable linear regressions to assess its association with primary outcomes, including 30-day symptoms of anxiety and/or depression.
ResultsOf 1388 respondents (adjusted response rate of 50%), 5.6% knew someone with COVID-19 in Vancouver, 0.8% in their course and 0.3% at home. Ten percent were overwhelmed and unable to access help. Knowing someone in Vancouver was associated with an 11-percentage-point increase in the probability of 30-day anxiety symptoms (s.e. 0.05, P ≤ 0.05), moderated by gender, with a significant interaction of the exposure and being female (coefficient −20, s.e. 0.09, P ≤ 0.05). No association was found with depressive symptoms.
ConclusionsPropinquity of COVID-19 cases may increase the likelihood of anxiety symptoms in students, particularly among men. Most students reported coping well, but additional support is needed for an emotionally overwhelmed minority who report being unable to access help.
Judicial Resources and the Public Trust Doctrine: A Powerful Tool of Environmental Protection?
- Anne Richardson Oakes
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- Journal:
- Transnational Environmental Law / Volume 7 / Issue 3 / November 2018
- Published online by Cambridge University Press:
- 17 September 2018, pp. 469-489
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United Kingdom Supreme Court Justice Robert Carnwath has urged the judiciary to develop ‘common laws of the environment’, which can operate within different legal frameworks, tailored where necessary towards specific constitutions or statutory codes. One such mechanism with the potential for repositioning environmental discourse in both common law and civil law jurisdictions is the doctrine of the public trust. Basing their arguments upon a heritage of civil law and common law, supporters of the public trust doctrine are currently testing its scope in United States federal courts via groundbreaking litigation aimed at forcing the federal government to uphold its duty to protect the atmosphere. This article considers whether common law judicial resourcefulness can transform a transatlantic hybrid of uncertain parentage into a powerful tool of environmental protection.
28 - Tier 4 options
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- By Tim McDougall, Cheshire & Wirral NHS Foundation Trust, Anne Worrall-Davies, University of Leeds, Lesley Hewson, Bradford District Care Trust, Rosie Beer, Greg Richardson, North Yorkshire & York Primary Care Trust
- Edited by Greg Richardson, Ian Partridge, Jonathan Barrett
-
- Book:
- Child and Adolescent Mental Health Services
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 259-269
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Summary
‘Two roads diverged in a wood, and I–
I took the one less travelled by,
And that has made all the difference.’
Robert Frost (1874–1963)Introduction
Tier 4 CAMHS aim to meet the needs of children and young people with the most complex, severe or persistent mental health problems. Tier 4 services include in-patient care (see Chapter 29), as well as a range of day care and intensive community home-based and outreach services for specific groups of children and young people.
Day services
Early descriptions of child and adolescent mental health day units emphasised 5-day ‘milieu’ provision with a strong emphasis on education and behaviour management (Brown, 1996), whereas now they frequently provide daily focused activities to which children and families are invited, depending on their needs. Currently, about half of UK day services are linked to in-patient units, and many in-patient units have a day programme (Green & Jacobs, 1998). It is impossible to classify day services owing to the enormous range in milieu and interventions provided (Green & Worrall- Davies, 2008). However, day services broadly offer:
• support and transition to community services following in-patient admission;
• intensive 5 days per week treatment packages for children and their families;
• treatment of disruptive behaviour, using multimodal treatment strategies with a combination of individual, family and psychopharmacological interventions;
• specialist management and programmes of care for younger children with developmental disorders such as autism, speech and language disorders or neuropsychiatric disorders;
• intensive intervention aimed at improving family functioning in situations of family breakdown or child maltreatment.
Provision and organisation
Day units can offer assessment and therapeutic services that are more specialised, complex and intensive than out-patient services, although they are still community-based and less disruptive than in-patient admission. Most also have the benefit of educational input. Close liaison with specialised education and Social Services is central to their work. There is general acceptance of the central importance of maintaining attachments and working with whole systems if the complex needs of children are to be met. Day units can work with children and young people individually and in groups, as well as with their families, while keeping the focus of concern within the community and avoiding the ‘out of sight, out of mind’ dilemma of in-patient services.
29 - In-patient psychiatric care
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- By Angela Sergeant, Leigh House Hospital, Winchester, Greg Richardson, North Yorkshire & York Primary Care Trust, Ian Partridge, Lime Trees CAMHS, York, Tim McDougall, Cheshire & Wirral NHS Foundation Trust, Anne Worrall-Davies, University of Leeds, Lesley Hewson, Bradford District Care Trust
- Edited by Greg Richardson, Ian Partridge, Jonathan Barrett
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- Book:
- Child and Adolescent Mental Health Services
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 270-283
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Summary
‘“It all comes”, said Pooh crossly, “of not having front doors big enough.”’
A. A. Milne, Winnie the PoohIntroduction
Despite the development of home treatment teams and early intervention psychosis services, the demand for in-patient child and adolescent beds remains. It is rare for young people with mental disorders to require inpatient services, but when they do, beds are few and far between. Reasons for admission include severity of illness, deterioration in psychological functioning despite community treatment, high risk to self or others, or family difficulties making treatment difficult, any of which may lead to the need for 24-hour care (Green & Worrall-Davies, 2008). In-patient care is a specialised field providing treatment for young people with serious psychiatric illness by skilled and experienced staff.
Who and what are in-patient units for?
There is a range of psychiatric, educational, social, criminal and societal indicators for admission to an in-patient service. It is usually impossible to separate the different aspects or contributors to the young person's disorder so that each can be provided by the different agencies responsible for it. Psychological disorders, because of adverse life experiences, are common and pure psychiatric disorders are rare, but they all have educational and social precursors and sequelae. Trying to compartmentalise children into unidisciplinary treatment pigeonholes is problematic as:
• admission to psychiatric in-patient units considerably disrupts education and the young person's functioning in the community
• education authorities have to meet young people's special educational needs but cannot isolate these from other social and mental health factors, which they often do not have the resources to address
• residential policies of Social Services departments tend to address young people's mental health and educational needs only as secondary considerations
• the Home Office and Ministry of Justice, which will provide care in a prison setting, have little investment in childhood preventative work for the large proportion of young people with conduct disorder and complex needs when they become adults.
Work on sharing residential responsibility and input requires considerable inter-departmental and inter-agency working, but each agency will be uncertain who is going to reap the most for investing in them, and the harvest is not guaranteed.
Developing a Clinical Prediction Rule for First Hospital-Onset Clostridium difficile Infections: A Retrospective Observational Study
- Anne Press, Benson S Ku, Lauren McCullagh, Lisa Rosen, Safiya Richardson, Thomas McGinn
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 37 / Issue 8 / August 2016
- Published online by Cambridge University Press:
- 28 April 2016, pp. 896-900
- Print publication:
- August 2016
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BACKGROUND
The healthcare burden of hospital-acquired Clostridium difficile infection (CDI) demands attention and calls for a solution. Identifying patients’ risk of developing a primary nosocomial CDI is a critical first step in reducing the development of new cases of CDI.
OBJECTIVETo derive a clinical prediction rule that can predict a patient’s risk of acquiring a primary CDI.
DESIGNRetrospective cohort study.
SETTINGLarge tertiary healthcare center.
PATIENTSTotal of 61,482 subjects aged at least 18 admitted over a 1-year period (2013).
INTERVENTIONNone.
METHODSPatient demographic characteristics, evidence of CDI, and other risk factors were retrospectively collected. To derive the CDI clinical prediction rule the patient population was divided into a derivation and validation cohort. A multivariable analysis was performed in the derivation cohort to identify risk factors individually associated with nosocomial CDI and was validated on the validation sample.
RESULTSAmong 61,482 subjects, CDI occurred in 0.46%. CDI outcome was significantly associated with age, admission in the past 60 days, mechanical ventilation, dialysis, history of congestive heart failure, and use of antibiotic medications. The sensitivity and specificity of the score, in the validation set, were 82.0% and 75.7%, respectively. The area under the receiver operating characteristic curve was 0.85.
CONCLUSIONThis study successfully derived a clinical prediction rule that will help identify patients at high risk for primary CDI. This tool will allow physicians to systematically recognize those at risk for CDI and will allow for early interventional strategies.
Infect Control Hosp Epidemiol 2016;37:896–900
Identification of (poly)phenol treatments that modulate the release of pro-inflammatory cytokines by human lymphocytes
- Christopher T. Ford, Siân Richardson, Francis McArdle, Silvina B. Lotito, Alan Crozier, Anne McArdle, Malcolm J. Jackson
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- Journal:
- British Journal of Nutrition / Volume 115 / Issue 10 / 28 May 2016
- Published online by Cambridge University Press:
- 17 March 2016, pp. 1699-1710
- Print publication:
- 28 May 2016
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Diets rich in fruits and vegetables (FV), which contain (poly)phenols, protect against age-related inflammation and chronic diseases. T-lymphocytes contribute to systemic cytokine production and are modulated by FV intake. Little is known about the relative potency of different (poly)phenols in modulating cytokine release by lymphocytes. We compared thirty-one (poly)phenols and six (poly)phenol mixtures for effects on pro-inflammatory cytokine release by Jurkat T-lymphocytes. Test compounds were incubated with Jurkat cells for 48 h at 1 and 30 µm, with or without phorbol ester treatment at 24 h to induce cytokine release. Three test compounds that reduced cytokine release were further incubated with primary lymphocytes at 0·2 and 1 µm for 24 h, with lipopolysaccharide added at 5 h. Cytokine release was measured, and generation of H2O2 by test compounds was determined to assess any potential correlations with cytokine release. A number of (poly)phenols significantly altered cytokine release from Jurkat cells (P<0·05), but H2O2 generation did not correlate with cytokine release. Resveratrol, isorhamnetin, curcumin, vanillic acid and specific (poly)phenol mixtures reduced pro-inflammatory cytokine release from T-lymphocytes, and there was evidence for interaction between (poly)phenols to further modulate cytokine release. The release of interferon-γ induced protein 10 by primary lymphocytes was significantly reduced following treatment with 1 µm isorhamnetin (P<0·05). These results suggest that (poly)phenols derived from onions, turmeric, red grapes, green tea and açai berries may help reduce the release of pro-inflammatory mediators in people at risk of chronic inflammation.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Contributors
-
- By Antonella Ballardini, Lex Bosman, Olof Brandt, Ann van Dijk, Catherine Fletcher, Carmela Vircillo Franklin, Richard Gem, Robert Glass, Peter Jeffery, Bram Kempers, Paolo Liverani, Charles B. McClendon, Meaghan McEvoy, Rosamond McKitterick, Éamonn Ó Carragáin, John Osborne, Paola Pogliani, Carol M. Richardson, Katharina Christa Schüppel, Joanna Story, Alan Thacker, Lacey Wallace
- Edited by Rosamond McKitterick, University of Cambridge, John Osborne, Carleton University, Ottawa, Carol M. Richardson, University of Edinburgh, Joanna Story, University of Leicester
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- Book:
- Old Saint Peter's, Rome
- Published online:
- 18 December 2013
- Print publication:
- 07 November 2013, pp xx-xxiv
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Notes on Contributors
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- By David Amigoni, Mark Asquith, Jane Bownas, Adelene Buckland, Carolyn Burdett, Pamela Dalziel, Christine DeVine, Tim Dolin, Roger Ebbatson, Trish Ferguson, Shanyn Fiske, Simon Gatrell, Sophie Gilmartin, William Greenslade, Ann Heilmann, Michael Herbert, John Hughes, Rena Jackson, Elizabeth Langland, Sarah E. Maier, Phillip Mallett, Francesco Marroni, Jane Mattisson, Andrew Nash, K. M. Newton, Francis O’Gorman, John Osborne, Patrick Parrinder, Andrew Radford, Fred Reid, Angelique Richardson, Mary Rimmer, Peter Robinson, Dennis Taylor, Jenny Bourne, Jane Thomas, Herbert F. Tucker, Norman Vance, Roger Webster, Rebecca Welshman, Glen Wickens, Melanie Williams, Keith Wilson, T. R. Wright
- Edited by Phillip Mallett, University of St Andrews, Scotland
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- Book:
- Thomas Hardy in Context
- Published online:
- 05 February 2013
- Print publication:
- 18 March 2013, pp ix-xvi
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Cognitive behavioural therapy for depression in advanced Parkinson's disease: a case illustration
- Thomas Richardson, Ann Marshall
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- Journal:
- The Cognitive Behaviour Therapist / Volume 5 / Issue 2-3 / September 2012
- Published online by Cambridge University Press:
- 16 July 2012, pp. 60-69
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Parkinson's disease (PD) is associated with significant symptoms of depression. Cognitive behaviour therapy (CBT) has been shown to be effective for depression in PD. However, much of the previous research focuses on working with younger adults in the earlier stages of the disease, despite evidence for greater risk of depression when PD symptoms are more severe. This paper provides a case illustration of using CBT for depression with an 84-year-old man with advanced PD. The results of an assessment are described and a psychological formulation is presented. The specific adaptations made to the therapy and illustrations of the content of therapy are discussed. This intervention resulted in improvements in global mental health and moderate reductions in depression. However, there was no effect on anxiety. This case highlights the complexity of conducting CBT with this population, and further research is needed to determine the modifications necessary to make such interventions effective.
Contributors
-
- By Avishek Adhikari, Susanne E. Ahmari, Anne Marie Albano, Carlos Blanco, Desiree K. Caban, Jonathan S. Comer, Jeremy D. Coplan, Ana Alicia De La Cruz, Emily R. Doherty, Bruce Dohrenwend, Amit Etkin, Brian A. Fallon, Michael B. First, Abby J. Fyer, Angela Ghesquiere, Jay A. Gingrich, Robert A. Glick, Joshua A. Gordon, Ethan E. Gorenstein, Marco A. Grados, James P. Hambrick, James Hanks, Kelli Jane K. Harding, Richard G. Heimberg, Rene Hen, Devon E. Hinton, Myron A. Hofer, Matthew J. Kaplowitz, Sharaf S. Khan, Donald F. Klein, Karestan C. Koenen, E. David Leonardo, Roberto Lewis-Fernández, Jeffrey A. Lieberman, Michael R. Liebowitz, Sarah H. Lisanby, Antonio Mantovani, John C. Markowitz, Patrick J. McGrath, Caitlin McOmish, Jeffrey M. Miller, Jan Mohlman, Elizabeth Sagurton Mulhare, Philip R. Muskin, Navin Arun Natarajan, Yuval Neria, Nicole R. Nugent, Mayumi Okuda, Mark Olfson, Laszlo A. Papp, Sapana R. Patel, Anthony Pinto, Kristin Pontoski, Jesse W. Richardson-Jones, Carolyn I. Rodriguez, Steven P. Roose, Moira A. Rynn, Franklin Schneier, M. Katherine Shear, Ranjeeb Shrestha, Helen Blair Simpson, Smit S. Sinha, Natalia Skritskaya, Jami Socha, Eun Jung Suh, Gregory M. Sullivan, Anthony J. Tranguch, Hilary B. Vidair, Tor D. Wager, Myrna M Weissman, Noelia V. Weisstaub
- Edited by Helen Blair Simpson, Columbia University, New York, Yuval Neria, Columbia University, New York, Roberto Lewis-Fernández, Columbia University, New York, Franklin Schneier, Columbia University, New York
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- Book:
- Anxiety Disorders
- Published online:
- 10 November 2010
- Print publication:
- 26 August 2010, pp vii-xii
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28 - Tier 4 options
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- By Tim McDougall, Lead Nurse, Cheshire & Wirral NHS Foundation Trust, Anne Worrall-Davies, MBChB, MMedSc, MRCPsych, Senior Lecturer in Child and Adolescent Psychiatry, University of Leeds, and Honorary Consultant in Child and Adolescent Psychiatry, NHS Leeds, Lesley Hewson, MBChB, MRCPsych, FRCPsych, Consultant Child and Adolescent Psychiatrist, Bradford District Care Trust, Rosie Beer, Retired Consultant in Child and Adolescent Psychiatry, Leeds, Greg Richardson, MBChB, DCH, DPM, FRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust
- Edited by Greg Richardson, Ian Partridge, Jonathan Barrett
-
- Book:
- Child and Adolescent Mental Health Services
- Published online:
- 02 January 2018
- Print publication:
- 01 February 2010, pp 259-269
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Summary
‘Two roads diverged in a wood, and I–
I took the one less travelled by,
And that has made all the difference.’
Robert Frost (1874–1963)Introduction
Tier 4 CAMHS aim to meet the needs of children and young people with the most complex, severe or persistent mental health problems. Tier 4 services include in-patient care (see Chapter 29), as well as a range of day care and intensive community home-based and outreach services for specific groups of children and young people.
Day services
Early descriptions of child and adolescent mental health day units emphasised 5-day ‘milieu’ provision with a strong emphasis on education and behaviour management (Brown, 1996), whereas now they frequently provide daily focused activities to which children and families are invited, depending on their needs. Currently, about half of UK day services are linked to in-patient units, and many in-patient units have a day programme (Green & Jacobs, 1998). It is impossible to classify day services owing to the enormous range in milieu and interventions provided (Green & Worrall- Davies, 2008). However, day services broadly offer:
• support and transition to community services following in-patient admission;
• intensive 5 days per week treatment packages for children and their families;
• treatment of disruptive behaviour, using multimodal treatment strategies with a combination of individual, family and psychopharmacological interventions;
• specialist management and programmes of care for younger children with developmental disorders such as autism, speech and language disorders or neuropsychiatric disorders;
• intensive intervention aimed at improving family functioning in situations of family breakdown or child maltreatment.
Provision and organisation
Day units can offer assessment and therapeutic services that are more specialised, complex and intensive than out-patient services, although they are still community-based and less disruptive than in-patient admission. Most also have the benefit of educational input. Close liaison with specialised education and Social Services is central to their work. There is general acceptance of the central importance of maintaining attachments and working with whole systems if the complex needs of children are to be met. Day units can work with children and young people individually and in groups, as well as with their families, while keeping the focus of concern within the community and avoiding the ‘out of sight, out of mind’ dilemma of in-patient services.
29 - In-patient psychiatric care
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- By Angela Sergeant, RMN, RGN, MSc, ENB 603, Consultant Nurse in Child and Adolescent Psychiatry, Leigh House Hospital, Winchester, Hampshire Partnership Trust, Greg Richardson, MBChB, DCH, DPM, FRCPsych, Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust, Ian Partridge, MA, MSc, CQSW, Social Worker, formerly at Lime Trees CAMHS, York, Tim McDougall, Lead Nurse, Cheshire & Wirral NHS Foundation Trust, Anne Worrall-Davies, MBChB, MMedSc, MRCPsych, Senior Lecturer in Child and Adolescent Psychiatry, University of Leeds, and Honorary Consultant in Child and Adolescent Psychiatry, NHS Leeds, Lesley Hewson, MBChB, MRCPsych, FRCPsych, Consultant Child and Adolescent Psychiatrist, Bradford District Care Trust
- Edited by Greg Richardson, Ian Partridge, Jonathan Barrett
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- Book:
- Child and Adolescent Mental Health Services
- Published online:
- 02 January 2018
- Print publication:
- 01 February 2010, pp 270-283
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Summary
‘“It all comes”, said Pooh crossly, “of not having front doors big enough.”’
A. A. Milne, Winnie the PoohIntroduction
Despite the development of home treatment teams and early intervention psychosis services, the demand for in-patient child and adolescent beds remains. It is rare for young people with mental disorders to require inpatient services, but when they do, beds are few and far between. Reasons for admission include severity of illness, deterioration in psychological functioning despite community treatment, high risk to self or others, or family difficulties making treatment difficult, any of which may lead to the need for 24-hour care (Green & Worrall-Davies, 2008). In-patient care is a specialised field providing treatment for young people with serious psychiatric illness by skilled and experienced staff.
Who and what are in-patient units for?
There is a range of psychiatric, educational, social, criminal and societal indicators for admission to an in-patient service. It is usually impossible to separate the different aspects or contributors to the young person's disorder so that each can be provided by the different agencies responsible for it. Psychological disorders, because of adverse life experiences, are common and pure psychiatric disorders are rare, but they all have educational and social precursors and sequelae. Trying to compartmentalise children into unidisciplinary treatment pigeonholes is problematic as:
• admission to psychiatric in-patient units considerably •• disrupts education and the young person's functioning in the community
• education authorities have to meet young people's special educational needs but cannot isolate these from other social and mental health factors, which they often do not have the resources to address
• residential policies of Social Services departments tend to address young people's mental health and educational needs only as secondary considerations
• the Home Office and Ministry of Justice, which will provide care in a prison setting, have little investment in childhood preventative work for the large proportion of young people with conduct disorder and complex needs when they become adults.
Work on sharing residential responsibility and input requires considerable inter-departmental and inter-agency working, but each agency will be uncertain who is going to reap the most for investing in them, and the harvest is not guaranteed.
Organization and interaction in psychiatric day centres
- Geoff Shepherd, Anne Richardson
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- Journal:
- Psychological Medicine / Volume 9 / Issue 3 / August 1979
- Published online by Cambridge University Press:
- 09 July 2009, pp. 573-579
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One of the major problems in the care of chronic patients is the design of suitable long-term environments. Following from the work of Tizard and his colleagues, a study is described which investigated the aspects of the organization, management practices and social interactions in 4 local authority day centres for the care of chronic patients in the community. It was found that these centres differed markedly in terms of their organization and management practices and that these differences were correlated with the nature and quality of staff-client (although not staff–staff) interactions. Client-oriented management attitudes were correlated with a more personal approach to clients' problems and a warmer quality of interaction. These differences did not seem attributable to different kinds of clients being involved in each centre. The results are discussed in terms of the possible causal mechanisms involved and their implications for designing systems of long-term care.
Siemens AG—Violations of the Foreign Corrupt Practices Act
- Alexandra Wrage, Anne Richardson, Cheryl J. Scarboro, (D..C. Bar No. 422175), Reid A. Muoio, Tracy L. Price, Denise Hansberry, Robert I. Dodge
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- Journal:
- International Legal Materials / Volume 48 / Issue 2 / April 2009
- Published online by Cambridge University Press:
- 27 February 2017, pp. 232-249
- Print publication:
- April 2009
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Rethinking an Assessment of Nicotine Dependence: A Sex, Gender and Diversity Analysis of the Fagerstrom Test for Nicotine Dependence
- Lindsay Richardson, Lorraine Greaves, Natasha Jategaonkar, Kirsten Bell, Ann Pederson, Ethel Tungohan
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- Journal:
- Journal of Smoking Cessation / Volume 2 / Issue 2 / 01 November 2007
- Published online by Cambridge University Press:
- 21 February 2012, pp. 59-67
- Print publication:
- 01 November 2007
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This article assesses whether the Fagerstrom Test for Nicotine Dependence (FTND), adequately reflects sex, gender and diversity related differences in nicotine dependence. Available studies on the FTND were reviewed and a sex, gender and diversity analysis (SGBA) of this instrument was conducted. Results indicate that sex and gender differences in nicotine dependence may undermine the ability of the FTND to present an adequate picture of dependence. Conducting a SGBA on this Fagerstrom test reveals that sex and gender differences likely limit the ability of this instrument to present an accurate picture of dependence in diverse groups. Further research is needed to enhance the sensitivity of the FTND.
3 - Bayesian Hierarchical Models for Inference in Microarray Data
- Edited by Kim-Anh Do, University of Texas, MD Anderson Cancer Center, Peter Müller, Swiss Federal Institute of Technology, Zürich, Marina Vannucci, Rice University, Houston
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- Bayesian Inference for Gene Expression and Proteomics
- Published online:
- 23 November 2009
- Print publication:
- 24 July 2006, pp 53-74
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Summary
Abstract
We review Bayesian hierarchical models for inference in microarray data. The chapter consists of two main parts that deal with use of Bayesian hierarchical models at different levels of analysis encountered in the context of microarrays. The first part reviews a Bayesian hierarchical model for the estimation of gene expression levels from Affymetrix GeneChip data, and for inference on differential expression. In the second part, an integrated model that incorporates expression-dependent normalization within an ANOVA model of differential expression is reviewed and compared to a model where normalization is preprocessed. The chapter concludes by discussing how predictive Bayesian model checking can be usefully included within the model inference.
Introduction
Background
Microarrays are one of the new technologies that have developed in line with genome sequencing and developments in miniaturization and robotics. The technology exploits the fact that single-stranded RNA (or DNA) molecules have a high affinity to form double-stranded structures. Pairing is specific and complementary strands have particularly high affinity for binding. On microarrays gene-specific sequences are attached in tiny specified locations. By hybridizing a cell sample of fragmented, fluorescently labeled RNA (or DNA) to the array and measuring the fluorescence at the defined locations, one can obtain measures of the amount of the different RNA or DNA transcripts present in the sample hybridized.
Arrays generally contain thousands of spots (or probes) at each of which a particular gene or sequence is represented. In effect, a microarray experiment thus represents data comparable to that obtained by performing tens of thousands of experiments of a similar type in parallel.
Cost-effectiveness of a supplementary class-based exercise program in the treatment of knee osteoarthritis
- Gerry Richardson, Neil Hawkins, Christopher James McCarthy, Pauline Mary Mills, Rachel Pullen, Christopher Roberts, Alan Silman, Jacqueline Ann Oldham
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 22 / Issue 1 / January 2006
- Published online by Cambridge University Press:
- 27 February 2006, pp. 84-89
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Objectives: The aim of this study was to assess the cost-effectiveness of a class-based exercise program supplementing a home-based program when compared with a home-based program alone. In addition, we estimated the probability that the supplementary class program is cost-effective over a range of values of a decision maker's willingness to pay for an additional quality-adjusted life-year (QALY).
Methods: The resource use and effectiveness data were collected as part of the clinical trial detailed elsewhere. Unit costs were estimated from published sources. The net benefit approach to cost-effectiveness analysis is used to estimate the probability of the intervention being cost-effective.
Results: The addition of a supplementary class-based group results in an increase in QALYs and lower costs. For all plausible values of a decision maker's willingness to pay for a QALY, the supplementary class group is likely to be cost-effective.
Conclusions: The addition of a class-based exercise program is likely to be cost-effective and, on current evidence, should be implemented.
Abusive experiences and psychiatric morbidity in women primary care attenders
- Jeremy Coid, Ann Petruckevitch, Wai-Shan Chung, Jo Richardson, Stirling Moorey, Gene Feder
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- Journal:
- The British Journal of Psychiatry / Volume 183 / Issue 4 / October 2003
- Published online by Cambridge University Press:
- 02 January 2018, pp. 332-339
- Print publication:
- October 2003
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Background
Abusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging.
AimsTo measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders.
MethodA cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression.
ResultsChildhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year.
ConclusionsAbuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.
10 - The use of complementary/alternative medicine
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- By Mary Ann Richardson, The National Center for Complementary and Alternative Medicine, Bethesda
- Edited by Michael J. Fisch, University of Texas, M. D. Anderson Cancer Center, Eduardo Bruera, University of Texas, M. D. Anderson Cancer Center
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- Book:
- Handbook of Advanced Cancer Care
- Published online:
- 04 August 2010
- Print publication:
- 27 March 2003, pp 88-95
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Summary
Introduction
Complementary and alternative medicine (CAM) or integrated therapies range from drug-like interventions with single herbs to complex herbal formulas, high dose vitamins and supplements, mind–body–spiritual interventions, physical approaches, energy-based therapies, and multifaceted treatment regimens. The lack of standardized products, the complexity of multiple regimens, and individualized treatments pose challenges to evaluation by researchers. Despite the lack of evidence to support efficacy, many patients with advanced cancer seek these approaches. As interest in CAM therapies continues to rise with growing public concerns about appropriate end-of-life care, this chapter presents a rationale for discussing CAM with patients and exploring the potential role of these therapies in conventional oncology care.
Palliative care has been described as “ … care that takes place in a context where … cure is no longer possible and disease modification provides diminishing returns.” The goal of palliative care is to provide for any unmet physical, psychosocial, and spiritual needs of terminally ill patients and their families. The most important concerns expressed by hospice patients are the existential, spiritual, familial, physical, and emotional aspects of illness; however, these concerns have rarely been the focus of care at the end of life., When cure is not an option, maintaining quality of life and controlling symptoms are more appropriate than potentially distressing treatments associated with limited improvement but physical and emotional suffering. Social and cultural forces are demanding a more holistic approach to convey empathy and compassion and support the dignity and quality of life in the final days.