Mental hospital reform in Asia: the case of Yuli Veterans Hospital, Taiwan

<p>Abstract</p> <p>Background</p> <p>Yuli Veterans Hospital (YVH) has been the largest mental hospital for the patients with chronic and severe mental illness in Taiwan for the past 50 years. While this hospital used to be a symbol of hopelessness among patients and their families and an unspoken shame among Taiwan psychiatry and mental health circles it now represents an example of how an old, custodial hospital can be transformed into a very different institution. In this case study we will describe the features of this transformation, which, over the past 20 years, has aimed to help extended stay inpatients with severe mental illness to integrate into the local community of Yuli even though it is not their original home.</p> <p>Methods</p> <p>Using historical documents and oral narratives from Yuli inhabitants, workers and patients of YVH, we will offer a case study of the Yuli model.</p> <p>Results</p> <p>There are four main components of the Yuli model: holistic medical support, vocational rehabilitation, case management, and the residential program. The four components help patients recover two essential features of their lives: vocational life and ordinary daily routines. As the process of recovery evolves, patients gradually regain inner stability, dignity, self-confidence, and a sense of control. The four components are critical to rebuild the structure and order of life of the patients and are indispensable and interdependent parts of one service package. They operate simultaneously to benefit the patients to the greatest degree possible.</p> <p>Discussion</p> <p>There are many challenges to the further development and financial viability of the model of services developed at YVH. There are also important questions concerning the replicability of the Yuli model in other sociocultural and service system contexts.</p> <p>Conclusion</p> <p>This case study reveals the possibility of transforming a custodial mental hospital into a hospital providing high quality care. Hospital and community are not in opposition. They are part of a continuum of care for the patients. We reinterpret and redefine the boundary and function of hospital and community, and thereby create a new service model, the Yuli Model, to help patients to reintegrate into the community. The Yuli model, which particularly focuses on the needs of people with long-standing illness and prolonged hospital stay, illustrates one approach to linking hospital and community in a creative and constructive manner.</p

Fatigue of survivors following cardiac surgery: Positive influences of preoperative prayer coping

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93766/1/j.2044-8287.2012.02068.x.pd

Does empathy predict altruism in the wild?

Why do people act altruistically? One theory is that empathy is a driver of morality. Experimental studies of this are often confined to laboratory settings, which often lack ecological validity. In the present study we investigated whether empathy traits predict if people will act altruistically in a real-world setting, "in the wild". We staged a situation in public that was designed to elicit helping, and subsequently measured empathic traits in those who either stopped to help or walked past and did not help. Results show that a higher number of empathic traits are a significant and positive predictor for altruistic behavior in a real-life situation. This supports the theory that the act of doing good is correlated with empathy.This work was supported by the Autism Research Trust and the Medical Research Council; Pinsent Darwin Trust, Medical Research Council and Cambridge Trust; National Institute for Health Research

Age and sex affect intersubject correlation of EEG throught development

Recent efforts have aimed to characterize clinical pediatric populations by using neurophysiological tests in addition to behavioral assays. Here we report on a data collection effort in which electroencephalography (EEG) was recorded in both juveniles and adults (N=114 participants, ages 6-44 years of age) during various stimulation protocols. The present analysis focuses on how neural responses during passive viewing of naturalistic videos vary with age and sex, and in particular, how similar they are within developmental groups. Similarity of neural responses was measured as the inter-subject correlation of the EEG. Stimulus-evoked neural responses are more similar among children and decrease in similarity with age. Among children, males respond more similarly to each other than females. This was uniformly true for a variety of videos. The decrease in group similarity with age may result from an overall decline in the magnitude of evoked responses, but this cannot explain the sex differences found in the young. We therefore propose that as children mature, neural function may become more variable

The Variability of Neural Responses to Naturalistic Videos Change with Age and Sex

Neural development is generally marked by an increase in the efficiency and diversity of neural processes. In a large sample (n=114) of human children and adults with ages ranging from 5 to 44 yr, we investigated the neural responses to naturalistic video stimuli. Videos from both real-life classroom settings and Hollywood feature films were used to probe different aspects of attention and engagement. For all stimuli, older ages were marked by more variable neural responses. Variability was assessed by the intersubject correlation of evoked electroencephalographic responses. Young males also had less-variable responses than young females. These results were replicated in an independent cohort (n = 303). When interpreted in the context of neural maturation, we conclude that neural function becomes more variable with maturity, at least during the passive viewing of real-world stimuli.Fil: Petroni, Agustín. City University of New York; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Cohen, Samantha S.. City University of New York; Estados UnidosFil: Ai, Lei. City University of New York; Estados UnidosFil: Langer, Nicolas. City University of New York; Estados UnidosFil: Henin, Simon. City University of New York; Estados UnidosFil: Vanderwal, Tamara. City University of New York; Estados UnidosFil: Milham, Michael P.. City University of New York; Estados UnidosFil: Parra, Lucas C.. City University of New York; Estados Unido

Skyrmion Multi-Walls

Skyrmion walls are topologically-nontrivial solutions of the Skyrme system which are periodic in two spatial directions. We report numerical investigations which show that solutions representing parallel multi-walls exist. The most stable configuration is that of the square $N$-wall, which in the $N\to\infty$ limit becomes the cubically-symmetric Skyrme crystal. There is also a solution resembling parallel hexagonal walls, but this is less stable.Comment: 7 pages, 1 figur

A brain-sparing diphtheria toxin for chemical genetic ablation of peripheral cell lineages.

Conditional expression of diphtheria toxin receptor (DTR) is widely used for tissue-specific ablation of cells. However, diphtheria toxin (DT) crosses the blood-brain barrier, which limits its utility for ablating peripheral cells using Cre drivers that are also expressed in the central nervous system (CNS). Here we report the development of a brain-sparing DT, termed BRAINSPAReDT, for tissue-specific genetic ablation of cells outside the CNS. We prevent blood-brain barrier passage of DT through PEGylation, which polarizes the molecule and increases its size. We validate BRAINSPAReDT with regional genetic sympathectomy: BRAINSPAReDT ablates peripheral but not central catecholaminergic neurons, thus avoiding the Parkinson-like phenotype associated with full dopaminergic depletion. Regional sympathectomy compromises adipose tissue thermogenesis, and renders mice susceptible to obesity. We provide a proof of principle that BRAINSPAReDT can be used for Cre/DTR tissue-specific ablation outside the brain using CNS drivers, while consolidating the link between adiposity and the sympathetic nervous system

Effects of a Single Intra-Articular Injection of a Microsphere-Formulation of Triamcinolone Acetonide on Knee Osteoarthritis Pain: A Double-Blinded, Randomized, Placebo-Controlled, Multinational Study

Background: Intra-articular corticosteroids relieve osteoarthritis pain, but rapid systemic absorption limits efficacy. FX006, a novel, microsphere-based, extended-release triamcinolone acetonide (TA) formulation, prolongs TA joint residence and reduces systemic exposure compared with standard TA crystalline suspension (TAcs). We assessed symptomatic benefits and safety of FX006 compared with saline-solution placebo and TAcs. Methods: In this Phase-3, multicenter, double-blinded, 24-week study, adults ≥40 years of age with knee osteoarthritis (Kellgren-Lawrence grade 2 or 3) and average-daily-pain (ADP)-intensity scores of ≥5 and ≤9 (0 to 10 numeric rating scale) were centrally randomized (1:1:1) to a single intra-articular injection of FX006 (32 mg), saline-solution placebo, or TAcs (40 mg). The primary end point was change from baseline to week 12 in weekly mean ADP-intensity scores for FX006 compared with saline-solution placebo. Secondary end points were area-under-effect (AUE) curves of the change in weekly mean ADP-intensity scores from baseline to week 12 for FX006 compared with saline-solution placebo, AUE curves of the change in weekly mean ADP-intensity scores from baseline to week 12 for FX006 compared with TAcs, change in weekly mean ADP-intensity scores from baseline to week 12 for FX006 compared with TAcs, and AUE curves of the change in weekly mean ADP-intensity scores from baseline to week 24 for FX006 compared with saline-solution placebo. Exploratory end points included week-12 changes in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Injury and Osteoarthritis Outcome Score Quality of Life (KOOS-QOL) subscale scores for FX006 compared with saline-solution placebo and TAcs. Adverse events were elicited at each inpatient visit. Results: The primary end point was met. Among 484 treated patients (n = 161 for FX006, n = 162 for saline-solution placebo, and n = 161 for TAcs), FX006 provided significant week-12 improvement in ADP intensity compared with that observed for saline-solution placebo (least-squares mean change from baseline: −3.12 versus −2.14; p < 0.0001) indicating ∼50% improvement. FX006 afforded improvements over saline-solution placebo for all secondary and exploratory end points (p < 0.05). Improvements in osteoarthritis pain were not significant for FX006 compared with TAcs using the ADP-based secondary measures. Exploratory analyses of WOMAC-A, B, and C and KOOS-QOL subscales favored FX006 (p ≤ 0.05). Adverse events were generally mild, occurring at similar frequencies across treatments. Conclusions: FX006 provided significant, clinically meaningful pain reduction compared with saline-solution placebo at week 12 (primary end point)

Spin-orbit coupling suppression and singlet-state blocking of spin-triplet Cooper pairs

An inhomogeneous magnetic exchange field at a superconductor/ferromagnet interface converts spin-singlet Cooper pairs to a spin-polarized triplet state. Although the decay envelope of triplet pairs within ferromagnetic materials is well studied, little is known about their decay in nonmagnetic metals and superconductors and, in particular, in the presence of spin-orbit coupling (SOC). Here, we investigate devices in which singlet and triplet supercurrents propagate into the s-wave superconductor Nb. In the normal state of Nb, triplet supercurrents decay over a distance of 5 nm, which is an order of magnitude smaller than the decay of spin-singlet pairs due to the SOC. In the superconducting state of Nb, triplet supercurrents are not able to couple with the singlet wave function and are thus blocked by the absence of available equilibrium states in the singlet gap. The results offer insight into the dynamics between s-wave singlet and s-wave triplet states