The Impact of Caffeine and Coffee on Human Health

The purpose of this Special Issue is to provide a thorough and up-to-date presentation of research investigating the impact of coffee and/or caffeine intake on various health outcomes. Areas of interest include, but are not limited to, the following topics: Human clinical trials of coffee or caffeine use in relation to disease or intermediate phenotypes. Epidemiological studies of habitual coffee or caffeine intake in relation to human health, among the general public, as well as, among special populations (i.e., children, pregnant women, diabetics, cancer patients, hypertensives, etc.). Mechanisms of action of nutrients and other bioactive components of coffee/caffeine. Studies integrating genetic or physiological markers of coffee/caffeine intake to investigations of coffee and health

Ten years of integrated care for mental disorders in the Netherlands

Background and problem statement: Integrated care for mental disorders aims to encompass forms of collaboration between different health care settings for the treatment of mental disorders. To this end, it requires integration at several levels, i.e. integration of psychiatry in medicine, of the psychiatric discourse in the medical discourse; of localization of mental health care and general health care facilities; and of reimbursement systems.  Description of policy practice: Steps have been taken in the last decade to meet these requirements, enabling psychiatry to move on towards integrated treatment of mental disorder as such, by development of a collaborative care model that includes structural psychiatric consultation that was found to be applicable and effective in several Dutch health care settings. This collaborative care model is a feasible and effective model for integrated care in several health care settings. The Bio Psycho Social System has been developed as a feasible instrument for assessment in integrated care as well.Discussion: The discipline of Psychiatry has moved from anti-psychiatry in the last century, towards an emancipated medical discipline. This enabled big advances towards integrated care for mental disorder, in collaboration with other medical disciplines, in the last decade.Conclusion: Now is the time to further expand this concept of care towards other mental disorders, and towards integrated care for medical and mental co-morbidity. Integrated care for mental disorder should be readily available to the patient, according to his/her preference, taking somatic co-morbidity into account, and with a focus on rehabilitation of the patient in his or her social roles.</p

Treatment of mental disorder in the primary care setting in the Netherlands in the light of the new reimbursement system: a challenge?

Introduction: Different professionals provide health care for mental disorder in the primary care setting. In view of the changing reimbursement system in the Netherlands, information is needed on their specific expertise. <br><br> Method: This study attempts to describe this by literature study, by assessment of expert opinions, and by consulting Associations of the relevant professions. <br><br> Results: There is no clear differentiation of expertise and tasks amongst these professionals in primary care. Notably, distinction between different psychotherapeutic treatment modes provided by psychologists is unclear. <br><br> Discussion: Research is needed to assess actual treatment modules in correlation with patient diagnostic classification for the different professions in primary care. An alternative way of classifying patients, that takes into account not only mental disorder or problems but especially the level of functioning, is proposed to discern which patients can be treated in primary care, and which patients should not. Integrated care models are promising, because many professionals can be involved in treatment of mental disorder in the primary care setting; especially for collaborative care models, evidence favours the treatment of common mental disorders in this setting. <br><br> Conclusion: Integrated care models, such as collaborative care, provide a basis for multidisciplinary care for mental disorder in the primary care setting. Professional responsibilities should be clearly differentiated in order to facilitate integrated care. The level of functioning of patients with mental disorder can be used as indication criterion for treatment in the primary care setting or in Mental Health Institutions. Research to establish the feasibility of this model is needed

Uncertainty Work:Dealing with a Psychiatric Crisis in Two European Community Mental Health Teams

The quest for how to deal with a crisis in a community setting, with the aim of deinstitutionalizing mental health care, and reducing hospitalization and coercion, is important. In this article, we argue that to understand how this can be done, we need to shift the attention from acute moments to daily uncertainty work conducted in community mental health teams. By drawing on an empirical ethics approach, we contrast the modes of caring of two teams in Utrecht and Trieste. Our analysis shows how temporality structures, such as watchful waiting, are important in dealing with the uncertainty of a crisis.</p