Care for patients with severe mental illness: the general practitioner's role perspective

BACKGROUND: Patients with severe mental illness (SMI) experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. METHODS: A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. RESULTS: 186 general practitioners distributed over urban areas (49%), urbanised rural areas (38%) and rural areas (15%) of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices.GPs also saw their role as giving support and information to the patient's family.However, they felt a need for recognition of their competencies when working with mental health care specialists. CONCLUSION: GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients

Structural Biology of Human H3K9 Methyltransferases

SET domain methyltransferases deposit methyl marks on specific histone tail lysine residues and play a major role in epigenetic regulation of gene transcription. We solved the structures of the catalytic domains of GLP, G9a, Suv39H2 and PRDM2, four of the eight known human H3K9 methyltransferases in their apo conformation or in complex with the methyl donating cofactor, and peptide substrates. We analyzed the structural determinants for methylation state specificity, and designed a G9a mutant able to tri-methylate H3K9. We show that the I-SET domain acts as a rigid docking platform, while induced-fit of the Post-SET domain is necessary to achieve a catalytically competent conformation. We also propose a model where long-range electrostatics bring enzyme and histone substrate together, while the presence of an arginine upstream of the target lysine is critical for binding and specificity. Enhanced version: This article can also be viewed as an enhanced version in which the text of the article is integrated with interactive 3D representations and animated transitions. Please note that a web plugin is required to access this enhanced functionality. Instructions for the installation and use of the web plugin are available i

The effect of climate change on avian offspring production: A global meta-analysis

Climate change affects timing of reproduction in many bird species, but few studies have investigated its influence on annual reproductive output. Here, we assess changes in the annual production of young by female breeders in 201 populations of 104 bird species (N = 745,962 clutches) covering all continents between 1970 and 2019. Overall, average offspring production has declined in recent decades, but considerable differences were found among species and populations. A total of 56.7% of populations showed a declining trend in offspring production (significant in 17.4%), whereas 43.3% exhibited an increase (significant in 10.4%). The results show that climatic changes affect offspring production through compounded effects on ecological and life history traits of species. Migratory and larger-bodied species experienced reduced offspring production with increasing temperatures during the chick-rearing period, whereas smaller-bodied, sedentary species tended to produce more offspring. Likewise, multi-brooded species showed increased breeding success with increasing temperatures, whereas rising temperatures were unrelated to reproductive success in single-brooded species. Our study suggests that rapid declines in size of bird populations reported by many studies from different parts of the world are driven only to a small degree by changes in the production of young.This meta-analysis was financed by the grant of the Polish National Science Centre (Narodowe Centrum Nauki) (no. 2017/27/B/NZ8/00465) awarded to Lucyna Hałupka.Peer reviewe

The effect of climate change on avian offspring production: A global meta-analysis

Climate change affects timing of reproduction in many bird species, but few studies have investigated its influence on annual reproductive output. Here, we assess changes in the annual production of young by female breeders in 201 populations of 104 bird species (N = 745,962 clutches) covering all continents between 1970 and 2019. Overall, average offspring production has declined in recent decades, but considerable differences were found among species and populations. A total of 56.7% of populations showed a declining trend in offspring production (significant in 17.4%), whereas 43.3% exhibited an increase (significant in 10.4%). The results show that climatic changes affect offspring production through compounded effects on ecological and life history traits of species. Migratory and larger-bodied species experienced reduced offspring production with increasing temperatures during the chick-rearing period, whereas smaller-bodied, sedentary species tended to produce more offspring. Likewise, multi-brooded species showed increased breeding success with increasing temperatures, whereas rising temperatures were unrelated to repro- ductive success in single-brooded species. Our study suggests that rapid declines in size of bird populations reported by many studies from different parts of the world are driven only to a small degree by changes in the production of young

Effect of oxygen on short-range order in the Ba1-xBixF2+x solid solution

Various compositions within the range of the fluorite-type solid solution in the BaF2–BiF3–BiOl.5 system are investigated by impedance spectroscopy. This study is carried out along two lines of compositions: δ1, corresponding to the Bal−2z/3Bi2z/3F2+4z/3Oz solid solution, where z is the oxygen rate; and δ2, corresponding to the Bal−xBixF2+x−0.30O0.15 solid solution, where x is the bismuth rate. An approach to the nature of the fluorine–oxygen order is proposed which derives from the clustering process in the Bal−xBixF2+x fluoride solid solution

Fluorite-like phases in the BaF 2 -BiF 3 -Bi 2 O 3 system-synthesis, conductivity and defect clustering

Abstract A fluorite-like solid solution Ba 1 À x Bi x O z F 2 + x À 2z on the basis of cubic BaF 2 was synthesised in the BaF 2 -Bi 2 O 3 -BiF 3 system and the homogeneity range at 873 K was determined. The samples were studied by X-ray powder diffraction and electron diffraction, and their transport properties were measured by the complex impedance method at 300-623 K. Tendencies of variation of lattice parameters and transport properties were determined. These tendencies are discussed on the basis of a defect clustering hypothesis. Thermal treatment at 573 K of the solid solution, quenched from 873 K results in the formation of a new ordered tetragonal fluorite-like phase with lattice parameters a = 9.5355(4) Å , c = 18.151(1) Å .

Fluorite-like phases in the BaF2-BiF3-Bi2O3 system-synthesis, conductivity and defect clustering

A fluorite-like solid solution Ba1 − xBixOzF2 + x − 2z on the basis of cubic BaF2 was synthesised in the BaF2-Bi2O3-BiF3 system and the homogeneity range at 873 K was determined. The samples were studied by X-ray powder diffraction and electron diffraction, and their transport properties were measured by the complex impedance method at 300-623 K. Tendencies of variation of lattice parameters and transport properties were determined. These tendencies are discussed on the basis of a defect clustering hypothesis. Thermal treatment at 573 K of the solid solution, quenched from 873 K results in the formation of a new ordered tetragonal fluorite-like phase with lattice parameters a = 9.5355(4) Å, c = 18.151(1) Å