Depression and associated physical diseases and symptoms

Depression can occur in association with virtually all the other psychiatric and physical diagnoses. Physical illness increases the risk of developing severe depressive illness. There are two broadly different mechanisms. The most obvious has a psychological or cognitive mechanism. Thus, the illness may provide the life event or chronic difficulty that triggers a depressive episode in a vulnerable Individual. Secondly more specific associations appear to exist between depression and particular physical disorders. These may turn out to be of particular etiological interest. The best examples are probably stroke and cardiovascular disease. Finally major depression, but especially minor depression, dysthymia, and depressive symptoms merge with other manifestations of human distress with which patients present to their doctors, Such somatic presentations test the conventional distinction between physical and mental disorder, and are a perennial source of controversy

Cuestiones legales y prácticas a raíz de los movimientos de población a través del Mediterráneo

Los movimientos de población son un fenómeno con el que debemos aprender a vivir y que debemos gestionar lo mejor que podamos por el interés de todos. Entre otras cuestiones, esto exige que el trato entre Estados se base en la equidad y la igualdad, más que sobre unas expectativas desfasadas y surrealistas de derecho soberano

Refugees and Responsibility in the Twenty-First Century: More Lessons Learned from the South Pacific

[G]overnments throughout the world have tried to avoid dealing with the difficult questions raised by refugee and related movements. One method is to seek to redefine the problem as one not involving obligation or responsibility. Some governments also use the law in an attempt to limit the scope of their obligations. Another technique . . . is to engage in an exercise of extra-territorial jurisdiction . . . and to seek to justify that practice on the ground that somehow obligations towards refugees need not be observed. States have also tried detention, discriminatory treatment, and denial of other human rights in their attempts to dissuade the refugee and asylum seekers . . . . In Australia, where there is no constitutional protection or Bill of Rights, the Government has continued to expand its field of executive, arbitrary power which began with the introduction of mandatory non-reviewable detention in 1991. In the case of the Tampa, Norway\u27s position, based on Article 98 of [the United Nations Convention on the Law of the Sea], customary international law and generally accepted humanitarian standards, was that Australia was obliged to allow those rescued into the nearest port: this, in Norway\u27s view, was Christmas Island. However, next port of call is not a self-defining or self-applying concept, and in many instances it may be relative to the particular circumstances of rescue . . . . [T]he premises of the international protection regime (which draws on the specifics of international refugee law, on human rights law, and on more generally applicable rules), does provide a normative and institutional framework within which States ought to seek solutions. The U.N. Committee on Human Rights found that [Australia\u27s] policy and practice of mandatory and non-reviewable detention was arbitrary and a breach of Article 9 of the International Covenant on Civil and Political Rights, and a similar conclusion was reached by the Australian Human Rights and Equal Opportunity Commission in 1998. The question effectively arising in the Tampa case was whether the State primarily engaged had the courage to respond internationally, or whether it would look no further than its own narrow and short-term self-interest. The Tampa incident is a reminder that the refugee regime is not a seamless web, even if certain core and often competing principles retain their normative power

Entry and Exclusion of Refugees: The Obligations of States and the Protection Function of the Office of the United Nations High Commissioner for Refugees

Refugee problems today tend to have one factor in common-the huge numbers of people involved. But whether it is a case of one or of a mass of individuals, each arriving asylum seeker represents a challenge to established principles of state sovereignty. International jurists once wrote of the free movement of persons between nations, unhampered by passport and visa control. Since the late nineteenth century, however, the principle most widely accepted has been that each state retains exclusive control- an absolute discretion- over the admission to its territory of foreign nationals, refugees or not. Although in practice many countries concede that certain individuals may have some claim to enter (e.g., the close family members of local citizens or lawful residents), such claims must rely for their enforcement and implementation upon municipal law, and only rarely does international law have any relevance

Reducing the health risks of severe winter weather among older people in the United Kingdom: an evidence-based intervention

Excess winter morbidity and mortality among older people remain significant public health issues in those European countries which experience relatively mild winter temperatures, particularly the United Kingdom (UK), Ireland, Portugal and Spain. In the UK, episodes of severe winter weather, when ambient temperatures fall below 5x C, are associated with peaks in general practitioner consultations,hospital admissions, and cardiovascular deaths among those aged over 65. While research indicates that such health risks could be substantially reduced by the adoption of appropriate behavioural strategies, accessible and credible advice on how older people can reduce risk during ‘cold snaps’ is lacking. This paper describes a programme of research that aimed: (a) to translate the relevant scientific literature into practical advice for older people in order to reduce health risk during episodes of severe winter weather ; and (b) to integrate this advice with a severe winter weather ‘Early Warning System’ developed by the UK Met Office. An advice booklet was generated through a sequential process of systematic review, consensus development, and focus group discussions with older people. In a subsequent field trial, a combination of the Met Office ‘Early Warning System’ and the advice booklet produced behavioural change among older people consistent with risk reduction. The results also show that long-held convictions about ‘healthy environments ’ and anxieties about fuel costs are barriers to risk reduction

Depression and violence: a Swedish population study.

BACKGROUND: Depression increases the risk of a range of adverse outcomes including suicide, premature mortality, and self-harm, but associations with violent crime remain uncertain. We aimed to determine the risks of violent crime in patients with depression and to investigate the association between depressive symptoms and violent crime in a cohort of twins. METHODS: We conducted two studies. The first was a total population study in Sweden of patients with outpatient diagnoses of depressive disorders (n=47,158) between 2001 and 2009 and no lifetime inpatient episodes. Patients were age and sex matched to general population controls (n=898,454) and risk of violent crime was calculated. Additionally, we compared the odds of violent crime in unaffected half-siblings (n=15,534) and full siblings (n=33,516) of patients with the general population controls. In sensitivity analyses, we examined the contribution of substance abuse, sociodemographic factors, and previous criminality. In the second study, we studied a general population sample of twins (n=23,020) with continuous measures of depressive symptoms for risk of violent crime. FINDINGS: During a mean follow-up period of 3·2 years, 641 (3·7%) of the depressed men and 152 (0·5%) of the depressed women violently offended after diagnosis. After adjustment for sociodemographic confounders, the odds ratio of violent crime was 3·0 (95% CI 2·8–3·3) compared with the general population controls. The odds of violent crime in half-siblings (adjusted odds ratio 1·2 [95% CI 1·1–1·4]) and full siblings (1·5, 95% CI 1·3–1·6) were significantly increased, showing some familial confounding of the association between depression and violence. However, the odds increase remained significant in individuals with depression after adjustment for familial confounding, and in those without substance abuse comorbidity or a previous violent conviction (all p<0·0001). In the twin study, during the mean follow-up time of 5·4 years, 88 violent crimes were recorded. Depressive symptoms were associated with increased risk of violent crime and a sensitivity analysis identified little difference in risk estimate when all crimes (violent and non-violent) was the outcome. INTERPRETATION: Risk of violent crime was increased in individuals with depression after adjustment for familial, sociodemographic and individual factors in two longitudinal studies. Clinical guidelines should consider recommending violence risk assessment in certain subgroups with depression.The Wellcome TrustThe Swedish Research CouncilPublishe

Enset‐based agricultural systems in Ethiopia: A systematic review of production trends, agronomy, processing and the wider food security applications of a neglected banana relative

Enset (Ensete ventricosum (Welw.) Cheesman) is the major starch staple of the Ethiopian Highlands, where its unique attributes enhance the food security of approximately 20 million people and have earned it the title “The Tree Against Hunger”. Yet enset‐based agriculture is virtually unknown outside of its narrow zone of cultivation, despite growing wild across much of East and Southern Africa. Here, we review historical production data to show that the area of land under enset production in Ethiopia has reportedly increased 46% in two decades, whilst yield increased 12‐fold over the same period, making enset the second most produced crop species in Ethiopia—though we critically evaluate potential issues with these data. Furthermore, we address a major challenge in the development and wider cultivation of enset, by reviewing and synthesizing the complex and fragmented agronomic and ethnobotanic knowledge associated with this species; including farming systems, processing methods, products, medicinal uses and cultural importance. Finally, we provide a framework to improve the quality, consistency and comparability of data collected across culturally diverse enset‐based agricultural systems to enhanced sustainable use of this neglected starch staple. In conclusion, we discuss the challenges and opportunities for enset cultivation beyond its restricted distribution, and the regional food security potential it could afford smallholders elsewhere in Southern and East Africa

Highly neurotic never-depressed students have negative biases in information processing

BACKGROUND: Cognitive theories associate depression with negative biases in information processing. Although negatively biased cognitions are well documented in depressed patients and to some extent in recovered patients, it remains unclear whether these abnormalities are present before the first depressive episode. METHOD: High neuroticism (N) is a well-recognized risk factor for depression. The current study therefore compared different aspects of emotional processing in 33 high-N never-depressed and 32 low-N matched volunteers. Awakening salivary cortisol, which is often elevated in severely depressed patients, was measured to explore the neurobiological substrate of neuroticism. RESULTS: High-N volunteers showed increased processing of negative and/or decreased processing of positive information in emotional categorization and memory, facial expression recognition and emotion-potentiated startle (EPS), in the absence of global memory or executive deficits. By contrast, there was no evidence for effects of neuroticism on attentional bias (as measured with the dot-probe task), over-general autobiographical memory, or awakening cortisol levels. CONCLUSIONS: These results suggest that certain negative processing biases precede depression rather than arising as a result of depressive experience per se and as such could in part mediate the vulnerability of high-N subjects to depression. Longitudinal studies are required to confirm that such cognitive vulnerabilities predict subsequent depression in individual subjects