MIXED AFFECTIVE STATES: A STUDY WITHIN A COMMUNITY MENTAL HEALTH TEAM WITH TREATMENT RECOMMENDATIONS

Introduction: Agitated Depression and Bipolar mixed states combine depressive and manic symptoms, reflecting severe forms of affective disorders with an increased suicide risk. These states have not been defined with adequate consensus and hence present a diagnostic and therapeutic challenge. In this study, we argue that both states are part of the bipolar spectrum rather than a distinct affective syndrome or a mixed anxiety-depression state. Methods: The current literature has been reviewed and suggestions are made for a unified definition of this entity, which would be valuable in recognising this dangerous state. We have then studied 17 cases of mixed states identified from a database held by a UK community mental health team. We have studied the treatments offered and estimated the time these treatments have taken to end the mixed state and so reduce the risk of suicide. Results: Not surprisingly, there are no clear recommendations for treatment of these mixed states. We found that The best results were achieved with a three pronged regimen including increasing/adding mood stabilisers; and/or increasing/adding antipsychotics; as well as decreasing antidepressants. Resolution was achieved in two and a half weeks. Discussion: From this work we have deduced several general principles, which are here reviewed and hence we have been able to suggest possible treatment strategies. Conclusion: Because of the close link between affective mixed states and suicidality, it is of great importance that patients be brought out of the mixed affective state as soon as possible, hence we believe that our findings are of importance in managing these patients. However we recommend further study on a larger sample in order to confirm our findings

How green is your supply chain? Evidence from ISO 14001 certified manufacturers in Malaysia

Extraordinary current consumption in the developed countries as well as in the Asian region, as a result of rapid industrialization, has increased the levels of energy and material consumption. This has posed negative consequences on the natural resources and the environment. The question of how to make economic and infrastructure growth environmentally and socially sustainable, so that it can continue to benefits people while conserving the natural assets and ecosystem continues to challenge policy makers, industry, and consumers. This research investigates the level of green supply chain management (GSCM) practices adopted by ISO 14001 certified manufacturers in Malaysia. Based on the data collected through the questionnaire survey, it was found that most manufacturers have not yet fully adopted the green practices within their supply chain activities. Only 17 percent of the total respondents were proactive adopters of the GSCM practices. The internal environmental practices have been found to be the top GSCM practices, followed by eco-design and investment recovery. The least common GSCM practice is reverse logistics. The study offers implications to both theory and practice

Analytic hierarchy process-based analysis to determine the barriers to implementing a material efficiency strategy: electrical and electronics’ companies in the Malaysian context

Material efficiency is one of the most important strategies for helping manufacturing companies achieve sustainability in their production activities. However, there are many barriers to the implementation of material efficiency strategies in the manufacturing processes and overall business operations. The aim of this study is to identify and evaluate the barriers faced by Electrical and Electronics (E&E) manufacturing companies in Malaysia in implementing material efficiency strategies. A mixed-mode research method was employed to collect data from these companies. Semi-structured interviews were used to identify the barriers faced by the Malaysian Electrical and Electronics (E&E) industry, while an Analytic Hierarchy Process (AHP) survey was utilized to determine the importance of each barrier. Seven companies participated in the semi-structured interviews, and 18 companies took part in the AHP survey. Nine barriers were generated from analysis of the interviews, and were then ranked by priority using the AHP method. These important findings could be used as a guide for E&E companies in managing or overcoming barriers during the implementation of material efficiency strategies and other sustainable manufacturing activitie

THE KRAEPELINIAN DICHOTOMY IN TERMS OF EMPLOYMENT OUTCOMES

We assess the effectiveness of return to employment, and hence social inclusion in patients with chronic schizophrenia and bipolar affective disorder within a British community mental health team

Public availability of information from WFME-recognized accreditation agencies

The World Federation for Medical Education (WFME) Recognition Programme was created to ensure the comparability of medical school accrediting agencies, so that the schools accredited by those agencies would have similar educational quality. WFME explicitly values transparency and has recognition criteria that relate to agencies making information publicly available. Our study examined 20 WFME-recognized agencies’ transparency by reviewing agency websites for 27 information elements related to accreditation standards, procedures, and processes. We contacted agencies as needed for information that we could not find on their websites. We were only able to retrieve additional information from 3 of the 12 agencies that we attempted to contact. We found that while 12 agencies had over 90% of expected information elements available, 6 agencies had less than 50%. Our findings illustrate barriers for those who wish to better understand medical school accreditation in some regions and raise questions about how comparable WFME-recognized agencies are

A KING\u27S COLLEGE LONDON GLOBAL HEALTH SOCIETY EVENT DISCUSSING GLOBAL MENTAL HEALTH TO INCREASE INTEREST IN PSYCHIATRY AS A CAREER: A PILOT STUDY

Introduction: Despite the launching of multiple initiatives to increase recruitment into psychiatry, the profession continues to remain undersubscribed. Studies have shown that teaching on global mental health can improve attitudes toward psychiatry in medical students. To the best of our knowledge, no studies have been published hitherto that evaluate if a brief teaching session (i.e. 60 minutes in duration) on global mental health improves perceptions of psychiatry and increases interest in this specialty as a career. Subjects and methods: We conducted a single-arm, pre- post- comparison study on participants who attended a King’s College London Global Health Society event on Global Mental Health. Participants completed a survey before and after exposure to the event. Our aims were to detect and measure if there were any changes in perceptions of psychiatry and if a brief teaching session on global mental health would increase interest in pursuing psychiatry as a career. Results: 71 out of 90 participants responded (77.8% response rate). Following exposure to the event, there were statistically significant improvements in the scores for, “Psychiatry is interesting” (pre-event score 4.41, post-event score 4.66 p value <0.001), “I would talk positively about psychiatry to other people” (pre-event score 4.02, post-event score 4.48 p value <0.00001), and, “I would consider psychiatry as a career” (pre-event score 3.24, post-event score 3.72 p value <0.001). Conclusion: The results of our pilot study suggest that a brief lecture on global mental health may improve perceptions of psychiatry and increase interest in this specialty as a career. We recommend that global mental health be introduced into the medical school curriculum since this may help to increase recruitment into psychiatry

Green product preferences considering cultural influences: a comparison study between Malaysia and Indonesia

Purpose – There is an increasing awareness among manufacturers to make production more sustainable in Southeast Asian countries such as Malaysia and Indonesia. Manufacturers are now urged to not only focus on the business profit but also concern on environment protection by producing green products. However, issues may arise regarding the preferences of customers on green products, which will vary due to the influence of cultural values. This will give an impact on the marketing of green products. The aim of this study is to identify the influence of cultural values on the green products design in Malaysia and Indonesia. Design/methodology/approach – A pretest on the survey instruments was performed to ensure the reliability and validity of the questionnaire. The collected data were statistically analyzed based on the satisfaction level, confirmatory factor analysis and structural equation modeling. Findings – The results showed that customer preferences in Malaysia were mostly influenced by uncertainty avoidance, long-term orientation and power distance, excluding collectivism and masculinity. In Indonesia, the dimension of uncertainty avoidance and long-term orientation had significant influence, whereas power distance, masculinity and collectivism dimension had no influence. Eco-label was identified as the most important factor for green products in Malaysia and having product services characteristics factor for product lifetime extension in Indonesia. Practical implications – For practices, the cultural values and preferred characteristics identified in this study provide valuable information to policymakers and businesses on what draws customers toward green products in Malaysia and Indonesia. This finding can be used as supported data for the policymakers in order to achieve sustainable development goal (SDGs) in Malaysia and Indonesia. Originality/value – The findings of this study provide valuable information for designers to design products with green characteristics that cater to the consumer market in Malaysia and Indonesia, as well as other countries which may have similar cultural traits

Microalgae as substrate in low cost terracotta-based microbial fuel cells: Novel application of the catholyte produced

© 2016 Elsevier Ltd. In this work, the by-product generated during the operation of cylindrical MFCs, made out of terracotta material, is investigated as a feasible means of degrading live microalgae for the first time. In addition to the low cost materials of this design, the reuse of the solution produced in the cathode renders the technology truly green and capable of generating bioenergy. In this study, the effect of a light/dark cycle or dark conditions only on the digestion of live microalgae with the catholyte is investigated. The results show that a combination of light/dark improves degradation and allows algae to be used as substrate in the anode. The addition of 12.5 mL of a 1:1 mix of catholyte and microalgae (pre-digested over 5 days under light/dark) to the anode, increases the power generation from 7 μW to 44 μW once all the organic matter in the anode had been depleted