Keith W. Daniel. Francis Poulenc: His Artistic Development and Musical Style (Ann Arbor: UMI Research Press, 1982), 390 pp.

Defining a composer's style and artistic development is an imposing task. A composer's style is what makes his music his. A definition of that style would determine all the features common to individual works, separating those specific to the composer from those common to his contemporaries. An account of his artistic development would add to the definition of his style the sources and changing nature of that style. This is the central concern of Keith W. Daniel's book, the first complete survey of the music of Poulenc. Considering both the diversity of sources for Poulenc's style and the size and diversity of his output, Daniel set himself a sizable undertaking. While the resulting study does not reach any great depth in dealing with individual works or with Poulenc's style as a whole, the book is a good introduction to the composer's life and works. On the whole, Mr. Daniel is to be commended for providing an often provocative study. His method of analysis and discussion raises some questions about our assumptions in dealing with the music of a 20th-century composer who is viewed as basically conservative and traditional. Mr. Daniel has raised many issues worthy of further investigation. It is a fine first step in a better understanding of the composer and his works

Mental health: future challenges

The aim of the Foresight Project on Mental Capital and Wellbeing(www.foresight.gov.uk) is to advise the Government on how to achieve the best possible mental development and mental wellbeing for everyone in the UK in the future. The starting point of the Project was to generate an understanding of the science of mental capital and wellbeing (MCW) and to develop a vision for how the size and nature of the challenges exposed by the Project could evolve over the next 20 years. To make this analysis tractable, the work was divided into five broad areas: ● Mental capital through life ● Learning through life ● Mental health ● Wellbeing and work, and ● Learning difficulties. This report presents the findings for “Mental health” and draws upon a comprehensive assessment of the scientific state-of-the art: overall, around 80 reviews have been commissioned across the five areas. Mental health is a term which is used in a number of different ways and which has unfortunately acquired a substantial stigma in all layers of society. While the main focus of this report is on mental ill-health, positive mental health is also vitally important and is also discussed. However, a more comprehensive consideration of positive mental health has been performed in other parts of the Project (as commissioned reviews and in the context of the future of work. This report starts by looking at the situation today, examining the prevalence of important categories of mental disorder. It then considers the risk and protective factors which influence mental ill health, and determines how its prevalence and impact could change in the future, if existing policies and expenditure remain broadly unchanged. An assessment of strategic choices and interventions to meet the future challenges of mental health (and the challenges associated with the other four areas listed above) will be documented in the final Project report which is due for publication in the autumn of 2008

Primary group size, social support, gender and future mental health status in a prospective study of people living in private households throughout Great Britain

Background. Structural characteristics of social networks such as primary group size have received less attention than measures of perceived social support. Previous research suggests that associations between social network size and later common mental disorder status may differ according to sex and initial mental state. Method. Adults participating in the 2000 British National Household Survey of psychiatric morbidity were randomly selected for follow-up 18 months later. The revised Clinical Interview Schedule (CIS-R) and the Interview Measure of Social Relations (IMSR) were administered at baseline and follow-up. Primary group size was defined as the total number of close relatives and friends. A four-level scale of common mental disorder was modelled with ordinal logistic regression, based on weighted data (n=2413). Findings. After adjusting for confounders, a primary group size of three or less at time 1 predicted worse mental health at time 2. This effect was greatest in men who were initially non-cases at baseline (averaged odds 4.5) and in women who were initially cases at baseline (average odds 2.9). Primary group size at time 2 was significantly predicted by level of common mental disorder at time 1 in women but not in men. Thus, confounding by baseline disorder does not explain risk of developing poor mental health in socially isolated men. Conclusion. This study replicates the strong effects of primary group size on future mental health that emerge when men and women are studied separately and when subjects are categorized according to baseline mental health status

The population impact of common mental disorders and long-term physical conditions on disability and hospital admission

Background: Long-term physical conditions (LTCs) consume the largest share of healthcare budgets. Although common mental disorders (CMDs) and LTCs often co-occur, the potential impact of improved mental health treatment on severe disability and hospital admissions for physical health problems remains unknown. Method: A cross-sectional study of 7403 adults aged 16–95 years living in private households in England was performed. LTCs were ascertained by prompted self-report. CMDs were ascertained by structured clinical interview. Disability was assessed using questions about problems with activities of daily living. Population impact and potential preventive gain were estimated using population-attributable fraction (PAF), and conservative estimates were obtained using ‘treated non-cases’ as the reference group. Results: Of the respondents, 20.7% reported at least one LTC. The prevalence of CMDs increased with the number of LTCs, but over two-thirds (71.2%) of CMD cases in people with LTCs were untreated. Statistically significant PAFs were found for CMDs and recent hospital admission [13.5%, 95% confidence intervals (CI) 6.6–20.0] and severe disability (31.3%, 95% CI 27.1–35.2) after adjusting for LTCs and other confounders. Only the latter remained significant when using the most conservative estimate of PAF (21.8%, 95% CI 14.0–28.9), and this was reduced only slightly when considering only participants with LTCs (18.5%, 95% CI 7.9–27.9). Conclusions: Better treatments for CMDs in people with LTCs could achieve almost the same population health gain in terms of reducing severe disability as those targeted at the entire population. Interventions to reduce the prevalence of CMDs among people with LTCs should be part of routine medical care

The general health, social networks and lifestyle behaviours of young people looked after by local authorities in Scotland

The survey of the mental health of young people looked after by local authorities in Scotland was the second major national survey focusing on the development and well-being of young people to be carried out by ONS. The first survey, carried out in 1999, obtained information about the mental health of nearly 900 young people living in private households in Scotland. (Meltzer, Gatward, Goodman & Ford, 2000). Both surveys were commissioned by the Scottish Executive Education Department and the Scottish Executive Health Department

The mental health of young people looked after by local authorities in Scotland

The survey of the mental health of young people looked after by local authorities in Scotland was the second major national survey focusing on the development and well-being of young people to be carried out by the Office for National Statistics (ONS). The first survey, carried out in 1999, obtained information about the mental health of nearly 900 young people living in private households in Scotland (Meltzer, Gatward, Goodman & Ford, 2000). Both surveys were commissioned by the Scottish Executive Education Department and the Scottish Executive Health Department

Cytoplasmic Assembly and Accumulation of Human Immunodeficiency Virus Types 1 and 2 in Recombinant Human Colony-Stimulating Factor-1-Treated Human Monocytes: An Ultrastructural Study

Recombinant human colony-stimulating factor-1-treated human peripheral blood-derived monocytes-macrophages are efficient host cells for recovery of the human immunodeficiency virus (HIV) from blood leukocytes of patients with acquired immunodeficiency syndrome. These cells can be maintained as viable monolayers for intervals exceeding 3 months. Infection with HIV resulted in virus-induced cytopathic effects, accompanied by relatively high levels of released progeny virus, followed by a prolonged low-level release of virus from morphologically normal cells. In both acutely and chronically infected monocytes, viral particles were seen budding into and accumulating within cytoplasmic vacuoles. The number of intravacuolar virions far exceeded those associated with the plasma membrane, especially in the chronic phase, and were concentrated in the perinuclear Golgi zone. In many instances, the vacuoles were identified as Golgi elements. Fusion of virus-laden vacuoles with primary lysosomes was rare. The pattern of cytoplasmic assembly of virus was observed with both HIV types 1 and 2 and in brain macrophages of an individual with acquired immunodeficiency syndrome encephalopathy. Immunoglobulin-coated gold beads added to acutely infected cultures were segregated from the vacuoles containing virus; relatively few beads and viral particles colocalized. The assembly of HIV virions within vacuoles of macrophages is in contrast to the exclusive surface assembly of HIV by T lymphocytes. Intracytoplasmic virus hidden from immune surveillance in monocytes-macrophages may explain, in part, the persistence of HIV in the infected human host

Perinatal psychiatric episodes: a population-based study on treatment incidence and prevalence

Perinatal psychiatric episodes comprise various disorders and symptom severity, which are diagnosed and treated in multiple treatment settings. To date, no studies have quantified the incidence and prevalence of perinatal psychiatric episodes treated in primary and secondary care, which we aimed to do in the present study. We designed a descriptive prospective study and included information from Danish population registers to study first-time ever and recurrent psychiatric episodes during the perinatal period, including treatment at psychiatric facilities and general practitioners (GPs). This was done for all women who had records of one or more singleton births from 1998 until 2012. In total, we had information on 822 439 children born to 491 242 unique mothers. Results showed first-time psychiatric episodes treated at inpatient facilities were rare during pregnancy, but increased significantly shortly following childbirth (0.02 vs 0.25 per 1000 births). In comparison, first-time psychiatric episodes treated at outpatient facilities were more common, and showed little variation across pregnancy and postpartum. For every single birth resulting in postpartum episodes treated at inpatient psychiatric facilities, 2.5 births were followed by an episode treated at outpatient psychiatric facility and 12 births by GP-provided pharmacological treatment. We interpret our results the following way: treated severe and moderate psychiatric disorders have different risk patterns in relation to pregnancy and childbirth, which suggests differences in the underlying etiology. We further speculate varying treatment incidence and prevalence in pregnancy vs postpartum may indicate that the current Diagnostic and Statistical Manual of Mental Disorders-5 peripartum specifier not adequately describes at-risk periods across moderate and severe perinatal psychiatric episodes

Debt income and mental disorder in the general population

Background The association between poor mental health and poverty is well known but its mechanism is not fully understood. This study tests the hypothesis that the association between low income and mental disorder is mediated by debt and its attendant financial hardship. Method The study is a cross-sectional nationally representative survey of private households in England, Scotland and Wales, which assessed 8580 participants aged 16–74 years living in general households. Psychosis, neurosis, alcohol abuse and drug abuse were identified by the Clinical Interview Schedule – Revised, the Schedule for Assessment in Neuropsychiatry (SCAN), the Alcohol Use Disorder Identification Test (AUDIT) and other measures. Detailed questions were asked about income, debt and financial hardship. Results Those with low income were more likely to have mental disorder [odds ratio (OR) 2.09, 95% confidence interval (CI) 1.68–2.59] but this relationship was attenuated after adjustment for debt (OR 1.58, 95% CI 1.25–1.97) and vanished when other sociodemographic variables were also controlled (OR 1.07, 95% CI 0.77–1.48). Of those with mental disorder, 23% were in debt (compared with 8% of those without disorder), and 10% had had a utility disconnected (compared with 3%). The more debts people had, the more likely they were to have some form of mental disorder, even after adjustment for income and other sociodemographic variables. People with six or more separate debts had a six-fold increase in mental disorder after adjustment for income (OR 6.0, 95% CI 3.5–10.3). Conclusions Both low income and debt are associated with mental illness, but the effect of income appears to be mediated largely by debt

Micro-Environment Causes Reversible Changes in DNA Methylation and mRNA Expression Profiles in Patient-Derived Glioma Stem Cells

In vitro and in vivo models are widely used in cancer research. Characterizing the similarities and differences between a patient\u27s tumor and corresponding in vitro and in vivo models is important for understanding the potential clinical relevance of experimental data generated with these models. Towards this aim, we analyzed the genomic aberrations, DNA methylation and transcriptome profiles of five parental tumors and their matched in vitro isolated glioma stem cell (GSC) lines and xenografts generated from these same GSCs using high-resolution platforms. We observed that the methylation and transcriptome profiles of in vitro GSCs were significantly different from their corresponding xenografts, which were actually more similar to their original parental tumors. This points to the potentially critical role of the brain microenvironment in influencing methylation and transcriptional patterns of GSCs. Consistent with this possibility, ex vivo cultured GSCs isolated from xenografts showed a tendency to return to their initial in vitro states even after a short time in culture, supporting a rapid dynamic adaptation to the in vitro microenvironment. These results show that methylation and transcriptome profiles are highly dependent on the microenvironment and growth in orthotopic sites partially reverse the changes caused by in vitro culturing