The European Mental Health Integration Index: reflections and conclusions

This paper is by one of the expert advisors to the development of the Mental Health Integration Index (MHII) (2014) a recent Europe-wide survey on mental health and integration and the policy and provision for supporting people with mental illness. The MHII serves to provide facts on integration in order to inform policy development. Method: Data gathering and interviews with key policy makers in 30 countries in Europe (the EU28 plus Switzerland and Norway). Data gathered enabled the production of an 18 indicator benchmarking index ranking the 30 countries based on their commitment to integrating those with mental illness. Results: The main findings were: mental illness exacts a substantial human and economic toll on Europe, and has a substantial treatment gap. Germany’s strong healthcare system and generous social provision put it at the top of the index. The UK and Scandinavian states are not far behind. The lowest-scoring countries in the index are from Europe’s south-east, where there is a long history of neglecting mental illness. It has to be said though that the leading countries are not the only sources of best practice in integrating those with mental illness. Employment is the field of greatest concern for those with mental illness, but also the area with the most inconsistent policies across Europe. Real investment separates those addressing the issue from those setting only aspirational policies. Europe as a whole is only in the early stages of the journey from institution- to community-based care. Lack of data makes greater understanding of this field difficult. Discussion and conclusions: The author reflects on a selection of the findings and considers areas for future concerted actions across Europe.This paper is by one of the expert advisors to the development of the Mental Health Integration Index (MHII) (2014) a recent Europe-wide survey on mental health and integration and the policy and provision for supporting people with mental illness. The MHII serves to provide facts on integration in order to inform policy development. Method: Data gathering and interviews with key policy makers in 30 countries in Europe (the EU28 plus Switzerland and Norway). Data gathered enabled the production of an 18 indicator benchmarking index ranking the 30 countries based on their commitment to integrating those with mental illness. Results: The main findings were: mental illness exacts a substantial human and economic toll on Europe, and has a substantial treatment gap. Germany’s strong healthcare system and generous social provision put it at the top of the index. The UK and Scandinavian states are not far behind. The lowest-scoring countries in the index are from Europe’s south-east, where there is a long history of neglecting mental illness. It has to be said though that the leading countries are not the only sources of best practice in integrating those with mental illness. Employment is the field of greatest concern for those with mental illness, but also the area with the most inconsistent policies across Europe. Real investment separates those addressing the issue from those setting only aspirational policies. Europe as a whole is only in the early stages of the journey from institution- to community-based care. Lack of data makes greater understanding of this field difficult. Discussion and conclusions: The author reflects on a selection of the findings and considers areas for future concerted actions across Europe

Application of SCOPE-C to measure social inclusion among mental health services users in Hong Kong

This study describes the construction of the Chinese version of the Social and Communities Opportunities Profile (SCOPE), henceforth, the SCOPE-C, to measure social inclusion among mental health services users in Hong Kong. The SCOPE-C was developed based on concept-mapping and benchmarking of census questions. The questionnaire consisted of 56 items, went through a standardized linguistic validation process and was pilot tested with qualitative feedback from five users of mental health services. Altogether 168 Chinese service users were recruited through various NGO mental health services to have three times face-to-face interview between October 2013 and July 2014. Results indicated that items related to satisfaction with opportunities and perceived opportunities in various social domains had high consistency. Nearly all the Kappa statistics and Pearson correlation coefficients between the baseline and two rounds of re-test were significant. The SCOPE-C was considered a valid instrument for Hong Kong mental health user population

Recent developments in unconventional superconductivity theory

The review of recent developments in the unconventional superconductivity theory is given. In the fist part I consider the physical origin of the Kerr rotation polarization of light reflected from the surface of superconducting $Sr_2RuO_4$. Then the comparison of magneto-optical responses in superconductors with orbital and spin spontaneous magnetization is presented. The latter result is applied to the estimation of the magneto-optical properties of neutral superfluids with spontaneous magnetization. The second part is devoted to the natural optical activity or gyrotropy properties of noncentrosymmetric metals in their normal and superconducting states. The temperature behavior of the gyrotropy coefficient is compared with the temperature behavior of paramagnetic susceptibility determining the noticeable increase of the paramagnetic limiting field in noncentrosymmetric superconductors. In the last chapter I describe the order parameter and the symmetry of superconducting state in the itinerant ferromagnet with orthorhombic symmetry. Finally the Josephson coupling between two adjacent ferromagnet superconducting domains is discussed.Comment: 15 page

Colloquium: Mechanical formalisms for tissue dynamics

The understanding of morphogenesis in living organisms has been renewed by tremendous progressin experimental techniques that provide access to cell-scale, quantitative information both on theshapes of cells within tissues and on the genes being expressed. This information suggests that ourunderstanding of the respective contributions of gene expression and mechanics, and of their crucialentanglement, will soon leap forward. Biomechanics increasingly benefits from models, which assistthe design and interpretation of experiments, point out the main ingredients and assumptions, andultimately lead to predictions. The newly accessible local information thus calls for a reflectionon how to select suitable classes of mechanical models. We review both mechanical ingredientssuggested by the current knowledge of tissue behaviour, and modelling methods that can helpgenerate a rheological diagram or a constitutive equation. We distinguish cell scale ("intra-cell")and tissue scale ("inter-cell") contributions. We recall the mathematical framework developpedfor continuum materials and explain how to transform a constitutive equation into a set of partialdifferential equations amenable to numerical resolution. We show that when plastic behaviour isrelevant, the dissipation function formalism appears appropriate to generate constitutive equations;its variational nature facilitates numerical implementation, and we discuss adaptations needed in thecase of large deformations. The present article gathers theoretical methods that can readily enhancethe significance of the data to be extracted from recent or future high throughput biomechanicalexperiments.Comment: 33 pages, 20 figures. This version (26 Sept. 2015) contains a few corrections to the published version, all in Appendix D.2 devoted to large deformation

Regulation of phosphorylase kinase by low concentrations of Ca ions upon muscle contraction: the connection between metabolism and muscle contraction and the connection between muscle physiology and Ca-dependent signal transduction

It had long been one of the crucial questions in muscle physiology how glycogenolysis is regulated in connection with muscle contraction, when we found the answer to this question in the last half of the 1960s. By that time, the two principal currents of muscle physiology, namely, the metabolic flow starting from glycogen and the mechanisms of muscle contraction, had already been clarified at the molecular level thanks to our senior researchers. Thus, the final question we had to answer was how to connect these two currents. We found that low concentrations of Ca ions (10−7–10−4 M) released from the sarcoplasmic reticulum for the regulation of muscle contraction simultaneously reversibly activate phosphorylase kinase, the enzyme regulating glycogenolysis. Moreover, we found that adenosine 3′,5′-monophosphate (cyclic AMP), which is already known to activate muscle phosphorylase kinase, is not effective in the absence of such concentrations of Ca ions. Thus, cyclic AMP is not effective by itself alone and only modifies the activation process in the presence of Ca ions (at that time, cyclic AMP-dependent protein kinase had not yet been identified). After a while, it turned out that our works have not only provided the solution to the above problem on muscle physiology, but have also been considered as the first report of Ca-dependent protein phosphorylation, which is one of the central problems in current cell biology. Phosphorylase kinase is the first protein kinase to phosphorylate a protein resulting in the change in the function of the phosphorylated protein, as shown by Krebs and Fischer. Our works further showed that this protein kinase is regulated in a Ca-dependent manner. Accordingly, our works introduced the concept of low concentrations of Ca ions, which were first identified as the regulatory substance of muscle contraction, to the vast field of Ca biology including signal transduction