An Insight into Life at Geometric Zagora Provided by the Animal Bones

This thesis is a study of the animal bone distribution at the Geometric period settlement of Zagora (ca. 850-700 BC), on the island of Andros. The animal bones were excavated during the 1967-74 University of Sydney excavations and analysed in 1977 by a specialist who compiled a report of her findings. The report is currently in preparation for publication and is the primary source for this thesis. The data it provided was limited but enough could be extracted to identify patterns that permitted a tentative reconstruction of social life and the economy at Zagora. There is a paucity of excavated settlements from the Greek EIA and few of these have published faunal material, an essential element in reconstructing past lifeways. Those preserved settlements from which animal bones have been published are not extensive with good domestic contexts but usually sites of minimal extent. Hence, it has not been possible to conduct an analysis of the spatial distribution of animal bones from such a settlement. Zagora, being an extensive settlement containing mainly domestic structures, is therefore unique and the animal bone report provided the opportunity for such a study to be undertaken. A number of analyses were performed using both statistical and non-statistical methods. Through these it was discovered that there is a relationship between the animal size and the size of the architectural unit within which it was found. Similarly, there appeared to be a relationship between larger architecture and the presence of fish, postulated as being a pelagic species. The patterns observed were interpreted as evidence of ‘special’ meals with a larger than usual number of diners in attendance and hence the need for a larger space to host them. Using the animal bones’ distribution and architectural evidence it is proposed that feasting was an important event at Zagora, conducted at the household level to possibly reinforce bonds of kinship and friendship. The evidence also suggests that the H area could have been inhabited by people of better means than elsewhere in the settlement, particularly by the hypaethral sanctuary. Ideally the animal bones would have been studied in conjunction with associated artefacts, but this was not possible and so this would be something desirable to be performed in the near future. With 21st century excavation techniques, the future Zagora excavations should provide greater granularity in the faunal information obtained from the settlement to allow better precision in subsequent analyses

TREC-Rio trial: a randomised controlled trial for rapid tranquillisation for agitated patients in emergency psychiatric rooms [ISRCTN44153243]

Agitated or violent patients constitute 10% of all emergency psychiatric treatment. Management guidelines, the preferred treatment of clinicians and clinical practice all differ. Systematic reviews show that all relevant studies are small and none are likely to have adequate power to show true differences between treatments. Worldwide, current treatment is not based on evidence from randomised trials. In Brazil, the combination haloperidol-promethazine is frequently used, but no studies involving this mix exist. TREC-Rio (Tranquilização Rápida-Ensaio Clínico [Translation: Rapid Tranquillisation-Clinical Trial]) will compare midazolam with haloperidol-promethazine mix for treatment of agitated patients in emergency psychiatric rooms of Rio de Janeiro, Brazil. TREC-Rio is a randomised, controlled, pragmatic and open study. Primary measure of outcome is tranquillisation at 20 minutes but effects on other measures of morbidity will also be assessed. TREC-Rio will involve the collaboration of as many health care professionals based in four psychiatric emergency rooms of Rio as possible. Because the design of this trial does not substantially complicate clinical management, and in several aspects simplifies it, the study can be large, and treatments used in everyday practice can be evaluated

Monsters, Laws of Nature, and Teleology in Late Scholastic Textbooks

In the period of emergence of early modern science, ‘monsters’ or individuals with physical congenital anomalies were considered as rare events which required special explanations entailing assumptions about the laws of nature. This concern with monsters was shared by representatives of the new science and Late Scholastic authors of university textbooks. This paper will reconstruct the main theses of the treatment of monsters in Late Scholastic textbooks, by focusing on the question as to how their accounts conceived nature’s regularity and teleology. It shows that they developed a naturalistic teratology in which, in contrast to the naturalistic explanations usually offered by the new science, finality was at central stage. This general point does not impede our noticing that some authors were closer to the views emerging in the Scientific Revolution insofar as they conceived nature as relatively autonomous from God and gave a relevant place to efficient secondary causation. In this connection, this paper suggests that the concept of the laws of nature developed by the new science –as exception-less regularities—transferred to nature’s regularity the ‘strong’ character that Late Scholasticism attributed to finality and that the decline of the Late Scholastic view of finality played as an important concomitant factor permitting the transformation of the concept of laws of nature

Treatment and outcomes of crisis resolution teams: a prospective multicentre study

<p>Abstract</p> <p>Background</p> <p>Crisis resolution teams (CRTs) aim to help patients in acute mental health crises without admitting them to hospital. The aims of this study were to investigate content of treatment, service practice, and outcomes of crises of CRTs in Norway.</p> <p>Methods</p> <p>The study had a multicentre prospective design, examining routine data for 680 patients and 62 staff members of eight CRTs. The clinical staff collected data on the demographic, clinical, and content of treatment variables. The service practices of the staff were assessed on the Community Program Practice Scale. Information on each CRT was recorded by the team leaders. The outcomes of crises were measured by the changes in Global Assessment of Functioning scale scores and the total scores on the Health of the Nation Outcome Scales between admission and discharge. Regression analysis was used to predict favourable outcomes.</p> <p>Results</p> <p>The mean length of treatment was 19 days for the total sample (N = 680) and 29 days for the 455 patients with more than one consultation; 7.4% of the patients had had more than twice-weekly consultations with any member of the clinical staff of the CRTs. A doctor or psychologist participated in 55.5% of the treatment episodes. The CRTs collaborated with other mental health services in 71.5% of cases and with families/networks in 51.5% of cases. The overall outcomes of the crises were positive, with a small to medium effect size. Patients with depression received the longest treatments and showed most improvement of crisis. Patients with psychotic symptoms and substance abuse problems received the shortest treatments, showed least improvement, and were most often referred to other parts of the mental health services. Length of treatment, being male and single, and a team focus on out-of-office contact were predictors of favourable outcomes of crises in the adjusted model.</p> <p>Conclusions</p> <p>Our study indicates that, compared with the UK, the Norwegian CRTs provided less intensive and less out-of-office care. The Norwegian CRTs worked more with depression and suicidal crises than with psychoses. To be an alternative to hospital admission, the Norwegian CRTs need to intensify their treatment and meet more patients outside the office.</p

Dietary intake of fish, omega-3, omega-6 polyunsaturated fatty acids and vitamin D and the prevalence of psychotic-like symptoms in a cohort of 33 000 women from the general population

<p>Abstract</p> <p>Background</p> <p>Low intake of fish, polyunsaturated fatty acids (PUFA) and vitamin D deficiency has been suggested to play a role in the development of schizophrenia. Our aim was to evaluate the association between the intake of different fish species, PUFA and vitamin D and the prevalence of psychotic-like symptoms in a population-based study among Swedish women.</p> <p>Methods</p> <p>Dietary intake was estimated using a food frequency questionnaire among 33 623 women aged 30-49 years at enrolment (1991/92). Information on psychotic-like symptoms was derived from a follow-up questionnaire in the years 2002/03. Participants were classified into three predefined levels: low, middle and high frequency of symptoms. The association between diet and psychotic-like symptoms was summarized in terms of relative risks (RR) and corresponding 95% confidence intervals and was evaluated by energy-adjusted multinomial logistic regression.</p> <p>Results</p> <p>18 411 women were classified as having a low level of psychotic-like symptoms, 14 395 as middle and 817 as having a high level. The risk of high level symptoms was 53% (95% CI, 30-69%) lower among women who ate fish 3-4 times per week compared to women who never ate fish. The risk was also lower for women with a high intake of omega-3 and omega-6 PUFA compared to women with a lower intake of these fatty acids. The effect was most pronounced for omega-6 PUFAs. The RR comparing the highest to the lowest quartile of omega-6 PUFAs intake was 0.78 (95% CI, 0.64-0.97). The associations were J-shaped with the strongest reduced risk for an intermediate intake of fish or PUFA. For fatty fish (herring/mackerel, salmon-type fish), the strongest inverse association was found for an intermediate intake (RR: 0.81, 95% CI, 0.66-0.98), whereas a high intake of fatty fish was associated with an increased risk of psychotic-like symptoms (RR: 1.90, 95% CI, 1.34-2.70). Women in the highest compared with the lowest quartile of vitamin D consumption experienced a 37% (95% CI, 22-50%) lower risk of psychotic-like symptoms.</p> <p>Conclusion</p> <p>Our findings raise a possibility that adult women with a high intake of fish, omega-3 or omega-6 PUFA and vitamin D have a lower rate of psychotic-like symptoms.</p

Packages of Care for Schizophrenia in Low- and Middle-Income Countries

In the third in a series of six articles on packages of care for mental disorders in low- and middle-income countries, Jair Mari and colleagues discuss the treatment of schizophrenia

An implementation study of the crisis resolution team model in Norway: Are the crisis resolution teams fulfilling their role?

Background The establishment of crisis resolution teams (CRTs) is part of the national mental health policy in several Western countries. The purpose of the present study is to describe characteristics of CRTs and their patients, explore the differences between CRTs, and examine whether the CRTs in Norway are organized according to the international CRT model. Methods The study was a naturalistic study of eight CRTs and 680 patients referred to these teams in Norway. Mental health problems were assessed using the Health of the Nation Outcome Scales (HoNOS), Global Assessment of Functioning Scales (GAF) and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). Results None of the CRTs operated 24 hours a day, seven days a week (24/7 availability) or had gate-keeping functions for acute wards. The CRTs also treated patients who were not considered for hospital admission. Forty per cent of patients waited more than 24 hours for treatment. Fourteen per cent had psychotic symptoms, and 69% had affective symptoms. There were significant variations between teams in patients' total severity of symptoms and social problems, but no variations between teams with respect to patients' aggressive behaviour, non-accidental self-injury, substance abuse or psychotic symptoms. There was a tendency for teams operating extended hours to treat patients with more severe mental illnesses. Conclusions The CRT model has been implemented in Norway without a rapid response, gate-keeping function and 24/7 availability. These findings indicate that the CRTs do not completely fulfil their intended role in the mental health system