Stigma and mental illness: are there cultural differences?

Most of the stigma research to date has been completed in western cultures. Not much is currently known about stigma towards mental illness in non-western cultures. Limited research has also been conducted with young people. Given that adolescence is a critical stage in the development of attitudes and identity formation, it seems an important time to investigate attitudes towards mental illness. The study investigated whether there were cultural differences in stigmatising attitudes towards people with mental illness, comparing British and Pakistani adolescents living in the UK. Factors shown to influence stigma were also examined. These included labelling of mental illness, familiarity with mental illness and perceived causal attributions. A quantitative non-experimental cross-sectional design was used. In total 100 adolescents (54 British and 46 Pakistani) completed the survey (online or paper based). Participants were asked to read a vignette describing a person with psychosis and complete a series of questionnaires relating to it. Results indicated that there were no significant differences in stigma between the two cultural groups. Pakistani adolescents considered that supernatural causes and immoral life style were more likely to cause mental illness. British adolescents were more likely to provide the correct psychiatric diagnosis for the problem described in the vignette. Both groups were found to have similar levels of contact with individuals with mental illness. Future research is needed to develop a better understanding of how mental illness is constructed and construed in non-western cultures. Additional studies are also required with adolescents. This would allow the development of culturally sensitive services and appropriate anti-stigma campaigns. The application of existing stigma models to non-western cultures and adolescents should be further investigated. The social psychological model appears to be a useful framework that could be used to aid our understanding of stigma in both populations

Mercury Rising: The Omnibus Autism Proceeding and What Families Should Know before Rushing out of Vaccine Court

This Comment sheds light on the “opt-out” provision of the Vaccine Act. It namely discusses the effect of short-form petitions and their impact on subsequent civil action, by examining consequences flowing from the Omnibus Autism Proceeding. In short, it argues that the Vaccine Court erred with its decision to permit short-form petitions by overlooking that procedure’s long-term implications on vaccine plaintiffs. In addition, this Comment lays out a scenario to illustrate the potential pitfalls of a hasty exit from the OAP and offers some guidance to plaintiffs to avoid this outcome. The final part of this Comment offers some ideas for improving the Vaccine Act to ensure that such an anomaly does not occur in the future

Mercury Rising: The Omnibus Autism Proceeding and What Families Should Know before Rushing out of Vaccine Court

This Comment sheds light on the “opt-out” provision of the Vaccine Act. It namely discusses the effect of short-form petitions and their impact on subsequent civil action, by examining consequences flowing from the Omnibus Autism Proceeding. In short, it argues that the Vaccine Court erred with its decision to permit short-form petitions by overlooking that procedure’s long-term implications on vaccine plaintiffs. In addition, this Comment lays out a scenario to illustrate the potential pitfalls of a hasty exit from the OAP and offers some guidance to plaintiffs to avoid this outcome. The final part of this Comment offers some ideas for improving the Vaccine Act to ensure that such an anomaly does not occur in the future

Mental Health On Trial: An In-Depth Look At The Criminalization of Mental Illness In The United States Criminal Justice System

The criminal justice system was created to identify, incarcerate, and rehabilitate men and women that have broken the law. However, over two million people with mental illnesses are placed into jails every year. The lack of proper psychological evaluation and diagnosis coupled with misunderstood evidence and economic hardship has produced a system that treats these men and women as criminals rather than someone suffering from an illness. When an individual with mental health issues comes into contact with the criminal justice system they are often improperly evaluated by first responders, wrongfully convicted, and inappropriately sentenced. The lack of proper psychological evaluation and diagnosis, coupled with misunderstood evidence and economic hardship, has produced a system that treats these men and women as criminals rather than individuals suffering from illness. The criminal justice systems, and its designated officials, are typically undereducated in the implications and cognitive processes of someone who has a mental illness. They are not trained to understand that, due to a medical condition, the “criminal” may have an altered perception of rules and social norms that does not fit within the typical guidelines of the system. This study explores the impact of this system on mentally ill offenders, the interpretation by both the defendant and the prosecution of the crimes committed, and the decisions behind sentencing the individual. It will look at how, if convicted, the penal system treats the mentally ill population and how/why recidivism rates are so high for these offenders. Due to gaps in knowledge on the part of those involved in the prosecution and possible conviction of said offenders, they frequently do not receive proper representation and treatment. If convicted, many of these individuals are seldom provided mental health care evaluations and are isolated from both staff and other prisoners, which causes them to become more distressed and symptomatic within the system

Relevance of Tea Shops and Cafes as Spaces for plot progression in Malayalam Cinema

Currently One of the most significant mass media for communication and storytelling is film. The film uses images, music, and sound effects to convey creative ideas, concepts, and emotions. Through its capability for visual portrayal, films engage, comprehend, and influence audiences. This paper entitled ‘Relevance of Teashops and Cafes as Spaces for Plot Progression in Malayalam Movies’ studies how films especially Malayalam films use the space of teashops and cafes in movies as a space of plot progression. Even though these locations are a necessary component in the production of Malayalam films, the role of teashops and cafes in the making of a film is a less-explored topic. The concept of space is crucial to the creation of films. A perfect setting is necessary for conveying all of the essence of the movie to the audience as well as the core idea of the movie.  The movie makes use of space for a variety of things, including setting up sets, filming scenes, and establishing distinct places. When Malayalam movies are taken into consideration the presence of a teashop or a cafe has always been an inevitable part. The locations of teashops and cafes were given a lot of attention in movie narratives, particularly in Malayalam films. In the atmosphere of these places, significant story developments and character growth take place. The teashop settings have been a major part of setting the overall tone and portraying the beauty of the film's setting in the majority of ancient Malayalam films. The cafes in the new Malayalam film function similarly by improving the mood of the film by creating lovely settings. The audience will be drawn to these locations as a result. The study attempts to provide a comprehensive understanding of the significance of teashop and cafe scenes in Malayalam films. The study focuses on the purpose of the teashop and café environments in the development of the story and other significant events in the film's narration. The study will use a qualitative methodology. Six major Malayalam films will be the subject of the analysis. For the study, a content analysis of six films from different periods that prominently featured cafe and teashop settings was chosen

Thoracic Surgery Workforce: Report of STS/AATS Thoracic Surgery Practice and Access Task Force—Snapshot 2010

BackgroundThe Society of Thoracic Surgeons (STS) and the American Association for Thoracic Surgery (AATS) have intermittently surveyed their combined membership. These manpower surveys have provided snapshots of thoracic surgery, documenting practice changes over time. At this critical time in US health care reform the physician workforce is of critical importance. This survey updates the data obtained from the 2000 and 2005 surveys.MethodsThe survey instrument was updated from the 2005 survey. It was received by 5265 surgeon members of the STS/AATS during November and December 2009. There was a superb 50% return rate. The data were entered into a comprehensive database. Perception Solutions, Inc, independently performed the analysis.ResultsThe median age of the active US thoracic surgeons is 52.9 years. Women comprise 3.4% of adult cardiac, 5.2% of congenital heart, and 7.9% of general thoracic surgeons. The decision to pursue a career in thoracic surgery was made before or in medical school by 45.3% of surgeons. The majority of survey respondents had a mean of 8.7 years of residency training after medical school graduation. The cumulative average educational debt was $56,000. Overall career satisfaction was 46$55,947 to $59,673. The number of additional years the currently active US cardiothoracic surgeon plans to practice is 12.6 years. Therefore, the projected retirement age of the thoracic surgery workforce will be 65. This is consistent among all surgeons: adult cardiac, 66 years; congenital heart, 65 years; and general thoracic, 67 years.ConclusionsThese data give a clear profile of the specialty at this time. The major challenges remain length of training and educational debt of the thoracic surgeon. Case volume, scope of practice, malpractice costs, and career satisfaction remain major elements to provide a positive environment to recruit new surgeons in to the specialty. The resident pool has contracted while the workforce ages and retirement looms. Significant shortages may develop as the US population ages in the environment of health care reform

Implementation of Fiber Element Model for Non-Linear Analysis

RC frames undergo inelastic deformations in the event of an extreme earthquake. Nonlinear modelling of the concrete sections is very much necessary for the simulation of realistic behaviour of RC frames in earthquake loading. Concentrated/lumped plasticity and distributed plasticity are the two different approaches for nonlinear modelling of RC elements available in literature. The main objective of the present study is to implement a displacement based fiber element (stiffness) for nonlinear analysis of RC Sections. The present study focused on the element formulation of both stiffness and flexibility based fiber models, direct integration and numerical integration and incorporation of popular confinement models for stress-strain relationship for concrete. The present study is extended to a probabilistic analysis using the implemented model. It is found that fiber elements are appropriate tool for incorporating nonlinearity in the RC sections

Improved costs and outcomes with conscious sedation vs general anesthesia in TAVR patients: Time to wake up?

BackgroundTranscatheter aortic valve replacement (TAVR) has become a commonplace procedure for the treatment of aortic stenosis in higher risk surgical patients. With the high cost and steadily increasing number of patients receiving TAVR, emphasis has been placed on optimizing outcomes as well as resource utilization. Recently, studies have demonstrated the feasibility of conscious sedation in lieu of general anesthesia for TAVR. This study aimed to investigate the clinical as well as cost outcomes associated with conscious sedation in comparison to general anesthesia in TAVR.MethodsRecords for all adult patients undergoing TAVR at our institution between August 2012 and June 2016 were included using our institutional Society of Thoracic Surgeons (STS) and American College of Cardiology (ACC) registries. Cost data was gathered using the BIOME database. Patients were stratified into two groups according to whether they received general anesthesia (GA) or conscious sedation (CS) during the procedure. No-replacement propensity score matching was done using the validated STS predicted risk of mortality (PROM) as a propensity score. Primary outcome measure with survival to discharge and several secondary outcome measures were also included in analysis. According to our institution's data reporting guidelines, all cost data is presented as a percentage of the general anesthesia control group cost.ResultsOf the 231 patients initially identified, 225 (157 GA, 68 CS) were included for analysis. After no-replacement propensity score matching, 196 patients (147 GA, 49 CS) remained. Overall mortality was 1.5% in the matched population with a trend towards lower mortality in the CS group. Conscious sedation was associated with significantly fewer ICU hours (30 vs 96 hours, p = <0.001) and total hospital days (4.9 vs 10.4, p<0.001). Additionally, there was a 28% decrease in direct cost (p<0.001) as well as significant decreases in all individual all cost categories associated with the use of conscious sedation. There was no difference in composite major adverse events between groups. These trends remained on all subsequent subgroup analyses.ConclusionConscious sedation is emerging as a safe and viable option for anesthesia in patients undergoing transcatheter aortic valve replacement. The use of conscious sedation was not only associated with similar rates of adverse events, but also shortened ICU and overall hospital stays. Finally, there were significant decreases in all cost categories when compared to a propensity matched cohort receiving general anesthesia