How to serve our ethnic minority communities better

On Jan 9, 2017, Theresa May, the British Prime Minister, gave a speech about “the burning injustice of mental illness”, mentioning “injustices in the way black people with mental ill health in particular are treated”, and promising that politicians would “take action to put things right.” In response to three decades of UK research on ethnic differences in mental health, such emotionally charged rhetoric has been commonplace, but has rarely produced meaningful change. Mental health care in ethnic minorities is complex, and needs dispassionate and objective scrutiny of evidence and its limitations, with careful disentanglement of the interactions between ethnicity, culture, community histories, legacies of racism, and the labyrinthine service structures that people with mental illness and their families must navigate to get appropriate help. In The Lancet Psychiatry, Phoebe Barnett and colleagues present findings from a systematic review and meta-analysis of ethnicity and legal detention of people with mental illness, an impressive attempt at providing just such scrutiny. Although the findings are not strikingly different from what is known, this comprehensive paper is a timely reminder of how far we are from fully understanding the problem—let alone solving it—and why the stated political intention to put things right might be easy to promise but hard to deliver

Black and minority ethnic people are more likely to be detained under the Mental Health Act 1983 : no clear evidence why

Question: Compared with White people, how frequently are people from Black and Minority Ethnic groups detained under the Mental Health Act 1983? Outcomes: Rates of compulsory detention under the Mental Health Act. METHODS Design: Systematic review with meta-analysis. Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, SIGLE, HMIC, Web of Science, Cochrane database and the National Research Register; 1984 to April 2005. CD-ROM for the British National Bibliography was also searched for relevant literature. Study selection and analysis: English language studies relating to compulsory detention under the Mental Health Act 1983 and including terms related to mental illness or forensic psychiatry, and with inclusion of 2 ethnic groups (any non-White). Odds of compulsory detention of people from Black and Minority Ethnic (BME) groups compared with White groups were combined using a fixed effects meta-analysis. Meta-regression was then used to explore reasons for heterogeneity between studies. It was based on subgroup analyses according to episode (first, second, etc), patient type (for example, civil or forensic), study quality, and year of publication. The authors then narratively discuss the possible theories for the difference in detention rates

Transition of care from child to adult mental health services : the great divide

Purpose of review: Adolescents with mental health problems often require transition of care from child and adolescent to adult mental health services. This review is a synthesis of current research and policy literature on transition to describe the barriers at the interface between child and adolescent mental health services and adult mental health services and outcomes of poor transition. Recent findings: Adolescence is a risk period for emergence of serious mental disorders. Child and adolescent mental health services and adult mental health services use rigid age cut-offs to delineate service boundaries, creating discontinuities in provision of care. Adolescent mental health services are patchy across the world. Several recent studies have confirmed that problems occur during transition in diverse settings across several countries. In physical health, there are emerging models of practice to improve the process and outcomes of transition, but there is very little comparable literature in mental healthcare. Summary: Poor transition leads to disruption in continuity of care, disengagement from services and is likely to lead to poorer clinical outcomes. Some young people, such as those with neurodevelopmental disorders and complex needs, are at a greater risk of falling through the care gap during transition. Services need robust and high-quality evidence on the process and outcomes of transition so that effective intervention strategies can be developed

Race and mental health : there is more to race than racism

Some minority ethnic groups in England and Wales have higher rates of admission for mental illness and more adverse pathways to care. Are the resulting accusations of institutional racism within psychiatry justified

A Cooperative Security Order for Asia-Pacific: Indian Perspectives on New Challenges and Opportunities

The Mongolian Journal of International Affairs; Number 11, 2004, Page 12-21 DOI: http://dx.doi.org/10.5564/mjia.v0i11.10

Characterization Of Motility Alterations Caused By The Impairment Of Dynein/dynactin Motor Protein Complex

Transport of intracellular cargo is an important and dynamic process required for cell maintenance and survival. Dynein is the motor protein that carries organelles and vesicles from the cell periphery to the cell center along the microtubule network. Dynactin is a protein that activates dynein for this transport process. Together, dynein and dynactin forms a motor protein complex that is essential for transport processes in all the vertebrate cells. Using fluorescent microscope based live cell imaging techniques and kymograph analyses, I studied dynein/dynactin disruptions on the intracellular transport in two different cell systems. In one set of experiments, effects of dynein heavy chain (DHC) mutations on the vesicular motility were characterized in the fungus model system Neurospora crassa. I found that many DHC mutations had a severe transport defect, while one mutation linked to neurodegeneration in mice had a subtle effect on intracellular transport of vesicles. In a different set of experiments in mammalian tissue culture CAD cells, I studied the effects of dynactin knockdown and dynein inhibition on mitochondrial motility. My results indicated that reductions in dynactin levels decrease the average number of mitochondrial movements and surprisingly, increase the mitochondrial run lengths. Also, I determined that the dynein inhibitory drug Ciliobrevin causes changes in mitochondrial morphology and decreases the number of mitochondrial movements inside cells. Overall, my research shows that distinct disruptions in the dynein and dynactin motor complex alters intracellular motility, but in different ways. So far, my studies have set the ground work for future experiments to analyze the motility mechanism of motor proteins having mutations that lead to neurodegenerative disorders

Possible Schemes for a Single Photon Switch

I consider the effectiveness of a single control photon to route a target photon using two processes: the first one uses the transient excitation of a two-level system and the second one which uses the permanent population transfer in a three-level Λ-system to route the target photon. In the absence of a single control photon and when the system has additional decay channels, I find ways to optimize the success probability of routing with an increasing number of photons in the control field

Ethnicity and the Mental Health Act 1983

Background Black and minority ethnic (BME) patients are disproportionately detained under the Mental Health Act 1983. There has been no systematic exploration of differences within and between ethnic groups, nor of the explanations put forward for this excess. Aims To systematically review detention and ethnicity, with meta-analyses of detention rates for BME groups, and to explore the explanations offered for ethnic differences in detention rates. Method Literature search and meta-analysis. Explanations offered were categorised, supporting literature was accessed and the strength of the evidence evaluated. Results In all, 49 studies met inclusion criteria; of these, 19 were included in the meta-analyses. Compared with White patients, Black patients were 3.83 times, BME patients 3.35 times and Asian patients 2.06 times more likely to be detained. The most common explanations related to misdiagnosis and discrimination against BME patients, higher incidence of psychosis and differences in illness expression. Many explanations, including that of racism within mental health services, were not supported by clear evidence. Conclusions Although BME status predicts psychiatric detention in the UK, most explanations offered for the excess detention of BME patients are largely unsupported

Combined Neuro-Fuzzy Vertical Handover Decision Criteria for LTE/LTE-A Networks

Verti??l h?nd?ver has gained signifi??nt imp?rt?n?e due t? the enh?n?ements in m?bility m?dels by the F?urth Gener?ti?n (4G) te?hn?l?gies. ? h?nd?ver de?isi?n s?heme in LTE netw?rks is either b?sed on single ?r multiple ?riteri?. The number ?f ?riteri? dire?tly depending ?n the t?t?l h?nd?ver time. Simil?rly, the time required f?r sele?ting ? t?rget netw?rk during h?nd?ver is ?ls? in?re?sed with the in?re?se in ? number ?f p?r?meters. Tr?diti?n?l h?nd?ver de?isi?n ?ppr???hes ?re m?inly b?sed ?n the single p?r?meter. But, with the intr?du?ti?n ?f heter?gene?us wireless netw?rks, the perf?rm?n?e ?f these single p?r?meter de?isi?n s?hemes is highly redu?ed. Theref?re, rese?r?hers intr?du?e multi-?riteri? h?nd?ver de?isi?n s?hemes. The ??mplexity ?nd pr??essing ?f multi-?riteri? during h?nd?ver is ? ??mplex j?b ?nd hen?e these s?hemes require high h?nd?ver time whi?h ultim?tely le?ds t? the high p??ket l?ss ?nd even bre?king ?f ??nne?ti?n. M?re?ver, these enh?n?ements ?re limited t? spe?ifi? s?en?ri?s ?nd hen?e d? n?t pr?vide supp?rt f?r generi? m?bility. T? ?ddress the ?h?llenges, ? generi? verti??l h?nd?ver m?n?gement s?heme f?r heter?gene?us wireless netw?rks is pr?p?sed. A Neur?-fuzzy b?sed verti??l h?nd?ver de?isi?n m?del has been offered in ?rder t? impr?ve Q?S in heter?gene?us wireless netw?rks. T? keep the ??nne?ti?n ?live during h?nd?ver ?n impr?ved h?nd?ver str?tegy has been offered