Functional thalamocortical connectivity at term equivalent age and outcome at 2 years in infants born preterm

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Challenging stigma and discrimination in communities:A focus group study identifying UK mental health service users' main campaign priorities

Background: Stigma and discrimination experienced by people with mental health problems have been identified as major obstacles to treatment and recovery. Less is known about how to effectively tackle stigma-discrimination, although there are numerous international, national and local programmes attempting to improve public mental health literacy and anti-discrimination evi-denced based practice. Aims: To explore mental health service users ’ views on how campaigns to address stigma and discrimination should prioritise their actions. Method: Qualitative study using focus group discussions, involving 33 persons aged between 25 and 75. Results: A triad of diminished credibility, dis-empowerment with particular refer-ence to communication problems and avoidance by their social network defined experiences of stigma. Reactions to stigma can be placed in four categories: avoid stigma, resign yourself to it, challenge it, or distance yourself from others with a mental health problem. A range of solutions was discussed with most favouring changes within the health services that are currently supporting them over traditional educational programmes with the public. Conclusions: For mental health service users stigma must be tackled on many different levels reflecting the varied and complex impact that negative social reactions have on an individual’s life. When asked to prioritise one area, most service users in our sample highlighted reforms within the health service for tack-ling stigma and discrimination

Gender differences in living with schizophrenia. A cross-sectional European multi-site study

The EPSILON project (European Psychiatric Services: Inputs Linked to Outcomes and Needs) is a cross-sectional study of the clinical and social characteristics, needs, satisfaction with services, quality of life, and service utilisation and costs for people with schizophrenia in five European sites (Amsterdam, Copenhagen, London, Santander, and Verona), This study examined five hypotheses: (1) Men will have more total needs and more unmet needs for: 'accommodation', 'substance misuse', 'psychotic symptoms', 'harm to others', and 'sexual expression', whereas women will have more total needs and more unmet needs in the domains of 'childcare' and 'harm to self', (2) Caregivers of male patients will show higher rates of psychological distress, and higher scores for 'supervision' and 'urging' than caregivers of female patients, (3) Male and female patients will show similar levels of satisfaction with services, both in total scores and subscores. (4) Male patients will show lower objective quality of life, but similar subjective quality of life compared with women. (5) Service utilization for men and women will differ, and patterns will vary by site. The results confirmed hypotheses I (in part) and 3, but failed to support hypotheses 2, 4 and 5. Graphical models were used to generate hypotheses for future research. The implications for planning separate services for male and female schizophrenic patients are discussed. (C) 2002 Elsevier Science B.V. All rights reserve

Specialization and integration of functional thalamocortical connectivity in the human infant

Item does not contain fulltextConnections between the thalamus and cortex develop rapidly before birth, and aberrant cerebral maturation during this period may underlie a number of neurodevelopmental disorders. To define functional thalamocortical connectivity at the normal time of birth, we used functional MRI (fMRI) to measure blood oxygen level-dependent (BOLD) signals in 66 infants, 47 of whom were at high risk of neurocognitive impairment because of birth before 33 wk of gestation and 19 of whom were term infants. We segmented the thalamus based on correlation with functionally defined cortical components using independent component analysis (ICA) and seed-based correlations. After parcellating the cortex using ICA and segmenting the thalamus based on dominant connections with cortical parcellations, we observed a near-facsimile of the adult functional parcellation. Additional analysis revealed that BOLD signal in heteromodal association cortex typically had more widespread and overlapping thalamic representations than primary sensory cortex. Notably, more extreme prematurity was associated with increased functional connectivity between thalamus and lateral primary sensory cortex but reduced connectivity between thalamus and cortex in the prefrontal, insular and anterior cingulate regions. This work suggests that, in early infancy, functional integration through thalamocortical connections depends on significant functional overlap in the topographic organization of the thalamus and that the experience of premature extrauterine life modulates network development, altering the maturation of networks thought to support salience, executive, integrative, and cognitive functions