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Knapp M Kanavos P King D Yesudian HM 《International journal of law and psychiatry》2005,28(5):514-531
Mental health problems and the services to address them are currently receiving more attention in the UK than ever. Mental health care in England--indeed, across the UK--is experiencing a much needed transformation. It is therefore highly pertinent to examine the patterns of psychotropic medication use, given their intended links to recovery, rehabilitation, and reintegration, as well as to explore the economic and other factors that appear to influence those patterns. These are the aims of this paper. Our attention will be primarily focused on England. What this analysis shows is that given a higher profile by government, including additional funding (although not really benefiting differentially compared to other parts of the health service) and the first national service framework, it is possible to see changes in service patterns, access and (to a degree) outcomes. These changes are occurring at a time when new classes of psychotropic medication are being introduced in a range of therapeutic areas, contributing to the relatively rapid growth of take-up but also raising questions about appropriateness, effectiveness, cost-effectiveness and equity. 相似文献
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Bite wounds on humans have rarely been comparatively analyzed, and the behavior leading to such bites is virtually unknown. Nevertheless, the behavior of a shark is reflected in the bite structure and should be an essential part of shark-accident analysis. This paper compares 3 nonfatal accidents on humans, caused by bull sharks, Carcharhinus leucas, that occurred within a 12-month period in the same area of the Bahamas. Examination focused on wound analysis and accident reconstruction to determine the most likely bite motivation of the sharks. Two sharks targeted the left calf areas of the victims; another one bit the back area of a person. Although both calf bites had a very similar appearance, examination concluded that one of them showed the same triggering behavior as for the shark who inflicted the very different-looking back bite. Those 2 bites were competitive, whereas the other calf bite was initially of exploratory nature, turning into a stress-related bite. 相似文献
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Pharmacokinetic studies of psilocybin in humans have shown the rapid dephosphorylation of psilocybin to psilocin with further conversion to 4-hydroxy-tryptophole (4HT) and 4-hydroxyindole-3-acetic acid (4HIAA) in plasma. Our study shows that psilocin also undergoes conjugation and can be found in the urine as the psilocin-glucuronide conjugate. Recoveries after enzymatic hydrolysis of the urine with beta-glucuronidase (Helix Pomatia or E. Coli) when compared to non-hydrolyzed urine confirmed the presence of the glucuronide. Detection of psilocin from hydrolyzed and extracted samples was optimized for GC/MS by derivatization with MSTFA. The method developed allows for the detection of psilocin in urine with a limit of quantitation of 10 ng/mL, based on 5 mL of spiked urine. Using this method, our laboratory has confirmed the presence of psilocin in 6 out of 8 urine samples, with concentrations ranging from 10 ng/mL to greater than 200 ng/mL. Before implementation of the hydrolysis and derivatization steps, our limit of detection was 200 ng/mL, based on spiked urine standards. No case samples were positive without hydrolysis and derivatization. 相似文献
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A basic but largely neglected issue in research on the reliability of children's testimony is the impact of certain questioning tactics (e.g., use of legalese and socioemotional intimidation) on the accuracy of children's reports. In the present study, 5- to 7-year-old children were interviewed about a standardized play event with free-recall cues and detailed questions that were specific or misleading. Linguistic complexity of questions (complex or simple) and socioemotional context of interview (supportive or intimidating) were varied between subjects. Results indicated that children were significantly less accurate in reporting the event when questioned with complex, developmentally inappropriate questions rather than simple questions, yet children rarely voiced their comprehension failures. In addition, children interviewed by a warm, supportive interviewer were more resistant to misleading questions about the event than were children interviewed in an intimidating manner. Theoretical interpretations and implications for investigative interviewing and policy are discussed. 相似文献