Auto-amputation of the tongue associated with flupenthixol induced extrapyramidal symptoms.

We report a case of tongue auto-amputation in a mentally retarded patient after a flupenthixol injection. Four days after flupenthixol administration, the patient developed orolingual dyskinetic movements involving mainly tongue biting and protrusion. Self-mutilation in this case may be secondary to flupenthixol induced acute atypical orolingual dyskinesia in the face of mental retardation.

Risk factors for HIV/AIDS and hepatitis C among the chronic mentally ill

The objective of this study was to document the prevalence of risk factors for HIV/AIDS and hepatitis C among people with chronic mental illness treated in a community setting.

Family caregivers of the mentally ill and adaptive coping

The issue investigated in this thesis concerned the adaptive coping strategies that caregivers of the mentally ill adopt at different stages of encounter with their family member’s illness. Specifically, family caregivers’ responses to the illness were investigated within the parameters of the Spaniol and Zipple (1994) 4-stage model of the evolution of caregivers’ responses to mental illness. The accuracy of the model’s representation of the experience of caregivers across all kinship relationships to the care-recipient was evaluated. Spaniol and Zipple proposed four stages which they termed (1) Discovery/Denial, (2) Recognition/Acceptance, (3) Coping and (4) Personal/Political Advocacy. The first stage is characterised by persistent denial of mental illness and seeking answers from multiple sources. The second stage involves caregivers’ expectations of professionals providing answers when the illness is recognised. At this stage caregivers experience guilt, embarrassment and blame. The cyclical nature of the illness impedes acceptance and caregivers experience a deep sense of loss and crisis of meaning as they gradually accept the reality of the situation. In the third stage coping replaces grieving and the issues encountered include loss of faith in professionals, disruption to family life and recurrent crises. Belief in family expertise grows and the focus of coping changes. The fourth stage proposes that caregivers become more assertive, self-blame decreases and the focus is upon changing the system. New meanings and values are integrated. This study found that the model did not accurately describe the experience of all caregivers. Caregiver did not deny mental illness and adaptive coping occurred throughout all stages. Coping evolved as the issues encountered changed and was independent of resolution of grief. The issues encountered were more extensive than the model proposed and differed according to kinship relationship to the care recipient. The ways in which adaptive coping evolved were identified, as were the issues and their accompanying responses. Caregivers coped by adaptively responding to the requirements of care provision, maintaining a sense of self worth and generating positive effect.

Caring for mentally ill relatives in rural Australia : a hermeneutic study

Ten people from an area of rural Australia recalled how they viewed caring for a mentally ill relative. Hermeneutic analysis of this material highlighted these carers' roles and learning experiences, interactions with health professionals, the stigma they experienced, their stories and language they used, and their perspectives on the future.

Good lives sexual offender treatment for mentally disordered offenders

Purpose – The main aim of this paper is to describe the content, structure and preliminary evaluation of a new Good Lives sexual offender treatment group (SOTG) for male mentally disordered offenders.

Design/methodology/approach – As evaluation and work on the SOTG is necessarily ongoing, case study descriptions of each patient who attended the SOTG and of their progress throughout SOTG are described.

Findings – Overall, the case study progress reports suggest that mentally disordered male patients made some notable progress on SOTG despite their differential and complex needs. In particular, attention to each patient's life goals and motivators appeared to play a key role in promoting treatment engagement. Furthermore, patients with lower intelligence quotient and/or indirect pathways required additional support to understand the links between the Good Lives Model (GLM) and their own risk for sexual offending.

Research limitations/implications – Further evaluations of SOTG groups, that incorporate higher numbers of participants and adequate control groups, are required before solid conclusions and generalisations can be made.

Practical implications – Practitioners should consider providing additional support to clients when implementing any future SOTGs for mentally disordered patients.

Originality/value – This is the first paper to outline and describe implementation of the GLM in the sexual offender treatment of mentally disordered male patients group format. As such, it will be of interest to any professionals involved in the facilitation of sexual offender treatment within this population.

Policing services with mentally ill people : developing greater understanding and best practice

Although it is now well known that there is a disproportionate number of people with mental illnesses in the criminal justice system, surprising little attention has been paid to the challenges faced by policing people with mental illnesses in the community. This article provides an overview of some of the key findings from a programme of research undertaken in Victoria to further understand and develop a best practice model at this interface. The areas covered will include the prevalence of psychiatric symptoms and mental illnesses among police cell detainees; the existing knowledge base and attitudes of police towards mentally ill people; the relationship between mental illness and offending; the frequency and nature of police apprehensions of mentally ill people under the Mental Health Act; the association among mental disorder, police shootings, and other injuries to people as a result of these encounters; and police interactions with victims of crime. The work highlights the need for ongoing improvements in policing people with mental illnesses, and particularly the need for improved inter-agency practices for dealing with them.

Characteristics of Mentally Disordered Youth Referred to a Forensic Satellite Clinic for Violence Risk Assessment: A Case Control Study

There is a lack of appropriate services to manage youth with comorbid mental health problems and violence risks. To address this gap, we implemented a forensic satellite clinic in a youth mental health service. This paper characterises offending histories among 45 young patients referred to the clinic, and compares them with matched clinical controls (n = 45). Levels of prior risk taking and aggression were prominent among referred patients. Forensic cases and controls did not differ on demographic and clinical variables, with the exception of psychiatric inpatient admissions, which were higher among referred patients. Group differences were observed for prior offending variables (e.g., physical aggression), which were significantly higher among referred patients than controls. Findings suggest that referrals were made to the clinic based on challenging and aggressive behaviour rather than specific clinical characteristics. The role of specialist assessment, treatment and management of violence risks in youth mental health services are discussed.

Developmental improvements in reaching correction efficiency are associated with an increased ability to represent action mentally

We investigated the purported association between developmental changes in the efficiency of online reaching corrections and improved action representation. Younger children (6-7years), older children (8-12years), adolescents (13-17years), and young adults (18-24years) completed a double-step reaching paradigm and a motor imagery task. Results showed similar nonlinear performance improvements across both tasks, typified by substantial changes in efficiency after 6 or 7years followed by incremental improvements. Regression showed that imagery ability significantly predicted reaching efficiency and that this association stayed constant across age. Findings provide the first empirical evidence that more efficient online control through development is predicted, partly, by improved action representation.

The abolition of defensive homicide : a step towards populist punitivism at the expense of mentally impaired offenders

The offence of defensive homicide was abolished in Victoria in November 2014, following a widely held perception that it was being abused by violent men. While primarily associated with battered women who killed in response to prolonged family violence — but who were unable to establish their offending as self-defence — a less publicised rationale underpinning the introduction of defensive homicide was to provide an alternative offence for offenders with cognitive impairments not covered by the mental impairment (formerly the insanity) defence. Cognitive impairments are complex and varied in their nature and symptomatology. Offenders presenting with cognitive impairments therefore require an appropriate range of legal responses to capture the nuances and appropriate moral culpability of their conduct. Drawing from an analysis of the cases of defensive homicide heard over its 10–year lifespan, this article contends that the abolition of defensive homicide did not adequately take into consideration the potential impacts on individuals whose mental conditions are not typically covered by the restrictive mental impairment defence. We further argue that the decision to abolish defensive homicide was driven by dominant, populist voices, without sufficient attention given to the offence’s potential to achieve the aims underpinning its enactment, including providing an alternative offence for women who kill in response to prolonged family violence.

New work ethics? Foucault and the spirit of 21st century capitalism

In a corporate environment that is changing at warp speed, performing consistently at high levels is more difficult and more necessary than ever. Narrow interventions simply aren't sufficient anymore. Companies can't afford to address their employees' cognitive capacities while ignoring their physical, emotional, and spiritual well-being. On the playing field or in the boardroom, high performance depends on how much people renew and recover energy as on how they expend it, on how they manage their lives as much as on how they manage their work. When people feel strong and resilient - physically, mentally, emotionally, and spiritually - they perform better, with more passion, for longer. They win, their families win, and the corporations that employ them win. (Jim Loehr and Tony Schwartz (2001) The Making of a Corporate Athlete, p.128)

Influence of aging pre-treatment on the compressive deformation of WE54 alloy

The effect of aging pre-treatment on the compressive deformation of a commercial WE54 alloy is studied. Age hardening treatments were performed at 170 °C, 250 °C and 300 °C. Compression testing was then carried out for the peak aged samples at temperatures between ambient and 450 °C. Twinning dominated the deformation at lower temperatures for all initial microstructures. This behaviour was replaced by slip dominated flow when the temperature was raised. The temperature of the transition from twinning to slip dominated flow was only mildly sensitive to the pre-treatment. It is also evident that dynamic recrystallization is retarded in this alloy.

Effect of carbon content on the recrystallization kinetics of Nb-steels

A rapid method was used to study the effect of carbon content on the kinetics of post-deformation softening, t50, in Nb-steels. The hot deformation behaviour of austenite was not affected by carbon. However, the t50 was influenced by the carbon with different effects in different temperature regimes. At deformation temperatures above the non-recrystallization temperature, Tnr, carbon produced a small change in the softening behaviour. However, the t50 was significantly retarded with increasing carbon content at deformation temperatures lower than Tnr, due to Nb(C,N) precipitates.

Pituitary adenylate cyclase-activating polypeptide induces translocation of its G-protein-coupled receptor into caveolin-enriched membrane microdomains, leading to enhanced cyclic AMP generation and neurite outgrowth in PC12 cells

Pituitary adenylate cyclase-activating polypeptide (PACAP), a member of the secretin/glucagon/vasoactive intestinal peptide family expressed throughout the nervous system, binds to the PACAP-specific G-protein-coupled receptor family members to promote both neuronal differentiation and survival. Although the PACAP receptor is known to activate its effector protein, adenylate cyclase (AC), and thus enhance cAMP generation, the molecular mechanism utilized by the receptor to activate AC is lacking. Here, we show that PACAP induces neurite outgrowth in PC12 cells by induction of translocation of the PACAP type 1 receptor (PAC1R) into caveolin-enriched Triton X-100-insoluble microdomains, leading to stronger PAC1R-AC interaction and elevated cAMP production. Moreover, we demonstrate that translocation of PAC1R is blocked by various treatments that selectively disrupt caveolae. As a result, intracellular cAMP level is decreased and consequently the PACAP-induced neurite outgrowth retarded. In contrast, addition of exogenous ganglioside GM1 to the cells shows the opposite effects. These results therefore identify the PACAP-induced translocation of its G-protein-coupled receptor into caveolae, where both AC and the regulating G-proteins reside, as the key molecular event in activating AC and inducing cAMP-mediated differentiation of PC12 cells.