A proposed new definition of mental health.

The authors propose a new approach to the definition of mental health, different than the definition proposed by the World Health Organization, which is established around issues of person's well-being and productivity. It is supposed to reflect the complexity of human life experience.

Optimising care for patients with cognitive impairment and dementia following hip fracture.

The global shift in demographics towards aging populations is leading to a commensurate increase in age-related disease and frailty. It is essential to optimise health services to meet current needs and prepare for anticipated future demands. This paper explores issues impacting on people living with cognitive impairment and/or dementia who experience a hip fracture and are cared for in acute settings.

Effectiveness of interventions to indirectly support food and drink intake in people with dementia: Eating and Drinking Well IN dementiA (EDWINA) systematic review.

Background: Risks and prevalence of malnutrition and dehydration are high in older people but even higher in older people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions aiming to improve, maintain or facilitate food/drink intake indirectly, through food service or dining environment modification, education, exercise or behavioural interventions in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia).

Methods: We comprehensively searched Medline and twelve further databases, plus bibliographies, for intervention studies with ≥3 cognitively impaired adult participants (any type/stage).

Effectiveness of interventions to directly support food and drink intake in people with dementia: systematic review and meta-analysis.

Background: Eating and drinking difficulties are recognised sources of ill health in people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions to directly improve, maintain or facilitate oral food and drink intake, nutrition and hydration status, in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). Interventions included oral nutrition supplementation, food modification, dysphagia management, eating assistance and supporting the social element of eating and drinking.

Factors that predict cognitive decline in patients with subjective cognitive impairment.

Background: Current evidence supports the concept of a preclinical phase of Alzheimer's disease (AD) where pathological and imaging changes are present in asymptomatic individuals. Subjective cognitive impairment (SCI) may represent the earliest point on the continuum of AD. A better understanding of the baseline characteristics of this group of patients that later decline in cognition will enhance our knowledge of the very early disease processes, facilitate preventive strategies, early diagnosis, timely follow-up and treatment.

EPA guidance on the role and responsibilities of psychiatrists.

Psychiatry is that branch of the medical profession, which deals with the origin, diagnosis, prevention, and management of mental disorders or mental illness, emotional and behavioural disturbances. Thus, a psychiatrist is a trained doctor who has received further training in the field of diagnosing and managing mental illnesses, mental disorders and emotional and behavioural disturbances. This EPA Guidance document was developed following consultation and literature searches as well as grey literature and was approved by the EPA Guidance Committee.

One lithium level >1.0 mmol/L causes an acute decline in eGFR: findings from a retrospective analysis of a monitoring database.

Objectives: Lithium is a mainstay of bipolar disorder treatment, however, there are still differences in opinion on the effects of lithium use on renal function. The aim of this analysis was to determine if there is an association between short-term exposure to various elevated lithium levels and estimated-glomerular filtration rate (eGFR) at ≤3 months, 6 months (±3 months) and 1 year (±3 months) follow-up.

Setting: Norfolk-wide (UK) lithium register and database.

The girl who swallows knives: uncontrollable deliberate self-harm in a teenage girl with borderline personality disorder.

The authors describe the case of a now 19-year-old girl who after a traumatic childhood, began to deliberately self-harm at the age of 13, often by cutting her forearms. More recently, however, swallowing inanimate objects has been her method of choice. At the time of writing, she has had over 150 accident and emergency department (A&E) attendances, over 10 gastroscopies and a laparotomy.

An unrecognised case of withdrawal neuroleptic malignant syndrome: a case report.

Withdrawal neuroleptic malignant syndrome is a not widely recognised variant of the rare adverse consequence of neuroleptic medication, neuroleptic malignant syndrome (NMS). We present a case to bring the disorder to the attention of clinicians responsible for treating serious mental illness and medical and judicial officers who may be involved in investigating serious untoward incidents occurring within a mental health care setting.

Promoting good nutrition in patients with dementia.

This article aims to raise awareness of good nutrition, the specific nutritional needs of individuals with dementia and the importance and implementation of protected mealtimes to prevent malnutrition in the hospital setting.

Twelve years old: the European Federation of Psychiatric Trainees (EFPT).

The European Federation of Psychiatric Trainees (EFPT) is an independent federation of national trainee associations; it represents over 12 000 trainees in 19 member countries across Europe. It is run by an annually elected board, comprising the President, Secretary-General, Treasurer, President elect and past President, and is governed by a written constitution.

Relatives in the resus room: don't overlook the patient!

Health care practitioners are becoming increasingly aware of the ethical dimensions of their work. In response, moves are being made to gather empirical data that serves to inform the decision-making process. Through a brief examination of one piece of empirical work, the author suggests that although such data is undoubtedly of value as a body of evidence to be used within an ethical debate, it can never replace the debate itself.

Getting it right? An exploration of issues relating to the biological sciences in nurse education and nursing practice.

Concerns have been expressed that bioscience education is not meeting the needs of nursing students in the UK. This paper explores the situation further by comparing student perceptions with those of experienced practitioners (Part One of the study) and also evaluates the confidence of staff nurses in explaining the rationale for care applied to a common but specific disorder (influenza; Part Two). Questionnaires were used.

Are fish oils an effective therapy in mental illness--an analysis of the data.

Objective: To review the literature regarding the use of fish oils in the treatment of psychiatric illness.

Method: A Medline search was conducted in September 1999.

Results: Five papers have investigated omega-3 fatty acids levels in depression.

Preceptorship: the progression from student to staff nurse.

Preceptorship assists the development from learner to accountable staff nurse. Time has to be available for preceptorship to be successful. The learning objectives need to be relevant for the individual preceptee.

Lamotrigine--an effective mood stabilizer?

Objective: To review the literature regarding the use of lamotrigine as a mood stabilizer, and to discuss its efficacy in treating this condition.

Data Sources: Data were obtained from MEDLINE, Micromedex, and Cochrane collaboration searches from January 1985 to July 1998.

Data Summary: There are insufficient data to confirm that lamotrigine is an effective mood stabilizer.

Use of neural networks in brain SPECT to diagnose Alzheimer's disease.

Unlabelled: The usefulness of artificial neural networks in the classification of 99mTc-HMPAO SPECT axial brain scans was investigated in a study group of Alzheimer's disease patients and age-matched normal subjects.

Methods: The cortical circumferential profiling (CCP) technique was used to extract information regarding patterns of cortical perfusion. Traditional analysis of the CCP data, taken from slices at the level of the basal ganglia, indicated significant perfusion deficits for Alzheimer's disease patients relative to normals, particularly in the left temporo-parietal and left posterior frontal areas of the cortex.

Understanding women's responses to treatment for cervical intra-epithelial neoplasia.

Laser treatment is held to prevent the development of cervical intra-epithelial neoplasia, or CIN, into invasive carcinoma of the cervix. Recent work has found that such treatment represents a considerable emotional upset in the lives of many women. In this study, the impact of treatment was further investigated, using a control group to separate the effects of diagnosis from those of treatment.