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Biomedical subjects

Richard Warner

Publications and source records attributed to Richard Warner.

14 recordsLinked to original sources
PubMed2006

Prevalence of common mental disorders in Italy: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD).

OBJECTIVE: To present 1-month, 12-month and lifetime prevalence estimates of mood, anxiety and alcohol disorders in Italy; and the socio-demographic correlates and comorbidity patterns of these estimated disorders. METHOD: A representative random sample of non-institutionalised citizens of Italy aged 18 or older (N=4,712) was interviewed between January 2001 and July 2003, with a weighted response rate of 71.3%. DSM-IV disorders were assessed by lay interviewers using Version 3.0 of the Composite International Diagnostic Interview (CIDI). RESULTS: A total of 11% of respondents reported a lifetime history of any mood disorder, 10.3% any anxiety disorder and 1.3% any alcohol disorder. About 5% reported having an anxiety disorder in the past 12 months compared to 3.3% for any mood disorder and 0.2% for any alcohol disorder. Major depression and specific phobia were the most common mental disorders. Women were twice as likely as men to report a mood disorder and four times as likely as men to report an anxiety disorder, while men were twice as likely as women to report an alcohol disorder. High comorbidity of mood and anxiety disorders was observed. Prevalence estimates were generally lower than in parallel surveys carried out in other Western European countries. CONCLUSION: A high proportion of adults in Italy have a history of mood, anxiety or alcohol disorders. The lower than expected prevalence estimate of alcohol use disorder may be due to under-reporting or to low social harm from alcohol consumption.

Adolescent↗
PubMed2006

An update on affirmative businesses or social firms for people with mental illness.

Social firms, or "affirmative businesses" as they are known in North America, are businesses created to employ people with disabilities and to provide a needed product or service. This Open Forum offers an overview of the development and status of social firms. The model was developed in Italy in the 1970s for people with psychiatric disabilities and has gained prominence in Europe. Principles include that over a third of employees are people with a disability or labor market disadvantage, every worker is paid a fair-market wage, and the business operates without subsidy. Independent of European influence, affirmative businesses also have developed in Canada, the United States, Japan, and elsewhere. The success of individual social firms is enhanced by locating the right market niche, selecting labor-intensive products, having a public orientation for the business, and having links with treatment services. The growth of the social firm movement is aided by legislation that supports the businesses, policies that favor employment of people with disabilities, and support entities that facilitate technology transfer. Social firms can empower individual employees, foster a sense of community in the workplace, and enhance worker commitment through the organization's social mission.

Australia↗
PubMed2005

Local projects of the world psychiatric association programme to reduce stigma and discrimination.

The World Psychiatric Association Programme to Reduce Stigma and Discrimination Because of Schizophrenia, which was launched in 1996, has established projects to fight stigma in 20 countries, using social-marketing techniques to enhance their effectiveness. This article describes some of the strategies used and the lessons learned in implementing two local antistigma projects. At each site the first steps were to establish an action committee and to conduct a local survey of perceived stigma. On the basis of the survey, the local action committee selected a few homogeneous and accessible target groups, such as students, employers, and criminal justice personnel. These smaller groups were targeted, because focusing on the general public is expensive and unlikely to have a measurable impact. Messages for the target groups and the media used to reach them were carefully selected, tested, and refined. The author gives examples of the work that was done with such target groups as high school students and the criminal justice system. Guidelines are provided for setting up a consumer speakers' bureau, which is valuable for addressing target groups. The bureau can be made up of people who have experienced mental illness, family members, and mental health professionals. Guidelines are also provided for establishing a media-watch organization, which can lobby news and entertainment media to exclude negative portrayals of people with mental illness. Organizers of local projects should be on the lookout for useful changes that can become permanent, such as changes in the curriculum for high school students or for police officers in training. Projects such as these can be effective in reducing stigma and can be relatively inexpensive.

Cooperative Behavior↗
PubMed2005

Problems with early and very early intervention in psychosis.

"Early intervention" can refer to two different approaches--intervention when the psychosis is already evident and intervention before a psychosis is fully apparent. Each carries a distinctly different set of risks. The hoped-for benefits of early intervention in a fully evident psychosis are based on research that reveals an association between intervention early in the illness and good outcome. Those suffering from a psychosis of recent onset, however, are more likely to experience a spontaneous remission of illness, and this may readily explain the observed association. Early intervention in such cases of good-prognosis psychosis may lead to unnecessary and, sometimes, protracted treatment for those who would do well with no treatment. Intervention in the supposed prodromal phase of psychosis presents more serious hazards. The screening instruments currently available are inadequate for the accurate prediction of psychosis, and the risks of negative effects for the large numbers of people who screen false-positive are considerable. These risks include unnecessary fear of illness, restriction of life goals, use of medication and their side-effects.

Humans↗
PubMed2004

Modeling hydrology, metribuzin degradation and metribuzin transport in macroporous tilled and no-till silt loam soil using RZWQM.

Due to the complex nature of pesticide transport, process-based models can be difficult to use. For example, pesticide transport can be effected by macropore flow, and can be further complicated by sorption, desorption and degradation occurring at different rates in different soil compartments. We have used the Root Zone Water Quality Model (RZWQM) to investigate these phenomena with field data that included two management conditions (till and no-till) and metribuzin concentrations in percolate, runoff and soil. Metribuzin degradation and transport were simulated using three pesticide sorption models available in RZWQM: (a) instantaneous equilibrium-only (EO); (b) equilibrium-kinetic (EK, includes sites with slow desorption and no degradation); (c) equilibrium-bound (EB, includes irreversibly bound sites with relatively slow degradation). Site-specific RZWQM input included water retention curves from four soil depths, saturated hydraulic conductivity from four soil depths and the metribuzin partition coefficient. The calibrated parameters were macropore radius, surface crust saturated hydraulic conductivity, kinetic parameters, irreversible binding parameters and metribuzin half-life. The results indicate that (1) simulated metribuzin persistence was more accurate using the EK (root mean square error, RMSE = 0.03 kg ha(-1)) and EB (RMSE = 0.03 kg ha(-1)) sorption models compared to the EO (RMSE = 0.08 kg ha(-1)) model because of slowing metribuzin degradation rate with time and (2) simulating macropore flow resulted in prediction of metribuzin transport in percolate over the simulation period within a factor of two of that observed using all three pesticide sorption models. Moreover, little difference in simulated daily transport was observed between the three pesticide sorption models, except that the EB model substantially under-predicted metribuzin transport in runoff and percolate >30 days after application when transported concentrations were relatively low. This suggests that when macropore flow and hydrology are accurately simulated, metribuzin transport in the field may be adequately simulated using a relatively simple, equilibrium-only pesticide model.

Agriculture↗
PubMed2002

Attitudes about schizophrenia from the pilot site of the WPA worldwide campaign against the stigma of schizophrenia.

BACKGROUND: A series of surveys were conducted to assess the attitudes of the public, and other groups, toward those with schizophrenia. The aim of these surveys was to aid in the planning and evaluation of the WPA anti-stigma initiative in Alberta, Canada. METHOD: A questionnaire was devised and administered via telephone to over 1,200 individuals in three Alberta cities, and in paper and pencil format to 40 members of the Schizophrenia Society of Alberta and 67 medical students. RESULTS: In contrast to some earlier findings, "loss of mind" was rated to be more disabling than any other handicapping condition. In general, respondents showed a relatively sophisticated understanding of schizophrenia and a higher level of acceptance than might have been predicted. Nonetheless, this acceptance was not as high for situations where closer personal contact was likely, and fears of dangerousness continue to be associated with schizophrenia. The majority of respondents, however, felt that treatment aided those with schizophrenia, expressed support for progressive programmes for the mentally ill, and stated that they would be willing to pay higher taxes so that programming could be improved. CONCLUSIONS: The results do not support the utility of a broad approach for an anti-stigma campaign, but rather suggest a more specific focus, such as perceived dangerousness.

Adolescent↗
PubMedDate not supplied

Early intervention in schizophrenia: a critique.

OBJECTIVE: Two forms of early intervention in psychosis are currently being proposed--intervention before the onset of illness with at-risk individuals and intervention after the onset of psychosis. METHOD: The risks and potential benefits associated with these two approaches were examined using published data and Bayes probability theorem. RESULTS: Claims for benefits from early intervention in established psychosis go back more than two hundred years to the nineteenth-century advocates for asylum construction. Theoretical support for early intervention in psychosis rests on data suggesting that a longer duration of untreated psychosis (DUP) is associated with poor outcome. The association of DUP with outcome, however, appears to be inseparable from the confounding influence of the good outcome expected in recent-onset psychosis. Although some researchers advocate treating people with premorbid features of psychosis or other high-risk indicators, adequate screening measures and effective interventions are not yet available. The most promising current screening measure, if applied to the general population, would be accurate only two percent of the time. The accuracy of these measures can be improved by screening only those patients who are referred to a clinic, but this strategy will result in many cases in the population-at-large being overlooked. DISCUSSION: The risks and potential benefits associated with the two early intervention approaches are very different. The provision of optimal treatment early in psychosis could produce benefits, but people with brief, good-prognosis psychotic episodes are likely to receive unnecessary treatment. Screening the general population or patients referred to a clinic will have little public health impact on the incidence of schizophrenia. There is likely to be considerable negative impact on those who are inaccurately labeled as being at imminent risk of psychosis and are treated accordingly.

Humans↗
PubMedDate not supplied

Improving service delivery for relapse management in multiple sclerosis.

This action research study was conducted over an 18 month period within a district general hospital. The study has improved the quality of the service provided to people experiencing a relapse of multiple sclerosis. The authors now identify and treat a three-fold increase in relapse patients. At least 85% of these patients are treated within 10 days of reporting symptoms to a specialist nurse. Before the study, only 12% of patients received treatment within this time. The authors' data identify what patients valued about this service and also inform debate around distress associated with relapse and how services should develop to respond to this. The study is of particular importance to the UK because the National Institute for Clinical Excellence (NICE) has published guidance to the NHS about the management of this specific patient group (NICE, 2003). This study also clearly demonstrates how specialist nursing services can combine a substantial clinical role with instigating and managing change in service delivery that results in improvements in patient care.

Attitude to Health↗