Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level

Physical disorders are, compared to the general population, more prevalent in people with severe mental illness (SMI). Although this excess morbidity and mortality is largely due to modifiable lifestyle risk factors, the screening and assessment of physical health aspects remains poor, even in developed countries. Moreover, specific patient, provider, treatment and system factors act as barriers to the recognition and to the management of physical diseases in people with SMI. Psychiatrists can play a pivotal role in the improvement of the physical health of these patients by expanding their task from clinical psychiatric care to the monitoring and treatment of crucial physical parameters. At a system level, actions are not easy to realize, especially for developing countries. However, at an individual level, even simple and very basic monitoring and treatment actions, undertaken by the treating clinician, can already improve the problem of suboptimal medical care in this population. Adhering to monitoring and treatment guidelines will result in a substantial enhancement of physical health outcomes. Furthermore, psychiatrists can help educate and motivate people with SMI to address their suboptimal lifestyle, including smoking, unhealthy diet and lack of exercise. The adoption of the recommendations presented in this paper across health care systems throughout the world will contribute to a significant improvement in the medical and related psychiatric health outcomes of patients with SMI.     

POWSIM: a computer program for assessing statistical power when testing for genetic differentiation

Knowledge of statistical power is essential for sampling design and data evaluation when testing for genetic differentiation. Yet, such information is typically missing in studies of conservation and evolutionary genetics, most likely because of complex interactions between the many factors that affect power. powsim is a 32‐bit Windows/DOS simulation‐based computer program that estimates power (and α error) for chi‐square and Fisher's exact tests when evaluating the hypothesis of genetic homogeneity. Optional combinations include the number of samples, sample sizes, number of loci and alleles, allele frequencies, and degree of differentiation (quantified as F_ST). powsim is available at http://www.zoologi.su.se/~ryman .     

Assessment of European streams with diatoms, macrophytes, macroinvertebrates and fish: a comparative metric-based analysis of organism response to stress

1. Periphytic diatoms, macrophytes, benthic macroinvertebrates and fish were sampled with standard methods in 185 streams in nine European countries to compare their response to degradation. Streams were classified into two main stream type groups (i.e. lowland, mountain streams); in addition, the lowland streams were grouped into four more specific stream types. 2. Principal components analysis with altogether 43 environmental parameters was used to construct complex stressor gradients for physical–chemical, hydromorphological and land use data. About 30 metrics were calculated for each sample and organism group. Metric responses to different stress types were analysed by Spearman Rank Correlation. 3. All four organism groups showed significant response to eutrophication/organic pollution gradients. Generally, diatom metrics were most strongly correlated to eutrophication gradients (85% and 89% of the diatom metrics tested correlated significantly in mountain and lowland streams, respectively), followed by invertebrate metrics (91% and 59%). 4. Responses of the four organism groups to other gradients were less strong; all organism groups responded to varying degrees to land use changes, hydromorphological degradation on the microhabitat scale and general degradation gradients, while the response to hydromorphological gradients on the reach scale was mainly limited to benthic macroinvertebrates (50% and 44% of the metrics tested correlated significantly in mountain and lowland streams, respectively) and fish (29% and 47%). 5. Fish and macrophyte metrics generally showed a poor response to degradation gradients in mountain streams and a strong response in lowland streams. 6. General recommendations on European bioassessment of streams were derived from the results.     

Structural investigations of octocoral sclerites

A common structural pattern (as observed under the SEM) in the main body of sectioned sclerites of the family Alcyoniidae, and octocorals in general, is the arrangement of acicular crystals in concentric layers. The crystals roughly follow the direction of the spicule axis, however, the sectioned tubercles of large Sinularia spicules have the acicular crystals oriented in the direction of the tubercles (i.e. perpendicular to the spicule axis), contrary to the sectioned tubercles of Sarcophyton and Lobophytum spicules. They reveal some rod-like structures, furcating the acute processes at the top of the tubercles. Sectioned small, club-like Sinularia sclerites show numerous tiny acicular crystals, oriented with their long axes at a fairly constant degree of inclination around a central axis. SEM studies of sectioned Cladiella sclerites show a granulate structure organized in concentric layers, but lacking acicular crystals. The Silurian Atractosella cataractaca show important characters in common with Recent alcyoniid species.     

DNA fingerprinting in horses using a simple (TG)n probe and its application to population comparisons

A synthetic polynucleotide (TG)_n was hybridized to equine DNA digested with HinfI and hypervariable hybridization patterns were obtained. Mendelian inheritance of these DNA fingerprinting patterns was confirmed by pedigree analysis. Estimates of the probabilities of identical band patterns in unrelated individuals of different breeds (Swedish Trotters, North Swedish Trotters, Thoroughbreds and Arabians) were in the range 1 times 10-⁴-7 times 10-⁶ The variability derived with the (TG)_n, probe in horses was higher than what we obtained with several other commmonly used probes for DNA fingerprinting. Individuals within breeds tended to be more similar to each other with regard to DNA fingerprint pattern than to individuals of other breeds. Moreover, a parsimony analysis made on the basis of the hybridization patterns gave clustering of individuals within breeds. The possibility of using hypervariable probes for the identification of breed-specific characters is discussed.     

Population differentiation in Crepis tectorum (Asteraceae): patterns of correlation among characters

This study examines the relationship among traits distinguishing populations of C. tectorum and the extent to which existing trait associations reflect underlying (genetic) tradeoffs. Highly consistent trait associations were found in a comparison of 52 populations representing the western part of the geographical range of the species. In addition to a tight integration of traits reflecting plant stature and inflorescence development, there were consistent links between vegetative and reproductive traits; populations characterized by individuals with large leaves and tall stems with terminal branches usually had larger heads, flowers and fruits (achenes) than those whose individuals had small leaves and a short stem branched from the base. There was a weak negative relationship between the extent of leaf dissection and plant stature; short and compact plants had more deeply lobed leaves than tall plants with terminal branches. Few of these associations were present among families representing a single population of C. tectorum , but there was remarkable similarity between the correlations at the between-population level and those obtained in two segregating F2 progenies of crosses between contrasting populations. Hence, provided that the F2 correlations have a strong genetic basis, it appears that the course of population divergence has been constrained by the underlying correlation structure, although some trait associations may also be a result of selection operating in a correlated fashion on functionally related traits, perhaps leading to linkage disequilibrium of parental traits in the first segregating generation of a cross between ecologically differentiated populations.