Suchergebnisse

Analyses were supported by the UK Medical Research Council (MR/M012190/1), Cancer Research UK (C8221/A19170 and 570/A16491) and the Wellcome Trust (Our Planet Our Health, Livestock Environment and People 205212/Z/16/Z). A.P.C. is supported by a Cancer Research UK Population Research Fellowship (C60192/A28516) and by the World Cancer Research Fund (WCRF UK), as part of the Word Cancer Research Fund International grant programme (2019/1953). EPIC-CVD has been supported by the European Union Framework 7 (HEALTH-F2-2012-279233), the European Research Council (268834), the UK Medical Research Council (G0800270 and MR/L003120/1), the British Heart Foundation (SP/09/002 and RG/08/014 and RG13/13/30194) and the UK National Institute of Health Research. The InterAct project was funded by the EU FP6 programme (grant number LSHM_CT_2006_037197) and provided the biomarker data in the sub-cohort that was used in the current study. The coordination of EPIC is financially supported by the European Commission (DGSANCO) and the International Agency for Research on Cancer. The national cohorts are supported by: Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Ge ' ne ' rale de l'Education Nationale, Institut National de la Sante ' et de la Recherche Me ' dicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF) (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF); Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC-Murcia, Regional Governments of Andaluci ' a, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Ska degrees ne and Va sterbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), UK Medical Research Council [1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford, MC_UU_12015/1 (N.J.W.), MC_UU_12015/5 (NGF), and MC_UU_12015/520], and NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014) to the MRC Epidemiology Unit Cambridge (N.J.W., N.G.F.). J.D. holds a British Heart Foundation Chair and an NIHR Senior Investigator Award. K.E.B. holds a Girdlers' New Zealand Health Research Council Fellowship. J.D. is funded by the National Institute for Health Research [Senior Investigator Award] [*]. A.W is supported by a BHF-Turing Cardiovascular Data Science Award and by the ECInnovative Medicines Initiative (BigData@Heart).M.S.reports funding from the Alpro Foundation whilst at the Cardiovascular Epidemiology Unit (up to 15-08-2016), and Core MRC Unit support through the Nutritional Epidemiology Programme (MC_UU_12015/5) whilst at the MRC Epidemiology Unit (15-08-2016 until now), during the conduct of the study. ; The authors thank all participants in the EPIC cohort for their invaluable contribution to the study. ; Epidemiological evidence indicates that diets rich in plant foods are associated with a lower risk of ischaemic heart disease (IHD), but there is sparse information on fruit and vegetable subtypes and sources of dietary fibre. This study examined the associations of major plant foods, their subtypes and dietary fibre with risk of IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods We conducted a prospective analysis of 490 311 men and women without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases = 8504), in 10 European countries. Dietary intake was assessed using validated questionnaires, calibrated with 24-h recalls. Multivariable Cox regressions were used to estimate hazard ratios (HR) of IHD. Results There was a lower risk of IHD with a higher intake of fruit and vegetables combined [HR per 200 g/day higher intake 0.94, 95% confidence interval (CI): 0.90–0.99, P-trend = 0.009], and with total fruits (per 100 g/day 0.97, 0.95–1.00, P-trend = 0.021). There was no evidence for a reduced risk for fruit subtypes, except for bananas. Risk was lower with higher intakes of nuts and seeds (per 10 g/day 0.90, 0.82–0.98, P-trend = 0.020), total fibre (per 10 g/day 0.91, 0.85–0.98, P-trend = 0.015), fruit and vegetable fibre (per 4 g/day 0.95, 0.91–0.99, P-trend = 0.022) and fruit fibre (per 2 g/day 0.97, 0.95–1.00, P-trend = 0.045). No associations were observed between vegetables, vegetables subtypes, legumes, cereals and IHD risk. Conclusions In this large prospective study, we found some small inverse associations between plant foods and IHD risk, with fruit and vegetables combined being the most strongly inversely associated with risk. Whether these small associations are causal remains unclear. ; UK Research & Innovation (UKRI) Medical Research Council UK (MRC) MR/M012190/1 G0800270 MR/L003120/1 1000143 MC_UU_12015/1 MC_UU_12015/5 MC_UU_12015/520 ; Cancer Research UK C8221/A19170 570/A16491 14136 C570/A16491 ; Wellcome Trust (Our Planet Our Health, Livestock Environment and People) 205212/Z/16/Z ; Cancer Research UK Population Research Fellowship C60192/A28516 ; World Cancer Research Fund (WCRF UK), as part of the Word Cancer Research Fund International grant programme 2019/1953 ; European Commission HEALTH-F2-2012-279233 ; European Research Council (ERC) European Commission 268834 ; British Heart Foundation SP/09/002 RG/08/014 RG13/13/30194 ; National Institute for Health Research (NIHR) ; European Commission LSHM_CT_2006_037197 ; European Commission European Commission Joint Research Centre ; International Agency for Research on Cancer ; Danish Cancer Society ; Ligue Contre le Cancer (France) ; Institut Gustave Roussy (France) ; Mutuelle Generale de l'Education Nationale (France) ; Institut National de la Sante et de la Recherche Medicale (Inserm) ; Deutsche Krebshilfe ; German Cancer Research Center (DKFZ) (Germany) ; Federal Ministry of Education & Research (BMBF) ; Hellenic Health Foundation (Greece) ; Associazione Italiana per la Ricerca sul Cancro (AIRC) ; Consiglio Nazionale delle Ricerche (CNR) ; Dutch Ministry of Public Health, Welfare and Sports (VWS) ; Netherlands Cancer Registry (NKR) ; LK Research Funds ; Dutch Prevention Funds ; Netherlands Organization for Scientific Research (NWO) ; World Cancer Research Fund International (WCRF) ; Instituto de Salud Carlos III PI13/00061 PI13/01162 ; Junta de Andalucia ; Regional Government of Asturias (Spain) ; Regional Government of Basque Country (Spain) ; Regional Government of Murcia (Spain) 6236 ; Regional Government of Navarra (Spain) ; Instituto de Salud Carlos III RD06/0020 ; Swedish Cancer Society ; Swedish Research Council ; County Council of Skane (Sweden) ; County Council of Vasterbotten (Sweden) ; NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme IS-BRC-1215-20014 ; British Heart Foundation ; NIHR Senior Investigator Award ; Girdlers' New Zealand Health Research Council Fellowship ; National Institute for Health Research (NIHR) ; BHF-Turing Cardiovascular Data Science Award ; ECInnovative Medicines Initiative (BigData@Heart) ; Alpro Foundation 15-08-2016 ; Core MRC Unit support through the Nutritional Epidemiology Programme MC_UU_12015/5

'In this 2ndedition, Robinson and Reiter give us an updated blueprint for full integration of behavioral health and primary care in practice. They review the compelling rationale, but their real contribution is telling us exactly HOW to think about it and how to do it. This latest book is a must for anyone interested in population health and the nuts and bolts of full integration through using the Primary Care Behavioral Health Consultation model.'Susan H McDaniel Ph.D., 2016 President, American Psychological Association Professor, University of Rochester Medical CenterThe best-selling guide to integrating behavioral health services into primary care is now updated, expanded and better than ever! Integration is exploding in growth, and it is moving inexorably toward the model outlined here. To keep pace, this revised text is a must for primary care clinicians and administrators. It is also essential reading for graduate classes in a variety of disciplines, including social work, psychology, and medicine. This updated edition includes: · A refined presentation of the Primary Care Behavioral Health (PCBH) model · The latest terms, trends and innovations in primary care · Comprehensive strategies and resource lists for hiring and training new Behavioral Health Consultants (BHC) · Step-by-step guidance for implementing the PCBH model · A plethora of evolved practice tools, including new Core Competency Tools for BHCs and primary care providers · Sample interventions for behaviorally influenced problems · The use of 'Third Wave' behavior therapies in primary care · Detailed program evaluation instructions and tools · The latest on financing integrated care · An entire chapter on understanding and addressing the prescription drug abuse epidemic · Experienced guidance on ethical issues in the PCBH model · Improved patient education handoutsWith all of the changes in health care, the potential for the Primary Care Behavioral Health (PCBH) model to improve primary care-and the health of the population-is greater than ever.This book should be the first read for anyone interested in realizing the potential of integration. Patricia Robinson Ph.D. is currently principal and consultant for the Mountainview Consulting Group Inc., a firm specializing in providing consultation, program implementation and training services for health care systems seeking to integrate behavioral health and primary medical services and/or develop effective methods for collecting and using clinical outcome data. Dr. Robinson obtained her Ph.D. in Psychology from Texas Womans University in 1979. Dr. Robinson worked in a student health setting at Kansas State University several years before joining the Mercer Island School District in 1981, where she served as Director of Childfind. During her employment at Mercer Island, Dr. Robinson developed school-based group treatment programs for behaviorally disabled adolescents and socially isolated elementary students. Jeff Reiter, Ph.D., ABPP. is a Clinical Psychologist with an ABPP in Behavioral Psychology. Co-director of Primary Care Behavioral Health Services for HealthPoint Community Health Centers, Seattle, WA, Dr. Reiter is the co-author of the book, Behavioral Consultation and Primary Care: A Guide to Integrating Services. Dr. Reiter spent eight years as a psychologist in the U.S. Air Force. In 2008, he was one of three consultants contracted by the U.S. Air Force to help implement integrated care services throughout their bases worldwide. His work in primary care recently earned him an APA Presidential Award for Innovative Practice, one of twelve given annually.

INTRODUCTION The Belgian government Integreo program (www.integreo.be) aims at a nationwide whole-system change in health and social care towards more Integrated Care (IC), by means of geographically defined integrated care projects (ICPs). Starting in early 2018, the twelve ICPs are implementing their action plan to change the organization of their regional network, covering up to 150.000 inhabitants, towards more IC. They receive limited financing: one FTE coordinator. As the final goal of the national plan is to anchor successful changes and scale-up best practices, FAITH.be (Federated consortium for Appraisal of Integrated care Teams in Health in Belgium) developed a mixed methods realist evaluation framework which aims at responding to the questions if, how, for whom and why the implementation of the ICP is successful or not so far, and learn lessons to help the ICPs to adjust their governance to support successful implementation of a whole-system change in their region. We will present preliminary insights of the implementation analysis, describing the main difficulties ICPs struggle with and how they address them. THEORY/METHODS We use participative action and realist methods following RAMESES II standards (http://www.ramesesproject.org/). Data collection tools are chosen in consultation with stakeholders: coordinators, partners of and policy makers. Intermediate results are fed back and discussed with the stakeholders. Two methods are combined: qualitative enquiry for all ICPs and case study methods for three selected ICPs. Normalization Process Theory (NPT) (1) is chosen to guide the analysis. RESULTS First observations show that ICPs struggle with divergence in vision about priorities and timelines between ICPs, Governmental agencies at both federal and regional level. After postponement of crucial policy decisions and delivery of promised ICT-tools, ICPs are forced to adapt their action plan, which impedes their coherence. Moreover, due to the limited financing, ICPs are expected to pre-finance their actions towards IC, which impedes the involvement of key stakeholders, such as GPs' and social care workers' organisations and raises tensions between care providers, e.g. working in a fee-for service system versus those working in bundled payment systems. Hence, this hinders collective action and participation. DISCUSSION These preliminary results will be further discussed and extended with the stakeholders. By the time of the conference, we will present the main issues for each social mechanism as described by NPT and explain why, how and for whom these difficulties occur and describe observed strategies to cope with them. CONCLUSIONS First results show how the divergence of visions between policy makers and stakeholders in ICPs, hinder ICPs to implement innovative actions towards IC. LESSONS LEARNED Even though co-creation is considered an important pillar of the Integreo Plan, the lack of convergence of visions between policy agencies and ICPs hinders the implementation of innovative actions towards IC. LIMITATIONS The results only reflect the views of ICPs, not the policy makers. SUGGESTIONS FOR FUTURE RESEARCH The results of the implementation analysis will be linked to the outcome and cost analysis of the ICPs (see: https://interfaithbel.blog/methodological-information/). 1. Murray E, Treweek S, Pope C, MacFarlane A, Ballini L, Dowrick C, et al. Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. BMC medicine. 2010;8:63.

BACKGROUND: The burden of traumatic brain injury (TBI) poses a large public health and societal problem, but the characteristics of patients and their care pathways in Europe are poorly understood. We aimed to characterise patient case-mix, care pathways, and outcomes of TBI. METHODS: CENTER-TBI is a Europe-based, observational cohort study, consisting of a core study and a registry. Inclusion criteria for the core study were a clinical diagnosis of TBI, presentation fewer than 24 h after injury, and an indication for CT. Patients were differentiated by care pathway and assigned to the emergency room (ER) stratum (patients who were discharged from an emergency room), admission stratum (patients who were admitted to a hospital ward), or intensive care unit (ICU) stratum (patients who were admitted to the ICU). Neuroimages and biospecimens were stored in repositories and outcome was assessed at 6 months after injury. We used the IMPACT core model for estimating the expected mortality and proportion with unfavourable Glasgow Outcome Scale Extended (GOSE) outcomes in patients with moderate or severe TBI (Glasgow Coma Scale [GCS] score ≤12). The core study was registered with ClinicalTrials.gov, number NCT02210221, and with Resource Identification Portal (RRID: SCR_015582). FINDINGS: Data from 4509 patients from 18 countries, collected between Dec 9, 2014, and Dec 17, 2017, were analysed in the core study and from 22 782 patients in the registry. In the core study, 848 (19%) patients were in the ER stratum, 1523 (34%) in the admission stratum, and 2138 (47%) in the ICU stratum. In the ICU stratum, 720 (36%) patients had mild TBI (GCS score 13-15). Compared with the core cohort, the registry had a higher proportion of patients in the ER (9839 [43%]) and admission (8571 [38%]) strata, with more than 95% of patients classified as having mild TBI. Patients in the core study were older than those in previous studies (median age 50 years [IQR 30-66], 1254 [28%] aged >65 years), 462 (11%) had serious comorbidities, 772 (18%) were taking anticoagulant or antiplatelet medication, and alcohol was contributory in 1054 (25%) TBIs. MRI and blood biomarker measurement enhanced characterisation of injury severity and type. Substantial inter-country differences existed in care pathways and practice. Incomplete recovery at 6 months (GOSE <8) was found in 207 (30%) patients in the ER stratum, 665 (53%) in the admission stratum, and 1547 (84%) in the ICU stratum. Among patients with moderate-to-severe TBI in the ICU stratum, 623 (55%) patients had unfavourable outcome at 6 months (GOSE <5), similar to the proportion predicted by the IMPACT prognostic model (observed to expected ratio 1·06 [95% CI 0·97-1·14]), but mortality was lower than expected (0·70 [0·62-0·76]). INTERPRETATION: Patients with TBI who presented to European centres in the core study were older than were those in previous observational studies and often had comorbidities. Overall, most patients presented with mild TBI. The incomplete recovery of many patients should motivate precision medicine research and the identification of best practices to improve these outcomes. FUNDING: European Union 7th Framework Programme, the Hannelore Kohl Stiftung, OneMind, and Integra LifeSciences Corporation. ; European Union 7th Framework program (EC grant 602150) with additional support from the Hannelore Kohl Stiftung (Germany), from OneMind (USA) and from Integra LifeSciences Corporation (USA).

INTRODUCTION The Belgian government Integreo program (www.integreo.be) aims at a nationwide whole-system change in health and social care towards more Integrated Care (IC), by means of geographically defined integrated care projects (ICPs). Starting in early 2018, the twelve ICPs are implementing their action plan to change the organization of their regional network, covering up to 150.000 inhabitants, towards more IC. They receive limited financing: one FTE coordinator. As the final goal of the national plan is to anchor successful changes and scale-up best practices, FAITH.be (Federated consortium for Appraisal of Integrated care Teams in Health in Belgium) developed a mixed methods realist evaluation framework which aims at responding to the questions if, how, for whom and why the implementation of the ICP is successful or not so far, and learn lessons to help the ICPs to adjust their governance to support successful implementation of a whole-system change in their region. We will present preliminary insights of the implementation analysis, describing the main difficulties ICPs struggle with and how they address them. THEORY/METHODS We use participative action and realist methods following RAMESES II standards (http://www.ramesesproject.org/). Data collection tools are chosen in consultation with stakeholders: coordinators, partners of and policy makers. Intermediate results are fed back and discussed with the stakeholders. Two methods are combined: qualitative enquiry for all ICPs and case study methods for three selected ICPs. Normalization Process Theory (NPT) (1) is chosen to guide the analysis. RESULTS First observations show that ICPs struggle with divergence in vision about priorities and timelines between ICPs, Governmental agencies at both federal and regional level. After postponement of crucial policy decisions and delivery of promised ICT-tools, ICPs are forced to adapt their action plan, which impedes their coherence. Moreover, due to the limited financing, ICPs are expected to pre-finance their actions towards IC, which impedes the involvement of key stakeholders, such as GPs' and social care workers' organisations and raises tensions between care providers, e.g. working in a fee-for service system versus those working in bundled payment systems. Hence, this hinders collective action and participation. DISCUSSION These preliminary results will be further discussed and extended with the stakeholders. By the time of the conference, we will present the main issues for each social mechanism as described by NPT and explain why, how and for whom these difficulties occur and describe observed strategies to cope with them. CONCLUSIONS First results show how the divergence of visions between policy makers and stakeholders in ICPs, hinder ICPs to implement innovative actions towards IC. LESSONS LEARNED Even though co-creation is considered an important pillar of the Integreo Plan, the lack of convergence of visions between policy agencies and ICPs hinders the implementation of innovative actions towards IC. LIMITATIONS The results only reflect the views of ICPs, not the policy makers. SUGGESTIONS FOR FUTURE RESEARCH The results of the implementation analysis will be linked to the outcome and cost analysis of the ICPs (see: https://interfaithbel.blog/methodological-information/). 1. Murray E, Treweek S, Pope C, MacFarlane A, Ballini L, Dowrick C, et al. Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. BMC medicine. 2010;8:63.

Administration-to-birth intervals of antenatal corticosteroids (ANS) vary. The significance of this variation is unclear. Specifically, to our knowledge, the shortest effective administration-to-birth interval is unknown. Objective:To explore the associations between ANS administration-to-birth interval and survival and morbidity among very preterm infants. Design, Setting, and Participants: The Effective Perinatal Intensive Care in Europe (EPICE) study, a population-based prospective cohort study, gathered data from 19 regions in 11 European countries in 2011 and 2012 on 4594 singleton infants with gestational ages between 24 and 31 weeks, without severe anomalies and unexposed to repeated courses of ANS. Data were analyzed November 2016. Exposure: Time from first injection of ANS to delivery in hours and days. Main Outcomes and Measures: Three outcomes were studied: in-hospital mortality; a composite of mortality or severe neonatal morbidity, defined as an intraventricular hemorrhage grade of 3 or greater, cystic periventricular leukomalacia, surgical necrotizing enterocolitis, or stage 3 or greater retinopathy of prematurity; and severe neonatal brain injury, defined as an intraventricular hemorrhage grade of 3 or greater or cystic periventricular leukomalacia. Results: Of the 4594 infants included in the cohort, 2496 infants (54.3%) were boys, and the mean (SD) gestational age was 28.5 (2.2) weeks and mean (SD) birth weight was 1213 (400) g. Mortality for the 662 infants (14.4%) unexposed to ANS was 20.6% (136 of 661). Administration of ANS was associated with an immediate and rapid decline in mortality, reaching a plateau with more than 50% risk reduction after an administration-to-birth interval of 18 to 36 hours. A similar pattern for timing was seen for the composite mortality or morbidity outcome, whereas a significant risk reduction of severe neonatal brain injury was associated with longer administration-to-birth intervals (greater than 48 hours). For all outcomes, the risk reduction associated with ANS was transient, with increasing mortality and risk for severe neonatal brain injury associated with administration-to-birth intervals exceeding 1 week. Under the assumption of a causal relationship between timing of ANS and mortality, a simulation of ANS administered 3 hours before delivery to infants who did not receive ANS showed that their estimated decline in mortality would be 26%. Conclusions and Relevance:Antenatal corticosteroids may be effective even if given only hours before delivery. Therefore, the infants of pregnant women at risk of imminent preterm delivery may benefit from its use. ; The research received funding from grant agreement 259882 from the European Union Seventh Framework Program (2007-2013). Additional funding in France was provided by the French Institute of Public Health Research/Institute of Public Health and its partners, including the French Health Ministry, the National Institute of Health and Medical Research, the National Institute of Cancer, and the National Solidarity Fund for Autonomy, by grant ANR-11-EQPX-0038 from the National Research Agency through the French Equipex Program of Investments in the Future, and by the PremUp Foundation; in Poland, by 2012-2015 allocation of funds for international projects from the Polish Ministry of Science and HigherEducation; and in Sweden, by regional agreementon medical training and clinical research betweenStockholm County Council and Karolinska Institutetand by the Department of Neonat al Medicine at theKarolinska University Hospital.

Nikolaos Mavropoulos Dissertation Abstract The Japanese expansionism in Asia and the Italian expansion in Africa: A comparative study of the early Italian and Japanese colonialism (1868-1901) Modern Japan and Italy were formed in the same period, the period of the New Imperialism, a time of diplomatic mistrust, protectionism, frenetic colonial and economic rivalry and of militarism, when the Great Powers (British Empire, the French Third Republic and the Russian Empire) had already established their hegemonic position in the world. Japan and Italy at the end of the 19th century were in need of stability, internal and external security, economic reorganization and immediate settlement of the economic and social problems arising from the rapid increase of their population. Furthermore, seeking to compete on an equal footing with the Powers of the era, claiming a place in the sun, they considered modernization and rapid industrialization as the only way forward. These facts as well as the policy of expansion that they partly adopted for the resolution of these issues are unique and particular. The phenomenon of the early Japanese colonialism in relation to that of the other states is intensely reminiscent, as to the origins and aspirations, of the corresponding Italian one. Its collation with that of Britain's or Germany's in the period under examination would be inappropriate. Britain even though also an island state was technologically developed, robust, having the most powerful fleet and the most extensive empire in the world. The German Empire although it too was formed late (1871) and bedevilled like Japan by the problem of overpopulation did not share the same concerns about securing its independence as it was the superpower of the era, industrialized and militarily all-powerful the very next day after its unification. Securing new markets, meeting industrial needs for raw materials, the quest for lebensraum and arable land constituted common elements for all the imperialist Powers. Besides, the human inclination towards imperialism is self-evident. Men, acting individually or collectively, have always sought to establish dominance over others, where possible. So, what are the particularities that constitute the Japanese and the Italian colonial project distinctive? Both states fearing their exclusion from the markets, their pushing aside from the international developments, their marginalisation and their conversion into supernumeraries in the era of the chaotic imperialist struggle, envisaged in their own colonial expansion their strategic security and survival. They both viewed military victories and territorial expansion as the shortest way to obtain a place in the sun. Thus, even if they had not achieved the degree of industrialization and of economic development of the more powerful states, still being weak and agrarian, they attempted to ensure their position in the world through the colonies and the trade. The problem of their economic backwardness and military weakness was causing insecurity and stress even when they were achieving successes. The expansion and the establishment of spheres of influence constituted a necessity for the survival of the nation. The possession of colonies would present to the world a powerful, prestigious and modern Italy and Japan, arbiters of developments and, in addition, it would contribute to the stability of the international system. So they participated in the colonial struggle imitating the imperialist powers. Contrary to Lenin's theory about the unbreakable relationship between imperialism and the export of surplus capital, in the dawn of their colonial adventure, Japan and Italy had difficulty in luring domestic capital into colonial investment since they had a shortage not an excess of private capital. Despite their terrible fiscal position however, immediately after their formation, they inaugurated a policy of expansion. It was then presumed by the respective ruling classes that the participation in the colonial game would be panacea, it would, as if by magic, form the lever that would topple and nullify their disadvantageous geopolitical position abroad and would resolve the economic and social problems of vital importance that beset them in the interior. This consideration, this common perception, these convictions which were shared by politicians, merchants, industrialists and military simultaneously in two regions of the world so remote and alienated between them provoke the interest of the scholar. Was this colonialism a simple "reaction" to the progress of the rest of the imperialists? In the manifestation of the Japanese and Italian imperialism up until 1901 what are the underlying characteristics, what is the role of the monarchy and of the religion or of social Darwinism, what is the impact on the conquered peoples? What are the advantages and disadvantages of the integration to the Japanese Empire of peoples racially related to it? What is the ideology, the theoretical pillars which were nurtured at the end of the 19th century and on which they supported the background of their subsequent colonial expansion? What are the particular elements, the impulses, the ideologies that the early Italian and the early Japanese colonialism shared, elements which even pushed them into fighting for similar goals in Beijing during the Boxer rebellion (1899-1901)? This research responds to these demanding questions as well as traces the origins of the two states', mutatis mutandis, similar and common historical evolution up until the middle of the 20th century by researching the relative literature and archives.

The rapid spread of COVID-19 and the large number of cases put a significant burden on the health systems of any developed country. Specialists in natural disasters and military medicine should be involved in the provision of medical care and observance of anti-epidemic measures. In some countries, including Italy, they were involved only after the situation was dramatically worsening with many clinical units and hospitals overloaded by infected patients. To curb the spread of COVID-19, most countries declared a state of emergency, and unprecedented measures have been taken to strengthen quarantine in suspected or positive symptomatic subjects. Nevertheless, the crisis associated with the unexpectedly global scale and tragedy of the pandemic and the inconsistency of actions of both society and individuals and specialized medical services, lead to insufficient effectiveness of the measures taken in a number of regions. In the present day, it is vital for every person to change its mindset ― relying on personal responsibility to comply with all recommendations of quarantine and anti-epidemic measures, and to reorganize departments and resources of medical institutions at all levels in order to withstand the spread of infection and at the same time provide all those in need with the necessary and appropriate medical care. Particular attention should be paid to the obstetric care service, given that even in normal times, the obstetric hospital is an area of increased responsibility for the life and health of mother and child and future mankind. Fulfillment of existing orders, instructions of national and regional committees, international and national protocols and clinical protocols should undoubtedly lead to a positive result, but this requires additional training of medical personnel at all levels. The purpose of this review is to propose quick key strategies for reassessing the maternity and neonatal wards/ hospitals based on the experience of health systems and organizations which faced the spread of this new coronavirus; this advice may be applied along with binding tight instructions in obstetric hospitals in order to proactively respond to a likely wave of growth in COVID-19. ; Актуальность. Быстрое распространение COVID-19 и большое количество заболевших накладывает значительную нагрузку на системы здравоохранения развитых государств. В ряде стран к оказанию медицинской помощи и соблюдению противоэпидемических мероприятий привлекаются специалисты по стихийным бедствиям и военной медицине, однако в некоторых странах, в том числе в Италии, они были задействованы после того, как многие клинические подразделения и стационары были перегружены. Для сдерживания распространения COVID-19 большинство стран объявили чрезвычайное положение, были приняты беспрецедентные меры по усилению карантинных мероприятий. Тем не менее кризис, связанный с неожиданно глобальным масштабом и трагичностью пандемии, и несогласованность действий как общества и отдельных граждан, так и специализированных медицинских служб приводят к недостаточной эффективности проводимых мероприятий в ряде регионов. Особое внимание следует уделить службе родовспоможения, учитывая, что и в спокойное время акушерский стационар является зоной повышенной ответственности за жизнь и здоровье матери и ребенка. Исполнение действующих приказов, указаний национальных и региональных комитетов, международных/национальных и клинических протоколов, несомненно, приведет к положительному результату, но требует дополнительного обучения и тренировки медицинского персонала всех уровней. Цель обзора ― предложить ключевые стратегии, основываясь на опыте регионов, ранее столкнувшихся с распространением нового коронавируса, которые могут быть быстро применены наряду с обязательными к исполнению действующими приказами и распоряжениями в акушерских стационарах, чтобы превентивно отреагировать на вероятную волну роста заболеваемости и носительства COVID-19.

January 2020 observed the onset of a new epidemic in Wuhan city of China where hundreds of people were noticed to be suffering from pneumonia like Severe acute respiratory syndrome(SARS) which later on termed as New Corona Virus Disease 2019 (COVID-19) by World Health Organization (WHO).1 The outbreak in China shook the World as many countries planned on restricting international travel and closing businesses momentarily.2 The outbreak of Covid-19, nevertheless, infected every country of the world around 20 million cases worldwide and about 0.7 million confirmed deaths with approximately 19% mortality rate and WHO declared it a pandemic on March 11, 2020.3 Pakistan is the world'sfifth-most-populouscountry with 207,774,520 human population. The rising whirl of Covid-19 hit Pakistan following the end of February 2020. Experts predicted the trade operations between Pakistan and China, the students and businesspersons (who frequently cross China-Pakistan border for academic and commercial purposes) to be the vulnerable portal of Covid-19 in Pakistan. Nevertheless, the Shia pilgrims visiting Iran, where immense religious congregations led to untold Covid-19 surge, were the major entry portal of Covid-19 in Pakistan and officials never reported any Covid-19 case of Chinese transmission in Pakistan. National Command and Control Centre reported around more than 280 thousand Covid-19 cases with 6,139 deaths on August 13, 2020 overall.4 The Covid-19 is on daily exponential rise in Pakistan and the limited resources, lack of equipment and human resource, unavailability of diagnostic kits and medicines have deteriorated the situation. Pakistan does not have an effective infection disease surveillance system to meet the millennium developmental goals in healthcare. Pakistan is struggling to control diseases such as hepatitis, diarrhea, respiratory diseases, typhoid, measles and many mosquito-borne diseases thereof.5 The present outbreak of Covid-19 has affected the whole world although its incidence is low in Pakistan which is continuously struggling to deal with multiple socio-economic factors including poverty, overpopulation, low literacy about common health and health care system issues natural disasters and lack of decisive precautionary approaches. Currently, there is no cure or vaccine available for the virus and therefore "prevention is better than cure". The preventive measures including lockdown strategies will further add economic crisis to the government and people. The dual frontiers of pandemic and economy could not be combated simultaneously; therefore, the government itself is trying to make a balanced strategy, which could minimally affect the lives of people on both issues. The international funding agencies should take serious notice of this pandemic and its rise in poor country like Pakistan with 220 million populations and come forward to assist Pakistan in fighting out Covid-19 as they are contributing in the eradication of other disease such as tuberculosis, human immunodeficiency virus infection and malaria. The smart lockdown proved to be the best strategies to combat this pandemic and have produced significant results in not only reducing the spread of disease but also running the wheel of economy. The government of Pakistan is further planning to narrow the margin of lockdown to micro smart lockdown to boost up economic activities and eradicate the load of Covid-19.

Background: There are few studies devoted to assessing the impact of meditation-intensive retreats on the well-being, positive psychology, and personality of experienced meditators. We aimed to assess whether a 1-month Vipassana retreat: (a) would increase mindfulness and well-being ; (b) would increase prosocial personality traits ; and (c) whether psychological changes would be mediated and/or moderated by non-attachment. Method: A controlled, non-randomized, pre-post-intervention trial was used. The intervention group was a convenience sample (n = 19) of experienced meditators who participated in a 1-month Vipassana meditation retreat. The control group (n = 19) comprised matched experienced meditators who did not take part in the retreat. During the retreat, the mean duration of daily practice was 8-9 h, the diet was vegetarian and silence was compulsory. The Experiences Questionnaire (EQ), Non-attachment Scale (NAS), Positive and Negative Affect Schedule (PANAS), Satisfaction With Life Scale (SWLS), Temperament Character Inventory Revised (TCI-R-67), Five Facets Mindfulness Questionnaire (FFMQ), Self-Other Four Immeasurables (SOFI) and the MINDSENS Composite Index were administered. ANCOVAs and linear regression models were used to assess pre-post changes and mediation/moderation effects. Results: Compared to controls, retreatants showed increases in non-attachment, observing, MINDSENS, positive-affect, balance-affect, and cooperativeness ; and decreases in describing, negative-others, reward-dependence and self-directedness. Non-attachment had a mediating role in decentring, acting aware, non-reactivity, negative-affect, balance-affect and self-directedness ; and a moderating role in describing and positive others, with both mediating and moderating effects on satisfaction with life. Conclusions: A 1-month Vipassana meditation retreat seems to yield improvements in mindfulness, well-being, and personality, even in experienced meditators. Non-attachment might facilitate psychological improvements of meditation, making it possible to overcome possible ceiling effects ascribed to non-intensive practices. ; Mninisterio de Economía y Empresas ; Network for Prevention and Health Promotion in Primary Care grant from the Institute de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness ; European Union ERDF funds ; Ctr Invest Blomed Red Salud Mental, Primary Care Prevent & Hlth Promot Res Network, Fac Hlth & Sport Sci, Zaragoza, Spain ; Ctr Invest Blomed Red Salud Mental, Primary Care Prevent & Hlth Promot Res Network, Inst Aragones Ciencias Salud, Zaragoza, Spain ; Univ Valencia, Dept Personal Evaluat & Psychol Treatment, Valencia, Spain ; CIBERObn Giber Physiopathol Obes & Nutr, Santiago De Compostela, Spain ; Univ Autonoma Barcelona, Hosp Santa Creu & St Pau Barcelona, Spain Ctr Invest Biomed Red Salud Mental, Dept Psicol Clin & Salut,CIBERSAM,Serv Psiquiatri, Madrid, Spain ; Univ Fed Sao Paulo, Dept Prevent Med, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, Brazil ; Hosp Israelita Albert Einstein, Sao Paulo, Brazil ; Univ Complutense Madrid, Red PROMOSAM, Psychopathol, Valencia, Spain ; Baraka Inst, San Sebastian, Spain ; Miguel Servet Hosp, Zaragoza, Spain ; Univ Zaragoza, Ctr Invest Biomed Red Salud Mental, Inst Aragones Ciencias Salud, RedIAPP, Zaragoza, Spain ; Mente Aberta – Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil ; MINECO: PSI2012-35500 ; Network for Prevention and Health Promotion in Primary Care grant from the Institute de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness: RD12/0005 ; Web of Science

International audience ; Writing history in the Islamic world involves both a literary aspect and a material presentation of the texts. One finds in the Muslim world historical chronicles presenting data in the form of tables (jadwal; taqwīm) or or other synthetic graphic forms, which demonstrates the author's intention to carry out a selection among the data. A literature which could be qualified as "para-historical" (geographical books, biographic dictionaries, chancellery treatises) also uses graphic modes. Il seems that presentation of "history in images" mainlely appears from the 14th century onwards, until the 19th century. In this article the author examines the origins and motivations which led historians to adopt this synthetic presentation of data: needs of the readers, a fast acquiring of historical culture, pegagogical an/or political function? The study of Islamic historiography presented under this form is a totally neew field of research, which as far as we currently know raises more questions than it answers. As a form of introduction, the author analyses exemples of this kind of presentation of data in other fields than history (astronomy, medicine). Although it is posssible that the historians were influenced by this tradition used in sciences, it may also be that the origins of this use are older than Islam. ; L'écriture de l'histoire dans le monde islamique concerne à la fois l'aspect littéraire et la présentation matérielle du texte. Il existe dans le monde musulman des chroniques historiques qui présentent les données sous la forme de tableaux (ǧadwāl ; taqwīm) ou sous d'autres formes graphiques synthétiques, ce qui peut témoigner de la part des auteurs leur volonté d'effectuer une sélection dans les faits. Une littérature que l'on peut qualifier de « para-historique » (ouvrages géographique, dictionnaires biographiques, traités de chancellerie) utilisent également le mode graphique. Il semble que cette présentation de « l'histoire en images » apparaît surtout à partir du XIVe siècle et qu'elle se poursuit jusqu'au XIXe siècle. Dans cet article, l'auteur s'interroge sur les origines et les motifs qui ont conduit les historiens à adopter cette présentation synthétique des données : besoin du public, acquérir rapidement une culture historique, fonction pédagogique et/ou politique ? L'étude de l'historiographie islamique représentée sous cette forme constitue un domaine de recherche tout à fait nouveau qui dans l'état de nos connaissances soulève plus de questions qu'elle n'apporte de réponses. En guise d'introduction, l'auteur examine quelques exemples de présentation des données sous forme graphique dans d'autres domaines que l'histoire (astronomie, médecine). Bien qu'il soit possible que les historiens aient été influencés par cette tradition utilisée pour les sciences, il se pourrait que l'origine soit à rechercher en amont de l'islam

International audience ; Writing history in the Islamic world involves both a literary aspect and a material presentation of the texts. One finds in the Muslim world historical chronicles presenting data in the form of tables (jadwal; taqwīm) or or other synthetic graphic forms, which demonstrates the author's intention to carry out a selection among the data. A literature which could be qualified as "para-historical" (geographical books, biographic dictionaries, chancellery treatises) also uses graphic modes. Il seems that presentation of "history in images" mainlely appears from the 14th century onwards, until the 19th century. In this article the author examines the origins and motivations which led historians to adopt this synthetic presentation of data: needs of the readers, a fast acquiring of historical culture, pegagogical an/or political function? The study of Islamic historiography presented under this form is a totally neew field of research, which as far as we currently know raises more questions than it answers. As a form of introduction, the author analyses exemples of this kind of presentation of data in other fields than history (astronomy, medicine). Although it is posssible that the historians were influenced by this tradition used in sciences, it may also be that the origins of this use are older than Islam. ; L'écriture de l'histoire dans le monde islamique concerne à la fois l'aspect littéraire et la présentation matérielle du texte. Il existe dans le monde musulman des chroniques historiques qui présentent les données sous la forme de tableaux (ǧadwāl ; taqwīm) ou sous d'autres formes graphiques synthétiques, ce qui peut témoigner de la part des auteurs leur volonté d'effectuer une sélection dans les faits. Une littérature que l'on peut qualifier de « para-historique » (ouvrages géographique, dictionnaires biographiques, traités de chancellerie) utilisent également le mode graphique. Il semble que cette présentation de « l'histoire en images » apparaît surtout à partir du XIVe siècle et qu'elle se poursuit jusqu'au XIXe siècle. Dans cet article, l'auteur s'interroge sur les origines et les motifs qui ont conduit les historiens à adopter cette présentation synthétique des données : besoin du public, acquérir rapidement une culture historique, fonction pédagogique et/ou politique ? L'étude de l'historiographie islamique représentée sous cette forme constitue un domaine de recherche tout à fait nouveau qui dans l'état de nos connaissances soulève plus de questions qu'elle n'apporte de réponses. En guise d'introduction, l'auteur examine quelques exemples de présentation des données sous forme graphique dans d'autres domaines que l'histoire (astronomie, médecine). Bien qu'il soit possible que les historiens aient été influencés par cette tradition utilisée pour les sciences, il se pourrait que l'origine soit à rechercher en amont de l'islam

• Mayor George S. Buck and Acting Health Commissioner Franklin C. Gram passed stricter measures yesterday.• At 3:30 pm yesterday, the health dept. became so overwhelmed with reports, the "telephone exchange could not handle them."• 812 cases at that time, also 22 deaths from influenza and 19 deaths from pneumonia.• Yesterday at 11 pm, there were 1,237 cases for the past 24 hours, average of 50/hour.• In that same 24 hours, 55 deaths from influenza and pneumonia.• Mayor George S. Buck increased the order, which now includes "all businesses not conducted for the distribution of food, clothing, medicines, and other essentials and all indoor meetings of more than ten persons unless authorized by the health commissioner."• Exceptions include governmental meetings, military gatherings, and meetings related to the Liberty loan.• Casket dealers in Buffalo told Commissioner Franklin C. Gram that there were not enough caskets to bury influenza victims within 24 hours of their deaths.• Commissioner Franklin C. Gram then announced that the dept. of health will produce caskets if there are not enough, and they sold at no cost to all, and will be given away to the poor.• "The health commissioner and his advisory committee announced that universal wearing of a cloth or gauze mask over the nose and mouth would stamp out the epidemic in a week or ten days."• Health Commissioner Franklin C. Gram recommends that everyone wear masks at home and in public areas. This may become an order if the influenza situation gets worse.• Employees of the health dept. and Health Commissioner Franklin C. Gram and some of his assistants have been seen wearing masks.• Major Brownrigg of Ft. Porter said that all doctors, nurses, and hospital corps men at the fort will have to wear masks all the time, under military order.• Post office, police, and fire departments will be requested to do the same.• Dr. Charles G. Stockton and Dr. Dewitt H. Sherman, members of the general committee, said they will be wearing masks today. • Others at the meeting yesterday included: Finley H. Greene, W. H. Pillsbury from the school dept., Chief Clerk August A. Schneider from the health dept, Dr. Frederick B. Willard, Major Brownrigg, and H. B. Franklin. Dr. Edward J. Meyer called by phone to give his report about "the hospital situation."• The new order will close "five and ten cent stores, pool rooms, bowling alleys, ice cream soda fountains, swimming pools, and other non-essential places."• "Department and clothing stores, groceries, drug stores, restaurants, and similar places will not be closed."• Indoor meetings of more than ten people will be prohibited, specifically regulated to avoid individuals evading the rules.• Health dept. employees will be on duty in shifts during the day and night during the epidemic.• In addition, the city is divided into 21 districts, with each district having a health inspector in charge of enforcing the regulations.• Military authorities at Ft. Porter provided 100 "sample masks" to use in educational displays for how they are to be used.• The Red Cross is making more of these masks.• Last night, a consignment was received from the Twentieth Century club Red Cross.• Chief Girvin will direct uniformed distribute information about how to care for influenza, as well as preventive measures, to all houses in the city.• "Broadside" sheets will be posted on telegraph poles and in factories today.• For the next week, information will be also distributed through the payroll of factories.• Health Commissioner Franklin C. Gram rejected the request of the Christian Science churches for exception from the order, and also announced that the Erie County Medical society's meeting will also be canceled for this month.• "The doctors will have no special privileges."• Mayor George S. Buck's proclamation is printed in this article, basically restates all the rules these articles describe.• It broadens the things that are restricted, and Mayor George S. Buck says, "The duration of this epidemic in Buffalo will depend very largely upon the honest cooperation of every individual citizen."• Chairman of the committee on factory control in the anti-influenza campaign Dr. P. H. Hourigan announced last night there will be a conference of all industrial physicians of Buffalo tonight at 8:30 pm at the Larkin Men's club rooms. This meeting will be to "arrive at uniform and cooperating methods of controlling the epidemic through factories."• All physicians are requested to come to this conference.• City bacteriologist, Dr. William G. Bissell, will talk about prevention/treatment of influenza.• General Chairman of the committee Finley H. Greene requested that factory superintendents post signs about how to prevent influenza near time clocks and in other places. This information could be cut out of newspapers and hung up.• Health Commissioner Franklin C. Gram denounced "quack medicine salesmen," saying that anyone that tried to sell things door to door to make money from this situation would be prosecuted.• Dr. Franklin C. Gram: "This is no time for medicinal profiteering. I have heard of quack nostrums being peddled. The police are notified to arrest anyone found in that business. The remedies for influenza are simple, cheap, and can be procured at any drug store. Influenza requires a cathartic, a gargle, and an oil for the nasal passages. A teaspoon of salt in a glass of water will do for a gargle. Vaseline or olive oil are soothing oils. Fresh air, good care and confidence are essential."• Dr. Franklin C. Gram had a meeting of the epidemic control committee in his office, and the members discussed preventive measures, including the suggestion that everyone in Buffalo wear a mask over the nose and mouth.• This is not an order yet because the committee would like to gain "popular support."• Masks are "easy to make," made out of gauze, cotton cloth, handkerchief, any cloth to cover nose and mouth.• Dr. Charles G. Stockton: "If everyone in the country would go masked at all times the epidemic would be conquered in the United States in a week to ten days."• Major Brownrigg of Ft. Porter, as well as the other doctors present, all agreed on the plan as effective, but possibly difficult to enforce.• The committee decided to wait to make the request an order until the other measures recently adopted were tested.• The two large casket corporations which usually supply Buffalo have said they cannot meet current demands. • Typically, the demand is for 30/day, but the number of deaths due to influenza and pneumonia alone exceed this number.• Casket manufacturers said that tomorrow there will be no caskets in Buffalo.• Health Commissioner Franklin C. Gram replied to this by saying that he has told the bureau of sanitation to produce caskets if there are no more. The health dept. will sell them to families, and give them away to the poor. ; Newspaper article ; 1, 5

AR is supported by the Swedish Research Council (#2019-01035); the Swedish state under the agreement between the Swedish government and the country councils, the ALF-agreement (#ALFGBG-717541); and King Gustaf V's 80-year foundation (#FAI-2019-0603). MS is supported by the Gothenburg Society of Medicine (#GLS-935039). DN is supported by The Academy of Finland, Finska Läkaresällskapet, and Institutional grant of Helsinki University Hospital. KB is supported by the Swedish Research Council (#2017-00915); the Alzheimer Drug Discovery Foundation (ADDF), USA (#RDAPB-201809-2016615); the Swedish Alzheimer Foundation (#AF-742881); Hjärnfonden, Sweden (#FO2017-0243); the Swedish state under the agreement between the Swedish government and the County Councils, the ALF-agreement (#ALFGBG-715986); the European Union Joint Program for Neurodegenerative Disorders (#JPND2019-466-236); and the National Institute of Health (NIH), USA (grant #1R01AG068398-01). HZ is a Wallenberg Scholar supported by grants from the Swedish Research Council (#2018-02532); the European Research Council (#681712); Swedish State Support for Clinical Research (#ALFGBG-720931); the Alzheimer Drug Discovery Foundation (ADDF), USA (#201809-2016862); the AD Strategic Fund and the Alzheimer's Association (#ADSF-21-831376-C, #ADSF-21-831381-C, and #ADSF-21-831377-C); the Olav Thon Foundation, the Erling-Persson Family Foundation, Stiftelsen för Gamla Tjänarinnor, Hjärnfonden, Sweden (#FO2019-0228); and the European Union's Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No 860197 (MIRIADE) and the UK Dementia Research Institute at UCL. Open access funding is provided by the Gothenburg University library. Publisher Copyright: © 2021, The Author(s). ; Background: The type I interferon (IFN) gene signature is present in a subgroup of patients with early rheumatoid arthritis (RA). Protein levels of IFNα have not been measured in RA and it is unknown whether they associate with clinical characteristics or treatment effect. Methods: Patients with early untreated RA (n = 347) were randomized to methotrexate combined with prednisone, certolizumab-pegol, abatacept, or tocilizumab. Plasma IFNα protein levels were determined by single molecular array (Simoa) before and 24 weeks after treatment initiation and were related to demographic and clinical factors including clinical disease activity index, disease activity score in 28 joints, swollen and tender joint counts, and patient global assessment. Results: IFNα protein positivity was found in 26% of the patients, and of these, 92% were double-positive for rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). IFNα protein levels were reduced 24 weeks after treatment initiation, and the absolute change was similar irrespective of treatment. IFNα protein positivity was associated neither with disease activity nor with achievement of CDAI remission 24 weeks after randomization. Conclusion: IFNα protein positivity is present in a subgroup of patients with early RA and associates with double-positivity for autoantibodies but not with disease activity. Pre-treatment IFNα positivity did not predict remission in any of the treatment arms, suggesting that the IFNα system is distinct from the pathways of TNF, IL-6, and T-cell activation in early RA. A spin-off study of the NORD-STAR randomized clinical trial, NCT01491815 (ClinicalTrials), registered 12/08/2011, https://clinicaltrials.gov/ct2/show/NCT01491815. ; Peer reviewed

This guide accompanies the following article: Dena T. Smith, 'A Sociological Alternative to the Psychiatric Conceptualization of Mental Suffering', Sociology Compass 5/5 (2011): 351–363, [DOI]. 10.1111/j.1751‐9020.2011.00369.x.Author's introductionThis article provides an introduction to the utility of sociology for studying suffering, particularly mental suffering. Further, this paper highlights the differences between the sociological and psychiatric approaches to understanding mental illness and mental suffering. The study of suffering is a longstanding tradition in sociology; Macro sociological studies focus on the likelihood to suffer under certain social conditions, while the micro‐level approach attends to definitions, and experiences of suffering. It is the ability to study both the macro and micro that make sociology so well‐equipped to address the complex concept of suffering. In short, this paper highlights the importance of a multidimensional perspective on suffering. As an example of the crucial role for sociologists in fully explicating suffering, I describe the narrow conceptualization of mental suffering (as mental illness) in contemporary psychiatry. While mental illness refers to specific symptom sets as defined by The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), mental suffering is something much more general and elusive to define and needs an explanation that extends beyond illness. This article provides: a broad overview of sociological understandings of suffering, a brief survey of sociological explanations of mental illness and mental suffering, and an exploration of biological psychiatry's approach to understanding mental strife.Author recommends

Horwitz, Allan 2002. Creating Mental Illness. Chicago: University of Chicago Press.
Cassell, Eric J. 2004. The Nature of Suffering and the Goals of Medicine. Oxford: Oxford University Press
Conrad, Peter 1992. 'Medicalization and Social Control.'Annual Review of Sociology 18: 209–32.
Kleinman, Arthur, Veena Das and Margaret Lock 1997. Social Suffering. Berkeley: University of California Press.
DeGloma, Thomas 2009. 'Expanding Trauma through Space and Time: Mapping the Rhetorical Strategies of Trauma Carrier Groups.'Social Psychology Quarterly 72: 105–21.
Wilkinson, Iain 2005. Suffering: A Sociological Introduction. Cambridge, UK: Polity.

Online materials

Depression, Culture and Genetics – A Podcast with Allan Horwitz: http://thesocietypages.org/officehours/2010/01/19/depression‐culture‐and‐genetics/
The Medicalization of Everything: A Podcast with Peter Conrad: http://thesocietypages.org/officehours/2010/08/02/peter‐conrad‐on‐the‐medicalization‐of‐everything/
http://www.nimh.nih.gov/index.shtml
American Psychiatric Publishing: http://www.psychiatryonline.com/

Focus questions

What is the difference between a macro and micro approach to studying mental suffering? What does each approach offer?
What is the psychiatric notion of mental illness and suffering? How does it differ from a sociological understanding?
Why would a multidimensional analysis of mental suffering add to understanding mental illness and suffering? Why is sociology so useful in this endeavour?

Seminar/Project ideaStudents identify one kind of mental suffering (specific mental illnesses such as depression or bipolar disorder would be one option) and write a paper on how a multidimensional analysis would be beneficial in order to fully understand their chosen issue. In other words, students would investigate the dominant, biological conceptualization, and then describe what sociological analysis already exists, and how the sociological imagination might more fully address the chosen form of suffering. An option would also be to have students present their case to the class.