психиатрия (страница 5)

Автор: Montgomery Stuart A

Successful management of patients with treatment-resistant depression is going to require a thorough understanding of the biological basis for both the depression and its failure to respond to standard treatments. This book clearly and succinctly summarizes the latest scientific research and its applications in clinical practice. A first step is a clear definition of what constitutes treatment-resistant depression so that clinical trials and other studies are using common criteria, enabling comparison and meta-analysis of their outcomes. The opening chapter reviews definitions and predictors of originating from different fields and discusses their usefulness in clinical practice and clinical research. The next chapter proposes a new definition, adapting terminology from medicine. Biological classification requires identification of genetic risk factors: with gene variants accounting for 50% of the variance in the clinical outcomes of antidepressant treatments this is clearly a fruitful area of research. Chapter 3 describes several genes already associated with treatment-resistant depression and, while further work is needed to translate findings into clinical recommendations, predicts that genetic prediction of TRD could became a widespread clinical reality within a few years. Most patients with TRD will be treated pharmacologically and three chapters review the latest evidence for pharmacological best practice, including switching strategies for antidepressants, the role of antipsychotics and augmentation strategies to complement lithium. There are two major alternatives to pharmacotherapy: neuromodulation and psychotherapy. The brain intervention chapter summarizes clinical research and experience with electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, deep brain stimulation and magnetic seizure therapy. The final chapter reviews the literature pertaining to the effectiveness of various forms of psychotherapy in patients who have not responded to antidepressant pharmacotherapy, revealing that patients who have not responded to one or two trials of antidepressant medication have a 30%-50% chance of responding to a focused psychotherapy. It proposes indications for psychotherapy in TRD and summarizes general therapeutic principles.

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Автор: Gregory Bock R

Cigarette smoking is estimated to lead to 4.9 million premature deaths per year worldwide. This is predicted to rise to 10 million by 2020. In western countries it kills half of all smokers who fail to stop. The prevailing model for tobacco addiction is that nicotine from cigarettes rewards smoking and punishes abstinence, tapping into a motivational system of operant conditioning that requires no conscious awareness. However, there are also accounts which involve cognitive biases and the effect of nicotine on impulse control. The brain pathways involved have been studied extensively, but the role of different nicotine receptor subtypes and other neurotransmitter systems is still subject to debate. In western countries, cigarette smoking as an adult has a heritability of 30-50% and candidate genes have been identified that may contribute in part to addiction susceptibility. Many socio-cultural correlates of cigarette smoking have been established, but a comprehensive model that accounts for these and links them with the psychobiological aspects of nicotine addiction has not been forthcoming. Structured behavioural support programmes aid cessation attempts, as do a number of pharmacotherapies, most notably nicotine replacement treatments and bupropion, but the underlying mechanisms are unclear. This book deals with the problems involved in understanding and treating nicotine and tobacco addiction. Topics covered include the nature of the worldwide health problem posed by cigarette smoking, the psychodynamics of cigarette addiction, and the basic pharmacology and biochemistry of nicotine and its effect on the brain. Further chapters analyse the genetic basis of susceptibility to nicotine addiction. Finally, the contributors address approaches to therapy. A continuing theme in the discussions throughout the book is how best to treat nicotine addiction, given that many smokers would like to stop smoking but are unable to do so because of their addiction. This book will be of great value to all psychologists and psychiatrists working on addiction, specifically to nicotine but also to other compounds and behaviours. It will also be of interest to neuroscientists and pharmacologists working on nicotine receptors and the brain pathways involved in dependence, as well as to biochemists, molecular biologist and to public health officials.

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Автор: Arnaldur Indri?ason

In den Tiefen des Langj?kull-Gletschers wird die Leiche eines seit Jahrzehnten vermissten Gesch?ftsmannes entdeckt. Damals wurde die Suche nach ihm eingestellt. Zwar war ein Kollege des Mannes des Mordes verd?chtigt worden, aber die Beweise fehlten. Kommissar Konr?? blieb jedoch stets von dessen Schuld ?berzeugt. Inzwischen ist Konr?? pensioniert, aber der Fund des Vermissten l?sst die Erinnerungen wieder wach werden. Und Konr?? beschlie?t, den Fall noch einmal aufzurollen. Mit dramatischen Folgen …

Исполнители: Walter Kreye

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Автор: Группа авторов

Water, energy and food are key resources to sustain life, and are the fundamental to national, regional and global economies. These three resources are interlinked in multiple ways, and the term “nexus” captures the interconnections. The nexus has been discussed, debated, researched, and advocated widely but the focus is often on the pairings of “water-energy” or “water-food” or “energy-food”. To really benefit from the nexus approach in terms of resource use efficiency it is essential to understand, operationalize and practice the nexus of all three resources. As demand for these resources increases worldwide, using them sustainability is a critical concern for scientists and citizens, governments and policy makers. Volume highlights include: Contributions to the global debate on water-energy-food nexus Examples of the nexus approach in practice from different regions of the world Perspectives on the future of the nexus agenda Water-Energy-Food Nexus: Theories and Practices is a valuable resource for students, research scholars and professionals in academic institutions with strong interests in interdisciplinary research involving geography, earth science, environmental science, environmental management, sustainability science, international development, and ecological economics. The volume will also be useful for professionals, practitioners and consultants in /NGOs, government, and international agencies.

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