Job satisfaction greatly determines the productivity and efficiency of human resources for health. Job satisfaction is said to be linked with employee's work environment, job responsibilities, powers; and time pressure among various health professionals. Objective of this study is to find out level of nurse job satisfaction and its association with different demographical variables.

Across section study was conducted in major eight hospitals in Erbil city which is the capital of Iraqi Kurdistan Region, from 1st of January 2012 to 1st January of 2013. Convenient type sample was choosed and involved 127 College graduated nurses from all (200) nurses in the service. Two types of questionnaires were used, 1st one closed ended questionnaire that include demographical criteria. 2nd type was Job Satisfaction Scale, a five-point Likert type scale with 15 items. SPSS was used for entering data and analyzing the results.

Out of all 127 nurses 63.8% were neither satisfied nor unsatisfied, 22% were satisfied while only 14.2 were not satisfied with their job. There was one only significant relation between job satisfaction and gender with p value≤ 0.05, while there were no significant association observed between job satisfaction and other demographic variables.

Our findings state a low level of overall satisfaction among nurses in major governmental hospitals in Erbil city. This ambiguous response may be due to poor environment of work, unclear future promotion, missing their real work position, attention and respect.

School dropout and subsequent youth unemployment are important risk factors for mental problems. It is important to understand which factors that may lead to youth dropping out of high school.

The aims were to explore the subjective experiences of people who had not completed high school and who had problems getting work. To examine how the parents’ involvement in the children's lives influenced their schooling experiences.

Five Norwegian men and five women (aged 18–28) who had not completed high school and who had not been able to find work were interviewed qualitatively. The interviews were transcribed in full and analyzed drawing on Grounded Theory.

The informants had struggled with an accumulation of risk factors constantly challenging their resilience, eventually resulting in dropout. In these individual educational trajectories, one experience was shared by most: the lack of stable parental involvement. Moving between parents or losing contact with parental figures all together made the direct involvement from parents in the child's learning activities over time more complicated. Several had experienced intense levels of marital conflict often ending in divorce with periods of little or no contact with one parent, thus threatening the child's emotional security and resulting in withdrawal or aggressive behavior. The low-achieving boys gave the non-practical focus of the high school curricula as an explanation for dropout. The high-achieving boys reported shyness. The girls focused on social and family issues.

This qualitative study suggests that parental involvement may be of importance to drop-out from school.

Although asthma has been one of the most investigated topics in psychosomatics, studies and papers on psychopathology in asthma are fairly scarce and of diverse meaning. Furthermore, psychopathology acoording to sex in asthma is not a common research topic.

Aim This study aims at analyzing psychopathology sex differences in asthmatics.

The psychopathology profile in a sample of 84 adult asthmatics in a hospital outpatient facility, mean age 34.62 (s.d.12.78), 36 male / 48 female, is studied. The Symptom Checklist-90-R (SCL-90-R) Self-Report Questionnaire was administered.

The symptomatic profile is characterized by higher scores in women, with a main elevation in the dimensions of Somatization (1.92), Depression (1.66), Obsession-Compulsion (1.62) and Anxiety (1.44) whereas lower scores are recorded in men, with a profile dominated by Hostility (1.70), Anxiety (1.68), Interpersonal Sensitivity (1.58) and Depression (1.44). These scores mainly contribute to the psychopathology pattern according to sex.

The possible clinical implications of the observed psychopathology sex differences should be taken into account in the management of these patients.

Recently, a renaissance of interest in ‘negative symptoms’ as emotional withdrawal or blunted affect, has occurred. Some investigators believe that these symptoms are important indicators of outcome, of response to treatment and of a distinct underlying pathologic process.

Research on the negative-symptom syndrome in schizophrenia has been handicapped until recently.

This research aims at studying whether acute phase proteins, precisely, Alpha1-glycoprotein, can be considered as a marker of negativesymptom in Schizophrenia.

29 chronic schizophrenics were assessed by the Positive and Negative Syndrome Scale (PANSS). A routine blood test including Alpha1-glycoprotein levels was carried out.

Alpha1-glycoprotein shows a positive correlation, according to Pearson correlation coefficient, with the Negative Scale at an almost significant level (p=.05), and at a significant level in the following items, Blunted affect (p=.03), Passive/apathetic Social Withdrawal (p=.01) of the Negative spectrum and Poor Attention (p=.02) of the General Psychopathology Scale.

There is a significant correlation with two Negative variables and an almost significant one, spite of the small sample, with the Negative Scale. Further studies with bigger samples are needed in order to consider alpha1-glycoprotein as a schizophrenia negative psychopathology marker.

The team work in institutions represents an evolution in the treatment of serious diseases when it makes the institution itself lightweight, affordable, reliable and effective at the same time. The present paper describes an experience of three years in a psychiatric day hospital where medical and psychotherapeutic aspects were incorporated into an original model, taking into account the valuable experiences of Racamier and Kaes in France, the observations on ‘something more’ of the Boston group (Stern et al.), the work of Correale in Italy.

In the present work we describe and evaluate the therapeutic model using three main indicators: treatment compliance, acute episodes and hospitalizations required in the observed period.

To identify which factors of our therapeutic model are relevant to severe mental disorders treatment.

The model offers patients, in the same session of care, psychiatric, psychotherapeutic, test taking, medical and rehabilitation services. The process involves three steps: evaluation, core-therapy and follow-up. Approximately 300 patients were treated following this protocol within three years of observation.

The indicators used in our model suggested a relationship between a successful treatment and patient's ability to actively use spaces of ‘institutional opportunity’ specifically designed in the project developed by the team.

An effective institutional treatment allows the patient to draw on personal coping skills, and not to be passivated thanks to the ‘real free spaces’ existing between a structured intervention and another.

More than 60% of psychiatric patients are smokers. Besides a culture of smoking allowance amongst these patients, in the last years all psychiatric services in developed countries are becoming smoking free. Several studies have found negative expectancies in staff and patients where smoking bans are planned. Nevertheless, not many studies have focused on objective measures as changes in medication and features of the admissions period.

We want to find differences in terms of clinical and treatment management in psychiatric hospitalization associated to smoking ban.

We collected data (regarding medication, socio-demographic and admission characteristics) from all patients admitted to an acute psychiatric hospital in two different time periods, before and after the smoking ban was in force. We collected data (regarding medication, sociodemographic and admission characteristics) from all patients admitted to an acute psychiatric hospital in two different time periods, before and after the smoking ban was in force.

More number of leaves of absence (p=0,020) and movement restrictions (p=0,001) during the ban period occurred in comparison to the pre-ban period. On the contrary a lack of significant differences in terms of hospital stay (duration (p=0,479), rate of involuntary admissions (p=0,371) and voluntary discharges (p=0,377)), use of sedatives and doses of antipsychotics was found (p= 0,640 and p=0,194).

More number of leaves of absence (p=0,020) and movement restrictions (p=0,001) during the ban period occurred in comparison to the pre-ban period. On the contrary a lack of significant differences in terms of hospital stay (duration (p=0,479), rate of involuntary admissions (p=0,371) and voluntary discharges (p=0,377)), use of sedatives and doses of antipsychotics was found (p= 0,640 and p=0,194).

The smoking-ban may have driven to increased grants for leave of absence that secondarily may have underpin demands for leave of absence in patients not allowed to and thus, it may have contribute to an increase in movement restrictions. Further studies with longer periods after the ban may clarify this issue. The smoking-ban may have driven to increased grants for leave of absence that secondarily may have underpin demands for leave of absence in patients not allowed to and thus, it may have contribute to an increase in movement restrictions. Further studies with longer periods after the ban may clarify this issue.

Autism spectrum disorder (ASD) affects 20–30% of adults with intellectual disability. This group are vulnerable to challenging behaviour and mental health problems.

To explore the extent to which ASD affects challenging behaviour among specialist mental health service users with intellectual disability.

To identify predictors of challenging behaviour among adults who have intellectual disability.

A cross-sectional study of 92 participants from a specialist mental health service for adults with intellectual disability in the UK. The presence/absence of ASD was confirmed using the Autism Diagnostic Observation Schedule. Challenging behaviour was assessed using the Developmental Behaviour Checklist (DBC).

Participants with ASD (N=48) had higher total DBC scores than those without ASD (N=44; mean=54.2 vs. 29.2). ASD, severity of intellectual disability, age, presence of psychiatric disorder and total number of needs were entered as independent variables into a linear regression. The model accounted for 51% of the variance and was statistically significant (F(5,91)=18.1, p<0.001). Presence of ASD and total number of needs were the only significant predictors of challenging behaviour. Presence of ASD had the highest standardised coefficient (β=0.56).

Participants with ASD had significantly higher levels of challenging behaviour than those without ASD. Challenging behaviour was also independently associated with total number of needs. Understanding which service users with intellectual disability have higher levels of challenging behaviour than others despite receiving psychiatric treatment, and the extent to which having ASD is a contributing factor, should inform the development of more effective services and lead to improved outcomes.

Pregabalin is a novel GABA-analogue approved for the treatment of partial onset seizures, neuropathic pain, and general anxiety disorder. Pregabalin has been classified as a Schedule V drug with a low risk of inflicting abuse or addiction. However, some publications have indicated that pregabalin may have a potential for abuse among patients with past or current opiate addiction.

We hypothesized that pregabalin might be abused my patients who were undergoing an opiate replacement therapy and never had an indication for taking pregabalin on medical grounds.

Urine specimens from 124 patients with opiate dependency syndrome and from 111 patients with other addiction disorders (alcohol, benzodiazepines, cannabis, amphetamines) were screened for pregabalin by means of a mass spectrometer analysis.

We found 12.1% of all urine specimens from patients with opiate addiction to be positive for pregabalin. None of the patients concerned had a medical indication for using pregabalin. In the control group, 2.7% of the patients were tested positively for pregabalin, due to their taking it regularly for chronic pain or general anxiety.

Our data suggest that pregabalin is liable to be abused among patients with opiate dependency syndrome. Thus, vigilance and caution are called for when patients with a past or current opiate dependency are exposed to treatment with pregabalin.

Among abstinent alcohol-dependent patients, sleep disorders are a wide-spread and persistent problem and have been associated with the risk of alcohol relapse. The melatonin-agonist agomelatine has been shown to improve overall sleep quality without daytime sedation.

To examine the effect of agomelatine on sleep quality in abstinent alcohol-dependet patients suffering from chronic sleep disorders.

9 alcohol-dependet patients suffering from chronic sleep disorders received nightly doses between 25 and 50 mg of agomelatine. Sleep quality was assesed using the Pittsburgh Sleep Quality Index prior and following 6 weeks of treatment with agomelatine. Prior and during treatment with agomelatine all patients were monitored for serum levels of liver enzymes.

After 6 weeks of agomelatine treatment, the Pittsburgh Sleep Quality Index global score for all patients had decreased significantly.

The present data suggest that agomelatine may improve the sleep quality of alcohol-dependent patients suffering from chronic sleep disorders.

Patients with severe mental illness (SMI) experience a 13- to 30-year reduction in life-expectancy. The majority of these deaths can be attributed to somatic health problems. The risk on somatic health problems is partly increased due to a reduced ability to request care and a health care organisation that is unable to fulfil the needs of these patients. Our previous work shows that a health-check-intervention can bypass the inability to request help of patients with SMI by detecting somatic healthproblems that were not detected previously[1].

To develop policy-recommendations to improve the health care organisation for the physical health of outpatients with SMI.

We aim to present a selection of policy-recommendations based on consensus between patients, family carers, general practitioners(GP) and mental health care staff

We used a three-round Delphi method. The first round consisted of an inventory of potential policy-recommendations, in the two consecutive rounds consensus was sought on a selection of recommendations.

The policy recommendations described improvement in collaboration among health care professionals; the need to educate involved professionals regarding the specific medical risks associated with patients with SMI; and defining the differences between GPs and mental health care professionals regarding their responsibilities to provide adequate care for the physical health of SMI patients.

Currently there are multiple barriers to optimal health care which can be overcome by implementing the suggested policy recommendations.

The GAF is a worldwide known rating scale for severity of illness in psychiatry and very much used in research papers. GAF covers the spectrum from positive mental health to severe psychopathology on a 100-points scale (1–100). From systematic literature reviews (Aas 2010; 2011), we know there are problems with GAF, including reliability and validity problems. How good GAF is, is an important question. Systematic literature searches have not identified qualitative studies of clinicians experience with GAF.

To collect information which can play a role in work to improve GAF.

An interview guide (with 28 questions) for qualitative interviews of clinicians was developed, with focus on issues considered important for an improved GAF (Aas 2010; 2011). Purposive sampling is used and sample size decided by saturation. Respondents varies in, for example: profession (psychiatrists, psychologists), experience with diagnostic categories, years of experience from psychiatry, and organization they work for.

The qualitative interviews have resulted in a considerable amount of information.

Collected information confirms that clinicians have unique experiences of importance for further work towards an improved GAF.

The decreased cerebral blood supply and hypoxia can impair the brain development of children with congenital heart defects (CHD) in utero.

We explored the impact of cardiopulmonary bypass (CPB) surgery on neurodevelopment outcomes in infants with CHD.

To assess psychomotor development of infants that underwent CPB surgery for CHD using the autologous placental umbilical cord blood (APUCB) in the first hours of life.

To prevent psychomotor retardation in infants after CPB surgery and implement early psycho-diagnosis and psycho-correction measures.

We analyzed a database of children enrolled in prospective studies on surgical support techniques from 2010 to 2012. We used the Bayley Scales of Infant Development (BSID-II) to study the cognitive and motor development. The study involved 90 infants of 1 to 2.5 years of age with CHD. Study group included 28 infants that underwent surgery with CPB and APUCB, conventional group included 62 infants that underwent surgery with CPB and donor blood.

Although the aggregate group of infants after CPB surgery displayed the mental retardation and/or psychomotor development in 40% of infants the average mental (MDI) and psychomotor (PDI) indices were within normal age limits in study and conventional group of infants respectively. The study group tended to show higher MDI 94.5±15.8 and PDI 91.4±15.3 compared with conventional group MDI 90.3±13.4 and PDI 86.3±14.5.

The considerable number of infants with cognitive retardation implies the development of early psychosocial programme of assistance to patients and the optimization of surgery using APUCB instead of donor blood.

The ability to recognize emotion is part of social cognition, a frequently analyzed parameter nowadays in the psychotic spectrum and also in other psychiatric disorders. The importance of this parameter is due to its facilitating role for psychotherapy and also by the role it plays for the social functioning of a person.

The evaluation of the relationship between emotion recognition and neurocognition in subjects with Bipolar Disorder.

The development of some specific intervention programs for subjects with Bipolar Disorder.

A group of subjects (n=34) with Affective Bipolar Disorder, according to ICD 10, was analyzed. The subjects had a clinical evolution between 5 and 10 years and they clinically presented psychotic symptoms. The parameters analyzed were: socio-demographical ones, neurocognition (attention, memory, executive function) and social cognition (emotion recognition ability).

A statistical significant correlation exists between the subjects ability to recognize ‘Joy’ and ‘Love’ (Spearman R = 0.403, p < 0.05). This shows a connection between these two emotions. Also there is a significant correlation between neurocognition and performance in emotion recognition (Spearman R = −0.504 and Spearman R = −0.421, p < 0.05).

Subjects with Bipolar Disorder show a lowered ability to be attentive, a decreased speed for processing information and a reduced performance in executive functions that are correlated with difficulties in recognizing emotions.

An increase of suicide rates have been associated with periods of economic crisis. Suicide rates in Spain are the first cause of nonnatural death, having surpassed traffic crash rates.

To study if the economic crisis affected the suicide rates and antidepressant consumption.

Suicide rates were extracted from the Spanish Statistic National Institute. Data about antidepressant consumption were extracted from the web page of the Spanish Department of National Health. Mean rate of suicide and mean rate of antidepressant consumption prior (2005–2007) and during the economic crisis (2008–2010) were compared. Data on antidepressant consumption are presented as antidepressant units per 100 people/year. Suicide rates are presented as rate per 100.000 people/year. Data are presented as mean ± standard deviation.

Unemployment mean rate was 9.2 ± 1.4 before the economic crisis, while it was 17.7 ± 20.5 during the economic crisis (p = 0.03). Mean rate of suicide before the economic crisis was 7.7 ± 0.19 while during the crisis was 7.2 ± 0.14 (p = 0.15). Antidepressant consumption increased significantly (p = 0.02) before the crisis (48.5 ± 11.9) compared to the crisis period (59.7 ± 16.7).

Our data show that during the Spanish economic crisis there was not an increase in the suicide rate but the antidepressant consumption increased significantly. Our results point to the fact that the Spanish population in time of economic crisis tend to take antidepressants instead of committing suicide.

The 2012, report ‘In the Line of Duty’ by the Ontario Ombudsman into the handling of Operational Stress Injuries (OSI) by the Ontario Provincial Police (OPP) and other Ontario police forces recommended that a study of all its officers be conducted to establish the prevalence of OSI. The purpose of this study, therefore, is to establish the current prevalence of OSI within the police forces of Ontario.

All (approximately 6,500) uniformed police officers, operational civilian employees, and formerly serving members of Ontario police forces are eligible for this study. Participants are contacted by e-mail and invited to complete an anonymous on-line survey that collects information on mood disorders, substance abuse, suicidality, police stress, stigma, and traumatic exposures. OSI is measured with the Post Traumatic Stress List (PCL) adopted for police. Results are analyzed according to police service (OPP or municipal police force), formerly serving members by service, and civilian employees by service.

OSI rates in police forces are compared to the 2012 Canadian military results. OSI rates are controlled for age, gender, general health, chronic conditions, pain and discomfort, physical activity, and childhood experiences. Correlations between stress (traumatic, operational, and organizational) and OSI are reported. Data are currently being analyzed.

Without a grasp on the severity and prevalence of OSI in Ontario police forces it is impossible to put into place prograns for prevention and recovery. This is the first and only study of the Ontraio ploice forces and will provide useful methodological and operational information.

Professor Liu, President of Shenzhen Kangning Hospital, came to Canada in 2008 and learned that Assertive Community Treatment Team (hospital without walls) might be one of the solutions to the shortage of inpatient beds. I was invited to conduct site visits, consultations, training sessions and workshops for the mental health professionals in Shenzhen since 2009. Doctors and administrative staff from Shenzhen were sent to Toronto, Canada to learn about the program implementation. Finally the Shenzhen ACT in China was established in November 2012.

To describe the development and adaptation of ACT model in Shenzhen China. To report the success and challenges of ACTT development in China.

To define the history and the purpose, its principles, its internal structure, the team composition, team dynamics, the target population, its characteristics of Shenzhen ACT within the demographic context. I will share my subjective experience regarding my observation, my perspectives and a brief comparison with ACT Teams in Toronto, Canada will be highlighted.

The China Shenzhen ACT Team was born in an institutional context where the community mental health care was still novel and not having enough infrastructures to support the work.

The Shenzhen ACT Team is the first ACT in China to experience the effectiveness and efficiency in taking care of severe mentally ill patients in the community. They have successfully implemented ACT service with the support from the hospital, municipal government and the neighbourhood community.

Female sexual dysfunction is a common problem with detrimental effects on woman's quality of life. It also has an economical and societal impact. It is defined as disorders of sexual desire, arousal, orgasm, and sexual pain which lead to personal distress.

The study was planned to determine the prevalence and determinants of female sexual dysfunction in women attending family health centers clinics in Alexandria.

Totally, 369 women aged 18–59 years were interviewed while they were attending Family Health Centers FHCs in Alexandria. Data were collected by personal interview in a questionnaire format in addition to physical examination (when allowed).

Arabic version of Female Sexual Function Index (ArFSFI) was used to evaluate sexual function.

The mean age of women was 29.62 ± 6.14 years. 73.4% of women had one or more sexual problems; however, 22.1% of the women with sexual problems were not distressed by these issues. We found that 66.4% of women had desire disorder, 52.6% of women had arousal disorder, 49.3% of women had lubrication disorder, 45% of women had orgasm disorder, 34.4% had dissatisfaction and 42% of women had pain disorder. The mean FSFI score was found to be 24.73 ± 4.75 out of a maximum total score of 36. The main domain scores were: desire 3.64 ± 0.75, arousal 3.92 ± 0.91, lubrication 4.35 ± 0.99, orgasm 4.17 ± 1.19, satisfaction 4.51 ± 1.26 and pain 4.15 ± 1.21 out of a maximum domain score of six.

FSD is a highly prevalent problem within the scope of this study. Age of marriage, duration of marriage, high parity, female genital mutilation (FGM) and presence of partner sexual dysfunction were found to be significantly associated with low sexual function in Egyptian women.

We need to consider both suppression of positive and negative emotions (PE and NE) in examining the effects of emotional suppression (ES) on health and adjustment. The purpose of study was to develop a new emotional suppression scale to measure suppression of PE and NE, and to examine the effects of emotional suppression of PE and NE on depression and short-term life satisfaction (LS).

Participants were 496 undergraduate and graduate students (240 men and 256 women). They completed three questionnaires for assessing ES, depression, and short-term LS, along with a questionnaire to test the validity of the Emotional Suppression Scale for Positive and Negative Emotions (ESS) that was developed in this study.

First, we confirmed two factors in the ESS, named as ‘suppression of PE’ and ‘suppression of NE.’ The alphas were .69 and .73 for men and .69 and .76 for women, respectively. and it was revealed that each subscale of the ESS has concurrent validity. Thereafter, hierarchical regression analyses showed that higher suppression of PE was associated with lower LS and higher depression. Meanwhile, suppression of NE did not show any significant associations with health and adjustment, which was inconsistent with previous findings. Moreover, no significant interactions between suppression of PE and NE were found.

In this study, the ESS was developed with factorial and concurrent validities. Moreover, this study suggests that the effects of emotional suppression on health and adjustment would be different depending on what type of emotions is suppressed.