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Background: Self-harm is a major healthcare problem in the United Kingdom, but monitoring of hospital presentations has largely been done separately in single centres. Multicentre monitoring of self-harm has been established as a result of the National Suicide Prevention Strategy for England. Method: Data on self-harm presentations to general hospitals in Oxford (one hospital), Manchester (three hospitals) and Leeds (two hospitals), collected through monitoring systems in each centre, were analysed for the 18-month period March 2000 to August 2001. Results: The findings were based on 7344 persons who presented following 10,498 episodes of self-harm. Gender and age patterns were similar in the three centres, 57.0% of patients being female and two-thirds (62.9%) under 35 years of age. The largest numbers by age groups were 15-19 year-old females and 20-24 year-old males. The female to male ratio decreased with age. Rates of self-harm were higher in Manchester than Oxford or Leeds, in keeping with local suicide rates. The proportion of patients receiving a specialist psychosocial assessment varied between centres and was strongly associated with admission to the general hospital. Approximately 80% of self-harm involved self-poisoning. Overdoses of paracetamol, the most frequent method, were more common in younger age groups, antidepressants in middle age groups, and benzodiazepines and sedatives in older age groups. Alcohol was involved in more than half (54.9%) of assessed episodes. The most common time of presentation to hospital was between 10 pm and 2 am. Conclusions: Multicentre monitoring of self-harm in England has demonstrated similar overall patterns of self-harm in Oxford, Manchester and Leeds, with some differences reflecting local suicide rates. Diurnal variation in time of presentation to hospital and the need for assessment of non-admitted patients have implications for service provision. © Springer-Verlag 2007.

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1. The immediate results of ECT are generally excellent, providing marked relief of symptoms in many psychoses. This relief amounts to a recovery in a high percentage of depressed patients. 2. A 10-year follow-up of 65 patients in whom depression was the cardinal difficulty reveals that 45 were relatively well, 16 moderately or slightly improved, and 4 unchanged or worse up to the time of the last contact. 3. Recurrences are common. Thirty-two of the depressed patients have had recurrences requiring further courses of treatment. After subsequent therapy, 18 were relatively well and the condition of 14 was fair or poor. 4. Electrocoma therapy does not accelerate or retard recurrences. 5. The immediate complications were few and relatively insignificant compared to the benefits obtained. The 9- to 10-year follow-up revealed no cumulative complications; we did not encounter epilepsy, spinal deformities, or mental deterioration due to the treatment. 6. During the 9-to 10-year study there were 9 deaths, the fi...

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Purpose: This study investigates the image quality of tomosynthesis slices obtained from several acquisition sets with synchrotron radiation using a breast phantom incorporating details that mimic various breast lesions, in a heterogeneous background. Methods: A complex Breast phantom (MAMMAX) with a heterogeneous background and thickness that corresponds to 4.5 cm compressed breast with an average composition of 50% adipose and 50% glandular tissue was assembled using two commercial phantoms. Projection images using acquisition arcs of 24°, 32°, 40°, 48°, and 56° at incident energy of 17 keV were obtained from the phantom with the synchrotron radiation for medical physics beamline at ELETTRA Synchrotron Light Laboratory. The total mean glandular dose was set equal to 2.5 mGy. Tomograms were reconstructed with simple multiple projection algorithm (MPA) and filtered MPA. In the latter case, a median filter, a sinc filter, and a combination of those two filters were applied on the experimental data prior to MPA reconstruction. Visual inspection, contrast to noise ratio, contrast, and artifact spread function were the figures of merit used in the evaluation of the visualisation and detection of low- and high-contrast breast features, as a function of the reconstruction algorithm and acquisition arc. To study the benefits of using monochromatic beams, single projection images at incident energies ranging from 14 to 27 keV were acquired with the same phantom and weighted to synthesize polychromatic images at a typical incident x-ray spectrum with W target. Results: Filters were optimised to reconstruct features with different attenuation characteristics and dimensions. In the case of 6 mm low-contrast details, improved visual appearance as well as higher contrast to noise ratio and contrast values were observed for the two filtered MPA algorithms that exploit the sinc filter. These features are better visualized at extended arc length, as the acquisition arc of 56° with 15 projection images demonstrates the highest image reconstruction quality. For microcalcifications, filtered MPA implemented with a combination of median and sinc filters indicates better feature appearance due to efficient suppression of background tissue. The image quality of these features is less sensitive to the acquisition arc. Calcifications with size ranging from 170 to 500 μm, like the ones presently studied, are well identified and visualized for all arcs used. The comparison of single projection images obtained under different beam conditions showed that the use of monochromatic beam can produce an image with higher contrast and contrast to noise ratio compared to an image corresponding to a polychromatic beam even when the latter is acquired with double incident exposure. Conclusions: Filter optimization in respect to the type of feature characteristics is important before the reconstruction. The MPA combined with median and sinc filters results in improved reconstruction of microcalcifications and low-contrast features. The latter are better visualized at extended arc length, while microcalcifications are less sensitive to this acquisition parameter. Use of monochromatic beams may result in tomographic images with higher contrast acquired at lower incident exposures. © 2012 American Association of Physicists in Medicine

A detectable difference in X-ray diffraction data of healthy and diseased breast tissues has been observed. This information can be used to generate images with a higher contrast than that of conventional transmission mammography. A diffraction enhanced breast imaging (DEBI) system that simultaneously combines transmission and diffraction breast images is currently being developed. This paper presents the imaging system requirements for a clinical DEBI system. The DEBI imaging system employs a phosphor coated L3Vision CCD camera. The DEBI principle has been assessed at the SYRMEP synchrotron beamline (Elettra, Trieste) and with a purpose built mammographic X-ray imaging unit. Diffraction enhanced images have been obtained of realistic breast tissue phantoms, consisting of 4 cm thick slabs of excised breast tissue containing embedded carcinomas. The images were obtained at pre-determined momentum transfer values, allowing some tissue characterization to be achieved during imaging, as well as optimizing image contrast This paper presents the current state of the project. The spatial resolution of the diffraction images have been studied using test phantoms and suggestions are made for the collimation systems necessary for a clinical system. A correction procedure applied to the diffraction images is also presented.