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This exploratory study investigates the overlap of somatization and depressive symp toms among older Jewish-Soviet immigrants to the United States. It has been sug gested that this group has depression often masked by somatic complaints. In order to test this hypothesis fifty-five respondents completed the Symptom Checklist 90, PERI Demoralization Scale and the Social Support Network Inventory. The somatiza tion subscale was found to be significantly higher among older Soviet immigrants than in a depressed group, yet the depression subscale was significantly lower. Com pared to a group of normal controls both the depression and somatization subscales were significantly elevated. Somatization, depression, and demoralization were elevated in Soviet immigrants. The results of this study are discussed in the context of the available literature on cross-cultural psychiatry and somatization. The clinical relevance of these findings is highlighted.

ABSTRACTA pollution damage function is developed, using data from a study on the sensitivity of morbidity to ambient air concentrations of individual pollutants. This function is used in a model which incorporates the costs and technology for pollution abatement in the St. Louis Airshed. A set of air quality standards is determined which minimizes morbidity subject to a given control budget constraint. The results indicate that there should be a greater reduction of the pollutants associated with stationary sources than of those characteristic of the automobile.

The Global Assessment of Relational Functioning Scale (GARF) has been proposed as an additional domain on Axis V, yet few validation studies have been conducted. This study examines the validity of the Brazilian-Portuguese version of the GARF. An experienced family therapist interviewed 34 families in which one member had a diagnosis of DSM-IV recurrent major depression. A semi-structured family interview was used to classify families into functional or dysfunctional. A second interviewer, blind to the earlier evaluation, used the GARF to assess the families' functioning. Validity coefficients with the best balance between sensitivity and specificity were obtained with a cut-off point of 70 on the GARF: sensitivity, 78%; specificity, 86%; positive predictive value, 95%; and negative predictive value, 50%. Regression analyses identified demographic and clinical variables that influenced GARF scores. The following variables accounted for 41% of the GARF's variance: patients' educational level, severity of the current depressive episode, and the role of the family member participating in the study. The Brazilian-Portuguese version of the GARF has acceptable validity coefficients, and may be a useful tool in cross-cultural settings.

While the use of epidemiological and anthropological methods to determine health risk factors is growing, combined work in the area of psychiatric epidemiology is still limited. This article presents a preliminary overview of the mental health needs and resources in Belize using historic, demographic, epidemiologic and ethnographic methods to survey both the needs and societal resources available to the ethnically heterogeneous population of this country. The projected epidemiological data suggest that the Belizean population is underserved, although these data by themselves fail to account for traditional therapeutic resource utilization and cultural conceptions of mental health, illness, risk and efficacy. On the basis of our initial findings, we conclude that there is a need to complement this study with cultural epidemiological research to achieve a more comprehensive understanding of the mental health situation in Belize.

Background: The Mapuche are the largest indigenous group in Chile; yet almost all data on the mental health of indigenous populations are from North America. Aim: The study examines the differential DSM-III-R prevalence rates of psychiatric disorders and service utilization among indigenous and non-indigenous community residence. Methods: The Composite International Diagnostic Interview (CIDI) was administered to a stratified random sample of 75 Mapuche and 434 non-Mapuche residents of the province of Cautín. Lifetime prevalence and 12-month prevalence rates were estimated. Results: Approximately 28.4% of the Mapuche population had a lifetime, and 15.7% a 12-month, prevalent psychiatric disorder compared to 38.0% and 25.7%, respectively, of the non-Mapuche. Few significant differences were noted between the two groups; however, generalized anxiety disorder, simple phobia, and drug dependence were less prevalent among the Mapuche. Service utilization among the Mapuche with mental illness was low. Conclusions: This is a preliminary study based on a small sample size. Further research on the mental health of indigenous populations of South America is needed.

Objectives: The primary objective of this study was to examine the perception of the quality of psychiatric services five years after apartheid, and specifically whether care for black patients had improved. Design: A survey was distributed to South African psychiatrists during a national congress and by mail. The questionnaire focused on the quality of psychiatric care in general, for black and white patients, the racial composition of each respondent's psychiatric practice currently, and the racial composition of the psychiatric practice during apartheid. Results: Psychiatric services in South Africa were viewed as deteriorating. The end of apartheid has done little to improve the quality of psychiatric care for both black and white patients. Although less pronounced, racial inequality in psychiatric care continues to exist. Psychiatric practices continue to be overrepresented with white patients. Conclusion: There remains a differential in quality of psychiatric care and further monitoring should continue. Continued efforts to improve racial equality and the need for greater awareness of cultural issues need to be addressed. Limitations of this study included possible social desirability bias, use of subjective rather than objective measures, and a survey that was limited in scope.

The number of reported early syphilis cases in San Francisco has increased steadily since 2005. It is not yet clear what factors are responsible for such an increase. A recent analysis of the sexual contact network of men who have sex with men with syphilis in San Francisco has discovered a large connected component, members of which have a significantly higher chance of syphilis and HIV compared to non-member individuals. This study investigates whether it is possible to exploit the existence of the largest connected component to design new notification strategies that can potentially contribute to reducing the number of cases. We develop a model capable of incorporating multiple types of notification strategies and compare the corresponding incidence of syphilis. Through extensive simulations, we show that notifying the community of the infection state of few central nodes appears to be the most effective approach, balancing the cost of notification and the reduction of syphilis incidence. Additionally, among the different measures of centrality, the eigenvector centrality reveals to be the best to reduce the incidence in the long term as long as the number of missing links (non-disclosed contacts) is not very large ; The work of J.S. and D.J. has been partially supported by the research grants MTM2014-52402-C3-3-P of the Spanish Government (MINECO) and MPCUdG2016/047 of the Universitat de Girona. J.S. and D.J. are members of the research groups 2014SGR-1083 and 2014SGR-555 of the Generalitat de Catalunya, respectively

The number of reported early syphilis cases in San Francisco has increased steadily since 2005. It is not yet clear what factors are responsible for such an increase. A recent analysis of the sexual contact network of men who have sex with men with syphilis in San Francisco has discovered a large connected component, members of which have a significantly higher chance of syphilis and HIV compared to non-member individuals. This study investigates whether it is possible to exploit the existence of the largest connected component to design new notification strategies that can potentially contribute to reducing the number of cases. We develop a model capable of incorporating multiple types of notification strategies and compare the corresponding incidence of syphilis. Through extensive simulations, we show that notifying the community of the infection state of few central nodes appears to be the most effective approach, balancing the cost of notification and the reduction of syphilis incidence. Additionally, among the different measures of centrality, the eigenvector centrality reveals to be the best to reduce the incidence in the long term as long as the number of missing links (non-disclosed contacts) is not very large ; The work of J.S. and D.J. has been partially supported by the research grants MTM2014-52402-C3-3-P of the Spanish Government (MINECO) and MPCUdG2016/047 of the Universitat de Girona. J.S. and D.J. are members of the research groups 2014SGR-1083 and 2014SGR-555 of the Generalitat de Catalunya, respectively