Emergency workers' experiences of the use of section 136 of the Mental Health Act 1983: interpretative phenomenological investigation.

AIMS AND METHOD: To explore the experiences of emergency workers dealing with incidents in which section 136 of the Mental Health Act 1983 is invoked by the police. Data from interviews with police officers and ambulance workers in a London locality were subject to interpretative phenomenological analysis. RESULTS: Participants felt they were the first port of call and that training should be improved to help them deal with those experiencing mental health crises in the community. Police participants noted time pressures trying to gain individuals' trust and described section 136 detention as sometimes feeling like a betrayal of the individual. Most participants had negative experiences of admissions to the 136 suite; several suggested ways of improving the admissions system. Several went beyond their expected duties to ensure that distressed individuals were supported before accessing mental healthcare services. CLINICAL IMPLICATIONS: Improving training of emergency workers in dealing with mental health crises would also help with aftercare decision-making. Learning identified from the participants' experiences lends support to collaboration between emergency and mental health services, an important step towards improving the section 136 process so that detainees can access help without unnecessary delay

Working parents and workplace flexibility in New Hampshire

This report, a joint effort between the Carsey Institute, UNH Cooperative Extension, and New Hampshire Employment Security, looks at working parents and their job flexibility and the importance it has for families trying to achieve a work-life balance

Design Matters : CBNRM and Democratic Innovation

Community-based natural resource management (CBRNM) aims to realize sustainable management of resources and improvements in livelihood. A central focus is the empowerment of indigenous and local communities through customary or devolved rights to common pool resources. Less attention is given to the extent to which inclusive forms of governance are realized in CBNRM. Democratic innovations are institutions designed explicitly to increase and deepen citizen participation in political decision-making. A number of exemplary cases around the world provide evidence that it is possible to empower citizens in ways that are inclusive and achieve desirable outcomes such as redistribution, recognition of marginalized groups, and improved livelihoods. By clarifying elements of the design of democratic innovations - in particular goods, tasks, mechanisms, and co-design - it is possible to understand how effective forms of participatory governance can be crafted. With careful attention to the endogenous practices of indigenous and local communities and the governance structures imposed by public authorities, CBNRM practitioners can draw on these elements of democratic design to craft forms of inclusive participatory governance that promote sustainable management of resources and improve livelihoods. A program of collaboration between CBNRM and democratic innovations practitioners will contribute to improvements amongst both communities of practice and the communities they serve

Introduction

Husserl’s philosophy, by the usual account, evolved through three stages: 1. development of an anti-psychologistic, objective foundation of logic and mathematics, rooted in Brentanian descriptive psychology; 2. development of a new discipline of "phenomenology" founded on a metaphysical position dubbed "transcendental idealism"; transformation of phenomenology from a form of methodological solipsism into a phenomenology of intersubjectivity and ultimately (in his Crisis of 1936) into an ontology of the life-world, embracing the social worlds of culture and history. We show that this story of three revolutions can provide at best a preliminary orientation, and that Husserl was constantly expanding and revising his philosophical system, integrating views in phenomenology, ontology, epistemology and logic with views on the nature and tasks of philosophy and science as well as on the nature of culture and the world in ways that reveal more common elements than violent shifts of direction. We argue further that Husserl is a seminal figure in the evolution from traditional philosophy to the characteristic philosophical concerns of the late twentieth century: concerns with representation and intentionality and with problems at the borderlines of the philosophy of mind, ontology, and cognitive science

2,3-Dimethoxy-10-oxostrychnidinium 2-(2,4,6-trinitroanilino)benzoate monohydrate: a 1:1 proton-transfer salt of brucine with o-picraminobenzoic acid

In the structure of the 1:1 proton-transfer compound of brucine with 2-(2,4,6-trinitroanilino)benzoic acid C23H27N2O4+ . C13H7N4O8- . H~2~O, the brucinium cations form the classic undulating ribbon substructures through overlapping head-to-tail interactions while the anions and the three related partial water molecules of solvation (having occupancies of 0.73, 0.17 and 0.10) occupy the interstitial regions of the structure. The cations are linked to the anions directly through N-H...O(carboxyl) hydrogen bonds and indirectly by the three water molecules which form similar conjoint cyclic bridging units [graph set R2/4(8)] through O-H...O(carbonyl) and O(carboxyl) hydrogen bonds, giving a two-dimensional layered structure. Within the anion, intramolecular N-H...O(carboxyl) and N H...O(nitro) hydrogen bonds result in the benzoate and picrate rings being rotated slightly out of coplanarity inter-ring dihedral angle 32.50(14)\%]. This work provides another example of the molecular selectivity of brucine in forming stable crystal structures and also represents the first reported structure of any form of the guest compound 2-(2,4,6-trinitroanilino)benzoic acid

Episodic Post-Shock Dust Formation in the Colliding Winds of Eta Carinae

Eta Carinae shows broad peaks in near-infrared (IR) JHKL photometry, roughly correlated with times of periastron passage in the eccentric binary system. After correcting for secular changes attributed to reduced extinction from the thinning Homunculus Nebula, these peaks have IR spectral energy distributions (SEDs) consistent with emission from hot dust at 1400-1700 K. The excess SEDs are clearly inconsistent, however, with the excess being entirely due to free-free wind or photospheric emission. One must conclude, therefore, that the broad near-IR peaks associated with Eta Carinae's 5.5 yr variability are due to thermal emission from hot dust. I propose that this transient hot dust results from episodic formation of grains within compressed post-shock zones of the colliding winds, analogous to the episodic dust formation in Wolf-Rayet binary systems like WR140 or the post-shock dust formation seen in some supernovae like SN2006jc. This dust formation in Eta Carinae seems to occur preferentially near and after periastron passage; near-IR excess emission then fades as the new dust disperses and cools. With the high grain temperatures and Eta Car's C-poor abundances, the grains are probably composed of corundum or similar species that condense at high temperatures, rather than silicates or graphite. Episodic dust formation in Eta Car's colliding winds significantly impacts our understanding of the system, and several observable consequences are discussed.Comment: MNRAS accepted; 8 pages, 5 figs, 2 color fig

Penetrating the Homunculus -- Near-Infrared Adaptive Optics Images of Eta Carinae

Near-infrared adaptive optics imaging with NICI and NaCO reveal what appears to be a three-winged or lobed pattern, the "butterfly nebula", outlined by bright Br$\gamma$ and H$_{2}$ emission and light scattered by dust. In contrast, the [Fe II] emission does not follow the outline of the wings, but shows an extended bipolar distribution which is tracing the Little Homunculus ejected in $\eta$ Car's second or lesser eruption in the 1890's. Proper motions measured from the combined NICI and NaCO images together with radial velocities show that the knots and filaments that define the bright rims of the butterfly were ejected at two different epochs corresponding approximately to the great eruption and the second eruption. Most of the material is spatially distributed 10\arcdeg to 20\arcdeg above and below the equatorial plane apparently behind the Little Homunculus and the larger SE lobe. The equatorial debris either has a wide opening angle or the clumps were ejected at different latitudes relative to the plane. The butterfly is not a coherent physical structure or equatorial torus but spatially separate clumps and filaments ejected at different times, and now 2000 to 4000 AU from the star.Comment: 42 pages, 12 figures, To appear in the Astronomical Journa

Controlled vocabularies in bioinformatics: A case study in the Gene Ontology

The automatic integration of information resources in the life sciences is one of the most challenging goals facing biomedical informatics today. Controlled vocabularies have played an important role in realizing this goal, by making it possible to draw together information from heterogeneous sources secure in the knowledge that the same terms will also represent the same entities on all occasions of use. One of the most impressive achievements in this regard is the Gene Ontology (GO), which is rapidly acquiring the status of a de facto standard in the field of gene and gene product annotations, and whose methodology has been much intimated in attempts to develop controlled vocabularies for shared use in different domains of biology. The GO Consortium has recognized, however, that its controlled vocabulary as currently constituted is marked by several problematic features - features which are characteristic of much recent work in bioinformatics and which are destined to raise increasingly serious obstacles to the automatic integration of biomedical information in the future. Here, we survey some of these problematic features, focusing especially on issues of compositionality and syntactic regimentation

Systemic Mycobacterium avium subspecies paratuberculosis infection in sheep : a thesis presented in the fulfilment of the requirements for the degree of Doctor of Philosophy in Veterinary Science at Massey University, Palmerston North, New Zealand

Publications removed from thesis due to copyright reasons: Smith, S. L., West, D. M., Wilson, P. R., de Lisle, G. W., Collett, M. G., Heuer, C., & Chambers, J. P. (2011). Detection of Mycobacterium avium subsp. paratuberculosis in skeletal muscle and blood of ewes from a sheep farm in New Zealand. New Zealand Veterinary Journal, 59(5), 240-243. doi:10.1080/00480169.2011.596257. Smith, S. L., West, D. M., Wilson, P. R., de Lisle, G. W., Collett, M. G., Heuer, C., & Chambers, J. P. (2013). The prevalence of disseminated Mycobacterium avium subsp. paratuberculosis infection in tissues of healthy ewes from a New Zealand farm with Johne's disease present. New Zealand Veterinary Journal, 61(1), 41-44. doi:10.1080/00480169.2012.704627. Smith, S. L., Wilson, P. R., Collett, M. G., Heuer, C., West, D. M., Stevenson, M., & Chambers, J. P. (2014). Liver biopsy histopathology for diagnosis of Johne's disease in sheep. Veterinary Pathology, 51(5), 915-918. doi:10.1177/0300985813516644. Smith, S. L., Singh, P., Harding, D., Lun, D., & Chambers, J. P. (2016). Thalidomide pharmacokinetics in sheep. New Zealand Veterinary Journal, 64(4), 238-242. doi: 10.1080/00480169.2015.1130663The systemic infection of organs and skeletal muscle outside the alimentary tract with Mycobacterium avium subspecies paratuberculosis (Map) has sparingly been mentioned in the many scientific studies undertaken in sheep, yet within the past decade a zoonotic association has been proposed. The occurrence of systemic Map infection at the time of slaughter might enable this organism to be present in food products, such as meat, destined for human consumption, creating a potential link to public health and may therefore attract some attention by the meat industry. There have been very few studies investigating whether meat has potential to expose humans to Map. With this lack of information, it is difficult for the meat industry to make informed decisions in the event that public perception establishes a link with Crohn’s disease. Chapter one provides a brief history of Map infection in ruminants and suggests there may be a need to identify steps that could be implemented to mitigate human exposure to Map. The aims for this thesis therefore were to i) determine whether skeletal muscle from naturally infected animals provides a source of Map for humans, ii) provide information on systemic Map infection in sheep, identifying classes of stock that may pose a risk for exposure iii) develop a histological diagnostic test for quantifying the cost of systemic Map infection in sheep with potential use in therapeutic efficacy studies, and iv) provide a potential means to mass screen sheep at time of slaughter using real time spectroscopy to identify systemically infected animals. Chapter two reviews the source of Map, transmission pathways and subsequent availability of modern diagnostic tests for identifying sheep infected with this organism. There is a lack of published information on systemic Map infection, with little known about how this event develops, how the immune system reacts when Map bacteraemia occurs, whether systemic 3 Map infection has a cost to production and whether quantification of this cost can be assessed with currently available diagnostic tests. The aim of Chapter three was to determine whether skeletal muscle from ewes with clinical Johne’s disease contained Map and therefore provided a potential source of Map for humans. Fifty one mixed-age, low body condition score ewes (1.5/5), from a farm where clinical Johne’s disease had been diagnosed, were necropsied. This included 48 ewes with Map infection confirmed by ileal BACTEC radiometric culture and 21 with clinical Johne’s disease confirmed by ileal histopathology. In 18 ewes with clinical Johne’s disease, Map was found in the culture of blood (n=13), blood and muscle (n=10) and muscle (n=5). In ewes without clinical Johne’s disease, Map was found in 5/30 animals including muscle (n=4) and blood (n=1). It was concluded that meat from ewes with clinical Johne’s disease is likely to contain Map and suggested that systemic Map infection may also occur in sheep without clinical disease when managed in direct contact with clinically affected ewes shortly before slaughter. The presence of Map within skeletal muscle was further investigated in Chapter four with 24 healthy mixed age ewes selected from one farm, which were not in contact with clinically affected ewes. Ileal and mesenteric lymph node cultures identified Map infection in 12/24 ewes. All other tissues and faeces were culture negative, and only 1/24 animals seroconverted. In flocks where Map is present, it appears that up to 50% of animals may be latently infected. Lack of positive culture from blood and muscle samples in latently infected sheep suggests that meat from healthy sheep may not be a source of human exposure to Map. In New Zealand, the current measure to mitigate human exposure to Map from meat products is the identification of clinically affected sheep prior to slaughter through ante-mortem inspection with emaciated animals rejected at time of slaughter and processed as pet food. 4 However, this screening process is non-specific with many different causes of emaciation. Currently there are no legal requirements or recommendations from the meat industry for the downgrading of meat from carcases with macroscopic signs of clinical Johne’s disease and, as such, meat from these sheep enters the human food chain. Identifying sheep with systemic Map infection is problematic, with diagnosis requiring solid or liquid media culture of Map or polymerase chain reaction (PCR) to identify Map specific DNA. These diagnostic tests are expensive, time consuming and require a high level of expertise. They are therefore unlikely to be adopted by the meat industry as a screening tool for systemic Map infection in sheep. With the aim to develop a diagnostic tool that is relatively quick, simple and cheap, 126 mixed age ewes in poor body condition were euthanised as described in Chapter five and their Johne’s disease status determined through histopathology and Ziehl Neelsen stain of the ileum and mesenteric lymph nodes. Sixty ewes were differentiated histopathologically with 51 clinically affected including Type 3b (n=40) and 3c (n=11) and nine not clinically affected with Type 1 (n=5), Type 2 (n=3) and Type 3a (n=1) ileal lesions. Hepatic epithelioid macrophage micro-granulomas (HEM) were observed only in ewes with Type 3b or 3c ileal lesions, all of which were ELISA positive. When present, HEM were in equal densities in liver section and biopsy samples. The sensitivity and specificity for liver histopathology (section or biopsy) for predicting clinical OJD was 96% (95% CI, 87-99%) and 100% (95% CI, 95-100%), respectively, and Cohen’s Kappa had an almost perfect level of agreement between HEM formation, ileal pathology and ELISA sero-positivity. This study determined that the presence of HEM provided a surrogate measure of ileal pathology, identified ewes with clinical Johne’s disease, and that biopsy samples and post mortem sections were equally suitable for the diagnosis of HEM. Encouraged by the predictive quality of HEM in Chapter five, it was hypothesised that the identification of HEM from biopsies may provide a method to follow the progression of Map 5 infection through serial sampling and to quantify the production cost of systemic Map infection. The longitudinal challenge study in Chapter six utilised the identification of HEM as an indicator of systemic Map infection in naïve lambs orally challenged with 1 x 109 organisms on ten occasions over 30 days. The presence of HEM was related to live weight gain, body condition score, development of clinical disease or occurrence of self-cure (recovery), and ELISA serology All challenged lambs developed HEM, a higher density of HEM was associated with increased ELISA S/P ratios with a Cohen’s kappa substantial level of agreement, and mean weight loss (-2.03kg) from 51 to 154 days post challenge with an almost perfect level of agreement. Thereafter, lower weight gain led to a mean body weight difference of -8kg at 195days compared to non-challenged lambs. Four challenged lambs had to be euthanised due to clinical OJD. After this period, the HEM density and ELISA S/P ratios declined, growth rates increased in the challenged lambs up to 482 days after which no HEM were detected and growth rates were equal between challenged and unchallenged groups. The challenged lambs failed to regain equivalent weights over the 820 days being 11kg lighter at the end of the study despite having equal body condition scores. The challenged lambs were smaller than the unchallenged lambs both in body height and length with multivariate ANOVA analysis determining the post mortem mean skeletal measurements of the poll to rump length and metacarpal/meta-tarsal bones being 4% and 5% shorter, respectively. There were no positive ELISA blood samples or histopathological lesions in any tissues sampled at necropsy from both groups of lambs at the end of the study, suggesting complete cure of the surviving challenged lambs. The findings demonstrated i) that artificial challenge can cause systemic Map infection, ii) systemic infection results in negative growth rates and a loss of body condition, iii) and in addition to the period of retarded growth losses occur from death of some lambs (4/18), iv) that the temporary poor weight gain impacted on the final weight, and v) that recovery to systemic Map infection 6 appears to occur in survivors of acute disease. Moreover, it was postulated that the identification of HEM from serial liver biopsies may have the potential to determine the therapeutic efficacy of new anti-mycobacterial drugs (such as thalidomide, Appendix one) or vaccines for preventing systemic Map infection. Chapter seven revisits the histopathological findings described in Chapter five, expanding from the microscopic visual identification of HEM to utilising spectroscopy and hyperspectral image analysis. The aims of this final study included identifying whether a spectral signature for skeletal muscle or liver exists in sheep with Johne’s disease and developing an algorithm that can identify the presence of systemic Map infection in sheep. Ninety five mixed aged ewes, of low body condition score from nine farms were euthanised and OJD was confirmed by histopathology in 10 animals. The liver and transected longissimus dorsi muscle were scanned using a visible light to near infrared (Vis-NIR) detector as well as 200 lamb livers from a slaughter house. The histological identification of HEM was used as a surrogate measure of systemic Map infection with HEM recorded in the 10 ewes with Johne’s disease and none of the 85 ewes without or the 200 lamb livers. There was no histopathological or hyperspectral differences identified for the transected longissimus dorsi muscle in the 95 ewes. However a a computer generated algorithm identified a hyperspectral signature for liver tissue that when applied, blind to the Johne’s disease status of the ewes was able to differentiate all 10 animals with Johne’s disease from the 85 ewes and 200 lambs without. This pilot study suggests that spectroscopy may have potential to be a useful real time tool for the identification of sheep with systemic Map infection at the time of slaughter. In conclusion, disseminated Map infection does occur in sheep with clinical OJD, and meat from these animals can be a source of Map for humans. Meat from healthy sheep or sheep without clinical OJD does not appear to expose consumers to Map. The identification of 7 HEM in liver biopsies has diagnostic value for identifying sheep with clinical OJD. In naturally infected sheep, HEM only appear when Map infection has progressed to clinical OJD. As opposed to high–dose artificial challenge, systemic Map infection under natural challenge conditions appears to require ileal pathology, suggesting different mechanisms for the occurrence of systemic infection in these two challenge types. Examination of serial liver biopsies and the identification of HEM has enabled the investigation of the production loss due to temporary progression and subsequent resolution of Map infection. The final study in this thesis has tested proof of concept for a new real time diagnostic test that has potential to mass screen sheep within abattoirs at point of slaughter using spectroscopy and hyperspectral analysis. However further research is required to validate this spectroscopic test