The mental health of newly remanded prisoners, the prison reception health screen and the resulting management of mental disorder at Durham prison

MD ThesisRecent cross-sectional studies have confirmed that the prevalence of mental disorder in English prisons is high but they provide little insight into the fate of the mentally disordered in prison. This thesis concentrates on a longitudinal study of mental disorder in 569 unconvicted adult male remand prisoners received into Durham prison between 1 October 1995 and 30 April 1996. Subjects were interviewed at reception by psychiatric researchers and monitored throughout the remand period. The data collected was used to establish the prevalence of mental disorder and substance misuse at reception into prison, effectiveness of prison reception screening, number of mentally disordered subjects identified and referred for psychiatric assessmentn, ature of psychiatric interventions, and final disposal of all subjects. Additional research was undertaken at Durham to evaluate health care provision at this prison, and, in order to comment on the generalisability of the findings, health care facilities at other prisons in England and Wales were investigated. More than a quarter of subjects at Durham prison were suffering from mental disorder. Serious disorders were especially prevalent and one in twenty remands was acutely psychotic. Drug and alcohol misuse was the norm. More than half of our subjects received current substance abuse or dependence diagnoses. Prison reception screening failed to identify nearly 80% of subjects with mental disorder, including 75% of those with acute psychosis. The treatment needs of the majority of mentally disordered subjects were overlooked in prison. Just over one quarter of mentally disordered subjects were referred for a psychiatric assessment. Contact with psychiatric services was frequently hampered by the prison regime and the actions of the courts. This resulted in acutely psychotic prisoners being released without adequate treatment or follow-up. Help for prisoners with drug and alcohol related problems was minimal. Detoxification regimes were insufficiently prescribed leaving the majority of subjects addicted to opiates, benzodiazepines and alcohol at risk of serious withdrawal. Inadequate resources, a lack of suitably trained health care staff, low morale and staff sickness hampered the delivery of effective health care at Durham prison. However, staff attitudes, institutionalised practices and negative responses from prisoners also made a significant contribution. Further inquiry indicates that Durham. prison is not unique in these respects. Problems of a similar nature are endemic in the Prison Health Service. Indeed, when the history of this organisation is traced it is apparent that such difficulties have plagued it throughout its existence.The Home Office: The Northern Region Health Authority

Towards a quality education for all

This document summarises the recommendations being proposed in the NCF and examines the implications of such recommendations. There can only be a meaningful strategy for the implementation of the NCF once the recommendations are debated and the full impact of their implications understood. This process of consultation needs to include all stakeholders in a professionally engaging manner. Moreover, the consultation and implementation strategies need to be based on the full understanding of a change management process. This document will therefore map out the way forward by presenting: • a summary of the recommendations being proposed by the NCF; • implications of these recommendations for implementation; • ideas about the management of change which underpin the consultation and implementation strategies the NCF would like to promote; • a strategy for the consultation process following the publication of the draft NCF; and • a proposed timeline for the implementation process of the NCF, following consultation and agreement with the wider educational community about the way forward.peer-reviewe

Recruitment of the Major Vault Protein by InlK: A Listeria monocytogenes Strategy to Avoid Autophagy

L. monocytogenes is a facultative intracellular bacterium responsible for listeriosis. It is able to invade, survive and replicate in phagocytic and non-phagocytic cells. The infectious process at the cellular level has been extensively studied and many virulence factors have been identified. Yet, the role of InlK, a member of the internalin family specific to L. monocytogenes, remains unknown. Here, we first show using deletion analysis and in vivo infection, that InlK is a bona fide virulence factor, poorly expressed in vitro and well expressed in vivo, and that it is anchored to the bacterial surface by sortase A. We then demonstrate by a yeast two hybrid screen using InlK as a bait, validated by pulldown experiments and immunofluorescence analysis that intracytosolic bacteria via an interaction with the protein InlK interact with the Major Vault Protein (MVP), the main component of cytoplasmic ribonucleoproteic particules named vaults. Although vaults have been implicated in several cellular processes, their role has remained elusive. Our analysis demonstrates that MVP recruitment disguises intracytosolic bacteria from autophagic recognition, leading to an increased survival rate of InlK over-expressing bacteria compared to InlK− bacteria. Together these results reveal that MVP is hijacked by L. monocytogenes in order to counteract the autophagy process, a finding that could have major implications in deciphering the cellular role of vault particles

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

‘Oh you pretty thing!’: How David Bowie ‘unlocked everybody’s inner queen’ in spite of the music press

The 1967 Sexual Offence Act decriminalised homosexual acts between men allowing gay men to discuss their sexuality in public. Few prominent popular musicians came-out until 1972 when David Bowie claimed that he was bisexual in an interview with Melody Maker. Music papers and Bowie had substantial cultural power: Bowie was a rising star and music papers recruited journalists who discussed and perpetuated social change. The subsequent conversation, however, reinforced negative stereotypes in constructing the queer subject and tried to safeguard commercial concerns due to the assumption that the market for popular music avoided queer music. This undermined arguments that associate permissive legislation with a permissive media and society, but, to some, representation alone empowered people and destabilised preconceptions about queer identity.Published versio

Hold-up costs, economies of scale and the make-or-buy decision

SIGLEAvailable from British Library Document Supply Centre-DSC:7755.0403(0020) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Steam-dealuminated, OSDA-free RHO and KFI-type zeolites as catalysts for the methanol-to-olefins reaction

RHO and KFI-type zeolites are synthesized in the absence of organic structure-directing agents (OSDAs), post-synthetically dealuminated via high temperature (600–800 °C) steam treatments, and evaluated as catalysts for converting methanol-to-light olefins (MTO). The proton forms of the as-made zeolites deactivate rapidly when tested for the MTO reaction (conducted at 400 °C and atmospheric pressure) due to their high aluminum content. Steam treatments lead to improvements in olefin selectivities and catalyst lifetimes with samples steamed at 600 °C giving the best combination of lifetime and olefin selectivity. Zeolite characterizations by ^(27)Al NMR, ^(29)Si NMR and argon physisorption indicate that the steam treatments extract framework aluminum, leading to reductions in the total number of Brønsted acid sites and the creation of mesopores that can facilitate transport of reactants. Poisoning of the acid sites external to the 8MR pores of the zeolites by treatments with trimethylphosphite results in longer catalyst lifetimes but do not affect the observed olefin selectivities, suggesting that olefins do not undergo secondary dimerization or methylation reactions at these sites

Steam-dealuminated, OSDA-free RHO and KFI-type zeolites as catalysts for the methanol-to-olefins reaction

RHO and KFI-type zeolites are synthesized in the absence of organic structure-directing agents (OSDAs), post-synthetically dealuminated via high temperature (600–800 °C) steam treatments, and evaluated as catalysts for converting methanol-to-light olefins (MTO). The proton forms of the as-made zeolites deactivate rapidly when tested for the MTO reaction (conducted at 400 °C and atmospheric pressure) due to their high aluminum content. Steam treatments lead to improvements in olefin selectivities and catalyst lifetimes with samples steamed at 600 °C giving the best combination of lifetime and olefin selectivity. Zeolite characterizations by ^(27)Al NMR, ^(29)Si NMR and argon physisorption indicate that the steam treatments extract framework aluminum, leading to reductions in the total number of Brønsted acid sites and the creation of mesopores that can facilitate transport of reactants. Poisoning of the acid sites external to the 8MR pores of the zeolites by treatments with trimethylphosphite results in longer catalyst lifetimes but do not affect the observed olefin selectivities, suggesting that olefins do not undergo secondary dimerization or methylation reactions at these sites