Matching service development to mental health needs: a case study of a rural county

The development of Somerset's mental health services from 1991 to 1996 involved the closure of the county's last long-stay hospital, and its replacement by more local in-patient provision and an expansion of community services. The process and outcome of this change is examined, drawing upon (a) an externally-commissioned evaluation in 1994-6 and (b) a comprehensive mental health needs assessment in 1996. The findings from these studies indicate that the development of accommodation for people with severe and long-term mental health problems has been dominated by the needs of long-stay residents in the old institutions. This led initially to geographical inequities and a shortage of supported accommodation for others with severe and enduring mental health problems. However, developments during this period also suggest a local capacity to detect and respond to unmet needs in this group

The use of multispectral sensing techniques to detect ponderosa pine trees under stress from insect or pathogenic organisms Annual progress report

Ground and aerial imaging techniques to detect tree damage caused by bark beetles in forested area

The use of multispectral sensing techniques to detect Ponderosa pine trees under stress from insect or pathogenic organisms

Multispectral sensing techniques for ground and airborne detection of Ponderosa pine trees under stress from insect or pathogenic organism

The use of multispectral sensing techniques to detect ponderosa pine trees under stress from insect or pathogenic organisms

Application of multispectral sensors to detect insect and disease infestation of ponderosa pine tree

High Energy Physics from High Performance Computing

We discuss Quantum Chromodynamics calculations using the lattice regulator. The theory of the strong force is a cornerstone of the Standard Model of particle physics. We present USQCD collaboration results obtained on Argonne National Lab's Intrepid supercomputer that deepen our understanding of these fundamental theories of Nature and provide critical support to frontier particle physics experiments and phenomenology.Comment: Proceedings of invited plenary talk given at SciDAC 2009, San Diego, June 14-18, 2009, on behalf of the USQCD collaboratio

Long-term persistence of rituximab in patients with rheumatoid arthritis: an evaluation of the UCL cohort from 1998 to 2020

OBJECTIVES: B cell depletion therapy based on rituximab in patients with RA was pioneered at University College London Hospitals/University College London in 1998. The objective of this study was to evaluate long-term persistence of rituximab and identify factors associated with discontinuation of treatment. METHODS: Retrospective review of medical records from all rituximab-treated RA patients followed up in a dedicated clinic (1998–2020). Data collected included gender, disease duration, previous DMARDs, autoantibody status, age and concomitant therapy at first cycle, length of follow-up, and number of cycles. Drug survival and factors associated with drug discontinuation were analysed using Kaplan–Meier survival curves, log-rank test and Cox regression analysis. RESULTS: A total of 404 patients were included. Median disease duration and age at time of first rituximab cycle were 10 and 57 years, respectively. Median total follow-up was 55 months and median number of cycles five. 93.1% of patients were seropositive. Overall, 31.2% of patients stopped rituximab, with the largest reason for discontinuing being primary inefficacy (42.1%). Comparison of Kaplan–Meier curves showed that rituximab drug survival was lower in seronegative patients and in patients who had previously failed at least one biologic DMARD (bDMARD). Cox regression analysis revealed that rituximab discontinuation was associated with a greater number of previous bDMARDs. CONCLUSION: Many patients with RA achieve good control of their disease with repeated cycles of rituximab treatment. The most common reasons for treatment discontinuation were either primary or secondary inefficacy. Patients who were seronegative and who had previously failed other bDMARDs were more at risk of drug discontinuation

Hawking radiation and thermodynamics of dynamical black holes in phantom dominated universe

The thermodynamic properties of dark energy-dominated universe in the presence of a black hole are investigated in the general case of a varying equation-of-state-parameter $w(a)$. We show that all the thermodynamics quantities are regular at the phantom divide crossing, and particularly the temperature and the entropy of the dark fluid are always positive definite. We also study the accretion process of a phantom fluid by black holes and the conditions required for the validity of the generalized second law of thermodynamics. As a results we obtain a strictly negative chemical potential and an equation-of-state parameter $w<-5/3.$Comment: 22 pages,3 figure

Serum markers of B-cell activation in pregnancy during late gestation, delivery, and the postpartum period

B cells are vital for the normal evolution of pregnancy due to their humoral and possible regulatory activities. Our group and others have documented that circulating B-cell subsets undergo changes from normal late pregnancy to the postpartum period. However, the underlying mechanisms are poorly understood. Therefore, this study examined the degree of B-cell activation in normal pregnancy by analyzing the levels of serum markers in healthy pregnant women during the third trimester of pregnancy, the day of delivery, and the postpartum period. METHOD OF STUDY: A prospective study including pregnant and non-pregnant women attending routine care was undertaken at a hospital clinic. Sociodemographic and clinical data were collected, along with peripheral blood samples. The serum levels of soluble CD23 (sCD23), B-cell-activating factor (BAFF), kappa (κ) and lambda (λ) free light chains (FLC), IgA, IgG, and IgM were quantified. RESULTS: Our study included 43 third trimester pregnant and 35 non-pregnant women. In the pregnant women, the median levels of sCD23, BAFF, IgG, and κ FLC were significantly higher during the postpartum period than during the third trimester of pregnancy. Compared to the non-pregnant women, the third trimester pregnant women had higher median BAFF levels and lower sCD23, IgA, IgG, and FLC levels. CONCLUSION: Changes in serum markers of B-cell kinetics that occur during pregnancy often persist into the postpartum period and affect the secretion of immunoglobulins from different classes. Further studies are needed to clarify the biological significance of our observations.info:eu-repo/semantics/publishedVersio

Serum antibodies in first-degree relatives of patients with IBD: A marker of disease susceptibility? A follow-up pilot-study after 7 years

Introduction: Various disease-specific serum antibodies were described in patients with inflammatory bowel disease and their yet healthy first-degree relatives. In the latter, serum antibodies are commonly regarded as potential markers of disease susceptibility. The present long-term follow-up study evaluated the fate of antibody-positive first-degree relatives. Patients and Methods: 25 patients with Crohn's disease, 19 patients with ulcerative colitis and 102 first-degree relatives in whom presence of ASCA, pANCA, pancreatic- and goblet-cell antibodies had been assessed were enrolled. The number of incident cases with inflammatory bowel disease was compared between antibody-positive and antibody-negative first-degree relatives 7 years after storage of serum samples. Results: 34 of 102 (33%) first-degree relatives were positive for at least one of the studied serum antibodies. In the group of first-degree relatives, one case of Crohn's disease and one case of ulcerative colitis were diagnosed during the follow-up period. However, both relatives did not display any of the investigated serum antibodies (p = 1). Discussion: The findings of our pilot study argue against a role of serum antibodies as a marker of disease susceptibility in first-degree relatives of patients with inflammatory bowel disease. However, these data have to await confirmation in larger ideally prospective multicenter studies before definite conclusions can be drawn

Serum antibodies in first-degree relatives of patients with IBD: A marker of disease susceptibility? A follow-up pilot-study after 7 years

Introduction: Various disease-specific serum antibodies were described in patients with inflammatory bowel disease and their yet healthy first-degree relatives. In the latter, serum antibodies are commonly regarded as potential markers of disease susceptibility. The present long-term follow-up study evaluated the fate of antibody-positive first-degree relatives. Patients and Methods: 25 patients with Crohn's disease, 19 patients with ulcerative colitis and 102 first-degree relatives in whom presence of ASCA, pANCA, pancreatic- and goblet-cell antibodies had been assessed were enrolled. The number of incident cases with inflammatory bowel disease was compared between antibody-positive and antibody-negative first-degree relatives 7 years after storage of serum samples. Results: 34 of 102 (33%) first-degree relatives were positive for at least one of the studied serum antibodies. In the group of first-degree relatives, one case of Crohn's disease and one case of ulcerative colitis were diagnosed during the follow-up period. However, both relatives did not display any of the investigated serum antibodies (p = 1). Discussion: The findings of our pilot study argue against a role of serum antibodies as a marker of disease susceptibility in first-degree relatives of patients with inflammatory bowel disease. However, these data have to await confirmation in larger ideally prospective multicenter studies before definite conclusions can be drawn