Children and Young People and the Mental Health Act 2007

This article considers three areas in which the Mental Health Act 2007 has introduced some positive change in relation to children and young people: admission to hospital, age appropriate facilities and advocacy. It also highlights issues of continuing concern. It does so in the light of the United Nations Convention on the Rights of the Child (‘the Convention’), which was ratified by the UK government in 1991 and applies to all those aged under 18

The Draft Mental Incapacity Bill

Despite the general agreement with the Law Commission’s assessment of the failings of the current system for decision-making on behalf of people who lack the capacity to make decisions for themselves, the steps towards achieving comprehensive reform, as recommended in its report, Mental Incapacity, has been a protracted process. Mental Incapacity was followed, two years later, by a consultation paper – 'Who Decides? Making Decisions on Behalf of Mentally Incapacitated People' – in which the Government sought views on the Law Commission’s recommendations for reform. In October 1999, the Lord Chancellor’s Department published 'Making Decisions', which set out the Government’s proposal for reform, "in the light of the responses to the consultation paper Who Decides".In June of last year the reform process moved to a significant stage with the publication of the Government’s draft Mental Incapacity Bill (‘the Draft Bill’). This set out proposals to reform the law: "in order to improve and clarify the decision making process for those aged 16 and over who are unable to make decisions for themselves." Thus provisions set out in the Draft Bill are based on the Law Commission’s recommendations

The legal aspects of the mental health care of adolescents

This thesis examines the complex legal framework for admission to hospital and treatment for mental disorder of adolescents. It identifies areas of uncertainty and makes recommendations on how these might be addressed. It does so by mapping the various legal routes for adolescent psychiatric care, including detention under the Mental Health Act 1983, and examining these through a 'human rights lens' which reflects international and European human rights standards, including the European Convention on Human Rights and the United Nations Convention on the Rights of the Child

Low Immunization Rate in Kidney Transplant Recipients Also After Dose 2 of the BNT162b2 Vaccine: Continue to Keep Your Guard up!

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Sensing of bacterial spores with 2D-IR spectroscopy

Ultrafast 2D-IR spectroscopy has proved to be a powerful analytical tool for the detection and differentiation of Bacillus spores as dry films on surfaces. Here, we expand on these findings by employing 2D-IR spectroscopy to study spores from B. atrophaeus (BG) in aqueous solution. Specific vibrational modes attributable to the calcium dipicolinate trihydrate biomarker for spore formation were observed alongside distinctive off-diagonal spectral features that can be used to differentiate spores from different Bacillus species, indicating that 2D-IR has potential for use as a sensing platform with both solid and liquid phase samples. The ability of 2D-IR to enhance the protein amide I band relative to the overlapping water bending vibration was exploited to compare the nature of the protein component of spores to that of solution phase protein molecules. The vibrational lifetime for the amide I band of the BG spore in H2O was 1.4 ± 0.1 ps, longer than those reported for the proteins in H2O solution. The nature of a band at 1710 cm-1 was also investigated. Collectively these results show the potential advantages of 2D-IR spectroscopy, with successful detection and classification of spores under different conditions being based on detailed molecular understanding of the spore state

Whole blood gene expression in infants with respiratory syncytial virus bronchiolitis

BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of viral bronchiolitis in infants worldwide, and environmental, viral and host factors are all of importance for disease susceptibility and severity. To study the systemic host response to this disease we used the microarray technology to measure mRNA gene expression levels in whole blood of five male infants hospitalised with acute RSV, subtype B, bronchiolitis versus five one year old male controls exposed to RSV during infancy without bronchiolitis. The gene expression levels were further evaluated in a new experiment using quantitative real-time polymerase chain reaction (QRT-PCR) both in the five infants selected for microarray and in 13 other infants hospitalised with the same disease. RESULTS: Among the 30 genes most differentially expressed by microarray nearly 50% were involved in immunological processes. We found the highly upregulated interferon, alpha-inducible protein 27 (IFI27) and the highly downregulated gene Charcot-Leyden crystal protein (CLC) to be the two most differentially expressed genes in the microarray study. When performing QRT-PCR on these genes IFI27 was upregulated in all but one infant, and CLC was downregulated in all 18 infants, and similar to that given by microarray. CONCLUSION: The gene IFI27 is upregulated and the gene CLC is downregulated in whole blood of infants hospitalised with RSV, subtype B, bronchiolitis and is not reported before. More studies are needed to elucidate the specificity of these gene expressions in association with host response to this virus in bronchiolitis of moderate severity

A field investigation of an African horse sickness outbreak in the controlled area of South Africa in 2016

An outbreak of African horse sickness (AHS) caused by AHS virus type 1 occurred within the South African AHS surveillance zone during April and May 2016. The index case was detected by a private veterinarian through passive surveillance. There were 21 cases in total, which is relatively low compared to case totals during prior AHS outbreaks in the same region (and of the same AHS virus type) in 2004, 2011 and 2014. The affected proportion of horses on affected properties was 0.07 (95% CI 0.04, 0.11). Weather conditions were conducive to high midge activity immediately prior to the outbreak but midge numbers decreased rapidly with the advent of winter. The outbreak was localized, with 18 of the 21 cases occurring within 8 km of the index property and the three remaining cases on two properties within 21 km of the index property, with direction of spread consistent with wind‐borne dispersion of infected midges. Control measures included implementation of a containment zone with movement restrictions on equids. The outbreak was attributed to a reversion to virulence of a live attenuated vaccine used extensively in South Africa. Outbreaks in the AHS control zones have a major detrimental impact on the direct export of horses from South Africa, notably to the European Union.The Equine Health Fund–Wits Health Consortium (Pty) Ltd and the Equine Research Centre (University of Pretoria).http://wileyonlinelibrary.com/journal/tbed2020-03-01hj2020Equine Research CentreProduction Animal Studie

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

[Disability] justice dictated by the surfeit of love:Simone Weil in Nigeria

How is Nigeria’s failure to fulfil its obligations as a signatory of the United Nations Convention on the Rights of Persons with Disabilities to be appreciated or even resolved? Answers to this are sought through a seminal criticism of human rights, namely, Simone Weil’s 1942 essay Human Personality. Weil questioned the ability of human rights concepts to cause the powerful to develop the emotional dispositions of empathy for those who suffer. Weil’s insights provide a convincing explanation that the indifference of Nigerian authorities towards the Convention may be accounted for by the weakness of human rights discourse to foster human capacity for empathy and care for those who suffer. Weil’s criticisms will serve as a point of departure for a particular way to circumvent this inadequacy of human rights discourse to achieve disability justice in Nigeria through other means. I argue that Weil, through her concept of attention, grappled with and offers a consciousness of suffering and vulnerability that is not only uncommon to existing juridical human rights approaches, but is achievable through the active participation in the very forms of suffering and vulnerability in which amelioration is sought. To provide empirical content to this argument, I turn to a short-lived initiative of the Nigerian disability movement, which if ethico-politically refined and widely applied, can supply an action-theoretical grounding for and be combined with Weil’s work to elevate agitations for disability justice above human rights to the realm of human obligations