The mental health strategy for Europe: Why service user leadership in research is indispensable

Recent European mental health strategies and programmes declare service user involvement to be essential in the development and evaluation of policy and services. In light of the announcement in March 2011 by the World Health Organization Regional Office for Europe of a forthcoming new mental health strategy for Europe, we propose that service user leadership in research is the most effective way of enhancing such involvement and consider what is required to broaden initiatives across Europe

Close to the bench as well as at the bedside: involving service users in all phases of translational research

Aim:  The paper aims to develop a model of translational research in which service user and other stakeholder involvement are central to each phase. Background:  ‘Translational’ is the current medical buzzword: translational research has been termed ‘bench to bedside’ research and promises to fast-track biomedical advances in the service of patient benefit. Models usually conceive of translational research as a ‘pipeline’ that is divided into phases: the early phase is characterized as the province of basic scientists and laboratory-based clinical researchers; the later phases focus on the implementation, dissemination and diffusion of health applications. If service user involvement is mentioned, it is usually restricted to these later phases. Methods:  The paper critically reviews existing literature on translational research and medicine. The authors develop a theoretical argument that addresses why a reconceptualization of translational research is required on scientific, ethical and pragmatic grounds. Results:  The authors reconceptualize the model of translational research as an interlocking loop rather than as a pipeline, one in which service user and other stakeholder involvement feed into each of its elements. The authors demonstrate that for the ‘interlocking loop’ model of translational research to be materialized in practice will require changes in how health research is structured and organized. Conclusion:  The authors demonstrate the scientific, ethical and pragmatic benefits of involving service users in every phase of translational research. The authors’ reconceptualized model of translational research contributes to theoretical and policy debates regarding both translational research and service user involvement

Tobacco Control and the World Trade Organization : Mapping Member States’ Positions after the Framework Convention on Tobacco Control

Objective To note the frequency of discussions and disputes about tobacco control measures at the World Trade Organization (WTO) before and after the coming into force of the Framework Convention on Tobacco Control (FCTC). To review trends or patterns in the positions taken by members of the WTO with respect to tobacco control measures. To discuss possible explanations for these observed trends/patterns. Methods We gathered data on tobacco-related disputes in the WTO since its establishment in 1995 and its forerunner, the General Agreement on Tariffs and Trade (GATT), prior-FCTC and post-FCTC. We also looked at debates on tobacco control measures within the WTO more broadly. To this end, we classified and coded the positions of WTO member states during discussions on tobacco control and the FCTC, from 1995 until 2013, within the Technical Barriers to Trade (TBT) Committee and the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Council. Results There is a growing interest within the WTO for tobacco-related issues and opposition to tobacco control measures is moving away from high-income countries towards low(er) income countries. Conclusions The growing prominence of tobacco issues in the WTO can be attributed at least in part to the fact that during the past decade tobacco firms have been marginalised from the domestic policy-making process in many countries, which has forced them to look for other ways and forums to influence decision-making. Furthermore, the finding that almost all recent opposition within the WTO to stronger tobacco regulations came from developing countries is consistent with a relative shift of transnational tobacco companies’ lobbying efforts from developed to developing countries

Ranked prediction of p53 targets using hidden variable dynamic modeling

Full exploitation of microarray data requires hidden information that cannot be extracted using current analysis methodologies. We present a new approach, hidden variable dynamic modeling (HVDM), which derives the hidden profile of a transcription factor from time series microarray data, and generates a ranked list of predicted targets. We applied HVDM to the p53 network, validating predictions experimentally using small interfering RNA. HVDM can be applied in many systems biology contexts to predict regulation of gene activity quantitatively

Near-field and far-field analysis of an azimuthally polarized slow Bloch mode microlaser

We report on the near- and far-field investigation of the slow Bloch modes associated with the G point of the Brillouin zone, for a honeycomb lattice photonic crystal, using near-field scanning optical microscopy (NSOM) and infra-red CCD camera. The array of doughnut-shaped monopolar mode (mode M) inside each unit cell, predicted previously by numerical simulation, is experimentally observed in the near-field by means of a metal-coated NSOM tip. In far-field, we detect the azimuthal polarization of the doughnut laser beam due to destructive and constructive interference of the mode radiating from the surface (mode TEM01*). A divergence of 2° for the laser beam and a mode size of (12.8 ± 1) μm for the slow Bloch mode at the surface of the crystal are also estimated. © 2010 Optical Society of America

Debating DSM-5:diagnosis and the sociology of critique

The development of the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders—the DSM-5—has reenergised and driven further forward critical discourse about the place and role of diagnosis in mental health. The DSM-5 has attracted considerable criticism, not least about its role in processes of medicalisation. This paper suggests the need for a sociology of psychiatric critique. Sociological analysis can help map fields of contention, and cast fresh light on the assumptions and nuances of debate around the DSM-5; it underscores the importance of diagnosis to the governance of social and clinical life, as well as the wider discourses critical commentaries connect with and are activated by. More normatively, a sociology of critique can indicate which interests and values are structuring the dialogues being articulated, and just how diverse clinical opinion regarding the DSM can actually be. This has implications for the considerations of health services and policy decision-makers who might look to such debates for guidance

Extent and retreat history of the Barra Fan Ice Stream offshore western Scotland and northern Ireland during the last glaciation

During the Last Glacial Maximum (LGM) the marine-terminating Barra Fan Ice Stream (BFIS), a major conduit of the British Irish Ice Sheet (BIIS), drained much of western Scotland and northwest Ireland with ice streaming onto the continental shelf of the Malin Sea. The extent and retreat history of this ice stream across the shelf, until now, is not well known. In particular, geochronological constraints on the history of this ice stream have thus far been restricted to deep-sea cores or terrestrial cosmogenic nuclide dating onshore, with ages across the shelf absent. To understand the possible external forcing factors acting on this marine terminating ice stream during retreat, improved geochronological constraint on its deglaciation is necessary. Here, we present new geophysical data, marine sediment cores and over forty radiocarbon dates to provide important constraints on maximum extent of the BFIS, as well as the timing and pattern of retreat back across the Malin Shelf. Dated moraines and grounding-zone wedges (GZW) seen in seafloor sub-bottom profiles provide evidence that the BFIS reached the Malin Shelf edge during the LGM and was at its maximum extent around 26.7 ka BP. The presence of two sets of GZWs suggests that the style of retreat was episodic. The new radiocarbon chronology shows that retreat from the shelf edge was underway by 25.9 ka BP, with the majority of the continental shelf ice free by 23.2 ka BP, and that glacimarine conditions were present in the Sea of Hebrides by 20.2 ka BP at the latest. Collectively, these results indicate that the majority of the Malin Shelf was free of grounded ice by ∼21.5–20 ka BP, which is up to 4000 years earlier than previously reconstructed. We attribute this early deglaciation to high relative sea level caused by glacial isostatic depression when the BIIS reached its maximum extent promoting ice shelf and grounding line instability. Two deep troughs, forming reverse bed slopes, aided the continued retreat of the BFIS. This suggests that local ice loading and bed morphology can be significant controls on the destabilisation of a marine-terminating ice stream and can override the influence of ocean and atmospheric temperatures

Weathering fluxes and sediment provenance on the SW Scottish shelf during the last deglaciation

The reconstruction of past ice sheet dynamics can shed a light on long-term ice stream activity, and in turn provide constraints on the response of modern ice sheets to climate change. The Hebrides Ice Stream (HIS) flowed across part of the western Scottish shelf to the shelf-break during the last glacial cycle and drained a large portion of the northern sector of the British Irish-Ice Sheet. To investigate the deglacial dynamics of the HIS following the Last Glacial Maximum, lead (Pb) isotope records were extracted from the FeMn oxyhydroxide and detrital fractions of recovered laminated glacimarine mud sequences to monitor the changing activity of HIS during its retreat. These provide timing and some source information of glacially weathered inputs to the marine environment. The FeMn oxyhydroxide fraction in the samples is dominated by allochthonous particles (pre-formed) and shows a marked decrease from radiogenic (≤ 20.05 206Pb/204Pb) at ~ 21 cal ka BP to less radiogenic Pb isotope compositions (~ 19.48) towards the Windermere Interstadial (15.4–13 ka). This decrease represents a reduction in the flux of subglacially-derived radiogenic Pb to the continental shelf is interpreted as being associated with the break-up of the ice-stream in western Scotland around that time. The Pb, Sr and Nd isotopic signatures of the detrital fraction indicate a preponderance of Moine-sourced fine sediments (originated from the NW Highlands) in the core locations from ~ 21 to 15 cal ka BP (Dimlington Stadial - Windermere Interstadial), most likely dictated by the orientation of ice flow, tidal and oceanic current directions and sediment delivery. In contrast, ice rafted debris in a ~ 21 cal ka BP old basal diamicton contains volcanic-derived material, suggesting different provenance for different grain sizes. The FeMn oxyhydroxide 208Pb/204Pb ratio shows an unusual inversion relative to the other Pb isotope ratios, and is attributed to the introduction of secondary weathering phases from a source with contrasting 208Pb/204Pb but similar 206Pb/204Pb and 207Pb/204Pb. In the detrital fraction, the inversions are constrained to periodic spikes, which may indicate an increased contribution from a high Th/U source, potentially the neighbouring Archaean amphibolitic Lewisian basement in the Outer Hebrides. This study demonstrates how geochemical investigation on continental shelves can be used to constrain the timing, activity and flow sources of palaeo-ice streams

A stratigraphic investigation of the Celtic Sea megaridges based on seismic and core data from the Irish-UK sectors

The Celtic Sea contains the world's largest continental shelf sediment ridges. These megaridges were initially interpreted as tidal features formed during post-glacial marine transgression, but glacigenic sediments have been recovered from their flanks. We examine the stratigraphy of the megaridges using new decimetric-resolution geophysical data correlated to sediment cores to test hypothetical tidal vs glacial modes of formation. The megaridges comprise three main units, 1) a superficial fining-upward drape that extends across the shelf above an unconformity. Underlying this drape is 2), the Melville Formation (MFm) which comprises the upper bulk of the megaridges, sometimes displaying dipping internal acoustic reflections and consisting of medium to coarse sand and shell fragments; characteristics consistent with either a tidal or glacifluvial origin. The MFm unconformably overlies 3), the Upper Little Sole Formation (ULSFm), previously interpreted to be of late Pliocene to early Pleistocene age, but here shown to correlate to Late Pleistocene glacigenic sediments forming a precursor topography. The superficial drape is interpreted as a product of prolonged wave energy as tidal currents diminished during the final stages of post-glacial marine transgression. We argue that the stratigraphy constrains the age of the MFm to between 24.3 and 14 ka BP, based on published dates, coeval with deglaciation and a modelled period of megatidal conditions during post-glacial marine transgression. Stratigraphically and sedimentologically, the megaridges could represent preserved glacifluvial features, but we suggest that they comprise post-glacial tidal deposits (MFm) mantling a partially-eroded glacial topography (ULSFm). The observed stratigraphy suggests that ice extended to the continental shelf-edge

Naive B cell output in HIV-infected and HIV-uninfected children.

In this study, we aimed to quantify KREC (kappa-deleting recombination excision circle) levels and naive B cell output in healthy HIV-uninfected children, compared with HIV-infected South African children, before and after starting ART (antiretroviral therapy). Samples were acquired from a Child Wellness Clinic (n = 288 HIV-uninfected South African children, 2 weeks-12 years) and the Children with HIV Early Antiretroviral Therapy (CHER) trial (n = 153 HIV-infected South African children, 7 weeks-8 years). Naive B cell output was estimated using a mathematical model combining KREC levels to reflect B cell emigration into the circulation, flow cytometry measures of naive unswitched B cells to quantify total body naive B cells, and their rates of proliferation using the intracellular marker Ki67. Naive B cell output increases from birth to 1 year, followed by a decline and plateau into late childhood. HIV-infected children on or off ART had higher naive B cell outputs than their uninfected counterparts (p = .01 and p = .04). This is the first study to present reference ranges for measurements of KRECs and naive B cell output in healthy and HIV-infected children. Comparison between HIV-uninfected healthy children and HIV-infected children suggests that HIV may increase naive B cell output. Further work is required to fully understand the mechanisms involved and clinical value of measuring naive B cell output in children