Changes in health-related quality of life following imprisonment in 92 women in England: a three month follow-up study

<p>Abstract</p> <p>Background</p> <p>Despite the considerable changes in the provision of health care to prisoners in the UK there is little published literature that attempts to examine broader aspects of health and the impact of imprisonment on these, focusing instead on disease specific areas. This is surprising given that one of the main drivers behind the changes was the need for improvements in the quality of care; examining changes in health outcomes should be an important part of monitoring service developments. This study assessed the health-related quality of life of women on entry into prison and examined changes during a period of three months imprisonment.</p> <p>Methods</p> <p>This was a prospective longitudinal study involving 505 women prisoners in England. The SF-36 was contained within a questionnaire designed to examine many aspects of imprisoned women's health. Participants completed this questionnaire within 72 hours of entering prison. The researchers followed up all participants who were still imprisoned three months later.</p> <p>Results</p> <p>The study achieved good response rates: 82% of women agreed to participate initially (n = 505), and 93% of those still imprisoned participating three months later (n = 112). At prison entry, women prisoners have lower mental component summary score (MCS) and physical component summary score (PCS) compared to women within the general population. The mental well-being of those 112 women still imprisoned after three months improved over this period of imprisonment, although remained poorer than that of the general population. The PCS did not improve significantly and remained significantly lower than that of the general population. Multivariate analyses showed that the only independent predictor of change in component score was the score at baseline.</p> <p>Conclusions</p> <p>The results highlight the poor health-related quality of life of women prisoners and highlight the scale of the challenge faced by those providing health care to prisoners. They also draw attention to the major health disadvantages of women offenders compared to women in general. While recent reforms may improve health services for prisoners, broader inequalities in the health of women are a more complex challenge.</p

Stem cell antigen 1 positive resident vascular stem cells and their contribution to vascular disease

Vascular remodelling occurs during many forms of cardiovascular disease (CVD). This vascular remodelling can be either symmetrical as observed in arteriosclerotic conditions (e.g. natural vascular aging, transplant arteriosclerosis and in-stent restenosis (ISR)), or asymmetrical as observed in atherosclerosis. An integral part of the pathology of symmetrical vascular remodelling is the formation of a “neointimal layer”, also known as “intimal medial thickening” (IMT), whereby cells (widely considered to be vascular smooth muscle cells (vSMC)) accumulate within the vessel and obstruct circulatory blood flow. Currently, there are two predominant and contrasting fields of thought as to the origin of these neointimal cells: 1. resident vSMCs and 2. resident vascular stem cells. While this thesis discusses both theories in detail; it focuses on the role of a stem cell antigen 1 positive (Sca1+) resident vascular stem cell, and shows evidence of its contribution to vascular remodelling both in vitro and in vivo. Previously, a Sca1+ adventitial cell has been shown to co-localise at the adventitial medial boundary with the hedgehog (Hh) signalling activation morphogen Shh and its receptor Patched 1. Moreover, Patched 1+ cells are present in the medial and intimal layers following vascular injury and remodelling. Therefore, the aim of this thesis was to investigate the role of Sca1+ adventitial progenitor cells (APC) during vascular remodelling, with a focus on exploring the role of Hh- responsive Sca1+ APC contribution to IMT. Characterisation of two widely used model cell lines (Sca1+ ESC and Sca1+ C3H) and APC highlighted variable expression profiles. Additionally, in vitro exposure of Sca1+ APC and Sca1+ C3H to Shh demonstrated contrasting maintenance of “stemness” responses (with Shh inducing significant maintenance of “stemness” in Sca1+ C3H but not in Sca1+ APC). Importantly, in vitro exposure of Sca1+ APC to Shh activated Hh signalling, and induced cellular proliferation and SMC differentiation, a process that was attenuated using the Hh specific inhibitor cyclopamine. Crucially, in vivo analysis demonstrated that Sca1+ APC proliferate/expand following injury-induced vascular remodelling, and Sca1+ Hh responsive cells were found in the neointima of remodelling vessels. In vivo analysis also demonstrated that the recapitulation of Hh signalling during vascular remodelling is essential to pathological IMT (as confirmed by significant attenuation of vascular remodelling following treatment with the cyclopamine). To conclude, Hh responsive Sca1+ resident vascular stem cells are key to the progression of pathological vascular remodelling and ultimately cardiovascular disease

Reducing harm and promoting positive media use strategies : new perspectives in understanding the impact of preschooler media use on health and development

Most children grow up in homes with easy access to multiple screens. Screen use by children between the ages of 0 to 5 has become a worldwide preoccupation. In the present narrative review, we examine child and parent screen use and its contribution to physical, cognitive, and social developmental outcomes. As research has mostly focused on the adverse consequences of screen media, we aim to depict both the negative and the positive infuences of screen usage. To provide a more nuanced portrait of the potential benefts and harms of screen use, we examine how consequences of media use vary according to the content of media (ex., educational, violent), context (ex., using screens during mealtimes), and the nature (ex., passive vs active use) of child screen use. Our review supports existing screen time guidelines and recommendations and suggests that media content, the context of use, and the nature of child use, as well as the parent’s own screen use, be considered clinically. Future research should seek to clarify how these dimensions jointly contribute to child screen use profles and associated consequences. Finally, child sex, behavioral/temperamental difculties, and family adversity appear to contribute to child screen use and its consequences and should be considered in future research. Suggestions for harm-reduction approaches are discussed

User experience in the newly refurbished CUED Library space: exploring the study needs and habits of library users through ethnographic and UX methods

This is an unpublished document

The Dichotomy of Vascular Smooth Muscle Differentiation/De- Differentiation in Health and Disease

Vascular smooth muscle cells (SMCs) are thought to display cellular plasticity by alternating between a quiescent ‘contractile’ differentiated phenotype and a proliferative ‘synthetic’ de-differentiated phenotype in response to induction of distinct developmental pathways or to local micro-environmental cues. This classic de-differentiation and re-programming process is associated with a significant loss in the expression of key SMC differentiation marker genes for a large number of proliferative vascular diseases in vivo and in sub-cultured cells in vitro. Regarded as essential for vascular regeneration and repair in vivo, phenotypic modulation represents a critical target for therapeutic intervention. However, recent evidence now suggests that this process of vascular regeneration may also involve differentiation of resident vascular stem cells and the accumulation of stem cell-derived myogenic, osteochondrogenic and macrophage-like phenotypes within vascular lesions in vivo and across sub-cultured SMC cell populations in vitro. This review summarises our current knowledge of vascular regeneration, de-differentiation and re-programming of vascular SMCs, and focuses on the accumulating evidence of a putative role for stem cell-derived progeny and the evolving dichotomy of the origin of SMC-like cells during intimal-medial thickening and the progression of arteriosclerotic disease

Native extracellular matrix orientation determines multipotent vascular stem cell proliferation in response to cyclic uniaxial tensile strain and simulated stent indentation

Cardiovascular disease is the leading cause of death worldwide, with multipotent vascular stem cells (MVSC) implicated in contributing to diseased vessels. MVSC are mechanosensitive cells which align perpendicular to cyclic uniaxial tensile strain. Within the blood vessel wall, collagen fibers constrain cells so that they are forced to align circumferentially, in the primary direction of tensile strain. In these experiments, MVSC were seeded onto the medial layer of decellularized porcine carotid arteries, then exposed to 10%, 1 Hz cyclic tensile strain for 10 days with the collagen fiber direction either parallel or perpendicular to the direction of strain. Cells aligned with the direction of the collagen fibers regardless of the orientation to strain. Cells aligned with the direction of strain showed an increased number of proliferative Ki67 positive cells, while those strained perpendicular to the direction of cell alignment showed no change in cell proliferation. A bioreactor system was designed to simulate the indentation of a single, wire stent strut. After 10 days of cyclic loading to 10% strain, MVSC showed regions of densely packed, highly proliferative cells. Therefore, MVSC may play a significant role in in-stent restenosis, and this proliferative response could potentially be controlled by controlling MVSC orientation relative to applied strain

The Australasian Students' Surgical Association: organizational growth amidst the challenges of the COVID-19 pandemic

[Extract] Student surgical societies play an important role in complementing university medical curricula in the delivery of surgical education, fostering interest in surgery and facilitating networking and career opportunities.1 The Australasian Students' Surgical Association (ASSA) was established in 2015 as a not-for-profit student-run organization aiming to unite the 26 student surgical societies across Australia and New Zealand.2 Through in-person conferences, Sydney-based leadership seminars and surgical workshops, the ASSA has successfully achieved its vision to support surgical education, foster student interest in surgery, and create a culture of collaboration amongst surgical societies. As the COVID-19 pandemic presented a variety of unforeseen challenges to the medical profession, student organizations across the world were required to adapt to the content and delivery of activities.3 The pandemic posed significant challenges for the ASSA to continue promoting a pre-vocational interest in surgery for Australian and New Zealand medical students and required innovative strategies to continue delivering educational opportunities. This need to adopt alternative approaches provided an opportunity for innovation and embracing technology to overcome COVID-19 related restrictions to continue achieving the goals for ASSA