Commissioning Liaison Psychiatry services

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A pilot study to support veterans in the criminal justice system

Project Nova is a pilot model in Norfolk and Suffolk of an intervention, to reach veterans at the earliest point of contact following their arrest. This evaluation of Project Nova provides an insight into the needs of veteran offenders at an early stage in the criminal justice pathway. It also helps the reader to understand whether these needs can be met shortly after arrest, and whether this has any impact on offending behaviour. This Report reflects on examples of best practice for working with this challenging and often hard to engage populatio

We Also Served: The Health and Well-being of Female Veterans in the UK

Women have served within the Armed Forces for over 100 years. Their contribution has been extraordinary but the prevailing military culture, together with evolving terms and conditions of Service, have left their mark on the health and well-being of many. Whilst it is right, therefore, to recognise the progress that has been made, there is a pressing need to evidence the impact of past policies and actions. This timely report is the first major step in addressing this. Almost thirty organisations, drawn from across the military charity sector as well as from statutory bodies including NHS England and NHS Improvement and the MOD, have contributed to this report. It is the first research project to consider holistically the full range of female veteran issues, uniquely capturing the lived experiences of women who have served. Perhaps most importantly, it provides an essential start point for a comprehensive evidence base that will enable debate with a level of insight and clarity that has been missing before, and which will ensure statutory and Service Charity provision is targeted accurately to meet the needs of those women who are serving and veterans. The report is clear that for many that is not yet the case, both for those in Service and for those who have transitioned to civilian lives. It is a timely warning that there is still work to do both in improving in-Service conditions to allow our servicewomen to thrive and, once they leave, for us to tailor our veteran support services to meet their specific needs. This will include the requirement to support and improve the needs of serving women, whether as partners, mothers or in different family situations, and its impact on well-being, whilst at the same time enabling military careers. A prioritised action pl an has been produced in order to a chieve real impact and create long-lasting change. Top of the list is a review of the impact on health and well-being outcomes of Service culture an d sexual harassment, issues which have long been discussed but which continue to persist, with a number of the recommendations from the recent Wigston Report yet to be fully implemented. The report also identifies considerable gaps in our understanding of how in-Service experiences impact on health, wealth, and socio-economic outcomes, and explores what further action is required. Overall, this report is unique in its breadth and depth, in the academically robust processes undertaken and in its capture of the lived experiences of female veterans from across the services and the decades. It is not an easy read. It is, however, a necessary read. By compiling the evidence, the report gives voice to our former servicewomen and sets out an irrefutable case for further and necessary cultural and policy change to improve the long-term health and well-being of those women who have served and are serving

Apathy and Its Response to Antipsychotic Review and Nonpharmacological Interventions in People With Dementia Living in Nursing Homes: WHELD, a Factorial Cluster Randomized Controlled Trial

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordObjectives Apathy is common, impactful, and difficult to manage in people with dementia. We evaluated the efficacy of nonpharmacological interventions, exercise, and social interaction, in combination with antipsychotic review, to reduce apathy in people with dementia living in nursing homes in a cluster randomized controlled trial (RCT). Methods Well-being and health for people with dementia (WHELD) program included a 2 × 2 × 2 factorial cluster RCT involving people with dementia living in 16 nursing homes in the United Kingdom. All homes received training in person-centered care, and were randomized to receive antipsychotic review, social interaction, and exercise, either alone or in combinations. Apathy was one of the secondary outcomes of the WHELD trial, and it was measured by the Neuropsychiatric Inventory–nursing home version at baseline and 9 months (n = 273). We used multilevel mixed effects linear regression models to assess the impact of the interventions on apathy. Results Prevalence of apathy was 44.0% (n = 120; 95% confidence interval [CI] 38.1%–49.9%) at baseline. Severity of apathy had significant positive correlations with dementia severity, neuropsychiatric symptoms, depressive symptoms, agitation, and the needs of the people with dementia (P < .001). Antipsychotic review reduced antipsychotic use, but it significantly increased apathy (β = 5.37; SE = 0.91; P < .001). However, antipsychotic review in combination with either social interaction (β = −5.84; SE = 1.15; P < .001) or exercise (β = −7.54; SE = 0.93; P < .001) significantly reduced apathy. Conclusions Antipsychotic review can play a significant role in improving apathy in people with dementia living in nursing homes, when combined with psychosocial interventions such as social interaction and exercise. Guidance must be adapted to reflect this subtlety in care.National Institute for Health Research (NIHR

The ERE of the "Red Rectangle" revisited

We present in this paper high signal-to-noise long-slit optical spectra of the Extended Red Emission (ERE) in the "Red Rectangle" (RR) nebula. These spectra, obtained at different positions in the nebula, reveal an extremely complex emission pattern on top of the broad ERE continuum. It is well known that three features converge at large distance from the central object, in wavelength and profile to the diffuse interstellar bands (DIBs) at 5797, 5849.8 and 6614 ang., (e.g. Sarre et al., 1995). In this paper we give a detailed inventory of all spectral subfeatures observed in the 5550--6850 ang. spectral range. Thanks to our high S/N spectra, we propose 5 new features in the RR that can be associated with DIBs. For the 5550--6200 ang. spectral range our slit position was on top of the NE spike of the X shaped nebula. A detailed description of the spatial profile-changes is given of the strongest features revealing that even far out in the nebula at 24 arcsec from the central star, there remains a small shift in wavelength of 1 respectively 2 ang between the ERE subfeatures and the DIB wavelengths of 5797.11 and 5849.78 ang.Comment: 8 pages, 9 figures accepted by Astronomy and Astrophysic

Synthesis of atropisomeric phosphino-triazoles and their corresponding gold(i) complexes

The synthesis of atropisomeric phoshino-triazoles is disclosed. It was found that the introduction of a phosphine functionality onto the 5-position of a 1,2,3-triazole ring could be highly restrictive towards the rotation around a triazole-aryl bond. VT NMR and chiral HPLC studies demonstrated that rotation was restricted even at high temperatures. Gold(I) chloride complexes of single-enantiomer phosphines were prepared and again demonstrated to be conformationally stable

Water in HD 209458b's atmosphere from 3.6 - 8 microns IRAC photometric observations in primary transit

The hot Jupiter HD 209458b was observed during primary transit at 3.6, 4.5, 5.8 and 8.0 microns using the Infrared Array Camera (IRAC) on the Spitzer Space Telescope. We detail here the procedures we adopted to correct for the systematic trends present in the IRAC data. The light curves were fitted including limb darkening effects and fitted using Markov Chain Monte Carlo and prayer-bead Monte Carlo techniques, finding almost identical results. The final depth measurements obtained by a combined Markov Chain Monte Carlo fit are at 3.6 microns, 1.469 +- 0.013 % and 1.448 +- 0.013 %; at 4.5 microns, 1.478 +- 0.017 % ; at 5.8 microns, 1.549 +- 0.015 % and at 8.0 microns 1.535 +- 0.011 %. Our results clearly indicate the presence of water in the planetary atmosphere. Our broad band photometric measurements with IRAC prevent us from determining the additional presence of other other molecules such as CO, CO2 and methane for which spectroscopy is needed. While water vapour with a mixing ratio of 10^-4-10^-3 combined with thermal profiles retrieved from the day-side may provide a very good fit to our observations, this data set alone is unable to resolve completely the degeneracy between water abundance and atmospheric thermal profile.Comment: 14 pages, 6 tables, 10 figures, Accepted for publication in MNRA

An ingress and a complete transit of HD 80606 b

We have used four telescopes at different longitudes to obtain near-continuous lightcurve coverage of the star HD 80606 as it was transited by its \sim 4-MJup planet. The observations were performed during the predicted transit windows around the 25th of October 2008 and the 14th of February 2009. Our data set is unique in that it simultaneously constrains the duration of the transit and the planet's period. Our Markov-Chain Monte Carlo analysis of the light curves, combined with constraints from radial-velocity data, yields system parameters consistent with previously reported values. We find a planet-to-star radius ratio marginally smaller than previously reported, corresponding to a planet radius of Rp = 0.921 \pm 0.036RJup .Comment: 6 pages, 2 figures, MNRAS accepte

Line-profile tomography of exoplanet transits -- II. A gas-giant planet transiting a rapidly-rotating A5 star

Most of our knowledge of extrasolar planets rests on precise radial-velocity measurements, either for direct detection or for confirmation of the planetary origin of photometric transit signals. This has limited our exploration of the parameter space of exoplanet hosts to solar- and later-type, sharp-lined stars. Here we extend the realm of stars with known planetary companions to include hot, fast-rotating stars. Planet-like transits have previously been reported in the lightcurve obtained by the SuperWASP survey of the A5 star HD15082 (WASP-33; V=8.3, v sin i = 86 km/sec). Here we report further photometry and time-series spectroscopy through three separate transits, which we use to confirm the existence of a gas giant planet with an orbital period of 1.22d in orbit around HD15082. From the photometry and the properties of the planet signal travelling through the spectral line profiles during the transit we directly derive the size of the planet, the inclination and obliquity of its orbital plane, and its retrograde orbital motion relative to the spin of the star. This kind of analysis opens the way to studying the formation of planets around a whole new class of young, early-type stars, hence under different physical conditions and generally in an earlier stage of formation than in sharp-lined late-type stars. The reflex orbital motion of the star caused by the transiting planet is small, yielding an upper mass limit of 4.1 Jupiter masses on the planet. We also find evidence of a third body of sub-stellar mass in the system, which may explain the unusual orbit of the transiting planet. In HD 15082, the stellar line profiles also show evidence of non-radial pulsations, clearly distinct from the planetary transit signal. This raises the intriguing possibility that tides raised by the close-in planet may excite or amplify the pulsations in such stars.Comment: 9 pages, 6 figures, accepted for publication in MNRA