Barriers to positive mental health in a young offenders institution: A qualitative study

Objective: To explore the barriers to positive mental health in a group of young offenders. Design A qualitative approach was used to provide insight into the ways in which mental health for young offenders is experienced and managed. Setting A Young Offenders Institute (YOI) accommodating males aged between 18 and 21 years. Method: Participants were recruited voluntarily using posters. Twelve offenders participated in focus groups and an additional three interviews were carried out with individuals who felt uncomfortable in the focus group situation. Results: Participants stressed that feelings in a YOI could not be shared due to the masculine ethos that had been created on the wings. Listener services were reported to be ineffective for support because using them would show weakness and vulnerability to other prisoners. Visiting time was the main highlight in the routine for most young offenders; however, leaving family and friends was difficult. In dealing with these emotions young offenders would use coping mechanisms, including acts of aggression to vent built-up frustrations. The issue of prison staff and their effect on mental health was raised by all offenders involved in the research. Unanimously, it was suggested that there are both excellent prison officers who engage with the prisoners, and staff who abuse their power and treat prisoners disrespectfully. Conclusion: Promoting mental health is not the principle business of a YOI. However, this research has generated some issues for consideration for governors and those working within this setting

Recovery priorities in degenerative cervical myelopathy: a cross-sectional survey of an international, online community of patients.

OBJECTIVES: To establish the recovery priorities of individuals suffering with degenerative cervical myelopathy (DCM). DESIGN: A cross-sectional, observational study. SETTING: Patients from across the world with a diagnosis of DCM accessed the survey over an 18-month period on Myelopathy.org, an international myelopathy charity. PARTICIPANTS: 481 individuals suffering from DCM completed the online survey fully. MAIN OUTCOME MEASURES: Functional recovery domains were established through qualitative interviews and a consensus process. Individuals were asked about their disease characteristics, including limb pain (Visual Analogue Scale) and functional disability (patient-derived version of the modified Japanese Orthopaedic Association score). Individuals ranked recovery domains (arm and hand function, walking, upper body/trunk function, sexual function, elimination of pain, sensation and bladder/bowel function) in order of priority. Priorities were analysed as the modal first priority and mean ranking. The influence of demographics on selection was analysed, with significance p<0.05. RESULTS: Of 659 survey responses obtained, 481 were complete. Overall, pain was the most popular recovery priority (39.9%) of respondents, followed by walking (20.2%), sensation (11.9%) and arm and hand function (11.5%). Sexual function (5.7%), bladder and bowel (3.7%) and trunk function (3.5%) were chosen less frequently. When considering the average ranking of symptoms, while pain remained the priority (2.6±2.0), this was closely followed by walking (2.9±1.7) and arm/hand function (3.0±1.4). Sensation ranked lower (4.3±2.1). With respect to disease characteristics, overall pain remained the recovery priority, with the exception of patients with greater walking impairment (p<0.005) who prioritised walking, even among patients with lower pain scores. CONCLUSIONS: This is the first study investigating patient priorities in DCM. The patient priorities reported provide an important framework for future research and will help to ensure that it is aligned with patient needs.NIHR Welcome Trus

Competing risks and deposit insurance governance convergence

Why do policies often seem to converge across countries at the same time? This question has been studied extensively in the diffusion literature. However, past research has not examined complex choice environments, especially where there are many alternatives. This article fills this gap in the literature. I show how Fine and Gray's Competing Risks Event History Analysis can be used to tease apart the causes of policy convergence. I apply the method to an examination of the reasons why, from the mid-1990s to 2007, many countries created independent deposit insurers. I find an interaction between international recommendations and regional peers' choices, particularly in the European Union. However, convergence appears to slow under the particular conditions of a banking crisis, regardless of how well independence is promoted. Possibly due to electoral incentives, democracies seem to have been more likely to create independent insurers. Ultimately, I demonstrate how competing risks analysis can help enable future research on policy choices, complementing methods previously applied in political economy. © The Author(s) 2013

How instructions modify perception: An fMRI study investigating brain areas involved in attributing human agency

Behavioural studies suggest that the processing of movement stimuli is influenced by beliefs about the agency behind these actions. The current study examined how activity in social and action related brain areas differs when participants were instructed that identicalmovement stimuli were either human or computer generated.Participants viewed a series of point-light animation figures derived frommotion-capture recordings of amoving actor, while functional magnetic resonance imaging (fMRI) was used to monitor patterns of neural activity. The stimuli were scrambled to produce a range of stimulus realism categories; furthermore, before each trial participants were told that they were about to view either a recording of human movement or a computersimulated pattern of movement. Behavioural results suggested that agency instructions influenced participants' perceptions of the stimuli. The fMRI analysis indicated different functions within the paracingulate cortex: ventral paracingulate cortex was more active for human compared to computer agency instructed trials across all stimulus types, whereas dorsal paracingulate cortex was activated more highly in conflicting conditions (human instruction, lowrealismor vice versa). These findings support the hypothesis that ventral paracingulate encodes stimuli deemed to be of human origin,whereas dorsal paracingulate cortex is involvedmore in the ascertainment of human or intentional agency during the observation of ambiguous stimuli. Our results highlight the importance of prior instructions or beliefs on movement processing and the role of the paracingulate cortex in integrating prior knowledge with bottom-up stimuli

A clinical prediction model for long-term functional outcome after traumatic spinal cord injury based on acute clinical and imaging factors.

To improve clinicians\u27 ability to predict outcome after spinal cord injury (SCI) and to help classify patients within clinical trials, we have created a novel prediction model relating acute clinical and imaging information to functional outcome at 1 year. Data were obtained from two large prospective SCI datasets. Functional independence measure (FIM) motor score at 1 year follow-up was the primary outcome, and functional independence (score ≥ 6 for each FIM motor item) was the secondary outcome. A linear regression model was created with the primary outcome modeled relative to clinical and imaging predictors obtained within 3 days of injury. A logistic model was then created using the dichotomized secondary outcome and the same predictor variables. Model validation was performed using a bootstrap resampling procedure. Of 729 patients, 376 met the inclusion criteria. The mean FIM motor score at 1 year was 62.9 (±28.6). Better functional status was predicted by less severe initial American Spinal Injury Association (ASIA) Impairment Scale grade, and by an ASIA motor score \u3e50 at admission. In contrast, older age and magnetic resonance imaging (MRI) signal characteristics consistent with spinal cord edema or hemorrhage predicted worse functional outcome. The linear model predicting FIM motor score demonstrated an R-square of 0.52 in the original dataset, and 0.52 (95% CI 0.52,0.53) across the 200 bootstraps. Functional independence was achieved by 148 patients (39.4%). For the logistic model, the area under the curve was 0.93 in the original dataset, and 0.92 (95% CI 0.92,0.93) across the bootstraps, indicating excellent predictive discrimination. These models will have important clinical impact to guide decision making and to counsel patients and families

Combined effect of coherent Z exchange and the hyperfine interaction in atomic PNC

The nuclear spin-dependent parity nonconserving (PNC) interaction arising from a combination of the hyperfine interaction and the coherent, spin-independent, PNC interaction from Z exchange is evaluated using many-body perturbation theory. For the 6s-7s transition in 133Cs, we obtain a result that is about 40% smaller than that found previously by Bouchiat and Piketty [Phys. Lett. B 269, 195 (1991)]. Applying this result to 133Cs, leads to an increase in the experimental value of nuclear anapole moment and exacerbates differences between constraints on PNC meson coupling constants obtained from the Cs anapole moment and those obtained from other nuclear parity violating experiments. Nuclear spin-dependent PNC dipole matrix elements, including contributions from the combined weak-hyperfine interaction, are also given for the 7s-8s transition in 211Fr and for transitions between ground-state hyperfine levels in K, Rb, Cs, Ba+, Au, Tl, Fr, and Ra+.Comment: Revtex4 preprint 19 pages 4 table

Bostonia: The Boston University Alumni Magazine. Volume 12

Founded in 1900, Bostonia magazine is Boston University’s main alumni publication

A prospective, multicenter, phase I matched-comparison group trial of safety, pharmacokinetics, and preliminary efficacy of riluzole in patients with traumatic spinal cord injury.

A prospective, multicenter phase I trial was undertaken by the North American Clinical Trials Network (NACTN) to investigate the pharmacokinetics and safety of, as well as obtain pilot data on, the effects of riluzole on neurological outcome in acute spinal cord injury (SCI). Thirty-six patients, with ASIA impairment grades A-C (28 cervical and 8 thoracic) were enrolled at 6 NACTN sites between April 2010 and June 2011. Patients received 50 mg of riluzole PO/NG twice-daily, within 12 h of SCI, for 14 days. Peak and trough plasma concentrations were quantified on days 3 and 14. Peak plasma concentration (Cmax) and systemic exposure to riluzole varied significantly between patients. On the same dose basis, Cmax did not reach levels comparable to those in patients with amyotrophic lateral sclerosis. Riluzole plasma levels were significantly higher on day 3 than on day 14, resulting from a lower clearance and a smaller volume of distribution on day 3. Rates of medical complications, adverse events, and progression of neurological status were evaluated by comparison with matched patients in the NACTN SCI Registry. Medical complications in riluzole-treated patients occurred with incidences similar to those in patients in the comparison group. Mild-to-moderate increase in liver enzyme and bilirubin levels were found in 14-70% of patients for different enzymes. Three patients had borderline severe elevations of enzymes. No patient had elevated bilirubin on day 14 of administration of riluzole. There were no serious adverse events related to riluzole and no deaths. The mean motor score of 24 cervical injury riluzole-treated patients gained 31.2 points from admission to 90 days, compared to 15.7 points for 26 registry patients, a 15.5-point difference (p=0.021). Patients with cervical injuries treated with riluzole had more-robust conversions of impairment grades to higher grades than the comparison group