Growing older in secure mental health care: the user experience

Background: The proportion of older adults using secure forensic psychiatric services is rising. Research is needed to examine the experience of older service users and evidence how adult services can adapt to meet their needs. Aim: To explore user experiences of being an older adult in secure forensic services. Methods: Thematic analysis of interviews and observations of weekly routines conducted with fifteen service users aged 50 and over residing in a low and medium secure NHS unit in England. Results: User experiences of ageing and age-related needs are reported using five themes: age-related identities; ward environments; participation in activities; management of physical health; and ageing futures. Older adults living with people their own age reported more social integration than those on wards dominated by younger adults. Most wished to self-manage their physical health needs with the support of primary care staff. Older adults were reluctant to identify as “old” or “vulnerable”. Some older adults downplayed their changing care needs. Conclusions: Placement of older people in adult secure services requires awareness of the age balance of the ward. A culture of inclusivity, sensitivity and respect for older persons’ agency is key to collaboratively meeting additional care needs and discharge planning

A qualitative study of older adults’ experiences of transitioning from secure forensic services – The TOPS Study

This was presented at the Faculty of Medicine, Health and Social Care Lunchtime Research Seminar. The presentation discusses the current findings of Phase 1 and 2 of the TOPS study

Food assistance to tuberculosis patients: lessons from Afghanistan.

Poverty, food insecurity and poor nutrition in the population are important contributors to the burden of tuberculosis (TB). For poor and food-insecure individuals, accessing and successfully completing anti-tuberculosis treatment over an extended period of time is challenging. Food and nutritional support as an incentive and enabler is employed by national TB control programmes (NTPs) worldwide as a means to encourage treatment initiation and adherence and to improve the nutritional status of patients with TB. It also offers a safety net for food-insecure households affected by TB to mitigate the financial consequences of the disease. This paper reports on the primary lessons from the review of the World Food Programme's (WFP's) Food Assistance Programme for TB patients in Afghanistan. It aims to inform the design, implementation and scale-up of TB programmes in settings where food insecurity and malnutrition are prevalent. It also documents qualitative findings that suggest that patients, their families and providers viewed food support as an important asset and an essential element of the national TB control strategy. While the impact on treatment success or case detection could not be quantified, it is likely that the WFP intervention had a positive impact on the patients and their households, therefore contributing to the success of the DOTS-based NTP

The influence of weathering and soil organic matter on Zn isotopes in soils

Zinc is an essential micronutrient that is ultimately released during mineral weathering. In soils, organic matter plays a key role in influencing Zn partitioning and therefore on Zn biogeochemical cycling. Soil organic matter is partitioned between carbon that is more readily available for decomposition by microorganisms, and more stable carbon transiently preserved from decomposition. The role of the stable pool of soil organic matter on Zn biogeochemical cycling remains poorly understood. The pool of stable carbon is controlled by combination with mineral constituents or is material that is intrinsically resistant to decomposition. The Zn stable isotopes are fractionated by interactions between Zn and soil mineral and organic constituents. This study reports the Zn isotope composition of five Icelandic soil profiles derived from the same parent basalt and characterized by contrasting degrees of weathering and organic matter content (δ66Zn = + 0.10 ± 0.05 to + 0.35 ± 0.02‰), the distribution of reactive mineral constituents available to form associations with soil organic matter, and the amount of stable organic carbon. Throughout these soils, the δ66Zn isotope variations are little influenced by mineral constituents, but rather by soil organic matter content. These data suggest that a combination of organic matter accumulation and Zn loss by leaching is required to explain the observed decrease in Zn concentration in soils and lighter soil δ66Zn with increasing organic carbon content. These results suggest that the presence of stable organic carbon in soils provides a pool of light Zn, attributed to the Zn isotope signature of organic matter partially preserved from decomposition. Crucially, this stable organic carbon pool may also contribute to the formation of the light Zn isotope sink reported in organic-rich marine sediments, a key output required to explain the oceanic mass balance of Zn isotopes

Modelling the social and structural determinants of tuberculosis: opportunities and challenges

INTRODUCTION: Despite the close link between tuberculosis (TB) and poverty, most mathematical models of TB have not addressed underlying social and structural determinants. OBJECTIVE: To review studies employing mathematical modelling to evaluate the epidemiological impact of the structural determinants of TB. METHODS: We systematically searched PubMed and personal libraries to identify eligible articles. We extracted data on the modelling techniques employed, research question, types of structural determinants modelled and setting. RESULTS: From 232 records identified, we included eight articles published between 2008 and 2015; six employed population-based dynamic TB transmission models and two non-dynamic analytic models. Seven studies focused on proximal TB determinants (four on nutritional status, one on wealth, one on indoor air pollution, and one examined overcrowding, socio-economic and nutritional status), and one focused on macro-economic influences. CONCLUSIONS: Few modelling studies have attempted to evaluate structural determinants of TB, resulting in key knowledge gaps. Despite the challenges of modelling such a complex system, models must broaden their scope to remain useful for policy making. Given the intersectoral nature of the interrelations between structural determinants and TB outcomes, this work will require multidisciplinary collaborations. A useful starting point would be to focus on developing relatively simple models that can strengthen our knowledge regarding the potential effect of the structural determinants on TB outcomes

Distribution patterns of phosphorylated Thr 3 and Thr 32 of histone H3 in plant mitosis and meiosis

Cell cycle dependent phosphorylation of conserved N-terminal tail residues of histone H3 has been described in both animal and plant cells. Through cytogenetic approaches using different plant species we show a detailed description of distribution patterns of phosphorylated histone H3 at either threonine 3 or threonine 32 in mitosis and meiosis. In meristematic cells of the large genome species Secale cereale, Vicia faba and Hordeum vulgare we have found that phosphorylation of both threonine residues begins in prophase, and dephosphorylation occurs in late anaphase. However, in the small genome species Arabidopsis thaliana dephosphorylation occurs at anaphase. In the first division of meiosis of species with large genomes phosphorylation of histone H3 at either threonine 3 or threonine 32 is seen first in diakinesis and extends to anaphase I, whereas in the second division these post-translational modifications are visible at metaphase II through anaphase II. While in A. thaliana dephosphorylation takes place at anaphase I and II. In all species analysed phosphorylated H3 at either threonine 3 or threonine 32 are distributed along the entire length of chromosomes during mitotic metaphase and metaphase I. In the second meiotic division threonine 3 phosphorylation is restricted to the pericentromeric domain, while phosphorylation of threonine 32 is widespread along chromosome arms of all species analysed.Research in the W.V. laboratory was supported by Fundação para a Ciência e Tecnologia, Portugal grant SFRH/BPD/26442 to A.D.C. and SFRH/ BPD/27219/2006 to M.D., respectively. D.D., R.K. and A.H. were supported by the Deutsche Forschungsgemeinschaft and by the Land Sachsen Anhal