Assessing needs for psychiatric treatment in prisoners: 1. Prevalence of disorder

BACKGROUND: High levels of psychiatric morbidity in prisoners have important implications for services. Assessing Needs for Psychiatric Treatment in Prisoners is an evaluation of representative samples of prisoners in a male and a female prison in London. This paper reports on the prevalence of mental disorders. In a companion paper, we describe how this translates into mental health treatment needs and the extent to which they have been met. METHODS: Prisoners were randomly sampled in a sequential procedure based on the Local Inmate Data System. We interviewed roughly equal numbers from the following groups: male remand; male sentenced prisoners (Pentonville prison); and female remand; female sentenced prisoners (Holloway prison). Structured assessments were made of psychosis, common mental disorders, PTSD, personality disorder and substance abuse. RESULTS: We interviewed 197 male and 171 female prisoners. Psychiatric morbidity in male and female, sentenced and remand prisoners far exceeded in prevalence and severity than in equivalent general population surveys. In particular, 12% met criteria for psychosis; 53.8% for depressive disorders; 26.8% for anxiety disorders; 33.1% were dependent on alcohol and 57.1% on illegal drugs; 34.2% had some form of personality disorder; and 69.1% had two disorders or more. Moreover, in the year before imprisonment, 25.3% had used mental health services. CONCLUSIONS: These rates of mental ill-health and their similarity in remand and sentenced prisoners indicate that diversion of people with mental health problems from the prison arm of the criminal justice system remains inadequate, with serious consequences for well-being and recidivism

Duration of adjuvant chemotherapy for stage III colon cancer

BACKGROUND Since 2004, a regimen of 6 months of treatment with oxaliplatin plus a fluoropyrimidine has been standard adjuvant therapy in patients with stage III colon cancer. However, since oxaliplatin is associated with cumulative neurotoxicity, a shorter duration of therapy could spare toxic effects and health expenditures. METHODS We performed a prospective, preplanned, pooled analysis of six randomized, phase 3 trials that were conducted concurrently to evaluate the noninferiority of adjuvant therapy with either FOLFOX (fluorouracil, leucovorin, and oxaliplatin) or CAPOX (capecitabine and oxaliplatin) administered for 3 months, as compared with 6 months. The primary end point was the rate of disease-free survival at 3 years. Noninferiority of 3 months versus 6 months of therapy could be claimed if the upper limit of the two-sided 95% confidence interval of the hazard ratio did not exceed 1.12. RESULTS After 3263 events of disease recurrence or death had been reported in 12,834 patients, the noninferiority of 3 months of treatment versus 6 months was not confirmed in the overall study population (hazard ratio, 1.07; 95% confidence interval [CI], 1.00 to 1.15). Noninferiority of the shorter regimen was seen for CAPOX (hazard ratio, 0.95; 95% CI, 0.85 to 1.06) but not for FOLFOX (hazard ratio, 1.16; 95% CI, 1.06 to 1.26). In an exploratory analysis of the combined regimens, among the patients with T1, T2, or T3 and N1 cancers, 3 months of therapy was noninferior to 6 months, with a 3-year rate of disease-free survival of 83.1% and 83.3%, respectively (hazard ratio, 1.01; 95% CI, 0.90 to 1.12). Among patients with cancers that were classified as T4, N2, or both, the disease-free survival rate for a 6-month duration of therapy was superior to that for a 3-month duration (64.4% vs. 62.7%) for the combined treatments (hazard ratio, 1.12; 95% CI, 1.03 to 1.23; P=0.01 for superiority). CONCLUSIONS Among patients with stage III colon cancer receiving adjuvant therapy with FOLFOX or CAPOX, noninferiority of 3 months of therapy, as compared with 6 months, was not confirmed in the overall population. However, in patients treated with CAPOX, 3 months of therapy was as effective as 6 months, particularly in the lower-risk subgroup. (Funded by the National Cancer Institute and others.

Using a knowledge exchange event to assess study participants’ attitudes to research in a rapidly evolving research context

Grant information: DJP, IJD and AMM are supported by Wellcome Trust Grant 104036. IJD, DJP, JPB and AMM, IB, EJK and SFW are supported by MRC Mental Health Data Pathfinder Grant MC_PC_17209. AMM and SML are supported by MRC Grant MC_PC_MR/R01910X/1. AMM is supported by MRC Grant MR/S035818/1. Theirworld Edinburgh Birth Cohort is funded by the charity Theirworld (www.theirworld.org), and is undertaken in the MRC Centre for Reproductive Health, which is funded by MRC Centre Grant (G1002033). CB and DJP are supported by Health Data Research UK, an initiative funded by UK Research and Innovation, Department of Health and Social Care (England) and the devolved administrations, and leading medical research charities.Peer reviewedPublisher PD

Strangers in the night: nightlife studies and new urban tourism

This paper draws together recent scholarship from the study of urban tourism and nightlife. Though studies of urban tourism do not always specifically address nightlife, and likewise studies of the night and nightlife do not always examine tourism, both bodies of research overlap in important ways. Concerns about commercialisation, gentrification, displacement, and urban change are to be found in both bodies of research. However, while the study of urban tourism typically recognises the erasure of the host / guest binary and seeks to destabilise the notion of who is a tourist or stranger, studies of nightlife often rest on a much clearer distinction between who belongs and who does not. An argument proposed here is that while the host / guest, tourist / non-tourist binary is perhaps reconfiguring, the night and nightlife spaces reinstate these binaries in various ways. This paper thinks through debates about tourists and residents in the night, focusing in particular on questions of belonging, place identification and gentrification through night-time uses

Controlling rectal and muscle temperatures: Can we offset diurnal variation in repeated sprint performance?

The present study investigated whether increasing morning rectal temperatures (Trec) to resting.evening levels, or decreasing evening Trec or muscle (Tm) temperatures to morning values, would influence repeated sprint (RS) performance in a causal manner. Twelve trained males underwent five sessions [age (mean ± SD) 21.8 ± 2.6 yr, peak oxygen uptake ( peak) 60.6 ± 4.6 mL kg min−1, stature 1.78 ± 0.07 m and body mass 76.0 ± 6.3 kg]. These included a control morning (M, 07:30 h) and evening (E, 17:30 h) session (5-min warm-up), and three further sessions consisting of a warm-up morning trial (ME, on a motorised treadmill) until Trec reached evening levels; and two cool-down evening trials (in 16–17°C water) until Trec (EMrec) or Tm (EMmuscle) values reached morning temperatures, respectively. All sessions included a 3 × 3-s task-specific warm-up followed by 10 × 3-s RS with 30-s recoveries performed on a non-motorised treadmill. Trec and Tm measurements were taken at the start of the protocol and following the warm-up or cool-down period. Values for Trec and Tm were higher in the evening compared to morning values (0.45°C and 0.57°C, P < 0.05). RS performance was lower in the M for distance covered (DC), average power (AP) and average velocity (AV) (9–10%, P < 0.05). Pre-cooling Trec and Tm in the evening reduced RS performance to levels observed in the morning (P < 0.05). However, an active warm-up resulted in no changes in morning RS performance. Diurnal variation in Trec and Tm is not wholly accountable for time-of-day oscillations in RS performance on a non-motorised treadmill; the exact mechanism(s) for a causal link between central temperature and human performance are still unclear and require more research

Highly efficient separation of actinides from lanthanides by a phenanthroline-derived bis-triazine ligand

The synthesis, lanthanide complexation, and solvent ex- traction of actinide(III) and lanthanide(III) radiotracers from nitric acid solutions by a phenanthroline-derived quadridentate bis-triazine ligand are described. The ligand separates Am(III) and Cm(III) from the lanthanides with remarkably high efficiency, high selectivity, and fast extraction kinetics compared to its 2,2'-bipyridine counterpart. Structures of the 1:2 bis-complexes of the ligand with Eu(III) and Yb(III) were elucidated by X-ray crystallography and force field calculations, respec-tively. The Eu(III) bis-complex is the first 1:2 bis-complex of a quadridentate bis-triazine ligand to be characterized by crystallography. The faster rates of extraction were verified by kinetics measurements using the rotating membrane cell technique in several diluents. The improved kinetics of metal ion extraction are related to the higher surface activity of the ligand at the phase interface. The improvement in the ligand's properties on replacing the bipyridine unit with a phenanthroline unit far exceeds what was anticipated based on ligand design alone

Digitizing localism: anticipating, assembling and animating a ‘space’ for UK hyperlocal media production

This paper presents an unconventional view of media production, not as the direct production of media content or forms, but the cultivation of spaces for media production taking place elsewhere. I draw on a close analysis of Destination Local, a program of UK charity Nesta, which focused on the implications of location-based technologies for the emergent field of ‘hyperlocal’ media. Although the first round of the program – the focus in this paper – funded 10 experimental projects alongside extensive research, my argument is that Destination Local was less a matter of enabling specific place-based hyperlocal media outlets. Rather, it was an attempt to anticipate, assemble and animate a broader UK hyperlocal media ‘space’, composed of both technical ecologies (e.g. data, devices, platforms, standards) and practical fields (e.g. journalism, software development, local government, community activism). This space, I argue, was anchored to a largely implicit political discourse of localism