Patient perspectives of being detained under section 136 of the Mental Health Act: findings from a qualitative study in London

Introduction Detention under section 136(1) of the Mental Health Act 1983 allows for the police to arrest a person from a public place and remove them to a ‘place of safety’, typically an emergency department or mental-health unit if it is ‘in the interests of that person or for the protection of other persons in immediate need of care or control’. Aims/objective: The aim of this study was to describe the views and perceptions of the process for people with lived experience of mental distress who have been detained under section 136 of the Mental Health Act 1983. Method Semi-structured interviews were conducted with a non-probability sample of people with lived experience of mental distress who have been detained under section 136 across Greater London. Interviews were transcribed and thematically analysed using grounded theory. Fifty-eight people with lived experience of mental distress detained under section 136, including four carers, participated in this study. Results Three interwoven themes were identified: (a) process or procedural issues; (b) the professional–patient relationship; and (c) the importance of a supportive therapeutic environment. Conclusion The length of time, multiple assessment points and processes juxtapose against the need for a humane physical environment and supportive therapeutic interactions from all professional agencies. It is unclear how changes proposed in the Policing and Crime Act 2017 will address these patient needs

Environmental challenges to operationalisation of South African rainfall enhancement

Most of the atmospheric moisture in systems moving across South Africa leaves the sub-continent as the weather systems move out over the ocean, only a tenth of it falls on the landmass as rain. An increase in the efficiency of the atmospheric moisture delivery system by means of rainfall enhancement is therefore an attractive concept. Rainfall enhancement functions by either providing additional Cloud Condensation Nuclei or Ice forming Nuclei that will beneficially influence the precipitation formation process, improving the efficiency of moisture to rainfall conversion. Systematic South African research into rainfall enhancement started in the 1970s. The South African Rainfall Enhancement Programme (SAREP), initiated in the late 1990\'s, is the most recent in a series of studies and was the first semi-operational rainfall enhancement project to occur in South Africa as a response to drought conditions. In a recent study (DWAF, 2004 in prep) to finalise SAREP and provide guidance on operationalising rainfall enhancement, it was recommended that environmental impact assessment must be undertaken before this technology is implemented further. Rainfall enhancement falls specifically within the jurisdiction of the National Water Act (NWA) and the National Environmental Management Act (NEMA). A licence to undertake rainfall enhancement activities is required from the Minister of Water Affairs and Forestry after an appropriate environmental impact assessment has been undertaken to inform his decision. This paper proposes an approach to fulfil the legal requirements for operationalising future rainfall enhancement. The interaction between the science of rainfall enhancement and the ability of scientific disciplines to determine relevant environmental impacts, to appropriately inform the decision-making process, is specifically highlighted. The data requirements identified by scientists during the study varies in duration and resource needs and does not differentiate between ongoing scientific research and the requisite information required for informed decision making. This paper contemplates an approach which provides for holistic and co-ordinated investigation of South African rainfall enhancement into the future. Water SA Vol. 30 (5) 2005: pp.88-9

Review of Geotechnical Investigations Resulting from the Roermond April 13, 1992 Earthquake

In 1987 the Engineering Geology section of the Delft University of Technology carried out a survey of the SE Netherlands to determine which areas were susceptible to liquefaction based on soil profile, groundwater levels and a Richter scale magnitude 6 earthquake along the principal rift fault through the Netherlands, the Peelrand fault system. The fault system has been active since the Triassic and forms part of the Rhine-North Sea rift system. The last major earthquake along the Peelrand fault was in 1933. Recently, in 1992, A 5.8 magnitude earthquake occurred at Roermond, near to the Dutch-German border. Though damage resulting from the earthquake was limited, remedial works to structures amounted to US$ 50 million in the Netherlands. The paper reviews geotechnical investigations associated with the earthquake carried out in the Netherlands. Much of the damage is attributed to liquefaction; excess pore pressures resulting from the earthquake caused sand vent eruptions, river-dyke failures and slope failures. Comparisons are made between the predictions of 1987 and that which occurred in 1992. Site investigation works are recording geotechnical and building data so as to allow for correlations between extents of damage, ground geotechnical profiles and building design. Models for liquefaction are reviewed to describe the slope failure as well as the sand vent phenomena. Densification of subsoil has been inferred from CPTs taken before and after the earthquake for some sites. Pile foundation damage has been investigated for buildings in Roermond for which their susceptibility to earthquake lateral forces in terms of stiffness and pile head working load is given

Human Granulocyte-Macrophage Colony Stimulating Factor: An Effective Direct Activator of Human Polymorphonuclear Neutrophilic Granulocytes

Granulocyet-macrophage colony-stimulating factor (GM-CSF) was shown to modulate different granulocyte functions. In the present study we investigated the effect of purified and recombinant human GM-CSF, particularly on the oxidative metabolism of isolated human granulocytes. In addition, ultrastructural changes upon stimulation were evaluated. For detection of granulocyte activation the following assay systems were used: 1) lucigenin-dependent chemiluminescence (CL),2) superoxide-dismutase (SOD) inhibitable cytochrome C-reduction (superoxide),3) horseradish peroxidase-mediated oxidation of phenol red (hydrogen peroxide),4) release of myeloperoxidase, 5) ultrastructural detection of hydrogen peroxide-production, and 6) scanning and transmission electron microscopy (SEM and TEM, respectively). A significant CL response was seen upon stimulation with recombinant human GM-CSF at concentrations ranging from 1 to 103 U/ml. The CL response started within 5-10 min with a maximum at 60 – 90 min and lasted more than 3 h. Thereafter granulocytes were completely deactivated to restimulation with the same mediator and with Tumor Necrosis Factor, but respondend to other triggers of the oxidative burst, whereas the response to f-met-leu-phe was significantly increased, The CL signal was completely blocked by an antiserum to GM-CSF. Moreover, the response was significantly inhibited by SOD and D-mannitol, suggesting the involvement of distinct reactive oxygen species (ROS) in generating the CL response. Significant amounts of superoxide were detected within 180 min after stimulation with GM-CSF, whereas, release of hydrogen peroxide and peroxidase were only minimal as shown by functional and ultrastructural assays. Activation of granulocytes could be visualized by SEM and TEM. GM-CSF stimulated cells showed an increased adherence to the substratum developing polarized filopodia and an increased number of intercellular vesicles within 30 min after addition of the stimulus. The results clearly demonstrate that GM-CSF directly stimulates granulocytes and, particularly, their oxidative metabolism. Therefore, GM-CSF which is probably released by epidermal cells appears to be a candidate for neutrophil activation in the skin, and thereby may play a crucial role in inflammatory skin diseases