"I kind of find that out by accident": probation staff experiences of pharmacological treatment for sexual preoccupation and hypersexuality

Purpose - This paper aimed to explore the views and experiences of probation staff working with individuals convicted of a sexual offence who have been prescribed medication to manage sexual arousal (MMSA). Design/methodology - Semi-structured interviews were utilised with a sample of probation staff (Offender Supervisors and Managers, n=12), who supervise individuals convicted of a sexual offence, either in prison, or post-release in the community. Data were analysed using thematic analysis. Findings - Two main themes emerged: (1) Barriers for probation staff and (2) Suspicious but hopeful. Theme one encapsulates factors that prevent probation staff from engaging with MMSA; theme two highlighted the samples' uncertainty and mistrust of the use of medication as a potential tool for risk management and scepticism about individuals' motivations, particularly in the community. Research limitations – The main limitation of this study was the differing levels of knowledge the sample had about MMSA and their subsequent ability to discuss MMSA other than in a theoretical sense. Practical implications - Practical implications include the need for further training for probation staff, improved collaboration between departments and ongoing support for staff to support the success of the MMSA intervention. Originality/value – This study offers a novel perspective on MMSA - that of the probation staff supervising prisoners taking MMSA. This has not been explored before, and the findings and associated implications are of importance for the treatment and care of those convicted of sexual offences

"I kind of find that out by accident": probation staff experiences of pharmacological treatment for sexual preoccupation and hypersexuality

Purpose - This paper aimed to explore the views and experiences of probation staff working with individuals convicted of a sexual offence who have been prescribed medication to manage sexual arousal (MMSA). Design/methodology - Semi-structured interviews were utilised with a sample of probation staff (Offender Supervisors and Managers, n=12), who supervise individuals convicted of a sexual offence, either in prison, or post-release in the community. Data were analysed using thematic analysis. Findings - Two main themes emerged: (1) Barriers for probation staff and (2) Suspicious but hopeful. Theme one encapsulates factors that prevent probation staff from engaging with MMSA; theme two highlighted the samples' uncertainty and mistrust of the use of medication as a potential tool for risk management and scepticism about individuals' motivations, particularly in the community. Research limitations – The main limitation of this study was the differing levels of knowledge the sample had about MMSA and their subsequent ability to discuss MMSA other than in a theoretical sense. Practical implications - Practical implications include the need for further training for probation staff, improved collaboration between departments and ongoing support for staff to support the success of the MMSA intervention. Originality/value – This study offers a novel perspective on MMSA - that of the probation staff supervising prisoners taking MMSA. This has not been explored before, and the findings and associated implications are of importance for the treatment and care of those convicted of sexual offences

Coupling electrons and vibrations in molecular quantum chemistry

We derive an electron-vibration model Hamiltonian in a quantum chemical framework, and explore the extent to which such a Hamiltonian can capture key effects of nonadiabatic dynamics. The model Hamiltonian is a simple two-body operator, and we make preliminary steps at applying standard quantum chemical methods to evaluating its properties, including mean-field theory, linear response, and a primitive correlated model. The Hamiltonian can be compared to standard vibronic Hamiltonians, but is constructed without reference to potential energy surfaces, through direct differentiation of the one- and two-electron integrals at a single reference geometry. The nature of the model Hamiltonian in the harmonic and linear-coupling regime is investigated for pyrazine, where a simple time-dependent calculation including electron-vibration correlation is demonstrated to exhibit the well-studied population transfer between the S$_2$ and S$_1$ excited states

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Nature documentaries as catalysts for change: Mapping out the 'Blackfish Effect'

It is essential for us to understand what drives human behaviour if we want to tackle anthropogenic damage to the environment. Popular media can play an important role in shaping public attitudes, behaviours and norms towards wildlife, and documentaries in particular have become an increasingly prominent tool for social change. There is, however, a need for robust impact evaluation both in documentary-making and in conservation, to refine future interventions. The 2013 documentary Blackfish portrayed human–orca interactions at the US-based marine park, SeaWorld. Following its release, SeaWorld suffered financial difficulties and the company underwent structural changes, including a cessation of its orca breeding programme. These impacts have often been attributed to the Blackfish documentary, but little evidence has been provided to justify these claims. We combined an analysis of stock market data and semi-structured interviews with 26 key informants to build an in-depth contribution analysis. We used General Elimination Methodology, a qualitative impact evaluation methodology to build an understanding of the impact of Blackfish. We found a consensus among stakeholder groups that Blackfish induced negative publicity for SeaWorld and a change in people's perceptions of captivity. As a result, attendance at the park decreased and the market value of the company dropped. Blackfish catalysed a whole movement against marine mammal captivity. There were three key factors that led to its impact: the support from major distribution channels which allowed it to reach major audiences, emotional impact of the content and timing of its release. Blackfish benefitted from a perfect storm, building upon decades of activism to create an appropriate cultural climate for its release in 2013

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions