An evaluation of subjective experiences, effects and overall satisfaction with clozapine treatment in a UK forensic service

Objectives: Patients prescribed clozapine were surveyed to assess (a) the effects, both positive and adverse, and overall satisfaction with clozapine in comparison to previously prescribed antipsychotics and (b) the relative significance of effects experienced, both positive and adverse, in terms of impact on subjective well-being. Methods: A total of 56 male patients prescribed clozapine at a forensic psychiatric hospital were surveyed using a 27-item questionnaire. All patients had been prescribed clozapine for a minimum of 3 months. Respondents were asked to rate effects and satisfaction with clozapine treatment in comparison with previously prescribed antipsychotic medication on a five-point scale. Respondents were also asked to rate effects experienced with clozapine treatment in terms of impact on subjective well-being on a five-point scale. Results: A total of 89% of respondents reported greater satisfaction with clozapine than with previously prescribed antipsychotic medication. A majority of patients reported positive effects in terms of an improvement in their quality of life (68%) and social abilities (52%) with clozapine in comparison with previously prescribed antipsychotics. Nocturnal hypersalivation (84%) and weight gain (57%) were the most common adverse effects. Hedonic responses were assessed for each effect in order to determine the associated subjective experiences. The most positive hedonic responses were for quality of life, mood and alertness. In terms of adverse impact on subjective well-being, nocturnal hypersalivation ranked highest. Conclusions: Patients in a UK forensic sample are largely satisfied with clozapine treatment. The subjective effects of clozapine treatment should be taken into account by clinicians when assessing response. This may provide an opportunity to highlight the positive changes and prioritize management of the most undesirable adverse effects, which is likely to promote compliance and improve longer term treatment outcomes

Preconception nutrition: building advocacy and social movements to stimulate action

Action to improve preconception nutrition is a collective, societal responsibility. We believe that the Developmental Origins of Health and Disease (DOHaD) society is ideally placed to facilitate the development of a global agenda for preconception nutrition which recognises the societal importance of nutrition for young women and men, and supports them in optimising their nutritional status for the benefit of the next generation. In this paper, we outline four key actions that can be taken by the members of DOHaD's international society located across 67 countries, and nine regional societies, to demonstrate this leadership role. The recommended actions to place preconception nutrition at the top of national and regional agendas include (i) continuing to build the scientific evidence, (ii) monitoring of progress made by governments and commercial companies, (iii) developing advocacy coalitions that unite individuals and organisations around common policy options and (iv) working with partners to develop an emotive and empowering preconception nutrition awareness campaign. Collectively, these actions hold the potential to develop into a preconception nutrition social movement to invoke high-level government support and across-sector policy action, while raising public demand for action and engaging corporate actors

Non-equilibrium Relaxation Study of Ferromagnetic Transition in Double-Exchange Systems

Ferromagnetic transition in double-exchange systems is studied by non-equilibrium relaxation technique combined with Monte Carlo calculations. Critical temperature and critical exponents are estimated from relaxation of the magnetic moment. The results are consistent with the previous Monte Carlo results in thermal equilibrium. The exponents estimated by these independent techniques suggest that the universality class of this transition is the same as that of short-range interaction models but is different from the mean-field one.Comment: 3 pages including 1 figure, submitted to J. Phys. Soc. Jp

A Model for the Analysis of Caries Occurrence in Primary Molar Tooth Surfaces

Recently methods of caries quantification in the primary dentition have moved away from summary ‘whole mouth’ measures at the individual level to methods based on generalised linear modelling (GLM) approaches or survival analysis approaches. However, GLM approaches based on logistic transformation fail to take into account the time-dependent process of tooth/surface survival to caries. There may also be practical difficulties associated with casting parametric survival-based approaches in a complex multilevel hierarchy and the selection of an optimal survival distribution, while non-parametric survival methods are not generally suitable for the assessment of supplementary information recorded on study participants. In the current investigation, a hybrid semi-parametric approach comprising elements of survival-based and GLM methodologies suitable for modelling of caries occurrence within fixed time periods is assessed, using an illustrative multilevel data set of caries occurrence in primary molars from a cohort study, with clustering of data assumed to occur at surface and tooth levels. Inferences of parameter significance were found to be consistent with previous parametric survival-based analyses of the same data set, with gender, socio-economic status, fluoridation status, tooth location, surface type and fluoridation status-surface type interaction significantly associated with caries occurrence. The appropriateness of the hierarchical structure facilitated by the hybrid approach was also confirmed. Hence the hybrid approach is proposed as a more appropriate alternative to primary caries modelling than non-parametric survival methods or other GLM-based models, and as a practical alternative to more rigorous survival-based methods unlikely to be fully accessible to most researchers

Ambiguity, multiple streams, and EU policy

The multiple streams framework draws insight from interactions between agency and institutions to explore the impact of context, time, and meaning on policy change and to assess the institutional and issue complexities permeating the European Union (EU) policy process. The authors specify the assumptions and structure of the framework and review studies that have adapted it to reflect more fully EU decision-making processes. The nature of policy entrepreneurship and policy windows are assessed to identify areas of improvement. Finally, the authors sketch out a research agenda that refines the logic of political manipulation which permeates the lens and the institutional complexity which frames the EU policy process

Brood patch and sex-ratio observations indicate breeding provenance and timing in New Zealand storm petrel (Fregetta maoriana)

We used measurements of brood patch and moult status to estimate the breeding phenology of New Zealand Storm-Petrel, using birds caught at sea within the Hauraki Gulf Marine Park near Auckland, New Zealand. Birds caught October–January had completely downy brood patches, whereas birds caught February–April had bare brood patches with an observed male bias in the February sex-ratio, consistent with a female pre-laying exodus typical of petrels and with the existence of an unknown colony in the region. No birds captured exhibited primary moult, which is known to occur in storm-petrels during their non-breeding season. Our data support the conclusion that the New Zealand storm-petrel breeds during January–June in northern New Zealand and that field surveys for the species on offshore islands in this region during this period are warrante

Aspects of Contact Metamorphism Produced by the New England Batholith, New South Wales

Forcefully emplaced plutons in the southern part of the New England Batholith, northern New South Wales, have produced extensive contact aureoles in Palaeozoic sediments and volcanics. This thesis describes the contact effects observed in pelitic, psammitic and impure calcareous sediments. Four metamorphic zones are recognised within pelitic sediments around the Walcha Road Adamellite (with distances from the contact in brackets): I) biotite zone (4 km - 1500 m); II) cordierite zone (1500 m - 500 m); III) cordierite + K-feldspar zone (500 m - 100 m); IV) cordierite + K-feldspar ± garnet zone (100 m - contact)

The Hyperfine Splitting in Charmonium: Lattice Computations Using the Wilson and Clover Fermion Actions

We compute the hyperfine splitting $m_{J/\psi}-m_{\eta_c}$ on the lattice, using both the Wilson and $O(a)$-improved (clover) actions for quenched quarks. The computations are performed on a $24^3\times48$ lattice at $\beta = 6.2$, using the same set of 18 gluon configurations for both fermion actions. We find that the splitting is 1.83\err{13}{15} times larger with the clover action than with the Wilson action, demonstrating the sensitivity of the spin-splitting to the magnetic moment term which is present in the clover action. However, even with the clover action the result is less than half of the physical mass-splitting. We also compute the decay constants $f_{\eta_c}$ and $f^{-1}_{J/\psi}$, both of which are considerably larger when computed using the clover action than with the Wilson action. For example for the ratio $f^{-1}_{J/\psi}/f^{-1}_{\rho}$ we find 0.32\err{1}{2} with the Wilson action and $0.48\pm 3$ with the clover action (the physical value is 0.44(2)).Comment: LaTeX file, 8 pages and two postscript figures. Southampton Preprint: SHEP 91/92-27 Edinburgh Preprint: 92/51