Factors explaining variation in recommended care pathways following hospital-presenting self-harm:a multilevel national registry study

BACKGROUND People who present to hospital following self-harm are at high risk of suicide. Despite this, there are considerable variations in the management of this group across hospitals and the factors influencing such variations are not well understood. AIMS The aim of this study was to identify the specific hospital and individual factors associated with care pathways following hospital-presenting self-harm. METHOD Data on presentations to hospitals by those aged 18 years and over were obtained from the National Self-Harm Registry Ireland for 2017 and 2018. Factors associated with four common outcomes following self-harm (self-discharge, medical and psychiatric admission and psychosocial assessment before discharge) were examined using multilevel Poisson regression models. RESULTS Care pathways following self-harm varied across hospitals and were influenced by both hospital and individual factors. Individual factors were primarily associated with self-discharge (including male gender, younger age and alcohol involvement), medical admission (older age, drug overdose as a sole method and ambulance presentations) and psychiatric admission (male gender, methods associated with greater lethality and older age). The hospital admission rate for self-harm was the only factor associated with all outcomes examined. The availability of psychiatric in-patient facilities and specialist mental health staff contributed to variation in psychiatric admissions and psychosocial assessments prior to discharge. Hospital factors explained the majority of observed variation in the provision of psychosocial assessments. CONCLUSIONS Characteristics of the presenting hospital and hospital admission rates influence the recommended care pathways following self-harm. Provision of onsite mental health facilities and specialist mental health staff has a strong impact on psychiatric care of these patients

Low temperature characterization of modulation doped SiGe grown on bonded silicon-on-insulator

Modulation doped pseudomorphic Si0.87Ge0.13 strained quantum wells were grown on bonded silicon-on-insulator (SOI) substrates. Comparison with similar structures grown on bulk Si(100) wafers shows that the SOI material has higher mobility at low temperatures with a maximum value of 16 810 cm 2/V s for 2.05 × 1011 cm – 2 carries at 298 mK. Effective masses obtained from the temperature dependence of Shubnikov–de Haas oscillations have a value of (0.27 ± 0.02) m0 compared to (0.23 ± 0.02) m0 for quantum wells on Si(100) while the cyclotron resonance effective masses obtained at higher magnetic fields without consideration for nonparabolicity effects have values between 0.25 and 0.29 m0. Ratios of the transport and quantum lifetimes, tau/tau q=2.13 ± 0.10, were obtained for the SOI material that are, we believe, the highest reported for any pseudomorphic SiGe modulation doped structure and demonstrates that there is less interface roughness or charge scattering in the SOI material than in metal–oxide–semiconductor field effect transistors or other pseudomorphic SiGe modulation doped quantum wells

Psychotropic medication involved in intentional drug overdose: implications for treatment.

Aims: Limited information is available on the source of medications taken in intentional drug overdoses (IDOs). The present study aimed to investigate the proportion of patients who engaged in IDOs with current prescriptions and the proportion of those that used their medicines in overdose acts, as well as the factors associated with patients who do so. Methods: The registration systems of three hospital emergency departments participating in the Irish National Registry of Deliberate Self Harm were screened over a continuous 6-month period and a consecutive series of 299 IDO presentations were identified. Results: Most of the IDO presentations involved female patients (59.9%) and half (50.4%) had a previous history of self-harm. The prescription of psychotropic drugs was associated with the use of these drugs in IDOs, particularly minor tranquilizers. Having a prescription of a minor tranquilizer increased the risk of using prescribed psychotropic drugs in IDOs even when controlling for other factors. Conclusion: These findings highlight the importance of considering the risk of IDO among patients who are prescribed minor tranquilizers

3D MAS NMR Experiment Utilizing Through-Space

We demonstrate a novel 3D NNC magic angle spinning NMR experiment that generates ¹⁵N–¹⁵N internuclear contacts in protein systems using an optimized ¹⁵N–¹⁵N proton assisted recoupling (PAR) mixing period and a ¹³C dimension for improved resolution. The optimized PAR condition permits the acquisition of high signal-to-noise 3D data that enables backbone chemical shift assignments using a strategy that is complementary to current schemes. The spectra can also provide distance constraints. The utility of the experiment is demonstrated on an M₀Aβ₁₋₄₂ fibril sample that yields high-quality data that is readily assigned and interpreted. The 3D NNC experiment therefore provides a powerful platform for solid-state protein studies and is broadly applicable to a variety of systems and experimental conditions.National Institute of Biomedical Imaging and Bioengineering (U.S.) (Grant EB-001960)National Institute of Biomedical Imaging and Bioengineering (U.S.) (Grant EB-002026

Orientational effects on the amplitude and phase of polarimeter signals in double resonance atomic magnetometry

Double resonance optically pumped magnetometry can be used to measure static magnetic fields with high sensitivity by detecting a resonant atomic spin response to a small oscillating field perturbation. Determination of the resonant frequency yields a scalar measurement of static field (B_0) magnitude. We present calculations and experimental data showing that the on-resonance polarimeter signal of light transmitted through an atomic vapour in arbitrarily oriented $B_0$ may be modelled by considering the evolution of alignment terms in atomic polarisation. We observe that the amplitude and phase of the magnetometer signal are highly dependent upon B_0 orientation, and present precise measurements of the distribution of these parameters over the full 4 pi solid angle

A feed-forward measurement scheme for periodic noise suppression in atomic magnetometry

We present an unshielded, double-resonance magnetometer in which we have implemented a feed-forward measurement scheme in order to suppress periodic magnetic noise arising from, and correlated with, the mains electricity alternating current line. The technique described here uses a single sensor to track ambient periodic noise and feed forward to suppress it in a subsequent measurement. This feed forward technique has shown significant noise suppression of electrical mains-noise features of up to 22 dB under the fundamental peak at 50 Hz, 3 dB at the first harmonic (100 Hz), and 21 dB at the second harmonic (150 Hz). This technique is software based, requires no additional hardware, and is easy to implement in an existing magnetometer

Grating chips for quantum technologies

We have laser cooled3x10^6 87Rb atoms to 3uK in a micro-fabricated grating magneto-optical trap (GMOT), enabling future mass-deployment in highly accurate compact quantum sensors. We magnetically trap the atoms, and use Larmor spin precession for magnetic sensing in the vicinity of the atomic sample. Finally, we demonstrate an array of magneto-optical traps with a single laser beam, which will be utilised for future cold atom gradiometry