2,537 research outputs found

    What are the key influences and challenges around weight management faced by patients in UK adult secure mental health settings? A focused ethnographic approach

    Get PDF
    Objectives Excess weight is highly prevalent in secure (forensic) mental health services and impacts negatively on patientsā€™ physical and mental health. This study sought to identify the key influences and challenges around weight management in United Kingdom (UK) adult secure mental health settings. Design Qualitative focussed ethnography. Analysis of written fieldnotes was undertaken through a combined inductive and deductive approach, informed by thematic analysis. Setting Low secure male mental health ward and associated patient activities and events, in a National Health Service (NHS) Trust delivering mental health, intellectual disability and neurorehabilitation services in the UK. Participants Twelve males (primarily White British) on the low secure ward; other male participants from low and medium secure services, who took part in group events and activities; and multidisciplinary low and medium secure services staff. Approximately 23 hours of observation were undertaken over a six-month period from April 2022. Results Secure mental healthcare delivered an overall ā€˜obesogenicā€™ environment, predisposing patients to excessive weight gain and sedentary behaviour, which was often perceived as inevitable. Key themes highlighted the heightened salience of food in secure settings; inadequacy of catered hospital food and shortcomings of alternative food options; limited physical activity opportunities; and understaffing. Ward culture was not conducive to healthy behaviours. Perceptions and behaviour towards the ethnographer were primarily positive and accepting. Conclusions Weight management in secure services is a complex challenge. In future, whole settingbased interventions to promote healthy weight are likely to be required. These should integrate physical and mental health, incorporate underpinning determinants such as adequate staffing and a culture promoting weight management, and involve both patients and staff

    X-ray spectroscopy and photometry of the long-period polar AI Tri with XMM-Newton

    Full text link
    Context. The energy balance of cataclysmic variables with strong magnetic fields is a central subject in understanding accretion processes on magnetic white dwarfs. With XMM-Newton, we perform a spectroscopic and photometric study of soft X-ray selected polars during their high states of accretion. Aims. On the basis of X-ray and optical observations of the magnetic cataclysmic variable AI Tri, we derive the properties of the spectral components, their flux contributions, and the physical structure of the accretion region in soft polars. Methods. We use multi-temperature approaches in our xspec modeling of the spectra to describe the physical conditions and the structures of the post-shock accretion flow and the accretion spot on the white-dwarf surface. In addition, we investigate the accretion geometry of the system by a timing analysis of the photometric data. Results. Flaring soft X-ray emission from the heated surface of the white dwarf dominates the X-ray flux during roughly 70% of the binary cycle. This component deviates from a single black body and can be described by a superimposition of mildly absorbed black bodies with a Gaussian temperature distribution. In addition, weaker hard X-ray emission is visible nearly all the time. The spectrum from the cooling post-shock accretion flow is most closely fitted by a combination of thermal plasma mekal models with temperature profiles adapted from prior stationary two-fluid hydrodynamic calculations. The soft X-ray light curves show a dip during the bright phase, which can be interpreted as self-absorption in the accretion stream. Phase-resolved spectral modeling supports the picture of one-pole accretion and self-eclipse. One of the optical light curves corresponds to an irregular mode of accretion. During a short XMM-Newton observation at the same epoch, the X-ray emission of the system is clearly dominated by the soft component.Comment: A&A, in press; 11 pages, 9 figures, 3 table

    Understanding weight management in adult secure mental health services: findings from a mixed-methods study in Northern England

    Get PDF
    Obesity and associated morbidity and mortality are major challenges for people with severe mental illness (SMI, including schizophrenia and bipolar disorder), particularly in secure (forensic) mental healthcare (patients who have committed a crime or have threatening behaviour). This research aimed to explore experiences of obesity in secure mental health settings, through a survey, focus groups and interviews. The survey was delivered to secure mental healthcare staff in a National Health Service (NHS) mental health trust in Northern England, and received 79 responses. Nine focus groups were conducted with current and former patients, carers and multidisciplinary staff in the same trust. Eleven semi-structured interviews were undertaken with multidisciplinary staff in a second NHS mental health trust in Northern England. Through thematic analysis two overarching issues were identified, concerning the contrasting perspectives expressed by different stakeholder groups, and the importance of a whole system approach. Overall, secure care was highlighted as an ā€˜obesogenicā€™ environment, conducive to excessive weight gain. Seven key influences included: medication, sedentary behaviour, patient motivation and intrinsic factors, catered food and alternatives, role of staff, and service delivery. In future, complex interventions engaging wide-ranging stakeholders are likely to be needed, with linked longitudinal studies to evaluate feasibility and impact

    XMM-Newton observations of the X-ray soft polar QS Telescopii

    Full text link
    Context. On the basis of XMM-Newton observations, we investigate the energy balance of selected magnetic cataclysmic variables, which have shown an extreme soft-to-hard X-ray flux ratio in the ROSAT All-Sky Survey. Aims. We intend to establish the X-ray properties of the system components, their flux contributions, and the accretion geometry of the X-ray soft polar QS Tel. In the context of high-resolution X-ray analyses of magnetic cataclysmic variables, this study will contribute to better understanding the accretion processes on magnetic white dwarfs. Methods. During an intermediate high state of accretion of QS Tel, we have obtained 20 ks of XMM-Newton data, corresponding to more than two orbital periods, accompanied by simultaneous optical photometry and phase-resolved spectroscopy. We analyze the multi-wavelength spectra and light curves and compare them to former high- and low-state observations. Results. Soft emission at energies below 2 keV dominates the X-ray light curves. The complex double-peaked maxima are disrupted by a sharp dip in the very soft energy range (0.1-0.5 keV), where the count rate abruptly drops to zero. The EPIC spectra are described by a minimally absorbed black body at 20 eV and two partially absorbed MEKAL plasma models with temperatures around 0.2 and 3 keV. The black-body-like component arises from one mainly active, soft X-ray bright accretion region nearly facing the mass donor. Parts of the plasma emission might be attributed to the second, virtually inactive pole. High soft-to-hard X-ray flux ratios and hardness ratios demonstrate that the high-energy emission of QS Tel is substantially dominated by its X-ray soft component.Comment: Accepted for publication in Astronomy and Astrophysics. 7 pages, 4 figures, 2 table

    Fast preparation of single hole spin in InAs/GaAs quantum dot in Voigt geometry magnetic field

    Full text link
    The preparation of a coherent heavy-hole spin via ionization of a spin-polarized electron-hole pair in an InAs/GaAs quantum dot in a Voigt geometry magnetic field is investigated. For a dot with a 17 ueV bright-exciton fine-structure splitting, the fidelity of the spin preparation is limited to 0.75, with optimum preparation occurring when the effective fine-structure of the bright-exciton matches the in-plane hole Zeeman energy. In principle, higher fidelities can be achieved by minimizing the bright-exciton fine-structure splitting.Comment: 8 pages, 10 figs, published PRB 85 155310 (2012

    The incidence of malignancy in the residual rectum of IBD patients after colectomy : a systematic review and meta-analysis

    Get PDF
    Acknowledgements The authors would like to kindly thank Mr. Rob Polson for his valuable assistance with the search strategy. Funding There was no funding provided for this study.Peer reviewedPublisher PD

    Near dispersion-less surface plasmon polariton resonances at a metal-dielectric interface

    Full text link
    Omni-directional light coupling to surface plasmon polariton (SPP) modes to make use of plasmon mediated near-field enhancement is challenging. We report possibility of near dispersion-less modes in structures with unpatterned metal-dielectric interfaces having 2-D dielectric patterns on top. We show that the position and dispersion of the excited modes can be controlled by the excitation geometry and the 2-D pattern. The anti-crossings resulting from the in-plane coupling of different SPP modes are also shown.Comment: 15 pages, 4 figure

    Vitamins and Perinatal Outcomes Among HIV-Negative Women in Tanzania.

    Get PDF
    Prematurity and low birth weight are associated with high perinatal and infant mortality, especially in developing countries. Maternal micronutrient deficiencies may contribute to these adverse outcomes. In a double-blind trial in Dar es Salaam, Tanzania, we randomly assigned 8468 pregnant women (gestational age of fetus, 12 to 27 weeks) who were negative for human immunodeficiency virus infection to receive daily multivitamins (including multiples of the recommended dietary allowance) or placebo. All the women received prenatal supplemental iron and folic acid. The primary outcomes were low birth weight (<2500 g), prematurity, and fetal death. The incidence of low birth weight was 7.8% among the infants in the multivitamin group and 9.4% among those in the placebo group (relative risk, 0.82; 95% confidence interval [CI], 0.70 to 0.95; P=0.01). The mean difference in birth weight between the groups was modest (67 g, P<0.001). The rates of prematurity were 16.9% in the multivitamin group and 16.7% in the placebo group (relative risk, 1.01; 95% CI, 0.91 to 1.11; P=0.87), and the rates of fetal death were 4.3% and 5.0%, respectively (relative risk, 0.87; 95% CI, 0.72 to 1.05; P=0.15). Supplementation reduced both the risk of a birth size that was small for gestational age (<10th percentile; 10.7% in the multivitamin group vs. 13.6% in the placebo group; relative risk, 0.77; 95% CI, 0.68 to 0.87; P<0.001) and the risk of maternal anemia (hemoglobin level, <11 g per deciliter; relative risk, 0.88; 95% CI, 0.80 to 0.97; P=0.01), although the difference in the mean hemoglobin levels between the groups was small (0.2 g per deciliter, P<0.001). Multivitamin supplementation reduced the incidence of low birth weight and small-for-gestational-age births but had no significant effects on prematurity or fetal death. Multivitamins should be considered for all pregnant women in developing countries. (ClinicalTrials.gov number, NCT00197548 [ClinicalTrials.gov].)
    • ā€¦
    corecore