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

Objectives Excess weight is highly prevalent in secure (forensic) mental health services and impacts negatively on patients’ 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 ‘obesogenic’ 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

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

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

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

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

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

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].)

The search for ZZ Ceti stars in the original Kepler mission

We report the discovery of 42 white dwarfs in the original Kepler mission field, including nine new confirmed pulsating hydrogen-atmosphere white dwarfs (ZZ Ceti stars). Guided by the Kepler-INT Survey (KIS), we selected white dwarf candidates on the basis of their U-g, g-r, and r-H_alpha photometric colours. We followed up these candidates with high-signal-to-noise optical spectroscopy from the 4.2-m William Herschel Telescope. Using ground-based, time-series photometry, we put our sample of new spectroscopically characterized white dwarfs in the context of the empirical ZZ Ceti instability strip. Prior to our search, only two pulsating white dwarfs had been observed by Kepler. Ultimately, four of our new ZZ Cetis were observed from space. These rich datasets are helping initiate a rapid advancement in the asteroseismic investigation of pulsating white dwarfs, which continues with the extended Kepler mission, K2.Comment: 9 pages, 6 figures, accepted for publication in MNRA

Near-Infrared Spectroscopy of Molecular Filaments in the Reflection Nebula NGC 7023

We present near-infrared spectroscopy of fluorescent molecular hydrogen (H_2) emission from molecular filaments in the reflection nebula NGC 7023. We derive the relative column densities of H_2 rotational-vibrational states from the measured line emission and compare these results with several model photodissociation regions covering a range of densities, incident UV-fields, and excitation mechanisms. Our best-fit models for one filament suggest, but do not require, either a combination of different densities, suggesting clumps of 10^6 cm^{-3} in a 10^4 - 10^5 cm^{-3} filament, or a combination of fluorescent excitation and thermally-excited gas, perhaps due to a shock from a bipolar outflow. We derive densities and UV fields for these molecular filaments that are in agreement with previous determinations.Comment: ApJ accepted, 26 pages including 5 embedded figures, uses AASTEX. Also available at http://www-astronomy.mps.ohio-state.edu/~martini/pubs.htm

Type-Decomposition of a Pseudo-Effect Algebra

The theory of direct decomposition of a centrally orthocomplete effect algebra into direct summands of various types utilizes the notion of a type-determining (TD) set. A pseudo-effect algebra (PEA) is a (possibly) noncommutative version of an effect algebra. In this article we develop the basic theory of centrally orthocomplete PEAs, generalize the notion of a TD set to PEAs, and show that TD sets induce decompositions of centrally orthocomplete PEAs into direct summands.Comment: 18 page