Exploring ‘Long-Stay’ Male Service Users’ Perception of their Physical Healthcare in Forensic Mental Health Services

Aims: To explore the experiences of Service Users detained in a High Secure Forensic Mental Health Service relating to their physical healthcare, including their attitudes toward physical wellbeing, and access and quality of service provisions. Background: Several factors affect the physical wellbeing of those detained in mental health services or forensic services. People with a severe and enduring mental health diagnosis are more likely to have physical health comorbidities, often because of antipsychotic medication. Those in forensic services are more likely to have greater physical health needs due to historic trauma and social factors and restricted access to health promoting resources once detained which can worsen with longer detentions. It is therefore important to explore and understand the needs of this group as they will experience a greater number of mediating factors that influence physical health. Methodology: Nine semi-structured interviews were conducted with adult males detained within secure services for over eight years who currently resided in a high secure service. A critical realist epistemological framework was adopted to explore and generate themes. Results: A thematic analysis identified three main themes; ‘The Meaning of Wellbeing’, ‘Being in a High Secure Forensic Environment’, and ‘The Role of Staff and the System’. The largest theme was the secure environment and participants' views on restrictions and impositions to their daily life. Participants were thoughtful about aspects that impact their health such as medication, individual responsibility, and diet. All agreed they were offered activities and access to healthcare; however motivation and staff availability could affect uptake amongst participants. These are explored further within the research. Conclusion: The themes offered an opportunity to hear and understand service user’s perspectives on an area that is becoming more considered. Recommendations discussed include integration of physical health and mental health services, staff training and employment of psychological approaches to physical healthcare

The Multitude of Molecular Hydrogen Knots in the Helix Nebula

We present HST/NICMOS imaging of the H_2 2.12 \mu m emission in 5 fields in the Helix Nebula ranging in radial distance from 250-450" from the central star. The images reveal arcuate structures with their apexes pointing towards the central star. Comparison of these images with comparable resolution ground based images reveals that the molecular gas is more highly clumped than the ionized gas line tracers. From our images, we determine an average number density of knots in the molecular gas ranging from 162 knots/arcmin^2 in the denser regions to 18 knots/arcmin^2 in the lower density outer regions. Using this new number density, we estimate that the total number of knots in the Helix to be ~23,000 which is a factor of 6.5 larger than previous estimates. The total neutral gas mass in the Helix is 0.35 M_\odot assuming a mass of \~1.5x10^{-5} M_\odot for the individual knots. The H_2 intensity, 5-9x10^{-5} erg s^{-1} cm^{-2} sr^{-1}, remains relatively constant with projected distance from the central star suggesting a heating mechanism for the molecular gas that is distributed almost uniformly in the knots throughout the nebula. The temperature and H_2 2.12 \mu m intensity of the knots can be approximately explained by photodissociation regions (PDRs) in the individual knots; however, theoretical PDR models of PN under-predict the intensities of some knots by a factor of 10.Comment: 26 pages, 3 tables, 10 figures; AJ accepte

Goldstone Gauginos

Models of supersymmetry with Dirac gauginos provide an attractive scenario for physics beyond the standard model. The "supersoft" radiative corrections and suppressed SUSY production at colliders provide for more natural theories and an understanding of why no new states have been seen. Unfortunately, these models are handicapped by a tachyon which is naturally present in existing models of Dirac gauginos. We argue that this tachyon is absent, with the phenomenological successes of the model preserved, if the right handed gaugino is a (pseudo-)Goldstone field of a spontaneously broken anomalous flavor symmetry.Comment: 5 pages, 1 figure. v2: minor changes to text, references added and update

Models of Goldstone Gauginos

Models with Dirac gauginos provide appealing scenarios for physics beyond the standard model. They have smaller radiative corrections to the Higgs mass, a suppression of certain SUSY production processes, and ameliorated flavor constraints. Unfortunately, they also generally have tachyons, the solutions to which typically spoil these positive features. The recently proposed "Goldstone Gaugino" mechanism provides a simple solution that eliminates these tachyonic states. We provide details on this mechanism and explore models for its origin. In particular, we find SUSY QCD models that realize this idea simply, and discuss scenarios for unification.Comment: 33 pages, 4 figure

Electronic health information exchange in underserved settings: examining initiatives in small physician practices & community health centers.

BackgroundHealth information exchange (HIE) is an important tool for improving efficiency and quality and is required for providers to meet Meaningful Use certification from the United States Centers for Medicare and Medicaid Services. However widespread adoption and use of HIE has been difficult to achieve, especially in settings such as smaller-sized physician practices and federally qualified health centers (FQHCs). We assess electronic data exchange activities and identify barriers and benefits to HIE participation in two underserved settings.MethodsWe conducted key-informant interviews with stakeholders at physician practices and health centers. Interviews were recorded, transcribed, and then coded in two waves: first using an open-coding approach and second using selective coding to identify themes that emerged across interviews, including barriers and facilitators to HIE adoption and use.ResultsWe interviewed 24 providers, administrators and office staff from 16 locations in two states. They identified barriers to HIE use at three levels-regional (e.g., lack of area-level exchanges; partner organizations), inter-organizational (e.g., strong relationships with exchange partners; achieving a critical mass of users), and intra-organizational (e.g., type of electronic medical record used; integration into organization's workflow). A major perceived benefit of HIE use was the improved care-coordination clinicians could provide to patients as a direct result of the HIE information. Utilization and perceived benefit of the exchange systems differed based on several practice- and clinic-level factors.ConclusionsThe adoption and use of HIE in underserved settings appears to be impeded by regional, inter-organizational, and intra-organizational factors and facilitated by perceived benefits largely at the intra-organizational level. Stakeholders should consider factors both internal and external to their organization, focusing efforts in changing modifiable factors and tailoring HIE efforts based on all three categories of factors. Collective action between organizations may be needed to address inter-organizational and regional barriers. In the interest of facilitating HIE adoption and use, the impact of interventions at various levels on improving the use of electronic health data exchange should be tested

Purified venom components inhibit EGFR phosphorylation in triple negative breast cancer

Abstract: EACR22-0963 Introduction Breast cancer remains the most commonly diagnosed type of cancer in both menopausal age women and adolescent/young adults. 10-20% of diagnosed breast cancers are deemed to be triple negative (TN), lacking expression of hormone receptors and HER2. Triple negative breast cancers (TNBC) present with poor patient prognosis, through their lack of effective treatment options. Studies report that epidermal growth factor receptor (EGFR) is expressed in 15–45% of all breast tumours and its expression is inversely related to hormone receptor expression. Expression of EGFR is indicative of poor prognosis, making it an attractive target for treatment in both TN and receptor expressing cancer subtypes. Development of resistance to current EGFR targeted therapeutics is common, leading to treatment failure and patient relapse, thus novel compound classes are needed. Venom peptides have evolved to be secreted into the lumen of the venom gland and stored ready for rapid delivery; therefore they are exceptionally stable. These proteins naturally act as ligands for a large variety of receptors and ion channels, making them a rich source of potentially novel drug like molecules. Material and Methods In this study the Venomtech Targeted-Venom Discovery ArrayEGFR (T-VDA™) containing 320 venom 2D HPLC fractions was screened using Abcam Human EGFR (pY1086) + total EGFR ELISA Kits to identify venom peptides with antagonistic activity against EGFR pY1086 phosphorylation. Optimal cell number, dosing and lysate concentrations were determined empirically. MDA-MB-468 TNBC cells were dosed at 20ug/ml for 2h with fractions, before being stimulated with 1x10-7M EGF for 5 mins. Further assay protocol was carried out as per manufacturer’s instructions. TMB Absorbance signal was measured using a CLARIOstarPLUS plate reader at 450nm (BMG LabTech). Results and Discussions Screening of the TVDAEGFR array (N=2) identified 7 hit fractions (2.2% hit rate) from the venoms of three distinct rattlesnake genera from Northern, Central and southern America, and 1 viper species from Northern Africa. These fractions were followed up with dose response, mass spec and drug like properties. Conclusion Purified protein components from the venoms of pit vipers and vipers show the capacity to antagonistically inhibit the phosphorylation of EGFR at specific tyrosine residues linked to downstream signalling pathways in TNBC cells. Thus, representing a novel chemical class for targeting EGF

Small neutrino masses due to R-symmetry breaking for a small cosmological constant

We describe a class of supersymmetric models in which neutrinos are kept light by an R-symmetry. In supergravity, R-symmetry must be broken to allow for a small cosmological constant after supersymmetry breaking. In the class of models described here, this R-symmetry breaking results in the generation of Dirac neutrino masses, connecting the tuning of the cosmological constant to the puzzle of neutrino masses. Surprisingly, under the assumption of low-scale supersymmetry breaking and superpartner masses close to a TeV, these masses are independent of the fundamental supersymmetry-breaking scale, and accommodate the correct magnitude. This offers a novel explanation for the vastly different scales of neutrino and charged fermion masses. These models require that R-symmetric supersymmetry exists at the TeV scale, and predict that neutrino masses are purely Dirac, implying the absence of neutrino-less double beta-decay. Interesting collider signals can arise due to charged scalars which decay leptonically, with branching ratios determined by the neutrino mixing matrix.Comment: 6 pages, 2 figures. v2 matches published versio

13C-Methyl isocyanide as an NMR probe for cytochrome P450 active site

The cytochromes P450 (CYPs) play a central role in many biologically important oxidation reactions, including the metabolism of drugs and other xenobiotic compounds. Because they are often assayed as both drug targets and anti-targets, any tools that provide: (a) confirmation of active site binding and (b) structural data, would be of great utility, especially if data could be obtained in reasonably high throughput. To this end, we have developed an analog of the promiscuous heme ligand, cyanide,with a 13CH3-reporter attached. This 13C-methyl isocyanide ligand binds to bacterial (P450cam) and membrane-bound mammalian (CYP2B4) CYPs. It can be used in a rapid 1D experiment to identify binders, and provides a qualitative measure of structural changes in the active site