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

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

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 ‘obesogenic’ 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

Feedback from massive stars at low metallicities : MUSE observations of N44 and N180 in the Large Magellanic Cloud

Accepted for publication in MNRAS, 27 pages, 21 figuresWe present MUSE integral field data of two HII region complexes in the Large Magellanic Cloud (LMC), N44 and N180. Both regions consist of a main superbubble and a number of smaller, more compact HII regions that formed on the edge of the superbubble. For a total of 11 HII regions, we systematically analyse the radiative and mechanical feedback from the massive O-type stars on the surrounding gas. We exploit the integral field property of the data and the coverage of the HeII$\lambda$5412 line to identify and classify the feedback-driving massive stars, and from the estimated spectral types and luminosity classes we determine the stellar radiative output in terms of the ionising photon flux $Q_{0}$. We characterise the HII regions in terms of their sizes, morphologies, ionisation structure, luminosity and kinematics, and derive oxygen abundances via emission line ratios. We analyse the role of different stellar feedback mechanisms for each region by measuring the direct radiation pressure, the pressure of the ionised gas, and the pressure of the shock-heated winds. We find that stellar winds and ionised gas are the main drivers of HII region expansion in our sample, while the direct radiation pressure is up to three orders of magnitude lower than the other terms. We relate the total pressure to the star formation rate per unit area, $\Sigma_{SFR}$, for each region and find that stellar feedback has a negative effect on star formation, and sets an upper limit to $\Sigma_{SFR}$ as a function of increasing pressure.Peer reviewe

Phonon-Induced Rabi-Frequency Renormalization of Optically Driven Single InGaAs/GaAs Quantum Dots

The authors thank the EPSRC (U.K.) EP/G001642, and the QIPIRC U.K. for financial support. A. N. is supported by the EPSRC and B.W. L. by the Royal Society.We study optically driven Rabi rotations of a quantum dot exciton transition between 5 and 50 K, and for pulse areas of up to 14 pi. In a high driving field regime, the decay of the Rabi rotations is nonmonotonic, and the period decreases with pulse area and increases with temperature. By comparing the experiments to a weak-coupling model of the exciton-phonon interaction, we demonstrate that the observed renormalization of the Rabi frequency is induced by fluctuations in the bath of longitudinal acoustic phonons, an effect that is a phonon analogy of the Lamb shift.Peer reviewe

Efficient Bayesian hierarchical functional data analysis with basis function approximations using Gaussian-Wishart processes

Functional data are defined as realizations of random functions (mostly smooth functions) varying over a continuum, which are usually collected with measurement errors on discretized grids. In order to accurately smooth noisy functional observations and deal with the issue of high-dimensional observation grids, we propose a novel Bayesian method based on the Bayesian hierarchical model with a Gaussian-Wishart process prior and basis function representations. We first derive an induced model for the basis-function coefficients of the functional data, and then use this model to conduct posterior inference through Markov chain Monte Carlo. Compared to the standard Bayesian inference that suffers serious computational burden and unstableness for analyzing high-dimensional functional data, our method greatly improves the computational scalability and stability, while inheriting the advantage of simultaneously smoothing raw observations and estimating the mean-covariance functions in a nonparametric way. In addition, our method can naturally handle functional data observed on random or uncommon grids. Simulation and real studies demonstrate that our method produces similar results as the standard Bayesian inference with low-dimensional common grids, while efficiently smoothing and estimating functional data with random and high-dimensional observation grids where the standard Bayesian inference fails. In conclusion, our method can efficiently smooth and estimate high-dimensional functional data, providing one way to resolve the curse of dimensionality for Bayesian functional data analysis with Gaussian-Wishart processes.Comment: Under revie

UBVRI photopolarimetry of the long period eclipsing AM Herculis binary V1309

We report simultaneous UBVRI photo-polarimetric observations of the long period (7.98 h) AM Her binary V1309 Ori. The length and shape of the eclipse ingress and egress varies from night to night. We suggest this is due to the variation in the brightness of the accretion stream. By comparing the phases of circular polarization zero-crossovers with previous observations, we confirm that V1309 Ori is well synchronized, and find an upper limit of 0.002 percent for the difference between the spin and orbital periods. We model the polarimetry data using a model consisting of two cyclotron emission regions at almost diametrically opposite locations, and centered at colatitude 35 (deg) and 145 (deg) on the surface of the white dwarf. We also present archive X-ray observations which show that the negatively polarised accretion region is X-ray bright.Comment: 11 pages, 12 figures (2 colour), Fig1 and Fig 4 are in lower resolution than in original paper, accepted for publication in Monthly Notices of the Royal Astronomical Societ

Need for achievement moderates the effect of motive-relevant challenge on salivary cortisol changes

The hypothalamic–pituitary–adrenal (HPA) axis plays a key role in the physiological response to stress, preparing the organism for appropriate action. While some research has examined universally relevant threats, other research has suggested that individual differences may moderate the relationship between stress and cortisol release, such that some individuals exhibit modified reactivity to personally relevant stressors or challenges. In the present study we investigated whether one individual difference—the implicit need for achievement—moderates the effect of motive-relevant challenge on salivary cortisol. Participants’ salivary cortisol and felt affect were measured before and after engagement in an achievement task. In the positive- and no-feedback conditions, individuals high in implicit achievement motivation demonstrated increased cortisol response to the task, whereas in the negative feedback condition, individuals high in implicit achievement motivation demonstrated a dampened cortisol response. Furthermore, changes in cortisol were accompanied by changes in felt affect in the same direction, specifically hedonic tone. These results suggest that the HPA axis also responds to non-social-evaluative challenge in a personality-contingent manner

Baylisascaris procyonis in raccoons (Procyon lotor) in eastern Tennessee

Raccoon (Procyon lotor) carcasses (n=118) were collected from July through December 2007 throughout eastern Tennessee. Necropsies were performed, and Baylisascaris procyonis was collected from the gastrointestinal tract of infected carcasses. Prevalence rates were determined for the overall sample population, males and females, and adults and juveniles. The sample population had a B. procyonis prevalence of 12.7%. Males and females had a prevalence of 15% and 11%, respectively; prevalence in adults and juvenile was 13% and 12.6%, respectively. There were no significant differences in prevalence rates between the different groups. Baylisascaris procyonis is an ascarid infection of raccoons that can infect humans and over 100 species of other animals. The presence of infection in raccoons, paired with the expansion of human populations in eastern Tennessee, is likely to lead to increased interactions between humans and raccoons and therefore an increased risk of human and domestic animal exposure to B. procyonis

N-methyl-N-((1-methyl-5-(3-(1-(2-methylbenzyl)piperidin-4-yl)propoxy)-1H-indol-2-yl)methyl)prop-2-yn-1-amine, a new cholinesterase and monoamine oxidase dual inhibitor

On the basis of N-((5-(3-(1-benzylpiperidin-4-yl)propoxy)-1-methyl-1H-indol-2-yl)methyl)-N-methylprop-2-yn-1-amine (II, ASS234) and QSAR predictions, in this work we have designed, synthesized, and evaluated a number of new indole derivatives from which we have identified N-methyl-N-((1-methyl-5-(3-(1-(2-methylbenzyl)piperidin-4-yl)propoxy)-1H-indol-2-yl)methyl)prop-2-yn-1-amine (2, MBA236) as a new cholinesterase and monoamine oxidase dual inhibitor.PostprintPostprintPeer reviewe