Inpatient forensic-psychiatric care: legal frameworks and service provision in three European countries

Laws governing the detention and treatment of mentally disordered offenders (MDOs) vary widely across Europe, yet little information is available about the features of these laws and their comparative advantages and disadvantages. The purpose of this article is to compare the legal framework governing detention in forensic psychiatric care in three European countries with long established services for MDOs, England, Germany and the Netherlands. A literature review was conducted alongside consultation with experts from each country. We found that the three countries differ in several areas, including criteria for admission, review of detention, discharge process, the concept of criminal responsibility, service provision and treatment philosophy. Our findings suggest a profound difference in how each country relates to MDOs, with each approach contributing to different pathways and potentially different outcomes for the individual. Hopefully making these comparisons will stimulate debate and knowledge exchange on an international level to aid future research and the development of best practice in managing this population

Long-term forensic mental health services: an exploratory comparison of 18 European countries

The objective of this study was to explore current provisions within forensic mental health inpatient services for people who require longer-term care within Europe. We used a structured questionnaire and follow-up semi-structured interviews with experts in forensic psychiatry in 18 European countries. All experts interviewed acknowledged the issue of ‘long-stay’ in forensic psychiatry with patient characteristics including chronic mental disorder, treatment-resistance and violent behavior. Formal and informal definitions of ‘long-stay’ varied widely between countries. Eight experts stated that long-stay services are currently available in their country. Of the countries without long-stay services, five experts expressed a need develop them. Improved quality of life and promotion of wellbeing were emphasized as the fundamental treatment philosophy. Even without an agreed definition of ‘long-stay’, it is clear that a proportion of mentally disordered offenders (MDOs) are ‘stuck’ in ‘the system’. Experts shared common concerns in terms of political pressures to contain dangerous MDOs for ensuring public safety as well as ethical debates regarding long-term forensic mental health care. Further research is required to promote dialogue between and within countries to address the balance of patient' rights and public safety, and to produce longitudinal and economic analyses of existing long-stay forensic service provisions

Measurement of the radial mode spectrum of photons through a phase-retrieval method

We propose and demonstrate a simple and easy-to-implement projective-measurement protocol to determine the radial index 'p' of a Laguerre-Gaussian (LGlp) mode. Our method entails converting any specified high-order LG0p mode into a near-Gaussian distribution that matches the fundamental mode of a single-mode fiber (SMF) through the use of two phase-screens (unitary transformations) obtained by applying a phase-retrieval algorithm. The unitary transformations preserve the orthogonality of modes and guarantee that our protocol can, in principle, be free of crosstalk. We measure the coupling efficiency of the transformed radial modes to the SMF for different pairs of phase-screens. Because of the universality of phase-retrieval methods, we believe that our protocol provides an efficient way of fully characterizing the radial spatial profile of an optical field

Depression and its associated factors among people living with HIV in the Volta region of Ghana

Depression among people living with HIV/AIDS in higher-income countries is associated with suboptimal adherence to antiretroviral therapy and though counterintuitive. Yet, less is known regarding how depression, social support, and other sociodemographic factors influence outcomes among people living with HIV, particularly in resource-limited settings like Ghana. In view of this gap, this study investigated factors associated with depressive symptoms among people living with HIV in the Volta region of Ghana. A total of 181 people living with HIV from a local antiretroviral clinic was purposively sampled for the study. The questionnaire included the Center for Epidemiologic Studies Depression Scale, the Internalized Stigma of HIV/AIDS Tool, and the Interpersonal Support Evaluation List-12. An independent student t-test, one-way analysis of variance, and chi-square test were conducted to ascertain the associations among the variables of interest. The magnitude of association was evaluated with multiple linear regression. The average depression score among the participants was 9.1±8.8 and 20.4% reported signs of depression. Majority (78%) of participants who were depressed were male compared to females (p = 0.031). In the multiple linear regression, every one-year increase in age was significantly associated with an estimated 0.012 standard deviation increase in depression scores (95% CI: 0.002–0.021) after adjusting for all other variables in the model. Every unit standard deviation increase in social support was significantly associated with an estimated 0.659 standard deviation increase in depression scores (95% CI:0.187–1.132), after adjusting for all other variables in the model. We found a high prevalence of depressive symptoms among people living with HIV especially among males. An increase in age and social support was associated with an increase in depressive symptoms among people living with HIV in this study. We recommend further study using longitudinal approach to understand this unexpected association between depression and social support among people living with HIV in Ghana

Depression and its associated factors among people living with HIV in the Volta region of Ghana

Depression among people living with HIV/AIDS in higher-income countries is associated with suboptimal adherence to antiretroviral therapy and though counterintuitive. Yet, less is known regarding how depression, social support, and other sociodemographic factors influence outcomes among people living with HIV, particularly in resource-limited settings like Ghana. In view of this gap, this study investigated factors associated with depressive symptoms among people living with HIV in the Volta region of Ghana. A total of 181 people living with HIV from a local antiretroviral clinic was purposively sampled for the study. The questionnaire included the Center for Epidemiologic Studies Depression Scale, the Internalized Stigma of HIV/AIDS Tool, and the Interpersonal Support Evaluation List-12. An independent student t-test, one-way analysis of variance, and chi-square test were conducted to ascertain the associations among the variables of interest. The magnitude of association was evaluated with multiple linear regression. The average depression score among the participants was 9.1±8.8 and 20.4% reported signs of depression. Majority (78%) of participants who were depressed were male compared to females (p = 0.031). In the multiple linear regression, every one-year increase in age was significantly associated with an estimated 0.012 standard deviation increase in depression scores (95% CI: 0.002–0.021) after adjusting for all other variables in the model. Every unit standard deviation increase in social support was significantly associated with an estimated 0.659 standard deviation increase in depression scores (95% CI:0.187–1.132), after adjusting for all other variables in the model. We found a high prevalence of depressive symptoms among people living with HIV especially among males. An increase in age and social support was associated with an increase in depressive symptoms among people living with HIV in this study. We recommend further study using longitudinal approach to understand this unexpected association between depression and social support among people living with HIV in Ghana

A deep investigation into the structure of carbon dots

Since their discovery, carbon dots (CDs) have been a promising nanomaterial in a variety of fields including nanomedicine. Despite their potential in this area, there are many obstacles to overcome for CDs to be approved for biomedical use. One major hindrance to CDs’ approval is related to their poorly defined structure. Herein a structural study of CDs is presented in order to rectify this shortcoming. The properties of three CDs which have significant promise in biomedical applications, black CDs (B-CDs), carbon nitride dots (CNDs), and yellow CDs (Y-CDs), are compared in order to develop a coherent structural model for each nanosystem. Absorption coefficients were measured for each system and this data gave insight on the level of disorder in each system. Furthermore, extensive structural characterization has been performed in order to derive structural information for each system. This data showed that B-CDs and CNDs are functionalized to a greater degree and are also more disordered and amorphous than Y-CDs. These techniques were used to develop a structural model consistent with the obtained data and what is known for carbonic nanostructures. These models can be used to analyze CD emission properties and to better understand the structure-property relationship in CDs

When and how to update systematic reviews: consensus and checklist.

Updating of systematic reviews is generally more efficient than starting all over again when new evidence emerges, but to date there has been no clear guidance on how to do this. This guidance helps authors of systematic reviews, commissioners, and editors decide when to update a systematic review, and then how to go about updating the review.This is the final version of the article. It first appeared from the BMJ Publishing Group via http://dx.doi.org/10.1136/bmj.i350

Updated threshold dose-distribution data for sesame

Sesame is classified as a “major” food allergen for which mandatory disclosure is required. Understanding reaction thresholds and how these vary within the allergic population is crucial in providing appropriate dietary advice to patients, providing guidance to the food industry, and informing dosing regimens for oral food challenges (FC). However, the largest data series used to derive a threshold dose-distribution for sesame included blinded challenge data from just 40 individuals.1 Data from low-dose, open FC can be used to supplement that from blinded FC, reducing uncertainty in estimating threshold dose-distributions for allergenic foods which otherwise lack sufficient data.2 We, therefore, undertook a systematic search of the literature and performed dose-distribution modelling of individual patient FC data (including open FC) to update estimated eliciting doses for sesame