A Systematic Review of the Effects of Urban Living on Suicidality and Self-Harm in the UK and Ireland

We conducted a systematic review to answer the following: (a) Is there any evidence to support increased prevalence of suicidality and self-harm (i.e. self-harm or suicidality) in urban versus rural environments? (b) What aspects of the urban environment pose risk for suicidality and self-harm? Thirty-five studies met our criteria. Our findings reflect a mixed picture, but with a tendency for urban living to be associated with an increased risk of suicidality and self-harm over rural living, particularly for those living in deprived areas. Further research should focus on the clustering and additive effects of risk and protective factors for suicidality and self-harm in urban environments

Relations of distinct psychopathic personality traits with anxiety and fear : findings from offenders and non-offenders

Early descriptions of psychopathy emphasise fearlessness and a lack of nervousness or anxiety as key characteristics of the disorder. However, conflicting evidence suggests that anxiety may be positively correlated with some aspects of the psychopathy construct. This position may seem somewhat paradoxical when considered alongside impaired processing of fear related stimuli in psychopathic personality. The aim of the current paper was to examine the distinct relations of callous, egocentric, and antisocial psychopathic traits with measures of anxiety and social anxiety in samples of non-offenders (Study 1) and violent offenders (Study 2). In Study 2 we also used an emotion recognition task to examine fearful face recognition. In Studies 1 and 2 we showed distinct and opposite significant relationships of egocentric and antisocial psychopathic traits with trait anxiety. Thus, while trait anxiety was negatively predicted by egocentric traits, it was predicted in a positive direction by antisocial traits in both samples. In Study 2 we found that callous traits were predictive of greater impairments in fearful face recognition. These findings suggest that anxiety and fear are distinguishable constructs in relation to psychopathic personality traits, and are discussed in terms of potentially separable mechanisms for these two constructs

Emotional expression recognition and attribution bias among sexual and violent offenders:a signal detection analysis

Research with violent offenders has consistently shown impaired recognition of other’s facial expressions of emotion. However, the extent to which similar problems can be observed among sexual offenders remains unknown. Using a computerized task, we presented sexual and violent offenders, and non-offenders, with male and female expressions of anger, disgust, fear, happiness, sadness, and surprise, morphed with neutral expressions at varying levels of intensity (10%, 55%, and 90% expressive). Based on signal detection theory, we used hit rates and false alarms to calculate the sensitivity index d-prime (d’) and criterion (c) for each emotional expression. Overall, sexual offenders showed reduced sensitivity to emotional expressions across intensity, sex, and type of expression, compared with non-offenders, while both sexual and violent offenders showed particular reduced sensitivity to fearful expressions. We also observed specific effects for high (90%) intensity female faces, with sexual offenders showing reduced sensitivity to anger compared with non-offenders and violent offenders, and reduced sensitivity to disgust compared with non-offenders. Furthermore, both sexual and violent offenders showed impaired sensitivity to high intensity female fearful expressions compared with non-offenders. Violent offenders also showed a higher criterion for classifying moderate and high intensity male expressions as fearful, indicative of a more conservative response style, compared with angry, happy, or sad. These results suggest that both types of offender show problems in emotion recognition, and may have implications for understanding the inhibition of violent and sexually violent behaviors

Integrated health services for children: a qualitative study of family perspectives.

This is the final version. Available from BMC via the DOI in this record. BACKGROUND: There is increasing evidence that integrated care improves child related quality of life and reduces health service use. However, there is limited evidence on family perspectives about the quality of integrated care for children's services. This study aimed to understand children, young people, and caregivers' perceptions of a new integrated care service, and to identify essential components of integrated care for children and young people with ongoing conditions. METHODS: A qualitative analysis of in-depth interviews with caregivers and children included families (N = 37) with children with one of four ongoing conditions (asthma, eczema, epilepsy, constipation) who had experienced a new integrated care service delivered in South London, UK. RESULTS: Four key components of integrated services identified were: that the key health-worker understood the health needs of the family in context; that professionals involved children and caregivers in treatment; that holistic care that supported the family unit was provided; and that families experienced coordination across health, social, and education systems. CONCLUSIONS: Children and families identify care navigation and a holistic approach as key components that make high quality integrated care services. Service developments strengthening these aspects will align well with family perspectives on what works and what matters.Guy’s and St Thomas Charit

The Children and Young People's Health Partnership Evelina London Model of Care: process evaluation protocol

Introduction Children and young people (CYP) in the UK have poor health outcomes, and there is increasing emergency department and hospital outpatient use. To address these problems in Lambeth and Southwark (two boroughs of London, UK), the local Clinical Commissioning Groups, Local Authorities and Healthcare Providers formed The Children and Young People’s Health Partnership (CYPHP), a clinical-academic programme for improving child health. The Partnership has developed the CYPHP Evelina London model, an integrated healthcare model that aims to deliver effective, coordinated care in primary and community settings and promote better self-management to over approximately 90 000 CYP in Lambeth and Southwark. This protocol is for the process evaluation of this model of care. Methods and analysis Alongside an impact evaluation, an in-depth, mixed-methods process evaluation will be used to understand the barriers and facilitators to implementing the model of care. The data collected mapped onto a logic model of how CYPHP is expected to improve child health outcomes. Data collection and analysis include qualitative interviews and focus groups with stakeholders, a policy review and a quantitative analysis of routine clinical and administrative data and questionnaire data. Information relating to the context of the trial that may affect implementation and/or outcomes of the CYPHP model of care will be documented. Ethics and dissemination The study has been reviewed by NHS REC Cornwall & Plymouth (17/SW/0275). The findings of this process evaluation will guide the scaling up and implementation of the CYPHP Evelina London Model of Care across the UK. Findings will be disseminated through publications and conferences, and implementation manuals and guidance for others working to improve child health through strengthening health systems. Trial registration number NCT03461848

The political views of doctors in the United Kingdom: A cross sectional study

Background: Little is known about the political views of doctors in the United Kingdom, despite their importance in the functioning of the National Health Service. Methods: Survey-based cross-sectional study in which we asked questions about voting behaviour in 2015 and 2017 UK general elections and 2016 referendum on leaving the European Union (Brexit) and questions relating to recent health policies. Results: 1,172 doctors (45.1% women) from 1,295 responded to an online survey. 60.5% described their political views as ‘left-wing’ and 62.2% described themselves as ‘liberal’. 79.4% of respondents voted to remain in the EU in the 2016 referendum compared to 48.1% of voters as a whole (χ2=819.8, p<0.001). 98.6% of respondents agreed that EU nationals working in the NHS should be able to remain in the UK after Brexit. The median score for the impact of Brexit on the NHS on a scale of 0 (worst impact) to 10 (best impact) was 2 (IQR=1-4). Most respondents agreed with the introduction of minimum alcohol pricing in the UK (73.9%), charging patients who are not eligible for NHS treatment for non-urgent care (70.6%) and protecting a portion of national spending for the NHS (87.1%). 65.8% thought there was too much use of NHS-funded private sector provision in their medical practice. Specialty, income and grade were associated with divergent opinions. Conclusions: UK doctors are left-leaning and liberal in general, which is reflected in their opinions on topical health policy issues. Doctors in the UK voted differently from the general electorate in recent polls

A unified framework for isotropic meshing based on narrow-band Euclidean distance transformation

In this paper, we propose a simple-yet-effective method for isotropic meshing relying on Euclidean distance transformation based centroidal Voronoi tessellation (CVT). Our approach improves the performance and robustness of computing CVT on curved domains while simultaneously providing high-quality output meshes. While conventional extrinsic methods compute CVTs in the entire volume bounded by the input model, we restrict the computation to a 3D shell of user-controlled thickness. Taking voxels which contain surface samples as sites, we compute the exact Euclidean distance transform on the GPU. Our algorithm is parallel and memory-efficient, and can construct the shell space for resolutions up to 20483 at interactive speed. The 3D centroidal Voronoi tessellation and restricted Voronoi diagrams are also computed efficiently on the GPU. Since the shell space can bridge holes and gaps smaller than a certain tolerance, and tolerate non-manifold edges and degenerate triangles, our algorithm can handle models with such defects, which typically cause conventional remeshing methods to fail. Our method can process implicit surfaces, polyhedral surfaces, and point clouds in a unified framework. Computational results show that our GPU-based isotropic meshing algorithm produces results comparable to state-of- the-art techniques, but is significantly faster than conventional CPU-based implementations.MOE (Min. of Education, S’pore)Published versio

YangZheng XiaoJi exerts anti-tumour growth effects by antagonising the effects of HGF and its receptor, cMET, in human lung cancer cells

BACKGROUND: Hepatocyte growth factor (HGF) is a cytokine that has a profound effect on cancer cells by stimulating migration and invasion and acting as an angiogenic factor. In lung cancer, the factor also plays a pivotal role and is linked to a poor outcome in patients. In particular, HGF is known to work in combination with EGF on lung cancer cells. In the present study, we investigated the effect of a traditional Chinese medicine reported in cancer therapies, namely YangZheng XiaoJi (YZXJ) on lung cancer and on HGF mediated migration and invasion of lung cancer cells. METHODS: Human lung cancer cells, SKMES1 and A549 were used in the study. An extract from the medicine was used. Cell migration was investigated using the EVOS and by ECIS. Cell–matrix adhesion and in vitro invasion were assessed. In vivo growth of lung cancer was tested using an in vivo xenograft tumour model and activation of the HGF receptor in lung tumours by an immunofluorescence method. RESULTS: Both lung cancer cells increased their migration in response to HGF and responded to YZXJ by reducing their speed of migration. YZXJ markedly reduced the migration and in vitro invasiveness induced by HGF. It worked synergistically with PHA665752 and SU11274, HGF receptor inhibitors on the lung cancer cells both on HGF receptor activation and on cell functions. A combination of HGF and EGF resulted in a greater increase in cell migration, which was similarly inhibited by YZXJ, and in combination with the HGF receptor and EGF receptor inhibitors. In vivo, YZXJ reduced the rate of tumour growth and potentiated the effects of PHA665752 on tumour growth. It was further revealed that YZXJ significantly reduced the degree of phosphorylation of the HGF receptor in lung tumours. CONCLUSION: YZXJ has a significant role in reducing the migration, invasion and in vivo tumour growth of lung cancer and acts to inhibit the migratory and invasive effects induced by HGF and indeed by HGF/EGF. This effect is likely attributed to the inhibition of the HGF receptor activation. These results indicate that YZXJ has a therapeutic role in lung cancer and that combined strategy with methods to block HGF and EGF should be considered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12967-015-0639-1) contains supplementary material, which is available to authorized users