Prevention of coronary heart disease in people with severe mental illnesses: a qualitative study of patient and professionals' preferences for care

BACKGROUND: People with severe mental illness (SMI) are at increased risk of developing coronary heart disease (CHD) and there is growing emphasis on the need to monitor their physical health. However, there is little consensus on how services for the primary prevention of CHD should be organised for this patient group. We explored the views of people with SMI and health professionals from primary care and community mental health teams (CMHTs) on how best to provide these services. METHODS: In-depth interviews were conducted with a purposive sample of patients with SMI (n = 31) and staff from primary care (n = 10) and community mental health teams (n = 25) in North Central London. Transcripts of the qualitative interviews were analysed using a 'framework' approach to identify the main themes in opinions regarding various service models. RESULTS: Cardiovascular risk factors in people with SMI were of concern to participants. However, there was some disagreement about the best way to deliver appropriate care. Although staff felt that primary care should take responsibility for risk factor screening and management, patients favoured CHD screening in their CMHT. Problems with both approaches were identified. These included a lack of familiarity in general practice with SMI and antipsychotic side effects and poor communication of physical health issues to the CMHT. Lack of knowledge regarding CHD risk factor screening and difficulties in interpreting screening results and implementing appropriate interventions exist in secondary care. CONCLUSION: Management of physical health care for people with SMI requires complex solutions that cross the primary-secondary care interface. The views expressed by our participants suggest that neither primary nor secondary care services on their own can provide a comprehensive service for all patients. The increased risk of CHD associated with SMI and antipsychotic medications requires flexible solutions with clear lines of responsibility for assessing, communicating and managing CHD risks

ЛУЧЕВАЯ ДИАГНОСТИКА ПОРОКА РАЗВИТИЯ ПЕЧЕНИ

Hepatic malformations are rare. We review the pathogenesis, morphology, classification, clinical presentation, and diagnosis of these malformations. We report a case of an accessory hepatic lobe masquerading as an abdominal tumor and detected with multilayer spiral CT and MRI. We discuss diagnostic signs as well as advantages and limitations of the two methods. The diagnosis was verified by pathology following an unconventional laparoscopic resection of the left hepatic lobe.Пороки развития печени - редкая врожденная патология. В работе приведена краткая информация о механизме возникновения таких аномалий и морфологических формах, о классификациях, клинической картине и возможностях их распознавания. Представлено собственное наблюдение одного из пороков развития печени, а именно наличие добавочной доли печени у пациентки, симулирующей новообразование брюшной полости. Для его идентификации были применены мультиспиральная компьютерная томография и магнитно-резонансная томография. Описана лучевая семиотика выявленной патологии. Отмечены достоинства и ограничения этих методов. Окончательный диагноз был поставлен на основании результатов лапароскопической атипичной резекции левой доли печени и последующего гистологического исследования операционного материала

Structural Biology of Human H3K9 Methyltransferases

SET domain methyltransferases deposit methyl marks on specific histone tail lysine residues and play a major role in epigenetic regulation of gene transcription. We solved the structures of the catalytic domains of GLP, G9a, Suv39H2 and PRDM2, four of the eight known human H3K9 methyltransferases in their apo conformation or in complex with the methyl donating cofactor, and peptide substrates. We analyzed the structural determinants for methylation state specificity, and designed a G9a mutant able to tri-methylate H3K9. We show that the I-SET domain acts as a rigid docking platform, while induced-fit of the Post-SET domain is necessary to achieve a catalytically competent conformation. We also propose a model where long-range electrostatics bring enzyme and histone substrate together, while the presence of an arginine upstream of the target lysine is critical for binding and specificity. Enhanced version: This article can also be viewed as an enhanced version in which the text of the article is integrated with interactive 3D representations and animated transitions. Please note that a web plugin is required to access this enhanced functionality. Instructions for the installation and use of the web plugin are available i

The effect of climate change on avian offspring production: A global meta-analysis

Climate change affects timing of reproduction in many bird species, but few studies have investigated its influence on annual reproductive output. Here, we assess changes in the annual production of young by female breeders in 201 populations of 104 bird species (N = 745,962 clutches) covering all continents between 1970 and 2019. Overall, average offspring production has declined in recent decades, but considerable differences were found among species and populations. A total of 56.7% of populations showed a declining trend in offspring production (significant in 17.4%), whereas 43.3% exhibited an increase (significant in 10.4%). The results show that climatic changes affect offspring production through compounded effects on ecological and life history traits of species. Migratory and larger-bodied species experienced reduced offspring production with increasing temperatures during the chick-rearing period, whereas smaller-bodied, sedentary species tended to produce more offspring. Likewise, multi-brooded species showed increased breeding success with increasing temperatures, whereas rising temperatures were unrelated to reproductive success in single-brooded species. Our study suggests that rapid declines in size of bird populations reported by many studies from different parts of the world are driven only to a small degree by changes in the production of young.This meta-analysis was financed by the grant of the Polish National Science Centre (Narodowe Centrum Nauki) (no. 2017/27/B/NZ8/00465) awarded to Lucyna Hałupka.Peer reviewe

The effect of climate change on avian offspring production: A global meta-analysis

Climate change affects timing of reproduction in many bird species, but few studies have investigated its influence on annual reproductive output. Here, we assess changes in the annual production of young by female breeders in 201 populations of 104 bird species (N = 745,962 clutches) covering all continents between 1970 and 2019. Overall, average offspring production has declined in recent decades, but considerable differences were found among species and populations. A total of 56.7% of populations showed a declining trend in offspring production (significant in 17.4%), whereas 43.3% exhibited an increase (significant in 10.4%). The results show that climatic changes affect offspring production through compounded effects on ecological and life history traits of species. Migratory and larger-bodied species experienced reduced offspring production with increasing temperatures during the chick-rearing period, whereas smaller-bodied, sedentary species tended to produce more offspring. Likewise, multi-brooded species showed increased breeding success with increasing temperatures, whereas rising temperatures were unrelated to repro- ductive success in single-brooded species. Our study suggests that rapid declines in size of bird populations reported by many studies from different parts of the world are driven only to a small degree by changes in the production of young

Effect of oxygen on short-range order in the Ba1-xBixF2+x solid solution

Various compositions within the range of the fluorite-type solid solution in the BaF2–BiF3–BiOl.5 system are investigated by impedance spectroscopy. This study is carried out along two lines of compositions: δ1, corresponding to the Bal−2z/3Bi2z/3F2+4z/3Oz solid solution, where z is the oxygen rate; and δ2, corresponding to the Bal−xBixF2+x−0.30O0.15 solid solution, where x is the bismuth rate. An approach to the nature of the fluorine–oxygen order is proposed which derives from the clustering process in the Bal−xBixF2+x fluoride solid solution

Fluorite-like phases in the BaF 2 -BiF 3 -Bi 2 O 3 system-synthesis, conductivity and defect clustering

Abstract A fluorite-like solid solution Ba 1 À x Bi x O z F 2 + x À 2z on the basis of cubic BaF 2 was synthesised in the BaF 2 -Bi 2 O 3 -BiF 3 system and the homogeneity range at 873 K was determined. The samples were studied by X-ray powder diffraction and electron diffraction, and their transport properties were measured by the complex impedance method at 300-623 K. Tendencies of variation of lattice parameters and transport properties were determined. These tendencies are discussed on the basis of a defect clustering hypothesis. Thermal treatment at 573 K of the solid solution, quenched from 873 K results in the formation of a new ordered tetragonal fluorite-like phase with lattice parameters a = 9.5355(4) Å , c = 18.151(1) Å .

Fluorite-like phases in the BaF2-BiF3-Bi2O3 system-synthesis, conductivity and defect clustering

A fluorite-like solid solution Ba1 − xBixOzF2 + x − 2z on the basis of cubic BaF2 was synthesised in the BaF2-Bi2O3-BiF3 system and the homogeneity range at 873 K was determined. The samples were studied by X-ray powder diffraction and electron diffraction, and their transport properties were measured by the complex impedance method at 300-623 K. Tendencies of variation of lattice parameters and transport properties were determined. These tendencies are discussed on the basis of a defect clustering hypothesis. Thermal treatment at 573 K of the solid solution, quenched from 873 K results in the formation of a new ordered tetragonal fluorite-like phase with lattice parameters a = 9.5355(4) Å, c = 18.151(1) Å