Perspectives on Homelessness: A Qualitative Study With Clinical Psychologists in Secondary Care Mental Health Services

Aims: People who are homeless are among the most vulnerable and socially excluded populations. While they have several mental health and physical health needs it has been suggested that many barriers prevent them from accessing the support they need. Healthcare professionals’ attitudes have been identified to have a significant influence in accessing care. Clinical psychologists have a significant role to play in working with homelessness, but their views towards homelessness are yet to be explored. This study evaluated clinical psychologists’ perspectives towards homelessness, what influences them and how they influence their practice. Method: Semi-structured interviews were conducted with twelve clinical psychologists working in secondary care mental health services. Thematic analysis was performed to identify their views towards homelessness. Results: The analysis identified three themes: (1) ‘Homelessness is a complex, social phenomenon’ describing the multi-layered nature of homelessness, whilst identifying non-blaming attitudes with the recognition that homelessness can happen to anyone, (2) ‘Homelessness is not for psychology’ describing that people affected by homelessness are not suitable for psychological therapy unless their basic needs are firstly met and (3) ‘Our role as Clinical Psychologists’ describing that clinical psychologists are not just therapists and acknowledging the influence clinical training, experience working with the population, and values have on professionals’ perspectives towards homelessness. Conclusion: Concluding this study identified that clinical psychologists have a significant role in ending psychological distress rooted in health and social inequalities. Services and organisations will need to nurture and support clinical psychologist to work with homelessness while they address service barriers to develop accessible services for all. Clinical training will need to prepare future psychologists to work more systemically to address the social determinants of health and help clinical psychologists to develop skills in consultations, working at a wider systemic level and at a policy level to address social issues such as homelessness, which contribute to psychological distress

Analysis of the Singular Function Boundary Integral Method for a Biharmonic Problem with One Boundary Singularity

In this article, we analyze the singular function boundary integral method (SFBIM) for a two-dimensional biharmonic problem with one boundary singularity, as a model for the Newtonian stick-slip flow problem. In the SFBIM, the leading terms of the local asymptotic solution expansion near the singular point are used to approximate the solution, and the Dirichlet boundary conditions are weakly enforced by means of Lagrange multiplier functions. By means of Green's theorem, the resulting discretized equations are posed and solved on the boundary of the domain, away from the point where the singularity arises. We analyze the convergence of the method and prove that the coefficients in the local asymptotic expansion, also referred to as stress intensity factors, are approximated at an exponential rate as the number of the employed expansion terms is increased. Our theoretical results are illustrated through a numerical experiment

Immortality, but not oncogenic transformation, of primary human cells leads to epigenetic reprogramming of DNA methylation and gene expression

Tumourigenic transformation of normal cells into cancer typically involves several steps resulting in acquisition of unlimited growth potential, evasion of apoptosis and non-responsiveness to growth inhibitory signals. Both genetic and epigenetic changes can contribute to cancer development and progression. Given the vast genetic heterogeneity of human cancers and difficulty to monitor cancer-initiating events in vivo, the precise relationship between acquisition of genetic mutations and the temporal progression of epigenetic alterations in transformed cells is largely unclear. Here, we use an in vitro model system to investigate the contribution of cellular immortality and oncogenic transformation of primary human cells to epigenetic reprogramming of DNA methylation and gene expression. Our data demonstrate that extension of replicative life span of the cells is sufficient to induce accumulation of DNA methylation at gene promoters and large-scale changes in gene expression in a time-dependent manner. In contrast, continuous expression of cooperating oncogenes in immortalized cells, although essential for anchorage-independent growth and evasion of apoptosis, does not affect de novo DNA methylation at promoters and induces subtle expression changes. Taken together, these observations imply that cellular immortality promotes epigenetic adaptation to highly proliferative state, whereas transforming oncogenes confer additional properties to transformed human cells

Low HDL Cholesterol, Smoking and IL-13 R130Q Polymorphism are Associated with Myocardial Infarction in Greek Cypriot Males. A Pilot Study

This study was carried out in Greek Cypriot males to identify risk factors that predispose to myocardial infarction (MI). Genetic and lipid risk factors were investigated for the first time in a Greek Cypriot male case-control study.Contrary to other studies, mean low density lipoprotein cholesterol did not differ between cases and controls. High density lipoprotein cholesterol on the other hand, although within normal range in cases and controls, was significantly higher in the control population. In agreement with many other studies, smoking was significantly more prevalent in cases compared with controls. In pooled cases and controls, smokers had a significantly lower HDL-C level compared with non-smokers. The frequency of the IL-13 R130Q homozygotes for the mutation (QQ), as well as the mutant allele were significantly higher in cases compared with controls. The IL-13 R130Q variant, or another locus, linked to it, may increase the risk of MI

Investigative MR cholangiopancreatography for primary sclerosing cholangitis-type lesions in children with IBD

Objectives: The aim of the study was to estimate the frequency of primary sclerosing cholangitis (PSC)-type lesions in children with inflammatory bowel disease (IBD) by means of magnetic resonance cholangiopancreatography (MRCP), and to investigate the association between a series of easily applicable data on the one hand and the presentation of such lesions at MRCP on the other hand. Methods: Collected demographic, laboratory, and magnetic resonance enterography data from the records of 73 children with IBD were cross-sectionally related to the MRCP-based diagnosis. Results: Around the time of MRCP, the distribution of IBD subtypes was 64.4%, 24.7%, and 11% for Crohn disease, indeterminate colitis, and ulcerative colitis, respectively. A total of 11 patients (15.1%) were identified with PSC-type lesions. Demographic and magnetic resonance enterography data were unrelated to the MRCP outcome. Biochemical abnormalities were of low prevalence (<50%) among patients with PSC. The abnormality prevalences of aspartate transaminase, alanine transaminase, and γ-glutamyl transferase were significantly higher in the PSC group, both at initial diagnosis of IBD and at the time of MRCP. Less-consistent results were documented for bilirubin and alkaline phosphatase, especially at initial diagnosis of IBD. Conclusions: The abnormality prevalences of aspartate transaminase, alanine transaminase, and γ-glutamyl transferase were significantly higher in the PSC group. Nevertheless, PSC-type lesions frequently occur in pediatric IBD, even if the biochemical profile is hardly indicative of this probability. © 2012 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition