"I kind of find that out by accident": probation staff experiences of pharmacological treatment for sexual preoccupation and hypersexuality

Purpose - This paper aimed to explore the views and experiences of probation staff working with individuals convicted of a sexual offence who have been prescribed medication to manage sexual arousal (MMSA). Design/methodology - Semi-structured interviews were utilised with a sample of probation staff (Offender Supervisors and Managers, n=12), who supervise individuals convicted of a sexual offence, either in prison, or post-release in the community. Data were analysed using thematic analysis. Findings - Two main themes emerged: (1) Barriers for probation staff and (2) Suspicious but hopeful. Theme one encapsulates factors that prevent probation staff from engaging with MMSA; theme two highlighted the samples' uncertainty and mistrust of the use of medication as a potential tool for risk management and scepticism about individuals' motivations, particularly in the community. Research limitations – The main limitation of this study was the differing levels of knowledge the sample had about MMSA and their subsequent ability to discuss MMSA other than in a theoretical sense. Practical implications - Practical implications include the need for further training for probation staff, improved collaboration between departments and ongoing support for staff to support the success of the MMSA intervention. Originality/value – This study offers a novel perspective on MMSA - that of the probation staff supervising prisoners taking MMSA. This has not been explored before, and the findings and associated implications are of importance for the treatment and care of those convicted of sexual offences

"I kind of find that out by accident": probation staff experiences of pharmacological treatment for sexual preoccupation and hypersexuality

Purpose - This paper aimed to explore the views and experiences of probation staff working with individuals convicted of a sexual offence who have been prescribed medication to manage sexual arousal (MMSA). Design/methodology - Semi-structured interviews were utilised with a sample of probation staff (Offender Supervisors and Managers, n=12), who supervise individuals convicted of a sexual offence, either in prison, or post-release in the community. Data were analysed using thematic analysis. Findings - Two main themes emerged: (1) Barriers for probation staff and (2) Suspicious but hopeful. Theme one encapsulates factors that prevent probation staff from engaging with MMSA; theme two highlighted the samples' uncertainty and mistrust of the use of medication as a potential tool for risk management and scepticism about individuals' motivations, particularly in the community. Research limitations – The main limitation of this study was the differing levels of knowledge the sample had about MMSA and their subsequent ability to discuss MMSA other than in a theoretical sense. Practical implications - Practical implications include the need for further training for probation staff, improved collaboration between departments and ongoing support for staff to support the success of the MMSA intervention. Originality/value – This study offers a novel perspective on MMSA - that of the probation staff supervising prisoners taking MMSA. This has not been explored before, and the findings and associated implications are of importance for the treatment and care of those convicted of sexual offences

Embedded Mean-Field Theory

We introduce embedded mean-field theory (EMFT), an approach that flexibly allows for the embedding of one mean-field theory in another without the need to specify or fix the number of particles in each subsystem. EMFT is simple, is well-defined without recourse to parameters, and inherits the simple gradient theory of the parent mean-field theories. In this paper, we report extensive benchmarking of EMFT for the case where the subsystems are treated using different levels of Kohn–Sham theory, using PBE or B3LYP/6-31G* in the high-level subsystem and LDA/STO-3G in the low-level subsystem; we also investigate different levels of density fitting in the two subsystems. Over a wide range of chemical problems, we find EMFT to perform accurately and stably, smoothly converging to the high-level of theory as the active subsystem becomes larger. In most cases, the performance is at least as good as that of ONIOM, but the advantages of EMFT are highlighted by examples that involve partitions across multiple bonds or through aromatic systems and by examples that involve more complicated electronic structure. EMFT is simple and parameter free, and based on the tests provided here, it offers an appealing new approach to a multiscale electronic structure

UK Healthcare Workers' Experiences of Major System Change in Elective Surgery During the COVID-19 Pandemic: Reflections on Rapid Service Adaptation

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted the delivery of elective surgery in the United Kingdom. The majority of planned surgery was cancelled or postponed in March 2020 for the duration of the first wave of the pandemic. We investigated the experiences of staff responsible for delivering rapid changes to surgical services during the first wave of the pandemic in the United Kingdom, with the aim of developing lessons for future major systems change (MSC). Methods: Using a rapid qualitative study design, we conducted 25 interviews with frontline surgical staff during the first wave of the pandemic. Framework analysis was used to organise and interpret findings. Results: Staff discussed positive and negative experiences of rapid service organisation. Clinician-led decision-making, the flexibility of individual staff and teams, and the opportunity to innovate service design were all seen as positive contributors to success in service adaptation. The negative aspects of rapid change were inconsistent guidance from national government and medical bodies, top-down decisions about when to cancel and restart surgery, the challenges of delivering emergency surgical care safely and the complexity of prioritising surgical cases when services re-started. Conclusion: Success in the rapid reorganisation of elective surgical services can be attributed to the flexibility and adaptability of staff. However, there was an absence of involvement of staff in wider system-level pandemic decisionmaking and competing guidance from national bodies. Involving staff in decisions about the organisation and delivery of MSC is essential for the sustainability of change processes

Anomalous molecular dynamics in the vicinity of conical intersections

Conical intersections between molecular electronic potential surfaces greatly affect various properties of the molecule. Molecular gauge theory is capable of explaining many of these often unexpected phenomena deriving from the physics of the conical intersection. Here we give an example of anomalous dynamics in the paradigm of the Exe Jahn-Teller model, which does not allow a simple explenation in terms of standard molecular gauge theory. By introducing a dual gauge theory, we unwind this surprising behavior by identifying it with an intrinsic spin Hall effect. Thus, this work link knowledge of condensed matter theories with molecular vibrations. Furthermore, via ab initio calculations the findings are as well demonstrated to appear in realistic systems such as the Li3 molecule.Comment: 5 pages, 2 figure

Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK

OBJECTIVE: The COVID-19 pandemic has set unprecedented demand on the healthcare workforce around the world. The UK has been one of the most affected countries in Europe. The aim of this study was to explore the perceptions and experiences of healthcare workers (HCWs) in relation to COVID-19 and care delivery models implemented to deal with the pandemic in the UK. METHODS: The study was designed as a rapid appraisal combining: (1) a review of UK healthcare policies (n=35 policies), (2) mass media and social media analysis of front-line staff experiences and perceptions (n=101 newspaper articles, n=1 46 000 posts) and (3) in-depth (telephone) interviews with front-line staff (n=30 interviews). The findings from all streams were analysed using framework analysis. RESULTS: Limited personal protective equipment (PPE) and lack of routine testing created anxiety and distress and had a tangible impact on the workforce. When PPE was available, incorrect size and overheating complicated routine work. Lack of training for redeployed staff and the failure to consider the skills of redeployed staff for new areas were identified as problems. Positive aspects of daily work reported by HCWs included solidarity between colleagues, the establishment of well-being support structures and feeling valued by society. CONCLUSION: Our study highlighted the importance of taking into consideration the experiences and concerns of front-line staff during a pandemic. Staff working in the UK during the COVID-19 pandemic advocated clear and consistent guidelines, streamlined testing of HCWs, administration of PPE and acknowledgement of the effects of PPE on routine practice

Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK

Objective The COVID-19 pandemic has set unprecedented demand on the healthcare workforce around the world. The UK has been one of the most affected countries in Europe. The aim of this study was to explore the perceptions and experiences of healthcare workers (HCWs) in relation to COVID-19 and care delivery models implemented to deal with the pandemic in the UK. Methods The study was designed as a rapid appraisal combining: (1) a review of UK healthcare policies (n=35 policies), (2) mass media and social media analysis of front-line staff experiences and perceptions (n=101 newspaper articles, n=1 46 000 posts) and (3) in-depth (telephone) interviews with front-line staff (n=30 interviews). The findings from all streams were analysed using framework analysis. Results Limited personal protective equipment (PPE) and lack of routine testing created anxiety and distress and had a tangible impact on the workforce. When PPE was available, incorrect size and overheating complicated routine work. Lack of training for redeployed staff and the failure to consider the skills of redeployed staff for new areas were identified as problems. Positive aspects of daily work reported by HCWs included solidarity between colleagues, the establishment of well-being support structures and feeling valued by society. Conclusion Our study highlighted the importance of taking into consideration the experiences and concerns of front-line staff during a pandemic. Staff working in the UK during the COVID-19 pandemic advocated clear and consistent guidelines, streamlined testing of HCWs, administration of PPE and acknowledgement of the effects of PPE on routine practice