Detoxification in rehabilitation in England: effective continuity of care or unhappy bedfellows?

There is evidence that residential detoxification alone does not provide satisfactory treatment outcomes and that outcomes are significantly enhanced when clients completing residential detoxification attend rehabilitation services (Gossop, Marsden, Stewart, & Rolfe, 1999; Ghodse, Reynolds, Baldacchino, et al., 2002). One way of increasing the likelihood of this continuity of treatment is by providing detoxification and rehabilitation within the same treatment facility to prevent drop-out, while the client awaits a rehabilitation bed or in the transition process. However, there is little research evidence available on the facilities that offer both medical detoxification and residential rehabilitation. The current study compares self-reported treatment provision in 87 residential rehabilitation services in England, 34 of whom (39.1%) reported that they offered detoxification services within their treatment programmes. Although there were no differences in self-reported treatment philosophies, residential rehabilitation services that offered detoxification were typically of shorter duration overall, had significantly more beds and reported offering more group work than residential rehabilitation services that did not offer detoxification. Outcomes were also different, with twice as many clients discharged on disciplinary grounds from residential rehabilitation services without detoxification facilities. The paper questions the UK classification of residential drug treatment services as either detoxification or rehabilitation and suggests the need for greater research focus on the aims, processes and outcomes of this group of treatment providers

Higher analogues of the discrete-time Toda equation and the quotient-difference algorithm

The discrete-time Toda equation arises as a universal equation for the relevant Hankel determinants associated with one-variable orthogonal polynomials through the mechanism of adjacency, which amounts to the inclusion of shifted weight functions in the orthogonality condition. In this paper we extend this mechanism to a new class of two-variable orthogonal polynomials where the variables are related via an elliptic curve. This leads to a `Higher order Analogue of the Discrete-time Toda' (HADT) equation for the associated Hankel determinants, together with its Lax pair, which is derived from the relevant recurrence relations for the orthogonal polynomials. In a similar way as the quotient-difference (QD) algorithm is related to the discrete-time Toda equation, a novel quotient-quotient-difference (QQD) scheme is presented for the HADT equation. We show that for both the HADT equation and the QQD scheme, there exists well-posed $s$-periodic initial value problems, for almost all \s\in\Z^2. From the Lax-pairs we furthermore derive invariants for corresponding reductions to dynamical mappings for some explicit examples.Comment: 38 page

Current-induced picosecond magnetization dynamics in a Ta/CoFeB/MgO Hall Bar (article)

This is the final version. Available on open access from IOP Publishing via the DOI in this record.The dataset associated with this article is located in ORE at: https://doi.org/10.24378/exe.1443Time-resolved Kerr microscopy (TRSKM) has been used to explore the small amplitude picosecond magnetization dynamics induced by spin-orbit torques in a Ta(4 nm)/Co40Fe40B20(1 nm)/MgO(1.6 nm)/Ta(1 nm) Hall bar structure. The time dependent polar magneto optical Kerr e ect was recorded following injection of a current pulse of 70 ps duration. Macrospin simulations provide a reasonable description of the precession and a transient background response as the eld strength and current polarity are varied, while con rming that the in-plane spin-orbit torque is dominant within this system. Increasing the current density within the simulations leads to coherent magnetization reversal. Inclusion of a modest in-plane bias eld is found to reduce both the switching current and the time required for switching. The orientation of the in-plane eld relative to the direction of the current determines whether the magnetization can be switched backwards and forwards by current pulses of the same or opposite polarity.Engineering and Physical Sciences Research Council (EPSRC

How primary care can contribute to good mental health in adults.

The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own. This paper describes how primary care practitioners can help stimulate such a grand alliance for health, by operating at four different levels - as individual practitioners, as organisations, as geographic clusters of organisations and as policy-makers

Hyaluronan Synthase Elevation in Metastatic Prostate Carcinoma Cells Correlates with Hyaluronan Surface Retention, a Prerequisite for Rapid Adhesion to Bone Marrow Endothelial Cells

Bone marrow is the primary site of metastasis in patients with advanced stage prostate cancer. Prostate carcinoma cells metastasizing to bone must initially adhere to endothelial cells in the bone marrow sinusoids. In this report, we have modeled that interaction in vitro using two bone marrow endothelial cell (BMEC) lines and four prostate adenocarcinoma cell lines to investigate the adhesion mechanism. Highly metastatic PC3 and PC3M-LN4 cells were found to adhere rapidly and specifically (70-90%) to BMEC-1 and trHBMEC bone marrow endothelial cells, but not to human umbilical vein endothelial cells (15-25%). Specific adhesion to BMEC-1 and trHBMEC was dependent upon the presence of a hyaluronan (HA) pericellular matrix assembled on the prostate carcinoma cells. DU145 and LNCaP cells were only weakly adherent and retained no cell surface HA. Maximal BMEC adhesion and RA encapsulation were associated with high levels of HA synthesis by the prostate carcinoma cells. Up-regulation of HA synthase isoforms Has2 and Has3 relative to levels expressed by normal prostate corresponded to elevated HA synthesis and avid BMEC adhesion. These results support a model in which tumor cells with up-regulated HA synthase expression assemble a cell surface hyaluronan matrix that promotes adhesion to bone marrow endothelial cells. This interaction could contribute to preferential bone metastasis by prostate carcinoma cells

Characterization of plexinA and two distinct semaphorin1a transcripts in the developing and adult cricket Gryllus bimaculatus

Guidance cues act during development to guide growth cones to their proper targets in both the central and peripheral nervous systems. Experiments in many species indicate that guidance molecules also play important roles after development, though less is understood about their functions in the adult. The Semaphorin family of guidance cues, signaling through Plexin receptors, influences the development of both axons and dendrites in invertebrates. Semaphorin functions have been extensively explored in Drosophila melanogaster and some other Dipteran species, but little is known about their function in hemimetabolous insects. Here, we characterize sema1a and plexA in the cricket Gryllus bimaculatus. In fact, we found two distinct predicted Sema1a proteins in this species, Sema1a.1 and Sema1a.2, which shared only 48% identity at the amino acid level. We include a phylogenetic analysis that predicted that many other insect species, both holometabolous and hemimetabolous, express two Sema1a proteins as well. Finally, we used in situ hybridization to show that sema1a.1 and sema1a.2 expression patterns were spatially distinct in the embryo, and both roughly overlap with plexA. All three transcripts were also expressed in the adult brain, mainly in the mushroom bodies, though sema1a.2 was expressed most robustly. sema1a.2 was also expressed strongly in the adult thoracic ganglia while sema1a.1 was only weakly expressed and plexA was undetectable

Women and Illegal Activities: Gender Differences and Women's Willingness to Comply Over Time

In recent years the topics of illegal activities such as corruption or tax evasion have attracted a great deal of attention. However, there is still a lack of substantial empirical evidence about the determinants of compliance. The aim of this paper is to investigate empirically whether women are more willing to be compliant than men and whether we observe (among women and in general) differences in attitudes among similar age groups in different time periods (cohort effect) or changing attitudes of the same cohorts over time (age effect) using data from eight Western European countries from the World Values Survey and the European Values Survey that span the period from 1981 to 1999. The results reveal higher willingness to comply among women and an age rather than a cohort effect. Working Paper 06-5

Evaluating case studies of community-oriented integrated care.

This paper summarises a ten-year conversation within London Journal of Primary Care about the nature of community-oriented integrated care (COIC) and how to develop and evaluate it. COIC means integration of efforts for combined disease-treatment and health-enhancement at local, community level. COIC is similar to the World Health Organisation concept of a Community-Based Coordinating Hub - both require a local geographic area where different organisations align their activities for whole system integration and develop local communities for health. COIC is a necessary part of an integrated system for health and care because it enables multiple insights into 'wicked problems', and multiple services to integrate their activities for people with complex conditions, at the same time helping everyone to collaborate for the health of the local population. The conversation concludes seven aspects of COIC that warrant further attention

Fibro-Vascular Coupling in the Control of Cochlear Blood Flow

Transduction of sound in the cochlea is metabolically demanding. The lateral wall and hair cells are critically vulnerable to hypoxia, especially at high sound levels, and tight control over cochlear blood flow (CBF) is a physiological necessity. Yet despite the importance of CBF for hearing, consensus on what mechanisms are involved has not been obtained.We report on a local control mechanism for regulating inner ear blood flow involving fibrocyte signaling. Fibrocytes in the super-strial region are spatially distributed near pre-capillaries of the spiral ligament of the albino guinea pig cochlear lateral wall, as demonstrably shown in transmission electron microscope and confocal images. Immunohistochemical techniques reveal the inter-connected fibrocytes to be positive for Na+/K+ ATPase β1 and S100. The connected fibrocytes display more Ca(2+) signaling than other cells in the cochlear lateral wall as indicated by fluorescence of a Ca(2+) sensor, fluo-4. Elevation of Ca(2+) in fibrocytes, induced by photolytic uncaging of the divalent ion chelator o-nitrophenyl EGTA, results in propagation of a Ca(2+) signal to neighboring vascular cells and vasodilation in capillaries. Of more physiological significance, fibrocyte to vascular cell coupled signaling was found to mediate the sound stimulated increase in cochlear blood flow (CBF). Cyclooxygenase-1 (COX-1) was required for capillary dilation.The findings provide the first evidence that signaling between fibrocytes and vascular cells modulates CBF and is a key mechanism for meeting the cellular metabolic demand of increased sound activity