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Characteristics of women admitted to medium secure care: a comparison of patients admitted to specialised single-sex and mixed-sex services in an English forensic psychiatric hospital
No full textBackground: Forensic mental health care has evolved from mixed-sex provision to specialised sex-specific services. It is important to understand how the characteristics of women admitted to medium secure care have changed over time and how this may impact on their outcomes after discharge.Objective: The study aims to describe and compare admission and discharge characteristics of two consecutive cohorts; women admitted between 1983 and 2001 to a mixed-sex medium secure care (‘Mixed’ cohort) and women admitted between 2005 and 2013 to single-sex medium secure care (‘Specialised’ cohort).Methods: Data came from a 30-year study of outcomes for first admissions to an NHS medium secure hospital (the ALACRITy study). Follow-up data were available up to a census date of June 30th 2013.Results: 93 women comprised the Mixed cohort (mean age 29.3 years; 81% White ethnicity; 49% personality disorder diagnosis) and 45 women comprised the Specialised cohort (mean age 32.4 years; 76% White ethnicity; 49% personality disorder diagnosis). The Specialised cohort were more likely than the Mixed cohort to be admitted from high security, or under a forensic section of the Mental Health Act. The Specialised cohort were more likely than the Mixed cohort to have previous convictions, or to have committed a ‘grave’ index offence warranting a life sentence. Over 95% of all women had received previous inpatient psychiatric care. The Specialised cohort had greater prevalence of alcohol use, self-harm and childhood adversity than the Mixed cohort. At the census, 99% of the Mixed cohort and 42% of the Specialised cohort had been discharged. Women in the Specialised cohort had a longer median length of stay than the Mixed cohort; 859 days and 229 days respectively. Over 80% of patients in the Mixed cohort were readmitted during the follow-up period.Conclusion: The study provides empirical data for two consecutive cohorts of women admitted to one medium secure hospital over the course of thirty years. Women admitted to single-sex services had more criminological and adverse trauma histories than women admitted to the earlier mixed-sex service. Further research is required to establish the long-term outcomes of women admitted to specialised single-sex medium secure care.</p
Profiling cerebral hemodynamics in sepsis and septic shock patients with transcranial doppler: a systematic review and meta-analysis.
No full textNeurological dysfunction is an early marker of sepsis. Cerebral hemodynamic disturbances are frequent in septic and septic shock and may play a key role in the development of sepsis-associated brain dysfunction. Our aim was to assess the existing evidence on the assessment of cerebral hemodynamics in sepsis with the use of transcranial Doppler (TCD). A systematic search of PubMed/Medline, EMBASE and Web of Science was conducted for eligible studies. We included studies published in English up to January 2025 observational and interventional articles using TCD were included. We analyzed data provided by TCD, including middle cerebral artery velocity (MCAv), pulsatility index, cerebral autoregulation indices, cerebral vaso-reactivity, estimated intracranial pressure (eICP), critical closing pressure, and their relationship with clinical outcomes, such as cerebral dysfunction and mortality. This systematic review was recorded in PROSPERO with the ID CRD42023449660. After screening 371 articles, 62 were reviewed in full text, and 29 met the inclusion criteria. A total of 1,087 patients were included, 558 of whom had confirmed septic shock. Mean MCA-v remained within normal limits, cerebral perfusion pressure was relatively low, without an increase in eICP. While cerebral autoregulation was often impaired in septic patients, assessment of cerebral vasoreactivity showed divergent results. The pulsatility index and impaired autoregulation were associated with the occurrence of neurological dysfunction. Cerebral hemodynamics are often altered in sepsis and septic shock and may contribute to neurological alterations observed in such patients. Further randomized trials are needed to identify effective interventions.</p
‘Firing Holes’ in Literary Tablets from Ashurbanipal’s Library: Punctuation and Performance
No full textThis paper aims to shed light on the so-called ‘firing holes’ in cuneiform tablets by combining analysis of their position with poetics. The holes are found in almost every genre of Mesopotamian scholarship, from literature to rituals to omens to medical and lexical texts. They occur especially often in tablets that were part of ancient libraries, in particular the collection known as ‘Ashurbanipal's library’ assembled by the Assyrian king in the seventh century BC in Nineveh, northern Iraq. Yet despite the frequency of these holes, they are usually overlooked and their meaning remains a mystery. The paper analyses the placement of the holes in relation to the text and its meaning, applying the methodology of close reading to three poems: the Babylonian Theodicy, Poem of the Righteous Sufferer, and Ninurta's Exploits. It is argued that the holes represent a form of punctuation that can either indicate pauses in performance, act as commas on a page, or serve as visual markers to draw attention to sections like a form of highlighting. Different manuscripts employ the holes in different ways, which is consistent with other punctuating practices cross-culturally. This has implications for our understanding of the performance of Mesopotamian poetry and its metrical structure, the interpretations of individual scribes, questions of emphasis, and the history of punctuation.</p
In vitro comparison of CD20xCD3 biosimilar antibodies against diffuse large B cell lymphoma (DLBCL) cell lines with different levels of expression of CD20
No full textAlthough CD20xCD3 bispecific antibodies (BsAbs) have demonstrated transformational activity inDLBCL, some patients fail to respond and others relapse. To begin to explore possible limitations wecompared the in vitro activity of four CD20xCD3 biosimilar BsAbs against four DLBCL cell lines withCD20 expression ranging over a hundred-fold. All four biosimilar BsAbs demonstrated superior invitro activity to rituximab, with biosimilar glofitamab consistently being the most potent. Moreover,biosimilar glofitamab and odronextamab retained significant activity in the presence of low-levelCD20 expression. Finally, one DLBCL cell line exhibited intrinsic resistance to all four CD20xCD3BsAbs despite inducing marked T-cell and NK cell activation.</p
Predictors of Informal Caregiver Burden in Parkinson’s: A Systematic Review
No full textBackground: Caregivers of people with Parkinson’s disease are at risk of experiencing caregiverburden. Understanding contributing factors is required to develop appropriatetargeted interventions and support for this group. This systematic review provides anupdated appraisal and synthesis of quantitative studies assessing predictors ofburden among informal caregivers of people with Parkinson’s.Method: Five electronic databases (APA PsycINFO, CINAHL, MEDLINE, Web of Science, andCochrane Library) were systematically searched (from inception until July 2024),supplemented by hand-searches. Study quality was assessed using the cross-sectional JBI Critical Appraisal Checklist. Results were synthesised narratively.Results: Forty-one studies were included. Predictors of increased burden included greaterimpact of motor symptoms on ADLs, greater severity of neuropsychiatric symptoms,poorer quality of life of the person with Parkinson’s, and poorer caregiver mentalhealth. Demographics, presence of motor symptoms, motor complications, andgeneral cognitive function did not predict burden. Evidence was inconclusive forseveral variables including disease stage and duration, motor symptom severity,functional ability, overall non-motor symptoms, mental health of the person withParkinson’s, and caregivers’ involvement and protective factors.Conclusion: Several areas for potential future intervention are indicated, althoughmethodological weaknesses within the literature constrain the robustness ofconclusions. Key areas for future research include exploring understudied variables(caregiver personality and coping style, relationship quality, and positive aspects ofcaregiving) that may be important predictors of burden, specifying and utilising amore consistent definition of “informal caregiver”, and recruiting younger and non-spousal caregivers and more diverse samples regarding disease severity.</p
Impacts of communication type and quality on patient safety incidents: A systematic review
No full textBackground:Poor communication in health care increases the risk for patient safety incidents. However, there is no up-to-date synthesis of these data.Purpose:To synthesize studies investigating how poor communication between health care practitioners and patients (and between different groups of practitioners) affects patient safety.Data Sources:Ovid MEDLINE, CINAHL, APA PsycInfo, CENTRAL, Scopus, and the ProQuest Dissertations & Theses Citation Index from 1 January 2013 to 7 February 2024.Study Selection:Studies published in any language that quantified the effects of poor communication on patient safety.Data Extraction:Two independent reviewers extracted data, assessed risk of bias, and appraised strength of evidence. Study heterogeneity precluded meta-analysis, so results were reported with narrative description, reporting medians and interquartile ranges (IQRs).Data Synthesis:Forty-six eligible studies (67 826 patients) were included. Risk of bias was low for 20, moderate for 16, and high for 10 studies. Four studies investigated whether poor communication was the only identified cause of a patient safety incident; here, poor communication caused 13.2% (IQR, 6.1% to 24.4%) of safety incidents. Forty-two studies investigated whether poor communication contributed to patient safety incidents alongside other causes; here, poor communication contributed to 24.0% (IQR, 12.0% to 46.8%) of safety incidents. Study heterogeneity was high in terms of setting, continent, health care staff, and safety incident type. The strength of the evidence was low or very low.Limitation:There was important study heterogeneity, generally low study quality, and poor reporting of essential data.Conclusion:Poor communication is a major cause of patient safety incidents. Research is needed to develop effective interventions and to learn more about how poor communication leads to patient safety incidents.Primary Funding Source:Stoneygate Trust. (PROSPERO: CRD42024507578)</p
Octopus Island: slide pack to support teaching in Key Stages 2 and 3
No full textThis resource accompanies Octopus Island, a comic about a group of children who move to an island in which they learn about the resources they have around them, and how to make the most of these in coping when life is hard.The resource comprises a set of slides to support teachers in Key Stage 2 and 3. Teaching ideas documents are also available in this collection. </p
A Corpus-Based Study of Evaluative Adjectives in Institutional Editorials in British Broadsheet and Tabloid Newspapers
No full textRecently, UK newspapers have evolved from mere news sources to tools that educate, update and engage readers by using language that conveys opinions/emotions, constructs newsworthiness and creates rapport. Such interpersonal language has been analysed in terms of evaluation, appraisal and stance. The literature in this field challenges assumptions of objectivity and impartiality in news reporting. However, research on evaluative language in newspaper editorials remains limited. Through a fine-grained framework of evaluation, this study offers new insights into authorial and non-authorial evaluations in British tabloid and broadsheet editorials, their targets of evaluation and their discourse functions. Blending theory and data, the framework builds on models such as appraisal theory (Martin and White 2005) and parameter-based approach to evaluation (Bednarek 2006b) and also draws on corpus analysis. Comprising eight evaluative parameters (e.g. Critical/Affective Assessment, Un/Expectedness and Un/Importance), it unpacks the role of evaluative language in expressing opinions/emotions, establishing writer-reader relations and enhancing news values in newspaper editorials. The corpus comprises 325 institutional editorials stratified by style, title and political orientation. Evaluative adjectives along the different parameters were quantitatively and qualitatively analysed. The findings reveal that tabloids’ evaluative style is characterised by explicitness, unexpectedness, dramatisation, frequent references to social actors’ emotions and beliefs and exaggeration. Tabloids focus on evaluating human behaviours, characters, values and ethics to enhance sensationalism and personalisation and emotionally engage with both advertisers and readers. Broadsheets, however, adopt a more mitigated, impersonal and implicit evaluative style by prioritising evaluating abstract concepts, states of affairs and propositions to maintain impersonalisation and objectivity.By introducing a new analytical framework linked to news values, this thesis expands our understanding of the semantic and pragmatic functions of evaluation within newspaper discourse. Perspectives on constructing a specialised corpus, recognising both authorial and non-authorial evaluative adjectives and their targets of evaluation are also provided. The findings have pedagogical implications, suggesting the use of newspaper texts in language classrooms, with a focus on evaluative language.</p
Politics of sponsorship: Fetishized narratives and authorial detours in Italian cinema
No full textThe production of sponsored films has historically depended on considerable financial and logistical resources, shaping corporate identities both internally and publicly. These films represent a pivotal moment in the evolution of media economics as an ideological and geopolitical tool for self-promotion. In this context, they frequently introduce an extra layer of storytelling that complements commodity fetishism. Yet, authors like Olmi, Ivens, Orsini, Bertolucci, Pontecorvo and the Taviani brothers navigated these corporate imperatives, documenting Italy’s national advancements in electrification, radiocommunication and industrial automation amid world conflicts, decolonization, labour disputes and environmental risks generated by energy consumption. This article explores how Italian corporate films encapsulate potent historical memories, creating a unique blend of authorial detours and corporate integration. In doing so, they critically reveal the interplay between humans, production systems, the environment and marginalized communities.</p
Identification of actionable targets using DEPArray-based sorting of pure carcinoma and stromal populations from formalin-fixed paraffin-embedded tissues followed by shallow whole-genome sequencing.
No full textFormalin-fixed paraffin-embedded (FFPE) tissue specimens represent precious resources for clinical genomic profiling studies, especially when coupled with comprehensive medical records. Even though next-generation sequencing (NGS) is an effective tool to detect somatic mutations and somatic copy number alterations (sCNA), the biggest challenges in unlocking clinically translatable genomic information from FFPE tissue are low DNA yields and degraded DNA, affected by variable formalin fixation. Another issue is that the proportion of carcinoma and other noncarcinoma cells is variable and can be confounded by intratumoral heterogeneity. To explore these challenges, we isolated pure carcinoma and stromal cells using the DEPArray™ NxT system, a microchip-based digital sorter that allows isolation of pure, homogeneous subpopulations of cells from FFPE samples. We isolated pure carcinoma and stromal cell populations from 12 FFPE tissues, including tissues from nine primary and metastatic breast cancer and three primary ovarian high-grade serous carcinomas. This was followed by downstream shallow whole-genome sequencing (WGS) for copy number landscape profiling (10 samples) and/or a targeted panel for somatic mutation and sCNA analysis (seven samples), subject to cell availability. Seven out of 10 samples (even some with low tumour content or of old age) produced good-quality genomic data, detecting sCNA in all carcinoma population samples but not in the stromal populations. Mutation analysis was performed successfully in 6/7 samples and somatic mutations were detected in all of them. Our workflow enabled the identification of clinically actionable targets, including PIK3CA, ERBB2, FGFR1/2, CDK6, CCNE1, KRAS amplifications and RB, BRCA1/2 losses in patients that would direct therapy. © 2025 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.</p