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Skyrmions are topologically protected quantum objects at the nanometre scale. They form perpendicular to an applied magnetic field at a certain temperature and arrange themselves in a typically hexagonal lattice. Using small angle neutron scattering we have determined the magnetic field versus temperature phase diagrams of the stability range of the different magnetic phases, the helical as well as the skyrmion phases in the multiferroic skyrmion material Cu$_2$OSeO$_3$. Therefore, a single crystal was mounted in different crystal orientations, i.e. unoriented and with the crystallographic $\langle1 1 0\rangle$ and $\langle1 0 0\rangle$ axis aligned parallel to the magnetic field. Furthermore, different cooling procedures were tested, cooling from the paramagnetic phase at zero magnetic field and field cooling through the skyrmion phase where metastable skyrmions are nucleated. From this, not only were the stability ranges of both the helical and skyrmion phases in this multiferroic skyrmion material determined, but the length of the spin helix and the skyrmion distances at different conditions was also determined through detailed analysis of the positions of the observed Bragg peaks. The obtained data provide valuable information about the scaling of the skyrmion distances and therefore their packing density. The knowledge about this tunability will serve as an important input for the theoretical understanding of the formation of skyrmions. Concerning technological applications, for example as high-density data storage devices in information technology, the temperature and magnetic field dependence of the packing density of skyrmions is of critical importance for their design. Therefore, the obtained knowledge is an essential input for future skyrmionics applications in high-density data storage, in low-energy spintronics or in skyrmionics quantum computation., 21 pages, 5 figures, Supplementary Information attached

Prisons are, by their very nature, gendered institutions. Despite women making up a\ud small percentage of the prison population (House of Commons Library, 2020), those\ud supporting prisoners are generally women - especially mothers and partners (Booth\ud and Masson, 2021; Codd, 2008). In understanding women’s experiences of criminal\ud justice, it is prudent to consider the women who are punished by the system despite\ud not being incarcerated themselves. This chapter sheds light on these women’s\ud experiences. First, through a review of the growing international literature that\ud illustrates how the economic and relational implications as well as the health, stigma\ud and care for children of prisoners are overwhelmingly experienced by women in the\ud community attempting to keep their families together. Following this, a case study\ud showcasing the excellent work of one organisation, The Straight Path Resettlement\ud Project (SPR) in Leicester, England, discusses Ferzana Dakri’s experience of\ud working in the community with ‘BAME’ Muslim women who have imprisoned loved\ud ones. In viewing prison as sites of punishment, and appreciating how these pains\ud extend beyond those incarcerated, this chapter draws attention to the multiple ways\ud that women supporting prisoners are simultaneously harmed.

Introduction C-reactive protein (CRP) is an important non-specific marker of both acute and chronic inflammation and can be elevated in patients with psoriatic arthritis (PsA). However, the use of CRP testing in the management of PsA can vary. This study investigated how CRP testing is implemented in real-world clinical practice for disease management of PsA. Methods A point-in-time survey of rheumatologists and dermatologists and their next six consulting patients with PsA was conducted in France, Germany, Italy, Spain, UK (EU5), and the USA between June and August 2018. Use of CRP testing was obtained by asking the physician to state (yes/no) whether CRP was used to aid PsA diagnosis and/or to monitor the patient’s disease activity. The number of CRP tests conducted in the last 12 months for each patient enrolled was provided. Results Data were collected for 2270 patients (USA, n = 595; EU5, n = 1675). In the EU5, CRP testing was conducted to aid diagnosis in 78.7% of patients (vs. 43.4% in USA) and CRP was used to monitor disease activity in 72.0% (vs. 34.6% in USA). The majority (80.9%) of patients in the EU5 had at least one CRP test in the last 12 months compared to 42.9% in the USA. Patients treated by rheumatologists (vs. dermatologists) were at least 50% more likely to have CRP tested for monitoring purposes, this difference being most pronounced in the USA. In the EU5, CRP testing was conducted a mean ± standard deviation of 2.7 ± 1.7 times during the last 12 months, versus 2.0 ± 1.4 in the USA. Conclusions CRP was more commonly used for the diagnosis and monitoring of PsA in Europe compared to the USA and was more commonly ordered by rheumatologists than dermatologists. In the absence of a better serum biomarker of inflammation, more data are needed to understand how CRP testing should be used in the diagnosis and management PsA.

In September 2020, in the midst of the COVID-19 pandemic, the Ministry of Justice (MoJ) released their ‘criminal courts recovery plan’ . This detailed their intentions to pass temporary legislation to extend the time that defendants could be legally held in custody awaiting trial in England and Wales by two months. The MoJ’s request was couched as a response to the excess of cases created by the restrictions imposed on courts from the pandemic . However, evidence suggests that a bottleneck existed long before COVID hit, and that this pandemic has intensified rather than caused this backlog . A joint letter sent to the Government from national organisations with expertise in justice have said these changes were ‘not good for victims, witnesses, people remanded to prison or prisons’ . \ud \ud Expanding this argument, we critically consider the possible implications of this extension to the remand period for the loved ones (family, friends and significant others ) of people in prison, who are often marginalised by their absence in prison literature, practices, and policy decisions. The pandemic has resulted in some very difficult public health decisions and it is our intention to focus on some of the consequences of these decisions for the loved ones of remanded prisoners. It is important to remember that it is the act of imprisonment, of any length, ‘that constitutes the punishment’ meaning that legislations that change the prison experience (in this instance, the duration of remand) bring with them significant, additional repercussions to the lives of prisoners and their loved ones. While in this article we often detail how these are punitive consequences, we appreciate that they were not implemented for punitive purposes.

Background: Inappropriate imaging and low-value care for low back pain (LBP) are common. A new patient-education booklet was created to overcome identified barriers to the delivery of recommended care, including the use of inappropriate imaging. Our aim was to assess the effectiveness of this booklet as part of primary care for LBP patients in comparison to usual care. Methods: A cluster-randomized trial was performed. The intervention involved providing practitioners with the new patient-education booklet and a 30-min training session on its use. The booklet was provided during the clinical consult to all consenting LBP patients in the intervention group. Primary outcomes were the proportion of patients presenting with LBP who underwent imaging examinations during the first three months of follow-up and PROMIS PF-20 (Patient-Reported Outcomes Measurement Information System, 20-item physical functioning short form) change between baseline and three-month follow-up. Secondary outcomes, including sick leave and imaging examinations at 12 months, were investigated. Logistic regression using GEE-estimation was used for dichotomous outcomes, Poisson regression using GEE-estimation for count outcomes, and linear mixed models for continuous outcomes. Results: Using the patient education booklet appeared to substantially reduce the proportion of LBP patients who underwent an imaging examination at three months, but the result was not statistically significant (OR 0.57, 95% confidence interval (Cl) 0.27 to 1.22). At 12 months, the effect was slightly larger and statistically significant (OR 0.50, 95%Cl 0.30 to 0.83, p = 0.008). No difference was observed in the PROMIS PF-20 T-score change between baseline and 3 months or 12 months (p = 0.365 and p = 0.923, respectively). The number of sick leave days in the intervention group was less than that in the control group at 3 months (RR 0.47, 95%Cl 0.26 to 0.83, p = 0.010) and at 12 months (RR 0.36, 95%Cl 0.18 to 0.72, p = 0.004). Conclusions: The booklet appeared to be effective in reducing the proportion of LBP patients who underwent imaging examinations over 12 months. The intervention had no discernible effect on the PROMIS PF20 T-score change. The number of sick leave days was substantially lower in the intervention group. Trial registration: ISRCTN, ISRCTN14389368, Registered 4 April 2019—Retrospectively registered.

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Background: Guidelines recommend a biopsychosocial framework for low back pain (LBP) management and the avoidance of inappropriate imaging. In clinical practice, care strategies are often inconsistent with evidence and guidelines, even though LBP is the most common disabling health condition worldwide. Unhelpful beliefs, attitudes and inappropriate imaging are common. LBP is understood to be a complex biopsychosocial phenomenon with many known multidimensional risk factors (symptom- and lifestyle-related, psychological and social) for persistent or prolonged disability, which should be identified and addressed by treatment. The STarT Back Tool (SBT) was developed for early identification of individual risk factors of LBP to enable targeted care. Stratified care according SBT has been shown to improve the effectiveness of care in a primary care setting. A biopsychosocially-oriented patient education booklet, which includes imaging guidelines and information, is one possible way to increase patients’ understanding of LBP and to reduce inappropriate imaging. Premeditated pathways, education of professionals, written material, and electronic patient registry support in health care organizations could help implement evidence-based care. Methods: We will use a Benchmarking Controlled Trial (BCT) design in our study. We will prospectively collect data from three health care regions before and after the implementation of a classification-based approach to LBP in primary care. The primary outcome will be change in PROMIS (Patient-Reported Outcomes Measurement Information System) (short form 20a) over 12-month follow-up. Discussion: The implementation of a classification-based biopsychosocial approach can potentially improve the care of LBP patients, reduce inappropriate imaging without increasing health-care costs, and decrease indirect costs by reducing work disability. Using the BCT we will be able to evaluate the effectiveness of the improvement strategy for the entire care pathway.

By using of high-resolution X-ray spectroscopic measurements and kinetic simulations, we demonstrate that the energy of femtosecond laser pulses is efficiently converted to X-ray radiation and produces exotic states in solid density plasma regions. It is shown that exotic hollow multicharged ions states can be obtained and studied not only by ultra-intense X-ray radiation of XFEL, but also upon using optical laser technology. We have concluded that observable features of the hollow-ion spectra are sensitive to such plasma parameters as density, temperature, hot-electron fraction, and intensity of X-ray pumping radiation and could be used for effective diagnostics of warm dense matter parameters.