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Migrants living in Europe constitute over half of the world's international migrants and are at higher risk of poor mental health than non-migrants, yet also face more barriers in accessing and engaging with services. Furthermore, the quality of care received is shaped by the experiences and attitudes of health professionals. The aim of this review was to identify professionals' attitudes towards migrants receiving mental healthcare and their perceptions of barriers and facilitators to service provision. Four electronic databases were searched, and 23 studies met the inclusion criteria. Using thematic synthesis, we identified three themes: 1) the management of multifaceted and complex challenges associated with the migrant status; 2) professionals' emotional responses to working with migrants; and 3) delivering care in the context of cultural difference. Professionals employed multiple strategies to overcome challenges in providing care yet attitudes towards this patient group were polarized. Professionals described mental health issues as being inseparable from material and social disadvantage, highlighting a need for effective collaboration between health services and voluntary organizations, and partnerships with migrant communities. Specialist supervision, reflective practice, increased training for professionals, and the adoption of a person-centered approach are also needed to overcome the current challenges in meeting migrants' needs. The challenges experienced by health professionals in attempting to meet migrant needs reflect frustrations in being part of a system with insufficient resources and without universal access to care that effectively stigmatizes the migrant status. [ABSTRACT FROM AUTHOR]

People are becoming increasingly sophisticated in their ability to navigate information spaces using search, hyperlinks, and visualization. But, mobile phones preclude the use of multiple coordinated views that have proven effective in the desktop environment (e.g., for business intelligence or visual analytics). In this work, we propose to model information as multivariate heterogeneous networks to enable greater analytic expression for a range of sensemaking tasks while suggesting a new, list‐based paradigm with gestural navigation of structured information spaces on mobile phones. We also present a mobile application, called Orchard, which combines ideas from both faceted search and interactive network exploration in a visual query language to allow users to collect facets of interest during exploratory navigation. Our study showed that users could collect and combine these facets with Orchard, specifying network queries and projections that would only have been possible previously using complex data tools or custom data science. [ABSTRACT FROM AUTHOR]

Release from prison is a vulnerable period, especially for people with severe mental illness. Critical Time Intervention (CTI) can be effective in improving service access and reducing negative outcomes. Nested within a randomised controlled trial of CTI, qualitative interviews were conducted with trial participants in both intervention (CTI) and treatment as usual (TAU) arms, CTI managers delivering the intervention and associated professionals. Data were analysed using a framework approach. Four themes were identified: uncertainty about post-release plans; inadequate housing provision; support during transition; and continuity of care. Interviewees shared common concerns about transition into the community but CTI participants felt less anxious about release and reported receiving more support with housing, access to services and community reintegration than during previous periods of incarceration. Professionals raised concerns about the time-limited nature of CTI and the impact of austerity measures on the availability of support following CTI. Implications for service delivery will be discussed. [ABSTRACT FROM AUTHOR]

BackgroundEvidence-based psychosocial treatments for schizophrenia founded on Western belief systems and values may not be efficacious in different cultures without adaptation. This systematic review analyses the nature and outcomes of culturally-adapted psychosocial interventions in schizophrenia, examining how interventions have been adapted, their efficacy and what features drive heterogeneity in outcome.MethodArticles identified by searching electronic databases from inception to 3 March 2016, reference lists and previous reviews were independently screened by two authors for eligible controlled trials. Data on the nature of adaptations was analysed inductively using thematic analyses. Meta-analyses were conducted using random effects models to calculate effect sizes (Hedges’ g) for symptoms.ResultsForty-six studies with 7828 participants were included, seven adapted for minority populations. Cultural adaptations were grouped into nine themes: language, concepts and illness models, family, communication, content, cultural norms and practices, context and delivery, therapeutic alliance, and treatment goals. Meta-analyses showed significant post-treatment effects in favour of adapted interventions for total symptom severity (n = 2345, g: −0.23, 95% confidence interval (CI) −0.36 to −0.09), positive (n = 1152, g: −0.56, 95% CI −0.86 to −0.26), negative (n = 855, g: −0.39, 95% CI −0.63 to −0.15), and general (n = 525, g: −0.75, CI −1.21 to −0.29) symptoms.ConclusionsThe adaptation process can be described within a framework that serves as a benchmark for development or assessment of future adaptations. Culturally adapted interventions were more efficacious than usual treatment in proportion to the degree of adaptation. There is insufficient evidence to show that adapted interventions are better than non-adapted interventions. Features of context, intervention and design influenced efficacy. Investigating whether adaptation improves efficacy, most importantly amongst ethnic minorities, requires better designed trials with comparisons against unadapted interventions. [ABSTRACT FROM AUTHOR]

Introduction: Women's Enhanced Medium Secure Services (WEMSS) is bespoke, gender-sensitive services which opened in the UK in 2007 at three pilot sites. This study is the first of its kind to explore the experiences of WEMSS staff, directly comparing them to staff in a standard medium secure service for women. The literature to date has focused on the experiences of service users or staff views on working with women in secure care. Aim: This qualitative study, embedded in a multimethod evaluation of WEMSS, aimed to explore the views and experiences of staff in WEMSS and comparator medium secure services. Methods: Qualitative interviews took place with nine WEMSS staff and nine comparator medium secure staff. Interviews focused on factors important for recovery, barriers to facilitating recovery and operational aspects of the service. Discussion: This study provides a rare insight into the perspectives of staff working in UK women's secure services, an under-researched area in the UK and internationally. Findings suggest that the success of services, including WEMSS, is compromised by operational factors such as the use of bank staff. Implications for practice: Comprehensive training and supervision should be mandatory for all staff, so best practice is met and staff adequately supported. [ABSTRACT FROM AUTHOR]

Elevated levels of insulin have been reported to induce both an arterial vasodilation mediated by nitric oxide (NO), and vasoconstriction mediated by endothelin and reactive oxygen radicals. Metformin, used to control blood glucose levels in type 2 diabetes, has also been shown to cause NO-mediated dilation of conduit arteries. It is possible that these contradictory vascular effects are due to a non-direct action on arteries. Therefore, the direct effect of high levels of insulin and metformin infusion on resistance artery diameter was evaluated. Experiments were carried out on the anesthetized pig; blood flow and pressure were measured in the iliac artery. An adjustable snare was applied to the iliac above the pressure and flow measurement site to induce step decreases (3-4 occlusions at 5 min intervals were performed for each infusion) in blood flow, and hence iliac pressure, and the conductance (Δflow / Δpressure) calculated. Saline, insulin (20 and 40 mUSP/l/min), and metformin (1 μg/ml/min) were infused separately downstream of the adjustable snare and their effect on arterial conductance assessed. Insulin at both infusion rates and metformin caused a significant reduction in peripheral vascular conductance. In conclusion, hyperinsulinemia and metformin infusion constrict resistance arterial vessels in vivo. [ABSTRACT FROM AUTHOR]

Background: Despite high levels of psychosocial risks, black women of Caribbean origin rarely consult health professionals regarding symptoms of perinatal depression. Reasons for this are unclear as there has been little perinatal mental health research among this ethnic group.Aim: To examine stakeholder perspectives on what might account for low levels of consultation for perinatal depression among a group of women who are, theoretically, vulnerable.Design Of Study: A qualitative study using focus group interviews.Setting: Community settings in the northwest of England.Method: A purposive sample of black Caribbean women (n = 42) was split into focus groups and interviewed. This sample was drawn from a larger study. Interviews were digitally recorded and transcribed verbatim. Framework analysis was used to generate themes.Results: Perceptions of practitioners' lack of compassion in delivering physical care and women's inability to develop confiding relationships with professionals during pregnancy and childbirth were significant barriers to consulting for depressive symptoms in particular, and health needs more generally. Advocating a 'stepped-care' approach, black Caribbean women suggested that new care pathways are required to address the full spectrum of perinatal mental health need. Apparently eschewing mono-ethnic, 'culturally sensitive' models, women suggested there was much to be gained from receiving care and support in mixed ethnic groups.Conclusion: Black Caribbean women's suggestions for more collaborative, community-based models of care are in line with policy, practice, and the views of members of other ethnic groups. Adopting such approaches might provide more sustainable mechanisms for improving access and engagement both among so-called hard-to-reach groups and more generally, thereby potentially improving maternal and child outcomes. [ABSTRACT FROM AUTHOR]

Objective: to explore the factors that might account for low levels of consultation for perinatal depression among Black Caribbean women and their absence from perinatal research in the UK.Design: qualitative study using in-depth interviews.Setting: antenatal clinics in a large teaching hospital and community health centres in the northwest of England.Participants: a purposive sample of 12 Black Caribbean women was selected from a larger mixed-method study involving both Black Caribbean (n=101) and White British (n=200) women.Findings: thematic analysis of women's narratives suggested that, despite attendance at antenatal classes, Black Caribbean women experienced difficulty conceptualising perinatal depression and expressed reservations about the nature and treatability of the condition. Personal and social imperatives to minimise distress, reluctance to discuss problems, and stoicism in the face of adversity were barriers to help-seeking. Black Caribbean women were willing to counter personal barriers and fears of engaging with mental health services to seek help. When they did so, however, health professionals appeared to be unable/unwilling to diagnose perinatal depression.Key conclusions: the absence of Black Caribbean women with perinatal depression from clinical practice and research may be because social, structural and personal barriers prevent these women from accessing the care and support they need.Implications for practice: in order to address the needs of child bearing women in a multi-cultural context, service providers need to ensure that culturally sensitive practice is a reality and not rhetoric. Education and training (both that given to women via antenatal classes and to health professionals) may need to be reviewed in order to improve cultural sensitivity and efficacy. [ABSTRACT FROM AUTHOR]

The Brenton blue butterfly, Orachrysops niobe (Trimen), is critically endangered and known only from one site near Knysna in theWestern Cape province of South Africa, now proclaimed as the Brenton Blue Butterfly Reserve (BBBR). We have explored associations between vegetation types and the presence of O. niobe's only host plant, Indigofera erecta (Thunb.), using Braun-Blanquet vegetation classification and ordination techniques as part of a broader research project at the BBBR. Positive correlations are demonstrated between the occurrence of I. erecta and certain thicket vegetation types dominated by Pterocelastrus tricuspidatus (candlewood trees). Ordinations using soil analysis and slope data have not detected significant environmental gradients influencing vegetation types. The high degree of vegetation heterogeneity at the BBBR appears to be driven in part by various disturbance histories. Historical ecological events at the site such as fire and megaherbivore impacts, and their role in sustaining the ideal habitat for I. erecta and O. niobe, are discussed. Management techniques for the BBBR such as controlled fires or the cutting of paths through the vegetation are evaluated and an optimum future management strategy is recommended. This is the most comprehensive vegetation study ever carried out at the habitat of an endangered butterfly in South Africa, and breaks new ground by using vegetation analysis to develop a well-informed management plan for conservation of this species. It has significance for the management of small sites where many such endangered butterflies occur. [ABSTRACT FROM AUTHOR]

Members of the sports medicine team for League 2 side Morecambe FC explain their approach to the prevention and treatment of hamstring injuries. They stress the importance of determining the possible underlying causes especially pelvic alignment and muscle imbalance with a subsequent effect on the sciatic nerve and its influence in the kinetic chain and the effects of differing playing surfaces. The importance of hydration and rest in maintaining maximal muscle function is stressed whilst acknowledging that the evidence base for most interventions is limited. In particular video gait analysis and measurement of possible leg length discrepancies are discussed with the prescription of orthotics if necessary. A more holistic approach is taken with the addition of an oriental medicine practitioner. Together this multi-disciplinary approach has substantially reduced the incidence of hamstring injury at the club. [ABSTRACT FROM AUTHOR]

Objective: This study examined the extent to which stigma-related concerns about mental health care account for the underuse of mental health services among low-income immigrant and U.S.-born black and Latina women.Methods: Participants included 15,383 low-income women screened for depression in county entitlement services who were asked about barriers to care, stigma-related concerns, and whether they wanted or were getting mental health care.Results: Among those who were depressed, compared with U.S.-born white women, each of the black groups were more likely to report stigma concerns (African immigrants, odds ratio [OR]=3.28, p=.004; Caribbean immigrants, OR=6.17, p=.005; U.S.-born blacks, OR=6.17, p=.06). Compared with U.S.-born white women, immigrant African women (OR=.18, p<.001), immigrant Caribbean women (OR=.11, p=.001), U.S.-born black women (OR=.31, p<.001), and U.S.-born Latinas (OR=.32, p=.03) were less likely to want treatment. Conversely, compared with U.S.-born white women, immigrant Latinas (OR=2.17, p=.02) were more likely to want treatment. There was a significant stigma-by-immigrant interaction predicting interest in treatment (p<.001). Stigma reduced the desire for mental health treatment for immigrant women with depression (OR=.35, p<.001) to a greater extent than it did for U.S.-born white women with depression (OR=.52, p=.24).Conclusions: Stigma-related concerns are most common among immigrant women and may partly account for underutilization of mental health care services by disadvantaged women from ethnic minority groups. [ABSTRACT FROM AUTHOR]

Dawn Edge's investigation of low levles of consultation for perinatal depression among Black Caribbeans found that social imperatives to be seen to cope in adverse circumstances coupled with long waiting times for 'talking therapies' and perceptions of unprofessional, culturally inappropriate counsellors present significant barriers to accessing care nd treatment for women from this ethnic group. [ABSTRACT FROM AUTHOR]

The article attempts to interpret and explain a set of developments within cosmology, which occurred during the 1950s. B. R. Martin, sociologist, claims to reveal certain inadequacies in the description given about the growth of radio astronomy, and in the model of scientific development derived from it, and wishes to draw attention to one major weakness in that account, before it becomes accepted as the definitive sociological interpretation of the growth of radio astronomy. He argues that, in the early 1950s, the pioneer Cambridge radio astronomers were searching for ways to establish their scientific repute. Among many current cosmological theories, the "steady-state" theory had the support of several theoretical astronomers in the Great Britain. The Cambridge group decided to embark on a programme of carrying out surveys of radio sources with the ultimate intention of testing steady-state theory, thereby demonstrating that radio astronomy could "do" cosmology and providing evidence of its scientific importance.

Inspections of rail vehicle multiple units are scheduled in British Rail mainly subject to the recommended interval between inspections of brake pads. This paper presents the development of a model of brake pad wear based on regression analysis and its subsequent use in the consideration of replacement and inspection strategies. The current scrapping size of 11 mm on motor vehicles proved to be too high for it was possible to extend pad life by as much as a third by reducing the scrapping size to 7 mm. On trailer vehicles it was found that the current scrapping size of 6 mm was satisfactory. [ABSTRACT FROM AUTHOR]

With the advent of more accurate diagnosis and more effective peptic ulcer management there has been a reduction in hospital admission over the past 10 years. Moreover the reduction in peptic ulcer surgery originally considered to be a possibility with the advent of H antagonists has now been demonstrated. The interest in Helicobacter pylori and its eradication may have further effects on the incidence of peptic ulcer in the future. Helicobacter testing is widely practiced at endoscopy and eradication therapy is instituted in all cases that are positive. This may have considerable implications in the future. [ABSTRACT FROM AUTHOR]