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Jones RM, Simpson AIF. Assisted death for prisoners and forensic patients: complexity and controversy illustrated by four recent cases. BJPsych Bull 2024:1-6. [PMID: 38708562 DOI: 10.1192/bjb.2024.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
Medical assistance in dying (MAiD) (which includes euthanasia and assisted suicide) is available in an increasing number of countries. In Belgium, The Netherlands and Switzerland (and was due to be implemented in Canada from 2024) eligibility includes mental suffering in the absence of any physical disorder. There are particular ethical and legal issues when considering MAiD for those involuntarily detained in prisons and hospitals. We describe four recent cases that illustrate these complexities, and highlight issues of equivalence of healthcare and self-determination against concerns about the criteria for determining eligibility of those with non-terminal conditions as well as the objections raised by victims and families and the demands for justice.
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Affiliation(s)
- Roland M Jones
- Centre for Addiction and Mental Health, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Alexander I F Simpson
- Centre for Addiction and Mental Health, Toronto, Canada
- University of Toronto, Toronto, Canada
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Wilkie T, Jones RM, Ramshaw L, Glancy G, Groat L, Chatterjee S. Contributors to Physician Burnout and Well-Being in Forensic Psychiatrists in Canada. J Am Acad Psychiatry Law 2024; 52:41-50. [PMID: 38467442 DOI: 10.29158/jaapl.230078-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The experience of burnout in forensic psychiatrists has not been well studied, with most studies focusing on the experiences of forensic nurses, the impact of vicarious trauma and compassion fatigue in forensic mental health professionals, and the risk of posttraumatic stress disorder related to workplace exposures. This study reports on a national survey (34% response rate) conducted with forensic psychiatrists across Canada to understand the rate of, and contributors to, burnout and professional fulfillment. Just over half of the physician respondents reported experiencing burnout, which is in line with other recent surveys in Canada that have indicated elevated levels of burnout since the onset of the pandemic. The highest rates were found among early-career psychiatrists and those whose values did not align with their workplace. Intellectual stimulation, the interface with the legal system, and flexibility in one's job were all strongly linked with professional fulfillment. The goal of this survey was not only to identify rates and variables affecting burnout and wellness in this population but also to expand the dialogue on potential interventions at institutional and systems levels that can reduce burnout, promote professional fulfillment, and enhance recruitment and retention in the field of forensic psychiatry.
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Affiliation(s)
- Treena Wilkie
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada.
| | - Roland M Jones
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Ramshaw
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
| | - Graham Glancy
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Groat
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
| | - Sumeeta Chatterjee
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
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Penney SR, Jones RM. Violence risk assessment in forensic mental health. Lancet Psychiatry 2023; 10:738-739. [PMID: 37739580 DOI: 10.1016/s2215-0366(23)00300-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 08/29/2023] [Indexed: 09/24/2023]
Affiliation(s)
- Stephanie R Penney
- The Centre for Addiction and Mental Health, University of Toronto, Toronto, ON M6J 1H4, Canada.
| | - Roland M Jones
- The Centre for Addiction and Mental Health, University of Toronto, Toronto, ON M6J 1H4, Canada
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Jones RM, Gerritsen C, Maheandiran M, Penney S, Simpson AI. Change in Severity of Mental Disorder of Remand Prisoners: An Observational Group-Based Trajectory Study. Can J Psychiatry 2023; 68:418-425. [PMID: 35849126 PMCID: PMC10331257 DOI: 10.1177/07067437221114095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mental disorder is common among prisoners; however, little is known about how illness severity changes during incarceration, and especially to what extent there are different trajectories of change. AIMS Our aims were to investigate trajectories of illness severity among male and female inmates with serious mental disorders, and to investigate whether clinical or demographic variables are associated with different trajectories. METHODS We carried out a retrospective cohort study of newly remanded inmates who had three or more serial measures of illness severity as measured by psychiatrists using the Clinical Global Impression-Corrections (CGI-C), and used group-based trajectory modelling to identify trajectories. We investigated whether clinical and demographic variables were associated with different groups. RESULTS We found an overall reduction in the severity of illness (mean change in CGI-C score -0.74, SD 1.5), with women showing greater improvement than men. We identified three distinct trajectories among men and three among women, all showing improvement in illness severity. Approximately 15% of the entire cohort had full resolution of symptoms, whereas the remainder showed partial improvement. Women, younger inmates, and those with substance use disorders were more likely to have full resolution of symptoms. CONCLUSIONS Although most prisoners showed improvement, and a small proportion had full resolution of symptoms, a significant number continued to have moderately severe symptoms. There is a need for comprehensive treatment within the detention centre, but also a need for transfer to hospital for those with severe symptoms as improvement within the correctional setting tends to be modest.
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Affiliation(s)
- Roland M. Jones
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Cory Gerritsen
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Stephanie Penney
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Alexander I.F. Simpson
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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van den Elzen P, Sander T, Palmans H, McManus M, Woodall N, Lee N, Fox OJL, Jones RM, Angal-Kalinin D, Subiel A. Alanine response to low energy synchrotron x-ray radiation. Phys Med Biol 2023; 68:065011. [PMID: 36731142 DOI: 10.1088/1361-6560/acb886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/01/2023] [Indexed: 02/04/2023]
Abstract
Objective. The radiation response of alanine is very well characterized in the MV photon energy range where it can be used to determine the dose delivered with an accuracy better than 1%, making it suitable as a secondary standard detector in cancer radiation therapy. This is not the case in the very low energy keV x-ray range where the alanine response is affected by large uncertainties and is strongly dependent on the x-ray beam energy. This motivated the study undertaken here.Approach. Alanine pellets with a nominal thickness of 0.5 mm and diameter of 5 mm were irradiated with monoenergetic x-rays at the Diamond Light Source synchrotron, to quantify their response in the 8-20 keV range relative to60Co radiation. The absorbed dose to graphite was measured with a small portable graphite calorimeter, and the DOSRZnrc code in the EGSnrc Monte Carlo package was used to calculate conversion factors between the measured dose to graphite and the absorbed dose to water delivered to the alanine pellets. GafChromic EBT3 films were used to measure the beam profile for modelling in the MC simulations.Main results. The relative responses measured in this energy range were found to range from 0.616 to 0.643, with a combined relative expanded uncertainty of 3.4%-3.5% (k= 2), where the majority of the uncertainty originated from the uncertainty in the alanine readout, due to the small size of the pellets used.Significance. The measured values were in good agreement with previously published data in the overlapping region of x-ray energies, while this work extended the dataset to lower energies. By measuring the response to monoenergetic x-rays, the response to a more complex broad-spectrum x-ray source can be inferred if the spectrum is known, meaning that this work supports the establishment of alanine as a secondary standard dosimeter for low-energy x-ray sources.
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Affiliation(s)
- P van den Elzen
- National Physical Laboratory, Medical Radiation Science Group, Teddington, United Kingdom
- University of Manchester, Department of Physics and Astronomy, Manchester, United Kingdom
- The Cockcroft Institute of Accelerator Science and Technology, Daresbury, United Kingdom
| | - T Sander
- National Physical Laboratory, Medical Radiation Science Group, Teddington, United Kingdom
| | - H Palmans
- National Physical Laboratory, Medical Radiation Science Group, Teddington, United Kingdom
- MedAustron Ion Therapy Center, Wiener Neustadt, Austria
| | - M McManus
- National Physical Laboratory, Medical Radiation Science Group, Teddington, United Kingdom
| | - N Woodall
- National Physical Laboratory, Medical Radiation Science Group, Teddington, United Kingdom
| | - N Lee
- National Physical Laboratory, Medical Radiation Science Group, Teddington, United Kingdom
| | - O J L Fox
- Diamond Light Source Ltd, Harwell Science Innovation Campus, Didcot, United Kingdom
| | - R M Jones
- University of Manchester, Department of Physics and Astronomy, Manchester, United Kingdom
- The Cockcroft Institute of Accelerator Science and Technology, Daresbury, United Kingdom
| | - D Angal-Kalinin
- University of Manchester, Department of Physics and Astronomy, Manchester, United Kingdom
- The Cockcroft Institute of Accelerator Science and Technology, Daresbury, United Kingdom
- Science and Technology Facilities Council, Accelerator Science and Technology Centre, Daresbury, United Kingdom
| | - A Subiel
- National Physical Laboratory, Medical Radiation Science Group, Teddington, United Kingdom
- University College London, UCL Cancer Institute, London, United Kingdom
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Busch L, Saini V, Budin R, Jones RM. PRN usage before and after discharge from a forensic inpatient unit: A series example of patients with intellectual disabilities. J Appl Res Intellect Disabil 2023; 36:405-410. [PMID: 36419217 DOI: 10.1111/jar.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/07/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022]
Abstract
Adults living with intellectual and developmental disabilities are often prescribed psychotropic medication on an "as needed" basis (PRN) in response to behavioural challenges. In the present study we conducted a retrospective analysis of medication administration records in the 6-months preceding and following discharge of 11 adults with intellectual and developmental disabilities to community settings from forensic inpatient units within a mental health hospital. We found a significant reduction in the frequency of PRN usage after discharge. We propose potential reasons for the difference in PRN administration across settings and make suggestions for future research.
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Affiliation(s)
- Louis Busch
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Valdeep Saini
- Department of Applied Disability Studies, Brock University, St. Catharines, Ontario, Canada
| | - Radek Budin
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Roland M Jones
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Simpson AI, Penney SR, Jones RM. Author reply to Letter to the Editor regarding 'Homicide associated with psychotic illness: What global temporal trends tell us about the association between mental illness and violence'. Aust N Z J Psychiatry 2023; 57:150. [PMID: 36112845 DOI: 10.1177/00048674221124509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Alexander I Simpson
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Stephanie R Penney
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roland M Jones
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Simpson AIF, Tran J, Jones RM. Ethical considerations regarding mental disorder and medical assistance in dying (MAiD) in the prison population. Med Sci Law 2023; 63:3-5. [PMID: 36571789 DOI: 10.1177/00258024221146725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
| | | | - Roland M Jones
- University of Toronto, Canada
- Centre for Addiction and Mental Health (CAMH), Canada
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Simpson AI, Penney SR, Jones RM. Homicide associated with psychotic illness: What global temporal trends tell us about the association between mental illness and violence. Aust N Z J Psychiatry 2022; 56:1384-1388. [PMID: 34933584 DOI: 10.1177/00048674211067164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Available evidence suggests that persons with serious forms of mental illness are 4-10 times more likely to commit homicide as compared to non-affected members of the general population. The relationship between homicide and psychotic illness has now been subject to longitudinal investigation in six different populations across eight studies covering time periods over the last six decades. With the exception of one study, these investigations demonstrate that homicide associated with psychotic illness appears relatively stable through time and, in most populations, is not related to factors that contribute to the rise and fall of total population homicide (TPH) rates. This suggests that illness and treatment factors are of most importance if we are to reduce the prevalence of this tragic illness complication.
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Affiliation(s)
- Alexander If Simpson
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,CAMH, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Stephanie R Penney
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roland M Jones
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Ray I, Fulham L, Simpson AI, Vogel T, Gerritsen C, Patel K, Jones RM. A comparison of men and women referred to provincial correctional mental health services in Ontario, Canada. Crim Behav Ment Health 2022; 32:358-370. [PMID: 36209470 DOI: 10.1002/cbm.2263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Women comprise around 15% of admissions to provincial correctional institutions in Canada. Women in custody are known to have a high prevalence of mental health concerns, but little is known about how those referred to mental health services compare with referred men at a similar stage of imprisonment. AIMS Our aim was to describe and compare clinical, social and demographic characteristics of a complete cohort of custodially remanded men and women who were referred to mental health services while under custodial remand in two correctional institutions. METHODS We carried out retrospective analysis of data obtained from 4040 men and 1734 provincially detained women referred to mental health services in two correctional centres holding mainly pre-trial prisoners and serving a large mixed urban-rural catchment area in Toronto, Canada over a nearly five-year period. Men and women were first screened using the Brief Jail Mental Health Screen. Those who screened positive were assessed using the Jail Screening Assessment Tool the Brief Psychopathology Rating Scale-Expanded (BPRS-E) and the Clinical Global Impression-Corrections (CGI-C). RESULTS There were many similarities between men and women, but also some important differences. Women were more socioeconomically disadvantaged than men. More women than men reported having children, yet fewer reported having any form of employment or social supports, although men were more likely to report unstable housing. In addition, women were significantly more likely to have mood and anxiety problems and to be self-harming, but did not differ from men in current psychotic symptoms. We also found differences in patterns of substance use, with a higher proportion of women using heroin and methamphetamines but fewer women having accessed addiction services. CONCLUSIONS Our findings have implications for clinicians and service planners. They underscore the value of systematic screening for identifying need. More specifically, they suggest need for increased availability of addiction services for women as well as ensuring support for those women who have dependent-age children. Improvement in supports for entry into employment is particularly needed for women, while men are particularly likely to need access to stable housing.
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Affiliation(s)
- Ipsita Ray
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | | | - Alexander I Simpson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Tobias Vogel
- Department of Forensic Psychiatry, University of Basel, Basel, Switzerland
| | - Cory Gerritsen
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Kiran Patel
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Roland M Jones
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
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Jones RM, Nilsson T, Walker S, Armentrout PB. Potassium Binding Interactions with Aliphatic Amino Acids: Thermodynamic and Entropic Effects Analyzed via a Guided Ion Beam and Computational Study. J Am Soc Mass Spectrom 2022; 33:1427-1442. [PMID: 35535863 DOI: 10.1021/jasms.2c00079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Noncovalent interactions between alkali metals and amino acids are critical for many biological processes, especially for proper function of protein ion channels; however, many precise binding affinities between alkali metals and amino acids still need to be measured. This study addresses this need by using threshold collision-induced dissociation with a guided ion beam tandem mass spectrometer to measure binding affinities between potassium cations and the aliphatic amino acids: Gly, Ala, hAla, Val, Leu, and Ile. These measurements are supplemented by theoretical calculations and include commentary on effects of enthalpy, entropy, and structural preference. Notably, all levels of theory indicate that the lowest-lying isomers at 298 K have K+ binding to the carbonyl oxygen in either a monodentate ([CO]) or bidentate ([CO,OH]) fashion, isomers that are linked in a double-well potential. This complicates the analysis of the data, although does not greatly influence the final results. Analysis of the resulting cross sections includes accounting for multiple ion-molecule collisions, internal energy of reactant ions, and unimolecular decay rates. The resulting experimental bond dissociation energies generally increase as the polarizability of the amino acid increases, results that agree well with quantum chemical calculations done at the B3LYP, B3P86, and MP2(full) levels of theory, with B3LYP-GD3BJ predicting systematically larger values.
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Affiliation(s)
- Roland M Jones
- Department of Chemistry, University of Utah, 315 South 1400 East Rm 2020, Salt Lake City, Utah 84112, United States
| | - Taylor Nilsson
- Department of Chemistry, University of Utah, 315 South 1400 East Rm 2020, Salt Lake City, Utah 84112, United States
| | - Samantha Walker
- Department of Chemistry, University of Utah, 315 South 1400 East Rm 2020, Salt Lake City, Utah 84112, United States
| | - P B Armentrout
- Department of Chemistry, University of Utah, 315 South 1400 East Rm 2020, Salt Lake City, Utah 84112, United States
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Jones RM, Van Den Bree M, Zammit S, Taylor PJ. The Relationship Between the Big Five Personality Factors, Anger-hostility, and Alcohol and Violence in Men and Women: A Nationally Representative Cohort of 15,701 Young Adults. J Interpers Violence 2022; 37:NP8559-NP8581. [PMID: 33283620 DOI: 10.1177/0886260520978178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Alcohol consumption is known to have a disinhibiting effect and is associated with a higher likelihood of aggressive behavior, especially among men. People with certain personality traits maybe more likely to behave aggressively when intoxicated, and there may also be variation by gender. We aimed to investigate whether the reason why men and women with certain personality traits are more likely to engage in violence may be because of their alcohol use.The Big Five personality traits and anger-hostility, alcohol consumption, and violence were measured by questionnaire in 15,701 nationally representative participants in the United States. We tested the extent to which alcohol mediates the relationship between personality factors and violence in men and women.We found that agreeableness was inversely associated with violence in both genders. Alcohol mediated approximately 11% of the effect in males, but there was no evidence of an effect in females. Anger-hostility was associated with violence in both sexes, but alcohol mediated the effect only in males. We also found that Extraversion was associated with violence and alcohol use in males and females. Alcohol accounted for 15% of the effect of extraversion on violence in males and 29% in females.The mechanism by which personality traits relate to violence may be different in men and women. Agreeableness and anger-hostility underpin the relationship between alcohol and violence in men, but not in women. Reducing alcohol consumption in men with disagreeable and angry/hostile traits would have a small but significant effect in reducing violence, whereas in women, reducing alcohol consumption among the extraverted, would have a greater effect.
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Affiliation(s)
| | | | - Stanley Zammit
- Cardiff University, Cardiff, UK
- University of Bristol, UK
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Zhao W, Jones RM, D'Agosta R, Baletto F. Making copper, silver and gold fullerene cages breathe. J Phys Condens Matter 2022; 34:224005. [PMID: 35245908 DOI: 10.1088/1361-648x/ac5b00] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/04/2022] [Indexed: 06/14/2023]
Abstract
We show that optical properties change when the fullerene structures of Au32, Cu32and Ag32inflate and deflate. We first observe significant differences in the extinction spectra employing a classical approach based on the Green's dyadic method. By means of real-time time-dependent density functional theory. We continue to calculate the optical spectrum (OP) via aδ-kick simulation, comparing results with the ground-state energetic property the HOMO-LUMO (HL) gap. Red-shift of the OP is expected as the fullerenes inflate, with only ±10% change in the size. As the fullerene breathes, a 0.8 eV shift in the first peak position could be observed in the gold nanoparticle. Ag has a smoother behaviour than both Au and Cu. We have also found changes in the optical spectra can not be directly interpreted as a result of changes in the HL gap.
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Affiliation(s)
- W Zhao
- Physics Department, King's College London, WC2R 2LS, United Kingdom
| | - R M Jones
- Physics Department, King's College London, WC2R 2LS, United Kingdom
| | - R D'Agosta
- Nano-bio Spectroscopy Group, Department of Polymers and Advanced Materials: Physics, Chemistry and Technology, Universidad del País Vasco UPV/EHU, Avenida de Tolosa 72, E-20018 San Sebastián, and Ikerbasque, Basque Foundation for Science, Plaza de Euskadi 5, E-48009 Bilbao, Spain
| | - F Baletto
- Physics Department, King's College London, WC2R 2LS, United Kingdom
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Whitmore L, Mackay RI, van Herk M, Jones JK, Jones RM. Focused VHEE (very high energy electron) beams and dose delivery for radiotherapy applications. Sci Rep 2021; 11:14013. [PMID: 34234203 PMCID: PMC8263594 DOI: 10.1038/s41598-021-93276-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/10/2021] [Indexed: 12/04/2022] Open
Abstract
This paper presents the first demonstration of deeply penetrating dose delivery using focused very high energy electron (VHEE) beams using quadrupole magnets in Monte Carlo simulations. We show that the focal point is readily modified by linearly changing the quadrupole magnet strength only. We also present a weighted sum of focused electron beams to form a spread-out electron peak (SOEP) over a target region. This has a significantly reduced entrance dose compared to a proton-based spread-out Bragg peak (SOBP). Very high energy electron (VHEE) beams are an exciting prospect in external beam radiotherapy. VHEEs are less sensitive to inhomogeneities than proton and photon beams, have a deep dose reach and could potentially be used to deliver FLASH radiotherapy. The dose distributions of unfocused VHEE produce high entrance and exit doses compared to other radiotherapy modalities unless focusing is employed, and in this case the entrance dose is considerably improved over existing radiations. We have investigated both symmetric and asymmetric focusing as well as focusing with a range of beam energies.
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Affiliation(s)
- L Whitmore
- Department of Physics and Astronomy, University of Manchester, Manchester, UK
- The Cockcroft Institute of Science and Technology, Daresbury, Warrington, UK
| | - R I Mackay
- The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - M van Herk
- The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - J K Jones
- The Cockcroft Institute of Science and Technology, Daresbury, Warrington, UK
- ASTeC, STFC Daresbury Laboratory, Daresbury, Warrington, UK
| | - R M Jones
- Department of Physics and Astronomy, University of Manchester, Manchester, UK.
- The Cockcroft Institute of Science and Technology, Daresbury, Warrington, UK.
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15
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Jones RM, Manetsch M, Gerritsen C, Simpson AIF. Patterns and Predictors of Reincarceration among Prisoners with Serious Mental Illness: A Cohort Study: Modèles et prédicteurs de réincarcération chez les prisonniers souffrant de maladie mentale grave : Une étude de cohorte. Can J Psychiatry 2021; 66:560-568. [PMID: 33155829 PMCID: PMC8138736 DOI: 10.1177/0706743720970829] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A small proportion of people who have serious mental illness and rapid and frequent incarcerations account for a disproportionate amount of overall service use and cost. It is important to describe such individuals, so that services can respond more effectively. METHODS We investigated a cohort of 4,704 incarcerated men and women who were discharged from a correctional mental health service and followed for a median of 535 days. We investigated social, clinical, demographic, and offense characteristics as predictors of return to the service using Cox survival analyses. Secondly, we characterized individuals as high-frequency service users as those who had 3 or more incarcerations during a 1-year period and investigated their characteristics. RESULTS We found that a higher rate of return to custody was associated with schizophrenia spectrum/bipolar affective disorder (BPAD), personality disorder traits, crack cocaine and methamphetamine use, and unstable housing. Charges of theft/robbery and breach of probation were also positively associated, and sex assault was negatively associated with return to custody. Within a 1-year time period, we found 7.2% of individuals were high-frequency service users, which accounted for 19.5% of all reincarcerations. CONCLUSION Identification of the characteristics of those with mental illness in custody, especially those who have high-frequency returns to custody, may provide opportunity to target resources more effectively. The primary targets of intervention would be to treat those with schizophrenia/BPAD and substance use problems, particularly those using stimulants, and addressing homelessness. This could reduce the problem of repeated criminalization of the mentally ill and reduce the overall incarceration rate.
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Affiliation(s)
- Roland M Jones
- 7978Centre for Addiction and Mental Health (CAMH), University of Toronto, Ontario, Canada.,Department of Psychiatry, 7938University of Toronto, Ontario, Canada
| | - Madleina Manetsch
- 7978Centre for Addiction and Mental Health (CAMH), University of Toronto, Ontario, Canada.,Forensic Psychiatric Clinic, Adolescent Forensic Psychiatry, University Psychiatric Clinics, Basel, Switzerland
| | - Cory Gerritsen
- 7978Centre for Addiction and Mental Health (CAMH), University of Toronto, Ontario, Canada.,Department of Psychiatry, 7938University of Toronto, Ontario, Canada
| | - Alexander I F Simpson
- 7978Centre for Addiction and Mental Health (CAMH), University of Toronto, Ontario, Canada.,Department of Psychiatry, 7938University of Toronto, Ontario, Canada
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Jones RM, Gildersleve CD. Quality and safety taken out of our hands? Anaesthesia 2021; 76:1136-1137. [PMID: 33687772 DOI: 10.1111/anae.15454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 12/01/2022]
Affiliation(s)
- R M Jones
- Royal Hospital for Children, Glasgow, UK
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Alabdulla M, Reagu SM, Al-Khal A, Elzain M, Jones RM. COVID-19 vaccine hesitancy and attitudes in Qatar: A national cross-sectional survey of a migrant-majority population. Influenza Other Respir Viruses 2021; 15:361-370. [PMID: 33605010 PMCID: PMC8014858 DOI: 10.1111/irv.12847] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/15/2022] Open
Abstract
Background Vaccine hesitancy is a global threat undermining control of preventable infections. Emerging evidence suggests that hesitancy to COVID‐19 vaccination varies globally. Qatar has a unique population with around 90% of the population being economic migrants, and the degree and determinants of hesitancy are not known. Methods This study was carried out to evaluate the degree of vaccine hesitancy and its socio‐demographic and attitudinal determinants across a representative sample. A national cross‐sectional study using validated hesitancy measurement tool was carried out from October 15, 2020, to November 15, 2020. A total of 7821 adults completed the survey. Relevant socio‐demographic data along with attitudes and beliefs around COVID‐19 vaccination were collected from the respondents. Results 20.2% of the respondents stated they would not take the vaccine and 19.8% reported being unsure about taking the prospective COVID‐19 vaccine. Citizens and females were more likely to be vaccine hesitators than immigrants and males, respectively. Concerns around the safety of COVID‐19 vaccine and its longer‐term side effects were the main concerns cited. Personal research around COVID‐19 and vaccine were by far the most preferred methods that would increase confidence in accepting the vaccine across all demographic groups. Conclusions This study reports an overall vaccine hesitancy of 20% toward the COVID‐19 vaccine and the influence of social media on attitudes toward vaccination which is in keeping with emerging evidence. This finding comes at a time that is close to the start of mass immunization and reports from a migrant‐majority population highlighting important socio‐demographic determinants around vaccine hesitancy.
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Affiliation(s)
- Majid Alabdulla
- Hamad Medical Corporation, Doha, Qatar.,College of Medicine, Qatar University, Doha, Qatar
| | | | | | | | - Roland M Jones
- Centre for Addiction and Mental Health and University of Toronto, Toronto, ON, Canada
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18
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Small KL, Henthorn NT, Angal-Kalinin D, Chadwick AL, Santina E, Aitkenhead A, Kirkby KJ, Smith RJ, Surman M, Jones J, Farabolini W, Corsini R, Gamba D, Gilardi A, Merchant MJ, Jones RM. Evaluating very high energy electron RBE from nanodosimetric pBR322 plasmid DNA damage. Sci Rep 2021; 11:3341. [PMID: 33558553 PMCID: PMC7870938 DOI: 10.1038/s41598-021-82772-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/07/2020] [Indexed: 01/18/2023] Open
Abstract
This paper presents the first plasmid DNA irradiations carried out with Very High Energy Electrons (VHEE) over 100-200 MeV at the CLEAR user facility at CERN to determine the Relative Biological Effectiveness (RBE) of VHEE. DNA damage yields were measured in dry and aqueous environments to determine that ~ 99% of total DNA breaks were caused by indirect effects, consistent with other published measurements for protons and photons. Double-Strand Break (DSB) yield was used as the biological endpoint for RBE calculation, with values found to be consistent with established radiotherapy modalities. Similarities in physical damage between VHEE and conventional modalities gives confidence that biological effects of VHEE will also be similar-key for clinical implementation. Damage yields were used as a baseline for track structure simulations of VHEE plasmid irradiation using GEANT4-DNA. Current models for DSB yield have shown reasonable agreement with experimental values. The growing interest in FLASH radiotherapy motivated a study into DSB yield variation with dose rate following VHEE irradiation. No significant variations were observed between conventional and FLASH dose rate irradiations, indicating that no FLASH effect is seen under these conditions.
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Affiliation(s)
- K L Small
- The University of Manchester, Manchester, UK.
- The Cockcroft Institute, Daresbury, UK.
| | - N T Henthorn
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - D Angal-Kalinin
- The University of Manchester, Manchester, UK
- The Cockcroft Institute, Daresbury, UK
- ASTeC, STFC Daresbury Laboratory, Daresbury, Warrington, UK
| | - A L Chadwick
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - E Santina
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - A Aitkenhead
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - K J Kirkby
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - R J Smith
- The Cockcroft Institute, Daresbury, UK
- ASTeC, STFC Daresbury Laboratory, Daresbury, Warrington, UK
| | - M Surman
- The Cockcroft Institute, Daresbury, UK
- ASTeC, STFC Daresbury Laboratory, Daresbury, Warrington, UK
| | - J Jones
- The Cockcroft Institute, Daresbury, UK
- ASTeC, STFC Daresbury Laboratory, Daresbury, Warrington, UK
| | - W Farabolini
- CERN, Geneva, Switzerland
- CEA Saclay, IRFU-DACM, Saclay, France
| | | | | | - A Gilardi
- CERN, Geneva, Switzerland
- Federico II, DIETI, University of Napoli, Napoli, Italy
| | - M J Merchant
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - R M Jones
- The University of Manchester, Manchester, UK
- The Cockcroft Institute, Daresbury, UK
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Simpson AIF, Gerritsen C, Maheandiran M, Adamo V, Vogel T, Fulham L, Kitt T, Forrester A, Jones RM. A Systematic Review of Reviews of Correctional Mental Health Services Using the STAIR Framework. Front Psychiatry 2021; 12:747202. [PMID: 35115956 PMCID: PMC8806032 DOI: 10.3389/fpsyt.2021.747202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 12/13/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Rising demand for correctional mental health services (CMHS) in recent decades has been a global phenomenon. Despite increasing research, there are major gaps in understanding the best models for CMHS and how to measure their effectiveness, particularly studies that consider the overall care pathways and effectiveness of service responses. The STAIR (Screening, Triage, Assessment, Intervention, and Re-integration) model is an evidence-based framework that defines and measures CMHS as a clinical pathway with a series of measurable, and linked functions. METHOD We conducted a systematic review of the reviews of CMHS elements employing PRISMA guidelines, organized according to STAIR pillars. We assessed the quality of included studies using the AMSTAR-2 criteria. Narrative reviews were read and results synthesized. RESULTS We included 26 review articles of which 12 were systematic, metaanalyses, and 14 narrative reviews. Two systematic reviews and seven narrative reviews addressed screening and triage with strong evidence to support specific screening and triage systems. There was no evidence for standardised assessment approaches. Eight systematic reviews and seven narrative reviews addressed interventions providing some evidence to support specific psychosocial interventions. Three systematic reviews and six narrative reviews addressed reintegration themes finding relatively weak evidence to support reintegration methods, with interventions often being jurisdictionally specific and lacking generalizability. CONCLUSIONS The STAIR framework is a useful way to organize the extant literature. More research is needed on interventions, assessment systems, care pathway evaluations, and reintegration models.
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Affiliation(s)
- Alexander I F Simpson
- Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Cory Gerritsen
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | | | - Vito Adamo
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Tobias Vogel
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lindsay Fulham
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Tamsen Kitt
- Department of Psychology, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Andrew Forrester
- Forensic Psychiatry, Department of Psychological Medicine and Clinical Neursciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Roland M Jones
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
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20
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Simpson AIF, Chatterjee S, Darby P, Jones RM, Maheandiran M, Penney SR, Saccoccio T, Stergiopoulos V, Wilkie T. Management of COVID-19 Response in a Secure Forensic Mental Health Setting: Réponse à la gestion de la COVID-19 dans un établissement sécurisé de santé mentale et de psychiatrie légale. Can J Psychiatry 2020; 65:695-700. [PMID: 32573397 PMCID: PMC7312094 DOI: 10.1177/0706743720935648] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic presents major challenges to places of detention, including secure forensic hospitals. International guidance presents a range of approaches to assist in decreasing the risk of COVID-19 outbreaks as well as responses to manage outbreaks of infection should they occur. METHODS We conducted a literature search on pandemic or outbreak management in forensic mental health settings, including gray literature sources, from 2000 to April 2020. We describe the evolution of a COVID-19 outbreak in our own facility, and the design, and staffing of a forensic isolation unit. RESULTS We found a range of useful guidance but no published experience of implementing these approaches. We experienced outbreaks of COVID-19 on two secure forensic units with 13 patients and 10 staff becoming positive. One patient died. The outbreaks lasted for 41 days on each unit from declaration to resolution. We describe the approaches taken to reduction of infection risk, social distancing and changes to the care delivery model. CONCLUSIONS Forensic secure settings present major challenges as some proposals for pandemic management such as decarceration or early release are not possible, and facilities may present challenges to achieve sustained social distancing. Assertive testing, cohorting, and isolation units are appropriate responses to these challenges.
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Affiliation(s)
- Alexander I F Simpson
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Sumeeta Chatterjee
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Padraig Darby
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Roland M Jones
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Margaret Maheandiran
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Stephanie R Penney
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Tania Saccoccio
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Vicky Stergiopoulos
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Treena Wilkie
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
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Blaisdell J, Turyk ME, Almberg KS, Jones RM, Stayner LT. Corrigendum to "Prenatal exposure to nitrate in drinking water and the risk of congenital malformations" [Environ. Res. 176 (Epub, 2019) 1-10/108553]. Environ Res 2020; 186:109269. [PMID: 32178840 DOI: 10.1016/j.envres.2020.109269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- J Blaisdell
- University of Illinois at Chicago, Division of Epidemiology and Biostatistics, USA
| | - M E Turyk
- University of Illinois at Chicago, Division of Epidemiology and Biostatistics, USA
| | - K S Almberg
- Univeristy of Illinois at Chicago,Division of Environmental and Occupational Health, USA
| | - R M Jones
- Univeristy of Illinois at Chicago,Division of Environmental and Occupational Health, USA
| | - L T Stayner
- University of Illinois at Chicago, Division of Epidemiology and Biostatistics, USA.
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Donoghue S, Jones RM, Bush A, Srinivas G, Bowling K, Andrews S. Cost effectiveness of intraoperative laparoscopic ultrasound for suspected choledocholithiasis; outcomes from a specialist benign upper gastrointestinal unit. Ann R Coll Surg Engl 2020; 102:598-600. [PMID: 32538107 DOI: 10.1308/rcsann.2020.0109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Common bile duct stones are present in 10% of patients with symptomatic gallstones. One-third of UK patients undergoing cholecystectomy will have preoperative ductal imaging, commonly with magnetic resonance cholangiopancreatography. Intraoperative laparoscopic ultrasound is a valid alternative but is not widely used. The primary aim of this study was to assess cost effectiveness of laparoscopic ultrasound compared with magnetic resonance cholangiopancreatography. MATERIALS AND METHODS A prospective database of all patients undergoing laparoscopic cholecystectomy between 2015 and 2018 at a district general hospital was assessed. Inclusion criteria were all patients, emergency and elective, with symptomatic gallstones and suspicion of common bile duct stones (derangement of liver function tests with or without dilated common bile duct on preoperative ultrasound, or history of pancreatitis). Patients with known common bile duct stones (magnetic resonance cholangiopancreatography or failed endoscopic retrograde cholangiogram) were excluded. Ninety-day morbidity data were also collected. RESULTS A total of 420 (334 elective and 86 emergency) patients were suspected to have common bile duct stones and were included in the study. The cost of a laparoscopic ultrasound was £183 per use. The cost of using the magnetic resonance cholangiopancreatography unit was £365 per use. Ten postoperative magnetic resonance cholangiopancreatographies were performed for inconclusive intraoperative imaging. The estimated cost saving was £74,650. Some 128 patients had common bile duct stones detected intraoperatively and treated. There was a false positive rate of 4.7%, and the false negative rate at 90 days was 0.7%. laparoscopic ultrasound use saved 129 bed days for emergency patients and 240 magnetic resonance cholangiopancreatography hours of magnetic resonance imaging. CONCLUSION The use of laparoscopic ultrasound during laparoscopic cholecystectomy for the detection of common bile duct stone is safe, accurate and cost effective. Equipment and maintenance costs are quickly offset and hospital bed days can be saved with its use.
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Affiliation(s)
| | | | - A Bush
- Torbay Hospital, Torquay, Devon, UK
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23
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Jones RM, Van Den Bree M, Zammit S, Taylor PJ. Change in the Relationship Between Drinking Alcohol and Risk of Violence Among Adolescents and Young Adults: A Nationally Representative Longitudinal Study. Alcohol Alcohol 2020; 55:439-447. [PMID: 32300785 DOI: 10.1093/alcalc/agaa020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 02/19/2020] [Accepted: 03/11/2020] [Indexed: 01/13/2023] Open
Abstract
AIMS To quantify the relationship between alcohol and violence with increasing age. METHODS Data were from The National Longitudinal Study of Adolescent to Adult Health (ADD Health) of 20,386 people representative of the US population. Mean age at the first wave of interviews was 16.2 years, with subsequent interviews mean of 1, 6.3 and 12.9 years later. We used random-effects models and predictive marginal effects of the association between varying quantities of alcohol consumption and violence while controlling for possible confounders. RESULTS Violence was reported by 19.1% of participants at wave I but just 2.1% at wave IV. The random-effects model showed that consuming 1-4 drinks on each occasion was associated with a modest increase in risk of violence in both males (odds ratio (OR) 1.36, 95% CI 1.13-1.63) and females (OR 1.33, 95% CI 1.03-1.72). For consumption of five or more drinks on each occasion, the risk remained similar for females (OR 1.40 (0.99-1.97)) but increased considerably for males (OR 2.41 (1.96-2.95)). Predictive marginal effects models confirmed that violence rates decreased with age. CONCLUSIONS Alcohol is most strongly linked to violence among adolescents, so programmes for primary prevention of alcohol-related violence are best targeted towards this age group, particularly males who engage in heavy episodic drinking.
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Affiliation(s)
- Roland M Jones
- Centre for Addiction and Mental Health (CAMH), University of Toronto, 1001 Queen Street West, Unit 3.4, Toronto, ON M6J 1H4, Canada
| | - Marianne Van Den Bree
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
| | - Stanley Zammit
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Pamela J Taylor
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Heath Park, Cardiff CF14 4XN, UK
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Jones RM, Thompson C, Bitter I. A systematic review of the efficacy and safety of second generation antipsychotics in the treatment of mania. Eur Psychiatry 2020; 21:1-9. [PMID: 16487905 DOI: 10.1016/j.eurpsy.2005.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2003] [Revised: 01/03/2005] [Accepted: 02/07/2005] [Indexed: 10/25/2022] Open
Abstract
AbstractSecond generation antipsychotic agents are increasingly used in the management of acute mania. A systematic review of the efficacy and safety of these agents, as both monotherapy and in combination with mood stabilisers, was performed to establish the evidence for their use. Randomised controlled trials (RCTs) were critically appraised in more detail than studies that presented lower levels of evidence such as case reports, case series and open label follow up studies. We found 11 RCTs reporting on patients treated with second generation antipsychotics for acute bipolar mania, of which three included randomisation between the second generation antipsychotic and placebo, and eight between a mood stabiliser combined with either the second generation antipsychotic or placebo. Data from non-randomised trials is also presented.
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Affiliation(s)
- R M Jones
- Mental Health Group, University of Southampton, Southampton, UK.
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25
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26
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Jones RM, Gerritsen C, Maheandiran M, Simpson AIF. Validation of the Clinical Global Impression-Corrections Scale (CGI-C) by Equipercentile Linking to the BPRS-E. Front Psychiatry 2020; 11:180. [PMID: 32265753 PMCID: PMC7100373 DOI: 10.3389/fpsyt.2020.00180] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 02/25/2020] [Indexed: 11/22/2022] Open
Abstract
Background: The Clinical Global Impression-Corrections (CGI-C) is an adaptation of the severity scale of the Clinical Global Impression for use in correctional facilities. Although it has been shown to have good inter-rater reliability, there have been no validation studies of this instrument. Method: We analyzed data from 726 initial assessments of persons detained in two correctional facilities and compared clinician's ratings for the CGI-C and modified Brief Psychiatric Rating Scale-Expanded (BPRS-E). We used equipercentile linkage and Spearman correlations to investigate concordance in the total sample, by diagnostic groups, and by gender. Results: We found that the CGI-C scores and BPRS-E scores among persons in remand settings were significantly correlated (ρ = 0.51, p < 0.001) and that correlations were the same for men and women. We found that points of equivalence can be reliably found between the two scales using equipercentile linkage, and that those with psychotic disorders had lower BPRS-E scores than those with mood/anxiety/situational stress for equivalent CGI-C scores. Conclusion: Overall, CGI-C ratings correspond well to BPRS-E ratings for both men and women remand prisoners across diagnoses, and the CGI-C appears to be a valid tool for the assessment of severity of symptoms in this setting.
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Affiliation(s)
- Roland M Jones
- Centre for Addiction and Mental Health (CAMH) and University of Toronto, Toronto, ON, Canada
| | - Cory Gerritsen
- Centre for Addiction and Mental Health (CAMH) and University of Toronto, Toronto, ON, Canada
| | - Margaret Maheandiran
- Centre for Addiction and Mental Health (CAMH) and University of Toronto, Toronto, ON, Canada
| | - Alexander I F Simpson
- Centre for Addiction and Mental Health (CAMH) and University of Toronto, Toronto, ON, Canada
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Jones RM, Patel K, Moscovici M, McMaster R, Glancy G, Simpson AI. Adaptation of the Clinical Global Impression for Use in Correctional Settings: The CGI-C. Front Psychiatry 2019; 10:687. [PMID: 31620035 PMCID: PMC6759827 DOI: 10.3389/fpsyt.2019.00687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/27/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Provision of mental health care in correctional settings presents unique challenges. There is a need for a simple-to-use tool to measure severity of mental illness in correctional settings that can be used by mental health staff from different disciplines. We adapted the severity scale of the Clinical Global Impression for use in correctional settings, which we have called CGI-C, and carried out a reliability study. Method: Clinical descriptions of typical inmate presentations were developed to benchmark each of the seven possible ratings of the CGI. Twenty-one case vignettes were then developed for study of inter-rater reliability, which were then rated using the CGI-C by five forensic psychiatrists (on three occasions) and 11 multidisciplinary health care clinicians (twice). The tool was introduced into clinical practice, and the first 57 joint assessments carried out by both a psychiatrist and a clinician in which a CGI-C was rated were compared to measure inter-rater reliability. Results: We found very good inter-rater and test-retest reliability in all analyses. Gwet's AC, calculated on initial ratings of the vignettes by the psychiatrists, was 0.85 (95% CI 0.81-0.90, p < 0.001) and 0.87 (95% CI 0.83-0.91, p < 0.001) for clinician ratings. Inter-rater reliability based on 57 joint face-to-face assessments of inmates showed Gwet's AC coefficient of 0.93 (95% CI 0.88-0.97). Conclusion: The CGI-C is simple to use, can be used by members of the multidisciplinary team, and shows high reliability. The advantage in correctional settings is that it can be used even with the most severely ill and behaviorally disturbed, based on observation and collateral information.
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Affiliation(s)
- Roland M Jones
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Kiran Patel
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Mario Moscovici
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Robert McMaster
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Graham Glancy
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
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Jones RM, Patel K, Simpson AIF. Assessment of need for inpatient treatment for mental disorder among female prisoners: a cross-sectional study of provincially detained women in Ontario. BMC Psychiatry 2019; 19:98. [PMID: 30917798 PMCID: PMC6437954 DOI: 10.1186/s12888-019-2083-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 03/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND International studies show a consistent finding of women in prisons as having a high prevalence of mental disorder. Most will be treated within the prison however the most severely ill require transfer to a hospital facility. The primary aim of our study was to survey the total provincial female prison population in Ontario, Canada, to determine the proportion that require treatment in a psychiatric hospital, and the security level required. The secondary aim was to investigate the validity and psychometric properties of DUNDRUM-1 and DUNDRUM-2 in making these assessments. METHODS We carried out a cross-sectional study of all remand and sentenced female inmates detained in all 16 provincial jails that hold women in Ontario. The severity of mental health need was categorised by mental health staff on a five-point scale. Two forensic psychiatrists then examined all medical files of prisoners that had been categorised in the highest two categories and a random sample of nearly a quarter of those in the third category. An overall opinion was then made as to whether admission was required, and whether a high intensity bed was needed, and files were rated using DUNDRUM-1 and DUNDRUM-2. RESULTS There were 643 female inmates in provincial prisons in Ontario. We estimated that approximately 43 (6.7%) required admission to a hospital facility, of which 21.6 [prorated] (3.4%) required a high intensity bed such as a psychiatric intensive care bed within a secure hospital. The DUNDRUM-1 and -2 tools showed good internal validity. Total scores on both DUNDRUM-1 and DUNDRUM-2 were significantly different between those assessed as needing admission and those who did not, and distinguished the level of security required. CONCLUSION This is the first study to determine level of need for prison to hospital transfers in Canada and can be used to inform service capacity planning. We also found that the DUNDRUM toolkit is useful in determining the threshold and priorities for hospital transfer of female prisoners.
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Affiliation(s)
- Roland M. Jones
- 0000 0000 8793 5925grid.155956.bCentre for Addiction and Mental Health (CAMH) and University of Toronto, Unit 3, 1001 Queen St West, Toronto, M6J 1H4 Canada
| | - Kiran Patel
- 0000 0000 8793 5925grid.155956.bCentre for Addiction and Mental Health (CAMH) and University of Toronto, Unit 1, 1001 Queen Street West, Toronto, ON M6J 1H4 Canada
| | - Alexander I. F. Simpson
- 0000 0000 8793 5925grid.155956.bCentre for Addiction and Mental Health (CAMH) and University of Toronto, Unit 3, 1001 Queen St West, Toronto, M6J 1H4 Canada
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Ray I, Simpson AIF, Jones RM, Shatokhina K, Thakur A, Mulsant BH. Clinical, Demographic, and Criminal Behavior Characteristics of Patients With Intellectual Disabilities in a Canadian Forensic Program. Front Psychiatry 2019; 10:760. [PMID: 31681051 PMCID: PMC6803491 DOI: 10.3389/fpsyt.2019.00760] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 09/20/2019] [Indexed: 11/30/2022] Open
Abstract
Background: People with intellectual disability (ID) and forensic issues constitute a challenging clinical group that has been understudied in forensic settings. Methods: We assessed the characteristics of patients with ID under the authority of the Ontario Review Board (ORB) in a large forensic program of a tertiary psychiatric hospital (excluding those with a cognitive disorder) and compared their characteristics with those of a non-ID control group. Results: Among 510 adult ORB patients, 47 had an ID diagnosis. ID patients were of younger age at index offense, with a lower level of education, and were less likely to have been married or employed, more likely to have committed a sexual offense, more likely to have a diagnosis of paraphilia, less likely to be "not criminally responsible," and more likely to be "unfit to stand trial." They were also more likely to have committed their index offenses against care professionals and be treated in a secure unit. Conclusion: Our findings have major implications for clinicians, clinical leaders, and policymakers about the specific needs of patients with ID presenting with forensic issues and differing needs in terms of treatment and risk management.
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Affiliation(s)
- Ipsita Ray
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Alexander I F Simpson
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roland M Jones
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Anupam Thakur
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Benoit H Mulsant
- Complex Care and Recovery Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Shi L, Baboi N, Jones RM. Beam phase retrieval based on higher order modes in cylindrical superconducting radio frequency cavities. Rev Sci Instrum 2018; 89:105105. [PMID: 30399702 DOI: 10.1063/1.5040191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/15/2018] [Indexed: 06/08/2023]
Abstract
The control of beam phase relative to the accelerating RF field within a superconducting cavity is important in many accelerator applications and is of particular importance for a free electron laser facility. As standard practice, the phase is usually inferred from the beam-induced transient field with respect to a timing reference. We report here on an alternative and novel means of beam phase determination based on beam-excited higher order electromagnetic modes and the accelerating electromagnetic mode, which are conveniently available from the same coupler. The monopole modes are immune to the electron beam offset and therefore are best suited for the task. A coupled circuit model is used to assist the development and to rapidly assess the facility of the method. Simulations based on the circuit model indicate that the resolution of this system depends critically on the signal to noise ratio. Beam-based measurements with a test setup were carried out at the European X-ray Free Electron Laser (XFEL), Germany. Based on this new method, we have routinely obtained a resolution of 0.1°. The best resolution observed with the current setup was 0.03°. These results agree very well with the predictions from those predicted by a circuit model. The system investigated here can be used to provide diagnostic information for the current low level RF system employed in the European XFEL. To this end, the associated electronics are under development. This monitor is the first of its kind that can deliver direct and online measurements of the beam phase with respect to the RF field.
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Affiliation(s)
- L Shi
- School of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Baboi
- Deutsches Elektronen-Synchrotron (DESY), Notkestrasse 85, 22607 Hamburg, Germany
| | - R M Jones
- School of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
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Simpson AIF, Jones RM. Two Challenges Affecting Access to Care for Inmates with Serious Mental Illness: Detecting Illness and Acceptable Services. Can J Psychiatry 2018; 63:648-650. [PMID: 30071756 PMCID: PMC6187441 DOI: 10.1177/0706743718792844] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Alexander I. F. Simpson
- Division of Forensic Psychiatry, Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario
| | - Roland M. Jones
- Division of Forensic Psychiatry, Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario
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Sood S, Haifer C, Yu L, Pavlovic J, Gow PJ, Jones RM, Visvanathan K, Angus PW, Testro AG. Early viral-specific T-cell testing predicts late cytomegalovirus reactivation following liver transplantation. Transpl Infect Dis 2018; 20:e12934. [PMID: 29809312 DOI: 10.1111/tid.12934] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/29/2018] [Accepted: 05/17/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although antiviral prophylaxis is effective in preventing early cytomegalovirus (CMV) reactivation following liver transplantation (OLT), it predisposes patients to late CMV after prophylaxis has ceased. QuantiFERON-CMV (QFN-CMV, Qiagen, The Netherlands) measures an individual's viral-specific immune response. METHODS Fifty-nine OLT recipients were prospectively monitored post-OLT in an observational cohort study. QFN-CMV was performed at regular time-points. An absolute QFN-CMV <0.1 IU/mL was considered non-reactive. RESULTS 50/59 (84.7%) had a reactive QFN-CMV by M6. 38/59 (64.4%) had antiviral prophylaxis or treatment before M6, with 31/38 (81.6%) developing a reactive QFN-CMV by 6 months. Over 90% already had a reactive result as early as 3 months post transplant, 3 patients (5.08%) developed late CMV between 6-12 months (median 251 days)-all had a non-reactive M6 QFN-CMV. And 2/3 experienced CMV disease. Non-reactive M6 QFN-CMV was significantly associated with late CMV (OR = 54.4, PPV = 0.33, NPV = 1.00, P = .003). CONCLUSION Although only 5% of recipients developed late CMV, 2/3 suffered CMV disease. M6 QFN-CMV has an excellent NPV for late CMV, suggesting patients who exhibit a robust ex vivo immune response at M6 can safely cease CMV monitoring. Furthermore, >90% already express viral-specific immunity as early as 3 months. Conceivably, antiviral prophylaxis could be discontinued early in these patients.
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Affiliation(s)
- S Sood
- Liver Transplant Unit Victoria, Austin Health, University of Melbourne, Melbourne, Vic., Australia.,Department of Gastroenterology & Hepatology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Vic., Australia.,Innate Immune Laboratory, St Vincent's Hospital, University of Melbourne, Melbourne, Vic., Australia
| | - C Haifer
- Liver Transplant Unit Victoria, Austin Health, University of Melbourne, Melbourne, Vic., Australia
| | - L Yu
- Innate Immune Laboratory, St Vincent's Hospital, University of Melbourne, Melbourne, Vic., Australia
| | - J Pavlovic
- Liver Transplant Unit Victoria, Austin Health, University of Melbourne, Melbourne, Vic., Australia
| | - P J Gow
- Liver Transplant Unit Victoria, Austin Health, University of Melbourne, Melbourne, Vic., Australia
| | - R M Jones
- Liver Transplant Unit Victoria, Austin Health, University of Melbourne, Melbourne, Vic., Australia
| | - K Visvanathan
- Innate Immune Laboratory, St Vincent's Hospital, University of Melbourne, Melbourne, Vic., Australia
| | - P W Angus
- Liver Transplant Unit Victoria, Austin Health, University of Melbourne, Melbourne, Vic., Australia
| | - A G Testro
- Liver Transplant Unit Victoria, Austin Health, University of Melbourne, Melbourne, Vic., Australia
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Jones RM, Bondurant RG, Hilscher FH, MacDonald JC. 412 Steer Performance Grazing Corn Residue and Supplemented with Modified Distillers Grains Plus Solubles with or without Urea. J Anim Sci 2018. [DOI: 10.1093/jas/sky073.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Telepsychiatry is the delivery of healthcare and the exchange of healthcare information for purposes of providing psychiatric services across distances (Yellowlees et al, 2003). In practice, this most often means an interaction between a patient and clinician who are in different sites, through the use of transmitted live sound and video images. The term telepsychiatry was first used by Dwyer in 1973 who described the use of closed-circuit television at Massachusetts General Hospital for consultations between psychiatrists and patients. However, telemedicine was pioneered at the Nebraska Psychiatric Institute nearly 20 years earlier (Wittson & Dutton, 1956).
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Affiliation(s)
- Roland M Jones
- Complex Care and Recovery Program, Forensic Division, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Alexander I F Simpson
- Complex Care and Recovery Program, Forensic Division, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
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Hassing HA, Engelstoft MS, Sichlau RM, Madsen AN, Rehfeld JF, Pedersen J, Jones RM, Holst JJ, Schwartz TW, Rosenkilde MM, Hansen HS. Oral 2-oleyl glyceryl ether improves glucose tolerance in mice through the GPR119 receptor. Biofactors 2016; 42:665-673. [PMID: 27297962 DOI: 10.1002/biof.1303] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 05/01/2016] [Accepted: 05/18/2016] [Indexed: 12/26/2022]
Abstract
The intestinal G protein-coupled receptor GPR119 is a novel metabolic target involving glucagon-like peptide-1 (GLP-1)-derived insulin-regulated glucose homeostasis. Endogenous and diet-derived lipids, including N-acylethanolamines and 2-monoacylglycerols (2-MAG) activate GPR119. The purpose of this work is to evaluate whether 2-oleoyl glycerol (2-OG) improves glucose tolerance through GPR119, using wild type (WT) and GPR 119 knock out (KO) mice. We here show that GPR119 is essential for 2-OG-mediated release of GLP-1 and CCK from GLUTag cells, since a GPR119 specific antagonist completely abolished the hormone release. Similarly, in isolated primary colonic crypt cultures from WT mice, GPR119 was required for 2-OG-stimulated GLP-1 release while there was no response in crypts from KO mice. In vivo, gavage with 2-oleyl glyceryl ether ((2-OG ether), a stable 2-OG analog with a potency of 5.3 µM for GPR119 with respect to cAMP formation as compared to 2.3 µM for 2-OG), significantly (P < 0.05) improved glucose clearance in WT littermates, but not in GPR119 KO mice. Finally, deletion of GPR119 in mice resulted in lower glucagon levels, whereas the levels of insulin and GIP were unchanged. In the present study we show that 2-OG stimulates GLP-1 secretion through GPR119 activation in vitro, and that fat-derived 2-MAGs are potent candidates for mediating fat-induced GLP-1 release through GPR119 in vivo. © 2016 BioFactors, 42(6):665-673, 2016.
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Affiliation(s)
- H A Hassing
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, Copenhagen, Denmark
- Laboratory for Molecular Pharmacology, Department of Neuroscience and Pharmacology, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
| | - M S Engelstoft
- Laboratory for Molecular Pharmacology, Department of Neuroscience and Pharmacology, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
- Section for Metabolic Receptology and Enteroendocrinology, Novo Nordisk Foundation Center for Metabolic Research, University of Copenhagen, Blegdamsvej 3, Copenhagen, 2200, Denmark
| | - R M Sichlau
- Laboratory for Molecular Pharmacology, Department of Neuroscience and Pharmacology, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
- Section for Metabolic Receptology and Enteroendocrinology, Novo Nordisk Foundation Center for Metabolic Research, University of Copenhagen, Blegdamsvej 3, Copenhagen, 2200, Denmark
| | - A N Madsen
- Laboratory for Molecular Pharmacology, Department of Neuroscience and Pharmacology, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
| | - J F Rehfeld
- Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej, Copenhagen, Denmark
| | - J Pedersen
- Department of Biomedical Science, Endocrinology Research Section, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
| | - R M Jones
- Arena Pharmaceutical Inc, San Diego, CA, 92121, USA
| | - J J Holst
- Department of Biomedical Science, Endocrinology Research Section, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
- Section for Translational Physiology, Novo Nordisk Foundation Center for Metabolic Research, Panum Institute, Blegdamsvej 3, Copenhagen, Denmark
| | - T W Schwartz
- Laboratory for Molecular Pharmacology, Department of Neuroscience and Pharmacology, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
- Section for Metabolic Receptology and Enteroendocrinology, Novo Nordisk Foundation Center for Metabolic Research, University of Copenhagen, Blegdamsvej 3, Copenhagen, 2200, Denmark
| | - M M Rosenkilde
- Laboratory for Molecular Pharmacology, Department of Neuroscience and Pharmacology, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
| | - H S Hansen
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, Copenhagen, Denmark
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Blagborough AM, Musiychuk K, Bi H, Jones RM, Chichester JA, Streatfield S, Sala KA, Zakutansky SE, Upton LM, Sinden RE, Brian I, Biswas S, Sattabonkot J, Yusibov V. Transmission blocking potency and immunogenicity of a plant-produced Pvs25-based subunit vaccine against Plasmodium vivax. Vaccine 2016; 34:3252-9. [PMID: 27177945 PMCID: PMC4915602 DOI: 10.1016/j.vaccine.2016.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/06/2016] [Accepted: 05/03/2016] [Indexed: 01/18/2023]
Abstract
Malaria transmission blocking (TB) vaccines (TBVs) directed against proteins expressed on the sexual stages of Plasmodium parasites are a potentially effective means to reduce transmission. Antibodies induced by TBVs block parasite development in the mosquito, and thus inhibit transmission to further human hosts. The ookinete surface protein P25 is a primary target for TBV development. Recently, transient expression in plants using hybrid viral vectors has demonstrated potential as a strategy for cost-effective and scalable production of recombinant vaccines. Using a plant virus-based expression system, we produced recombinant P25 protein of Plasmodium vivax (Pvs25) in Nicotiana benthamiana fused to a modified lichenase carrier protein. This candidate vaccine, Pvs25-FhCMB, was purified, characterized and evaluated for immunogenicity and efficacy using multiple adjuvants in a transgenic rodent model. An in vivo TB effect of up to a 65% reduction in intensity and 54% reduction in prevalence was observed using Abisco-100 adjuvant. The ability of this immunogen to induce a TB response was additionally combined with heterologous prime-boost vaccination with viral vectors expressing Pvs25. Significant blockade was observed when combining both platforms, achieving a 74% and 68% reduction in intensity and prevalence, respectively. This observation was confirmed by direct membrane feeding on field P. vivax samples, resulting in reductions in intensity/prevalence of 85.3% and 25.5%. These data demonstrate the potential of this vaccine candidate and support the feasibility of expressing Plasmodium antigens in a plant-based system for the production of TBVs, while demonstrating the potential advantages of combining multiple vaccine delivery systems to maximize efficacy.
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Affiliation(s)
- A M Blagborough
- Department of Life Sciences, Sir Alexander Fleming Building, Imperial College London, Imperial College Road, South Kensington, London SW7 2AZ, UK.
| | - K Musiychuk
- Fraunhofer USA Center for Molecular Biotechnology, Newark, DE, USA
| | - H Bi
- Fraunhofer USA Center for Molecular Biotechnology, Newark, DE, USA
| | - R M Jones
- Fraunhofer USA Center for Molecular Biotechnology, Newark, DE, USA
| | - J A Chichester
- Fraunhofer USA Center for Molecular Biotechnology, Newark, DE, USA
| | - S Streatfield
- Fraunhofer USA Center for Molecular Biotechnology, Newark, DE, USA
| | - K A Sala
- Department of Life Sciences, Sir Alexander Fleming Building, Imperial College London, Imperial College Road, South Kensington, London SW7 2AZ, UK
| | - S E Zakutansky
- Department of Life Sciences, Sir Alexander Fleming Building, Imperial College London, Imperial College Road, South Kensington, London SW7 2AZ, UK
| | - L M Upton
- Department of Life Sciences, Sir Alexander Fleming Building, Imperial College London, Imperial College Road, South Kensington, London SW7 2AZ, UK
| | - R E Sinden
- Jenner Institute, The University of Oxford, Roosevelt Road, Oxford OX9 2PP, UK
| | - I Brian
- Jenner Institute, The University of Oxford, Roosevelt Road, Oxford OX9 2PP, UK
| | - S Biswas
- Jenner Institute, The University of Oxford, Roosevelt Road, Oxford OX9 2PP, UK
| | - J Sattabonkot
- Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - V Yusibov
- Fraunhofer USA Center for Molecular Biotechnology, Newark, DE, USA
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Engelstoft MS, Norn C, Hauge M, Holliday ND, Elster L, Lehmann J, Jones RM, Frimurer TM, Schwartz TW. Structural basis for constitutive activity and agonist-induced activation of the enteroendocrine fat sensor GPR119. Br J Pharmacol 2015; 171:5774-89. [PMID: 25117266 DOI: 10.1111/bph.12877] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 08/04/2014] [Accepted: 08/06/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND PURPOSE GPR119 is a Gαs-coupled 7TM receptor activated by endogenous lipids such as oleoylethanolamide (OEA) and by the dietary triglyceride metabolite 2-monoacylglycerol. GPR119 stimulates enteroendocrine hormone and insulin secretion. But despite massive drug discovery efforts in the field, very little is known about the basic molecular pharmacology of GPR119. EXPERIMENTAL APPROACH GPR119 receptor signalling was studied in transfected cells. Mutational mapping (30 mutations in 23 positions) was performed on residues required for ligand-independent and agonist-induced GPR119 activation (AR231453 and OEA). Novel Rosetta-based receptor modelling was applied, using a composite template approach with segments from different X-ray structures and fully flexible ligand docking. KEY RESULTS The increased signalling induced by increasing the cell surface expression of GPR119 in the absence of agonist and the inhibitory effect of two synthetic inverse agonists demonstrated that GRP119 signals with a high degree of constitutive activity through the Gαs pathway. The mutational maps for AR231453 and OEA were very similar and, surprisingly, also similar to the mutational map for residues affecting the constitutive signalling - albeit with key differences. Surprisingly, almost all residues in extracellular loop-2b were important for the constitutive activity. The molecular modelling and docking demonstrated that AR231453 binds in a 'vertical' pocket in between mutational hits reaching from the centre of the receptor out to extracellular loop-2b. CONCLUSIONS AND IMPLICATIONS The high constitutive activity of GPR119 should be taken into account in future drug discovery efforts, which can now be guided by the detailed knowledge of the physiochemical properties of the extended ligand-binding pocket.
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Affiliation(s)
- M S Engelstoft
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Receptology and Enteroendocrinology, University of Copenhagen, Copenhagen, Denmark; Laboratory for Molecular Pharmacology, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
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Page MM, Ekinci EI, Jones RM, Angus PW, Gow PJ, O'Brien RC. Liver transplantation for the treatment of homozygous familial hypercholesterolaemia in an era of emerging lipid-lowering therapies. Intern Med J 2015; 44:601-4. [PMID: 24946816 DOI: 10.1111/imj.12444] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 01/07/2014] [Indexed: 12/24/2022]
Abstract
Homozygous familial hypercholesterolaemia (FH) causes severe premature coronary artery disease because of very high levels of low density lipoprotein (LDL)-cholesterol. Standard lipid-lowering drugs and LDL-apheresis may not be sufficiently effective. Liver transplantation replaces defective LDL receptors and vastly improves the lipid profile, and we present the first report of an Australian adult to receive this treatment. Emerging drug treatments for FH may be alternatives to LDL-apheresis and transplantation, but long-term safety and efficacy data are lacking for all of these options.
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Affiliation(s)
- M M Page
- Lipid Disorders Clinic, Royal Perth Hospital, Perth, Western Australia, Australia
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Young DB, Jones RM. Analytical performance issues: quantifying response time in carbon monoxide monitors to produce high-resolution measurements. J Occup Environ Hyg 2014; 11:D17-D19. [PMID: 24283340 DOI: 10.1080/15459624.2013.839880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- D B Young
- a Division of Environmental and Occupational Health Sciences, School of Public Health , University of Illinois at Chicago , Chicago , Illinois
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Jones RM, Ashford R, Cork J, Palmer S, Wood E, Spyvee P, Parks S, Bennett A, Brewer J, Delahay R, Chambers M, Sawyer J. Evaluation of a method to detect Mycobacterium bovis in air samples from infected Eurasian badgers (Meles meles) and their setts. Lett Appl Microbiol 2013; 56:361-5. [PMID: 23384280 DOI: 10.1111/lam.12055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 01/24/2013] [Accepted: 01/31/2013] [Indexed: 11/29/2022]
Abstract
Environmental air sampling was evaluated as a method to detect the presence of M. bovis in the vicinity of infected badgers and their setts. Airborne particles were collected on gelatine filters using a commercially available air sampling instrument and tested for the presence of M. bovis using bacteriological culture and real-time PCR. The sensitivity of bacteriological culture was broadly similar to that of real-time PCR when testing samples artificially spiked with M. bovis. Sampling was undertaken from directly under the muzzles of badgers which had been experimentally infected with M. bovis (37 samples), within enclosures housing the experimentally infected animals (50 samples), and in the vicinity of setts with resident infected wild badgers (52 samples). The methods employed did not detect M. bovis from either infected badgers or artificial or natural setts known to contain infected animals. However, samples taken at four of the six natural setts were positive for Mycobacterium gordonae.
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Affiliation(s)
- R M Jones
- Animal Health and Veterinary Laboratories Agency Weybridge, Addlestone, UK
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Jones RM, Mercante JW, Neish AS. Reactive oxygen production induced by the gut microbiota: pharmacotherapeutic implications. Curr Med Chem 2012; 19:1519-29. [PMID: 22360484 DOI: 10.2174/092986712799828283] [Citation(s) in RCA: 158] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 12/22/2011] [Accepted: 12/26/2011] [Indexed: 12/18/2022]
Abstract
The resident prokaryotic microbiota of the mammalian intestine influences diverse homeostatic functions, including regulation of cellular growth, maintenance of barrier function, and modulation of immune responses. However, it is unknown how commensal prokaryotic organisms mechanistically influence eukaryotic signaling networks. Recent data has demonstrated that gut epithelia contacted by enteric commensal bacteria rapidly generate reactive oxygen species (ROS). While the induced generation of ROS via stimulation of formyl peptide receptors is a cardinal feature of the cellular response of phagocytes to pathogenic or commensal bacteria, evidence is accumulating that ROS are also similarly elicited in other cell types, including intestinal epithelia, in response to microbial signals. Additionally, ROS have been shown to serve as critical second messengers in multiple signal transduction pathways stimulated by proinflammatory cytokines and growth factors. This physiologically-generated ROS is known to participate in cellular signaling via the rapid and transient oxidative inactivation of a defined class of sensor proteins bearing oxidant-sensitive thiol groups. These proteins include tyrosine phosphatases that serve as regulators of MAP kinase pathways, cytoskeletal dynamics, as well as components involved in control of ubiquitination-mediated NF-κB activation. Consistently, microbial-elicited ROS has been shown to mediate increased cellular proliferation and motility and to modulate innate immune signaling. These results demonstrate how enteric microbiota influence regulatory networks of the mammalian intestinal epithelia. We hypothesize that many of the known effects of the normal microbiota on intestinal physiology, and potential beneficial effects of candidate probiotic bacteria, may be at least partially mediated by this ROS-dependent mechanism.
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Affiliation(s)
- R M Jones
- Emory University School of Medicine, Atlanta, GA 30322, USA
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Pritchard GC, Smith RP, Errington J, Hannon S, Jones RM, Mearns R. Prevalence of Coxiella burnetii in livestock abortion material using PCR. Vet Rec 2011; 169:391. [PMID: 21900261 DOI: 10.1136/vr.d4693] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- G C Pritchard
- Animal Health and Veterinary Laboratories Agency (AHVLA) - Bury St Edmunds, Rougham Hill, Suffolk IP33 2RX, UK.
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Jones RM, Lichtenstein P, Grann M, Långström N, Fazel S. Alcohol use disorders in schizophrenia: a national cohort study of 12,653 patients. J Clin Psychiatry 2011; 72:775-9; quiz 878-9. [PMID: 21733478 DOI: 10.4088/jcp.10m06320] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 10/01/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Comorbid alcohol use disorders (AUDs) in schizophrenia are associated with increased morbidity, more inpatient treatment, and violent offending. It is of clinical importance to identify those with schizophrenia who may go on to develop an alcohol use disorder; however, the risk factors are not well understood. The aim of this study was to identify risk factors for the development of an AUD in patients after they had been diagnosed with schizophrenia. METHOD We conducted a retrospective case-control study of 12,653 individuals diagnosed with ICD-defined schizophrenia in Sweden in 1973-2004, using data from national registers. We tested the associations between individual factors (marital status, immigrant status, and previous violent offending), sociodemographic factors (income and education), and parental risk factors (AUDs, psychosis, and violent offending) ICD-defined and AUD development using logistic regression modeling. RESULTS Over a median follow-up of 17.3 years, 7.6% of patients had at least 1 hospital diagnosis of AUD. After adjustment for gender and age at diagnosis in a multivariate regression model, previous violent offending (OR = 2.1; 95% CI, 1.8-2.5), low education (OR = 1.3; 95% CI, 1.1-1.5), maternal AUD (OR = 1.9; 95% CI, 1.4-2.7), and paternal AUD (OR = 1.9; 95% CI, 1.5-2.3) remained independently associated with increased risk of patient AUD. CONCLUSIONS AUDs are a common sequela of schizophrenia. Risk factors that could be identified at the time of first presentation include low educational attainment, previous violent offending, and parental history of AUDs and may inform clinical treatment and follow-up of those most at risk.
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Affiliation(s)
- Roland M Jones
- Department of Psychological Medicine and Neurology, Cardiff University, Cardiff CF14 4XN, UK.
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Polyakov AV, White TA, Jones RM, Borodin PM, Searle JB. Natural hybridization between extremely divergent chromosomal races of the common shrew (Sorex araneus, Soricidae, Soricomorpha): hybrid zone in Siberia. J Evol Biol 2011; 24:1393-402. [PMID: 21507114 DOI: 10.1111/j.1420-9101.2011.02266.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chromosomal races of the common shrew differ in sets of metacentric chromosomes and on contact may produce hybrids with extraordinarily complex configurations at meiosis I that are associated with reduced fertility. There is an expectation that these may be some of the most extreme tension zones available for study and therefore are of interest as potential sites for reproductive isolation. Here, we analyse one of these zones, between the Novosibirsk race (characterized by metacentrics go, hn, ik, jl, mp and qr) and the Tomsk race (metacentrics gk, hi, jl and mn and acrocentrics o, p, q and r), which form hybrids with a chain-of-nine (CIX) and a chain-of-three (CIII) configuration at meiosis I. At the Novosibirsk-Tomsk hybrid zone, the CIX chromosomes form clines of 8.53 km standardized width on average, whereas the cline for the CIII chromosomes was 52.83 km wide. The difference in these cline widths fits with the difference in meiotic errors expected with the CIX and CIII configuration, and we produce estimates of selection against hybrids with these types of configurations, which we relate to dispersal and age of the hybrid zone. The hybrid zone is located at the isocline at 200 m altitude above sea level; this relationship between the races and altitude is suggested at both coarse and fine scales. This indicates adaptive differences between the races that may in turn have been promoted by the chromosome differences. Thus, the extreme chromosomal divergence between the Novosibirsk and Tomsk may be associated with genic differentiation, but it is still striking that, despite the large chromosomal differences, reproductive isolation between the Novosibirsk and Tomsk races has not occurred.
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Affiliation(s)
- A V Polyakov
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia
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Jones RM, Ellis RJ, Cox WJ, Errington J, Fuller C, Irvine RM, Wakeley PR. Development and validation of RT-PCR tests for the detection and S1 genotyping of infectious bronchitis virus and other closely related gammacoronaviruses within clinical samples. Transbound Emerg Dis 2011; 58:411-20. [PMID: 21477114 PMCID: PMC7169724 DOI: 10.1111/j.1865-1682.2011.01222.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Two tests were developed that allow the detection and genotyping of infectious bronchitis virus (IBV) and other closely related gammacoronaviruses. The first test employs a one-step, reverse transcription-polymerase chain reaction (RT-PCR) assay in which the amplification is monitored in real time using a TaqMan(®) probe. This real-time RT-PCR test was used to examine a panel of field samples and its performance compared to virus isolation in embryonated fowls' eggs. A total of 323 field samples were tested; 176 samples were positive using the real-time RT-PCR method, but only three were positive by virus isolation. Sequencing was used to confirm the positive real-time RT-PCR results for a subset of samples. The test is suitable for swabs and post-mortem samples and has been shown to be highly sensitive and specific. The second test, a genotyping method, was developed for identification of the strain of IBV present in field samples based on nucleotide variations within the gene encoding the S1 subunit of the surface spike (S) glycoprotein. This method was developed to provide a tool to inform vaccination decisions and for ongoing surveillance to detect new and emerging strains of IBV within the UK. The performance of the test was evaluated using laboratory isolates of IBV and field samples. Both tests are suitable for use in a high-throughput diagnostic laboratory.
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Affiliation(s)
- R M Jones
- Veterinary Laboratories Agency, Weybridge, New Haw, Addlestone, Surrey, UK.
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Jones RM, Twomey DF, Hannon S, Errington J, Pritchard GC, Sawyer J. Detection of Coxiella burnetii in placenta and abortion samples from British ruminants using real-time PCR. Vet Rec 2011; 167:965-7. [PMID: 21262712 DOI: 10.1136/vr.c4040] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A real-time PCR was developed to detect Coxiella burnetii (the cause of Q fever) in ruminant placentas and aborted fetuses. Primer and probe sets previously developed for human tissue studies were used to target the insertion sequence IS1111 gene for C burnetii. The assay was highly sensitive, with a limit of detection of 10 copies of template, theoretically equating to a single bacterium, and did not cross-react with a panel of other bacteria. To determine sensitivity on field samples submitted for the diagnosis of abortion, results using the IS1111 PCR assay were compared with a com1 PCR assay. When applied to ruminant abortion material, including placental cotyledons and fetal samples, the IS1111 and com1 assays yielded positive results in 23 (25 per cent) of 93 and 19 (20 per cent) of 93 samples, respectively. One infected goat herd was monitored for 31 months: 57 (92 per cent) of 62 placental cotyledon samples from aborting and non-aborting goats, and 10 (30 per cent) of 33 fetal samples were positive by the IS1111 PCR assay.
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Affiliation(s)
- R M Jones
- Veterinary Laboratories Agency (VLA) - Weybridge, New Haw, Addlestone, Surrey
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Jones RM, Arlidge J, Gillham R, Reagu S, van den Bree M, Taylor PJ. Efficacy of mood stabilisers in the treatment of impulsive or repetitive aggression: systematic review and meta-analysis. Br J Psychiatry 2011; 198:93-8. [PMID: 21282779 DOI: 10.1192/bjp.bp.110.083030] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Individuals with repetitive or impulsive aggression in the absence of other disorders may be diagnosed with intermittent explosive disorder according to DSM-IV, but no such diagnostic category exists in ICD-10. Mood stabilisers are often used off-license for the treatment of aggression associated with a variety of psychiatric conditions, but their efficacy in these and in idiopathic aggression is not known. AIMS To summarise and evaluate the evidence for the efficacy of mood stabilisers (anticonvulsants/lithium) in the treatment of impulsive or repetitive aggression in adults. METHOD A meta-analysis of randomised controlled trials that compared a mood stabiliser with placebo in adults without intellectual disability, organic brain disorder or psychotic illness, identified as exhibiting repetitive or impulsive aggression. RESULTS Ten eligible trials (489 participants) were identified A pooled analysis showed an overall significant reduction in the frequency/severity of aggressive behaviour (standardised mean difference (SMD) = -1.02, 95% CI -1.54 to -0.50), although heterogeneity was high (I(2) = 84.7%). When analysed by drug type, significant effects were found in the pooled analysis of three phenytoin trials (SMD = -1.34, 95% CI -2.16 to -0.52), one lithium trial (SMD = -0.81, 95% CI -1.35 to -0.28), and two oxcarbazepine/carbamazepine trials (SMD = -1.20, 95% CI -1.83 to -0.56). However, when the results of only those studies that had a low risk of bias were pooled (347 participants), there was no significant reduction in aggression (SMD = -0.28, 95% CI -0.73 to 0.17, I(2) = 71.4%). CONCLUSIONS There is evidence that mood stabilisers as a group are significantly better than placebo in reducing aggressive behaviour, but not all mood stabilisers appear to share this effect. There is evidence of efficacy for carbamazepine/oxcarbazepine, phenytoin and lithium. Many studies, however, were at risk of bias and so further randomised controlled trials are recommended.
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Affiliation(s)
- Roland M Jones
- Department of Psychological Medicine and Neurology, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN.
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Bulatova N, Jones RM, White TA, Shchipanov NA, Pavlova SV, Searle JB. Natural hybridization between extremely divergent chromosomal races of the common shrew (Sorex araneus, Soricidae, Soricomorpha): hybrid zone in European Russia. J Evol Biol 2010; 24:573-86. [PMID: 21159004 DOI: 10.1111/j.1420-9101.2010.02191.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Moscow and Seliger chromosomal races of the common shrew differ by Robertsonian fusions and possibly whole-arm reciprocal translocations (WARTs) such that their F₁ hybrids produce a chain-of-eleven configuration at meiosis I and are expected to suffer substantial infertility. Of numerous hybrid zones that have been described in the common shrew, those between the Moscow and Seliger races involve the greatest chromosomal difference. We collected 211 individuals from this zone to generate a total dataset of 298 individuals from 187 unique global positioning system (GPS) locations within the vicinity of interracial contact. We used a geographic information system (GIS) to map the location of the hybrid zone, which follows a direct route between two lakes, as would be anticipated from tension zone theory. Even within the central area of the hybrid zone, there is a much higher frequency of pure race individuals than hybrid, making this a clear example of a bimodal zone in the sense of Jiggins & Mallet (2000). The zone runs through good habitat for common shrews, but nevertheless it is very narrow (standard cline widths: 3-4 km), as would be anticipated from low hybrid fitness. There is clear potential for an interruption to gene flow and build-up of reproductive isolation. As found in some other hybrid zones, there is a high frequency of novel genetic variants, in this case, new chromosomal rearrangements. Here, we report a de novo Robertsonian fission and a de novo reciprocal translocation, both for the first time in the common shrew. There is an extraordinarily high frequency of de novo mutations recorded in F₁ hybrids in the zone and we discuss how chromosomal instability may be associated with such hybrids. The occurrence of a de novo Robertsonian fission is of considerable significance because it provides missing evidence that fissions are the basis of the novel acrocentric forms found and apparently selected for in certain common shrew hybrid zones.
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Affiliation(s)
- N Bulatova
- A. N. Severtsov Institute of Ecology and Evolution, Russian Academy of Sciences, Moscow, Russia
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