Mental health and capacity laws in Northern Ireland and the COVID-19 pandemic: Examining powers, procedures and protections under emergency legislation

This article examines the changes made to mental health and capacity laws in Northern Ireland through temporary emergency legislation, known as the Coronavirus Act 2020. The purpose of the legislation was to respond to the emergency situation created by the COVID-19 pandemic, in particular the increase pressure placed on health services in the United Kingdom. An overview is provided of the government's rationale for the changes to Northern Ireland mental health and capacity laws, as well as exploring how they are likely to be operationalised in practice. Consideration is also given as to how such changes may impact upon existing human rights protections for persons assessed as lacking mental capacity. It is argued that it is important that regular parliamentary oversight is maintained in relation to the potential impact and consequences of such changes during the period they are in force. This should be done in order to assess whether they remain a necessary, proportionate and least restrictive response to the challenges faced in managing mental health and capacity issues in Northern Ireland during this public health emergency.

Phyllopertha horticola (Coleoptera: Scarabaeidae) larvae in eastern Austrian mountainous grasslands and the associated damage risk related to soil, topography and management

The soil-dwelling larvae of several Scarabaeidae species (white grubs), like the cockchafer (Melolontha melolontha) and the garden chafer (Phyllopertha horticola), are serious pests in European cultivated grassland, reducing grass yield and destroying the turf by root-feeding. Nevertheless, the factors responsible for the development of large grub populations and the associated damage risk are poorly understood. The objectives of the study were to survey grub densities in grassland sites with different damage histories and find correlations with environmental and management variables. Data on grub densities were collected at 10 farms in the eastern Austrian Alps in September and October 2011. At each farm, one recently damaged site (high risk) and one site at which grub damage had never been observed by the farmers (undamaged site = low risk; each site: 500 m²) were sampled. All sites were dominated by P. horticola (99% of 1,422 collected individuals; maximum density 303 grubs/m²), which indicates that grub damage there is mainly caused by that species. Recently damaged sites tended to higher grub densities than undamaged sites. However, 3 out of 10 undamaged sites harbored high grub populations as well. Humus content together with the depth of the A-horizon significantly explained 38% of P. horticola grub density variance, with highest densities in deeper humus-rich soils. The risk of grub damage was positively connected to the humus content and negatively related to the cutting frequency. For the investigated mountainous grassland sites, these results suggest an important role of humus for the development of high grub densities and an effect of management intensity on grub damage.

Subsurface earthworm casts can be important soil microsites specifically influencing the growth of grassland plants

Earthworms (Annelida: Oligochaeta) deposit several tons per hectare of casts enriched in nutrients and/or arbuscular mycorrhizal fungi (AMF) and create a spatial and temporal soil heterogeneity that can play a role in structuring plant communities. However, while we begin to understand the role of surface casts, it is still unclear to what extent plants utilize subsurface casts. We conducted a greenhouse experiment using large mesocosms (volume 45 l) to test whether (1) soil microsites consisting of earthworm casts with or without AMF (four Glomus taxa) affect the biomass production of 11 grassland plant species comprising the three functional groups grasses, forbs, and legumes, (2) different ecological groups of earthworms (soil dwellers-Aporrectodea caliginosa vs. vertical burrowers-Lumbricus terrestris) alter potential influences of soil microsites (i.e., four earthworms × two subsurface microsites × two AMF treatments). Soil microsites were artificially inserted in a 25-cm depth, and afterwards, plant species were sown in a regular pattern; the experiment ran for 6 months. Our results show that minute amounts of subsurface casts (0.89 g kg-1 soil) decreased the shoot and root production of forbs and legumes, but not that of grasses. The presence of earthworms reduced root biomass of grasses only. Our data also suggest that subsurface casts provide microsites from which root AMF colonization can start. Ecological groups of earthworms did not differ in their effects on plant production or AMF distribution. Taken together, these findings suggest that subsurface earthworm casts might play a role in structuring plant communities by specifically affecting the growth of certain functional groups of plants.

Comparison of extradural fentanyl, bupivacaine and two fentanyl-bupivacaine mixtures of pain relief after abdominal surgery

Fentanyl 50 micrograms, bupivacaine 50 mg and two mixtures containing fentanyl 50 micrograms and bupivacaine 25 mg or 12.5 mg (0.25 and 0.125%), respectively, in a volume of 10 ml were administered via thoracic extradural catheters to 24 patients after major abdominal surgery. All patients received all four treatments, in a randomized order, so that each patient received one of the 24 possible combinations of the four treatments. Pain relief was assessed by a linear analogue pain scale and the Prince Henry Hospital pain score. The duration of pain relief, effects on ventilatory frequency, heart rate, arterial pressure and central venous pressure were also recorded. Mean reductions in the analogue pain scale for fentanyl, bupivacaine, and fentanyl in 0.25% and 0.125% bupivacaine were 80 (SEM 5) %, 87 (4) %, 86 (5) % and 77 (5) %, respectively (ns). Pain scores decreased by 62 (6) %, 83 (5) %, 77 (6) % and 72 (6) %, respectively (ns). Mean arterial pressure decreased to 90 (2) %, 70 (2) %, 81 (2) % and 82 (3) %, respectively, of pretreatment values. In this respect, bupivacaine alone was significantly different from the three other treatments (P < 0.001). Hypotension (reduction in arterial pressure greater than 25% of pretreatment mean arterial pressure) was also more frequent after bupivacaine alone (P < 0.01). Effects on ventilation, heart rate and central venous pressure did not differ between the four treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

[Chronic polyneuritis of the Guillain-Barré type. Significance of long-term electroneurographic follow-up findings]

Nineteen patients with various forms of chronic polyneuritis of the Guillain-Barré type were attributed by uniform clinical criteria to the different subgroups and their electroneurographic findings followed during the clinical course. The follow-up studies were conducted for 1 to 12 years with a mean of 5.3 years. All patients were treated with steroids and/or Azathioprin, in addition, six patients were subjected to plasma exchange therapy. Of the 13 patients without plasma exchange four demonstrated improvement of electroneurographic parameters, four were unchanged, two deteriorated. The six patients treated with additional plasma exchange showed improvement in four cases and deterioration in two cases. No correlation was found between clinical findings and long-term electroneurographic data. Improvement of electroneurographic data was usually less impressive than the clinical recovery. Following plasma exchange treatment three patients showed remarkable, however only temporary improvement of electroneurographic data which also did not correlate to the long-term outcome. Therefore, the long-term follow-up of electroneurographic findings renders no decisive prognostic statement in chronic polyneuritis.

Focal intracerebral accumulation of a novel type of amyloid protein. An early stage of cerebral amyloidoma?

The brain of a 60-year-old patient with bronchial carcinoma presented a focal amyloid deposit in the white matter associated with myelin and axonal destruction. An additional lesion was found in the basal ganglia. This silent focal intracerebral accumulation of amyloid substance may be a prestadium of a "cerebral amyloidoma". The histochemical and immunohistochemical analysis of the accumulated amyloid indicated that it may belong to a novel type of amyloid.

The angiogenesis of the micrencephalic rat brains caused by methylazoxymethanol acetate. III. Internal angioarchitecture of cortex

The intracortical angioarchitecture of normal and micrencephalic rat brains was examined. The neuroblast migration was disturbed by injection of the neurotoxin methylazoxymethanol acetate, administered on day E14. The internal vascularization of the malformed cortex showed severe damage to the layered distribution of vascular trunks in contrast to controls. A pathological course and marked variability in the density of the radial vessels were seen in the parieto-occipital areas, in which the neuroblast migration was most severely affected. These observations show the decisive role of neuroblast migration and maturation in the development of the cortical angioarchitecture.

[Plasma exchange treatment in chronic polyneuritis of the Guillain-Barré type. Experiences with 9 personal cases]

Following a review of pertinent literature, nine cases of chronic polyneuritis are reported, who underwent a total of 21 series of plasma exchange treatment during immunosuppressive medication. The effect of treatment was variable. Four out of 7 patients with relapsing and/or stepwise progressive disease demonstrated reproducible improvement of neurological signs. The three others responded to a lesser degree. Two patients with a chronic progressive course experienced only mild improvement. In general, the reaction to plasma exchange did not correlate with duration and severity of the previous clinical course, reaction to immunosuppressive drugs, or electrophysiological and morphological findings in muscle and nerve biopsies. Moreover, a clear correlation with pathogenic effects of patient-IgG in animal experiments ("passive transfer") was not discernible.