Which doctors and with what problems contact a specialist service for doctors? A cross sectional investigation

Background: In the United Kingdom, specialist treatment and intervention services for doctors are underdeveloped. The MedNet programme, created in 1997 and funded by the London Deanery, aims to fill this gap by providing a self-referral, face-to-face, psychotherapeutic assessment service for doctors in London and South-East England. MedNet was designed to be a low-threshold service, targeting doctors without formal psychiatric problems. The aim of this study was to delineate the characteristics of doctors utilising the service, to describe their psychological morbidity, and to determine if early intervention is achieved. Methods: A cross-sectional study including all consecutive self-referred doctors (n = 121, 50% male) presenting in 2002–2004 was conducted. Measures included standardised and bespoke questionnaires both self-report and clinician completed. The multi-dimensional evaluation included: demographics, CORE (CORE-OM, CORE-Workplace and CORE-A) an instrument designed to evaluate the psychological difficulties of patients referred to outpatient services, Brief Symptom Inventory to quantify caseness and formal psychiatric illness, and Maslach Burnout Inventory. Results: The most prevalent presenting problems included depression, anxiety, interpersonal, self-esteem and work-related issues. However, only 9% of the cohort were identified as severely distressed psychiatrically using this measure. In approximately 50% of the sample, problems first presented in the preceding year. About 25% were on sick leave at the time of consultation, while 50% took little or no leave in the prior 12 months. A total of 42% were considered to be at some risk of suicide, with more than 25% considered to have a moderate to severe risk. There were no significant gender differences in type of morbidity, severity or days off sick. Conclusion: Doctors displayed high levels of distress as reflected in the significant proportion of those who were at some risk of suicide; however, low rates of severe psychiatric illness were detected. These findings suggest that MedNet clients represent both ends of the spectrum of severity, enabling early clinical engagement for a significant proportion of cases that is of importance both in terms of personal health and protecting patient care, and providing a timely intervention for those who are at risk, a group for whom rapid intervention services are in need and an area that requires further investigation in the UK

The Shape of Things to Come: New Urbanism, the Grid and the Cul-De-Sac

There is much debate in the UK, North America and Australia within both crime prevention and planning concerning New Urbanism and the design of suburban housing layouts. New Urbanism promotes high-density, mixed-use residential developments in "walkable" neighbourhoods close to public transport, employment and amenities. One significant factor is New Urbanism's support for permeability and the preference of the grid street layout over the cul-de-sac (Morrow-Jones et al., 2004). The authors present the evidence as it relates to the grid and the cul-de-sac across a range of inter-disciplinary issues such as crime, walkability, social interaction, travel behaviour, traffic safety, cost and sustainability and housing preferences.This paper provides a brief history of the grid and cul-de-sac, discusses their respective strengths and weaknesses and concludes that any "one-size-fits-all" approach is myopic and simplistic. It calls for a more holistic approach to understanding the localised and contextual dimension to suburban street layouts and how they may affect human behaviour. The paper highlights key areas for future research and calls for more inter-disciplinary debate and cooperation, particularly between environmental criminologists, planners and town centre managers

Live to cheat another day: bacterial dormancy facilitates the social exploitation of beta-lactamases

The breakdown of antibiotics by β-lactamases may be cooperative, since resistant cells can detoxify their environment and facilitate the growth of susceptible neighbours. However, previous studies of this phenomenon have used artificial bacterial vectors or engineered bacteria to increase the secretion of β-lactamases from cells. Here, we investigated whether a broad-spectrum β-lactamase gene carried by a naturally occurring plasmid (pCT) is cooperative under a range of conditions. In ordinary batch culture on solid media, there was little or no evidence that resistant bacteria could protect susceptible cells from ampicillin, although resistant colonies could locally detoxify this growth medium. However, when susceptible cells were inoculated at high densities, late-appearing phenotypically susceptible bacteria grew in the vicinity of resistant colonies. We infer that persisters, cells that have survived antibiotics by undergoing a period of dormancy, founded these satellite colonies. The number of persister colonies was positively correlated with the density of resistant colonies and increased as antibiotic concentrations decreased. We argue that detoxification can be cooperative under a limited range of conditions: if the toxins are bacteriostatic rather than bacteridical; or if susceptible cells invade communities after resistant bacteria; or if dormancy allows susceptible cells to avoid bactericides. Resistance and tolerance were previously thought to be independent solutions for surviving antibiotics. Here, we show that these are interacting strategies: the presence of bacteria adopting one solution can have substantial effects on the fitness of their neighbours

Limiting white pine weevil attacks by side and overstory shade in the Prince George Forest Region

A study was initiated in 1985 to measure the effects of side and overstory shade on attack by white pine weevil and on annual growth in interior white spruce. The study was undertaken in the Prince George Forest Region where the weevil causes extensive damage to plantations of interior white spruce. Annual attack rates decreased significantly with increased brush cover. The treatment with side shade was achieved using narrow strip cuts running east and west. Side and overstory shade also reduced annual growth. Results indicate that up to 6% reductions in annual attack rates could be expected for at least 5 years following treatment but that differences in attack rates between treatments took at least three years to appear

Managing crime and the fear of crime at railway stations––a case study in South Wales (UK)

Rail users consistently perceive their risks from crime to be significantly higher than official statistics suggest, discouraging many from using rail transport. The aims of the paper include a discussion of Crime Prevention Through Environmental Design (CPTED) and current policy initiatives for reducing crime and the fear of crime on the railways. This exploratory study focuses on adult passengers' perceptions of crime and nuisance as they relate to the management, design and maintenance of railway stations and their immediate access routes. The study innovatively utilises interactive virtual reality (VR) scenes of ‘representative' stations as the environmental stimulus and concludes that such an approach provides an analytical and pragmatic framework for managers of railway stations that are unlikely to receive Secure Station accreditation

Tackling Crime and Fear of Crime Whilst Waiting at Britain's Railway Stations

Crime on the railways in Britain is an increasing concern for train operating companies,the British Transport Police (BTP), passengers, and local residents. Significantly,rail users consistently perceive their risks from crime to be considerably higher thanofficial crime statistics indicate, having a negative affect on levels of patronage. Thisarticle presents an exploratory study of passengers’ fear of crime while waiting atrailway stations using Quick Time Virtual Reality (QTVR) walkthrough scenes. QTVRarguably represents an innovative, dynamic, and interactive environmental stimulusfor gaining insights into passengers’ fear of crime. Visibility at stations was identifiedas a crucial factor in determining levels of fear of crime. The design of the stationshelter is analyzed as an example of how crime prevention through environmentaldesign (CPTED) is being implemented on railway stations by Valley Lines (Wales and Borders Trains) on its network in South Wales (UK)

Beta defensin-2 is reduced in central but not in distal airways of smoker COPD patients

Background: Altered pulmonary defenses in chronic obstructive pulmonary disease (COPD) may promote distal airways bacterial colonization. The expression/activation of Toll Like receptors (TLR) and beta 2 defensin (HBD2) release by epithelial cells crucially affect pulmonary defence mechanisms. Methods: The epithelial expression of TLR4 and of HBD2 was assessed in surgical specimens from current smokers COPD (s-COPD; n = 17), ex-smokers COPD (ex-s-COPD; n = 8), smokers without COPD (S; n = 12), and from non-smoker non-COPD subjects (C; n = 13). Results: In distal airways, s-COPD highly expressed TLR4 and HBD2. In central airways, S and s-COPD showed increased TLR4 expression. Lower HBD2 expression was observed in central airways of s-COPD when compared to S and to ex-s-COPD. s-COPD had a reduced HBD2 gene expression as demonstrated by real-time PCR on micro-dissected bronchial epithelial cells. Furthermore, HBD2 expression positively correlated with FEV1/FVC ratio and inversely correlated with the cigarette smoke exposure. In a bronchial epithelial cell line (16 HBE) IL-1β significantly induced the HBD2 mRNA expression and cigarette smoke extracts significantly counteracted this IL-1 mediated effect reducing both the activation of NFkB pathway and the interaction between NFkB and HBD2 promoter. Conclusions: This study provides new insights on the possible mechanisms involved in the alteration of innate immunity mechanisms in COPD. © 2012 Pace et al

Second broods of Pissodes strobi (Coleoptera: Curculionidae) in previously attacked leaders of Interior spruce

Oviposition and successful brood production by spruce weevil, Pissodes strobi, were observed below the previous year’s attacked, dead leader in as many as 19.5 percent of current attacked trees in a 15-year-old plantation of interior spruce. This occurrence may have significant impacts upon weevil survey and control programmes and, ultimately, the regime under which the stand will be managed

What do older people learn from young people? : Intergenerational learning in ‘day centre’ community settings in Malta

This study analyses what motivates older people to attend ‘day centres’ in Malta and what they believe that they derive from young people who carry out their placements at these day ‘centres’ These young people, who are aged 16–17, attend a vocational college in Malta and are studying health and social care. The study is based on a qualitative approach and employs the usage of focus groups. The main findings are that the elderly see the students as helping them on an emotional level by giving them encouragement, and on a practical level, by offering them insights that help them in modern-day life