Adolescent inpatient activity 1999–2010: analysis of English Hospital Episode Statistics data

Objective: To investigate patterns and trends of adolescent (10–19 years) inpatient activity in England by sex, disease category, and admitting speciality. Data 9 632 844 Finished Consultant Episodes (FCEs) from English patients aged 1–19 between 1999/2000 and 2010/2011 (Hospital Episode Statistics data). Analyses Age trends by sex and major International Classification of Disease 10 (ICD10) chapter; differences in activity rates by age and sex; inpatient activity trends over the past decade, disaggregated by sex, admitting speciality and ICD10 chapter. Results: Adolescent female patients account for more activity than girls aged 1–9 (139.4 vs 107.2 FCEs/1000). Female inpatient activity increases significantly between age 10 (70.9 FCEs/1000) and 19 (281.7 FCES/1000, of which non-obstetric care accounts for 155.9 FCEs/1000). Male activity increases much less during adolescence, with lower overall rates among adolescents than younger children (93.7 vs 142.9 FCEs/1000). Between 1999 and 2010, total adolescent inpatient activity increased faster among adolescents (10–19 years) (+14.2%) than younger children (1–9 years) (+11.0%). Adolescent FCEs/1000 increased by 12.8%, including higher rates admitted under Paediatrics (+47.5%) and Paediatric Surgery (+23.2%). Adolescents were admitted across a range of specialities. Conclusions: These data challenge the belief that adolescents are a healthy group who rarely use inpatient services. In England, use of inpatient services is higher among female patients aged 10–19 years than those aged 1–9 years, while adolescent activity has increased faster than for younger children over the past 11 years. Improving service quality for adolescents will require engagement of the many different teams that care for them

The impact of masculinity upon men with psychosis who reside in secure forensic settings

Purpose Masculinity is a core cognitive structure that plays a central role in organising attitudinal and behavioural processes. Yet there is limited research focussing upon the meaning of masculinity for men who have a past history of violent behaviour, who experience psychotic phenomena and reside in secure forensic settings. The paper aims to discuss these issues. Design/methodology/approach Q-methodology was used to elucidate the factors regarding how men who experience psychotic phenomena perceive their masculinity. Ten participants from a secure forensic setting performed a 49-statement Q-sort task. Findings Principal component factor analysis with varimax rotation was performed on the ten completed Q-sorts which revealed a three-factor solution, accounting for 57 per cent of the variance in the data. The factors were interpreted and discussed under the following headings: “assured and asserting maverick”, “calm, confident, composed conformist” and “nurturing provider in the face of adversity”. This revealed that men with psychosis have different, predominantly pro-social explanatory frameworks for their representation of masculinity. Research limitations/implications This study revealed that men with psychosis have different, predominantly pro-social explanatory frameworks for their representation of masculinity. However, the study was limited by its lack of longitudinal assessment and the inclusion of a greater number of participants may have enhanced the representativeness and generalisability of the findings. Practical implications Therapeutic discussions in respect of masculinity itself could provide men with the opportunity to develop newer, more adaptive conceptualisations of themselves, help them develop greater self-awareness and understanding of the sources of their presenting concerns, which in turn could enhance a provisional formulation of their difficulties. It would also be potentially valuable to understand how these patterns of masculinity map onto coping, recovery style and service engagement. Furthermore, services could also benefit from becoming more aware of hospitalisation being a shameful perhaps stigmatizing time for men with psychosis. Social implications It may be useful for people working in healthcare settings to be aware of how the service users they support perceive their masculinity, so the existential and deeper needs of male patients are provided with enough consideration. This is an important point, as some individuals are often reluctant or neglect to enquire about individual’s psychotic experiences and gender identification. Originality/value Although forensic psychiatric care is primarily populated by men who have committed violent acts, there is a limited research focussing upon the meaning of masculinity in this context. This is in spite of evidence which shows that maladaptive perceptions of masculinity can be reinforced during time spent residing in secure settings. The cultural constructs of masculinity and their respective impact upon the diagnosis, management and outcome of psychosis has also received little attention. Therefore, this research represents new and significant contributions to the field

Gemini/GMOS photometry of intermediate-age star clusters in the Large Magellanic Cloud

We present Gemini South GMOS g,i photometry of 14 intermediate-age Large Magellanic Cloud (LMC) star clusters, namely: NGC 2155, 2161, 2162, 2173, 2203, 2209, 2213, 2231, 2249, Hodge 6, SL 244, 505, 674, and 769, as part of a continuing project to investigate the extended Main Sequence Turnoff (EMSTO) phenomenon. Extensive artificial star tests were made over the observed field of view. These tests reveal the observed behaviour of photometric errors with magnitude and crowding. The cluster stellar density radial profiles were traced from star counts over the extent of the observed field. We adopt clus- ter radii and build colour-magnitude diagrams (CMDs) with cluster features clearly identified. We used the cluster (g,g-i) CMDs to estimate ages from the matching of theoretical isochrones. The studied LMC clusters are confirmed to be intermediate-age clusters, which range in age 9.10 < log(t) < 9.60. NGC 2162 and NGC 2249 look like new EMSTO candidates, in addition to NGC 2209, on the basis of having dual red clumps.Comment: MNRAS, accepte

Determination of mean atmospheric densities from the explorer ix satellite

Mean atmospheric densities from changes in orbital elements of Explorer IX satellit

SkyMapper Southern Survey: First Data Release (DR1)

We present the first data release (DR1) of the SkyMapper Southern Survey, a hemispheric survey carried out with the SkyMapper Telescope at Siding Spring Observatory in Australia. Here, we present the survey strategy, data processing, catalogue construction and database schema. The DR1 dataset includes over 66,000 images from the Shallow Survey component, covering an area of 17,200 deg$^2$ in all six SkyMapper passbands $uvgriz$, while the full area covered by any passband exceeds 20,000 deg$^2$. The catalogues contain over 285 million unique astrophysical objects, complete to roughly 18 mag in all bands. We compare our $griz$ point-source photometry with PanSTARRS1 DR1 and note an RMS scatter of 2%. The internal reproducibility of SkyMapper photometry is on the order of 1%. Astrometric precision is better than 0.2 arcsec based on comparison with Gaia DR1. We describe the end-user database, through which data are presented to the world community, and provide some illustrative science queries.Comment: 31 pages, 19 figures, 10 tables, PASA, accepte

Revised You’re Welcome Criteria and Future Developments in Adolescent Healthcare

In 2011, the Department of Health (England) will publish revised You’re Welcome criteria. This is the first comprehensive attempt to define good quality health services for young people (11-19 years) and provide a self-assessment tool applicable to all adolescent health services. It builds on a growing understanding of the distinctiveness and importance of adolescent health, and the demands placed on adolescent health services. This article reviews changing understandings of the nature of adolescence, including physical, psychological and social transition, evolving patterns of morbidity and mortality, adolescence as part of a life-course approach to health and health behaviours, and the specific needs of young people when using health services. We describe key features of the You're Welcome criteria and discuss the views of young people and professionals involved in revising them, as well as relevant published literature. Lastly, we discuss how the perspective of social paediatrics may be useful in guiding professionals towards a more holistic approach to adolescent care in the future

Ligand selectivity in stabilising tandem parallel folded G-quadruplex motifs in human telomeric DNA sequences

Biophysical studies of ligand interactions with three human telomeric repeat sequences (d(AGGG(TTAGGG)n, n = 3, 7 and 11)) show that an oxazole-based ‘click’ ligand, which induces parallel folded quadruplexes, preferentially stabilises longer telomeric repeats providing evidence for selectivity in binding at the interface between tandem quadruplex motifs

The health benefits of secondary education in adolescents and young adults: An international analysis in 186 low-, middle- and high-income countries from 1990 to 2013.

BACKGROUND: The health benefits of secondary education have been little studied. We undertook country-level longitudinal analyses of the impact of lengthening secondary education on health outcomes amongst 15-24 year olds. METHODS: Exposures: average length of secondary and primary education from 1980 to 2013.Data/Outcomes: Country level adolescent fertility rate (AFR), HIV prevalence and mortality rate from 1989/90 to 2013 across 186 low-, middle- and high-income countries.Analysis: Longitudinal mixed effects models, entering secondary and primary education together, adjusted for time varying GDP and country income status. Longitudinal structural marginal models using inverse probability weighting (IPW) to take account of time varying confounding by primary education and GDP. Counterfactual scenarios of no change in secondary education since 1980/1990 were estimated from model coefficients for each outcome. FINDINGS: Each additional year of secondary education decreased AFR by 8.4% in mixed effects models and 14.6% in IPW models independent of primary education and GDP. Counterfactual analyses showed the proportion of the reduction in adolescent fertility rate over the study period independently attributable to secondary education was 28% in low income countries. Each additional year of secondary education reduced mortality by 16.9% for 15-19 year and 14.8% for 20-24 year old young women and 11.4% for 15-19 year and 8.8% for 20-24 year old young men. Counterfactual scenarios suggested 12% and 23% of the mortality reduction for 15-19 and 20-24 year old young men was attributable to secondary education in low income countries. Each additional year of secondary education was associated with a 24.5% and 43.1% reduction in HIV prevalence amongst young men and women. INTERPRETATION: The health benefits associated with secondary education were greater than those of primary education and were greatest amongst young women and those from low income countries. Secondary education has the potential to be a social vaccine across many outcomes in low and middle income countries

The Extended Main-Sequence Turn-off Clusters of the Large Magellanic Cloud - Missing links in Globular Cluster Evolution

Recent observations of intermediate age (1 - 3 Gyr) massive star clusters in the Large Magellanic Cloud (LMC) have revealed that the majority possess bifurcated or extended main-sequence turn-off (EMSTO) morphologies. This effect can be understood to arise from subsequent star formation amongst the stellar population with age differences between constituent stars amounting to 50 - 300 Myr. Age spreads of this order are similarly invoked to explain the light element abundance variations witnessed in ancient globular clusters. In this paper we explore the proposition that the clusters exhibiting the EMSTO phenomenon are a general phase in the evolution of massive clusters, one that naturally leads to the particular chemical properties of the ancient globular cluster population. We show that the isolation of EMSTO clusters to intermediate ages is the consequence of observational selection effects. In our proposed scenario, the EMSTO phenomenon is identical to that which establishes the light element abundance variations that are ubiquitous in the ancient globular cluster population. Our scenario makes a strong prediction: EMSTO clusters will exhibit abundance variations in the light elements characteristic of the ancient GC population.Comment: ApJ accepted. 33 pages, 5 figure