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Secure forensic mental health services offer care and treatment to mentally disordered offenders, with high rates of schizophrenia and major mental illness in these groups. Much of the excess morbidity and mortality seen among patients with schizophrenia is due to cardiovascular disease and obesity. Sedentary behaviour is associated with negative symptoms of schizophrenia and obesity.
The aim of this study was to ascertain the level of sedentary behaviour among inpatients in a secure forensic psychiatric hospital, Dundrum, Ireland, using a structured self-report measure of sedentary behaviours, the SIT-Q
A cross sectional study of self-reported sedentary behaviour was completed amongst the secure forensic inpatient population of Dundrum Hospital (N=94). Demographic details, details pertaining to diagnoses, ward level of dependency and length of stay were collated.
The majority of patients in the sample were male (89%) and the most common diagnosis was schizophrenia (71.7%). Mean age was 44.7 years (SD 11.42). 58.2% met criteria for obesity. We found high rates of self-reported sedentary behaviour across all wards of the service, with significantly high rates of sedentary behaviour being associated with screen time use in the hospital, including both personal screen time and therapeutic sessions based on screen time.
Sedentary behaviour among in-patients in secure forensic hospitals is a significant issue. Measuring sedentary behaviour in a systematic manner is possible and identifies a potentially modifiable target to reduce co-morbidity and pre-mature mortality independent of other risk factors in this vulnerable patient group.
Secure forensic mental health services treat patient with high rates of treatment resistant psychoses, typically schizophrenia. These groups have high rates of obesity and medical co-morbidities. Population based studies have identified high risk groups in the event of SARS-CoV-2 infection, including those with long term medical conditions.
The aim of this study was to compare the vulnerability to serious adverse outcome in the event of COVID-19 infection in a forensic psychiatric patient population.
All patients of a complete National Forensic Mental Health Service (n=141) were rated for risk of adverse outcome in the event of SARS-CoV-2 infection, using two structured tools, the COVID-AGE tool and the COVID-Risk tool.
Eighty-two patients (58.2%) met criteria for obesity, 32 had type II diabetes and 28 were hypertensive. Mean chronological age was 45.5 years (SD 11.4, median 44.1), while mean COVID-AGE was 59.1 years (SD 19.4, median 58.0), mean difference 13.6 years (SD 15.6) paired t=10.9, df=140, p=0.000. Three patients (2.1%) were chronologically over 70 years compared to 40 (28.4%) with a COVID-AGE over 70 (X2=6.99, df=1, p=0.008, Fishers exact test p=0.027).
These risk assessments may identify the extent of increased risk among a uniquely medically vulnerable patient group. Patients in secure forensic psychiatric services represent a high-risk group for adverse outcomes in the event of SARS-COV-2 infection. Population based cocooning and self-isolating guidance based on chronological age may not be sufficient. There is an urgent need for better physical health research and treatment in this group.
The World Health Organization has developed training material to support its QualityRights Initiative. These documents offer excellent strategies to limit coercion. However, the negative portrayal of psychiatry, the absolute prohibition on involuntary treatment and the apparent acceptance of the criminalisation of individuals with mental illness are causes for concern.
Since the discovery of periodic variability of Class II methanol masers associated with high-mass star formation, several possible driving mechanisms have been proposed to explain this phenomenon. Here the colliding wind binary (CWB) hypothesis is proposed to describe the periodic variability. It is shown that the recombination of a partially ionized gas describes the flare profiles remarkably well. In addition, the quiescent state flux density is also described remarkably well by the time-dependent change of the electron density. This suggests that the periodicity is caused by the time-dependent change in the radio free-free emission from the background HII regions against which the maser is projected.
Begun in 1874 and published in 1880, a detailed survey of the stones of Stonehenge was one of the earliest works of William Matthew Flinders Petrie (1853–1942), the energetic archaeologist who is remembered as a pioneering Egyptologist. It is reissued here alongside Sir Richard Colt Hoare's 1829 analysis of the barrows surrounding Stonehenge, thus giving modern readers a valuable two-part snapshot of nineteenth-century investigations into this famous site. Hoare (1758–1838), a Wiltshire baronet with a keen interest in archaeology and topography, conducted excavations on the site of the stones in the early 1800s, which were later referred to by Petrie, whose measurements were much more accurate (up to one tenth of an inch). Petrie's numbering system for the stones, as set out in this publication, is still in use today. Many of his groundbreaking works in Egyptology are also reissued in the Cambridge Library Collection.