Prisons in England and Wales have reached a low point in service delivery. Despite initial improvements after National Health Service transfer in 2006, it has deteriorated since 2010, with numerous reports giving cause for concern. Improvements are now urgently required, and political courage and a revised national programme of expenditure are necessary.

Apart from their effector functions in allergic disorders, tissue-resident mast cells (MC) are gaining recognition as initiators of inflammatory events through their distinctive ability to secrete many bioactive molecules harbored in cytoplasmic granules. Activation triggers mediator release through a regulated exocytosis named degranulation. MC activation is still substantiated by measuring systemic levels of MC-restricted mediators. However, identifying the anatomical location of MC activation is valuable for disease diagnosis. We designed a computer-assisted morphometric method based on image analysis of methylene blue (MB)-stained normal mouse skin tissue sections that quantitates actual in situ MC activation status. We reasoned MC cytoplasm could be viewed as an object featuring unique relative mass values based on activation status. Integrated optical density and area (A) ratios were significantly different between intact and degranulated MC (p<0.001). The examination of fractal characteristics is of translational diagnostic/prognostic value in cancer and readily applied to quantify cytoskeleton morphology and vasculature. Fractal dimension (D), a measure of their comparative space filling capacity and structural density, also differed significantly between intact and degranulated MC (p<0.001). Morphometric analysis provides a reliable and reproducible method for in situ quantification of MC activation status.

The elevated risk of suicide in prison and after release is a well-recognised and serious problem. Despite this, evidence concerning community-based offenders' suicide risk is sparse. We conducted a population-based nested case–control study of all people in a community justice pathway in England and Wales. Our data show 13% of general population suicides were in community justice pathways before death. Suicide risks were highest among individuals receiving police cautions, and those having recent, or impending prosecution for sexual offences. Findings have implications for the training and practice of clinicians identifying and assessing suicidality, and offering support to those at elevated risk.

Shell artefacts in Island Southeast Asia have often been considered local variants of ground-stone implements, introduced in the Late Pleistocene from Mainland Southeast Asia. The discovery of a well-preserved Tridacna shell adze from Ilin Island in the Philippines, suggests, however, a different interpretation. Using radiocarbon dating, X-ray diffraction and stratigraphic and chronological placement within the archaeological record, the authors place the ‘old shell’ effect into context, and suggest that shell technology was in fact a local innovation that emerged in the early Middle Holocene. The chronology and distribution of these artefacts has significant implications for the antiquity of early human interaction between the Philippines and Melanesia. It may have occurred long before the migrations of Austronesian-speaking peoples and the emergence of the Lapita Cultural Complex that are traditionally thought to mark the first contact.

The authors compare pottery assemblages in the Marianas and the Philippines to claim endorsement for a first human expansion into the open Pacific around 1500 BC. The Marianas are separated from the Philippines by 2300km of open sea, so they are proposing an epic pioneering voyage of men and women, with presumably some cultivated plants but apparently no animals. How did they manage this unprecedented journey?