Outside the protection of Earth's atmosphere, astronauts are exposed to low doses of high linear energy transfer (LET) radiation. Future NASA plans for deep space missions or a permanent settlement on the moon are limited by the health risks associated with space radiation exposures. There is a paucity of direct epidemiological data for low dose exposures to space radiation-relevant high LET ions. Health risk models are used to estimate the risk for such exposures, though these models are based on high dose experiments. There is increasing evidence, however, that low and high dose exposures result in different signaling events at the molecular level, and may involve different response mechanisms. Further, despite their low abundance, high LET particles have been identified as the major contributor to health risk during manned space flight. The human skin is exposed in every external radiation scenario, making it an ideal epithelial tissue model in which to study radiation induced effects. Here, we exposed an in vitro three dimensional (3-D) human organotypic skin tissue model to low doses of high LET oxygen (O), silicon (Si) and iron (Fe) ions. We measured proliferation and differentiation profiles in the skin tissue and examined the integrity of the skin's barrier function. We discuss the role of secondary particles in changing the proportion of cells receiving a radiation dose, emphasizing the possible impact on radiation-induced health issues in astronauts.
Patients who have been discharged from forensic services often have conditions they have to abide by as part of their discharge, and failure to do so leads to recall. We interviewed six men who had been conditionally discharged from forensic services and then been recalled into hospital to find out what they thought went wrong. The reasons they gave for why things went wrong included feeling that the system was unfair and made them feel like criminals even though they did not feel they had put anyone at risk. Some of them were not fully aware of the conditions they needed to adhere to, and some of them had breached the conditions but did not take responsibility for what had happened. In addition, supervision was felt to be very controlling and disruptive rather than supportive when patients were often lonely, bored and needing support. Most participants reported that they experienced poor standards of aftercare in hostels they were required to reside in. In the future, care of patients after conditional discharge should include better communication between patients and their supervisory team, recognition of the need for more support and improvements in the standards of care in hostels, as well as a collaborative approach to risk assessment that might reduce the frequency of relapse and readmission. This study explores how male patients suffering from dual diagnosis in a forensic unit perceive being recalled and readmitted following conditional discharge and their views about how services might be improved. A qualitative approach was used drawing on grounded theory techniques. Audiotaped semistructured interviews collected data from a purposefully selected sample of six participants who had been recalled and met the inclusion criteria of the study. Data were analysed using the constant comparative method. Most participants perceived the recall system as unfair, inappropriately criminalized their behaviour and was based on an assessment of risk that they did not understand or accept. Participants were not fully aware of the conditions of their discharge, and most did not accept responsibility for their role in being recalled and blamed the system. Care following discharge was rarely seen as positive, and poor standards in hostels were reported by most participants. Supervision was often seen as disruptive and controlling, and focused more on surveillance rather than support. Better communication might have helped them understand and adhere to the conditions of their discharge. Participants identified the importance of family and friends to their recovery, the importance of having their own accommodation, and the need to be more independent.
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