“It’s a matter of building bridges…” – feasibility of a carer involvement intervention for inpatients with severe mental illness

Background Family and friends (carer) involvement in the treatment of people with mental illness is widely recommended. However, the implementation remains poor, especially during hospital treatment, where carers report being excluded from care decisions. Methods We developed structured clinical procedures to maximise carer involvement in inpatient treatment. The aim of this study was to test their feasibility across four inpatient wards in East London and explore experiences of the participants. The intervention was delivered by clinicians (social therapists, nurses and psychiatrists) who were trained by the research team. Thirty patients and thirty carers received the intervention and completed research assessments and qualitative interviews after the intervention. 80% of the patients were followed up after six weeks of admission to complete quantitative questionnaires. Six clinicians were interviewed to explore their views on the intervention. Thematic analysis was used to analyse qualitative data. Results The intervention was found to be feasible to be delivered within the first week of admission in more than a half of the patients (53%) who provided consent. The main reasons why the interventions was not delivered in the remaining 47% of patients included staff or carers not being available, withdrawal of consent from the patient or patient being discharged prior to the intervention. Two themes were identified through thematic analysis. The first captured participant experiences of the intervention as facilitating a three-way collaborative approach to treatment. The second covered how patients’ mental states and practicalities of inpatient care acted as barriers and facilitators to the intervention being implemented. Conclusions Carer involvement in hospital treatment for mental illness is more difficult to implement than is commonly thought. This study has shown that a simple structured approach can facilitate a trialogue and that patients, clinicians and carers appreciate this approach to care. Our intervention provides clear and simple manualised clinical procedures that clinicians can follow. However, even the implementation of such procedures may be challenging in the absence of wider organisational support. The involvement of senior managers and clinical leaders might play a key role in overcoming barriers and support front-line clinicians to prioritise and implement carer involvement

QCD Down Under: Building Bridges

The strong coupling regime of QCD is responsible for 99% of hadronic phenomena. Though considerable progress has been made in solving QCD in this non-perturbative region, we nevertheless have to rely on a disparate range of models and approximations. If we are to gain an understanding of the underlying physics and not just have numerical answers from computing `` black'' boxes, we must build bridges between the parameter space where models and approximations are valid to the regime describing experiment, and between the different modellings of strong dynamics. We describe here how the Schwinger-Dyson/Bethe-Salpeter approach provides just such a bridge, linking physics, the lattice and experiment.Comment: 8 pages, 10 figures. Opening talk at Workshop on QCD Down Under, March 2004, Barossa Valley and Adelaide (to be published in the Proceedings

Thermal analysis and energy-efficient solutions to preserve listed building façades. The INA-Casa building heritage

Energy efficiency of building heritage derived from pre-regulation period is one of the most debated topics in Europe. Building facades, through opaque walls and thermal bridges, are a major source of transmission heat losses and require sustainable and consistent solutions. Aiming to achieve an energy demand reduction, thermal features of building facades were evaluated by field measurements and simulations for one INA-Casa listed apartment building built in the 1950s. Non-destructive insulating solutions have been proposed and a comparison between transmission heat loss coefficient in the current situation and the designed intervention was made. Results show that before the renovation, opaque walls and thermal bridges respectively contributed to 25% and 44% of total transmission heat loss in the case-study building facade. After the renovation, total impact was reduced up to 70% depending on whether high performance windows were replaced; in particular, the impact of opaque walls and thermal bridges were reduced by 66% and 82%, respectively. Interventions performed primarily on the internal layer of the facade with insulation elements, when appropriately designed, strengthen the negative effects of thermal bridges in junctions. Findings show that an accurate insulation design allows for both more efficient conditions and the preservation of the heritage-listed building

Building bridges--burning bridges

With the banks, the bridge brings to the stream the one and the other expanse of the landscape lying behind them. It brings stream and bank and land into each other's neighborhood. Martin Heidegger, 1951 buildings often carry symbolic messages. Probably the most obvious one is transported by bridges, transforming landscapes, countries, or people, which had been separated before, into neighbors. But, in contradiction to their constitutional idea of peace, bridges can also develop into symbols of a dangerous threat or domination. This is what happens especially in wartime. Shortly after coming into power in the summer of 1933 Adolf Hitler ordered the construction of the Reichsautobahnen, a vast motorway system for Germany. Work on one of the most extensive infrastructure projects of its times was started the same year under supervision of the Inspector General for German Roadways, Fritz Todt. Due to the concept of a street network avoiding intersections at the same level, bridges became a central constituent of the motorway project. Furthermore, besides their technical task, motorway bridges also developed into an important element for propaganda. In fact, even if many of the approximately 5000 motorway bridges built under the Nazi regime cannot be valued as outstanding constructions, the comprehensive quality of design in nearly all the structures--reaching from small culverts to gigantic viaducts--played a key role for the international enthusiasm towards the German motorways. Against many widespread beliefs, the aspect of war preparation only played a marginal role during the first years of motorway construction. But, as the war approached, this situation rapidly changed and especially the bridge builders got increasingly involved in the war machinery. In 1938 Todt was ordered to build a 400-mile-long line of defensive forts and tank traps. Works on this so-called Westwall were supervised by an extraordinarily effective branch office of the Inspectorate General, soon known under the name Organisation Todt (OT). At first only needed for their general engineering skills, many of the bridge builders soon returned to their original profession. Being distributed by the OT on bridge building brigades, they followed on the heels of the forward moving army, rebuilding bridges that had been damaged during the fighting. Surprisingly, the works on the motorways were not totally stopped when the war broke out, and the plans for the motorway network were even extended with every victory of the German army. Thus, also the architects involved in the motorway project had plenty of planning to do. But, the expression of their bridges underwent a decent change. From sober and harmonious engineering structures they developed into gigantic monuments of a conquering, militarized country. When the war tide finally turned, most of these projects still were nothing more than hypertrophic dreams--dreams that finally turned into the nightmare of the destruction of German bridges by the own retreating army. It is the aim of the author to discuss the involvement of German bridge builders in the war process through exemplary projects. Therefore, the paper would mainly focus on the works of some key figures for German bridge building of that time, such as the architects Paul Bonatz and Friedrich Tamms, and the engineers Karl Schaechterle, Gottwalt Schaper and Fritz Leonhardt.hry 2451/29945Conference co-sponsored by the Institute of Fine Arts; Canadian Centre for Architecture, Montreal; and Princeton University's School of Architecture

WAC in FYW: building bridges and teachers as architects

Students entering the first-year writing classroom directly out of high school often tell me that they had to 'write differently for each teacher and class.' Imagine their confusion and apprehension when they are told that one of the objectives of FYW is to prepare them for academic writing across all disciplines! How can teachers incorporate cross-curricular skills into their lessons? More importantly, amongst the already-complex demands on the purposes and goals of FYW courses, how do students learn these techniques that teachers deem 'easily-transferrable'? I argue, first, that the FYW classroom is an ideal location to present students with the individual tools for writing in any discipline. We discuss elements of writing like organization, idea development, thesis statements, citation, and the writing process within our courses as part of the standard curriculum. Therefore, I argue that the multi-faceted roles of FYW teachers include the characteristic of architect, and assert that transforming our lessons into WAC lessons involves the incorporation of examples, standards, and formats from outside disciplines. Mentioning how thesis statements tie together English and Religion papers or how dividing a paper into sections enhances the organization of Biology lab reports and Business reports establishes connections for students. With some simple additions to teachers' lessons, students will find that the writing techniques they learn are just as crucial and useful in both core and major classes. Building these bridges reinforces the lifelong importance of writing and helps students continue to develop their writing skills across and through the college curriculum

Building Bridges

I am deeply honored to assume the role of president of this organization and to stand in front of so many friends and colleagues whom I have known over the years. Many of you are people with whom I have worked through AALS, some are former colleagues from Georgetown or current colleagues from Richmond, and still others I know only through your scholarship and reputation. It is my hope that this year will provide an opportunity for me to reconnect with many of you as we pursue our shared interest in further strengthening and supporting our system of legal education. [...

Building Bridges

A program to help high school students reach their full potential celebrates its 10th year