Treatment approaches for dual diagnosis clients in England

Introduction - Dual diagnosis (DD, co-occurrence of substance use and mental health problems) prevalence data in England are limited to specific regions and reported rates vary widely. Reliable information on actual service provision for dual diagnosis clients has not been collated. Thus a national survey was carried out to estimate dual diagnosis prevalence in treatment populations and describe the service provision available for this client population in drug/alcohol (DAS) and mental health services (MHS). Design - A questionnaire was sent to managers of 706 DAS and 2374 MHS. Overall, 249 (39%) DAS and 493 (23%) MHS participated in the survey. Results - In both DAS and MHS, around 32% of clients were estimated to have dual diagnosis problems. However, fewer than 50% of services reported assessing clients for both problem areas. Regarding specific treatment approaches, most services (DAS: 88%, MHS: 87%) indicated working jointly with other agencies. Significantly fewer services used joint protocols (DAS: 55%, MHS: 48%) or shared care arrangements, including access to external drug/alcohol or mental health teams (DAS: 47%, MHS: 54%). Only 25% of DAS and 17% of MHS employed dual diagnosis specialists. Conclusions - Dual diagnosis clients constitute a substantial proportion of clients in both DAS and MHS in England. Despite recent policy initiatives, joint working approaches tend to remain unstructured

Gradient design of metal hollow sphere (MHS) foams with density gradients

This is the post-print version of the final paper published in Composites Part B: Engineering. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2011 Elsevier B.V.Metal hollow sphere (MHS) structures with a density gradient have attracted increasing attention in the effort to pursue improved energy absorption properties. In this paper, dynamic crushing of MHS structures of different gradients are discussed, with the gradients being received by stacks of hollow spheres of the same external diameter but different wall thicknesses in the crushing direction. Based on the dynamic performance of MHS structures with uniform density, a crude semi-empirical model is developed for the design of MHS structures in terms of gradient selections for energy absorption and protection against impact. Following this, dynamic responses of density graded MHS foams are comparatively analyzed using explicit finite element simulation and the proposed formula. Results show that the simple semi-empirical model can predict the response of density gradient MHS foams and is ready-to-use in the gradient design of MHS structures.The National Science Foundation of China and the State Key Laboratory of Explosion Science and Technology (Beijing Institute of Technology

On the extrapolation of magneto-hydro-static equilibria on the sun

Modeling the interface region between solar photosphere and corona is challenging, because the relative importance of magnetic and plasma forces change by several orders of magnitude. While the solar corona can be modeled by the force-free assumption, we need to take care about plasma forces (pressure gradient and gravity) in photosphere and chromosphere, here within the magneto-hydro-static (MHS) model. We solve the MHS equations with the help of an optimization principle and use vector magnetogram as boundary condition. Positive pressure and density are ensured by replacing them with two new basic variables. The Lorentz force during optimization is used to update the plasma pressure on the bottom boundary, which makes the new extrapolation works even without pressure measurement on the photosphere. Our code is tested by using a linear MHS model as reference. From the detailed analyses, we find that the newly developed MHS extrapolation recovers the reference model at high accuracy. The MHS extrapolation is, however, numerically more expensive than the nonlinear force-free field (NLFFF) extrapolation and consequently one should limit their application to regions where plasma forces become important, e.g. in a layer of about 2 Mm above the photosphere.Comment: accepted for publication in Ap

Constraining isocurvature perturbations with the 21 cm emission from minihaloes

We investigate the effects of isocurvature perturbations on the 21 cm radiation from minihaloes (MHs) at high redshifts and examine constraints on the isocurvature amplitude and power spectrum using the next generation of radio telescopes such as the Square Kilometre Array. We find that there is a realistic prospect of observing the isocurvature imprints in the 21 cm emission from MHs, but only if the isocurvature spectral index is close to 3 (i.e. the spectrum is blue). When the isocurvature fraction increases beyond ∼10 per cent of the adiabatic component, we observe an unexpected decline in the 21 cm fluctuations from small-mass MHs, which can be explained by the incorporation small MHs into larger haloes. We perform a detailed Fisher-matrix analysis and conclude that the combination of future cosmic microwave background and 21 cm experiments (such as CMBPol and the Fast Fourier Transform Telescope) is ideal in constraining the isocurvature parameters, but will stop short of distinguishing between cold dark matter and baryon types of isocurvature perturbations, unless the isocurvature fraction is large and the spectrum is blue

A coordinate free description of magnetohydrostatic equilibria

The question what geometrical restrictions are imposed on static magnetic fields by the magnetohydrostatic (MHS) equation is addressed. The general mathematical problem is therefore to determine the solutions of the MHS equations in the corona subject to an arbitrary normal component of the magnetic field at the boundary and arbitrary connectivity. What constraints the MHS equations impose on the geometry of the solutions, expressed in metric tensors, will be determined

The mixed Hodge structure on the fundamental group of hyperelliptic curves and higher cycles

In this paper we give a geometrical interpretation of an extension of mixed Hodge structures (MHS) obtained from the canonical MHS on the group ring of the fundamental group of a hyperelliptic curve modulo the fourth power of its augmentation ideal. We show that the class of this extension coincides with the regulator image of a canonical higher cycle in a hyperelliptic jacobian. This higher cycle was introduced and studied by Collino.Comment: 22 pages, 3 figures. To appear in: Journal of Algebraic Geometr

Trends and impact factors of mental health service utilization among resettled humanitarian migrants in Australia : findings from the BNLA cohort study

Resettled humanitarian migrants (HMs) have high levels of mental disorders, but factors associated with the utilization of mental health services (MHS) are poorly understood. We aimed to explore trends and impact factors of MHS utilization among HMs in the process of resettlement in Australia. A total of 2311 HMs from the 1st (2013), 3rd, and 5th (2018) waves of a national cohort study were included. MHS utilization in the past year was assessed by two indicators: having MHS contacts and the frequency of MHS contacts. Trends were identified by Cochran-Armitage tests, and generalized linear mixed models and ordered logistic models were fitted to explore impact factors of MHS utilization. The proportion of having MHS contacts significantly rose from 13.0% to 29.4% over the five years. MHS utilization was mainly driven by perceived needs, such as post-traumatic stress disorders and the degree of post-migration stress. Unemployment and strong belongingness to the local community were also associated with having MHS contacts. No significant gender difference was found in having MHS contacts but females tended to contact MHS more frequently. Resettled HMs have a persistent dilemma of high mental illness prevalence and MHS underutilization. Sustainable mental health education and long-term resettlement services targeted at social integration that consider gender difference are urgently needed in host countries