Investigating the association between characteristics of local crisis care systems and service use in an English national survey

Supplementary material is available online at https://doi.org/10.1192/bjo.2023.595This paper presents independent research commissioned and funded by the National Institute for Health and Care Research (NIHR) Policy Research Programme, conducted by the NIHR Policy Research Unit (PRU) in Mental Health. Research by N.S. is supported by the NIHR Applied Research Collaboration (ARC) South London at King’s College Hospital NHS Foundation Trust. N.S. is a member of King’s Improvement Science, which offers co-funding to the NIHR ARC South London and is funded by King’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London and South London and Maudsley NHS Foundation Trust), and the Guy’s and St Thomas’ Foundation. Research by A.R.-G. is also supported by the Spanish Ministry of Universities and the Next Generation European Union funds. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or its arm’s-length bodies, or other government departments.Background In England, a range of mental health crisis care models and approaches to organising crisis care systems have been implemented, but characteristics associated with their effectiveness are poorly understood. Aims To (a) develop a typology of catchment area mental health crisis care systems and (b) investigate how crisis care service models and system characteristics relate to psychiatric hospital admissions and detentions. Method Crisis systems data were obtained from a 2019 English national survey. Latent class analyses were conducted to identify discernible typologies, and mixed-effects negative binomial regression models were fitted to explore associations between crisis care models and admissions and detention rates, obtained from nationally reported data. Results No clear typology of catchment area crisis care systems emerged. Regression models suggested that provision of a crisis telephone service within the local crisis system was associated with a 11.6% lower admissions rate and 15.3% lower detention rate. Provision of a crisis cafe was associated with a 7.8% lower admission rates. The provision of a crisis assessment team separate from the crisis resolution and home treatment service was associated with a 12.8% higher admission rate. Conclusions The configuration of crisis care systems varies considerably in England, but we could not derive a typology that convincingly categorised crisis care systems. Our results suggest that a crisis phone line and a crisis cafe may be associated with lower admission rates. However, our findings suggest crisis assessment teams, separate from home treatment teams, may not be associated with reductions in admission and detentions.National Institute for Health and Care Research (NIHR) Policy Research ProgrammeNIHR Applied Research Collaboration (ARC) South London at King’s College Hospital NHS Foundation TrustKing’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London and South London and Maudsley NHS Foundation Trust)Spanish Ministry of Universities and the Next Generation European Union fund

Estimation of specific cutting energy in an S235 alloy for multi-directional ultrasonic vibration-assisted machining using the Finite Element Method

The objective of this work is to analyze the influence of the vibration-assisted turning process on the machinability of S235 carbon steel. During the experiments using this vibrational machining process, the vibrational amplitude and frequency of the cutting tool were adjusted to drive the tool tip in an elliptical or linear motion in the feed direction. Furthermore, a finite element analysis was deployed to investigate the mechanical response for different vibration-assisted cutting conditions. The results show how the specific cutting energy and the material’s machinability behave when using different operational cutting parameters, such as vibration frequency and tool tip motion in the x-axis, y-axis, and elliptical (x-y plane) motion. Then, the specific cutting energy and material’s machinability are compared with a conventional turning process, which helps to validate the finite element method (FEM) for the vibration-assisted process. As a result of the operating parameters used, the vibration-assisted machining process leads to a machinability improvement of up to 18% in S235 carbon steel. In particular, higher vibration frequencies were shown to increase the material’s machinability due to the specific cutting energy decrease. Therefore, the finite element method can be used to predict the vibration-assisted cutting and the specific cutting energy, based on predefined cutting parameters.Peer ReviewedPostprint (published version

Diversity and public television: analysis of subtitling as an accessibility service

The present article addresses media pluralism from a critical perspective, as a guarantor of attention to social and cultural diversity. The study focuses on deaf individuals, and an analysis is conducted of subtitles as one of the services that guarantees universal access to the contents offered by Spanish Radio and Television (Radiotelevisión Española, RTVE) for social and cultural diversity. Likewise, given the changes in audiovisual consumption in the form of streaming, and the rise of on-demand content, an analysis is not only performed of linear television, but also of live online and on-demand content. For this, a quantitative analysis was performed of a random sample of more than 5000 RTVE programs (2017-2018), to establish the number of subtitled programs for deaf individuals, their schedule, and the types of contents that included this service. Also, a qualitative analysis was performed on a sample of 72 programs distributed among the different channels belonging to this public corporation. Lastly, to evaluate the quality and suitability of the subtitles, an online survey was provided, which was completed by 183 deaf individuals who were users of the RTVE subtitles. Through this combination of methods, we were able to analyze and evaluate the cultural pluralism of RTVE through the subtitles provided for the deaf, associating it with the defense of the fundamental right of freedom of expression and social inclusion, values that must be guaranteed in democratic societies

Attitudes of mothers and health care providers towards behavioural interventions promoting breastfeeding uptake: A systematic review of qualitative and mixed-method studies

PURPOSE: Recommendations for exclusive breastfeeding are not often adhered to despite the robust evidence of its benefits. This systematic review aims to collate evidence on the attitudes mothers and health care providers have towards breastfeeding interventions to understand what aspects best contribute to acceptability and feasibility. METHODS: This review further investigates the value of identifiable behaviour change techniques (BCTs) to uncover which components of an intervention are perceived to be most useful and acceptable. The main biomedical databases were searched, and 17 (n = 17) studies met the inclusion criteria. RESULTS: A total of nine BCTs were identified within the interventions. The thematic analysis produced four main domains: usefulness, accessibility, value and sustainability. Women discussed the importance of the support they received in these interventions and demonstrated a positive view towards three BCTs: 'social support (unspecified)', 'instruction on how to perform behaviour' and 'demonstration of behaviour'. Additionally, women highlighted the benefit of personal, non-clinical and flexible emotional and practical support from peers, lactation consultants and support groups. Health care providers echoed these opinions and specifically highlighted the usefulness of interventions that allowed for continuity of care and more personal breastfeeding support. CONCLUSIONS: These findings suggest that ongoing practical as well as emotional support is crucial for standard in-hospital support to succeed at increasing breastfeeding rates. Future research would need to better understand the nuances of the interventions among women and providers to enhance their implementation

Estudio sobre la asertividad y las habilidades sociales en el alumnado de Educación Social

El estudio de las habilidades sociales ha experimentado un notable auge en los últimos años. La experiencia personal cotidiana nos indica que pasamos un alto porcentaje de nuestro tiempo en alguna forma de interacción social ya sea diádica o en grupo y tenemos experiencia de que las relaciones sociales positivas son una de las mayores fuentes de autoestima y bienestar personal. Al mismo tiempo, comprobamos que la competencia social de un sujeto, tiene una contribución importante a su competencia personal puesto que hoy en día el éxito personal y social parece estar más relacionado con la sociabilidad y las habilidades interpersonales del sujeto que con sus habilidades cognitivas e intelectuales. Esta competencia social es una competencia fundamental que ha de tener adquirida todo educador/a social. El presente estudio analiza descriptivamente las habilidades sociales y la asertividad del alumnado de la titulación de educación social, con el objetivo de ser la base para elaborar e implementar un programa de intervención transversal en dicha titulación a nivel de equipo docente. Se presentan aquellos datos más significativos del estudio, mostrando especial interés en aquellas dimensiones que más influyen, determinan y/o modulan las habilidades sociales y la asertividad. De igual modo, teniendo también como premisa fundamental a la titulación objeto de estudio.The study of social skills has experienced a remarkable boom in recent years. The everyday experience tells us that we had a high percentage of our time in some form of social interaction either dyadic or group and we have experience of positive social relationships are a major source of self-esteem and personal wellbeing. At the same time, we found that social competence of a subject, has an important contribution to personal competence today as personal and social success seems more related to sociability and interpersonal skills of the subject with their cognitive abilities and intellectuals. This social competence is a basic skill that must have acquired all educator social. This descriptive study examines the social and assertiveness skills of students in the degree of social education, with the goal to be the basis for developing and implementing an intervention program in that degree cross-level teaching team. Those data are presented highlights of the study, showing special interest in those dimensions that most influence, determine and / or modulate social skills and assertiveness. Similarly, taking also as a fundamental premise for certification under study

Análisis de la formación del docente en andalucía a través de la evolución de los centros de profesorado. Estudio de casos

El presente artículo está estructurado en dos partes diferenciadas e interdependientes. En primer lugar, se hace un recorrido diacrónico (periodo 1984-2009) de la creación de los Centros de Profesorado, en cuanto su creación y a los diferentes cambios normativos, que afectan, tanto en su organización y funcionamiento, como en su concepción de la formación del profesorado. En segundo lugar, se presenta un estudio observacional de carácter descriptivo, centrado en el análisis de la formación ofertada por un Centro de Profesorado en Andalucía (España), desde el año 2002 hasta el 2009. Dicho análisis se interesa por desglosar en macrocategorías aspectos tales como: características de las actividades, tipología de la formación, destinatarios potenciales y surgimiento de las necesidades formativas, de entre las más relevantes.This article is structured into two distinct and interdependent parts. First, we make a diachronic journey of the creation of Teacher Development Services (between the years 1984- 2009) and the various policy changes in both its organization and operation, as in the way of understanding the teacher training. Secondly, an observational study case is presented with a cualitative methodology about an analysis of the training offered by a Teacher Development Center in Andalusian (Spain), from 2002 until 2009. This analysis focuses on characteristics aspects such as: the personality nature of activities, types of training, potential recipients and the emergence of training needs, among the most important

Copper Glufosinate-Based Metal−Organic Framework as a Novel Multifunctional Agrochemical

Pesticides are agrochemical compounds used to kill pests (insects, rodents, fungi, or unwanted plants), which are key to meet the world food demand. Regrettably, some important issues associated with their widespread/extensive use (contamination, bioaccumulation, and development of pest resistances) demand a reduction in the amount of pesticide applied in crop protection. Among the novel technologies used to combat the deterioration of our environment, metal−organic frameworks (MOFs) have emerged as innovative and promising materials in agroindustry since they possess several features (high porosity, functionalizable cavities, ecofriendly composition, etc.) that make them excellent candidates for the controlled release of pesticides. Moving toward a sustainable development, in this work, we originally describe the use of pesticides as building blocks for the MOF construction, leading to a new type of agricultural applied MOFs (or AgroMOFs). Particularly, we have prepared a novel 2D-MOF (namely, GR-MOF-7) based on the herbicide glufosinate and the widely used antibacterial and fungicide Cu2+. GR-MOF-7 crystallizes attaining a monoclinic P21/c space group, and the asymmetric unit is composed of one independent Cu2+ ion and one molecule of the Glu2− ligand. Considering the significant antibacterial activity of Cu-based compounds in agriculture, the potential combined bactericidal and herbicidal effect of GR-MOF-7 was investigated. GR-MOF-7 shows an important antibacterial activity against Staphylococcus aureus and Escherichia coli (involved in agricultural animal infections), improving the results obtained with its individual or even physical mixed precursors [glufosinate and Cu(NO3)2]. It is also an effective pesticide against germination and plant growth of the weed Raphanus sativus, an invasive species in berries and vines crops, demonstrating that the construction of MOFs based on herbicide and antibacterial/antifungal units is a promising strategy to achieve multifunctional agrochemicals. To the best of our knowledge, this first report on the synthesis of an MOF based on agrochemicals (what we have named AgroMOF) opens new ways on the safe and efficient MOF application in agriculture.project MOFseidon PID2019-104228RB-I00Juan de la Cierva incorporation JC2019-038894-I and Multifunctional Metallodrugs in Diagnosis and Therapy Network (MICIU) RED2018-102471-TComunidad de MadridEuropean Regional Development Fund-FEDER 2014-2020-OE REACTUEUniversidad de Granada/CBUAEuropean Union NextGenerationEU/PRT

Evidencing built health system reconfiguration policy

BACKGROUND: Current built health system reconfiguration evidence is insufficient to support policy decisions on the best settings for healthcare provision. As a result, the “built health system” (the buildings, physical environments, engineering infrastructure and the building standards, guidance and evidence that support them) remain misunderstood. We explore several literature review types that have supported built health system policy, and the methodological, interdisciplinary and theoretical challenges of conducting high-impacting systematised reviews. Then establish how they might provide a robust basis for prioritising the reconfiguration of significant capital investments. METHODS/DESIGN: Five literature reviews undertaken to inform built health system reconfiguration policy are used as an empirical basis to help establish clearer scientific grounds for built health system infrastructure policy. The methods, benefits and empirical limitations of systematic, scoping, narrative, realistic and rapid reviews are compared. DISCUSSION: The methodological, interdisciplinary and theoretical shortcomings of existing evidence on built health system reconfiguration need to be addressed. This paper conceptualises this evidence and offers a new evidence co-production framework

Implementación de un sistema de logística en cadena de suministro cables DTH de una empresa de servicio en telecomunicaciones.

Este documento contiene archivo en PDF.Las Empresas, solicitan con frecuencias estudios de distribución de planta, por las constantes perdidas de recursos tanto materiales como económicos, El objetivo de esta propuesta es realizar un análisis del proceso de logística, por medio de la implementación de mejoras que optimicen los métodos de trabajo y la organización de la empresa, para el incremento de la productividad. Aplicando una de las herramientas de control de problemas como el diagrama de Pareto y distribución de planta SLP (sistematic layout planning), se identifica que la principal causa de tiempos improductivos en el proceso de logística, (recepción y entrega de antenas DTH), es la mala distribución de las instalaciones, que afectan al proceso de la logística, seguido del inadecuado método para control operacional, generando más del 62% de los tiempos improductivos. Esto significa queel costo anual de las perdidas relacionadas con la suma de los tiempos improductivos a reducir alcanza los $23.400. En conclusión la propuesta aspira el incremento de la eficiencia desde el 62$ 23,400. In conclusion, the proposal aims to increase in efficiency from 62% to 90% with the implementation of this work

Tectonic evolution of the Bajo Segura Basin northern limit. Implications for the Crevillente Fault Evolution

En este estudio presentamos los resultados del análisis estructural del borde norte de la cuenca del Bajo Segura, en la cordillera Bética oriental. En este borde se desarrolla el sinclinal de Crevillente; se trata de un pliegue de propagación de falla con geometría de crecimiento y vergente al sur asociado a la falla de Crevillente (sector Abanilla-Alicante). El estudio cuantitativo de la discordancia progresiva asociada a dicho pliegue ha puesto de manifiesto que la actividad de esta falla se inició en el Tortoniense, aumentó durante el Messiniense y, a partir de ese momento se ha mantenido constante o ha disminuido durante el Plioceno y el Cuaternario. La escasez de depósitos cuaternarios deformados no implica que no exista actividad cuaternaria de la falla de Crevillente (sector Abanilla-Alicante), ya que la mayoría de los depósitos más recientes son discontinuos o se localizan al sur, alejados de la zona de máxima deformación. Por otro lado, el hecho de que la actividad de la falla del Bajo Segura, situada en el borde meridional de la cuenca, se iniciara durante el Plioceno, parece indicar una migración de la deformación hacia el sur.We here present a structural analysis of the northern area of the Bajo Segura Basin, in the eastern Betic Cordillera. In this area the Crevillente syncline occurs, which consists of a fault-propagation fold related to the Crevillente Fault (Abanilla-Alicante sector). This south vergent syncline shows a growth geometry. The analysis of the growth sequence evidences that the Crevillente Fault (Abanilla-Alicante sector) tectonic activity started in the Tortonian, increased during Messinian and has decreased or kept constant during Pliocene and Quaternary times. The scarcity of deformed Quaternary deposits does not indicate a lack of tectonic activity of the Crevillente Fault (Abanilla-Alicante sector), because most of the recent sediments are discontinuous and deposited far from area of maximum deformation. Taking into account that the Bajo Segura Fault (located in the opposite southern margin of the basin) started in the Pliocene, it seems that tectonic deformation in the Bajo Segura Basin migrated southwards from the Crevillente Fault (Abanilla-Alicante sector) to the Bajo Segura Fault.El presente trabajo ha sido financiado gracias al proyecto de investigación CGL2011-30153-C02-02 del Ministerio de Ciencia e Innovación, así como por el Grupo de Investigación de la Universidad de Alicante VIGROB053