Cultures of psychiatry and the professional socialization process: the case of containment methods for disturbed patients

Acute mental disorder necessitating admission to hospital is often accompanied by disturbed behaviour that threatens the health of the person concerned or that of those around them. A range of containment methods are used by psychiatric professionals to keep patients and staff safe. These strategies are strongly emotive and attract strong moral valuations, yet differ sharply between countries. This paper reports a study to investigate the relationship between attitudes to these containment methods, and exposure to psychiatric education and practice. It was hypothesized that the culture of psychiatry in the study country would socialise students' views towards the locally dominant pattern of relative evaluations. Nine cohorts of student psychiatric nurses at different stages of their training at one UK University were asked to complete ratings on 11 containment methods. Containment methods fell into five groups, with mechanical restraint and net beds attracting the most severe disapproval. Neither the relative evaluation of methods, nor the intensity of those evaluations, changed systematically with duration of training. The findings support the interpretation that the relative evaluations of psychiatric containment methods are a property of wider national cultures, rather than an isolated tradition of professional psychiatric practice

Experimental determination of the dispersion relation of magnetosonic waves

Magnetosonic waves are commonly observed in the vicinity of the terrestrial magnetic equator. It has been proposed that within this region they may interact with radiation belt electrons, accelerating some to high energies. These wave-particle interactions depend upon the characteristic properties of the wave mode. Hence, determination of the wave properties is a fundamental part of understanding these interaction processes. Using data collected during the Cluster Inner Magnetosphere Campaign, this paper identifies an occurrence of magnetosonic waves, discusses their generation and propagation properties from a theoretical perspective, and utilizes multispacecraft measurements to experimentally determine their dispersion relation. Their experimental dispersion is found to be in accordance with that based on cold plasma theory

Magnetic Dipole Absorption of Radiation in Small Conducting Particles

We give a theoretical treatment of magnetic dipole absorption of electromagnetic radiation in small conducting particles, at photon energies which are large compared to the single particle level spacing, and small compared to the plasma frequency. We discuss both diffusive and ballistic electron dynamics for particles of arbitrary shape. The conductivity becomes non-local when the frequency is smaller than the frequency \omega_c characterising the transit of electrons from one side of the particle to the other, but in the diffusive case \omega_c plays no role in determining the absorption coefficient. In the ballistic case, the absorption coefficient is proportional to \omega^2 for \omega << \omega_c, but is a decreasing function of \omega for \omega >> \omega_c.Comment: 25 pages of plain TeX, 2 postscipt figure

Law, politics and the governance of English and Scottish joint-stock companies 1600-1850

This article examines the impact of law on corporate governance by means of a case study of joint-stock enterprise in England and Scotland before 1850. Based on a dataset of over 450 company constitutions together with qualitative information on governance practice, it finds little evidence to support the hypothesis that common-law regimes such as England were more supportive of economic growth than civil-law jurisdictions such as Scotland: indeed, levels of shareholder protection were slightly stronger in the civil-law zone. Other factors, such as local political institutions, played a bigger role in shaping organisational forms and business practice

Schlieren Studies of Compressibility Effects on Dynamic Stall of Airfoils in Transient Pitching Motion

Compressibility effects on the flowfield of an airfoil executing rapid transient pitching motion from 0 - 60 degrees over a wide range of Mach numbers and pitching rates were studied using a stroboscopic schlieren flow visualization technique. The studies have led to the first direct experiments] documentation of multiple shocks on the airfoil upper surface flow for certain conditions. Also, at low Mach numbers, additional coherent vortical structures were found to be present along with the dynamic stall vortex, whereas at higher Mach numbers, the flow was dominated by a single vortex. The delineating Mach number for significant compressibility effects was 0.3 and the dynamic stall process was accelerated by increasing the Mach number above that value. Increasing the pitch rate monotonically delayed stall to angles of attack as large as 27 degrees.AFOSR-MIPR-87-0029 and 88-0010NAVAIRAR

The hidden burden of adult allergic rhinitis : UK healthcare resource utilisation survey

Funding Funding for this survey was provided by Meda Pharma.Peer reviewedPublisher PD

Stakeholder perceptions of key aspects of high-quality cancer care to assess with patient reported outcome measures: A systematic review

Performance measurement is the process of collecting, analyzing, and reporting standard-ized measures of clinical performance that can be compared across practices to evaluate how well care was provided. We conducted a systematic review to identify stakeholder perceptions of key symptoms and health domains to test as patient-reported performance measures in oncology. Stakeholders included cancer patients, caregivers, clinicians, and healthcare administrators. Standard review methodology was used, consistent with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). MEDLINE/PubMed, EMBASE, and the Cochrane Library were searched to identify relevant studies through August 2020. Four coders independently reviewed entries and con-flicts were resolved by a fifth coder. Efficacy and effectiveness studies, and studies focused exclusively on patient experiences of care (e.g., communication skills of providers) were excluded. Searches generated 1813 articles and 1779 were coded as not relevant, leaving 34 international articles for extraction. Patients, caregivers, clinicians, and healthcare administrators prioritize psychosocial care (e.g., distress) and symptom management for patient-reported performance measures. Patients and caregivers also perceive that maintaining physical function and daily activities are critical. Clinicians and administrators perceive control of specific symptoms to be critical (gastrointestinal symptoms, pain, poor sleep). Results were used to inform testing at six US cancer centers

Influence of Gamma-Ray Emission on the Isotopic Composition of Clouds in the Interstellar Medium

We investigate one mechanism of the change in the isotopic composition of cosmologically distant clouds of interstellar gas whose matter was subjected only slightly to star formation processes. According to the standard cosmological model, the isotopic composition of the gas in such clouds was formed at the epoch of Big Bang nucleosynthesis and is determined only by the baryon density in the Universe. The dispersion in the available cloud composition observations exceeds the errors of individual measurements. This may indicate that there are mechanisms of the change in the composition of matter in the Universe after the completion of Big Bang nucleosynthesis. We have calculated the destruction and production rates of light isotopes (D, 3He, 4He) under the influence of photonuclear reactions triggered by the gamma-ray emission from active galactic nuclei (AGNs). We investigate the destruction and production of light elements depending on the spectral characteristics of the gamma-ray emission. We show that in comparison with previous works, taking into account the influence of spectral hardness on the photonuclear reaction rates can increase the characteristic radii of influence of the gamma-ray emission from AGNs by a factor of 2-8. The high gamma-ray luminosities of AGNs observed in recent years increase the previous estimates of the characteristic radii by two orders of magnitude. This may suggest that the influence of the emission from AGNs on the change in the composition of the medium in the immediate neighborhood (the host galaxy) has been underestimated.Comment: 13 pages, 13 figures, 3 table

Support and Assessment for Fall Emergency Referrals (SAFER 1) trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: evaluation of costs and benefits using a pragmatic cluster randomised trial

Background: Many emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology - hand-held computers with computerised clinical decision support (CCDS) software - to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community falls services. Methods/Design: Pragmatic cluster randomised trial with a qualitative component. We shall allocate 72 paramedics ('clusters') at random between receiving the intervention and a control group delivering care as usual, of whom we expect 60 to complete the trial. Patients are eligible if they are aged 65 or older, live in the study area but not in residential care, and are attended by a study paramedic following an emergency call for a fall. Seven to 10 days after the index fall we shall offer patients the opportunity to opt out of further follow up. Continuing participants will receive questionnaires after one and 6 months, and we shall monitor their routine clinical data for 6 months. We shall interview 20 of these patients in depth. We shall conduct focus groups or semi-structured interviews with paramedics and other stakeholders. The primary outcome is the interval to the first subsequent reported fall (or death). We shall analyse this and other measures of outcome, process and cost by 'intention to treat'. We shall analyse qualitative data thematically. Discussion: Since the SAFER 1 trial received funding in August 2006, implementation has come to terms with ambulance service reorganisation and a new national electronic patient record in England. In response to these hurdles the research team has adapted the research design, including aspects of the intervention, to meet the needs of the ambulance services. In conclusion this complex emergency care trial will provide rigorous evidence on the clinical and cost effectiveness of CCDS for paramedics in the care of older people who have fallen

Formation of Supermassive Black Holes

Evidence shows that massive black holes reside in most local galaxies. Studies have also established a number of relations between the MBH mass and properties of the host galaxy such as bulge mass and velocity dispersion. These results suggest that central MBHs, while much less massive than the host (~ 0.1%), are linked to the evolution of galactic structure. In hierarchical cosmologies, a single big galaxy today can be traced back to the stage when it was split up in hundreds of smaller components. Did MBH seeds form with the same efficiency in small proto-galaxies, or did their formation had to await the buildup of substantial galaxies with deeper potential wells? I briefly review here some of the physical processes that are conducive to the evolution of the massive black hole population. I will discuss black hole formation processes for `seed' black holes that are likely to place at early cosmic epochs, and possible observational tests of these scenarios.Comment: To appear in The Astronomy and Astrophysics Review. The final publication is available at http://www.springerlink.co