Developing the mental health workforce capacity in primary care: implementing the role of graduate primary care mental health workers in England

The scale of current demand on primary care services from people seeking help with common mental health problems places enormous pressure on the existing front line workers in general practice. The paucity of training opportunities and competing pressures to deliver improved services across a range of general practice targets remains a major challenge for primary care professionals. The impact of government policy, to improve both access to and choice of treatments, has raised public expectations. The commissioning of the graduate workforce, the graduate worker in primary care mental health(GWPCMH), commenced in 2002, in response to the publication of target numbers detailed in the Priorities and Planning Framework, (DoH, 2002). It signalled a determination to expand the workforce provision and improve the quality of care for service users with common mental health problems. This paper examines the scale of common mental health problems, the policy response and the commissioning process. Particular attention is given to examining the barriers that have been shown to affect implementation, identifying the key influencers and the resources required to train these workers

Water Quality Characterization, Stormwater Analyses, and Statistical Modeling of Stream Water Quality in the Little Pigeon River Watershed of the Great Smoky Mountains National Park

Scheduled road construction prompted intensive water quality monitoring of the adjacent stream, the Little Pigeon River. Three phases of monitoring was planned to fully assess any impacts construction may have: pre, during, and post construction monitoring. One year of pre-construction monitoring has been completed. Three monitoring sites were installed. Site 1 was below, Site 2 in the middle, and Site 3 above all road construction. Each site had a YSI sonde that measured 15-minute pH, turbidity, conductivity, temperature, and stage. Storm samples were also captured through use of an Isco auto-sampler. Additionally, bi-weekly grab samples were taken at each site. All collected storm and grab samples were measured for pH, conductivity, acid neutralizing capacity, chloride, nitrate, sulfate, and ten metals including aluminum. In addition to the three main stream sites, Site 4 was located on Ramsey Prong in the south-east side of the watershed. It contained a YSI sonde that measured 15-minute pH, conductivity, temperature, and stage. Four grab samples were taken during base flow at Site 4. Two precipitation stations were also operated that contained bulk and sequential precipitation collectors in addition to tipping bucket rain gauges. Acid deposition is a major water quality driving force. pH and acid neutralizing capacity (ANC) are often used as indicators of acid deposition effects during base and storm flow. Descriptive statistics of sonde and base flow grab sample stream indicates acceptable base flow stream pH for Sites 1 – 3. However, Site 4 mean stream pH of 5.76 indicates unsuitable conditions for aquatic ecosystems. Sonde data and storm samples showed numerous occasions of episodic acidification at Sites 1 – 4 when using stream pH 5.5 as the criteria for acidity (Lachance and Bobee 1991). Similar to pH, base flow ANC iv was acceptable at Sites 1 and 2. However, Sites 3 and 4 mean base flow ANC indicated high sensitivity to acid deposition. Site 4 was likely affected by acid deposition but Anakeesta geology is also believed to play a role in the depressed stream pH and ANC. Increased stream concentrations of aluminum, sulfate, and nitrate are also indicators of acid deposition impacts. Mean stream aluminum, sulfate, and nitrate concentrations increased 25 to 59%, 12 to 24%, and 33 to 39%, respectively compared to base flow concentrations. Notably, mean concentrations of sulfate and nitrate found in precipitation samples were comparable to mean concentrations observed during storm flow. Mean concentrations of aluminum found in precipitation are not comparable to base or storm flow stream concentrations. This indicates soil leaching of aluminum caused from acid deposition. Using EPA criteria, numerous occasions of metal exceedances occurred during base and storm flow at Sites 1 – 3. Data for calcium and magnesium indicates low hardness during base and storm flow. This exacerbates problems associated with metal toxicity. Exceedances increased during storm flow as expected. Metal exceedance of EPA criteria for aluminum, copper, and zinc endured for at least 20.75 hours during a storm event on July, 25, 2004. However, several studies showed that metals concentrations must exceed EPA criteria by three fold to reach lethal concentrations that kill 50% (LC50) of brook and bull trout (Kazalauskiene et al. 2003 and Hansen et al. 2001.) LPR exceedances were not as severe and the duration for the LC50 values were also longer than observed continuous metal exceedances in the LPR. Turbidity and pH are perhaps two of the most commonly measured stream water quality parameters due to their overall importance on aquatic ecosystems. A large v quantity of sonde pH and turbidity was collected during this study. The data were used throughout this document to describe pH and turbidity. Multiple linear regression models were also constructed using sonde data. Storm event data were isolated to build a storm event pH and turbidity multiple linear regression models. Ultimately, lagged stage, sine and cosine functions of the day fraction, and total rain volume were used to predict storm event pH. Similarly, stage, stage2, stage intensity, and sine and cosine functions of the year fraction were used to predict storm event turbidity. Both models had several deficiencies that possibly prevented the best possible linear regression parameters from being estimated. Error residuals were not normally distributed and were serially correlated. However, high r2 values and application to a validation storm event data set showed the models were able to reasonably predict storm event pH and turbidity. The developed storm event linear regression models for pH and turbidity serve several purposes. The models show association between the response and predictor variables. From the associations developed causes for increased turbidity and decreased pH may be inferred (i.e. precipitation input depresses pH and increases turbidity). Additionally, a major objective was to form a basis of comparison of pre, during, and post construction water quality. In order to do this major water quality drivers must be understood in order to fully assess construction impacts. An understanding is particularly important for storm events because mean or median base flow water quality can be compared for pre, during, and post construction, comparing mean or median storm events is likely to be very misleading. The uniqueness of each storm event and the relative infrequency of significant storm events can cause mean or median to be misleading. Regression models allow the water quality to essentially be normalized for the size of the vi storm event and seasonal and diel patterns. The developed preconstruction storm event models should fit the during and post construction water quality. If not, construction impacts can be inferred. As stated above, a major objective was to form a basis of comparison for water quality during the various stages of this study. Once data from other phases of this study have been collected independent comparisons from the water quality sites may be completed. With these data it was prudent to first establish that the three main stream sites’ water quality were significantly different. Sonde and base flow pH was chosen to ascertain significant differences between stream sites. All sites had significantly different sonde and base flow pH with one exception. Mean base flow pH at Sites 1 and 2 were not found to differ significantly. A number of interesting water quality attributes were noticed during this study. Sonde base flow pH, temperature, and dissolved oxygen exhibited distinct diel cycles. Temperature and dissolved oxygen were caused by air temperature variation. Interestingly, pH diel cycles are believed to be due to biological photosynthesis and respiration. A slight diel cycle in conductivity also corresponded to biological action. Another unexpected water quality attribute was upward pH spikes at the onset of storm events. A 2.07 unit increase in pH was observed at Site 1 in response to a storm event on September 3, 2003. However, increases were generally one pH unit in magnitude. Examination of storm event water quality data showed these pH increases were due to increased stream alkalinity. Precipitation also showed similar alkalinity increases which indicate antecedent accumulation in the watershed of alkalinity from an unknown source

Mechanism of shot peening enhancement for the fatigue performance of AA7050-T7451

Shot peening is a dynamic cold working process involving the impingement of peening media onto a substrate surface. Shot peening is commonly employed as a surface treatment technique within the aerospace industry during manufacturing, in order to improve fatigue performance of structural components. The compressive residual stress induced during shot peening is understood to result in fatigue crack growth retardation, improving the performance of shot peened components. However, shot peening is a compromise between the benefit of inducing a compressive residual stress and causing detrimental surface damage. Due to the relatively soft nature of AA7050-T7451, shot peening can result in cracking of the constituent particles, the effect of which is recognized as a ‘critically detrimental influence upon the component’s fatigue performance.’ The intention of this thesis is to understand the balance and fundamentals of these competing phenomena, through analysis involving a comparative study throughout the fatigue life cycle of ‘as manufactured’ versus shot peened AA7050-T7451. A series of dog bone samples were manufactured, with a subset undergoing shot peening surface treatment. Microstructural grain characterization and comparison of ‘as manufactured’ and shot peened AA7050-T7451 has been carried out using scanning electron microscope (SEM), electron back scatter diffraction (EBSD), and energy dispersive spectroscopy (EDS) techniques. A residual stress analysis through interrupted fatigue of ‘as manufactured’ and shot peened AA7050-T7451 was completed utilizing a combination of x-ray diffraction (XRD) and nano-indentation. The fatigue life cycle performance of the ‘as manufactured’ versus shot peened material has been evaluated, including qualitative analysis and comparison of crack initiation and propagation in ‘as manufactured’ and shot peened material. Through this experimentation and analysis, this thesis endeavors to answer the question of what is the mechanism for shot peening enhancement for fatigue performance. An objective of this work is to understand how a cracked particle starts to incubate the short crack into the matrix within a residual stress field

Advancement Of Understanding In Physical Science And Reduction Of Mathematical Anxiety Through The Use Of Supplemental Mathematics Material

The purpose of this study was to determine if supplementary mathematics materials (created to be complementary to a physical science course) could provide a significant change in the attitudes and performance of the students involved. The supplementary text was provided in the form of a booklet. Participants were students in a physical science class. Students were given surveys to evaluate existing knowledge of physical science, mathematics skill, and mathematics anxiety in the context of a science class. Students were divided into control and experimental groups by lab section, with the experimental group receiving a supplemental booklet. At the end of the semester, another anxiety survey was given. The anxiety surveys and test grades were compared between groups. Anxiety scores were compared between the beginning and end of the semester within each group. Too few students reported using the booklets for a reliable statistical comparison (of grades) to be made. A statistically significant difference in mathematics anxiety levels was found between the groups

Benefits to Australia from ACIAR-funded Research

Research and Development/Tech Change/Emerging Technologies,

Wurzburg

n/

Blowout Limits of Flames in High-Speed Airflows: Critical Damkohler Number

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/76825/1/AIAA-2008-4571-208.pd

Correlation and Analysis of Blowout Limits of Flames in High-Speed Airflows

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/77362/1/AIAA-13329-435.pd

Social media, professional media and mobilisation in contemporary Britain: explaining the strengths and weaknesses of the citizens’ movement 38 degrees

Digital media continue to reshape political activism in unexpected ways. Within a period of a few years, the internet-enabled UK citizens’ movement 38 Degrees has amassed a membership of 3 million and now sits alongside similar entities such as America’s MoveOn, Australia’s GetUp! and the transnational movement Avaaz. In this article, we contribute to current thinking about digital media and mobilisation by addressing some of the limitations of existing research on these movements and on digital activism more generally. We show how 38 Degrees’ digital network repertoires coexist interdependently with its strategy of gaining professional news media coverage. We explain how the oscillations between choreographic leadership and member influence and between digital media horizontalism and elite media-centric work constitute the space of interdependencies in which 38 Degrees acts. These delicately balanced relations can quickly dissolve and be replaced by simpler relations of dependence on professional media. Yet despite its fragility, we theorise about how 38 Degrees may boost individuals’ political efficacy, irrespective of the outcome of individual campaigns. Our conceptual framework can be used to guide research on similar movements