What is the impact of health trainer interventions within a mental health setting?

This paper relates to a single case study that was part of a larger project using a tried and tested evaluation methodology to evaluate the role of health trainers (HTs) working with groups who are considered ‘difficult’ to engage in health care. In this example, the HTs were based in a mental health centre run by a charity. The service was commissioned by a Primary Care Trust (PCT) located in the North East of England. Data collected between April 2010 and July 2011 included quantitative data from 72 service users from the National Data Collection and Reporting System. Additional quantitative data were obtained from the HTs relating to the usage of group activities and a satisfaction questionnaire completed by service users. Qualitative data included interviews with four key stakeholders, a focus group with service users, case studies and progress reports provided as part of the Centre’s annual reporting requirements for the PCT. Findings reveal that more service users aged 26-44 used the service compared with national figures. Partnership working was essential to embed the initiative into the Centre. HT interventions that were flexible, and gave service users options, encouraged mental health promotion. The success of the intervention depended less on what the HT did and more importantly on how they did it

Evaluation of insulation materials and composites for use in a nuclear radiation environment, phase 2

The nuclear heating of the propellant in all of the four baseline RNS configurations studied was much lower than that of the nuclear flight module configuration with the 5000-MW NERVA analyzed previously. Although the nuclear heating has been reduced, the effect of nuclear heating on the propellant as well as the effect of nuclear heating on internal structures such as antivortex baffles, screens, and sump components cannot be neglected. In addition, it was found that the present analytical precedures were not able to predict boundary layer initiation and breakoff points with the accuracy necessary to predict propellant thermodynamic nonequilibrium (stratification) and/or mixing

Joint Strategic Needs Assessment for substance misuse services in Nottinghamshire. Final report

This Joint Strategic Needs Assessment contributes to identifying need and quality service delivery of substance misuse services to young people in the Nottinghamshire County Council. This report contributes to the identification of strategic need for planning, in line with the JSNA for Commissioners, and within the time-frame of delivering drafts plans and latest needs assessment by March 2013. A joint strategic needs assessment (JSNA) analyses health needs of populations to inform and guide commissioning of health, well-being and social care services within a local authority area. Producing an annual JSNA has been a statutory requirement for the NHS and local authorities since 2007.The Health and Social Care Bill 2011 proposes a central role for JSNAs so that health and well-being board partners jointly analyse current and future health needs of populations. Local authority-based public health will become responsible for commissioning drug and alcohol prevention, treatment and linked recovery support in April 2013. This Needs Assessment focuses on drug and alcohol use by children and young people within Nottinghamshire and the impact of parent/carer use on children and young people. The purpose is to identify the level of need within the population and review the effectiveness of current services with a view to making recommendations to inform strategy and commissioning decisions for 2012/13

Computer automation of ultrasonic testing

Report describes a prototype computer-automated ultrasonic system developed for the inspection of weldments. This system can be operated in three modes: manual, automatic, and computer-controlled. In the computer-controlled mode, the system will automatically acquire, process, analyze, store, and display ultrasonic inspection data in real-time. Flaw size (in cross-section), location (depth), and type (porosity-like or crack-like) can be automatically discerned and displayed. The results and pertinent parameters are recorded

Μελέτη επιπτώσεων συνδρομολόγησηςεφαρμογών σε πολυπύρηνες αρχιτεκτονικές

Understanding viral transmission dynamics within populations of reservoir hosts can facilitate greater knowledge of the spillover of emerging infectious diseases. While bat-borne viruses are of concern to public health, investigations into their dynamics have been limited by a lack of longitudinal data from individual bats. Here, we examine capture-mark-recapture (CMR) data from a species of Australian bat (Myotis macropus) infected with a putative novel Alphacoronavirus within a Bayesian framework. Then, we developed epidemic models to estimate the effect of persistently infectious individuals (which shed viruses for extensive periods) on the probability of viral maintenance within the study population. We found that the CMR data analysis supported grouping of infectious bats into persistently and transiently infectious bats. Maintenance of coronavirus within the study population was more likely in an epidemic model that included both persistently and transiently infectious bats, compared with the epidemic model with non-grouping of bats. These findings, using rare CMR data from longitudinal samples of individual bats, increase our understanding of transmission dynamics of bat viral infectious diseases

A Randomized Trial of Nighttime Physician Staffing in an Intensive Care Unit

Background Increasing numbers of intensive care units (ICUs) are adopting the practice of nighttime intensivist staffing despite the lack of experimental evidence of its effectiveness. Methods We conducted a 1-year randomized trial in an academic medical ICU of the effects of nighttime staffing with in-hospital intensivists (intervention) as compared with nighttime coverage by daytime intensivists who were available for consultation by telephone (control). We randomly assigned blocks of 7 consecutive nights to the intervention or the control strategy. The primary outcome was patients’ length of stay in the ICU. Secondary outcomes were patients’ length of stay in the hospital, ICU and in-hospital mortality, discharge disposition, and rates of readmission to the ICU. For length-of-stay outcomes, we performed time-to-event analyses, with data censored at the time of a patient’s death or transfer to another ICU. Results A total of 1598 patients were included in the analyses. The median Acute Physiology and Chronic Health Evaluation (APACHE) III score (in which scores range from 0 to 299, with higher scores indicating more severe illness) was 67 (interquartile range, 47 to 91), the median length of stay in the ICU was 52.7 hours (interquartile range, 29.0 to 113.4), and mortality in the ICU was 18%. Patients who were admitted on intervention days were exposed to nighttime intensivists on more nights than were patients admitted on control days (median, 100% of nights [interquartile range, 67 to 100] vs. median, 0% [interquartile range, 0 to 33]; P\u3c0.001). Nonetheless, intensivist staffing on the night of admission did not have a significant effect on the length of stay in the ICU (rate ratio for the time to ICU discharge, 0.98; 95% confidence interval [CI], 0.88 to 1.09; P=0.72), ICU mortality (relative risk, 1.07; 95% CI, 0.90 to 1.28), or any other end point. Analyses restricted to patients who were admitted at night showed similar results, as did sensitivity analyses that used different definitions of exposure and outcome. Conclusions In an academic medical ICU in the United States, nighttime in-hospital intensivist staffing did not improve patient outcomes. (Funded by University of Pennsylvania Health System and others; ClinicalTrials.gov number, NCT01434823.

Together forever? Explaining exclusivity in party-firm relations

Parties and firms are the key actors of representative democracy and capitalism respectively and the dynamic of attachment between them is a central feature of any political economy. This is the first article to systematically analyse the exclusivity of party-firm relations. We consider exclusivity at a point in time and exclusivity over time. Does a firm have a relationship with only one party at a given point in time, or is it close to more than one party? Does a firm maintain a relationship with only one party over time, or does it switch between parties? Most important, how do patterns of exclusivity impact on a firm’s ability to lobby successfully? We propose a general theory, which explains patterns of party-firm relations by reference to the division of institutions and the type of party competition in a political system. A preliminary test of our theory with Polish survey data confirms our predictions, establishing a promising hypothesis for future research

An exploratory study on the potential of social enterprise to act as the institutional glue of network governance

This study combines two topics of contemporary salience for public administration: social enterprise and governance networks. While operating at different levels, both are institutions which attempt to draw together the three pillars of state, market, and civil society. Nevertheless, the respective literatures focus on particular aspects of the three pillars. We connect the two concepts and suggest that some social enterprises can act as the institutional glue of networks due to their ability to benefit organizations in each of the three sectors. This requires social enterprises to have the managerial capacity to diffuse social know-how, and is facilitated by the trust of other organizations and a supportive policy framework. The links are explicated at the conceptual level before providing evidence from South Korea and the UK. Finally, research propositions are offered, which suggest new avenues for future research

How and When Socially Entrepreneurial Nonprofit Organizations Benefit From Adopting Social Alliance Management Routines to Manage Social Alliances?

Social alliance is defined as the collaboration between for-profit and nonprofit organizations. Building on the insights derived from the resource-based theory, we develop a conceptual framework to explain how socially entrepreneurial nonprofit organizations (SENPOs) can improve their social alliance performance by adopting strategic alliance management routines. We test our framework using the data collected from 203 UK-based SENPOs in the context of cause-related marketing campaign-derived social alliances. Our results confirm a positive relationship between social alliance management routines and social alliance performance. We also find that relational mechanisms, such as mutual trust, relational embeddedness, and relational commitment, mediate the relationship between social alliance management routines and social alliance performance. Moreover, our findings suggest that different types of social alliance motivation can influence the impact of social alliance management routines on different types of the relational mechanisms. In general, we demonstrate that SENPOs can benefit from adopting social alliance management routines and, in addition, highlight how and when the social alliance management routines–social alliance performance relationship might be shaped. Our study offers important academic and managerial implications, and points out future research directions