Ethnic inequalities and pathways to care in psychosis in England: a systematic review and meta-analysis

© The Author(s). 2018Background: As part of a national programme to tackle ethnic inequalities, we conducted a systematic review and meta-analysis of research on ethnic inequalities in pathways to care for adults with psychosis living in England and/or Wales. Methods: Nine databases were searched from inception to 03.07.17 for previous systematic reviews, including forward and backward citation tracking and a PROSPERO search to identify ongoing reviews. We then carried forward relevant primary studies from included reviews (with the latest meta-analyses reporting on research up to 2012), supplemented by a search on 18.10.17 in MEDLINE, Embase, PsycINFO and CINAHL for primary studies between 2012 and 2017 that had not been covered by previous meta-analyses. Results: Forty studies, all conducted in England, were included for our updated meta-analyses on pathways to care. Relative to the White reference group, elevated rates of civil detentions were found for Black Caribbean (OR = 3.43, 95% CI = 2.68 to 4.40, n = 18), Black African (OR = 3.11, 95% CI = 2.40 to 4.02, n = 6), and South Asian patients (OR = 1.50, 95% CI 1.07 to 2.12, n = 10). Analyses of each Mental Health Act section revealed significantly higher rates for Black people under (civil) Section 2 (OR = 1.53, 95% CI = 1.11 to 2.11, n = 3). Rates in repeat admissions were significantly higher than in first admission for South Asian patients (between-group difference p < 0.01). Some ethnic groups had more police contact (Black African OR = 3.60, 95% CI = 2.15 to 6.05, n = 2; Black Caribbean OR = 2.64, 95% CI = 1.88 to 3.72, n = 8) and criminal justice system involvement (Black Caribbean OR = 2.76, 95% CI = 2.02 to 3.78, n = 5; Black African OR = 1.92, 95% CI = 1.32 to 2.78, n = 3). The White Other patients also showed greater police and criminal justice system involvement than White British patients (OR = 1.49, 95% CI = 1.03 to 2.15, n = 4). General practitioner involvement was less likely for Black than the White reference group. No significant variations over time were found across all the main outcomes. Conclusions: Our updated meta-analyses reveal persisting but not significantly worsening patterns of ethnic inequalities in pathways to psychiatric care, particularly affecting Black groups. This provides a comprehensive evidence base from which to inform policy and practice amidst a prospective Mental Health Act reform. Trial registration: CRD42017071663Peer reviewedFinal Published versio

Voltage scanning and technical upgrades at the Collinear Resonance Ionization Spectroscopy experiment

To optimize the performance of the Collinear Resonance Ionization Spectroscopy (CRIS) experiment at CERN-ISOLDE, technical upgrades are continuously introduced, aiming to enhance its sensitivity, precision, stability, and efficiency. Recently, a voltage-scanning setup was developed and commissioned at CRIS, which improved the scanning speed by a factor of three as compared to the current laser-frequency scanning approach. This leads to faster measurements of the hyperfine structure for systems with high yields (more than a few thousand ions per second). Additionally, several beamline sections have been redesigned and manufactured, including a new field-ionization unit, a sharper electrostatic bend, and improved ion optics. The beamline upgrades are expected to yield an improvement of at least a factor of 5 in the signal-to-noise ratio by suppressing the non-resonant laser ions and providing time-of-flight separation between the resonant ions and the collisional background. Overall, the presented developments will further improve the selectivity, sensitivity, and efficiency of the CRIS technique.Comment: 10 pages. Under review at NIM B as part of the proceedings of EMIS 2022 at RAON, South Kore

Can dissonance engineering improve risk analysis of human–machine systems?

The paper discusses dissonance engineering and its application to risk analysis of human–machine systems. Dissonance engineering relates to sciences and technologies relevant to dissonances, defined as conflicts between knowledge. The richness of the concept of dissonance is illustrated by a taxonomy that covers a variety of cognitive and organisational dissonances based on different conflict modes and baselines of their analysis. Knowledge control is discussed and related to strategies for accepting or rejecting dissonances. This acceptability process can be justified by a risk analysis of dissonances which takes into account their positive and negative impacts and several assessment criteria. A risk analysis method is presented and discussed along with practical examples of application. The paper then provides key points to motivate the development of risk analysis methods dedicated to dissonances in order to identify the balance between the positive and negative impacts and to improve the design and use of future human–machine system by reinforcing knowledge

The Mechanical Quarrying of Ironstone.

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Highway maintenance plan 1992

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Dartmoor National Park Traffic management strategy

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