Project Vigilant:Evaluation Report

Produced for Thames Valley Polic

Management of type 2 diabetes mellitus in people with severe mental illness: an online cross-sectional survey of healthcare professionals

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Objectives To establish healthcare professionals' (HCPs) views about clinical roles, and the barriers and enablers to delivery of diabetes care for people with severe mental illness (SMI). Design Cross-sectional, postal and online survey. Setting Trusts within the National Health Service, mental health and diabetes charities, and professional bodies. Participants HCPs who care for people with type 2 diabetes mellitus (T2DM) and/or SMI in the UK. Primary and secondary outcome measures The barriers, enablers and experiences of delivering T2DM care for people with SMI, informed by the Theoretical Domains Framework. Results Respondents were 273 HCPs, primarily mental health nurses (33.7%) and psychiatrists (32.2%). Only 25% of respondents had received training in managing T2DM in people with SMI. Univariate analysis found that mental health professionals felt responsible for significantly fewer recommended diabetes care standards than physical health professionals (P<0.001). For those seeing diabetes care as part of their role, the significant barriers to its delivery in the multiple regression analyses were a lack of knowledge (P=0.003); a need for training in communication and negotiation skills (P=0.04); a lack of optimism about the health of their clients (P=0.04) and their ability to manage T2DM in people with SMI (P=0.003); the threat of being disciplined (P=0.02); fear of working with people with a mental health condition (P=0.01); a lack of service user engagement (P=0.006); and a need for incentives (P=0.04). The significant enablers were an understanding of the need to tailor treatments (P=0.04) and goals (P=0.02) for people with SMI. Conclusions This survey indicates that despite current guidelines, diabetes care in mental health settings remains peripheral. Even when diabetes care is perceived as part of an HCP's role, various individual and organisational barriers to delivering recommended T2DM care standards to people with SMI are experienced.Peer reviewe

Effectiveness of home based early intervention on children’s BMI at age 2: randomised controlled trial

Objective To assess the effectiveness of a home based early intervention on children’s body mass index (BMI) at age 2

Framing best practice: National Standards for the primary prevention of sexual assault through education (National Sexual Assault Prevention Education Project for NASASV)

In 2008, the Rudd Labor Government identified the prevention of violence against women as a priority for action. The National Sexual Assault Prevention Education Research Project (SAPE) was established to complete a one-year project to develop and trial a national sexual assault prevention education framework. The project was to identify best or promising practice models for doing sexual assault prevention education in the Australian context with the aim of building upon existing prevention education activities to provide a framework that can be implemented across Australia by prevention educators, service providers, policy makers and funding bodies. In considering existing prevention programs the following areas were of particular interest: programs that have incorporated men as well as women, that are targeted to culturally and sexually diverse groups, and that address the specific needs of regional women and men and people with disabilities. Another key component of the consultation process was to identify programs that included some form of evaluation, particularly programs that have included steps toward assessing behavioural change. In addition, the research was to identify some of the barriers to wider implementation of primary sexual assault prevention education. This report provides a comprehensive discussion of the research underpinning the framework, along with some of the researchers' analysis of the 32 fieldwork interviews that were completed with workers and other key individuals in most states in Australia. Six national standards for sexual assault prevention education are identified and described as the framework for increasing the capacity of the sector to deliver high quality primary prevention education programs

MnDOT Flash Flood Vulnerability and Adaptation Assessment Pilot Project

MnDOT planners and engineers have long considered minimizing the risk of flash flooding in the siting and design of the state\u2019s roadway network. However, as has been the standard practice worldwide, they have traditionally assumed that future climate conditions will be similar to those recorded in the past. Climate change challenges this assumption and calls for new approaches to understanding vulnerabilities across the highway system and at specific transportation facilities so that appropriate actions, adaptations, can be taken to minimize expanding risks. This project, one of 19 Federal Highway Administration (FHWA) climate vulnerability pilot studies nationwide looking at the effects of climate hazards on the transportation system, represents a starting point for developing these new approaches. The focus of this pilot study is on flash flooding risks to the highway system. While flooding is not the only threat to the state\u2019s highway system posed by climate change, it is likely to be one of the most significant and has already caused extensive disruptions to the transportation system in many areas

A three-regime model of speculative behaviour: modelling the evolution of the S&P 500 composite index

We examine whether a three-regime model that allows for dormant, explosive and collapsing speculative behaviour can explain the dynamics of the S&P 500. We extend existing models of speculative behaviour by including a third regime that allows a bubble to grow at a steady rate, and propose abnormal volume as an indicator of the probable time of bubble collapse. We also examine the financial usefulness of the three-regime model by studying a trading rule formed using inferences from it, whose use leads to higher Sharpe ratios and end of period wealth than from employing existing models or a buy-and-hold strategy

South Florida Climate Change Vulnerability Assessment and Adaptation Pilot Project

In 2013, the Federal Highway Administration (FHWA) sponsored climate resilience pilot studies in selected states and metropolitan areas in the U.S. The intent of these pilot studies was to examine approaches to \u201cconduct climate change and extreme weather vulnerability assessments of transportation infrastructure and to analyze options for adapting and improving resiliency.\u201d The Broward Metropolitan Planning Organization (MPO), as lead agency on behalf of the region\u2019s three MPOs, and in partnership with other agencies, received one of the pilot projects. The project studied the southeast Florida four-county region. This report presents the results of this study. Five study objectives were adopted to guide the analysis: 1) provide adaptation analysis capability, 2) identify adaptation projects and strategies, 3) apply a vulnerability framework and provide feedback to the planning process, 4) enhance decision support and 5) strengthen institutional capacity. The study examined three climate change-related stresses: sea level rise inundation, storm surge flooding, and heavy precipitation induced flooding. Only roadway and passenger rail facilities on the designated regional transportation network were considered as part of this analysis. The overall approach to the vulnerability assessment was based on the FHWA\u2019s Climate Change and Extreme Weather Vulnerability Assessment Framework. A scoring system was used to rate each road and rail link in the region with respect to their vulnerability to permanent sea level rise inundation and periodic inundation from storm surge and heavy rainfall