The Care Programme Approach and the end of indefinitely renewable Leave of Absence in Scotland

ObjectiveTo consider the relationship between the restriction of leave of absence (LOA) to 12 months, the introduction of community care orders (CCOs) and the implementation of the Care Programme Approach (CPA).DesignMultiple methods were employed: scrutiny of Mental Welfare Commission for Scotland (MWC) records; questionnaire to consultant psychiatrists and mental health officers (MHOs) regarding attitudes; survey of psychiatrists in respect of outcomes for named patients.SettingScotlandSubjectsTwo hundred and sixty six patients who were affected by the changes introduced by the Mental Health (Patients in the Community) Act 1995.ResultsInformation was available for 195 (73%) patients in relation to CPA. Of these 113 (58%) were included on CPA and for 63/113 (56%) (63/195 (32%)) CPA was considered to have enhanced patient care.Where CPA was considered useful it was because it was seen as bringing people together, enhancing the patient’s role in treatment and managing difficult situations. Negative comments regarding CPA were that it was unnecessary as the patient’s needs were straightforward, it duplicated current practices or it was too bureaucratic.ConclusionsDespite concerns expressed by professionals about the restriction to LOA and the guidance that patients should be on CPA, for only a minority of patients was CPA described as enhancing care. Questions are raised about the low use of CCOs and CPA by psychiatrists for patients who reached the new limits of LOA

Intelligence within BAOR and NATO's Northern Army Group

During the Cold War the UK's principal military role was its commitment to the North Atlantic Treaty Organisation (NATO) through the British Army of the Rhine (BAOR), together with wartime command of NATO's Northern Army Group. The possibility of a surprise attack by the numerically superior Warsaw Pact forces ensured that great importance was attached to intelligence, warning and rapid mobilisation. As yet we know very little about the intelligence dimension of BAOR and its interface with NATO allies. This article attempts to address these neglected issues, ending with the impact of the 1973 Yom Kippur War upon NATO thinking about warning and surprise in the mid-1970s. It concludes that the arrangements made by Whitehall for support to BAOR from national assets during crisis or transition to war were - at best - improbable. Accordingly, over the years, BAOR developed its own unique assets in the realm of both intelligence collection and special operations in order to prepare for the possible outbreak of conflict

Breast, cervical, and colorectal cancer screening rates amongst female Cambodian, Somali, and Vietnamese immigrants in the USA

<p>Abstract</p> <p>Introduction</p> <p>Minority women, particularly immigrants, have lower cancer screening rates than Caucasian women, but little else is known about cancer screening among immigrant women. Our objective was to assess breast, cervical, and colorectal cancer screening rates among immigrant women from Cambodia, Somalia, and Vietnam and explore screening barriers.</p> <p>Methods</p> <p>We measured screening rates by systematic chart review (N = 100) and qualitatively explored screening barriers via face-to-face questionnaire (N = 15) of women aged 50–75 from Cambodia, Somalia, and Vietnam attending a general medicine clinic (Portland, Maine, USA).</p> <p>Results</p> <p><it>Chart Review </it>– Somali women were at higher risk of being unscreened for breast, cervical, and colorectal cancer compared with Cambodian and Vietnamese women. A longer period of US residency was associated with being screened for colorectal cancer. We observed a 7% (OR 1.07, 95% CI 1.01–1.13, p = 0.01) increase in the odds that a woman would undergo a fecal occult blood test for each additional year in the US, and a 39% increase in the odds of a woman being screened by colonoscopy or flexible sigmoidoscopy for every five years of additional US residence (OR 1.39, 95% CI 1.21–1.61, p = 0.02). We did not observe statistically significant relationships between odds of being screened by mammography, clinical breast exam or papanicolaou test according to years in the US. <it>Questionnaire </it>– We identified several barriers to breast, cervical, and colorectal cancer screening, including discomfort with exams conducted by male physicians.</p> <p>Discussion</p> <p>Somali women were less likely to be screened for breast, cervical, and colorectal cancer than Cambodian and Vietnamese women in this population, and uptake of colorectal cancer screening is associated with years of residency in this country. Future efforts to improve equity in cancer screening among immigrants may require both provider and community education.</p

The Vehicle, 1969, Vol. 11 no. 2

Vol. 11, No. 2 Table of Contents Short Story: The TripCharles Whitepage 4 PhotoDale Huberpage 5 A NightRoger Zulaufpage 6 Sixteen-year-old Students...NBpage 6 LostJim Biropage 6 The AmateurRoger Zulaufpage 7 ManRoger Zulaufpage 7 My CamelotRonald Garnerpage 7 The Rose and the BriarKenneth L. Folkertspage 9 Who Am I?Frank McKennedypage 10 PhotoDale Huberpage 11 Mr. Samuel ClemensLarry A. Millerpage 11 Lock OutAra Childspage 12 Excuse MeRoger Zulaufpage 12 On Shadows from a Candle \u2767Michael G. McKeepage 12 beginning of an endCaryl Dagropage 12 DrawingMADpage 13 We Ain\u27t Un HurJames Birchlerpage 13 Genesis II, 18 \u2767Michael G. McKeepage 13 Short Story: A Patent Leather PaleEleanor Aikenpage 14 hungry childRoger Zulaufpage 15 DrawingRoger Zulaufpage 15 PhotoRoger Digglepage 16 Do You Like The Rain?Linda Boltmanpage 17 Seasons ChangePerry J. Carterpage 17 PhotoDale Huberpage 19 Whistling TreesPam McKinneypage 19 PostscriptThomas W. Reapage 20 PhotoDale Huberpage 20https://thekeep.eiu.edu/vehicle/1020/thumbnail.jp

The Vehicle, 1969, Vol. 11 no. 2

Vol. 11, No. 2 Table of Contents Short Story: The TripCharles Whitepage 4 PhotoDale Huberpage 5 A NightRoger Zulaufpage 6 Sixteen-year-old Students...NBpage 6 LostJim Biropage 6 The AmateurRoger Zulaufpage 7 ManRoger Zulaufpage 7 My CamelotRonald Garnerpage 7 The Rose and the BriarKenneth L. Folkertspage 9 Who Am I?Frank McKennedypage 10 PhotoDale Huberpage 11 Mr. Samuel ClemensLarry A. Millerpage 11 Lock OutAra Childspage 12 Excuse MeRoger Zulaufpage 12 On Shadows from a Candle \u2767Michael G. McKeepage 12 beginning of an endCaryl Dagropage 12 DrawingMADpage 13 We Ain\u27t Un HurJames Birchlerpage 13 Genesis II, 18 \u2767Michael G. McKeepage 13 Short Story: A Patent Leather PaleEleanor Aikenpage 14 hungry childRoger Zulaufpage 15 DrawingRoger Zulaufpage 15 PhotoRoger Digglepage 16 Do You Like The Rain?Linda Boltmanpage 17 Seasons ChangePerry J. Carterpage 17 PhotoDale Huberpage 19 Whistling TreesPam McKinneypage 19 PostscriptThomas W. Reapage 20 PhotoDale Huberpage 20https://thekeep.eiu.edu/vehicle/1020/thumbnail.jp