Validity, reliability, acceptability, and utility of the Social Inclusion Questionnaire User Experience (SInQUE): a clinical tool to facilitate social inclusion amongst people with severe mental health problems.

BACKGROUND: Individuals with severe mental health problems are at risk of social exclusion, which may complicate their recovery. Mental health and social care staff have, until now, had no valid or reliable way of assessing their clients' social inclusion. The Social Inclusion Questionnaire User Experience (SInQUE) was developed to address this. It assesses five domains: social integration; productivity; consumption; access to services; and political engagement, in the year prior to first psychiatric admission (T1) and the year prior to interview (T2) from which a total score at each time point can be calculated. AIMS: To establish the validity, reliability, and acceptability of the SInQUE in individuals with a broad range of psychiatric diagnoses receiving care from community mental health services and its utility for mental health staff. METHOD: Participants were 192 mental health service users with psychosis, personality disorder, or common mental disorder (e.g., depression, anxiety) who completed the SInQUE alongside other validated outcome measures. Test-retest reliability was assessed in a sub-sample of 30 participants and inter-rater reliability was assessed in 11 participants. SInQUE ratings of 28 participants were compared with those of a sibling with no experience of mental illness to account for shared socio-cultural factors. Acceptability and utility of the tool were assessed using completion rates and focus groups with staff. RESULTS: The SInQUE demonstrated acceptable convergent validity. The total score and the Social Integration domain score were strongly correlated with quality of life, both in the full sample and in the three diagnostic groups. Discriminant validity and test-retest reliability were established across all domains, although the test-retest reliability on scores for the Service Access and Political Engagement domains prior to first admission to hospital (T1) was lower than other domains. Inter-rater reliability was excellent for all domains at T1 and T2. CONCLUSIONS: The component of the SInQUE that assesses current social inclusion has good psychometric properties and can be recommended for use by mental health staff

Identifying factors that promote and limit the effective use of real-time patient experience feedback: a mixed-methods study in secondary care

Objectives: The Friends and Family Test (FFT) is commissioned by the National Health Service (NHS) in England to capture patient experience as a real-time feedback initiative for patient-centred quality improvement (QI). The aim of this study was to create a process map in order to identify the factors that promote and limit the effective use of FFT as a real-time feedback initiative for patient-centred QI. Setting: This study was conducted at a large London NHS Trust. Services include accident and emergency, inpatient, outpatient and maternity, which routinely collect FFT patient experience data. Participants: Healthcare staff and key stakeholders involved in FFT. Interventions: Semi-structured interviews were conducted on fifteen participants from a broad range of professional groups to evaluate their engagement with the FFT. Interview data were recorded, transcribed, and analysed for using deductive thematic analysis. Results: Concerns related to inefficiency in the flow of FFT data, lack of time to analyse FFT reports (with emphasis on high level reporting rather than QI), insufficient access to FFT reports and limited training provided to understand FFT reports for frontline staff. The sheer volume of data received was not amenable to manual thematic analysis resulting in inability to acquire insight from the free-text. This resulted in staff ambivalence towards FFT as a near real-time feedback initiative. Conclusions: The results state that there is too much FFT free text for meaningful analysis, and the output is limited to the provision of sufficient capacity and resource to analyse the data, without consideration of other options, such as text analytics and amending the data collection tool

Male frequent attenders of general practice and their help seeking preferences

Background: Low rates of health service usage by men are commonly linked to masculine values and traditional male gender roles. However, not all men conform to these stereotypical notions of masculinity, with some men choosing to attend health services on a frequent basis, for a variety of different reasons. This study draws upon the accounts of male frequent attenders of the General Practitioner's (GP) surgery, examining their help-seeking preferences and their reasons for choosing services within general practice over other sources of support. Methods: The study extends thematic analysis of interview data from the Self Care in Primary Care study (SCinPC), a large scale multi-method evaluation study of a self care programme delivered to frequent attenders of general practice. Data were collected from 34 semi-structured interviews conducted with men prior to their exposure to the intervention. Results: The ages of interviewed men ranged from 16 to 72 years, and 91% of the sample (n= 31) stated that they had a current health condition. The thematic analysis exposed diverse perspectives within male help-seeking preferences and the decision-making behind men's choice of services. The study also draws attention to the large variation in men's knowledge of available health services, particularly alternatives to general practice. Furthermore, the data revealed some men's lack of confidence in existing alternatives to general practice. Conclusions: The study highlights the complex nature of male help-seeking preferences, and provides evidence that there should be no 'one size fits all' approach to male service provision. It also provides impetus for conducting further studies into this under researched area of interest. © 2011 WPMH GmbH

Atomic Carbon in Galaxies

We present new measurements of the ground state fine-structure line of atomic carbon at 492 GHz in a variety of nearby external galaxies, ranging from spiral to irregular, interacting and merging types. In comparison with CO(1-0), the CI(1-0) intensity stays fairly comparable in the different environments, with an average value of the ratio of the line integrated areas in Kkm/s of CI(1-0)/CO(1-0) = 0.2 +/- 0.2. However, some variations can be found within galaxies, or between galaxies. Relative to CO lines, CI(1-0) is weaker in galactic nuclei, but stronger in disks, particularly outside star forming regions. Also, in NGC 891, the CI(1-0) emission follows the dust continuum at 1.3mm extremely well along the full length of the major axis where molecular gas is more abundant than atomic gas. Atomic carbon therefore appears to be a good tracer of molecular gas in external galaxies, possibly more reliable than CO. Atomic carbon can contribute significantly to the thermal budget of interstellar gas. Cooling due to C and CO amounts typically to 2 x 10^{-5} of the FIR continuum or 5% of the CII line. However, C and CO cooling reaches 30% of the gas total, in Ultra Luminous InfraRed Galaxies, where CII is abnormally faint. Together with CII/FIR, the emissivity ratio CI(1-0)/FIR can be used as a measure of the non-ionizing UV radiation field in galaxies.Comment: 26 pages, 8 figure

Lattice anisotropy as microscopic origin of static stripes in cuprates

Structural distortions in cuprate materials offer a microscopic origin for anisotropies in electron transport in the basal plane. Using a real-space Hartree-Fock approach, we consider the ground states of the anisotropic Hubbard (t_x \ne t_y) and t-J (t_x \ne t_y, J_x \ne J_y) models. Symmetrical but inhomogeneous (``polaronic'') charge structures in the isotropic models are altered even by rather small anisotropies to one-dimensional, stripe-like features. We find two distinct types of stripe, namely uniformly filled, antiphase domain walls and non-uniform, half-filled, in-phase ones. We characterize their properties, energies and dependence on the model parameters, including filling and anisotropy in t (and J). We discuss the connections among these results, other theoretical studies and experimental observation.Comment: 18 pages, 16 figures, 8 table

From teaching physics to teaching children : beginning teachers learning from pupils

This paper discusses the development of beginning physics teachers' pedagogical content knowledge (PCK) in the context of teaching basic electricity during a one-year Professional Graduate Diploma in Education course (PGDE) and beyond. This longitudinal study used repeated semi-structured interviews over a period of four-and-a-half years. The interview schedule followed a line of development through the secondary school electrical syllabus in Scotland. Fifteen student teachers were interviewed during the PGDE year. Six of them were followed up at the end of the Induction Year (their first year as a newly qualified teacher), and again two-and-a-half years later. Thematic analysis of the interviews showed that before the beginning teachers had taught any classes, their initial focus was on how to transform their own subject matter knowledge (SMK) about electricity into forms that were accessible to pupils. As the beginning teachers gained experience working with classes, they gave vivid descriptions of interacting with particular pupils when teaching electricity which showed the development of their pedagogical knowledge. This played a significant role in the teachers' change of focus from teaching physics to teaching children as they transformed their SMK into forms that were accessible to pupils and developed their general pedagogical knowledge

Origin of G-type Antiferromagnetism and Orbital-Spin Structures in LaTiO3{\rm LaTiO}_3

The possibility of the $D_{3d}$ distortion of ${\rm TiO}_6$ octahedra is examined theoretically in order to understand the origin of the G-type antiferromagnetism (AFM(G)) and experimentally observed puzzling properties of ${\rm LaTiO}_3$. By utilizing an effective spin and pseudospin Hamiltonian with the strong Coulomb repulsion, it is shown that AFM(G) state is stabilized through the lift of the $t_{2g}$-orbital degeneracy accompanied by a tiny $D_{3d}$-distortion . The estimated spin-exchange interaction is in agreement with that obtained by the neutron scattering. Moreover, the level-splitting energy due to the distortion can be considerably larger than the spin-orbit interaction even when the distortion becomes smaller than the detectable limit under the available experimental resolution. This suggests that the orbital momentum is fully quenched and the relativistic spin-orbit interaction is not effective in this system, in agreement with recent neutron-scattering experiment.Comment: 9 pages, 6 figure

Magnetic field diagnostics and spatio-temporal variability of the solar transition region

Magnetic field diagnostics of the transition region from the chromosphere to the corona faces us with the problem that one has to apply extreme UV spectro-polarimetry. While for coronal diagnostic techniques already exist through infrared coronagraphy above the limb and radio observations on the disk, for the transition region one has to investigate extreme UV observations. However, so far the success of such observations has been limited, but there are various projects to get spectro-polarimetric data in the extreme UV in the near future. Therefore it is timely to study the polarimetric signals we can expect for such observations through realistic forward modeling. We employ a 3D MHD forward model of the solar corona and synthesize the Stokes I and Stokes V profiles of C IV 1548 A. A signal well above 0.001 in Stokes V can be expected, even when integrating for several minutes in order to reach the required signal-to-noise ratio, despite the fact that the intensity in the model is rapidly changing (just as in observations). Often this variability of the intensity is used as an argument against transition region magnetic diagnostics which requires exposure times of minutes. However, the magnetic field is evolving much slower than the intensity, and thus when integrating in time the degree of (circular) polarization remains rather constant. Our study shows the feasibility to measure the transition region magnetic field, if a polarimetric accuracy on the order of 0.001 can be reached, which we can expect from planned instrumentation.Comment: Accepted for publication in Solar Physics (4.Mar.2013), 19 pages, 9 figure