Parental perceptions of barriers to mental health services for young people

Aim: This study explores a range of barriers that parents encountered in accessing mental health services. The study also explored whether parents experienced similar barriers to accessing services in 2003 and 2013. Methods: One hundred and thirty-four parents of young people attending an initial assessment at a Child and Adolescent Mental Health Service (CAMHS) or headspace centre completed a questionnaire assessing 10 general barriers to care. These data were compared to those collected from 129 participants at CAMHS in 2003. Results: The ranking of barriers to mental health care for their children was similar for both survey years, with \u27wait time being too long\u27 and \u27help being too expensive\u27 the two highest ranked barriers. Cost factors were related to not knowing that the services did not charge fees and having to take time off work to attend appointments. Multiple referral steps and uncertain wait times were the main concerns regarding wait times. The overall strength with which barriers were endorsed remained relatively low; however, at least 40% of the sample agreed they had experienced four of the barriers in both years. Conclusions: Despite relatively low endorsement of barriers, there are substantial proportions of parents who experienced some barriers to services, and services should continue working to reduce them to facilitate timely access. There is a particular need for more service-related information to clarify that public sector mental health services do not charge fees. Methods such as rapid initial assessment and actively managing wait lists may go some way to reducing perceived wait time barriers

Dynamics of open quantum systems

The coupling between the states of a system and the continuum into which it is embedded, induces correlations that are especially large in the short time scale. These correlations cannot be calculated by using a statistical or perturbational approach. They are, however, involved in an approach describing structure and reaction aspects in a unified manner. Such a model is the SMEC (shell model embedded in the continuum). Some characteristic results obtained from SMEC as well as some aspects of the correlations induced by the coupling to the continuum are discussed.Comment: 16 pages, 5 figure

Resonance trapping and saturation of decay widths

Resonance trapping appears in open many-particle quantum systems at high level density when the coupling to the continuum of decay channels reaches a critical strength. Here a reorganization of the system takes place and a separation of different time scales appears. We investigate it under the influence of additional weakly coupled channels as well as by taking into account the real part of the coupling term between system and continuum. We observe a saturation of the mean width of the trapped states. Also the decay rates saturate as a function of the coupling strength. The mechanism of the saturation is studied in detail. In any case, the critical region of reorganization is enlarged. When the transmission coefficients for the different channels are different, the width distribution is broadened as compared to a chi_K^2 distribution where K is the number of channels. Resonance trapping takes place before the broad state overlaps regions beyond the extension of the spectrum of the closed system.Comment: 18 pages, 8 figures, accepted by Phys. Rev.

Kemod: A Mixed Chemical Kinetic And Equilibrium Model of Aqueous and Solid Phase Geochemical Reactions

This report presents the development of a mixed chemical Kinetic and Equilibrium MODel (KEMOD), in which every chemical species can be treated either as a equilibrium-controlled or as a kinetically controlled reaction. The reaction processes include aqueous complexation, adsorption/ desorption, ion exchange, precipitation/dissolution, oxidation/reduction, and acid/base reactions. Further development and modification of KEMOD can be made in: (1) inclusion of species switching solution algorithms, (2) incorporation of the effect of temperature and pressure on equilibrium and rate constants, and (3) extension to high ionic strength

Phase transitions in open quantum systems

We consider the behaviour of open quantum systems in dependence on the coupling to one decay channel by introducing the coupling parameter $\alpha$ being proportional to the average degree of overlapping. Under critical conditions, a reorganization of the spectrum takes place which creates a bifurcation of the time scales with respect to the lifetimes of the resonance states. We derive analytically the conditions under which the reorganization process can be understood as a second-order phase transition and illustrate our results by numerical investigations. The conditions are fulfilled e.g. for a picket fence with equal coupling of the states to the continuum. Energy dependencies within the system are included. We consider also the generic case of an unfolded Gaussian Orthogonal Ensemble. In all these cases, the reorganization of the spectrum occurs at the critical value $\alpha_{crit}$ of the control parameter globally over the whole energy range of the spectrum. All states act cooperatively.Comment: 28 pages, 22 Postscript figure

Ethics and Floods: A Systematic Review

Disaster ethics is a developing field of inquiry recognizing the wide variety of ethical issues confronting various professionals involved in planning for and responding to different types of disasters. This article explores how ethical issues related to floods are addressed in academic literature. The review involved analysis of publications on ethics and floods identified in a systematic literature search of electronic databases that included sociological, biomedical, and geophysical sources. The review methods were guided by the PRISMA Statement on systematic reviews, adapted to this topic area, and followed by a qualitative analysis of the included publications. All articles were analyzed using NVivo software version 11. The qualitative analysis showed that further research is needed on the ethical issues involved in flood disasters. Ethical guidelines are needed for flood planners and responders that are based on the consistent application of well-established ethical principles, values, and virtues to the specific circumstances arising with each flood. Flexibility is required in applying such approaches. The results suggest that interdisciplinary collaboration (sociological, biomedical, geophysical, engineering, and ethical) could contribute significantly to the development of ethics in floods

Dynamics of quantum systems

A relation between the eigenvalues of an effective Hamilton operator and the poles of the $S$ matrix is derived which holds for isolated as well as for overlapping resonance states. The system may be a many-particle quantum system with two-body forces between the constituents or it may be a quantum billiard without any two-body forces. Avoided crossings of discrete states as well as of resonance states are traced back to the existence of branch points in the complex plane. Under certain conditions, these branch points appear as double poles of the $S$ matrix. They influence the dynamics of open as well as of closed quantum systems. The dynamics of the two-level system is studied in detail analytically as well as numerically.Comment: 21 pages 7 figure

Interfering Doorway States and Giant Resonances. I: Resonance Spectrum and Multipole Strengths

A phenomenological schematic model of multipole giant resonances (GR) is considered which treats the external interaction via common decay channels on the same footing as the coherent part of the internal residual interaction. The damping due to the coupling to the sea of complicated states is neglected. As a result, the formation of GR is governed by the interplay and competition of two kinds of collectivity, the internal and the external one. The mixing of the doorway components of a GR due to the external interaction influences significantly their multipole strengths, widths and positions in energy. In particular, a narrow resonance state with an appreciable multipole strength is formed when the doorway components strongly overlap.Comment: 20 pages, LaTeX, 3 ps-figures, to appear in PRC (July 1997

Observation of resonance trapping in an open microwave cavity

The coupling of a quantum mechanical system to open decay channels has been theoretically studied in numerous works, mainly in the context of nuclear physics but also in atomic, molecular and mesoscopic physics. Theory predicts that with increasing coupling strength to the channels the resonance widths of all states should first increase but finally decrease again for most of the states. In this letter, the first direct experimental verification of this effect, known as resonance trapping, is presented. In the experiment a microwave Sinai cavity with an attached waveguide with variable slit width was used.Comment: to be published in Phys. Rev. Let

Is stroke early supported discharge still effective in practice? A prospective comparative study

Objective: Randomised controlled trials have shown the benefits of Early Supported Discharge (ESD) of stroke survivors. Our aim was to evaluate whether ESD is still beneficial when operating in the complex context of frontline healthcare provision. Design: We conducted a cohort study with quasi experimental design. A total of 293 stroke survivors (transfer independently or with assistance of one, identified rehabilitation goals) within two naturally formed groups were recruited from two acute stroke units: ‘ESD’ n=135 and ‘Non ESD’ n=158 and 84 caregivers. The ‘ESD’ group accessed either of two ESD services operating in Nottinghamshire, UK. The ‘Non ESD’ group experienced standard practices for discharge and onward referral. Outcome measures (primary: Barthel Index) were administered at baseline, 6 weeks, 6 months and 12 months. Results: The ESD group had a significantly shorter length of hospital stay (P=0.029) and reported significantly higher levels of satisfaction with services received (P<0.001). Following adjustment for age differences at baseline, participants in the ESD group (n=71) had significantly higher odds (compared to the Non ESD group, n=85) of being in the ⩾90 Barthel Index category at 6 weeks (OR = 1.557, 95% CI 2.579 to 8.733), 6 months (OR = 1.541, 95% CI 2.617 to 8.340) and 12 months (OR 0.837, 95% CI 1.306 to 4.087) respectively in relation to baseline. Carers of patients accessing ESD services showed significant improvement in mental health scores (P<0.01). Conclusion: The health benefits of ESD are still evident when evidence based models of these services are implemented in practice