The position of carers in mental health care: exploring experience-based co-design

Experience Based Co-Design (EBCD) is a service design strategy that meaningfully involves service users and translates qualitative data into action. EBCD has not been applied within the context of designing family engagement within a mental health context, and there is little research exploring the mechanisms that ensure successful implementation. Therefore the aim of this project was to explore the processes that facilitate the EBCD work with carers and family involvement. Sixteen participants were recruited from an existing EBCD project who reflected the multiple stakeholders. The study adopted a grounded theory approach and the interview data were analysed accordingly. The preliminary theory produced offers an understanding of the processes involved within an EBCD project with carers, and can be used to inform the successful implementation of future projects. The preliminary theory suggests that for a project to be successful, it needs to be addressing an organisational need with sufficient senior level support. Buy-in from staff can be supported by the problem being made visible. Once established, previously separate groups can work together towards a shared aim and develop simple solutions that can be easily implemented into clinical practice. The EBCD project was not completed at the time of this report, and so may not reflect the end processes. Future research should be conducted to examine the impact of organisational disruption on the effectiveness of EBCD, by completing a project with this range of stakeholders in a more stable setting

The effect of carbon arc radiations on certain components of the blood in children

While acting as a resident Medical Officer in the Royal Hospital for Sick Children, Edinburgh, the writer was very much impressed by the general improvement he saw in certain cases attending the Artificial Heliotherapy Department of the hospital.These cases were Bent to the department, not suffering from any definite disease, but labelled "General Debility ", "Anaemia ", "Post-operative debility ", "Debility from chronic sepsis ", etc.The beneficial effects of Heliotherapy in Rickets, Surgical Tuberculosis and other definite diseases are well known and have been most thoroughly investigated by hosts of observers. However it occurred to the writer to investigate a series of such children and find out whether the beneficial effects of the Heliotherapy could be accounted for, by any changes in certain components of their blood.The selected children were all of a type so very common in any large medical out -patient department of a city hospital. The type of child represented is well known to all pediatricians. It is the child of the poorer hospital class, probably living in one of the worst quarters of the city, inefficiently clothed, under nourished but yet not showing any of the clinical manifestations of rickets. There is usually a long history of chronic ill -health. The child is said to sleep badly, eat little, is easily tired, looks pale and is under average weight and height. When examined no definite disease is found but what usually strikes one is the very bad posture of these children probably from an undernourished muscular system. The child is usually labelled general debility or some such term and given a tonic. Previous to artificial heliotherapy, there usually was little improvement with this treatment unless the children were sent to the country or seaside (natural heliotherapy).Now, however, these children make up a large percentage of the children attending the Heliotherapy Dept, as outpatients and their improvement is most encouraging to all those interested in the use of artificial heliotherapy. The investigation aimed at finding out if any changes in certain components of the blood in these children could account for their improvement.The components investigated were the Red Blood Corpuscles, the White Blood Corpuscles, the Haemoglobin content and the Platelets. The Calcium and phosphorus concentrations in the blood were also estimated at intervals in case any change in these important inorganic constituents of the blood could cause the effect noted.All of these children showed such a marked improvement in colour along with the other manifestations, that the writer was hopeful some important changes could be demonstrated in the blood components investigated, to account for the great change in the/ 5. the child's health. It was with this idea that the investigation was carried out, and though the results obtained are not as convincing as was hoped, yet they are so uniform that in the writer's mind, it is certain that Actinotherapy has a very definite therapeutic action on a blood of poor qualities, the latter being due more to the nourishment of the individual than to any definite organic disease.May not most of these children be suffering from an insufficiency of some vitamin, either A, D or some other not yet isolated, and that sunlight has the same effect here as in Vitamin D insufficiency

Slow Death

Prose Edito

Invasion of the shovelnose ray (Rhinobatos typus) by Neoheterocotyle rhinobatidis and Merizocotyle icopae (Monogenea : Monocotylidae)

This study examined the route of infection by free-swimming larvae of 2 monocotylid monogeneans that inhabit the gills (Neoheterocotyle rhinobatidis) and the nasal tissue (Merizocotyle icopae) of the shovelnose ray, Rhinobatos typus, from Heron Island on the Great Barrier Reef, Australia. Larvae of N. rhinobatidis and M. icopae attached directly to the gills and the nasal tissue of the ray, respectively, and did not first settle on the skin. Initial development of the post-oncomiracidium of N. rhinobatidis was rapid and hamuli formed between 6 and 24 h p.i. at a mean temperature of 26 °C. However, growth then slowed markedly and was variable; only 2 fully mature individuals were found 20 days p.i. at a mean temperature of 24·5 °C. Development of M. icopae was slow and variable throughout; hamuli did not appear until 10 days p.i. and no mature individuals were obtained even 22 days p.i. at a mean temperature of 24·5 °C. No character could be found as an indicator of parasite age for N. rhinobatidis or M. icopae due to the high variability in development in both species.L. A. Chisholm and I. D. Whittingto

Processes in an experience-based co-design project with family carers in community mental health

Experience-based co-design (EBCD) is a service design strategy that facilitates collaborative work between professional staff and service users toward common goals. There is a lack of published examples of it in relation to family carer engagement within a mental health context, and little research exploring the mechanisms behind successful implementation. The aim of this study was to explore the processes that facilitated EBCD with carer involvement. The study adopted a grounded theory–informed approach involving interviews with 16 participants of an existing EBCD project in an English National Health Service (NHS) trust, reflecting multiple stakeholders. EBCD can be thrown off track in two ways: conflict and getting “bogged down.” Leadership by project and design-group leaders could return group cohesion and maintain project momentum. The developed model reflects key processes. Future research should examine EBCD projects with similar ranges of stakeholders and in contexts with different levels of organizational change

Preliminary flight evaluation of an engine performance optimization algorithm

A performance seeking control (PSC) algorithm has undergone initial flight test evaluation in subsonic operation of a PW 1128 engined F-15. This algorithm is designed to optimize the quasi-steady performance of an engine for three primary modes: (1) minimum fuel consumption; (2) minimum fan turbine inlet temperature (FTIT); and (3) maximum thrust. The flight test results have verified a thrust specific fuel consumption reduction of 1 pct., up to 100 R decreases in FTIT, and increases of as much as 12 pct. in maximum thrust. PSC technology promises to be of value in next generation tactical and transport aircraft

Development and flight test of a helicopter, X-band, portable precision landing system concept

A beacon landing system (BLS) is being developed and flight tested as a part of NASA's Rotorcraft All-Weather Operations Research Program. The system is based on state-of-of-the-art X-band radar technology and digital processing techniques. The bLS airborne hardware consists of an X-band receiver and a small micropreocessor, installed in conjunction wht the aircraft instrument landing system (ILS) receiver. The microprocessor analyzes the X-band, BLS pulses and outputs ILS-compatible localizer and glide slope signals. Range information is obtained using an on-board weather/mapping radar in conjunction with the BLS. The ground station is an inexpensive, portable unit; it weighs less than 70 lb and can be quickly deployed at a landing site. Results from the flight-test program show that the BLS has a significant potential for providing rotorcaraft with low-cost, precision instrument approach capability in remote areas