Tackling Health Inequalities in Scotland: an Innovative Approach to Implement the ‘Early Years’ Policy into Practice

Major health inequalities existing across the world and are often closely linked with degrees of social disadvantage. Scotland is fully committed to tackling this major challenge of health and social inequalities. One key focus is ensuring that every child and young person has equal access to opportunities and health improvements. This is supported by a series of national guidelines and ‘early years’ policy drivers. To implement these policies in practice, one National Health Service (NHS) health board (Lanarkshire) in collaboration with the University of the West of Scotland (UWS), adopted an innovative approach to develop the Best Possible Start (BPS) program of focused activity to reshape ‘early years’ services and ways of working. The foundation for the program was the national transformational initiative ‘Getting it right for every child (GIRFEC)’. This is based on the belief that the developments of the child and their experiences in the early years have a major impact on the child’s future life chances. The early nurturing environment is seen crucial in influencing emotional attachment. The BPS program focused on reshaping and streamlining the related health services in the early years between preconception and early school years. This is incorporated in the universal pathway of care encompassing all ‘early years’ services and related professionals. This universal pathway of care is underpinned with evidence based practice, workforce development, building research capacity and influencing leadership in the workplace. This paper presents a detailed overview of the BPS program including the structure, strategic aims and the rationale underpinning the pathway of care

Influencing Leadership and Building Research Capacity through the Implementation of Health Policy into Practice

Leadership in nursing and midwifery is a cornerstone to guide and support teams in the dynamic and rapidly changing health environment. Developing research capacity in health is also a key factor to produce and implement a sound evidence base for practice. Internationally, building health service research capacity is a recognized essential factor to influence and inform policy and practice. This includes developing research capacity across the range of individuals and teams, organisations and networks. This paper describes how one NHS Health Board in Scotland promoted a supportive environment and activities to develop leadership and increase research capacity to support implementation of national Early Years policies into practice

The effect of charging rate on the graphite electrode of commercial lithium-ion cells : a post-mortem study

Increased charging rates negatively affect the lifetime of lithium-ion cells by increasing cell resistance and reducing capacity. This work is a post-mortem study of 18650-type cells subjected to charge rates of 0.7-, 2-, 4-, and 6-C. For cells charged at 0.7-C to 4-C, this performance degradation is primarily related to surface film thickness with no observable change in surface film chemical composition. However, at charge rates of 6-C, the chemical composition of the surface film changes significantly, suggesting that this change is the reason for the sharper increase in cell resistance compared to the lower charge rates. In addition, we found that surface film formation was not uniform across the electrode. Surface film was thicker and chemically different along the central band of the electrode “jelly roll”. This result is most likely attributable to an increase in temperature that results from non-uniform electrode wetting during manufacture. This non-uniform change further resulted in active material delamination from the current collector owing to chemical changes to the binder for the cell charged at 6-C

Aspirin for the older person: report of a meeting at the Royal Society of Medicine, London, 3rd November 2011

On November 23rd 2011, the Aspirin Foundation held a meeting at the Royal Society of Medicine in London to review current thinking on the potential role of aspirin in preventing cardiovascular disease and reducing the risk of cancer in older people. The meeting was supported by Bayer Pharma AG and Novacyl

Exact diagonalization of the S=1/2 Heisenberg antiferromagnet on finite bcc lattices to estimate properties on the infinite lattice

Here we generate finite bipartite body-centred cubic lattices up to 32 vertices. We have studied the spin one half Heisenberg antiferromagnet by diagonalizing its Hamiltonian on each of the finite lattices and hence computing its ground state properties. By extrapolation of these data we obtain estimates of the T = 0 properties on the infinite bcc lattice. Our estimate of the T = 0 energy agrees to five parts in ten thousand with third order spin wave and series expansion method estimates, while our estimate of the staggered magnetization agrees with the spin wave estimate to within a quarter of one percent.Comment: 16 pages, LaTeX, 1 ps figure, to appear in J.Phys.

Spin-1/2 J1-J2 model on the body-centered cubic lattice

Using exact diagonalization (ED) and linear spin wave theory (LSWT) we study the influence of frustration and quantum fluctuations on the magnetic ordering in the ground state of the spin-1/2 J1-J2 Heisenberg antiferromagnet (J1-J2 model) on the body-centered cubic (bcc) lattice. Contrary to the J1-J2 model on the square lattice, we find for the bcc lattice that frustration and quantum fluctuations do not lead to a quantum disordered phase for strong frustration. The results of both approaches (ED, LSWT) suggest a first order transition at J2/J1 $\approx$ 0.7 from the two-sublattice Neel phase at low J2 to a collinear phase at large J2.Comment: 6.1 pages 7 figure

Structure and lithium transport pathways in Li₂FeSiO₄ cathodes for lithium batteries

The importance of exploring new low-cost and safe cathodes for large-scale lithium batteries has led to increasing interest in Li(2)FeSiO(4). The structure of Li(2)FeSiO(4) undergoes significant change on cycling, from the as-prepared γ(s) form to an inverse β(II) polymorph; therefore it is important to establish the structure of the cycled material. In γ(s) half the LiO(4), FeO(4), and SiO(4) tetrahedra point in opposite directions in an ordered manner and exhibit extensive edge sharing. Transformation to the inverse β(II) polymorph on cycling involves inversion of half the SiO(4), FeO(4), and LiO(4) tetrahedra, such that they all now point in the same direction, eliminating edge sharing between cation sites and flattening the oxygen layers. As a result of the structural changes, Li(+) transport paths and corresponding Li-Li separations in the cycled structure are quite different from the as-prepared material, as revealed here by computer modeling, and involve distinct zigzag paths between both Li sites and through intervening unoccupied octahedral sites that share faces with the LiO(4) tetrahedra

A study of the diagnostic accuracy of the PHQ-9 in primary care elderly

<p>Abstract</p> <p>Background</p> <p>The diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) for assessment of depression in elderly persons in primary care settings in the United States has not been previously addressed. Thus, the purpose of this study was to evaluate the test performance of the PHQ-9 for detecting major and minor depression in elderly patients in primary care.</p> <p>Methods</p> <p>A prospective study of diagnostic accuracy was conducted in two primary care, university-based clinics in the Pacific Northwest of the United States. Seventy-one patients aged 65 years or older participated; all completed the PHQ-9 and the 15-item Geriatric Depression Scale (GDS) and underwent the Structured Clinical Interview for Depression (SCID). Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, and likelihood ratios (LRs) were calculated for the PHQ-9, the PHQ-2, and the 15-item GDS for major depression alone and the combination of major plus minor depression.</p> <p>Results</p> <p>Two thirds of participants were female, with a mean age of 78 and two chronic health conditions. Twelve percent met SCID criteria for major depression and 13% minor depression. The PHQ-9 had an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.74-1.00) for major depression, while the PHQ-2 and the 15-item GDS each had an AUC of 0.81 (95% CI for PHQ-2, 0.64-0.98, and for 15-item GDS, 0.70-0.91; <it>P </it>= 0.551). For major and minor depression combined, the AUC for the PHQ-9 was 0.85 (95% CI, 0.73-0.96), for the PHQ-2, 0.80 (95% CI, 0.68-0.93), and for the 15-item GDS, 0.71 (95% CI, 0.55-0.87; <it>P </it>= 0.187).</p> <p>Conclusions</p> <p>Based on AUC values, the PHQ-9 performs comparably to the PHQ-2 and the 15-item GDS in identifying depression among primary care elderly.</p