Using de-identified electronic health records to research mental health supported housing services: A feasibility study

BACKGROUND: Mental health supported housing services are a key component in the rehabilitation of people with severe and complex needs. They are implemented widely in the UK and other deinstitutionalised countries but there have been few empirical studies of their effectiveness due to the logistic challenges and costs of standard research methods. The Clinical Record Interactive Search (CRIS) tool, developed to de-identify and interrogate routinely recorded electronic health records, may provide an alternative to evaluate supported housing services. METHODS: The feasibility of using the Camden and Islington NHS Foundation Trust CRIS database to identify a sample of users of mental health supported accommodation services. Two approaches to data interrogation and case identification were compared; using structured fields indicating individual's accommodation status, and iterative development of free text searches of clinical notes referencing supported housing. The data used were recorded over a 10-year-period (01-January-2008 to 31-December-2017). RESULTS: Both approaches were carried out by one full-time researcher over four weeks (150 hours). Two structured fields indicating accommodation status were found, 2,140 individuals had a value in at least one of the fields representative of supported accommodation. The free text search of clinical notes returned 21,103 records pertaining to 1,105 individuals. A manual review of 10% of the notes indicated an estimated 733 of these individuals had used a supported housing service, a positive predictive value of 66.4%. Over two-thirds of the individuals returned in the free text search (768/1,105, 69.5%) were identified via the structured fields approach. Although the estimated positive predictive value was relatively high, a substantial proportion of the individuals appearing only in the free text search (337/1,105, 30.5%) are likely to be false positives. CONCLUSIONS: It is feasible and requires minimal resources to use de-identified electronic health record search tools to identify large samples of users of mental health supported housing using structured and free text fields. Further work is needed to establish the availability and completion of variables relevant to specific clinical research questions in order to fully assess the utility of electronic health records in evaluating the effectiveness of these services

Teleological Essentialism

Placeholder essentialism is the view that there is a causal essence that holds category members together, though we may not know what the essence is. Sometimes the placeholder can be filled in by scientific essences, such as when we acquire scientific knowledge that the atomic weight of gold is 79. We challenge the view that placeholders are elaborated by scientific essences. On our view, if placeholders are elaborated, they are elaborated Aristotelian essences, a telos. Utilizing the same kinds of experiments used by traditional essentialists—involving superficial change (study 1), transformation of insides (study 2), acquired traits (study 3) and inferences about offspring (study 4)—we find support for the view that essences are elaborated by a telos. And we find evidence (study 5) that teleological essences may generate category judgments

Amino Acids in the Asteroidal Water-Bearing Salt Crystals Hosted in the Zag Meteorite

Solid evidence of liquid water in primitive meteorites is given by the ordinary chondrites H5 Monahans (1998) and H3-6 Zag. Aqueous fluid inclusion-bearing halite (NaCl) crystals were shown to be common in Zag. These striking blue/purple crystals (Figure 1), which gained the coloration from electron-trapping in the Cl-vacancies through exposure to ionizing radiation, were determined to be over 4.0-4.7 billion years old by I-Xe dating. The halite grains are present as discrete grains within an H-chondrite matrix with no evidence for aqueous alteration that indicates a xenogenic source, possibly ancient cryovolcanism. They were proposed to be formed from the cryovolcanic plumes on icy C-type asteroids (possibly Ceres), and were transferred and incorporated into the H chondrite parent asteroid following the eruption event(s). A unique aspect of these halites is that they contain abundant solid inclusions hosted within the halites alongside the water inclusions. The solid inclusions were suggested to be entrained within the fluid erupted from the cryovolcanic event(s), and were shown to be comprised of abundant organics. Spectrofluorometric study and Raman imaging of the halites have identified macromolecular carbon and aliphatic carbon compounds. In order to investigate the type of organics present in Zag and in particular within the fluid-bearing halites, we studied for the first time the amino acid contents of a selected mineral (halite) phase in a meteorite sample

The Promise and Perils of Private Voluntary Regulation: Labor Standards and Work Organization in Two Mexican Garment Factories

This paper is part of a larger project on globalization and labor standards organized by Professor Richard Locke of M.I.T.. In addition to the results presented in this paper (some of which appear as well in Monica Romis, "Beneath Corporate Codes of Conduct: What Drives Compliance in Two Mexican Garment Factories," (Masters Thesis, Dept. of Urban Studies and Planning, M.I.T., 2005)), the project entailed field research in China, Turkey, Europe and the United States as well as systematic analysis of Nike’s factory audits of working conditions in over 800 factories in 51 countries.What role can private voluntary regulation play in improving labor standards and working conditions in global supply chain factories? How does this system relate to and interact with other systems of labor regulation and work organization? This paper seeks to address these questions through a structured comparison of two factories supplying Nike, the world’s largest athletic footwear and apparel company. These two factories have many similarities - both are in Mexico, both are in the apparel industry, both produce more or less the same products for Nike (and other brands) and both are subject to the same code of conduct. On the surface, both factories appear to have similar employment (i.e., recruitment, training, remuneration) practices and they receive comparable scores when audited by Nike’s compliance staff. However, underlying (and somewhat obscured by) these apparent similarities, significant differences in actual labor conditions exist between these two factories. What drives these differences in working conditions? What does this imply for traditional systems of monitoring and codes of conduct? Field research conducted at these two factories reveals that beneath the code of conduct and various monitoring efforts aimed at enforcing it, workplace conditions and labor standards are shaped by very different patterns of work organization and human resource management policies

Global parameter search reveals design principles of the mammalian circadian clock

Background: Virtually all living organisms have evolved a circadian (~24 hour) clock that controls physiological and behavioural processes with exquisite precision throughout the day/night cycle. The suprachiasmatic nucleus (SCN), which generates these ~24 h rhythms in mammals, consists of several thousand neurons. Each neuron contains a gene-regulatory network generating molecular oscillations, and the individual neuron oscillations are synchronised by intercellular coupling, presumably via neurotransmitters. Although this basic mechanism is currently accepted and has been recapitulated in mathematical models, several fundamental questions about the design principles of the SCN remain little understood. For example, a remarkable property of the SCN is that the phase of the SCN rhythm resets rapidly after a 'jet lag' type experiment, i.e. when the light/ dark (LD) cycle is abruptly advanced or delayed by several hours. Results: Here, we describe an extensive parameter optimization of a previously constructed simplified model of the SCN in order to further understand its design principles. By examining the top 50 solutions from the parameter optimization, we show that the neurotransmitters' role in generating the molecular circadian rhythms is extremely important. In addition, we show that when a neurotransmitter drives the rhythm of a system of coupled damped oscillators, it exhibits very robust synchronization and is much more easily entrained to light/dark cycles. We were also able to recreate in our simulations the fast rhythm resetting seen after a 'jet lag' type experiment. Conclusion: Our work shows that a careful exploration of parameter space for even an extremely simplified model of the mammalian clock can reveal unexpected behaviours and non-trivial predictions. Our results suggest that the neurotransmitter feedback loop plays a crucial role in the robustness and phase resetting properties of the mammalian clock, even at the single neuron level

Novel colours and the content of experience

I propose a counterexample to naturalistic representational theories of phenomenal character. The counterexample is generated by experiences of novel colours reported by Crane and Piantanida. I consider various replies that a representationalist might make, including whether novel colours could be possible colours of objects and whether one can account for novel colours as one would account for binary colours or colour mixtures. I argue that none of these strategies is successful and therefore that one cannot fully explain the nature of the phenomenal character of perceptual experiences using a naturalistic conception of representation

Prioritizing Preferable Locations for Increasing Urban Tree Canopy in New York City

This paper presents a set of Geographic Information System (GIS) methods for identifying and prioritizing tree planting sites in urban environments. It uses an analytical approach created by a University of Vermont service-learning class called “GIS Analysis of New York City\u27s Ecology” that was designed to provide research support to the MillionTreesNYC tree planting campaign. These methods prioritize tree planting sites based on need (whether or not trees can help address specific issues in the community) and suitability (biophysical constraints and planting partners’ existing programmatic goals). Criteria for suitability and need were based on input from three New York City tree-planting organizations. Customized spatial analysis tools and maps were created to show where each organization may contribute to increasing urban tree canopy (UTC) while also achieving their own programmatic goals. These methods and associated custom tools can help decision-makers optimize urban forestry investments with respect to biophysical and socioeconomic outcomes in a clear and accountable manner. Additionally, the framework described here may be used in other cities, can track spatial characteristics of urban ecosystems over time, and may enable further tool development for collaborative decision-making in urban natural resource management

Integrating the promotion of physical activity within a smoking cessation programme: Findings from collaborative action research in UK Stop Smoking Services

Background: Within the framework of collaborative action research, the aim was to explore the feasibility of developing and embedding physical activity promotion as a smoking cessation aid within UK 6/7-week National Health Service (NHS) Stop Smoking Services. Methods: In Phase 1 three initial cycles of collaborative action research (observation, reflection, planning, implementation and re-evaluation), in an urban Stop Smoking Service, led to the development of an integrated intervention in which physical activity was promoted as a cessation aid, with the support of a theoretically based self-help guide, and self monitoring using pedometers. In Phase 2 advisors underwent training and offered the intervention, and changes in physical activity promoting behaviour and beliefs were monitored. Also, changes in clients’ stage of readiness to use physical activity as a cessation aid, physical activity beliefs and behaviour and physical activity levels were assessed, among those who attended the clinic at 4-week post-quit. Qualitative data were collected, in the form of clinic observation, informal interviews with advisors and field notes. Results: The integrated intervention emerged through cycles of collaboration as something quite different to previous practice. Based on field notes, there were many positive elements associated with the integrated intervention in Phase 2. Self-reported advisors’ physical activity promoting behaviour increased as a result of training and adapting to the intervention. There was a significant advancement in clients’ stage of readiness to use physical activity as a smoking cessation aid. Conclusions: Collaboration with advisors was key in ensuring that a feasible intervention was developed as an aid to smoking cessation. There is scope to further develop tailored support to increasing physical activity and smoking cessation, mediated through changes in perceptions about the benefits of, and confidence to do physical activity

South Korea's automotive labour regime, Hyundai Motors’ global production network and trade‐based integration with the European Union

This article explores the interrelationship between global production networks(GPNs) and free trade agreements (FTAs) in the South Korean auto industry and its employment relations. It focuses on the production network of the Hyundai Motor Group (HMG) — the third biggest automobile manufacturer in the world — and the FTA between the EU and South Korea. This was the first of the EU’s ‘new generation’ FTAs, which among other things contained provisions designed to protect and promote labour standards. The article’s argument is twofold. First, that HMG’s production network and Korea’s political economy (of which HMG is a crucial part) limited the possibilities for the FTA’s labour provisions to take effect. Second, that the commercial provisions in this same FTA simultaneously eroded HMG’s domestic market and corporate profitability, leading to adverse consequences for auto workers in the more insecure and low-paid jobs. In making this argument, the article advances a multiscalar conceptualization of the labour regime as an analytical intermediary between GPNs and FTAs. It also provides one of the first empirical studies of the EU–South Korea FTA in terms of employment relations, drawing on 105 interviews with trade unions, employer associations, automobile companies and state officials across both parties

A Valid and Reliable Instrument for Cognitive Complexity Rating Assignment of Chemistry Exam Items

The design and use of a valid and reliable instrument for the assignment of cognitive complexity ratings to chemistry exam items is described in this paper. Use of such an instrument provides a simple method to quantify the cognitive demands of chemistry exam items. Instrument validity was established in two different ways: statistically significant correlations between expert-based cognitive complexity ratings and student performance (as measured through statistical difficulty of items), and statistically significant correlations between expert-based cognitive complexity ratings and student mental effort ratings. Key benefits associated with instrument use include an enhanced understanding of the cognitive complexity of chemistry assessment tasks and as a means for characterizing exam content for the measurement of cognitive development