1,433 research outputs found
The addition of granulocyte macrophage colony stimulating factor (GM-CSF) to juvenile systemic lupus erythematosus serum can reduce abnormal neutrophil apoptosis
GaN Nanowire Schottky Barrier Diodes
A new concept of vertical gallium nitride (GaN) Schottky barrier diode based on nanowire (NW) structures and the principle of dielectric REduced SURface Field (RESURF) is proposed in this paper. High-threading dislocation density in GaN epitaxy grown on foreign substrates has hindered the development and commercialization of vertical GaN power devices. The proposed NW structure, previously explored for LEDs offers an opportunity to reduce defect density and fabricate low cost vertical GaN power devices on silicon (Si) substrates. In this paper, we investigate the static characteristics of high-voltage GaN NW Schottky diodes using 3-D TCAD device simulation. The NW architecture theoretically achieves blocking voltages upward of 700 V with very low specific on-resistance. Two different methods of device fabrication are discussed. Preliminary experimental results are reported on device samples fabricated using one of the proposed methods. The fabricated Schottky diodes exhibit a breakdown voltage of around 100 V and no signs of current collapse. Although more work is needed to further explore the nano-GaN concept, the preliminary results indicate that superior tradeoff between the breakdown voltage and specific on-resistance can be achieved, all on a vertical architecture and a foreign substrate. The proposed NW approach has the potential to deliver low cost reliable GaN power devices, circumventing the limitations of today's high electron mobility transistors (HEMTs) technology and vertical GaN on GaN devices
‘Talking a different language’: an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services
Background: Organizational culture is manifest in patterns of behaviour underpinned by beliefs, values, attitudes and assumptions, which can influence working practices. Cultural factors and working practices have been suggested to influence the transition of young people moving from child to adult mental health services. Failure to manage and integrate transitional care effectively can lead to young people losing contact with health and social care systems, resulting in adverse effects on health, well-being and potential.
Methods: The study aim was to identify the organisational factors which facilitate or impede transition of young people from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) from the perspective of health professionals and representatives of voluntary organisations. Specific objectives were (i) to explore organizational cultures, structures, processes and resources which influence transition from child to adult mental health services; (ii) identify factors which constitute barriers and facilitators to transition and continuity of care and (iii) make recommendations for service improvements. Within an exploratory, qualitative design thirty four semi-structured interviews were conducted with health and social care professionals working in CAMHS and AMHS in four NHS Mental Health Trusts and four voluntary organizations, in England.
Results: A cultural divide appears to exist between CAMHS and AMHS, characterized by different beliefs, attitudes, mutual misperceptions and a lack of understanding of different service structures. This is exacerbated by working practices relating to communication and information transfer which could impact negatively on transition, relational, informational and cross boundary continuity of care. There is also evidence of a cultural shift, with some positive approaches to collaborative working across services and agencies, involving joint posts, parallel working,
shared clinics and joint meetings.
Conclusions: Cultural factors embodied in mutual misperceptions, attitudes, beliefs exist between CAMHS and AMHS. Working practices can exert either positive or negative effects on transition and continuity of care. Implementation of shared education and training, standardised approaches to record keeping and information transfer, supported by compatible IT resources are recommended, alongside management strategies which evaluate the achievement of outcomes related to transition and continuity of care
'Talking a different language': an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services.
BACKGROUND: Organizational culture is manifest in patterns of behaviour underpinned by beliefs, values, attitudes and assumptions, which can influence working practices. Cultural factors and working practices have been suggested to influence the transition of young people moving from child to adult mental health services. Failure to manage and integrate transitional care effectively can lead to young people losing contact with health and social care systems, resulting in adverse effects on health, well-being and potential.
METHODS: The study aim was to identify the organisational factors which facilitate or impede transition of young people from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) from the perspective of health professionals and representatives of voluntary organisations. Specific objectives were (i) to explore organizational cultures, structures, processes and resources which influence transition from child to adult mental health services; (ii) identify factors which constitute barriers and facilitators to transition and continuity of care and (iii) make recommendations for service improvements. Within an exploratory, qualitative design thirty four semi-structured interviews were conducted with health and social care professionals working in CAMHS and AMHS in four NHS Mental Health Trusts and four voluntary organizations, in England.
RESULTS: A cultural divide appears to exist between CAMHS and AMHS, characterized by different beliefs, attitudes, mutual misperceptions and a lack of understanding of different service structures. This is exacerbated by working practices relating to communication and information transfer which could impact negatively on transition, relational, informational and cross boundary continuity of care. There is also evidence of a cultural shift, with some positive approaches to collaborative working across services and agencies, involving joint posts, parallel working, shared clinics and joint meetings.
CONCLUSIONS: Cultural factors embodied in mutual misperceptions, attitudes, beliefs exist between CAMHS and AMHS. Working practices can exert either positive or negative effects on transition and continuity of care. Implementation of shared education and training, standardised approaches to record keeping and information transfer, supported by compatible IT resources are recommended, alongside management strategies which evaluate the achievement of outcomes related to transition and continuity of care
Rural men and mental health: their experiences and how they managed
There is a growing awareness that a primary source of information about mental health lies with the consumers. This article reports on a study that interviewed rural men
with the aim of exploring their mental health experiences within a rural environment. The results of the interviews are a number of stories of resilience and survival that
highlight not only the importance of exploring the individuals' perspective of their issues, but also of acknowledging and drawing on their inner strengths. Rural men face a number of challenges that not only increase the risk of mental illness but also decrease the likelihood of them seeking and/or finding professional support. These men's stories, while different from each other, have a common thread of coping. Despite some support from family and friends participants also acknowledged that seeking out professional support could have made the recovery phase easier. Mental health nurses need to be aware, not only of the barrier to professional support but also of the significant resilience that individuals have and how it can be utilised
‘I will not be thrown out of the country because I’m an immigrant’: Eastern European migrants’ responses to hate crime in a semi-rural context in the wake of Brexit
This article examines Eastern European migrants’ experiences of and responses to hate crime. Following the UK European Union Membership Referendum (‘Brexit’ vote), there was an increase in reported hate crimes against immigrants. The study focuses on the experiences of migrants in Lincolnshire, a region of England which has a significant migrant population, and which had one of the highest ‘leave’ votes. The focus on white migrants in this semi-rural setting offers an original perspective in the field of hate crime studies. We draw on semi-structured interviews and observations to identify temporal, spatial, and relational factors in responses to hate crime. We uncover the insecure occupation of a ‘third space’ constituted by material, discursive, and emotional practices. This positioning was destabilised post referendum; but there was also evidence of the operation of agency within processes of ‘othering’, suggesting a transition from victim identity to emergent political subject
‘I will not be thrown out of the country because I’m an immigrant’: Eastern European migrants’ responses to hate crime in a semi-rural context in the wake of Brexit
This article examines Eastern European migrants’ experiences of and responses to hate crime. Following the UK European Union Membership Referendum (‘Brexit’ vote), there was an increase in reported hate crimes against immigrants. The study focuses on the experiences of migrants in Lincolnshire, a region of England which has a significant migrant population, and which had one of the highest ‘leave’ votes. The focus on white migrants in this semi-rural setting offers an original perspective in the field of hate crime studies. We draw on semi-structured interviews and observations to identify temporal, spatial, and relational factors in responses to hate crime. We uncover the insecure occupation of a ‘third space’ constituted by material, discursive, and emotional practices. This positioning was destabilised post referendum; but there was also evidence of the operation of agency within processes of ‘othering’, suggesting a transition from victim identity to emergent political subject
Differences in management approaches for lupus nephritis within the UK
\ua9 The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology.Objectives: Outcomes of therapy for LN are often suboptimal. Guidelines offer varied options for treatment of LN and treatment strategies may differ between clinicians and regions. We aimed to assess variations in the usual practice of UK physicians who treat LN. Methods: We conducted an online survey of simulated LN cases for UK rheumatologists and nephrologists to identify treatment preferences for class IV and class V LN. Results: Of 77 respondents, 48 (62.3%) were rheumatologists and 29 (37.7%) were nephrologists. A total of 37 (48.0%) reported having a joint clinic between nephrologists and rheumatologists, 54 (70.0%) reported having a multidisciplinary team meeting for LN and 26 (33.7%) reported having a specialized lupus nurse. Of the respondents, 58 (75%) reported arranging a renal biopsy before starting the treatment. A total of 20 (69%) of the nephrologists, but only 13 (27%) rheumatologists, reported having a formal departmental protocol for treating patients with LN (P < 0.001). The first-choice treatment of class IV LN in pre-menopausal patients was MMF [41 (53.2%)], followed by CYC [15 (19.6%)], rituximab [RTX; 12 (12.5%)] or a combination of immunosuppressive drugs [9 (11.7%)] with differences between nephrologists’ and rheumatologists’ choices (P \ubc 0.026). For class V LN, MMF was the preferred initial treatment, irrespective of whether proteinuria was in the nephrotic range or not. RTX was the preferred second-line therapy for non-responders. Conclusion: There was variation in the use of protocols, specialist clinic service provision, biopsies and primary and secondary treatment choices for LN reported by nephrologists and rheumatologists in the UK
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