“I’m just a long history of people rejecting referrals” experiences of young people who fell through the gap between child and adult mental health services

The paediatric-adult split in mental health care necessitates young people to make a transition between services when they reach the upper end of child and adolescent mental health services (CAMHS). However, we know that this transition is often poor, and not all young people who require ongoing support are able to continue care in adult mental health services (AMHS). These young people are said to have fallen through the gap between services. This research aimed to explore the reasons why young people fall through the gap between CAMHS and AMHS, and what effect his has had on them and their families. Narrative interviews were conducted with 15 young people and 15 parents, representing 19 unique transition stories. Themes were identified collaboatively using thematic analysis. Reasons for falling through the gap were grouped into systemic problems and problems with the quality of care received. Effects of alling through the gap were grouped into separate themes for young people (feeling abandoned; struggling to manage without continued care; problems with medication) and parents (emotional impact of care ending; parents taking an active role in the young person’s care). To our knowledge, this is the firt qualitative study that has focused only on the experiences of young people who have fallen through the gap between services. This research adds novel findings o existing literature regarding barriers to transition and the effectsof discontinuity of care

Rancang Bangun Aplikasi Penentuan Harga Pokok Produksi Berdasarkan Biaya Taksiran pada UMKM Sepatu dan Sandal Suroso

Micro, Small and Medium Enterprises (SMEs) Shoes and Sandals Suroso strive to improve and develop the industry, one of the efforts is to find out information about the costs of production are used to determine the cost of goods manufactured correctly. Currently, SMEs do not have a basis in determining the cost of goods manufactured according to customer order. In determining the cost of goods manufactured, SMEs just do a sum the raw material cost and direct labor cost, without counting the factory overhead cost. The resulted of the selling price of shoes and sandals are charged to customers is not as expected by the SMEs, so the profit can get unstable then. Because these problems, the author makes an application that can calculate the cost of goods manufactured is based on estimated cost by determining the raw material cost, direct labor cost, and factory overhead cost. Based on trial results on SMEs Shoes and Sandals Suroso can be concluded that the application has been made to produce information on the estimated raw material cost, the estimated direct labor cost, the estimated factory overhead cost, the estimated cost of goods manufactured, and reporting of customer order in each period, so the information can be used by SMEs as a basis for determining the selling price of its products

Remote ischemic preconditioning in patients with intermittent claudication

OBJECTIVE: Remote ischemic preconditioning (RIPC) is a phenomenon in which a short period of sub-lethal ischemia in one organ protects against subsequent bouts of ischemia in another organ. We hypothesized that RIPC in patients with intermittent claudication would increase muscle tissue resistance to ischemia, thereby resulting in an increased ability to walk. METHODS: In a claudication clinic, 52 ambulatory patients who presented with complaints of intermittent claudication in the lower limbs associated with an absent or reduced arterial pulse in the symptomatic limb and/or an ankle-brachial index <0.90 were recruited for this study. The patients were randomly divided into three groups (A, B and C). All of the patients underwent two tests on a treadmill according to the Gardener protocol. Group A was tested first without RIPC. Group A was subjected to RIPC prior to the second treadmill test. Group B was subjected to RIPC prior to the first treadmill test and then was subjected to a treadmill test without RIPC. In Group C (control group), both treadmill tests were performed without RIPC. The first and second tests were conducted seven days apart. Brazilian Clinical Trials: RBR-7TF6TM. RESULTS: Group A showed a significant increase in the initial claudication distance in the second test compared to the first test. CONCLUSION: RIPC increased the initial claudication distance in patients with intermittent claudication; however, RIPC did not affect the total walking distance of the patients

Optimalisasi Rantai Pasok Komoditas Pertanian Strategis di Jawa Timur

This study aims to identify value chain of &nbsp;strategic agricultural commodities in East Java. In addition, this study formulate supply chain optimization of strategic agricultural commodities in East Java. This study uses several analysis approaches, namely 1) input output analysis; 2) supply chain descriptive analysis, 3) supply chain management institutional pattern analysis, 4) trading margin analysis, 5) value chain analysis, 6) root problem analysis; and 7) Process Hierarchy Analysis (AHP).The results of this study indicate that there are three strategic commodities in East Java, namely sugar cane, cayenne pepper and corn. These strategic agricultural commodities have a fairly long supply chain. On average, producers (farmers/breeders) receive the lowest price margins among other supply chain actors. Collectors and wholesalers are known to receive the most margins

Paramyxovirus Glycoprotein Incorporation, Assembly and Budding: A Three Way Dance for Infectious Particle Production

Paramyxoviruses are a family of negative sense RNA viruses whose members cause serious diseases in humans, such as measles virus, mumps virus and respiratory syncytial virus; and in animals, such as Newcastle disease virus and rinderpest virus. Paramyxovirus particles form by assembly of the viral matrix protein, the ribonucleoprotein complex and the surface glycoproteins at the plasma membrane of infected cells and subsequent viral budding. Two major glycoproteins expressed on the viral envelope, the attachment protein and the fusion protein, promote attachment of the virus to host cells and subsequent virus-cell membrane fusion. Incorporation of the surface glycoproteins into infectious progeny particles requires coordinated interplay between the three viral structural components, driven primarily by the matrix protein. In this review, we discuss recent progress in understanding the contributions of the matrix protein and glycoproteins in driving paramyxovirus assembly and budding while focusing on the viral protein interactions underlying this process and the intracellular trafficking pathways for targeting viral components to assembly sites. Differences in the mechanisms of particle production among the different family members will be highlighted throughout

Analysis and reduction of on-load DC winding induced voltage in wound field switched flux machines

DC winding induced voltage pulsation in wound field switched flux (WFSF) machines causes DC winding current ripple and field excitation fluctuation, challenges the DC power source and deteriorates the control performance. Hence, reducing this pulsation is important in the design of a WFSF machine. In this paper, based on the analytical models, rotor skewing and rotor iron piece pairing are proposed and comparatively investigated by the finite element (FE) method to reduce the on-load DC winding induced voltage in WFSF machines having partitioned stators and concentrated AC windings. FE results show that peak to peak value of the on-load DC winding induced voltage in the analysed 12/10-pole partitioned stator WFSF (PS-WFSF) machines can be reduced by 78.42% or 77.16% by using rotor skewing or rotor pairing, respectively, whilst the torque density can be maintained by >90%. As for the 12/11-, 12/13- and 12/14-pole PS-WFSF machines, by using rotor iron piece inner arc pairing, the on-load DC winding induced voltage can be reduced by 64.11%, 52.12% and 76.49%, respectively, whilst the torque density can also be maintained by more than 90%. Prototypes are built and tested to verify the analytical and FE results

National energy policies and global environmental issues : a theoretical framework for reconciling domestic and international law

The concern relating to the greenhouse effect, which is presumed to be the result of carbon dioxide emissions created when fossil fuels such as petroleum and coal are burned, is affecting even more the energy matter which stands at the top of the domestic and foreign policy agendas of several countries. National strategies to confront these challenges are variably assorted according to the diverse geopolitical and geological backgrounds. A multiplication of regional institutions may render the experiment of integrating climate change and energy security policies more open to other solutions than experimented by world economy since the end of Cold war. Furthermore, the new global players have the possibilities in the regional institutions to gradually prepare their own legal systems and policy priorities to be compatible with the global environmental challenges.Paper presented by Paolo Farah at the Conference \u201cItalian Researchers in China", Embassy of Italy, Scientific and Technological Office, Beijing, China. Panel discussants of the submitted paper composed by Prof. Nerina Boschiero \u2013 Full Professor of International Law, Director, Department of Public, Civil Procedure, International and European Law, Faculty of Law, University of Milan and Huang Zhenzhong - Vice-Dean, Faculty of Law, Beijing Normal University. Beijing, 24th September 200