How Community Organizations Promote Continuity of Care for Young People with Mental Health Problems

Young people between the ages of 16 and 25 who experience mental health problems experience transitions and need help from a variety of organizations. Organizations promote continuity of care by assisting young adults with developmental, service, and systemic transitions. Providers offer specific services to help transitions and also form cooperative relationships with other community organizations. Results from a survey of 100 service providers in one community describe organizational attributes and practices which are associated with continuity of care in a regional system for young adults. Data analyses show that full-service organizations which practice cultural competence offer more specific services that foster continuity of care. Larger, full-service organizations are also more likely to have more extensive and collaborative inter-organizational networks that help young adults continue care over time within the regional system of care

Sustainable EPM rubber compounds

Two important aspects that should be considered when designing new, sustainable rubber products are the bio-based character of the rubber compound ingredients and the recyclability of the vulcanized rubber product. In this work, both are addressed by compounding a thermoreversible cross-linked EPM rubber with pyrolysis carbon black and squalane as sustainable filler and plasticizer, respectively. The resulting rubber product is fully reprocessable in the melt and it displays material properties comparable to those of compounds with conventional additives with high retention of the material properties upon reprocessing

Practical application of thermoreversibly Cross-linked rubber products

Currently, rubber products cannot simply be reprocessed after their product life, due to the irreversible cross-linking methods traditionally applied. The purpose of this work is to investigate how thermoreversible cross-linking of rubbers via Diels Alder chemistry can be used for the development of recyclable rubber products. Unfortunately, the applicability of the thermoreversible EPM-g-furan/BM system appears to be limited to room temperature applications, because of the rapid deterioration of the compression set at elevated temperatures compared to irreversibly cross-linked EPM. However, the use of EPM rubber modified with thiophene or cyclopentadiene moieties may extend the temperature application range and results in rubber products with acceptable properties. Finally, rubber products generally comprise fillers such as silica, carbon black or fibers. In this context, the reinforcing effect of short cut aramid fibers on the material properties of the newly developed thermoreversibly cross-linked EPM rubbers was also studied. The material properties of the resulting products were found to be comparable to those of a fiber reinforced, peroxide cured reference sample

Cross-linking of rubber in the presence of multi-functional cross-linking aids via thermoreversible Diels-Alder chemistry

Furan-functionalized polyketone (PK-FU) was added to a furan-functionalized ethylene-propylene rubber (EPM-FU). The mixture was subsequently cross-linked with a bismaleimide through Diels-Alder chemistry in order to improve the mechanical properties of the rubber. Infrared spectroscopy showed the reversible interaction between both polymers and the bismaleimide cross-linker. Likewise, mechanical measurements indicated the re-workability of the mixtures with no evident differences in storage modulus and mechanical properties after several heating cycles. The cross-link density and mechanical properties, such as hardness, tensile properties and compression set, could be modulated by changing the degree of furan functionalization of PK-FU and the PK-FU loading in the blends. It is concluded that PK-FU has some characteristics of an inert filler, but mainly acts as a multi-functional cross-linking aid, enabling larger amounts of bismaleimide to cross-link EPM-FU

Barriers to the development of palliative care in Western Europe

The Eurobarometer Survey of the <i>EAPC Task Force on the Development of Palliative Care in Europe</i> is part of a programme of work to produce comprehensive information on the provision of palliative care across Europe. Aim: To identify barriers to the development of palliative care in Western Europe. Method: A qualitative survey was undertaken amongst boards of national associations, eliciting opinions on opportunities for, and barriers to, palliative care development. By July 2006, 44/52 (85%) European countries had responded to the survey; we report here on the results from 22/25 (88%) countries in Western Europe. Analysis: Data from the Eurobarometer survey were analysed thematically by geographical region and by the degree of development of palliative care in each country. Results: From the data contained within the Eurobarometer, we identified six significant barriers to the development of palliative care in Western Europe: (i) Lack of palliative care education and training programmes (ii) Lack of awareness and recognition of palliative care (iii) Limited availability of/knowledge about opioid analgesics (iv) Limited funding (v) Lack of coordination amongst services (vi) Uneven palliative care coverage. Conclusion: Findings from the EAPC Eurobarometer survey suggest that barriers to the development of palliative care in Western Europe may differ substantially from each other in both their scope and context and that some may be considered to be of greater significance than others. A number of common barriers to the development of the discipline do exist and much work still remains to be done in the identified areas. This paper provides a road map of which barriers need to be addressed

An easy synthetic way to exfoliate and stabilize MWCNTs in a thermoplastic pyrrole-containing matrix assisted by hydrogen bonds

This work focuses on the design of an engineered thermoplastic polymer containing pyrrole units in the main chain and hydroxyl pendant groups (A-PPy-OH), which help in achieving nanocomposites containing well-distributed, exfoliated and undamaged MWCNTs. The thermal annealing at 100 °C of the pristine nanocomposite promotes the redistribution of the nanotubes in terms of a percolative network, thus converting the insulating material in a conducting soft matrix (60 μΩ m). This network remains unaltered after cooling to r.t. and successive heating cycles up to 100 °C thanks to the effective stabilization of MWCNTs provided by the functional polymer matrix. Notably, the resistivity-temperature profile is very reproducible and with a negative temperature coefficient of -0.002 K-1, which suggests the potential application of the composite as a temperature sensor. Overall, the industrial scale by which A-PPy-OH can be produced offers a straightforward alternative for the scale-up production of suitable polymers to generate multifunctional nanocomposites

Effect of Rubber Polarity on Cluster Formation in Rubbers Cross-Linked with Diels-Alder Chemistry

Diels-Alder chemistry has been used for the thermoreversible cross-linking of furan-functionalized ethylene/propylene (EPM) and ethylene/vinyl acetate (EVM) rubbers. Both furan-functionalized elastomers were successfully cross-linked with bismaleimide to yield products with a similar cross-link density. NMR relaxometry and SAXS measurements both show that the apolar EPM-g-furan precursor contains phase-separated polar clusters and that cross-linking with polar bismaleimide occurs in these clusters. The heterogeneously cross-linked network of EPM-g-furan contrasts with the homogeneous network in the polar EVM-g-furan. The heterogeneous character of the cross-links in EPM-g-furan results in a relatively high Youngs modulus, whereas the more uniform cross-linking in EVM-g-furan results in a higher tensile strength and elongation at break

Minimal versus specialist equipment in the delivery of pulmonary rehabilitation: Protocol for a non-inferiority randomised controlled trial

Introduction Pulmonary rehabilitation (PR), an exercise and education programme for people with chronic lung disease, aims to improve exercise capacity, breathlessness and quality of life. Most evidence to support PR is from trials that use specialist exercise equipment, for example, treadmills (PR-gym). However, a significant proportion of programmes do not have access to specialist equipment with training completed with minimal exercise equipment (PR-min). There is a paucity of robust literature examining the efficacy of supervised, centre-based PR-min. We aim to determine whether an 8-week supervised, centre-based PR-min programme is non-inferior to a standard 8-week supervised, centre-based PR-gym programme in terms of exercise capacity and health outcomes for patients with chronic lung disease. Methods and analysis Parallel, two-group, assessor blinded and statistician-blinded, non-inferiority randomised trial. 436 participants will be randomised using minimisation at the individual level with a 1:1 allocation to PR-min (intervention) or PR-gym (control). Assessment will take place pre-PR (visit 1), post-PR (visit 2) and 12 months following visit 1 (visit 3). Exercise capacity (incremental shuttle walk test), dyspnoea (Chronic Respiratory Questionnaire (CRQ)-Dyspnoea), health-related quality of life (CRQ), frailty (Short Physical Performance Battery), muscle strength (isometric quadriceps maximum voluntary contraction), patient satisfaction (Global Rating of Change Questionnaire), health economic as well as safety and trial process data will be measured. The primary outcome is change in exercise capacity between visit 1 and visit 2. Two sample t-tests on an intention to treat basis will be used to estimate the difference in mean primary and secondary outcomes between patients randomised to PR gym and PR-min. Ethics and dissemination London-Camden and Kings Cross Research Ethics Committee and Health Research Authority have approved the study (18/LO/0315). Results will be submitted for publication in peer-reviewed journals, presented at international conferences, disseminated through social media, patient and public routes and directly shared with stakeholders. Trial registration number ISRCTN16196765.National Institute for Health Research grant number PB-PG-0816–2002