Factors Associated with Patient Satisfaction of Community Mental Health Services: A Multilevel Approach

Community care is increasingly the mainstay of mental healthcare provision in many countries and patient satisfaction is an important barometer of quality of patient care. This paper explores the key factors associated with patient satisfaction with community mental health services in England and then compares providers’ performance on patient satisfaction. Our analysis is based on patient-level responses from the community mental health survey, which is run annually by the Care Quality Commission (CQC) for the years 2010 to 2013. We perform a repeated cross-section analysis, identifying factors associated with patient satisfaction via a multi-level ordered probit model, including both patient- and provider-level variables. We identify hospital-specific effects via empirical Bayes estimation. Our analysis identifies a number of novel results. First, patient characteristics such as older age, being employed, and being able to work, are associated with higher satisfaction, while being female is associated with lower satisfaction. Service contact length, time since last visit, condition severity and admission to a mental health institution, are all associated with lower satisfaction. Second, treatment type affects satisfaction, with patients receiving talking therapies or being prescribed medications being more satisfied. Third, care continuity and involvement, as proxied by having a care plan, is associated with higher satisfaction. Fourth, seeing a health professional closer to the community improves satisfaction, with patients seeing a community-psychiatric nurse, a social worker or a mental-health support worker being more satisfied. Finally, our study identifies the need for service integration, with patients experiencing financial, accommodation, or physical health needs being less satisfied. At a provider level, we find a negative association between the percentage of occupied beds and satisfaction. We further identify significant provider-specific effects after accounting for observable differences in patient and provider characteristics which suggests significant differences in provider quality of care

Fibrational induction meets effects

This paper provides several induction rules that can be used to prove properties of effectful data types. Our results are semantic in nature and build upon Hermida and Jacobs’ fibrational formulation of induction for polynomial data types and its extension to all inductive data types by Ghani, Johann, and Fumex. An effectful data type μ(TF) is built from a functor F that describes data, and a monad T that computes effects. Our main contribution is to derive induction rules that are generic over all functors F and monads T such that μ(TF) exists. Along the way, we also derive a principle of definition by structural recursion for effectful data types that is similarly generic. Our induction rule is also generic over the kinds of properties to be proved: like the work on which we build, we work in a general fibrational setting and so can accommodate very general notions of properties, rather than just those of particular syntactic forms. We give examples exploiting the generality of our results, and show how our results specialize to those in the literature, particularly those of Filinski and Støvring

Antibody localization in horse, rabbit, and goat antilymphocyte sera

The localization of antibodies was studied in rabbit, goat, and horse ALS raised by weekly immunization with canine or human spleen cells for 4 to 12 weeks. A combination of analytic techniques was used including column chromatography, electrophoresis, immunoelectrophoresis, determination of protein concentration, and measurement of antibody titers. In the rabbit and goat ALS, virtually all of the leukoagglutinins and lymphocytotoxins were in the easily separable IgG; accidentally induced thromboagglutinins were in the same location. In the rabbit hemagglutinins were found in both the IgG and IgM, whereas in the goat these were almost exclusively in the IgM. The antiwhite cell antibodies were most widely distributed in the horse. The cytotoxins were primarily in the IgG, but the leukoagglutinins were most heavily concentrated in the T-equine globulin which consists mostly of IgA. By differential ammonium sulfate precipitation of a horse antidoglymphocyte serum, fractions were prepared that were rich in IgG and IgA. Both were able to delay the rejection of canine renal homografts, the IgA-rich preparation to a somewhat greater degree. The findings in this study have been discussed in relation to the refining techniques that have been used for the production of globulin from heterologous ALS. © 1970

Affective iconic words benefit from additional sound–meaning integration in the left amygdala

Recent studies have shown that a similarity between sound and meaning of a word (i.e., iconicity) can help more readily access the meaning of that word, but the neural mechanisms underlying this beneficial role of iconicity in semantic processing remain largely unknown. In an fMRI study, we focused on the affective domain and examined whether affective iconic words (e.g., high arousal in both sound and meaning) activate additional brain regions that integrate emotional information from different domains (i.e., sound and meaning). In line with our hypothesis, affective iconic words, compared to their non‐iconic counterparts, elicited additional BOLD responses in the left amygdala known for its role in multimodal representation of emotions. Functional connectivity analyses revealed that the observed amygdalar activity was modulated by an interaction of iconic condition and activations in two hubs representative for processing sound (left superior temporal gyrus) and meaning (left inferior frontal gyrus) of words. These results provide a neural explanation for the facilitative role of iconicity in language processing and indicate that language users are sensitive to the interaction between sound and meaning aspect of words, suggesting the existence of iconicity as a general property of human language

Radiometric temperature analysis of the Hayabusa spacecraft re-entry

Hayabusa, an unmanned Japanese spacecraft, was launched to study and collect samples from the surface of the asteroid 25143 Itokawa. In June 2010, the Hayabusa spacecraft completed it’s seven year voyage. The spacecraft and the sample return capsule (SRC) re-entered the Earth’s atmosphere over the central Australian desert at speeds on the order of 12 km/s. This provided a rare opportunity to experimentally investigate the radiative heat transfer from the shock-compressed gases in front of the sample return capsule at true-flight conditions. This paper reports on the results of observations from a tracking camera situated on the ground about 100 km from where the capsule experienced peak heating during re-entry

Shock tunnel studies of scramjet phenomena

Commissioning of the new T4 shock tunnel at the University of Queensland implied that it was no longer necessary to focus the work of the research group about an annual test series conducted in the T3 shock tunnel in Canberra. Therefore, it has been possible to organize a group for work to proceed along lines such that particular personnel are associated with particular project areas. The format of this report consists of a series of reports on specific project areas, with a brief general introduction commenting on each report. The introduction is structured by project areas, with the title of the relevant report stated under the project area heading. The reports themselves follow in the order of the project area headings

Shock tunnel studies of scramjet phenomena, supplement 5

A series of reports are presented on SCRAMjet studies, shock tunnel studies, and expansion tube studies. The SCRAMjet studies include: (1) Investigation of a Supersonic Combustion Layer; (2) Wall Injected SCRAMjet Experiments; (3) Supersonic Combustion with Transvers, Circular, Wall Jets; (4) Dissociated Test Gas Effects on SCRAMjet Combustors; (5) Use of Silane as a Fuel Additive for Hypersonic Thrust Production, (6) Pressure-length Correlations in Supersonic Combustion; (7) Hot Hydrogen Injection Technique for Shock Tunnels; (8) Heat Release - Wave Interaction Phenomena in Hypersonic Flows; (9) A Study of the Wave Drag in Hypersonic SCRAMjets; (10) Parametric Study of Thrust Production in the Two Dimensional SCRAMjet; (11) The Design of a Mass Spectrometer for use in Hypersonic Impulse Facilities; and (12) Development of a Skin Friction Gauge for use in an Impulse Facility. The shock tunnel studies include: (1) Hypervelocity flow in Axisymmetric Nozzles; (2) Shock Tunnel Development; and (3) Real Gas Efects in Hypervelocity Flows over an Inclined Cone. The expansion tube studies include: (1) Investigation of Flow Characteristics in TQ Expansion Tube; and (2) Disturbances in the Driver Gas of a Shock Tube

Airfoil section characteristics as applied to the prediction of air forces and their distribution on wings

The results of previous reports dealing with airfoil section characteristics and span load distribution data are coordinated into a method for determining the air forces and their distribution on airplane wings. Formulas are given from which the resultant force distribution may be combined to find the wing aerodynamic center and pitching moment. The force distribution may also be resolved to determine the distribution of chord and beam components. The forces are resolved in such a manner that it is unnecessary to take the induced drag into account. An illustration of the method is given for a monoplane and a biplane for the conditions of steady flight and a sharp-edge gust. The force determination is completed by outlining a procedure for finding the distribution of load along the chord of airfoil sections

An Adaptive Capacity Guide Book: assessing, building and evaluating the capacity of communities to adapt in a changing climate

A capacity to adapt to change is essential for managing Australia’s natural resources. The individuals, communities and organisations who manage our natural resources all have an innate capacity to adapt to change. Changes in climate, markets and technology have shaped the way we adapt the management of natural resources in urban, rural and coastal landscapes. Some of these changes are predictable and easy to manage. Others are expected, but their timing and magnitude are uncertain. Whatever the future holds, this guide can be used to build our capacity to meet future change with confidence