3,170 research outputs found

    Making sense of partnerships: a study of police and housing department collaboration for tackling drug and related problems on public housing estates

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    In recent years, interdepartmental partnerships within the public sector have been heralded as effective instruments for addressing complex social problems. For example, it is claimed that they can motivate staff and facilitate innovative practices that lead to improvements in service delivery. However, though partnerships are widely promoted as a panacea within the sector, there is a paucity of research that has looked at them from a critical perspective or examined how they operate in practice. The aim of this project is to explore the realities of partnership working by focusing on collaboration between the police and housing departments to tackle problems associated with illicit drug activity and anti-social behaviour (ASB) on three Australian public housing estates. The rationale for the project is that, though only a small minority of tenants are perpetrators, their actions can seriously blight the lives of their neighbours. Usually it is the housing department that responds to complaints relating to ASB but, in the more serious cases that are deemed criminal, the police also perform a role. Three locations were chosen as case studies. East Devonport in Tasmania and Girrawheen in Western Australia are areas with a large public housing stock. In East Devonport ASB and illicit drug activities are seen as nascent problems while in Girrawheen these problems are viewed as more pervasive, but to date there has been only limited collaboration between the police and housing departments. Collingwood in Victoria includes a large system-built housing estate that has become a location for the buying and selling of drugs. In Collingwood, police and housing departments have, for many years, worked on a series of partnership projects to address the problem and to enhance community wellbeing. The empirical component of the project entailed two stages. The fi rst stage initiated meetings between the police and housing departments in order for them to agree to a memorandum of understanding (MoU) on partnership protocols. The second stage reported on existing and new activities undertaken by both departments over a twelve month period. The research methods entailed participant observation, secondary data collection and qualitative interviews with key personnel. The fi ndings from the case studies are structured around three thematic areas: setting up partnerships, the benefi ts of partnerships, and the obstacles that can impact on partnership working

    Behavior Management

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    Phytoplankton communities and acclimation in a cyclonic eddy in the southwest Indian Ocean

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    A study of phytoplankton in a cyclonic eddy was undertaken in the Mozambique Basin between Madagascar and southern Africa during austral winter. CHEMTAX analysis of pigment data indicated that the community comprised mainly haptophytes and diatoms, with Prochlorococcus, prasinophytes and pelagophytes also being prominent to the east and west of the eddy. There was little difference in community structure, chlorophyll-specific absorption [a*ph(440)] and pigment:TChla ratios between the surface and the sub-surface chlorophyll maximum (SCM), reflecting acclimation to fluctuating light conditions in a well mixed upper layer. Values for a*ph(440) were low for diatom dominance, high where prokaryote proportion was high, and intermediate for flagellate dominated communities. Chlorophyll c and fucoxanthin:TChla ratios were elevated over most of the eddy, while 19′-hexanoyloxyfucoxanthin ratios increased in the eastern and western sectors. In a community comprising mainly flagellates and Prochlorococcus to the west of the eddy, there was high a*ph(440) at the surface and elevated ratios for divinyl chlorophyll a, chlorophyll b and 19′-hexanoyloxyfucoxanthin at the SCM. An increase in diadinoxanthin:TChla ratios and a decline in the quantum efficiency of photochemistry in PSII under high light conditions, indicated some photoprotection and photoinhibition at the surface even in a well mixed environment. Diadinoxanthin was the main photoprotective carotenoid within the eddy, while zeaxanthin was the dominant photoprotective pigment outside the eddy. The results of this study will be useful inputs into appropriate remote sensing models for estimating primary production and the size class distribution of phytoplankton in eddies in the southwest Indian Ocean

    Likelihood inference for exponential-trawl processes

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    Integer-valued trawl processes are a class of serially correlated, stationary and infinitely divisible processes that Ole E. Barndorff-Nielsen has been working on in recent years. In this Chapter, we provide the first analysis of likelihood inference for trawl processes by focusing on the so-called exponential-trawl process, which is also a continuous time hidden Markov process with countable state space. The core ideas include prediction decomposition, filtering and smoothing, complete-data analysis and EM algorithm. These can be easily scaled up to adapt to more general trawl processes but with increasing computation efforts.Comment: 29 pages, 6 figures, forthcoming in: "A Fascinating Journey through Probability, Statistics and Applications: In Honour of Ole E. Barndorff-Nielsen's 80th Birthday", Springer, New Yor

    Physicians Infrequently Adhere to Hepatitis Vaccination Guidelines for Chronic Liver Disease

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    Background and Goals:Hepatitis A (HAV) and hepatitis B (HBV) vaccination in patients with chronic liver disease is an accepted standard of care. We determined HAV and HBV vaccination rates in a tertiary care referral hepatology clinic and the impact of electronic health record (EHR)-based reminders on adherence to vaccination guidelines.Methods:We reviewed the records of 705 patients with chronic liver disease referred to our liver clinic in 2008 with at least two follow-up visits during the subsequent year. Demographics, referral source, etiology, and hepatitis serology were recorded. We determined whether eligible patients were offered vaccination and whether patients received vaccination. Barriers to vaccination were determined by a follow-up telephone interview.Results:HAV and HBV serologic testing prior to referral and at the liver clinic were performed in 14.5% and 17.7%; and 76.7% and 74% patients, respectively. Hepatologists recommended vaccination for HAV in 63% and for HBV in 59.7% of eligible patients. Patient demographics or disease etiology did not influence recommendation rates. Significant variability was observed in vaccination recommendation amongst individual providers (30-98.6%), which did not correlate with the number of patients seen by each physician. Vaccination recommendation rates were not different for Medicare patients with hepatitis C infection for whom a vaccination reminder was automatically generated by the EHR. Most patients who failed to get vaccination after recommendation offered no specific reason for noncompliance; insurance was a barrier in a minority.Conclusions:Hepatitis vaccination rates were suboptimal even in an academic, sub-speciality setting, with wide-variability in provider adherence to vaccination guidelines. © 2013 Thudi et al

    Skin prick testing in patients using beta-blockers: a retrospective analysis

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    <p>Abstract</p> <p>Rationale</p> <p>The use of beta-blockers is a relative contraindication in allergen skin testing yet there is a paucity of literature on adverse events in this circumstance. We examined a population of skin tested patients on beta-blockers to look for any adverse effects.</p> <p>Methods</p> <p>Charts from 2004-2008 in a single allergy clinic were reviewed for any patients taking a beta-blocker when skin tested. Data was examined for skin test reactivity, type of skin test, concomitant asthma diagnosis, allergens tested, and adverse events.</p> <p>Results</p> <p>One hundred and ninety-one patients were taking beta-blockers when skin testing occurred. Seventy-two patients had positive skin tests. No tests resulted in an adverse event.</p> <p>Conclusions</p> <p>This data demonstrates the relative safety of administrating of skin prick tests to patients on beta-blocker treatment. Larger prospective studies are needed to substantiate the findings of this study.</p

    In-reach specialist nursing teams for residential care homes : uptake of services, impact on care provision and cost-effectiveness

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    Background: A joint NHS-Local Authority initiative in England designed to provide a dedicated nursing and physiotherapy in-reach team (IRT) to four residential care homes has been evaluated.The IRT supported 131 residents and maintained 15 'virtual' beds for specialist nursing in these care homes. Methods: Data captured prospectively (July 2005 to June 2007) included: numbers of referrals; reason for referral; outcome (e.g. admission to IRT bed, short-term IRT support); length of stay in IRT; prevented hospital admissions; early hospital discharges; avoided nursing home transfers; and detection of unrecognised illnesses. An economic analysis was undertaken. Results: 733 referrals were made during the 2 years (range 0.5 to 13.0 per resident per annum)resulting in a total of 6,528 visits. Two thirds of referrals aimed at maintaining the resident's independence in the care home. According to expert panel assessment, 197 hospital admissions were averted over the period; 20 early discharges facilitated; and 28 resident transfers to a nursing home prevented. Detection of previously unrecognised illnesses accounted for a high number of visits. Investment in IRT equalled £44.38 per resident per week. Savings through reduced hospital admissions, early discharges, delayed transfers to nursing homes, and identification of previously unrecognised illnesses are conservatively estimated to produce a final reduction in care cost of £6.33 per resident per week. A sensitivity analysis indicates this figure might range from a weekly overall saving of £36.90 per resident to a 'worst case' estimate of £2.70 extra expenditure per resident per week. Evaluation early in implementation may underestimate some cost-saving activities and greater savings may emerge over a longer time period. Similarly, IRT costs may reduce over time due to the potential for refinement of team without major loss in effectiveness. Conclusion: Introduction of a specialist nursing in-reach team for residential homes is at least cost neutral and, in all probability, cost saving. Further benefits include development of new skills in the care home workforce and enhanced quality of care. Residents are enabled to stay in familiar surroundings rather than unnecessarily spending time in hospital or being transferred to a higher dependency nursing home setting

    Bmi-1 dependence distinguishes neural stem cell self-renewal from progenitor proliferation

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    Stem cells persist throughout life by self-renewing in numerous tissues including the central(1) and peripheral(2) nervous systems. This raises the issue of whether there is a conserved mechanism to effect self-renewing divisions. Deficiency in the polycomb family transcriptional repressor Bmi-1 leads to progressive postnatal growth retardation and neurological defects(3). Here we show that Bmi-1 is required for the self-renewal of stem cells in the peripheral and central nervous systems but not for their survival or differentiation. The reduced self-renewal of Bmi-1-deficient neural stem cells leads to their postnatal depletion. In the absence of Bmi-1, the cyclin-dependent kinase inhibitor gene p16(Ink4a) is upregulated in neural stem cells, reducing the rate of proliferation. p16(Ink4a) deficiency partially reverses the self-renewal defect in Bmi-1(-/-) neural stem cells. This conserved requirement for Bmi-1 to promote self-renewal and to repress p16(Ink4a) expression suggests that a common mechanism regulates the self-renewal and postnatal persistence of diverse types of stem cell. Restricted neural progenitors from the gut and forebrain proliferate normally in the absence of Bmi-1. Thus, Bmi-1 dependence distinguishes stem cell self-renewal from restricted progenitor proliferation in these tissues.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62726/1/nature02060.pd

    Quantum feedback control of a superconducting qubit: Persistent Rabi oscillations

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    The act of measurement bridges the quantum and classical worlds by projecting a superposition of possible states into a single, albeit probabilistic, outcome. The time-scale of this "instantaneous" process can be stretched using weak measurements so that it takes the form of a gradual random walk towards a final state. Remarkably, the interim measurement record is sufficient to continuously track and steer the quantum state using feedback. We monitor the dynamics of a resonantly driven quantum two-level system -- a superconducting quantum bit --using a near-noiseless parametric amplifier. The high-fidelity measurement output is used to actively stabilize the phase of Rabi oscillations, enabling them to persist indefinitely. This new functionality shows promise for fighting decoherence and defines a path for continuous quantum error correction.Comment: Manuscript: 5 Pages and 3 figures ; Supplementary Information: 9 pages and 3 figure
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