Women's secure hospital services: national bed numbers and distribution.

A mapping exercise as part of a pathway study of women in secure psychiatric services in the England and Wales was conducted. It aimed to (i) establish the extent and range of secure service provision for women nationally and (ii) establish the present and future care needs and pathways of care of women mentally disordered offenders (MDO) currently in low, medium and enhanced medium secure care. The study identified 589 medium secure beds, 46 enhanced medium secure beds (WEMSS) and 990 low secure beds for women nationally. Of the 589 medium secure beds, the majority (309, 52%) are in the NHS and under half (280, 48%) are in the independent sector (IS). The distribution of low secure beds is in the opposite direction, the majority (745, 75%) being in the IS and 254 (25%) in the NHS. Medium secure provision for women has grown over the past decade, but comparative data for low secure provision are not available. Most women are now in single sex facilities although a small number of mixed sex units remain. The findings have implications for the future commissioning of secure services for women

Exciton lifetime and emission polarization dispersion in strongly in-plane asymmetric nanostructures

We present experimental and theoretical investigation of exciton recombination dynamics and the related polarization of emission in highly in-plane asymmetric nanostructures. Considering general asymmetry- and size-driven effects, we illustrate them with a detailed analysis of InAs/AlGaInAs/InP elongated quantum dots. These offer a widely varied confinement characteristics tuned by size and geometry that are tailored during the growth process, which leads to emission in the application-relevant spectral range of 1.25-1.65 {\mu}m. By exploring the interplay of the very shallow hole confining potential and widely varying structural asymmetry, we show that a transition from the strong through intermediate to even weak confinement regime is possible in nanostructures of this kind. This has a significant impact on exciton recombination dynamics and the polarization of emission, which are shown to depend not only on details of the calculated excitonic states but also on excitation conditions in the photoluminescence experiments. We estimate the impact of the latter and propose a way to determine the intrinsic polarization-dependent exciton light-matter coupling based on kinetic characteristics.Comment: 11 pages, 8 figure

Assessing the Value Provided by ERP Applications Through Organizational Activities

When managers and stockholders consider making an investment in information technology (IT), as with any other investment, a major concern is whether this investment will add to the performance of their organization. However, it is difficult to identify the nature of the linkage between an investment in IT in general, and Enterprise Resource Planning (ERP), in particular, to an organization\u27s performance. In this study we extend the work of Barua et al. , Lerch and Mangal, and Tallon et al. We develop a model to identify the value ERP applications add to Porter\u27s organizational primary activities and the information systems (IS) applications related to ERP that help deliver added value through organizational characteristics. This new model should help in assessing the potential value of an ERP investment. We examine the relationship of ERP applications and organizational characteristics to an organization\u27s primary activities by a path analysis of more than 200 medium and large sized manufacturing firms. The results of this investigation indicate that organizational characteristics mediate the relationship between IS applications and the value ERP can add to the organizational primary activities. Consequently, organizations with different characteristics may add different value to their primary activities by using ERP applications. We found that each primary activity was supported by some, though not necessarily all, IS applications included in most ERP packages. We conclude that, an organization\u27s characteristics are related to the return that may be gained from the use of ERP systems. We offer recommendations on how organizations can use ERP to add value to their primary activities, based on their organizational characteristics

The Detection of a 3.5-h Period in the Classical Nova Velorum 1999 (V382 Vel) and the Long Term Behavior of the Nova Light Curve

We present CCD photometry, light curve and time series analysis of the classical nova V382 Vel (N Vel 1999). The source was observed for 2 nights in 2000, 21 nights in 2001 and 7 nights in 2002 using clear filters. We report the detection of a distinct period in the light curve of the nova P=0.146126(18) d (3.5 h). The period is evident in all data sets, and we interpret it as the binary period of the system. We also measured an increase in the amplitude modulation of the optical light (in magnitude) by more than 55% from 2000 to 2001 and about 64% from 2001 to 2002. The pulse profiles in 2001 show deviations from a pure sinusoidal shape which progressively become more sinusoidal by 2002. The main cause of the variations in 2001 and 2002 can be explained with the occultation of the accretion disk by the secondary star. We interpret the observed deviations from a pure sinusoidal shape as additional flux resulting from the aspect variations of the irradiated face of the secondary star.Comment: 16 pages and 4 figures, accepted as it stands to be published in the Astronomical Journal (AJ

Assessing the Effect of Spaceflight on the Propensity for Astronauts to Develop Disk Herniation

BACKGROUND: A previous study [1] reported that the instantaneous risk of developing a Herniated Nucleus Pulposus (HNP) was higher in astronauts who had flown at least one mission, as compared with those in the corps who had not yet flown. However, the study only analyzed time to HNP after the first mission (if any) and did not account for the possible effects of multiple missions. While many HNP's occurred well into astronauts' careers or in some cases years after retirement, the higher incidence of HNPs relatively soon after completion of space missions appears to indicate that spaceflight may lead to an increased risk of HNP. The purpose of this study was to support the Human System Risk Board assessment of back pain, evaluate the risk of injury due to dynamic loads, and update the previous dataset which contained events up to December 31, 2006. METHODS: Data was queried from the electronic medical record and provided by the Lifetime Surveillance of Astronaut Health. The data included all 330 United States astronauts from 1959 through February 2014. Cases were confirmed by Magnetic Resonance Imaging, Computerized Tomography, Myelography, operative findings, or through clinical confirmation with a neurologist or neurosurgeon. In this analysis, astronauts who had an HNP at selection into the corps or had an HNP diagnosis prior to their first flight were excluded. The statistical challenges in using the available data to separate effects of spaceflight from those associated with general astronaut training and lifestyle on propensity to develop HNPs are many. The primary outcome is reported date of first HNP (if any), which at best is only an approximation to the actual time of occurrence. To properly analyze this data with a survival analysis model, one must also know the "exposure" time - i.e. how long each astronaut has been at risk for developing an HNP. If an HNP is reported soon after a mission, is it mission caused or general? If the former, exposure time should be counted from the time of landing (assuming the risk of HNP occurring during a mission is zero). If the latter, exposure time should be counted from the time of selection; however we can't directly know which one to use. In our analysis we take both of these possibilities into account with a competing risks model, wherein two distinct stochastic processes are going on: TG = time to HNP (general) and TS = time to HNP (spaceflight). Under this type of model, whichever of these occurs first is what we observe; in other words we don't observe TG or TS, only min(TG, TS). Here, we parameterized the model in terms of separate Weibull hazard functions for each process and estimated all parameters using maximum likelihood. In addition, we allowed for a "cured fraction" - i.e. the possibility that some astronauts may never develop an HNP. RESULTS: Results will include a depiction of the competing hazard functions as well as a probability curve for the relative likelihood that an HNP reported at a given time after a mission is actually mission caused. Other factors, such as dwell time in microgravity and vehicle landing environment will be explored. An overall assessment as to whether spaceflight truly exacerbates HNP risk will be made

The structure of Cu(110) (2×3)–N; pseudo‐square reconstruction of a rectangular mesh substrate

The structure of the Cu(110)(2×3)–N phase has been investigated by parallel studies using 3‐keV Li+ and 2‐keV He+ion scattering and scanned energy mode normal emission N 1s photoelectron diffraction. The Li+ion scattering results provide clear evidence for anadsorbate‐induced reconstruction of the Cu surface and, in particular, indicate a shortening of the Cu–Cu atomic spacing along the 〈100〉 azimuth to a value of 2.7±0.1 Å, similar to the 〈110〉 spacing of 2.55 Å. A model of the surface consistent with this result involves a pseudo‐square Cu top atom layer with N atoms occupying alternate hollow sites leading to a local structure which is a 6% distorted Cu(100)c(2×2)–N phase. He+ion scattering data provides support for the N hollow adsorption sites. Scanned energy mode photoelectron diffraction is insensitive to the nature of the reconstruction but provides information on the local adsorption sites and, hence, on the lateral registry of the reconstructed overlayer and the underlying substrate

Geriatric pharmacotherapy : optimisation through integrated approach in the hospital setting

Since older patients are more vulnerable to adverse drug-related events, there is a need to ensure appropriate prescribing in these patients in order to prevent misuse, overuse and underuse of drugs. Different tools and strategies have been developed to reduce inappropriate prescribing; the available measures can be divided into medication assessment tools, and specific interventions to reduce inappropriate prescribing. Implicit criteria of inappropriate prescribing focus on appropriate dosing, search for drug-drug interactions, and increase adherence. Explicit criteria are consensus-based standards focusing on drugs and diseases and include lists of drugs to avoid in general or lists combining drugs with clinical data. These criteria take into consideration differences between patients, and stand for a medication review, by using a systematic approach. Different types of interventions exist in order to reduce inappropriate prescribing in older patients, such as: educational interventions, computerized decision support systems, pharmacist-based interventions, and geriatric assessment. The effects of these interventions have been studied, sometimes in a multifaceted approach combining different techniques, and all types seem to have positive effects on appropriateness of prescribing. Interdisciplinary teamwork within the integrative pharmaceutical care is important for improving of outcomes and safety of drug therapy. The pharmaceutical care process consists offour steps, which are cyclic for an individual patient. These steps are pharmaceutical anamnesis, medication review, design and follow-up of a pharmaceutical care plan. A standardized approach is necessary for the adequate detection and evaluation of drug-related problems. Furthermore, it is clear that drug therapy should be reviewed in-depth, by having full access to medical records, laboratory values and nursing notes. Although clinical pharmacists perform the pharmaceutical care process to manage the patient’s drug therapy in every day clinical practice, the physician takes the ultimate responsibility for the care of the patient in close collaboration with nurses

Mental Disorder, Substance Use and Criminal Justice Contact

In May 2003, the Minister of State for Mental Health brought together representatives from Ministry of Health Services (MOHS), Ministry of Children and Family Development (MCFD), Ministry of Attorney General (MAG) and the Ministry for Public Safety and Solicitor General (MPSSG) to address the prevalence of people with mental and substance use disorders who are involved in the justice system. The result was a cross-ministry commitment to develop a report about mentally disordered offenders in the justice system in order to identify the high priority and long-term issues for this population and provide recommendations to address these concerns. The many challenges associated with mental health, substance use and the justice system are recognized world wide, and a number of reforms are underway in different jurisdictions. Invariably, these reforms reflect a combination of local needs, resources, legislation and a consideration of available evidence. A critical first step in the process of reform is careful review of available information. In British Columbia, the provincial government has formed an interministerial steering committee, with research support provided through the University of British Columbia. The UBC team, in collaboration with other experts in Canada and abroad, collected and analysed information in the following formats: Literature Review: A scholarly review of the international literature. To our knowledge, this is the most comprehensive review available of the professional literature pertaining to mental disorders, substance use disorders and criminal justice contact. Survey of Other Jurisdictions: A survey highlighting areas of need and opportunities for reform in jurisdictions across Canada and elsewhere. BC Data Analysis: A report examining the administrative data for addressing mental illness and substance use in relation to the justice system in BC. These analyses are based on an unprecedented linkage of administrative information concerning corrections and health services for the population. In 1999/2000, there were 52,000 individuals (43,859 adults and 8,234 youth) involved with the provincial corrections system. Almost 15,000 (29 percent) of the total cohort were classified as mentally disordered offenders. The prevalence rate is nearly twice the rate for the general British Columbia population. &nbsp