Use of the Strengths & Difficulties Questionnaire to identify treatment needs in looked after children referred to CAMHS

© The Author(s) 2019Background: In England and Wales, the Strengths & Difficulties Questionnaire (SDQ) is used to assess and monitor looked after children’s (LAC) mental health; and some targeted CAMHS teams use it to decide who can access services. However, the ability of the single-informant SDQ to identify LAC who need mental health treatment is insufficiently understood. Methods: 144 LAC referrals to a Targeted CAMHS Team were screened as part of a larger study. To establish how well the SDQ identified children who required treatment, Total Difficulties Scores (TDS) from single-informant SDQs submitted at referral were compared to treatment recommendations following routine CAMHS assessment in a real-world setting. To explain the results, clinicians (n=9) from the team were interviewed and key themes identified using Thematic Analysis. Results: Optimal accuracy calculations for SDQs completed by carers (TDS=17, sensitivity .67, specificity .57), teachers (TDS=17, sensitivity .79, specificity .71) and young people (TDS=14, sensitivity.79, specificity .42) compared to the outcome of routine CAMHS assessments indicated that the number of children whose treatment needs were not identified by their SDQ score may be unacceptably high. Key themes from clinician interviews identified possible gaps and limitations: Developmental Trauma and Attachment Difficulties, A different kind of ‘patient?’, Seeing the bad but neglecting the sad, and The importance of clinical judgement. Conclusions: Contrary to UK Government policy, this study suggests that the single-report SDQ should not be relied upon as a sole means of identifying mental health difficulties in this vulnerable, high-risk population.Peer reviewedFinal Accepted Versio

Les femmes en philo, qu’est-ce que ça mange en hiver ?

Cet article propose d'explorer les enjeux liés à la domination du genre masculin dans les milieux académiques au sein de la discipline philosophie. Deux jeunes chercheuses formées à l'université du Québec à Montréal partagent leur expérience, leur prise de conscience et retracent la trajectoire qui les a amenées à co-fonder ou à rejoindre l'association Fillosophie.Philosophy is a field dominated by the male gender. This domination manifests itself by numerous problems for women in philosophy. This paper questions the causes and the nature of women’s roles in philosophy, through the experience of two of them

Informing Prison Theatre Improvement through World Café Conversations with Prisoners

This paper aims to acquaint readers with the participatory consultation and research method of ‘World Café’ in the context of evaluating a theatre-based arts project delivered in a UK prison with adult male sex offenders. Our prison-based study involved 12 inmates who took part in a World Café with a follow up questionnaire, following participation in a 2-week theatre arts project. We found that the theatre project had positive impact upon prisoner a) health and well-being, b) self-esteem and confidence and c) the ability to develop healthy relationships. The conversational approach to World Café as described by Brown and Issacs (2005) enabled us to collect qualitative data and build consensus, whilst allowing individual perspective to be shared and valued in a group context. Our prison participants reported the World Café method was an enjoyable mechanism to enable reflection upon their experiences

Deep Mixing and Metallicity: Carbon Depletion in Globular Cluster Giants

We present the results of an observational study of the efficiency of deep mixing in globular cluster red giants as a function of stellar metallicity. We determine [C/Fe] abundances based on low-resolution spectra taken with the Kast spectrograph on the 3m Shane telescope at Lick Observatory. Spectra centered on the 4300 Angstrom CH absorption band were taken for 42 bright red giants in 11 Galactic globular clusters ranging in metallicity from M92 ([Fe/H]=-2.29) to NGC 6712 ([Fe/H]=-1.01). Carbon abundances were derived by comparing values of the CH bandstrength index S2(CH) measured from the data with values measured from a large grid of SSG synthetic spectra. Present-day abundances are combined with theoretical calculations of the time since the onset of mixing, which is also a function of stellar metallicity, to calculate the carbon depletion rate across our metallicity range. We find that the carbon depletion rate is twice as high at a metallicity of [Fe/H]=-2.3 than at [Fe/H]=-1.3, which is a result qualitatively predicted by some theoretical explanations of the deep mixing process.Comment: 10 pages including 11 figures, emulateapj format, accepted by A

Light-Element Abundance Variations at Low Metallicity: the Globular Cluster NGC 5466

We present low-resolution (R~850) spectra for 67 asymptotic giant branch (AGB), horizontal branch and red giant branch (RGB) stars in the low-metallicity globular cluster NGC 5466, taken with the VIRUS-P integral-field spectrograph at the 2.7-m Harlan J. Smith telescope at McDonald Observatory. Sixty-six stars are confirmed, and one rejected, as cluster members based on radial velocity, which we measure to an accuracy of 16 km s-1 via template-matching techniques. CN and CH band strengths have been measured for 29 RGB and AGB stars in NGC 5466, and the band strength indices measured from VIRUS-P data show close agreement with those measured from Keck/LRIS spectra previously taken of five of our target stars. We also determine carbon abundances from comparisons with synthetic spectra. The RGB stars in our data set cover a range in absolute V magnitude from +2 to -3, which permits us to study the rate of carbon depletion on the giant branch as well as the point of its onset. The data show a clear decline in carbon abundance with rising luminosity above the luminosity function "bump" on the giant branch, and also a subdued range in CN band strength, suggesting ongoing internal mixing in individual stars but minor or no primordial star-to-star variation in light-element abundances.Comment: 10 pages, emulateapj format, AJ accepte

A Survey of CN and CH Variations in Galactic Globular Clusters from SDSS Spectroscopy

We present a homogeneous survey of the CN and CH bandstrengths in eight Galactic globular clusters observed during the course of the Sloan Extension for Galactic Understanding and Exploration (SEGUE) sub-survey of the SDSS. We confirm the existence of a bimodal CN distribution among RGB stars in all of the clusters with metallicity greater than [Fe/H] = -1.7; the lowest metallicity cluster with an observed CN bimodality is M53, with [Fe/H] ~ -2.1. There is also some evidence for individual CN groups on the subgiant branches of M92, M2, and M13, and on the red giant branches of M92 and NGC 5053. Finally, we quantify the correlation between overall cluster metallicity and the slope of the CN bandstrength-luminosity plot as a means of further demonstrating the level of CN-enrichment in cluster giants. Our results agree well with previous studies reported in the literature.Comment: AJ submitted; 80 pages, 22 figure

High-resolution μCT of a mouse embryo using a compact laser-driven X-ray betatron source

High-resolution microcomputed tomography with benchtop X-ray sources requires long scan times because of the heat load limitation on the anode. We present an alternative, high-brightness plasma-based X-ray source that does not suffer from this restriction. A demonstration of tomography of a centimeter-scale complex organism achieves equivalent quality to a commercial scanner. We will soon be able to record such scans in minutes, rather than the hours required by conventional X-ray tubes

Calculating daily dose in the Observational Medical Outcomes Partnership Common Data Model

Purpose: We aimed to develop a standardized method to calculate daily dose (i.e., the amount of drug a patient was exposed to per day) of any drug on a global scale using only drug information of typical observational data in the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) and a single reference table from Observational Health Data Sciences And Informatics (OHDSI). Materials and Methods: The OMOP DRUG_STRENGTH reference table contains information on the strength or concentration of drugs, whereas the OMOP DRUG_EXPOSURE table contains information on patients' drug prescriptions or dispensations/claims. Based on DRUG_EXPOSURE data from the primary care databases Clinical Practice Research Datalink GOLD (United Kingdom) and Integrated Primary Care Information (IPCI, The Netherlands) and healthcare claims from PharMetrics® Plus for Academics (USA), we developed four formulas to calculate daily dose given different DRUG_STRENGTH reference table information. We tested the dose formulas by comparing the calculated median daily dose to the World Health Organization (WHO) Defined Daily Dose (DDD) for six different ingredients in those three databases and additional four international databases representing a variety of healthcare settings: MAITT (Estonia, healthcare claims and discharge summaries), IQVIA Disease Analyzer Germany (outpatient data), IQVIA Longitudinal Patient Database Belgium (outpatient data), and IMASIS Parc Salut (Spain, hospital data). Finally, in each database, we assessed the proportion of drug records for which daily dose calculations were possible using the suggested formulas. Results: Applying the dose formulas, we obtained median daily doses that generally matched the WHO DDD definitions. Our dose formulas were applicable to &gt;85% of drug records in all but one of the assessed databases. Conclusion: We have established and implemented a standardized daily dose calculation in OMOP CDM providing reliable and reproducible results.</p

Calculating daily dose in the Observational Medical Outcomes Partnership Common Data Model

Purpose: We aimed to develop a standardized method to calculate daily dose (i.e., the amount of drug a patient was exposed to per day) of any drug on a global scale using only drug information of typical observational data in the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) and a single reference table from Observational Health Data Sciences And Informatics (OHDSI). Materials and Methods: The OMOP DRUG_STRENGTH reference table contains information on the strength or concentration of drugs, whereas the OMOP DRUG_EXPOSURE table contains information on patients' drug prescriptions or dispensations/claims. Based on DRUG_EXPOSURE data from the primary care databases Clinical Practice Research Datalink GOLD (United Kingdom) and Integrated Primary Care Information (IPCI, The Netherlands) and healthcare claims from PharMetrics® Plus for Academics (USA), we developed four formulas to calculate daily dose given different DRUG_STRENGTH reference table information. We tested the dose formulas by comparing the calculated median daily dose to the World Health Organization (WHO) Defined Daily Dose (DDD) for six different ingredients in those three databases and additional four international databases representing a variety of healthcare settings: MAITT (Estonia, healthcare claims and discharge summaries), IQVIA Disease Analyzer Germany (outpatient data), IQVIA Longitudinal Patient Database Belgium (outpatient data), and IMASIS Parc Salut (Spain, hospital data). Finally, in each database, we assessed the proportion of drug records for which daily dose calculations were possible using the suggested formulas. Results: Applying the dose formulas, we obtained median daily doses that generally matched the WHO DDD definitions. Our dose formulas were applicable to &gt;85% of drug records in all but one of the assessed databases. Conclusion: We have established and implemented a standardized daily dose calculation in OMOP CDM providing reliable and reproducible results.</p

Developing a sense of place toolkit: Identifying destination uniqueness

It has long been recognised that the tangible and intangible characteristics that make a location distinctive and memorable, contribute significantly to destination image. How this destination feel is communicated, has largely been the domain of place branding and destination marketing, which have the potential to miss stakeholder voices. Recently though, practitioners are starting to carefully consider ‘sense of place’; that is an emotional attachment to place, which is defined more carefully in the literature review of this article, and which corresponds with long-running academic discussions. This paper attempts to identify some of these and bridge the gap between academic theory on sense of place and practice. In the UK, many rural areas are now seeking to operationalise sense of place through toolkit documents that might inform landscape interpretation and destination branding. A scenario echoed internationally, where local distinctiveness features in both rural and urban planning. However, sense of place in a tourism context, and more specifically the development of these toolkits, has received limited academic attention. Hence, this paper presents the case of Morecambe Bay, and the development of a dedicated sense of place toolkit. The subsequent case emerges from a collaboration between academics and practitioners and draws on participant observation, semi-structured interviews and document analysis. Specifically, the paper outlines a series of workshop activities developed with destination stakeholders and identifies how these inform subsequent toolkit design. It offers a critical analysis of the benefits and potential pitfalls of employing this approach. This case is of value to academics and destination stakeholders interested in identifying and communicating the uniqueness and emotional tone of the destination. Key lessons and recommendations are identified for those engaging in similar toolkit development initiatives