DUNDRUM-2: Prospective validation of a structured professional judgment instrument assessing priority for admission from the waiting list for a forensic mental health hospital

<p>Abstract</p> <p>Background</p> <p>The criteria for deciding who should be admitted first from a waiting list to a forensic secure hospital are not necessarily the same as those for assessing need. Criteria were drafted qualitatively and tested in a prospective 'real life' observational study over a 6-month period.</p> <p>Methods</p> <p>A researcher rated all those presented at the weekly referrals meeting using the DUNDRUM-1 triage security scale and the DUNDRUM-2 triage urgency scale. The key outcome measure was whether or not the individual was admitted.</p> <p>Results</p> <p>Inter-rater reliability and internal consistency for the DUNDRUM-2 were acceptable. The DUNDRUM-1 triage security score and the DUNDRUM-2 triage urgency score correlated r = 0.663. At the time of admission, after a mean of 23.9 (SD35.9) days on the waiting list, those admitted had higher scores on the DUNDRUM-2 triage urgency scale than those not admitted, with no significant difference between locations (remand or sentenced prisoners, less secure hospitals) at the time of admission. Those admitted also had higher DUNDRUM-1 triage security scores. At baseline the receiver operating characteristic area under the curve for a combined score was the best predictor of admission while at the time of admission the DUNDRUM-2 triage urgency score had the largest AUC (0.912, 95% CI 0.838 to 0.986).</p> <p>Conclusions</p> <p>The triage urgency items and scale add predictive power to the decision to admit. This is particularly true in maintaining equitability between those referred from different locations.</p

Unsteady numerical simulation of double diffusive convection heat transfer in a pulsating horizontal heating annulus

A numerical study is conducted on time-dependent double-diffusive natural convection heat transfer in a horizontal annulus. The inner cylinder is heated with sinusoidally-varying temperature while the outer cylinder is maintained at a cold constant temperature. The numerical procedure used in the present work is based on the Galerkin weighted residual method of finite-element formulation by incorporating a non-uniform mesh size. Comparisons with previous studies are performed and the results show excellent agreement. In addition, the effects of pertinent dimensionless parameters such as the thermal Rayleigh number, Buoyancy ratio, Lewis number, and the amplitude of the thermal forcing on the flow and heat transfer characteristics are considered in the present study. Furthermore, the amplitude and frequency of the heated inner cylinder is found to cause significant augmentation in heat transfer rate. The predictions of the temporal variation of Nusselt and Sherwood numbers are obtained and discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45860/1/231_2005_Article_64.pd