Quality of Longer Term Mental Health Facilities in Europe: Validation of the Quality Indicator for Rehabilitative Care against Service Users’ Views

BACKGROUND: The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. METHOD: At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. RESULTS: 1750/2495 (70%) users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning). A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. CONCLUSIONS: Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care. Interventions that improve quality of care in these settings may promote service users' autonomy

CRITICAL BEHAVIOUR OF THE FERROMAGNET (NH4)2 Cu (Cl1-xBrx)4 2H2O

The critical behaviour of the random bond ferromagnet (NH4)2 Cu (Cl1-xBrx)4 2H2O was studied by magnetic susceptibility measurements. We found for the mixed compounds a critical exponent γ = 1.40 ± 0.06. This value is larger than the exponent determined for the pure (x = 1) system (γ = 1.24 ± 0.03)

Tsunamigenic potential of a newly discovered active fault zone in the outer Messina Strait, Southern Italy

The 1908 Messina tsunami was the most catastrophic tsunami hitting the coastline of southern Italy in the younger past. The source of this tsunami, however, is still heavily debated, and both rupture along a fault and a slope failure have been postulated as potential origin of the tsunami. Here we report a newly-discovered active Fiumefreddo-Melito di Porto Salvo Fault Zone (F-MPS_FZ), which is located in the outer Messina Strait in a proposed landslide source area of the 1908 Messina tsunami. Tsunami modeling showed that this fault zone would produce devastating tsunamis by assuming slip amounts of ≥ 5 m. An assumed slip of up to 17 m could even generate a tsunami comparable to the 1908 Messina tsunami, but we do not consider the F-MPS_FZ as a source for the 1908 Messina tsunami because its E-W strike contradicts seismological observations of the 1908 Messina earthquake. Future researches on the F-MPS_FZ, however, may contribute to the tsunami risk assessment in the Messina Strait