Uses and Abuses of Patient Reported Outcome Measures (PROMs): Potential Iatrogenic Impact of PROMs Implementation and How It Can Be Mitigated

Abstract Having been a national advocate for the use of patient reported outcome measures (PROMs) in Child and Adolescent Mental Health Services (CAMHS) in the UK for the last decade, I have become increasingly concerned that unless the potential iatrogenic impact of widespread policy requirement for use of PROMs (Department of Health, Children and Young People's Health Outcomes Strategy, 2012) is recognised and addressed their real potential benefits (Sapyta et al., J Clin Psychol 61(2):145-153, 2005) may never be realized. Drawing on examples from PROMs implementation in CAMHS in the UK (Wolpert et al., J Ment Health 21(2):165-173, 2012a; Child Adolesc Mental Health 17(3):129-130, 2012b). I suggest key ways forward if PROMs are to support best clinical practice rather than undermine it

An adaptive Metropolis-Hastings scheme: sampling and optimization

We propose an adaptive Metropolis-Hastings algorithm in which sampled data are used to update the proposal distribution. We use the samples found by the algorithm at a particular step to form the information-theoretically optimal mean-field approximation to the target distribution, and update the proposal distribution to be that approximatio. We employ our algorithm to sample the energy distribution for several spin-glasses and we demonstrate the superiority of our algorithm to the conventional MH algorithm in sampling and in annealing optimization.Comment: To appear in Europhysics Letter

Considering Harm and Safety in Youth Mental Health: A Call for Attention and Action

The possibility of harm from mental health provision, and in particular harm from youth mental health provision, has been largely overlooked. We contend that if we continue to assume youth mental health services can do no harm, and all that is needed is more services, we continue to risk the possibility that the safety of children and young people is unintentionally compromised. We propose a three level framework for considering harm from youth mental health provision (1. ineffective engagement, 2. ineffective practice and 3. adverse events) and suggest how this framework could be used to support quality improvement in services

Commentary: Why measuring clinical change at the individual level is challenging but crucial - commentary on Jensen and Corralejo (2017)

Jensen and Corralejo highlight that most mental health intervention research focuses on the group level rather than individual level. They looked at parent-reported outcomes for up to 24 children and found that individual-level findings appear to tell a less positive story than the more traditional group-level finding. They call for more reporting of outcomes at individual level

The importance of shared research goals for a world in which no one is held back by mental health problems

The importance of shared research goals for a world in which no one is held back by mental health problems

Preserving and Promoting Minnesota’s Recreational Trails: State v. Hess

This article assesses the significance of Hess for Minnesota’s recreational trail system and the conversion of rails to trails. Part II describes the legal context within which Hess was decided, with particular emphasis on the methodology of constructing ancient deeds to railroads and the public policy underlying the MTA. Part III sets forth the facts giving rise to the Hess decision and details the approach adopted by the court of appeals—an approach which, if affirmed by the supreme court, would have facilitated a parcel by parcel attack on the state’s ownership of its recreational trails and potentially limited the application of the shifting public use doctrine established in Washington Wildlife. Part IV discusses the supreme court’s analysis of the issues, its interpretative methodology, and the normative justification of its approach. Part V concludes that Hess establishes a strong legal and policy foundation for the past and future conversion of rail corridors into recreational trails, promotes the public interest, and avoids plunging the state into a costly parcel by parcel battle to save its contiguous recreational trail system

Stratigraphic and structural analysis of the J1 Sandstone, Scotts Bluff Trend, Scotts Bluff and Morrill counties, Nebraska

Scotts Bluff Trend is a group of 10 oil fields that produce from the Cretaceous J Sandstone. Production was previously thought to be aligned along this trend due to structural influence.;For this study well logs were utilized in analyzing structural and stratigraphic elements, as well as hydrocarbon predictability. The Scotts Bluff Trend appears to sit upon a residual structural high. A comprehensive look reveals that stratigraphic influence is superimposed on the structural high.;J1 Sandstone reservoirs were mapped assuming a NW--SE depositional trend. Deposition was in a shallow-marine bar environment. Central-bar, bar-margin and interbar facies are recognized which interfinger laterally into the surrounding trapping siltstone.;A predictor of hydrocarbons was attempted by way of resistivity mapping. Although unsuccessful, use of these resistivity maps in conjunction with structural and stratigraphic maps has led to the recognition of at least seven prospects

Collective Intelligence for Control of Distributed Dynamical Systems

We consider the El Farol bar problem, also known as the minority game (W. B. Arthur, ``The American Economic Review'', 84(2): 406--411 (1994), D. Challet and Y.C. Zhang, ``Physica A'', 256:514 (1998)). We view it as an instance of the general problem of how to configure the nodal elements of a distributed dynamical system so that they do not ``work at cross purposes'', in that their collective dynamics avoids frustration and thereby achieves a provided global goal. We summarize a mathematical theory for such configuration applicable when (as in the bar problem) the global goal can be expressed as minimizing a global energy function and the nodes can be expressed as minimizers of local free energy functions. We show that a system designed with that theory performs nearly optimally for the bar problem.Comment: 8 page

Sensory motor systems of artificial and natural hands

The surgeon Ambroise Paré designed an anthropomorphic hand for wounded soldiers in the 16th century. Since that time, there have been advances in technology through the use of computer-aided design, modern materials, electronic controllers and sensors to realise artificial hands which have good functionality and reliability. Data from touch, object slip, finger position and temperature sensors, mounted in the fingers and on the palm, can be used in feedback loops to automatically hold objects. A study of the natural neuromuscular systems reveals a complexity which can only in part be realised today with technology. Highlights of the parallels and differences between natural and artificial hands are discussed with reference to the Southampton Hand. The anatomical structure of parts of the natural systems can be made artificially such as the antagonist muscles using tendons. Theses solutions look promising as they are based on the natural form but in practice lack the desired physical specification. However, concepts of the lower spinal loops can be mimicked in principle. Some future devices will require greater skills from the surgeon to create the interface between the natural system and an artificial device. Such developments may offer a more natural control with ease of use for the limb deficient person

How does the British public understand mental health? A qualitative analysis of open-text responses

BACKGROUND: An individual's understanding of mental health can influence their attitudes towards those experiencing mental health problems, and also impact their response to any mental health problems they experience. However, what the lay public understand about mental health is not well explored in existing research. AIMS: This study aims to gain a deeper insight into what the general public understand by the term 'mental health problem'. METHODS: Data were taken from a large-scale representative sample of adults from Great Britain (n = 2,708). A thematic analysis was carried out on an open-text question which asked people what they understood by the term 'mental health problem'. RESULTS: Six themes were identified in the thematic analysis, which included understanding mental health through thinking about cause and effect, thinking about the location of mental health problems in the body, the universality and variation of mental health problems, reflections on lived experience and identifying a specific mental health problem. CONCLUSION: The analysis suggests that there are many diverse ways the public conceptualises mental health. The themes identified may be useful for future quantitative analyses, and also may suggest how information about mental health can be best communicated to the public