Factors Associated with Patient Satisfaction of Community Mental Health Services: A Multilevel Approach

Community care is increasingly the mainstay of mental healthcare provision in many countries and patient satisfaction is an important barometer of quality of patient care. This paper explores the key factors associated with patient satisfaction with community mental health services in England and then compares providers’ performance on patient satisfaction. Our analysis is based on patient-level responses from the community mental health survey, which is run annually by the Care Quality Commission (CQC) for the years 2010 to 2013. We perform a repeated cross-section analysis, identifying factors associated with patient satisfaction via a multi-level ordered probit model, including both patient- and provider-level variables. We identify hospital-specific effects via empirical Bayes estimation. Our analysis identifies a number of novel results. First, patient characteristics such as older age, being employed, and being able to work, are associated with higher satisfaction, while being female is associated with lower satisfaction. Service contact length, time since last visit, condition severity and admission to a mental health institution, are all associated with lower satisfaction. Second, treatment type affects satisfaction, with patients receiving talking therapies or being prescribed medications being more satisfied. Third, care continuity and involvement, as proxied by having a care plan, is associated with higher satisfaction. Fourth, seeing a health professional closer to the community improves satisfaction, with patients seeing a community-psychiatric nurse, a social worker or a mental-health support worker being more satisfied. Finally, our study identifies the need for service integration, with patients experiencing financial, accommodation, or physical health needs being less satisfied. At a provider level, we find a negative association between the percentage of occupied beds and satisfaction. We further identify significant provider-specific effects after accounting for observable differences in patient and provider characteristics which suggests significant differences in provider quality of care

Pressure Distribution on a Slotted R.A.F. 31 Airfoil in the Variable Density Wind Tunnel

Measurements were made in the variable density wind tunnel to determine the pressure distribution over one section of a R.A.F. 31 airfoil with a leading edge slot fully open. To provide data for the study of scale effect on this type of airfoil, the tests were conducted with air densities of approximately one and twenty atmospheres

The Drag and Interference of a Nacelle in the Presence of a Wing

A wing interference investigation was conducted to determine why the N.A.C.A. cowling did not yield the expected increase in speed when adapted to the outboard nacelles of trimotored airplanes

Experiments with a Model Water Tunnel

This report describes a model water tunnel built in 1928 by the NACA to investigate the possibility of using water tunnels for aerodynamic investigations at large scales. The model tunnel is similar to an open-throat wind tunnel, but uses water for the working fluid

Novel optical imaging technique to determine the 3-D orientation of collagen fibers in cartilage: variable-incidence angle polarization-sensitive optical coherence tomography

Objective: To investigate a novel optical method to determine the three dimensional (3-D) structure of articular cartilage collagen non-destructively. Methods: Polarization-sensitive optical coherence tomography was used to determine the apparent optical birefringence of articular cartilage for a number of different illumination directions. A quantitative method based on the theory of light propagation in uniaxial crystalline materials was validated on equine flexor tendon. Qualitative maps of fiber polar and azimuthal orientation at sites on the posterior and anterior segments of the equine third metacarpophalangeal (fetlock) joint were produced, and the azimuthal orientations compared with data from a split-line experiment. Results: Polar and azimuthal angles of cut flexor tendon broadly agreed with the nominal values but suggested that the accuracy was limited by our method of determining the apparent birefringence. On intact equine fetlock joints we found a non-zero polar tilt that changed in direction at various points along the apex, moving from the sagittal ridge outwards. The azimuthal orientation changes from being parallel to the sagittal ridge in the posterior region to being inclined to the ridge in the anterior region. This broadly agrees with split-line data for the anterior region but differs in the posterior region, possibly reflecting depth-dependent orientation changes. Conclusion: General quantitative agreement was found between our method and histology in validation experiments. Qualitative results for cartilage suggest a complicated 3-D structure that warrants further study. There is potential to develop this approach into a tool that can provide depth-resolved information on collagen orientation in near real-time, non-destructively and in vivo. (c) 2008 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved

Tests of N.A.C.A. airfoils in the variable-density wind tunnel Series 230.

The results of tests of six airfoils having the N.A.C.A. 230 mean line and varying in thickness from 0.06c to 0.21c are presented. These results agree with previous findings in showing that aerodynamically the best section is one of moderate thickness. The data are of value mainly in connection with the design of tapered wings having sections based on the N.A.C.A. 230 mean line

Tests on Thrust Augmenters for Jet Propulsion

This series of tests was undertaken to determine how much the reaction thrust of a jet could be increased by the use of thrust augmenters and thus to give some indication as to the feasibility of jet propulsion for airplanes. The tests were made during the first part of 1927 at the Langley Memorial Aeronautical Laboratory. A compressed air jet was used in connection with a series of annular guides surrounding the jet to act as thrust augmenters. The results show that, although it is possible to increase the thrust of a jet, the increase is not large enough to affect greatly the status of the problem of the application of jet propulsion to airplanes

Energy Measurements and Preparation of Canonical Phase States of a Nano-Mechanical Resonator

We show that a continuous quantum non-demolition measurement of the energy of a nanomechanical resonator can be achieved by monitoring the resonator with a quantum point contact via a Cooper-pair box. This technique can further be used to prepare highly non-classical states of two resonators, such as canonical phase-reference states, and so-called "noon" states.Comment: 4 pages, revtex 4, 3 eps figures. v2: improvements to presentatio

Tests of N.A.C.A. airfoils in the variable-density wind tunnel Series 24

This note is the fifth of a series covering an investigation of a number of related airfoils. It presents the results obtained from tests of a group of six low-cambered airfoils in the variable-density wind tunnel. The mean camber lines are identical for the six airfoils and are of such a form that the maximum mean camber is 2 per cent of the chord and is at a position 0.4 of the chord behind the loading edge. The airfoils differ in thickness only, the maximum-thickness/chord ratios being 0.06, 0.09, 0.12, 0.15, 0.18, and 0.21. The results have been presented in the form of both infinite and finite aspect-ratio characteristics. The values of C(sub L) max/C(sub d) degrees min for this group of airfoils are among the highest thus far obtained, the minimum profile drags being approximately equal to those for the symmetrical series of corresponding thickness, while the maximum lift coefficients are considerably higher