Transitions of care from child and adolescent mental health services to adult mental health services (TRACK Study) : a study of protocols in Greater London

Background: Although young people's transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper presents findings from a survey of transition protocols in Greater London. Methods: A questionnaire survey (Jan-April 2005) of Greater London CAMHS to identify transition protocols and collect data on team size, structure, transition protocols, population served and referral rates to AMHS. Identified transition protocols were subjected to content analysis. Results: Forty two of the 65 teams contacted (65%) responded to the survey. Teams varied in type (generic/targeted/in-patient), catchment area (locality-based, wider or national) and transition boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer to AMHS, per CAMHS team (mean 12.3, range 0–70, SD 14.5, n = 37) was greater than the annual average number of cases actually accepted by AMHS (mean 8.3, range 0–50, SD 9.5, n = 33). In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely similar in stated aims and policies, but differed in key procedural details, such as joint working between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While the centrality of service users' involvement in the transition process was identified, no protocol specified how users should be prepared for transition. A major omission from protocols was procedures to ensure continuity of care for patients not accepted by AMHS. Conclusion: At least 13 transition protocols were in operation in Greater London in April 2005. Not all protocols meet all requirements set by government policy. Variation in protocol-sharing organisational units and transition process suggest that practice may vary. There is discontinuity of care provision for some patients who 'graduate' from CAMHS services but are not accepted by adult services

Effects of Electron Correlations on Hofstadter Spectrum

By allowing interactions between electrons, a new Harper's equation is derived to examine the effects of electron correlations on the Hofstadter energy spectra. It is shown that the structure of the Hofstadter butterfly ofr the system of correlated electrons is modified only in the band gaps and the band widths, but not in the characteristics of self-similarity and the Cantor set.Comment: 13 pages, 5 Postscript figure

Tuning the proximity effect in a superconductor-graphene-superconductor junction

We have tuned in situ the proximity effect in a single graphene layer coupled to two Pt/Ta superconducting electrodes. An annealing current through the device changed the transmission coefficient of the electrode/graphene interface, increasing the probability of multiple Andreev reflections. Repeated annealing steps improved the contact sufficiently for a Josephson current to be induced in graphene.Comment: Accepted for publication in Phys. Rev.

Sickle cell disease in pregnancy

Structural and quantitative changes at the polypeptide chains of haemoglobin lead to defective red blood cells with a life span 1/5th of the normal, a much smaller capacity of oxygen saturation, and a less pliable structure that easily deforms in situations of hypoxia, stress, acidosis, dehydration, cold and prolonged physical effort etc. Multi-organ vaso-occlusion and hypoxia ensues, causing severe bone pains, sequestration, infarction and anaemia. Increased physiologic demands of pregnancy, aggravate falciformation resulting to poor perfusion of the placenta predisposing to preterm pregnancy loss, intrauterine growth retardation, pre-eclampsia, severe anaemia and increased perinatal and maternal morbidity and mortality. Urinary tract, respiratory and bone infections, as well as cardiac and neurologic complications are common. Treatment is preventive and symptomatic. It aims at reducing high risk combinations, and a meticulous follow-up to prevent the woman from developing complications and not dying from these complications. Though vasso-occlusive pain crises and severe anaemia may be fatal they may be remedied by generous use of analgesics, adequate hydration and exchange transfusion. Sickle cell anaemia the most common of the three major haemoglobinopathies is more frequent with individuals of African descent, haemoglobin C is more predominant in the coast of Africa west of the river Niger while alpha thalassemia and beta thalassemia haemoglobin are frequent in the Mediterranean and Southeast Asian countries respectively. Keywords: sickle cell anaemia, haemoglobin S, haemoglobin, thalassemia haemoglobin, haemoglobinopathy, pregnancy, vaso-occlusion, bone pain crises, exchange transfusion Clinics in Mother and Child Health Vol. 1(1) 2004: 53-6

Happy diamond anniversary JMS! A decade analysis of the Journal of Management Studies

The Journal of Management Studies, founded in 1963, is celebrating its 60 th year. Clark et al. (2014) conducted a bibliometric analysis for its 50 th anniversary assessing whether the journal had maintained its leading international ranking and sustained its mission to serve as a broad-based management outlet. In this review, we build on and extend their findings by examining trends in the journal over the past decade (2012–22). We present a broader analysis of JMS by exploring its unique identity within the management journal ecosystem and examining its scope and breadth in terms of topics, methods, and author demographics to document JMS's evolution, impact, reach, and accessibility. We develop a new bibliometric framework that employs a mix of qualitative and quantitative analyses (including regression, text, and language analysis) to cover a broad range of considerations for a journal and its stakeholders. In so doing, we contribute to the bibliometric and review research areas by proposing new metrics (related to diversity, equity, and inclusion) and analysis tools to assess the relative position of an academic journal. Employing this framework, we conclude that JMS has retained and enhanced its position as a leading, cutting-edge general management journal.</p

Nonequilibrium effects due to charge fluctuations in intrinsic Josephson systems

Nonequilibrium effects in layered superconductors forming a stack of intrinsic Josephson junctions are investigated. We discuss two basic nonequilibrium effects caused by charge fluctuations on the superconducting layers: a) the shift of the chemical potential of the condensate and b) charge imbalance of quasi-particles, and study their influence on IV-curves and the position of Shapiro steps.Comment: 17 pages, 2 figures, revised version slightly shortene