Unmet health needs in patients with coronary heart disease: implications and potential for improvement in caring services

BACKGROUND: Improving the quality of health care services requires tailoring facilities to fulfil patients' needs. Satisfying patients' healthcare needs, listening to patients' opinions and building a closer provider-user partnership are central to the NHS. Few published studies have discussed cardiovascular patients' health needs, but they are not comprehensive and fail to explore the contribution of outcome to needs assessment. METHOD: A comprehensive self-administered health needs assessment (HNA) questionnaire was developed for concomitant use with generic (Short Form-12 and EuroQOL) and specific (Seattle Angina Questionnaire) health-related quality of life (HRQL) instruments on 242 patients admitted to the Acute Cardiac Unit, Nottingham. RESULTS: 38% reported difficulty accessing health facilities, 56% due to transport and 32% required a travelling companion. Mean HRQOL scores were lower in those living alone (P < 0.05) or who reported unsatisfactory accommodation. Dissatisfaction with transport affected patients' ease of access to healthcare facilities (P < 0.001). Younger patients (<65 y) were more likely to be socially isolated (P = 0.01). Women and patients with chronic disease were more likely to be concerned about housework (P < 0.05). Over 65 s (p < 0.05) of higher social classes (p < 0.01) and greater physical needs (p < 0.001) had more social needs, correlating moderately (0.32 < r < 0.63) with all HRQL domains except SAQ-AS. Several HRQL components were highly correlated with the HNA physical score (p < 0.001). CONCLUSIONS: Patients wanted more social (suitable accommodation, companionship, social visits) and physical (help aids, access to healthcare services, house work) support. The construct validity and intra-class reliability of the HNA tool were confirmed. Our results indicate a gap between patients' health needs and available services, highlighting potential areas for improvement in the quality of services

Detecting Botnets Through Log Correlation

Botnets, which consist of thousands of compromised machines, can cause a significant threat to other systems by launching Distributed Denial of Service attacks, keylogging, and backdoors. In response to this threat, new effective techniques are needed to detect the presence of botnets. In this paper, we have used an interception technique to monitor Windows Application Programming Interface system calls made by communication applications. Existing approaches for botnet detection are based on finding bot traffic patterns. Our approach does not depend on finding patterns but rather monitors the change of behaviour in the system. In addition, we will present our idea of detecting botnet based on log correlations from different hosts.

Experimenting with Innate Immunity

libtissue is a software system for implementing and testing AIS algorithms on real-world computer security problems. AIS algorithms are implemented as a collection of cells, antigen and signals interacting within a tissue compartment. Input data to the tissue comes in the form of realtime events generated by sensors monitoring a system under surveillance, and cells are actively able to affect the monitored system through response mechanisms. libtissue is being used by researchers on a project at the University of Nottingham to explore the application of a range of immune-inspired algorithms to problems in intrusion detection. This talk describes the architecture and design of libtissue, along with the implementation of a simple algorithm and its application to a computer security problem.

National evaluation of NHS genetics service investments: emerging issues from the cancer genetics pilots

In seeking to fulfil the ambition of the 2003 genetics white paper, Our Inheritance, Our Future, to ‘mainstream’ genetic knowledge and practices, the Department of Health provided start-up funding for pilot services in various clinical areas, including seven cancer genetics projects. To help to understand the challenges encountered by such an attempt at reconfiguring the organization and delivery of services in this field, a programme-level evaluation of the genetics projects was commissioned to consider the organizational issues faced. Using a qualitative approach, this research has involved comparative case-study work in 11 of the pilot sites, including four of the seven cancer genetics pilots. In this paper, the researchers present early findings from their work, focusing in particular on the cancer genetics pilots. They consider some of the factors that have influenced how the pilots have sought to address pre-existing sector, organizational and professional boundaries to these new ways of working. The article examines the relationship between these factors and the extent to which pilots have succeeded in setting up boundary-spanning services, dealing with human-resource issues and creating sustainable, ‘mainstreamed’ provision which attracts ongoing funding in a volatile NHS commissioning environment where funding priorities do not always favour preventive, risk-assessment services.

Young people with learning disabilities who sexually abuse: understanding, identifying and responding from within generic education and welfare services

This chapter will start by providing an overview of current knowledge about young people with learning disabilities who sexually abuse. Research cited will, unless otherwise indicated, be limited to UK studies since international variations in the definitions of both learning disability and sexual abuse make the use of a wider literature base problematic – particularly that relating to prevalence and incidence. It will then go on to report key findings from a recent study (Fyson et al, 2003; Fyson, 2005) which examined how special schools and statutory child protection and youth offending services in four English local authorities responded to sexually inappropriate or abusive behaviours exhibited by young people with learning disabilities. It will conclude by highlighting areas of current practice which give cause for concern, and suggest some pointers for future best practice.