An Examination of the Use of Coercion by Assertive Outreach and Community Mental Health Teams in Northern Ireland.

In mental health services over recent decades, the positive move away from hospital-based care to community-based services has entailed that people with higher levels of need are being supported by community mental health services. This paper begins by reviewing the literature on coercion in the field of community-based mental health care and treatment. It is argued that the lack of a critical understanding of the concept and how it is used by practitioners and agencies can have serious repercussions for the rights of service users. Using a quasi-experimental, longitudinal design, the authors then seek to test some of the ideas about coercion by comparing the activities of assertive outreach and community mental health teams in Northern Ireland, particularly the key ideas of perceived coercion, workers’ strategies and engagement with services. Key findings were that assertive outreach appeared to be more successful at reducing perceived coercion, minimizing the need for coercive strategies, engaging high-risk clients and reducing inpatient bed use. These findings are compared with other studies in this area. The authors also argue that there is a need for greater transparency in the way that practitioners use coercive measures and more explicit guidance is required in this crucial area of mental health practice.

Characterisation of the Interaction of Lactate Dehydrogenase With Tween-20 Using Isothermal Titration Calorimetry, Interfacial Rheometry and Surface Tension Measurements

In this study the nature of the interaction between Tween-20 and lactate dehydrogenase (LDH) was investigated using isothermal titration calorimetry (ITC). In addition the effects of the protein and surfactant on the interfacial properties were followed with interfacial rheology and surface tension measurements in order to understand the mechanism by which the surfactant prevents protein adsorption to the air– water interface. Comparisons were made with Tween-40 and Tween-80 in order to further investigate the mechanism. ITC measurements indicated a weak, probably hydrophobic, interaction between Tween-20 and LDH. Prevention of LDH adsorption to the air–water interface by the Tween surfactants was correlated with surface energy rather than surfactant CMC. While surface pressure appears to be the main driving force for the displacement of LDH from the air–water interface by Tween-20 a solubilisation mechanism may exist for other protein molecules. More generally the results of this study highlight the value of the use of ITC and interfacial measurements in characterising the surface behaviour of mixed surfactant and protein systems.

Reflecting the Public Value of Sport: A game of two halves

This article draws on qualitative research that explores the concept of public value in the delivery of sport services by the organization Sport England. The research took place against a backdrop of shifting priorities following the award of the 2012 Olympic Games to London. It highlights the difficulties that exist in measuring the qualitative nature of the public value of sport and suggests there is a need to understand better the idea. Research with organizations involved alongside Sport England in the delivery of sport is described. This explores the potential to create a public value vision, how to measure it and how to focus public value on delivery beyond the aim of ‘sport for sports sake’ and more towards ‘sport for the greater good’. The article argues that this represents a game of ‘two halves’ in which the first half focuses on 2012 with the second half concerned with its legacy.

Moderate adolescent drug use and the development of substance use self-regulation

This article presents a re-conceptualization of moderate adolescent drug use. It is argued that experimentation with alcohol and other drugs during the teenage years may play an important role in the development of regulatory competency in relation to drug consumption in adulthood. When such regulatory skills fail to emerge in young people, during the transition to adulthood, the likelihood of serious alcohol- or drug-related harm is increased. The article reviews the empirical evidence of poor self-regulation as a predictor of long-term alcohol-and drug-related problems, places self-regulation within a broader theoretical framework, and considers the policy and practice implications of this conceptualization.