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.

Exploring the Views of Police Officers on the Use of Video Taped Evidence in Child Abuse Cases in Northern Ireland

This paper sets out to explore the views and attitudes of police officers in the Greater Belfast area, concerning the process and use of video taped interviews with child witnesses, subsequently used as court evidence in child abuse cases. The information was collected by means of a postal questionnaire, completed by police officers who had all experienced joint interviews with social workers of child witnesses. With the increased use of video evidence as an alternative to the distressing experience of a child appearing in court to give evidence, the research findings and conclusions provide clear messages about future developments both nationally and internationally.

The use of process simulation methods in support of organisational learning in availability contracting

Traditional business models in the aerospace industry are based on a conventional supplier to customer relationship based on the design, manufacture and subsequent delivery of the physical product. Service provision, from the manufacturer's perspective, is typically limited to the supply of procedural documentation and the provision of spare parts to the end user as the product passes through the latter stages of its intended lifecycle. Challenging economic and political conditions have resulted in end users re-structuring their core business activities, particularly in the defence sector. This has resulted in the need for original equipment manufacturers (OEMs) to integrate and manage support service activities in partnership with the customer to deliver platform availability. This improves the probability of commercial sustainability for the OEM through shared operational risks while reducing the cost of platform ownership for the customer. The need for OEMs to evolve their design, manufacture and supply strategies by focusing on customer requirements has revealed a need for reconstruction of traditional internal behaviours and design methodologies. Application of organisational learning is now a well recognised principle for innovative companies to achieve long term growth and sustained technical development, and hence, greater market command. It focuses on the process by which the organisation's knowledge and value base changes, leading to improved problem solving ability and capacity for action. From the perspective of availability contracting, knowledge and the processes by which it is generated, used and retained, become primary assets within the learning organisation. This paper will introduce the application of digital methods to asset management by demonstrating how the process of learning can benefit from a digital approach, how product and process design can be integrated within a virtual framework and finally how the approach can be applied in a service context.

Use of luminescent gold compounds in the design of thin-film oxygen sensors

The use of two gold compounds incorporated into thin plastic films as luminescence quenching oxygen sensors is described. The films are sensitive both to gaseous oxygen and to oxygen dissolved in nonaqueous media such as ethanol. The luminescence quenching of these sensors by oxygen obeys the Stern-Volmer equation and Stern-Volmer constants of 5.35 x 10(-3) and 0.9 x 10(-3) Torr(-1) are found, respectively, for the two dyes in a polystyrene polymer matrix. The sensitivity of the films is strongly influenced by the nature of the polymer matrix, and greatest sensitivity was found in systems based an the polymers polystyrene or cellulose acetate butyrate. Sensitivity was not found to be temperature dependent though raising the temperature hom 15 to 50 degrees C did result in a slight decrease in emission intensity and a hypsochromic shift in the emission wavelength. The rate of response and recovery of the sensors can be increased either by decreasing film thickness or by increasing the operating temperature. The operational and storage stability of these films is generally good though exposure to light should be avoided as one of the dyes tends to undergo photobleaching probably due to a photoinduced ligand substitution reaction.

Use of recycled demolition aggregate in precast products, phase II: Concrete paving blocks

A study undertaken at the University of Liverpool has investigated the potential for using construction and demolition waste (C&DW) as aggregate in the manufacture of a range of precast concrete products, i.e. building and paving blocks and pavement flags. Phase II, which is reported here, investigated concrete paving blocks. Recycled demolition aggregate can be used to replace newly quarried limestone aggregate, usually used in coarse (6 mm) and fine (4 mm-to-dust) gradings. The first objective, as was the case with concrete building blocks, was to replicate the process used by industry in fabricating concrete paving blocks in the laboratory. The compaction technique used involved vibration and pressure at the same time, i.e. a vibro-compaction technique. An electric hammer used previously for building blocks was not sufficient for adequate compaction of paving blocks. Adequate compaction could only be achieved by using the electric hammer while the specimens were on a vibrating table. The experimental work involved two main series of tests, i.e. paving blocks made with concrete- and masonry-derived aggregate. Variables that were investigated were level of replacement of (a) coarse aggregate only, (b) fine aggregate only, and (c) both coarse and fine aggregate. Investigation of mechanical properties, i.e. compressive and tensile splitting strength, of paving blocks made with recycled demolition aggregate determined levels of replacement which produced similar mechanical properties to paving blocks made with newly quarried aggregates. This had to be achieved without an increase in the cement content. The results from this research programme indicate that recycled demolition aggregate can be used for this new higher value market and therefore may encourage demolition contractors to develop crushing and screening facilities for this. (C) 2011 Published by Elsevier Ltd.

The use of recycled demolition aggregate in precast concrete products – Phase III: Concrete pavement flags

A study undertaken at the University of Liverpool has investigated the potential for using construction and demolition waste (C&DW) derived aggregate in the manufacture of a range of precast concrete products, i.e. building and paving blocks and pavement flags. Phase III, which is reported here, investigated
concrete pavement flags. This was subsequent to studies on building and paving blocks. Recycled demolition aggregate can be used to replace newly quarried limestone aggregate, usually used in coarse (6 mm) and fine (4 mm-to-dust) gradings. The first objective was, as was the case with concrete building
and paving blocks, to replicate the process used by industry in fabricating concrete pavement flags in the laboratory. The ‘‘wet’’ casting technique used by industry for making concrete flags requires a very workable mix so that the concrete flows into the mould before it is compressed. Compression squeezes out water from the top as well as the bottom of the mould. This industrial casting procedure was successfully replicated in the laboratory by using an appropriately modified cube crushing machine and a special mould typical of what is used by industry. The mould could be filled outside of the cube crushing machine and then rolled onto a steel frame and into the machine for it to be compressed. The texture and mechanical properties of the laboratory concrete flags were found to be similar to the factory ones. The experimental work involved two main series of tests, i.e. concrete flags made with concrete- and
masonry-derived aggregate. Investigation of flexural strength was required for concrete paving flags. This is different from building blocks and paving blocks which required compressive and tensile splitting strength respectively. Upper levels of replacement with recycled demolition aggregate were determined
that produced similar flexural strength to paving flags made with newly quarried aggregates, without requiring an increase in the cement content. With up to 60% of the coarse or 40% of the fine fractions replaced with concrete-derived aggregates, the target mean flexural strength of 5.0 N/mm2 was still
achieved at the age of 28 days. There was similar detrimental effect by incorporating the fine masonry-derived aggregate. A replacement level of 70% for coarse was found to be satisfactory and also conservative. However, the fine fraction replacement could only be up to 30% and even reduced to 15% when used for mixes where 60% of the coarse fraction was also masonry-derived aggregate.

Use of the impedance cardiogram in public access defibrillators as an indicator of cardiopulmonary resuscitation effectiveness

An algorithm has been developed for a Public Access Defibrillator which utilizes distinctive features from the impedance cardiogram (ICG) recorded via defibrillator pads to advise both lay users and minimally trained bystanders to ensure CPR effectiveness. Following ethical approval, data were collected and marked. CPR was administered by trained personnel. 211 cases were gathered and the training set included 106 cases. A retrospective analysis was carried out of simultaneously recorded ECG and ICG. The speed of compressions was calculated by counting the outstanding waves in the ICG during CPR. Also if the base-to-peak amplitude of the ICG is greater than a minimum threshold, the corresponding compressions were classified as being applied with adequate force. For the validation set, adequate speed was detected with 91.45% sensitivity and 96.27% specificity (79826s) and adequate force with 99.94% sensitivity and 97.91% specificity (91973s). © 2011 CCAL.

Use of data dependence graphs in the design of bit-level systolic arrays

The use of bit-level systolic array circuits as building blocks in the construction of larger word-level systolic systems is investigated. It is shown that the overall structure and detailed timing of such systems may be derived quite simply using the dependence graph and cut-set procedure developed by S. Y. Kung (1988). This provides an attractive and intuitive approach to the bit-level design of many VLSI signal processing components. The technique can be applied to ripple-through and partly pipelined circuits as well as fully systolic designs. It therefore provides a means of examining the relative tradeoff between levels of pipelining, chip area, power consumption, and throughput rate within a given VLSI design.

Session 4: CVD, diabetes and cancer - Evidence for the use of the Mediterranean diet in patients with CHD

Diet is associated with the development of CHD. The incidence of CHD is lower in southern European countries than in northern European countries and it has been proposed that this difference may be a result of diet. The traditional Mediterranean diet emphasises a high intake of fruits, vegetables, bread, other forms of cereals, potatoes, beans, nuts and seeds. It includes olive oil as a major fat source and dairy products, fish and poultry are consumed in low to moderate amounts. Many observational studies have shown that the Mediterranean diet is associated with reduced risk of CHD, and this result has been confirmed by meta-analysis, while a single randomised controlled trial, the Lyon Diet Heart study, has shown a reduction in CHD risk in subjects following the Mediterranean diet in the secondary prevention setting. However, it is uncertain whether the benefits of the Mediterranean diet are transferable to other non-Mediterranean populations and whether the effects of the Mediterranean diet will still be feasible in light of the changes in pharmacological therapy seen in patients with CHD since the Lyon Diet Heart study was conducted. Further randomised controlled trials are required and if the risk-reducing effect is confirmed then the best methods to effectively deliver this public health message worldwide need to be considered.

Labour Law as Human Rights Law: A Critique of the Use of ‘Dignity’ by Freedland and Kountouris

In their recent book, The Legal Construction of Personal Work Relations, Mark Freedland and Nicola Kountouris present an ambitious study of the personal scope of (what they would not want to call) ‘employment’ law. The book does this within a broader argument that calls for the reconceptualization of labour law as a whole, and it is this broader argument on which I shall focus in this chapter. Their aim, in urging us to see labour law through the lens of ‘dignity’ is to bring labour law and human rights law into closer alignment than has sometimes been the case in the past. Increasingly, dignity is seen as providing a, sometimes the, foundation of human rights law, particularly in Europe. I shall suggest that whilst the aim of constructing a new set of foundations for labour law is a worthy and increasingly urgent task, the concepts on which Freedland and Kountouris seek to build their project pose significant difficulties. In particular, their espousal of ‘dignity’ presents problems that must be addressed if their reconceptualization is not to prove a blind alley.

A Validation Study for the Use of ROS1 Immunohistochemical Staining in Screening for ROS1 Translocations in Lung Cancer

INTRODUCTION: The presence of ROS proto-oncogene 1, receptor tyrosine kinase gene (ROS1) rearrangements in lung cancers confers sensitivity to ROS kinase inhibitors, including crizotinib. However, they are rare abnormalities (in ∼1% of non-small cell lung carcinomas) that are typically identified by fluorescence in situ hybridization (FISH), and so screening using immunohistochemical (IHC) staining would be both cost- and time-efficient.

METHODS: A cohort of lung tumors negative for other common mutations related to targeted therapies were screened to assess the sensitivity and specificity of IHC staining in detecting ROS1 gene rearrangements, enriched by four other cases first identified by FISH. A review of published data was also undertaken.

RESULTS: IHC staining was 100% sensitive (95% confidence interval: 48-100) and 83% specific (95% confidence interval: 86-100) overall when an h-score higher than 100 was used. Patients with ROS1 gene rearrangements were younger and typically never-smokers, with the tumors all being adenocarcinomas with higher-grade architectural features and focal signet ring morphologic features (two of five). Four patients treated with crizotinib showed a partial response, with three also showing a partial response to pemetrexed. Three of four patients remain alive at 13, 27, and 31 months, respectively.

CONCLUSION: IHC staining can be used to screen for ROS1 gene rearrangements, with patients herein showing a response to crizotinib. Patients with tumors that test positive according to IHC staining but negative according to FISH were also identified, which may have implications for treatment selection.