Is NHS Direct meeting the needs of mental health callers?

Background: NHS Direct is a new service that offers 24-hour advice from trained nurses. The National Service Framework for Mental Health and the National Strategy for Carers both mention NHS Direct as an important source of support for people with mental health problems. Aims: This paper reports findings from an evaluation of the Department of Health's NHS Direct mental health initiative. This initiative was established to ensure that NHS Direct can meet the needs of callers with mental health problems by offering additional training to all staff and improving the database of mental health services. Method: The findings reported here are based on routine computer data provided by 12 out of 17 NHS Direct sites, 552 data forms completed by nurse advisers from the 17 sites, and 111 questionnaires administered over the telephone with callers to the 17 sites. Results: Mental health calls accounted for 3% of NHS Direct's workload, although these calls were often longer and more complex than other calls. The majority of callers to the service were in touch with other services for their mental health problems (59%), typically their GP. Most callers had 'moderate' mental health problems, as indicated by the Global Assessment of Functioning Scale. Generally callers were satisfied with the service they received, although satisfaction was lower in some areas than previous studies of NHS Direct. Conclusions: Improvements could be made in the mechanisms for referring callers on to other services, and training to increase nurse advisers' knowledge of mental health problems.

Composite control of non-linear singularly perturbed systems: meeting a design objective

Using the integral manifold approach, a composite control—the sum of a fast control and a slow control—is derived for a particular class of non-linear singularly perturbed systems. The fast control is designed completely at the outset, thus ensuring the stability of the fast transients of the system and, furthermore, the existence of the integral manifold. A new method is then presented which simplifies the derivation of a slow control such that the singularly perturbed system meets a preselected design objective to within some specified order of accuracy. Though this approach is, by its very nature, ad hoc, the underlying procedure is easily extended to more general classes of singularly perturbed systems by way of three examples.

Current level of consensus on probiotic science: report of an expert meeting, London, 23 November 2009

The present paper summarizes  the consensus views of a group of 9 European clinicians and scientists on the current state of scientific knowledge on probiotics, covering those areas where there is substantial evidence for beneficial effects and those  where the evidence base is poor or inconsistent. There was general agreement that probiotic effects were species and often strain specific. The experts agreed  that some probiotics were effective in reducing the incidence and duration of rotavirus diarrhoea in infants, antibiotic-associated diarrhoea in adults and, for certain probiotics, Clostridium difficile infections. Some probiotics are associated with symptomatic improvements in irritable bowel syndrome and alleviation of digestive discomfort. Probiotics can reduce the frequency and severity of necrotizing enterocolitis in premature infants and have been shown to regulate intestinal immunity.  Several other clinical effects of probiotics, including their role in inflammatory bowel disease, atopic dermatitis, respiratory or genito-urinary infections or H.pylori adjuvant treatment were thought promising but inconsistent.

Hyperresolution global land surface modeling: meeting a grand challenge for monitoring Earth's terrestrial water

Monitoring Earth's terrestrial water conditions is critically important to many hydrological applications such as global food production; assessing water resources sustainability; and flood, drought, and climate change prediction. These needs have motivated the development of pilot monitoring and prediction systems for terrestrial hydrologic and vegetative states, but to date only at the rather coarse spatial resolutions (∼10–100 km) over continental to global domains. Adequately addressing critical water cycle science questions and applications requires systems that are implemented globally at much higher resolutions, on the order of 1 km, resolutions referred to as hyperresolution in the context of global land surface models. This opinion paper sets forth the needs and benefits for a system that would monitor and predict the Earth's terrestrial water, energy, and biogeochemical cycles. We discuss six major challenges in developing a system: improved representation of surface‐subsurface interactions due to fine‐scale topography and vegetation; improved representation of land‐atmospheric interactions and resulting spatial information on soil moisture and evapotranspiration; inclusion of water quality as part of the biogeochemical cycle; representation of human impacts from water management; utilizing massively parallel computer systems and recent computational advances in solving hyperresolution models that will have up to 109 unknowns; and developing the required in situ and remote sensing global data sets. We deem the development of a global hyperresolution model for monitoring the terrestrial water, energy, and biogeochemical cycles a “grand challenge” to the community, and we call upon the international hydrologic community and the hydrological science support infrastructure to endorse the effort.

The development and impact of the Livestock Guru: meeting the knowledge needs of poor livestock keepers in Tamil Nadu, India

Livestock keepers comprise 2/3rds of the 2.8 billion households living on less than two dollars per day. However, as a group they tend to be marginalised and excluded from formal service provision, particularly in relation to animal health. Therefore, the following paper describes the development of the Livestock Guru, a multi-media learning programme created to meet the knowledge needs of poor livestock keepers in Tamil Nadu, India. The findings from the study illustrate the importance of both appropriate visuals, voice-overs but also the need for addressing issues in the environment in which learning will take place.

Food and Health Forum meeting - nutritional approaches to cardiovascular health: workshop report

This report summarises the proceedings of a meeting held by the Food and Health Forum at the Royal Society of Medicine, London, on 12 October 2011. The objective of the meeting was to highlight nutritional strategies targeted at cardiovascular health. This included a review of the effects of various foods, nutrients and ingredients on maintenance of healthy cholesterol levels, endothelial function and blood pressure

Understanding and representing atmospheric convection across scales: recommendations from the meeting held at Dartington Hall, Devon, UK, 28–30 January 2013

As weather and climate models move toward higher resolution, there is growing excitement about potential future improvements in the understanding and prediction of atmospheric convection and its interaction with larger-scale phenomena. A meeting in January 2013 in Dartington, Devon was convened to address the best way to maximise these improvements, specifically in a UK context but with international relevance. Specific recommendations included increased convective-scale observations, high-resolution virtual laboratories, and a system of parameterization test beds with a range of complexities. The main recommendation was to facilitate the development of physically based convective parameterizations that are scale-aware, non-local, non-equilibrium, and stochastic.

RMetS special interest group meeting: high resolution data assimilation

Data assimilation (DA) systems are evolving to meet the demands of convection-permitting models in the field of weather forecasting. On 19 April 2013 a special interest group meeting of the Royal Meteorological Society brought together UK researchers looking at different aspects of the data assimilation problem at high resolution, from theory to applications, and researchers creating our future high resolution observational networks. The meeting was chaired by Dr Sarah Dance of the University of Reading and Dr Cristina Charlton-Perez from the MetOffice@Reading. The purpose of the meeting was to help define the current state of high resolution data assimilation in the UK. The workshop assembled three main types of scientists: observational network specialists, operational numerical weather prediction researchers and those developing the fundamental mathematical theory behind data assimilation and the underlying models. These three working areas are intrinsically linked; therefore, a holistic view must be taken when discussing the potential to make advances in high resolution data assimilation.