877 resultados para Police services for the mentally ill
Resumo:
The rapid increase in renewable energy generation from wind has increased concerns about the impacts that wind arrays have on the marine environment and what these impacts mean for society. One method for identifying the impacts of offshore wind farms (OWFs) on human welfare is through the assessment and valuation of ecosystem services. Using an ecosystem services approach, this paper reviews the impacts of OWFs on the ecosystem services delivered by marine environments. During the construction phase, supporting services such as reduced energy capture and nutrient cycling are changed due to the introduction of hard substrate and the reduction in soft sediment habitat at turbine bases. This may lead to changes in all other ecosystem services, both negative and positive. Quantifying these changes, however, is a challenge partly due to data limitations and a lack of clear understanding of the impacts of OWFs on the marine ecosystems. Scientific effort needs to quantitatively explore the impacts of OWFs on ecosystem functionality and the gathering of data that enables the assessment of changes to ecosystem services. Data needed to better quantify and value the impacts of OWFs on ecosystem services are suggested. The development of methods which integrate socioeconomic valuation of ecosystem services into the evaluation of renewable energy devices compliments efforts in assessing the environmental impacts and should enable a holistic assessment of the impact of renewable energy production and greenhouse gas mitigation technologies on the U. K. carbon footprint.
Resumo:
OBJECTIVES: (1) Describe the population of mentally ill offenders over whom Ontario Review Board (ORB) held jurisdiction. (2) Assess the influences of psychopathology and criminal factors on criminal career. METHOD: This study was a retrospective case series design that reviewed all offenders who were court ordered for psychiatric evaluation at Mental Health Services Site of Providence Care in Kingston, Ontario from 1993 to 2007 (N=347). Eighty five subjects were found not criminally responsible on the account of mental disorder and were included in statistical analysis (n=85). Bivariate associations between five key variables and two outcome variables, seriousness of crime and recidivism, were examined. Logistic regressions were conducted to test the role of the predictor variables on the outcome variables. RESULTS: Age and change in principal psychiatric diagnosis over time were shown to be associated with seriousness of crime. Timing of psychiatric onset, early signs of deviance and change in diagnosis were shown to be associated with recidivism. On the whole, study population did not markedly vary in their distribution of variables by the outcome variables. Regression model included timing of psychiatric onset; psychiatric history; existence of criminal associate; child abuse history; and early signs of deviance. Recidivism was shown to be predicted by early signs of deviance (OR=8.154, p<0.05). Existence of criminal associates was shown to have substantial values of odds ratio at marginal significance (OR=7.577, p=0.13). CONCLUSION: Seriousness of crime is a complex factor that could not be sufficiently predicted by any one or combinations of study variables. Recidivism is better predicted by criminality factors than psychopathology. In the future, an exploratory analysis that more broadly examines the psychopathology and criminal factors in Canadian forensic population is needed. Findings from this study have important clinical and legal implications.
Resumo:
The “crisis of the social issue” in the EU has led to a certain consensus in the need to renew the organizational and institutional model of public administration. The core of the reform implies important administrative changes in most of the European welfare states. Those changes are inspired on theories such as the new public management, management by objectives or partnership. Such changes involve both semantic (“sharing responsibilities”, “effective costs”, or the substitution of “citizen under an administration” by “consumer”) and political (predominance of scattered forms of power and the individualization of responsibilities) transformations which operate in the framework of individuals and State relations. The paradigms of activation and flexicurity have been central in this public administration modernization project. This commitment with new forms of governance of social issues has important consequences for the political and moral foundations of social cohesion, and the Spanish case is not an exception. This paper aims at looking at those representations of “modernization” (as they appear in debates about the employment services restructuring policies) in detail as well as providing references to the trajectory of such reforms of public services since the early eighties to the beginning of the crisis.
Resumo:
The development of wideband network services and the new network infrastructures to support them have placed much more requirements on current network management systems. Issues such as scalability, integrity and interoperability have become more important. Existing management systems are not flexible enough to support the provision of Quality of Service (QoS) in these dynamic environments. The concept of Programmable Networks has been proposed to address these requirements. Within this framework, CORBA is regarded as a middleware technology that can enable interoperation among the distributed entities founds in Programmable Networks. By using the basic CORBA environment in a heterogeneous network environment, a network manager is able to control remote Network Elements (NEs) in the same way it controls its local resources. Using this approach both the flexibility and intelligence of the overall network management can be improved. This paper proposes the use of two advanced features of CORBA to enhance the QoS management in a Programmable Network environment. The Transaction Service can be used to manage a set of tasks, whenever the management of elements in a network is correlated; and the Concurrency Service can be used to coordinate multiple accesses on the same network resources. It is also shown in this paper that proper use of CORBA can largely reduce the development and administration of network management applications.
Resumo:
Summary A concern amongst policy makers to identify high cost and low productivity populations has created a new interest in identifying those who experience adversities across the life-course. This paper outlines the development of conceptual understandings of families whose children experience multiple adversities and links this with later poor outcomes in adult life and examines some of the research challenges in establishing such linkages. Findings It is argued that current thinking with regard to these issues reflects historical domains within which services to children and to adults are located. The challenge to domain thinking is both horizontal and vertical. Policy being required to address the horizontal axis by co-ordinating planned approaches to multiple needs across services. And policy being necessary to address the vertical cleavage between children’s and adult services in ways which join up services across the life path; conceptually and practically acknowledging the links between child and adult experiences. Application Such policy developments will inevitably require social work to develop alternative paradigms for understanding the needs of children and adults and designing services to effectively meet these.
Resumo:
Aim: The purpose of this study was to evaluate the patient-centredness of community palliative care from the perspective of family members who were responsible for the care of a terminally ill family member. Method: A survey questionnaire was mailed to families of a deceased family member who had been designated as palliative and had received formal home care services in the central west region of the Province of Ontario, Canada. Respondents reported on service use in the last four weeks of life; the Client-Centred Care Questionnaire (CCCQ) was used to evaluate the extent to which care was patient-centred. The accessibility instrument was used to assess respondent perception of access to care. Descriptive and inferential statistics were used for data analyses. Results: Of the 243 potential participants, 111 (46.0%) family caregivers completed the survey questionnaire. On average, respondents reported that they used five different services during the last four weeks of the care recipient's life. When asked about programme accessibility, care was also perceived as largely accessible and responsive to patients' changing needs (M=4.3 (SD=1.04)]. Most respondents also reported that they knew what service provider to contact if they experienced any problems concerning the care of their family member. However, this service provider was not consistent among respondents. Most respondents were relatively positive about the patient-centred care they received. There were however considerable differences between some items on the CCCQ. Respondents tended to provide more negative ratings concerning practical arrangement and the organization of care: who was coming, how often and when. They also rated more negatively the observation that service providers were quick to say something was possible when it was not the case. Bivariate analyses found no significant differences in CCCQ or accessibility domain scores by caregiver age, care recipient age, income, education and caregiver sex. Conclusions: Patient-centred care represents a service attribute that should be recognized as an important outcome to assess the quality of service delivery. This study demonstrates how this attribute can be evaluated in the provision of care. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.
Resumo:
Background: The incidence of delirium in ventilated patients is estimated at up to 82%, and it is associated with longer intensive care and hospital stays, and long-term cognitive impairment and mortality. The pathophysiology of delirium has been linked with inflammation and neuronal apoptosis. Simvastatin has pleiotropic properties; it penetrates the brain and, as well as reducing cholesterol, reduces inflammation when used at clinically relevant doses over the short term. This is a single centre randomised, controlled trial which aims to test the hypothesis that treatment with simvastatin will modify delirium incidence and outcomes.
Methods/Design: The ongoing study will include 142 adults admitted to the Watford General Hospital Intensive Care Unit who require mechanical ventilation in the first 72 hours of admission. The primary outcome is the number of delirium- and coma-free days in the first 14 days. Secondary outcomes include incidence of delirium, delirium- and coma-free days in the first 28 days, days in delirium and in coma at 14 and 28 days, number of ventilator-free days at 28 days, length of critical care and hospital stay, mortality, cognitive decline and healthcare resource use. Informed consent will be taken from patient's consultee before randomisation to receive either simvastatin (80 mg) or placebo once daily. Daily data will be recorded until day 28 after randomisation or until discharge from the ICU if sooner. Surviving patients will be followed up on at six months from discharge. Plasma and urine samples will be taken to investigate the biological effect of simvastatin on systemic markers of inflammation, as related to the number of delirium- and coma-free days, and the potential of cholinesterase activity and beta-amyloid as predictors of the risk of delirium and long-term cognitive impairment.
Discussion: This trial will test the efficacy of simvastatin on reducing delirium in the critically ill. If patients receiving the statin show a reduced number of days in delirium compared with the placebo group, the inflammatory theory implicated in the pathogenesis of delirium will be strengthened.
Resumo:
This study sought to explore the changing nature of the financial services industry in Toronto, Canada and the impact that these changes will have on the vocational educational outcomes required by Ontario Colleges of Applied Arts and Technology (CAAT) graduates who wish to enter the financial services industry. The study was descriptive and exploratory, based on both quantitative and qualitative data. Triangulation of 3 data sources (a collection of newspaper articles from the Toronto Star between July 1999 and June 2000, the calendars of the 25 CAATs, and a survey questionnaire prepared by me and distributed to subject matter experts who are key practitioners in the financial services industry) was used. The study contains a discussion of how the financial services industry is changing. The first question to be answered was: What do current practitioners in financial services perceive to be the knowledge, skills, and attitudes that will be required of future graduates for employment within the financial services industry? The study found that Ontario CAAT's graduates entering the financial services field need both business and financial services vocational learning outcomes. Colleges should have 2 programs 1 in accounting and 1 in financial services. The report addresses which specific topics should be included in the financial services program. The second question to be answered was: How does this anticipated profile of knowledge, skills, and attitudes change depending on the degree of implementation of the new technologies by the survey respondent? The study found no pattern. The third question to be answered was: In what way do existing programs need to change in the area of accreditation as perceived by the respondents? The study found that for accreditation, 3 credentials should be addressed within the financial services program. These are the Canadian Securities, the Life Underwriters, and the Certified Financial Planner designations. The last question to be answered was: What new knowledge, skills, and attitudes need to be incorporated into college curricula to address changing needs in the employment sector? For each Ontario CAAT which has a financial services program (excluding accounting), their program was reviewed in light of the topics as perceived by professionals in the financial services industry.
Resumo:
Some egalitarians argue against public services that are free for all, on the grounds that free access appears to primarily benefit the middle classes. I advocate, instead, the inclusion of the middle classes in public services, arguing that only truly universal intake of public services prevents the inegalitarian effects of economic segregation. Such universal participation in public services is achieved, partly, through subsidies for, and regulation of, privately produced services.
Resumo:
As of 1999. the state of Kerala has 3210 offices of scheduled commercial banks (SCBS). In all, there are 48 commercial banks operating in Kerala, which includes PSBs, OPBs, NPBS. FBs, and Gramin Banks. The urban areas give a complete picture of the competition in the present day banking scenario with the presence of all bank groups. Semi-urban areas of Kerala have 2196 and urban areas have 593 as on March 1995.“ The study focuses on the selected segments ofthe urban customers in Kerala which is capable of giving the finer aspects of variation in customer behaviour in the purchase of banking products and services. Considering the exhaustive nature of such an exercise, all the districts in the state have not been brought under the purview of the study. Instead. three districts with largest volume of business in terms of deposits, advances, and number of offices have been short listed as representative regions for a focused study. The study focuses on the retail customer segment and their perceptions on the various products or services offered to them. Non Resident Indians (NRIs), and Traders and Small—ScaIe Industries segments have also been included in the study with a view to obtain a comparative picture with respect to perception on customer satisfaction and service quality dimensions and bank choice behaviour. The research is hence confined to customer behaviour and the implications for possible strategies for segmentation within the retail segment customers
Resumo:
Purpose – This paper proposes assessing the context within which integrated logistic support (ILS) can be implemented for whole life performance of building services systems. Design/methodology/approach – The use of ILS within a through-life business model (TLBM) is a better framework to achieve a well-designed, constructed and managed product. However, for ILS to be implemented in a TLBM for building services systems, the practices, tools and techniques need certain contextual prerequisites tailored to suit the construction industry. These contextual prerequisites are discussed. Findings – The case studies conducted reinforced the contextual importance of prime contracting, partnering and team collaboration for the application of ILS techniques. The lack of data was a major hindrance to the full realisation of ILS techniques within the case studies. Originality/value – The paper concludes with the recognition of the value of these contextual prerequisites for the use of ILS techniques within the building industry.
Resumo:
This paper analyses developments in the growth and configuration of the institutional savings markets within the European Union. The paper discusses the changing socio-economic context in which investment services within the EU are being delivered. The is followed by an examination of drivers of market integration such as the growth and consolidation of the fund management industry, the demographic and fiscal pressures for reform of pensions markets and the process and effects of the deregulation of investment services markets. There is a review of outstanding sources of market segmentation. The projections for future growth in pensions are outlined and implications for real estate investment assessed. It is concluded that, although numerous imponderables render reliable quantitative projections problematic, growth and restructuring of the institutional savings market is likely to increase cross-border capital flows to real estate markets.
Resumo:
In this paper we report on a major empirical study of centripetal and centrifugal forces in the City of London financial services agglomeration. The study sheds light on (1) the manner and magnitude of firm interaction in the agglomeration; (2) the characteristics of the agglomeration that aid the competitiveness of incumbent firms; and (3) the problems associated with agglomeration. In addressing these issues, we use the data to (1) test emerging theory that explains the high productivity and innovation of agglomerations in terms of their ability to generate and diffuse knowledge; and (2) evaluate the ‘end of geography’ thesis.
Resumo:
Our review looks at pollinator conservation and highlights the differences in approach between managing for pollination services and preserving pollinator diversity. We argue that ecosystem service management does not equal biodiversity conservation, and that maintaining species diversity is crucial in providing ecosystem resilience in the face of future environmental change. Management and policy measures therefore need to focus on species not just in human dominated landscapes but need to benefit wider diversity of species including those in specialised habitats. We argue that only by adopting a holistic ecosystem approach we can ensure the conservation and sustainable use of biodiversity and ecosystem services in the long-term.