Patients' and health professionals' views on primary care for people with serious mental illness:focus group study

Objective: To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design: Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting: Six primary care trusts in the West Midlands. Participants: Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results: Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and preferred to consult their own GP, who listened and was willing to learn, rather than be referred to a different GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions: Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness.

Korrupció: mérhetőség és modellezés = In the core of our study we focus on the connection of Foreign Direct Investment and corruption.

Tanulmányunk középpontjában a közvetlen külföldi befektetések és a korrupció kapcsolata áll. Feltételezésünk az, hogy a közvetlen külföldi befektetők a kevésbé korrupt országokat kedvelik, mivel a korrupció egy további kockázati tényezőt jelent a befektetők számára, amely növelheti a befektetések költségeit. Megítélésünk szerint ezt kvantitatív módszerekkel lehet a leginkább vizsgálni, így elemzésünk során 79 országot vizsgálunk meg 10 évre vonatkozó átlagokkal a GRETL program és az OLS becslőfüggvény segítségével. Több modell lefuttatása után azt az eredményt kaptuk, hogy a közvetlen külföldi befektetők döntéseiben a korrupció szignifikáns tényező, a két változó között negatív korrelációt figyelhetünk meg. ____ We assume that investors prefer countries where corruption level is lower, as corruption an additional risk factor that might increase the cost of investment. We believe that the best way to prove the previous statement if we use quantitative methods, so we set up a model where 79 countries are tested for 10 years averages, with the help of the GRETL and OLS estimator. After running several models our finding was that corruption is a significant factor in the decisions of foreign investors, and there is a negative correlation between corruption and FDI.

A szénlábnyom mérése – Fókuszban a közúti áruszállítás és raktározás (Measurement the carbon footprint – focus on road transport and warehousing)

Mai világunkban egyre több olyan erőforrást élünk fel, amelyek hatását az otthonunknak számító Föld egyszerűen már nem képes helyreállítani. Ebben számos jelenség mellett a gazdaság globalizációja, az élesedő versenyhelyzet, a fogyasztói társadalom további térnyerése, ebből adódóan pedig a logisztikai folyamatok intenzitásának növekedése kulcsszerepet játszik. A logisztikát érő kritikáknak ösztönözniük kell a vállalatok szakembereit arra, hogy változtassanak ezen. Ehhez elengedhetetlen a jelenlegi működés szénlábnyomának mérése. Csak a jelenállapot felmérése szolgálhat alapjául a fejlesztéseknek. A szerzők tanulmányának célja a szénlábnyomszámítás egy gyakorlati alkalmazásának ismertetése. Esettanulmány jelleggel bemutatják egy nagy nemzetközi vállalat hazai leányvállalatának a szénlábnyom-számítása során alkalmazott módszertanát. A számítások során a vállalat disztribúciós logisztikai folyamataira fókuszálnak, kiemelten vizsgálták a közúti szállítás és a raktározás széndioxid-kibocsátását. Számításaikban igyekeztek pontosak lenni, a hazai energiamixre számolt legfrissebb konverziós faktorokkal számoltak. Meggyőződésük, hogy az ilyen esettanulmányok hasznosak, hiszen a bemutatott módszertan mintául, útmutatásul szolgálhat további vállalatok számára. Reményeik szerint ezzel segíthetik, hogy minél több hazai vállalat kezdje el széndioxid-kibocsátásának szisztematikus és tudományos alapokon nyugvó mérését. ____ Due to globalization, intense competition and the consumer society logistics processes have been intensified during the last decades. This led to increased environmental strain generating intense criticism towards logistics profession. In order to decrease the environmental burden of logistics several professionals and companies have tried to make progress in this field and introduced techniques that are capable to measure the Carbon Footprint of logistics. Still public case studies are very limited. The paper presents the case of the Hungarian subsidiary of a big multinational FMCG firm. Calculations are built on the actual conversion factor developed for the Hungarian energy mix. A complex set of key performance indi actors usable to capture key characteristics of the present situation is presented. Not only the constructs of these KPIs are described in the paper but a detailed description of methodology used to calculate them is also given. The authors hope such detailed case study description will help other companies as well to initiate sustainable logistics programs.

Do institutions matter in business strategy? – The changing focus of strategic management to institutions: a literature review

The post-crisis managerial literature emphasizes the roles of institutional factors in any disruption of the ecosystem of market capitalism and puts it in the middle of its analytical framework. It has become clear that nowadays, scientific discussions about the measure of increase of direct state involvement in certain economic areas has become more relevant. The socio-economic model based on market coordination was no doubt shaken by the crisis in 2008 across the world and inspired various representatives of the scientific and political community to revise their theses on coordination mechanisms that support the way out of an economic downturn. This paper intends to give a brief summary of the two leading strategic management approaches (Porter’s five forces and the resource-based view of the firm) on institutions. The author’s aim is to demonstrate that incorporation of the institution-based view into the mainstream theories can enrich the analytical framework of strategic management by providing deeper understanding of the contextual factors that underpin interactions between institutions and organizations.

Social Studies in Other Nations: A Focus on Nigerian Social Studies/Global Education

This paper discusses the role of the role of social studies education in Nigeria. Amidst problems of mass education, funding, inequities, intolerance, corruption, weak governance, access to quality education, curriculum development, effective instructional methods, research, and teacher education, Nigeria embarks upon a democratic path to national unity and peace.

Identifying the Components of Job Satisfaction Attributes: A Focus on Private Club Managers

The objectives of this study were to determine job attribute factors affecting overall job satisfaction and satisfaction factors predicting intention to choose and stay within a current job among managers of private clubs in the U.S. The findings indicate that selfworth and salary and benefits are significantly related to the overall job satisfaction. In addition, overall job satisfaction was a strong predictor for private club managers’ intention to choose the current job held, if given a second chance

Health, Wellness Focus within Resort Hotels

This study analyzes the rising importance of the development and enhancement of a health and wellness focus within resort hotels. Market trends, consumer demands, revitalization efforts, and bottomline impacts are examined as they relate to the resort spa industry of today.

An experimental and modelling study of the capture of CO2 from gas mixtures with different techniques, with focus on multicomponent effects.

In the present work, the deviations in the solubility of CO2, CH4, and N2 at 30 °c in the mixed gases (CO2/CH4) and (CO2/N2) from the pure gas behavior were studied using the dual-mode model over a wide range of equilibrium composition and pressure values in two glassy polymers. The first of which was PI-DAR which is the polyimide formed by the reaction between 4, 6-diaminoresorcinol dihydrochloride (DAR-Cl) and 2, 2’-bis-(3, 4-dicarboxyphenyl) hexafluoropropane dianhydride (6FDA). The other glassy polymer was TR-DAR which is the corresponding thermally rearranged polymer of PI-DAR. Also, mixed gas sorption experiments for the gas mixture (CO2/CH4) in TR-DAR at 30°c took place in order to assess the degree of accuracy of the dual-mode model in predicting the true mixed gas behavior. The experiments were conducted on a pressure decay apparatus coupled with a gas chromatography column. On the other hand, the solubility of CO2 and CH4 in two rubbery polymers at 30⁰c in the mixed gas (CO2/CH4) was modelled using the Lacombe and Sanchez equation of state at various values of equilibrium composition and pressure. These two rubbery polymers were cross-linked poly (ethylene oxide) (XLPEO) and poly (dimethylsiloxane) (PDMS). Moreover, data about the sorption of CO2 and CH4 in liquid methyl dietahnolamine MDEA that was collected from literature65-67 was used to determine the deviations in the sorption behavior in the mixed gas from that in the pure gases. It was observed that the competition effects between the penetrants were prevailing in the glassy polymers while swelling effects were predominant in the rubbery polymers above a certain value of the fugacity of CO2. Also, it was found that the dual-mode model showed a good prediction of the sorption of CH4 in the mixed gas for small pressure values but in general, it failed to predict the actual sorption of the penetrants in the mixed gas.

The feasibility of determining the effectiveness and cost-effectiveness of medication organisation devices compared with usual care for older people in a community setting : systematic review, stakeholder focus groups and feasibility randomised controlled trial

This project was funded by National Institute for Health Research (NIHR) Health Technology Assessment Programme and will be published in full in Health Technology Assessment; Vol. 20, No. 50. See the NIHR Journals Library website for further project information.

Beat that word : How listeners integrate beat gesture and focus in multimodal speech discourse

Peer reviewed

Beat that Word : How Listeners Integrate Beat Gesture and Focus in Multimodal Speech Discourse

Peer reviewed

Design and protocol for the Focusing on Clozapine Unresponsive Symptoms (FOCUS) trial : a randomised controlled trial

Acknowledgements Thank you to all the participants who agreed to take part in the trial. This study was supported NHS Research Scotland (NRS), through Chief Scientist Office (CSO) and the Scottish Mental Health Research Network, and the Clinical Research Network-Mental Health. We are grateful to the Psychosis Research Unit (PRU) Service User Reference Group (SURG) for their consultation regarding the design of the study and contribution to the developments of study related materials. We are grateful to our Independent Trial Steering Committee and Independent Data Monitoring Committee for provided oversight of the trial. Funding This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme (project number10/101/02) and will be published in full in Health Technology Assessment. Visit the HTA programme website for further project information. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.

Can aberrometry provide rapid and reliable measures of subjective depth of focus following multifocal intraocular lens implantation?

Purpose: To determine whether the ‘through-focus’ aberrations of a multifocal and accommodative intraocular lens (IOL) implanted patient can be used to provide rapid and reliable measures of their subjective range of clear vision. Methods: Eyes that had been implanted with a concentric (n = 8), segmented (n = 10) or accommodating (n = 6) intraocular lenses (mean age 62.9 ± 8.9 years; range 46-79 years) for over a year underwent simultaneous monocular subjective (electronic logMAR test chart at 4m with letters randomised between presentations) and objective (Aston open-field aberrometer) defocus curve testing for levels of defocus between +1.50 to -5.00DS in -0.50DS steps, in a randomised order. Pupil size and ocular aberration (a combination of the patient’s and the defocus inducing lens aberrations) at each level of blur was measured by the aberrometer. Visual acuity was measured subjectively at each level of defocus to determine the traditional defocus curve. Objective acuity was predicted using image quality metrics. Results: The range of clear focus differed between the three IOL types (F=15.506, P=0.001) as well as between subjective and objective defocus curves (F=6.685, p=0.049). There was no statistically significant difference between subjective and objective defocus curves in the segmented or concentric ring MIOL group (P>0.05). However a difference was found between the two measures and the accommodating IOL group (P<0.001). Mean Delta logMAR (predicted minus measured logMAR) across all target vergences was -0.06 ± 0.19 logMAR. Predicted logMAR defocus curves for the multifocal IOLs did not show a near vision addition peak, unlike the subjective measurement of visual acuity. However, there was a strong positive correlation between measured and predicted logMAR for all three IOLs (Pearson’s correlation: P<0.001). Conclusions: Current subjective procedures are lengthy and do not enable important additional measures such as defocus curves under differently luminance or contrast levels to be assessed, which may limit our understanding of MIOL performance in real-world conditions. In general objective aberrometry measures correlated well with the subjective assessment indicating the relative robustness of this technique in evaluating post-operative success with segmented and concentric ring MIOL.