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There are growing calls to reduce, and where possible eliminate, the use of seclusion and restraint in mental health settings, but the attitudes and beliefs of consumers, carers and mental health professionals towards these practices are not well understood. The aim of this study was to compare the attitudes of mental health service consumers, carers and mental health professionals towards seclusion and restraint in mental health settings. In particular, it aimed to explore beliefs regarding whether elimination of seclusion and restraint was desirable and possible.
In 2014, an online survey was developed and widely advertised in Australia via the National Mental Health Commission and through mental health networks. The survey adopted a mixed-methods design, including both quantitative and qualitative questions concerning participants’ demographic details, the use of seclusion and restraint in practice and their views on strategies for reducing and eliminating these practices.
In total 1150 survey responses were analysed. A large majority of participants believed that seclusion and restraint practices were likely to cause harm, breach human rights, compromise trust and potentially cause or trigger past trauma. Consumers were more likely than professionals to view these practices as harmful. The vast majority of participants believed that it was both desirable and feasible to eliminate mechanical restraint. Many participants, particularly professionals, believed that seclusion and some forms of restraint were likely to produce some benefits, including increasing consumer safety, increasing the safety of staff and others and setting behavioural boundaries.
There was strong agreement across participant groups that the use of seclusion and restraint is harmful, breaches human rights and compromises the therapeutic relationship and trust between mental health service providers and those who experience these restrictive practices. However, some benefits were also identified, particularly by professionals. Participants had mixed views regarding the feasibility and desirability of eliminating these practices.
The interpretations of the Wallace site offered by Huffman and Earley are invalid. The site is not Upper Republican in affiliation, the structural remains in it do not support the interpretations made, and the proposed correspondences to Pawnee cosmology are based on unjustified assumptions.
Edge effects have been studied extensively in fragmented landscapes, often with conflicting findings. Edge effects may also be important in other situations, such as linear clearings (e.g. along roads, power lines or train tracks). We tested for responses of small mammals to a narrow (c. 10 m) linear clearing created by a railway in the largest area of Atlantic Forest in southern Brazil. Only two environmental variables, light intensity and train noise, were greatest at the edge and decreased with distance from the edge. Temperature differed (greater extremes and more variable) only at the edge itself. The few small mammal species that were only rarely captured at the edge resulted in an apparent edge-effect with respect to species richness. The abundance of small mammals, however, was independent of distance from the railway. There was no correlation between resource availability at the tracks and abundance of small mammals. Edge effects were minimal, which suggests that narrow railways (in contrast with roads) in unfragmented landscapes probably do not have a significant impact (if any) on wildlife, as found elsewhere and especially in tropical forests. The use of railways instead of roads is a potential strategy to minimize the effects of traversing important habitats for commercial reasons.
Optical properties and thermal relaxation dynamics of resonantly excited plasmons are important in applications for optoelectronics, biomedicine, energy, and catalysis. Geometric optics of polydimethylsiloxane (PDMS) thin films containing uniformly or asymmetrically distributed polydisperse reduced AuNPs or uniformly distributed monodisperse solution-synthesized AuNPs were recently evaluated using a compact linear algebraic sum. Algebraic calculation of geometric transmission, reflection, and attenuation for AuNP-PDMS films provides a simple, workable alternative to effective medium approximations, computationally expensive methods, and fitting of experimental data. This approach allows for the summative optical responses of a sequence of 2D elements comprising a 3D assembly to be analyzed. Thin PDMS films containing 3-7 micron layers of reduced AuNPs were fabricated with a novel diffusive-reduction synthesis technique. Rapid diffusive reduction of AuNPs into asymmetric PDMS thin films provided superior photothermal response relative to thicker films with AuNPs reduced throughout, with a photon-to-heat conversion of up to 3000°C/watt which represents 3-230-fold increase over previous AuNP-functionalized systems. Later work showed that introduction of AuNPs into PDMS enhanced thermoplasmonic dissipation coincident with internal reflection of incident resonant irradiation. Measured thermal emission and dynamics of AuNP-PDMS thin films exceeded emission and dynamics attributable by finite element analysis to Mie absorption, Fourier heat conduction, Rayleigh convection, and Stefan-Boltzmann radiation. Refractive-index matching experiments and measured temperature profiles indicated AuNP-containing thin films internally reflected light and dissipated power transverse to the film surface. Enhanced thermoplasmonic dissipation from metal-polymer nanocomposite thin films could affect opto- and bio-electronic implementation of these systems.
Hart and Lovis clearly hold different views than do I about how to view incongruities in age determinations on food residue as compared to those on context dates on other short-lived materials. I explain how I came to the conclusions I drew in my earlier study (Roper 2013a) and suggest that I am evaluating my results, and those of others, by looking for patterns in the incongruities, rather than individually explaining away incongruent dates. I also briefly review some work with a collaborator being undertaken to correct the obvious problem with age-offset dates on residue.
Age offsets of accelerator mass spectrometry (AMS) assays on food residue taken from pottery vessels are well-documented in Europe and Asia in cultural contexts were freshwater aquatic products are attested, but are less well studied in North America. The present study examines a series of residue dates from the late prehistoric Central Plains of North America, comparing them with context dates run on annual plant remains. At least 13 of 23 assays are either incongruent with ages on annual plant remains, inconsistent among themselves within a site, or not credible for their cultural context. The conclusion is that food residue from ceramics does not produce consistently accurate dates. Some possible factors that may serve to introduce old carbon to residue samples are discussed. It also is noted that one's conclusions about the reliability of residue may be conditioned by the precision of the age determinations and by the goals of a specific chronology-building effort.
To report a case series of elective removal of bone-anchored hearing aid implants, and reasons for removal.
Retrospective review of a prospectively collected database.
Two tertiary referral centres in the Manchester area: Manchester Royal Infirmary and Salford Royal University Hospital.
A series of 499 adults and children who had undergone a total of 602 implant insertions (1984–2008).
Main outcome measures:
Implant removal rates, and reasons.
Twenty-seven of the 602 implants (4.5 per cent) required removal. Of these, 12 were due to pain (2.0 per cent), seven to persistent infection (1.2 per cent), three to failure of osseointegration (0.5 per cent), three to trauma (0.5 per cent) and two to other reasons (0.4 per cent).
Chronic implant site pain represents the main reason why implants are removed electively, and affects 2 per cent of all implants. This complication has important medico-legal implications and should be discussed when obtaining informed consent for implantation.
Late prehistoric sites on the Central Plains contain both grit/grog- (mineral-) tempered pottery and shell-tempered pottery. This appearance of shell-tempered pottery around cal A.D. 1000 has traditionally been explained as a colonization from the Mississippi River valley with further dispersal via trade. As a result, very little is known about the role of this material in the region. We report the results of a provenance analysis of shell-tempered pottery from seven sites extending from the Missouri River valley to north-central Kansas. We use petrography and oxidation analysis to compare the shell-tempered pottery across these localities and the shell-tempered to the mineral-tempered pottery from each locality, and we compare mineral inclusions and clay characteristics in all pottery with published geological and pedological information for each locality. The results demonstrate that shell-tempered pottery was locally produced throughout at least a portion of the Central Plains. Differences in firing technology are apparent across the study area and may play a role in the distribution of shell-tempered pottery. Two other results are the identification of composite temper in a notable proportion of the sherds studied, and indications of from where on the landscape Central Plains potters were procuring their raw materials.
Bone-anchored hearing aid implantations have been performed in Manchester for over 20 years. This study examined a range of variables that can occur during the implantation process, and the effect they may have on successful outcome.
Retrospective study and literature review.
Tertiary referral centre in central Manchester.
Details of 602 bone-anchored hearing aid implantation procedures were retrieved from the departmental database. The overall complication rate was 23.9 per cent. The rate of revision surgery was 12.1 per cent.
This study involved a significantly larger number of patients than any previously reported, similar study. Possible reasons for differences in outcomes, and recommendations for best practice, are discussed.
A number of acridines have been tested for ability to inhibit conidia of strains of Aspergillus nidulans. The effectiveness of any one acridine in growth inhibition and killing involves interaction of genotype and conditions of treatment such as temperature, pH, treatment medium and light intensity. Mutant alleles which confer growth resistance to acriflavine are selective in their actions towards other acridines, may differ in their dominance relationships with different acridines and are even selective with regard to the conditions under which they confer acriflavine resistance. Certain pairs of acridines, used simultaneously, show additive effects, potentiation, or annulment by one of inhibition caused by the other.
Some of these findings have been applied in a study of factors affecting acridine-induced mutation in Aspergillus conidia. Under conditions which permit metabolism, acriflavine induces a high frequency of unstable morphological variants. One such variant has been shown to be a disomic. Using a system of reversion from auxotrophy to prototrophy, acriflavine-induced mutation has been obtained both with high light intensities and in the absence of light. In the latter case recombination as a feature of the mutation process is excluded.
Lyman et al.’s recent history of graphic depictions of culture change attributes the first use of bar graphs to James Ford in 1935. Ford, though, was anticipated in 1915 by Frederick Sterns, working with pottery from 27 late prehistoric Nebraska phase lodge sites in eastern Nebraska. Sterns used both tabular data summaries and divided bar graphs to show ordered variation over space in vessel neck diameter, types of appendages, and type of decoration. Underlying this analysis was a conception of these dimensions as varying independently of one another. Geographic groups within the Nebraska phase therefore exhibit clinal variation and can be characterized by differing proportions of attributes. Sterns’s work never became very well-known as archaeologists on the Central Plains turned to typological analysis for organizing pottery assemblages.
Mark Mitchell's analysis of the legacy of the Missouri Basin Project (MBP) identified the direct historical approach as one discourse that shaped the MBP legacy. While that identification is certainly correct, the discussion is too limited in two ways. First, the use of the direct historical approach for tracing ethnicity was more limited than is generally recognized. Second, and more seriously, the rich documentary and ethnographic record of the Plains Village lifeway became a too readily used source of specific analogies for reading the archaeological record. Theory became irrelevant. Some of the numerous inaccuracies this produced are only recently being corrected.
The objective of this study was to determine the prevalence, circumstances, and outcome of fractures in males with Duchenne muscular dystrophy (DMD) attending neuromuscular clinics. Three hundred and seventy-eight males (median age 12 years, range 1 to 25 years) attending four neuromuscular centres were studied by case-note review supplemented by GP letter or by interview at the time of clinic attendance. Seventy-nine (20.9%) of these patients had experienced fractures. Forty-one percent of fractures were in patients aged 8 to 11 years and 48% in independently ambulant patients. Falling was the most common mechanism of fracture. Upper-limb fractures were most common in males using knee–ankle–foot orthoses (65%) while lower-limb fractures predominated in independently mobile and wheelchair dependent males (54% and 68% respectively). Twenty percent of ambulant males and 27% of those using orthoses lost mobility permanently as a result of the fracture. In a substantial proportion of males, the occurrence of a fracture had a significant impact on subsequent mobility.
Temperature and respiratory gas (CO2 and O2) concentrations were measured in the foraging tunnels of burrows naturally inhabited by two species of southern African mole-rats, the Cape mole-rat Georhychus capensis and the Damaraland mole-rat Cryptomys damarensis. Both species are completely fossorial and inhabit closed burrow systems. Tunnels of G. capensis burrows had a mean diameter of 8.7 cm and a depth, measured to the roof of the tunnel, of 6.2 cm; those of C. damarensis had a mean diameter of 6.5 cm and depth of 40 cm. In both species, the mean concentration of CO2 was higher, and mean concentration of O2 lower, in burrows than in the surrounding soil or in ambient air. Mean and minimum values of O2 were 20.4% and 19.8%, respectively, in G. capensis and 20.4% and 19.9% in C. damarensis; mean and maximum values of CO2 were 0.4% and 1.2% in G. capensis and 0.4% and 6.0% in C. damarensis. Temperature varied between 18.5 and 24.2 °C in burrows of G. capensis by comparison with an ambient range of 16.9 to 26.8 °C; and from 19.6 to 29.3 °C in burrows of C. damarensis by comparison with an ambient range of 8.6 to 30.8 °C. Thus a burrowing habit seems to offer both species protection from extremes of temperature without entailing the cost of a grossly abnormal respiratory environment. From a review of the relevant literature, we conclude that average concentrations of CO2 and O2 in mammalian burrows often do not differ greatly from ambient values. However, more work is needed to determine the respiratory gas concentrations in the immediate vicinity of active, burrowing animals.
Stochastic resonance (SR) is a phenomenon whereby random fluctuations and noise can enhance the detectability and/or the coherence of a weak signal in certain nonlinear dynamical systems (see e.g. Moss et al. (1994a), Wiesenfeld and Moss (1995); Bulsara and Gammaitoni (1996) and references therein). There is growing evidence that SR may play a role in the extreme sensitivity exhibited by various sensory neurons (Longtin et al., 1991; Douglass et al., 1993; Bezrukov and Vodyanoy, 1995; Collins et al., 1996) it has also been suggested that SR could feature at higher levels of brain function, such as in the perceptual interpretation of ambiguous figures (Riani and Simonotto, 1994; Simonotto et al., 1997; Bressloff and Roper, 1998). In the language of information theory, the main topic of this volume, SR is a method for optimising the Shannon information transfer rate (transinformation) of a memoryless channel (Heneghan et al., 1996).
Most studies of SR have been concerned with external noise, that is, a stochastic forcing term is deliberately added to a non-linear system that is controllable by the experimentalist. The archetype is one of a damped particle moving in a double well potential. If the particle is driven by a weak periodic force, i.e. one in which the forcing amplitude is less than the barrier height, it will be confined to a single well and will oscillate about the minimum. However, if the particle is driven by weak noise it will switch between wells with a transition rate which depends exponentially on the noise strength, D (imagine cooking popcorn on a low heat in a large pan).
Antibodies against variable antigens expressed on the surface of Plasmodium falciparum-infected erythrocytes are believed
to be important for protection against malaria. A target for these antibodies is the P. falciparum erythrocyte membrane
protein 1, PfEMP1, which is encoded by around 50 var genes and undergoes clonal variation. Using agglutination and
mixed agglutination tests and flow cytometry to analyse the recognition of variant antigens on parasitized erythrocytes by
plasma antibodies from individuals living in Daraweesh in eastern Sudan, an area of seasonal and unstable malaria
transmission, we show that these antibodies recognize different variant antigens expressed by parasites of different
genotype. Comparing the levels and acquisition of antibody to variant antigens in pairs of parasite isolates expressing
different variant types, there is a correlation between the acquisition of antibodies to some combinations of variant antigens
but not to others. These results indicate that (1) a single infection will induce the production of antibodies recognizing
several variants of surface-expressed antigens, (2) the repertoire of variable antigens expressed by different parasites is
overlapping and the degree of overlap differs between isolates, and (3) the expression of at least some variant antigens is