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Crisis resolution teams (CRTs) offer brief, intensive home treatment for people experiencing mental health crisis. CRT implementation is highly variable; positive trial outcomes have not been reproduced in scaled-up CRT care.
To evaluate a 1-year programme to improve CRTs’ model fidelity in a non-masked, cluster-randomised trial (part of the Crisis team Optimisation and RElapse prevention (CORE) research programme, trial registration number: ISRCTN47185233).
Fifteen CRTs in England received an intervention, informed by the US Implementing Evidence-Based Practice project, involving support from a CRT facilitator, online implementation resources and regular team fidelity reviews. Ten control CRTs received no additional support. The primary outcome was patient satisfaction, measured by the Client Satisfaction Questionnaire (CSQ-8), completed by 15 patients per team at CRT discharge (n = 375). Secondary outcomes: CRT model fidelity, continuity of care, staff well-being, in-patient admissions and bed use and CRT readmissions were also evaluated.
All CRTs were retained in the trial. Median follow-up CSQ-8 score was 28 in each group: the adjusted average in the intervention group was higher than in the control group by 0.97 (95% CI −1.02 to 2.97) but this was not significant (P = 0.34). There were fewer in-patient admissions, lower in-patient bed use and better staff psychological health in intervention teams. Model fidelity rose in most intervention teams and was significantly higher than in control teams at follow-up. There were no significant effects for other outcomes.
The CRT service improvement programme did not achieve its primary aim of improving patient satisfaction. It showed some promise in improving CRT model fidelity and reducing acute in-patient admissions.
It is well known that assumptions of monotonicity in size-bias couplings may be used to prove simple, yet powerful, Poisson approximation results. Here we show how these assumptions may be relaxed, establishing explicit Poisson approximation bounds (depending on the first two moments only) for random variables which satisfy an approximate version of these monotonicity conditions. These are shown to be effective for models where an underlying random variable of interest is contaminated with noise. We also state explicit Poisson approximation bounds for sums of associated or negatively associated random variables. Applications are given to epidemic models, extremes, and random sampling. Finally, we also show how similar techniques may be used to relax the assumptions needed in a Poincaré inequality and in a normal approximation result.
How did the Stalin Prize function in the Soviet fine art establishment of the 1940s and 1950s and how were the awards interpreted by members of the artistic community and the public? This examination of the discussions of the Stalin Prize Committee and unrehearsed responses to the awards reveals an institution that operated at the intersection of political and expert-artistic standards within which the parameters of postwar socialist realism were negotiated and to some extent defined. The Stalin Prize for the Fine Arts played an important part in the development of the leader cult and contributed to the self-aggrandizement of an elite minority. The symbolic capital of the Stalin Prize was compromised by its role, perceived or actual, in the consolidation of a generational and ideological hegemony within the Soviet art world and the establishment of an aesthetic blueprint for socialist realism.
While materials design in the context of texture dependent properties is well developed, theoretical tools for microstructure design in the context of grain boundary sensitive properties have not yet been established. In the present work, we present an invertible relationship between texture and grain boundary network structure for the case of spatially uncorrelated two-dimensional textures. By exploiting this connection, we develop mathematical tools that permit the rigorous optimization of grain boundary network structure. Using a specific multi-objective materials design case study involving elastic, plastic and kinetic properties, we illustrate the utility of this texture mediated approach to grain boundary network design. We obtain a microstructure that minimizes grain boundary network diffusivity while simultaneously improving yield strength by an amount equal to half of the theoretically possible range. The theoretical tools developed here could complement experimental grain boundary engineering efforts to help accelerate the discovery of materials with improved performance.
The uptake of small screen technology by adolescents is widespread, particularly in industrial nations. Whether the same is true for Australian Aboriginal youth is less clear as there is a dearth of research in this regard. Therefore, in this exploratory study the use of small screen technology by Indigenous students was examined. Twenty-four Indigenous adolescents (mean age 16.4 years) attending a boarding school in a remote region of Western Australia participated in individual and in-depth structured interviews that queried their use of: (1) television, (2) video games, (3) computers, (4) the internet, and (5) mobile phones. The results showed that mobile phones were the most frequently used and the most popular (i.e., they were nominated as first choice in a hypothetical scenario), followed by the internet, whereas television, video games and computers were used less often. It did appear that mobile phones were used by participating Aboriginal adolescents in ways similar to non-Indigenous adolescents (e.g., not only to make phone calls, but also to send text messages and access the internet). However, their mobile phone use did reflect differences based on their cultural values and identity, and also reflected their physical distance from their family (i.e., because of their enrolment at a boarding school). This study supports anecdotal evidence of a rapid uptake of mobile phones by Indigenous adolescents. It also suggests that as the small screen technology of choice, they have the potential to be utilised for educational opportunities.
We consider probability measures supported on a finite discrete interval [0, n]. We introduce a new
finite difference operator ∇n, defined as a linear combination of
left and right finite differences. We show that this operator ∇n plays a key
role in a new Poincaré (spectral gap) inequality with respect to binomial weights, with
the orthogonal Krawtchouk polynomials acting as eigenfunctions of the relevant operator.
We briefly discuss the relationship of this operator to the problem of optimal transport
of probability measures.
I must admit that, after more than a decade of teaching and researching political parties, I found being selected to and participating in the 1980 Democratic National Convention an exhiliarating experience.
The Alabama delegate-selection process was a very competitive primary with extensive activity by the Carter and Kennedy organizations and by the individual delegate candidates. In varying degrees, the delegate candidates stumped their constituencies with personal appearances, letters, rallies, sample ballots, newspaper ads, group endorsements, and assorted other campaign gimmicks.
The selection process consisted primarily of a statewide primary (1) to allocate Alabama's delegates and alternate delegates among the presidential candidates, and (2) to elect the members of that delegation. Over 500 candidates ran for the 45 delegate and 32 alternate delegate positions in that primary. The primary actually was conducted by congressional district, with 33 candidates running for four delegate and three alternate delegate positions in my CD. The ballot was structured by sex (females listed first) and the voter was instructed to vote for up to four females and up to four males. Delegates were allocated to presidential candidates according to a formula which was roughly proportional; and individual delegates were selected by an equally fair but more complex formula.
Radiative isoelectronic impurity complexes consisting of pairs of Be atoms that bind excitons can be formed in both Si and SiGe/Si superlattices during growth by molecular beam epitaxy. We describe the conditions under which these radiative complexes can be formed and show that they can be localized in the alloy layers of a superlattice. Experimental results from samples with grown-in Be are compared to previous results from ion implanted samples. Superlattices of varying well widths are examined and a narrowing of the no-phonon linewidth is observed.
The Women in Materials (WIM) program, supported by the National Science Foundation, is a collaboration between Simmons College, a predominately undergraduate women’s college, and the Cornell Center for Materials Research (CCMR). For the past four years, this program has provided unusual curricular and research opportunities for undergraduate women at Simmons College. This program demonstrates a successful model for enhancing undergraduate science and technology preparation through collaboration between primarily undergraduate institutions (PUIs) and NSF-supported Materials Research Science and Engineering Centers.
Thin film aluminum fibers with grain sizes of 35 and 100 nm were pulled in a microtensile tester. The larger grains led to greater yield and tensile strengths but smaller strains to failure. Both samples had mechanical strengths 3–6 times greater than bulk aluminum. In addition, the small grained fibers had a strain rate sensitivity exponent of 0.26 suggesting diffusion controlled plastic deformation mechanisms.
To evaluate various in-situ reinforcement schemes, a computer controlled containerless directional solidification system has been used to produce NiAl-based polyphase composites containing up to two intermetallic phases and at least one ductile phase. Systems evaluated include Ni-Al-Cr, Ni-Al-Mo, Ni-Al-V ternary systems that form NiAl/α-refractory metal eutectics and a three phase eutectic in the Ni-Al-Cr-Nb system. Initial screening of these in-situ composites has included morphological characterization, four point bend testing, temperature dependent yield strength evaluation and compressive creep testing. Occasional growth defects termed “banding” currently interrupt the continuity of these composite structures and limit the attainment of optimum properties. However, both the creep strength and toughness of NiAl were improved by in-situ reinforcement.
Ferroelectric and other high dielectric constant metal oxides currently are sought-after for a variety of applications in the electronics industry. To meet the demand of preparation of these interesting materials in a manner compatible with traditional silicon-based fabrication procedures, chemical vapor deposition routes are desired for film growth. Compounds displaying high vapor phase stability are necessary as precursors for these applications. Additionally, in general, it is preferred to utilize compounds in a liquid state, due to the more rapid re-establishment of equilibrium at a liquid-vapor interface, compared to that present at a solid-vapor interface. This combination of desired molecular properties, in turn, presents a great challenge to the coordination chemist. Several of the metals of interest for these uses reside in groups 2–5. Common design features are emerging for the ligands best suited for attachment to these metals for subsequent utilization in the deposition of metal oxides. In order to achieve coordinative saturation of the relatively high ionic radii exhibited by most of these elements, multidentate, monoanionic ligands are relied upon. In the past, most often, homoleptic ligand sets have been employed, thereby reducing the chance for ligand scrambling to occur during the growth process. Such disproportionation processes have been credited, in previous work, with the observation of a temporal decay in vapor pressure of heteroleptic compounds. In some interesting new developments, it has been found that heteroleptic compounds possess sufficient vapor phase integrity to permit their evaluation as CVD precursors. These, and related, results are presented herein.
We have investigated the local electron transport in polycrystalline silicon (pc-Si) thin-films by atomic force microscopy (AFM)-based measurements of the electron-beam-induced current (EBIC). EVA solar cells are produced at UNSW by <i>EVAporation</i> of a-Si and subsequent <i>solid-phase crystallization</i>–a potentially cost-effective approach to the production of pc-Si photovoltaics. A fundamental understanding of the electron transport in these pc-Si thin films is of prime importance to address the factors limiting the efficiency of EVA solar cells. EBIC measurements performed in combination with an AFM integrated inside an electron microscope can resolve the electron transport across individual grain boundaries. AFM-EBIC reveals that most grain boundaries present a high energy barrier to the transport of electrons for both p-type and n-type EVA thin-films. Furthermore, for p-type EVA pc-Si, in contrast with n-type, charged grain boundaries are seen. Recombination at grain boundaries seems to be the dominant factor limiting the efficiency of these pc-Si solar cells.
We assessed methicillin-resistant Staphylococcus aureus (MRSA) infection and colonization in hospitalized prisoners. Of 434 admission surveillance cultures, 58 (13%) were positive for MRSA. The sensitivity of admission surveillance cultures of samples from the anterior nares was 72% and increased to 84% when the calculation included cultures of wound samples. Hospitalized prisoners are at high risk for MRSA infection and colonization, and surveillance should include cultures of nares and wound samples.
A study was conducted to determine whether intramammary antibiotic treatment of heifer mammary glands following the first milking after calving was effective for reducing the percentage of mammary quarters infected during early lactation. Jersey and Holstein heifers from two research herds were assigned to one of three treatment groups: (1) no intramammary infusion following the first milking after parturition, (2) intramammary infusion of all quarters with pirlimycin hydrochloride following the first milking after parturition and (3) intramammary infusion of all quarters with novobiocin sodium plus penicillin G procaine following the first milking after parturition. Almost 93% of Jersey heifers (40/43) and 73·1% of quarters (125/171) were infected at the first milking. Almost 77% of quarters (33/43) were cured following treatment with pirlimycin, 61·8% (21/34) were cured following treatment with penicillin-novobiocin and 39·6% (19/48) of infections were eliminated spontaneously in the untreated control group. Significantly fewer infections were observed in pirlimycin or penicillin-novobiocin treated mammary glands of Jersey heifers during early lactation than in untreated control mammary glands. Almost 89% of Holstein heifers (32/36) and 52·8% of quarters (76/144) were infected at the first milking. About 57% (12/21) of quarters were cured following treatment with pirlimycin, 41·4% (12/29) were cured following treatment with penicillin-novobiocin and 23·1% (6/26) of infections were eliminated spontaneously in the untreated negative control group. Significantly fewer infections were observed in pirlimycin treated mammary glands of Holstein heifers during early lactation than in untreated control mammary glands. However, no significant differences were observed following penicillin-novobiocin treatment of Holstein heifers after the first milking of lactation compared with untreated control quarters. Coagulase-negative staphylococci, Streptococcus uberis and Streptococcus dysgalactiae subsp dysgalactiae were isolated most frequently in heifers from both herds.
Dicentrodus possessed bicuspid teeth with a flat base and nonserrated or finely serrated, labio-lingually compressed, highly unequal cusps. Originally known from the late Visean–early Serpukhovian of Scotland (D. bicuspidatus), it is now known also to occur in the middle Visean of North America. This is the earliest occurrence of a xenacanthid yet reported from North America; its presence is based on incomplete teeth, which are easily distinguished from other xenacanthid genera. The cross-continental distribution of Dicentrodus, like that of other xenacanthid genera, can be explained by an increasing body of data that intimate that xenacanthids were euryhaline sharks and not restricted to a freshwater habitat.