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Part 2 of the Housing Act (Wales) 2014 and its implementation has been keenly observed by governments outside of Wales, as they continue to search for policy solutions to help address the homelessness crisis. This article examines the extent to which there has been policy transfer from Wales to other national contexts and the potential for such transfer to occur in the future. It is identified that some transfer has already taken place within the UK and there is the potential for future policy transfer both within the UK and internationally. Adaptation to each of the new contexts is necessary to underpin successful transfer of provisions of the Act; however, outside of the UK this will need to be more extensive and include the introduction of a right to housing.
Alongside an increasing focus on ‘prevention’, moving homeless adults into work is frequently considered an important part of helping them overcome homelessness and sustain an ‘independent’ life. However, a growing evidence base shows that work does not always offer the means to escape poverty, and many in employment face housing insecurity. Relatedly, there is increasing concern about the phenomenon of ‘in-work homelessness’. Drawing on new data from a study of people’s experience of homelessness in Wales, this article considers the hitherto underexplored topic of being both in work and homeless. The article provides a critical examination of how homelessness policy operates in practice, through presenting evidence of the experiences of a marginalised group (namely, working homeless people as users of homelessness services). It also considers how policy and practice could be modified to improve outcomes for homeless people and how prevention could play out in other contexts and welfare regimes.
Rates of homelessness and poor mental health present significant challenges across the globe. In this article, we explore how these intersecting issues have been addressed in Wales through Part 2 of the Housing (Wales) Act 2014 through a paradigm shift towards a prevention model. This article reports findings from a study (conducted between 2016 and 2018) which evaluated the processes and impacts of the Act against the backdrop of welfare reform and systemic changes taking place in Wales and the UK. Using new evidence, we offer a critical examination of how homelessness prevention policy operates in practice and how social values and power affect policy implementation. We offer new evidence of the translation of policy into practice through the experiences of two stakeholder groups: people with mental health needs and service providers. In doing so, we offer a critique of how policy and practice could be modified to improve outcomes for homeless people with implications for prevention policy in Wales and in other contexts and different welfare regimes.
More than 68 million people worldwide have been forcibly displaced and one-third of these are refugees. This article offers an overview of the current literature and reviews the epidemiology and evidence-based psychological and pharmacological management of post-traumatic stress disorder (PTSD), sleep disturbance and pain in refugees and asylum seekers. It also considers the relationship between sleep disturbance and PTSD and explores concepts of pain in relation to physical and psychological trauma and distress. During diagnosis, clinicians must be aware of ethnic variation in the somatic expression of distress. Treatments for PTSD, pain and sleep disturbance among refugees and asylum seekers are essentially the same as those used in the general population, but treatment strategies must allow for cultural and contextual factors, including language barriers, loss of freedom and threat of repatriation.
After reading this article you will be able to:
•recognise the challenges faced by the large number of refugees worldwide
•understand the relationship between PTSD, sleep disturbance and pain in refugees
•broadly understand the evidence for psychological and pharmacological therapy for treating PTSD, sleep disturbance and pain in refugees.
Although relapse in psychosis is common, a small proportion of patients will not relapse in the long term. We examined the proportion and predictors of patients who never relapsed in the 10 years following complete resolution of positive symptoms from their first psychotic episode.
Patients who previously enrolled in a 12-month randomized controlled trial on medication discontinuation and relapse following first-episode psychosis (FEP) were followed up after 10 years. Relapse of positive symptoms was operationalized as a change from a Clinical Global Impression scale positive score of <3 for at least 3 consecutive months to a score of ⩾3 (mild or more severe). Baseline predictors included basic demographics, premorbid functioning, symptoms, functioning, and neurocognitive functioning.
Out of 178 first-episode patients, 37 (21%) never relapsed during the 10-year period. Univariate predictors (p ⩽ 0.1) of patients who never relapsed included a duration of untreated psychosis (DUP) ⩽30 days, diagnosed with non-schizophrenia spectrum disorders, having less severe negative symptoms, and performing better in logical memory immediate recall and verbal fluency tests. A multivariate logistic regression analysis further suggested that the absence of any relapsing episodes was significantly related to better short-term verbal memory, shorter DUP, and non-schizophrenia spectrum disorders.
Treatment delay and neurocognitive function are potentially modifiable predictors of good long-term prognosis in FEP. These predictors are informative as they can be incorporated into an optimum risk prediction model in the future, which would help with clinical decision making regarding maintenance treatment in FEP.
Although school-based programmes for the identification of children and young people (CYP) with mental health difficulties (MHD) have the potential to improve short- and long-term outcomes across a range of mental disorders, the evidence-base on the effectiveness of these programmes is underdeveloped. In this systematic review, we sought to identify and synthesise evidence on the effectiveness and cost-effectiveness of school-based methods to identify students experiencing MHD, as measured by accurate identification, referral rates, and service uptake.
Electronic bibliographic databases: MEDLINE, Embase, PsycINFO, ERIC, British Education Index and ASSIA were searched. Comparative studies were included if they assessed the effectiveness or cost-effectiveness of strategies to identify students in formal education aged 3–18 years with MHD, presenting symptoms of mental ill health, or exposed to psychosocial risks that increase the likelihood of developing a MHD.
We identified 27 studies describing 44 unique identification programmes. Only one study was a randomised controlled trial. Most studies evaluated the utility of universal screening programmes; where comparison of identification rates was made, the comparator test varied across studies. The heterogeneity of studies, the absence of randomised studies and poor outcome reporting make for a weak evidence-base that only generate tentative conclusions about the effectiveness of school-based identification programmes.
Well-designed pragmatic trials that include the evaluation of cost-effectiveness and detailed process evaluations are necessary to establish the accuracy of different identification models, as well as their effectiveness in connecting students to appropriate support in real-world settings.
Transient Ischaemic Attack (TIA) is a neurologic event with symptom resolution within 24 hours. Early specialist assessment of TIA reduces risk of stroke and death. National United Kingdom (UK) guidelines recommend patients with TIA are seen in specialist clinics within 24 hours (high risk) or seven days (low risk).
We aimed to develop a complex intervention for patients with low risk TIA presenting to the emergency ambulance service. The intervention is being tested in the TIER feasibility trial, in line with Medical Research Council (MRC) guidance on staged development and evaluation of complex interventions.
We conducted three interrelated activities to produce the TIER intervention:
•Survey of UK Ambulance Services (n = 13) to gather information about TIA pathways already in use
•Scoping review of literature describing prehospital care of patients with TIA
•Synthesis of data and definition of intervention by specialist panel of: paramedics; Emergency Department (ED) and stroke consultants; service users; ambulance service managers.
The panel used results to define the TIER intervention, to include:
1.Protocol for paramedics to assess patients presenting with TIA and identify and refer low risk patients for prompt (< 7day) specialist review at TIA clinic
2.Patient Group Directive and information pack to allow paramedic administration of aspirin to patients left at home with referral to TIA clinic
3.Referral process via ambulance control room
4.Training package for paramedics
5.Agreement with TIA clinic service provider including rapid review of referred patients
We followed MRC guidance to develop a clinical intervention for assessment and referral of low risk TIA patients attended by emergency ambulance paramedic. We are testing feasibility of implementing and evaluating this intervention in the TIER feasibility trial which may lead to fully powered multicentre randomized controlled trial (RCT) if predefined progression criteria are met.
VLBI observations at 2.3 GHz of SN1987A on 28 February 1987 yielded no fringes, implying, for an optically thin shell, a lower bound on the (outer) diameter of 1.9 mas. From the comparison of the VLBI and optical results, we infer that the radiosphere of SN1987A was either about equal to, or larger than, the photosphere of the supernova five days after the explosion.
The discrepancy between abundances computed using optical recombination lines (ORLs) and collisionally excited lines (CELs) is a major, unresolved problem with significant implications for the determination of chemical abundances throughout the Universe. In planetary nebulae (PNe), the most common explanation for the discrepancy is that two different gas phases coexist: a hot component with standard metallicity, and a much colder plasma enhanced in heavy elements. This dual nature is not predicted by mass loss theories, and direct observational support for it is still weak. In this work, we present our recent findings that demonstrate that the largest abundance discrepancies are associated with close binary central stars. OSIRIS-GTC tunable filter imaging of the faint O ii ORLs and MUSE-VLT deep 2D spectrophotometry confirm that O ii ORL emission is more centrally concentrated than that of [Oiii] CELs and, therefore, that the abundance discrepancy may be closely linked to binary evolution.
It is necessary to calculate location-specific marine ΔR values in order to calibrate marine samples using calibration curves such as those provided through the IntCal98 (Stuiver et al. 1998) data. Where known-age samples are available, this calculation is straightforward (i.e. Stuiver et al. 1986). In the case that a paired marine/terrestrial sample calculation is performed, however, the standard calculation (i.e. Stuiver and Braziunas 1993) requires that the samples are treated as relating to isochronous events. This may not be an appropriate assumption for many archaeological paired samples. In this paper, we present an approach to calculating marine ΔR values that does not require the dated events to be treated as isochronous. When archaeological evidence allows the dated events to be tightly temporally constrained, the approach presented here and that described by Stuiver and Braziunas (1993) give very similar results. However, where tight temporal constraints are less certain, the 2 approaches can give rise to differing results. The example analysis considered here shows that a ΔR of −81 ± 64 14C yr is appropriate for samples in the vicinity of Nenumbo (Reef Islands, southeast Solomon Islands) around the period 2000–3000 BP.
The link of the Hipparcos and VLBI extragalactic reference frames has been achieved with a precision of 0.0005″ in global orientation at the epoch of the catalogue (1991.25) and of 0.0003″/yr in rate of rotation by VLBI observations of 12 radio-emitting stars.
The results of photometric and spectroscopic observations of dwarf novae are presented. The data were obtained during an international program of multiwavelength observations, held in 1986 February at several observatories, of dwarf novae during the first and subsequent days of outburst. During the campaign numerous dwarf novae were monitored in order to catch them in outburst. Preliminary results and analysis of some objects are reported elsewhere. A total of 30 dwarf novae were observed in the northern and southern hemispheres. Among them 37% were caught in outburst, including 10% on the rise to outburst and 17% in decline. Photometric observations were carried out in the UBVRI system and colour indexes were calculated.
In recent years several authors have questioned the reality of a widely accepted and apparently large increase in marine biodiversity through the Cenozoic. Here we use collection-level occurrence data from the rich and uniquely well documented New Zealand (NZ) shelfal marine mollusc fauna to test this question at a regional scale. Because the NZ data were generated by a small number of workers and have been databased over many decades, we have been able to either avoid or quantify many of the biases inherent in analyses of past biodiversity. In particular, our major conclusions are robust to several potential taphonomic and systematic biases and methodological uncertainties, namely non-uniform loss of aragonitic faunas, biostratigraphic range errors, taxonomic errors, choice of time bins, choice of analytical protocols, and taxonomic rank of analysis.
The number of taxa sampled increases through the Cenozoic. Once diversity estimates are standardized for sampling biases, however, we see no evidence for an increase in marine mollusc diversity in the NZ region through the middle and late Cenozoic. Instead, diversity has been approximately constant for much of the past 40 Myr and, at the species and genus levels, has declined over the past ~5 Myr. Assuming that the result for NZ shelfal molluscs is representative of other taxonomic groups and other temperate faunal provinces, then this suggests that the postulated global increase in diversity is either an artifact of sampling bias or analytical methods, resulted from increasing provinciality, or was driven by large increases in diversity in tropical regions. We see no evidence for a species-area effect on diversity. Likewise, we are unable to demonstrate a relationship between marine temperature and diversity, although this question should be re-examined once refined shallow marine temperature estimates become available.
A highly accurate multi-point pressure measurement system based on MEMS pressure sensors spliced into a fiber optic cable and suitable for downhole deployment in a CO2 sequestration well was designed, developed and tested in the laboratory. An interrogator system based on a pulsed laser excitation was shown to be capable of multiple (potentially 60+) point sensor measurements on a single fiber. The interrogator was interfaced with the GE PredixTM industrial internet to demonstrate a remote monitoring system. Sensor packages were fabricated and tested at high temperatures and pressures in supercritical CO2. Environmental and stress testing of the sensor components and package indicated areas in which the design of the package should be further improved.
North American studies show bipolar disorder is associated with elevated
rates of problem gambling; however, little is known about rates in the
different presentations of bipolar illness.
To determine the prevalence and distribution of problem gambling in
people with bipolar disorder in the UK.
The Problem Gambling Severity Index was used to measure gambling problems
in 635 participants with bipolar disorder.
Moderate to severe gambling problems were four times higher in people
with bipolar disorder than in the general population, and were associated
with type 2 disorder (OR = 1.74, P = 0.036), history of
suicidal ideation or attempt (OR = 3.44, P = 0.02) and
rapid cycling (OR = 2.63, P = 0.008).
Approximately 1 in 10 patients with bipolar disorder may be at moderate
to severe risk of problem gambling, possibly associated with suicidal
behaviour and a rapid cycling course. Elevated rates of gambling problems
in type 2 disorder highlight the probable significance of modest but
unstable mood disturbance in the development and maintenance of such
C46 was a Commission of the Executive Committee of the IAU under Division XII (Union-Wide Activities), then after 2012 under Division C (Education, Outreach, and Heritage). It was the only commission dealing exclusively with astronomy education; a previous Commission 38 (Exchange of Astronomers), which allocated travel grants to astronomers who needed them, and a Working Group on the Worldwide Development of Astronomy, have been absorbed by Commission 46.