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The clinical and public mental health aspects of alcohol misuse in older people (both men and women) have increasing relevance for both old age and addiction psychiatrists. Clinical presentations are often complex and involve a number of different psychiatric, physical, and psychosocial factors. The assessment, treatment, and aftercare of alcohol-related and other comorbid mental disorders will also involve a broad range of interventions from a wide range of practitioners. Given its growing clinical relevance, there are particular areas such as alcohol-related brain damage and drug interactions with alcohol that deserve special attention.
Substance misuse in older people represents a growing clinical and public health problem within primary care.
The aim of article is to explore policy and research evidence for informing best practice in the assessment, treatment effectiveness, treatment implementation and approaches to recovery for older people with substance misuse in primary care.
Relevant search terms were used to examine the databases MEDLINE, EMBASE, CINAHL and PsychINFO up to January 2016.
An age-sensitive approach is required to overcome barriers to assessment. Training is essential for developing relevant knowledge, skills and attitudes. Clinical audit be used to develop care pathways, particularly for older people with dual diagnosis. There is also a need to develop closer links between primary care and the secondary care specialties, as well as added value in working with carers and voluntary agencies.
Further research is needed to inform more effective approaches to treatment. Adequate funding for workforce development and quality improvement in service development are also essential to improve health outcomes and quality of life in older people with substance misuse.
Alcohol-related dementia represents an underrecognised mental disorder with both clinical and public mental health aspects. There is considerable scope for improving its assessment within both mainstream and specialist mental health services, but ongoing challenges remain in ensuring its timely detection so that appropriate preventative and rehabilitative interventions can be applied.
The clinical and public mental health aspects of alcohol misuse in older people (both men and women) have increasing relevance for both old age and addiction psychiatrists. Clinical presentations are often complex and involve a number of different psychiatric, physical and psychosocial factors. The assessment, treatment and aftercare of alcohol-related and comorbid other mental disorders will also involve a broad range of interventions from a wide range of practitioners. Given its growing clinical relevance, there are particular areas, such as alcohol-related brain damage and drug interactions with alcohol, that deserve special attention.
Fractals have unique properties such as self-similarity and space-filling. The use of fractal geometry in antenna design provides a good method for achieving the desired miniaturization, multi-band, and wideband properties. In this communication, novel fractal geometry is proposed based on which a multiband antenna is designed. The proposed antenna has fractal patches which are shaped as different iterations of an eight-pointed star. The multiband behavior is in the frequency range from 4.50 to 17.00 GHz. The proposed antenna is designed on a dielectric substrate Roggers RO4003 lossy with a dielectric constant of εr = 3.55. The antenna has applications in commercial and military communication system.
This chapter examines the theme of transitions in energy systems. It assesses the literature that explores the genesis, growth, and management of transitions. This literature provides a multi-level framework for large-scale, transformative change in technology systems, involving a hierarchy of changes from experiments to niches to technology regimes.
The chapter also covers specific innovation systems and experiments in the energy sector that may have the potential for larger impact and could lead to new niches or technology regimes. These experiments include technology-driven innovations in generation and end-use; system-level innovations that could reconfigure existing systems; and business model innovations centered on energy service delivery. Experiments in generation include hybrid systems, where multiple primary energy sources help address issues such as intermittency. Experiments in end-use include technology options for the simultaneous delivery of multiple energy services, or energy and non-energy services. System-level experiments include innovations in storage, distributed generation, and the facilitation of energy efficiency by effectively monetizing savings in energy use.
In some of these experiments, technology can lead to changing relationships between actors or changing roles for actors; for example, the process of consumers becoming producers is seen in small-scale biogas projects. These changing relationships present both challenges and opportunities for influencing the transition process. The chapter also discusses policy and institutional issues that affect transitions. Finally, it is seen that although technological research, development, and innovation are important, a wide-scale, equitable, and accessible transformation to energy systems for sustainable development needs to be tackled as a socio-political issue.