bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing behavioural activation in inpatient psychiatric wards
Authors: Curran Joe , Lawson Paul , Houghton Simon , Gournay Kevin
Published: August 2011

Behavioural activation is a contemporary behavioural treatment for depression that has the potential advantages of being more readily adopted in psychiatric inpatient environments than more complex psychological treatment approaches and requiring less intensive training than these approaches. In this article the theoretical and empirical foundations of behavioural activation are described along with an outline of the therapeutic process and key interventions used. Consideration is then given to factors influencing the implementation of BA in psychiatric inpatient environments.
The challenges of developing dual diagnosis capabilities for acute inpatient staff
Authors: Hughes Elizabeth , Robertson Neil , Kipping Cheryl , Lynch Claire
Published: August 2011

Dual diagnosis poses particular challenges for inpatient mental health services. Workers have low levels of training, clinical experience and support to deliver integrated care that combines mental health and substance use interventions. In addition, inpatient workers have to balance being therapeutic with ensuring that illicit substance use does not occur on the wards. This often leads to confrontation and poor engagement.In order to improve the capabilities of the workers to deliver more effective interventions for this group of service users, dual diagnosis training should be a high priority for acute inpatient services. However, there are a number of challenges in the implementation of this including lack of resources to fund training and specialist roles, lack of time to attend training (and supervision), and lack of time to implement learning in routine care.This paper will describe the policy drivers for the improvement of dual diagnosis care in acute psychiatric inpatient services, and how two initiatives in London are overcoming some of the obstacles and showing some promising initial outcomes. This paper will make recommendations for future research and developments.
New ways of working in acute inpatient care: a case for change
Authors: Baguley Ian , Alexander Jane , Middleton Hugh , Hope Roslyn
Published: August 2011

This position paper focuses on the current tensions and challenges of aligning inpatient care with innovations in mental health services. It argues that a cultural shift is required within inpatient services. Obstacles to change including traditional perceptions of the role and responsibilities of the psychiatrist are discussed. The paper urges all staff working in acute care to reflect on the service that they provide, and to consider how the adoption of new ways of working might revolutionise the organisational culture. This cultural shift offers inpatient staff the opportunity to fully utilise their expertise. New ways of working may be perceived as a threat to existing roles and responsibilities or as an exciting opportunity for professional development with increased job satisfaction. Above all, the move to new ways of working, which is gathering pace throughout the UK, could offer service users1 a quality of care that meets their needs and expectations.
Workforce planning in child and adolescent mental health services and addiction services: a New Zealand perspective
Authors: Wille Annemarie , Nixon Barry
Published: August 2011

New Zealand is not alone in facing challenges for the building and sustaining of a future health workforce that can meet the needs of a diverse population. In this article, the author describes how New Zealand has begun to build on models developed from the UK and elsewhere to attend to workforce issues in the child and adolescent mental health and addictions sector. The workforce planning development model being implemented by the Werry Centre for Child and Adolescent Mental Health has a solid pedigree, with a very New Zealand focused process for implementation.
Sowing the seeds of change: trainee clinical psychologists' experiences of service user and carer involvement on placement
Authors: Tickle Anna , Davison Clark
Published: August 2011

The training of future mental health professionals offers one avenue of change to improve service user and carer involvement in mental health services. This study looked at experiences of trainees on the University of Surrey's Clinical Psychology Doctorate programme in involving service users and carers on training placements. Twenty trainees completed a self‐report semistructured questionnaire providing qualitative data that were analysed using thematic analysis. A number of benefits of service user and carer involvement in training were identified as well as practical considerations, including factors that might facilitate or limit such involvement on training placements. It is intended that the findings will prove useful to others involved with the training of mental health professionals.
A national survey of psychosocial intervention training and skills in early intervention services in England
Authors: Brabban Alison , Kelly Mike
Published: August 2011

This study aimed to determine the level of training in psychosocial interventions among staff in the 119 early intervention in psychosis (EIP) teams that were established at the time. A brief questionnaire was sent to each of the teams asking for details of the composition of the team, and for details of any training in psychosocial interventions (PSI) the members of the team had undergone. Fifty‐two questionnaires were returned (44%). Over half of the teams had input from social workers, clinical psychologists and occupational therapists to compliment the nursing provision, though less than 50% employed support workers or had specific psychiatry input. All but two of the teams returning the questionnaire had members of staff trained in PSI though the type of training tended to reflect availability of local training provision. The results are discussed and practical recommendations are made to ensure evidencebased care is implemented within EIP.
Training to develop family inclusive routine practice and specialist family interventions in Somerset
Authors: Burbach Frank , Stanbridge Roger
Published: August 2011

Current national policies present a challenge to the existing mental health workforce as most staff have not been trained to work with people within the context of their social support network. This paper presents two complementary training initiatives designed to enable mental health staff to meet the range of needs of families: (1) an in‐house accredited (one‐year) course that has enabled the successful creation of specialist family intervention in psychosis teams; and (2) a whole‐team trust‐wide training programme (three‐day course) to promote partnership working with families by both community and inpatient teams. Issues that have enabled the successful translation of training to practice are considered.
The role of intrinsic factors in the implementation of psychosocial interventions into routine clinical practice
Authors: Fleming M , Savage‐Grainge A , Martin C , Hill C , Brown S , Buckle J , Miles J
Published: August 2011

Despite the efficacy, political will and numbers of mental health practitioners trained in psychosocial interventions, they remain scarcely available in routine clinical practice. External factors such as the inability of mental health organisations to develop strategies to support the use of psychosocial interventions have been implicated. This study compares data from two groups, one that had completed psychosocial intervention training (n=104) and one that had not received psychosocial intervention training (n=102). Both groups completed measures of self‐efficacy, locus of control and an application of psychosocial interventions to practice. Results showed that psychosocial intervention training significantly increased the level of self‐efficacy for using psychosocial interventions in practice. The group that had received psychosocial interventions training had lower internal locus of control orientation. Self‐efficacy was significantly related to using psychosocial interventions in practice. There is a discussion of the implications of these findings.
Facilitating and limiting factors of training available to staff of specialist CAMHS
Authors: Edwards Ruth , Williams Richard , Dogra Nisha , O'Reilly Michelle , Vostanis Panos
Published: August 2011

Specialist CAMHS provide skilled assessment and interventions for children, young people and their families who have mental health disorders. The training needs of the staff who work in specialist CAMHS are not always clear or prioritised, due to the complexities and differing contexts in which specialist CAMHS are provided. The aim of this paper was to establish stakeholders' experiences of service complexities and challenges that affect training within specialist CAMHS. The project employed interviews to gain wide‐ranging consultation with key stakeholder groups. The sample consisted of 45 participants recruited from policy departments, professional bodies, higher education providers, commissioners, service managers, and practitioners. The participants identified a number of themes that limit training, and put forward solutions on how these could be facilitated in the future. Emerging themes related to leadership and the role of service managers, strategic management of training, commissioning, levels of staff training, resources, impact of training on service users, and availability of training programmes. The findings emphasise the need for the strategic workforce planning of training to meet service delivery goals. Policy, commissioning, workforce training strategies, service needs, and delivery of training should be integrated and closely linked.
Child and adolescent mental health services (CAMHS): providing services for children and young people with learning disabilities
Authors: Nixon Barry , Hooton Sue , Jones Ann
Published: August 2011

Targets set in 2005 by the Department of Health in the form of a public service agreement (PSA, 2003‐2006) standard require the development of comprehensive CAMHS, which provide services for children and young people with learning disabilities (LD). This standard presents particular challenges to the existing national CAMHS workforce.This paper reports on a specific project to undertake a northwest regional audit regarding capacity and capability of staff working in CAMHS to care for children and young people with learning disabilities.
Addressing infection control in pre‐registration mental health nurse training
Authors: Stacey Gemma , Cole Mark
Published: August 2011

Health care associated infection has become a health service priority that transcends all clinical areas. Education is commonly cited as the cornerstone of effective practice on the tacit assumption that the knowledgeable practitioner will execute their skills more effectively. Consequently, infection control training has become embedded within the pre‐registration curriculum, however, students undertaking the mental health branch have been critical of an unduly adult focus to the topic, which fails to address their specific educational requirements. An educational intervention based on a problem‐based learning approach was developed to address this contention. The intervention received a three‐way evaluation from students who attended the session, a mental health lecturer/ facilitator and an infection control educator/ adviser. The results suggest that students were able to develop salient material, which recognised the principles of infection control practice, while placing it in the context of mental health nursing. The students gave positive feedback in terms of the mode of teaching and the relevance of the content.
Training graduate primary care mental health workers to work with people with a diagnosis of personality disorder
Authors: Woodward Catherine , Jones Alan , Martin Tasim
Published: August 2011

It is recognised that training is required for staff working with people with a diagnosis of personality disorder, as it poses challenges requiring particular skills and abilities (National Institute for Mental Health in England, 2003a). The proposal to train graduate primary care mental health workers (GPCMHWs) to work with the client group met with some scepticism by senior clinicians. However, the experience of providing training and supervision to the graduate primary care mental health workers to work with clients with personality disorder in Camden and Islington has proved positive. Several characteristics of the GPCMHWs identified in the training literature might contribute to this positive experience. Those factors include cognitive ability, motivation to learn, age, and attitudes. Initial findings from the evaluation of the training shows that graduate workers respond positively to the training, showing improvements in self‐rated knowledge and skills relating to working with the client group, and an eagerness to learn more. The relevance of this to the personality disorder capabilities framework are described.
New Ways of Working and the issue of responsibility and accountability
Authors: Vize Christine
Published: August 2011

The issue of responsibility and accountability is central to the development of New Ways of Working (NWW), and has also been central to the concerns that members of some professions have expressed about it. Clarity about who is responsible for what, and who is accountable to whom, is particularly important when there are new types of worker roles in the team, and when existing workers are working in a different way or extending their role. NWW emphasises the appropriate distribution of responsibility and team decision‐making, which together are designed to promote patient safety. Distributing responsibility and accountability does not mean diluting or diffusing it; this model supports all workers being responsible for the standards of their own practice, and moves away from the ill‐defined, and perhaps unrealistic, notion of the doctor being ultimately responsible for all patients.The National Workforce Programme has worked with a wide range of stakeholders, including professional regulators and employers, to produce guidance on responsibility and accountability. This guidance is currently in draft form and will be published on the New Ways of Working website (www.newwaysofworking.org.uk) as soon as the final version is published.
Service user perspectives on a new model of inpatient care: a qualitative study
Authors: Healey Christine , Mills Catherine , Fahey Vikki , Hyde‐Price Cathy , Shah Jinesh , Kinderman Peter
Published: August 2011

The New Ways of Working (NWW) initiative was launched in 2004 to build a more flexible and skilled mental health workforce. This paper explores the journey through inpatient care under a new acute care team (ACT) model, piloted in Mersey Care NHS Trust as part of the redesign of services under the NWW. Fourteen service users were interviewed face‐to‐face, using an interview schedule of open‐ended questions administered by service user and carer interviewers. Service user perspectives on the admission process and inpatient care were reported as predominantly negative. Service user perspectives on the discharge process and aftercare were reported as predominantly positive. The need for clear and unambiguous care pathways, adequate information, good communication, and to have continuity of care and positive relationships with staff emerged as key themes.
New Ways of Working in child and adolescent mental health services ‐ 'keep the baby but throw out the bathwater'
Authors: Morris Tim , Anderson Yvonne , Nixon Barry
Published: August 2011

This paper focuses on the policy context that led to the development of the New Ways of Working in child and adolescent mental health services (NWW CAMHS) project and the future direction of change that is its legacy. NWW CAMHS represents a merging of policy and practice across what is sometimes a divide between adult and child services. In some aspects, CAMHS had already adopted what became known as a NWW in adult mental health with multidisciplinary teams characterised by dispersed patterns of responsibility and leadership. In other areas, particularly the involvement of service users and carers, CAMHS has been less forward‐thinking. There continues to be a significant workforce challenge for children's services and a risk that innovation and development will not be fully inclusive of the full range of service users' needs. It is important that the lessons learned from the national workforce programme are kept while the usual boundaries to development across services are broken down.
The Creating Capable Teams Approach (CCTA) ‐ a toolkit to support teams to introduce New Ways of Working and New Roles
Authors: Hollingsworth Nicki
Published: August 2011

The Creating Capable Teams Approach (CCTA) was developed as part of the National Institute for Mental Health National Workforce Programme (NIMHE NWP). This article will identify what the CCTA is, explore its development and implementation and highlight some of the outcomes and plans for further development.
Enhancing cultural competence in mental health settings: from undergraduate training to continuing education
Authors: Nayar Shoba , Tse Samson , Sobrun‐Maharaj Amritha
Published: August 2011

New Zealand is a country of many cultures and ethnicities. With a growing Asian community, cultural capability of the mental health workforce is essential to ensure that Asians have equity in access to appropriate and high quality services. Literature indicates a growing need to develop resources and enhance knowledge on cultural competence to assist health service providers to address the needs of people from diverse backgrounds. Yet, at what stage of training and/or practice are health professionals gaining access to this knowledge?Consultation with local health services and tertiary education institutions revealed a gap in the knowledge of Asian mental health being taught in the curriculum of students undertaking training to become health professionals. Further research indicated a need and desire from tertiary institutions to have access to Asian mental health material for both enhancing students' learning, and promoting the concept of continuing education following graduation. As a result, an interactive, self‐administrative CD‐rom comprising three modules: self‐reflection; Asian philosophies; and clinical issues was compiled.Early feedback indicates that the CD‐rom has tremendous potential in terms of applicability to enhancing current curriculum and for teaching students skills such as accessing articles and web based resources, valuable for the purposes of continuing education. Continuing education with regards to cultural competence is not just for qualified health professionals but needs to be integrated as part of students training as health practitioners, in order to ensure health care providers are able to provide effective and culturally responsive services.
Breakaway training for NHS staff: time for a fresh approach?
Authors: Mott Andy , Dobson Paul , Walton James , Highfield Penny , Harries Lee , Seal Robert , Butland Peter
Published: August 2011

Since the early 1980s, breakaway training has been synonymous with many prevention and management of violence and aggression (PMVA) training programmes in social care and NHS settings. However, for almost three decades, this community has continued to accept a training approach that has been largely unsupported by a robust underpinning methodology or evidence base. The validity of this historical training approach will be examined in context with the available literature, and will seek to identify the fundamental flaws that have been inherent in the traditional system. This paper will conclude by making some practical suggestions on how the efficacy of personal protective training may be improved, based on the emerging findings from other scientific fields.
Biogeography migration algorithm for traveling salesman problem
Authors: Mo Hongwei , Xu Lifang
Published: August 2011

Purpose

Biogeography‐based optimization algorithm is a new kind of optimization algorithm based on biogeography. It is designed based on the migration strategy of animals to solve the problem of optimization. The purpose of this paper is to present a new algorithm – biogeography migration algorithm for traveling salesman problem (TSPBMA). A new special migration operator is designed for producing new solutions.

Design/methodology/approach

The paper gives the definition of TSP and models of TSPBMA; introduces the algorithm of TSPBMA in detail and gives the proof of convergence in theory; provides simulation results of TSPBMA compared with other optimization algorithms for TSP and presents some concluding remarks and suggestions for further work.

Findings

The TSPBMA is tested on some classical TSP problems. The comparison results with the other nature‐inspired optimization algorithms show that TSPBMA is useful for TSP combination optimization. Especially, the designed migration operator is very effective for TSP solving. Although the proposed TSPBMA is not better than ant colony algorithm in the respect of convergence speed and accuracy, it provides a new way for this kind of problem.

Originality/value

The migration operator is a new strategy for solving TSPs. It has never been used by any other evolutionary algorithm or swarm intelligence before TSPBMA.
Reducing data dimensionality using random projections and fuzzy k‐means clustering
Authors: Aswani Kumar Ch.
Published: August 2011

Purpose

The purpose of this paper is to introduce a new hybrid method for reducing dimensionality of high dimensional data.

Design/methodology/approach

Literature on dimensionality reduction (DR) witnesses the research efforts that combine random projections (RP) and singular value decomposition (SVD) so as to derive the benefit of both of these methods. However, SVD is well known for its computational complexity. Clustering under the notion of concept decomposition is proved to be less computationally complex than SVD and useful for DR. The method proposed in this paper combines RP and fuzzy k‐means clustering (FKM) for reducing dimensionality of the data.

Findings

The proposed RP‐FKM is computationally less complex than SVD, RP‐SVD. On the image data, the proposed RP‐FKM has produced less amount of distortion when compared with RP. The proposed RP‐FKM provides better text retrieval results when compared with conventional RP and performs similar to RP‐SVD. For the text retrieval task, superiority of SVD over other DR methods noted here is in good agreement with the analysis reported by Moravec.

Originality/value

The hybrid method proposed in this paper, combining RP and FKM, is new. Experimental results indicate that the proposed method is useful for reducing dimensionality of high‐dimensional data such as images, text, etc.
Robust control of quadrotor MAV using self‐organizing interval type‐II fuzzy neural networks (SOIT‐IIFNNs) controller
Authors: Chen Xiangjian , Li Di , Xu Zhijun , Bai Yue
Published: August 2011

Purpose

Quadrotor micro aerial vehicle (MAV) is nonlinear and under actuated plant, and it is difficult to obtain an accurate mathematical model for quadrotor MAV due to uncertainties. The purpose of this paper is to propose one robust control strategy for quadrotor MAV to accommodate system uncertainties, variations, and external disturbances.

Design/methodology/approach

The robust control strategy is composed of two self‐organizing interval type‐II fuzzy neural networks (SOIT‐IIFNNs) and one PD controller: the PD controller is adopted to control the attitude and position; one of the SOIT‐IIFNNs is designed to learn the inverse model of quadrotor MAV online; the other SOIT‐IIFNNs is the copy of the former one to compensate for model errors, system uncertainties and external disturbances, both structure and parameters of SOIT‐IIFNNs are tuned online at the same time, and then the stability of the resulting quadrotor MAV closed‐loop control system is proved using Lyapunov stability theory.

Findings

The validity of the proposed control method has been verified through real‐time experiments. The experimental results show that the performance of SOIT‐IIFNNs is significantly improved compared with Backstepping‐based controller.

Practical implications

This approach has been used in quadrotor MAV, the controller works well, and it could guarantee quadrotor MAV control system with good performances under uncertainties, variations, and external disturbances.

Originality/value

The proposed SOIT‐IIFNNs controller is interesting for the design of an intelligent control scheme. The main contributions of this paper are: the overall closed‐loop control system is globally stable, demonstrated by Lyapunov stable theory; the tracking error can be asymptotically attenuated to a desired small level around zero by appropriate chosen parameters and learning rates; and the quadrotor MAV control system based on SOIT‐IIFNNs controller can achieve favorable tracking performance.
Inside the Youth Justice Board: ambiguity and influence in New Labour's youth justice
Authors: Souhami Anna
Published: August 2011

Purpose

The Youth Justice Board (YJB) was established in 1998 as a central part of the Labour government's radical programme of youth justice reform. Yet while it has had a central role in directing the culture, organisation and activities of youth justice in England and Wales, it is poorly understood. As its future hangs in the balance, this paper seeks to draw on a unique empirical study of the operation of the YJB to explore what it is, what it does and why it is so difficult to describe.

Design/methodology/approach

The research involved 18 months' ethnographic fieldwork. For one calendar year (2006‐2007), research focused on the internal operation of the YJB including observations of meetings, depth interviews and documentary analysis. A second strand of research explored the regional operation of the YJB. This involved observations of regional monitors and assessment processes and interviews and focus groups with Youth Offending Teams staff.

Findings

The research shows that the YJB is an inherently ambiguous organisation. This ambiguity has made it simultaneously highly insecure and extremely productive, enabling it to extend its influence and activities beyond those initially envisaged in New Labour's reforms. However, the difficulty in defining the YJB also suggests the full effect of its activities will only become clear once it has gone.

Originality/value

While there has been much academic interest in the YJB, this research is the only empirical study of it. It, therefore gives a unique insight into the organisation and culture of the English and Welsh youth justice system.
International business curriculum design: identifying the voice of the customer using QFD
Authors: Gonzalez Marvin E. , Quesada Gioconda , Mueller James , Mueller Rene D.
Published: August 2011

Purpose

Curriculum development in higher education must be continuously evaluated in this dynamic business environment, where business needs change day‐to‐day. The literature on the application of quality function deployment (QFD) to curriculum design is increasing, with student opinion representing the sole voice of the customer. The purpose of this paper is to present an alternative approach to QFD curriculum design by using a survey of employers, not students, to represent the voice of the customer.

Design/methodology/approach

This paper applies the widely used quality management process of QFD to the curriculum development process of a major international business program.

Findings

The findings illustrate the application of QFD's house of quality in international business curriculum development and best practices benchmarking.

Practical implications

The results of this study are useful to any university to revise or design new academic programs. It presents a methodology to design curriculum based on the voice of the real customer: industry, without forgetting about the expertise of academicians.

Originality/value

This study is intended to be one of the first in defining the customer as the industry, instead of just students or academic experts. The combination of all stakeholders in the curriculum design of international business will help universities make better decisions regarding international business programs.
Building global competencies through experiential coursework in international travel and tourism
Authors: Vance Charles M. , Sibeck Gary , McNulty Yvonne , Hogenauer Alan
Published: August 2011

Purpose

The purpose of this paper is to examine strengths and limitations of current experiential approaches for enhancing international business education, and propose a new, particularly cost‐effective approach grounded in the travel and tourism industry and specific context of international cruises.

Design/methodology/approach

This study combines an analysis of current literature with an examination of actual case experience.

Findings

A particularly successful short‐term experiential learning approach was used at a private university in southern California that is focused on the specific international business context of the international cruise industry within travel and tourism. The authors believe that this approach has significant merit to be included as a viable option for helping students develop important international business competencies required to compete in an increasingly global marketplace. With its specific focus on the international cruise industry and experiential travel agency operational design, this approach provides not only the opportunity to learn about general culture and business environments in the areas of travel, but also allows the practical application of many international and domestic business concepts and skills within a specific global industry context.

Research limitations/implications

The present study is limited to a very few experiences and within the international cruise industry. Future applied research in international business education should provide more rigorous analyses for verifying intended student learning outcomes, as well as examine applications within other contexts within the growing field of international travel and tourism.

Practical implications

The approach described here provides practical information for developing similar experiential coursework for enhancing international business education, and is particularly useful for smaller educational institutions that may lack the ability to offer and participate fully in more extensive options such as study abroad and international internships.

Originality/value

The approach described in the paper provides a highly relevant context for international business experiential education that is economical for students and schools alike.
Culture clash
Authors: Rajaram Kumaran , Bordia Sarbari
Published: August 2011

Purpose

The purpose of this paper is to investigate a new trend of training mainland Chinese students in Western‐style business education in Singapore. The paper examines the influence of the inferred learning effectiveness and cultural dislocation variables when measured across ten commonly used instructional techniques.

Design/methodology/approach

The use of consensual qualitative research allowed the data to be qualitatively analysed. The random selection of 20 participants represents mainland Chinese students, from the northern, southern, eastern and western regions. The study reports the level of knowledge acquisition, the relationship between comfort and knowledge acquired and the differences between the active and passive instructional techniques on students' learning effectiveness.

Findings

Rote‐learning styles of instructional techniques may not be the Chinese students' only preferred choice in terms of acquisition of knowledge and how they learn most effectively.

Research limitations/implications

The present exploratory study provides a starting‐point for further research into understanding how to teach Western‐based business education to mainland Chinese students in Singapore.

Practical implications

The findings will give institutions conducting Western‐based education programs in Singapore an advantage in providing effective learning pedagogies, and will assist in increasing their quality, which will enable them to nurture well‐qualified business professionals.

Social implications

The quality of the educational standard and its compatibility with the Asian client base are further enhanced both in terms of contents' intensity and educational services provided to students.

Originality/value

The paper offers practical help from the perspective of the curriculum design and development of an effective business educational framework to sustain profitability by offering tailor‐made, superior quality course programs.
Research watch
Authors: Holttum Sue
Published: August 2011

Purpose

This paper is one in a series of quarterly reflections on recent research in mental health and social inclusion.

Design/methodology/approach

Two papers are summarised here, representing two sides of a coin: one reviewing research on tackling stigma against people with experience of mental distress; the other illustrating how people with a diagnosis of bipolar disorder (or 'manic‐depression'), can manage to continue in work and other valued social roles.

Findings

The first paper suggests that some approaches to tackling stigma work better than others, and people researching them need to use measures that accurately capture change. Community‐based participatory research allows researchers and people with experience of mental distress to collaborate and capture outcomes that will really make a difference to people's lives. The second paper illustrates how people with a diagnosis of bipolar disorder can not only continue to work but also participate in other socially valued roles.However, it was important to have support for developing self‐understanding and for discovering which strategies were most helpful personally for managing stressors. To conclude: people with severe mental health conditions can and do continue to live well in society, but this requires, in addition to personal coping strategies, continued attention to reducing stigma and discrimination and to understanding what works in achieving this.

Originality/value

This paper summarises a recent review paper on research into effective ways of tackling stigma against people experiencing mental distress, and a recent paper illustrating how people can live well in the community with bipolar disorder.
Historical recovery heroes – Isaac Newton
Authors: Wakely Elizabeth , Carson Jerome
Published: August 2011

Purpose

Isaac Newton has been described as the father of modern science. What is less well known is that he had mental health problems. Here, the authors aim to review the literature on his problems and life to see if he was a mental health recovery hero.

Design/methodology/approach

The paper reviewed all the published papers on Newton's mental health problems, as well as many of the biographies written on him.

Findings

Scholars of Newton have focussed most of their attention on Newton's breakdown of 1693. This has been attributed to mercurialism or paranoid psychosis. The more likely explanation is depression or bipolar disorder. Personality factors are also critical in understanding Newton; he had a troubled upbringing and problems in relating to others. The latter enabled him to focus exclusively on his research and experiments and may have contributed to his greatness.

Originality/value

The authors have brought to bear their insights as a professional historian and as a clinical psychologist, giving this paper a unique perspective from previous uni‐disciplinary reviews.
Painting outside the lines
Authors: Prendergast Carol , Swan Poonam
Published: August 2011

Purpose

The purpose of this paper is to share the empowering journey of Kim Noble, an artist who has Dissociative Identity Disorder, a condition formerly known as Multiple Personality Disorder.

Design/methodology/approach

An overview of the social inclusion aspects of Kim Noble's artistic projects are explored via a detailed interview.

Findings

Far from being just a creative tool for self‐expression, art is a powerful means of regaining control as a service user and of connecting members of the public who would not ordinarily unite.

Originality/value

Valuable for commissioners and service users to see how arts can promote recovery, all other material on this artist has concentrated only on her condition and not how art has promoted social inclusion.
Recovery, social inclusion and the practice of psychiatrists
Authors: Currie Alan
Published: August 2011

Purpose

Being excluded blights the lives of the mentally ill. Exclusion is both cause and consequence of mental ill‐health and extends beyond material deprivation to exclusion from the activities which give meaning to life. Promoting inclusion is central to the work of all mental health practitioners and the purpose of this paper is to advance the practices which support this.

Design/methodology/approach

The literature on what supports social inclusion and the related concept of recovery is reviewed. The working practices and prevailing theoretical models in psychiatry are also considered in the context of understanding how these practices and models can support socially inclusive and recovery‐orientated ways of working.

Findings

Social inclusion and recovery interact dynamically. Central to being “in recovery” is the experience of being included. Social inclusion is also a platform on which to participate in life's activities and to learn to “live well” again. The practices which support these approaches are consistent with medical models of care, with the bio‐psychosocial model that prevails in psychiatric practice and with existing guidelines on the nature and purpose of the therapeutic relationship.

Originality/value

Obstacles are described that impede adopting new practices and these include creating additional work, increased risk in a risk averse environment, and incompatibility with current models of medical practice. This paper seeks to describe the cost of exclusion, the value of inclusion, the practices which support recovery and social inclusion and to refute the arguments for not adopting these ways of working.
New buffer operators with variable weight based on average tempo and their optimization
Authors: Dai Wen‐zhan , Wu Zi‐heng , Yang Ai‐ping
Published: August 2011

Purpose

The purpose of this paper is to solve the problem existing in the forecast of impact disturbance grey system.

Design/methodology/approach

Under the axiomatic system of buffer operator in grey system theory, a novel kind of buffer operators with variable weight λ based on the principle of average tempo of time sequence and using new information is proposed. The optimization solution for variable weight λ is obtained by using genetic algorithm. It is proved that the new buffer operators are effective.

Findings

The results show that the new buffer operators accord with the buffer operator's three axioms and the monotonicity non‐variable axiom. It is proved theoretically and in practice that the new buffer operators are more useful than other buffer operators in grey modeling for sequence with impact disturbance.

Practical implications

The novel buffer operators can reduce the randomness of grey sequence distorted by impact factors, and the forecast accuracy of a model which is built through the process with a novel buffer operator is significantly increased.

Originality/value

The paper succeeds in constructing two novel buffer operators with variable weight and the properties of novel operators are studied. The method to solve optimization value of weight is proposed. The method widens the scope of grey model application.
Principle and method of comprehensive evaluation for breeding target character value shown as an interval number
Authors: Ruilin Guo , Qiufang Wu , Yafei Liu , Yanzhen Liu , Guangzhi Mao , Jinshun Wang
Published: August 2011

Purpose

The paper seeks to attempt to solve a decision‐making problem for breeding target character shown as an interval number.

Design/methodology/approach

A new comprehensive evaluation method is proposed based on similarity‐difference theory and interval number theory. Data from Winter Wheat Group I Variety Regional Test in Henan Province in 2009‐2010 were analysed using the proposed method.

Findings

The results showed that Zhou 99233 was a good variety; Yuxhan No. 7, An 05‐28, Xun K8, Jinyumai 378 and Zhoumai 18 were better ones; 08 luo 36,and Xuke 718 ordinary ones, and others worse ones. Based on this, the feasibility of the method was discussed. It showed that the proposed method had some obvious merits, such as simple arithmetic, convenient operation, flexible and practical, fast and effective.

Practical implications

The application of a live example indicated that its evaluation effect was satisfactory.

Originality/value

The paper succeeds in solving a decision‐making problem for breeding target character shown as an interval number.
Propionic acid affects immune status and metabolism in adipose tissue from overweight subjects
Authors: Al‐Lahham Sa’ad , Roelofsen Han , Rezaee Farhad , Weening Desiree , Hoek Annemieke , Vonk Roel , Venema Koen
Published: August 2011

Eur J Clin Invest 2012; 42 (4): 357–364

Background  Adipose tissue is a primary site of obesity‐induced inflammation, which is emerging as an important contributor to obesity‐related diseases such as type 2 diabetes. Dietary fibre consumption appears to be protective. Short‐chain fatty acids, e.g. propionic acid, are the principal products of the colonic fermentation of dietary fibre and may have beneficial effects on adipose tissue inflammation.

Materials and methods  Human omental adipose tissue explants were obtained from overweight (mean BMI 28·8) gynaecological patients who underwent surgery. Explants were incubated for 24 h with propionic acid. Human THP‐1 monocytic cells were differentiated to macrophages and incubated with LPS in the presence and absence of propionic acid. Cytokine and chemokine production were determined by multiplex‐ELISA, and mRNA expression of metabolic and macrophages genes was determined by RT‐PCR.

Results  Treatment of adipose tissue explants with propionic acid results in a significant down‐regulation of several inflammatory cytokines and chemokines such as TNF‐α and CCL5. In addition, expression of lipoprotein lipase and GLUT4, associated with lipogenesis and glucose uptake, respectively, increased. Similar effects on cytokine and chemokine production by macrophages were observed.

Conclusion  We show that propionic acid, normally produced in the colon, may have a direct beneficial effect on visceral adipose tissue, reducing obesity‐associated inflammation and increasing lipogenesis and glucose uptake. Effects on adipose tissue as a whole are at least partially explained by effects on macrophages but likely also adipocytes are involved. This suggests that, in vivo, propionic acid and dietary fibres may have potential in preventing obesity‐related inflammation and associated diseases.
Achieving a clinically relevant composite outcome of an HbA1c of <7% without weight gain or hypoglycaemia in type 2 diabetes: a meta‐analysis of the liraglutide clinical trial programme
Authors: Zinman B. , Schmidt W. E. , Moses A. , Lund N. , Gough S.
Published: August 2011

Aim: Effective type 2 diabetes management requires a multifactorial approach extending beyond glycaemic control. Clinical practice guidelines suggest targets for HbA1c, blood pressure and lipids, and emphasize weight reduction and avoiding hypoglycaemia. The phase 3 clinical trial programme for liraglutide, a human glucagon‐like peptide 1 analogue, showed significant improvements in HbA1c and weight with a low risk of hypoglycaemia compared to other diabetes therapies. In this context, we performed a meta‐analysis of data from these trials evaluating the proportion of patients achieving a clinically relevant composite measure of diabetes control consisting of an HbA1c <7% without weight gain or hypoglycaemia.

Methods: A prespecified meta‐analysis was performed on 26‐week patient‐level data from seven trials (N = 4625) evaluating liraglutide with commonly used therapies for type 2 diabetes: glimepiride, rosiglitazone, glargine, exenatide, sitagliptin or placebo, adjusting for baseline HbA1c and weight, for a composite outcome of HbA1c <7.0%, no weight gain and no hypoglycaemic events.

Results: At 26 weeks, 40% of the liraglutide 1.8 mg group, 32% of the liraglutide 1.2 mg group and 6–25% of comparators (6% rosiglitazone, 8% glimepiride, 15% glargine, 25% exenatide, 11% sitagliptin, 8% placebo) achieved this composite outcome. Odds ratios favoured liraglutide 1.8 mg by 2.0‐ to 10.5‐fold over comparators.

Conclusions: As assessed by the composite outcome of HbA1c <7%, no hypoglycaemia and no weight gain, liraglutide was clearly superior to the other commonly used therapies. However, the long‐term clinical impact of this observation remains to be shown.
Effect of Load Level on the Performance of a Dual Fuel Compression Ignition Engine Operating on Syngas Fuels With Varying H2/CO Content
Authors: Sahoo B. B. , Saha U. K. , Sahoo N.
Published: August 2011

Syngas, an environmentally friendly alternative gaseous fuel for internal combustion engine operation, mainly consists of carbon monoxide (CO) and hydrogen (H2). It can substitute fossil diesel oil in a compression ignition diesel engine through dual fuel operation route. In the present investigation, experiments were conducted in a constant speed single cylinder direct injection diesel engine fuelled with syngas-diesel in a dual fuel operation mode. The main contribution of this study is to introduce the new synthetic gaseous fuel (syngas) including the possible use of CO gas, an alternative diesel engine fuel. In this work, four different H2 and CO compositions of syngas were chosen for dual fuel study under different engine loading levels. Keeping the same power output at the corresponding tested loads, the engine performance of dual fuel operations were compared to that of diesel mode for the entire load range. The maximum diesel replacement in the engine was found to be 72.3% for 100% H2 fuel. This amount replacement rate was reduced for the low energetic lower H2 content fuels. The brake thermal efficiency was always found highest (about 21%) in the case of diesel mode operation. However, the 100% H2 syngas showed a comparative performance level with diesel mode at the expense of higher NOx emissions. At 80% engine load, the brake thermal efficiency was found to be 15.7% for 100% CO syngas. This value increased to 16.1%, 18.3% and 19.8% when the 100% CO syngas composition was replaced by H2 contents of 50%, 75% and 100%, respectively. At part loads (i.e., at 20% and 40%), dual fuel mode resulted a poor performance including higher emission levels. In contrast, at higher loads, syngas fuels showed a good competitive performance to diesel mode. At all the tested loads, the NOx emission was observed highest for 100% H2 syngas as compared to other fuel conditions, and a maximum of 240 ppm was found at 100% load. However, when the CO fractions of 25%, 50% and 100%, were substituted to hydrogen fuel, the emission levels got reduced to 175 ppm, 127 ppm, and 114 ppm, respectively. Further, higher CO and HC emission levels were recorded for 25%, 50%, and 100% CO fraction syngas fuels due to their CO content. Ignition delay was found to increase for the dual fuel operation as compared to diesel mode, and also it seemed to be still longer for higher H2 content syngas fuels. The peak pressure and maximum rate of pressure rise were found to decrease for all the cases of dual fuel operation, except for 100% H2 syngas (beyond 60% load). The reduction in peak pressure resulted a rise in the exhaust gas temperature at all loads under dual fuel operation. The present investigation provides some useful experimental data which can be applied to the possible existing engine parameters modifications to produce a competitive syngas dual fuel performance at all the loading operations.