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Background: Previous studies on the elderly mentally ill (graduates) have been undertaken in mental hospital settings and on populations being resettled from hospitals. This paper aims to assess the characteristics and service needs of an epidemiological sample of elderly mentally ill.Aims: The aim of this study was to identify the characteristics, problems, service utilization and needs of a sample of elderly patients with functional psychosis in a defined epidemiological area.Method: Data collected by PRiSM on psychotic patients who lived in two districts of Maudsley Hospital's catchment area were analyzed using the characteristics, problems and the needs for mental health services of those patients who were over the age of 64. These patients were compared with younger patients using the same data.Results: The elderly patients differed significantly in their characteristics and problems from the younger mentally ill persons. The needs assessment procedure (Camberwell Assessment of Needs, CAN) was less sensitive to physical and psychiatric needs of the elderly as it did not reflect the differences between the two age groups.Conclusions: The lower rate of schizophrenia in the elderly mentally ill compared to the younger community patients and asylum mentally ill is discussed. The explanation may lie in the natural history of the disorder or more plausibly in the implementation of `community care policy'. The paper concluded that a needs assessment procedure specifically designed to assess the needs of the elderly is required.

BACKGROUND--There is little information on the costs of maintaining a district nebuliser compressor service. This retrospective study examines the issue, reliability, and maintenance costs of electrical compressors to assist the prediction of future costs, taking into account recent safety legislation. METHODS--Records of issue, repair, and replacement for the period 1982-91 were reviewed. The current policy of repairing and replacing as necessary, and three other theoretical costings, were considered. RESULTS--The number of compressors being issued is increasing. Repaired compressors are less reliable and frequency of repair is a function of compressor age. The current policy is the most cost effective. CONCLUSIONS--To repair and replace nebuliser compressors as necessary is the most economical policy under the present terms offered by the manufacturers, but changes in safety legislation will affect the provision of such services.

The Food Stamp Program (FSP) is designed to increase the food expenditures & the diet status of low-income households. Here, data from the Special Low-Income Component of the 1977/78 Nationwide Food Consumption Survey were utilized to estimate effects of FSP participation on food expenditures, nutrient availability, & nutrient intake. The estimation procedure utilized a principal components index for characterizing availability & intake of the included nutrients. Results show that FSP participation & FSP bonus increased food expenditures & improved the nutritional status of diets of low-income household members. Nutrient availability & intake levels for FSP participants were increased by as much as 10-15% per week for selected nutrients. 6 Tables, 22 References. Modified HA

This article utilises a choice theory based on a three-equation simultaneous model to analyse determinants of contraception, desired number of children and fertility. The results show that a simultaneous choice model predicts the consequences of modernisation on human fertility and suggests ways that economic growth affects family size by proximate or intermediate variables

Background Carers are key providers of care and support to mental health patients and mental health policies consistently mandate carer involvement. Understanding carers' experiences of and views about assessment for involuntary admission and subsequent detention is crucial to efforts to improve policy and practice. Aims We aimed to synthesise qualitative evidence of carers' experiences of the assessment and detention of their family and friends under mental health legislation. Method We searched five bibliographic databases, reference lists and citations. Studies were included if they collected data using qualitative methods and the patients were aged 18 or older; reported on carer experiences of assessment or detention under mental health legislation anywhere in the world; and were published in peer-reviewed journals. We used meta-synthesis. Results The review included 23 papers. Themes were consistent across time and setting and related to the emotional impact of detention; the availability of support for carers; the extent to which carers felt involved in decision-making; relationships with patients and staff during detention; and the quality of care provided to patients. Carers often described conflicting feelings of relief coupled with distress and anxiety about how the patient might cope and respond. Carers also spoke about the need for timely and accessible information, supportive and trusting relationships with mental health professionals, and of involvement as partners in care. Conclusions Research is needed to explore whether and how health service and other interventions can improve the involvement and support of carers prior to, during and after the detention of family members and friends.

Background: PISA results appear to have a large impact upon government policy. The phenomenon is growing, with more countries taking part in PISA testing and politicians pointing to PISA results as reasons for their reforms. Purpose: The aims of this research were to depict the policy reactions to PISA across a number of jurisdictions, to see whether they exhibited similar patterns and whether the same reforms were evident. Sources of evidence: We investigated policy and media reactions to the 2009 and 2012 PISA results in six cases: Canada, China (Shanghai), England, France, Norway and Switzerland. Cases were selected to contrast high-performing jurisdictions (Canada, China) with average performers (England, France, Norway and Switzerland). Countries that had already been well reported on in the literature were excluded (Finland, Germany). Design and methods: Policy documents, media reports and academic articles in English, French, Mandarin and Norwegian relating to each of the cases were critically evaluated. Results: A policy reaction of 'scandalisation' was evident in four of the six cases; a technique used to motivate change. Five of the six cases showed 'standards-based reforms' and two had reforms in line with the 'ideal-governance' model. However, these are categorisations: the actual reforms had significant differences across countries. There are chronological problems with the notion that PISA results were causal with regard to policy in some instances. Countries with similar PISA results responded with different policies, reflecting their differing cultural and historical education system trajectories. Conclusions: The connection between PISA results and policy is not always obvious. The supranational spell of PISA in policy is in the way that PISA results are used as a magic wand in political rhetoric, as though they conjure particular policy choices. This serves as a distraction from the ideological basis for reforms. The same PISA results could motivate a range of different policy solutions.

To validate and test a German version of the revised Parent Report of Children's Abilities questionnaire (PARCA-R). Multicentre cross-sectional study. Parents of infants born <32 gestational weeks, completed the PARCA-R within three weeks before the follow-up assessment of their child at age two years. Infants were assessed using the Mental Development Index (MDI) of the Bayley Scales of Infant Development 2nd edition (BSID-II). Pearson correlation between the Parent Report Composite (PRC) of the PARCA-R and MDI was tested. The optimal PRC cut-off for predicting moderate-to-severe mental delay, defined as MDI<70, was identified through the receiver operating characteristic (ROC) curve. PARCA-R and BSID-II data were collected from 154 consecutive infants [51% girls, mean (SD) gestational age 29.0 (2.0) weeks, birth weight 1174 (345) grams] at 23.2 (1.6) months of corrected age. The PRC score [70.5 (31.1)] correlated with the MDI [92.2 (17.3); R = 0.54; p < 0.0001]. The optimal PRC cut-off for identifying mental delay was 44 with 0.81 (0.54-0.96) sensitivity (95%-CI), 0.81 (0.74-0.87) specificity, area under the ROC curve of 0.840 (0.729-0.952). The German version of the PARCA-R had good validity with the BSID-II and PCR scores < 44 proved optimal discriminatory power for the identification of mental delay at two years of corrected age.

The rise of evangelical feminism challenges traditional Christian beliefs related to gender roles in society, the home, and the church. This comprehensive defense of complementarianism contributes to the debate with systematic argumentation and exegetical analysis.

Bubble emission mechanisms from submerged large igneous provinces remains enigmatic. The Kerguelen Plateau, a large igneous province in the southern Indian Ocean, has a long sustained history of active volcanism and glacial/interglacial cycles of sedimentation, both of which may cause seafloor bubble production. We present the results of hydroacoustic flare observations around the underexplored volcanically active Heard Island and McDonald Islands on the Central Kerguelen Plateau. Flares were observed with a split‐beam echosounder and characterized using multifrequency decibel differencing. Deep‐tow camera footage, water properties, water column δ3He, subbottom profile, and sediment δ13C and δ34S data were analyzed to consider flare mechanisms. Excess δ3He near McDonald Islands seeps, indicating mantle‐derived input, suggests proximal hydrothermal activity; McDonald Islands flares may thus indicate CO2, methane, and other minor gas bubbles associated with shallow diffuse hydrothermal venting. The Heard Island seep environment, with subbottom acoustic blanking in thick sediment, muted 3He signal, and δ13C and δ34S fractionation factors, suggest that Heard Island seeps may either be methane gas (possibly both shallow biogenic methane and deeper‐sourced thermogenic methane related to geothermal heat from onshore volcanism) or a combination of methane and CO2, such as seen in sediment‐hosted geothermal systems. These data provide the first evidence of submarine gas escape on the Central Kerguelen Plateau and expand our understanding of seafloor processes and carbon cycling in the data‐poor southern Indian Ocean. Extensive sedimentation of the Kerguelen Plateau and additional zones of submarine volcanic activity mean additional seeps or vents may lie outside the small survey area proximal to the islands ; The overall science of the project is supported by Australian Antarctic Science Program (AASP) grant 4338. E.S.' PhD research is sup- ported by the Australian Research Council's Special Research Initiative Antarctic Gateway Partnership (Project ID SR140300001) and by an Australian Government Research Training Program Scholarship. S.C.J. is sup- ported by iCRAG under SFI, European Regional Development Fund, and industry partners, as well as ANZIC‐ IODP. J.M.W. is supported by ARC grant DE140100376 and DP180102280

AbstractThe production of an agricultural commodity involves a sequence of processes: planting/growing, harvesting, sorting/grading, postharvest treatment, packing, and exporting. A Bayesian network has been developed to represent the level of potential infestation of an agricultural commodity by a specified pest along an agricultural production chain. It reflects the dependency of this infestation on the predicted level of pest challenge, the anticipated susceptibility of the commodity to the pest, the level of impact from pest control measures as designed, and any variation from that due to uncertainty in measure efficacy. The objective of this Bayesian network is to facilitate agreement between national governments of the exporters and importers on a set of phytosanitary measures to meet specific phytosanitary measure requirements to achieve target levels of protection against regulated pests. The model can be used to compare the performance of different combinations of measures under different scenarios of pest challenge, making use of available measure performance data. A case study is presented using a model developed for a fruit fly pest on dragon fruit in Vietnam; the model parameters and results are illustrative and do not imply a particular level of fruit fly infestation of these exports; rather, they provide the most likely, alternative, or worst‐case scenarios of the impact of measures. As a means to facilitate agreement for trade, the model provides a framework to support communication between exporters and importers about any differences in perceptions of the risk reduction achieved by pest control measures deployed during the commodity production chain.