Older adults in secure mental health care: health,social wellbeing and security needs measured with HoNOS-secure across different age groups

The number of older offenders is rapidly increasing in the United Kingdom and some older adults with mental health issues are referred to secure care services. It is therefore important to understand their unique characteristics in order to develop services based on their individual needs rather than chronological age. This study explored wellbeing and security needs of younger and older patients admitted to a secure psychiatric hospital. HoNOS-secure assessment at admission and discharge was extracted and used to build an anonymous data-set. Group comparison and score change during admission were conducted for six age groups: 18–24, 25–34, 35–44, 45–54, 55–64 and 65+. Younger patients improved on most measures whereas older patients aged 55–65+ showed little improvement or deterioration over time. This finding suggests that the subscales are sensitive to age difference although the needs measured by HoNOS-secure are less likely to inform the decision to discharge.     

Stability and change in subjective quality of life of adolescents in secure residential care

Subjective quality of life (QoL) is an outcome measure often used in the field of psychiatry. While upcoming strength-based rehabilitation theories place strong emphasis on subjective QoL, it has hardly ever been investigated in adolescents with severe psychiatric problems who are admitted to secure residential care. Therefore, the aim of this study was to investigate the stability and change of subjective QoL of adolescents with severe psychiatric problems. Additionally, the effect of discharge and re-entering society on subjective QoL was studied. In a four-wave longitudinal study, the subjective QoL of 172 male adolescents with severe psychiatric problems was examined. Five subjective QoL domains remained stable over time, while five other domains changed. A decrease in satisfaction with family relations and social participation was observed for discharged adolescents. These results warrant for continuing guidance of adolescents in order for them to positively adapt to a new life outside secure residential care.     

52例坠崖自杀案例分析

目的：通过对山岳型景区高坠自杀案件的现场分析、损伤形态及案情调查情况进行分析,为高坠死亡案件的定性提供参考。方法收集52例黄山景区2002—2012年内坠崖自杀案例的资料,从年龄、性别、籍贯、事发时段、坠落地点、损伤检验、行为方式等方面进行分析。结果52例坠崖自杀案例中,男性的自杀率明显高于女性,外省籍比例明显高于本省籍,年龄分布于19~50岁,案发时间段多在16：00~24：00,损伤形态以复合伤为主,均不同程度伴有颅脑损伤、胸腹腔器官损伤及体表划擦伤。结论高坠死亡案件的定性需要进行现场勘验、案情调查走访等综合分析。     

我国高等教育成本与收费的经济学分析

高等教育改革是当今世界教育改革的热点和重点领域。目前我国高等教育的经费来源实现了多渠道,但主要由政府和个人承担。优化我国高等教育成本分担有以下四个途径：加大政府财政对高等教育的支持力度;扩大高等教育的融资渠道,鼓励企业、个人等社会力量支持高等教育;大力发展民办教育;进一步完善和扩大高校助学贷款的规模和范围。     

Survival of Very High Blood Alcohol Concentration Without Consequential Damage in a Patient Without a Previous Substance Use Disorder

Intoxications with alcohol may lead to death depending on (maximum) blood alcohol concentration (BAC) and accompanying factors such as liver function, tolerance, and comedication. Death may occur due to ethanol‐induced respiratory depression and/or aspiration of gastric content (due to an impaired gag reflex); thus, securing of the airway and ventilation is occasionally necessary. A case of a 58‐year‐old female patient with depression who demonstrated a very high BAC of 8.68 gm/L (0.868%) following ingestion of large amounts of alcohol with suicidal intent is presented. Intubation and ventilation were life‐saving, and the patient did not develop any physical or consequential damage. As the patient had not regularly used alcohol or any other psychotropic agent, tolerance could be ruled out. This case emphasizes the necessity of rapid securing of the airway in patients with alcohol intoxication and respiratory depression and, furthermore, illustrates the large interindividual differences regarding ethanol susceptibility.     

Changes in staff confidence and attributions for challenging behaviour after training in positive behavioural support,within a forensic mental health setting: a replication study with follow-up

Positive behavioural support (PBS) is a proactive approach to managing challenging behaviour. Staff in a forensic mental health service were provided training in PBS. The study aimed to assess the effectiveness of training by measuring changes to staff confidence and attributions for challenging behaviour before training, post training and at six-month follow-up. Qualified and unqualified staff were compared, as were male and female staff. Confidence was measured using an adapted version of the Confidence in Coping with Patient Aggression Instrument. The Challenging Behaviour Attributions Scale and the Causal Dimension Scale II assessed staff attributions. Staff confidence levels in working with challenging behaviour increased following PBS training, and this increase was maintained at six-month follow-up, for unqualified, qualified, male and female staff. Changes in attributions for challenging behaviour were observed post training; however changes were not maintained at follow-up. Limitations and clinical implications were outlined.     

按照政治家标准培养高级领导干部的路径探求

在世情、国情、党情发生深刻变化的新形势下,要提高领导干部的领导水平和执政水平,提高拒腐防变和抵御风险能力,必须仔细甄别政治家和政客的联系与区别。要按照政治家的标准,结合当前我国经济社会发展的需要,提高高级领导干部的理论修养,加强制度监督,在实践中提升执政能力,实现提升个人政治素养与有效治理国家的良性互动,不断推进历史进步。     

浅议高速铁路消防安全管理工作

高铁的开通运营,在为广大旅客提供方便、快捷、舒适旅行条件的同时,也给消防安全管理工作带来了前所未有的压力。拟分析高铁消防安全管理存在的有利条件和特殊火灾危险性,从四个方面对当前高铁消防安全管理工作存在的问题和隐患进行归纳,并有针对性地提出加强高铁消防安全管理的对策和建议。     

高科技与新的教育革命

现行教育是工业化的一部分,贯彻的是工业明的基本原则,高度的标准化、专业化、集中化和同步化,这在许多方面违背人才成长的规律。高科技的发展和推广必然会引起新的教育革命,对劳动的素质提高了新的要求,并提出了崭新的教学手段,逐步使群体教育转化为个性教育,使刚性教育转化为柔性教育,能更好地培养学生的个性和创造