Physical health problems are common in SMI subjects. Many patients completed 2 years follow up suggesting that this format of programme is an acceptable option for SMI patients. Cardiovascular risk factors were significantly improved. Interventions such as the Well-being Support Programme should be made widely available to people with SMI.
Introduction:Patients with severe mental illness (SMI) have higher rates of cardiovascular disease (CVD) morbidity and mortality than the general population. In the UK, data were limited regarding the known prevalence of physical health screening of SMI patients.Aims:A total of 966 patients with SMI from seven geographically varied regions in the UK agreed to participate in a 2-year nurse-led intervention (Well-being Support Programme), designed to improve their overall physical health by providing basic physical health checks, health promotion advice, weight management and physical activity groups in secondary care.Results:At baseline, only 31% of participants had undergone a recent physical health check. There were high rates of obesity (BMI > 30 in 49%), glucose abnormalities (12.4%), hypertension/prehypertension (50%), hyperlipidaemia (71%), poor diet (32%), low exercise levels (37.4%) and smoking (50%).Conclusions:Patients with SMI where healthcare professionals have concerns regarding their physical health, have potentially modifiable risk factors for CVD, which remain undiagnosed. Programmes designed to address the physical health problems in SMI need to be implemented and evaluated in this already marginalised group of people.
Purpose -This paper aims to describe the origins of the concept of a psychologically informed environment (PIE), as now adopted and applied in homelessness resettlement, placing this in the context of work recently carried out under the aegis of the Royal College of Psychiatrists' Centre for Quality Improvement to recognise and promote ''enabling environments'' in all areas of social practice. Design/methodology/approach -This paper gives an historical account of the contemporary development of new thinking and practical applications for enhancing community mental health and well-being. Findings -The concept of an enabling environment (EE) arose out of efforts to up-date for the twenty-first century the post-war concept of a therapeutic community, for all services working with the same basic core values and psycho-social awareness. The EE approach now applies this framework more flexibly, yet with a clear operational focus in each sector, to a wider range of organisational contexts, social practice and agencies outside the therapy and care services world. From the outset, homelessness resettlement and social housing practice was seen as a key part of the overall ambition. Practical implications -Understanding the values base behind social-psychological approaches in social practice environments helps to translate these ideas into service-led improvements in actual frontline services practice. In particular, the enabling environments approach offers a handy tool for self-assessment and service improvement, which is fully compatible with the PIE's philosophy. Originality/value -The concept of a PIE is currently acquiring momentum within homelessness resettlement work in the UK. In helping to establish the underlying values framework for psychologically-informed services; and also provide tools for such services to use, this paper makes a contribution to help inform developing practice.
Wetland habitat continues to be lost in many watersheds across Canada and new program tools are needed to help restore drained wetlands. We used a reverse auction to restore drained wetlands in the Assiniboine River Watershed (ARW) of east‐central Saskatchewan which is an important target area for wetland restoration in the North American Waterfowl Management Plan (NAWMP). The reverse auction format was discriminative, with sealed bids and two rounds of bidding. Bidders could submit bids for 12‐year term agreements and/or perpetual conservation easements, and bids were submitted by quarter section (160 acres). Bids could be either in cultivated cropland or perennial forage, and were evaluated using an environmental benefits index based on the incremental increase in predicted hatched waterfowl nests relative to bid price. Potential bidders were solicited via contacts with existing conservation project cooperators, and a public media campaign. In the first round, 20 bidders submitted 118 bids to restore 713 wetlands totaling 670 acres at a price of $837,000. All bids were for 12‐year term agreements. Bid prices to restore drained wetlands within cultivated land were higher than for perennial forage. In the second round, 30 bids from seven bidders were approved to restore 211 wetlands totaling 211 acres in perennial forage at a price of $182,000. The price of successful bids varied from $20.83 to $391.22 per acre per year (average $118.52). The reverse auction provided information on cost variability and funding required for achieving NAWMP wetland restoration objectives in the ARW. La perte d'habitats humides dans de nombreux bassins hydrographiques du Canada se poursuit, d'où la nécessité d'élaborer de nouveaux programmes et outils pour favoriser la restauration des milieux humides qui ont été drainés. Nous avons procédéà une enchère inversée en ligne pour restaurer les milieux humides drainés dans le bassin hydrographique de la rivière Assiniboine dans la partie du centre‐est de la Saskatchewan, qui constitue une zone cible importante de la restauration des milieux humides dans le Plan nord‐américain de la gestion de la sauvagine (PNAGS). L'enchère inversée en ligne était discriminatoire et comprenait des offres secrètes et deux tours d'enchère. Les enchérisseurs pouvaient soumettre des offres soit pour des ententes d'une durée de douze ans, soit pour des servitudes de conservation perpétuelles, pour une superficie de un quart de section (160 acres) dans les deux cas. Les offres, qui pouvaient comprendre des terres cultivées ou des terres couvertes de plantes fourragères vivaces, ont étéévaluées à l'aide d'un indice des avantages environnementaux fondé sur l'augmentation progressive du nombre prévu d'œufs éclos dans les nids de sauvagine par rapport au prix offert. Nous avons joint des enchérisseurs potentiels par l'intermédiaire des coordinateurs de projets de conservation existants et de campagnes de publicité‐médias. Au premier tour, 20 enchérisseurs ont soumis 118 offres pour restaurer 713 milieux humides totalisant 670 acres, au prix de 837 000$. Toutes les offres visaient des ententes de douze ans. Le prix des offres pour restaurer les milieux humides drainés à l'intérieur des terres cultivées était plus élevé que le prix des offres pour restaurer les milieux humides drainés à l'intérieur des terres couvertes de plantes fourragères vivaces. Au deuxième tour, trente offres soumises par sept enchérisseurs ont été retenues pour restaurer 211 milieux humides totalisant 211 acres de terres couvertes de plantes fourragères vivaces, au prix de 182 000$. Le prix des offres retenues variait de 20,83$à 391,22$ l'acre par année (moyenne de 118,52$). L'enchère inversée en ligne a permis d'obtenir de l'information sur la variabilité des coûts et le financement nécessaire pour atteindre les objectifs de restauration des milieux humides du PNAGS dans le bassin hydrographique de la rivière Assiniboine.
The Northfield Experiments took place at Hollymoor Hospital, Northfield, Birmingham, during World War II. The first experiment was conducted by Bion & Rickman. The second evolved gradually; many people contributed to its success, including Foulkes, Main and Bridger. The experiments were an important landmark in the evolution of theory and practice in group psychotherapy and in the therapeutic community movement. They were not carried out solely as responses to the need for mass treatment of neurotic disorders among army personnel; antecedent factors, the theoretical orientation of the practitioners and the nature of army life were equally important. The two experiments differed in pace and in recognition of the needs of higher-order systems, particularly the military hierarchy. They shared many underlying concepts, including responsibility to society, the therapeutic use of groups (including the hospital community) and an emphasis on process. Lessons learned at Northfield remain relevant to the practice of psychiatry today.
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