Background: The use of compulsory treatment under the Mental Health Act (MHA) has continued to rise in the UK and in other countries. The Joint Crisis Plan (JCP) is a statement of service users' wishes for treatment in the event of a future mental health crisis. It is developed with the clinical team and an independent facilitator. A recent pilot RCT showed a reduction in the use of the MHA amongst service users with a JCP. The JCP is the only intervention that has been shown to reduce compulsory treatment in this way. The CRIMSON trial aims to determine if JCPs, compared with treatment as usual, are effective in reducing the use of the MHA in a range of treatment settings across the UK. Methods/Design: This is a 3 centre, individual-level, single-blind, randomised controlled trial of the JCP compared with treatment as usual for people with a history of relapsing psychotic illness in Birmingham, London and Lancashire/Manchester. 540 service users will be recruited across the three sites. Eligible service users will be adults with a diagnosis of a psychotic disorder (including bipolar disorder), treated in the community under the Care Programme Approach with at least one admission to a psychiatric inpatient ward in the previous two years. Current inpatients and those subject to a community treatment order will be excluded to avoid any potential perceived pressure to participate. Research assessments will be conducted at baseline and 18 months. Following the baseline assessment, eligible service users will be randomly allocated to either develop a Joint Crisis Plan or continue with treatment as usual. Outcome will be assessed at 18 months with assessors blind to treatment allocation. The primary outcome is the proportion of service users treated or otherwise detained under an order of the Mental Health Act (MHA) during the follow-up period, compared across randomisation groups. Secondary outcomes include overall costs, service user engagement, perceived coercion and therapeutic relationships. Sub-analyses will explore the effectiveness of the JCP in reducing use of the MHA specifically for Black Caribbean and Black African service users (combined). Qualitative investigations with staff and service users will explore the acceptability of the JCPs. Discussion: JCPs offer a potential solution to the rise of compulsory treatment for individuals with psychotic disorders and, if shown to be effective in this trial, they are likely to be of interest to mental health service providers worldwide.
A range of economic dimensions is examined, including trade in goods and services (notably tourism), direct foreign investment, international migration, and development assistance. Following a brief review of the evolving relationship from 1959 to 1990, the nature of the economic relationship between Canada and Cuba is analyzed in more detail for the 1990 to 2009 era.
223 p., Argues that certain iconic poems have shaped the canon of American poetry. Not merely "canonical" in the usual sense, iconic poems enjoy a special cultural sanction and influence; they have become discourses themselves, generating our notions about American poetry. By "iconic" the author means extraordinarily famous works like Henry Wadsworth Longfellow's "Paul Revere's Ride," Walt Whitman's "Song of Myself," and Claude McKay's "If We Must Die," that do not merely reside in the national memory but that have determined each poet's reception and thus have shaped the history of American poetry.
The emergence of a modeling industry in Jamaica that valorizes idiosyncratic style has opened up a space in which black images of beauty take center stage. Caribbean Fashion Week is the major platform for displaying internationally acclaimed Jamaican models. Showcasing a high percentage of decidedly black male and female models wearing spectacular designer clothes, Caribbean Fashion Week enables multiple readings of the body as cultural text. The permissive modeling aesthetic engenders capricious images of beauty that contest the very conception of the 'model' as a mold into which a singular figure of beauty is impressed.
Cubans are wildly optimistic about the transformations that will occur once the United States lifts its long-standing embargo on Cuba. Overlooked in these discussions, however, is how Cuba's health-care industry may be harmed by any serious easing of trade and travel restrictions between the two countries.
Harriet Tubman, William Hall and Mifflin Wistar Gibbs were among those whose courage and conviction advanced our nascent society's ideals of freedom and equality. Thousands braved a perilous path to freedom through the Underground Railroad, conducted by valiant leaders like Harriet Tubman.
Manuel,Zapata Olivella (Author) and Darío,Henao Restrepo (Author)
Format:
Book, Whole
Language:
Spanish
Publication Date:
2010
Published:
Bogotá: Ministerio de Cultura
Location:
African American Research Center, Library, University of Illinois at Urbana-Champaign
Notes:
667 p, An extensive novel on the African diaspora in the Americas covering five hundred years of history. Covers black heroes, Yoruba religion, fairy tales and songs of African tradition.
