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With the precipitous changes of the platform formerly known as Twitter, brought on by the change of ownership in late 2022, many networked educators sought, and continue to seek, new digital spaces to continue fostering and developing their digital practice. The authors of this article had all been actively networked on Twitter, and wanted to explore these changes in their professional worlds. As we sought out these spaces we critically began to interrogate our own practices on this platform to gain a deeper understanding of our practice going forward. We’ve approached this exploration through three vectors: an examination of the terms we use to describe movement from platform to platform, digital identity formation and disruption, and building human connection in digital spaces. The findings from our exploration yielded the following conclusions: (1) With regard to metaphors of movement (i.e., “migration”) we leave space open as to which metaphor to use as no metaphor is a perfect fit to explain the complexity of this phenomenon. (2) Digital identity/ies are multifaceted and sometimes place-specific, but some networked affordances seemed to encourage an ever-evolving digital identity more than other spaces. (3) Finally, digital spaces afford us the ability to carve out our own communities from the wider academic community, in the process developing a more owned and voiced identity. However as social media platforms are fleeting, those connections – and identities – are in danger of getting co-opted or deleted as platforms rise and fall.

We live in times of certain uncertainty with Higher Education in constant need of reflexive adaptation. The Reimagining Higher Education project, funded by the Association for Learning Development in Higher Education (ALDinHE), explored creatively and playfully the future of education. It invited the academic community to participate in workshops to reflect on the current status of Higher Education and, at the same time, to conceptualise what form a humane and integrated Learning Development, the holistic and sustainable fostering of academic literacies and practices, would take within that Higher Education system. The outcome is an open-source guide of Higher Education models, real and idealised, that potentially have the power to change perspectives and attitudes. In this short presentation, we (the project team) will showcase the guide, outlining what a more inclusive, empowering, and creative academia would look like. Our research participants have imaged the unimaginable: universities open, accessible, full of trust, care and laughter. Please join us to further reflect on the future of academia, with hope and positivity.

With the precipitous changes of the platform formerly known as Twitter, brought on by the change of ownership in late 2022, many networked educators sought, and continue to seek, new digital spaces to continue fostering and developing their digital practice. The authors of this article had all been actively networked on Twitter, and wanted to explore these changes in their professional worlds. As we sought out these spaces we critically began to interrogate our own practices on this platform to gain a deeper understanding of our practice going forward. We've approached this exploration through three vectors: an examination of the terms we use to describe movement from platform to platform, digital identity formation and disruption, and building human connection in digital spaces. The findings from our exploration yielded the following conclusions: (1) With regard to metaphors of movement (i.e., "migration") we leave space open as to which metaphor to use as no metaphor is a perfect fit to explain the complexity of this phenomenon. (2) Digital identity/ies are multifaceted and sometimes place-specific, but some networked affordances seemed to encourage an ever-evolving digital identity more than other spaces. (3) Finally, digital spaces afford us the ability to carve out our own communities from the wider academic community, in the process developing a more owned and voiced identity. However as social media platforms are fleeting, those connections -- and identities -- are in danger of getting co-opted or deleted as platforms rise and fall.

Academic writing in Higher Education (HE) is contested practice freighted with meaning, never more so than for widening participation students, still placed as ‘outsiders’ and often left feeling unwelcome and ‘un-voiced’. Ironically, as Molinari (2022) argues, universities were originally more diverse in form and content, not heavily ‘literate’ but oral, discursive and creative. As HE has become ostensibly more ‘open’ the system has become more normative, more formally rule-bound, more ‘written’ – and hence more exclusive. A recent example in the UK is the Office for Students’ attack on inclusive assessment, pushing instead for more emphasis on spelling, punctuation and grammar. Alongside this tension, many in the Learning Development (LD) community feel that discipline academics do not see the ‘teaching’ of academic writing as part of their pedagogic and assessment repertoire, preferring to send students to LD ‘to be fixed’. However, academics and LDs engaged in discussion and free writing (Elbow 1998, 1999) on this topic at a LondonMet L&T Conference presented views that were more nuanced and sympathetic. There was a deep appreciation of the ‘real’ work that academic writing does with and for students; but also a sense that they did not know how to build writing into their practice(s). And so was born this staff Guide: a playful, creative and yet intensely practical guide for academic staff who want to empower their students to write – often, playfully, experimentally – on their way to ‘becoming’, and becoming academic. Presenting the Guide in the resource showcase allowed us to highlight the continuing centrality of writing. Lecturers and university staff can use it to engage students in ‘writing to learn’ rather than ‘learning to write’.

Community mental health care in the UK was established by two influential mental health acts (MHAs). The 1930 MHA legislated for voluntary admissions and outpatient clinics. The 1959 MHA required hospitals to provide local follow- up after discharge, required them to work closely with local social services and obliged social services to help with accommodation and support. An effect of this was to establish highly sectorized services for populations of about 50,000. These were served by multidisciplinary teams (generic CMHTs), which accepted all local referrals from family doctors. Sector CMHTs evolved a pragmatic approach with an emphasis on skill-sharing and outreach, depending heavily on community psychiatric nurses. The NHS is funded by central taxation, with no distortion of clinical practice by per-item service fees. It is highly centrally regulated, with a strong emphasis on evidence-based treatments. Since 2000, generic sector teams have gradually been replaced or enhanced by Crisis Resolution Home Treatment teams, Assertive Outreach Teams and Early Intervention Teams. Assertive Outreach Teams were resorbed into CMHTs, based on outcome evidence. The last decade has seen a major expansion in outpatient psychotherapy (Improving Access to Psychological Treatments (IAPT) services) and in specialist teams for personality disorders and perinatal psychiatry. The traditional continuity of care across the inpatient-outpatient divide has recently been broken. During the last decade of austerity, day care services have been decimated, and (along with the reduction in availability of beds) compulsory admission rates have risen sharply. Mental health care is still disadvantaged, receiving 11% of the NHS spend while accounting for 23% of the burden of disease.

There is a feeling in the Learning Development community – and in academia more generally – that discipline staff see the academic writing of students as a problem better ‘fixed’ by others. However, staff at a writing workshop held within a learning and teaching conference revealed positions that were more nuanced, inflected, compassionate and ‘responsible’ than this. Writing collaboratively around the words produced by staff at our workshop, led to new insights into ways that staff could support student writing as an emergent practice. We decided to collect and share the many ways that discipline staff might be encouraged to harness writing in their own curriculum spaces: a staff guide on supporting writing and other forms of learning and assessment emerged. In this paper we discuss collaborative writing as a method of inquiry as we explore the contested terrain of academic writing, challenge the notion of ‘writing skills’, and model a more emergent form of exploratory writing.

Introduction The primary aim of the National Institute of Health Research-funded global health research group, Warwick-India-Canada (WIC), is to reduce the burden of psychotic disorders in India. India has a large pool of undetected and untreated patients with psychosis and a treatment gap exceeding 75%. Evidence-based packages of care have been piloted, but delivery of treatments still remains a challenge. Even when patients access treatment, there is minimal to no continuity of care. The overarching ambition of WIC programme is to improve patient outcomes through (1) developing culturally tailored clinical interventions, (2) early identification and timely treatment of individuals with mental illness and (3) improving access to care by exploiting the potential of digital technologies.Methods and analysis This multicentre, multicomponent research programme, comprising five work packages and two cross-cutting themes, is being conducted at two sites in India: Schizophrenia Research Foundation, Chennai (South India) and All India Institute of Medical Sciences, New Delhi (North India). WIC will (1) develop and evaluate evidence-informed interventions for early and first-episode psychosis; (2) determine pathways of care for early psychosis; (3) investigate the efficacy and cost-effectiveness of community care models, including digital and mobile technologies; (4) develop strategies to reduce the burden of mental illnesses among youth; (5) assess the economic burden of psychosis on patients and their carers; and (6) determine the feasibility of an early intervention in psychosis programme in India.Ethics and dissemination This study was approved by the University of Warwick’s Biomedical and Scientific Research Ethics Committee (reference: REGO-2018-2208), Coventry, UK and research ethics committees of all participating organisations. Research findings will be disseminated through peer-reviewed scientific publications, presentations at learnt societies and visual media.

This paper maps our experience of conceptualising and teaching an interdisciplinary first-year undergraduate ‘Higher Education Orientation’ module against the seminal paper written by Lea and Street in 1998. We argue for third spaces within the curriculum and for practices that re-imagine what education is and what the university could be.

This case study illustrates what happened when we took a playful approach in a first year undergraduate academic skills module and a graduate Facilitating Student Learning module asking our students to “draw to learn.” We found that they not only enjoyed the challenges we set them, but also that they “blossomed” and approached their academic writing with more confidence and joy. Hence we argue for a more ludic approach to learning and teaching in Higher Education to enable Widening Participation students and their tutors to become the academic writers they want to be. In particular “blind drawing” seems to be a powerful tool for diminishing the fear of failure and for fostering deep understanding as well as self-confidence.

Abstract Background Patient reported outcome measures (PROMs) are widely used in mental healthcare research for quality of life assessment but most fail to capture the breadth of health and non-health domains that can be impacted. We report the psychometric validation of a novel, multi-dimensional instrument based on Amartya Sen’s capability approach intended for use as an outcome measure in mental health research. Methods The Oxford Capabilities Questionnaire for Mental Health (OxCAP-MH) is a 16-item self-complete capability measure that covers multiple domains of functioning and welfare. Data for validation of the instrument were collected through a national randomised controlled trial of community treatment orders for patients with psychosis. Complete OxCAP-MH data were available for 172 participants. Internal consistency was established with Cronbach’s alpha; an interclass correlation coefficient was used to assess test-retest reliability in a sub-sample (N = 50) tested one week apart. Construct validity was established by comparing OxCAP-MH total scores with established instruments of illness severity and functioning: EuroQol (EQ-5D), Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF) and Objective Social Outcomes Index (SIX). Sensitivity was established by calculating standard error of measurement using distributional methods. Results The OxCAP-MH showed good internal consistency (Cronbach’s alpha 0.79) and test-retest reliability (ICC = 0.86). Convergent validity was evidenced by strong correlations with the EQ-5D (VAS 0.52, p

Abstract Background In 2008, the Mental Health Act (MHA) 2007 amendments to the MHA 1983 were implemented in England and Wales. The amendments were intended to remove perceived obstacles to the detention of high risk patients with personality disorders (PDs), sexual deviance and learning disabilities (LDs). The AMEND study aimed to test the hypothesis that the implementation of these changes would lead to an increase in numbers or proportions of patients with these conditions who would be assessed and detained under the MHA 2007. Method A prospective, quantitative study of MHA assessments undertaken between July–October 2008–11 at three English sites. Data were collected from local forms used for MHA assessment documentation and patient electronic databases. Results The total number of assessments in each four month period of data collection varied: 1034 in 2008, 1042 in 2009, 1242 in 2010 and 1010 in 2011 (n = 4415). Of the assessments 65.6% resulted in detention in 2008, 71.3% in 2009, 64.7% in 2010 and 63.5% in 2011. There was no significant change in the odds ratio of detention when comparing the 2008 assessments against the combined 2009, 2010 and 2011 data (OR = 1.025, Fisher‘s exact Χ 2 p = 0.735). Only patients with LD and ‘any other disorder or disability of the mind’ were significantly more likely to be assessed under the MHA post implementation (Χ2 = 5.485, P = 0.018; Χ2 = 24.962, P > 0.001 respectively). There was no significant change post implementation in terms of the diagnostic category of detained patients. Conclusions In the first three years post implementation, the 2007 Act did not facilitate the compulsory care of patients with PDs, sexual deviance and LDs.

Abstract Background Most studies investigating the effectiveness of Community Treatment Orders (CTOs) use readmission to hospital as the primary outcome. Another aim of introducing CTOs was to improve continuity of care. Our study was a 3-year prospective follow-up which tested for associations between CTOs and continuity of care. Methods Our study sample included 333 patients recruited to the Oxford Community Treatment Order Trial (OCTET). We collected data on continuity of care using eight previously operationalized measures. We analysed the association between CTOs and continuity of care in two ways. First, we tested the association between continuity of care and OCTET randomisation arm (CTO versus voluntary care via Section 17 leave). Second, we analysed continuity of care and CTO exposure independent of randomisation; using any exposure to CTO, number of days on CTO, and proportion of outpatient days on CTO as outcomes. Results 197 (61%) patients were made subject to CTO during the 36-month follow-up. Randomisation to CTO arm was significantly associated with having a higher proportion of clinical documents copied to the user but no other measures of continuity. Having a higher proportion of outpatient days on CTO (irrespective of randomisation) was associated with fewer 60 day breaks without community contact. A sensitivity analysis found that any exposure to CTO and a higher proportion of outpatient days on CTO were associated with fewer days between community mental health team contacts and 60 day breaks without contact. Conclusion We found some evidence of an association between CTO use and better engagement with the community team in terms of increased contact and fewer breaks in care. Those with CTO experience had a higher number of inpatient admissions which may have acted as a mediator of this association. We found limited evidence for an association between CTO use and other measures of continuity of care.

Background The appropriate medical treatment test (ATT), included in the Mental Health Act (MHA) (1983, as amended 2007), aims to ensure that detention only occurs when treatment with the purpose of alleviating a mental disorder is available. Aims As part of the Assessing the Impact of the Mental Health Act (AMEND) project, this qualitative study aimed to assess professionals' understanding of the ATT, and its impact on clinical practice. Method Forty-one professionals from a variety of mental health subspecialties were interviewed. Interviews were coded related to project aims, and themes were generated in an inductive process. Results We found that clinicians are often wholly relied upon for the ATT. Considered treatment varied depending on the patient's age rather than diagnosis. The ATT has had little impact on clinical practice. Conclusions Our findings suggest the need to review training and support for professionals involved in MHA assessments, with better-defined roles. This may enable professionals to implement the ATT as its designers intended.

This case study shows how we have used textscrolls to address academic reading in our Facilitating Student Learning postgraduate module. We outline how we explored with staff the potential of the textscroll to offer a more welcoming, accessible, collaborative and dialogic encounter with reading than the codex (bound book or article). Drawing briefly on a literature review commissioned when part of the LearnHigher Centre for Excellence in Teaching and Learning, we consider reading not just as a semantic or linguistic activity but as a socio-political one, especially for those, like our students, who are typically placed as educational outsiders. We harness the work of Dave Middlebrook (one of our co-authors) and his discussion of the power relations of the bound text and the liberatory potential of the unrolled textscroll. We conclude with an example of what happened when one of our staff participants took scrolls back to her third year Design students, and we argue that utilising emancipatory teaching practices can make higher education more inclusive.

Este trabalho estuda relatos escritos da Primeira Guerra Mundial (1914-1918) através de uma análise da classificação do gênero e as estratégicas narrativas usadas por escritores clássicos e contemporâneos britânicos e canadenses. Verifica-se que as narrativas mais recentes incluem muitos temas importantes da literatura clássica bem como outros novos, de acordo com as mudanças sociais que tem ocorrido desde então. Na metodologia, os relatos contemporâneos mostram diferenças significativas da obra clássica, uma vez que aquelas tratem da questão de que como um evento que não se lembre mais possa ser recuperado ou reconstruído.

Background: Coercion comprises formal coercion or compulsion [treatment under a section of the Mental Health Act (MHA)] and informal coercion (a range of treatment pressures, including leverage). Community compulsion was introduced in England and Wales as community treatment orders (CTOs) in 2008, despite equivocal evidence of effectiveness. Little is known about the nature and operation of informal coercion. Design: The programme comprised three studies, with associated substudies: Oxford Community Treatment Order Evaluation Trial (OCTET) – a study of CTOs comprising a randomised controlled trial comparing treatment on CTO to voluntary treatment via Section 17 Leave (leave of absence during treatment under section of the MHA), with 12-month follow-up, an economic evaluation, a qualitative study, an ethical analysis, the development of a new measure of capabilities and a detailed legal analysis of the trial design; OCTET Follow-up Study – a follow-up at 36 months; and Use of Leverage Tools to Improve Adherence in community Mental Health care (ULTIMA) – a study of informal coercion comprising a quantitative cross-sectional study of leverage, a qualitative study of patient and professional perceptions, and an ethical analysis. Participants: Participants in the OCTET Study were 336 patients with psychosis diagnoses, currently admitted involuntarily and considered for ongoing community treatment under supervision. Participants in the ULTIMA Study were 417 patients from Assertive Outreach Teams, Community Mental Health Teams and substance misuse services. Outcomes: The OCTET Trial primary outcome was psychiatric readmission. Other outcomes included measures of hospitalisation, a range of clinical and social measures, and a newly developed measure of capabilities – the Oxford Capabilities Questionnaire – Mental Health. For the follow-up study, the primary outcome was the level of disengagement during the 36 months. Results: Community treatment order use did not reduce the rate of readmission [(59 (36%) of 166 patients in the CTO group vs. 60 (36%) of 167 patients in the non-CTO group; adjusted relative risk 1.0 (95% CI 0.75 to 1.33)] or any other outcome. There were no differences for any subgroups. There was no evidence that it might be cost-effective. Qualitative work suggested that CTOs’ (perceived) focus on medication adherence may influence how they are experienced. No general ethical justification was found for the use of a CTO regime. At 36-month follow-up, only 19 patients (6% of 329 patients) were no longer in regular contact with services. Longer duration of compulsion was associated with longer time to disengagement (p = 0.023) and fewer periods of discontinuity (p

This paper explores integrated peer mentoring in the context of offering students an element of choice in their assignments. We decided to undertake a pilot study with a group of first year undergraduate education-studies students who come from non-traditional backgrounds, but the concept is widely applicable. We argue that creative approaches to assignment practice can promote inclusion and give students, not traditionally welcome in the academy, ownership, voice and pride.

Background: Poor adherence to long-term antipsychotic injectable (LAI) medication in patients with psychotic disorders is associated with a range of negative outcomes. No psychosocial intervention has been found to be consistently effective in improving adherence. Objectives: To test whether or not offering financial incentives is effective and cost-effective in improving adherence and to explore patient and clinician experiences with such incentives. Design: A cluster randomised controlled trial with economic and nested qualitative evaluation. The intervention period lasted for 12 months with 24 months’ follow-up. The unit of randomisation was mental health teams in the community. Setting: Community teams in secondary mental health care. Participants: Patients with a diagnosis of schizophrenia, schizoaffective psychosis or bipolar illness, receiving ≤ 75% of their prescribed LAI medication. In total, 73 teams with 141 patients (intervention n = 78 and control n = 63) were included. Interventions: Participants in the intervention group received £15 for each LAI medication. Patients in the control group received treatment as usual. Main outcome measures: Primary outcome: adherence to LAI medication (the percentage of received out of those prescribed). Secondary outcomes: percentage of patients with at least 95% adherence; clinical global improvement; subjective quality of life; satisfaction with medication; hospitalisation; adverse events; and costs. Qualitative evaluation: semistructured interviews with patients in the intervention group and their clinicians. Results: Primary outcome: outcome data were available for 131 patients. Baseline adherence was 69% in the intervention group and 67% in the control group. During the intervention period, adherence was significantly higher in the intervention group than in the control group (85% vs. 71%) [adjusted mean difference 11.5%, 95% confidence interval (CI) 3.9% to 19.0%; p = 0.003]. Secondary outcome: patients in the intervention group showed statistically significant improvement in adherence of at least 95% (adjusted odds ratio 8.21, 95% CI 2.00 to 33.67; p = 0.003) and subjective quality of life (difference in means 0.71, 95% CI 0.26 to 1.15; p = 0.002). Follow-ups: after incentives stopped, adherence did not differ significantly between groups, neither during the first 6 months (adjusted difference in means –7.4%, 95% CI –17.0% to 2.1%; p = 0.175) nor during the period from month 7 to month 24 (difference in means –5.7%, 95% CI –13.1% to 1.7%; p = 0.130). Cost-effectiveness: the average costs of the financial incentives was £303. Overall costs per patient were somewhat higher in the intervention group, but the difference was not significant. Semistructured interviews: the majority of patients and clinicians reported positive experiences with the incentives beyond their monetary value. These included improvement in the therapeutic relationship. The majority of both patients and clinicians perceived no negative impact after the intervention was stopped after 1 year. Conclusions: Financial incentives are effective in improving adherence to LAI medication. Health-care costs (including costs of the financial incentive) are unlikely to be increased substantially by this intervention. Once the incentives stop, the advantage is not maintained. The experiences of both patients and clinicians are largely, but not exclusively, positive. Whether or not financial incentives are effective for patients with more favourable background, those on oral mediation or for shorter or longer time periods remains unknown. Trial registration: Current Controlled Trials ISRCTN77769281. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 70. See the NIHR Journals Library website for further project information.

Este artigo discute o romance For Whom the Bell Tolls, 1940 [Por quem os sinos dobram], do escritor e jornalista americano Ernest Hemingway, uma ficção sobre a Guerra Civil Espanhola que o autor escreveu na Espanha enquanto servia como correspondente de guerra. O romance, favorável à causa legalista, parece assumir uma posição mais política que os romances e histórias anteriores de Hemingway, mas, na verdade, desenvolve mais uma variação do típico “herói de Hemingway”, celebrado em quase toda a obra do autor: o indivíduo solitário, corajoso, destinado ao fracasso, mas determinado a extrair algum significado da vida em um mundo absurdo.

This article examines the adaptation of an historical person, the Air-Force officer and CIA operative named Edward G. Landsdale, as a model for fictional characters in three novels – English, American, and French – dealing with the early years of the Americaninvolvement in Vietnam. Landsdale’s political career and the historical background of his contribution to the creation of the anti-Communist state of South Vietnam is outlined, followed by an examination of his fictionalization in Graham Greene’s The Quiet American (1955), Eugene Burdick and William J. Lederer’s The Ugly American (1958), and Jean Lartéguy’s Yellow Fever (Eng. Transl. 1965). It is seen that Greene’s model is disputed, whileall three novels actually underestimate Landsdale’s historical importance.Neste artigo, examina-se a adaptação de uma pessoa histórica, o oficial da Força Aérea e agente da CIA Edward G. Landsdale, como modelo para personagens ficcionais em três romances – um inglês, um americano e um francês – que abordam os primeiros anos doenvolvimento americano no Vietnã. É delineada sua carreira política, bem como os antecedentes históricos de sua contribuição para a criação do Estado anticomunista do Vietnã do Sul. Em seguida, faz-se um estudo de sua ficcionalização em The Quiet American, de Graham Greene (1955), The Ugly American (1958), de Eugene Burdick e William J. Lederer, e Yellow Fever, de Jean Lartéguy (Tradução inglesa de 1965). Observa-se que o modelo de Greene é questionado, enquanto todos os três romances, na verdade, subestimam a importância histórica de Landsdale.

Aside from documentary films of the First World War, fiction films may be categorized as period films, cinematic aptations of classic war novels, and, much the greatest in number, fiction films made after the war. The period films are useful for their clues to public attitudes during or in the decades immediately after the conflict. For example, silent films made during the war, like D.W. Griffith’s Hearts of the World (1918), which used actual footage, were propaganda evidently intended to induce the United States to progress from economic assistance to active military participation on the side of the Allies. The story of the young man, Ben Herron, going off to war would become typical in fiction films made thereafter, since such stories have elements that a mass audience, many of whom had fathers, sons, husbands, brothers, etc. in the military, can actually identify with. As propaganda, such movies—and this would be the case with the Second World War even more—may serve an important political end, by arguably having a much greater influence on public consciousness than official government propaganda, which usually arouses more suspicion. In fact, the US government during both world wars would make a direct appeal to Hollywood producers. Aside from documentary films of the First World War, fiction films may be categorized as period films, cinematic aptations of classic war novels, and, much the greatest in number, fiction films made after the war. The period films are useful for their clues to public attitudes during or in the decades immediately after the conflict. For example, silent films made during the war, like D.W. Griffith’s Hearts of the World (1918), which used actual footage, were propaganda evidently intended to induce the United States to progress from economic assistance to active military participation on the side of the Allies. The story of the young man, Ben Herron, going off to war would become typical in fiction films made thereafter, since such stories have elements that a mass audience, many of whom had fathers, sons, husbands, brothers, etc. in the military, can actually identify with. As propaganda, such movies—and this would be the case with the Second World War even more—may serve an important political end, by arguably having a much greater influence on public consciousness than official government propaganda, which usually arouses more suspicion. In fact, the US government during both world wars would make a direct appeal to Hollywood producers.

Offering a modest financial incentive to people with psychosis can promote adherence to depot antipsychotic medication, but the cost-effectiveness of this approach has not been examined.Economic evaluation within a pragmatic cluster-randomised controlled trial. 141 patients under the care of 73 teams (clusters) were randomised to intervention or control; 138 patients with diagnoses of schizophrenia, schizo-affective disorder or bipolar disorder participated. Intervention participants received £15 per depot injection over 12 months, additional to usual acute, mental and community primary health services. The control group received usual health services. Main outcome measures: incremental cost per 20% increase in adherence to depot antipsychotic medication; incremental cost of 'good' adherence (defined as taking at least 95% of the prescribed number of depot medications over the intervention period).Economic and outcome data for baseline and 12-month follow-up were available for 117 participants. The adjusted difference in adherence between groups was 12.2% (73.4% control vs. 85.6% intervention); the adjusted costs difference was £598 (95% CI -£4,533, £5,730). The extra cost per patient to increase adherence to depot medications by 20% was £982 (95% CI -£8,020, £14,000). The extra cost per patient of achieving 'good' adherence was £2,950 (CI -£19,400, £27,800). Probability of cost-effectiveness exceeded 97.5% at willingness-to-pay values of £14,000 for a 20% increase in adherence and £27,800 for good adherence.Offering a modest financial incentive to people with psychosis is cost-effective in promoting adherence to depot antipsychotic medication. Direct healthcare costs (including costs of the financial incentive) are unlikely to be increased by this intervention.ISRCTN.com 77769281.

Neste artigo são discutidas as narrativas ficcionais e jornalísticas da Segunda Guerra Mundial no contexto de discórdia da sociedade norte-americana, que esteve dividida entre isolacionistas e intervencionistas durante os primeiros anos da guerra. A participação espontânea na guerra e a dúvida sobre uma percepção clara por que os homens lutavam têm sido questionadas por historiadores revisionistas. Era consenso geral, entanto, que a guerra era tanto justa como necessária. As questões políticas e sociais da guerra, como o totalitarismo, o racismo e outras formas de opressão, não são ignoradas pelas narrativas ficcionais sobre os combates. As narrativas jornalísticas e os filmes de Hollywood ocupam-se mais em mostrar o combatente como representante de valores americanos.

Resumo: o presente trabalho procura estabelecer algumas características do filme anti-guerra a partir da premissa de que as diferenças culturais e raciais dos inimigos de guerra são apagadas e a noção de uma humanidade em comum, emotivamente atraente mas teoricamente problemática, e transmitida ao espectador Argumenta-se, aqui, no entanto, que tal mensagem humanística não constitui uma proposta utópica para pôr fim à guerra, mas sim uma proposta que vem a contrapor a ideologia patriótica usada pelos governos para justificar a guerra. Palavras-chave: filmes de guerra, filmes anti-guerra, patriotismo, humanismo

Aside from documentary films of the First World War, fiction films may be categorized as period films, cinematic aptations of classic war novels, and, much the greatest in number, fiction films made after the war. The period films are useful for their clues to public attitudes during or in the decades immediately after the conflict. For example, silent films made during the war, like D.W. Griffith’s Hearts of the World (1918), which used actual footage, were propaganda evidently intended to induce the United States to progress from economic assistance to active military participation on the side of the Allies. The story of the young man, Ben Herron, going off to war would become typical in fiction films made thereafter, since such stories have elements that a mass audience, many of whom had fathers, sons, husbands, brothers, etc. in the military, can actually identify with. As propaganda, such movies—and this would be the case with the Second World War even more—may serve an important political end, by arguably having a much greater influence on public consciousness than official government propaganda, which usually arouses more suspicion. In fact, the US government during both world wars would make a direct appeal to Hollywood producers.

Este trabalho analisa alguns textos do romancista contemporâneo Don DeLillo, cuja obra Paul Auster diz ser fundamental para compreender a sociedade norte-americana neste fim de século. Nele pretende-se assinalar a natureza dos temas de sua obra e a relevância dos mesmos para um mundo globalizado, destacando-se os tópicos sobre o poder militar, o terrorismo e o poder do capital, tratando, em especial, a hegemonia das linguagens do poder e a resistência a elas.

This paper explores the role that notemaking strategies can play as part of an emancipatory pedagogy designed to empower students. We will argue that being taught active notemaking is fundamental in enabling students to use information with confidence and thus that notemaking allows students to gain a voice (Bowl, 2005; Burns et al., 2006) within their own education. Rather than taking a psychological approach to notemaking, we suggest that notemaking allows students to take ownership of ideas and concepts in powerful ways (Gibbs, 1994 cited Burns and Sinfield, 2004), ways that reinforce understanding and build knowledge. These processes and practices can essentially help students to learn what they want to learn - and, pragmatically, to write essays that are adequately researched and correctly referenced (Burns and Sinfield, 2004). The final focus will be on the collaborative development of NoteMaker, a Reusable Learning Object (RLO) designed for use across the university and across the sector.

Community care has been seen a remarkable expansion in research in the last thirty years. Such research is beset with difficulties including fixing models long enough to get clear comparisons, the absence of consistency in description (particularly of comparator services) and the inevitable contamination from the ‘Pioneer’ effect of highly motivated teams. Assertive Community Treatment (ACT) teams are the most intensively researched but the evidence is contradictory. ACT is a complex intervention and a meta‐regression analysis is reported here that distinguished between the studies in terms of their component parts to identify effective and redundant ingredients. This analysis clari‐ fied the overwhelming impact of variation in comparator services. It also confirmed that the core ingredients in traditional generic CMHTs (multidisciplinary working, home‐based care and combined health and social care) ensured an equally effective outcome to the more intensively staffed and carefully prescribed ACT teams. Community mental health services need not follow one prescriptive model. Developing local services should be guided by the research into how effective aspects of care can be in‐ corporated into locally meaningful structures rather than importing complex systems from other health care cultures.

Este trabalho estuda relatos escritos da Primeira Guerra Mundial (1914-1918) através de uma análise da classificação do gênero e as estratégicas narrativas usadas por escritores clássicos e contemporâneos britânicos e canadenses. Verifica-se que as narrativas mais recentes incluem muitos temas importantes da literatura clássica bem como outros novos, de acordo com as mudanças sociais que tem ocorrido desde então. Na metodologia, os relatos contemporâneos mostram diferenças significativas da obra clássica, uma vez que aquelas tratem da questão de que como um evento que não se lembre mais possa ser recuperado ou reconstruído.