No abstract

The use of nurses' holding power is a poorly explored aspect of psychiatric inpatient care. This study examined the use of Section 5(4) at the Maudsley Hospital, London, since the introduction of the 1983 Mental Health Act. Between 1983 and 1996 nurses' holding powers were used on 25 occasions. Seventy two per cent of patients detained under Section 5(4) of the Mental Health Act 1983 were subsequently detained under Section 5(2). Results were broadly consistent with previous studies, although some significant inconsistencies were observed which can probably be attributed to small sample sizes. Further, multicentre research is needed in order that substantive conclusions can be drawn.

Insufficient priority is being given to meet the physical health-care needs of people with mental illness. Mental health nurses, as the largest professional group working in mental health care, have a pivotal role in improving the physical health and well-being of people with mental illness. Through health-promotion strategies, alongside recovery-focused support aimed at avoiding deteriorating physical health, mental health nurses can significantly contribute to improving the current rate of premature death experienced by people with enduring mental illness. Drawing from contemporary policy, alongside practical examples taken from the published literature, this paper considers what constitutes recommended best practice in dealing with the physical health-care needs of people with mental illness. The role that UK-based health-care policy plays in shaping care delivery that meets the needs of people with mental illness is explored and placed within the context of global health concerns. Recommendations are made on how mental health nursing can work to provide evidence for a reassertion that nurses are well placed to work across organizational and professional boundaries to deliver person-centred care and a holistic approach to population health and well-being.

1. Introduced carnivores are often cryptic, making it difficult to quantify their presence in ecosystems, and assess how this varies in relation to management interventions. Survey design should thus seek to improve detectability and maximize statistical power to ensure sound inference regarding carnivore population trends. Roads may facilitate carnivore movements, possibly leading to high detectability. Therefore, targeting roads may improve inferences about carnivore populations. 2. We assessed our ability to monitor feral cats Felis catus and red foxes Vulpes vulpes on-and off-road, with explicit consideration of the location of monitoring sites on our ability to detect population changes. We also assessed whether there was evidence of spatial or temporal interaction between these species that might influence their roaduse. 3. Surveys were conducted in a conservation reserve in southeastern Australia between 2016 and 2018. At each of 30 sites, we deployed two motion-sensor cameras, one on-road, and the other off-road. Using occupancy models, we estimated cat and fox occupancy and detectability, and conducted a power analysis to assess our ability to detect declines in occupancy under three monitoring regimes (efforts targeted equally on-and off-road, efforts targeted entirely off-road and efforts targeted entirely onroad). 4. On average, on-road detectability was seven times higher for cats and three times higher for foxes. Targeting survey effort on-road yielded the greatest power for detecting declines in both species, but our ability to detect smaller declines decreased with decreasing initial occupancy probability. No level of decline was detectable for cats This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

No single strategy is used or appropriate for managing dual relationships in rural settings. Employers and professional bodies should provide clearer guidance for clinicians both in the management of dual relationships and the distinction between boundary crossings and boundary violation. Clinicians are clearly seeking to represent and protect the patients' interests; consideration should be given by consumer groups to steps that can be taken by patients to reciprocate.