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The paper sets out the work of the Mental Health Unit, part of the Health and Offender Partnerships Directorate. It explains the functions of the Unit in advising and taking decisions on behalf of the Home Secretary in exercising his powers in relation to dangerous mentally disordered offenders. It also sets out the work of the Unit in relation to the new Mental Health Bill. The Unit's role in developing Government policy in relation to mentally disordered offenders is not covered here.

Healthcare employs informatics to offer its services through information technology where the social network can aid virtual medical learning. Since the usage of the internet and other electronic tools for medical services delivery is at the initial stage, it is essential to examine the factors that condition patients and medical elements in a virtual environment can develop relationship models on the health services. So, the authors have systematically reviewed virtual medical learning and offered some suggestions for the upcoming works. The authors have also discovered gaps in the state-of-the-art papers and provided solutions for them.

Numerous novel advancements have changed the old exercise of therapeutic and analytic learning. Virtual spaces have quickly turned into a section of the learning technology vision. Given the importance of its achievements and endless low-cost expansion of the educational system, virtual education has been considered as one of the issues raised by the information communities. Medicine and health are some of the most important fields in virtual technologies. Hence, in this paper, we have used a systematic literature review to deeply examine virtual medical learning. After establishing exclusion and inclusion criteria, an independent systematic search in Google Scholar, ACM, Scopus, Eric, Science Direct, Springer link, Emerald, Global ProQuest and IEEE for relevant studies have been performed, and 21 papers have been analyzed. Detailed data have been mined out of the papers.

The authors have found that virtual medical learning improves and expands the knowledge core and meaningfully affects the exercise. Virtual learning (VL) has been used in many therapeutic zones, like therapeutic learning, surgery, diagnosing, combining and regularizing processes. It has presented a fundamental access point and a referral mechanism for all of a course's component communities. It can also simplify communicative education, allowing learners to get abilities before applying them in a real-world situation. Also, the communicative characteristics of different VL programs can somehow be like direct teaching.

Some excellent work may be removed owing to applying the filters to select the primary papers. Surveying all the documents on the topic of virtual medical learning is impossible, too. Nevertheless, the authors have tried to present a perfect survey of virtual medical learning. The results will be helpful for scholars to propose better virtual medical learning techniques.

E-learning has become an indispensable additional learning tool in medical education. The introduction of new learning technologies, the exponential growth of Internet usage and the advent of the World Wide Web can change the face of higher education. The results will be helpful for scholars for the upcoming works. The application of a literature review of partial least squares theory was useful for offering comprehensive literary coverage and completing the knowledge development analysis. The authors have backed scholars and experts for better understanding the development of virtual medical learning systems via presenting comparative data and scrutinizing the present advances.

The paper enhances intellectual knowledge by improving the conception of virtual medical learning. It informs the development, use of virtual medical learning and the upcoming works. The lack of comprehensive papers in this field has increased the importance of this paper. The present paper can handle the pace of publications.

Confounding is of central importance in epidemiologic studies. Its definition has been under wide debate over the past decades. The classical definition is straightforward and easy-to-implement. Nevertheless, it is data-driven and has drawbacks. The more recent counterfactual definition captures the essential roles a confounder plays in causal inference. It would be beneficial for researchers to grasp substantive knowledge in causal structure and broadly adopt the latter definition. There are various methods of handling confounding issues. The choice of one option over another depends on various factors, including the nature of the study, sample size and rarity of events.

Since 1990 the National Health Service (NHS) has undergone a sustained period of change. This change has been necessary to prepare the NHS for the task of meeting a demand for services that continues to rise more rapidly than the availability of resources. Anecdotal evidence suggests that one of the most popular ways for trusts to improve their ability to meet demand is through mergers with other trusts. However, little rigorous research has been conducted to assess the extent or effectiveness of this strategy. A research project was, therefore, initiated to better understand the extent and impact of merger activity within the NHS. A questionnaire was developed and distributed to the chief executive, finance director, medical director and human resources director in all the 460 trusts that are currently members of the NHS confederation. In total the survey generated 459 responses out of a possible total of 1,840; an encouraging response rate of 25 per cent. The results of this research provide significant new evidence that “merger mania” has taken hold within the NHS. While 46 per cent of all responding trusts indicated that they had already merged, are actively involved in a merger, proposing to merge or are talking to prospective partners, a further 18.7 per cent of all trusts are forming strategic alliances rather than opting for a full merger. The dominant justification for merging are the beliefs that it will facilitate the reconfiguration of services and ultimately improve patient care. The paper concludes with a discussion of the significance of these results, before making recommendations with regard to their implications for future merger activity within the NHS.

Using data from the General Social Survey (2002), structural equation modeling is employed to examine the intersections and relationships between various socio-demographic and contextual variables, patient trust, and patient preference for behaviors that indicate a desire to be an active health care participant. In so doing, a gap in the literature is addressed by uniting previous research on patient trust with research on patient participation. Findings reveal that patient trust in doctors and various socio-demographic and contextual variables are associated with people wanting to participate in the health care process by learning about medical issues on their own and by contributing to medical decisions. Results also shed new light on past research, which finds a relationship between various socio-demographic variables and patient trust. Specifically, they highlight the importance of distinguishing between patient trust in doctors and patient trust in the broader health care institution and the economic pressures it exerts on doctors. A discussion of what these findings might mean for our understanding of the doctor-patient relationship and the delivery of health care concludes the chapter.

A high proportion of forensic mental health service users (FSUs) are recalled to secure hospitals from conditional discharge in the community. The limited research on recall to date has preliminarily identified why FSUs are recalled, but not how they make sense of the process. The purpose of this paper is to develop a conceptual understanding of how FSUs make sense of being recalled to hospital.

A constructivist grounded theory approach was used. Semi-structured interviews were carried out with 11 FSUs from different levels of forensic service security who had been recalled varying numbers of times across a wide timeframe.

A theoretical model was constructed to illustrate the process of how FSUs make sense of being recalled. FSUs appraise being recalled on a continuum from negative to positive, based on their experiences when conditionally discharged and their reflections on the circumstances of being recalled. The nature of their appraisal appears to reciprocally influence their subsequent attitudes towards and their engagement with forensic services.

The proposed mechanism of how FSUs make sense of being recalled, particularly their dynamic appraisal of it, should now be investigated longitudinally. Future qualitative research could explore forensic service staff perspectives on recall.

Enhancing the positivity of FSUs’ appraisals about being recalled may improve their attitudes about and engagement with forensic services.

This is the first research study to construct a theoretical model of recall.

The purpose of this paper is to indicate that when webotherapy is applied, it can be of benefit to clients in giving them insight into their problems, resulting in a change of behavior.

Webotherapy, which can be conducted with individuals or groups, refers to the use of web resources or other online reading material (e.g. e‐books, e‐journals) to assist clients (especially children and young adults) in their healing process. It may be defined as the use of web resources to help others gain additional insight and to help them cope with everyday life. Most people have probably read web resources to determine how others have approached a delicate issue.

This paper suggests that webotherapy is a potentially powerful method for psychologists, librarians, schoolteachers and counselors to use on many levels. It begins with a brief review of the history of webotherapy, continues with a discussion of some approaches to webotherapy (developmental, clinical, and interactive), then addresses the four basic stages of webotherapy (identification, selection, presentation, and follow‐up), and finally discusses the benefits and limitations of webotherapy.

The paper discusses webotherapy and offers a review of literature on related fields.

This paper deals with a problem relevant to the development and use of the Electronic Patient Record, and in particular looks forward to the time when such records are shared between large numbers of health carers. It asks questions concerning decision‐making about how much of the health care record an individual Health Care Practitioner of any stated specialism (notionally in the British National Health Service, but generally applicable) should be able to see of the record, in relation to his or her perceived need. The authors conclude that a Health Care Practitioner meeting the criteria for a Health Care Professional should largely determine the information he or she needs to allow the practice of good health care (“need‐to‐know”). On the other hand those whose work does not accord them Health Care Professional status should, where appropriate, be granted access to data by the Health Care Professionals for whom they work (“allowed‐to‐know”). Finally, it presents and briefly describes an object‐oriented model to illustrate the authors’ conclusions.

The process of statutory community aftercare for restricted hospital order service users is acknowledged as successful. Previous research examining the attitudes of forensic psychiatrists to the use of restriction orders has indicated that they view them as a useful clinical tool in some circumstances, particularly where there is evidence of previous breakdown of follow‐up. This study, as part of a larger project examining the effectiveness of statutory community aftercare, focused on the attitudes of social supervisors to the process of conditional discharge and their role within it. The findings showed that social supervisors agree that there are positive and negative aspects to the process. They overwhelmingly agreed that the legal framework ensured that service users continued engagement with psychiatric services, leading to enhanced compliance with treatment and follow‐up, but recognised that, at times, the role, because of its control aspect, created tension in the social worker‐service user relationship. Social supervisors suggested that investment should be made into providing appropriate accommodation for this group of people and, where appropriate, access to drug and alcohol misuse services.

The purpose of this paper is to explore the experience and possibilities for misdiagnosis of women with ASD in secure and forensic hospitals, via the medium of a lived experience case study. To consider the clinical value of the patient perspective of and insight into their disorder. The case study is supplemented by relevant associations to the MHA Code of Practice, the CQC report, Monitoring the Mental Health Act (MHA) 2016–2017, published on 27 February 2018 and current research findings in the fields of service provision, quality of care and treatment of female patients with a diagnosis of ASD.

A review and commentary of the author’s lived experience of a formal diagnostic assessment for ASD as a female patient in a secure and forensic hospital. In reviewing aspects of the author’s clinical assessment, the author has made contextual reference to the MHA Code of Practice, the CQC report, Monitoring the MHA 2016–2017, published on 27 February 2018, and current research findings. The account focuses on aspects of the author’s recent experience assessment and treatment for ASD which the author believes may be of use in informing clinical practice.

Open-ended exploration of a lived experience account/case study of a diagnostic assessment of an adult female patient for ASD, demonstrating the possible ambiguity of responses to questionnaire-based assessment tools and other deficiencies inherent to the assessment process and care and treatment of adult female ASD sufferers in secure and forensic hospitals.

The author uses the lived experience as a patient to review and provide commentary on the clinical assessment for ASD. This review is, therefore, informed by an authentic patient perspective and not clinical perspectives. This paper highlights the need for further research into the diagnostic assessment of females for ASD in a secure and forensic hospitals.

First, to encourage practitioners to extend their range of thinking to be more inclusive of the patient perspective when performing a diagnostic assessment. Second, to increase practitioner awareness of the deficiencies in the current service provision for adult female patients diagnosed with ASD in secure and forensic hospitals.

To improve patient experience of diagnostic assessment for ASD and the quality of the assessment and patient outcomes in secure and forensic hospitals.

The paper is original in concept in that it considers the inclusion of patient experience/views in assessment and formulation and links them to wider social policy and practice guidance. The case study is an authentic patient account informed by the author’s experience of secure and forensic psychiatric hospitals. The value of the paper may be determined by the extent to which the paper encourages practitioners to consider the patient perspective and experience of the diagnostic assessment and how this and subsequent care and treatment may affect the adult female patient in secure and forensic hospitals.