The Walk-in Counselling Model of Service Delivery: Who Benefits Most?

The walk-in counselling (WIC) model of service delivery has been found to reduce psychological distress more quickly than a traditional model of service delivery involving a wait list. A question remains, however, as to the relative benefit of the WIC model for different client groups. The present study uses graphical inspection and multilevel modeling to conduct moderator analyses comparing two agencies, one with a WIC clinic and the other with a traditional wait list approach, and their relative impact on psychological distress. Key findings regarding the differential benefits for different types of presenting problems as well as clients at different stages of change are discussed. La recherche montre qu\u27un service de consultation sans rendez-vous réduit la détresse psychologique plus rapidement qu\u27un modèle traditionnel fonctionnant avec liste d\u27attente. Les bénéfices relatifs du modèle de consultation sans rendez-vous pour différentes clientèles demeurent cependant méconnus. Cette étude utilise l\u27inspection de graphiques et la modélisation multiniveau afin de mener une analyse de modération qui compare deux cliniques: sans rendez-vous ou suivant le modèle traditionnel avec liste d\u27attente. L\u27étude examine les impacts relatifs de ces modèles sur la détresse psychologique. Les principaux résultats portent sur les bénéfices différentiels selon les problématiques de santé mentale présentées et selon les stades de changement des usagers

Cost-effectiveness analysis of single-session walk-in counselling

Background: An increasing number of family service agencies and community-based mental health service providers are implementing a single-session walk-in counselling (SSWIC) as an alternative to traditional counselling. However, few economic evaluations have been undertaken. Aims: To conduct a cost-effectiveness analysis of two models of service delivery, SSWIC compared to being waitlisted for traditional counselling. Methods: A quasi-experimental design was employed. Data were collected from two community-based Family Service Agencies, one using SSWIC and one using traditional counselling. Participants were assessed at baseline and four weeks after the baseline. Cost-effectiveness was estimated from the societal and payer’s perspective. Results: The societal and payer’s costs for SSWIC were higher than for those waiting for traditional counselling, and health outcomes were better. SSWIC is not cost-effective compared to being on the waitlist for traditional counselling (or, for a few patients, having received counselling, but after a wait of several weeks). Conclusions: SSWIC has the potential to reduce the pressure on the mental health care system by reducing emergency visits and wait lists for ongoing mental health services and eliminating costly-no shows at counselling appointments. Long-term studies involving multiple walk-in counselling services and comparison services are needed to support the findings of this study

Founder cell configuration drives competitive outcome within colony biofilms

Bacteria can form dense communities called biofilms, where cells are embedded in a self-produced extracellular matrix. Exploiting competitive interactions between strains within the biofilm context can have potential applications in biological, medical, and industrial systems. By combining mathematical modelling with experimental assays, we reveal that spatial structure and competitive dynamics within biofilms are significantly affected by the location and density of the founder cells used to inoculate the biofilm. Using a species-independent theoretical framework describing colony biofilm formation, we show that the observed spatial structure and relative strain biomass in a mature biofilm comprising two isogenic strains can be mapped directly to the geographical distributions of founder cells. Moreover, we define a predictor of competitive outcome that accurately forecasts relative abundance of strains based solely on the founder cells’ potential for radial expansion. Consequently, we reveal that variability of competitive outcome in biofilms inoculated at low founder density is a natural consequence of the random positioning of founding cells in the inoculum. Extension of our study to non-isogenic strains that interact through local antagonisms, shows that even for strains with different competition strengths, a race for space remains the dominant mode of competition in low founder density biofilms. Our results, verified by experimental assays using Bacillus subtilis, highlight the importance of spatial dynamics on competitive interactions within biofilms and hence to related applications

When high similarity copycats lose and moderate similarity copycats gain: The impact of comparative evaluation

Copycats imitate features of leading brands to free ride on their equity. The prevailing belief is that the more similar copycats are to the leader brand, the more positive their evaluation is, and thus the more they free ride. Three studies demonstrate when the reverse holds true: Moderate-similarity copycats are actually evaluated more positively than high-similarity copycats when evaluation takes place comparatively, such as when the leader brand is present rather than absent. The results demonstrate that blatant copycats can be less and subtle copycats can be more perilous than is commonly believed. This finding has implications for marketing theory and practice and trademark law

A comparison of walk-in counselling and the wait list model for delivering counselling services

Background: Walk-in counselling has been used to reduce wait times but there are few controlled studies to compare outcomes between walk-in and the traditional model of service delivery. Aims: To compare change in psychological distress by clients receiving services from two models of service delivery, a walk-in counselling model and a traditional counselling model involving a wait list Method: Mixed methods sequential explanatory design including quantitative comparison of groups with one pre-test and two follow ups, and qualitative analysis of interviews with a subsample. 524 participants 16 years and older were recruited from two Family Counselling Agencies; the General Health Questionnaire assessed change in psychological distress; prior use of other mental health and instrumental services was also reported. Results: Hierarchical linear modelling revealed clients of the walk-in model improved faster and were less distressed at the 4-week follow-up compared to the traditional service delivery model. At the 10-week follow-up, both groups had improved and were similar. Participants receiving instrumental services prior to baseline improved more slowly. Qualitative interviews confirmed participants valued the accessibility of the walk-in model. Conclusions: This study improves methodologically on previous studies of walk-in counselling, an approach to service delivery that is not conducive to randomized controlled trials

Thiosemicarbazones active against Clostridium difficile

A set of closely related furylidene thiosemicarbazones was prepared and screened against various clinically important Gram-positive bacteria. One compound containing an ethylene spacer and a 5-nitrofuryl group was found to have promising activity against Clostridium difficile

Nine Tolkien Scholars Respond to Charles W. Mills’s “The Wretched of Middle-Earth: An Orkish Manifesto”

In spite of being written over three decades ago, Mills’s posthumously published “Manifesto” not only anticipates but transcends the majority, if not the totality, of the scholarship on Tolkien, race, and racisms which has been published since 2003. Scholars in philosophy and related fields familiar with Mills’s work will recognize that the essay was a “critical exploration of [how] a fictional racial hierarchy strikingly illuminates the ongoing influence of certain old racist ideas on our present day [sic] social realities.” Reid has invited a wide-ranging Tolkienists who have read the essay to respond, briefly, on the significance of the essay to their wor

Comparison of functional and anatomical estimations of visual acuity in two species of coral reef fish

The high-contrast, complex patterns typical of many reef fish serve several purposes, including providing disruptive camouflage and a basis for vision-based communication. In trying to understand the role of a specific pattern, it is important to first assess the extent to which an observer can resolve the pattern, itself determined, at least in part, by the observer's visual acuity. Here, we studied the visual acuity of two species of reef fish -and- using both anatomical and behavioural estimates. The two species share a common habitat but are members of different trophic levels (predator versus herbivore/omnivore) and perform different visual tasks. On the basis of the anatomical study, we estimated visual acuity to lie between 4.1 and 4.6\ua0cycles\ua0degforand 3.2 and 3.6 cycles degforBehavioural acuity estimates were considerably lower, ranging between 1.29 and 1.36 cycles degforand 1.61 and 1.71 cycles degforOur results show that two species from the same habitat have only moderately divergent visual capabilities, despite differences in their general life histories. The difference between anatomical and behavioural estimates is an important finding as the majority of our current knowledge on the resolution capabilities of reef fish comes from anatomical measurements. Our findings suggest that anatomical estimates may represent the highest potential acuity of fish but are not indicative of actual performance, and that there is unlikely to be a simple scaling factor to link the two measures across all fish species