Improving responses to depression and related disorders: evaluation of a innovative, general, mental health care workers training program

<p>Abstract</p> <p>Background</p> <p>Australian General Practitioners have been beneficiaries of extensive training in mental health care delivery over the last few years but less so other workers who support those with mental illness. Training is needed as it is widely recognised that the most effective interventions to prevent and treat mental disorders are often not readily available. The Mental Health Aptitudes into Practice (MAP) training package is a broad, innovative, interdisciplinary, general mental health training aimed at improving responses to individuals with depression and related disorders. The modular structure of this training program meant that such training could be targeted at those with varied backgrounds. Two hundred and seventy one days of free MAP training was delivered across Victoria in 2004/2005. The evaluation reported here assessed whether changes occurred in the trainees' confidence, mental health literacy, attitudes towards effective treatments, mental health knowledge and skills and community mental health ideology following training.</p> <p>Methods</p> <p>These elements were assessed using pen and paper tests prior, immediately following, 6 months after and then 12 months after the training. Trainees' confidence, mental health literacy and social distance were measured using scales that have been used in evaluations of Mental Health First Aid Training. Community mental health ideology was measured using a sub-scale of the Community Attitudes to the Mentally Ill (CAMI) scale. The trainees' knowledge and skills were accessed using instrumentation specifically designed for this evaluation.</p> <p>Results</p> <p>Following training, participants had more confidence in their ability to work with those who have mental health issues and less desire for social distance from them. Participants' knowledge and skills in relation to the treatment of mental disorders increased. These changes were observed immediately after training. The limited existing evidence suggests these changes were sustained six and twelve months later.</p> <p>Conclusions</p> <p>MAP training can be used to develop the capacity and capabilities of mental health workers.</p

Fit for Purpose—Re-Designing Australia’s Mental Health Information System

Background: Monitoring and reporting mental health is complex. Australia's first National Mental Health Strategy in 1992 included a new national commitment to accountability and data collection in mental health. This article provides a narrative review of thirty years of experience. Materials and Methods: This review considers key documents, policies, plans and strategies in relation to the evolution of mental health data and reporting. Documents produced by the Federal and the eight state and territory governments are considered, as well as publications produced by key information agencies, statutory authorities and others. A review of this literature demonstrates both its abundance and limitations. Results: Australia's approach to mental health reporting is characterised by duplication and a lack of clarity. The data available fail to do justice to the mental health services provided in Australia. Mental health data collection and reporting processes are centrally driven, top-down and activity-focused, largely eschewing actual health outcomes, the social determinants of mental health. There is little, if any, link to clearly identifiable service user or carer priorities. Consequently, it is difficult to link this process longitudinally to clinical or systemic quality improvement. Initial links between the focus of national reform efforts and mental health data collection were evident, but these links have weakened over time. Changes to governance and reporting, including under COVID, have made the task of delivering accountability for mental health more difficult. Conclusion: Australia's current approach is not fit for purpose. It is at a pivotal point in mental health reform, with new capacity to use modelled data to simulate prospective mental health reform options. By drawing on these new techniques and learning the lessons of the past, Australia (and other nations) can design and implement more effective systems of planning, reporting and accountability for mental health

Attacking Group Protocols by Refuting Incorrect Inductive Conjectures

Automated tools for finding attacks on flawed security protocols often fail to deal adequately with group protocols. This is because the abstractions made to improve performance on fixed 2 or 3 party protocols either preclude the modelling of group protocols all together, or permit modelling only in a fixed scenario, which can prevent attacks from being discovered. This paper describes Coral, a tool for finding counterexamples to incorrect inductive conjectures, which we have used to model protocols for both group key agreement and group key management, without any restrictions on the scenario. We will show how we used Coral to discover 6 previously unknown attacks on 3 group protocols

Update on Risk Reduction Activities for a Liquid Advanced Booster for NASA's Space Launch System

No abstract availabl

Lower Income Levels in Australia Are Strongly Associated With Elevated Psychological Distress: Implications for Healthcare and Other Policy Areas

Background: Australia is a high-income country with increasing income inequality. It is unclear whether Australia's well-developed mental healthcare system is making a difference to population mental health and the Federal Government has targeted outcomes accountability in service funding strategies. In high-income countries, evidence generally suggests that income inequalities increase mental disorders among the poor. This study examined psychological-distress rates—a marker of mental ill- health—as varying by income among Australians living within and outside of capital cities.Methods: Secondary data analysis was undertaken using the population-level mental health indicator of the Kessler Psychological Distress Scale (K10) as reported for 12,332 adults in the 2011/2012 National Health Survey (NHS) of Australia. K10 scores of 22 and higher indicated high/very-high distress, and 30 and higher denoted very-high distress. Very-high distress levels are strongly predictive of serious mental illness.Results: Among the poorest one-fifth of Australians, 1 in 4 people have psychological distress at a high/very-high level; this compares to about 1 in 20 people in the richest one-fifth of Australians. About 1-in-10 people making up the poorest one-fifth of Australians have current very-high distress, and this reduces to &lt;1-in-50 people in the richest one-fifth. These disparities are consistent both within and outside of capital cities. The national prevalence of elevated distress within income quintiles varies greatly, with Poor/Rich Quintile Ratios of typically 4–5 for high/very-high levels and 7–8 for very-high levels. These effects operate more powerfully in areas marked by higher scores on the Index of Relative Socioeconomic Disadvantage.Conclusions: Altering the strong association of lower income levels in Australia with elevated psychological distress would require a multi-dimensional social policy and healthcare approach. To assess the effectiveness of adopted strategies, population level indicators need to be developed with regular data-collection. The Poor/Rich quintile ratio (P/R QR) for high/very high K10 scores is a potential candidate for a mental health inequality outcome indicator since it is easily calculated from data obtained from a regularly conducted national survey, is easily understood and resonates with a wider audience. Further research on the development of such indicators is also needed

A Case Study of Laser Wind Sensor Performance Validation by Comparison to an Existing Gage

A case study concerning validation of wind speed measurements made by a laser wind sensor mounted on a 190 square foot floating platform in Muskegon Lake through comparison with measurements made by pre-existing cup anemometers mounted on a met tower on the shore line is presented. The comparison strategy is to examine the difference in measurements over time using the paired-t statistical method to identify intervals when the measurements were equivalent and to provide explanatory information for the intervals when the measurements were not equivalent. The data was partitioned into three sets: not windy (average wind speed measured by the cup anemometers ≤ 6.7m/s) windy but no enhanced turbulence (average wind speed measured by the cup anemometers \u3e 6.7m/s), and windy with enhanced turbulence associated with storm periods. For the not windy data set, the difference in the average wind speeds was equal in absolute value to the precision of the gages and not statistically significant. Similar results were obtained for the windy with no enhanced turbulence data set and the average difference was not statistically significant (α=0.01). The windy with enhanced turbulence data set showed significant differences between the buoy mounted laser wind sensor and the on-shore mast mounted cup anemometers. The sign of the average difference depended on the direction of the winds. Overall, validation evidence is obtained in the absence of enhanced turbulence. In addition, differences in wind speed during enhanced turbulence were isolated in time, studied and explained

Perceived need for mental health care and barriers to care in the Netherlands and Australia

This study of Australian and Dutch people with anxiety or depressive disorder aims to examine people's perceived needs and barriers to care, and to identify possible similarities and differences. Data from the Australian National Survey of Mental Health and Well-Being and the Netherlands Study of Depression and Anxiety were combined into one data set. The Perceived Need for Care Questionnaire was taken in both studies. Logistic regression analyses were performed to check if similarities or differences between Australia and the Netherlands could be observed. In both countries, a large proportion had unfulfilled needs and self-reliance was the most frequently named barrier to receive care. People from the Australian sample (N = 372) were more likely to perceive a need for medication (OR 1.8; 95% CI 1.3-2.5), counselling (OR 1.4; 95% CI 1.0-2.0) and practical support (OR 1.8; 95% CI 1.2-2.7), and people's overall needs in Australia were more often fully met compared with those of the Dutch sample (N = 610). Australians were more often pessimistic about the helpfulness of medication (OR 3.8; 95% CI 1.4-10.7) and skills training (OR 3.0; 95% CI 1.1-8.2) and reported more often financial barriers for not having received (enough) information (OR 2.4; 95% CI 1.1-5.5) or counselling (OR 5.9; 95% CI 2.9-11.9). In both countries, the vast majority of mental health care needs are not fulfilled. Solutions could be found in improving professionals' skills or better collaboration. Possible explanations for the found differences in perceived need and barriers to care are discussed; these illustrate the value of examining perceived need across nations and suggest substantial commonalities of experience across the two countries

Models of the SL9 Impacts II. Radiative-hydrodynamic Modeling of the Plume Splashback

We model the plume "splashback" phase of the SL9 collisions with Jupiter using the ZEUS-3D hydrodynamic code. We modified the Zeus code to include gray radiative transport, and we present validation tests. We couple the infalling mass and momentum fluxes of SL9 plume material (from paper I) to a jovian atmospheric model. A strong and complex shock structure results. The modeled shock temperatures agree well with observations, and the structure and evolution of the modeled shocks account for the appearance of high excitation molecular line emission after the peak of the continuum light curve. The splashback region cools by radial expansion as well as by radiation. The morphology of our synthetic continuum light curves agree with observations over a broad wavelength range (0.9 to 12 microns). A feature of our ballistic plume is a shell of mass at the highest velocities, which we term the "vanguard". Portions of the vanguard ejected on shallow trajectories produce a lateral shock front, whose initial expansion accounts for the "third precursors" seen in the 2-micron light curves of the larger impacts, and for hot methane emission at early times. Continued propagation of this lateral shock approximately reproduces the radii, propagation speed, and centroid positions of the large rings observed at 3-4 microns by McGregor et al. The portion of the vanguard ejected closer to the vertical falls back with high z-component velocities just after maximum light, producing CO emission and the "flare" seen at 0.9 microns. The model also produces secondary maxima ("bounces") whose amplitudes and periods are in agreement with observations.Comment: 13 pages, 9 figures (figs 3 and 4 in color), accepted for Ap.J. latex, version including full figures at: http://oobleck.tn.cornell.edu/jh/ast/papers/slplume2-20.ps.g