Venturing into schools : locating mental health initiatives in complex environments

Schools provide viable settings for mental health promotion initiatives, such as programs to develop students’ social and emotional capabilities (SEC). Complexity in the school environments into which initiatives are introduced, such as diverse student capabilities, school structures, and teachers’ knowledge and confidence, will play an integral role in the success of those initiatives. This paper investigates the environments of schools about to receive the KidsMatter mental heath promotion, prevention and early intervention initiative in Australia, using information sourced from questionnaires about 2598 students and their teachers in 50 Australian primary schools. The focus of the report is on the status of the schools’ work in one of the key focus areas for the intervention, namely students’ SEC. Analysis showed relatively high levels of students’ SEC across the whole sample, but with sub-group differences. Teachers’ attitudes towards SEC learning were highly positive. Teachers’ self-rated knowledge and approaches in dealing with SEC were moderate, and point to requirements for additional pre-service and professional development. The extent of regular and sustained delivery of SEC programs and mental health initiatives in general showed variability, suggesting the need to attend to school systems and structural supports. Implications of these areas of diversity in school environments on the selection and methods of delivery of mental health promotion programs in schools are discussed.peer-reviewe

"If you are just sick you could make your own chicken soup". But if it's a mental illness "you can't fix yourself". Teaching secondary school students about mental illness.

Published version of the paper reproduced here with permission from the publisher.This paper reports a classroom based investigation into the MindMatters curriculum resource “Understanding Mental Illness” (UMI). We observed the teaching of the UMI module in three secondary classrooms. We measured students’ knowledge, attitudes and behavioural intentions in relation to mental illness before and after teaching of the UMI module. We also held focussed discussions with teachers about teaching the UMI module and teaching about mental illness and mental health in general. Paired sample t-tests on students’ knowledge, attitudes and behavioural intentions, showed statistically significant improvements in students’ scores from pre-teaching to post teaching. Students’ in-class comments also indicated their increasing awareness of issues related to mental illness. Discussions with teachers raised pedagogical issues such as, finding ways to teach about profound issues such as mental illness in non-trivial ways; accommodating differing levels of development of students’ conceptual understandings; and the value of stories for changing people’s knowledge and attitudes. Teachers highlighted a lack of teacher expertise about mental illness and the implications this has for integrating modules such as UMI across the curriculum. Teachers also indicated a need for frameworks of scope and sequence to guide teaching about UMI in particular, and mental health in general

Implementing a new initiative in mental health in Australian primary schools

Published version of the paper reproduced here with permission from the publisher.Student wellbeing is of central concern for parents/caregivers and teachers and for state and national governments. In Australia in recent times several major initiatives have been undertaken to address the area of student mental health, including the KidsMatter Initiative. Across 2007-8 a trial of KidsMatter was carried out in 101 schools across Australia. Part of the roll-out of KidsMatter was a detailed evaluation of its implementation. Thus, in this paper we report on findings associated with the implementation of the KidsMatter Initiative. Underpinned by a framework of quality, fidelity and dosage (Domitrovich, 2008) we used Latent Class Analysis to create an Implementation Index, which was used to classify KidsMatter schools into high implementation and low implementation categories. Profiles of the high and low categories provide insights to the characteristics of successful and less successful implementation. This analysis shows the influence of factors associated with both the KidsMatter initiative and the environments in the sites where KidsMatter was implemented

KidsMatter Early Childhood Evaluation Report

KidsMatter Early Childhood is the Australian national early childhood mental health promotion, prevention and early intervention initiative specifically developed for early childhood services. It was trialled in 111 long day care services and preschools during 2010 and 2011. KMEC involves the people who have a significant influence on young children’s lives – parents, carers, families and early childhood educators, along with a range of community and health professionals – in making a positive difference to young children’s mental health and wellbeing during this important developmental period. The KMEC initiative provides a framework to enable services to plan and implement evidencebased mental health promotion, prevention and early intervention strategies. These strategies aim to improve the mental health and wellbeing of children from birth to school age, reduce mental health difficulties among children, and achieve greater support for children experiencing mental health difficulties and their families.KidsMatter Australian Early Childhood Mental Health Initiative was developed through collaboration between beyondblue, the Australian Psychological Society and Early Childhood Australia, and with funding from the Australian Government Department of Health and Ageing and beyondblue

Involvement in Bullying During High School: A Survival Analysis Approach

© 2018 Springer Publishing Company. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This author accepted manuscript is made available following 12 month embargo from date of publication (June 2018) in accordance with the publisher’s archiving policyKnowledge about the risks of bullying involvement during any year of high school is an important element of interventions for changing the likelihood of being bullied. Three cohorts of Australian students (n = 1,382) were tracked from 7th grade to 11th grade. The study showed that some students continue their involvement in bullying, while in addition, new bullies and new victims emerge during each high school year. The findings indicated that the risk of bullying involvement ranged from 16% (as a bully) to 36% (as a victim), increasing to 54.5% and 56.3%, respectively, if a student was a bully or a victim in 7th grade. The risk to students of becoming victims, bullies, or bully–victims in each year of high school suggests that bullying prevention initiatives should be designed to suit students at different stages of adolescent development

KidsMatter Primary Evaluation Final Report

KidsMatter is an approach to the promotion of good mental health, the prevention of mental illness, and early intervention where problems arise. It requires a whole-of-school approach and has four key components – a positive school community; social and emotional learning for students; parenting support and education and early intervention for students with mental health difficulties. Based on approaches already tested by the World Health Organization and the American Collaborative for Academic, Social and Emotional Learning, it has been adapted to suit Australian conditions.KidsMatter Primary and KidsMatter Early Childhood are being conducted in collaboration between beyondblue: the national depression initiative, which is contributing funding of $3.5 million, the Australian Psychological Society, Principals Australia and Early Childhood Australia

Does implementation matter if comprehension is lacking? A qualitative investigation into perceptions of advance care planning in people with cancer

Purpose: While advance care planning holds promise, uptake is variable and it is unclear how well people engage with or comprehend advance care planning. The objective of this study was to explore how people with cancer comprehended Advance Care Plans and examine how accurately advance care planning documentation represented patient wishes. Methods: This study used a qualitative descriptive design. Data collection comprised interviews and an examination of participants’ existing advance care planning documentation. Participants included those who had any diagnosis of cancer with an advance care plan recorded: Refusal of Treatment Certificate; Statement of Choices; and/or Enduring Power of Attorney (Medical Treatment) at one cancer treatment centre. Results: Fourteen participants were involved in the study. Twelve participants were female (86%). The mean age was 77 (range: 61-91) and participants had completed their advance care planning documentation between 8 and 72 weeks prior to the interview (mean 33 weeks). Three themes were evident from the data: Incomplete advance care planning understanding and confidence; Limited congruence for attitude and documentation; Advance care planning can enable peace of mind. Complete advance care planning understanding was unusual; most participants demonstrated partial comprehension of their own advance care plan, and some indicated very limited understanding. Participants’ attitudes and their written document congruence was limited, but advance care planning was seen as helpful. Conclusions: This study highlighted advance care planning was not a completely accurate representation of patient wishes. There is opportunity to improve how patients comprehend their own advance care planning documentation

P-Rex1 directly activates RhoG to regulate GPCR-driven Rac signalling and actin polarity in neutrophils

ABSTRACT G-protein-coupled receptors (GPCRs) regulate the organisation of the actin cytoskeleton by activating the Rac subfamily of small GTPases. The guanine-nucleotide-exchange factor (GEF) P-Rex1 is engaged downstream of GPCRs and phosphoinositide 3-kinase (PI3K) in many cell types, and promotes tumorigenic signalling and metastasis in breast cancer and melanoma, respectively. Although P-Rex1-dependent functions have been attributed to its GEF activity towards Rac1, we show that P-Rex1 also acts as a GEF for the Rac-related GTPase RhoG, both in vitro and in GPCR-stimulated primary mouse neutrophils. Furthermore, loss of either P-Rex1 or RhoG caused equivalent reductions in GPCR-driven Rac activation and Rac-dependent NADPH oxidase activity, suggesting they both function upstream of Rac in this system. Loss of RhoG also impaired GPCR-driven recruitment of the Rac GEF DOCK2, and F-actin, to the leading edge of migrating neutrophils. Taken together, our results reveal a new signalling hierarchy in which P-Rex1, acting as a GEF for RhoG, regulates Rac-dependent functions indirectly through RhoG-dependent recruitment of DOCK2. These findings thus have broad implications for our understanding of GPCR signalling to Rho GTPases and the actin cytoskeleton

The Effect of Pre-Injury Anti-Platelet Therapy on the Development of Complications in Isolated Blunt Chest Wall Trauma: A Retrospective Study

INTRODUCTION: The difficulties in the management of the blunt chest wall trauma patient in the Emergency Department due to the development of late complications are well recognised in the literature. Pre-injury anti-platelet therapy has been previously investigated as a risk factor for poor outcomes following traumatic head injury, but not in the blunt chest wall trauma patient cohort. The aim of this study was to investigate pre-injury anti-platelet therapy as a risk factor for the development of complications in the recovery phase following blunt chest wall trauma. METHODS: A retrospective study was completed in which the medical notes were analysed of all blunt chest wall trauma patients presenting to a large trauma centre in Wales in 2012 and 2013. Using univariate and multivariable logistic regression analysis, pre-injury platelet therapy was investigated as a risk factor for the development of complications following blunt chest wall trauma. Previously identified risk factors were included in the analysis to address the influence of confounding. RESULTS: A total of 1303 isolated blunt chest wall trauma patients presented to the ED in Morriston Hospital in 2012 and 2013 with complications recorded in 144 patients (11%). On multi-variable analysis, pre-injury anti-platelet therapy was found to be a significant risk factor for the development of complications following isolated blunt chest wall trauma (odds ratio: 16.9; 95% confidence intervals: 8.2-35.2). As in previous studies patient age, number of rib fractures, chronic lung disease and pre-injury anti-coagulant use were also found to be significant risk factors. CONCLUSIONS: Pre-injury anti-platelet therapy is being increasingly used as a first line treatment for a number of conditions and there is a concurrent increase in trauma in the elderly population. Pre-injury anti-platelet therapy should be considered as a risk factor for the development of complications by clinicians managing blunt chest wall trauma

Out of the Pacific and Back Again: Insights into the Matrilineal History of Pacific Killer Whale Ecotypes

Killer whales (Orcinus orca) are the most widely distributed marine mammals and have radiated to occupy a range of ecological niches. Disparate sympatric types are found in the North Atlantic, Antarctic and North Pacific oceans, however, little is known about the underlying mechanisms driving divergence. Previous phylogeographic analysis using complete mitogenomes yielded a bifurcating tree of clades corresponding to described ecotypes. However, there was low support at two nodes at which two Pacific and two Atlantic clades diverged. Here we apply further phylogenetic and coalescent analyses to partitioned mitochondrial genome sequences to better resolve the pattern of past radiations in this species. Our phylogenetic reconstructions indicate that in the North Pacific, sympatry between the maternal lineages that make up each ecotype arises from secondary contact. Both the phylogenetic reconstructions and a clinal decrease in diversity suggest a North Pacific to North Atlantic founding event, and the later return of killer whales to the North Pacific. Therefore, ecological divergence could have occurred during the allopatric phase through drift or selection and/or may have either commenced or have been consolidated upon secondary contact due to resource competition. The estimated timing of bidirectional migration between the North Pacific and North Atlantic coincided with the previous inter-glacial when the leakage of fauna from the Indo-Pacific into the Atlantic via the Agulhas current was particularly vigorous