Transformational Education through Intercultural Service Learning Immersions

The article  describes how the intercultural ministry students at Avondale College in Australia learn to engage new cultures and ways of relating

Calculation of disease dynamics in a population of households

Early mathematical representations of infectious disease dynamics assumed a single, large, homogeneously mixing population. Over the past decade there has been growing interest in models consisting of multiple smaller subpopulations (households, workplaces, schools, communities), with the natural assumption of strong homogeneous mixing within each subpopulation, and weaker transmission between subpopulations. Here we consider a model of SIRS (susceptible-infectious-recovered-suscep​tible) infection dynamics in a very large (assumed infinite) population of households, with the simplifying assumption that each household is of the same size (although all methods may be extended to a population with a heterogeneous distribution of household sizes). For this households model we present efficient methods for studying several quantities of epidemiological interest: (i) the threshold for invasion; (ii) the early growth rate; (iii) the household offspring distribution; (iv) the endemic prevalence of infection; and (v) the transient dynamics of the process. We utilize these methods to explore a wide region of parameter space appropriate for human infectious diseases. We then extend these results to consider the effects of more realistic gamma-distributed infectious periods. We discuss how all these results differ from standard homogeneous-mixing models and assess the implications for the invasion, transmission and persistence of infection. The computational efficiency of the methodology presented here will hopefully aid in the parameterisation of structured models and in the evaluation of appropriate responses for future disease outbreaks

Hydroecological impacts of climate change modelled for a lowland UK wetland

Conservation management of wetlands often rests on modifying hydrological functions to establish or maintain desired flora and fauna. Hence the ability to predict the impacts of climate change is highly beneficial. Here, the physically based, distributed model MIKE SHE was used to simulate hydrology for the Lambourn Observatory at Boxford, UK. This comprises a 10 ha lowland riparian wetland protected for conservation, where the degree of variability in the peat, gravel and chalk geology has clouded hydrological understanding. Notably, a weathered layer on the chalk aquifer surface seals it from overlying deposits, yet is highly spatially heterogeneous. Long-term monitoring yielded observations of groundwater and surface water levels for model calibration and validation. Simulated results were consistent with observed data and reproduced the effects of seasonal fluctuations and in-channel macrophyte growth. The adjacent river and subsidiary channel were found to act as head boundaries, exerting a general control on water levels across the site. Discrete areas of groundwater upwellings caused raised water levels at distinct locations within the wetland. These were concurrent to regions where the weathered chalk layer is absent. To assess impacts of climate change, outputs from the UK Climate Projections 2009 ensemble of global climate models for the 2080s are used to obtain monthly percentage changes in climate variables. Changes in groundwater levels were taken from a regional model of the Chalk aquifer. Values of precipitation and evapotranspiration were seen to increase, whilst groundwater levels decreased, resulting in the greater dominance of precipitation. The discrete areas of groundwater upwelling were seen to diminish or disappear. Simulated water levels were linked to specific requirements of wetland plants using water table depth zone diagrams. Increasing depth of winter and summer groundwater levels leads to a loss of Glyceria maxima and Phragmites australis, principal habitat for the endangered Vertigo moulinsiana. Further, the reduced influx of base-rich groundwater and increased dominance of high pH rain-fed waters alters the acidity of the soil. This leads to changes in species composition, with potential reductions in Carex paniculata, Caltha palustris and Typha latifolia

The Journey Home- Guiding Intangible Knowledge Production in the Analysis of Ancestral Remains (Final Report)

This study, co-developed by David Schaepe, Director, Stó:lo Research and Resource Management Centreand Susan Rowley, Associate Professor, Department of Anthropology, University of British Columbia, stems from the Journey Home Project, a repatriation of ancestral remains from the UBC Lab of Archaeology (LOA) to the Stó:lo Nation of southwestern B.C.    For the Stó:lo, knowing as much as possible about these ancestors informs their process. How can scientific research address Stó:lo questions and aid this repatriation? Opportunity recently arose for scientific study, stimulating a Stó:lo-LOA dialogue touching on multiple issues of scientific process, knowledge production and intellectual property. What types of anthropological research and scientific analyses can be applied to answer community-based questions? What are the details and cultural implications of analyses — both destructive and non-destructive? Who decides which questions to ask and which means of research to implement? Who interprets the results? Who owns those data? How do ‘scientific’ and ‘cultural’ ways of knowing relate? Who is allowed to share in and benefit from this knowledge? These questions are central to the Stó:lo ’s relationship with both their ancestors and LOA.   This study aims to provide guidelines for generating knowledge within a mutually acceptable framework of authority, control, and use. These critical issues are at the forefront of our conversations as we work together to complete The Journey Home

Liaison psychiatry—measurement and evaluation of service types, referral patterns and outcomes (LP-MAESTRO): a protocol

Introduction: We describe the protocol for a project that will use linkage of routinely collected NHS data to answer a question about the nature and effectiveness of liaison psychiatry services in acute hospitals in England. Methods and analysis: The project will use three data sources: (1) Hospital Episode Statistics (HES), a database controlled by NHS Digital that contains patient data relating to emergency department (ED), inpatient and outpatient episodes at hospitals in England; (2) ResearchOne, a research database controlled by The Phoenix Partnership (TPP) that contains patient data relating to primary care provided by organisations using the SystmOne clinical information system and (3) clinical databases controlled by mental health trusts that contain patient data relating to care provided by liaison psychiatry services. We will link patient data from these sources to construct care pathways for patients who have been admitted to a particular hospital and determine those patients who have been seen by a liaison psychiatry service during their admission. Patient care pathways will form the basis of a matched cohort design to test the effectiveness of liaison intervention. We will combine healthcare utilisation within care pathways using cost figures from national databases. We will compare the cost of each care pathway and the impact of a broad set of health-related outcomes to obtain preliminary estimates of cost-effectiveness for liaison psychiatry services. We will carry out an exploratory incremental cost-effectiveness analysis from a whole system perspective. Ethics and dissemination: Individual patient consent will not be feasible for this study. Favourable ethical opinion has been obtained from the NHS Research Ethics Committee (North of Scotland) (REF: 16/NS/0025) for Work Stream 2 (phase 1) of the Liaison psychiatry—measurement and evaluation of service types, referral patterns and outcomes study. The Confidentiality Advisory Group at the Health Research Authority determined that Section 251 approval under Regulation 5 of the Health Service (Control of Patient Information) Regulations 2002 was not required for the study ‘on the basis that there is no disclosure of patient identifiable data without consent’ (REF: 16/CAG/0037). Results of the study will be published in academic journals in health services research and mental health. Details of the study methodology will also be published in an academic journal. Discussion papers will be authored for health service commissioners

The nature and activity of liaison mental services in acute hospital settings: a multi-site cross sectional study

Background: To describe the clinical activity patterns and nature of interventions of hospital-based liaison psychiatry services in England. Methods: Multi-site, cross-sectional survey. 18 acute hospitals across England with a liaison psychiatry service. All liaison staff members, at each hospital site, recorded data on each patient they had face to face contact with, over a 7 day period. Data included location of referral, source of referral, main clinical problem, type of liaison intervention employed, staff professional group and grade, referral onto other services, and standard assessment measures. Results: A total of 1475 face to face contacts from 18 hospitals were included in the analysis, of which approximately half were follow-up reviews. There was considerable variation across sites, related to the volume of Emergency Department (ED) attendances, number of hospital admissions, and work hours of the team but not to the size of the hospital (number of beds). The most common clinical problems were co-morbid physical and psychiatric symptoms, self-harm and cognitive impairment. The main types of intervention delivered were diagnosis/formulation, risk management and advice. There were differences in the type of clinical problems seen by the services between EDs and wards, and also differences between the work conducted by doctors and nurses. Almost half of the contacts were for continuing care, rather than assessment. Eight per cent of all referrals were offered follow up with the LP team, and approximately 37% were referred to community or other services. Conclusions: The activity of LP services is related to the flow of patients through an acute hospital. In addition to initial assessments, services provide a wide range of differing interventions, with nurses and doctors carrying out distinctly different roles within the team. The results show the volume and diversity of LP work. While much clinical contact is acute and confined to the inpatient episode, the LP service is not defined solely by an assessment and discharge function; cases are often complex and nearly half were referred for follow up including liaison team follow up