Culture clash? Recovery in mental health under Australia's National Disability Insurance Scheme - a case study

Objective: Using a case study, we aim to report on the compatibility of funding and policy settings under Australia’s National Disability Insurance Scheme (NDIS) with the delivery of evidence based, recovery-oriented psychosocial services. Type of program or service: We refect on the impact of the NDIS on a psychosocial rehabilitation service run by Woden Community Service (WCS), one of the major service providers in the Australian Capital Territory, and specifcally its Transition to Recovery (TRec) program. Methods: We examine NDIS funding and policy settings and consider the recovery-oriented practices underpinning psychosocial programs like TRec. The construct of the program, its staffng and related issues are considered. The article draws on a formal evaluation of TRec conducted in 2015. Results: The NDIS is having a seismic impact on Australia’s psychosocial sector. Despite its positive evaluation, the future of the TRec program is problematic. Practically, service exit points have disappeared, reducing the program’s capacity to properly transition clients between services and effectively increasing the likelihood of relapse. More generally, current NDIS policies are threatening the fdelity of WCS’s approach to recovery practice. Lessons learnt: This case study highlights tension between a new public insurance scheme primarily aimed at better managing consistent conditions and circumstances, and the recovery philosophy which has emerged in relation to episodic mental illness. This has implications for psychosocial services nationwide. The psychosocial rehabilitation sector has always been a peripheral element of Australia’s mental health service mix. The advent of the NDIS offers hope that this may change. However, WCS’s experience suggests that the NDIS must reconsider how best to foster recovery-oriented practice in mental health. This should be part of a more fundamental reconceptualisation of the role of psychosocial rehabilitation services in contemporary mental health care, not just for NDIS recipients. This work is urgent if Australia is to nurture its already rare psychosocial rehabilitation workforce and not see it dissipate

Integrative and comparative genomic analyses identify clinically relevant pulmonary carcinoid groups and unveil the supra-carcinoids

International audienceThe worldwide incidence of pulmonary carcinoids is increasing, but little is known about their molecular characteristics. Through machine learning and multi-omics factor analysis, we compare and contrast the genomic profiles of 116 pulmonary carcinoids (including 35 atypical), 75 large-cell neuroendocrine carcinomas (LCNEC), and 66 small-cell lung cancers. Here we report that the integrative analyses on 257 lung neuroendocrine neoplasms stratify atypical carcinoids into two prognostic groups with a 10-year overall survival of 88% and 27%, respectively. We identify therapeutically relevant molecular groups of pulmonary car-cinoids, suggesting DLL3 and the immune system as candidate therapeutic targets; we confirm the value of OTP expression levels for the prognosis and diagnosis of these diseases, and we unveil the group of supra-carcinoids. This group comprises samples with carcinoid-like morphology yet the molecular and clinical features of the deadly LCNEC, further supporting the previously proposed molecular link between the low-and high-grade lung neuroendocrine neoplasms

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

BIOGRAPHY

Jill Buckley Smith is an Information Specialist and one of the four enthusiastic librarians in the HealthInsite Editorial Team. Jill has worked in the electronic information services area since the late 1970s, initially with the Education Information Service at the National Library in Canberra, and then in Computer Based Search Services and the National Library’s Reference and Information Services. She moved from there to the Commonwealth Department of Health’s library in the early 1990s and later managed the HealthROM CDROM product. In 1998, when the Department of Health was funded to create a health website for Australians, Jill, Prue and Stephanie formed the original ‘content ’ team for the project, which aimed to make it easy for health information consumers to find quality health information on the Internet. Prue brought her cataloguing and indexing skills to develop the metadata specifications for the project, while Stephanie contributes both reference and cataloguing experience to the team in maintaining HealthInsite’s topic pages, liaising with information partners and answering user enquiries. Jill manages the HealthInsite quality assessment process and topic page creation and maintenance. Russell joined the team in late 2000, havin

Acute effects of whole-body vibration on muscle activity, strength, and power

McBride. Acute effects of whole-body vibration on muscle activ-ity, strength, and power. J. Strength Cond. Res. 20(2):257±261. 2006.—The purpose of this study was to investigate the effects of a single bout of whole-body vibration on isometric squat (IS) and countermovement jump (CMJ) performance. Nine moder-ately resistance-trained men were tested for peak force (PF) dur-ing the IS and jump height (JH) and peak power (PP) during the CMJ. Average integrated electromyography (IEMG) was measured from the vastus medialis, vastus lateralis, and biceps femoris muscles. Subjects performed the 2 treatment conditions, vibration or sham, in a randomized order. Subjects were tested for baseline performance variables in both the IS and CMJ, and were exposed to either a 30-second bout of whole-body vibration or sham intervention. Subjects were tested immediately follow-ing the vibration or sham treatment, as well as 5, 15, and 30 minutes posttreatment. Whole-body vibration resulted in a sig-nificantly higher (p # 0.05) JH during the CMJ immediately following vibration, as compared with the sham condition. No significant differences were observed in CMJ PP; PF during IS or IEMG of the vastus medialis, vastus lateralis, or biceps fe-moris during the CMJ; or IS between vibration and sham trea-ments. Whole-body vibration may be a potential warm-up pro-cedure for increasing vertical JH. Future research is warranted addressing the influence of various protocols of whole-body vi-bration (i.e., duration, amplitude, frequency) on athletic perfor-mance