Building service capacity within a Regional District Mental Health Service: recommendations from an indigenous mental health symposium

[Abstract]: In response to recent developments within the mental health services of south-east Queensland, the Toowoomba District Mental Health Service (TDMHS) has developed a Model of Service Delivery, which outlines the range of services provided for consumers across their lifespan. Indigenous consumers of the TDMHS come from a wide area of communities in the surrounding shires (Rural, remote and metropolitan areas (RRMA) 4-7). It was recognised by the service that Indigenous mental health consumers have unique needs and, because of these needs, this area of service delivery required greater attention and further development. In December 2004, a symposium was organised by the service to bring together a range of speakers and delegates working in the area of Indigenous mental health to discuss issues and work towards developing strategies to enable the service to better meet the needs of Indigenous consumers in this region of south-east Queensland. Issues: The symposium program consisted of keynote speakers and invited papers and culminated with an afternoon workshop that collated the symposium’s main issues and themes around building service capacity for Indigenous mental health consumers. The objective of the workshop was ‘Identifying ways to meet Indigenous mental health needs’. This workshop gave the delegates a chance to reflect, discuss and brainstorm the major issues of concern relating to this question. A group facilitator guided the discussion and organised the delegates into groups to evaluate, debate and propose recommendations for each of the major issues that emerged. Lessons learned: The feedback and discussion arising from the workshop is presented. Sixteen major themes emerged from the workshop. Seven of these were voted by the participants as being dominant and in greatest need of discussion: (1) communication; (2) cultural respect; (3) culturally appropriate clinical tools; (4) supportive management; (5) patient compliance; (6) career structure; and (7) empowerment. These seven themes are discussed and recommendations arising from the workshop are noted

Nuclear magnetic resonance investigation of the heavy fermion system Ce2_2CoAl7_7Ge4_4

We present nuclear magnetic resonance (NMR) and nuclear quadrupole resonance (NQR) measurements performed on single crystalline \ccag{}, a member of a recently discovered family of heavy fermion materials Ce$_2M$Al$_7$Ge$_4$ ($M$ = Co, Ir, Ni, or Pd). Previous measurements indicated a strong Kondo interaction as well as magnetic order below $T_M = 1.8$ K. Our NMR spectral measurements show that the Knight shift $K$ is proportional to the bulk magnetic susceptibility $\chi$ at high temperatures. A clear Knight shift anomaly ($K \not\propto \chi$) is observed at coherence temperatures $T^* \sim 17.5$ K for $H_0 \parallel \hat{c}$ and 10 K for $H_0 \parallel \hat{a}$ at the ${}^{59}$Co site, and $T^* \sim 12.5$ K at the ${}^{27}$Al(3) site for $H_0 \parallel \hat{a}$ characteristic of the heavy fermion nature of this compound. At high temperatures the ${}^{59}$Co NMR spin-lattice relaxation rate $T_1^{-1}$ is dominated by spin fluctuations of the 4$f$ local moments with a weak metallic background. The spin fluctuations probed by ${}^{59}$Co NMR are anisotropic and larger in the basal plane than in the $c$ direction. Furthermore, we find $(T_1TK)^{-1} \propto T^{-1/2}$ at the ${}^{59}$Co site as expected for a Kondo system for $T > T^*$ and $T> T_K$. ${}^{59}$Co NQR \slrr{} measurements at low temperatures indicate slowing down of spin fluctuations above the magnetic ordering temperature $T_M \sim 1.8$ K. A weak ferromagnetic character of fluctuations around $\mathbf{q}=0$ is evidenced by an increase of $\chi T$ versus $T$ above the magnetic ordering temperature. We also find good agreement between the observed and calculated electric field gradients at all observed sites

Barriers to the up-take of telemedicine in Australia - A view from providers

Introduction: The continued poorer health status of rural and remote Australians when compared with their urban counterparts is cause for concern. The use of advanced technology to improve access to health care has the potential to assist in addressing this problem. Telemedicine is one example of such technology which has advanced rapidly in its capacity to increase access to healthcare services or provide previously unavailable services. The important anticipated benefits of greater access to healthcare services are improved health outcomes and more cost-effective delivery

Exploring resilience in rural GP registrars – implications for training

Background: Resilience can be defined as the ability to rebound from adversity and overcome difficult circumstances. General Practice (GP) registrars face many challenges in transitioning into general practice, and additional stressors and pressures apply for those choosing a career in rural practice. At this time of international rural generalist medical workforce shortages, it is important to focus on the needs of rural GP registrars and how to support them to become resilient health care providers. This study sought to explore GP registrars' perceptions of their resilience and strategies they used to maintain resilience in rural general practice

A decade of Australian Rural Clinical School graduates: Where are they and why?

Introduction: The Australian Rural Clinical School (RCS) initiative has been addressing the rural medical workforce shortage at the medical education level for over a decade. A major expectation of this initiative is that it will improve rural medical workforce recruitment and subsequent retention through a rurally based undergraduate clinical training experience. The longitudinal nature of these workforce initiatives means that definitive evidence of its impact on the shortage of rural doctors is yet to be provided; however, to date cross-sectional studies are accumulating a measure of efficacy for these initiatives by monitoring early career factors such as internship location choice and speciality choice of RCS graduates. This article reports on a study in one RCS that is monitoring the impact of rural undergraduate clinical training on trends in workforce participation patterns of its graduates as long as 9 years in the workforce. Career location and speciality choice are reported as well as perspectives on early career intentions and the reality of making career and life decisions as a doctor in the medical workforce

Structural role of the tyrosine residues of cytochrome c

The tertiary structures of horse, tuna, Neurospora crassa, horse [Hse65,Leu67]- and horse [Hse65,Leu74]-cytochromes c were studied with high-resolution 1H n.m.r. spectroscopy. The amino acid sequences of these proteins differ at position 46, which is occupied by phenylalanine in the horse proteins but by tyrosine in the remaining two, and at positions 67, 74 and 97, which are all occupied by tyrosine residues in horse and tuna cytochrome c but in the other proteins are substituted by phenylalanine or leucine, though there is only one such substitution per protein. The various aromatic-amino-acid substitutions do not seriously affect the protein structure

Identifying the dominant personality profiles in medical students: Implications for their well-being and resilience

Purpos

GPU Accelerated Prognostics

Prognostic methods enable operators and maintainers to predict the future performance for critical systems. However, these methods can be computationally expensive and may need to be performed each time new information about the system becomes available. In light of these computational requirements, we have investigated the application of graphics processing units (GPUs) as a computational platform for real-time prognostics. Recent advances in GPU technology have reduced cost and increased the computational capability of these highly parallel processing units, making them more attractive for the deployment of prognostic software. We present a survey of model-based prognostic algorithms with considerations for leveraging the parallel architecture of the GPU and a case study of GPU-accelerated battery prognostics with computational performance results