Defining Australian Indigenous wellbeing: do we really want the answer? Implications for policy and practice

ABSTRACT: Indigenous wellbeing is a current priority for the Australian Government. Given this prioritisation one might be tempted to conclude that a readily accessible and consensual definition of Indigenous wellbeing would be available. Such a definition would be important, for example, in the design and delivery of programmes of psychotherapy that aim to improve wellbeing. A literature review was undertaken to locate such a definition. In particular, the relevance of definitions to Indigenous Australians living in remote communities was of interest. While a small number of definitions are frequently cited in the literature, there is not unanimity in their acceptance. It became obvious that the terms “health” and “wellbeing” are often confused. Sometimes health is included as a component of wellbeing, sometimes wellbeing is included as a subset of health, sometimes the terms are used jointly as in “health and wellbeing”, and sometimes persuasive arguments are made that health and wellbeing are different. The politics of wellbeing is a potent theme in the literature. It seems that the indices of wellbeing that are important to the Government may not always be important to Indigenous Australians. Current Australian Government policy could be seen to be more focused on gently steering Indigenous Australians to adopt a Western style of living rather than providing opportunities for them to live lives of personal meaning and value. This tension may well be a fundamental issue in addressing Indigenous wellbeing.&nbsp

The impact of family and other social involvement on overall client satisfaction for individuals with developmental disabilities

This study investigated the impact of family and other social involvement on overall client satisfaction for individuals with developmental disabilities. The family-related outcome measures reviewed included social-role fulfillment, the existence of a natural support network, and the existence of intimate relationships. The other social outcome measures investigated included the impact of having friends, community involvement, and community interaction. This study found that there was a relationship between the life satisfaction level of individuals with mental retardation and their level of social involvement. Also discussed were various variables that impact family involvement such as parenting styles, family characteristics, reasons for out-of-home placements, siblings\u27 role, and specific problems related to unique transitional periods during the individuals\u27 lifetime. Quality of life issues and their relation to family and social involvement are discussed. Recommendations to enhance family involvement for service providers were made

Beyond patient-centered care: Enhancing the patient experience in mental health services through patient-perspective care

Delivering mental health services as patient-centered care has been an international priority for more than 50 years. Despite its longevity there is still not widespread agreement regarding how it should be defined or how it should guide the delivery of services. Generally, though, prioritizing the patient’s values and preferences seem to be at the core of this particular approach. It is not clear, however, that services attend to patient values and preferences as closely as they should. Terms such as “treatment resistant” and “noncompliant” seem to belie an attitude where the therapist’s opinion is privileged rather than the patients. To improve the effectiveness and efficiency of mental health services a move from patient-centered care to patient-perspective care is recommended. An attitude of patient-perspective care would require service providers recognizing that help can only ever be defined by the helpee rather than the helper. A patient-perspective service that was structured around the preferences and perspectives of patients might finally help to end the long-term suffering of many people who experience mental health problems

Differential Effects of Race and Poverty on Ambulatory Care Sensitive Conditions

This study is a continuation of an earlier study that examined hospitalization rates for ambulatory care sensitive (ACS) conditions, as a proxy for quality of care, and found evidence of a racial disparity among African American and White Medicare beneficiaries. The current study sought to determine whether neighborhood socioeconomic status (SES) explained this disparity. Differences in rates of ACS hospitalizations by race were assessed using Cochran-Mantel Haenszel tests and Poisson regression. Unadjusted rate ratios for ACS hospitalization for African Americans vs. Whites were found to be higher in low poverty areas (rate ratio (RR)=1.13; 95% CI (1.08, 1.17)) than in high poverty areas (RR=0.97; 95% CI (0.89, 1.05)). After controlling for various indicators of area SES in multivariate analyses race differences in ACS hospitalization rates persisted. Rural neighborhoods and those with higher percent of non-high school graduates were associated with greater risk of ACS hospitalizations

Cognitive and Neural Correlates of Mathematical Giftedness in Adults and Children: A Review.

Most mathematical cognition research has focused on understanding normal adult function and child development as well as mildly and moderately impaired mathematical skill, often labeled developmental dyscalculia and/or mathematical learning disability. In contrast, much less research is available on cognitive and neural correlates of gifted/excellent mathematical knowledge in adults and children. In order to facilitate further inquiry into this area, here we review 40 available studies, which examine the cognitive and neural basis of gifted mathematics. Studies associated a large number of cognitive factors with gifted mathematics, with spatial processing and working memory being the most frequently identified contributors. However, the current literature suffers from low statistical power, which most probably contributes to variability across findings. Other major shortcomings include failing to establish domain and stimulus specificity of findings, suggesting causation without sufficient evidence and the frequent use of invalid backward inference in neuro-imaging studies. Future studies must increase statistical power and neuro-imaging studies must rely on supporting behavioral data when interpreting findings. Studies should investigate the factors shown to correlate with math giftedness in a more specific manner and determine exactly how individual factors may contribute to gifted math ability

A realist case study of a regional hospital\u27s response to improve emergency department access in the context of Australian healthcare reforms

Introduction: Major health-care reforms have extended across all Australian public hospitals in recent years. Improving emergency department (ED) access has been a focus of these reforms.Objective: This study evaluates how the national reforms have led to improvement in ED access in a regional hospital in remote Australia.Methods: Assessing a complex scenario such as national reforms and the challenges faced by the regional hospital to implement these reforms requires in-depth analysis. A realist evaluation theory-based approach was employed, allowing investigation of what, how, why, and for whom change occurred. A case study mixed methods design was adopted within the realist framework to answer these questions about change.Results and Conclusion: The study identified moderate improvement in ED access as a result of the reforms (investment in infrastructure and workforce and the introduction of ED targets). Clinical leadership and support from management were essential for the improvement. Without ongoing investment and clinical redesign activities, however, sustainability of the improvement may prove difficult

Ultrafast Coherent Electron Spin Flip in a Modulation-Doped CdTe Quantum Well

International audienceWe report the experimental realization of coherent electron spin flip in a modulation-doped CdTe quantum well. Coherent spin rotation is realized with an off-resonant laser pulse, which induces a polarization-dependent optical Stark shift in the trion resonance. Complete electron spin flip is made possible by a laser pulse designed to avoid excessive excitations of nearby exciton resonances and minimizes detrimental many-body effects. These results demonstrate an effective approach for ultrafast optical spin control in a complex spin system

Space Transportation System Availability Requirement and Its Influencing Attributes Relationships

It is important that engineering and management accept the need for an availability requirement that is derived with its influencing attributes. It is the intent of this paper to provide the visibility of relationships of these major attribute drivers (variables) to each other and the resultant system inherent availability. Also important to provide bounds of the variables providing engineering the insight required to control the system's engineering solution, e.g., these influencing attributes become design requirements also. These variables will drive the need to provide integration of similar discipline functions or technology selection to allow control of the total parts count. The relationship of selecting a reliability requirement will place a constraint on parts count to achieve a given availability requirement or if allowed to increase the parts count will drive the system reliability requirement higher. They also provide the understanding for the relationship of mean repair time (or mean down time) to maintainability, e.g., accessibility for repair, and both the mean time between failure, e.g., reliability of hardware and availability. The concerns and importance of achieving a strong availability requirement is driven by the need for affordability, the choice of using the two launch solution for the single space application, or the need to control the spare parts count needed to support the long stay in either orbit or on the surface of the moon. Understanding the requirements before starting the architectural design concept will avoid considerable time and money required to iterate the design to meet the redesign and assessment process required to achieve the results required of the customer's space transportation system. In fact the impact to the schedule to being able to deliver the system that meets the customer's needs, goals, and objectives may cause the customer to compromise his desired operational goal and objectives resulting in considerable increased life cycle cost of the fielded space transportation system