The trend in mental health-related mortality rates in Australia 1916-2004: implications for policy

Background: This study determines the trend in mental health-related mortality (defined here as the aggregation of suicide and deaths coded as “mental/behavioural disorders”), and its relative numerical importance, and to argue that this has importance to policy-makers. Its results will have policy relevance because policy-makers have been predominantly concerned with cost-containment, but a re-appraisal of this issue is occurring, and the trade-off between health expenditures and valuable gains in longevity is being emphasised now. This study examines longevity gains from mental health-related interventions, or their absence, at the population level. The study sums mortality data for suicide and mental/behavioural disorders across the relevant ICD codes through time in Australia for the period 1916-2004. There are two measures applied to the mortality rates: the conventional age-standardised headcount; and the age-standardised Potential Years of Life Lost (PYLL), a measure of premature mortality. Mortality rates formed from these data are analysed via comparisons with mortality rates for All Causes, and with circulatory diseases, cancer and motor vehicle accidents, measured by both methods. Results: This study finds the temporal trend in mental health-related mortality rates (which reflects the longevity of people with mental illness) has worsened through time. There are no gains. This trend contrasts with the (known) gains in longevity from All Causes, and the gains from decreases achieved in previously rising mortality rates from circulatory diseases and motor vehicle accidents. Also, PYLL calculation shows mental health-related mortality is a proportionately greater cause of death compared with applying headcount metrics. Conclusions: There are several factors that could reverse this trend. First, improved access to interventions or therapies for mental disorders could decrease the mortality analysed here. Second, it is important also that new efficacious therapies for various mental disorders be developed. Furthermore, it is also important that suicide prevention strategies be implemented, particularly for at-risk groups. To bring the mental health sector into parity with many other parts of the health system will require knowledge of the causative factors that underlie mental disorders, which can, in turn, lead to efficacious therapies. As in any case of a knowledge deficit, what is needed are resources to address that knowledge gap. Conceiving the problem in this way, ie as a knowledge gap, indicates the crucial role of research and development activity. This term implies a concern, not simply with basic research, but also with applied research. It is commonplace in other sectors of the economy to emphasise the trichotomy of invention, innovation and diffusion of new products and processes. This three-fold conception is also relevant to addressing the knowledge gap in the mental health sector

The impact of LASPO on routes to justice

This research underlines the emotional, social, financial and mental health impacts for individuals who have attempted to resolve their legal problems without legal aid, following the implementation of the Legal Aid, Sentencing and Punishment of Offenders Act (LASPO) in 2013. LASPO introduced funding cuts to legal aid and narrowed the scope and financial eligibility criteria, with the result that fewer people could access legal advice and representation for problems in areas such as family, employment and welfare benefits law. We interviewed over 100 people in the Liverpool City Region, with problems in at least one of these areas of law, to understand how LASPO had affected their options for resolving those issues. We also interviewed a number of advice providers and legal aid practitioners, and analysed national data from Citizens Advice. Many participants reported significant financial deprivation as a result of trying but not being able to resolve their legal issues. Some were unable to afford food, adequate housing or other essentials. A lack of preventive legal help led to delays in resolution, which often made problems worse. There was also evidence that costs were passed to other parts of the public sector, including an increased reliance on welfare benefits as a result of unresolved employment issues. Family law • The high cost of legal fees is a key barrier to justice. Some participants who paid for legal advice or representation reported going into debt as a result. • People’s inability to pay for expert or specialist evidence without legal aid may have led to courts making decisions on the basis of insufficient information. • Cuts to legal aid have had a negative impact on children’s lives, especially in relation to child contact cases. Employment law • The main barriers to justice are the high cost of legal representation, the difficulty of navigating the tribunal process without support and a low level of knowledge about employment rights. • Many participants reported that the costs of bringing their claims to tribunal were disproportionate to the value of the claims. This deterred them from bringing claims and made it harder to find a solicitor willing to take their case. • Participants had fewer options for accessing third-sector specialist advice and representation. Those participants who went to tribunal had to represent themselves as a result, and in general they lacked the skills or experience to do this competently. Welfare benefits law • LASPO has significantly reduced the capacity of voluntary sector organisations to provide welfare law advice. There is almost no specialist advice left to provide support to appeal benefits decisions. • The removal of welfare benefits law from the scope of legal aid has exacerbated the impact of recent welfare reforms, which is likely to have affected disabled people disproportionately. Most participants tried multiple routes to resolve a single issue: attempting to resolve problems on their own, trying to access free advice and taking steps to get paid advice or representation before courts or tribunals. But without legal aid, almost all the participants struggled to solve their problems

Ionization state, excited populations and emission of impurities in dynamic finite density plasmas: I. The generalized collisional-radiative model for light elements

The paper presents an integrated view of the population structure and its role in establishing the ionization state of light elements in dynamic, finite density, laboratory and astrophysical plasmas. There are four main issues, the generalized collisional-radiative picture for metastables in dynamic plasmas with Maxwellian free electrons and its particularizing to light elements, the methods of bundling and projection for manipulating the population equations, the systematic production/use of state selective fundamental collision data in the metastable resolved picture to all levels for collisonal-radiative modelling and the delivery of appropriate derived coefficients for experiment analysis. The ions of carbon, oxygen and neon are used in illustration. The practical implementation of the methods described here is part of the ADAS Project

Remunerating private psychiatrists for participating in case conferences

BACKGROUND: On 1 November 2000, a series of new item numbers was added to the Medicare Benefits Schedule, which allowed for case conferences between physicians (including psychiatrists) and other multidisciplinary providers. On 1 November 2002, an additional set of numbers was added, designed especially for use by psychiatrists. This paper reports the findings of an evaluation of these item numbers. RESULTS: The uptake of the item numbers in the three years post their introduction was low to moderate at best. Eighty nine psychiatrists rendered 479 case conferences at a cost to the Health Insurance Commission of $70,584. Psychiatrists who have used the item numbers are generally positive about them, as are consumers. Psychiatrists who have not used them have generally not done so because of a lack of knowledge, rather than direct opposition. The use of the item numbers is increasing over time, perhaps as psychiatrists become more aware of their existence and of their utility in maximising quality of care. CONCLUSION: The case conferencing item numbers have potential, but as yet this potential is not being realised. Some small changes to the conditions associated with the use of the item numbers could assist their uptake

Chronicles of Oklahoma

Notes and Documents section for Volume 48, Number 4, Winter 1970-71. It includes a narrative of a historical train trip through northern and eastern states, correspondence between the society's president and the letter's author regarding the making of the account, a chronicle of the history of the oldest boarding school operated in the United States called the Riverside Indian School, and an Oklahoma weather report

A novel role for syndecan-3 in angiogenesis.

Syndecan-3 is one of the four members of the syndecan family of heparan sulphate proteoglycans and has been shown to interact with numerous growth factors via its heparan sulphate chains. The extracellular core proteins of syndecan-1,-2 and -4 all possess adhesion regulatory motifs and we hypothesized that syndecan-3 may also possess such characteristics. Here we show that a bacterially expressed GST fusion protein consisting of the entire mature syndecan-3 ectodomain has anti-angiogenic properties and acts via modulating endothelial cell migration. This work identifies syndecan-3 as a possible therapeutic target for anti-angiogenic therapy.This work was funded by Arthritis Research-UK (Grant No. 19207) and funds from the William Harvey Research Foundation both to JRW

A link between labor participation, mental health and class of medication for mental well-being

We examined the relationship between mental health and labor participation. Analysis was based on the Australian National Health Survey, providing a nationally representative sample using 14,788 observations. Accounting for endogeneity, analysis revealed that females were almost twice more responsive to changes in mental health on labor participation compared to males. Among Australians who did not take medication for mental wellbeing, poorer levels of mental health was associated with a reduction in the probability of labor participation. Among females with poorer mental health, taking any medication for mental well-being led to a decrease in the probability of labor participation. This relationship was not significant for males

Dynamics and Radiation of Young Type-Ia Supernova Remnants: Important Physical Processes

We examine and analyze the physical processes that should be taken into account when modeling young type-Ia SNRs, with ages of several hundred years. It is shown, that energy losses in the metal-rich ejecta can be essential for remnants already at this stage of evolution. The influence of electron thermal conduction and the rate of the energy exchange between electrons and ions on the temperature distribution and the X-radiation from such remnants is studied. The data for Tycho SNR from the XMM-Newton X-ray telescope have been employed for the comparison of calculations with observations.Comment: 19 pages, 8 figure

precision control of the electron longitudinal bunch shape using an emittence-exchange beam line

We report on the experimental generation of relativistic electron bunches with a tunable longitudinal bunch shape. A longitudinal bunch-shaping (LBS) beam line, consisting of a transverse mask followed by a transverse-to-longitudinal emittance exchange (EEX) beam line, is used to tailor the longitudinal bunch shape (or current profile) of the electron bunch. The mask shapes the bunch's horizontal profile, and the EEX beam line converts it to a corresponding longitudinal profile. The Argonne wakefield accelerator rf photoinjector delivers electron bunches into a LBS beam line to generate a variety of longitudinal bunch shapes. The quality of the longitudinal bunch shape is limited by various perturbations in the exchange process. We develop a simple method, based on the incident slope of the bunch, to significantly suppress the perturbations.1162Ysciescopu