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

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

Clinical communication skills learning outcomes among first year medical students are consistent irrespective of participation in an interview for admission to medical school

Background: Although contentious most medical schools interview potential students to assess personal abilities such as communication. Aims: To investigate any differences in clinical communication skills (CCS) between first year students admitted to UQ medical school with or without an admissions interview. Methods: A retrospective analysis of 1495 student assessment scores obtained after structured communication skills training (CCS) between 2007 and 2010. Results: The average assessment score was 3.76 ([95% CI, 3.73-3.78]) and adjusting for student characteristics, showed no main effect for interview (p=0.89). The strongest predictor of scores was gender with females achieving significantly higher scores (3.91 [95% CI, 3.54-4.28] vs. 3.76 [95% CI, 3.39-4.13]; p≤0.001). Conclusions: Data show no differences in post-training assessment measures between students who were interviewed during selection or not. Further research about the quality and retention of communications skills after training is warranted

Complex microwave conductivity of Na-DNA powders

We report the complex microwave conductivity, $\sigma=\sigma_1-i\sigma_2$, of Na-DNA powders, which was measured from 80 K to 300 K by using a microwave cavity perturbation technique. We found that the magnitude of $\sigma_1$ near room temperature was much larger than the contribution of the surrounding water molecules, and that the decrease of $\sigma_1$ with decreasing temperature was sufficiently stronger than that of the conduction of counterions. These results clearly suggest that the electrical conduction of Na-DNA is intrinsically semiconductive.Comment: 16 pages, 7 figure

Investigating the relationship between social cognition, neuropsychological function and post-traumatic stress disorder in acquired brain injury

Literature suggests that aspects of social cognition, as well as neuropsychological difficulties play a key role in the development and maintenance of Post-Traumatic Stress Disorder (PTSD) symptoms in brain injury survivors. The present study aimed to explore the direct relationship between measures of neuropsychological function and social cognition, and psychological outcomes related to PTSD. A quantitative, cross-sectional, correlational design was employed, using correlational and multivariate regression methods of analysis. Forty-nine adult brain injury survivors were administered a range of measures of neuropsychological function (memory, executive function and attention); social cognition (Mentalization, emotion recognition, social judgment making and emotion-based decision-making) and Psychological outcomes related to PTSD (depression, anxiety, anger and PTSD symptoms). Significant relationships were found between measures of Mentalization, attention and memory, and symptoms relating to depression and PTSD. Selective visual attention and Mentalization were found to account for 37% of the relevant variance for depressive symptoms, while Mentalization and delayed memory recall accounted for 24% of the relevant variance for PTSD symptoms. Different measures of Mentalization showed unexpected correlation directions, which had significant implications for the role Mentalization might play in maintaining PTSD symptoms. The findings suggest an association between aspects of social cognition and neuropsychological functioning, and psychological outcomes related to PTSD. It is thought that impairments in these areas could play a role in maintaining these outcomes in Acquired Brain Injury survivors

Fluctuation-Facilitated Charge Migration along DNA

We propose a model Hamiltonian for charge transfer along the DNA double helix with temperature driven fluctuations in the base pair positions acting as the rate limiting factor for charge transfer between neighboring base pairs. We compare the predictions of the model with the recent work of J.K. Barton and A.H. Zewail (Proc.Natl.Acad.Sci.USA, {\bf 96}, 6014 (1999)) on the unusual two-stage charge transfer of DNA.Comment: 4 pages, 2 figure

Collapse of superconductivity in a hybrid tin-graphene Josephson junction array

When a Josephson junction array is built with hybrid superconductor/metal/superconductor junctions, a quantum phase transition from a superconducting to a two-dimensional (2D) metallic ground state is predicted to happen upon increasing the junction normal state resistance. Owing to its surface-exposed 2D electron gas and its gate-tunable charge carrier density, graphene coupled to superconductors is the ideal platform to study the above-mentioned transition between ground states. Here we show that decorating graphene with a sparse and regular array of superconducting nanodisks enables to continuously gate-tune the quantum superconductor-to-metal transition of the Josephson junction array into a zero-temperature metallic state. The suppression of proximity-induced superconductivity is a direct consequence of the emergence of quantum fluctuations of the superconducting phase of the disks. Under perpendicular magnetic field, the competition between quantum fluctuations and disorder is responsible for the resilience at the lowest temperatures of a superconducting glassy state that persists above the upper critical field. Our results provide the entire phase diagram of the disorder and magnetic field-tuned transition and unveil the fundamental impact of quantum phase fluctuations in 2D superconducting systems.Comment: 25 pages, 6 figure