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At low temperatures, quantum corrections, originating from the interference of the many paths an electron may take between two points, tend to dominate the transport properties of two-dimensional conductors. These quantum corrections increase the resistivity in systems such as two-dimensional electron gases (2DEGs) without spin–orbit coupling (SOC), a phenomenon called weak localisation. Including symmetry-breaking SOC leads to a change from weak localisation (WL) to weak anti-localisation (WAL) of the electronic states, i.e. a WL-to-WAL transition. Here, we revisit the Cooperon, the propagator encoding quantum corrections, within the context of ultra-clean graphene-based van der Waals heterostructures with strong symmetry-breaking Bychkov-Rashba SOC to yield two completely counter-intuitive results. Firstly, we find that quantum corrections vary non-monotonically with the SOC strength, a clear indication of non-perturbative physics. Secondly, we observe the exact opposite of that seen in 2DEGs with strong SOC: a WAL-to-WL transition. This dramatic reversal is driven by mode entanglement of the pseudospin and spin degrees of freedom describing graphene’s electronic states. We obtain these results by constructing a non-perturbative treatment of the Cooperon, and observe distinct features in the SOC dependence of the quantum corrections to the electrical conductivity that would otherwise be missed by standard perturbative approaches.Spin orbit coupling (SOC) is an important feature of graphene-based heterostructures wherein careful engineering can be used to govern some of the resultant properties. Here, the authors theoretically investigate the impact on resistivity for ultra-clean graphene showing that it is different from the semiconducting counterpart because the conductivity at large SOC is suppressed instead of enhanced due to pseudospin-spin entanglement. [ABSTRACT FROM AUTHOR]

The current study investigated the impact of emotional abuse on self-concealment in a sample of 126 college students currently in a romantic heterosexual relationship. This study also examined whether emotion dysregulation moderated the relationship between emotional abuse and self-concealment. Results showed emotion dysregulation moderated the relationship between emotional abuse and self-concealment. When emotion dysregulation was low, being in an emotionally abusive relationship was positively associated with self-concealment. When emotion dysregulation was high, emotional abuse was not associated with self-concealment. In the context of intimate partner emotional abuse, this study suggests self-concealment is an attempt to cope with unwanted internal events, which may be especially salient among people with low emotion dysregulation. [ABSTRACT FROM AUTHOR]

The current cross-sectional study adopted structural equation modeling (SEM) to examine the association between childhood adversity and criminal thinking, and the role of attachment being a mediator in this relationship, in an offending sample. Data were collected from a sample of 209 inmates (169 of which were male) in a local jail. The results of SEM analyses indicated that childhood adversity was positively associated with attachment anxiety, attachment avoidance, and criminal thinking. Attachment avoidance was positively associated with criminal thinking and mediated the influence of childhood adversity on criminal thinking. Specifically, greater childhood adversity predicted higher attachment avoidance, which in turn was associated with higher levels of criminal thinking. Attachment anxiety did not correlate with criminal thinking; nor did it mediate the influence of childhood adversity on criminal thinking. The findings suggested that childhood adversity and insecure attachment are important risk factors in treating criminal thinking. Practitioners may consider incorporating therapies that facilitate self-reflective functions into offender rehabilitation programs or offer a taste of secure base for justice-involved individuals with childhood adversity. [ABSTRACT FROM AUTHOR]

Television weathercasters are uniquely situated to inform their audiences about the local impacts of global climate change and a growing number of them are adopting the role of climate change educator. We surveyed all American broadcast meteorology professionals in 2015 (N = 2,059; response rate = 22.6%), 2016 (N = 2017; response rate = 31.2%), and 2017 (N = 2,177; response rate = 22.1%) to assess weathercasters' interest in reporting about climate change; if, where, and how they report about climate change; and the reactions they get from their audiences when they do. Many participating weathercasters indicated that they were moderately or very interested in reporting about climate change, especially using local historical climate information (56%). Just over half of the weathercasters (57.9%) had used one or more communication mode to inform their viewers, or other people in their community, about the local impacts of climate change in the prior year. The most commonly used modes were social media (42.7%), school visits (36.3%), community events (33.1%), and on-air broadcasts (31.3%). Most weathercasters who had reported about climate change on air indicated they received either positive viewer feedback or little feedback (61.9%); conversely, weathercasters who had not reported about climate change expected to receive mostly negative feedback (44.2%). In sum, this analysis suggests that large numbers of weathercasters have adopted the role of climate change educator in their communities; they use a range of communication modes to share climate change information with their audiences and receive mostly positive feedback from their audiences when they do. [ABSTRACT FROM AUTHOR]

Twelve experiments examined ways of improving informal reasoning, as assesed by presenting students with accessible, current, and interesting social and political issues, eliciting reasoning about them, and scoring the reasoning for quality of argument. The experiments addressed: (1) the impact of established instructional programs that emphasized critical thinking (Experiments 1-4); (2) the impact of an investigator-designed high school level minicourse (Experiments 5-7); (3) the responsiveness of subjects to prompts that asked them to develop arguments more fully, and the relation of their responses to general intelligence (Experiments 8-10); (4) checks on the validity of the testing methodology (Experiments 11-12). Two of the established instructional programs had a beneficial effect. The minicourse had a particularly large effect on students' attention to the other side of the case, the most neglected aspect of informal reasoning. The prompting studies showed that subjects could develop their arguments far more than they normally did. Finally, subjects with higher intelligence were actually somewhat more biased in their reasoning. In summary: people can reason much better than they typically do on the sorts of issues posed; people are not performing near the limits of their abilities; strategies and standards of good reasoning can improve reasoning; and education can develop students' reasoning much further than education typically does. [ABSTRACT FROM AUTHOR]

Rural mental health outcomes have been persistently poorer than those in larger cities suggesting that the prevailing investments to improve matters are not working. Mental health researchers and service providers from New South Wales, Victoria, Western Australia and the Australian Capital Territory met in Orange in October 2018 to explore issues pertaining to rural mental health and well‐being. The group recognised and acknowledged that rural residents experience a series of interconnected geographical, demographic, social, economic and environmental challenges which are not addressed adequately by the current mix of services. This declaration has been endorsed by those listed below and we welcome further support. We list ten interrelated problems and ten solutions. As a group, we take this declaration as an opportunity to invite discussion about how we can collectively improve the mental health of rural residents through research, service design and delivery. We invite the reader to consider endorsing this declaration. A short summary of supporting evidence is available online at https://www.crrmh.com.au/. [ABSTRACT FROM AUTHOR]

There is a call for drawing on client voice to provide a rich, nuanced understanding of factors influencing substance treatment engagement as to maximizing treatment benefits. We interviewed 60 clients in a short-term inpatient substance treatment program and examined facilitators and barriers to treatment engagement. Thematic analysis yielded four themes, including perceived treatment needs, trust and counselor rapport, peer inspiration, and organizational factors. Perceived treatment needs serve as both a facilitator and a barrier wherein the acknowledgment of needs led to greater treatment engagement whereas a lack of perceived needs hindered treatment engagement. The establishment of trust and counselor rapport and peer inspiration facilitated treatment engagement. Clients rated several organizational factors including a lack of treatment provision, gender-responsive treatment and infrastructure, and ineffective communication with nonclinical staff as barriers to treatment engagement. Clinical implications include enhancing treatment motivation and counselor rapport, establishing gender-responsive treatment programs, and providing trainings for staff. [ABSTRACT FROM AUTHOR]

The article focuses on the 12th Australian Rural and Remote Mental Health Symposium Communiqué. Topics discussed include the 12th Rural and Remote Mental Health Symposium (26-28 October 2020) was timely and built on the success and learning's from previous symposia; and the outstanding efforts of the Australia and New Zealand Mental Health Association meant that we were able to meet on a virtual platform with live plenary and panel sessions and recorded parallel sessions.

Defining an ideal 'tourism climate' has been an often-visited research topic where explanations have evolved from global- to location-specific indices tailored to tourists' recreational behavior. Unfortunately, as indices become increasingly specific, they are less translatable across geographies because they may only apply to specific activities, locales, climates, or populations. A key need in the future development of weather and climate indices for tourism has been a translatable, meteorologically based index capturing the generalized ambient atmospheric conditions yet considering local climatology. To address this need, this paper tests the applicability of the spatial synoptic classification (SSC) as a tool to predict visitor attendance response in the tourism, recreation, and leisure (TRL) sector across different climate regimes. Daily attendance data is paired with the prevailing synoptic weather condition at Atlanta and Indianapolis zoological parks from September 2001 to June 2011, to review potential impacts ambient atmospheric conditions may have on visitor attendances. Results indicate that 'dry moderate' conditions are most associated with high levels of attendance and 'moist polar' synoptic conditions are most associated with low levels of attendance at both zoological parks. Comparing visitor response at these zoo locations, visitors in Indianapolis showed lower levels of tolerance to synoptic conditions which were not 'ideal.' Visitors in Indianapolis also displayed more aversion to 'polar' synoptic regimes while visitors in Atlanta displayed more tolerance to 'moist tropical' synoptic regimes. Using a comprehensive atmospheric measure such as the SSC may be a key to broadening application when assessing tourism climates across diverse geographies. [ABSTRACT FROM AUTHOR]

The article reports that most of the Americans want to know more abou climate change. If the public wants to learn more about climate change, this creates a demand for more public engagement efforts. About all climate scientists affirm that human-caused climate change is happening and only around 1 in 7 Americans are aware of this.

Unequal health care outcomes for those with mental illness mean that access to integrated models is critical to supporting good physical and mental health care. This is especially so in rural areas where geographic and structural issues constrain the provision of health services. Guided by a conceptual framework about rural and remote health, this study draws on interviews with health providers and other staff and examines the dynamics of integrated primary and community-based specialist care for people with severe and persistent mental illnesses living in rural Australia. Findings show that the facilitation of sustainable linkages between general practice and community mental health requires the skilful exercise of power, knowledge, and resources by partners in order to address the social and structural factors that influence local health situations. These findings suggest that incremental processes of integration that are responsive to patients' and stakeholders' needs and that build on success and increased trust may be more effective than those imposed from the 'top down' that pay insufficient attention to local contexts. [ABSTRACT FROM AUTHOR]

Background: We aimed to understand the relationships of the weather as biometeorological and hospital admissions due to common mental and behavioural disorders in a national setting in recent years. Methods: This is an ecological study. Ten percent of daily hospital admissions from the included hospitals (n = 1618) across Germany that were available between 1 January 2009 and 31 December 2011 (n = 5 235 600) were extracted from Statistisches Bundesamt, Germany. We identified F01-F51 mental ad behavioural disorders by International Classification of Diseases version 10 as the study outcomes. Daily weather data from 64 weather stations covering 13 German States including air temperature, humidity, wind speed, cloud cover, radiation flux and vapour pressure were obtained and generated into physiologically equivalent temperature (PET). We then plotted two-way fractional-polynomial regression. Results: For the most subtypes, the highest admissions were recorded in spring. There were small peaks in autumn or late winter for a few subtypes as well. Admissions of delirium peaked when PET was at 0 °C. Admissions of personality disorders peaked at the coldest – when PET was at − 10 °C. Admissions of schizophrenia and nonorganic sleep disorder peaked when PETs were between 0 and −10 °C while admissions of eating disorders dropped when PETs were above 10 °C. Admissions of depression and anxiety disorder did not vary much across PETs. Moreover, admissions of reaction to stress and dissociate disorder peaked when PETs were between 0 and 10 °C as well. Conclusions: More medical resources could have been needed for mental health on days when PETs were <10 °C than on other days. [ABSTRACT FROM AUTHOR]

Student debt is a national concern. The authors address debt in the classroom to enhance students' understanding of the consequences of debt and the need for caution when financing their education. However, student feedback indicates this understanding has a delayed effect on borrowing behavior and underscores the importance of making difficult behavioral changes sooner rather than later in order to lower student debt levels. [ABSTRACT FROM AUTHOR]

Objectives:Older adults are the fastest growing age group in Australia, necessitating an increase in appropriate mental health services in the coming years. While Internet-delivered mental health treatments have been established as acceptable and efficacious among younger samples, little research has explored whether they would be similarly useful in older populations. Methods:The participants were part of the Australian Rural Mental Health study, which explores mental health and well-being in residents of non-metropolitan New South Wales. A postal survey was used to assess knowledge of and intentions to use Internet-delivered mental health treatments. Demographics, mental health, and frequency of Internet use were also measured. Results:The survey was completed by 950 adults aged 50–93. The sample was largely unfamiliar with Internet mental health services, with 75% reporting that they had never heard of them and a further 20% not knowing any details of what they involved. Intentions to use these services were also low, at 13.5%; however, this increased with level of familiarity. Respondents with higher psychological distress, higher education, and more frequent Internet use were significantly more likely to consider using Internet treatments. Conclusions:Among older adults, overall awareness of Internet-delivered mental health treatments appears to be limited; however, higher familiarity contributes to higher intentions to use these treatments. Importantly, respondents with higher distress and greater computer literacy were more likely to consider mental health treatments delivered via the Internet. Future research exploring strategies to increase the promotion of these services to older samples may further improve their perceptions and use. [ABSTRACT FROM PUBLISHER]

This article focuses on Protective Orders in international arbitration where the dispute involves intellectual property rights and high technology subject matter and requires a specific confidentiality regime. Such disputes commonly arise from Technology Transfer Agreements, Research & Development Agreements, and Patent & Know-How Licenses. The subject matter in such disputes will, typically, involve not only disclosure of technically sensitive confidential documents, but also Product and/or Process Descriptions and site visits. Where, as is often the case, the parties compete in the same technical sector, mechanisms are required to find a balance between adequately protecting party confidentiality in such subject matter, while also providing sufficient disclosure to the counterparty, experts and the Arbitral Tribunal to facilitate the arbitral process. This article outlines the Institutional Rules which provide the necessary mechanisms to achieve that balance and contains a sample Protective Order which may serve as a useful guide to those faced with resolving a procedural issue of this nature. It also focuses particularly on the WIPO Rules, which have been crafted specifically for disputes involving Intellectual Property Rights and other high technology subject matter. [ABSTRACT FROM AUTHOR]

The article presents the authors' study of the court case Beaman v. Freesmeyer and the section 1983 claim filed by the defendant to determine the applicability of the Brady ruling on the section 1983 claim and the immunity rights of civil service and law enforcement personnel. Topics discussed include a comprehensive summary of the court case Beaman v. Freesmeyer and the assessment of the U.S. District Court of Illinois and the Seventh Circuit Appellate Court on the section 1983 claim

The article discusses the court case Currie v. Chhabra, filed in the U.S. Court of Appeals for the Seventh Circuit, which involves the provision of medical care to arrestee Philip Okoro prior to his Gerstein probable cause hearing. Topics explored include the arrest of Okoro without warrant due to suspected misdemeanor crime, the health concerns of Okoro that requires medical attention, and the application of the Fourth Amendment to the U.S. Constitution by the Seventh Circuit.

The article discusses the court case Zimmerman vs. Doran wherein the U.S. Court of Appeals for the Seventh Circuit dealt with the qualified immunity doctrine and its application to officers who were sued for false arrest.

The experiment was designed to test the hypothesis that caricatures, relative to photographs, are 'superfaithfuP carriers of information for facial recognition. Subjects were shown fifteen pictures of people's faces and were then asked to pick those same people out of a set of fifty-four pictures. There were three sets of pictures: caricatures, profile-view photographs, and three-quarter-view photographs. There were nine groups of subjects: for three groups the exposure and test stimuli were in the same medium, for six groups the test stimuli were in one of the media not previously seen. Points were scored for the number of people correctly identified and the number of false positives. Facial recognition within medium was very good, but was seriously disrupted by any medium shift, especially those involving caricatures. It is argued that the superfidelity of caricature may be manifest only when the task involves recognition of actual persons rather than their pictures. [ABSTRACT FROM AUTHOR]

Background: Community-based rural education opportunities have expanded in Australia, attracting more medical students to placements in rural and remote settings. Aim: To identify the factors in an integrated, community-engaged rural placement that may contribute to preparedness for practice (P4P) from the perspective of students and clinicians. Method: Forty-two semi-structured interviews with medical students, supervisors and clinicians analysed thematically. Results: Opportunities for clinical learning, personal and professional development and cultural awareness were reported by students and clinicians as key factors that contribute to P4P. Potential barriers in rural and remote settings included geographical and academic isolation, perceived educational risk and differing degrees of program engagement. Conclusions: A longitudinal clinical placement in a rural setting may enable development of enhanced competencies leading to P4P. A rural setting can provide a unique experience through hands-on learning, enhanced personal and professional development opportunities and observation of the cultural and contextual impact on health. [ABSTRACT FROM AUTHOR]

The article discusses the U.S. Supreme Court case Fisher versus University of Texas, which deals with racial classifications in higher education admissions. After assessing whether the race-conscious admissions plans are a legitimate constitutional means of securing student-body diversity in higher education, the Supreme Court published its opinion and remanded the case to the U.S. Court of Appeals for the Fifth Circuit.

Background/aim Private providers of Medicare funded services are an integral part of the Australian primary health-care system. Evidence on private occupational therapy practice in rural and remote Australian settings is sparse. Methods Providers of private occupational therapy services in outer regional and remote areas were surveyed regarding location and type of services provided, practice models and demographics. Descriptive statistics were used to summarise the findings. Results Thirty-seven respondents completed the survey. In remote areas a number of occupational therapy services are not provided and no practices are based in very remote towns. One quarter of respondents visit at least five towns each week and one third had other paid employment. Nearly half indicated they will leave private practice within the next five years and nearly one third believed they could not sustain their practice. Medicare Chronic Disease Management was the main income source of only around half the respondents. Conclusions There is a potential market failure of private occupational therapy in rural and remote areas, impacting on people who need these services and on workforce replacement. Contributing factors include population imbalance between cities and regional/remote areas, financial implications where only face-to-face contact is paid for and low incomes and levels of health insurance in regional/remote areas. Potential strategies include addressing the lack of reimbursement for travel, enabling private providers to overcome barriers to providing student placements and recognising rural practice as a specialist field. [ABSTRACT FROM AUTHOR]

Grassland birds are often affected negatively by habitat fragmentation. Outcomes include greater nest predation and brood parasitism, decreased colonization rates of small, isolated patches, and greater nest density in remnant core habitats. These effects have been well documented in the Midwest, but little is known about fragmentation and edge effects on grassland birds in the fragmented agricultural fields within the forested landscapes of the northeastern United States. From 2002 to 2010, we assessed how edges and edge types affected nest-site location and daily nest survival (DNS) of Savannah Sparrows {Passerculus sandwichensis) and Bobolinks (Dolichonyx oryzivorus) breeding in 11 fields (range: 13.2-38.3 ha; mean = 21.1 ha) within a large agricultural region of Vermont. Mean (± SD) distance to edge was 80.3 ± 39.6 m for Savannah Sparrows (n = 995) and 94.5 ± 56.5 m for Bobolinks (n = 652). Both species nested significantly less than expected within 50 m of the edge. For Savannah Sparrows nesting within 50 m of the edge, DNS increased with increased distance from the edge. Birds initiating nests later in the season nested closer to edges, but renests were farther from edges than first nests. Distance to edge had no detectable consequence for Bobolink nest success. Both species used portions of fields near hedgerows less than expected but used wetland, forest, agricultural, road, and developed edges in proportion to availability. For both species, DNS did not vary among edge types. Although edges were used less than expected, nesting near edges had only minor consequences for nest success. [ABSTRACT FROM AUTHOR]

Background: The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. Methods: A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. Results: The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose-response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. Conclusions: An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for such problems compared with data from metropolitan centres. Using a measure of Provisional Service Need those with greater needs were more likely to access specialist services, even in remote regions, although a substantial proportion of those with the highest service need sought no professional help. Geographic and financial barriers to service use were identified and perception of service adequacy was relatively low, especially among those with the highest levels of distress and greatest adversity. [ABSTRACT FROM AUTHOR]

Several pieces of literature suggest that most individuals who are successfully integrated into cults do not typically manifest symptoms of mental illness. However, the public is often taken aback by the lack of autonomy displayed by cult members and is bewildered by the ability of the cult leader and other cult members to transform fundamental personality functioning in an individual. Within the framework of an object relations model of personality structure and functioning as delineated by Otto Kernberg and using existing data concerning the cult experience, the authors engage in a theoretical exploration of cult membership. The authors propose that some behaviors exhibited by cult members may be a function of an object relations--level regression, which is exemplified by the activation of primitive defensive operations that are usually relegated to those suffering with severe personality disorders. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative project was to explore employment-related considerations through the perspectives of supported employment consumers with both psychiatric disabilities and criminal offense histories. Fourteen individuals participated in semi-structured interviews. Resulting themes included the importance of nonvocational services; relationship between mental illness and criminal activity; impact of mental illness and offense history on employment; helpful elements of supported employment; and recovery and advice to others. These findings help to explain how supported employment can mitigate social underachievement and social decline in an especially high need population. [ABSTRACT FROM AUTHOR]

The diagnosis of rejection in kidney transplant patients is based on histologic classification of a graft biopsy. The current 'gold standard' is the Banff 97 criteria; however, there are several limitations in classifying rejection based on biopsy samples. First, a biopsy involves an invasive procedure. Second, there is significant variance among blinded pathologists in the interpretation of a biopsy. And third, there is also variance between the histology and the molecular profiles of a biopsy. To increase the positive predictive value of classifiers of rejection, a Banff committee is developing criteria that integrate histologic and molecular data into a unified classifier that could diagnose and prognose rejection. To develop the most appropriate molecular criteria, there have been studies by multiple groups applying omics technologies in attempts to identify biomarkers of rejection. In this review, we discuss studies using genome-wide data sets of the transcriptome and proteome to investigate acute rejection, chronic allograft dysfunction, and tolerance. We also discuss studies which focus on genetic biomarkers in urine and peripheral blood, which will provide clinicians with minimally invasive methods for monitoring transplant patients. We also discuss emerging technologies, including whole-exome sequencing and RNA-Seq and new bioinformatic and systems biology approaches, which should increase the ability to develop both biomarkers and mechanistic understanding of the rejection process. [ABSTRACT FROM AUTHOR]

Background: With the move to community care and increased involvement of generalist health care providers in mental health, the need for health service partnerships has been emphasised in mental health policy. Within existing health system structures the active strategies that facilitate effective partnership linkages are not clear. The objective of this study was to examine the evidence from peer reviewed literature regarding the effectiveness of service linkages in primary mental health care. Methods: A narrative and thematic review of English language papers published between 1998 and 2009. Studies of analytic, descriptive and qualitative designs from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted to examine what service linkages have been used in studies of collaboration in primary mental health care. Findings from the randomised trials were tabulated to show the proportion that demonstrated clinical, service delivery and economic benefits. Results: A review of 119 studies found ten linkage types. Most studies used a combination of linkage types and so the 42 RCTs were grouped into four broad linkage categories for meaningful descriptive analysis of outcomes. Studies that used multiple linkage strategies from the suite of "direct collaborative activities" plus "agreed guidelines" plus "communication systems" showed positive clinical (81%), service (78%) and economic (75%) outcomes. Most evidence of effectiveness came from studies of depression. Long term benefits were attributed to medication concordance and the use of case managers with a professional background who received expert supervision. There were fewer randomised trials related to collaborative care of people with psychosis and there were almost none related to collaboration with the wider human service sectors. Because of the variability of study types we did not exclude on quality or attempt to weight findings according to power or effect size. Conclusion: There is strong evidence to support collaborative primary mental health care for people with depression when linkages involve "direct collaborative activity", plus "agreed guidelines" and "communication systems". [ABSTRACT FROM AUTHOR]

Background: Primary care services have not generally been effective in meeting mental health care needs. There is evidence that collaboration between primary care and specialist mental health services can improve clinical and organisational outcomes. It is not clear however what factors enable or hinder effective collaboration. The objective of this study was to examine the factors that enable effective collaboration between specialist mental health services and primary mental health care. Methods: A narrative and thematic review of English language papers published between 1998 and 2009. An expert reference group helped formulate strategies for policy makers. Studies of descriptive and qualitative design from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted on factors reported as enablers or barriers to development of service linkages. These were tabulated by theme at clinical and organisational levels and the inter-relationship between themes was explored. Results: A thematic analysis of 30 papers found the most frequently cited group of factors was "partnership formation", specifically role clarity between health care workers. Other factor groups supporting clinical partnership formation were staff support, clinician attributes, clinic physical features and evaluation and feedback. At the organisational level a supportive institutional environment of leadership and change management was important. The expert reference group then proposed strategies for collaboration that would be seen as important, acceptable and feasible. Because of the variability of study types we did not exclude on quality and findings are weighted by the number of studies. Variability in local service contexts limits the generalisation of findings. Conclusion: The findings provide a framework for health planners to develop effective service linkages in primary mental health care. Our expert reference group proposed five areas of strategy for policy makers that address organisational level support, joint clinical problem solving, local joint care guidelines, staff training and supervision and feedback. [ABSTRACT FROM AUTHOR]

To evaluate an innovative rural service offering comprehensive primary health care for mental health service clients. A formative evaluation using mixed methods. A rural NSW community. Fifteen health care providers and 120 adult clients. A monthly clinic held in a general practice to provide primary health care for clients of the community mental health team. Client utilisation and clinic activity data. Provider views of service effectiveness, possible improvements and sustainability. The GP Clinic has operated successfully for 2.5 years without access block. Some 52% of clients had no physical illness and 82% were referred to other health and community services. In total, 40% continued to attend the clinic while 32% went on to consult a GP independently. Client access to care improved as did collaboration between the community mental health team and primary care providers. The GP Clinic is a straightforward and flexible service model that could be used more widely. [ABSTRACT FROM AUTHOR]

Objective Multidisciplinary care has been shown as the most effective option for chronic disease. The aim of the Team-link study was to assess the effectiveness of an intervention to improve teamwork among general practitioners (GPs), practice staff and allied health professionals (AHPs). This paper describes changes to teamwork using qualitative data collected in the study. Design Qualitative data about changes in internal and external professional collaboration were collected from facilitators’ observations, GPs’ reports and responses to a survey of AHPs assessing multidisciplinary teamwork. Setting Multidisciplinary teams within general practices and external collaborations with AHPs including dietitians, diabetic educators, exercise physiologists, podiatrists, psychologists and physiotherapists. Participants GPs, practice nurses, practice staff, AHPs. Intervention A 6-month intervention consisting of an educational workshop and structured facilitation using specially designed materials, backed up by informal telephone support, was delivered to 26 practices. Main Outcome Measure Data were analysed thematically using an approach based on identifying actors and associated collaborative actions. Results New and enhanced communication pathways were observed between GPs, practice staff, patients and AHPs following the intervention. The enhanced information sharing expedited communication and improved interprofessional collaboration within general practices and with AHPs. There was evidence of increased patient participation and empowerment in the care process and improved collaboration by practice staff and allied health providers. Conclusion The Team-link intervention improved professional collaboration among GPs, practice staff, AHPs and patients, increasing understanding and trust and enhancing multidisciplinary teamwork for chronic disease care in primary care settings. [ABSTRACT FROM AUTHOR]

The article discusses the case Lalowski v. City of Des Plaines under which an Appeals Court held that Illinois' interest in operating an efficient and effective police department outweighed the speech interest of police officer Dick Lalowski who verbally harassed and insulted an abortion protester.

Stigma impedes the social integration of persons recovering from psychiatric disability, especially those with criminal histories. Little is known about factors that lessen this stigma. Four hundred and four adults listened to one of four vignettes describing a 25-year-old male with schizophrenia and responded to a standard set of items measuring social distance. The individual who was gainfully employed (vs. unemployed), or who had a prior misdemeanor (vs. felony) criminal offense, elicited significantly less stigma. Employment may destigmatize a person coping with both psychiatric disability and a criminal record. Mental health services should encourage paid employment and other paths to community integration. [ABSTRACT FROM AUTHOR]

Abstract: Asthma is a complex polygenic disease, the prevalence of which has been on the rise for last few decades. Defining the underpinnings of allergic immune responses and the factors predisposing to asthma are fundamental investigative challenges. T cell costimulatory pathways play critical roles in the pathogenesis of asthma. In this review, we analyze the current state of the art of T cell costimulation in allergic airway inflammation. Also, we discuss both immune and bioinformatic approaches as potential strategies for analyzing multiple costimulatory pathways relevant to asthma. [Copyright &y& Elsevier]

Background: The paper examines the key issues experienced in recruiting and retaining practice involvement in a large complex intervention trial in Australian General Practice Methods: Reflective notes made by research staff and telephone interviews with staff from general practices which expressed interest, took part or withdrew from a trial of a complex general practice intervention. Results: Recruitment and retention difficulties were due to factors inherent in the demands and context of general practice, the degree of engagement of primary care organisations (Divisions of General Practice), perceived benefits by practices, the design of the trial and the timing and complexity of data collection, Conclusion: There needs to be clearer articulation to practices of the benefits of the research to participants and streamlining of the design and processes of data collection and intervention to fit in with their work practices. Ultimately deeper engagement may require additional funding and ongoing participation through practice research networks. [ABSTRACT FROM AUTHOR]

Acquiring and maintaining employment is often challenging for individuals with psychiatric disabilities, and for those with a history of criminal offenses additional obstacles exist. This project used focus groups to identify ways in which supported employment providers deliver effective services to persons with mental illness and offense histories. Successful providers report that a sense of hope, a trusting relationship, realistic and sincere expectations about work, and optimism on the part of both the consumer and provider are key ingredients, as are the consumer's remorse for past criminal activity and an action-oriented attitude toward change. Barriers to success with this population include stigma, which varies based on psychiatric symptoms and the nature of the criminal offense, and inadequate support. Successful employment reflects persistence, clinical and law enforcement supports as needed, lifestyle adjustments, face to face meetings with employers, effective disclosure strategies, and documenting work readiness using portfolios. Providers also cited many contributions of employment to recovery, including increased financial resources, pride, social connections to the community, and quality of life. Training of future professionals should promote skills in advocacy, helping consumers develop work portfolios and other assets, and a view of employment support that is holistic and individualized. [ABSTRACT FROM AUTHOR]

Objective: To identify strategies local managers can use to optimise recruitment and retention of mental health staff in rural locations. Design: Forty-one staff were interviewed about factors that attracted them to work in remote locations, their initial intentions and factors that encourage them to stay. Setting: The former Far West Health Area of New South Wales. Results: Overall job satisfaction was high (68%). Key attractors were rural lifestyle and environment. Family reasons, the field of work and the rural lifestyle were factors that keep staff in their positions. Some mentioned the desire to achieve professional goals and see projects completed. Many staff reported that their initial intentions to stay had remained the same (43.9%). Reasons for extended intention to stay were: greater career opportunities; a desire to complete professional goals; extension of positions; and personal factors. The most common reason for leaving was better career opportunities. Other reasons included: changes to personal commitments; heavy workloads or burnout; service management; and workplace politics. A large number of respondents mentioned key differences when comparing rural and metropolitan areas: more travel (greater distances); less service options for referral; greater spectrum of illnesses and conditions; more autonomy and responsibility. Conclusions: Strategies to recruit and retain staff must take account of personal needs and aspirations. While there is room for state strategies to improve employment incentives, there is also considerable scope for local managers to improve the design and attractiveness of jobs. [ABSTRACT FROM AUTHOR]