How will information about the genetic risk of mental disorders reduce stigma?

Objectives: To suggest ways of testing hypotheses about the impact that information on genetic risk may have on the social stigma of mental disorders and to analyse the implications of these hypotheses for genetic screening for mental disorders.

Method: Literature review and critical analysis and synthesis.

Results: An optimistic view is that information on the genetic risk for mental disorders will reduce blame and social stigma experienced by individuals living with mental disorder. A more pessimists view is that genetic risk information and the use of predictive genetic testing will lead to earlier stigmatization of those at risk of mental disorders. Research is identified that is needed to provide a better understanding of the implications of predictive genetic testing for the stigmatization of different mental health disorders.

Conclusions: It is essential that research on the genetics of mental disorders is accompanied by social science research on the ways in which genetic findings influence the lives of those who are tested.

Knowledge distribution nodes and home based businesses : role of local business associations and local council in Casey LGA

This paper examines the structure, function and role of local business associations in home based business development within an urban region. Casey local government area (LGA), Victoria, is the focus, where nine local business associations in the area (as well as the local council) are evaluated in the context of support for local-based business development. The evaluation draws upon primary data collected by surveys of local home based businesses, and follows up by semi-structured interviews of representatives from these business associations and the local council. This paper identifies that local business associations are fragmented and have significant overlap in their activities, of which the commonest activity is acting as a knowledge distribution node. The cash strapped local council is the most important node. All are restricted by vision and resources. As a result, the services provided have little impact on sustainable business development in Casey.

MidiCities : test beds for innovative delivery of urban transformation

Cities globally and nationally are facing a range of daunting challenges to respond to a suite of emerging imperatives including a low carbon future, oil vulnerability, demographic re-composition, and the prospect of unpredictable economic shocks. To pursue a future that is sustainable and resilient requires substantial transformation of existing urban areas and creation of new mechanisms to guide and manage delivery of physical, economic and social changes.

Mid-sized cities provide legible, nimble test beds for exploring cross-disciplinary models and innovative governance and delivery techniques. Australia’s ‘MidiCities’ – home to 4 million urban dwellers frequently overlooked by urban policy or research effort – are emerging as crucibles of innovation and experimentation. Most of these cities retain that essential key ingredient for sustainable urbanism, economic resilience and community identity: a strong, highly legible city centre with a tightly clustered diversity of facilities and functions – the multi-functional activity centre that metropolitan suburban hubs yearn to grow up to become!

These diverse MidiCities are passing a threshold of self-confident sophistication, and are now providing valuable lessons for each other, which could be adopted or adapted by metropolitan cities where scale and complexity can often overwhelm the search for new and appropriate approaches to delivery of rapid change while maintaining clear guidance toward the vision of a ‘preferred’ future. A network of professionals working with Australian and New Zealand MidiCities is coalescing toward a cross-disciplinary platform for exchange of experiences and information, mutual support, improved research and understanding, capacity-building and the refinement of new specialist skills and structures.

Mind the gap! : A discussion on the disparity between low and high income countries in the provision of mental health care and the implications for capacity building in Kenya’s nursing workforce.

About fourteen per cent of the global burden of disease has been attributed to mental, neurological and substance use disorders. A number of initiatives have been launched in recent years to respond to this, the World Health Organisation (WHO) introduced the Mental Health Gap Action Programme (mhGAP) to address the widening gap between what is needed to provide adequate mental health services and what is currently available, especially in low and middle income countries where the gap is widest.
This discussion paper will focus on mental health nursing in Kenya, a country in East Africa with a population of 42 million people. Mental illness is common in Kenya with up to twenty five per cent prevalence rates, yet mental health services are sparse at the tertiary and primary care level and mental health remains a low budget and policy priority for the government. The aim of this paper is to raise participants’ awareness of the challenges of delivering mental health nursing care in low-income countries such as Kenya, and to explore possible solutions to the problem.

Does extensive free narrative prompting minimise the effect of mental reinstatement on children's recall of events?

The effect of mental reinstatement on children's recall is unclear. One factor that may impact its effectiveness is the degree to which interviewers prompt children during an interview. We examined whether interviewers’ degree of narrative prompting moderated the effect of mental context reinstatement during children's recall of a staged event. Younger and older children were interviewed 7–10 days after the event. Half were told to mentally reinstate the context and half were not. In a fully crossed design, half also received extended narrative prompting during the interview and half did not. We predicted that extensive narrative prompting should reduce any observable benefit of mental reinstatement, especially for older children. However, mental reinstatement had no beneficial effect on recall performance. It is possible that methodological differences, low statistical power, and a small effect size may have reduced the observable benefit of mental reinstatement in comparison to other studies. Overall, the findings of this study suggest that until further research can clearly define the parameters in which mental reinstatement is useful, and therefore produce findings with greater consistency across studies, there is little support for its use in investigative interviews with child witnesses.

The relationships between insomnia, sleep apnoea and depression: findings from the American National Health and Nutrition Examination Survey, 2005-2008.

Objective: To determine the association between insomnia, obstructive sleep apnoea (OSA), and comorbid insomnia- OSA and depression, while controlling for relevant lifestyle and health factors, among a large population-based sample of US adults. Method: We examined a sample of 11,329 adults (≥18 years) who participated in the National Health and Nutrition Examination Survey (NHANES) during the years 2005-2008. Insomnia was classified via a combination of self-reported positive physician diagnosis and high-frequency 'trouble falling asleep', 'waking during the night', 'waking too early', and 'feeling unrested during the day'. OSA was classified as a combination of a positive response to a physician-diagnosed condition, in addition to a high frequency of self-reported nocturnal 'snoring', 'snorting/stopping breathing' and 'feeling overly sleepy during the day'. Comorbid insomnia-OSA was further assessed by combining a positive response to either insomnia (all), or sleep apnoea (all), as classified above. Depressive symptomology was assessed by the Patient Health Questionnaire-9 (PHQ-9), with scores of >9 used to indicate depression. Odds ratios (ORs) and 95% confidence intervals (CIs) for sleep disorders and depression were attained from logistic regression modelling adjusted for sex, age, poverty level, smoking status and body mass index (BMI). Results: Those who reported insomnia, OSA or comorbid insomnia-OSA symptoms reported higher rates of depression (33.6%, 22.2%, 27.1%, respectively), and consistently reported poorer physical health outcomes than those who did not report sleep disorders. After adjusting for sex, age, poverty level, smoking status and BMI (kg/m2), insomnia (OR 6.57, 95% CI 3.89-11.11), OSA (OR 5.14, 95% CI 3.14-8.41) and comorbid insomnia-OSA (OR 6.67, 95% CI 4.44-10.00) were associated with an increased likelihood of reporting depression. © The Royal Australian and New Zealand College of Psychiatrists 2014.