Legal duties following the discharge of mental health patients

In the recent decision of Hunter and New England Local Health District v McKenna; Hunter and New England Local Health District v Simon, the High Court of Australia held that a hospital and its medical staff owed no common law duty of care to third parties claiming for mental harm, against the background of statutory powers to detain mentally ill patients. This conclusion was based in part on the statutory framework and in part on the inconsistency which would arise if such a duty was imposed. If such a duty was imposed in these circumstances, the consequence may be that doctors would generally detain rather than discharge mentally ill persons to avoid the foreseeable risk of harm to others. Such an approach would be inconsistent with the policy of the mental health legislation , which favours personal liberty and discharge rather than detention unless no other care of a less restrictive kind is appropriate and reasonably available.

Predictors of mental health in midlife and older Australian women: A multilevel investigation

The purpose of this article is to examine the factors associated with women's mental health. A random sample of 340 Australian women aged 40–55 completed surveys on menopausal and lifestyle factors and mental health at three time points. We used hierarchical models to show that decrements in mental health were associated with a corresponding increase in some midlife symptoms (p < .01), time (p < .01), and poor physical health (p < .01), but the effect was not permanent. In older women, mental health was associated with physical functioning, climacteric symptoms, and time, while individual variations in mental health score were largely explained by lifestyle factors.

4th International Workshop on Theory and Application of Visualizations and Human-centric Aspects in Processes

This is the fourth TAProViz workshop being run at the 13th International Conference on Business Process Management (BPM). The intention this year is to consolidate on the results of the previous successful workshops by further developing this important topic, identifying the key research topics of interest to the BPM visualization community. Towards this goal, the workshop topics were extended to human computer interaction and related domains. Submitted papers were evaluated by at least three program committee members, in a double blind manner, on the basis of significance, originality, technical quality and exposition. Three full and one position papers were accepted for presentation at the workshop. In addition, we invited a keynote speaker, Jakob Pinggera, a postdoctoral researcher at the Business Process Management Research Cluster at the University of Innsbruck, Austria.

Patterns of care: Primary research in mental health nursing

The foundation of mental health nursing has historically been grounded in an interpersonal, person-centred process of health care, yet recent evidence suggests that the interactional work of mental health nursing is being eroded. Literature emphasises the importance of person-centred care on consumer outcomes, a model reliant upon the intimate engagement of nurses and consumers. Yet, the arrival of medical interventions in psychiatry has diverted nursing work from the therapeutic nursing role to task-based roles delegated by medicine, distancing nurses from consumers. This study used work sampling methodology to observe the proportion of time nurses working in an inpatient mental health setting engage in specific activities. The observations of this study determined that nurses' time is accounted for 31.65% in direct care, 51.63% in indirect care and 16.71% in service related activities.

A subculture of mental toughness in an Australian Football League club

Objective The current study aimed to provide a subcultural analysis of mental toughness in a high-performance context in sport. Design Using Schein's (1990) framework of organisational culture, an exploratory qualitative analysis, employing focus group and individual interviews, was used to investigate mental toughness in an Australian Football League club. Method Nine senior coaches and players participated in focus group and individual interviews. Photo elicitation was used as a method to capture mental toughness through the identification of prominent club artefacts. Participants were considered to have significant subcultural knowledge of their football club and were willing to describe personal experiences and perceptions of mental toughness through this cultural lens. Deductive and inductive analyses were conducted to capture the core themes of mental toughness across the disparate levels of Schein's organisational framework. Results Mental toughness was found to be a socially derived term marked by unrelenting standards and sacrificial displays. These acts were underpinned by subcultural values emphasising a desire for constant improvement, a team first ethos, relentless effort, and the maintenance of an infallible image. At its core, mental toughness was assumed to be an internal concept, epitomised an idealised form of masculinity, elitist values, and was rhetorically depicted through metaphors of war. Conclusions It may be difficult to understand mental toughness without giving attention to the contextual norms related to the term. Appreciating how people promote, instil, and internalise prized ideals coveted as mental toughness could be intriguing for future research in sport psychology.

Accelerating Pseudo-Marginal MCMC using Gaussian Processes

Pseudo-marginal methods such as the grouped independence Metropolis-Hastings (GIMH) and Markov chain within Metropolis (MCWM) algorithms have been introduced in the literature as an approach to perform Bayesian inference in latent variable models. These methods replace intractable likelihood calculations with unbiased estimates within Markov chain Monte Carlo algorithms. The GIMH method has the posterior of interest as its limiting distribution, but suffers from poor mixing if it is too computationally intensive to obtain high-precision likelihood estimates. The MCWM algorithm has better mixing properties, but less theoretical support. In this paper we propose to use Gaussian processes (GP) to accelerate the GIMH method, whilst using a short pilot run of MCWM to train the GP. Our new method, GP-GIMH, is illustrated on simulated data from a stochastic volatility and a gene network model.

Minimizing overprocessing waste in business processes via predictive activity ordering

Overprocessing waste occurs in a business process when effort is spent in a way that does not add value to the customer nor to the business. Previous studies have identied a recurrent overprocessing pattern in business processes with so-called "knockout checks", meaning activities that classify a case into "accepted" or "rejected", such that if the case is accepted it proceeds forward, while if rejected, it is cancelled and all work performed in the case is considered unnecessary. Thus, when a knockout check rejects a case, the effort spent in other (previous) checks becomes overprocessing waste. Traditional process redesign methods propose to order knockout checks according to their mean effort and rejection rate. This paper presents a more fine-grained approach where knockout checks are ordered at runtime based on predictive machine learning models. Experiments on two real-life processes show that this predictive approach outperforms traditional methods while incurring minimal runtime overhead.

Developing a best practice pathway to support improvements in Indigenous Australians' mental health and well-being: A qualitative study

Objective: There is a need to adapt pathways to care to promote access to mental health services for Indigenous people in Australia. This study explored Indigenous community and service provider perspectives of well-being and ways to promote access to care for Indigenous people at risk of depressive illness. Design: A participatory action research framework was used to inform the development of an agreed early intervention pathway; thematic analysis Setting: 2 remote communities in the Northern Territory. Participants: Using snowball and purposive sampling, 27 service providers and community members with knowledge of the local context and the diverse needs of those at risk of depression were interviewed. 30% of participants were Indigenous. The proposed pathway to care was adapted in response to participant feedback. Results: The study found that Indigenous mental health and well-being is perceived as multifaceted and strongly linked to cultural identity. It also confirms that there is broad support for promotion of a clear pathway to early intervention. Key identified components of this pathway were the health centre, visiting and community-based services, and local community resources including elders, cultural activities and families. Enablers to early intervention were reported. Significant barriers to the detection and treatment of those at risk of depression were identified, including insufficient resources, negative attitudes and stigma, and limited awareness of support options. Conclusions: Successful early intervention for wellbeing concerns requires improved understanding of Indigenous well-being perspectives and a systematic change in service delivery that promotes integration, flexibility and collaboration between services and the community, and recognises the importance of social determinants in health promotion and the healing process. Such changes require policy support, targeted training and education, and ongoing promotion.

Understanding mental toughness in Australian soccer: Perceptions of players, parents, and coaches

We explored mental toughness in soccer using a triangulation of data capture involving players (n = 6), coaches (n = 4), and parents (n = 5). Semi-structured interviews, based on a personal construct psychology (Kelly, 1955/1991) framework, were conducted to elicit participants' perspectives on the key characteristics and their contrasts, situations demanding mental toughness, and the behaviours displayed and cognitions employed by mentally tough soccer players. The results from the research provided further evidence that mental toughness is conceptually distinct from other psychological constructs such as hardiness. The findings also supported Gucciardi, Gordon, and Dimmock's (2009) process model of mental toughness. A winning mentality and desire was identified as a key attribute of mentally tough soccer players in addition to other previously reported qualities such as self-belief, physical toughness, work ethic/motivation, and resilience. Key cognitions reported by mentally tough soccer players enabled them to remain focused and competitive during training and matches and highlighted the adoption of several forms of self-talk in dealing with challenging situations. Minor revisions to Gucciardi and colleagues' definition of mental toughness are proposed.

Analytical model of reactive transport processes with spatially variable coefficients

Analytical solutions of partial differential equation (PDE) models describing reactive transport phenomena in saturated porous media are often used as screening tools to provide insight into contaminant fate and transport processes. While many practical modelling scenarios involve spatially variable coefficients, such as spatially variable flow velocity, v(x), or spatially variable decay rate, k(x), most analytical models deal with constant coefficients. Here we present a framework for constructing exact solutions of PDE models of reactive transport. Our approach is relevant for advection-dominant problems, and is based on a regular perturbation technique. We present a description of the solution technique for a range of one-dimensional scenarios involving constant and variable coefficients, and we show that the solutions compare well with numerical approximations. Our general approach applies to a range of initial conditions and various forms of v(x) and k(x). Instead of simply documenting specific solutions for particular cases, we present a symbolic worksheet, as supplementary material, which enables the solution to be evaluated for different choices of the initial condition, v(x) and k(x). We also discuss how the technique generalizes to apply to models of coupled multispecies reactive transport as well as higher dimensional problems.

Special Issue on Spatial Moment Techniques for Modelling Biological Processes

Over the last two decades, there has been an increasing awareness of, and interest in, the use of spatial moment techniques to provide insight into a range of biological and ecological processes. Models that incorporate spatial moments can be viewed as extensions of mean-field models. These mean-field models often consist of systems of classical ordinary differential equations and partial differential equations, whose derivation, at some point, hinges on the simplifying assumption that individuals in the underlying stochastic process encounter each other at a rate that is proportional to the average abundance of individuals. This assumption has several implications, the most striking of which is that mean-field models essentially neglect any impact of the spatial structure of individuals in the system. Moment dynamics models extend traditional mean-field descriptions by accounting for the dynamics of pairs, triples and higher n-tuples of individuals. This means that moment dynamics models can, to some extent, account for how the spatial structure affects the dynamics of the system in question.

The designed environment and how it affects brain morphology and mental health

Background The environment is inextricably related to mental health. Recent research replicates findings of a significant, linear correlation between a childhood exposure to the urban environment and psychosis. Related studies also correlate the urban environment and aberrant brain morphologies. These findings challenge common beliefs that the mind and brain remain neutral in the face of worldly experience. Aim There is a signature within these neurological findings that suggests that specific features of design cause and trigger mental illness. The objective in this article is to work backward from the molecular dynamics to identify features of the designed environment that may either trigger mental illness or protect against it. Method This review analyzes the discrete functions putatively assigned to the affected brain areas and a neurotransmitter called dopamine, which is the primary target of most antipsychotic medications. The intention is to establish what the correlations mean in functional terms, and more specifically, how this relates to the phenomenology of urban experience. In doing so, environmental mental illness risk factors are identified. Conclusions Having established these relationships, the review makes practical recommendations for those in public health who wish to use the environment itself as a tool to improve the mental health of a community through design.

Lost in space: The place of the architectural milieu in the aetiology and treatment of schizophrenia

Purpose – Psychological and epidemiological literature suggests that the built environment plays both causal and therapeutic roles in schizophrenia, but what are the implications for designers? The purpose of this paper is to focus on the role the built environment plays in psycho‐environmental dynamics, in order that negative effects can be avoided and beneficial effects emphasised in architectural design. Design/methodology/approach – The approach taken is a translational exploration of the dynamics between the built environment and psychotic illness, using primary research from disciplines as diverse as epidemiology, neurology and psychology. Findings – The built environment is conceived as being both an agonist and as an antagonist for the underlying processes that present as psychosis. The built environment is implicated through several means, through the opportunities it provides. These may be physical, narrative, emotional, hedonic or personal. Some opportunities may be negative, and others positive. The built environment is also an important source of unexpected aesthetic stimulation, yet in psychotic illnesses, aesthetic sensibilities characteristically suffer from deterioration. Research limitations/implications – The findings presented are based on research that is largely translated from very different fields of enquiry. Whilst findings are cogent and logical, much of the support is correlational rather than empirical. Social implications – The WHO claims that schizophrenia destroys 24 million lives worldwide, with an exponential effect on human and financial capital. Because evidence implicates the built environment, architectural and urban designers may have a role to play in reducing the human costs wrought by the illness. Originality/value – Never before has architecture been so explicitly implicated as a cause of mental illness. This paper was presented to the Symposium of Mental Health Facility Design, and is essential reading for anyone involved in designing for improved mental health.

Complete and interpretable conformance checking of business processes

This article presents a method for checking the conformance between an event log capturing the actual execution of a business process, and a model capturing its expected or normative execution. Given a business process model and an event log, the method returns a set of statements in natural language describing the behavior allowed by the process model but not observed in the log and vice versa. The method relies on a unified representation of process models and event logs based on a well-known model of concurrency, namely event structures. Specifically, the problem of conformance checking is approached by folding the input event log into an event structure, unfolding the process model into another event structure, and comparing the two event structures via an error-correcting synchronized product. Each behavioral difference detected in the synchronized product is then verbalized as a natural language statement. An empirical evaluation shows that the proposed method scales up to real-life datasets while producing more concise and higher-level difference descriptions than state-of-the-art conformance checking methods.

Violence against the adolescents of Kolkata: A study in relation to the socio-economic background and mental health

This study attempts to understand the nature of violence suffered by the adolescents of Kolkata (erstwhile Calcutta) and to identify its relation with their socio-economic background and mental health variables such as anxiety, adjustment, and self-concept. It is a cross-sectional study covering a total of 370 adolescents (182 boys and 188 girls) from six higher secondary schools in Kolkata. The data was gathered by way of a semi-structured questionnaire and three standard psychological tests. Findings revealed that 52.4%, 25.1%, and 12.7% adolescents suffered psychological, physical, and sexual violence in the last year. Older adolescents (aged 17–18 years) suffered more psychological violence than the younger ones (15–16 years) (p < 0.05). Sixty nine (18.6%) adolescent students stood witness to violence between adult members in the family. More than three-fifth (61.9%) adolescents experienced at least one type of violence, while one-third (32.7%) experienced physical or sexual violence or both. Whatever its nature is, violence leaves a scar on the mental health of the victims. Those who have been through regular psychological violence reported high anxiety, emotional adjustment problem, and low self-concept. Sexual abuse left a damaging effect on self-concept (p < 0.05), while psychological violence or the witnessing of violence prompted high anxiety scores (p < 0.05), poor emotional adjustment (p < 0.05), and low self-concept (p < 0.05). This study stresses the need to provide individual counselling services to the maltreated adolescents of Kolkata so that their psychological traumas can heal and that they can move on in life with new hopes and dreams.