Cultural safety, diversity and the servicer user and carer movement in mental health research

This study will be of interest to anyone concerned with a critical appraisal of mental health service users’ and carers’ participation in research collaboration and with the potential of the postcolonial paradigm of cultural safety to contribute to the service user research (SUR) movement. The history and nature of the mental health field and its relationship to colonial processes provokes a consideration of whether cultural safety could focus attention on diversity, power imbalance, cultural dominance and structural inequality, identified as barriers and tensions in SUR. We consider these issues in the context of state-driven approaches towards SUR in planning and evaluation and the concurrent rise of the SUR movement in the UK and Australia, societies with an intimate involvement in processes of colonisation. We consider the principles and motivations underlying cultural safety and SUR in the context of the policy agenda informing SUR. We conclude that while both cultural safety and SUR are underpinned by social constructionism constituting similarities in principles and intent, cultural safety has additional dimensions. Hence, we call on researchers to use the explicitly political and self-reflective process of cultural safety to think about and address issues of diversity, power and social justice in research collaboration.

Optimizing preventative maintenance strategies for linear assets

Linear assets are engineering infrastructure, such as pipelines, railway lines, and electricity cables, which span long distances and can be divided into different segments. Optimal management of such assets is critical for asset owners as they normally involve significant capital investment. Currently, Time Based Preventive Maintenance (TBPM) strategies are commonly used in industry to improve the reliability of such assets, as they are easy to implement compared with reliability or risk-based preventive maintenance strategies. Linear assets are normally of large scale and thus their preventive maintenance is costly. Their owners and maintainers are always seeking to optimize their TBPM outcomes in terms of minimizing total expected costs over a long term involving multiple maintenance cycles. These costs include repair costs, preventive maintenance costs, and production losses. A TBPM strategy defines when Preventive Maintenance (PM) starts, how frequently the PM is conducted and which segments of a linear asset are operated on in each PM action. A number of factors such as required minimal mission time, customer satisfaction, human resources, and acceptable risk levels need to be considered when planning such a strategy. However, in current practice, TBPM decisions are often made based on decision makers’ expertise or industrial historical practice, and lack a systematic analysis of the effects of these factors. To address this issue, here we investigate the characteristics of TBPM of linear assets, and develop an effective multiple criteria decision making approach for determining an optimal TBPM strategy. We develop a recursive optimization equation which makes it possible to evaluate the effect of different maintenance options for linear assets, such as the best partitioning of the asset into segments and the maintenance cost per segment.

Mental health facility design: The case for person-centred care

There is a schism between a growing chorus for person-centred models of care and the prevalent paradigms for the design of mental health facilities. This argument proposes that architectural solutions have traditionally been geared around staff-centred concerns like ease of patient management. It suggests that the demands for person-centred models of care are important because evidence suggests that the physical environment is a causal factor in mental illness, and that even minor concessions towards person-centred models of care consistently exert a disproportionate and sustained positive influence on the behaviour of mental health patients. While the traditional mental health unit layout is unsatisfactory for person-centred care and effective recovery, other approaches that have been well tested and found to be effective is described along with a statement about subtle details that will improve facilities for all users.

Strategies for the suspension and prevention of disconnection: Rendering disconnection as socioecenomic lubricant with Facebook

This paper attends to the idea of disconnection as a way of theorising people’s lived experience of social networking sites. Enrolling and extending a disconnective practice lens we suggest that the disconnective strategies of suspension and prevention are operational necessities for those we might see as the users and owners of sites such as Facebook. Indeed, our work demonstrates that disconnection in these contexts need not be associated only with modes of resistance and departure, but can also act as socioeconomic lubricant.

Investment strategies in retirees' decumulation phase

This thesis consists of three studies on investment strategies for Australian retirees. Specifically, it investigates retirees' preference between alternative drawdown strategies in the presence of government pensions, appropriate management of longevity risk through the use of deferred annuities and asset allocation in retirement. It finds drawdown strategies linked to life expectancy to be the best performers. Deferred annuities are found to improve retirement incomes for risk averse retirees. For retirees who want to meet certain wealth thresholds in retirement, equity dominated portfolios provide superior outcomes for higher threshold levels.

Émile Durkheim and Thomas Luckmann: Religion, spirituality and mental health

This chapter examines connections between religion, spirituality and mental health. Religion and spirituality influence the way people conceive themselves, others and the world around them, as well as how they behave – and are strongly associated with numerous mental health outcomes. Religion and spirituality therefore demand the attention of those who seek a comprehensive understanding of the factors that affect mental health. Mental health professionals are increasingly being asked to consider their clients’ religious and/or spiritual beliefs when devising their treatment plans, making the study of religion and spirituality an essential area of learning for those working in the mental health field. Initial discussion in this chapter will focus on the different approaches taken by sociologists in studying mental health. Emile Durkheim, one of the founders of sociology, proposed that religion was fundamental to societal wellbeing and was the first to demonstrate a link between religion and mental health at a population level in the late 19th century. Durkheim’s classic theory of religion, together with the work of Thomas Luckmann and other contemporary social theorists who have sought to explain widespread religious change in Western countries since World War II will be examined. Two key changes during this period are the shift away from mainstream Christian religions and the widespread embracing of ‘spirituality’ as an alternative form of religious expression. In combination, the theories of Durkheim, Luckmann and other sociologists provide a platform from which to consider reasons for variations in rates of mental health problems observed in contemporary Western societies according to people’s religious/spiritual orientation. This analysis demonstrates the relevance of both classic and contemporary sociological theories to issues confronting societies in the present day.

Is group more cost effective than individual cognitive behaviour therapy? The evidence is not solid yet

This paper critically evaluates the empirical evidence of 36 studies regarding the comparative cost-effectiveness of group and individual cognitive behaviour therapy (CBT) as a whole, and also for specific mental disorders (e.g. depression, anxiety, substance abuse) or populations (e.g. children). Methods of calculating costs, as well as methods of comparing treatment outcomes were appraised and criticized. Overall, the evidence that group CBT is more cost-effective than individual CBT is mixed, with group CBT appearing to be more cost effective in treating depression and children, but less cost effective in treating drugs and alcohol dependence, anxiety and social phobias. In addition, methodological weaknesses in the studies assessed are noted. There is a need to improve cost calculation methodology, as well as more solid and a greater number of empirical cost-effectiveness studies before a firm conclusion can be reached that group CBT is more cost effective then individual CBT.

Religion, spirituality, and mental health and social behaviour in young adulthood: A longitudinal study

Background The concept spirituality appears to be gaining increasing attention for its potential relationship to mental health, despite there being an absence of consensus on what spirituality is or whether it can be distinguished from religion (or religiousness) in operational terms. Spirituality is a term that is embraced within secular and non-secular contexts alike. As a consequence, spirituality as a concept encompasses forms of religiosity that are embedded in traditional religion and those that have little or no connection to traditional religious teachings. The emergence of religious/spiritual beliefs that depart from traditional religious thought represents one key feature of widespread religious change in contemporary societies. Non-traditional religious/spiritual beliefs need to be viewed within this context and thus be differentiated from traditional religious/spiritual beliefs when investigating connections between religion, spirituality, and mental health. Aims The current study seeks to compare the mental health of those whose beliefs are rooted in religious tradition with those whose beliefs deviate from traditional religious thought. The two main objectives of this study are: (1) to determine the extent to which religious background predicts endorsement of traditional and non-traditional religious/spiritual beliefs and church attendance in young adulthood, and; (2) to determine whether differential relationships exist between current religiosity, religious background, and mental health in young adulthood, and whether any observed differences are attributable to other characteristics of respondents like sociodemographic factors and health-risk behaviours. Methods Data were derived from the Mater-University of Queensland Study of Pregnancy, a longitudinal, prospective study of maternal and child health from the prenatal period to 21 years post-delivery. Religiosity was assessed among the study children in young adulthood from three items measured at the time of the 21-year follow-up. Religious background was assessed from information provided by the study mothers in earlier phases of the study. Young adult responses to items included in the Young Adult Self Report (Achenbach, 1997) were used to assess cases of anxiety/depression and externalising behaviour, and delusional ideation was assessed from their responses to the 21-item Peters et al. Delusions Inventory (PDI) (Peters & Garety, 1996). Results Belief in a spiritual or higher power other than God was found to be positively related to anxiety/depression, disturbed ideation, suspiciousness and paranormal ideation, high total PDI scores, as well as antisocial behaviour in young adulthood, regardless of gender. These associations persisted after adjustment for potential confounders. By contrast, young adults who maintain a traditional belief in God appear to be no different to those who reject this belief in regard to anxiety/depression. Belief in God was found to have no association with antisocial behaviour for males, but was observed to have a weak negative relationship with antisocial behaviour for females. This association failed to reach statistical significance however, after adjustment for other religious/spiritual and social characteristics. No associations were found between young adult belief in God and disturbed, suspicious or paranormal ideation, although a positive relationship was identified for high total PDI scores. Weekly church attendance was observed to reduce the likelihood of antisocial behaviour in young adulthood among males, but not females. Religious ideation was found to more prevalent among young adults who attend church on either a weekly or infrequent basis. No long-term effects on anxiety/depression or antisocial behaviour were evident from maternal belief in God, church attendance or religious affiliation in the young adults’ early lives. However, maternal church attendance predicted religious ideation in young adulthood. Offspring of mothers affiliated with a Pentecostal church in the prenatal period appear to have a high rate of religious ideation and high total PDI scores. Paranormal ideation in young adulthood appears to have no association with maternal religiosity in a young adult’s early life. Conclusion The findings from this study suggest that young adults who endorse non-traditional religious/spiritual beliefs are at greater risk for poorer mental health and aberrant social behaviour than those who reject these beliefs. These results suggest that a non-traditional religious/spiritual belief system involves more than mere rejection of traditional religious doctrine. This system of belief may be a marker for those who question the legitimacy of established societal norms and values, and whose thoughts, attitudes and actions reflect this position. This possibility has implications for mental health and wellbeing at both an individual and a societal level and warrants further research attention.

Calculation of the speed of walking of individuals with transfemoral amputation fitted with bone-anchored prosthesis

Typically, the walking ability of individuals with a transfemoral amputation (TFA) can be represented by the speed of walking (SofW) obtained in experimental settings. Recent developments in portable kinetic systems allow assessing the level of activity of TFA during actual daily living outside the confined space of a gait lab. Unfortunately, only minimal spatio-temporal characteristics could be extracted from the kinetic data including the cadence and the duration on gait cycles. Therefore, there is a need for a way to use some of these characteristics to assess the instantaneous speed of walking during daily living. The purpose of the study was to compare several methods to determine SofW using minimal spatial gait characteristics.

Use of parametric modelling and climate-based metrics for the efficient design of daylight strategies in buildings with complex geometries

The purpose of this research is to assess daylight performance of buildings with climatic responsive envelopes with complex geometry that integrates shading devices in the façade. To this end two case studies are chosen due to their complex geometries and integrated daylight devices. The effect of different parameters of the daylight devices is analysed through Climate base daylight metrics.

The culture of young women's drinking: Implications for developing effective policing strategies. Report to National Drug Strategy Law Enforcement Committee

Alcohol-related mortality and morbidity represents a substantial financial burden on communities across the world. Adolescence and young adulthood is a peak period for heavy episodic alcohol consumption, with over a third of all people aged 14-19 years having been at risk of acute alcoholrelated harm at least once in the previous 12 months (Australian Institute of Health and Welfare [AIHW], 2011). Excessive alcohol consumption has long been seen as a male problem; however, a gradual shift towards a social acceptance of female drunkenness has narrowed the gap in drinking quantity and style between men and women (Grucza, Bucholz, Rice, & Bierut, 2008). The presented data point to the vulnerability of women to the consequences of acute alcohol intoxication and indicate that alcohol-related offending by women is on the rise. Taken together, these findings reveal that alcohol-related harms and aggression for young women are becoming more prevalent and problematic. This report addressed these issues from a policing perspective...

Psychological services for asylum seekers in the community: Challenges and solutions

Objective: Given the Australian government’s current policy of placing asylum seekers into the community while their applications for asylum are being considered, it is important that mental health practitioners are able to offer culturally safe, sensitive, and competent services in this context. Method: A qualitative approach was used to interview seven practitioners, who provided services to asylum seekers at a specialist health clinic in the community. These professionals used their experience to identify the psychosocial issues faced by these asylum seekers, the challenges of providing culturally effective services to this group, and how these services can be improved. Result: Data were thematically analysed using NVivo. The findings indicated that participants perceived that clients experienced psychological, health, and cultural difficulties. The stress and uncertainty around visa applications emerged as the most severe factor impacting asylum seekers’ mental health. Working effectively with interpreters and culturally adapting assessment and treatment for these clients emerged as effective strategies. Gathering information in a conversational way and using clients’ different cultural explanatory models were methods used to identify and address mental health issues, rather than using formal measures. Interventions were eclectic and holistic, and reflected treatments that were appropriate for the clients’ cultural backgrounds. Conclusion: The study has implications for how psychological services are offered to asylum seekers in the community. Further, it identifies areas that can be incorporated in the future training of practitioners.

"It broke our hearts": Understanding parents' lived experiences of their child's admission to an acute mental health care facility

This article reports the evaluative findings of an Early Psychosis Education Program (EPEP) designed to support parents caring for their child who was recently admitted to the psychiatric intensive care unit of an inpatient mental health care facility in Australia. The EPEP offered education on mental illness, treatment options, and medication, as well as information on the recovery model of care. The EPEP was facilitated by two RNs and was evaluated for educational effectiveness using a simple pre- and postevaluation questionnaire. The evaluation revealed two themes expressed by parents: "We didn't see it coming," and "Hopelessness and helplessness." The themes highlighted the parents' lack of mental health care knowledge prior to the EPEP, which had a significant impact on the parents' experiences and well-being. The evaluative findings highlighted a need for a nurse-led EPEP within the community. A community EPEP has the potential to strengthen the partnership between parents, families, and mental health service providers and to help with the provision of a recovery framework of care.

Evolutionary optimization and game strategies for advanced multi-disciplinary design : applications to aeronautics and UAV design

Many complex aeronautical design problems can be formulated with efficient multi-objective evolutionary optimization methods and game strategies. This book describes the role of advanced innovative evolution tools in the solution, or the set of solutions of single or multi disciplinary optimization. These tools use the concept of multi-population, asynchronous parallelization and hierarchical topology which allows different models including precise, intermediate and approximate models with each node belonging to the different hierarchical layer handled by a different Evolutionary Algorithm. The efficiency of evolutionary algorithms for both single and multi-objective optimization problems are significantly improved by the coupling of EAs with games and in particular by a new dynamic methodology named “Hybridized Nash-Pareto games”. Multi objective Optimization techniques and robust design problems taking into account uncertainties are introduced and explained in detail. Several applications dealing with civil aircraft and UAV, UCAV systems are implemented numerically and discussed. Applications of increasing optimization complexity are presented as well as two hands-on test cases problems. These examples focus on aeronautical applications and will be useful to the practitioner in the laboratory or in industrial design environments. The evolutionary methods coupled with games presented in this volume can be applied to other areas including surface and marine transport, structures, biomedical engineering, renewable energy and environmental problems.