675 resultados para Mental Capacity Act


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Background Best practice clinical health care is widely recognised to be founded on evidence based practice. Enhancing evidence based practice via the rapid translation of new evidence into every day clinical practice is fundamental to the success of health care and in turn health care professions. There is little known about the collective research capacity and culture of the podiatry profession across Australia. Thus, the aim of this study was to investigate the research capacity and culture of the podiatry profession within Australia and determine if there were any differences between podiatrists working in different health sectors and workplaces. Method All registered podiatrists were eligible to participate in a cross-sectional online survey. The Australian Podiatry Associations disseminated the survey and all podiatrists were encouraged to distribute it to colleagues. The Research Capacity and Culture (RCC) tool was used to collect all research capacity and culture item variables using a 10-point scale (1 = lowest; 10 = highest). Additional demographic, workplace and health sector data variables were also collected. Mann–Whitney-U, Kruskal–Wallis and logistic regression analyses were used to determine any difference between health sectors and workplaces. Word cloud analysis was used for qualitative responses of individual motivators and barriers to research culture. Results There were 232 fully completed surveys (6% of Australian registered podiatrists). Overall respondents reported low success or skills (Median rating < 4) on the majority of individual success or skill items. Podiatrists working in multi-practitioner workplaces reported higher individual success or skills in the majority of items compared with sole practitioners (p < 0.05). Non-clinical and public health sector podiatrists reported significantly higher post-graduate study enrolment or completion, research activity participation, provisions to undertake research and individual success or skill than those working privately. Conclusions This study suggests that podiatrists in Australia report similar low levels of research success or skill to those reported in other allied health professions. The workplace setting and health sector seem to play key roles in self reported research success and skills. This is important knowledge for podiatrists and researchers aiming to translate research evidence into clinical practice.

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The suitability of human mesenchymal stem cells (hMSCs) in regenerative medicine relies on retention of their proliferative expansion potential in conjunction with the ability to differentiate toward multiple lineages. Successful utilisation of these cells in clinical applications linked to tissue regeneration requires consideration of biomarker expression, time in culture and donor age, as well as their ability to differentiate towards mesenchymal (bone, cartilage, fat) or non-mesenchymal (e.g., neural) lineages. To identify potential therapeutic suitability we examined hMSCs after extended expansion including morphological changes, potency (stemness) and multilineage potential. Commercially available hMSC populations were expanded in vitro for > 20 passages, equating to > 60 days and > 50 population doublings. Distinct growth phases (A-C) were observed during serial passaging and cells were characterised for stemness and lineage markers at representative stages (Phase A: P+5, approximately 13 days in culture; Phase B: P+7, approximately 20 days in culture; and Phase C: P+13, approximately 43 days in culture). Cell surface markers, stem cell markers and lineage-specific markers were characterised by FACS, ICC and Q-PCR revealing MSCs maintained their multilineage potential, including neural lineages throughout expansion. Co-expression of multiple lineage markers along with continued CD45 expression in MSCs did not affect completion of osteogenic and adipogenic specification or the formation of neurospheres. Improved standardised isolation and characterisation of MSCs may facilitate the identification of biomarkers to improve therapeutic efficacy to ensure increased reproducibility and routine production of MSCs for therapeutic applications including neural repair.

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Assessing testamentary capacity in the terminal phase of an illness or at a person's deathbed is fraught with challenges for both doctors and lawyers. Numerous issues need to be considered when assessing capacity for a will. These issues are exacerbated when such an assessment needs to be undertaken at the bedside of a dying patient. The nature and severity of the illness, effects on cognition of the terminal illness, effects of medication, urgency, psychological and emotional factors, interactions with carers, family and lawyers, and a range of other issues confound and complicate the assessment of capacity. What is the doctor's role in properly assessing capacity in this context and how does this role intersect with the legal issues? Doctors will play an increasing role in assessing testamentary capacity in this setting. The ageing of society, more effective treatment of acute illness and, often, the prolongation of dying are only some of the factors leading to this increasing need. However, despite its importance and increasing prevalence, the literature addressing this challenging practical area is scarce and offers limited guidance. This paper examines these challenges and discusses some practical approaches.

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Muscle hypertrophy occurs following increased protein synthesis, which requires activation of the ribosomal complex. Additionally, increased translational capacity via elevated ribosomal RNA (rRNA) synthesis has also been implicated in resistance training-induced skeletal muscle hypertrophy. The time course of ribosome biogenesis following resistance exercise (RE) and the impact exerted by differing recovery strategies remains unknown. In the present study, the activation of transcriptional regulators, the expression levels of pre-rRNA, and mature rRNA components were measured through 48 h after a single-bout RE. In addition, the effects of either low-intensity cycling (active recovery, ACT) or a cold-water immersion (CWI) recovery strategy were compared. Nine male subjects performed two bouts of high-load RE randomized to be followed by 10 min of either ACT or CWI. Muscle biopsies were collected before RE and at 2, 24, and 48 h after RE. RE increased the phosphorylation of the p38-MNK1-eIF4E axis, an effect only evident with ACT recovery. Downstream, cyclin D1 protein, total eIF4E, upstream binding factor 1 (UBF1), and c-Myc proteins were all increased only after RE with ACT. This corresponded with elevated abundance of the pre-rRNAs (45S, ITS-28S, ITS-5.8S, and ETS-18S) from 24 h after RE with ACT. In conclusion, coordinated upstream signaling and activation of transcriptional factors stimulated pre-rRNA expression after RE. CWI, as a recovery strategy, markedly blunted these events, suggesting that suppressed ribosome biogenesis may be one factor contributing to the impaired hypertrophic response observed when CWI is used regularly after exercise.

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Exploring high-performance anode materials is currently one of the most urgent issues towards practical sodium-ion batteries (SIBs). In this work, Bi2S3 is demonstrated to be a high-capacity anode for SIBs for the first time. The specific capacity of Bi2S3 nanorods achieves up to 658 and 264 mAh g-1 at a current density of 100 and 2000 mA g-1, respectively. A full cell with Na3V2(PO4)3-based cathode is also assembled as a proof of concept and delivers 340 mAh g-1 at 100 mA g-1. The sodium storage mechanism of Bi2S3 is investigated by ex-situ XRD coupled with high-resolution TEM (HRTEM), and it is found that sodium storage is achieved by a combined conversion-intercalation mechanism.

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Three-dimensional (3D) Fe2(MoO4)3 microspheres with ultrathin nanosheet constituents are first synthesized as anode materials for the lithium-ion battery. It is interesting that the single-crystalline nanosheets allow rapid electron/ion transport on the inside, and the high porosity ensures fast diffusion of liquid electrolyte in energy storage applications. The electrochemical properties of Fe2(MoO4)3 as anode demonstrates that 3D Fe2(MoO4)3 microspheres deliver an initial capacity of 1855 mAh/g at a current density of 100 mA/g. Particularly, when the current density is increased to 800 mA/g, the reversible capacity of Fe2(MoO4)3 anode still arrived at 456 mAh/g over 50 cycles. The large and reversible capacities and stable charge–discharge cycling performance indicate that Fe2(MoO4)3 is a promising anode material for lithium battery applications. Graphical abstract The electrochemical properties of Fe2(MoO4)3 as anode demonstrates that 3D Fe2(MoO4)3 microspheres delivered an initial capacity of 1855 mAh/g at a current density of 100 mA/g. When the current density was increased to 800 mA/g, the Fe2(MoO4)3 still behaved high reversible capacity and good cycle performance.

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Flood extent mapping is a basic tool for flood damage assessment, which can be done by digital classification techniques using satellite imageries, including the data recorded by radar and optical sensors. However, converting the data into the information we need is not a straightforward task. One of the great challenges involved in the data interpretation is to separate the permanent water bodies and flooding regions, including both the fully inundated areas and the wet areas where trees and houses are partly covered with water. This paper adopts the decision fusion technique to combine the mapping results from radar data and the NDVI data derived from optical data. An improved capacity in terms of identifying the permanent or semi-permanent water bodies from flood inundated areas has been achieved. Computer software tools Multispec and Matlab were used.

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Although the importance of clathrin- and caveolin-independent endocytic pathways has recently emerged, key aspects of these routes remain unknown. Using quantitative ultrastructural approaches, we show that clathrin-independent carriers (CLICs) account for approximately three times the volume internalized by the clathrin-mediated endocytic pathway, forming the major pathway involved in uptake of fluid and bulk membrane in fibroblasts. Electron tomographic analysis of the 3D morphology of the earliest carriers shows that they are multidomain organelles that form a complex sorting station as they mature. Proteomic analysis provides direct links between CLICs, cellular adhesion turnover, and migration. Consistent with this, CLIC-mediated endocytosis of key cargo proteins, CD44 and Thy-1, is polarized at the leading edge of migrating fibroblasts, while transient ablation of CLICs impairs their ability to migrate. These studies provide the first quantitative ultrastructural analysis and molecular characterization of the major endocytic pathway in fibroblasts, a pathway that provides rapid membrane turnover at the leading edge of migrating cells.

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Many developing countries are experiencing rapid expansion in mining with associated water impacts. In most cases mining expansion is outpacing the building of national capacity to ensure that sustainable water management practices are implemented. Since 2011, Australia's International Mining for Development Centre (IM4DC) has funded capacity building in such countries including a program of water projects. Five projects in particular (principally covering experiences from Peru, Colombia, Ghana, Zambia, Indonesia, Philippines and Mongolia) have provided insight into water capacity building priorities and opportunities. This paper reviews the challenges faced by water stakeholders, and proposes the associated capacity needs. The paper uses the evidence derived from the IM4DC projects to develop a set of specific capacity-building recommendations. Recommendations include: the incorporation of mine water management in engineering and environmental undergraduate courses; secondments of staff to suitable partner organisations; training to allow site staff to effectively monitor water including community impacts; leadership training to support a water stewardship culture; training of officials to support implementation of catchment management approaches; and the empowerment of communities to recognise and negotiate solutions to mine-related risks. New initiatives to fund the transfer of multi-disciplinary knowledge from nations with well-developed water management practices are called for.

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Internationally there is a growing interest in the mental wellbeing of young people. However, it is unclear whether mental wellbeing is best conceptualized as a general wellbeing factor or a multidimensional construct. This paper investigated whether mental wellbeing, measured by the Mental Health Continuum-Short Form (MHC-SF), is best represented by: (1) a single-factor general model; (2) a three-factor multidimensional model or (3) a combination of both (bifactor model). 2,220 young Australians aged between 16 and 25 years completed an online survey including the MHC-SF and a range of other wellbeing and mental ill-health measures. Exploratory factor analysis supported a bifactor solution, comprised of a general wellbeing factor, and specific group factors of psychological, social and emotional wellbeing. Confirmatory factor analysis indicated that the bifactor model had a better fit than competing single and three-factor models. The MHC-SF total score was more strongly associated with other wellbeing and mental ill-health measures than the social, emotional or psychological subscale scores. Findings indicate that the mental wellbeing of young people is best conceptualized as an overarching latent construct (general wellbeing) to which emotional, social and psychological domains contribute. The MHC-SF total score is a valid and reliable measure of this general wellbeing factor.

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Over 50% of young people have dated by age 15. While romantic relationship concerns are a major reason for adolescent help-seeking from counselling services, we have a limited understanding of what types of relationship issues are most strongly related to mental health issues and suicide risk. This paper used records of 4019 counselling sessions with adolescents (10–18 years) seeking help from a national youth counselling service for a romantic relationship concern to: (i) explore what types and stage (pre, during, post) of romantic concerns adolescents seek help for; (ii) how they are associated with mental health problems, self-harm and suicide risk; and (iii) whether these associations differ by age and gender. In line with developmental-contextual theory, results suggest that concerns about the initiation of relationships are common in early adolescence, while concerns about maintaining and repairing relationships increase with age. Relationship breakups were the most common concern for both male and female adolescents and for all age groups (early, mid, late adolescence). Data relating to a range of mental health issues were available for approximately half of the sample. Post-relationship concerns (including breakups) were also more likely than pre- or during-relationship concerns to be associated with concurrent mental health issues (36.8%), self-harm (22.6%) and suicide (9.9%). Results draw on a staged developmental theory of adolescent romantic relationships to provide a comprehensive assessment of relationship stressors, highlighting post-relationship as a particularly vulnerable time for all stages of adolescence. These findings contribute to the development of targeted intervention and support programs.

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While the majority of violent threats – defined as an expression of intent to do harm or act out violently against someone or something – do not progress to actual violence, a small proportion of threateners do go on to enact violence. Most researchers argue that violence risk assessments are inadequate for assessing threats of violence, which raises the question: how should a threat assessment (TA) be conducted? To begin to understand available frameworks for assessing threats, a systematic review of TA research literature was conducted. Most TA literature pertains to a specific domain (schools, public figure threats, workplaces) and target audience (clinicians, school personnel, law enforcement). TA guidelines are typically based on literature reviews with some based on empirical measures and others having no strong evidential basis. The most common concepts in TA are exploration of the threatener's mental health, the motivation for the threat and the presence of any plans. Rather than advocating for the development of a protocol for conducting TA, this article outlines the common areas of inquiry in assessing threats and highlights the limitations of current TA guidelines.

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The business value of information technology (IT) is realized through the continuous use of IT subsequent to users’ adoption. Understanding post-adoptive IT usage is useful in realizing potential IT business value. Most previous research on post-adoptive IT usage, however, dismisses the unintentional and unconscious aspects of usage behavior. This paper advances understanding of the unintentional, unconscious, and thereby automatic usage of IT features during the post-adoptive stage. Drawing from Social Psychology literature, we argue human behaviors can be triggered by environmental cues and directed by the person’s mental goals, thereby operating without a person’s consciousness and intentional will. On this basis, we theorize the role of a user’s innovativeness goal, as the desired state of an act to innovate, in directing the user’s unintentional, unconscious, and automatic post-adoptive IT feature usage behavior. To test the hypothesized mechanisms, a human experiment employing a priming technique, is described.

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In 2015, Victoria passed laws removing the time limit in which a survivor of child sexual abuse can commence a civil claim for personal injury. The law applies also to physical abuse, and to psychological injury arising from those forms of abuse. In 2016, New South Wales made almost identical legal reforms. These reforms were partly motivated by the recommendations of inquiries into institutional child abuse. Of particular relevance is that the Australian Royal Commission Into Institutional Responses to Child Sexual Abuse recommended in 2015 that all States and Territories remove their time limits for civil claims. This presentation explores the problems with standard time limits when applied to child sexual abuse cases (whether occurring within or beyond institutions), the scientific, ethical and legal justifications for lifting the time limits, and solutions for future law reform.