Challenges in implementing evidence-based practice into mental health services

This paper highlights challenges in implementing mental health policy at a service delivery level. It describes an attempt to foster greater application of recovery-orientated principles and practices within mental health services. Notwithstanding a highly supportive policy environment, strong support from service administrators, and an enthusiastic staff response to training, application of the training and support tools was weaker than anticipated. This paper evaluates the dissemination trial against key elements to promote sustained adoption of innovations. Organisational and procedural changes are required before mental health policies are systematically implemented in practice.

'Faith-based' organisations and contemporary welfare

This paper explores issues arising from the welfare reform process in the United States and Australia. The involvement of faith-based organisations in both countries has evolved in different historical, social, political and cultural contexts. The paper will explore three main themes. First, it examines the relevance of the term 'faith-based' to describe the nature of the relationship between charities and churches in the mixed economy of welfare in the Australian context. Second, it provides a critical analysis of the reform processes, suggesting implications for the future of church-based organisations. Third, it maps directions for cross-comparative research of church-based social services provision in both countries.

Quality of service in flexible workflows through process constraints

Workflow technology has delivered effectively for a large class of business processes, providing the requisite control and monitoring functions. At the same time, this technology has been the target of much criticism due to its limited ability to cope with dynamically changing business conditions which require business processes to be adapted frequently, and/or its limited ability to model business processes which cannot be entirely predefined. Requirements indicate the need for generic solutions where a balance between process control and flexibility may be achieved. In this paper we present a framework that allows the workflow to execute on the basis of a partially specified model where the full specification of the model is made at runtime, and may be unique to each instance. This framework is based on the notion of process constraints. Where as process constraints may be specified for any aspect of the workflow, such as structural, temporal, etc. our focus in this paper is on a constraint which allows dynamic selection of activities for inclusion in a given instance. We call these cardinality constraints, and this paper will discuss their specification and validation requirements.

Models of psychological service provision under Australia's better outcomes in mental health care program

The Access to Allied Psychological Services component of Australia's Better Outcomes in Mental Health Care program enables eligible general practitioners to refer consumers to allied health professionals for affordable, evidence-based mental health care, via 108 projects conducted by Divisions of General Practice. The current study profiled the models of service delivery across these projects, and examined whether particular models were associated with differential levels of access to services. We found: 76% of projects were retaining their allied health professionals under contract, 28% via direct employment, and 7% some other way; Allied health professionals were providing services from GPs' rooms in 63% of projects, from their own rooms in 63%, from a third location in 42%; and The referral mechanism of choice was direct referral in 51% of projects, a voucher system in 27%, a brokerage system in 24%, and a register system in 25%. Many of these models were being used in combination. No model was predictive of differential levels of access, suggesting that the approach of adapting models to the local context is proving successful.

Introducing evidence-based family assessment and therapy in child and youth mental health services: Applying systemic principles to maintain, sustain and build capacity

The purpose of this article is to overview the context of the mental health service in which we work, and family therapy's status prior to and after the impact of changes wrought by the introduction of the National Mental Health Policy. We then explore some key issues that we think contribute to the persistence of the occlusion of family therapy in child psychiatric services; and the strategies that we developed and are continuing to develop to support change, finally, we describe the use of a family assessment instrument that we believe is central to our change strategy.

Searching the world wide web for local services and facilities: A review on the patterns of location-based queries

Many queries sent to search engines refer to specific locations in the world. Location-based queries try to find local services and facilities around the user’s environment or in a particular area. This paper reviews the specifications of geospatial queries and discusses the similarities and differences between location-based queries and other queries. We introduce nine patterns for location-based queries containing either a service name alone or a service name accompanied by a location name. Our survey indicates that at least 22% of the Web queries have a geospatial dimension and most of these can be considered as location-based queries. We propose that location-based queries should be treated different from general queries to produce more relevant results.

Vertical handover based adaptions for multimedia applications in pervasive systems

This paper proposes an architecture for pervasive computing which utilizes context information to provide adaptations based on vertical handovers (handovers between heterogeneous networks) while supporting application Quality of Service (QoS). The future of mobile computing will see an increase in ubiquitous network connectivity which allows users to roam freely between heterogeneous networks. One of the requirements for pervasive computing is to adapt computing applications or their environment if current applications can no longer be provided with the requested QoS. One of possible adaptations is a vertical handover to a different network. Vertical handover operations include changing network interfaces on a single device or changes between different devices. Such handovers should be performed with minimal user distraction and minimal violation of communication QoS for user applications. The solution utilises context information regarding user devices, user location, application requirements, and network environment. The paper shows how vertical handover adaptations are incorporated into the whole infrastructure of a pervasive system

Increased availability and scalability for clustered services via the wait time calculation, trust based filtering and redirection of TCP connection requests

The paper describes two new transport layer (TCP) options and an expanded transport layer queuing strategy that facilitate three functions that are fundamental to the dispatching-based clustered service. A transport layer option has been developed to facilitate. the use of client wait time data within the service request processing of the cluster. A second transport layer option has been developed to facilitate the redirection of service requests by the cluster dispatcher to the cluster processing member. An expanded transport layer service request queuing strategy facilitates the trust based filtering of incoming service requests so that a graceful degradation of service delivery may be achieved during periods of overload - most dramatically evidenced by distributed denial of service attacks against the clustered service. We describe how these new options and queues have been implemented and successfully tested within the transport layer of the Linux kernel.

The information specialist in the clinical team: Building expertise in evidence-based healthcare

The Clinician Development Program (CDP) is an initiative of Queensland Health’s Quality Improvement and Enhancement Program. At the Royal Brisbane & Royal Women's Hospital Health Service Districts, evidence-base practice (EBP) is an important CDP area in which several projects were carried out in 2002. This paper describes one such project. A medical librarian was invited to accompany the clinical team on morning rounds in the Medical Assessment & Planning Unit (MAPU). The librarian conducted information skills training in the ward and helped clinicians to answer questions directly related to patient care. Questions not answered during the round were followed-up, usually within 48 hours, and responses emailed to the consultant who led the rounds. At the project’s conclusion the librarian was invited to continue as a member of the MAPU clinical team, thus acknowledging the valuable role an information specialist can play in incorporating research evidence into patient care. Clinical librarianship (CL) creates a space, albeit a contentious one, for the health librarian at the bedside. This paper describes an Australian CL project and attempts to demystify the role of an information specialist in EBP. It also highlights some of the challenges facing librarians and clinicians attempting to embed EBP in clinical settings.