Outcomes for elderly patients with mental illness following relocation from a stand-alone psychiatric hospital to community-based extended care units

Objective: To assess the outcomes for a group of elderly patients with mental illness following their discharge from a stand-alone psychiatric facility to seven extended care units (ECUs). Method: All patients (n = 60) who were relocated to the ECUs were assessed using a number of standardized clinical and general functioning instruments at 6 months and 6 weeks pre-move, and again at 6 weeks, 6 months and 18 months post-move. Results: By 18 months post-discharge, 13 of the 60 patients (21.7%) had died and seven others had been transferred to nursing homes. Those who died were older and had significantly higher levels of physical ill health when compared to those who did not die. Changes on measures of clinical and behavioural functioning in those who remained in the study did not reach statistical significance by 18 months post-move. However, participants did demonstrate improvements in quality of life with significantly higher scores on measures of social contact and community access. Conclusions: The mortality observed in the follow-up period is likely to be related to physical ill health and old age rather than the trauma associated with relocation. While overall functioning did not improve following relocation, patients had more independence and greater access to community-based activities.

Graphic satire and public life in the age of terror

This paper investigates media representations of international insecurity through a selection of newspaper cartoons from some of the major daily Australian broadsheets. Since 2001, cartoonists such as Bruce Petty, John Spooner and Bill Leak (in The Age and The Australian) have provided an ongoing and vehement critique of the Australian government’s policies of ‘border protection’, the ‘war on terror’ and the words of mass distraction associated with Australia joining the war in Iraq. Cartoonists are often said to represent the ‘citizen’s perspective’ of public life through their graphic satire on the editorial pages of our daily newspapers. Increasingly, they can also be seen to be fulfilling the role of public intellectuals, defined by Richard A. Posner as ‘someone whose place it is publicly to raise embarrassing questions, to confront orthodoxy and dogma, to be someone who cannot easily be co-opted by governments and corporations’. Cartoonists enjoy an independence and freedom from censorship that is rarely extended to their journalistic colleagues in the print media and it is this independence that is the vital component in their being categorised as public intellectuals. Their role is to ‘question over and over again what is postulated as self-evident, to disturb people’s mental habits, to dissipate what is familiar and accepted, to re-examine rules and institutions’ (Posner, 2003: 31). With this useful — if generalised — definition in mind, the paper considers how cartoonists have contributed to debates concerning international insecurity in public life since 2001.

The origin of the pelagobenthic metazoan life cycle: what's sex got to do with it?

The biphasic (pelagobenthic) life cycle is found throughout the animal kingdom, and includes gametogenesis, embryogenesis, and metamorphosis. From a tangled web of hypotheses on the origin and evolution of the metazoan pelagobenthic life cycle, current opinion appears to favor a simple, larval-like holopelagic ancestor that independently settled multiple times to incorporate a benthic phase into the life cycle. This hypothesis derives originally from Haeckel's (1874) Gastraea theory of ontogeny recapitulating phylogeny, in which the gastrula is viewed as the recapitulation of a gastracan ancestor that evolved via selection on a simple, planktonic hollow ball of cells to develop the capacity to feed. Here, we propose an equally plausible hypothesis that the origin of the metazoan pelagobenthic life cycle was a direct consequence of sexual reproduction in a likely holobenthic ancestor. In doing so, we take into account new insights from poriferan development and from molecular phylogenies. In this scenario, the gastrula does not represent a recapitulation, but simply an embryological stage that is an outcome of sexual reproduction. The embryo can itself be considered as the precursor to a biphasic lifestyle, with the embryo representing one phase and the adult another phase. This hypothesis is more parsimonious because it precludes the need for multiple, independent origins of the benthic form. It is then reasonable to consider that multilayered, ciliated embryos ultimately released into the water column are subject to natural selection for dispersal/longevity/feeding that sets them on the evolutionary trajectory towards the crown metazoan planktonic larvae. These new insights from poriferan development thus clearly support the intercalation hypothesis of bilaterian larval evolution, which we now believe should be extended to discussions of the origin of biphasy in the metazoan last common ancestor.