Public and private psychiatry: Can they work together and is it worth the effort?

Objective: Partnerships in mental health care, particularly between public and private psychiatric services, are being increasingly recognized as important for optimizing patient management and the efficient organization of services. However, public sector mental health services and private psychiatrists do not always work well together and there seem to be a number of barriers to effective collaboration. This study set out to investigate the extent of collaborative 'shared care' arrangements between a public mental health service and private psychiatrists practising nearby. It also examined possible barriers to collaboration and some possible solutions to the identified problems. Method: A questionnaire examining the above factors was sent to all public sector mental health clinicians and all private psychiatrists in the area. Results: One hundred and five of the 154 (68.2%) public sector clinicians and 103 of the 194 (53.1%) private psychiatrists returned surveys. The main barriers to successful collaboration identified by members of both sectors were: 'Difficulty communicating' endorsed by 71.4% of public clinicians and 72% of private psychiatrists, 'Confusion of roles and responsibilities' endorsed by 62.9% and 66%, respectively, and 'Different treatment approach' by 47.6% and 45.6%, respectively. Over 60% of private psychiatrists identified problems with access to the public system as a barrier to successful shared care arrangements. It also emerged, as hypothesized, that the public and private systems tend to manage different patient populations and that public clinicians in particular are not fully aware of the private psychiatrists' range of expertise. This would result in fewer referrals for shared care across the sectors. Conclusions: A number of barriers to public sector clinicians and private psychiatrists collaborating in shared care arrangements were identified. The two groups surveyed identified similar barriers. Some of these can potentially be addressed by changes to service systems. Others require cultural shifts in both sectors. Improved communications including more opportunities for formal and informal meetings between people working in the two sectors would be likely to improve the understanding of the complementary sector's perspective and practice. Further changes would be expected to require careful work between the sectors on training, employment and practice protocols and initiatives, to allow better use of the existing services and resources.

Development of a quasi-chemical viscosity model for fully liquid slags in the Al2O3-CaO-'FeO'-MgO-SiO2 system. Part 1. Description of the model and its application to the MgO, MgO-SiO2, Al2O3-MgO and CaO-MgO sub-systems

A structurally-based quasi-chemical viscosity model for fully liquid slags in the Al2O3 CaO-'FeO'-MgO-SiO2 system has been developed. The model links the slag viscosities to the internal structures of the melts through the concentrations of various Si0.5O, Me2/nn+O and Me1/nn+Si0.25O viscous flow structural units. The concentrations of these structural units are derived from a quasi-chemical thermodynamic model of the system. The model described in this series of papers enables the viscosities of liquid slags to be predicted within experimental uncertainties over the whole range of temperatures and compositions in the Al2O3 CaOMgO-SiO2 system.

Development of a quasi-chemical viscosity model for fully liquid slags in the Al2O3-CaO-'FeO'-MgO-SiO2 system. Part 2. A review of the experimental data and the model predictions for the Al2O3-CaO-MgO, CaO-MgO-SiO2 and Al2O3-MgO-SiO2 systems

A structurally-based quasi-chemical viscosity model has been developed for the Al2O3 CaO-'FeO'-MgO-SiO2 system. The model links the slag viscosity to the internal structure of melts through the concentrations of various anion/cation Si0.5O, Me2/nn+O and Me1/nn+Si0.25O viscous flow structural units. The concentrations of structural units are derived from the quasi-chemical thermodynamic model. The focus of the work described in the present paper is the analysis of experimental data and the viscosity models for fully liquid slags in the Al2O3-CaO-MgO, Al2O3 MgO-SiO2 and CaO-MgO-SiO2 systems.

Verification and validation of autonomous systems

NASA is working on complex future missions that require cooperation between multiple satellites or rovers. To implement these systems, developers are proposing and using intelligent and autonomous systems. These autonomous missions are new to NASA, and the software development community is just learning to develop such systems. With these new systems, new verification and validation techniques must be used. Current techniques have been developed based on large monolithic systems. These techniques have worked well and reliably, but do not translate to the new autonomous systems that are highly parallel and nondeterministic.

Proteome analysis of extracellular proteins regulated by the las and rhl quorum sensing systems in Pseudomonas aeruginosa PAO1

The las and rhl quorum sensing (QS) systems regulate the expression of several genes in response to cell density changes in Pseudomonas aeruginosa. Many of these genes encode surface-associated or secreted virulence factors. Proteins from stationary phase culture supernatants were collected from wild-type and P. aeruginosa PAO1 mutants deficient in one or more of the lasRI, rhIRI and vfr genes and analysed using two-dimensional gel electrophoresis. All mutants released significantly lower amounts of protein than the wild-type. Protein spot patterns from each strain were compared using image analysis and visible spot differences were identified using mass spectrometry. Several previously unknown OS-regulated proteins were characterized, including an aminopeptidase (PA2939), an endoproteinase (PrpL) and a unique 'hypothetical' protein (PA0572), which could not be detected in the culture supernatants of Delta/as mutants, although they were unaffected in Deltarhl mutants. Chitin-binding protein (CbpD) and a hypothetical protein (PA4944) with similarity to host factor I (HF-1) could not be detected when any of the lasRI or rhIRI genes were disrupted. Fourteen proteins were present at significantly greater levels in the culture supernatants of OS mutants, suggesting that QS may also negatively control the expression of some genes. Increased levels of two-partner secretion exoproteins (PA0041 and PA4625) were observed and may be linked to increased stability of their cognate transporters in a CS-defective background. Known QS-regulated extracellular proteins, including elastase (lasB), LasA protease (lasA) and alkaline metalloproteinase (aprA) were also detected.

Defenses against oxidative stress in Neisseria gonorrhoeae and Neisseria meningitidis: Distinctive systems for different lifestyles

Defenses against oxidative stress are crucial for the survival of the pathogens Neisseria meningitidis and Neisseria gonorrhoeae. An Mn(II) uptake system is involved in manganese (Mn)-dependent resistance to superoxide radicals in N. gonorrhoeae. Here, we show that accumulation of Mn also confers resistance to hydrogen peroxide killing via a catalase-independent mechanism. An mntC mutant of N. meningitidis is susceptible to oxidative killing, but supplementation of growth media with Mn does not enhance the organism's resistance to oxidative killing. N. meningitidis is able to grow in the presence of millimolar levels of Mn ion, in contrast to N. gonorrhoeae, whose growth is retarded at Mn concentrations >100 mumol/L, indicating that Mn homeostasis in the 2 species is probably quite different. N. meningitidis superoxide dismutase B plays a role in protection against oxidative killing. However, a sodC mutant of N. meningitidis is no more sensitive to oxidative killing than is the wild type. A cytochrome c peroxidase (Ccp) is present in N. gonorrhoeae but not in N. meningitidis. Investigations of a ccp mutant revealed a role for Ccp in protection against hydrogen peroxide killing. These differences in oxidative defenses in the pathogenic Neisseria are most likely a result of their localization in different ecological niches.

Offensive language, offensive behaviour and public nuisance: Empirical and theoretical analyses

Offensive behaviour and offensive language - new Queensland public nuisance offence - interpretation and enforcement by police and magistrates - impact of changes to legislation on the number and nature of prosecutions for legally unacceptable behaviour and language coming before the courts - results of empirical study indicate that public nuisance offence is not meeting its objectives - not being targeted only at behaviour which threatens the safety or security of people using public space as was its intention.