Integrated depression management: a proposed trial of a new model of care in a low vision rehabilitation setting

Purpose:
Depression is a common problem among people with visual impairment and contributes to functional decline. This article presents a study protocol to evaluate a new model of care for those patients with depressive symptoms in which psychological treatment is integrated into low vision rehabilitation services. Low vision staff will be trained to deliver "problem solving therapy for primary care" (PST-PC), an effective psychological treatment developed specifically for delivery by non-mental health care staff. PST-PC is delivered in 8 weekly telephone sessions of 30-45 minutes duration and 4 monthly maintenance sessions. We predict this new integrated model of care will significantly reduce depressive symptoms and improve the quality of life for people with visual impairment.

Methods and Design:
A randomized controlled trial of PST-PC will be implemented nationally across low vision rehabilitation services provided by Vision Australia. Clients who screen positive for depressive symptoms and meet study criteria will be randomized to receive PST-PC or usual care, consisting of a referral to their general practitioner for more detailed assessment and treatment. Outcome measures include depressive symptoms and behaviors, quality of life, coping and psychological adjustment to visual impairment. Masked assessments will take place pre- and post-intervention as well as at 6- and 12-month follow-up.

Conclusion:
We anticipate that this innovative service delivery model will lead to sustained improvements in clients' quality of life in a cost effective manner and provide an innovative service delivery model suitable for other health care areas in which depression is co-morbid.

A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention

Private-sector organizations play a critical role in shaping the food environments of individuals and populations. However, there is currently very limited independent monitoring of private-sector actions related to food environments. This paper reviews previous efforts to monitor the private sector in this area, and outlines a proposed approach to monitor private-sector policies and practices related to food environments, and their influence on obesity and non-communicable disease (NCD) prevention. A step-wise approach to data collection is recommended, in which the first (‘minimal’) step is the collation of publicly available food and nutrition-related policies of selected private-sector organizations. The second (‘expanded’) step assesses the nutritional composition of each organization's products, their promotions to children, their labelling practices, and the accessibility, availability and affordability of their products. The third (‘optimal’) step includes data on other commercial activities that may influence food environments, such as political lobbying and corporate philanthropy. The proposed approach will be further developed and piloted in countries of varying size and income levels. There is potential for this approach to enable national and international benchmarking of private-sector policies and practices, and to inform efforts to hold the private sector to account for their role in obesity and NCD prevention.

Design with nature : a proposed model for coastal settlements in Australia adapting to climate change and extreme weather events

The Australian coast is rich in history and is scattered with coastal settlements amongst a contrasting landscape with infinite visual and ecological diversity. These attributes provide the opportunity to create sustainable and resilient settlements, linking the wholeness of a place to the foundation of living in harmony with nature. On the contrary the coastal regions of Australia are facing dynamic changes of population growth including the looming impact of a changing climate. Acknowledging these challenges, the Australian Government highlighted that one of the key requirements for a sustainable future is to establish sustainable settlements that are resilient against the impacts of climate change. Recent government studies and reports highlighted various possible impacts to the Australian coast and regional settlements due to sea level rise with associated coastal recession, extreme weather events, flooding, and prolonged heat waves. Various adaptation frameworks are proposed to deal with this issue, but very few consider the relationship between ecological systems and human built environments. The resilience planning of settlements must consider the co-evolution of human and nature under future climate effects. This paper is thus seeking answers to the question: How can the theoretical principles of Design with Nature (McHarg, 1967) and The Nature of Order (Alexander, 1980) provide for input to a adaptation model for settlements along the coast? Reflecting on a literature review of these two well established theories, the author select key principles from both as input to a ecological design based adaptation model for coastal settlements, which establishes a system of unfolding steps to create sustainable communities that connect with the landscape, and are resilient against future impacts of change.

An examination of a proposed DSM-IV pathological gambling hierarchy in a treatment seeking population: similarities with substance dependence and evidence for three classification systems

Toce-Gerstein et al. (Addiction 98:1661–1672, 2003) investigated the distribution of Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV) pathological gambling criteria endorsement in a U.S. community sample for those people endorsing a least one of the DSM-IV criteria (n = 399). They proposed a hierarchy of gambling disorders where endorsement of 1–2 criteria were deemed ‘At-Risk’, 3–4 ‘Problem gamblers’, 5–7 ‘Low Pathological’, and 8–10 ‘High Pathological’ gamblers. This article examines these claims in a larger Australian treatment seeking population. Data from 4,349 clients attending specialist problem gambling services were assessed for meeting the ten DSM-IV pathological gambling criteria. Results found higher overall criteria endorsement frequencies, three components, a direct relationship between criteria endorsement and gambling severity, clustering of criteria similar to the Toce-Gerstein et al. taxonomy, high accuracy scores for numerical and criteria specific taxonomies, and also high accuracy scores for dichotomous pathological gambling diagnoses. These results suggest significant complexities in the frequencies of criteria reports and relationships between criteria.

A proposed definition of the engineering methodology

BACKGROUND An adequately concise and accurate definition of the profession of engineering that can simultaneously encompass a majority of the profession and be reasonably understood by a majority of society arguably remains as an elusive goal yet to be attained.While numerous definitions of the profession exist they tend to describe specific methods or approaches deployed in the practice of engineering rather than be suitably descriptive of the profession of engineering.The lack of an adequate, accurate and relevant definition of the profession of engineering has, and continues to, present disadvantages to the profession. While acknowledging this problem the profession continues to rely on existing inadequate, inaccurate, or irrelevant definitions of itself as it struggles to attain the degree of awareness, recognition, and appreciation of its significant benefits that directly impact society and the individual.Accordingly in many countries the choice of engineering as a career path often ranks below other profession choices such as medicine, law, and management - especially with adolescent girls. Also the relevance and role of professional engineering in socio-economic and socio-political contexts is often undervalued or neglected – especially in national and international policy discussions and development.PURPOSETo provide a clear, concise, and accurate definition of the profession of engineering that is acceptable for most, if not all, major stakeholders.METHOD A review of historical and contemporary definitions of professional engineering is provided. Using Koen’s definition of the engineering method in conjunction with Shulman’s set of characteristics common to professions a more generic definition is derived that seeks to simultaneously accommodate the homogenous multi-disciplinary attributes of professional engineering as well as accommodate the discipline specific attributes.RESULTS A proposed definition of the engineering methodology has been developed. A background introduction and justified derivation is provided for the proposed definition.CONCLUSIONS The limitations and inadequacies of historical and contemporary definitions of professional engineering have been considered. Using Koen’s definition as a basis a more generic multi-disciplinary and more contemporary definition is derived and presented. The goal of the proposed definition of the engineering methodology is to provide a more concise, more accurate, and most importantly a more comprehensible definition of the profession of engineering for the purpose of being applied to all major stakeholders of the profession.

A proposed approach to systematically identify and monitor the corporate political activity of the food industry with respect to public health using publicly available information.

Unhealthy diets represent one of the major risk factors for non-communicable diseases. There is currently a risk that the political influence of the food industry results in public health policies that do not adequately balance public and commercial interests. This paper aims to develop a framework for categorizing the corporate political activity of the food industry with respect to public health and proposes an approach to systematically identify and monitor it. The proposed framework includes six strategies used by the food industry to influence public health policies and outcomes: information and messaging; financial incentive; constituency building; legal; policy substitution; opposition fragmentation and destabilization. The corporate political activity of the food industry could be identified and monitored through publicly available data sourced from the industry itself, governments, the media and other sources. Steps for country-level monitoring include identification of key food industry actors and related sources of information, followed by systematic data collection and analysis of relevant documents, using the proposed framework as a basis for classification of results. The proposed monitoring approach should be pilot tested in different countries as part of efforts to increase the transparency and accountability of the food industry. This approach has the potential to help redress any imbalance of interests and thereby contribute to the prevention and control of non-communicable diseases.

A proposed roadmap to optimise the adjudication of complex payment disputes in Australia

In Australia, statutory construction adjudication has recently received a lot of criticism due to the increasing amount of determinations that have been quashed upon judicial review, and anecdotal evidence from some quarters showing dissatisfaction with the quality of adjudication decisions. Such criticism is particularly aimed at adjudications of large and technically and legally complex payment disputes, where adjudicators are under pressure to consider substantial volumes of submissions in very tight timeframes. More specifically, criticisms have been directed at, inter alia, adjudicator’s regulations, procedural fairness, jurisdictional powers and finality of decisions. This paper reviews the measures to improve the quality of adjudications of complex payment disputes then proposes a roadmap by selecting the Qld model as a benchmark but suggesting further improvements identified and explained via specific steps or pit stops. The pit stops include criteria for timeframes of complex claims, appointment, regulation and powers of adjudicators and a review system on the merits to control the quality of adjudication decisions replicating the Singapore model. The findings remain as blunt instruments and deemed as hypotheses to inform subsequent empirical research which the authors are currently undertaking to further investigate, strengthen and validate the findings of this study in order to propose a reliable and useful guide to any parliament seeking to optimise its statutory adjudication to effectively deal with complex payment disputes.

Accessibility impact of proposed Australian high speed rail

High speed rail (also commonly known as HSR) is highly regarded as one of the most significant innovation for mass passenger transportation to travellers willing to pay for reduced travel impediments (shorter travel time, convenience, safety, security, comfort, reliability, flexibility, uniqueness and attractiveness). The transport policy in Australia has until now focused primarily on private passenger car transport and air transportation to the degree that State and Federal Governments’ commitments and actions of rail-oriented mass transportation system still remains sketchy in spite of occasional political and public attentions into it. This has resulted in a limited use of passenger rail as a regional transport system. Using one of the several alternative HSR alignments proposed for the South-Eastern Coast of Australia connecting Melbourne, Canberra, Sydney and Brisbane, this study assesses the regional accessibility impacts of Australian HSR system by means of four indicators: location accessibility, economic potential accessibility, daily accessibility and commuting accessibility. These indicators are commonly used in transport geography literature and they offer different concepts of changes in regional accessibility conditions due to a long distance transport system. The results provide an understanding of differential effects on regional accessibility based on the geographical location and size of urban areas along HSR corridor.