Enablers and barriers to accessing mental health services for adults with high prevalence psychological disorders in South West Victoria

Knowing what services are available and how to access them can be challenging in rural areas. The aim of the South West Mental Health Mapping project was to identify the level, accessibility and effectiveness of mental health services for high prevalence psychological disorders amongst the adult population in the South West region of Victoria. This study includes data from a number of sources: regional records of the number and location of health professionals; a telephone survey of 1297 people in five Local Government Areas in the region; and a social network analysis of contact points. Additional qualitative interviews and surveys were conducted with 25 service recipients and 37 health professionals to identify issues from different perspective. This paper will focus on the social network analysis of the project. It highlights the relative prominence of each type of service provider within the overall network. The social network map shows the centrality of the General Practitioner and the wide range of agencies that become involved in supporting people with mental health issues. The discussion identifies primary contact points for people seeking help and places of referral. The main barrier acknowledged by people requiring assistance was lack of knowledge about where to go for help. Enablers included Medicare Better Access funded schemes. The findings show that there is a reasonable range of mental health professionals across the region, although there are challenges with recruitment and retention of staff. Even with available services, a major problem is communicating this information to potential consumers

Defining and measuring the outcomes of inclusive community for people with disability, their families and the communities with whom they engage

This paper explores the meaning of ‘inclusive community’ as understood by a major disability service provider in Victoria, Australia. Scope is a major non government agency with 1300 staff, a $50M annual budget and over 4500 clients. The recent adoption of a new Strategic plan for the organisation has focused significant attention on the priority area of building welcoming and inclusive communities. Given this mandate, the organisation has begun research to define and measure outcomes for people with a disability, their families, and the communities with whom they engage, as a result of increased community inclusion. This paper reviews literature on outcomes definition relevant to this task and suggests that outcome measures to date, especially within the field of disability, have offered a set of outcomes that are too limited in their aspiration and breadth. It has been the experience within Scope that people with a disability, including people with intellectual, multiple and complex disabilities, aspire to and experience outcomes across a far broader range of life domains than is currently captured in either existing disability outcome measures or in government policies that frame service delivery. As a result, the paper introduces an emerging outcomes framework which seeks to define outcomes across a range of citizenship domains.

Supporting knowledge transfer in web-based managed IT support

Purpose – The purpose of this paper is to highlight the importance and complexities of the knowledge transfer process in the provision of effective managed after-sales IT support, when the web is used for service delivery.

Design/methodology/approach – The paper features an interpretive case study of a multinational Managed Service Provider (MSP) and a focus group of representatives from five comparable MSPs.

Findings – The paper finds that MSPs that use web-based channels for the provision of after-sales IT support services need to address a range of important social and organisational issues in order to realise cost and efficiency-based benefits.

Research limitations/implications – The paper provides a four stage processual model of knowledge transfer in the provision of web-based managed after-sales IT support services. The barriers and enablers of knowledge transfer at each stage are identified. The paper adopts a MSP perspective and suggests that further research from the customer perspective is required.

Practical implications – The paper highlights some important social and organisational enablers and barriers, which will guide MSPs when providing managed after-sales IT support using webbased channels.

Originality/value – The paper provides the first staged model of inter-organisational knowledge transfer in a complex multi-organisational and multi-channel web-based context.

Above the trust and security in cloud computing : a notion towards innovation

While the nascent Cloud Computing paradigm supported by virtualization has the upward new notion of edges, it lacks proper security and trust mechanisms. Edges are like on demand scalability and infinite resource provisioning as per the `pay-as-you-go' manner in favour of a single information owner (abbreviated as INO from now onwards) to multiple corporate INOs. While outsourcing information to a cloud storage controlled by a cloud service provider (abbreviated as CSP from now onwards) relives an information owner of tackling instantaneous oversight and management needs, a significant issue of retaining the control of that information to the information owner still needs to be solved. This paper perspicaciously delves into the facts of the Cloud Computing security issues and aims to explore and establish a secure channel for the INO to communicate with the CSP while maintaining trust and confidentiality. The objective of the paper is served by analyzing different protocols and proposing the one in commensurate with the requirement of the security property like information or data confidentiality along the line of security in Cloud Computing Environment (CCE). To the best of our knowledge, we are the first to derive a secure protocol by successively eliminating the dangling pitfalls that remain dormant and thereby hamper confidentiality and integrity of information that is worth exchanging between the INO and the CSP. Besides, conceptually, our derived protocol is compared with the SSL from the perspectives of work flow related activities along the line of secure trusted path for information confidentiality.

How dynamic capabilities drive performance in the Indian IT industry : the role of information and co-ordination

This study examines key issues and effects of capability management on a fast-growing area of knowledge-intensive global business services – IT outsourcing and offshoring. An exploratory study is undertaken of Indian companies providing complex process-oriented offshore IT services to their global customers. The analysis of the data related to the service provider side shows that developing dynamic capabilities is strongly driven by management and top-clients and results in the development of business processes and in establishing a strategic partnership with the client organization. Key findings are that information exchange and coordination are the key to a leveraging firm performance.

Establishing trust in hybrid cloud computing environments

Establishing trust for resource sharing and collaboration has become an important issue in distributed computing environment. In this paper, we investigate the problem of establishing trust in hybrid cloud computing environments. As the scope of federated cloud computing enlarges to ubiquitous and pervasive computing, there will be a need to assess and maintain the trustworthiness of the cloud computing entities. We present a fully distributed framework that enable trust-based cloud customer and cloud service provider interactions. The framework aids a service consumer in assigning an appropriate weight to the feedback of different raters regarding a prospective service provider. Based on the framework, we developed a mechanism for controlling falsified feedback ratings from iteratively exerting trust level contamination due to falsified feedback ratings. The experimental analysis shows that the proposed framework successfully dilutes the effects of falsified feedback ratings, thereby facilitating accurate and fair assessment of the service reputations.

Trust ticket deployment : a notion of a data owner's trust in cloud computing

While cloud computing (CC) is a scalable model of shared infrastructure and on-demand computing, it lacks a transparent trust and security mechanism. A data owner (DO) loses control over the data outsourced to a machine in the cloud controlled and operated by a cloud service provider (CSP). This machine is at a location unknown to a data owner. This loss of control over data is further intensified with the lack of managing users' access to the data from practical cloud computing perspectives. In this paper, we introduce a new mechanism of ensuring trust and security in Software as a Service (SaaS) CC. Trust Ticket, with the supporting protocols, is our mechanism that helps a data owner in establishing a link between a CSP and a registered user. In our mechanism, a user first gets registered with a DO before receiving a Trust Ticket and a secret key from that DO. Each Trust Ticket is unique and encrypted. On completing the registration of each user, the DO apprises the CSP of the Trust Ticket. Trust Ticket and secret key are respectively for the registered user's getting accepted to the CSP and having a view of the data owner's data upon a successful verification by the CSP. We have done our experiment in Java network programming by creating an emulated cloud computing framework under the VMware ESXi 4.1 hyper visor based platform. Using the framework, we have evaluated our algorithmic protocol for Trust Ticket. We have also compared our work with prior work. Overall performance of our work is better. We argue that our proposed algorithmic protocol for Trust Ticket deployment establishes a data owner's trust. This trust is established through a data owner's control over data and a registered user, because a registered user is linked with a CSP by a data owner through Trust Ticket.

Custom essay writing : an exploration

In late 2010, three things happened. Firstly, I graded the final submission of a student who had, to date, been producing work that was, on the whole, pass/credit standard. Their last essay was outstanding. It was well organised, cleverly argued, well referenced and enjoyable to read. Turnitin assured me that the paper was not plagiarised but I remained suspicious because it seemed ‘too good to be true’. In the end, I gave it 91/100. Later in the same year, the final two events happened. I discovered that a large scale essay writing service provider from the USA was opening a ‘branch’ in Australia. Finally, a colleague from the States told me how she had become enraged to see a custom writing essay provider as a (busy) stallholder at her orientation week market day. She was furious, surely this is illegal? Interested in finding out ‘what (if anything) this might mean to Deakin?’, Toija and I approached Teaching and Learning in our faculty to see if they might fund a small experiment. They did, and the presentation will contain a record of this exploratory project. This project had a very simple premise. What would we receive if we ordered a custom written essay for one of the ALC101 assignment questions? Would it pass?

Australia's health 2006 : the tenth biennial report of the Australian Institute of Health and Welfare

The report shows that Australians generally have good health and are privileged to have a range of health care services available to them. There are stark exceptions to this that can be confronting—even if well-known already—notably the generally much poorer health status of Indigenous Australians.

Health care service provider and funding arrangements are both increasingly complex and increasingly costly to both individuals and taxpayers. A continuing challenge is how to balance both the complementary and competitive perspectives of government and non-government agencies, professional groups, and small businesses. Overall, national expenditure on health was 9.7% of GDP in 2003–04; and average health expenditure per person has grown by an average 3.8% each year between 1997–98 to 2002–03. Expenditure on aids and appliances, health research and pharmaceuticals contributed more to this growth than other areas.

While the ageing of the population is having a significant impact on the number and type of health care services delivered, high quality services for children continue to be a priority. Australia’s health 2006 has a special chapter focusing on children and their health. The chapter highlights the fact that while our children are generally very healthy, there are concerns that their ongoing health could be affected by more and more of them becoming overweight or obese. Levels of diabetes are now rising among our children and it is a continuing concern that asthma and mental health problems affect so many of them.

Event extraction using behaviors of sentiment signals and burst structure in social media

Significant world events often cause the behavioral convergence of the expression of shared sentiment. This paper examines the use of the blogosphere as a framework to study user psychological behaviors, using their sentiment responses as a form of ‘sensor’ to infer real-world events of importance automatically. We formulate a novel temporal sentiment index function using quantitative measure of the valence value of bearing words in blog posts in which the set of affective bearing words is inspired from psychological research in emotion structure. The annual local minimum and maximum of the proposed sentiment signal function are utilized to extract significant events of the year and corresponding blog posts are further analyzed using topic modeling tools to understand their content. The paper then examines the correlation of topics discovered in relation to world news events reported by the mainstream news service provider, Cable News Network, and by using the Google search engine. Next, aiming at understanding sentiment at a finer granularity over time, we propose a stochastic burst detection model, extended from the work of Kleinberg, to work incrementally with stream data. The proposed model is then used to extract sentimental bursts occurring within a specific mood label (for example, a burst of observing ‘shocked’). The blog posts at those time indices are analyzed to extract topics, and these are compared to real-world news events. Our comprehensive set of experiments conducted on a large-scale set of 12 million posts from Livejournal shows that the proposed sentiment index function coincides well with significant world events while bursts in sentiment allow us to locate finer-grain external world events.

Patient and business rules extraction and formalisation using SVN and SBVR for automated healthcare

This paper describes advances in automated health service selection and composition in the Ambient Assisted Living (AAL) domain. We apply a Service Value Network (SVN) approach to automatically match medical practice recommendations to health services based on sensor readings in a home care context. Medical practice recommendations are extracted from National Health and Medical Research Council (NHMRC) guidelines. Service networks are derived from Medicare Benefits Schedule (MBS) listings. Service provider rules are further formalised using Semantics of Business Vocabulary and Business Rules (SBVR), which allows business participants to identify and define machine-readable rules. We demonstrate our work by applying an SVN composition process to patient profiles in the context of Type 2 Diabetes Management.

Detecting and mitigating HX-DoS attacks against cloud web services

Cyber-Physical Systems allow for the interaction of the cyber world and physical worlds using as a central service called Cloud Web Services. Cloud Web Services can sit well within three models of Cyber- Physical Systems, Software-as-a-Service (SaaS), Platform-as-a-Service (PaaS), and Infrastructure-as-a- Service (IaaS). With any Cyber-Physical system use Cloud Web Services it inherits a security problem, the HX-DoS attack. HX-DoS attack is a combination of HTTP and XML messages that are intentionally sent to flood and destroy the communication channel of the cloud service provider. The relevance of this research is that TCP/IP flood attacks are a common problem and a lot of research to mitigate them has previously been discussed. But HTTP denial of service and XML denial of service problem has only been addressed in a few papers. In this paper, we get closer to closing this gap on this problem with our new defence system called Pre- Decision, Advance Decision, Learning System (ENDER). In our previous experiments using our Cloud Protector, we were successful at detecting and mitigate 91% with a 9% false positive of HX-DoS attack traffic. In this paper, ENDER was able to improve upon this result by being trained and tested on the same data, but with a greater result of 99% detection and 1% false positive.

Three phases of the Pacific Islands Project (1995–2010)

The Pacific Islands Project (PIP), funded by AusAid and managed by the Royal Australasian College of Surgeons (RACS), has progressed through three phases from 1995 to 2010. During this time, it has sent over 520 teams to 11 Pacific Island Countries, providing over 60 000 consultations and some 16 000 procedures. In addition to this delivery of specialist medical and surgical services that were not previously available in-country, the project has contributed as a partner in capacity building with the Fiji School of Medicine and Ministries of Health of the individual nations. By 2011, Fiji School of Medicine, which began postgraduate specialist training in 1998, had awarded 51 doctors a diploma in surgery (1 year), 20 of whom had completed their Masters in Medicine (4 years). PIP was independently evaluated on completion of every phase, including the bridging Phase III (2006–2010). The project delivered on its design, to deliver services, and also helped build capacity. The relationship established with the RACS throughout the project allowed Pacific Island graduates to access the Rowan Nicks scholarship, and the majority of MMed graduates received International Travel Grants to attend the Annual Scientific Meeting. PIP has been a highly successful partnership in delivering and building specialist medical services. Although AusAid contributed some $20 million over 16 years, the value added from pro bono contributions by Specialist Teams, Specialty Coordinators and the Project Directors amounted to an equivalent amount. With the emergence of Pacific Island-trained specialists, PIP is ready to move into a new phase where the agendas are set, monitored and managed within the Pacific, and RACS fulfils the role of a service provider. A critical mass of Pacific Island surgeons has been trained, so that sub-specialization will be an option for the general surgeons of the larger island nations.

Examining the impact of reimbursement on referral to bone density testing for older adults: 8 years of data from the Barwon Statistical Division, Australia

Summary
In 2007, Medicare Australia revised reimbursement guidelines for dual energy X-ray absorptiometry (DXA) for Australians aged ≥70 years; we examined whether these changes increased DXA referrals in older adults. Proportions of DXA referrals doubled for men and tripled for women from 2003 to 2010; however, rates of utilization remained low.

Introduction
On April 1, 2007 Medicare Australia revised reimbursement guidelines for DXA for Australians aged ≥70 year; changes that were intended to increase the proportion of older adults being tested. We examined whether changes to reimbursement increased DXA referrals in older adults, and whether any sex differences in referrals were observed in the Barwon Statistical Division.

Methods
Proportions of DXA referrals 2003–2010 based on the population at risk ascertained from Australian Census data and annual referral rates and rate ratios stratified by sex, year of DXA, and 5-year age groups. Persons aged ≥70 years referred to the major public health service provider for DXA clinical purposes (n = 6,096; 21 % men).

Results
DXA referrals. Proportions of DXA referrals for men doubled from 0.8 % (2003) to 1.8 % (2010) and tripled from 2.0 to 6.3 % for women (all p < 0.001). For 2003–2006, referral ratios of men/women ranged between 1:1.9 and 1:3.0 and for 2007–2010 were 1:2.3 to 1:3.4. Referral ratios <2007:≥2007 were 1:1.7 for men aged 70–79 years (p < 0.001), 1:1.2 for men aged 80–84 years (p = 0.06), and 1:1.3 for men 85+ years (p = 0.16). For women, the ratios <2007:≥2007 were 1:2.1 (70–79 years), 1.1.5 (80–84 years), and 1:1.4 (85+ years) (all p < 0.001).

Conclusions
DXA referral ratios were 1:1.6 (men) and 1:1.8 (women) for 2007–2010 vs. 2003–2006; proportions of referrals doubled for men and tripled for women from 2003 to 2010. Overall, rates of DXA utilization remained low. Policy changes may have had minimal influence on referral; thus, ongoing evaluation over time is warranted.

Costs of psychosis in 2010: findings from the second Australian national survey of psychosis

Objectives
To estimate the annual costs of psychosis in Australia from societal and government perspectives and assess whether average costs per person differ by principal service provider at time of census.

Methods
Costs of psychosis encompassing health sector costs, other sector costs, and productivity losses were assessed for 2010 using a prevalence-based, bottom-up approach. Resource use data were obtained from the second Australian National Survey of Psychosis and unit costs were from government and non-government organization (NGO) sources. Costs to society were assessed by principal service provider at census: public specialized mental health services (PSMHS) and NGOs during the census month (current clients), and PSMHS in the 11 months preceding census (recent clients), and any differences were ascertained.

Results
The average annual costs of psychosis to society are estimated at $77,297 per affected individual, comprising $40,941 in lost productivity, $21,714 in health sector costs, and $14,642 in other sector costs. Health sector costs are 3.9-times higher than those for the average Australian. Psychosis costs Australian society $4.91 billion per annum, and the Australian government almost $3.52 billion per annum. There are significant differences between principal service providers for each cost category. Current PSMHS clients had the highest health sector costs overall, and the highest mental health ambulatory, inpatient, and antipsychotic medication costs specifically. NGO clients had the highest other sector costs overall and the highest NGO assistance, supported employment, and supported accommodation costs. Recent PSMHS clients had the lowest productivity losses for reduced participation and the highest costs for absenteeism and presenteeism.

Conclusions
The costs of psychosis are broad ranging and very high. Development and implementation of cost-effective prevention, treatment, and support strategies is critical to maximizing the efficiency of service delivery. A needs-based framework based on principal service provider and recency of contact may facilitate this process.