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.

Issues in the implementation of cross-cultural management in Australia-evidence from a study of selected public and private sector organisations

This study examines the current status of cross-cultural management (CCM) in Australia.

The study is based on Reyes' (2004) Ph.D research of a qualitative nature in five organisations in the public and private sectors selected from a sample of organisations which appear to lead the field in Australia in respect of CCM. Literature is also surveyed to present a picture of the current legal and institutional setting of CCM in Australia and provide a context for the study.

Analysis of the findings highlights the gap between cross-cultural rhetoric and action in workplace situations. Problems are identified leading to incomplete and inadequate implementation of CCM in the respondent organisations. The study argues for the need for management to take a systems approach to the formulation and implementation of CCM. Some suggestions are made for improvements in the future.

Production of Australian freshwater crayfish in earthen-based systems using pelleted diets and forage crops as food

Juvenile Cherax destructor (commonly called theyabby) were cultured in earthen-based ponds and tanks for 70–105d, and were fed pellets and/or a forage crop of the perennialwhiteclover, Trifolium repens. Three supplementary feedingstrategies were evaluated. Yabby growth on pellets consistently exceeded (by67–159%) that obtained on clover. Base-line yields for extensiveproduction systems are around 400 kg ha^–1. Thesupplementary addition of T. repens produced yields of 635kg ha^–1 (in ponds) to 1086 kgha^–1 (in tanks). The sequential addition of cut-cloverto tanks stimulated growth to levels approaching those achieved on pellets.Yabbies stocked into ponds at 17 m^–2 and fed 33%protein pellets for 100 d, resulted in a yield of 1117 kgha^–1.Pellet inputs at a rate of 129–249 g m^–2(dry matter) and 38–83 g m^–2 (protein) over70–100 d resulted in acceptable growth and feed utilisationindices. Clover inputs of 534–682 g m–2 (asdry matter) or 84–177 g m^–2 (as protein)produced reasonable growth rates but poor feed utilisation indices. Aconsiderable quantity of the dry matter and protein content of clover waseitherinefficiently utilised or directed into other production pathways. In tanks,clover inputs from 113–296 g m^–2 (drymatter) and 24–54 g m^–2 (protein) weresufficient to maintain high growth rates for 4 weeks, while in ponds, inputs of21 g m^–2 (dry matter) and 4.3 gm^–2 (protein) were sufficient for 3 weeks. During theearly weeks of production no growth advantage was gained by providing pelletstoanimals cultured in forage-based systems. Forage depletion occurred after3–4 weeks and was probably a major growth limiting factor.

Public interest, ethics, and the balanced scorecard: implications for the accounting profession

The accounting profession bos been grappling with the issue of public interest responsibility for a number of years. The aim of this paper is to examine how a balanced scorecard (BSC) model can be used by the accounting profession to more effectively incorporate a public interest responsibility in its strategic framework. By using a BSC model, the paper provides an integrated framework for translating strategic values into a comprehensive set of objectives, performance measures and improvement actions.

Potential applications of discrete-event simulation and fuzzy rule-based systems to structural reliability and availability

This chapter discusses and illustrates some potential applications of discrete-event simulation (DES) techniques in structural reliability and availability analysis, emphasizing the convenience of using probabilistic approaches in modern building and civil engineering practices. After reviewing existing literature on the topic, some advantages of probabilistic techniques over analytical ones are highlighted. Then, we introduce a general framework for performing structural reliability and availability analysis through DES. Our methodology proposes the use of statistical distributions and techniques – such as survival analysis – to model component-level reliability. Then, using failure- and repair-time distributions and information about the structural logical topology (which allows determination of the structural state from their components’ state), structural reliability, and availability information can be inferred. Two numerical examples illustrate some potential applications of the proposed methodology to achieving more reliable and structural designs. Finally, an alternative approach to model uncertainty at component level is also introduced as ongoing work. This new approach is based on the use of fuzzy rule-based systems and it allows the introduction of experts’ opinions and evaluations in our methodology.

Innovations in knowledge processing and decision making in agent-based systems

This chapter introduces knowledge processing and decision making using agent-based technologies. The importance of creating effective and efficient computerized systems for extracting information and processing knowledge as well as for supporting decision making activities is highlighted. Then, an overview covering agent-based software tools and development methodologies, and usability and challenges of agent-based systems in industrial applications is presented. The contribution of each chapter included in this book is also described.

Toward Omics-Based, Systems Biomedicine, and Path and Drug Discovery Methodologies for Depression-Inflammation Research.

Meta-analyses confirm that depression is accompanied by signs of inflammation including increased levels of acute phase proteins, e.g., C-reactive protein, and pro-inflammatory cytokines, e.g., interleukin-6. Supporting the translational significance of this, a meta-analysis showed that anti-inflammatory drugs may have antidepressant effects. Here, we argue that inflammation and depression research needs to get onto a new track. Firstly, the choice of inflammatory biomarkers in depression research was often too selective and did not consider the broader pathways. Secondly, although mild inflammatory responses are present in depression, other immune-related pathways cannot be disregarded as new drug targets, e.g., activation of cell-mediated immunity, oxidative and nitrosative stress (O&NS) pathways, autoimmune responses, bacterial translocation, and activation of the toll-like receptor and neuroprogressive pathways. Thirdly, anti-inflammatory treatments are sometimes used without full understanding of their effects on the broader pathways underpinning depression. Since many of the activated immune-inflammatory pathways in depression actually confer protection against an overzealous inflammatory response, targeting these pathways may result in unpredictable and unwanted results. Furthermore, this paper discusses the required improvements in research strategy, i.e., path and drug discovery processes, omics-based techniques, and systems biomedicine methodologies. Firstly, novel methods should be employed to examine the intracellular networks that control and modulate the immune, O&NS and neuroprogressive pathways using omics-based assays, including genomics, transcriptomics, proteomics, metabolomics, epigenomics, immunoproteomics and metagenomics. Secondly, systems biomedicine analyses are essential to unravel the complex interactions between these cellular networks, pathways, and the multifactorial trigger factors and to delineate new drug targets in the cellular networks or pathways. Drug discovery processes should delineate new drugs targeting the intracellular networks and immune-related pathways.

A community based systems diagram of obesity causes

INTRODUCTION: Application of system thinking to the development, implementation and evaluation of childhood obesity prevention efforts represents the cutting edge of community-based prevention. We report on an approach to developing a system oriented community perspective on the causes of obesity. METHODS: Group model building sessions were conducted in a rural Australian community to address increasing childhood obesity. Stakeholders (n = 12) built a community model that progressed from connection circles to causal loop diagrams using scripts from the system dynamics literature. Participants began this work in identifying change over time in causes and effects of childhood obesity within their community. The initial causal loop diagram was then reviewed and elaborated by 50 community leaders over a full day session. RESULTS: The process created a causal loop diagram representing community perceptions of determinants and causes of obesity. The causal loop diagram can be broken down into four separate domains; social influences; fast food and junk food; participation in sport; and general physical activity. DISCUSSION: This causal loop diagram can provide the basis for community led planning of a prevention response that engages with multiple levels of existing settings and systems.

Minimal-order functional observer-based residual generators for fault detection and isolation of dynamical systems

This paper examines the design of minimal-order residual generators for the purpose of detecting and isolating actuator and/or component faults in dynamical systems. We first derive existence conditions and design residual generators using only first-order observers to detect and identify the faults. When the first-order functional observers do not exist, then based on a parametric approach to the solution of a generalized Sylvester matrix equation, we develop systematic procedures for designing residual generators utilizing minimal-order functional observers. Our design approach gives lower-order residual generators than existing results in the literature. The advantages for having such lower-order residual generators are obvious from the economical and practical points of view as cost saving and simplicity in implementation can be achieved, particularly when dealing with high-order complex systems. Numerical examples are given to illustrate the proposed fault detection and isolation schemes. In all of the numerical examples, we design minimum-order residual generators to effectively detect and isolate actuator and/or component faults in the system.

A platform for dynamic organization of agents in agent-based systems

In most agent-based systems, different middle agents are employed to increase their flexibility. However, there are still three issues remain unsolved. In centralized architecture with single middle agent, the middle agent itself is a bottleneck and suffers from single point failure; middle agents in distributed architecture lack capability of dynamic organization of agents; The reliability is not strong because of the single point failure and lack of effective architecture. We introduce a platform with ring architectural model to solve all above problems. In the platform, multiple middle agents are dynamically supported for solving the first problem. For solving the second problem, middle agents dynamically manage the registration and cancellation of service provider agents and application teams, each of which includes a set of closely interacting requester agents to complete an independent task. Redundancy middle agent technique is proposed for solving the third problem. All middle agents are of the feature of proliferation and self-cancellation according to the sensory inputs from their environment. For organizing the middle agents effectively, a ring architectural model is proposed. We demonstrate the applicability of the platform by its application and present experimental evidence that the platform is flexible and robust.

Tracking the nomadic life of the educational researcher :- what future for feminist public intellectual(s) and/in the performative postmodern university

Is the idea of the liberal university dead, has the post modern university any chance of being emancipatory, has the theory practice divide merely collapsed in an era of 'new knowledge work', or has the university just become one aspect of market state and global capitalism. Knowledge based economies simultaneously locate universities as central to the commodification and management of knowledge while the legitimacy of the university and the academic as knowledge producers is challenged by post modernist, feminist, postcolonial and indigenous claims within a wider trend towards the 'democratisation of knowledge' and a new educational instrumentalism and opportunism. What becomes of the educational researcher, and indeed for their professional organizations, in this changing socio political and economic scenario? Is our role one of policy service or policy critique, technical expert or public intellectual? In particular what place is there for feminist public intellectuals in a socalled era of post feminism and public-/private convergence? The paper draws on recent debates around the nature of knowledge based societies, trends in relations between policy and educational research, and draws upon feminist and critical perspectives to mount a case for the importance of the postmodern university and the public intellectual.