Sixth Annual Report of the Independent Monitoring Group for A Vision for Change - the Report of the Expert Group on Mental Health Policy - July 2012

Sixth Annual Report of the Independent Monitoring Group for A Vision for Change – the Report of the Expert Group on Mental Health Policy – July 2012 This is the 6th Annual Report of the Independent Monitoring Group for A Vision for Change (IMG) and the final report of the Second Group. It is clear to the IMG that the implementation of A Vision for Change (AVFC) to date including 2011 has been slow and inconsistent. There is a continued absence of a National Mental Health Service Directorate with authority and control of resources. Such a body has the potential to give strong corporate leadership and act as a catalyst for change. Click here to download HSE National and Regional Progress ReportsHSE – 6th Annual Report HSE – National and Regional Progress Report Progress Reports from Government DepartmentsDepartment of Children and Youth AffairsDepartment of Education and SkillsDepartment of Health Department of Justice and Equality Department of Social ProtectionDepartment of Environment, Community & Local Government National Mental Health Programme Plan Consultation Document What We Heard Submissions Received by the IMGAmnesty International Ireland submission Association of Occupational Therapists submission College of Psychiatry of Ireland submissionCollege of Psychiatry of Ireland – Press Release regarding Social Psychiatry and Recovery Conference College of Psychiatry of Ireland – regarding Psychotherapy Training for Psychiatric TraineesCollege of Psychiatry of Ireland – regarding relationship with Pharmaceutical Industry College of Psychiatry of Ireland – Mental Health in Primary CareDisability Federation of IrelandHealth Research Board submission Irish Association of Social Workers – Adult Mental Health Irish Association of Social Workers – Child and Adolescent Mental Health Irish College of General PractitionersMental Health CommissionMental Health ReformPharmaceutical Society of IrelandIrish Advocacy Network Childrens Mental Health CoalitionNational Disability AuthorityNational Service Users ExecutiveNational Service Users Executive – Second Opinions ReportNational Federation of Voluntary BodiesHeadstrong  

Horizontal stratification of the sand fly fauna (Diptera: Psychodidae) in a transitional vegetation between caatinga and tropical rain forest, state of Bahia, Brazil

A study about the horizontal stratification of the sand fly fauna in two distinct ecosystems, caatinga area, endemic for visceral leishmaniasis, and the tropical rain forest area, endemic for cutaneous leishmaniasis, was performed in the state of Bahia, Brazil. Lutzomyia longipalpis was predominant in the caatinga, and following it came the species L. capixaba and L. oswaldoi. In the tropical rain forest other species were found, such as L. intermedia, L. migonei, L. whitmani, L. yuilli, L.fischeri, L. damascenoi, L. evandroi, L. monticola, and L. lenti. It was found that the geographical limits of the vector species of visceral and cutaneous leishmaniasis are clearly defined by the biological and phytogeographic characteristics.

The Strength of Promissory Representation : What Makes MPs Change their Positions ?

The paper analyses the positional congruence between pre-election statements in the Swiss voting assistance application "smartvote" and post-election behaviour in the Swiss lower house between 2003 and 2009. For this purpose, we selected 34 smartvote questions which subsequently came up in parliament. Unlike previous studies which assessed the program-to-policy linkage of governments or party groups the paper examines the question at the level of individual MPs which seems appropriate for political systems which follow the idea of power dispersion. While the average rate of political congruence is at some 85 percent, a multivariate analysis detects the underlying factors which push or curb a candidate's propensity to change his or her mind once elections are over. The results show that positional changes are more likely if (1) MPs are freshmen, (2) individual voting behaviour is invisible to the public, (3) the vote is not about a party's core issue, (4) the MP belongs to a party which is located in the political centre, and (5) if the pre-election statement is in disagreement with the majority position of the legislative party group. The last-mentioned factor is paramount: the farer away a candidate's pre-election profile from his or her party is located, the weaker turns out to be the electoral link of promissory representation.

Specific mutations in the estrogen receptor change the properties of antiestrogens to full agonists.

The estrogen receptor (ER) stimulates transcription of target genes by means of its two transcriptional activation domains, AF-1 in the N-terminal part of the receptor and AF-2 in its ligand-binding domain. AF-2 activity is dependent upon a putative amphipathic alpha-helix between residues 538 and 552 in the mouse ER. Point mutagenesis of conserved hydrophobic residues within this region reduces estrogen-dependent transcriptional activation without affecting hormone and DNA binding significantly. Here we show that these mutations dramatically alter the pharmacology of estrogen antagonists. Both tamoxifen and ICI 164,384 behave as strong agonists in HeLa cells expressing the ER mutants. In contrast to the wild-type ER, the mutant receptors maintain nuclear localization and DNA-binding activity after ICI 164,384 treatment. Structural alterations in AF-2 caused by gene mutations such as those described herein or by estrogen-independent signaling pathways may account for the insensitivity of some breast cancers to tamoxifen treatment.

Hungry for Change: Social Exclusion, Food Poverty and Homelessness in Dublin

This study investigates the impact of poverty and social exclusion on the food, diet and nutrition of people out-of-home in Dublin. The research involved a food frequency survey carried out with 75 people out of home, qualitative interviews with 12 individuals as well as a self-completion questionnaire administered to 18 food service providers in Dublin city. One of the main findings from the study was that the extent and experience of food poverty among homeless people was not only conditioned by income inadequacy and other socio-economic and cultural determinants, but particularly, by access to accommodation, as well as the quality of that accommodation. The report makes a number of practice and policy recommendations to tackle food poverty and homelessness. The qualitative approaches to food poverty employed for use with this sample of people out-of-home aimed to deal in depth with issues around food consumption. Through drawing a sub-sample from those who participated in the survey research (a process of recapture), the authors sought to expand on the survey questionnaire information on food issues. The themes for the Focus Group Discussions (FGDs) emerged from the analysis of the survey questionnaires and 4 key thematic areas were selected. i) Access to cooking, preparation and storage facilities ii) Access, choice and constraints in food purchase and consumption iii) Access to information about healthy diet, food preparation and storage iv) Expectations, cultures, values and choice concerning eating The qualitative aspect of the research enquiry eventually generated one FGD and seven semi-structured interviews representing the views of a total of 12 persons all of whom had completed the initial survey questionnaire.This resource was contributed by The National Documentation Centre on Drug Use.

Addiction and Change: How Aaddictions Develop and Addicted People Recover

Contents: 1. Models of addiction and change 2. The process of human intentional behavior change 3. The well maintained addiction : an ending and a beginning 4. Exploring precontemplation, contemplation, and preparation stages of becoming addicted 5. Repeated and regular use : moving from preparation to action on the road to addiction 6. Precontemplation for recovery : cultivating seeds for change 7. The decision to change : moving from the contemplation to the preparation stage of recovery 8. Preparing for action : creating a plan 9. Taking action to change an addiction 10. The long haul : well-maintained recovery 11. Prevention : interfering with the process of becoming addicted 12. Designing interventions for recovery 13. Research on addiction and change. "The stages-of-change model has become widely known as a framework for conceptualizing recovery. Less well known are the processes that drive movement through the stages or how the stages apply to becoming addicted. From Carlo DiClemente, codeveloper of the Transtheoretical Model, this book offers a panoramic view of the entire continuum of addictive behavior change. Illuminated is the common path that individuals travel as they establish and reinforce new patterns of behavior, whether they are developing an addiction or struggling to free themselves from one, and regardless of the specific addictive behavior. Presenting cutting-edge research with significant clinical implications, the book addresses crucial questions of why, when, and how to intervene to bolster recovery in those already addicted and reach out effectively to people at risk. It is essential reading for clinicians, prevention specialists, and policymakers." [from Book Jacket]This resource was contributed by The National Documentation Centre on Drug Use.

Assessing the Relationship between the Baseline Value of a Continuous Variable and Subsequent Change over Time

Analyzing the relationship between the baseline value and subsequent change of a continuous variable is a frequent matter of inquiry in cohort studies. These analyses are surprisingly complex, particularly if only two waves of data are available. It is unclear for non-biostatisticians where the complexity of this analysis lies and which statistical method is adequate.With the help of simulated longitudinal data of body mass index in children,we review statistical methods for the analysis of the association between the baseline value and subsequent change, assuming linear growth with time. Key issues in such analyses are mathematical coupling, measurement error, variability of change between individuals, and regression to the mean. Ideally, it is better to rely on multiple repeated measurements at different times and a linear random effects model is a standard approach if more than two waves of data are available. If only two waves of data are available, our simulations show that Blomqvist's method - which consists in adjusting for measurement error variance the estimated regression coefficient of observed change on baseline value - provides accurate estimates. The adequacy of the methods to assess the relationship between the baseline value and subsequent change depends on the number of data waves, the availability of information on measurement error, and the variability of change between individuals.

Use-dependent block of the voltage-gated Na+ channel by tetrodotoxin and saxitoxin: Effect of pore mutations that change ionic selectivity.

Voltage-gated Na(+) channels (NaV channels) are specifically blocked by guanidinium toxins such as tetrodotoxin (TTX) and saxitoxin (STX) with nanomolar to micromolar affinity depending on key amino acid substitutions in the outer vestibule of the channel that vary with NaV gene isoforms. All NaV channels that have been studied exhibit a use-dependent enhancement of TTX/STX affinity when the channel is stimulated with brief repetitive voltage depolarizations from a hyperpolarized starting voltage. Two models have been proposed to explain the mechanism of TTX/STX use dependence: a conformational mechanism and a trapped ion mechanism. In this study, we used selectivity filter mutations (K1237R, K1237A, and K1237H) of the rat muscle NaV1.4 channel that are known to alter ionic selectivity and Ca(2+) permeability to test the trapped ion mechanism, which attributes use-dependent enhancement of toxin affinity to electrostatic repulsion between the bound toxin and Ca(2+) or Na(+) ions trapped inside the channel vestibule in the closed state. Our results indicate that TTX/STX use dependence is not relieved by mutations that enhance Ca(2+) permeability, suggesting that ion-toxin repulsion is not the primary factor that determines use dependence. Evidence now favors the idea that TTX/STX use dependence arises from conformational coupling of the voltage sensor domain or domains with residues in the toxin-binding site that are also involved in slow inactivation.

A vision for change: Report of the Expert Group on Mental Health Policy (2006)

This report, the first comprehensive review of mental health policy since 'Planning for the Future' was published in 1984, makes a series of recommendations for the mental health services, including the closure of all psychiatric hospitals and re-investment of the resources into a community-based mental health service.This resource was contributed by The National Documentation Centre on Drug Use.

Implementing A vision for change: moving towards a modern, quality and responsive mental health service. Carlow / Kilkenny / South Tipperary.

The key element of the HSE South’s Programme is to enhance and develop community mental health services in Carlow, Kilkenny and South Tipperary, to enable the service user to remain in the community to the greatest extent possible. HSE South has prioritised the implementation of the change programme and has allocated more than €20m capital funding and over €1.75m revenue funding to support this comprehensive development programme. Speaking at the briefings Mr. Pat Healy, Regional Director of Operations, HSE South said, “When this plan is delivered, clients will have access to the highest standards of services in all three counties, which should significantly improve these clients’ treatment programmes and quality of life. The National Service Users Executive are supporting the change programme, which is of immense importance to HSE South. The programme heralds the enhancement and development of community mental health services, the closure of old long stay institutions, the separation of North and South Tipperary acute inpatient mental health services and development of appropriate acute inpatient services, for the extended catchment area, in line with the national strategy for mental health “A Vision for Change”. The programme also acts on recommendations of the Mental Health Commission.”This resource was contributed by The National Documentation Centre on Drug Use.

Change in cognitive errors and coping over the course of brief psychodynamic intervention.

OBJECTIVE: Cognitive change over the course of psychodynamic psychotherapy has been postulated by several models, but has rarely been studied. Based on the adaptive skills model (Badgio, Halperin, & Barber, 1999), it is reasonable to expect that very brief dynamic psychotherapy may be associated with change in coping patterns and cognitive errors (also known as cognitive distortions) y. METHOD: N = 50 outpatients presenting with various psychiatric disorders and undergoing 4 sessions of Brief Psychodynamic Intervention (BPI; Despland, Drapeau, & de Roten, 2005; Despland, Michel, & de Roten, 2010) were included in this naturalistic study (mean age: 31 years; 56% female; all Caucasian). Cognitive errors and coping strategies were assessed using the Cognitive Errors Rating Scale (Drapeau et al., 2008) and Coping Patterns Rating Scale (Perry et al., 2005). These observer rated methods were applied to the verbatim transcriptions of all 4 therapy sessions completed by each patient. RESULTS: Results indicate change in both cognitive errors and coping patterns over the course of BPI, including an increase in the Overall Coping Functioning and a decrease in unhelpful coping processes, such as isolation, which reflects a shift in participant appraisal towards stress appraised as a challenge at the end of treatment. These changes predicted symptom change at the end of treatment. While cognitive errors also changed over the course of BPI, no predictive effect was found with regard to symptom change. CONCLUSIONS: These results are interpreted within the framework of common change principles in psychotherapy. Implications and future research are discussed.

Behaviour change at population, community and individual levels: NICE Public Health Guidance 6

This guidance is aimed at those responsible for helping people to change their behaviour to improve their health. This includes policy makers and those working in local authorities and the community and voluntary sectors. It gives advice on how to plan and run relevant initiatives. The recommendations include the following advice: base interventions on a proper assessment of the target group, where they are located and the behaviour which is to be changed: careful planning is the cornerstone of success  work with other organisations and the community itself to decide on and develop initiatives build on the skills and knowledge that already exists in the community, for example, by encouraging networks of people who can support each other take account of and resolve problems that prevent people changing their behaviour (for example, the costs involved in taking part in exercise programmes or buying fresh fruit and vegetables, or lack of knowledge about how to make changes) base all interventions on evidence of what works train staff to help people change their behaviour evaluate all interventions.This resource was contributed by The National Documentation Centre on Drug Use.

CHANGE

CHANGE is a multi-faceted programme which seeks to transform the way lone parents think about food. The programme focuses on education, health and the affordability of healthy food for lone parents, as a particularly disadvantaged low-income group. The key activities include training programmes for lone parents and a community garden which engages the wider community. Five training programmes will be developed over the three years; Healthy Eating (basic and advanced), Food Growing, Community Gardening and Community Resilience The community garden is supported by Northside Partnership, Coolock Development Council and Sphere 17 regional youth service, who are all represented on the steering group and contribute some human resources to maintaining and developing the garden.     Part of theCFI Programme 2013-2015 Initiative Type Community Food Growing Projects Nutrition Education and Training Programmes Location Dublin 11 Dublin 13 Dublin 3 Dublin 5 Dublin 7 Dublin 9 Target Groups Lone parents Funding Safefood Partner Agencies Coolock Development Council Connect with this Initiative Facebook

Will climate change drive alien invasive plants into areas of high protection value? An improved model-based regional assessment to prioritise the management of invasions.

Species distribution models (SDMs) studies suggest that, without control measures, the distribution of many alien invasive plant species (AIS) will increase under climate and land-use changes. Due to limited resources and large areas colonised by invaders, management and monitoring resources must be prioritised. Choices depend on the conservation value of the invaded areas and can be guided by SDM predictions. Here, we use a hierarchical SDM framework, complemented by connectivity analysis of AIS distributions, to evaluate current and future conflicts between AIS and high conservation value areas. We illustrate the framework with three Australian wattle (Acacia) species and patterns of conservation value in Northern Portugal. Results show that protected areas will likely suffer higher pressure from all three Acacia species under future climatic conditions. Due to this higher predicted conflict in protected areas, management might be prioritised for Acacia dealbata and Acacia melanoxylon. Connectivity of AIS suitable areas inside protected areas is currently lower than across the full study area, but this would change under future environmental conditions. Coupled SDM and connectivity analysis can support resource prioritisation for anticipation and monitoring of AIS impacts. However, further tests of this framework over a wide range of regions and organisms are still required before wide application.

Climate change impact on biodiversity in Switzerland: a review. Journal for Nature Conservation

A noticeable increase in mean temperature has already been observed in Switzerland and summer temperatures up to 4.8 K warmer are expected by 2090. This article reviews the observed impacts of climate change on biodiversity and consider some perspectives for the future at the national level. The following impacts are already evident for all considered taxonomic groups: elevation shifts of distribution toward mountain summits, spread of thermophilous species, colonisation by new species from warmer areas and phenological shifts. Additionally, in the driest areas, increasing droughts are affecting tree survival and fish species are suffering from warm temperatures in lowland regions. These observations are coherent with model projections, and future changes will probably follow the current trends. These changes will likely cause extinctions for alpine species (competition, loss of habitat) and lowland species (temperature or drought stress). In the very urbanised Swiss landscape, the high fragmentation of the natural ecosystems will hinder the dispersal of many species towards mountains. Moreover, disruptions in species interactions caused by individual migration rates or phenological shifts are likely to have consequences for biodiversity. Conversely, the inertia of the ecosystems (species longevity, restricted dispersal) and the local persistence of populations will probably result in lower extinction rates than expected with some models, at least in 21st century. It is thus very difficult to estimate the impact of climate change in terms of species extinctions. A greater recognition by society of the intrinsic value of biodiversity and of its importance for our existence will be essential to put in place effective mitigation measures and to safeguard a maximum number of native species.