Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative

Data are reported on the background and performance of the K6 screening scale for serious mental illness (SMI) in the World Health Organization (WHO) World Mental Health (WMH) surveys. The K6 is a six-item scale developed to provide a brief valid screen for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) SMI based on the criteria in the US ADAMHA Reorganization Act. Although methodological studies have documented good K6 validity in a number of countries, optimal scoring rules have never been proposed. Such rules are presented here based on analysis of K6 data in nationally or regionally representative WMH surveys in 14 countries (combined N = 41,770 respondents). Twelve-month prevalence of DSM-IV SMI was assessed with the fully-structured WHO Composite International Diagnostic Interview. Nested logistic regression analysis was used to generate estimates of the predicted probability of SMI for each respondent from K6 scores, taking into consideration the possibility of variable concordance as a function of respondent age, gender, education, and country. Concordance, assessed by calculating the area under the receiver operating characteristic curve, was generally substantial (median 0.83; range 0.76-0.89; inter-quartile range 0.81-0.85). Based on this result, optimal scaling rules are presented for use by investigators working with the K6 scale in the countries studied. Copyright (c) 2010 John Wiley & Sons, Ltd.

AGE DIFFERENCES IN THE PREVALENCE AND CO-MORBIDITY OF DSM-IV MAJOR DEPRESSIVE EPISODES: RESULTS FROM THE WHO WORLD MENTAL HEALTH SURVEY INITIATIVE

Background: Although depression appears to decrease in late life, this could be due to misattribution of depressive symptoms to physical disorders that increase in late we. Methods: We investigated this issue by studying age differences in co-morbidity of DSM-IV major depressive episodes (MDE) with chronic physical conditions in the WHO World Mental Health (WMH) surveys, a series of community epidemiological surveys of respondents in 10 developed countries (n = 52,485) and 8 developing countries (n = 37,265). MDE and other mental disorders were assessed with the Composite International Diagnostic Interview (CIDI). Organic exclusion rules were not used to avoid inappropriate exclusion of cases with physical co-morbidity. Physical conditions were assessed with a standard chronic conditions checklist. Results: Twelve-month DSM-IV/CIDI MDE was significantly less prevalent among respondents ages 65+ than younger respondents in developed but not developing countries. Prevalence of co-morbid mental disorders generally either decreased or remained stable with age, while co-morbidity of MDE with mental disorders generally increased with age. Prevalence of physical conditions, in comparison, generally increased with age, while co-morbidity of MDE with physical conditions generally decreased with age. Depression treatment was lowest among the elderly in developed and developing countries. Conclusions: The weakening associations between MDE and physical conditions with increasing age argue against the suggestion that the low estimated prevalence of MDE among the elderly is due to increased confounding with physical disorders. Future study is needed to investigate processes that might lead to a decreasing impact of physical illness on depression among the elderly. Depression and Anxiety 27:351-364, 2010. (C) 2009 Wiley-Liss, Inc.

Treatment of suicidal people around the world

Background Suicide is a leading cause of death worldwide; however, little information is available about the treatment of suicidal people, or about barriers to treatment. Aims To examine the receipt of mental health treatment and barriers to care among suicidal people around the world. Method Twenty-one nationally representative samples worldwide (n=55 302; age 18 years and over) from the World Health Organization`s World Mental Health Surveys were interviewed regarding past-year suicidal behaviour and past-year healthcare use. Suicidal respondents who had not used services in the past year were asked why they had not sought care. Results Two-fifths of the suicidal respondents had received treatment (from 17% in low-income countries to 56% in high-income countries), mostly from a general medical practitioner (22%), psychiatrist (15%) or non-psychiatrist (15%). Those who had actually attempted suicide were more likely to receive care. Low perceived need was the most important reason for not seeking help (58%), followed by attitudinal barriers such as the wish to handle the problem alone (40%) and structural barriers such as financial concerns (15%). Only 7% of respondents endorsed stigma as a reason for not seeking treatment. Conclusions Most people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.

Economic incentives for global conservation of wildlife: New international policy directions

Growing economic globalisation by extending the operation of markets is a two-edged sword as far as nature conservation is concerned. In some circumstances, it threatens the conservation of nature and in other cases, it provides economic incentives that foster the conservation of biodiversity. This article shows how global policy directions have altered in that regard. Initially the World Conservation Union (IUCN) favoured bans on trade in endangered species. This view was enshrined in the Convention on International Trade in Endangered Species (CITES). Subsequently, with the upsurge of support for market-based economic liberalism, IUCN recognised that economic and market incentives, if linked to appropriate property rights, could foster biodiversity conservation. This is reflected in the International Convention on Biological Diversity. While there is conflict between this convention and CITES, its extent has been exaggerated. As explained, in certain cases, trade restrictions of the type adopted in CITES are appropriate for nature conservation whereas the market-oriented policy of the Convention on Biological Diversity can be effective in some different situations. Whether or not the extension of markets in wildlife and wildlife products and growing economic globalisation favours nature conservation varies according to the circumstances.

A new integrable model of strongly correlated electrons with Hubbard-like interaction

A new completely integrable model of strongly correlated electrons is proposed which describes two competitive interactions: one is the correlated one-particle hopping, the other is the Hubbard-like interaction. The integrability follows from the fact that the Hamiltonian is derivable from a one-parameter family of commuting transfer matrices. The Bethe ansatz equations are derived by algebraic Bethe ansatz method.

Space: Irrealis objects in technology policy and their role in a new political economy

In this article, I show how new spaces are being prefigured for colonization in new economy policy discourses. Drawing on a corpus of 1.3 million words collected from legislatures throughout the world, I show the role of policy language in creating the foundations of an emergent form of political economy: The analysis is informed by principles from critical discourse analysis (CDA), classical political economy and critical media studies. It foregrounds a functional aspect of language called process metaphor to show how aspects of human activity are prefigured for mass commodification by the manipulation of realis and irrealis spaces. I also show how the fundamental element of any new political economy, the property element, is being largely ignored. Current moves to create a privately owned global space, which is as concrete as landed property - namely, the electromagnetic spectrum - has significant ramifications for the future of social relations in any global knowledge economy.

Scientists as policy-makers: Towards a new partnership

There is an urgent need to link social science research with policy making to address many key issues confronting countries across the globe. Policy makers need the benefit of social science research which is relevant, timely, transdisciplinary, methodologically capable of capturing global and local trends, swift to respond to fundamental issues, and offering findings which are clearly articulated, effectively disseminated, and oriented to outcomes. For this a new partnership is needed between social scientists and policy makers. We can gain a clearer picture of the nature of this desired partnership by probing the dichotomy between the world of science and the world of policy making. The experience of UNESCO and its programme Management of Social Transformations provides some valuable lessons.

Educating speech-language pathologists for a multicultural world

This paper presents critical elements and current needs in educating speech-language pathologists for a multicultural world. A proposed paradigm shift in clinical teaching using the UK model is also introduced. In addition, a case study on the American Speech Language Hearing Association's efforts in implementing the Multicultural Action Agenda by networking with the Asian Pacific Islander caucus is described. A survey of multicultural elements in programs in Australia and New Zealand is included. finally, suggestions for collaboration with those in established professional bodies to meet the increasing needs of a multicultural world are provided. copyright (C) 2001 S. Karger AG. Basel.

Can long-distance dispersal be inferred from the New Zealand plant fossil record?

New Zealand is generally thought to have been physically isolated from the rest of the world for over 60 million years. But physical isolation may not mean biotic isolation, at least on the time scale of millions of years. Are New Zealand's present complement of plants the direct descendants of what originally rafted from Gondwana? Or has there been total extinction of this initial flora with replacement through long-distance dispersal (a complete biotic turnover)? These are two possible extremes which have come under recent discussion. Can the fossil record be used to decide the relative importance of the two endpoints, or is it simply too incomplete and too dependent on factors of chance? This paper suggests two approaches to the problem-the use of statistics to apply levels of confidence to first appearances in the fossil record and the analysis of trends based on the entire palynorecord. Statistics can suggest that the first appearance of a taxon was after New Zealand broke away from Gondwana-as long as the first appearance in the record was not due to an increase in biomass from an initially rare state. Two observations can be drawn from the overall palynorecord that are independent of changes in biomass: (1) The first appearance of palynotaxa common to both Australia and New Zealand is decidedly non-random. Most taxa occur first in Australia. This suggests a bias in air or water transport from west to east. (2) The percentage of endemic palynospecies in New Zealand shows no simple correlation with the time New Zealand drifted into isolation. The conifer macrorecord also hints at complete turnover since the Cretaceous.

Cultural frictions: John Romeril's The 'Floating World'

Hailed as an 'unruly masterpiece', John Romeril's The Floating World is one of the few 'new wave' Australian plays representing Australians and their Asian 'others' to be restaged periodically since its premiere in 1974. Paying particular attention to production of the play that have used Japanese theatre forms such as kabuki and bunraku, this article focuses primarily on the ways in which the significations of race have been interpreted by the critical establishment. The fascinating stage history of The Floating World is treated as a barometer of Australian theatre's response to the challenge of representing cultural conflict, during a period marked by public debate about the desirability, and inevitability, of Australia's political, economic and cultural 'enmeshment' with Asia.

A new approach for detecting and mapping sewage impacts

Increased nitrogen loading has been implicated in eutrophication occurrences worldwide. Much of this loading is attributable to the growing human population along the world's coastlines. A significant component of this nitrogen input is from sewage effluent, and delineation of the distribution and biological impact of sewage-derived nitrogen is becoming increasingly important. Here, we show a technique that identifies the source, extent and fate of biologically available sewage nitrogen in coastal marine ecosystem. This method is based on the uptake of sewage nitrogen by marine plants and subsequent analysis of the sewage signature (elevated delta N-15) in plant tissues. Spatial analysis is used to create maps of delta N-15 and establish coefficient of variation estimates of the mapped values. We show elevated delta N-15 levels in marine plants near sewage outfalls in Moreton Bay, Australia, a semi-enclosed bay receiving multiple sewage inputs. These maps of sewage nitrogen distribution are being used to direct nutrient reduction strategies in the region and will assist in monitoring the effectiveness of environmental protection measures. (C) 2001 Elsevier Science Ltd. All rights reserved.

Using the World Wide Web to revolutionise technology transfer and training in the water and wastewater industries

Industry professionals of the near future will be supported by an IT infrastructure that enables them to complete a task by drawing on resources and people with expertise anywhere in the world, and access to knowledge through specific training programs that address the task requirements. The increasing uptake of new technologies enables information to reach a diverse population and to provide flexible learning environments 24 hours a day, 7 days a week. This paper examines one of the key areas where the World Wide Web will impact on the water and wastewater industries, namely technology transfer and training. The authors will present their experiences of developing online training courses for wastewater industry professionals over the last two years. The perspective is that of two people working at the coalface.