Assessing perceived need for mental health care in a community survey: development of the Perceived Need for Care Questionnaire (PNCQ)

Background: The Perceived Need for Care Questionnaire (PNCQ) was designed for the Australian National Survey of Mental Health and Wellbeing. The PNCQ complemented collection of data on diagnosis and disability with the survey participants' perceptions of their needs for mental health care and the meeting of those needs. The four-stage design of the PNCQ mimics a conversational exploration of the topic of perceived needs. Five categories of perceived need are each assigned to one of four levels of perceived need (no need, unmet need, partially met need and met need). For unmet need and partially met need, information on barriers to care is collected, Methods: Inter-rater reliabilities of perceived needs assessed by the PNCQ were examined in a study of 145 anxiety clinic attenders. Construct validity of these items was tested, using a multi-trait multi-method approach and hypotheses regarding extreme groups, in a study with a sample of 51 general practice and community psychiatric service patients. Results: The instrument is brief to administer and has proved feasible for use in various settings. Inter-rater reliabilities for major categories, measured by the kappa statistic, exceeded 0.60 in most cases; for the summary category of all perceived needs, inter-rater reliability was 0.62. The multi-trait multi-method approach lent support to the construct validity of the instrument, as did findings in extreme groups. Conclusions: The PNCQ shows acceptable feasibility, reliability and validity, adding to the range of assessment tools available for epidemiological and health services research.

Self-reported needs for care among persons who have suicidal ideation or who have attempted suicide

This study examined the self-reported needs of suicidal users of mental health services and the extent to which needs were met. Data on 10,641 adults were available from the Australian National Survey of Mental Health and Well-being. In the year before the survey, 245 persons with suicidal ideation used services, 37 of whom had attempted suicide. Suicidal persons reported a range of needs, especially for counseling, medication, and information. More than half of those with suicidal ideation and those who had attempted suicide who reported any needs felt that their needs had not been fully met. Suicidal persons were significantly more likely to perceive that they had needs.

Suicidal ideation and suicide attempts as predictors of mental health service use

Objective: To examine the extent to which suicidal ideation and suicide attempts are predictive of service use. Design and setting: The National Survey of Mental Health and Wellbeing considered service utilisation in relation to self-reported mental health problems. Service utilisation was inquired of in relation to hospital-based care (including both specialist mental health and general care settings), as well as consultations with a range of health professionals (both specialist and non-specialist mental health professionals, including psychiatrists, psychologists and general practitioners) on an outpatient basis. Participants: Secondary analysis of self-report data from 10 641 randomly selected Australian adults who participated in the National Survey of Mental Health and Wellbeing in 1997. The key predictor variables were reported suicidal ideation and suicide attempts over the past 12 months. Main outcome measures: Use of services for mental health problems (past 12 months). Results: When considered in isolation, individuals reporting suicidal ideation were more likely to make use of at least one type of service for mental health problems than non-suicidal individuals (OR, 17.3; 95% Cl, 13.2-22.6), and individuals reporting suicide attempts were even more likely to do so (OR, 32.3; 95% CI, 9.0-115.4). In the case of suicidal ideation, this effect remained significant after controlling for a range of potential confounders. For suicide attempts, the effect of mental health service use was no longer significant after other variables were taken into account. Conclusions: Suicidal individuals are likely to make use of services, and a high proportion of suicides may be preventable through appropriate healthcare system responses.

Perceived need for mental health care: influences of diagnosis, demography and disability

Background. Recent major epidemiological studies have adopted increasingly multidimensional approaches to assessment. Several of these have included some assessment of perceived need for mental health care. The Australian National Survey of Mental Health and Wellbeing, conducted in 1997, included a particularly detailed examination of this construct, with an instrument with demonstrated reliability and validity. Methods. A clustered probability sample of 10641 Australians responded to the field questionnaire for this survey, including questions on perceived need either where there had been service utilization, or where a disorder was detected by administration of sections of the Composite International Diagnostic Interview. The confidentialized unit record file generated from the survey was analysed for determinants of perceived need. Results. Perceived need is increased in females, in people in the middle years of adulthood, and in those who have affective disorders or co-morbidity. Effects of diagnosis and disability can account for most of the differences in gender specific rates. With correction for these effects through regression, there is less perceived need for social interventions and possibly more for counselling in females; disability is confirmed as strongly positively associated with perceived need, as are the presence of affective disorders or co-morbidity. Conclusions. The findings of this study underscore the imperative for mental health services to be attentive and responsive to consumer perceived need. The substantial majority of people who are significantly disabled by mental health problems are among those who see themselves as having such needs.

How different is Mediterranean Caulerpa taxifolia (Caulerpales : Chlorophyta) to other populations of the species?

The green macroalgal species Caulerpa taxifolia is indigenous to tropical/subtropical Australia, ranging as far south as 28degrees and 29degrees 15' S on the Australian mainland east and west coasts, respectively. The origin of disjunct populations of the species, discovered in 2000 on the Australian mainland east coast at localities to 35degrees S remains unknown, variously attributed to introduced exotic strains or range extensions from other eastern Australian populations. Some naturally occurring Australian populations of C. taxifolia are similar to Mediterranean C. taxifolia. In Australia, large broad forms of the species, which have been known in the region since 1860, grow luxuriantly in sheltered seagrass meadows, with some of these populations tolerating minimum surface seawater temperatures in winter of 12.5 to 14.5degreesC. Accordingly, the contention that the Mediterranean has been invaded by a genetically-modified, large, cold-adapted strain of C. taxifolia may be incorrect. It is crucial that genetic markers (DNA fingerprinting, microsatellites) sensitive at the population level are used to accurately determine the genetic relatedness of C. taxifolia populations.

Projetos estratégicos no setor de exploração e produção de petróleo

Este artigo explora os elementos e o papel das técnicas envolvidos no gerenciamento bem-sucedido de projetos estratégicos aplicados ao setor de exploração e produção (E&P) de óleo e gás do Reino Unido. Primeiramente, é apresentada uma revisão de literatura das técnicas de gerenciamento de projetos estratégicos. Em seguida, são descritos e validados 50 elementos multidisciplinares envolvidos nesse tipo de gerenciamento, explorando-se até que ponto as técnicas consideram, em termos teóricos, tais elementos. Complementarmente, é apresentada uma pesquisa que identifica os elementos do sucesso envolvidos no gerenciamento de projetos estratégicos e verifica até que ponto as técnicas consideram tais elementos na prática. Finalmente, são propostos conjuntos de técnicas para o gerenciamento bem-sucedido de projetos estratégicos de E&P no Reino Unido. O artigo traz ainda algumas conclusões e futuras direções de pesquisa, com ênfase na extensão da metodologia proposta à realidade brasileira, já que os resultados são exclusivos do ambiente britânico.

The Farol Deposit (Depósito do Farol) – a Pleistocene beach deposit from Cape Mondego (Figueira da Foz, West Central Portugal)*

Among the Pleistocene and Holocene units recorded near the marine cliffs of Cape Mondego (Figueira da Foz, West Central Portugal) stands out the Farol Deposit (Depósito do Farol), at an altitude of ±95 m above present sea level. It is a marine terrace with three exposures of interstratified conglomerates and sands, overlapped by calclititic-fanglomerates. This sedimentary setting indicates that deposition took place in a seashore environment influenced by the proximity of a marine palaeocliff. The deposit has an interesting subfossil fauna with abraded and fragmented shells of Nucella lapillus (LINNÉ, 1758), Patella vulgata (LINNÉ, 1758) and Littorina littorea (LINNÉ, 1758), suggesting the existence of an environment with colder surface seawater, when compared with the present day Portuguese seashore. These specimens belonged to marine communities adapted to live in intertidal rocky platforms, which have been exposed to the cyclic action of waves and tidal flows, on the swash and surf zones. The Farol Deposit can be related to an Early/Middle Pleistocene “cold-water” episode, earlier to the Isotopic Stages 7 and 11. This episode occurred before the deposition of the units Quiaios Sands (Areias de Quiaios) and Cantanhede Sands (Areias de Cantanhede) (Sicilian?), but later than the Arazede Sands (Areias de Arazede) and Marinha das Ondas Sands (Areias de Marinha das Ondas) (Early Pleistocene).

Archaeological Remains Accounting for the Presence and Exploitation of the North Atlantic Right Whale Eubalaena glacialis on the Portuguese Coast (Peniche, West Iberia), 16th to 17th Century

The former occurrence of the North Atlantic right whale Eubalaena glacialis on the Portuguese coast may be inferred from the historical range of that species in Europe and in NW Africa. It is generally accepted that it was the main prey of coastal whaling in the Middle Ages and in the pre-modern period, but this assumption still needs firming up based on biological and archaeological evidence. We describe the skeletal remains of right whales excavated at Peniche in 2001-2002, in association with archaeological artefacts. The whale bones were covered by sandy sediments on the old seashore and they have been tentatively dated around the 16th to 17th centuries. This study contributes material evidence to the former occurrence of E. glacialis in Portugal (West Iberia). Some whale bones show unequivocal man-made scars. These are associated to wounds from instruments with a sharp-cutting blade. This evidence for past human interaction may suggest that whaling for that species was active at Peniche around the early 17th century.

Anurans of the Serra do Caraça, southeastern Brazil: species composition and phenological patterns of calling activity

Annual patterns of calling and breeding activity of 38 anuran species were studied at Serra do Caraça, an 11,233 ha reserve located in a contact zone between Cerrado and Atlantic forest at the southern Espinhaço range, southeastern Brazil. Five patterns were evident: (1) species that call year-round or nearly year-round with larger aggregations generally observed in the rainy months, (2) species with opportunistic calling activity associated with rainfall during the wettest months of the year, (3) winter species, (4) explosive breeders with intense calling activity triggered by heavy rains during the rainy season or only in the beginning of the rainy season, and (5) summer species with variable breeding seasons. Both the monthly number of species with calling males and the monthly number of species that showed the maximum class of calling males were positively correlated with both mean monthly temperature and monthly precipitation.

How reliable is the monitoring of permanent vegetation plots? A test with multiple observers

Questions: A multiple plot design was developed for permanent vegetation plots. How reliable are the different methods used in this design and which changes can we measure? Location: Alpine meadows (2430 m a.s.l.) in the Swiss Alps. Methods: Four inventories were obtained from 40 m(2) plots: four subplots (0.4 m(2)) with a list of species, two 10m transects with the point method (50 points on each), one subplot (4 m2) with a list of species and visual cover estimates as a percentage and the complete plot (40 m(2)) with a list of species and visual estimates in classes. This design was tested by five to seven experienced botanists in three plots. Results: Whatever the sampling size, only 45-63% of the species were seen by all the observers. However, the majority of the overlooked species had cover < 0.1%. Pairs of observers overlooked 10-20% less species than single observers. The point method was the best method for cover estimate, but it took much longer than visual cover estimates, and 100 points allowed for the monitoring of only a very limited number of species. The visual estimate as a percentage was more precise than classes. Working in pairs did not improve the estimates, but one botanist repeating the survey is more reliable than a succession of different observers. Conclusion: Lists of species are insufficient for monitoring. It is necessary to add cover estimates to allow for subsequent interpretations in spite of the overlooked species. The choice of the method depends on the available resources: the point method is time consuming but gives precise data for a limited number of species, while visual estimates are quick but allow for recording only large changes in cover. Constant pairs of observers improve the reliability of the records.