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Care plans in community mental health: an audit focusing on people with recent hospital admissions
No full textThe final publication is available at Springer via: http://dx.doi.org/10.1007/s11414-016-9504-0Care planning is a key requirement for recovery-focused mental health care. Audit tools are available so that services can assess their alignment with accepted care planning standards but few benchmarks are available, especially for health services outside the United Kingdom. To assess implementation of recommended care planning in an Australian mental health setting for people recently hospitalised, a sample of service user records was audited against care plan requirements. Of 164 eligible records, 113 (69%) showed a care plan. Of the 113 care plans, 40 (35%) contained a risk assessment and 1 (1%) a crisis management plan. Thirty five (31%) contained some social needs assessment, 1 (1%) contained a physical health assessment, and 53 (47%) identified a primary healthcare physician. This audit indicated a large gap between recommendations and actual practice. Similar audits in other health services are required. Action is needed to integrate care planning into behavioural health practice
Enumerating Virus-Like Particles and Bacterial Populations in the Sinuses of Chronic Rhinosinusitis Patients Using Flow Cytometry
No full textThis is an
open access article distributed under the terms of the
Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are
credited.There is increasing evidence to suggest that the sinus microbiome plays a role in the pathogenesis
of chronic rhinosinusitis (CRS). However, the concentration of these microorganisms
within the sinuses is still unknown.We show that flow cytometry can be used to
enumerate bacteria and virus-like particles (VLPs) in sinus flush samples of CRS patients.
This was achieved through trialling 5 sample preparation techniques for flow cytometry. We
found high concentrations of bacteria and VLPs in these samples. Untreated samples produced
the highest average bacterial and VLP counts with 3.3 ± 0.74 x 107 bacteria ml-1 and
2.4 ± 1.23 x 109 VLP ml-1 of sinus flush (n = 9). These counts were significantly higher than
most of the treated samples (p < 0.05). Results showed 103 and 104 times inter-patient variation
for bacteria and VLP concentrations. This wide variation suggests that diagnosis and
treatment need to be personalised and that utilising flow cytometry is useful and efficient for
this. This study is the first to enumerate bacterial and VLP populations in the maxillary sinus
of CRS patients. The relevance of enumeration is that with increasing antimicrobial resistance,
antibiotics are becoming less effective at treating bacterial infections of the sinuses,
so alternative therapies are needed. Phage therapy has been proposed as one such alternative,
but for dosing, the abundance of bacteria is required. Knowledge of whether phages
are normally present in the sinuses will assist in gauging the safety of applying phage therapy
to sinuses. Our finding, that large numbers of VLP are frequently present in sinuses,
indicates that phage therapy may represent a minimally disruptive intervention towards the
nasal microbiome. We propose that flow cytometry can be used as a tool to assess microbial
biomass dynamics in sinuses and other anatomical locations where infection can cause
disease
Interventions to delay functional decline in people with dementia: a systematic review of systematic reviews.
No full textThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Objective
To summarise existing systematic reviews that assess the effects of non-pharmacological, pharmacological and alternative therapies on activities of daily living (ADL) function in people with dementia.
Design
Overview of systematic reviews.
Methods
A systematic search in the Cochrane Database of Systematic Reviews, DARE, Medline, EMBASE and PsycInfo in April 2015. Systematic reviews of randomised controlled trials conducted in people with Alzheimer's disease or dementia measuring the impact on ADL function were included. Methodological quality of the systematic reviews was independently assessed by two authors using the AMSTAR tool. The quality of evidence of the primary studies for each intervention was assessed using GRADE.
Results
A total of 23 systematic reviews were included in the overview. The quality of the reviews varied; however most (65%) scored 8/11 or more on the AMSTAR tool, indicating high quality. Interventions that were reported to be effective in minimising decline in ADL function were: exercise (6 studies, 289 participants, standardised mean difference (SMD) 0.68, 95% CI 0.08 to 1.27; GRADE: low), dyadic interventions (8 studies, 988 participants, SMD 0.37, 95% CI 0.05 to 0.69; GRADE: low) acetylcholinesterase inhibitors and memantine (12 studies, 4661 participants, donepezil 10 mg SMD 0.18, 95% CI 0.03 to 0.32; GRADE: moderate), selegiline (7 studies, 810 participants, SMD 0.27, 95% CI 0.13 to 0.41; GRADE: low), huperzine A (2 studies, 70 participants, SMD 1.48, 95% CI 0.95 to 2.02; GRADE: very low) and Ginkgo biloba (7 studies, 2530 participants, SMD 0.36, 95% CI 0.28 to 0.44; GRADE: very low).
Conclusions
Healthcare professionals should ensure that people with dementia are encouraged to exercise and that primary carers are trained and supported to provide safe and effective care for the person with dementia. Acetylcholinesterase inhibitors or memantine should be trialled unless contraindicated.
Trial registration number
CRD42015020179
Review of Nineteenth-Century British Literature Then and Now: Reading with Hindsight by Simon Dentith.
No full textReview of Nineteenth-Century British Literature Then and Now: Reading with Hindsight by Simon Dentith
My Memoir Betrayed Me: A Neo-Expressivist Study of The Other Side of the Sky: A Memoir by Farah Ahmedi
No full textThis paper is a neo-expressivist study of The Other Side of the Sky: A Memoir by a young adult Afghan refugee Farah Ahmedi. As opposed to expressivism, neo-expressivism rests on the idea that expression in writing is not of a single, authentic self but something more than this. While expressing, one is expressing something else, and is also being expressed. This paper rhetorically analyses the metaphors that the text under study uses to see what else is being expressed through the writer. The detailed analysis of the metaphors used in the text reveals author’s ‘internalized oppression,’ and ‘double consciousness’ that create a narrative—white savior narrative—other than the apparent survival story of the writer in the memoir. The study converges neo-expressivism with the postcolonial perspective of ‘internalized oppression,’ and ‘double consciousness’ to complicate the use of memoir in an expressivist pedagogy classroom where personal writing is considered a window to imaginative, psychological, social, and spiritual development of the student writers
Maengmoom
No full text'Maengmoom' is the Thai word for spider. Twenty-five years ago many Australian families adopted children from Thai orphanages. This story explores the powerlessness of such children and one child’s approach to gaining agency in a world that threatens to overwhelm. Maengmoom’s discovery of her unique gift enables her to use this special thing to make her dreams come true
Review of Here Where We Live by Cassie Flanagan Willanski.
No full textReview of Here Where We Live by Cassie Flanagan Willanski
Review of Space and Place in Children’s Literature, 1789 to the Present edited by Maria Sachiko Cecire, Hannah Field, Kavita Mudan Finn and Malini Roy.
No full textReview of Space and Place in Children’s Literature, 1789 to the Present edited by Maria Sachiko Cecire, Hannah Field, Kavita Mudan Finn and Malini Roy
