42040828
The Station Community Mental Health Centre Inc: nurturing and empowering.
INTRODUCTION
Consumer-driven community mental health services play an important role in rehabilitation, recovery, and advocacy in rural and remote Australia. The origins of services often lie in the need to provide options for people with mental illness and their carers when there is a lack of on-the-ground support. This article adds to the information about the strengths and limitations of consumer-driven mental health services by presenting the findings of an evaluation of The Station Inc. in rural South Australia. This consumer-driven mental health service provides a safe and supportive environment, social connections, and activities for its members (those with a lived experience of mental illness). Using a realist evaluation approach, the evaluation identified the contextual factors and the program mechanisms that produce positive outcomes for members.


METHOD
The evaluation was conducted as participatory action research with The Station members, volunteers, management committee members, and staff involved in all phases of the research process. Because of the complexity of The Station's functioning a realist evaluation using qualitative data was conducted to identify how the program worked, for whom, and in what circumstances. Twenty-five in-depth interviews were conducted with participants who were randomly selected from within the groups identified above. Interviews focused on The Station's role in assisting recovery from mental illness, the limitations and strengths of the program, and relationships with the mental health system. The Station's goals, policies and procedures, and the role of stakeholders were analysed in order to identify any links among these contextual factors, program mechanisms, and program outcomes. Qualitative data were entered into descriptive categories in N6 software (QSR; www.qsr.international.com). Data from the stakeholder analysis were entered into Microsoft Excel. Using an iterative approach to include the three data sets, a model was developed that identified important contextual factors that linked with two groups of program mechanisms that produced positive outcomes for members.


RESULTS
Program mechanisms are categorised by descriptive themes referred to as 'nurturing' and 'empowering'. Nurturing' is experienced as feeling of belonging and being accepted 'as one is' and 'empowerment' mechanisms engender a belief in oneself. Respondents identified features of The Station's program, policies, atmosphere, connections and networks, stakeholder relationships, and staff and volunteers that are nurturing and empowering. Five key contextual factors enable the program mechanisms to work. The Station's coordinators ensure that nurturing and empowerment processes are highlighted through careful facilitation. The governance arrangements, policies, and administrative systems at The Station are well developed but flexibly implemented so that they support the nurturing and empowerment processes. Support and legitimacy for the program is obtained from the mental health system at state and local levels. The Station obtains resources and connections to its rural community through key stakeholders and a peak organisation One Voice Network acts as an advocate.


CONCLUSIONS
Information about the benefits and limitations of consumer-driven mental health services in rural and remote Australia is in short supply. Increasing the available information about the contribution these services make may result in services being legitimised, understood, and resourced within mental health systems thus making the services sustainable. The benefits of consumer-driven services are that they provide flexibility and adaptation, an ability to capture the energy and passion of rural communities to improve the wellbeing of community members, and they overcome the power differential that exists between professionals and 'patients' or 'clients'.
31260021
Improving transfer of mental health care for rural and remote consumers in South Australia.
In Australia, it is commonplace for tertiary mental health care to be provided in large regional centres or metropolitan cities. Rural and remote consumers must be transferred long distances, and this inevitably results in difficulties with the integration of their care between primary and tertiary settings. Because of the need to address these issues, and improve the transfer process, a research project was commissioned by a national government department to be conducted in South Australia. The aim of the project was to document the experiences of mental health consumers travelling from the country to the city for acute care and to make policy recommendations to improve transitions of care. Six purposively sampled case studies were conducted collecting data through semistructured interviews with consumers, country professional and occupational groups and tertiary providers. Data were analysed to produce themes for consumers, and country and tertiary mental healthcare providers. The study found that consumers saw transfer to the city for mental health care as beneficial in spite of the challenges of being transferred over long distances, while being very unwell, and of being separated from family and friends. Country care providers noted that the disjointed nature of the mental health system caused problems with key aspects of transfer of care including transport and information flow, and achieving integration between the primary and tertiary settings. Improving transfer of care involves overcoming the systemic barriers to integration and moving to a primary care-led model of care. The distance consultation and liaison model provided by the Rural and Remote Mental Health Services, the major tertiary provider of services for country consumers, uses a primary care-led approach and was highly regarded by research participants. Extending the use of this model to other primary mental healthcare providers and tertiary facilities will improve transfer of care.
44836362
A defective retrovirus particle (SE21Q1b) packages and reverse transcribes cellular RNA, utilizing tRNA-like primers.
Linial and co-workers described a quail cell line, SE21Q1b, transformed by a single provirus of Rous sarcoma virus that is defective in virus assembly, in as much as the virus particles produced, SE21, contain cellular rather than viral RNA. In other respects these particles are normal, and the amount of endogenous DNA synthesis by disrupted virus particles is comparable to that of normal virus. We now report that endogenous DNA synthesis by SE21 virions uses RNA primers of the same size as tRNA species and that about 17% of these are bound to polyadenylate-containing RNA templates. Previous studies have shown that with wild-type Rous sarcoma virus, DNA synthesis is exclusively initiated on a tRNATrp species base paired to a specific location on the viral RNA. In contrast, we interpreted our data with SE21 as evidence that many different tRNA-primed initiations occurred, that predominantly species other than tRNATrp were used, and that the base pairing between template and primer RNAs included significant nucleotide mismatching. A subpopulation of the DNA synthesized by SE21 virions from tRNA-like primers was both initiated and terminated at discrete locations. These species are therefore analogous to the strong-stop DNA synthesized by wild-type virus.
12250389
Letter: Evidence for non-repetitive subunits in the genome of Rous sarcoma virus.
3193958
The influence of protection, palliation and costs on mobility optimization of residents in nursing homes: a thematic analysis of discourse.
BACKGROUND
With the aging of the population, increasing numbers of older people live in nursing homes. Discourse such as policies and standards highlight the need to optimize the mobility independence of residents. This is expected to occur in a way that is safe for residents and staff whilst meeting the residents' needs. The influence of discourse on health care delivery can be poorly understood, being at times hidden or taken for granted. The aim of this study was to uncover discourse relevant to resident mobility optimization to enable the origins and reasoning behind existing and intersecting policy and practice to be critically appraised.


DESIGN
Narrative literature review and thematic analysis with a focus on discourse were employed for this study.


DATA SOURCES
Databases (CINAHL and Ovid Medline) and websites of relevant professional and governmental bodies were accessed.


METHOD
A literature search centered on retrieval of texts focused on discourses that influenced goals to optimize resident mobility. Database searches for texts covered the period from 1994 to 2011. Iterative thematic analysis focussed on the texts' socio-cultural context and influence.


FINDINGS
Four discourses emerged that potentially influence goals to optimize resident mobility: safe manual handling; falls prevention; palliative care; and costs and funding constraints to individualized care. These discourses may influence mobility care in the direction of more routinized, passive and dependency support approaches. A common overarching theme was that of collaboration and communication.


CONCLUSION
Discourses such as safe manual handling, falls prevention, palliative care and cost constraints to individualized care can negatively impact on the goal to optimize the mobility of residents in nursing homes. Inter-professional approaches where staff work collaboratively and communicate well may counter such influences and ensure individualized care that focuses more effectively on resident mobility.
5420801
Predicting child abuse and neglect: ethical, theoretical and methodological challenges.
AIMS
This paper explores the ethical, theoretical and methodological implications of predictive testing in studies of child abuse, neglect and harm.


BACKGROUND
The use of screening instruments to make predictions about children who may later be abused, neglected or at risk of exclusion is promoted in research and policy. The recent UK Action Plan on Social Exclusion suggests that health visitors and community midwives should be trained to use these tools in practice.


METHOD
Position paper.


CONCLUSIONS
The accuracy of screening instruments to identify children who will be abused or neglected has not been established. Even if the theoretical and methodological challenges of predictive instruments could be overcome, the ethical implications of their use are very difficult for nurses and midwives.


RELEVANCE TO CLINICAL PRACTICE
Nurses, midwives and health visitors require high levels of awareness of risk factors in working with children and families. We have a responsibility to reach professional judgements about risks of harm for individuals. This is best performed through improving skills in working with parents and carers to identify those factors which may impede their ability to offer safe developmental care to their children.
28897037
The synthesis of RNA by mammalian cells treated with the aminonucleoside of puromycin.
Abstract The aminonucleoside of puromycin will inhibit RNA synthesis in cultured hamster embryo cells with little effect on protein synthesis for several hours. In other systems, the drug-induced inhibition of RNA synthesis has been interpreted as a specific inhibition of ribosomal RNA (rRNA) synthesis with only a small effect on messenger RNA (mRNA) synthesis. In contrast, no evidence was found in this system for such a selective inhibition, as the synthesis of rRNA, ‘heavy nuclear’ RNA, and polysomal mRNA were all inhibited to approximately equal extent by the drug. In addition, the results are consistent with the interpretation that rRNA synthesized in the presence of the drug is open to more than normal degradation during its maturation and incorporation into ribosomes.