Connectome dysfunction in patients at clinical high risk for psychosis and modulation by oxytocin.

Abnormalities in functional brain networks (functional connectome) are increasingly implicated in people at Clinical High Risk for Psychosis (CHR-P). Intranasal oxytocin, a potential novel treatment for the CHR-P state, modulates network topology in healthy individuals. However, its connectomic effects in people at CHR-P remain unknown. Forty-seven men (30 CHR-P and 17 healthy controls) received acute challenges of both intranasal oxytocin 40 IU and placebo in two parallel randomised, double-blind, placebo-controlled cross-over studies which had similar but not identical designs. Multi-echo resting-state fMRI data was acquired at approximately 1 h post-dosing. Using a graph theoretical approach, the effects of group (CHR-P vs healthy control), treatment (oxytocin vs placebo) and respective interactions were tested on graph metrics describing the topology of the functional connectome. Group effects were observed in 12 regions (all pFDR < 0.05) most localised to the frontoparietal network. Treatment effects were found in 7 regions (all pFDR < 0.05) predominantly within the ventral attention network. Our major finding was that many effects of oxytocin on network topology differ across CHR-P and healthy individuals, with significant interaction effects observed in numerous subcortical regions strongly implicated in psychosis onset, such as the thalamus, pallidum and nucleus accumbens, and cortical regions which localised primarily to the default mode network (12 regions, all pFDR < 0.05). Collectively, our findings provide new insights on aberrant functional brain network organisation associated with psychosis risk and demonstrate, for the first time, that oxytocin modulates network topology in brain regions implicated in the pathophysiology of psychosis in a clinical status (CHR-P vs healthy control) specific manner.

Reliability and Validity of the 6-Minute Step Test for Clinical Assessment of Cardiorespiratory Fitness in People at Risk of Cardiovascular Disease.

Giacomantonio, N, Morrison, P, Rasmussen, R, and MacKay-Lyons, MJ. Reliability and validity of the 6-minute step test for clinical assessment of cardiorespiratory fitness in people at risk of cardiovascular disease. J Strength Cond Res 34(5): 1376-1382, 2020-The purpose of this study was to determine the test-retest reliability and validity of the 6-minute step test (6MST) as a potential assessment of cardiorespiratory fitness (CRF) of people at risk of cardiovascular disease (CVD). A prospective, cross-sectional, correlational study design was used. A single cohort of 30 adults with 2 or more risk factors for CVD was recruited. Exercise tests were scheduled on 2 days, separated by 1 week. Validity was determined by comparing 6MST results with those obtained in a symptom-limited treadmill test and the 6-minute walk test (6MWT). Main outcome variables were peak heart rate (HRpeak) and peak oxygen consumption (V[Combining Dot Above]O2peak) measured during the 6MST, treadmill test, and 6MWT. Test-retest reliability of HRpeak and V[Combining Dot Above]O2peak during the 6MST was very strong (intraclass correlation coefficient [ICC], 0.92; 95% confidence interval [CI], 0.83-0.97 and ICC, 0.93; 95% CI, 0.84-0.97, respectively). Correlations were also very strong between 6MST and treadmill test HRpeak (r = 0.81) and between 6MST and treadmill test V[Combining Dot Above]O2peak (r = 0.88). Correlations were moderate between 6MST HRpeak and 6MWT steady-state HR (r = 0.57) and strong between 6MST V[Combining Dot Above]O2peak and 6MWT steady-state V[Combining Dot Above]O2 (r = 0.70). The 6MST seems to be a reliable, valid option for assessing CRF of people at risk of CVD in a broad range of clinical settings. Providing practical, accessible tests will help facilitate the goal of establishing CRF as a clinical vital sign. The next step in the development of the 6MST should be to identify the most appropriate 6MST predictor variables to estimate V[Combining Dot Above]O2max.

Metapopulation dynamics of roseate terns: Sources, sinks and implications for conservation management decisions.

Habitat management to restore or create breeding sites may allow metapopulations to increase in size and reduce the risk of demographic stochasticity or disasters causing metapopulation extinction. However, if newly restored or created sites are of low quality, they may act as sinks that draw individuals away from better quality sites to the detriment of metapopulation size. Following intensive conservation effort, the metapopulation of roseate tern (Sterna dougallii) in NW Europe is recovering from a large crash in numbers, but most former colonies remain unoccupied and hence are potential targets for restoration. To inform conservation efforts, we studied the dynamics of this metapopulation with a multistate integrated population model to assess each of the three main colonies for important demographic contributors to population growth rate, source/sink status and possible density dependence. All three study colonies are managed for roseate terns (and other tern species) in similar ways, but the demographic processes vary considerably between colonies. The largest colony is a source involved in almost all dispersal, and its growth is determined by survival rates and productivity. Productivity and juvenile apparent survival at the largest colony appear to be density-dependent. Although the mechanisms are unclear, this may provide an increasing impetus for emigration of recruits to other colonies in future. The smallest of the three colonies is a sink, relying on immigration for its growth. Simulation models suggest the metapopulation would be c. 10% larger in the absence of dispersal to the sink colony. This work indicates that, due to variable site quality, aims to enhance both distribution and size of metapopulations may be mutually exclusive. In this case, before future attempts to encourage recolonisation of former sites, assessments of site suitability should be undertaken, focusing on food availability and isolation from predators to maximise the likelihood of attaining levels of productivity and survival that avoid creation of a sink population to the detriment of the overall metapopulation size.

The association between gratitude and burden in Australian mental health carers: a cross-sectional study.

The level of carer burden has increased as carers take on more responsibility for mental health consumers as a result of the contemporary shift in the delivery of services from institutional to community settings. Interventions are required to mitigate mental health carer burden. Therefore, we examined the association between dispositional gratitude and burden in a cross-sectional survey of 231 Australian mental health carers. Dispositional gratitude was assessed by the S-GRAT, and carer burden was measured using the Involvement Evaluation Questionnaire. The results of a general linear model demonstrated that higher levels of a lack of sense of deprivation were significantly associated with lower levels of tension, worrying and urging. In contrast, higher levels of simple appreciation were significantly associated with higher levels of supervision, worrying and urging. Our findings highlight that gratitude interventions should focus on promoting a lack of sense of deprivation and appreciation of others in order to reduce mental health carer burden.

Influence of bioaugmentation and biostimulation on PAH degradation in aged contaminated soils: Response and dynamics of the bacterial community.

Polycyclic aromatic hydrocarbons (PAHs) represent a group of hazardous compounds that are ubiquitous and persistent. The main aim of this study was to investigate the degradation of PAHs in chronically contaminated, aged and weathered soils obtained from a former gas plant of Australia. Biostimulation and bioaugmentation using individual isolates (Rhodococcus sp. (NH2), Achromobacter sp. (NH13), Oerskovia paurometabola (NH11), Pantoea sp. (NH15), Sejongia sp. (NH20), Microbacterium maritypicum (NH30) and Arthrobacter equi (NH21)) and a consortium of these isolates were tested during mesocosm studies. A significant reduction (99%) in PAH concentration was observed in all the treatments. In terms of the abundance of PAH-degrading genes and microbial community structure during PAH degradation, qPCR results revealed that Gram-positive bacteria were dominant over other bacterial communities in all the treatments. 16S sequencing results revealed that the inoculated organisms did not establish themselves during the treatment. However, substantial bacterial community changes during the treatments were observed, suggesting that the natural community exhibited sufficient resilience and diversity to enable an active, but changing degrading community at all stages of the degradation process. Consequently, biostimulation is proposed as the best strategy to remediate PAHs in aged, weathered and chronically contaminated soils.

Spatial Distribution of Novel and Legacy Brominated Flame Retardants in Soils Surrounding Two Australian Electronic Waste Recycling Facilities.

Informal recycling of electronic waste (e-waste) has been shown to cause significant brominated flame retardant (BFR) contamination of surrounding soils in a number of Asian and West African countries. However, to the authors' knowledge, there have been no published studies demonstrating polybrominated diphenyl ether (PBDE) and novel brominated flame retardant (NBFR) soil contamination from regulated "formal" e-waste processing facilities in developed countries. This study reports on PBDEs (-28, -47, -99, -100, -153, -154, -183, and -209) and NBFRs (PBT, PBEB, HBB, EH-TBB, BTBPE and DBDPE) in 36 soil samples surrounding two Australian e-waste recycling plants and a further eight reference soils. Overall ∑PBDE concentrations ranged 0.10-98 000 ng/g dw (median; 92 ng/g dw) and ∑NBFRs ranged ND-37 000 ng/g dw (median 2.0 ng/g dw). Concentrations in soils were found to be significantly negatively associated with distance from one of the e-waste facilities for ∑penta-BDEs, BDE-183, BDE-209, and ∑NBFR compound groups. ANOVA tests further illustrated the potential for e-waste recycling to significantly elevate concentrations of some BFRs in soils over distances up to 900 m compared to references sites. This study provides the first evidence of soil contamination with PBDEs and NBFRs originating from formal e-waste recycling facilities in Australia, which may have implications for e-waste recycling practices throughout the world.

Carers' involvement in decision making about antipsychotic medication: A qualitative study.

BACKGROUND: Current Australian mental health policy recommends that carers should be involved in the provision of mental health services. Carers often provide intensive support to mental health consumers and gain detailed insight into their lives. As such, carers could make valuable contributions to well-informed decisions about mental health consumers' use of antipsychotic medication. OBJECTIVES: The aim of this study was to explore carers' participation in antipsychotic medication decision making. METHODS: Snowball sampling was used to enrol 29 carers in this study. Of these carers, 19 participated in semi-structured interviews, and ten participated in a focus group. Data were analysed thematically. RESULTS: Four main themes emerged from the analysis. The findings highlighted that carers typically received little or no information about antipsychotic medication. Carers commonly addressed the shortfall in information by obtaining additional information through online sources or distributing among carer networks material that they had developed themselves. Almost all carers emphasized that they should be involved in decisions about antipsychotic medication, but noted that they were typically excluded. The lack of involvement in medication decisions was a source of frustration, as carers could contribute saliently through sharing detailed knowledge about mental health consumers' lives, address communication gaps that resulted from disjointed care and improve communication between health professionals and mental health consumers. CONCLUSION: Health professionals could consider improving the extent to which they collaborate with carers in medication decisions.

Australian mental health nurses' perspectives about the identification and management of antipsychotic medication side effects: a cross-sectional survey.

BACKGROUND: Currently, little is known about mental health nurses' management of antipsychotic medication side effects. AIMS: This study examined how Australian mental health nurses' attitudes and service processes influence the assessment of antipsychotic medication side effects. METHODS: Participants were included if they were registered nurses in Australian mental health settings. An online questionnaire was distributed via email. Multivariate logistic regression was used to examine associations between attitudes and awareness, and use of antipsychotic medication assessment tools. RESULTS: Only one quarter of the respondents were currently using a tool. In cases where the service had a clear system for agreeing responsibility about monitoring consumers between primary and secondary care, respondents were three times more likely to still be using one or more tool. When the service had reliable systems in place to remind staff that side effect assessments were due, respondents were five times more likely to continue using assessment tools. CONCLUSION: Australian mental nurses are not routinely using antipsychotic medication side effect assessment tools. The routine use of assessment tools would improve if systems were implemented to enhance their use.

Understanding advocacy practice in mental health: a multidimensional scalogram analysis of case records.

BACKGROUND: Few studies have examined mental health consumers' motives for seeking advocacy assistance. AIMS: This study aimed to identify factors that influenced mental health consumers' use of advocacy services. METHODS: The analysis was based on 60 case records that were sourced from a community advocacy service. Each record was dichotomously coded across 11 variables to generate a series of categorical data profiles. The data set was then analysed using multidimensional scalogram analysis to reveal key relationships between subsets of variables. RESULTS: The results indicated that mental health consumers commonly reported a sense of fear, which motivated them to contact the advocacy service in the hope that advocates could intervene on their behalf through effective communication with health professionals. Advocates often undertook such intervention either through attending meetings between the consumer and health professionals or contacting health professionals outside of meetings, which was typically successful in terms of achieving mental health consumers' desired outcome. The resolution of most concerns suggests that they were often legitimate and not the result of a lack of insight or illness symptoms. CONCLUSION: Health professionals might consider exploring how they respond when consumers or carers raise concerns about the delivery of mental health care.

Winery biomass waste degradation by sequential sonication and mixed fungal enzyme treatments.

To increase the efficiency of winery-derived biomass biodegradation, grape pomace was ultrasonicated for 20min in the presence of 0.25M, 0.5Mand1.0MKOH and 1.0MNaOH. This was followed by treatment with a 1:1 (v/v) mix of crude enzyme preparation derived from Phanerochaete chrysosporium and Trametes versicolor for 18h and a further 18h treatment with a 60:14:4:2 percent ratio combination of enzymes derived from Aspergillus niger: Penicillium chrysogenum: Trichoderma harzianum: P. citrinum, repsectively. Process efficiency was evaluated by its comparison to biological only mixed fungal degradation over 16days. Ultrasonication treatment with 0.5MKOH followed by mixed enzyme treatment yielded the highest lignin degradation of about 13%. Cellulase, ß-glucosidase, xylanase, laccase and lignin peroxidase activities of 77.9, 476, 5,390.5, 66.7 and 29,230.7U/mL, respectively, were observed during biomass degradation. Gas chromatography-mass spectrometry (GC-MS) analysis of the degraded material identified commercially important compounds such as gallic acid, lithocholic acid, glycolic acid and lactic acid which were generated in considerable quantities. Thus, the combination of sonication pre-treatment and enzymatic degradation has the potential to considerably improve the breakdown of agricultural biomass and produce commercially useful compounds in markedly less time (<40h) with respect to biological only degradation (16days).

Chemometric Analysis of Lavender Essential Oils Using Targeted and Untargeted GC-MS Acquired Data for the Rapid Identification and Characterization of Oil Quality.

Standard raw material test methods such as the ISO Standard 11024 are focused on the identification of lavender oil and not the actual class/quality of the oil. However, the quality of the oil has a significant effect on its price at market. As such, there is a need for raw material tests to identify not only the type of oil but its quality. This paper describes two approaches to rapidly identifying and classifying lavender oil. First, the ISO Standard 11024 test method was evaluated in order to determine its suitability to assess lavender oil quality but due to its targeted and simplistic approach, it has the potential to miss classify oil quality. Second, utilizing the data generated by the ISO Standard 11024 test methodology, an untargeted chemometric predicative model was developed in order to rapidly assess and characterize lavender oils (Lavandulaangustifolia L.) for geographical/environmental adulteration that impact quality. Of the 170 compounds identified as per the ISO Standard 11024 test method utilizing GC-MS analyses, 15 unique compounds that greatly differentiate between the two classes of lavender were identified. Using these 15 compounds, a predicative multivariate chemometric model was developed that enabled lavender oil samples to be reliably differentiated based on quality. A misclassification analysis was performed and it was found that the predictions were sound (100% matching rate). Such an approach will enable producers, distributers, suppliers and manufactures to rapidly screen lavender essential oil. The authors concede that the validation and implementation of such an approach is more difficult than a conventional chromatographic assay. However, the rapid, reliable and less problematic screening is vastly superior and easily justifies any early implementation validation difficulties and costs.

Two-dimensional semiconductor nanocrystals: properties, templated formation, and magic-size nanocluster intermediates.

CONSPECTUS: Semiconductor nanocrystals having an extended length dimension and capable of efficiently transporting energy and charge would have useful applications in solar-energy conversion and other emerging technologies. Pseudocylindrical semiconductor nanowires and quantum wires are available that could potentially serve in this role. Sadly, however, their defective surfaces contain significant populations of surface trap sites that preclude efficient transport. The very large surface area of long wires is at least part of the problem. As electrons, holes, and excitons migrate along a nanowire or quantum wire, they are exposed to an extensive surface and to potentially large numbers of trap sites. A solution to this dilemma might be found by identifying "long" semiconductor nanocrystals of other morphologies that are better passivated. In this Account, we discuss a newly emerging family of flat semiconductor nanocrystals that have surprising characteristics. These thin, flat nanocrystals have up to micrometer-scale (orthogonal) lateral dimensions and thus very large surface areas. Even so, their typical photoluminescence efficiencies of 30% are astonishingly high and are 2 orders of magnitude higher than those typical of semiconductor quantum wires. The very sharp emission spectra of the pseudo-two-dimensional nanocrystals reflect a remarkable uniformity in their discrete thicknesses. Evidence that excitons are effectively delocalized and hence transported over the full dimensions of these nanocrystals has been obtained. The excellent optical properties of the flat semiconductor nanocrystals confirm that they are exceptionally well passivated. This Account summarizes the two synthetic methods that have been developed for the preparation of pseudo-two-dimensional semiconductor nanocrystals. A discussion of their structural features accounts for their discrete, uniform thicknesses and details the crystal-lattice expansions and contractions they exhibit. An analysis of their optical properties justifies the sharp photoluminescence spectra and high photoluminescence efficiencies. Finally, a bilayer mesophase template pathway is elucidated for the formation of the nanocrystals, explaining their flat morphologies. Magic-size nanocluster intermediates are found to be potent nanocrystal nucleants, allowing the synthesis temperatures to be decreased to as low as room temperature. The potential of these flat semiconductor nanocrystals in the form of nanoribbons or nanosheets for long-range energy and charge transport appears to be high.

Chemical Pollutants Sorbed to Ingested Microbeads from Personal Care Products Accumulate in Fish.

The prevalence of microplastics (<5 mm) in natural environments has become a widely recognized global problem. Microplastics have been shown to sorb chemical pollutants from their surrounding environment, thus raising concern as to their role in the movement of these pollutants through the food chain. This experiment investigated whether organic pollutants sorbed to microbeads (MBs) from personal care products were assimilated by fish following particle ingestion. Rainbow fish (Melanotaenia fluviatilis) were exposed to MBs with sorbed polybrominated diphenyl ethers (PBDEs; BDE-28, -47, -100, -99, -153, -154, -183, 200 ng g(-1); BDE-209, 2000 ng g(-1)) and sampled at 0, 21, 42, and 63 days along with two control treatments (food only and food + clean MBs). Exposed fish had significantly higher Σ8PBDE concentrations than both control treatments after just 21 days, and continued exposure resulted in increased accumulation of the pollutants over the experiment (ca. 115 pg g(-1) ww d(-1)). Lower brominated congeners showed the highest assimilation whereas higher brominated congeners did not appear to transfer, indicating they may be too strongly sorbed to the plastic or unable to be assimilated by the fish due to large molecular size or other factors. Seemingly against this trend, however, BDE-99 did not appear to bioaccumulate in the fish, which may be due to partitioning from the MBs or it being metabolized in vivo. This work provides evidence that MBs from personal care products are capable of transferring sorbed pollutants to fish that ingest them.

A candidate reference method using ICP-MS for sweat chloride quantification.

BACKGROUND: The aim of the study was to develop a method for sweat chloride (Cl) quantification using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) to present to the Joint Committee for Traceability in Laboratory Medicine (JCTLM) as a candidate reference method for the diagnosis of cystic fibrosis (CF). METHODS: Calibration standards were prepared from sodium chloride (NaCl) to cover the expected range of sweat Cl values. Germanium (Ge) and scandium (Sc) were selected as on-line (instrument based) internal standards (IS) and gallium (Ga) as the off-line (sample based) IS. The method was validated through linearity, accuracy and imprecision studies as well as enrolment into the Royal College of Pathologists of Australasia Quality Assurance Program (RCPAQAP) for sweat electrolyte testing. RESULTS: Two variations of the ICP-MS method were developed, an on-line and off-line IS, and compared. Linearity was determined up to 225 mmol/L with a limit of quantitation of 7.4 mmol/L. The off-line IS demonstrated increased accuracy through the RCPAQAP performance assessment (CV of 1.9%, bias of 1.5 mmol/L) in comparison to the on-line IS (CV of 8.0%, bias of 3.8 mmol/L). Paired t-tests confirmed no significant differences between sample means of the two IS methods (p=0.53) or from each method against the RCPAQAP target values (p=0.08 and p=0.29). CONCLUSIONS: Both on and off-line IS methods generated highly reproducible results and excellent linear comparison to the RCPAQAP target results. ICP-MS is a highly accurate method with a low limit of quantitation for sweat Cl analysis and should be recognised as a candidate reference method for the monitoring and diagnosis of CF. Laboratories that currently practice sweat Cl analysis using ICP-MS should include an off-line IS to help negate any pre-analytical errors.

Are deficits in cognition associated with psychotic-like experiences after cannabis?

Not all individuals who smoke cannabis report psychotic-like experiences. Given that risk factors for psychotic disorders are multifaceted, precipitating factors to psychotic-like experiences after cannabis are likely to be equally complex. Reduced neurocognitive performance is associated with both psychosis risk and cannabis use. Therefore, it is possible cognitive performance may differentiate those who report psychotic-like experiences after cannabis from those who do not. We determined whether those reporting psychotic/dysphoric experiences after cannabis had reduced neurocognitive performance compared to those reporting primarily euphoric experiences. METHODS: Participants were recruited on the basis of responses to the cannabis high captured by the Psychosis-Dysphoric and Euphoric experiences subscales from the Cannabis Experiences Questionnaire (CEQ). RESULTS: Compared to participants reporting primarily euphoric cannabis experiences (n = 36; 44% male; mean age (SD) = 28 (9) years), those who reported psychotic/dysphoric experiences (n = 40; 45% male; mean age (SD) = 26 (5) years) demonstrated significantly faster responses to a trial and error learning task. In the presence of distracters, those with psychotic/dysphoric experiences after cannabis made more errors on a Continuous Performance Task. CONCLUSIONS: Those who report psychotic/dysphoric experiences after cannabis have subtle inefficiencies in their cognitive processes. The multiple factors which predict vulnerability to psychotic-like experiences after cannabis require further investigation.

Antipsychotic medication side effect assessment tools: A systematic review.

OBJECTIVE: The aim of this systematic review was to critically appraise the psychometric properties of antipsychotic medication side effect assessment tools. METHODS: Systematic searches were undertaken in PubMed, CINAHL and CENTRAL from inception to October 2014. Studies were included if they detailed the evaluation of psychometric properties of antipsychotic medication side effect assessment tools in mental health populations. Studies were excluded if they examined the use of antipsychotic medication side effect assessment tools in non-mental health populations, including people suffering from dementia, Parkinsonism and Alzheimer's. Narrative reviews and studies published in any language other than English were also excluded. RESULTS: Content validity was appropriately established for only one of the tools, reliability was inappropriately evaluated for all but one tool, and the assessment of responsiveness was not acceptable for any tool. CONCLUSION: Further psychometric studies are warranted to consolidate the psychometric properties of the included antipsychotic medication side effect assessment tools before any of these tools can be confidently recommended for either research or clinical purposes.

Bioremediation potential of diesel-contaminated Libyan soil.

Bioremediation is a broadly applied environmentally friendly and economical treatment for the clean-up of sites contaminated by petroleum hydrocarbons. However, the application of this technology to contaminated soil in Libya has not been fully exploited. In this study, the efficacy of different bioremediation processes (necrophytoremediation using pea straw, bioaugmentation and a combination of both treatments) together with natural attenuation were assessed in diesel contaminated Libyan soils. The addition of pea straw was found to be the best bioremediation treatment for cleaning up diesel contaminated Libyan soil after 12 weeks. The greatest TPH degradation, 96.1% (18,239.6mgkg(-1)) and 95% (17,991.14mgkg(-1)) were obtained when the soil was amended with pea straw alone and in combination with a hydrocarbonoclastic consortium respectively. In contrast, natural attenuation resulted in a significantly lower TPH reduction of 76% (14,444.5mgkg(-1)). The presence of pea straw also led to a significant increased recovery of hydrocarbon degraders; 5.7log CFU g(-1) dry soil, compared to 4.4log CFUg(-1) dry soil for the untreated (natural attenuation) soil. DGGE and Illumina 16S metagenomic analyses confirm shifts in bacterial communities compared with original soil after 12 weeks incubation. In addition, metagenomic analysis showed that original soil contained hydrocarbon degraders (e.g. Pseudoxanthomonas spp. and Alcanivorax spp.). However, they require a biostimulant (in this case pea straw) to become active. This study is the first to report successful oil bioremediation with pea straw in Libya. It demonstrates the effectiveness of pea straw in enhancing bioremediation of the diesel-contaminated Libyan soil.

Recovery and Borderline Personality Disorder: A Description of the Innovative Open Borders Program.

Although Recovery-oriented approaches to delivering mental health services are now promoted in health services across the globe, there is an ongoing need to adapt these approaches to meet the unique needs of consumers with a diagnosis of borderline personality disorder. The lived experience of borderline personality disorder includes emotional dysregulation, intense and unstable relationships, self-harming behaviours, fear of abandonment, and a limited capacity to cope with stress. These experiences present a range of challenges for those who deliver Recovery-oriented services and advocate the principles of empowerment and self-determination. This paper describes a novel crisis intervention program, "Open Borders," which has been established to meet the unique needs of people with a borderline personality disorder diagnosis. Open Borders is a Recovery-oriented model that is run at a public, state-wide residential facility for mental health consumers in Western Australia, and offers alternative pathways to achieving mental health Recovery, including self-referral and short-term admission to a residential facility. The aims of the program are to break the cycle of hospital admission, reduce rates of self-harm, and support the complex Recovery journey of consumers with a diagnosis of borderline personality disorder. Open Borders provides an exemplar for other health service organisations seeking to establish Recovery-oriented crisis intervention alternatives.

An ethnographic action research study to investigate the experiences of Bindjareb women participating in the cooking and nutrition component of an Aboriginal health promotion programme in regional Western Australia.

OBJECTIVE: To investigate the experiences of women participating in a cooking and nutrition component of a health promotion research initiative in an Australian Aboriginal regional community. DESIGN: Weekly facilitated cooking and nutrition classes were conducted during school terms over 12 months. An ethnographic action research study was conducted for the programme duration with data gathered by participant and direct observation, four yarning groups and six individual yarning sessions. The aim was to determine the ways the cooking and nutrition component facilitated lifestyle change, enabled engagement, encouraged community ownership and influenced community action. SETTING: Regional Bindjareb community in the Nyungar nation of Western Australia. SUBJECTS: A sample of seventeen Aboriginal women aged between 18 and 60 years from the two kinships in two towns in one shire took part in the study. The recruitment and consent process was managed by community Elders and leaders. RESULTS: Major themes emerged highlighting the development of participants and their recognition of the need for change: the impact of history on current nutritional health of Indigenous Australians; acknowledging shame; challenges of change around nutrition and healthy eating; the undermining effect of mistrust and limited resources; the importance of community control when developing health promotion programmes; finding life purpose through learning; and the need for planning and partnerships to achieve community determination. CONCLUSIONS: Suggested principles for developing cooking and nutrition interventions are: consideration of community needs; understanding the impact of historical factors on health; understanding family and community tensions; and the engagement of long-term partnerships to develop community determination.