The socio-demographics and clinical profile of patients referred to the GP liaison psychiatry service within a metropolitan Aboriginal medical service.

OBJECTIVE: This study aimed to describe the social demographics and clinical profile of patients referred to the psychiatry service within the local Queensland metropolitan Aboriginal Medical Service (AMS). METHOD: This was a retrospective cohort study of patients referred to the psychiatry service provided at three clinics of a metropolitan AMS, over an 18-month period. Medical records were accessed to determine demographic and diagnostic information. RESULTS: Diagnostically, 53% of patients had mood/anxiety disorders, 10% psychosis, 23% substance use and 14% with other diagnoses. There was approximately 50% non-attendance rate with no statistical difference between gender and age groups. The highest proportion of non-attenders within age groups was males 45-54 years old. The patients needed to travel an average of 20 km to attend the AMS. CONCLUSION: The high non-attendance rates, and proportionately more males within the age group 45-54 years who were more likely to not attend their mental health appointments, suggested a target area for outreach services which have been implemented in the AMS. Some of the recommended solutions included confirming attendance the day prior and supporting with transport. This study highlighted the large distance that Aboriginal and Torres Strait Islander people must travel to access culturally appropriate service.

Natural selection has driven the recurrent loss of an immunity gene that protects Drosophila against a major natural parasite.

Polymorphisms in immunity genes can have large effects on susceptibility to infection. To understand the origins of this variation, we have investigated the genetic basis of resistance to the parasitoid wasp Leptopilina boulardi in Drosophila melanogaster. We found that increased expression of the gene lectin-24A after infection by parasitic wasps was associated with a faster cellular immune response and greatly increased rates of killing the parasite. lectin-24A encodes a protein that is strongly up-regulated in the fat body after infection and localizes to the surface of the parasite egg. In certain susceptible lines, a deletion upstream of the lectin-24A has largely abolished expression. Other mutations predicted to abolish the function of this gene have arisen recurrently in this gene, with multiple loss-of-expression alleles and premature stop codons segregating in natural populations. The frequency of these alleles varies greatly geographically, and in some southern African populations, natural selection has driven them near to fixation. We conclude that natural selection has favored the repeated loss of an important component of the immune system, suggesting that in some populations, a pleiotropic cost to lectin-24A expression outweighs the benefits of resistance.

Human rights implications of introducing a new mental health act - principles, challenges and opportunities.

OBJECTIVE: The United Nations Convention on the Rights of Persons with Disabilities (CRPD), 2006 has influenced the evolution of mental health legislation to protect and promote human rights of individuals with mental illness. This review introduces how the human rights agenda can be systematised into mental health services. Exploration is made of how some principles of CRPD have been incorporated into Queensland's Mental Health Act 2016. CONCLUSION: Although progress has been made in some areas, e.g. heavier reliance on capacity assessment and new supported decision-making mechanisms, MHA 2016 has continued to focus on involuntary treatment. A Human Rights Act 2019 has been passed by the Queensland parliament, which may fill in the gap by strengthening positive rights.

How important is vehicle safety for older consumers in the vehicle purchase process?

OBJECTIVE: This study aimed to investigate the importance of vehicle safety to older consumers in the vehicle purchase process. METHODS: Older (n = 102), middle-aged (n = 791), and younger (n = 109) participants throughout the eastern Australian states of Victoria, New South Wales, and Queensland who had recently purchased a new or used vehicle completed an online questionnaire about their vehicle purchase process. RESULTS: When asked to list the 3 most important considerations in the vehicle purchase process (in an open-ended format), older consumers were mostly likely to list price as their most important consideration (43%). Similarly, when presented with a list of vehicle factors (such as price, design, Australasian New Car Assessment Program [ANCAP] rating), older consumers were most likely to identify price as the most important vehicle factor (36%). When presented with a list of vehicle features (such as automatic transmission, braking, air bags), older consumers in the current study were most likely to identify an antilock braking system (41%) as the most important vehicle feature, and 50 percent of older consumers identified a safety-related vehicle feature as the highest priority vehicle feature (50%). When asked to list up to 3 factors that make a vehicle safe, older consumers in the current study were most likely to list braking systems (35%), air bags (22%), and the driver's behavior or skill (11%). When asked about the influence of safety in the new vehicle purchase process, one third of older consumers reported that all new vehicles are safe (33%) and almost half of the older consumers rated their vehicle as safer than average (49%). A logistic regression model was developed to predict the profile of older consumers more likely to assign a higher priority to safety features in the vehicle purchasing process. The model predicted that the importance of safety-related features was influenced by several variables, including older consumers' beliefs that they could protect themselves and their family from a crash, their traffic infringement history, and whether they had children. CONCLUSIONS: These findings are consistent with previous research that suggests that, though older consumers highlight the importance of safety features (i.e., seat belts, air bags, braking), they often downplay the role of safety in their vehicle purchasing process and are more likely to equate vehicle safety with the presence of specific vehicle safety features or technologies rather than the vehicle's crash safety/test results or crashworthiness. The findings from this study provide a foundation to support further research in this area that can be used by policy makers, manufacturers, and other stakeholders to better target the promotion and publicity of vehicle safety features to particular consumer groups (such as older consumers). Better targeted campaigns may help to emphasize the value of safety features and their role in reducing the risk of injury/death. If older consumers are better informed of the benefits of safety features when purchasing a vehicle, a further reduction in injuries and deaths related to motor vehicle crashes may be realized.

A preliminary estimation of motorcyclist fatal injury risk by BAC level relative to car/van drivers.

OBJECTIVE: This study sought to quantify the fatal injury risks for motorcyclists associated with the riders' blood alcohol concentrations (BACs). METHOD: Using a case-control study design with New Zealand data, fatal injury risk curves for motorcyclists and car drivers were modeled. A total of 142 fatally injured drivers/riders (cases) and 58,000 control drivers/riders were studied. For motorcyclists, there were 13 cases and 194 controls. RESULTS: The rate of increase in fatal injury risk with increasing BAC was not found to be different for motorcyclists compared to car/van drivers. However, because the baseline risk for motorcyclists was already considerably higher than for car/van drivers, even modest amounts of alcohol were associated with very high risks for motorcyclists compared to sober car/van drivers. It was estimated that, relative to their sober risk, motorcycle riders at BAC = 0.03 percent have 3 times the fatality risk (95% confidence interval [CI] = 2.8-3.5) and, at BAC = 0.08, 20 times the fatality risk (95% CI = 15.0-27.3). CONCLUSIONS: Interventions focused on reducing the alcohol consumption of motorcycle riders are clearly required when the degree of risk even at low alcohol levels is as disturbingly high as estimated in the current study.

Good practice in the conduct and reporting of survey research.

Survey research is sometimes regarded as an easy research approach. However, as with any other research approach and method, it is easy to conduct a survey of poor quality rather than one of high quality and real value. This paper provides a checklist of good practice in the conduct and reporting of survey research. Its purpose is to assist the novice researcher to produce survey work to a high standard, meaning a standard at which the results will be regarded as credible. The paper first provides an overview of the approach and then guides the reader step-by-step through the processes of data collection, data analysis, and reporting. It is not intended to provide a manual of how to conduct a survey, but rather to identify common pitfalls and oversights to be avoided by researchers if their work is to be valid and credible.