RESUMEN
BACKGROUND: Mental health care in Australia is fragmented and inaccessible for people experiencing severe and complex mental ill-health. Partners in Recovery is a Federal Government funded scheme that was designed to improve coordination of care and needs for this group. Support Facilitators are the core service delivery component of this scheme and have been employed to work with clients to coordinate their care needs and, through doing so, bring the system closer together. OBJECTIVE: To understand how Partners in Recovery Support Facilitators establish themselves as a new role in the mental health system, their experiences of the role, the challenges that they face and what has enabled their work. METHODS: In-depth qualitative interviews were carried out with 15 Support Facilitators and team leaders working in Partners in Recovery in two regions in Western Sydney (representing approximately 35 % of those working in these roles in the regions). Analysis of the interview data focused on the work that the Support Facilitators do, how they conceptualise their role and enablers and barriers to their work. RESULTS: The support facilitator role is dominated by efforts to seek out, establish and maintain connections of use in addressing their clients' needs. In doing this Support Facilitators use existing interagency forums and develop their own ad hoc groupings through which they can share knowledge and help each other. Support Facilitators also use these groups to educate the sector about Partners in Recovery, its utility and their own role. The diversity of support facilitator backgrounds are seen as both and asset and a barrier and they describe a process of striving to establish an internally collective identity as well as external role clarity and acceptance. At this early stage of PIR establishment, poor communication was identified as the key barrier to Support Facilitators' work. CONCLUSIONS: We find that the Support Facilitators are building the role from within and using trial and error to develop their practice in coordination. We argue that a strong organisational hierarchy is necessary for support facilitation to be effective and to allow the role to develop effectively. We find that their progress is limited by overall program instability caused by changing government policy priorities.
RESUMEN
A 2-stage algorithmic framework was developed to automatically classify digitized photomicrographs of tissues obtained from bovine liver, lung, spleen, and kidney into different histologic categories. The categories included normal tissue, acute necrosis, and inflammation (acute suppurative; chronic). In the current study, a total of 60 images per category (normal; acute necrosis; acute suppurative inflammation) were obtained from liver samples, 60 images per category (normal; acute suppurative inflammation) were obtained from spleen and lung samples, and 60 images per category (normal; chronic inflammation) were obtained from kidney samples. An automated support vector machine (SVM) classifier was trained to assign each test image to a specific category. Using 10 training images/category/organ, 40 test images/category/organ were examined. Employing confusion matrices to represent category-specific classification accuracy, the classifier-attained accuracies were found to be in the 74-90% range. The same set of test images was evaluated using a SVM classifier trained on 20 images/category/organ. The average classification accuracies were noted to be in the 84-95% range. The accuracy in correctly identifying normal tissue and specific tissue lesions was markedly improved by a small increase in the number of training images. The preliminary results from the study indicate the importance and potential use of automated image classification systems in the histologic identification of normal tissues and specific tissue lesions.