Rationale and methods for a cross-sectional study of mental health and wellbeing following river flooding in rural Australia, using a community-academic partnership approach.

BACKGROUND: Climate change is associated with greater frequency, duration, intensity and unpredictability of certain weather-related events, including floods. Floods harm mental health. There is limited understanding of the mental health and well-being effects from river flooding, particularly over the longer term and in rural contexts. This paper describes the rationale, aims, objectives, study design and socio-demographic characteristics of the sample for a study measuring associations between flood experience and mental health and wellbeing of residents (particularly those most likely to be negatively impacted and hard to reach) in rural NSW Australia 6 months following a devastating flood in 2017. To our knowledge, the study is the first of its kind within Australia in a rural community and is an important initiative given the likelihood of an increasing frequency of severe flooding in Australia given climate change. METHODS: A conceptual framework (The Flood Impact Framework) drawing on social ecological approaches was developed by the research team. It was based on the literature and feedback from the community. The Framework describes putative relationships between flood exposure and mental health and wellbeing outcomes. Within a community-academic partnership approach, a cross-sectional survey was then undertaken to quantify and further explore these relationships. RESULTS: The cross-sectional survey was conducted online (including on mobile phone) and on paper between September and November 2017 and recruited 2530 respondents. Of those, 2180 provided complete demographic data, among whom 69% were women, 91% were aged 25-74, 4% identified as Aboriginal and/or Torres Strait Islander, 9% were farmers and 33% were business owners. CONCLUSIONS: The study recruited a wide range of respondents and the partnership facilitated the community's engagement with the design and implementation of the study. The study will provide a basis for a follow-up study, that will aim to improve the understanding of mental health and wellbeing effects over the longer term. It will provide an important and original contribution to understanding river flooding and mental health in rural Australia, a topic that will grow in importance in the context of human-induced climate change, and identify critical opportunities to strengthen services, emergency planning and resilience to future flooding.

Long-term effects of severe closed head injury on memory: evidence from a consecutive series of young adults.

Long-term cognitive sequelae of severe closed head injury were studied in a consecutive series of 39 young head-injury adults without gross intellectual deficits. Testing was carried out 2-5 years post-injury. Patients with a post-traumatic amnesia (PTA) greater than 3 weeks were impaired on a wide range of tests, particularly those requiring long-term retention of complex materials or where time constraints were a salient feature. Patients with a PTA of 1-3 weeks were unimpaired on all tasks. The results suggest that in young adults a threshold of brain damage related to long-term cognitive impairment operates at around a 2-3 week PTA duration.

Determinants of performance on the Rey-Osterrieth Complex Figure Test: an analysis, and a new technique for single-case assessment.

The aim of the study was to identify factors determining performance on the Rey - Osterrieth Complex Figure Test in a normal population, in terms of accuracy of initial copy and delayed recall. Both immediate copy and delayed recall were related to age, and especially to the strategy adopted at the initial copy. A regression equation was derived whereby delayed recall could be predicted from the strategy adopted at the initial copy and the subject's age. This should prove useful in the analysis of Rey - Osterrieth performance in individual cases.

Self-report of memory skills after temporal lobectomy: the effect of clinical variables.

Forty-eight patients who had undergone unilateral temporal lobectomy for the relief of focal epilepsy 6 months to 6 years prior to contact were asked to rate themselves on a questionnaire designed to look at "real-life" memory skills. The temporal lobe patients, as a group, saw themselves as having poorer memories than normals, but only 3 out of 43 items showed significant differences between right-and left-sided lobectomy patients. Our hypotheses that age at operation, reduction in seizure frequency and time since operation (in the left temporal lobe patients only) would determine the extent of subject complaint of memory were fully confirmed. In addition, sex of the patient was found to be a significant variable. The status of subjective and objective measures of memory as indices of "real-life" memory skills is discussed.