The governance of primary mental health planning by Primary Health Networks

The establishment of Primary Health Networks (PHNs) was accompanied by assignment of responsibility for funding for primary mental healthcare. To ensure this funding is spent in line with government priorities, the Federal government developed a planning document with established priorities and guidance documents for how the planning document should be completed. This paper examines how these documents shape service delivery through enabling some activities and excluding others and identifies the assumptions that underpin these documents. Data were drawn from discourse and content analysis of completed planning documents from the PHNs and of the guidance documents and from reflection upon mental health planning from 55 interviews with key personnel from six PHNs. Service delivery is shaped by outcome measures that promote service access, cost‐effectiveness and clinical effectiveness, contributing to service options that favour self‐management for mild mental illness and clinical (but not social) services for people with severe mental illness. There is also limited scope for mental health promotion with prevention activities focused upon populations identified by the government as being at‐risk. This occurs to the detriment of other at‐risk populations.     

Exploring changes in treatment effects across design stages in adaptive trials

The recently published Committee for Medicinal Products for Human Use reflection paper on flexible designs highlights a controversial issue regarding the interpretation of adaptive trials. The guideline suggests that a test for heterogeneity should be preplanned and if treatment effect estimates differ significantly between design stages then data collected before and after the interim analysis might not be combined in a formal analysis. In this paper we investigate error rates for such a procedure in the presence of calendar-time effects. Furthermore, we present an alternative testing strategy based on change point methods. In a simulation study we demonstrate that our procedure performs well in comparison to that suggested by the guideline.     

On the limits of generalizability: applying resource exchange theory to gay relationship processes

In the present studies, we examined patterns of interpersonal resource exchange (E. B. Foa & U. G. Foa, 1980; U. G. Foa & E. B. Foa, 1974) among gay male and female couples. Study 1 was quantitative in nature, whereas Study 2 was qualitative in nature. In Study 1 (n's = 61 male couples and 54 female couples), we explicitly tested the hypotheses that partners in same-sex romantic relationships would exchange affection and respect positively and significantly; results indicated that affection (but not respect) was exchanged or reciprocated positively and significantly among gay male (but not gay female) pairs. In Study 2 (n's = 15 male couples and 15 female couples), we asked the research question, but did not test any formal hypotheses, as to whether same-sex romantic pairs would spontaneously invoke interpersonal resource exchange and other reinforcement processes when describing their relationships; results indicated that gay female (but not gay male) couples appeared to adopt a communal, rather than exchange, orientation toward their relationships with regard to displays of affection. Implications for the study of relationship processes among same-sex romantic pairs are discussed.     

Women's perceptions of the effects of menopause and hormone replacement therapy on skin

Although women frequently associate skin issues with menopause and hormone replacement therapy (HRT), little work has been done to investigate a possible relationship. A questionnaire was given to women attending a specialist menopause clinic; 87 women responded. Skin problems generally were common, with over 64% of respondents reporting past problems. Around half felt that the menopause had resulted in skin changes; dry skin was the predominant complaint at this stage. However, use of HRT in the short term did not result in any conclusive trends in skin condition in the majority of users.     

Women and technology: A review of training initiatives

Abstract

This paper considers the entry of women into technological areas of work, their subsequent career progression and return to work after a career break. It considers the development of those training programmes and related initiatives which have attempted to encourage girls and young women to enter non-traditional areas of work, and others which help women return to work after a career break. It emphasizes that such training needs to address the psychological and social issues which arise, as well as provide for new technical knowledge and skills. In doing so it reviews some of the courses which are currently available and comments on their apparent success. In its concluding problems it refers to the on-going problem of funding such training and of providing a supportive database.     

Nineteen‐Month‐Olds' Understanding of the Conventionality of Object Labels Versus Desires

We assessed 19‐month‐olds' appreciation of the conventional nature of object labels versus desires. Infants played a finding game with an experimenter who stated her intention to find the referent of a novel word (word group), to find an object she wanted (desire group), or simply to look in a box (control group). A 2nd experimenter then administered a comprehension task to assess infants' tendency to extend information to a 2nd person who was not present at the time of learning. Results indicate that infants chose the target object when the 2nd experimenter asked for the referent of the novel label but not when she requested the referent of her desire. These findings demonstrate that 19‐month‐olds understand that words are conventional, but desires are not.     

A dual frailty model for lifetime analysis in maritime transportation

Lifetime Data Analysis - We consider changes in ownership of commercial shipping vessels from an event history perspective. Each change in ownership can be influenced by the properties of the...