ORCID Profile
0000-0003-2397-4337
Current Organisations
Gold Coast Hospital and Health Service
,
Bond University
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Publisher: Wiley
Date: 02-07-2018
DOI: 10.1111/ANEC.12483
Publisher: MDPI AG
Date: 05-05-2023
Abstract: One of the aims of our paper “The Paradox of Suicide Prevention” is to promote greater discourse on suicide prevention, with a particular focus on the mental health models used for the identification of, and interventions with, in iduals who come into contact with tertiary mental health services [...]
Publisher: MDPI AG
Date: 15-11-2022
Abstract: The recognition that we cannot use risk stratification (high, medium, low) to predict suicide or to allocate resources has led to a paradigm shift in suicide prevention efforts. There are challenges in adapting to these new paradigms, including reluctance of clinicians and services to move away from traditional risk categorisations and conversely, the risk of a pendulum swing in which the focus of care swings from one approach to determining service priority and focus (e.g., diagnosis, formulation, risk and clinical care) to a new focus (e.g., suicide specific and non-clinical care), potentially supplanting the previous approach. This paper argues that the Prevention Paradox provides a useful mental model to support a shift in paradigm, whilst maintaining a balanced approach that incorporates new paradigms within the effective aspects of existing ones. The Prevention Paradox highlights the seemingly paradoxical situation where the greatest burden of disease or death is caused by those at low to moderate risk due their larger numbers. Current planning frameworks and resources do not support successful or sustainable adoption of these new approaches, leading to missed opportunities to prevent suicidal behaviours in healthcare. Adopting systems approaches to suicide prevention, such as the Zero Suicide Framework, implemented in a large mental health service in Australia and presented in this paper as a case study, can support a balanced approach of population- and in idual-based suicide prevention efforts. Results demonstrate significant reductions in re-presentations with suicide attempts for consumers receiving this model of care however, the increasing numbers of placements compromise the capacity of clinical teams to complete all components of standardised pathway of care. This highlights the need for review of resource planning frameworks and ongoing evaluations of the critical aspects of the interventions.
Publisher: Public Library of Science (PLoS)
Date: 21-05-2021
DOI: 10.1371/JOURNAL.PONE.0251737
Abstract: During pandemics Agent Based Models (ABMs) can model complex, fine-grained behavioural interactions occurring in social networks, that contribute to disease transmission by novel viruses such as SARS-CoV-2. We present a new agent-based model (ABM) called the Discrete-Event, Simulated Social Agent based Network Transmission model (DESSABNeT) and demonstrate its ability to model the spread of COVID-19 in large cities like Sydney, Melbourne and Gold Coast. Our aim was to validate the model with its disease dynamics and underlying social network. DESSABNeT relies on disease transmission within simulated social networks. It employs an epidemiological SEIRD+M (Susceptible, exposed, infected, recovered, died and managed) structure. One hundred simulations were run for each city, with simulated social restrictions closely modelling real restrictions imposed in each location. The mean predicted daily incidence of COVID-19 cases were compared to real case incidence data for each city. R eff and health service utilisation outputs were compared to the literature, or for the Gold Coast with daily incidence of hospitalisation. DESSABNeT modelled multiple physical distancing restrictions and predicted epidemiological outcomes of Sydney, Melbourne and the Gold Coast, validating this model for future simulation work. DESSABNeT is a valid platform to model the spread of COVID-19 in large cities in Australia and potentially internationally. The platform is suitable to model different combinations of social restrictions, or to model contact tracing, predict, and plan for, the impact on hospital and ICU admissions, and deaths and also the rollout of COVID-19 vaccines and optimal social restrictions during vaccination.
Publisher: Sciedu Press
Date: 19-10-2022
DOI: 10.5430/JHA.V11N2P8
Abstract: Objective: Matching safety and quality improvements to the complexity of healthcare, Gold Coast Mental Health and Specialist Services implemented a new response to clinical incidents: the Gold Coast Clinical Incident Response Framework (GC-CIRF). It utilises a Restorative Just Culture (RJC) framework and Safety II principles. This paper evaluates its impact.Methods: Staff surveys measured perceptions of just culture and second victim experiences. Quality of recommendations were compared before and after implementation. For the 19 incidents that occurred after the implementation of GC-CIRF, audits of the review processes were undertaken, measuring several components.Results: Results show significant improvement in staff perceptions of just culture and second victim experiences. Review of incident review data showed several shifts in line with Safety II and RJC. The process audit demonstrated inclusion of a broad range of stakeholders, and significant improvements in the quality and strength of recommendations.Conclusions: Embedding RJC and Safety II concepts into the incident review process is associated with improved measures of culture and review outputs. The integration of Safety II concepts and support of cultural shifts will require further work and committed leadership at all levels.
Publisher: Wiley
Date: 20-07-2022
DOI: 10.1111/EJN.15747
Abstract: Stress resilience, and behavioural and cardiovascular impacts of chronic stress, are theorised to involve integrated neuro‐endocrine/inflammatory/transmitter/trophin signalling. We tested for this integration, and whether behaviour/emotionality, together with myocardial ischaemic tolerance, are consistently linked to these pathways across erse conditions in male C57Bl/6 mice. This included Restraint Stress (RS), 1 h restraint/day for 14 days Chronic Unpredictable Mild Stress (CUMS), seven stressors randomised over 21 days Social Stress (SS), 35 days social isolation with brief social encounters in final 13 days and Control conditions (CTRL un‐stressed mice). Behaviour was assessed via open field (OFT) and sucrose preference (SPT) tests, and neurobiology from frontal cortex (FC) and hippoc al transcripts. Endocrine factors, and function and ischaemic tolerance in isolated hearts, were also measured. Model characteristics ranged from no behavioural or myocardial changes with homotypic RS, to increased emotionality and cardiac ischaemic injury (with apparently distinct endocrine/neurobiological profiles) in CUMS and SS models. Highly integrated expression of HPA axis, neuro‐inflammatory, BDNF, monoamine, GABA, cannabinoid and opioid signalling genes was confirmed across conditions, and consistent otentially causal correlations identified for (i) locomotor activity (noradrenaline, ghrelin FC Crhr1 , Tnfrsf1b , Il33 , Nfkb1 , Maoa , Gabra1 hippoc al Il33 ) (ii) thigmotaxis (adrenaline, leptin) (iii) anxiety‐like behaviour (adrenaline, leptin FC Tnfrsf1a hippoc al Il33 ) (iv) depressive‐like behaviour (ghrelin FC/hippoc al s100a8 ) and (v) cardiac stress‐resistance (noradrenaline, leptin FC Il33 , Tnfrsf1b , Htr1a , Gabra1 , Gabrg2 hippoc al Il33 , Tnfrsf1a , Maoa , Drd2 ). Data support highly integrated pathway responses to stress, and consistent adipokine, sympatho‐adrenergic, inflammatory and monoamine involvement in mood and myocardial disturbances across erse conditions.
Publisher: Informa UK Limited
Date: 02-01-2021
No related grants have been discovered for Nicolas J.C. Stapelberg.