BackgroundEach year, many young Australians aged between 16 and 25 years experience a mental health disorder, yet only a small proportion access services and even fewer receive timely and evidence-based treatments. Today, with ever-increasing access to the Internet and use of technology, the potential to provide all young people with access (24 hours a day, 7 days a week) to the support they require to improve their mental health and well-being is promising.ObjectiveThe aim of this study was to use participatory design (PD) as research methodologies with end users (young people aged between 16 and 25 years and youth health professionals) and our research team to develop the Mental Health eClinic (a Web-based mental health clinic) to improve timely access to, and better quality, mental health care for young people across Australia.MethodsA research and development (R&D) cycle for the codesign and build of the Mental Health eClinic included several iterative PD phases: PD workshops; translation of knowledge and ideas generated during workshops to produce mockups of webpages either as hand-drawn sketches or as wireframes (simple layout of a webpage before visual design and content is added); rapid prototyping; and one-on-one consultations with end users to assess the usability of the alpha build of the Mental Health eClinic.ResultsFour PD workshops were held with 28 end users (young people n=18, youth health professionals n=10) and our research team (n=8). Each PD workshop was followed by a knowledge translation session. At the conclusion of this cycle, the alpha prototype was built, and one round of one-on-one end user consultation sessions was conducted (n=6; all new participants, young people n=4, youth health professionals n=2). The R&D cycle revealed the importance of five key components for the Mental Health eClinic: a home page with a visible triage system for those requiring urgent help; a comprehensive online physical and mental health assessment; a detailed dashboard of results; a booking and videoconferencing system to enable video visits; and the generation of a personalized well-being plan that includes links to evidence-based, and health professional–recommended, apps and etools.ConclusionsThe Mental Health eClinic provides health promotion, triage protocols, screening, assessment, a video visit system, the development of personalized well-being plans, and self-directed mental health support for young people. It presents a technologically advanced and clinically efficient system that can be adapted to suit a variety of settings in which there is an opportunity to connect with young people. This will enable all young people, and especially those currently not able or willing to connect with face-to-face services, to receive best practice clinical services by breaking down traditional barriers to care and making health care more personalized, accessible, affordable, and available.

Summary Project Synergy aims to test the potential of new and emerging technologies to enhance the quality of mental health care provided by traditional face‐to‐face services. Specifically, it seeks to ensure that consumers get the right care, first time (delivery of effective mental health care early in the course of illness). Using co‐design with affected individuals, Project Synergy has built, implemented and evaluated an online platform to assist the assessment, feedback, management and monitoring of people with mental disorders. It also promotes the maintenance of wellbeing by collating health and social information from consumers, their supportive others and health professionals. This information is reported back openly to consumers and their service providers to promote genuine collaborative care. The online platform does not provide stand‐alone medical or health advice, risk assessment, clinical diagnosis or treatment; instead, it supports users to decide what may be suitable care options. Using an iterative cycle of research and development, the first four studies of Project Synergy (2014–2016) involved the development of different types of online prototypes for young people (i) attending university; (ii) in three disadvantaged communities in New South Wales; (iii) at risk of suicide; and (iv) attending five headspace centres. These contributed valuable information concerning the co‐design, build, user testing and evaluation of prototypes, as well as staff experiences during development and service quality improvements following implementation. Through ongoing research and development (2017–2020), these prototypes underpin one online platform that aims to support better multidimensional mental health outcomes for consumers; more efficient, effective and appropriate use of health professional knowledge and clinical skills; and quality improvements in mental health service delivery.

percutaneous therapeutic interventions under X-ray control were performed in patients with exudative complications. Results: Sensitivity, specificity and diagnostic accuracy of ultrasound imaging were respectively 84.7%, 73.4% and 78.8%. Sensitivity, specificity and diagnostic efficiency of cytological and microbiological examination of our data were, respectively, 86.9%, 95.2% and 91.6%. 737 miniinvasive percutaneous interventions were hold totaly. The implementation of miniinvasive percutaneous interventions helped to stop the disease process and to avoid open surgical procedures in 91.7% of cases. Conclusion: Fine-needle diagnostic puncture is a highly informative method for diagnosis of the nature and details of tissue damage and pathological process phase. The timely refining ultrasound diagnosis of various clinical and morphological forms of acute pancreatitis combined with diagnostic fine-needle puncture conducting allows to approach differentiately to the implementation of miniinvasive percutaneous interventions and to justify a strategic position in the surgical treatment of destructive pancreatitis.

Objective: To determine if screening in general practice and related medical settings improves management and clinical outcomes in people with depression. Data sources: The Medline (1966–2002), EMBASE (1980–2002) and PsycINFO (1966–2002) databases were searched. These were supplemented by searching the Cochrane databases (to 2002); performing additional specific searches on Medline, EMBASE and PsycINFO; scrutinising reference lists of selected articles; and querying experts. Study selection: Inclusion criteria were: review of prospective studies with a primary focus of depression screening in general practice settings; review of studies of healthy populations or people with known depression; publication in a peer‐reviewed journal; and written in English. Eleven reviews that satisfied these criteria were assessed for quality using the Oxman and Guyatt Index. Four reviews met the criterion of a score of five or more. Data extraction: One author tabulated relevant material (including number and type of studies, outcomes/endpoints, measures of association/statistical results, and findings) from the four key reviews. A second author independently checked the accuracy of this extracted material. Data synthesis: Brief self‐report instruments have acceptable psychometric properties and are practical for use in general practice settings. Screening increases the recognition and diagnosis of depression and, when integrated with a commitment to provide coordinated and prompt follow‐up of diagnosis and treatment, clinical outcomes are improved. Conclusions: Although controversial, the evidence is now in favour of the appropriate use of screening tools in primary care.

This review highlighted the difference between legislation and practice. While many countries have enacted laws, insufficient resources have been committed to support the objectives to realise the protection of rights enshrined in legislation. Additionally, many people may not know that the laws exist or do not have the money or social supports to fight for their rights. Many countries, however, have commenced a concerted approach to tackling the larger issues and have developed comprehensive action plans to address the social participation rights of people with disability.

Background: The Mental Health eClinic (MHeC; including health promotion, assessment, screening, triage protocols, treatment via video conferencing, and self-directed mental health support) aims to deliver best practice clinical services to people experiencing mental health problems by breaking down traditional barriers to care and making healthcare more personalised, accessible, affordable and available. Objective: The aim of this study was to use participatory design (PD) methodologies with end-users (young people and youth health professionals) and our research team to develop the MHeC to improve timely access to, and beter quality, mental health care for young people across Australia. Methods: A research and development (R&D) cycle for the co-design and build of the MHeC included several iterative PD phases: PD workshops; knowledge translation of ideas generated during workshops to wireframes; rapid prototyping and one-on-one consultations with end-users, including assessing usability of the alpha build of the MHeC. Results: Four PD workshops with end users and our research team (n=37), four knowledge translation sessions, and one round of one-on-one end-user consultation sessions (n=6) were conducted. The iterative R&D cycle validated five main components of the MHeC for young people: home page and triage system; a comprehensive physical and mental health assessment; a detailed dashboard of results; a booking and video visit system; and, links to apps and etools recommended by youth health professionals. Conclusions:The MHeC presents a technologically-advanced and clinically-efficient system that can be adapted to suit a variety of settings in which there is an opportunity to connect with young people. This will enable many young people, and especially those currently not able or willing to connect to face-to-face services, to receive the right intervention from the right service at the right time.

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