Treatment of cannabis use among people with psychotic disorders : critical review of randomised controlled trials

There is growing and converging evidence that cannabis may be a major risk factor in people with psychotic disorders and prodromal psychotic symptoms. The lack of available pharmacological treatments for cannabis use indicates that psychological interventions should be a high priority, especially among people with psychotic disorders. However, there have been few randomised controlled trials (RCTs) of psychological interventions among this group. In the present study we critically overview RCTs of psychological and pharmacologic interventions among people with psychotic disorders, giving particular attention to those studies which report cannabis use outcomes. We then review data regarding treatment preferences among this group. RCTs of interventions within "real world" mental health systems among adults with severe mental disorders suggest that cannabis use is amenable to treatment in real world settings among people with psychotic disorders. RCTs of manual guided interventions among cannabis users indicate that while brief interventions are associated with reductions in cannabis use, longer interventions may be more effective. Additionally, RCTs reviewed suggest treatment with antipsychotic medication is not associated with a worsening of cannabis cravings or use and may be beneficial. The development of cannabinoid agonist medication may be an effective strategy for cannabis dependence and suitable for people with psychotic disorders. The development of cannabis use interventions for people with psychotic disorders should also consider patients' treatment preferences. Initial results indicate face-to-face interventions focussed on cannabis use may be preferred. Further research investigating the treatment preferences of people with psychotic disorders using cannabis is needed.

The effect of Tai Chi on health related quality of life in people with elevated blood glucose or diabetes : a randomized controlled trial

Purpose The aim was to assess the effects of a Tai Chi based program on health related quality of life (HR-QOL) in people with elevated blood glucose or diabetes who were not on medication for glucose control. Method 41 participants were randomly allocated to either a Tai Chi intervention group (N = 20) or a usual medical care control group (N = 21). The Tai Chi group involved 3 x 1.5 hour supervised and group-based training sessions per week for 12 weeks. Indicators of HR-QOL were assessed by self-report survey immediately prior to and after the intervention. Results There were significant improvements in favour of the Tai Chi group for the SF36 subscales of physical functioning (mean difference = 5.46, 95% CI = 1.35-9.57, P < 0.05), role physical (mean difference = 18.60, 95% CI = 2.16-35.05, P < 0.05), bodily pain (mean difference = 9.88, 95%CI = 2.06-17.69, P < 0.05) and vitality (mean difference = 9.96, 95% CI = 0.77-19.15, P < 0.05). Conclusions The findings show that this Tai Chi program improved indicators of HR-QOL including physical functioning, role physical, bodily pain and vitality in people with elevated blood glucose or diabetes who were not on diabetes medication.

Appraisal of the quality of care of older people with cognitive impairment presenting to emergency departments

The medical records of 273 patients 75 years and older were reviewed to evaluate quality of emergency department (ED) care through the use of quality indicators. One hundred fifty records contained evidence of an attempt to carry out a cognitive assessment. Documented evidence of cognitive impairment (CI) was reported in 54 cases. Of these patients, 30 had no documented evidence of an acute change in cognitive function from baseline; of 26 patients discharged home with preexisting CI (i.e., no acute change from baseline), 15 had no documented evidence of previous consideration of this issue by a health care provider; and 12 of 21 discharged patients who screened positive for cognitive issues for the first time were not referred for outpatient evaluation. These findings suggest that the majority of older adults in the ED are not receiving a formal cognitive assessment, and more than half with CI do not receive quality of care according to the quality indicators for geriatric emergency care. Recommendations for improvement are discussed.

Exploring the effect of companion robots on emotional expression in older people with dementia : a pilot randomized controlled trial

This pilot study aimed to compare the effect of companion robots (PARO) to participation in an interactive reading group on emotions in people living with moderate to severe dementia in a residential care setting. A randomized crossover design, with PARO and reading control groups, was used. Eighteen residents with mid- to late-stage dementia from one aged care facility in Queensland, Australia, were recruited. Participants were assessed three times using the Quality of Life in Alzheimer’s Disease, Rating Anxiety in Dementia, Apathy Evaluation, Geriatric Depression, and Revised Algase Wandering Scales. PARO had a moderate to large positive influence on participants’ quality of life compared to the reading group. The PARO intervention group had higher pleasure scores when compared to the reading group. Findings suggest PARO may be useful as a treatment option for people with dementia; however, the need for a larger trial was identified.

‘My people right here…’ Indigenous young people, alienation and paint sniffing in inner Brisbane

This paper describes and explains the social worlds of a group of young Murris who are engaged in chroming (paint sniffing) and who sleep rough in inner Brisbane. In particular, the paper considers the ways young Indigenous drug users describe their marginalisation from wider society and its structures of opportunity, but it also includes some reflections from their youth worker and a young man who frequents the young people’s squat. The paper demonstrates the centrality of racism and material disadvantage to the experience of a group of young Aboriginal and Torres Strait Islander sniffers, a perspective largely unreflected in the literature on Indigenous volatile substance misuse. Further, the young people’s ways of interacting with the broader society are described to explain the ways their rejection of mainstream norms form a significant political response to their marginality and reflect, at least in part, the wider Indigenous historical experience. The work draws on theories of alienation and subculture to analyse the young people’s descriptions of their social estrangement and the formation of the ‘paint sniffer group’. It is concluded that paint sniffing among urban Indigenous youth is, at least in part, an obnoxious and encoded distillation of a wider Indigenous rebuttal of broader societal norms, and that the dominant — normalising — modes of treatment risk further alienating an already oppositional group of young people.

Children, young people and their social and spatial citizenship rights

The use of public space by children and young people is a contentious issue in a number of developed and developing countries and a range of measures are frequently deployed to control the public space which usually deny the rights of children and young people to claim the space for their use. Child and youth curfews, oppressive camera surveillance and the unwarranted attentions of police and private security personnel as control measures in public space undermine attempts to secure greater participation by children and young people in constructing positive strategies to address concerns that impact on them and others in a local area. Evidence from research in Scotland undertaken by Article 12 (2000) suggests that young people felt strongly that they did not count in local community matters and decision making and the imposition on them of a curfew by the adult world of the local area created resentment both at the harshness of the measure and disappointment at an opportunity lost to be consulted and involved in dealing with perceived problems of the locality. This is an important cluster of linked issues as Brown (1998:116) argues that young people are ‘selectively constructed as “problem” and “other” with their concerns marginalised, their lifestyles problematised and their voices subdued’, and this flows into their use of public space as their claims to its use as an aspect of social citizenship are usually cast as inferior or rejected as they ‘stand outside the formal polity’ as ‘non persons’. This has major implications for the ways in which young people view their position in a community as many report a feeling of not being wanted, valued or tolerated. The ‘youth question’ according to Davis (1990) acts as a form of ‘screen’ on which observers and analysts project hopes and fears about the state of society, while in the view of Loader (1996:89) the ‘question of young people’ sits within a discourse comprising two elements, the one being youth, particularly young males, as the ‘harbinger of often unwelcome social change and threat’ and the other element ‘constructs young people as vulnerable’. This discourse of threat is further exemplified in the separation of children from teenagers as Valentine (1996) suggests, the treatment of younger children using public space is often dramatically different to that of older children and the most feared stage of all, 'youth'

Destination know-where : a road map of a PhD journey in theatre for young people

Within contemporary performance arenas young people are fast becoming part of the vanguard of contemporary performance. Performativity, convergence and openness of form are key animating concepts in the landscape of Theatre for Young People (TYP). To ignore what is taking place in the making of performance for and by young people is to ignore the new possibilities in meaning-making and theatrical form. This thesis investigates the contemporary practice within the field of Theatre for Young People. Pivotal to the study are three hallmarks of contemporary performance – shifting notions of performativity; convergence articulated in the use of technology and theatrical genres; and Umberto Eco’s realisation of openness in form and authorship. The thesis draws from theatre and performance studies, globalisation theory and youth studies. Using interviews of Theatre for Young People practitioners and observation of thirty-nine performances, this thesis argues that young people and Theatre for Young People companies are among the leaders of a paradigm shift in developing and delivering performance works. In this period of rapid technological change young people are embracing and manipulating technology (sound, image, music) to represent whom they are and what they want to say. Positioned as ‘cultural catalysts’ (McRobbie, 1999), ‘the new pioneers’ (Mackay, 1993) and ‘first navigators’ (Rushkoff, 1996) young people are using mediatised culture and digital technologies with ease, placing them at the forefront of a shift in cultural production. The processes of deterritorialisation allows for the synthesis of new cultural and performance genres by fragmenting and hybridising traditional cultural categories and forms including the use of new media technologies. Almost half of all TYP performances now incorporate the technologies of reproduction. The relationship between live and mediatised forms, the visceral and the virtual is allowing young people to navigate and make meaning of cultural codes and cultural forms as well as to engage in an open dialogue with their audiences. This thesis examines the way young people are using elements of deterritorialisation to become producers of new performance genres. The thesis considers the contemporary situation in relation to issues of performance making and performance delivery within a global, networked and technology-driven society.

Grouping people in social networks using a weighted multi-constraints clustering method

Grouping users in social networks is an important process that improves matching and recommendation activities in social networks. The data mining methods of clustering can be used in grouping the users in social networks. However, the existing general purpose clustering algorithms perform poorly on the social network data due to the special nature of users' data in social networks. One main reason is the constraints that need to be considered in grouping users in social networks. Another reason is the need of capturing large amount of information about users which imposes computational complexity to an algorithm. In this paper, we propose a scalable and effective constraint-based clustering algorithm based on a global similarity measure that takes into consideration the users' constraints and their importance in social networks. Each constraint's importance is calculated based on the occurrence of this constraint in the dataset. Performance of the algorithm is demonstrated on a dataset obtained from an online dating website using internal and external evaluation measures. Results show that the proposed algorithm is able to increases the accuracy of matching users in social networks by 10% in comparison to other algorithms.

STALKERBOT : learning to navigate dynamic human environments by following people

Service robots that operate in human environments will accomplish tasks most efficiently and least disruptively if they have the capability to mimic and understand the motion patterns of the people in their workspace. This work demonstrates how a robot can create a humancentric navigational map online, and that this map re ects changes in the environment that trigger altered motion patterns of people. An RGBD sensor mounted on the robot is used to detect and track people moving through the environment. The trajectories are clustered online and organised into a tree-like probabilistic data structure which can be used to detect anomalous trajectories. A costmap is reverse engineered from the clustered trajectories that can then inform the robot's onboard planning process. Results show that the resultant paths taken by the robot mimic expected human behaviour and can allow the robot to respond to altered human motion behaviours in the environment.

Speaking truth to power : sexism, outrage and the public consciousness

Alan Jones's now infamous comment that women are destroying the joint' sparked a flurry of observations and interpretations in the national and international media and in the blogosphere about the motivations and meanings of such a statement. The overriding tone of this commentary was outrage - how dare an influential figure like Jones state with such blatant and provocative hostility that women are at best unsuitable for leadership and at worst, damaging our public and private institutions? The answers, as we have seen, are likely to be complex, but an alternative question could also be posed. Why the outrage? Public male figures have, throughout history, made derogatory, demeaning and sexist remarks about women, and the material effects of gender inequality continue to be felt- consider the gender pay gap and glass ceiling phenomenon for starters. So why did this particular comment ignite such widespread indignation and anger?

Risk-taking, harm and help-seeking : reported by young people in treatment at a youth alcohol and drug counselling service

Regarded as a normative component of development, risk-taking by young people is a well-researched subject, and some risk-taking behaviours, such as substance use, are particularly well covered because of their potential to adversely affect health and wellbeing. What has remained unclear is the extent of young people's risk-taking while engaged in alcohol and other drug (AOD) treatment, their awareness of the related harms of risk-taking behaviours, and their prior help-seeking for these harms - information which may have a significant impact on the quality and relevance of the care they receive. This paper reports the findings from a brief pilot study exploring those factors in a clinical sample of young people engaged in ongoing AOD counselling.

People capabilities for promoting sustainability in facilities management practices

Sustainability needs to be embedded throughout the life-cycle of a construction project. From project conception, planning, design, construction stage, operation and maintenance to demolition, each phase of development should embrace principles of sustainability and the stakeholder involved should be empowered with the necessary skills. Past research explored the importance of ensuring sustainability measures during the occupancy phase based on considerations of Life-Cycle Cost Analysis and a project’s long-term detrimental impact on the environment. Facility managers are in a unique position to promote sustainability over longer periods of project engagement and can apply a high level of influence on the built assets through management and upgrades. There is growing interest among facility managers in incorporating sustainability measures into day-to-day practice. More, however, needs to be done. Previous studies have identified barriers such as the lack of sustainability knowledge and skills, poor access to information, and unwillingness to change among facility management (FM) practitioners and stakeholders. This inhibits proper implementation of sustainable practices in the FM sector. A number of key factors, such as knowledge discrepancy, time constraints, diversity of FM functions and a lack of incentives, require urgent remedy. The capability of FM professionals and stakeholders will be a key enabler in managing the sustainability agenda, as it is central to the improvement of competency and innovation in an organization. Compared to the attempts at developing sustainability guidelines and performance measurement, research efforts relating to people capabilities and skills are still lagging behind. This paper discusses the progress to date of a research project aimed at formulating a people capabilities framework for sustainable FM practices based on expert opinions and industry feedback. Through literature review, the paper explores the challenges of incorporating sustainability principles into general FM practices before focusing specifically on FM personnel capabilities that may impact on the implementation of a holistic sustainability agenda in real life practice. The results of an industry survey are used to propose an action framework to identify, promote and utilise people capabilities in order to promote sustainability integration in FM practices. The paper provides a useful information source for FM personnel and organizations to bridge the gap between extensive tools on sustainable design and construction assessment at the front end and the need to maintain focus throughout the project life-cycle.

Nurses’ role in caring for people with a comorbidity of mental illness and intellectual disability : A literature review

This article examines literature on the role of the nurse caring for people with a dual disability (DD) of intellectual disability and mental illness. A search of the literature between 2000 and 2010 resulted in a total of 21 articles that met the inclusion criteria. Seven key categories of the role of the nurse were identified: (i) advocacy/health promotion (including working with family); (ii) assessment/case management; (iii) behavioural interventions; (iv) communication; (v) leadership and the nurse’s role within the multidisciplinary team; (vi) functions regarding medication administration; and (vii) safety/risk management. There is a paucity of research about the role of nurses working with people with DD, although a number of opinion-based articles exist. This article identifies a need for the role of the nurse working in DD to be more clearly articulated and for the development of evidence to guide best practice.