Should mental health issues be addressed in primary care, and can it be done? Views of rural general practitioners in Queensland

Objective: The aim of this paper was to examine self-efficacy and perceived appropriateness among rural general practitioners (GPs) in regards to screening and intervention for physical, lifestyle and mental health issues. ----- Method: Fifty GPs from 25 practices in eight rural Queensland towns completed a written survey designed for the study. ----- Results: General practitioners rated opportunistic screening or assessment for smoking and for detection of relapse of mental disorders as the most appropriate, with even cardiovascular and diabetes risk falling behind these. Self-efficacy was highest for medical disorders for smoking assessment. It was significantly lower for alcohol, mental health issues, and addressing risks of physical disorder in people with mental disorders. ----- Conclusions: High appropriateness ratings suggest that current strategies to boost self-efficacy of GPs in addressing mental health issues are timely.

The status of Australian nurse practitioners : the first national census

A five-section questionnaire was mailed to all 234 authorised Australian nurse practitioners in late 2007. An 85% response rate was achieved (202 responses). Respondents had a mean age of 47.0 years and 84.2% were women. Only 145 nurse practitioners (72% of respondents) reported being employed in Australia at the time of the census. Emergency nurse practitioners were the most commonly employed nationally (26.9%). Nearly one third of employed nurse practitioners reported that they were still awaiting approval to prescribe medications despite this being a core legislated skill. Over 70% stated that lack of Medicare provider numbers and lack of authority to prescribe through the Pharmaceut ical Benef its Scheme was extremely limiting to their practice. These findings are consistent with the international literature describing establishment of reformative

Cannabis use and misuse prevalence among people with psychosis

Background: Increasing attention has been given by researchers to cannabis use in individuals with psychosis. As psychoses are relatively low-prevalence disorders, research has been mostly been restricted to small-scale studies of treatment samples.The reported prevalence estimates obtained from these studies vary widely. Aims: To provide prevalence estimates based on larger samples and to examine sources of variability in prevalence estimates across studies. Method: Data from 53 studies of treatment samples and 5 epidemiological studies were analysed. Results: Based on treatment sample data, prevalence estimates were calculated for current use (23.0%), current misuse (11.3%),12-month use (29.2%),12-month misuse (18.8%), lifetime use (42.1%) and lifetime misuse (22.5%). Epidemiological studies consistently reported higher cannabis use and misuse prevalence in people with psychosis. Conclusions: The factor most consistently associated with increased odds of cannabis prevalence was specificity of diagnosis. Factors such as consumption patterns and study design merit further consideration.

Third space in cyberspace : Indigenous youth, new technologies and literacies

This chapter analyses the affordances and constraints of an online literacy program designed for Indigenous Australian youth through a partnership between the Indigenous community, university staff and local schools. The after-school program sought to build on the cultural resources and experiences of the young people through a dialogic process of planning, negotiating, implementing, reflecting, and renegotiating the program with participants and a range of stakeholders. In the majority of cases, students presented themselves as part of pervasive global popular cultures, often hot-linking their webpages to pop icons and local sports stars. Elders regarded their competency as a potential cultural tool and community resource.

Young people, imagination and re-engagement in the middle years

This article reports on the first stage of a study that uses Young People as Researchers methodology to investigate the phenomenon of middle-year student disengagement. The study obtains student perspectives on the meanings of engagement and disengagement using a variety of innovative research methods. The first stage of the study focused on a two-day workshop giving students and teachers an overview of the project and providing training and experience in conducting research in their schools. The process employed by the study provides spaces and resources for critical thinking and encourages imaginative responses to the real life problems confronting the students and their peers and affecting their educational engagement. This article describes ways in which engagement is viewed both theoretically and through the empirical work of the student researchers, and how various applications of ‘disciplined imagination’ connect with methods of investigating and understanding engagement.

An examination of the utility of the AUDIT in people with schizophrenia

Objective: To examine the reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) compared to a structured diagnostic interview, the Composite international Diagnostic Interview (CIDI; 12-month version) in psychiatric patients with a diagnosis of schizophrenia. Method: Patients (N = 71, 53 men) were interviewed using the CIDI (Alcohol Misuse Section; 12-month version) and then completed the AUDIT. Results: The CIDI identified 32.4% of the sample as having an alcohol use disorder. Of these, 5 (7.0%) met diagnostic criteria for harmful use of alcohol, 1 (1.4%) met diagnostic criteria for alcohol abuse and 17 (23.9%) met diagnostic criteria for alcohol dependence. The AUDIT was found to have good internal reliability (coefficient = 0.85). An AUDIT cutoff of greater than or equal to 8 had a sensitivity of 87% and specificity of 90% in detecting CIDI-diagnosed alcohol disorders. All items except Item 9 contributed significantly to discriminant validity. Conclusions: The findings replicate and extend previous findings of high rates of alcohol use disorders in people with severe mental illness. The AUDIT was found to be reliable and valid in this sample and can be used with confidence as a screening instrument for alcohol use disorders in people with schizophrenia.

Contrasting views and experiences of health professionals on the management of comorbid substance misuse and mental disorders

Objectives: To determine opinions and experiences of health professionals concerning the management of people with comorbid substance misuse and mental health disorders. Method: We conducted a survey of staff from mental health services and alcohol and drug services across Queensland. Survey items on problems and potential solutions had been generated by focus groups. Results: We analysed responses from 112 staff of alcohol and drug services and 380 mental health staff, representing a return of 79% and 42% respectively of the distributed surveys. One or more issues presented a substantial clinical management problem for 98% of respondents. Needs for increased facilities or services for dual disorder clients figured prominently. These included accommodation or respite care, work and rehabilitation programs, and support groups and resource materials for families. Needs for adolescent dual diagnosis services and after-hours alcohol and drug consultations were also reported. Each of these issues raised substantial problems for over 70% of staff. Another set of problems involved coordination of client care across mental health and alcohol and drug services, including disputes over duty of care. Difficulties with intersectoral liaison were more pronounced for alcohol and drug staff than for mental health. A majority of survey respondents identified 13 solutions as practical. These included routine screening for dual diagnosis at intake, and a range of proposals for closer intersectoral communication such as exchanging client information, developing shared treatment plans, conducting joint case conferences and offering consultation facilities. Conclusions: A wide range of problems for the management of comorbid disorders were identified. While solution of some problems will require resource allocation, many may be addressed by closer liaison between existing services.

Aligning school reform and teacher education reform in the middle years : an Australian case study

This paper discusses the development of a new Bachelor of Education (Middle Years of Schooling) at The University of Queensland, Australia. The middle years of schooling have increasingly been the focus of education reform initiatives in Australia, but this has not been accompanied by significant increases in the number of teacher education institutions offering specialised middle schooling-level teacher preparation programmes. Considering the rapidly changing social and economic context and the emergent state of middle schooling in Australia, the programme represented a conceptual and practical opportunity and challenge for The University of Queensland team. Working collaboratively, the team sought to design a teacher education preservice programme that was both responsive and generative: that is, responsive to local school contexts and to current education research and reform at national and international levels; and generative of cutting-edge theories and practices associated with middle schooling, teachers' work, and teacher education. This paper focuses on one component of the Middle Years of Schooling Teacher Education programme at The University of Queensland; namely, the practicum. We first present the underlying principles of the practicum programme and then examine "dilemmas" that emerged early in the practicum. These issues and tensions were associated with the ideals of "middle years" philosophy and the pragmatics of school reform associated with that approach. Within this context, we explore what it means to be both responsive and generative, and describe how we as teacher educators negotiated the extremes these terms implied.

Beyond the intercultural to the accented body : an Australian perspective

'Beyond the intercultural to the Accented Body’ foregrounds contemporary choreography as a multi-modal practice which is increasingly interdisciplinary and engages with interactive technologies. These concepts are explored in the context of intercultural dance and performance practices particularly in relation to issues of identity, hybridity, the diaspora and transformation. Four models of intercultural choreography are proposed: in-country immersion; collaborative international exchanges through sharing of culturally diverse practices; hybrid practices of diasporic artists; and implicit intercultural connections. The latter model is investigated via a case study of an interactive, multi-site and interdisciplinary collaboration Accented Body.

Health, Death, and Indigenous Australians in the Coronial system

This paper details research conducted in Queensland during the first year of operation of the new Coroners Act 2003. Information was gathered from all completed investigations between December 2003 and December 2004 across five categories of death: accidental, suicide, natural, medical and homicide. It was found that 25 percent of the total number of Indigenous deaths recorded in 2004 were reported to, and investigated by, the Coroner, in comparison to 9.4 percent of non-Indigenous deaths. Moreover, Indigenous people were found to be over-represented in each category of death, except in death in a medical setting, where they were absent.

Globalist Fallacies, Fictions and Facts: The MAI and Neo-classic Ideology

There is little evidence, historical or otherwise, to suggest that the needs of people and societies change greatly over time. Whilst acknowledging the benefits of the many recent technological innovations that are part of the contemporary milieu, I am reluctant to see such advances as sufficient rationale for the dismantling of the social contract between a government and its citizenry. The Multilateral Agreement on Investment (MAI) highlights the move amongst developed countries to replace a national policy focus with a multilateral approach to global policy formulation that transcends the sovereignty of nation states. The purpose of this paper is to refute the assumptions underpinning multilateralist assertions that government has a diminishing role to play in the global society, and that national sovereignty, due to the increasingly important role of multilateral agreements and the global economy, is ‘a thing of the past’ (Arthur Asher, background briefing interview, Radio National, February 1, 1998). The basic premises that underpin the globalist argument1 for the diminishing role of government are that: • Economic growth increases jobs, prosperity, and freedom. • Free trade is an imperative for successful globalisation because financial sector performance - which depends on deregulation - is integral to global economic growth. • Information technology is revolutionising global trade and making globalisation inevitable. • Globalisation through deregulation, makes national boundaries meaningless, and therefore, national regulatory policies anachronistic. This paper compares the aforementioned axiomatic premises of globalisation to actual outcomes, events, and trends in the real world.

The foraging behaviour of the Black rat (Rattus rattus) within Australian macadamia orchards

The black rat (Rattus rattus) has been shown to be the primary species responsible for causing significant crop losses within the Australian macadamia industry. This species success within macadamia orchards is directly related to the flexibility expressed in its foraging behaviour. In this paper a conceptual foraging model is presented which proposes that the utilisation of resources by rodents within various components of the system is related not only to their relative abundance, but also to predator avoidance behaviour. Nut removal from high predation risk habitats during periods of low resource abundance in low risk compartments of the system is considered an essential behaviour that allows high rodent densities to be maintained throughout the year.

Promoting creativity in education : from policy to practice : an Australian perspective

In the 21st century, our global community is changing to increasingly value creativity and innovation as driving forces in our lives. This paper will investigate how educators need to move beyond the rhetoric to effective practices for teaching and fostering creativity. First, it will describe the nature of creativity at different levels, with a focus on personal and everyday creativity. It will then provide a brief snapshot of creativity in education through the lens of new policies and initiatives in Queensland, Australia. Next it will review two significant areas related to enriching and enhancing students’ creative engagement and production: 1) influential social and environmental factors; and 2) creative self-efficacy. Finally, this paper will propose that to effectively promote student creativity in schools, we need to not only emphasise policy, but also focus on establishing a shared discourse about the nature of creativity, and researching and implementing effective practices for supporting and fostering creativity. This paper has implications for educational policy, practice and teacher training that are applicable internationally.

Enhancing road safety for young drivers : how Graduate Driver Licensing initiatives can complement "anti-hooning" legislation

Street racing and associated (hooning) behaviours have attracted increasing concern in recent years. While New Zealand and all Australian jurisdictions have introduced “antihooning” legislation and allocated significant police resources to managing the problem, there is limited evidence of the road safety implications of hooning. However, international and Australian data suggests that drivers charged with a hooning offence tend to be young males who are accompanied by one or more peers, and hooning-related crashes tend to occur at night. In this regard, there is considerable evidence that drivers under the age of 25 are over-represented in crash statistics, and are particularly vulnerable soon after obtaining a Provisional licence, when driving at night, and when carrying peer-aged passengers. The similarity between the nature of hooning offenders, offences and crashes, and road safety risks for young drivers in general, suggests that hooning is an issue that may be viewed as part of the broader young driver problem. Many jurisdictions have recently implemented a range of evidence-based strategies to address young driver road safety, and this paper will present Queensland crash and offence data to highlight the potential benefit of Graduated Driver Licensing initiatives, such as night driving restrictions and peer-aged passenger restrictions, to related road safety issues, including hooning. An understanding of potential flow-on effects is important for evaluations of anti-hooning legislation and Graduated Driver Licensing programs, and may have implications for future law enforcement resource allocation and policy development.