Differentiating first episode substance induced and primary psychotic disorders with concurrent substance use in young people

Objective: Substance use is common in first-episode psychosis, and complicates the accurate diagnosis and treatment of the disorder. The differentiation of substance-induced psychotic disorders (SIPD) from primary psychotic disorders (PPD) is particularly challenging. This cross-sectional study compares the clinical, substance use and functional characteristics of substance using first episode psychosis patients diagnosed with a SIPD and PPD. Method: Participants were 61 young people (15-24 years) admitted to a psychiatric inpatient service with first episode psychosis, reporting substance use in the past month. Diagnosis was determined using the Psychiatric Research Interview for DSM-IV Substance and Mental disorders (PRISM-IV). Measures of clinical (severity of psychotic symptoms, level of insight, history of trauma), substance use (frequency/quantity, severity) and social and occupational functioning were also administered. Results: The PRISM-IV differentially diagnosed 56% of first episode patients with a SIPD and 44% with a PPD. Those with a SIPD had higher rates of substance use and disorders, higher levels of insight, were more likely to have a forensic and trauma history and had more severe hostility and anxious symptoms than those with a PPD. Logistic regression analysis indicated a family history of psychosis, trauma history and current cannabis dependence were the strongest predictors of a SIPD. Almost 80% of diagnostic predictions of a SIPD were accurate using this model. Conclusions: This clinical profile of SIPD could help to facilitate the accurate diagnosis and treatment of SIPD versus PPD in young people with first episode psychosis admitted to an inpatient psychiatric service.

The impact of penalty increases on speeding behaviour in Queensland and a characterisation of speeding offenders

This project examined the effects of speeding penalty changes that occurred in Queensland in 2003 on the behaviour of speeding offenders. These penalty changes included increasing the number of offence categories, and in turn narrowing the range of speeds associated with the offence categories; increasing the monetary fines for all offences, with the largest increases observed for high-range offences; and introducing automatic licence suspension and an eight demerit point penalty for the highest offence category. To explore the impact of the penalty changes, offence data collected for two cohorts of motorists in Queensland who were caught speeding prior to and subsequent to the penalty changes (N = 84,456) were compared. The first cohort consisted of individuals (operators of all vehicles including motorcycles) who committed a speeding offence in May 2001 (two years prior to the speeding penalty change); and individuals who committed a speeding offence in May 2003 (one month after the introduction of the penalty change). Four measures of recidivism were devised and used to assess the effects of the new penalties with regard to deterring the speeding behaviour of offenders. Additionally, the project investigated the relationship between speeding offences, other risky driving behaviours, crash involvement, and criminal behaviour.

Some reflection of research 'Schools' and geographies

Reflecting on real and perceived differences between European and North American research cultures, I challenge views that ‘European’ research is under appreciated or discriminated against, and caution against isolationist European positions. Instead, I argue that although no distinctive and coherent European tradition or culture really exists, there may be elements of the prevalent research culture that can be turned into an advantage for Europe-based and/or European-trained researchers in helping to influence and improve one, global research conversation. Of course, a range of sub-communities and sub-conversations will and should exist, but there is no reason for these to be based on geography.

Research report : computer surfaces and cross-infection

The computer is fast becoming part of the furniture in many hospital settings. Increasing reliance on the computer for documentation and dissemination of information in patient-care areas has increased the need to consider this equipment as a potential environmental reservoir for microorganisms. This paper reports on a small experimental study which investigated the potential role of computers in cross-infection. The results indicate that computer surfaces are similar to other environmental surfaces and carry the same risks for cross-infection.

The nurse researcher : an added dimension to qualitative research methodology

Nurse researchers are increasingly adopting qualitative methodologies for research practice and theory development. These approaches to research are, in many cases, more appropriate for the field of nursing inquiry than the previously dominant techno-rational methods. However, there remains the issue of adapting methodologies developed in other academic disciplines to the nursing research context. This paper draws upon my own experience with interpretive research to raise questions about the issue of nursing research within a social science research framework. The paper argues that by integrating the characteristics of nursing practice with the characteristics of research practice, the researcher can develop a 'nursing lens', an approach to qualitative research that brings an added dimension to social science methodologies in the nursing research context. Attention is drawn to the unique nature of the nurse-patient relationship, and the ways in which this aspect of nursing practice can enhance nursing research. Examples are given from interview transcripts to support this position.

Developing a model for collaborative research

Collaboration between nurses in clinical and educational settings has been advocated as a means of ensuring nursing research is both practice oriented and scientifically valid. This paper describes a model, jointly developed by colleagues from the Nursing Departments of Alfred Hospital and La Trobe University, to foster collaborative research and steer research projects generated by clinical nurses from conceptualisation to publication.

Building intercultural competence one “Patch” at a time

This paper describes a program called Patches that was implemented to assist a group of Australian and Malaysian pre-service teachers to enhance their intercultural competence through their involvement in a series of reciprocal learning activities. Each learning experience was considered a “patch” that eventually created a “quilt of intercultural learning.” The purpose of this study was to enhance the intercultural competence of domestic and international students through organized intercultural activities, through a series of reflective writing sessions, and mutual engagement on a common project. The effectiveness of the Patches program was analysed in accordance with Deardorff’s elements of intercultural competence. The qualitative findings indicate that both cohorts of preservice teachers showed elements of intercultural competence through participation in the program, with both groups reporting a deeper appreciation and understanding of how to communicate more effectively in intercultural contexts.

Intravascular device-related research : future priority areas for cancer nursing

The majority of cancer nurses have to manage intravascular devices (IVDs) on a daily basis, thus placing nurses in the strongest position to generate and use best available evidence to inform this area of practice and to ensure that patients are receiving the best care available. Our literature clearly reflects that cancer nurses are concerned about complications associated with IVDs (eg, extravasation,1 IVD-related bloodstream infection [IVD-BSI],2,3 and thrombosis4). Although enormous attention is given to this area, a number of nursing practices are not sufficiently based on empirical evidence.5,6 Nurses need to set goals and priorities for future research and investments. Priority areas for future research are suggested here for your consideration.

Student or scholar? Transforming identities through a research writing group

This article explores the role a writing group played in influencing the scholarly identities of a group of doctoral students by fostering their writing expertise. While the interest in writing groups usually centres on their potential to support doctoral students to publish, few studies have been conducted and written by the students themselves. Using a situated learning perspective on identity, we explore the connection that emerged between our perceptions of ourselves as developing expertise as scholarly writers and the function of the writing group as a dynamic space for transforming our identities. Findings show that our writing group served as a flexible and interactive Community of Practice (CoP) that shaped critical and durable shifts in identity amongst members.

Cloud computing for healthcare research information sharing

With the widespread application of healthcare Information and Communication Technology (ICT), constructing a stable and sustainable data sharing circumstance has attracted rapidly growing attention in both academic research area and healthcare industry. Cloud computing is one of long dreamed visions of Healthcare Cloud (HC), which matches the need of healthcare information sharing directly to various health providers over the Internet, regardless of their location and the amount of data. In this paper, we discuss important research tool related to health information sharing and integration in HC and investigate the arising challenges and issues. We describe many potential solutions to provide more opportunities to implement EHR cloud. As well, we introduce the development of a HC related collaborative healthcare research example, thus illustrating the prospective of applying Cloud Computing in the health information science research.

ACE research vignette 022 : family business succession : when death takes a hand

This series of research vignettes is aimed at sharing current and interesting research findings from our team of international Entrepreneurship researchers. In this vignette, Dr. Mervyn Morris considers the impact on family business operations due to the sudden and unexpected death of a key family member.

Key priorities for Australian infection control : summary of findings from the launch of the Centre for Research Excellence in Reducing Healthcare Associated Infections

The launch of the Centre of Research Excellence in Reducing Healthcare Associated Infection (CRE-RHAI) took place in Sydney on Friday 12 October 2012. The mission of the CRE-RHAI is to generate new knowledge about strategies to reduce healthcare associated infections and to provide data on the cost-effectiveness of infection control programs. As well as launching the CRE-RHAI, an important part of this event was a stakeholder Consultation Workshop, which brought together several experts in the Australian infection control community. The aims of this workshop were to establish the research and clinical priorities in Australian infection control, assess the importance of various multi-resistant organisms, and to gather information about decision making in infection control. We present here a summary and discussion of the responses we received.