Integrated versus non-integrated management and care for clients with co-occurring mental health and substance use disorders : a qualitative systematic review of randomised controlled trials

The purpose of this paper is to conduct a qualitative review of randomised controlled trials in relation to the treatment of adults with co-occurring mental health and substance use disorder (MH/SUD). In particular, integrated approaches are compared with non-integrated approaches to treatment. Ten articles were identified for inclusion in the review. The findings are equivocal with regard to the superior efficacy of integrated approaches to treatment, although the many limitations of the studies need to be considered in our understanding of this finding. Clearly, this is an extremely challenging client group to engage and maintain in intervention research, and the complexity and variability of the problems render control particularly difficult. The lack of available evidence to support the superiority of integration is discussed in relation to these challenges. Much remains to be investigated with regard to integrated management and care for people with co-occurring and MH/SUD, particularly for specific combinations of dual diagnosis and giving consideration to the level of inter-relatedness between the disorders.

Demographic and clinical correlates of comorbid substance use disorders in psychosis : multivariate analyses from an epidemiological sample

Background: While there has been substantial research examining the correlates of comorbid substance abuse in psychotic disorders, it has been difficult to tease apart the relative importance of individual variables. Multivariate analyses are required, in which the relative contributions of risk factors to specific forms of substance misuse are examined, while taking into account the effects of other important correlates. Methods: This study used multivariate correlates of several forms of comorbid substance misuse in a large epidemiological sample of 852 Australians with DSMIII- R-diagnosed psychoses. Results: Multiple substance use was common and equally prevalent in nonaffective and affective psychoses. The most consistent correlate across the substance use disorders was male sex. Younger age groups were more likely to report the use of illegal drugs, while alcohol misuse was not associated with age. Side effects secondary to medication were associated with the misuse of cannabis and multiple substances, but not alcohol. Lower educational attainment was associated with cannabis misuse but not other forms of substance abuse. Conclusion: The profile of substance misuse in psychosis shows clinical and demographic gradients that can inform treatment and preventive research.

Eco-retrofitting with building integrated living systems

Building integrated living systems (BILS), such as green roofs and living walls, could mitigate many of the challenges presented by climate change and biodiversity protection. However, few if any such systems have been constructed, and current tools for evaluating them are limited, especially under Australian subtropical conditions. BILS are difficult to assess, because living systems interact with complex, changing and site-specific social and environmental conditions. Our past research in design for eco-services has confirmed the need for better means of assessing the ecological values of BILS - let alone better models for assessing their thermal and hydrological performance. To address this problem, a research project is being developed jointly by researchers at the Central Queensland University (CQ University) and the Queensland University of Technology (QUT), along with industry collaborators. A mathematical model under development at CQ University will be applied and tested to determine its potential for predicting their complex, dynamic behaviour in different contexts. However, the paper focuses on the work at QUT. The QUT school of design is generating designs for living walls and roofs that provide a range of ecosystem goods and services, or ‘eco-services’, for a variety of micro-climates and functional contexts. The research at QUT aims to develop appropriate designs, virtual prototypes and quantitative methods for assessing the potential multiple benefits of BILS in subtropical climates. It is anticipated that the CQ University model for predicting thermal behaviour of living systems will provide a platform for the integration of ecological criteria and indicators. QUT will also explore means to predict and measure the value of eco-services provided by the systems, which is still largely uncharted territory. This research is ultimately intended to facilitate the eco-retrofitting of cities to increase natural capital and urban resource security - an essential component of sustainability. The talk will present the latest range of multifunctional, eco-productive living walls, roofs and urban space frames and their eco-services.

Multidisciplinary students on Property core units : comparative analysis of introductory and advanced units

The composition of many professional services firms in the Urban Development area has moved away from a discipline specific ‘silo’ structure to a more multidisciplinary environment. The benefits of multidisciplinarity have been seen in industry by providing synergies across many of the related disciplines. Similarly, the Queensland University of Technology, Bachelor of Urban Development degree has sought to broaden the knowledge base of students and achieve a greater level of synergy between related urban development disciplines through the introduction of generic and multidisciplinary units. This study aims to evaluate the effectiveness of delivering core property units in a multidisciplinary context. A comparative analysis has been undertaken between core property units and more generic units offered in a multidisciplinary context from introductory, intermediate and advanced years within the property program. This analysis was based on data collected from course performance surveys, student performance results, a student focus group and was informed by a reflective process from the student perspective and lecturer/ tutor feedback. The study showed that there are many benefits associated with multidisciplinary unit offerings across the QUT Urban Development program particularly in the more generic units. However, these units require a greater degree of management. It is more difficult to organise, teach and coordinate multidisciplinary student cohorts due to a difference in prior knowledge and experience between each of the discipline groups. In addition, the interaction between lecturers/ tutors and the students frequently becomes more limited. A perception exists within the student body that this more limited face to face contact with academic staff is not valuable which may be exacerbated by the quality of complimentary online teaching materials. For many academics, non-attendance at lectures was coupled with an increase in email communication. From the limited data collected during the study there appears to be no clear correlation between large multidisciplinary student classes and student academic performance or satisfaction.

Toward a fuzzy domain ontology extraction method for adaptive e-learning

With the widespread applications of electronic learning (e-Learning) technologies to education at all levels, increasing number of online educational resources and messages are generated from the corresponding e-Learning environments. Nevertheless, it is quite difficult, if not totally impossible, for instructors to read through and analyze the online messages to predict the progress of their students on the fly. The main contribution of this paper is the illustration of a novel concept map generation mechanism which is underpinned by a fuzzy domain ontology extraction algorithm. The proposed mechanism can automatically construct concept maps based on the messages posted to online discussion forums. By browsing the concept maps, instructors can quickly identify the progress of their students and adjust the pedagogical sequence on the fly. Our initial experimental results reveal that the accuracy and the quality of the automatically generated concept maps are promising. Our research work opens the door to the development and application of intelligent software tools to enhance e-Learning.

Dancing doctorates down-under? Defining and assessing ‘doctorateness’ when embodiment enters the thesis

Assessment frames the focus of this paper, which emerges from our collaborative research, Dancing Between Diversity and Consistency: Refining Assessment in Postgraduate Degrees in Dance, funded by the Australian Learning and Teaching Council (ALTC). We examine the attributes of danced ‘doctorateness’, giving special attention to those factors in the Australian environment, which may endow resilience to concepts of excellence, independent thinking and originality when kinaesthetic knowledge becomes pivotal to research. Have the small pool of examiners and relationships between academia and the professional artistic environment shaped these doctorates in a particular way? Can these perspectives illuminate and forge parameters by which to legitimate danced insight? These and related issues are interrogated giving voice to supervisors, research deans, candidates and industry professionals across Australia who participated in this research project.

Behaviour disorders and teacher negligence

The purpose of this paper is to examine the legal implications of the continuing rise in the number of school children diagnosed with behaviour disorders. Not only are teachers now subject to a dense grid of legal regulation, they are also increasingly vulnerable to actions in tort. It will be argued here that as more and more children are labelled ‘disordered’, the duty of care become more onerous, and hence harder for teachers to meet. As a consequence, teachers are more likely to face claims of negligence. It is concluded that while the schooling system needs to retain a healthy scepticism about each new pathologising disorder that seeks special status for its sufferers, it also needs to provide greater training and resources for teachers regarding disorder management. It is also concluded that recent changes to negligence law regarding the issue of ‘reasonable foreseeability’ within breach of duty of care, may not be as significant as might have been hoped by the teaching community. Indeed, the elevated standard of care required by the increasing numbers of disordered pupils, places teachers in an ever more difficult legal position.

Behaviour disorders and the negligent teacher

The purpose of this paper is to examine the legal implications of the continuing rise in the number of school children diagnosed with behaviour disorders. Not only are teachers now subject to a dense grid of legal regulation, they are also increasingly vulnerable to actions in tort. It will be argued here that as more and more children are labelled ‘disordered’, then the concomitant duty of care requirements for teachers becomes more onerous. As a consequence, teachers are less likely to be able to defend themselves against claims of negligence. It is concluded that while the schooling system needs to retain a healthy scepticism about each new pathologising disorder that seeks special status for its sufferers, it also needs to provide greater training and resources for teachers regarding disorder management. It is also concluded that recent changes to negligence law regarding the issue of ‘reasonable foreseeability’ within breach of duty of care, may not be as significant as might have been hoped by the teaching community. Indeed, the elevated standard of care, as required by increasing numbers of disordered pupils, place teachers in an ever more difficult legal position.

Corneal confocal microscopy : a novel noninvasive means to diagnose neuropathy in patients with Fabry disease

ABSTRACT: Neuropathy is a cause of significant disability in patients with Fabry disease, yet its diagnosis is difficult. In this study we compared the novel noninvasive techniques of corneal confocal microscopy (CCM) to quantify small-fiber pathology, and non-contact corneal esthesiometry (NCCA) to quantify loss of corneal sensation, with established tests of neuropathy in patients with Fabry disease. Ten heterozygous females with Fabry disease not on enzyme replacement therapy (ERT), 6 heterozygous females, 6 hemizygous males on ERT, and 14 age-matched, healthy volunteers underwent detailed quantification of neuropathic symptoms, neurological deficits, neurophysiology, quantitative sensory testing (QST), NCCA, and CCM. All patients with Fabry disease had significant neuropathic symptoms and an elevated Mainz score. Peroneal nerve amplitude was reduced in all patients and vibration perception threshold was elevated in both male and female patients on ERT. Cold sensation (CS) threshold was significantly reduced in both male and female patients on ERT (P < 0.02), but warm sensation (WS)and heat-induced pain (HIP) were only significantly increased in males onERT (P<0.01). However, corneal sensation assessed withNCCAwas significantly reduced in female (P < 0.02) and male (P < 0.04) patients on ERT compared with control subjects. According to CCM, corneal nerve fiber and branch density was significantly reduced in female (P < 0.03) and male (P < 0.02) patients on ERT compared with control subjects. Furthermore, the severity of neuropathic symptoms and the neurological component of the Mainz Severity Score Index correlated significantly with QSTand CCM. This study shows that CCM and NCCA provide a novel means to detect early nerve fiber damage and dysfunction, respectively, in patients with Fabry disease.

Enhancing Student Learning in Large Undergraduate Clasees by Using Audio-visual Case Studies

Critical skills such as identifying and appreciating issues that confront firms engaging in international business, and the ability to undertake creative decision-making, are considered fundamental to the study of International Business. It has been argued that using audio-visual case studies can help develop such skills. However, this is difficult due to a lack of Australian case studies. This paper reviews the literature outlining the advantages believed to result from the use of audio-visual case studies, describes a project implemented in a large cohort of students studying International Business, reports on a pilot evaluation of the project, and outlines the findings and conclusions of the survey.

Rethinking Prostitution : feminism, sex and the self

Prostitution is a difficult issue, particularly for feminists. Are prostitutes victims of exploitation or the most honest of women? Are clients perverts or just acting instinctively? Should prostitution be eliminated or supported? This book examines these contemporary questions and offers a way of thinking about the issues, which does not rely on these inappropriate and often ineffectual options. Repositioning the institution and its main players outside the confines of the prostitution debate offers new and exciting ways of thinking and acting for all those interested in moving this discussion into the twenty-first century.

Small molecule–biopolymer interactions : Ultraviolet–visible and fluorescence spectroscopy and chemometrics

Interactions between small molecules with biopolymers e.g. the bovine serum albumin (BSA protein), are important, and significant information is recorded in the UV–vis and fluorescence spectra of their reaction mixtures. The extraction of this information is difficult conventionally and principally because there is significant overlapping of the spectra of the three analytes in the mixture. The interaction of berberine chloride (BC) and the BSA protein provides an interesting example of such complex systems. UV–vis and fluorescence spectra of BC and BSA mixtures were investigated in pH 7.4 Tris–HCl buffer at 37 °C. Two sample series were measured by each technique: (1) [BSA] was kept constant and the [BC] was varied and (2) [BC] was kept constant and the [BSA] was varied. This produced four spectral data matrices, which were combined into one expanded spectral matrix. This was processed by the multivariate curve resolution–alternating least squares method (MCR–ALS). The results produced: (1) the extracted pure BC, BSA and the BC–BSA complex spectra from the measured heavily overlapping composite responses, (2) the concentration profiles of BC, BSA and the BC–BSA complex, which are difficult to obtain by conventional means, and (3) estimates of the number of binding sites of BC.

Simultaneous determination of three synthetic glucocorticoids by differential pulse stripping voltammetry with the aid of chemometrics

A novel voltammetric method for simultaneous determination of the glucocorticoid residues prednisone, prednisolone, and dexamethasone was developed. All three compounds were reduced at a mercury electrode in a Britton-Robinson buffer (pH 3.78), and well-defined voltammetric waves were observed. However, the voltammograms of these three compounds overlapped seriously and showed nonlinear character, and thus, it was difficult to analyze the compounds individually in their mixtures. In this work, two chemometrics methods, principal component regression (PCR) and partial least squares (PLS), were applied to resolve the overlapped voltammograms, and the calibration models were established for simultaneous determination of these compounds. Under the optimum experimental conditions, the limits of detection (LOD) were 5.6, 8.3, and 16.8 µg l-1 for prednisone, prednisolone, and dexamethasone, respectively. The proposed method was also applied for the determination of these glucocorticoid residues in the rabbit plasma and human urine samples with satisfactory results.

Mapping personal trip OD from probe data

The paper analyses the expected value of OD volumes from probe with fixed error, error that is proportional to zone size and inversely proportional to zone size. To add realism to the analysis, real trip ODs in the Tokyo Metropolitan Region are synthesised. The results show that for small zone coding with average radius of 1.1km, and fixed measurement error of 100m, an accuracy of 70% can be expected. The equivalent accuracy for medium zone coding with average radius of 5km would translate into a fixed error of approximately 300m. As expected small zone coding is more sensitive than medium zone coding as the chances of the probe error envelope falling into adjacent zones are higher. For the same error radii, error proportional to zone size would deliver higher level of accuracy. As over half (54.8%) of the trip ends start or end at zone with equivalent radius of ≤ 1.2 km and only 13% of trips ends occurred at zones with equivalent radius ≥2.5km, measurement error that is proportional to zone size such as mobile phone would deliver higher level of accuracy. The synthesis of real OD with different probe error characteristics have shown that expected value of >85% is difficult to achieve for small zone coding with average radius of 1.1km. For most transport applications, OD matrix at medium zone coding is sufficient for transport management. From this study it can be drawn that GPS with error range between 2 and 5m, and at medium zone coding (average radius of 5km) would provide OD estimates greater than 90% of the expected value. However, for a typical mobile phone operating error range at medium zone coding the expected value would be lower than 85%. This paper assumes transmission of one origin and one destination positions from the probe. However, if multiple positions within the origin and destination zones are transmitted, map matching to transport network could be performed and it would greatly improve the accuracy of the probe data.

Mining trading partners’ preferences for efficient multi-issue bargaining in E‑business

Classical negotiation models are weak in supporting real-world business negotiations because these models often assume that the preference information of each negotiator is made public. Although parametric learning methods have been proposed for acquiring the preference information of negotiation opponents, these methods suffer from the strong assumptions about the specific utility function and negotiation mechanism employed by the opponents. Consequently, it is difficult to apply these learning methods to the heterogeneous negotiation agents participating in e‑marketplaces. This paper illustrates the design, development, and evaluation of a nonparametric negotiation knowledge discovery method which is underpinned by the well-known Bayesian learning paradigm. According to our empirical testing, the novel knowledge discovery method can speed up the negotiation processes while maintaining negotiation effectiveness. To the best of our knowledge, this is the first nonparametric negotiation knowledge discovery method developed and evaluated in the context of multi-issue bargaining over e‑marketplaces.