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. (C) 2004 Elsevier Ltd. All rights reserved.

Co-opting conservation: Migrant resource control and access to national park management in the Philippine uplands

The history of political and economic inequality in forest villages can shape how and why resource use conflicts arise during the evolution of national parks management. In the Philippine uplands, indigenous peoples and migrant settlers co-exist, compete over land and forest resources, and shape how managers preserve forests through national parks. This article examines how migrants have claimed lands and changed production and exchange relations among the indigenous Tagbanua to build on and benefit from otherwise coercive park management on Palawan Island, the Philippines. Migrant control over productive resources has influenced who, within each group, could sustain agriculture in the face of the state's dominant conservation narrative - valorizing migrant paddy rice and criminalizing Tagbanua swiddens. Upon settling, migrant farmers used new political and economic strengths to tap into provincial political networks in order to be hired at a national park. As a result, they were able to steer management to support paddy rice at the expense of swidden cultivation. While state conservation policy shapes how national parks impact upon local resource access and use, older political economic inequalities in forest villages build on such policies to influence how management affects the livelihoods of poor households.

The future of competition: Co-creating unique value with customers

The article presents a review of the book "The Future of Competition: Co-Creating Unique Value With Customers," by C. K. Prahalad and Venkat Ramaswamy

Steatosis: Co-factor in other liver diseases

The prevalence of fatty liver is rising in association with the global increase in obesity and type 2 diabetes. In the past, simple steatosis was regarded as benign, but the presence of another liver disease may provide a synergistic combination of steatosis, cellular adaptation, and oxidative damage that aggravates liver injury. In this review, a major focus is on the role of steatosis as a co-factor in chronic hepatitis C (HCV), where the mechanisms promoting fibrosis and the effect of weight reduction in minimizing liver injury have been most widely studied. Steatosis, obesity, and associated metabolic factors may also modulate the response to alcohol- and drug-induced liver disease and may be risk factors for the development of hepatocellular cancer. The pathogenesis of injury in obesity-related fatty liver disease involves a number of pathways, which are currently under investigation. Enhanced oxidative stress, increased susceptibility to apoptosis, and a dysregulated response to cellular injury have been implicated, and other components of the metabolic syndrome such as hyperinsulinernia and hyperglycemia are likely to have a role. Fibrosis also may be increased as a by-product of altered hepatocyte regeneration and activation of bipotential hepatic progenitor cells. In conclusion, active management of obesity and a reduction in steatosis may improve liver injury and decrease the progression of fibrosis.

Moreton Bay, Queensland, Australia: An example of the co-existence of significant marine mammal populations and large-scale coastal development

Recent analyses assert that large marine vertebrates such as marine mammals are now 'functionally or entirely extinct in most coastal ecosystems'. Moreton Bay is a large diverse marine ecosystem bordering the fastest growing area in Australia. The human population is over 1.6 million and increasing yearly by between 10% and 13% with resultant impacts upon the adjoining marine environment. Nonetheless, significant populations of three species of marine mammals are resident within Moreton Bay and a further 14 species are seasonal or occasional visitors. This paper reviews the current and historical distributions and abundance of these species in the context of the current management regime and suggests initiatives to increase the resilience of marine mammal populations to the changes wrought by the burgeoning human population in coastal environments. (C) 2004 Elsevier Ltd. All rights reserved.

The co-evolutionary dynamics of IS engagement

In this paper we consider the co-evolutionary dynamics of IS engagement where episodic change of implementation increasingly occurs within the context of linkages and interdependencies between systems and processes within and across organisations. Although there are many theories that interpret the various motors of change be it lifecycle, teleological, dialectic or evolutionary, our paper attempts to move towards a unifying view of change by studying co-evolutionary dynamics from a complex systems perspective. To understand how systems and organisations co-evolve in practice and how order emerges, or fails to emerge, we adopt complex adaptive systems theory to incorporate evolutionary and teleological motors, and actor-network theory to incorporate dialectic motors. We illustrate this through the analysis of the implementation of a novel academic scheduling system at a large research-intensive Australian university.