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.

How do other people influence your driving speed? Exploring the 'who' and the 'how' of social influences on speeding from a qualitative perspective

Using only legal sanctions to manage the speed at which people drive ignores the potential benefits of harnessing social factors such as the influence of others. Social influences on driver speeds were explored in this qualitative examination of 67 Australian drivers. Focus group interviews with 8 driver types (young, mid-age and older males and females, and self-identified Excessive and Rare speeders) were guided by Akers’ social learning theory (Akers, 1998). Findings revealed two types of influential others: people known to the driver (passengers and parents), and unknown other drivers. Passengers were generally described as having a slowing influence on drivers: responsibility for the safety of people in the car and consideration for passenger comfort were key themes. In contrast, all but the Rare speeders reported increasing their speed when driving alone. Parental role modelling was also described. In relation to other drivers, key themes included speeding to keep up with traffic flow and perceived pressure to drive faster. This ‘pressure’ from others to ‘speed up’ was expressed in all groups and reported strategies for managing this varied. Encouragingly, examples of actual or anticipated social rewards for speeding were less common than examples of social punishments. Three main themes relating to social punishments were embarrassment, breaching the trust of others, and presenting an image of a responsible driver. Impression management and self-presentation are discussed in light of these findings. Overall, our findings indicate scope to exploit the use of social sanctions for speeding and social praise for speed limit compliance to enhance speed management strategies.

The failure of Australian legislation on indirect discrimination to detect the systemic racism which prevents Aboriginal people from fully participating in the workforce

Government figures put the current indigenous unemployment rate at around 23%, 3 times the unemployment rate for other Australians. This thesis aims to assess whether Australian indirect discrimination legislation can provide a remedy for one of the causes of indigenous unemployment - the systemic discrimination which can result from the mere operation of established procedures of recruitment and hiring. The impact of those practices on indigenous people is examined in the context of an analysis of anti-discrimination legislation and cases from all Australian jurisdictions from the time of the passing of the Racial Discrimination Act by the Commonwealth in 1975 to the present. The thesis finds a number of reasons why the legislation fails to provide equality of opportunity for indigenous people seeking to enter the workforce. In nearly all jurisdictions it is obscurely drafted, used mainly by educated middle class white women, and provides remedies which tend to be compensatory damages rather than change to recruitment policy. White dominance of the legal process has produced legislative and judicial definitions of "race" and "Aboriginality" which focus on biology rather than cultural difference. In the commissions and tribunals complaints of racial discrimination are often rejected on the grounds of being "vexatious" or "frivolous", not reaching the required standard of proof, or not showing a causal connection between race and the conduct complained of. In all jurisdictions the cornerstone of liability is whether a particular employment term, condition or practice is reasonable. The thesis evaluates the approaches taken by appellate courts, including the High Court, and concludes that there is a trend towards an interpretation of reasonableness which favours employer arguments such as economic rationalism, the maintenance of good industrial relations, managerial prerogative to hire and fire, and the protection of majority rights. The thesis recommends that separate, clearly drafted legislation should be passed to address indigenous disadvantage and that indigenous people should be involved in all stages of the process.

The theory of planned behaviour applied to young people's use of social networking websites

Despite the increasing popularity of social networking websites (SNWs), very little is known about the psychosocial variables which predict people’s use of these websites. The present study used an extended model of the theory of planned behaviour (TPB), including the additional variables of self-identity and belongingness, to predict high level SNW use intentions and behaviour in a sample of young people aged between 17 and 24 years. Additional analayses examined the impact of self-identity and belongingness on young people’s addictive tendencies towards SNWs. University students (N = 233) completed measures of the standard TPB constructs (attitude, subjective norm and perceived behavioural control), the additional predictor variables (self-identity and belongingness), demographic variables (age, gender, and past behaviour) and addictive tendencies. One week later, they reported their engagement in high level SNW use during the previous week. Regression analyses partially supported the TPB, as attitude and subjective norm signficantly predicted intentions to engage in high level SNW use with intention signficantly predicting behaviour. Self-identity, but not belongingness, signficantly contributed to the prediction of intention, and, unexpectedly, behaviour. Past behaviour also signficantly predicted intention and behaviour. Self-identity and belongingness signficantly predicted addictive tendencies toward SNWs. Overall, the present study revealed that high level SNW use is influenced by attitudinal, normative, and self-identity factors, findings which can be used to inform strategies that aim to modify young people’s high levels of use or addictive tendencies for SNWs.

There is no relationship : service provider staff on how LGBT young people experience policing

There has been an extended engagement with how young people experience policing, with a focus on the intersection between policing and indigeneity, ethnicity, gender, and social class. Interestingly, sexuality and/or gender diversity has been almost completely overlooked, both nationally and internationally. This paper reports on LGBT youth service providers’ accounts about police and LGBT young people interactions. It overviews the outcomes of semi-structured interviews with key LGBT youth service providers in different regions of Brisbane, Queensland. As the first qualitative engagement with these issues from the perspective of service providers, it highlights not only how LGBT young people experience policing, but also how service providers need to ‘work the system’ of policing to produce the best outcomes for LGBT young people.

“I want to see the Queen” : experiences of service use by ageing people with an intellectual disability

People with intellectual disability are a relatively new but growing minority group within Australia's ageing population. Disability policies point to the equal right of people with disabilities to a quality of life similar to that of other citizens. Disability services are increasingly required to provide individualised and responsive services, irrespective of age, for people with lifelong disabilities. The present study explored the everyday lives of older people with intellectual disability in Victoria and Queensland, examining their experiences of using disability services and the ways in which services responded to their ageing. The aim of the study was to inform practice and service development for older people with intellectual disability. The findings suggest that services facilitate important social relationships with other service users and staff. Most older people had a sense of belonging and led busy but directionless lives in two disconnected worlds. Their lives were subject to significant external present-focused control. Yet, despite this, neither services nor family members took responsibility for ensuring their sense of continuity or supporting the development of plans about their future. The experiences described suggest an urgent need for, but significant challenges in the implementation of, holistic indivdualised planning similar to the UK concept of person-centred planning.

Identifiable, queer and risky : the role of the body in policing experiences for LGBT young people

This paper explores how visibly non-heteronormative bodies mediate policing experiences of LGBT (lesbian, gay, bisexual, transgender) young people, an area that has been mostly ignored in research about policing young people. Informed by interviews with 35 LGBT young people in Brisbane, Queensland, this paper addresses this gap by exploring how the non-heteronormative body mediates policing experiences of LGBT young people. Drawing on Foucault (1984), Butler (1990a), and other queer theory, the paper argues young non-heteronormative bodies visibly perform ‘queerness’, are read by police, and shape police-LGBT youth interactions. While this is complicated by looking at-risk (in terms of risk factors like homelessness, substance abuse), and looking risky (in terms of risk-taking or criminalised activities), the paper concludes noting how youthful LGBT bodies are regulated by police as non-heteronormative and deviant.

Elderly people's use of and attitudes towards assistive devices

People in developed countries are living longer with the help of medical advances. Literature has shown that older people prefer to stay independent and live at home for as long as possible. Therefore, it is important to find out how to best accommodate and assist them in maintaining quality of life and independence as well as easing human resources. Researchers have claimed that assistive devices assist in older people’s independence, however, only a small number of studies regarding the efficiency of assistive devices have been undertaken of which several have stated that devices are not being used. The overall aim of this research was to identify whether the disuse and ineffectiveness of assistive devices are related to change in abilities or related to the design of the devices. The objective was to gather information from the elderly; to identify what assistive devices are being used or not used and to gain an understanding on their attitudes towards assistive devices. Research was conducted in two phases. The initial phase of the research was conducted with the distribution of questionnaires to people over the age of fifty that asked general questions and specific questions on type of devices being used. Phase One was followed on by Phase Two, where participants from Phase One who had come in contact with assistive devices were invited to participate in a semi-structured interview. Questions were put forth to the interviewee on their use of and attitudes towards assistive devices. Findings indicated that the reasons for the disuse in assistive devices were mostly design related; bulkiness, reliability, performance of the device, difficulty of use. The other main reason for disuse was socially related; elderly people preferred to undertake activities on their own and only use a device as a precaution or when absolutely necessary. They would prefer not having to rely on the devices. Living situation and difference in gender did not affect the preference for the use of assistive devices over personal assistance. The majority strongly supported the idea of remaining independent for as long as possible. In conclusion, this study proposes that through these findings, product designers will have a better understanding of the requirements of an elderly user. This will enable the designers to produce assistive devices that are more practical, personalised, reliable, easy to use and tie in with the older people’s environments. Additional research with different variables is recommended to further justify these findings.

Developing authentic achievement for disengaged young people using an electronic portfolio system

Credentials are a salient form of cultural capital and if a student’s learning and productions are not assessed, they are invisible in current social systems of education and employment. In this field, invisible equals non-existent. This paper arises from the context of an alternative education institution where conventional educational assessment techniques currently fail to recognise the creativity and skills of a cohort of marginalised young people. In order to facilitate a new assessment model an electronic portfolio system (EPS) is being developed and trialled to capture evidence of students’ learning and their productions. In so doing a dynamic system of arranging, exhibiting, exploiting and disseminating assessment data in the form of coherent, meaningful and valuable reports will be maintained. The paper investigates the notion of assessing development of creative thinking and skills through the means of a computerised system that operates in an area described as the efield. A model of the efield is delineated and is explained as a zone existing within the internet where free users exploit the cloud and cultivate social and cultural capital. Drawing largely on sociocultural theory and Bourdieu’s concepts of field, habitus and capitals, the article positions the efield as a potentially productive instrument in assessment for learning practices. An important aspect of the dynamics of this instrument is the recognition of teachers as learners. This is seen as an integral factor in the sociocultural approach to assessment for learning practices that will be deployed with the EPS. What actually takes place is argued to be assessment for learning as a field of exchange. The model produced in this research is aimed at delivering visibility and recognition through an engaging instrument that will enhance the prospects of marginalised young people and shift the paradigm for assessment in a creative world.

In-session processes in online counselling with young people : an exploratory approach

Aims : The aim of this study was to conduct an exploratory investigation into the in-session processes and behaviours that occur between therapists and young people in online counseling. Method: The Consensual Qualitative Research method was employed to identify in-session behaviours and a coding instrument was developed to determine their frequency of use and assess whether nuances carried in the meaning of text messages have an influential effect during sessions. Eighty-five single-session transcripts were examined in total by two independent coders. Results: Sample statistics revealed that, on average, rapport-building processes were used more consistently across cases with both types of processes having a moderately strong positive effect on young people. However, closer examination of these processes revealed weaker positive effects for in-session behaviours that rely more heavily on verbal and non-verbal cues to be accurately interpreted. Implications for Practice and Future Research: These findings imply that therapists may focus more on building rapport than accomplishing tasks with young people during online counselling sessions due to the absence of verbal and non-verbal information when communicating via text messages.

Building resilience to prevent mental health problems in young people : The resourceful adolescent programme (RAP)

This chapter describes an evidence-based programme called the Resourceful Adolescent Program (RAP), which has been successful in building resilience in young people to prevent depressive symptoms developing.The programme adopts a strengths-focused approach. It aims to build a range of coping resources that foster teenagers’ abilities to maintain a positive sense of self and regulate emotions in the face of the vicissitudes of everyday struggles and difficult life events.This groupbased programme can be implemented routinely in schools or by counselling professionals as an early intervention or prevention programme. While there is no universal definition, ‘resilience’ generally means the process of avoiding the negative trajectories associated with exposure to risk factors (Fergus and Zimmerman, 2005). Current models of resilience are also very clear that there ‘are many pathways to resilience’ (Bonanno, 2004) and there is no

Daggy shirts, daggy slogans? marketing unions to young people

In light of declining trade union density, specifically among young workers, this article explores how trade unions recruit, service and organize young people. Our focus is the way in which trade unions market their services to the young. We use, as a lens of analysis, the services and social marketing literature and the concept of an ‘unsought, experience good’ to explore trade union strategy. Based on interviews with a number of union officials in the state of Queensland, it is clear that unions see the issue of recruitment of young people as significant, and that innovative strategies are being used in at least some unions. However, the research also indicates that despite union awareness, strategies are uneven and resource allocation is patchy. While the research was carried out in one state, the results and conclusion are broadly applicable to the Australian labour movement as a whole, and have implications for union movements in other Anglophone countries.

The population approach to falls injury prevention in older people : findings of a two community trial

Background: There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury.---------- Aim: To quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age.---------- Methods: Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States.---------- Results: The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest.---------- Conclusion: The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those are intensively implemented.