A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders

Objective: Excessive alcohol consumption is common among people with psychotic disorders. While there is an extensive literature on the efficacy of psychological treatments for excessive drinking, few studies have examined interventions addressing this issue among people with psychotic disorders. Method: Systematic searches in PubMed and PsycINFO were conducted to identify randomized controlled trials comparing manual guided psychological interventions for excessive alcohol consumption among individuals with psychotic disorders. Of the 429 articles identified, 7 met inclusion criteria. Data were extracted from each study regarding study sample characteristics, design, results, clinical significance of alcohol consumption results, and methodological limitations. Results: Assessment interviews, brief motivational interventions and lengthier cognitive behavior therapy have been associated with reductions in alcohol consumption among people with psychosis. While brief interventions (i.e., 1-2 sessions) were generally as effective as longer duration psychological interventions (i.e., 10 session) for reducing alcohol consumption, longer interventions provided additional benefits for depression, functioning and other alcohol outcomes. Conclusion: Excessive alcohol consumption among people with psychotic disorders is responsive to psychological interventions. It is imperative that such approaches are integrated within standard care for people with psychosis.

Reasons for substance use among people with mental disorders

Background: Comorbidity of mental disorders and substance use continues to be a major problem. To inform the development of more effective interventions for these co-existing disorders, this paper aimed to determine if there are clear variations in the reasons for tobacco, alcohol or cannabis use across people with different mental disorders. Methods: Data from five randomized controlled trials on co-existing disorders that measured reasons for tobacco, alcohol or cannabis use using the Drug Use Motives Questionnaire, Reasons for Smoking Questionnaire or via free response are reported and combined. Two studies involved participants with depression, two involved participants with a psychotic disorder and one involved participants with a range of mental disorders. A series of logistic regressions were conducted to examine differences in reasons for tobacco, alcohol or cannabis use and to compare these reasons between people with psychotic disorders or depression. Results: Participants had a mean age of 38 (SD=12) and just over half (60%) were male. Forty-six percent of participants had a psychotic disorder and 54% experienced depression. Data from 976 participants across the five studies were included in the analyses. Tobacco and alcohol were primarily used to cope, while cannabis was primarily used for pleasure. People with psychotic disorders were more likely than people with depression to use tobacco for coping, pleasure and illness motives. People with depression, in contrast, were more likely to use alcohol for these reasons and social reasons. Conclusions: It may be important to tailor interventions for co-existing mental disorders and substance use by substance type and type of mental disorder. For example, interventions might be improved by including alternative coping strategies to tobacco and/or alcohol use, by addressing the social role of alcohol and by helping people with mental disorders using cannabis to gain pleasure from their lives in other ways.

Treatment of cannabis use among people with psychotic disorders : critical review of randomised controlled trials

There is growing and converging evidence that cannabis may be a major risk factor in people with psychotic disorders and prodromal psychotic symptoms. The lack of available pharmacological treatments for cannabis use indicates that psychological interventions should be a high priority, especially among people with psychotic disorders. However, there have been few randomised controlled trials (RCTs) of psychological interventions among this group. In the present study we critically overview RCTs of psychological and pharmacologic interventions among people with psychotic disorders, giving particular attention to those studies which report cannabis use outcomes. We then review data regarding treatment preferences among this group. RCTs of interventions within "real world" mental health systems among adults with severe mental disorders suggest that cannabis use is amenable to treatment in real world settings among people with psychotic disorders. RCTs of manual guided interventions among cannabis users indicate that while brief interventions are associated with reductions in cannabis use, longer interventions may be more effective. Additionally, RCTs reviewed suggest treatment with antipsychotic medication is not associated with a worsening of cannabis cravings or use and may be beneficial. The development of cannabinoid agonist medication may be an effective strategy for cannabis dependence and suitable for people with psychotic disorders. The development of cannabis use interventions for people with psychotic disorders should also consider patients' treatment preferences. Initial results indicate face-to-face interventions focussed on cannabis use may be preferred. Further research investigating the treatment preferences of people with psychotic disorders using cannabis is needed.

Brave new green world : consequences of a carbon economy for the conservation of Australian biodiversity

Pricing greenhouse gas emissions is a burgeoning and possibly lucrative financial means for climate change mitigation. Emissions pricing is being used to fund emissions-abatement technologies and to modify land management to improve carbon sequestration and retention. Here we discuss the principal land-management options under existing and realistic future emissions-price legislation in Australia, and examine them with respect to their anticipated direct and indirect effects on biodiversity. The main ways in which emissions price-driven changes to land management can affect biodiversity are through policies and practices for (1) environmental plantings for carbon sequestration, (2) native regrowth, (3) fire management, (4) forestry, (5) agricultural practices (including cropping and grazing), and (6) feral animal control. While most land-management options available to reduce net greenhouse gas emissions offer clear advantages to increase the viability of native biodiversity, we describe several caveats regarding potentially negative outcomes, and outline components that need to be considered if biodiversity is also to benefit from the new carbon economy. Carbon plantings will only have real biodiversity value if they comprise appropriate native tree species and provide suitable habitats and resources for valued fauna. Such plantings also risk severely altering local hydrology and reducing water availability. Management of regrowth post-agricultural abandonment requires setting appropriate baselines and allowing for thinning in certain circumstances, and improvements to forestry rotation lengths would likely increase carbon-retention capacity and biodiversity value. Prescribed burning to reduce the frequency of high-intensity wildfires in northern Australia is being used as a tool to increase carbon retention. Fire management in southern Australia is not readily amenable for maximising carbon storage potential, but will become increasingly important for biodiversity conservation as the climate warms. Carbon price-based modifications to agriculture that would benefit biodiversity include reductions in tillage frequency and livestock densities, reductions in fertiliser use, and retention and regeneration of native shrubs; however, anticipated shifts to exotic perennial grass species such as buffel grass and kikuyu could have net negative implications for native biodiversity. Finally, it is unlikely that major reductions in greenhouse gas emissions arising from feral animal control are possible, even though reduced densities of feral herbivores will benefit Australian biodiversity greatly.

Exploring Indigenous representations in Australian film and literature for the Australian Curriculum

The Australian Curriculum: English, v.5 (ACARA, 2013) now being implemented in Queensland asks teachers and curriculum designers to incorporate the cross curriculum priority (CCP)of Indigenous issues through Aboriginal and Torres Strait Islander histories and cultures. In the Australian Curriculum English, (AC:E) one way to address this CCP is by including texts by and about Aboriginal and Torres Strait Islander people. With the rise of promising and accomplished young, Indigenous filmmakers such as Ivan Sen, Rachael Perkins, Wayne Blair and Warwick Thornton, this guide focuses on the suitable films for schools implementing the Australian Curriculum in terms of cultural representations. This annotated guide suggests some films suitable for inclusion in classroom study and suggests some companion texts (novels, plays, television series and animations, documentaries, poetry and short stories) that may be studied alongside the films. Some of these are by Indigenous filmmakers and writers, and others features Aboriginal and Torres Strait Island representations in character and/or themes.

Does a 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine prevent respiratory exacerbations in children with recurrent protracted bacterial bronchitis, chronic suppurative lung disease and bronchiectasis : protocol for a randomised controlled trial

Background Recurrent protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis are characterised by a chronic wet cough and are important causes of childhood respiratory morbidity globally. Haemophilus influenzae and Streptococcus pneumoniae are the most commonly associated pathogens. As respiratory exacerbations impair quality of life and may be associated with disease progression, we will determine if the novel 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) reduces exacerbations in these children. Methods A multi-centre, parallel group, double-blind, randomised controlled trial in tertiary paediatric centres from three Australian cities is planned. Two hundred six children aged 18 months to 14 years with recurrent PBB, CSLD or bronchiectasis will be randomised to receive either two doses of PHiD-CV or control meningococcal (ACYW(135)) conjugate vaccine 2 months apart and followed for 12 months after the second vaccine dose. Randomisation will be stratified by site, age (<6 years and >= 6 years) and aetiology (recurrent PBB or CSLD/bronchiectasis). Clinical histories, respiratory status (including spirometry in children aged >= 6 years), nasopharyngeal and saliva swabs, and serum will be collected at baseline and at 2, 3, 8 and 14 months post-enrolment. Local and systemic reactions will be recorded on daily diaries for 7 and 30 days, respectively, following each vaccine dose and serious adverse events monitored throughout the trial. Fortnightly, parental contact will help record respiratory exacerbations. The primary outcome is the incidence of respiratory exacerbations in the 12 months following the second vaccine dose. Secondary outcomes include: nasopharyngeal carriage of H. influenzae and S. pneumoniae vaccine and vaccine-related serotypes; systemic and mucosal immune responses to H. influenzae proteins and S. pneumoniae vaccine and vaccine-related serotypes; impact upon lung function in children aged >= 6 years; and vaccine safety. Discussion As H. influenzae is the most common bacterial pathogen associated with these chronic respiratory diseases in children, a novel pneumococcal conjugate vaccine that also impacts upon H. influenzae and helps prevent respiratory exacerbations would assist clinical management with potential short- and long-term health benefits. Our study will be the first to assess vaccine efficacy targeting H. influenzae in children with recurrent PBB, CSLD and bronchiectasis.

Marker gene elimination from transgenic barley, using co-transformation with adjacent 'twin T-DNAs' on a standard Agrobacterium transformation vector

We have tested a methodology for the elimination of the selectable marker gene after Agrobacterium-mediated transformation of barley. This involves segregation of the selectable marker gene away from the gene of interest following co-transformation using a plasmid carrying two T-DNAs, which were located adjacent to each other with no intervening region. A standard binary transformation vector was modified by insertion of a small section composed of an additional left and right T-DNA border, so that the selectable marker gene and the site for insertion of the gene of interest (GOI) were each flanked by a left and right border. Using this vector three different GOIs were transformed into barley. Analysis of transgene inheritance was facilitated by a novel and rapid assay utilizing PCR amplification from macerated leaf tissue. Co-insertion was observed in two thirds of transformants, and among these approximately one quarter had transgene inserts which segregated in the next generation to yield selectable marker-free transgenic plants. Insertion of non-T-DNA plasmid sequences was observed in only one of fourteen SMF lines tested. This technique thus provides a workable system for generating transgenic barley free from selectable marker genes, thereby obviating public concerns regarding proliferation of these genes.

Rediscovering law students as citizens: Critical thinking and the public value of legal education

In a series of publications over the last decade, Australian National University Professor Margaret Thornton has documented a disturbing change in the nature of legal education. This body of work culminates in a recently published book based on interviews with 145 legal academics in Australia, the United Kingdom, New Zealand and Canada. In it, Thornton describes a feeling of widespread unease among legal academics that society, government, university administrators and students themselves are moving away from viewing legal education as a public good which benefits both students and society. Instead, legal education is increasingly being viewed as a purely private good, for consumption by the student in the quest for individual career enhancement.

Re-valuing construction materials and components through design for disassembly

The construction industry accounts for a significant portion of the material consumption of our industrialised societies. That material consumption comes at an environmental cost, and when buildings and infrastructure projects are demolished and discarded, after their useful lifespan, that environmental cost remains largely unrecovered. The expected operational lifespan of modern buildings has become disturbingly short as buildings are replaced for reasons of changing cultural expectations, style, serviceability, locational obsolescence and economic viability. The same buildings however are not always physically or structurally obsolete; the materials and components within them are very often still completely serviceable. While there is some activity in the area of recycling of selected construction materials, such as steel and concrete, this is almost always in the form of down cycling or reprocessing. Very little of this material and component resource is reuse in a way that more effectively captures its potential. One significant impediment to such reuse is that buildings are not designed in a way that facilitates easy recovery of materials and components; they are designed and built for speed of construction and quick economic returns, with little or no consideration of the longer term consequences of their physical matter. This research project explores the potential for the recovery of materials and components if buildings were designed for such future recovery; a strategy of design for disassembly. This is not a new design philosophy; design for disassembly is well understood in product design and industrial design. There are also some architectural examples of design for disassembly; however these are specialist examples and there is no significant attempt to implement the strategy in the main stream construction industry. This paper presents research into the analysis of the embodied energy in buildings, highlighting its significance in comparison with operational energy. Analysis at material, component, and whole-of-building levels shows the potential benefits of strategically designing buildings for future disassembly to recover this embodied energy. Careful consideration at the early design stage can result in the deconstruction of significant portions of buildings and the recovery of their potential through higher order reuse and upcycling.

Malnutrition, gastroenteritis and trypsinogen concentration in hospitalised aboriginal children

Objective: To explore relationships between malnutrition and pancreatic damage in hospitalised aboriginal children. Methods: Immunoreactive trypsinogen (IRT) concentrations were measured in two populations of hospitalised aboriginal children in Australia; 472 children aged 0-3 years, in Alice Springs (Northern Territory); and 187 children aged 0-16 years in Mount Isa (Queensland). Correlation of whole blood IRT with height and weight z-scores, four-site skinfold thickness and upper arm circumference was sought. Results: In Mount Isa, the geometric mean IRT concentration rose with decreasing weight z-score. The IRT concentration was otherwise unrelated to nutritional indices. Sixty percent of the 39 Mount Isa patients with gastroenteritis and 24.5% of the 358 Alice Springs patients with gastroenteritis had an IRT concentration in the upper quartile for their population, compared with 16% for patients with other diagnoses in both populations. Conclusions: A high IRT concentration in patients with low weight z-scores is a confounding effect of gastroenteritis, and may result from subclinical pancreatic disease in gastroenteritis.

The dynamics of individual teacher autonomy: A case study of teachers' work in a Queensland secondary school

The emphasis on collegiality and collaboration in the literature on teachers' work and school reform has tended to underplay the significance of teacher autonomy. This thesis explores the dynamics of teachers' understandings and experiences of individual teacher autonomy (as contrasted with collective autonomy) in an independent school in Queensland which promoted itself as a 'teachers' school' with a strong commitment to individual teacher autonomy. The research was a case study which drew on methodological signposts from critical, feminist and traditional ethnography. Intensive fieldwork in the school over five months incorporated the ethnographic techniques of observation, interviews and document analysis. Teachers at Thornton College understood their experience of individual autonomy at three interrelated levels--in terms of their work in the classroom, their working life in the school, and their voice in the decision-making processes of the school. They felt that they experienced a great deal of individual autonomy at each of these three levels. These understandings and experiences of autonomy were encumbered or enabled by a range of internal and external stakeholder groups. There were also a number of structural influences (community perceptions, market forces, school size, time and bureaucracy) emerging from the economic, social and political structures in Australian society which influenced the experience of autonomy by teachers. The experience of individual teacher autonomy was constantly shifting, but there were some emergent patterns. Consensus on educational goals and vision, and strong expressions of trust and respect between teachers and stakeholders in the school, characterised the contexts in which teachers felt they experienced high levels of autonomy in their work. The demand for accountability and desire for relatedness motivated stakeholders and structural forces to influence teacher autonomy. Some significant gaps emerged between the rhetoric of a commitment to individual teacher autonomy and decision-making practices in the school, that gave ultimate power to the co-principals. Despite the rhetoric and promotion of non-hierarchical structures and collaborative decision-making processes, many teachers perceived that their experience of individual autonomy remained subject to the exercise of 'partial democracy' by school leaders.

Thermodynamics Of Aluminum Strontium Alloys

The activity of strontium in liquid Al-Sr alloys (X(Sr) less-than-or-equal-to 0.17) at 1323 K has been determined using the Knudsen effusion-mass loss technique. At higher concentrations (X(Sr) greater-than-or-equal-to 0.28), the activity of strontium has been determined by the pseudoisopiestic technique. Activity of aluminium has been derived by Gibbs-Duhem integration. The concentration - concentration structure factor of Bhatia and Thornton at zero wave vector has been computed from the thermodynamic data. The behaviour of the mean square thermal fluctuation in composition and the thermodynamic mixing functions suggest association tendencies in the liquid state. The associated solution model with Al2Sr as the predominant complex can account for the properties of the liquid alloy. Thermodynamic data for the intermetallic compunds in the Al-Sr system have been derived using the phase diagram and the Gibbs' energy and enthalpy of mixing of liquid alloys. The data indicate the need for redetermination of the phase diagram near the strontium-rich corner.

Thermodynamics of Aluminium -Strontium Alloys

The activity of strontium in liquid Al-Sr alloys (X(Sr) less-than-or-equal-to 0.17) at 1323 K has been determined using the Knudsen effusion-mass loss technique. At higher concentrations (X(Sr) greater-than-or-equal-to 0.28), the activity of strontium has been determined by the pseudoisopiestic technique. Activity of aluminium has been derived by Gibbs-Duhem integration. The concentration - concentration structure factor of Bhatia and Thornton at zero wave vector has been computed from the thermodynamic data. The behaviour of the mean square thermal fluctuation in composition and the thermodynamic mixing functions suggest association tendencies in the liquid state. The associated solution model with Al2Sr as the predominant complex can account for the properties of the liquid alloy. Thermodynamic data for the intermetallic compunds in the Al-Sr system have been derived using the phase diagram and the Gibbs' energy and enthalpy of mixing of liquid alloys. The data indicate the need for redetermination of the phase diagram near the strontium-rich corner.