Enhancing employment services for people with severe mental illness: the challenge of the Australian service environment

Objectives:  Comparatively few people with severe mental illness are employed despite evidence that many people within this group wish to obtain, can obtain and sustain employment, and that employment can contribute to recovery. This investigation aimed to: (i) describe the current policy and service environment within which people with severe mental illness receive employment services; (ii) identify evidence-based practices that improve employment outcomes for people with severe mental illness; (iii) determine the extent to which the current Australian policy environment is consistent with the implementation of evidence-based employment services for people with severe mental illness; and (iv) identify methods and priorities for enhancing employment services for Australians with severe mental illness through implementation of evidence-based practices. Method:  Current Australian practices were identified, having reference to policy and legal documents, funding body requirements and anecdotal reports. Evidence-based employment services for people with severe mental illness were identified through examination of published reviews and the results of recent controlled trials. Results:  Current policy settings support the provision of employment services for people with severe mental illness separate from clinical services. Recent studies have identified integration of clinical and employment services as a major factor in the effectiveness of employment services. This is usually achieved through co-location of employment and mental health services. Conclusions:  Optimal evidence-based employment services are needed by Australians with severe mental illness. Providing optimal services is a challenge in the current policy environment. Service integration may be achieved through enhanced intersectoral links between employment and mental health service providers as well as by co-locating employment specialists within a mental health care setting.

Psychoanalytic perspectives on substance use and antisocial personality disorder

Psychoanalysis and related psychodynamic psychotherapies have historically had a limited engagement with substance use and antisocial personality disorders. This in part reflects an early preoccupation with ‘transference neuroses’ and in part reflects later de-emphasis of diagnosis and focus on therapeutic process. Nonetheless, psychoanalytic perspectives can usefully inform thinking about approaches to treatment of such disorders and there are psychoanalytic constructs that have specific relevance to their treatment. This paper reviews some prominent strands of psychoanalytic thinking as they pertain to the treatment of substance abuse and antisocial personality disorders. It is argued that, while Freudian formulations lead to a primarily pessimistic view of the prospect of treatment of such disorders, both the British object relations and the North American self psychology traditions suggest potentially productive approaches. Finally the limited empirical evidence from brief psychodynamically informed treatments of substance use disorders is reviewed. It is concluded that such treatments are not demonstrably effective but that, since no form of psychotherapy has established high efficacy with substance use disorders, brief psychdynamic therapies are not necessarily of lesser value than other treatments and may have specific value for particular individuals and in particular treatment contexts.

Using a knowledge-based approach : the way healthy communities make decisions

The planning for Knowledge Cities faces significant challenges due to the lack of effective information tools. These challenges are magnified while planning healthy communities. The Australian Health Information Council (AHIC) concluded in its last report that health information needs to be shared more effectively (AHIC, 2008). Some research justifies the use of Decision Support Systems (DSS) as an E-planning tool, particularly in the context of healthy communities. However, very limited research has been conducted in this area to date, especially in terms of evaluating the impact of these tools on decision-makers within the health planning practice. The paper presents the methodological instruments which were developed to measure the impact of the E-planning tool (i.e., Health Decision Support System [HDSS])) on a group of health planners, namely, the Logan Beaudesert Health Coalition (LBHC). The paper is focused on the culture in which decisions were made before and after the intervention of the HDSS. Subsequently, the paper presents the observed impact of the HDSS tool, to facilitate a knowledge-based decision-making approach. This study is an attempt to make some contribution to the Knowledge Cities literature in the context of planning healthy communities by adopting E-planning tools.

Attitudinal impact of hybridized writing about a socioscientific issue

The development of scientifically literate citizens remains an important priority of science education; however, growing evidence of students’ disenchantment with school science continues to challenge the realisation of this aim. This triangulation mixed methods study investigated the learning experiences of 152 9th grade students as they participated in an online science-writing project on the socioscientific issue of biosecurity. Students wrote a series of hybridized scientific narratives, or BioStories, that integrate scientific information about biosecurity with narrative storylines. The students completed an online Likert-style questionnaire, the BioQuiz, which examined selected aspects of their attitudes toward science and science learning, prior to their participation in the project, and upon completion of the writing tasks. Statistical analyses of these results and interview data obtained from participating students suggest that hybridized writing about a socioscientific issue developed more positive attitudes toward science and science learning, particularly in terms of the students’ interest and enjoyment. Implications for research and teaching are also discussed.

Water sensitive urban design through the lens of urban metabolism

Stormwater pollution has been recognised as one of the main causes of aquatic ecosystem degradation and poses a significant threat to both the goal of ecological sustainable development as well as human health and wellbeing. In response, water sensitive urban design (WSUD) practices have been put forward as a strategy to mitigate the detrimental impacts of urban stormwater runoff quality and to safeguard ecosystem functions. However, despite studies that support its efficiency in urban stormwater management, the mainstreaming of WSUD remains a significant challenge. This paper proposes that viewing WSUD through the lens of the integrated urban metabolism framework which encourages an interdisciplinary approach and facilitates dialogue through knowledge transfer is a strategy in which the implementation of WSUD can be mainstreamed.

Influence of physical and chemical parameters on the treatment of heavy metals in polluted stormwater using zeolite : A review

Zeolite-based technology can provide a cost effective solution for stormwater treatment for the removal of toxic heavy metals under increasing demand of safe water from alternative sources. This paper reviews the currently available knowledge relating to the effect of properties of zeolites such as pore size, surface area and Si:Al ratio and the physico-chemical conditions of the system such as pH, temperature, initial metal concentration and zeolite concentration on heavy metal removal performance. The primary aims are, to consolidate available knowledge and identify knowledge gaps. It was established that an in-depth understanding of operational issues such as, diffusion of metal ions into the zeolite pore structure, pore clogging, zeolite surface coverage by particulates in stormwater as well as the effect of pH on stormwater quality in the presence of zeolites is essential for developing a zeolite-based technology for the treatment of polluted stormwater. The optimum zeolite concentration to treat typical volumes of stormwater and initial heavy metal concentrations in stormwater should also be considered as operational issues in this regard. Additionally, leaching of aluminium and sodium ions from the zeolite structure to solution were identified as key issues requiring further research in the effort to develop cost effective solutions for the removal of heavy metals from stormwater.

Development of an autonomous unmanned aerial system to collect time-stamped samples from the atmosphere and localize potential pathogen sources

This paper presents the hardware development and testing of a new concept for air sampling via the integration of a prototype spore trap onboard an unmanned aerial system (UAS).We propose the integration of a prototype spore trap onboard a UAS to allow multiple capture of spores of pathogens in single remote locations at high or low altitude, otherwise not possible with stationary sampling devices.We also demonstrate the capability of this system for the capture of multiple time-stamped samples during a single mission.Wind tunnel testing was followed by simulation, and flight testing was conducted to measure and quantify the spread during simulated airborne air sampling operations. During autonomous operations, the onboard autopilot commands the servo to rotate the sampling device to a new indexed location once the UAS vehicle reaches the predefined waypoint or set of waypoints (which represents the region of interest). Time-stamped UAS data are continuously logged during the flight to assist with analysis of the particles collected. Testing and validation of the autopilot and spore trap integration, functionality, and performance is described. These tools may enhance the ability to detect new incursions of spores

Improving patient privacy and confidentiality in one regional Emergency Department – a quality project

Background: Patient privacy and confidentiality (PPaC) is an important consideration for nurses and other members of the health care team. Can a patient expect to have confidentiality and in particular privacy in the current climate of emergency health care? Do staff who work in the Emergency Department (ED) see confidentiality as an important factor when providing emergency care? These questions are important to consider. Methods: This is a two phased quality improvement project, developed and implemented over a six month period in a busy regional, tertiary referral ED. Results: Issues identified for this department included department design and layout, overcrowding due to patient flow and access block, staff practices and department policies which were also impacted upon by culture of the team, and use of space. Conclusions: Changes successful in improving this issue include increased staff awareness about PPaC, intercom paging prior to nursing handover to remove visitors during handover, one visitor per patient policy, designated places for handover, allocated bed space for patient reviews/assessment and a strategy to temporarily move the patient if procedures would have been undertaken in shared bed space. These are important issues when considering policy, practice and department design in the ED.

The global division of labour and the division in global labour

Since the 1980s the locus of manufacturing and some services have moved to countries of the Global South. Liberalization of trade and investment has added two billion people to world labour supply and brought workers everywhere into intense competition with each other. Under orthodox neoliberal and neoclassical approaches free trade and open investment should benefit all countries and lead to convergence. However considerable differences in wages and working hours exist between workers of the Global North and those of the Global South. The organising question for the thesis is why workers in different countries but the same industries get different wages. Empirical evidence reviewed in the thesis shows that productivity does not explain these wage differences and that workers in some parts of the South are more productive than workers in the North. Part of the thesis examines the usefulness of explanations drawn from Marxist, institutionalist and global commodity chain approaches. There is a long established argument in Marxist and neo-Marxist writings that differences between North and South result from imperialism and the exercise of power. This is the starting point to review ways of understanding divisions between workers as the outcome of a global class structure. In turn, a fault line is postulated between productive and unproductive labour that largely replicates the division between the Global North and the Global South. Workers and their organizations need shared actions if they are to resist global competition and wage disparities. Solidarity has been the clarion of progressive movements from the Internationals of the early C19th through to the current Global Unions and International Confederation of Trade Unions (ICTU). The thesis examines how nationalism and particular interests have undermined solidarity and reviews the major implications for current efforts to establish and advance a global labour position.

Non-pharmacological interventions for breathlessness management in patients with lung cancer : A systematic review

The aim is to review the published scientific literature for studies evaluating nonpharmacological interventions for breathlessness management in patients with lung cancer. The following selection criteria were used to systematically search the literature: studies were to be published research or systematic reviews; they were to be published in English and from 1990 to 2007; the targeted populations were adult patients with dyspnoea/breathlessness associated with lung cancer; and the study reported on the outcomes from use of non-pharmacological strategies for breathlessness. This review retrieved five studies that met all inclusion criteria. All the studies reported the benefits of non-pharmacological interventions in improving breathlessness regardless of differences in clinical contexts, components of programmes and methods for delivery. Analysis of the available evidence suggests that tailored instructions delivered by nurses with sufficient training and supervision may have some benefits over other delivery approaches. Based on the results, non-pharmacological interventions are recommended as effective adjunctive strategies in managing breathlessness for patients with lung cancer. In order to refine such interventions, future research should seek to explore the core components of such approaches that are critical to achieving optimal outcomes, the contexts in which the interventions are most effective, and to evaluate the relative benefits of different methods for delivering such interventions.

Diversity in Knowledge Management : A Cultural Approach

This paper reviews diversity in knowledge management (KM) from a cultural perspective; it argues that culturally embedded theories and practices influence the practice of knowledge management. It further presents and analyses several case studies and in particular a case study of the Islamic culture focusing on its traditional approach to both Islamic knowledge and management. The analysis of this case reveals the cultural challenges that emerge in the process of applying essentially Western management theories within an Islamic culture with particular reference to knowledge management theories. The paper concludes that the concept of knowledge management must take into account the diversity of national culture in which the organization exists and that the concept of knowledge management will benefit from a diversity perspective rather than a universality perspective.

Knowledge-based urban development redefined : from theory to practice knowledge-based development of cities

The concept of knowledge-based urban development has first come to the urban planning and development agenda during the very last years of the 20th century as a promising paradigm to support the transformation process of cities into knowledge cities and their societies into knowledge societies. However, soon after the exponentially rapid advancements experienced, during the first decade of the 21st century, particularly, in the domains of economy, society, management and technology along with the severe impacts of climate change, have made the redefinition of the term a necessity. This paper, first, reports the findings of the review of the relatively short but dynamic history of urbanisation experiences of our cities around the globe. The paper, then, focuses on the 21st century urbanisation context and discusses the conceptual base of the knowledge-based development of cities and how this concept found application ground in many parts of the world. Following this, the paper speculates development of future cities by particularly highlighting potential challenges and opportunities that previously have not been fully considered. This paper, lastly, introduces and elaborates how relevant theories support the better conceptualisation of this relatively new, but rapidly emerging paradigm, and redefines it accordingly.

Knowledge based urban development in classrooms : planning Taipei's knowledge based development

Rapid urbanisation of the global population over the last two centuries has inevitably brought with it a number of challenges and opportunities for economic, environmental and social sustainability of regions. This is arguably a result of rapid globalisation and subsequent growth in knowledge and service based economic markets. This paper reviews the introduction of a specialised teaching structure where the concepts of Knowledge Based Urban Development and Knowledge Cities were taught to various students of the discipline of Urban and Regional Planning at the Queensland University of Technology, through their study tour to the city of Taipei, Taiwan. The concepts were conveyed under the name ‘Taipei Metropolis Knowledge Based Regional Planning Studio’ and its methodology reviewed a series of tasks that was considered to provide a stronger level of understanding of how Knowledge Cities and Knowledge Based Urban Development had been formed in some areas of Taiwan. Findings from this international collaborative planning studio indicate that students have gained a greater level of understanding and insight into planning systems and processes in a trans-cultural context. The students have also been exposed to ideas and knowledge that have challenged conventional perspectives and encouraged global awareness.

Advance directives, autonomy and the refusal of life-sustaining medical treatment

As Australian society 1s agemg, individuals are increasingly concerned about managing their future, including making decisions about the medical treatment they may wish to receive or refuse if they lose decision-making capacity. To date, there has been relatively little research into the extent to which legal regulation allows competent adults to make advance refusals of life-sustaining medical treatment that will bind health professionals and others when a decision needs to be made at a future time. This thesis aims to fill this gap in the research by presenting the results of research into the legal regulation of advance directives that refuse life-sustaining medical treatment. In the five papers that comprise this thesis, the law that governs this area is examined, and the ethical principle of autonomy is used to critically evaluate that law. The principal finding of this research is that the current scheme of regulation is ineffective to adequately promote the right of a competent adult to make binding advance directives about refusal of medical treatment. The research concludes that legislation should be enacted to enable individuals to complete an advance directive, only imposing restrictions to the extent that this is necessary to promote individual autonomy. The thesis first examines the principle of autonomy upon which the common law (and some statutory law) is expressed to be based, to determine whether that principle is an appropriate one to underpin regulation. 1 The finding of the research is that autonomy can be justified as an organising principle on a number of grounds: it is consistent with the values of a liberal democracy; over recent decades, it is a principle that has been even more prominent within the discipline of medical ethics; and it is the principle which underpins the legal regulation of a related topic, namely the contemporaneous refusal of medical treatment. Next, the thesis reviews the common law to determine whether it effectively achieves the goal of promoting autonomy by allowing a competent adult to make an advance directive refusing treatment that will operate if he or she later loses decision-making capacity. 2 This research finds that conunon law doctrine, as espoused by the judiciary, prioritises individual choice by recognising valid advance directives that refuse treatment as binding. However, the research also concludes that the common law, as applied by the judiciary in some cases, may not be effective to promote individual autonomy, as there have been a number of circumstances where advance directives that refuse treatment have not been followed. The thesis then examines the statutory regimes in Australia that regulate advance directives, with a focus on the regulation of advance refusals of life-sustaining medical treatment.3 This review commences with an examination ofparliamentary debates to establish why legislation was thought to be necessary. It then provides a detailed review of all of the statutory regimes, the extent to which the legislation regulates the form of advance directives, and the circumstances in which they can be completed, will operate and can be ignored by medical professionals. The research finds that legislation was enacted mainly to clarify the common law and bring a level of certainty to the field. Legislative regimes were thought to provide medical professionals with the assurance that compliance with an advance directive that refuses life-sustaining medical treatment will not expose them to legal sanction. However, the research also finds that the legislation places so many restrictions on when an advance directive refusing treatment can be made, or will operate, that they have not been successful in promoting individual autonomy.

The extent of six sigma methodologies usage in services

The last two decades have seen the application of six sigma methodologies in many manufacturing and also some service industries. Six sigma’s success in manufacturing is well published. But the same cannot be said about its implementation in services. Applying six sigma to services is still limited to only a small number of services. This paper reviews the application of six sigma in service industries. Emphasis is given to application issues such as what are necessary critical success factors and key performance indicators in order for a project to be successful. A pilot study was carried out in order to highlight the issues discussed. Regardless of the service that is provided, a number of guidelines can be commonly applied to varying types of services. The aim of this paper is to help widen the scope of six sigma application in services.