Subjective and Objective Indicators of Recovery in Severe Mental Illness: a Cross-Sectional Study

Background: This study aimed to determine whether subjective dimensions of recovery such as empowerment are associated with self-report of more objective indicators such as level of participation in the community and income from employment. A secondary aim was to investigate the extent to which diagnosis or other consumer characteristics mediated any relationship between these variables. Methods: The Community Integration Measure, the Empowerment Scale, the Recovery Assessment Scale, and the Camberwell Assessment of Needs Short Appraisal Schedule were administered to a convenience sample of 161 consumers with severe mental illness. Results: The majority of participants had a primary diagnosis of schizophreniform, anxiety/depression or bipolar affective disorder. The Empowerment Scale was quite strongly correlated with the Recovery Assessment Scale and the Community Integration Measure. Participants with a diagnosis of bipolar affective disorder had signifi cantly higher recovery and empowerment scores than participants with schizophrenia or depression. Both empowerment and recovery scores were significantly higher for people engaged in paid employment than for those receiving social security benefits. Conclusions: The measurement of subjective dimensions of recovery such as empowerment has validity in evaluation of global recovery for people with severe mental illness. A diagnosis of bipolar disorder is associated with higher scores on subjective and objective indicators of recovery.

Multiculturalism, education for sustainable development (ESD) and the shifting discursive landscape of social inclusion

Australia has a long and sometimes turbulent relationship with the migrant Other. This paper examines a component of this relationship via the window of contemporary multicultural policy. The paper begins with an analysis of the political and social conditions that enabled a national and bipartisan policy of multiculturalism to emerge as formalised federal policy during the late 1960s and early 1970s. The paper re-problematises the influences that helped shape Australia's articulation of race and ethnicity and argues that multiculturalism, within a post-September 11 environment, can no longer be framed solely within its traditional framework of social justice. The paper positions education for sustainable development (ESD) as an emerging discursive field that provides educators with an alternative road map for critiquing Australia's fluid relationship with the migrant Other. By linking the tenets of multiculturalism with ESD, this paper suggests pre-service teacher educators are presented with a productive, and at the same time politically palatable, means for regaining pedagogical traction for a semi-dormant agenda of social inclusion.

Competences and capabilities for innovation in supply chain relationships

There is little empirical research on the relational capabilities and competences in supply chain relationships, and the important links that exist between relational capabilities, competences and supply chain innovation. This study addresses some of that knowledge gap gained through a case study of the Australian freight services sector. Findings suggest that different competences developed by supply chain participants support different ways to enable operational effectiveness. Road freight businesses should acquire knowledge of how to select and manage inter-firm relationships that provide the greatest benefit, acquiring competences that either improve their current capabilities or assist them to explore strategies that ensure incremental innovation and supply chain performance objectives are met.

The HRM practices of innovative knowledge-intensive firms

There is little research on HRM practices in knowledge-intensive firms (KIFs), especially in comparison to that conducted in traditional production environments. Whether such HRM practices are appropriate for KIFs, particularly ones that differentiate themselves on their ability to innovate, is the basis of this research. The study investigates the HRM practices being used by four innovative firms: two KIFs and two traditional production companies. The findings suggest that there are some similarities between the HRM practices of the case firms, but there are also important differences. Specifically, the KIFs emphasise use of selection criteria and processes that secure a workforce with a desire for challenging work and the ability to work collaboratively. The KIFs are also more likely to provide a breadth of training and development opportunities for teams and individuals, to make extensive use of performance management systems, and to utilise a range of strategies to encourage and reward innovation.

Reconfiguration or innovation in supply chains?

This research explores supply chain competitiveness and dynamic capabilities. It examines a pilot group of Australian supply chain organisations to understand the importance of dynamic capability in building innovation capacity for competitive advantage, and the concept of adopting a strategic approach to supply chain relationship building. A supply chain is after all a group of intra and interorganisational relationships delivering demand to end-users. This exploratory study confirms a positive relationship between the variables indicating both a strategic intent to develop relational capability, and very strong predictive linkages between the importance placed on developing supply chain dynamic capability and achieving supply chain innovation capacity as a competitive advantage.

Modelling and performance evaluation of the IEEE 802.11 DCF for real-time control

Popular wireless networks, such as IEEE 802.11/15/16, are not designed for real-time applications. Thus, supporting real-time quality of service (QoS) in wireless real-time control is challenging. This paper adopts the widely used IEEE 802.11, with the focus on its distributed coordination function (DCF), for soft-real-time control systems. The concept of the critical real-time traffic condition is introduced to characterize the marginal satisfaction of real-time requirements. Then, mathematical models are developed to describe the dynamics of DCF based real-time control networks with periodic traffic, a unique feature of control systems. Performance indices such as throughput and packet delay are evaluated using the developed models, particularly under the critical real-time traffic condition. Finally, the proposed modelling is applied to traffic rate control for cross-layer networked control system design.

Nobody says no : student self-censorship in a collaborative knowledge building activity

This paper explores student self-censorship within an online learning environment. Self-censorship in group activity can be seen as a two-edged sword. While it can be advantageous that a student censor personal frustration and angst when working with others, if the self-censorship impacts on the cognitive contribution a student makes then this may significantly impact upon the overall quality of the group’s collective knowledge artefact. This paper reports on a study where it was found that students had self censored both their feelings and ideas as they collaboratively worked together.

The visual arts: ways of seeing

In this chapter, Felicity McArdle provides a framework for planning,implementing and assessing quality experiences in the visual arts. She describes the importance of embedding Indigenous perspectives and knowledge in the curriculum and how to a build a repertoire of resources and practical ideas to assist children to become eff ective communicators through the use of symbol systems for meaning-making.

Impact of disability on families : Grandparents’ perspectives

Background Caring for a child with a disability can be a unique and challenging experience, with families often relying on informal networks for support. Often, grandparents are key support resources, yet little is known about their roles and experiences. Reporting on data collected in a larger Australian study, this article explores grandparents' experiences of caring for a child with a disability and the impact on their family relationships and quality of life. Method A qualitative purposive sampling design was utilised; semi-structured interviews were conducted with 22 grandparents (17 women, 5 men) of children with a disability. Grandparents ranged in age from 55 to 75 years old and lived within a 90-min drive of Brisbane, Australia. Interviews were transcribed and responses analysed using a thematic approach, identifying categories, themes and patterns. Findings Four key themes characterised grandparents' views about their role in the family: holding own emotions (decision to be positive), self-sacrifice (decision to put family needs first), maintaining family relationships (being the ‘go-between’) and quality of life for family in the future (concerns about the future). Conclusions Grandparents are central to family functioning and quality of life, but this contribution comes with a significant cost to their own personal well-being. Implications for policy, practice and research are discussed, particularly grandparents' fear that their family could not cope without their support.

What determines real-world meal size? Evidence for pre-meal planning

The customary approach to the study of meal size suggests that ‘events’ occurring during a meal lead to its termination. Recent research, however, suggests that a number of decisions are made before eating commences that may affect meal size. The present study sought to address three key research questions around meal size: the extent to which plate cleaning occurs; prevalence of pre-meal planning and its influence on meal size; and the effect of within-meal experiences, notably the development of satiation. To address these, a large-cohort internet-based questionnaire was developed. Results showed that plate cleaning occurred at 91% of meals, and was planned from the outset in 92% of these cases. A significant relationship between plate cleaning and meal planning was observed. Pre meal plans were resistant to modification over the course of the meal: only 18% of participants reported consumption that deviated from expected. By contrast, 28% reported continuing eating beyond satiation, and 57% stated that they could have eaten more at the end of the meal. Logistic regression confirmed pre-meal planning as the most important predictor of consumption. Together, our findings demonstrate the importance of meal planning as a key determinant of meal size and energy intake.

Negative affect-induced food intake in non-dieting women is reward driven and associated with restrained-disinhibited eating subtype

In humans the presence of negative affect is thought to promote food intake, but there is widespread variability. Susceptibility to negative affect-induced eating may depend on trait eating behaviours, notably ‘emotional eating’, ‘restrained eating’ and ‘disinhibited eating’, but the evidence is not consistent. In the present study, 30 non-obese, non-dieting women were given access to palatable food whilst in a state of negative or neutral affect, induced by a validated autobiographical recall technique. As predicted, food intake was higher in the presence of negative affect; however, this effect was moderated by the pattern of eating behaviour traits and enhanced wanting for the test food. Specifically, the High Restraint-High Disinhibition subtype in combination with higher scores on emotional eating and food wanting was able to predict negative-affect intake (adjusted R2 = .61). In the absence of stress, individuals who are both restrained and vulnerable to disinhibited eating are particularly susceptible to negative affect food intake via stimulation of food wanting. Identification of traits that predispose individuals to overconsume and a more detailed understanding of the specific behaviours driving such overconsumption may help to optimise strategies to prevent weight gain.

‘Expected satiety’ changes hunger and fullness in the inter-meal interval

Previously, we have shown that foods differ markedly in the satiety that they are expected to confer (compared calorie-for-calorie). In the present study we tested the hypothesis that ‘expected satiety’ plays a causal role in the satiety that is experienced after a food has been consumed. Before lunch, participants (N = 32) were shown the ingredients of a fruit smoothie. Half were shown a small portion of fruit and half were shown a large portion. Participants then assessed the expected satiety of the smoothie and provided appetite ratings, before, and for three hours after its consumption. As anticipated, expected satiety was significantly higher in the ‘large portion’ condition. Moreover, and consistent with our hypothesis, participants reported significantly less hunger and significantly greater fullness in the large portion condition. Importantly, this effect endured throughout the test period (for three hours). Together, these findings confirm previous reports indicating that beliefs and expectations can have marked effects on satiety and they show that this effect can persist well into the inter-meal interval. Potential explanations are discussed, including the prospect that satiety is moderated by memories of expected satiety that are encoded around the time that a meal is consumed.

Breastfeeding self-efficacy and alternative techniques to overcome maternal or infant breastfeeding challenges : a retrospective descriptive study

Background: Breastfeeding is the internationally accepted ideal in infant feeding. Ensuring mothers and babies receive optimal benefits, in both the short and long term, is dependent upon the successful establishment of breastfeeding in the first week. Many maternal and infant challenges can occur during the establishment of breastfeeding (Lactogenesis II). There are also many methods and devices (alternative techniques) which can be used to help, but the majority do not have an evidence-base. The mother.s self-confidence (self-efficacy) can be challenged by these unexpected circumstances, but understanding of the relationship is unclear. Method: This descriptive study used mail survey (including the Breastfeeding Self-Efficacy Scale . Short Form) to obtain the mother.s reports of their self-efficacy and their breastfeeding experience during the first week following birth, as well as actual use of alternative techniques. This study included all mothers of full term healthy singleton infants from one private hospital in Brisbane who began any breastfeeding. The data collection took place from November 2008 to February 2009. Ethical approval was granted from the research site and QUT Human Research Ethics Committee. Results: A total of 128 questionnaires were returned, a response rate of 56.9%. The sample was dissimilar to the Queensland population with regard to age, income, and education level, all of which were higher in this study. The sample was similar to the Queensland population in terms of parity and marital status. The rate of use of alternative techniques was 48.3%. The mean breastfeeding self-efficacy score of those who used any alternative technique was 43.43 (SD=12.19), and for those who did not, it was 58.32 (SD=7.40). Kruskal-Wallis analysis identified that the median self efficacy score for those who used alternative techniques was significantly lower than median self efficacy scores for those who did not use alternative techniques. The reasons women used alternative techniques varied widely, and their knowledge of alternative techniques was good. Conclusion: This study is the first to document breastfeeding self-efficacy of women who used alternative techniques to support their breastfeeding goals in the first week postpartum. An individualised clinical intervention to develop women.s self-efficacy with breastfeeding is important to assist mother/infant dyads encountering challenges to breastfeeding in the first week postpartum.

Wound problems following hip arthroplasty before and after the introduction of a direct thrombin inhibitor for thromboprophylaxis

NICE guidelines have stated that patients undergoing elective hip surgery are at increased risk for venous thromboembolic events (VTE) following surgery and have recommended thromboprophylaxis for 28-35 days1, 2. However the studies looking at the new direct thrombin inhibitors have only looked at major bleeding. We prospectively looked at wound discharge in patients who underwent hip arthroplasty and were given dabigatran postoperatively between March 2010 and April 2010 (n=56). We retrospectively compared these results to a matched group of patients who underwent similar operations six months earlier when all patients were given dalteparin routinely postoperatively until discharge, and discharged home on 150mg aspirin daily for 6 weeks (n=67). Wound discharge after 5 days was significantly higher in the patients taking dabigatran (32% dabigatran n=18, 10% dalteparin n=17, p=0.003) and our rate of delayed discharges due to wound discharge significantly increased from 7% in the dalteparin group (n=5) to 27% for dabigatran (n=15, p=0.004). Patients who received dabigatran were more than five times as likely to return to theatre with a wound complication as those who received dalteparin (7% dabigatran n=4, vs. 1% dalteparin n=1), however, this was not statistically significant (p=0.18). The significantly higher wound discharge and return to theatre rates demonstrated in this study have meant that we have changed our practice to administering dalteparin until the wound is dry and then starting dabigatran. Our study demonstrates the need for further clinical studies regarding wound discharge and dabigatran.

AskNow Instant Messaging: innovation in virtual reference

In late 2006, the National Library of Australia implemented a trial Instant Messaging service that ran in parallel with the AskNow chat reference service for a six month period. The trial was a resounding success, proving both a demand for an IM service and the suitability of the medium for reference service provision in a collaborative environment. The trial also allowed the collection of a significant body of data on user expectations, librarian experience and the nature of enquiries. This article begins by introducing the concept of IM and discusses the impetus for its use as a channel for reference service provision. It presents and analyses data collected from user surveys, session transcripts, usage statistics, staff surveys and other staff feedback mechanisms, and explores the issues arising from the data analysis. The article concludes by discussing the IM system architecture that the NLA is currently developing, which will allow the Library to move forward with an ongoing IM service.