Defining dual diagnosis : a qualitative study of the views of health care workers

Background: 'Dual diagnosis' is the term of choice in many countries to describe clients with co-occurring mental health and alcohol and other drug (AOD) issues. However, it is not known if its meaning is consistently represented within and across health care services. This uncertainty has significant implications for referral, consultation and research.
Aim: To obtain information about the way that different health care professionals understand the term 'dual diagnosis'.
Method: Twenty-nine health care workers across five service types (medical, mental health, AOD, dual diagnosis and community health) in Victoria, Australia were interviewed about their understanding of the term 'dual diagnosis'.
Results: The findings indicated that service providers working in AOD and Mental Health had a shared general understanding of what was meant by 'dual diagnosis', despite uncertainties about more specific inclusion criteria. In contrast, medical and community health staff lacked a similar shared understanding, and were more likely to recommend change, but offered no consensus on alternatives.
Conclusion: The results indicate that while the term 'dual diagnosis' has value in efficiently directing attention to the complexity of treatment issues, health practitioners cannot assume it will convey the intended meaning outside mental health or AOD services. Clear articulation of the intended definition may be a necessary requirement in wider health care communication.

Exploring general practitioners' experience of informing women about prenetal screening tests for foetal abnomalities : a qualitative focus group study

Background: Recent developments have made screening tests for foetal abnormalities available earlier in pregnancy and women have a range of testing options accessible to them. It is now recommended that all women, regardless of their age, are provided with information on prenatal screening tests. General Practitioners (GPs) are often the first health professionals a woman consults in pregnancy. As such, GPs are well positioned to inform women of the increasing range of prenatal screening tests available. The aim of this study was to explore GPs experience of informing women of prenatal genetic screening tests for foetal abnormality.
Methods: A qualitative study consisting of four focus groups was conducted in metropolitan and rural Victoria, Australia. A discussion guide was used and the audio-taped transcripts were independently coded
by two researchers using thematic analysis. Multiple coders and analysts and informant feedback were employed to reduce the potential for researcher bias and increase the validity of the findings.
Results: Six themes were identified and classified as 'intrinsic' if they occurred within the context of the consultation or 'extrinsic' if they consisted of elements that impacted on the GP beyond the scope of the
consultation. The three intrinsic themes were the way GPs explained the limitations of screening, the extent to which GPs provided information selectively and the time pressures at play. The three extrinsic
factors were GPs' attitudes and values towards screening, the conflict they experienced in offering screening information and the sense of powerlessness within the screening test process and the health
care system generally. Extrinsic themes reveal GPs' attitudes and values to screening and to disability, as well as raising questions about the fundamental premise of testing.
Conclusion: The increasing availability and utilisation of screening tests, in particular first trimester tests,has expanded GPs' role in facilitating women's informed decision-making. Recognition of the importance
of providing this complex information warrants longer consultations to respond to the time pressures that GPs experience. Understanding the intrinsic and extrinsic factors that impact on GPs may serve to shape
educational resources to be more appropriate, relevant and supportive.

Children's perceptions of the role of police: a qualitative study

A qualitative methodology, using open-ended questions, was employed to explore the perceptions of 112 children regarding the role of police. The children, aged 5 to 6 and 7 to 8 years, were asked to comment on what police officers do when they go to work, what direct and indirect experiences they have had with the police, and the positive and negative aspects of being a police officer. The findings revealed that children emphasise the punitive role of police; very few children identified with non-punitive roles. This punitive theme was evident irrespective of the children's experiences, age, and whether they could recall television shows involving police. The practical implications of our findings for police relations with children, particularly in a forensic interview context, are discussed.

A qualitative investigation of the safety culture of two organisations

A qualitative investigation of the safety culture of two contrasting organisations was undertaken. The research sought to identify categories and themes in the data that highlighted similarities and differences in salient safety issues for employees from the two organisations. The participants were 131 employees attending safety training sessions in a large national retail organisation and a heavy manufacturing organisation. Unobtrusive observation was used to collect data during the safety training sessions. Thematic analysis was used to identify emergent categories and themes from the data. Ten broad categories with relevant themes were identified and provided some insight into the safety culture of the two organisations, with both similarities and differences being evident. Participants from both organisations mentioned management issues in relation to safety, discussed the impact of employee risk- taking behaviour on safety, made reference to a blame culture, and raised integrity issues regarding safety. For the manufacturing organisation, a number of themes focused on contractor issues, while in the retail organisation, several themes highlighted differences in safety attitudes between head office and store-level employees.

A qualitative study of multi-channel marketing performance measurement issues

The aim of this study was to provide quantitative research propositions for future researchers studying multi-channel marketing performance. The literature suggests that multi-channel marketing is becoming more prevalent and offers many opportunities to organisations. Multi-channel marketing is, however, more complex to implement and measure than 'traditional' single or dual-channel marketing. Thirty-one senior marketing executives from a diverse range of industries were asked to provide a 'single key challenge' in the area of multi-channel marketing. The findings suggest that the main areas of multi-channel marketing measurement problems are: (a) understanding return on channel investment, (b) understanding customer channel preference and (c) isolating individual channel impact. The paper concludes by using both the qualitative findings and implementation theory to provide propositions for future research as well as tentative management Guidelines.

A cross-cultural examination of barriers to social inclusion for children : a qualitative study using child-centred methods

Social exclusion is a risk factor for mental health problems. This study aims to identify the factors that contribute to social exclusion for children from several cultural backgrounds, living in low-socioeconomic status (SES) areas. Children from English, Chinese and Arabic speaking backgrounds participated in semi-structured interviews. They were asked questions around three prominent themes of social exclusion: exclusion from school, social activities and social networks. Children from English and Chinese speaking backgrounds experienced exclusion at school, from social activities or in social networks. The major barriers to social inclusion, which differed across cultural groups, included bullying, time constraints, economic resources and parental permission. Although money is a barrier to social inclusion, there are several other barriers that need to be considered, such as bullying, time and parental permission, and they may differ by culture. Mental health promotion programmes in schools and communities need to address these barriers in a culturally appropriate manner.

Convergent interviewing : a qualitative diagnostic technique for researchers

Purpose – This paper aims to widen knowledge of and explore how convergent interviewing can be used to identify key issues within an organization.
Design/methodology/approach – This paper introduces the convergent interviewing technique and describes the method of selecting the interview subjects. The construction of a round of interviews is explained. The content of the interviews is described and the particular probing nature of the questions demanded by the convergent interview process is explained. The ways to analyze the full set of interviews for groupings or categories is also described. The case study example of a broad research question about influences on work behaviors in a local government council is used to illustrate the convergent interviewing technique.
Findings – The key issues revealed by using the technique can be subsequently used for a variety of research and consulting purposes and settings. Convergent interviewing is an effective research method, which conserves resources.
Originality/value – Convergent interviewing enables researchers to determine the most important and/or key issues within a population rather than a full list of issues in an organization or barriers to change in a particular organizational context.

Email correspondence : a qualitative data collection tool for organisational researchers

This paper proposes a novel method for qualitative data collection in organisational research, that of email correspondence. This approach involves written communication between the researcher and each respondent, as a conversational dialogue is constructed. An overview of this method of engaging vvith respondents is provided. The author then discusses how email correspondence was used in two studies of middle managers, outlining both the benefits and challenges experienced. Lessons learned for future use of the method are also considered. Email correspondence proved a valuable tool in revealing respondents' workplace experiences, and this method provides opportunity for organisational researchers seeking to explore employees' personal reflections.

Students' perception of an online marketing subject : a qualitative approach

Extant literature supports the growing importance of offering flexible modes of learning delivery in order to meet the needs of a diverse student cohort. The increased use of information and communication technologies (ICT) has lead to an enriched learning experience, but has also posed a number of constraints and challenges for students. Although there is an abundance of research regarding students’ perceptions, attitudes and satisfaction with the online learning environment, most of this is taken from the perspective of the distance education student. The purpose of this qualitative study is to examine these issues from the perspective of a mixed cohort of students (both on and off campus), who are required to complete a core, undergraduate marketing unit exclusively online.

Authenticity in a modern music industry : a qualitative exploration into 'selling out'

This paper looks at the impact of authenticity in the modern music industry. With a focus on the influence of an artist’s life cycle and the evolution of the music industry, this paper explores the relationship between authenticity, the concept of selling out and social perception. A conceptual model is presented depicting the above relationships derived from the relevant literature. The paper concludes with a discussion of the method that will be used to undertake this research.

Internal auditor perceptions on audit committee interactions : a qualitative study in Malaysian public corporations

Audit committees (AC) and the internal audit function (IAF) are two key corporate governance mechanisms. The primary objective of this study is to provide insights into internal auditors' perceptions of their interactions with AC members in Malaysia. The paper thus contributes to the extant literature by providing additional evidence from a South-east Asian country which is recognised as being characterised with a high power distance culture and a developing capital market. The findings are based on in-depth interviews of the heads of the internal audit function (HIAFs) from 11 publicly listed companies. The results indicate infrequent informal communications and limited private meetings between the HIAFs and ACs, and a need for clear reporting lines. Further, ACs are seen to be held in high esteem for their authority and are expected to take on greater leadership in the inquiry of management's decision-making. These findings highlight the importance of the leadership role of ACs in supporting the IAF.

Experiences of disability consumer-directed care users in Australia : results from a longitudinal qualitative study

The rapidly growing body of literature suggests that Consumer-directed Care (CDC) has the potential to empower consumers and improve the flexibility and quality of care. However, reports highlighting quality and risk concerns associated with CDC focusing on a longer time frame have been few. This paper presents the findings from a qualitative longitudinal evaluation of an Australian CDC programme. Focusing on the period between 2003 and 2008, it reports on the experiences of 12 families caring for a dependent family member. It is based on two external evaluations completed 6 and 36 months after enrolment, and one internal evaluation completed 48 months after enrolment. The findings were triangulated with internal memos, reports and minutes of meetings, as well as with the theoretical literature. The study demonstrates that CDC harbours considerable benefits for people with disabilities and their carers. However, the study also suggests that, over time, carers may experience an increased sense of isolation and lack of support as a result of their involvement in the CDC programme. The paper argues that the development of safeguards addressing these weaknesses is crucial for the sustainability of CDC programmes in contexts where risk cannot be simply transferred onto consumers.

Effect of hydrogen/air flow rates and scan rate on the flame ionisation detection response of phopholipids, and their quantitative and qualitative analysis by Iatroscan (Mark‐6s) TLC‐FID

The combined effect of scan speed, hydrogen and air flow rates on the flame ionization detection (FID) peak response of phospholipid classes has been studied to determine the optimum levels of these parameters. The phospholipid composition of different types of commercial lecithins, as well as lecithins combined with fish oils, has been analyzed by Iatroscan TLC‐FID Mark‐6s under optimized conditions. An air flow rate of 2 L/min, a hydrogen flow rate of 150–160 mL/min, and a scan speed of 30 s/rod seem to be the ideal conditions for scanning phospholipids with complete pyrolysis in the flame in the Mark‐6 model. Increasing the scan speed rapidly decreased the FID response. A hydrogen flow rate as high as 170 mL/min could be used at relatively low air flow rates (&#x003C2 L/min) and the response declined when both air flow rate and hydrogen flow rate increased simultaneously. Both linear and curvilinear relationships had highly significant correlations (p&#x003C0.01) with the sample load. Time course reactions, including the hydrolysis of phosphatidylserine using enzymes, can be successfully monitored by the Iatroscan TLC‐FID Chromarod system.

Having a baby in the new land : a qualitative exploration of the experiences of Asian migrants in rural Tasmania, Australia

Introduction: Australia is a land of cultural diversity. Cultural differences in maternity care may result in conflict between migrants and healthcare providers, especially when migrants have minimal English language knowledge. The aim of the study was to investigate Asian migrant women’s child-birth experiences in a rural Australian context.

Method: The study consisted of semi-structured interviews conducted with 10 Asian migrant women living in rural Tasmania to explore their childbirth experiences and the barriers they faced in accessing maternal care in the new land. The data were analysed using grounded theory and three main categories were identified: ‘migrants with traditional practices in the new land’, ‘support and postnatal experiences’ and ‘barriers to accessing maternal care’.

Results: The findings revealed that Asian migrants in Tasmania faced language and cultural barriers when dealing with the new healthcare system. Because some Asian migrants retain traditional views and practices for maternity care, confusion and conflicting expectations may occur. Family and community play an important role in supporting migrant women through their maternity care.

Conclusions: Providing interpreting services, social support for migrant women and improving the cross-cultural training for healthcare providers were recommended to improve available maternal care services.