958 resultados para Substance misuse


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Over less than a decade, we have witnessed a seismic shift in the way knowledge is produced and exchanged. This is opening up new opportunities for civic and community engagement, entrepreneurial behaviour, sustainability initiatives and creative practices. It also has the potential to create fresh challenges in areas of privacy, cyber-security and misuse of data and personal information. The field of urban informatics focuses on the use and impacts of digital media technology in urban environments. Urban informatics is a dynamic and cross-disciplinary area of inquiry that encapsulates social media, ubiquitous computing, mobile applications and location-based services. Its insights suggest the emergence of a new economic force with the potential for driving innovation, wealth and prosperity through technological advances, digital media and online networks that affect patterns of both social and economic development. Urban informatics explores the intersections between people, place and technology, and their implications for creativity, innovation and engagement. This paper examines how the key learnings from this field can be used to position creative and cultural institutions such as galleries, libraries, archives and museums (GLAM) to take advantage of the opportunities presented by these changing social and technological developments. This paper introduces the underlying principles, concepts and research areas of urban informatics, against the backdrop of modern knowledge economies. Both theoretical ideas and empirical examples are covered in this paper. The first part discusses three challenges: a. People, and the challenge of creativity: The paper explores the opportunities and challenges of urban informatics that can lead to the design and development of new tools, methods and applications fostering participation, the democratisation of knowledge, and new creative practices. b. Technology, and the challenge of innovation: The paper examines how urban informatics can be applied to support user-led innovation with a view to promoting entrepreneurial ideas and creative industries. c. Place, and the challenge of engagement: The paper discusses the potential to establish place-based applications of urban informatics, using the example of library spaces designed to deliver community and civic engagement strategies. The discussion of these challenges is illustrated by a review of projects as examples drawn from diverse fields such as urban computing, locative media, community activism, and sustainability initiatives. The second part of the paper introduces an empirically grounded case study that responds to these three challenges: The Edge, the Queensland Government’s Digital Culture Centre which is an initiative of the State Library of Queensland to explore the nexus of technology and culture in an urban environment. The paper not only explores the new role of libraries in the knowledge economy, but also how the application of urban informatics in prototype engagement spaces such as The Edge can provide transferable insights that can inform the design and development of responsive and inclusive new library spaces elsewhere. To set the scene and background, the paper begins by drawing the bigger picture and outlining some key characteristics of the knowledge economy and the role that the creative and cultural industries play in it, grasping new opportunities that can contribute to the prosperity of Australia.

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Few studies have investigated iatrogenic outcomes from the viewpoint of patient experience. To address this anomaly, the broad aim of this research is to explore the lived experience of patient harm. Patient harm is defined as major harm to the patient, either psychosocial or physical in nature, resulting from any aspect of health care. Utilising the method of Consensual Qualitative Research (CQR), in-depth interviews are conducted with twenty-four volunteer research participants who self-report having been severely harmed by an invasive medical procedure. A standardised measure of emotional distress, the Impact of Event Scale (IES), is additionally employed for purposes of triangulation. Thematic analysis of transcript data indicate numerous findings including: (i) difficulties regarding patients‘ prior understanding of risks involved with their medical procedure; (ii) the problematic response of the health system post-procedure; (iii) multiple adverse effects upon life functioning; (iv) limited recourse options for patients; and (v) the approach desired in terms of how patient harm should be systemically handled. In addition, IES results indicate a clinically significant level of distress in the sample as a whole. To discuss findings, a cross-disciplinary approach is adopted that draws upon sociology, medicine, medical anthropology, psychology, philosophy, history, ethics, law, and political theory. Furthermore, an overall explanatory framework is proposed in terms of the master themes of power and trauma. In terms of the theme of power, a postmodernist analysis explores the politics of patient harm, particularly the dynamics surrounding the politics of knowledge (e.g., notions of subjective versus objective knowledge, informed consent, and open disclosure). This analysis suggests that patient care is not the prime function of the health system, which appears more focussed upon serving the interests of those in the upper levels of its hierarchy. In terms of the master theme of trauma, current understandings of posttraumatic stress disorder (PTSD) are critiqued, and based on data from this research as well as the international literature, a new model of trauma is proposed. This model is based upon the principle of homeostasis observed in biology, whereby within every cell or organism a state of equilibrium is sought and maintained. The proposed model identifies several bio-psychosocial markers of trauma across its three main phases. These trauma markers include: (i) a profound sense of loss; (ii) a lack of perceived control; (iii) passive trauma processing responses; (iv) an identity crisis; (v) a quest to fully understand the trauma event; (vi) a need for social validation of the traumatic experience; and (vii) posttraumatic adaption with the possibility of positive change. To further explore the master themes of power and trauma, a natural group interview is carried out at a meeting of a patient support group for arachnoiditis. Observations at this meeting and members‘ stories in general support the homeostatic model of trauma, particularly the quest to find answers in the face of distressing experience, as well as the need for social recognition of that experience. In addition, the sociopolitical response to arachnoiditis highlights how public domains of knowledge are largely constructed and controlled by vested interests. Implications of the data overall are discussed in terms of a cultural revolution being needed in health care to position core values around a prime focus upon patients as human beings.

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Background Cannabis use appears to exacerbate psychotic symptoms and increase risk of psychotic relapse. However, the relative contribution of cannabis use compared with other risk factors is unclear. The influence of psychotic symptoms on cannabis use has received little attention. Aims To examine the influence of cannabis use on psychotic symptom relapse and the influence of psychotic symptom severity on relapse in cannabis use in the 6 months following hospital admission. Method At baseline, 84 participants with recent-onset psychosis were assessed and 81 were followed up weekly for 6 months, using telephone and face-to-face interviews. Results A higher frequency of cannabis use was predictive of psychotic relapse, after controlling for medication adherence, other substance use and duration of untreated psychosis. An increase in psychotic symptoms was predictive of relapse to cannabis use, and medication adherence reduced cannabis relapse risk. Conclusions The relationship between cannabis use and psychosis may be bidirectional, highlighting the need for early intervention programmes to target cannabis use and psychotic symptom severity in this population.

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This exhibition catalogue essay provides an introduction to psychedelic culture during the postwar period. It describes the early use of LSD in psychiatric circles and its conception as a psychotomimetic substance. It then considers its use by literary figures such as Aldous Huxley and followers of the Beat Generation. Timothy Leary's role as an LSD philosopher is also explained as is the rise of the Hippies and the ensuing counterculture. This culture produced a range of cultural forms such as music, fashion, graphic design and other visual arts that were informed by hallucinations experienced under the influence of LSD. It concludes with a description of the end of the Hippie movement in the 1970s.

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Alcohol misuse and violence is a major public safety concern. Although the extent and nature of alcohol-related violence has been examined there is a paucity of research surrounding the ongoing construction and re-construction of gender identity and its relationship to aggression and alcohol consumption. A social constructionist perspective was used to explore women’s perceptions and experiences of drinking alcohol and incidents of public violence and aggression. Two methods were used. Firstly, an exploratory study consisting of three in-depth interviews and three focus groups to examine the ideas women constructed in relation to their experiences; and further, an online survey to explore self-reported drinking patterns among men and women. The main themes emerging from the qualitative material were ‘planned drinking to excess’ (incorporating the rituals of a ‘pre-drink’ routine), and perceptions of appropriate feminine behaviour (particularly in relation to excessive drinking and alcohol related aggression in and around licensed venues). The survey data indicated that men continue to consume more alcohol and at higher levels than women, while women’s involvement in aggressive incidents on a night out being similar to that of men. Both genders considered that women’s involvement in aggressive incidents in and around licensed venues as ‘unfeminine’. Understanding drinking as a socially constructed activity adds to our understanding of the meaning of drinking for women, and in particular, young women. This perspective may allow more focussed initiatives to address the social and health related harms associated with drinking in and around licensed venues.

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This report is an update of an earlier one produced in January 2010 (see Carrington et al. 2010) which remains as an ePrint through the project’s home page. This report focuses on our examination of extant data which have been sourced with respect to unintentional serious and violent harm, including injuries, to males living in regional and remote Australia . and which were available in public data bases at production. Such harm typically might be caused by, for example, transport accidents, occupational exposures and hazards, burns and so on. Thus unintentional violent harm can cause physical trauma the consequences of which can lead to chronic conditions including psychological harm or substance abuse.

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Within Australia, motor vehicle injury is the leading cause of hospital admissions and fatalities. Road crash data reveals that among the factors contributing to crashes in Queensland, speed and alcohol continue to be overrepresented. While alcohol is the number one contributing factor to fatal crashes, speeding also contributes to a high proportion of crashes. Research indicates that risky driving is an important contributor to road crashes. However, it has been debated whether all risky driving behaviours are similar enough to be explained by the same combination of factors. Further, road safety authorities have traditionally relied upon deterrence based countermeasures to reduce the incidence of illegal driving behaviours such as speeding and drink driving. However, more recent research has focussed on social factors to explain illegal driving behaviours. The purpose of this research was to examine and compare the psychological, legal, and social factors contributing to two illegal driving behaviours: exceeding the posted speed limit and driving when over the legal blood alcohol concentration (BAC) for the drivers licence type. Complementary theoretical perspectives were chosen to comprehensively examine these two behaviours including Akers’ social learning theory, Stafford and Warr’s expanded deterrence theory, and personality perspectives encompassing alcohol misuse, sensation seeking, and Type-A behaviour pattern. The program of research consisted of two phases: a preliminary pilot study, and the main quantitative phase. The preliminary pilot study was undertaken to inform the development of the quantitative study and to ensure the clarity of the theoretical constructs operationalised in this research. Semi-structured interviews were conducted with 11 Queensland drivers recruited from Queensland Transport Licensing Centres and Queensland University of Technology (QUT). These interviews demonstrated that the majority of participants had engaged in at least one of the behaviours, or knew of someone who had. It was also found among these drivers that the social environment in which both behaviours operated, including family and friends, and the social rewards and punishments associated with the behaviours, are important in their decision making. The main quantitative phase of the research involved a cross-sectional survey of 547 Queensland licensed drivers. The aim of this study was to determine the relationship between speeding and drink driving and whether there were any similarities or differences in the factors that contribute to a driver’s decision to engage in one or the other. A comparison of the participants self-reported speeding and self-reported drink driving behaviour demonstrated that there was a weak positive association between these two behaviours. Further, participants reported engaging in more frequent speeding at both low (i.e., up to 10 kilometres per hour) and high (i.e., 10 kilometres per hour or more) levels, than engaging in drink driving behaviour. It was noted that those who indicated they drove when they may be over the legal limit for their licence type, more frequently exceeded the posted speed limit by 10 kilometres per hour or more than those who complied with the regulatory limits for drink driving. A series of regression analyses were conducted to investigate the factors that predict self-reported speeding, self-reported drink driving, and the preparedness to engage in both behaviours. In relation to self-reported speeding (n = 465), it was found that among the sociodemographic and person-related factors, younger drivers and those who score high on measures of sensation seeking were more likely to report exceeding the posted speed limit. In addition, among the legal and psychosocial factors it was observed that direct exposure to punishment (i.e., being detected by police), direct punishment avoidance (i.e., engaging in an illegal driving behaviour and not being detected by police), personal definitions (i.e., personal orientation or attitudes toward the behaviour), both the normative and behavioural dimensions of differential association (i.e., refers to both the orientation or attitude of their friends and family, as well as the behaviour of these individuals), and anticipated punishments were significant predictors of self-reported speeding. It was interesting to note that associating with significant others who held unfavourable definitions towards speeding (the normative dimension of differential association) and anticipating punishments from others were both significant predictors of a reduction in self-reported speeding. In relation to self-reported drink driving (n = 462), a logistic regression analysis indicated that there were a number of significant predictors which increased the likelihood of whether participants had driven in the last six months when they thought they may have been over the legal alcohol limit. These included: experiences of direct punishment avoidance; having a family member convicted of drink driving; higher levels of Type-A behaviour pattern; greater alcohol misuse (as measured by the AUDIT); and the normative dimension of differential association (i.e., associating with others who held favourable attitudes to drink driving). A final logistic regression analysis examined the predictors of whether the participants reported engaging in both drink driving and speeding versus those who reported engaging in only speeding (the more common of the two behaviours) (n = 465). It was found that experiences of punishment avoidance for speeding decreased the likelihood of engaging in both speeding and drink driving; whereas in the case of drink driving, direct punishment avoidance increased the likelihood of engaging in both behaviours. It was also noted that holding favourable personal definitions toward speeding and drink driving, as well as higher levels of on Type-A behaviour pattern, and greater alcohol misuse significantly increased the likelihood of engaging in both speeding and drink driving. This research has demonstrated that the compliance with the regulatory limits was much higher for drink driving than it was for speeding. It is acknowledged that while speed limits are a fundamental component of speed management practices in Australia, the countermeasures applied to both speeding and drink driving do not appear to elicit the same level of compliance across the driving population. Further, the findings suggest that while the principles underpinning the current regime of deterrence based countermeasures are sound, current enforcement practices are insufficient to force compliance among the driving population, particularly in the case of speeding. Future research should further examine the degree of overlap between speeding and drink driving behaviour and whether punishment avoidance experiences for a specific illegal driving behaviour serve to undermine the deterrent effect of countermeasures aimed at reducing the incidence of another illegal driving behaviour. Furthermore, future work should seek to understand the factors which predict engaging in speeding and drink driving behaviours at the same time. Speeding has shown itself to be a pervasive and persistent behaviour, hence it would be useful to examine why road safety authorities have been successful in convincing the majority of drivers of the dangers of drink driving, but not those associated with speeding. In conclusion, the challenge for road safety practitioners will be to convince drivers that speeding and drink driving are equally risky behaviours, with the ultimate goal to reduce the prevalence of both behaviours.

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The drive for comparability of financial information is to enable users to distinguish similarities and differences in economic activities for an entity over time and between entities so that their resource allocation decisions are facilitated. With the increased globalisation of economic activities, the enhanced international comparability of financial statements is often used as an argument to advance the convergence of local accounting standards to international financial reporting standards (IFRS). Differences in the underlying economic substance of transactions between jurisdictions plus accounting standards allowing alternative treatments may render this expectation of increased comparability unrealistic. Motivated by observations that, as a construct, comparability is under-researched and not well understood, we develop a comparability framework that distinguishes between four types of comparability. In applying this comparability framework to pension accounting in the Australian and USA contexts, we highlight a dilemma: while regulators seek to increase the likelihood that similar events are accounted for similarly, an unintended consequence may be that preparers are forced to apply similar accounting treatment to events that are, in substance, different.

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Introduction and Aims: Long-term use of benzodiazepines remains common, and conveys significant risk. Providing psychological intervention in association with gradual dose reduction increases cessation rates above dose reduction alone, but appropriate psychological support is difficult to obtain. This study was undertaken to assess the outcomes of an uncontrolled case series of an internet-based cognitive-behaviour therapy (I-CBT) for benzodiazepine cessation. Design and Method: Users of benzodiazepines for > 3 months who wanted to reduce or cease benzodiazepines participated in the trial. They completed online assessments and accessed 13 newsletters on managing withdrawal symptoms and developing alternate ways to cope with life events. Therapist assistance was provided by email. Follow-up was at 3 and 6 months and feedback was obtained via comments and emails. Results: Program ratings and emailed comments of the program were positive. Thirty-two people registered for the program and 14 (44%) completed a 6-month follow-up. Of these, 8 (57%) reduced weekly intake by at least half, including 5 (36%) who ceased use. Shorter duration of use and birth outside Australia predicted greater percentage reductions at 3 months, while being partnered and in paid employment predicted reductions at 6 months. Discussion and Conclusion: While results were encouraging, controlled research is required to confirm the efficacy of the program, and engagement of both users and prescribers needs further attention.

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Background The increasing popularity and use of the internet makes it an attractive option for providing health information and treatment, including alcohol/other drug use. There is limited research examining how people identify and access information about alcohol or other drug (AOD) use online, or how they assess the usefulness of the information presented. This study examined the strategies that individuals used to identify and navigate a range of AOD websites, along with the attitudes concerning presentation and content. Methods Members of the general community in Brisbane and Roma (Queensland, Australia) were invited to participate in a 30-minute search of the internet for sites related to AOD use, followed by a focus group discussion. Fifty one subjects participated in the study across nine focus groups. Results Participants spent a maximum of 6.5 minutes on any one website, and less if the user was under 25 years of age. Time spent was as little as 2 minutes if the website was not the first accessed. Participants recommended that AOD-related websites should have an engaging home or index page, which quickly and accurately portrayed the site’s objectives, and provided clear site navigation options. Website content should clearly match the title and description of the site that is used by internet search engines. Participants supported the development of a portal for AOD websites, suggesting that it would greatly facilitate access and navigation. Treatment programs delivered online were initially viewed with caution. This appeared to be due to limited understanding of what constituted online treatment, including its potential efficacy. Conclusions A range of recommendations arise from this study regarding the design and development of websites, particularly those related to AOD use. These include prudent use of text and information on any one webpage, the use of graphics and colours, and clear, uncluttered navigation options. Implications for future website development are discussed.

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Reducing or preventing the misuse of firearms (whether criminal, suicidal or accidental) is central to gun controls policy. In June 1997 the New Zealand Government received the recommendations of the Review of Firearms Control, an independent inquiry commissioned by the Minister of Police and chaired by Sir Thomas Thorp.The Review comprehensively examined several firearm-related issues, including the nature and extent of serious firearm offending in New Zealand. The research presented in this article was commissioned by the Review. Based on a population of 709 offences for the 12 months ending 30 June 1996, this study provides an analysis of serious firearm offending in New Zealand and discusses the implications of these findings for gun controls policy.

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This paper draws on the work of the ‘EU Kids Online’ network funded by the EC (DG Information Society) Safer Internet plus Programme (project code SIP-KEP-321803); see www.eukidsonline.net, and addresses Australian children’s online activities in terms of risk, harm and opportunity. In particular, it draws upon data that indicates that Australian children are more likely to encounter online risks — especially around seeing sexual images, bullying, misuse of personal data and exposure to potentially harmful user-generated content — than is the case with their EU counterparts. Rather than only comparing Australian children with their European equivalents, this paper places the risks experienced by Australian children in the context of the mediation and online protection practices adopted by their parents, and asks about the possible ways in which we might understand data that seems to indicate that Australian children’s experiences of online risk and harm differ significantly from the experiences of their Europe-based peers. In particular, and as an example, this paper sets out to investigate the apparent conundrum through which Australian children appear twice as likely as most European children to have seen sexual images in the past 12 months, but parents are more likely to filter their access to the internet than is the case with most children in the wider EU Kids Online study. Even so, one in four Australian children (25%) believes that what their parents do helps ‘a lot’ to improve their internet experience, and Australian children and their parents are a little less likely to agree about the mediation practices taking place in the family home than is the case in the EU. The AU Kids Online study was carried out as a result of the ARC Centre of Excellence for Creative Industries and Innovation’s funding of a small scale randomised sample (N = 400) of Australian families with at least one child, aged 9–16, who goes online. The report on Risks and safety for Australian children on the internet follows the same format and uses much of the contextual statement around these issues as the ‘county level’ reports produced by the 25 EU nations involved in EU Kids Online, first drafted by Livingstone et al. (2010). The entirely new material is the data itself, along with the analysis of that data.

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Formulary apportionment does not attempt to undertake a transactional division of a highly integrated multinational entity. Rather, it allocates income to the jurisdictions based on an economically justifiable formula. Opposition to formulary apportionment is generally based on the argument that it is not a theoretically superior (or optimal) model because of the implementation difficulties. The conclusion that the unitary taxation model may be theoretically superior to the current arm's-length model that applies to multinational banks, despite significant implementation, compliance, and enforcement issues, is based on the unitary taxation model providing greater alignment with the unique features of these banks. The formulary apportionment model looks to the economic substance of the multinational entity and, in this sense, adopts a substance-over- form approach. Formulary apportionment further recognizes the impossibility of using arm's-length pricing for economically interdependent multinational entities. A final advantage to formulary apportionment, which is also a consequence of this model achieving greater inter-nation equity, is the elimination of double taxation.

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Blogs and other online platforms for personal writing such as LiveJournal have been of interest to researchers across the social sciences and humanities for a decade now. Although growth in the uptake of blogging has stalled somewhat since the heyday of blogs in the early 2000s, blogging continues to be a major genre of Internet-based communication. Indeed, at the same time that mass participation has moved on to Facebook, Twitter, and other more recent communication phenomena, what has been left behind by the wave of mass adoption is a slightly smaller but all the more solidly established blogosphere of engaged and committed participants. Blogs are now an accepted part of institutional, group, and personal communications strategies (Bruns and Jacobs, 2006); in style and substance, they are situated between the more static information provided by conventional Websites and Webpages and the continuous newsfeeds provided through Facebook and Twitter updates. Blogs provide a vehicle for authors (and their commenters) to think through given topics in the space of a few hundred to a few thousand words – expanding, perhaps, on shorter tweets, and possibly leading to the publication of more fully formed texts elsewhere. Additionally, they are also a very flexible medium: they readily provide the functionality to include images, audio, video, and other additional materials – as well as the fundamental tool of blogging, the hyperlink itself. Indeed, the role of the link in blogs and blog posts should not be underestimated. Whatever the genre and topic that individual bloggers engage in, for the most part blogging is used to provide timely updates and commentary – and it is typical for such material to link both to relevant posts made by other bloggers, and to previous posts by the present author, both to background material which provides readers with further information about the blogger’s current topic, and to news stories and articles which the blogger found interesting or worthy of critique. Especially where bloggers are part of a larger community of authors sharing similar interests or views (and such communities are often indicated by the presence of yet another type of link – in blogrolls, often in a sidebar on the blog site, which list the blogger’s friends or favourites), then, the reciprocal writing and linking of posts often constitutes an asynchronous, distributed conversation that unfolds over the course of days, weeks, and months. Research into blogs is interesting for a variety of reasons, therefore. For one, a qualitative analysis of one or several blogs can reveal the cognitive and communicative processes through which individual bloggers define their online identity, position themselves in relation to fellow bloggers, frame particular themes, topics and stories, and engage with one another’s points of view. It may also shed light on how such processes may differ across different communities of interest, perhaps in correlation with the different societal framing and valorisation of specific areas of interest, with the socioeconomic backgrounds of individual bloggers, or with other external or internal factors. Such qualitative research now looks back on a decade-long history (for key collections, see Gurak, et al., 2004; Bruns and Jacobs, 2006; also see Walker Rettberg, 2008) and has recently shifted also to specifically investigate how blogging practices differ across different cultures (Russell and Echchaibi, 2009). Other studies have also investigated the practices and motivations of bloggers in specific countries from a sociological perspective, through large-scale surveys (e.g. Schmidt, 2009). Blogs have also been directly employed within both K-12 and higher education, across many disciplines, as tools for reflexive learning and discussion (Burgess, 2006).

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Objective - this study examined the clinical utility and precision of routine screening for alcohol and other drug use among women attending a public antenatal service. Study design - a survey of clients and audit of clinical charts. Participants and setting - clients attending an antenatal clinic of a large tertiary hospital in Queensland, Australia, from October to December 2009. Measurements and findings - data were collected from two sources. First, 32 women who reported use of alcohol or other drugs during pregnancy at initial screening were then asked to complete a full substance use survey. Second, data were collected from charts of 349 new clients who attended the antenatal clinic during the study period. Both sensitivity (86%, 67%) and positive predictive value (100%, 92%) for alcohol and other drug use respectively, were high. Only 15% of surveyed women were uncomfortable about being screened for substance use in pregnancy, yet the chart audit revealed poor staff compliance. During the study period, 25% of clients were either not screened adequately or not at all. Key conclusions and implications for practise - despite recommended universal screening in pregnancy and the apparent acceptance by our participants, alcohol and other drug (A&OD) screening in the antenatal setting remains problematic. Investigation into the reasons behind, and ways to overcome, the low screening rate could improve health outcomes for mothers and children in this at-risk group. Targeted education and training for midwives may form part of the solution as these clinicians have a key role in implementing prevention and early intervention strategies.