Using participatory action research in a community-based initiative addressing complex mental health needs

Objective: This paper describes the first phase of a larger project that utilizes participatory action research to examine complex mental health needs across an extensive group of stakeholders in the community. Method: Within an objective qualitative analysis of focus group discussions the social ecological model is utilized to explore how integrative activities can be informed, planned and implemented across multiple elements and levels of a system. Seventy-one primary care workers, managers, policy-makers, consumers and carers from across the southern metropolitan and Gippsland regions of Victoria, Australia took part in seven focus groups. All groups responded to an identical set of focusing questions. Results: Participants produced an explanatory model describing the service system, as it relates to people with complex needs, across the levels of social ecological analysis. Qualitative themes analysis identified four priority areas to be addressed in order to improve the system's capacity for working with complexity. These included: (i) system fragmentation; (ii) integrative case management practices; (iii) community attitudes; and (iv) money and resources. Conclusions: The emergent themes provide clues as to how complexity is constructed and interpreted across the system of involved agencies and interest groups. The implications these findings have for the development and evaluation of this community capacity-building project were examined from the perspective of constructing interventions that address both top-down and bottom-up processes.

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.

High speed rail and regional competitiveness

The presence of High Speed Rail (HSR) systems influences market shares of road and air transport, and the development of cities and regions they serve. With the deployment of HSR infrastructure, changes in accessibility have occurred. These changes have lead researchers to investigate effects on the economic and spatial derived variables. Contention exists when managing the trade off between efficiency, and access points which are usually in the range of hundreds of kilometres apart. In short, it is argued that intermediate cities, bypassed by HSR services, suffer a decline in their accessibility and developmental opportunities. The present Chapter will analyse possible impacts derived from the presence of HSR infrastructure. In particular, it will consider small and medium agglomerations in the vicinity of HSR corridors, not always served by HSR stations. Thus, a methodology is developed to quantify accessibility benefits and their distribution. These benefits will be investigated in relation to different rail transit strategies integrating HSR infrastructure where a HSR station cannot be positioned. These strategies are selected principally for the type of service offered: (i) cadenced, (ii) express, (iii) frequent or (iv) non-stopping. Furthermore, to ground the theoretical approach linking accessibility and competitiveness, a case study in the North-Eastern Italian regions will be used for the application of the accessibility distributive patterns between the HSR infrastructure and the selected strategies. Results indicate that benefits derive from well informed decisions on HSR station positioning and the appropriate blend of complementary services in the whole region to interface HSR infrastructure. The results are significant for all countries in Europe and worldwide, not only for investing in HSR infrastructure, but mostly in terms of building territorial cohesion, while seeking international recognition for developing successful new technology and systems.

Different inflections

Australia has often been defined by its landscape – actual, romanticized, imagined – iconic images and experiences taken up by artists in a myriad of ways. This paper examines inter/intra cultural practices of three Australian dance companies and their directors, and how they inflect images of Australia in different ways. Each artist brings perspectives from their particular hybridized cultural and ethnic backgrounds as well as their formative dance experiences. In their practices, notions of landscape embrace physical, metaphorical and spiritual dimensions. Kai Tai Chan, who founded the One Extra Company in 1976, pioneered accessible and confronting intercultural dance theatre in Australia from the 1970s to the 1990s, challenging our notions of what it is to be Australian. A Chinese Malay who came to Australia to study architecture, he stayed to create a significant body of work in which different cultural frameworks became lenses through which to explore stories of ordinary lives and experiences, revealing complexities of the human condition and larger social-political issues. Spiritual connections feature strongly in the practice of another Chinese Malay Australian, Tony Yap. Here the landscape is an inner one influenced by a form of Malaysian trance dance known as the sen-siao (“spirit cloud”) tradition. Yap has forged a unique space in the Australian dance and theatre scene, exploring a movement language informed by psycho-physical research, Asian shamanistic trance dance, Butoh, voice and visual design. Whilst primarily a solo performer, his practice includes collaborations with Asian diasporic as well as Anglo Australian cross-cultural visual and sound artists. His work is situated in a metaphysical rather than socio political context. In contrast, the newest company to emerge on the intercultural Australian stage is Polytoxic, reflecting a Pacific rather than Asian inflection. Key members, Fa’alafi and Efeso Fa’anana (both of Samoan descent) and Leah Shelton (of Anglo-Saxon descent), aim to critique the exoticism and cultural kitsch that often accompanies representations of the Pacific islands, with a pastiche of street dance, cabaret and contemporary techniques, blended with traditional Polynesian vocabulary. A parallel aim is to provide audiences with insights into the traditions and history of Samoa from the perspective of the artists as contemporary Australians. This examination, spanning three decades of inter/intra cultural practices, reveals stylistic, generational and philosophical differences with a commonality of variously inflected notions of landscape, spirituality and identity.

An exploration of the technical, social and macro-societal pressures influencing the adoption of online social networking services by organisations

Measuring the business value that Internet technologies deliver for organisations has proven to be a difficult and elusive task, given their complexity and increased embeddedness within the value chain. Yet, despite the lack of empirical evidence that links the adoption of Information Technology (IT) with increased financial performance, many organisations continue to adopt new technologies at a rapid rate. This is evident in the widespread adoption of Web 2.0 online Social Networking Services (SNSs) such as Facebook, Twitter and YouTube. These new Internet based technologies, widely used for social purposes, are being employed by organisations to enhance their business communication processes. However, their use is yet to be correlated with an increase in business performance. Owing to the conflicting empirical evidence that links prior IT applications with increased business performance, IT, Information Systems (IS), and E-Business Model (EBM) research has increasingly looked to broader social and environmental factors as a means for examining and understanding the broader influences shaping IT, IS and E-Business (EB) adoption behaviour. Findings from these studies suggest that organisations adopt new technologies as a result of strong external pressures, rather than a clear measure of enhanced business value. In order to ascertain if this is the case with the adoption of SNSs, this study explores how organisations are creating value (and measuring that value) with the use of SNSs for business purposes, and the external pressures influencing their adoption. In doing so, it seeks to address two research questions: 1. What are the external pressures influencing organisations to adopt SNSs for business communication purposes? 2. Are SNSs providing increased business value for organisations, and if so, how is that value being captured and measured? Informed by the background literature fields of IT, IS, EBM, and Web 2.0, a three-tiered theoretical framework is developed that combines macro-societal, social and technological perspectives as possible causal mechanisms influencing the SNS adoption event. The macro societal view draws on the concept of Castells. (1996) network society and the behaviour of crowds, herds and swarms, to formulate a new explanatory concept of the network vortex. The social perspective draws on key components of institutional theory (DiMaggio & Powell, 1983, 1991), and the technical view draws from the organising vision concept developed by Swanson and Ramiller (1997). The study takes a critical realist approach, and conducts four stages of data collection and one stage of data coding and analysis. Stage 1 consisted of content analysis of websites and SNSs of many organisations, to identify the types of business purposes SNSs are being used for. Stage 2 also involved content analysis of organisational websites, in order to identify suitable sample organisations in which to conduct telephone interviews. Stage 3 consisted of conducting 18 in-depth, semi-structured telephone interviews within eight Australian organisations from the Media/Publishing and Galleries, Libraries, Archives and Museum (GLAM) industries. These sample organisations were considered leaders in the use of SNSs technologies. Stage 4 involved an SNS activity count of the organisations interviewed in Stage 3, in order to rate them as either Advanced Innovator (AI) organisations, or Learning Focussed (LF) organisations. A fifth stage of data coding and analysis of all four data collection stages was conducted, based on the theoretical framework developed for the study, and using QSR NVivo 8 software. The findings from this study reveal that SNSs have been adopted by organisations for the purpose of increasing business value, and as a result of strong social and macro-societal pressures. SNSs offer organisations a wide range of value enhancing opportunities that have broader benefits for customers and society. However, measuring the increased business value is difficult with traditional Return On Investment (ROI) mechanisms, ascertaining the need for new value capture and measurement rationales, to support the accountability of SNS adoption practices. The study also identified the presence of technical, social and macro-societal pressures, all of which influenced SNS adoption by organisations. These findings contribute important theoretical insight into the increased complexity of pressures influencing technology adoption rationales by organisations, and have important practical implications for practice, by reflecting the expanded global online networks in which organisations now operate. The limitations of the study include the small number of sample organisations in which interviews were conducted, its limited generalisability, and the small range of SNSs selected for the study. However, these were compensated in part by the expertise of the interviewees, and the global significance of the SNSs that were chosen. Future research could replicate the study to a larger sample from different industries, sectors and countries. It could also explore the life cycle of SNSs in a longitudinal study, and map how the technical, social and macro-societal pressures are emphasised through stages of the life cycle. The theoretical framework could also be applied to other social fad technology adoption studies.

Barriers to information transfer for multi-trauma patients upon discharge from the Emergency Department in a tertiary level hospital

Purpose: Communication is integral to effective trauma care provision. This presentation will report on barriers to meaningful information transfer for multi-trauma patients upon discharge from the Emergency Department (ED) to the care areas of Intensive Care Unit, High Dependency Unit, and Perioperative Services. This is an ongoing study at one tertiary level hospital in Queensland. Method: This is a multi-phase, mixed method study. In Phase 1 data were collected about information transfer. This Phase was initially informed by a comprehensive literature review, then via focus groups, chart audit, staff survey and review of national and international trauma forms. Results: The barriers identified related to nursing handover, documented information, time inefficiency, patient complexity and stability and time of transfer. Specifically this included differences in staff expectations and variation in the nursing handover processes, no agreed minimum dataset of information handed over, missing, illegible or difficult to find information in documentation (both medical and nursing), low compliance with some forms used for documentation. Handover of these patients is complex with information coming from many sources, dealing with issues is more difficult for these patients when transferred out of hours. Conclusions and further directions: This study investigated the current communication processes and standards of information transfer to identify barriers and issues. The barriers identified were the structure used for documentation, processes used (e.g. handover), patient acuity and time. This information is informing the development, implementation and evaluation of strategies to ameliorate the issues identified.

Preventing injuries on a state-wide basis : researchers and parliamentary committees are partners in turning injury prevention and safety research into practice and policy

Context: Parliamentary committees established in Westminster parliaments, such as Queensland, provide a cross-party structure that enables them to recommend policy and legislative changes that may otherwise be difficult for one party to recommend. The overall parliamentary committee process tends to be more cooperative and less adversarial than the main chamber of parliament and, as a result, this process permits parliamentary committees to make recommendations more on the available research evidence and less on political or party considerations. Objectives: This paper considers the contributions that parliamentary committees in Queensland have made in the past in the areas of road safety, drug use as well as organ and tissue donation. The paper also discusses the importance of researchers actively engaging with parliamentary committees to ensure the best evidence based policy outcomes. Key messages: In the past, parliamentary committees have successfully facilitated important safety changes with many committee recommendations based on research results. In order to maximise the benefits of the parliamentary committee process it is essential that researchers inform committees about their work and become key stakeholders in the inquiry process. Researchers can keep committees informed by making submissions to their inquiries, responding to requests for information and appearing as witnesses at public hearings. Researchers should emphasise the key findings and implications of their research as well as considering the jurisdictional implications and political consequences. It is important that researchers understand the differences between lobbying and providing informed recommendations when interacting with committees. Discussion and conclusions: Parliamentary committees in Queensland have successfully assisted in the introduction of evidence based policy and legislation. In order to present best practice recommendations, committees rely on the evidence presented to them including the results of researchers. Actively engaging with parliamentary committees will help researchers to turn their results into practice with a corresponding decrease in injuries and fatalities. Developing an understanding of parliamentary committees, and the typical inquiry process used by these committees, will help researchers to present their research results in a manner that will encourage the adoption of their ideas by parliamentary committees, the presentation of these results as recommendations within the report and the subsequent enactment of the committee’s recommendations by the government.

Psychedelic Culture

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.

Open source innovation in physical products : advantages and disadvantages, a corporate perspective

A better understanding of Open Source Innovation in Physical Product (OSIP) might allow project managers to mitigate risks associated with this innovation model and process, while developing the right strategies to maximise OSIP outputs. In the software industry, firms have been highly successful using Open Source Innovation (OSI) strategies. However, OSI in the physical world has not been studied leading to the research question: What advantages and disadvantages do organisations incur from using OSI in physical products? An exploratory research methodology supported by thirteen semi-structured interviews helped us build a seven-theme framework to categorise advantages and disadvantages elements linked with the use of OSIP. In addition, factors impacting advantage and disadvantage elements for firms using OSIP were identified as: „h Degree of openness in OSIP projects; „h Time of release of OSIP in the public domain; „h Use of Open Source Innovation in Software (OSIS) in conjunction with OSIP; „h Project management elements (Project oversight, scope and modularity); „h Firms. Corporate Social Responsibility (CSR) values; „h Value of the OSIP project to the community. This thesis makes a contribution to the body of innovation theory by identifying advantages and disadvantages elements of OSIP. Then, from a contingency perspective it identifies factors which enhance or decrease advantages, or mitigate/ or increase disadvantages of OSIP. In the end, the research clarifies the understanding of OSI by clearly setting OSIP apart from OSIS. The main practical contribution of this paper is to provide manager with a framework to better understand OSIP as well as providing a model, which identifies contingency factors increasing advantage and decreasing disadvantage. Overall, the research allows managers to make informed decisions about when they can use OSIP and how they can develop strategies to make OSIP a viable proposition. In addition, this paper demonstrates that advantages identified in OSIS cannot all be transferred to OSIP, thus OSIP decisions should not be based upon OSIS knowledge.

Which way from here? The spatiality of maps & navigation in first-person single-player video games

Player experience of spatiality in first-person, single-player games is informed by the maps and navigational aids provided by the game. This project uses textual analysis to examine the way these maps and navigational aids inform the experience of spatiality in Fallout 3, BioShock and BioShock 2. Spatiality is understood as trialectic, incorporating perceived, conceived and lived space, drawing on the work of Henri Lefebvre and Edward Soja. The most prominent elements of the games’ maps and navigational aids are analysed in terms of how they inform players’ experience of the games’ spaces. In particular this project examines the in-game maps these games incorporate, the waypoint navigation and fast-travel systems in Fallout 3, and the guide arrow and environmental cues in the BioShock games.

Editoral : Correspondence regarding Anker SD, Koehler F, Abraham WT. Telemedicine and remote management of patients with heart failure. The Lancet 2011; 378: 731–39. Published 20 August 2011.

We read the excellent review of telemonitoring in chronic heart failure (CHF)1 with interest and commend the authors on the proposed classification of telemedical remote management systems according to the type of data transfer, decision ability and level of integration. However, several points require clarification in relation to our Cochrane review of telemonitoring and structured telephone support2. We included a study by Kielblock3. We corresponded directly with this study team specifically to find out whether or not this was a randomised study and were informed that it was a randomised trial, albeit by date of birth. We note in our review2 that this randomisation method carries a high risk of bias. Post-hoc metaanalyses without these data demonstrate no substantial change to the effect estimates for all cause mortality (original risk ratio (RR) 0·66 [95% CI 0·54, 0·81], p<0·0001; revised RR 0·72 [95% CI 0·57, 0·92], p=0·008), all-cause hospitalisation (original RR 0·91 [95% CI 0·84, 0·99] p=0·02; revised RR 0.92 [95% CI 0·84, 1·02], p=0·10 ) or CHF-related hospitalisation (original RR 0·79 [95% CI 0·67, 0·94] p=0·008; revised RR 0·75 [95% CI 0·60, 0·94] p=0·01). Secondly, we would classify the Tele-HF study4, 5 as structured telephone support, rather than telemonitoring. Again, inclusion of these data alters the point-estimate but not the overall result of the meta-analyses4. Finally, our review2 does not include invasive telemonitoring as the search strategy was not designed to capture these studies. Therefore direct comparison of our review findings with recent studies of these interventions is not recommended.

Towards testing a new first-order decision making model for the procurement of public sector major infrastructure

Given global demand for new infrastructure, governments face substantial challenges in funding new infrastructure and simultaneously delivering Value for Money (VfM). As background to this challenge, a brief review is given of current practice in the selection of major public sector infrastructure in Australia, along with a review of the related literature concerning the Multi-Attribute Utility Approach (MAUA) and the effect of MAUA on the role of risk management in procurement selection. To contribute towards addressing the key weaknesses of MAUA, a new first-order procurement decision making model is mentioned. A brief summary is also given of the research method and hypothesis used to test and develop the new procurement model and which uses competition as the dependent variable and as a proxy for VfM. The hypothesis is given as follows: When the actual procurement mode matches the theoretical/predicted procurement mode (informed by the new procurement model), then actual competition is expected to match optimum competition (based on actual prevailing capacity vis-à-vis the theoretical/predicted procurement mode) and subject to efficient tendering. The aim of this paper is to report on progress towards testing this hypothesis in terms of an analysis of two of the four data components in the hypothesis. That is, actual procurement and actual competition across 87 road and health major public sector projects in Australia. In conclusion, it is noted that the Global Financial Crisis (GFC) has seen a significant increase in competition in public sector major road and health infrastructure and if any imperfections in procurement and/or tendering are discernible, then this would create the opportunity, through the deployment of economic principles embedded in the new procurement model and/or adjustments in tendering, to maintain some of this higher level post-GFC competition throughout the next business cycle/upturn in demand including private sector demand. Finally, the paper previews the next steps in the research with regard to collection and analysis of data concerning theoretical/predicted procurement and optimum competition.

Peer passenger identity and passenger pressure on young drivers' speeding intentions

Young drivers, aged 17 to 24 years, have the highest fatality rate in Australia. It is believed that part of this risk is due to pressure from peer passengers to engage in speeding; which may be active (i.e., verbal encouragement) or passive (i.e., perceived pressure on the part of the driver). The Theory of Planned Behaviour (TPB) was used to investigate this impact of peer passengers on young drivers, particularly the influence of the type of peer pressure and a driver’s level of identification with their passengers. A scenario-based questionnaire was constructed, informed by focus groups and pilot studies, and distributed to university students (N = 398). The questionnaire measured participants’ intentions and the TPB constructs, including two components of perceived behaviour control, within a baseline scenario as well as an experimental scenario in which the variables of type of pressure and identification were manipulated. Consistent with the hypotheses, the study found that attitudes and self-efficacy significantly predicted intentions over and above the variance explained by the sociodemographic variables of age, gender, self-esteem, sensation seeking, as well as past behaviour and exposure. Across the scenarios, attitudes explained between 4.3% and 14.5%, while self-efficacy to refrain from speeding explained between 4.9% and 17.1%, of the unique variance in intentions to speed. However, contrary to expectations, intentions to speed were found to be higher in the “no passenger” than “passenger present” conditions, although this finding is not completely inconsistent with recent literature. A high level of identification with passengers led to higher intentions to speed than low identification as expected, but, inconsistent with expectations, different types of pressure (i.e., active versus passive) did not influence intentions to speed.

Reorienting diaspora : China and India as franchise nations

In this paper, I outline a new approach towards media and diaspora using the concept of the ‘franchise nation’. It is my contention that current theories on migration, media and diaspora with their emphasis on exile, multiple belongings, hybrid identities and their representations are inadequate to the task of explaining the emergence of a new trend in diaspora, home and host nation relationship. This, I suggest, is a recent shift most notable in the attitudes of the Chinese and Indian governments toward their diasporas. From earlier eras where Chinese sojourners were regarded as disloyal and Indians overseas left to fend for themselves, Chinese and Indian migrants are today directly addressed and wooed by their nations of origin. This change is motivated in part by the realisation that diasporic populations are, in fact, resources that can bring significant influence to bear on home nation interests within host nations. Such sway in foreign lands gains greater importance as China and India are, by virtue of their economic rise and prominence on the world stage, subject to ever more intense international scrutiny. Members of these diasporas have willingly responded to these changes by claiming and cultivating pivotal roles for themselves within host nations as spokespersons, informants and representatives, trading on their assumed familiarity with home cultures, language and commerce. As a result, China and India have initiated a number of statecraft strategies in recent years to (re)engage their diasporas. Both nations have identified media as amongst the key instruments of their strategies. New media enhances the ability of all parties—home and host states, institutions and individuals—to participate, interact and reciprocate. While China’s centralised government has utilised the notion of soft power (ruan shili) to describe its practices, India’s efforts are diffused along the lines of nation branding via myriad labels like India Inc. and the Global Indian. To explain this emergent trend, I propose a new framework, franchise nation, defined as a reciprocal relationship between nation and diaspora that is characterised by mutual obligations and benefits. In appropriating this phrase from Stephenson, I liken contemporary statecraft operating in China and India to a business franchising system wherein benefits may be economic or cultural and; those thus connected signal their willingness for mutual exchange and concede a sense of obligation. As such, franchise nation is not concerned with remote, unidirectional interference in home nation affairs a la Anderson’s ‘long-distance nationalism’. Rather, it is a framework that seeks to reflect more closely the dynamism of the relationship between diaspora, home and host nations.

Teaching and Learning in Maritime Security: A Literature Review

With the rise in attacks and attempted attacks on marine‐based critical infrastructure, maritime security is an issue of increasing importance worldwide. However, there are three significant shortfalls in the efforts to overcome potential threats to maritime security: the need for greater understanding of whether current standards of best practice are truly successful in combating and reducing the risks of terrorism and other security issues, the absence of a collective maritime security best practice framework and the need for improved access to maritime security specific graduate and postgraduate (long) courses. This paper presents an overview of existing international, regional national standards of best practice and shows that literature concerning the measurement and/ or success of standards is virtually non‐existent. In addition, despite the importance of maritime workers to ensuring the safety of marine based critical infrastructure, a similar review of available Australian education courses shows a considerable lack of availability of maritime security‐specific courses other than short courses that cover only basic security matters. We argue that the absence of an Australian best practice framework informed by evaluation of current policy responses – particularly in the post 9/11 environment – leaves Australia vulnerable to maritime security threats. As this paper shows, the reality is that despite the security measures put in place post 9/11, there is still considerable work to be done to ensure Australia is equipped to overcome the threats posed to maritime security.