Electronic health records: essential tools in integrating substance abuse treatment with primary care.

While substance use problems are considered to be common in medical settings, they are not systematically assessed and diagnosed for treatment management. Research data suggest that the majority of individuals with a substance use disorder either do not use treatment or delay treatment-seeking for over a decade. The separation of substance abuse services from mainstream medical care and a lack of preventive services for substance abuse in primary care can contribute to under-detection of substance use problems. When fully enacted in 2014, the Patient Protection and Affordable Care Act 2010 will address these barriers by supporting preventive services for substance abuse (screening, counseling) and integration of substance abuse care with primary care. One key factor that can help to achieve this goal is to incorporate the standardized screeners or common data elements for substance use and related disorders into the electronic health records (EHR) system in the health care setting. Incentives for care providers to adopt an EHR system for meaningful use are part of the Health Information Technology for Economic and Clinical Health Act 2009. This commentary focuses on recent evidence about routine screening and intervention for alcohol/drug use and related disorders in primary care. Federal efforts in developing common data elements for use as screeners for substance use and related disorders are described. A pressing need for empirical data on screening, brief intervention, and referral to treatment (SBIRT) for drug-related disorders to inform SBIRT and related EHR efforts is highlighted.

Descriptions of Scottish Priority Marine Features (PMFs).

Background The seas around Scotland are rich and diverse – Scotland’s position at the edge of the continental shelf, the long coastline, large area of sea and the mixing of warm and coldwater currents combine to make its waters a special place for marine wildlife and habitats. Scotland has over 18,000 km of coastline and its inshore and offshore areas are among the largest of any EU country, representing 13% of all European seas. Scotland’s seas are of outstanding scenic, historical and cultural value and are part of the national identity at home and abroad. The Marine (Scotland) Act 2010 and the UK Marine and Coastal Access Act 2009 include new powers and duties to ensure that our seas are managed sustainably for future generations, integrating the economic growth of marine industries with the need to protect these assets. Measures to conserve Scotland’s marine natural heritage are based on a three pillar approach, with action at the wider seas level (e.g. marine planning or sectoral controls); specific species conservation measures (e.g. improved protection for seals); and through site protection measures - the identification of new Marine Protected Areas (MPAs). To help target action under each of the three pillars, Scottish Natural Heritage (SNH) and the Joint Nature Conservation Committee (JNCC) have generated a focused list of habitats and species of priority conservation importance - the Priority Marine Features (PMFs). The aim of the current study was to produce a descriptive catalogue of the Scottish PMFs (including component habitats and species where appropriate) to serve as a reference for future nature conservation action. Whilst derived from available existing accounts, the succinct 1-page descriptions are written from a Scottish perspective, refining, but clearly linking to more generic UK, EC or OSPAR (Oslo and Paris Commission) commentary. Available information on the geographic distribution of the features was collated as part of the project and a summary map is provided in each description. Main findings  This project has generated a descriptive catalogue of the 81 PMFs that have been identified in the seas around Scotland (out to the limit of the UK continental shelf). The list comprises 26 broad habitats (e.g. burrowed mud), seven low or limited mobility species (e.g. ocean quahog) and 48 mobile species, including fish (e.g. blue ling) and marine mammals (e.g. minke whale).  Information on the distribution of the PMFs was collated within a Geographic Information System (GIS). This is the first time that data about such a diverse range of Scottish marine nature conservation interests have been compiled within a single repository. These data have and will be used in conjunction with other contextual base-mapping to inform the development of nature conservation advice and commentary (e.g. in the production of the Scotland’s Marine Atlas - Baxter et al., 2011).  The feature distribution mapping used in the production of this report is being made available to view online via the National Marine Plan Interactive web portal (NMPi - http://www.gov.scot/Topics/marine/seamanagement/nmpihome). As new or refined data on Scottish PMFs become available, these will be fed into updates to the project geodatabase and NMPi.

Descriptions of Scottish Priority Marine Features (PMFs).

Background The seas around Scotland are rich and diverse – Scotland’s position at the edge of the continental shelf, the long coastline, large area of sea and the mixing of warm and coldwater currents combine to make its waters a special place for marine wildlife and habitats. Scotland has over 18,000 km of coastline and its inshore and offshore areas are among the largest of any EU country, representing 13% of all European seas. Scotland’s seas are of outstanding scenic, historical and cultural value and are part of the national identity at home and abroad. The Marine (Scotland) Act 2010 and the UK Marine and Coastal Access Act 2009 include new powers and duties to ensure that our seas are managed sustainably for future generations, integrating the economic growth of marine industries with the need to protect these assets. Measures to conserve Scotland’s marine natural heritage are based on a three pillar approach, with action at the wider seas level (e.g. marine planning or sectoral controls); specific species conservation measures (e.g. improved protection for seals); and through site protection measures - the identification of new Marine Protected Areas (MPAs). To help target action under each of the three pillars, Scottish Natural Heritage (SNH) and the Joint Nature Conservation Committee (JNCC) have generated a focused list of habitats and species of priority conservation importance - the Priority Marine Features (PMFs). The aim of the current study was to produce a descriptive catalogue of the Scottish PMFs (including component habitats and species where appropriate) to serve as a reference for future nature conservation action. Whilst derived from available existing accounts, the succinct 1-page descriptions are written from a Scottish perspective, refining, but clearly linking to more generic UK, EC or OSPAR (Oslo and Paris Commission) commentary. Available information on the geographic distribution of the features was collated as part of the project and a summary map is provided in each description. Main findings  This project has generated a descriptive catalogue of the 81 PMFs that have been identified in the seas around Scotland (out to the limit of the UK continental shelf). The list comprises 26 broad habitats (e.g. burrowed mud), seven low or limited mobility species (e.g. ocean quahog) and 48 mobile species, including fish (e.g. blue ling) and marine mammals (e.g. minke whale).  Information on the distribution of the PMFs was collated within a Geographic Information System (GIS). This is the first time that data about such a diverse range of Scottish marine nature conservation interests have been compiled within a single repository. These data have and will be used in conjunction with other contextual base-mapping to inform the development of nature conservation advice and commentary (e.g. in the production of the Scotland’s Marine Atlas - Baxter et al., 2011).  The feature distribution mapping used in the production of this report is being made available to view online via the National Marine Plan Interactive web portal (NMPi - http://www.gov.scot/Topics/marine/seamanagement/nmpihome). As new or refined data on Scottish PMFs become available, these will be fed into updates to the project geodatabase and NMPi.

Retirement patterns of Australian doctors aged 65 years and older.

OBJECTIVE: To investigate retirements over a 4-year period among Australian general practitioners (UPs) and specialists aged 65 years and over, and factors influencing retirement. METHODS: Data from Medicine in Australia: Balancing Employment and Life (MABEL) for the years 2009-12 were analysed for 435 GPs and 643 specialists aged 65 years and over at the time of entry to the MABEL survey. Discrete time survival analysis was used. RESULTS: The retirement rates were 4.1% (2009), 5.1% (2010), 4.2% (2011) and 10.4% (2012). Retirement was associated with: (1) the intention to leave medical work in 2009 and 2010; (2) working fewer hours in private consulting rooms in 2010 and 2012; (3) having lower job satisfaction in 2009 and 2011; (4) being older in 2009; (5) working fewer hours in a public hospital in 2012; and (6) working fewer hours in a private hospital in 2010. Doctors who intended to reduce their working hours were less likely to retire in 2009. CONCLUSIONS: Strategies to support doctors at the late career stage to provide their valued contributions to the medical workforce for as long as possible may include increasing job satisfaction and addressing barriers to reducing work hours.

Small amount credit contract reforms in Australia: household survey evidence & analysis

A review of small amount credit contract regulation in Australia began in 2015 as mandated under s 335A of the National Consumer Credit Protection Act 2009 (Cth). The review panel sought comprehensive data on industry and consumer characteristics and trends. To provide such evidence, consumer groups commissioned original empirical research using data collected from a longitudinal survey that monitors the financial position and attitudes of Australian households. This data on household use of small amount credit contract loans was extracted for the last decade, allowing detailed analysis of the historical patterns and developing trends. The data indicates that overall demand for small amount short duration credit is growing in Australia, the consumer base is broadening, and the predominant form of lending today is online. Deeper analysis highlights the varying motivations of borrower households and their different stages and levels of financial difficulty. It also confirms the socio-economic, employment, educational and financial disadvantages of most households using these loans and their vulnerability to adverse changes in personal circumstances and negative external shocks.

Does Affirmative Action Work? Evidence from the Operation of Fair Employment Legislation in Northern Ireland

An affirmative action programme, established by the Fair Employment (Northern Ireland) Act 1989, has been an important attempt to ensure ‘fair participation’ in employment for both Catholics and Protestants in Northern Ireland since 1990. The programme includes detailed monitoring of the community background of employees and requires employers to undertake remedial action where fair participation is not evident. Agreements were concluded between the regulatory agency and many employers specifying what affirmative action measures were required. Based on the annual monitoring returns submitted between 1990 and 2005, this article evaluates the effectiveness of the affirmative action programme in promoting fair employment participation using fixed effects models. The analysis shows that there has been a general shift towards workforce integration in Northern Ireland but the increase of under-represented groups in agreement concerns is greater than in concerns with no agreement. The success of agreements, however, is limited to certain industrial sectors and medium-sized enterprises.

Towards a literacy of attention

In 1997, business trend analyst Linda Stone proposed the term "continuous partial attention" to characterise the contemporary experience of wanting to be ‘a live node on the network’. She argued that while it can be a positive and functional behaviour, it also has the potential to be disabling, compromising reflective and creative thought. Subsequent studies have explored the ways in which technology has slowly disrupted the idea and experience of a "centred" and "bounded" self. Studies of ‘Gen Y’ show the ease with which young people accommodate this multiplying of the self as they negotiate their partial friendships and networks of interest with family and work. In teaching and learning circles in tertiary education we talk a lot about problems of student ‘disengagement’. In characterising our challenge this way, are we undermining our potential to understand the tendencies of contemporary learners? This paper begins a consideration of how traditional models, frameworks and practices might oppose these partially engaged but continuously connected and interpersonal "dividuals". What questions does this provoke for learning environments towards harnessing yet counterpointing the crisis students might experience; to recognise but also integrate their multiple selves towards what they aim to become through the process of learning?

Mentoring preservice teachers in primary mathematics

A literature-based instrument gathered data about 147 final-year preservice teachers’ perceptions of their mentors’ practices related to primary mathematics teaching. Five factors characterized effective mentoring practices in primary mathematics teaching had acceptable Cronbach alphas, that is, Personal Attributes (mean scale score=3.97, SD [standard deviation]=0.81), System Requirements (mean scale score=2.98, SD=0.96), Pedagogical Knowledge (mean scale score=3.61, SD=0.89), Modelling (mean scale score=4.03, SD=0.73), and Feedback (mean scale score=3.80, SD=0.86) were .91, .74, .94, .89, and .86 respectively. Qualitative data (n=44) investigated mentors’ perceptions of mentoring these preservice teachers, including identification of successful mentoring practices and ways to enhance practices.

Communicating ecologically positive development

It is difficult to present a paradigm shift from resource efficient to ecologically sustainable design, when many students have not yet thought about what sustainability is, let alone what it implies for the design of the built environment ‘Positive Development’ requires students to think beyond green building to something that does not yet exist. The concept of ecologically positive development suggests a product, building, system or urban area that leaves the ecological base and public estate better off than if no development had occurred. For some years now, I have experimented with communicating this paradigm shift in design to students and professionals ‐ with mixed results. This paper discusses some of the challenges, failures and successes in shifting design studio work from environmentally‐sensitive to eco-positive. The framework underlying this exploration is action research. Conclusions about the success of the strategies used for overcoming perceptual barriers to new typologies of architecture are drawn from recent student feedback. The talk will show examples of student projects that attempt eco-positive development projects.

Creative Commons : fair to share?

This article explores new the realities of the permissions culture and “all rights reserved copyright” in the networked environment and poses the question: why is lending a copy of a book sharing but emailing a PDF of it piracy? It explores new approaches to publishing and distribution of books by highlighting two books in the Aduki Independent Press catalogue. It was modeled on a presentation delivered by Elliott Bledsoe at the Changing Climates in Arts Publishing forum run by Artlink and the Copyright Agency Limited in Adelaide, Australia on 9 May 2009 and in Sydney, Australia on 27 June 2009.

The 'Dirty Work' of the Lie

The panel "Duplicity/Complicity: Performing and Misperforming Lies" at PSi #15 in Croatia in July 2009 examined the half-truths, hidden assumptions and power relations embedded in every act of performance through an analysis of the way bodies, buildings, personae and communities perform and misperform lies. It was a collection of new academic voices from Australia and Croatia, intersecting and colliding and, at times, outright lying, with each other and with commentary from Alan Read. Inspired by this successful adventure in collaborative academic mis-performance, "The ‘Dirty Work’ of the Lie" takes the challenge set by the Prelude Panel at PSI #15 and subjects the ideas emerging from this panel to "friendly fire" in order to build a multi authored response to 'performance that lies', with reference to the work of A Chorus of Women, disabled artists Bill Shannon, Aaron Williamson and Kathryn Araneillo, US dance performer Ann Liv Young and US theatre and festival director Peter Sellars. In doing so, "The 'Dirty Work' of the Lie" provides a reflexive response to the duplicity inherent in the performances, and also in our own academic analyses. With Alan Read acting as interlocutor, each contributor will creatively respond to a paper presented by another, developing the key intersecting issues that emerged through the formation of the panel. These issues include impression management, self-belief and performers who are 'taken in by their own act', the dirty work of taking others in with an act, the guerrilla dimension of lying, the productivity of the lie, and questions of audience engagement and ethics. As a result, this new paper tests how the 'misperformance' of lies across different cultural sites, be it deliberate or accidental, can become a productive – and, indeed, politicised – aspect of cultural performance, betraying accepted attitudes, ideas and structures of authority and offering alternative visions. Through it’s distinctively multi vocal texture, "The 'Dirty Work' of the Lie" also interrogates the modes of analysis available to us, questioning the 'duplicity' in our reflecting, responding and listening to each other as well as the work.

Assurance of learning : the role of work integrated learning and industry partners

In the partnering with students and industry it is important for universities to recognize and value the nature of knowledge and learning that emanates from work integrated learning experiences is different to formal university based learning. Learning is not a by-product of work rather learning is fundamental to engaging in work practice. Work integrated learning experiences provide unique opportunities for students to integrate theory and practice through the solving of real world problems. This paper reports findings to date of a project that sought to identify key issues and practices faced by academics, industry partners and students engaged in the provision and experience of work integrated learning within an undergraduate creative industries program at a major metropolitan university. In this paper, those findings are focused on some of the particular qualities and issues related to the assessment of learning at and through the work integrated experience. The findings suggest that the assessment strategies needed to better value the knowledges and practices of the Creative Industries. The paper also makes recommendations about how industry partners might best contribute to the assessment of students’ developing capabilities and to continuous reflection on courses and the assurance of learning agenda.

A Fair Go Beyond the School Gate? Systemic factors affecting participation and attainment in tertiary education by Queensland students from LSES backgrounds

The purpose of this project was to conduct an empirical study that would result in findings that inform systemic policy development aimed at improving tertiary participation and attainment by students from low socioeconomic status (LSES) backgrounds in Queensland. The project focuses on systemic policy, initiatives and programs that encourage tertiary education participation and attainment by individuals from LSES backgrounds, rather than on institution-specific initiatives or programs. While the broad remit was to consider tertiary education participation, the study particularly highlights issues pertaining to LSES student participation and attainment in the higher education sector, given the notable under representation of this demographic subgroup in Australian universities. This study supports the strategic priority of addressing professional skills shortages and innovations aiming to improve human and social capital in the state of Queensland. The ultimate goal is to contribute to the enhancement of Queensland’s education and training system by maximising participation and attainment by people from LSES backgrounds in higher education, thereby improving their quality of life and future life choices and opportunities. The study addressed the following five research questions: 1. What are the major factors that promote or inhibit participation and attainment in tertiary education by LSES students in Queensland? 2. To what extent do systemic policies or practices(systemic factors) of Queensland’s tertiary education system promote or inhibit participation and attainment by LSES students? That is, what features of Queensland’s tertiary education system have a significant effect on participation and attainment by LSES students? 3. What system policies or practices are found to boost participation and attainment by LSES students in other jurisdictions? 4. What evidence is there to suggest that policies or practices that have boosted participation and attainment by LSES students in other jurisdictions would be successful if implemented in Queensland? 5. What are the implications of the research findings for Queensland’s tertiary education system to improve participation and attainment by LSES students? The project adopted a mixed methods approach to data collection. A comprehensive review of the literature was conducted to identify relevant state, national and international literature. Both qualitative and quantitative methodologies were used to collect data from a range of key stakeholders.