Andrew Cashin

Autism in the criminal justice detention system: a review of the literature

&NA; Little is known about the experience of people with autism in custody. A review of the literature that explored the relationship between autism and criminality and the criminal justice detention system was conducted. Literature suggests that people with autism are potentially overrepresented within the criminal justice system. There is little research that has examined the experiences of people with autism spectrum disorders in custody. There is very little to guide service design to develop autism support services for people in prison.

The Triad of Impairment in Autism Revisited

TOPIC The triad of impairment referred to at present in the autism-related literature is a behavioral triad. This paper extends this thinking of the triad of impairment to the triad that underlies the behavioral manifestation. The real triad of impairment. PURPOSE This paper considers the thinking and information processing style of autism and takes the next transitional step in understanding the triad of impairment. SOURCES USED Contemporary literature on autism and information processing. CONCLUSIONS Exceptional pioneering work in the late 1970s gave rise to the concept of the triad of impairments as the central plank of the construct of autism: impaired communication; impaired social skills; and a restricted and repetitive way of being-in-the-world. This clear articulation of the structures of the phenomena allowed a new way for professionals and families to see and understand autism, and to relate to those with autism. Like the evolution of many concepts, this was a transitional idea. The original triad of impairments described the behavioral manifestation; the actual triad of impairments is at the level of cognitive processing. The actual triad of impairment is static and ubiquitous unlike the variable and fluctuating behavioral manifestation. The actual triad of impairment in autism is visual as opposed to linguistic processing, impaired abstraction, and lack of theory of mind. The actual triad is central to all diagnosis that together makes up the autism spectrum.

Painting the vortex: The existential structure of the experience of parenting a child with autism

The experience of parenting a child with autism is one of change to the parents self. The associated triad of impairment in autism of impaired communication, social skills and a repetitive way of being permeates into the self of the parent through the medium of the social parent child relationship. This is a progressive process likened to the parent being pulled into a vortex. The existential mechanisms through which this may plausibly occur are considered.

Narrative Therapy: A Psychotherapeutic Approach in the Treatment of Adolescents With Asperger's Disorder

TOPIC The conundrum of how to carry out psychotherapy with an adolescent whose primary currency of information exchange is visual as opposed to linguistic, and who is unable to develop a unified base of knowledge and hence generalize concepts, has confronted many mental health nurses in their encounters with individuals with Aspergers disorder. At the currently estimated escalating rate of occurrence of 1 to every 100 individuals having an autism spectrum disorder, and the estimate that 80% of these people have average or above intelligence, it makes sense that Aspergers disorder is frequently encountered by child and adolescent mental health nurses. Aspergers disorder represents a different way of being in the world that is associated with a higher frequency of anxiety disorders and depression than experienced by neurotypical counterparts. The inherent concretization in the externalization techniques in narrative therapy provide a novelly successful approach to psychotherapy with people with Aspergers disorder and in many cases resolution of the conundrum. PURPOSE This paper considers the features of Aspergers disorder and its consonance with the techniques of narrative therapy, and utilizes a case example that shows the potential efficacy of the application of this established approach in a new context. SOURCES Contemporary literature on autism and narrative therapy. CONCLUSIONS The implication of the potential application of narrative therapy in psychotherapy with individuals with autism is raised.

The relationship between exercise and hopelessness in prison

This paper reports on the relationship between the levels of self-reported physical exercise and mental well-being (as measured using the Beck Hopelessness Scale) in a cohort of 914 prisoners within New South Wales, Australia. A significant inverse relationship between self-reported exercise in minutes per week and hopelessness was identified. The need to include exercise as a factor in inmate health plans is discussed.

Nurse practitioner prescribing practice in Australia

Purpose: In Australia, nurse practitioner (NP) services are a relatively new development with little being known about the prescribing practices of Australian NPs. The aim of this study was to conduct the first national study of Australian NP prescribing practices. Data sources: Focus groups were conducted to inform construction of an electronic survey that was available for all NPs and NP candidates across Australia to complete. Conclusions: Seventy‐two percent of authorized NPs and 39% of NP candidates reported that their practice involved prescribing pharmaceutical agents. Of those respondents who did prescribe during the course of their practice, 59% (n = 29) of the authorized NPs and 64% (n = 16) of the NP candidates reported that they usually prescribe at least once a day. The results from this study suggest that fewer Australian NPs prescribe than do NPs in the United States, and those who do prescribe do so less frequently. Implications for practice: The current health policy framework in Australia while creating space for the role of the NP is restricting the roles utility and potential contribution to the health care of Australians.

Nurse practitioner prescribing practices: the most frequently prescribed medications

AIMS AND OBJECTIVES To explore which medications Australian nurse practitioners most frequently prescribe. BACKGROUND Although nurse practitioners in Australia have prescriptive authority, little is known about which specific medications nurse practitioners are prescribing and how frequently they do so. DESIGN Descriptive electronic survey. METHODS A total of 209 nurse practitioners reported current prescribing practices. Medications reported were categorised according to the Australian Medicines Handbook major drug classifications and frequencies presented. RESULTS Seventy-eight per cent of respondents reported prescribing medications as part of their Nurse Practitioner practice. In total, participants reported prescribing 234 separate medications from most Australian Medicines Handbook major drug classifications. Medications from the classification anti-infective drugs were most frequently prescribed followed by medications from analgesic, psychotropic, cardiovascular, musculoskeletal, genitourinary and gastrointestinal classifications. CONCLUSION The majority of nurse practitioners in Australia prescribe medications in their clinical practice, although the proportion of nurse practitioners prescribing has not changed significantly in the past four years. The medications prescribed are comparable with those most frequently prescribed by all prescribers in Australia and highlight the diversity in scope of practice among nurse practitioners. RELEVANCE TO CLINICAL PRACTICE Findings highlight the importance of Nurse Practitioners a capacity to prescribe wide variety of medications, especially in practice areas such acute, primary and emergency care. The unique role nurse practitioners in relation to management of patients with infective processes and patients requiring pain relief is highlighted. Insight into current Nurse Practitioner prescribing trends informs future Nurse Practitioner curricular and future continuing education programmes. Findings give unique insight for future service planning, especially service providers considering introducing nurse practitioners to their service. The finding that nurse practitioners prescribing patterns are similar to other non-nurse practitioner prescribers in Australia highlights the potential for service providers to introduce new models of care that are Nurse Practitioner lead.

An ethnographic study of forensic nursing culture in an Australian prison hospital

Forensic nurses are faced with unique challenges in their attempt to deliver nursing care in a custodial environment. * The impact of such challenges on the cultural dynamic of forensic nursing and consequently on healthcare delivery is largely unknown. * The aim of this ethnographic study was to explore the nursing culture within an Australian prison hospital and the migration of the culture over a 12-month period. * At the end of the study, the nursing culture was found to be one of hope, although with no clearly articulated vision of nurse-hood or patient-hood and model within which to practice nursing. * The ability to articulate practice is central to the development of mental health nursing in any context. Abstract Forensic nurses are faced with unique challenges in their attempt to deliver nursing care in a custodial environment. The impact of such challenges on the cultural dynamic of forensic nursing and consequently on healthcare delivery is largely unknown. The aim of this ethnographic study was to explore the nursing culture within an Australian prison hospital and the migration of the culture over a 12-month period. At the end of the study the nursing culture was found to be one of hope, although with no clearly articulated vision of nurse-hood or patient-hood and model within which to practice nursing.

Nurse practitioner prescribing practice in Australia: Confidence in aspects of medication management

The findings of the 2010 national survey of nurse practitioner (NP) prescribing in Australia related to confidence in prescribing are reported. A significant correlation between years endorsed as a NP and prescribing confidence was found. NPs in Australia were significantly more confident in the prescribing aspects of commencing a new medication than adjusting or ceasing a medication prescribed by others. These findings are discussed in relation to promotion of the quality use of medicines and identification of potential strategies to promote the ongoing positive evolution of NP practice in Australia.

A modified hermeneutic phenomenological approach toward individuals who have autism

Individuals with autism have a unique cognitive processing style characterized by impaired abstraction, impaired theory of mind, and visual as opposed to linguistic processing of information. A consequence of this unique cognitive processing style is that traditional ways of hermeneutical phenomenological examination may be inadequate to achieve the kind of understanding of experience toward which this method is directed. In order to stay true to Heideggers hermeneutic phenomenology, we needed to develop modifications to this research methodology, which include the use of visual aids to promote participant engagement and access the eidetic memory of a participant with autism, so as to elicit concrete descriptors of an experience.