Linda Jenner

Demographic and clinical correlates of comorbid substance use disorders in psychosis: multivariate analyses from an epidemiological sample ☆

BACKGROUND While there has been substantial research examining the correlates of comorbid substance abuse in psychotic disorders, it has been difficult to tease apart the relative importance of individual variables. Multivariate analyses are required, in which the relative contributions of risk factors to specific forms of substance misuse are examined, while taking into account the effects of other important correlates. METHODS This study used multivariate correlates of several forms of comorbid substance misuse in a large epidemiological sample of 852 Australians with DSM-III-R-diagnosed psychoses. RESULTS Multiple substance use was common and equally prevalent in nonaffective and affective psychoses. The most consistent correlate across the substance use disorders was male sex. Younger age groups were more likely to report the use of illegal drugs, while alcohol misuse was not associated with age. Side effects secondary to medication were associated with the misuse of cannabis and multiple substances, but not alcohol. Lower educational attainment was associated with cannabis misuse but not other forms of substance abuse. CONCLUSION The profile of substance misuse in psychosis shows clinical and demographic gradients that can inform treatment and preventive research.

A brief motivational intervention for substance misuse in recent-onset psychosis

Substance misuse is common in early psychosis, and impacts negatively on outcomes. Little is known about effective interventions for this population. We report a pilot study of brief intervention for substance misuse in early psychosis (Start Over and Survive: SOS), comparing it with Standard Care (SC). Twenty-five in-patients aged 18-35 years with early psychosis and current misuse of non-opioid drugs were allocated randomly to conditions. Substance use and related problems were assessed at baseline, 6 weeks and 3, 6 and 12 months. Final assessments were blind to condition. All 13 SOS participants who proceeded to motivational interviewing reported less substance use at 6 months, compared with 58% (7/12) in SC alone. Effects were well maintained to 12 months. However, more SOS participants lived with a relative or partner, and this also was associated with better outcomes. Engagement remained challenging: 39% (16/41) declined participation and 38% (5/13) in SOS only received rapport building. Further research will increase sample size, and address both engagement and potential confounds.

Safety and effectiveness of high-dose midazolam for severe behavioural disturbance in an emergency department with suspected psychostimulant-affected patients.

Objectives:  To trial high‐dose midazolam sedation protocol for uncooperative patients with suspected psychostimulant‐induced behavioural disorders. End‐points were effectiveness and safety.

A systematic review of interventions for co-occurring substance use and borderline personality disorders

ISSUES The aim of this study was to undertake a systematic review on effective treatment options for co-occurring substance use and borderline personality disorders to examine effective treatments for this group. APPROACH A systematic review using a narrative analysis approach was undertaken as there were too few studies within each intervention type to undertake a meta-analysis. The inclusion criteria comprised of English language studies (between 1999 and 2014) and a sample of >70% borderline personality disorder, with measurable outcomes for substance use and borderline personality disorder. All abstracts were screened (n = 376) resulting in 49 studies assessed for eligibility, with 10 studies, examining three different treatment types, included in the final review. KEY FINDINGS There were four studies that examined dialectical behaviour therapy (DBT), three studies that examined dynamic deconstructive psychotherapy (DDP) and three studies that examined dual-focused schema therapy (DFST). Both DBT and DDP demonstrated reductions in substance use, suicidal/self-harm behaviours and improved treatment retention. DBT also improved global and social functioning. DFST reduced substance use and both DFST and DPP improved treatment utilisation, but no other significant positive changes were noted. IMPLICATIONS Overall, there were a small number of studies with small sample sizes, so further research is required. However, in the absence of a strong evidence base, there is a critical need to respond to this group with co-occurring borderline personality disorder and substance use. CONCLUSION Both DBT and DPP showed some benefit in reducing symptoms, with DBT the preferred option given its superior evidence base with women in particular.

Comparisons of the MINOS near and far detector readout systems at a test beam

MINOS is a long baseline neutrino oscillation experiment that uses two detectors separated by 734 km. The readout systems used for the two detectors are different and have to be independently calibrated. To verify and make a direct comparison of the calibrated response of the two readout systems, test beam data were acquired using a smaller calibration detector. This detector was simultaneously instrumented with both readout systems and exposed to the CERN PS T7 test beam. Differences in the calibrated response of the two systems are shown to arise from differences in response non-linearity, photomultiplier tube crosstalk, and threshold effects at the few percent level. These differences are reproduced by the Monte Carlo (MC) simulation to better than 1% and a scheme that corrects for these differences by calibrating the MC to match the data in each detector separately is presented. The overall difference in calorimetric response between the two readout systems is shown to be consistent with zero to a precision of 1.3% in data and 0.3% in MC with no significant energy dependence.

Status of the HeLiCal contribution to the polarised positron source for the International Linear Collider

The positron source for the International Linear Collider (ILC) is a helical undulator-based design, which can generate unprecedented quantities of polarised positrons. The HeLiCal collaboration [1] takes responsibility for the design and prototyping of the superconducting helical undulator, which is a highly demanding short period device with very small aperture, and also leads the start to end simulations of the polarised electrons and positrons to ensure that the high polarisation levels generated survive from the source up to the collision point. This paper will provide an update on the work of the collaboration, focusing on these two topic areas, and will also discuss future plans.

Workplace alcohol harm reduction intervention in Australia: Cluster non-randomised controlled trial

INTRODUCTION AND AIMS The workplace holds substantial potential as an alcohol harm reduction and prevention setting. Few studies have rigorously examined strategies to reduce workplace alcohol-related harm. Hence, an in-situ 3 year trial of a comprehensive alcohol harm reduction intervention in Australian manufacturing workplaces was undertaken. DESIGN AND METHODS Informed by a gap analysis, a multi-site trial was undertaken. Three manufacturing industry companies, located at four separate worksites, with a minimum of 100 employees were recruited through a local industry network. Based on worksite location, two worksites were allocated to the intervention group and two to the comparison group. The pre-specified primary outcome measure, risky drinking (Alcohol Use Disorders Identification Test, AUDIT-C) and other self-report measures were collected pre-intervention (T1), 12 months (T2) and 24 months post-intervention (T3). RESULTS No significant intervention effect was observed for the primary outcome measure, risky drinking. Significant intervention effects were observed for increased awareness of alcohol policy and employee assistance. At T3, the odds of intervention group participants being aware of the workplace policy and aware of employee assistance were 48.9% (95% confidence interval 29.3-88.9%) and 79.7% (11.5%, 91.8%), respectively, greater than comparison group participants. DISCUSSION AND CONCLUSIONS Comprehensive tailored workplace interventions can be effective in improving workplace alcohol policy awareness. This is one of few workplace alcohol trials undertaken to-date and the findings make an important contribution to the limited evidence base for workplace alcohol harm prevention initiatives.

Challenge of polarized beams at future colliders

A short overview is given about the potential of polarized beams at future colliders is given. In particular the baseline design for polarized beams at the ILC is presented and the physics case for polarized e− and e+ is discussed. In order to fulfil the precision requirements spin tracking from the source to the interaction point is needed. Updates concerning the theoretical calculations as well as their implementation in simulation codes are reported.

Status Of The HeLiCal Contribution To The Polarised Positron Source For The International Linear Collider

The positron source for the International Linear Collider (ILC) is a helical undulator-based design, which can generate unprecedented quantities of polarised positrons. The HeLiCal collaboration [1] takes responsibility for the design and prototyping of the superconducting helical undulator, which is a highly demanding short period device with very small aperture, and also leads the start to end simulations of the polarised electrons and positrons to ensure that the high polarisation levels generated survive from the source up to the collision point. This paper will provide an update on the work of the collaboration, focusing on these two topic areas, and will also discuss future plans.

A co-produced cultural approach to workplace alcohol interventions: barriers and facilitators

Abstract Background: There is increasing recognition that the workplace holds potential as an alcohol prevention/intervention setting. However, few robust studies of workplace interventions have been conducted. Research to-date has yielded mixed results. The current study aimed to address this knowledge gap by undertaking a process evaluation of the Workplace Alcohol Harm Reduction Project (WRAHP), a co-produced workplace alcohol intervention. Methods: A process evaluation was embedded within the WRAHP intervention trial. It included site visits (n = 41), site observations (N = 8) and on-site semi-structured key informant interviews (N = 50), conducted over the 3-year evaluation period. Results: A ‘whole-of-workplace’ plus a ‘co-production’ approach during intervention development and implementation contributed to uptake and sustainability. Seven potential barriers or facilitators emerged: (i) attitudes toward alcohol in the workplace, (ii) policy development and awareness, (iii) referral pathways and access to support, (iv) participation and equity: production pressure, (v) participation and equity: language barriers, (vi) communication and (vii) sustainability of the intervention. Conclusions: Embedding a tailored alcohol intervention within a ‘worker-wellbeing’ framework promoted acceptance. This approach enabled barriers to be addressed whilst identifying facilitators of success. These results add to a growing evidence base regarding the value of interventions that target alcohol and support replication of similar co-produced interventions in other workplace settings.