text:
- MargaretMargaret Lyons
- 3 years ago
- Views:
1 QUEENSLAND ALCOHOL AND OTHER DRUG TREATMENT SERVICE DELIVERY FRAMEWORK March 2015 The aim of Alcohol and Other Drug Treatment Services in Queensland is to provide effective, evidence- informed prevention, treatment and harm reduction responses that build a Queensland community with the lowest possible levels of alcohol, tobacco and drug related harm.
2 About this document This framework document describes the common ground underpinning alcohol and other drug (AOD) treatment service delivery in Queensland. It outlines the mission, aims, objectives, values, understandings, established tools, therapeutic approaches, practice principles and standards that inform the state s AOD treatment sector. The document has been developed by a partnership of statewide AOD policy, sector and workforce development organisations based on direct input, feedback and research from AOD treatment providers from across Queensland. The framework is not intended to replace organisational policy or compel workers to practice in a particular manner. However it is intended to reflect a consensus across AOD treatment providers both government and non- government on common and accepted good practice. The potential applications of this framework include: Communicating with other sectors the overall aim, purpose and defining characteristics of AOD treatment in Queensland As a benchmark against which to assess new or alternative treatment approaches to determine whether they are consistent with what is commonly accepted as good practice As a critical reflection tool for individual workers and services to enhance their practice For orienting new workers to the sector This framework was informed by Surveys conducted with Public Health Alcohol Tobacco and Other Drug Services (ATODS) and non- government AOD service providers in April and May 2014 Data collected at the Queensland AOD Convention held on Wednesday 23 rd July 2014 at Rydges Hotel, Brisbane. The Convention was attended by 107 service managers, policy makers and sector leaders from across the government and non- government AOD sector in Queensland The Queensland AOD Convention Report released in October 2014 The Queensland AOD Treatment Service Delivery Framework was officially released in March For more information contact one of the following authors: Rebecca MacBean Chief Executive Officer, Queensland Network of Alcohol and other Drug Agencies Jeff Buckley Principal Consultant, Statewide Clinical Support Services (Insight/Dovetail) Metro North Hospital & Health Service Kate Podevin Principal Policy Officer, Mental Health Alcohol and Other Drugs Branch, Department of Health Linda Hipper Director, Addiction Services, Metro South Hospital & Health Service Chair, AOD Service Improvement Group, Queensland Health Dion Tatow General Manager Business Innovation & Service Development, Queensland Aboriginal and Islander Health Council Eddie Fewings Substance Use Policy and Program Officer Queensland Aboriginal and Islander Health Council
3 Introduction The use of alcohol, tobacco and other drugs causes a range of issues and problems for many Queenslanders. Whilst many people are able to use substances without experiencing any significant harm, there is a proportion of the population who require specialist support ranging from brief, one- off assistance to complex, long term treatment. Providing the right support, at the right time, for the right duration, can help avoid or reduce a range of physical, psychological and social harms from occurring for these individuals, their families and their communities. The way in which AOD services are delivered in Queensland is affected by a number of factors including national and state- based policies, geographical location, service system capacity and other broad economic, environmental and social determinants. In particular the vast distances and diverse make- up of the state s communities presents complex challenges in terms of meeting client need, minimising sector fragmentation and reducing barriers to treatment. The impact of recent natural disasters must also be considered when planning, delivering and reviewing AOD treatment services in Queensland. Harm minimisation comprises three pillars: supply reduction (efforts to reduce the availability of alcohol and other drugs), demand reduction (efforts to reduce people seeking to use alcohol and other drugs through prevention, early intervention and treatment measures) and harm reduction (measures to minimise the harms that a person may experience as a result of their substance use). The majority of AOD treatment provision falls under the domains of demand reduction and harm reduction. Alongside the National Drug Strategy sits the National Drug Strategy Aboriginal and Torres Strait Islander People's Complementary Action Plan , which provides a nationally co- ordinated and integrated approach to reduce drug- related harm among Aboriginal and Torres Strait Islander People. Current AOD Policy Context National AOD Policy Australia is recognised internationally as having a comprehensive and pragmatic approach to AOD policy which for the past 30 years has been based upon the principles of harm minimisation. This approach is enshrined within the National Drug Strategy The Plan strongly advocates the need for a holistic approach to health and the importance of community controlled services, detailing 6 Key Result Areas based on the themes enhanced capacity; a whole- of- government commitment; improved access; holistic approaches; workforce initiatives; and sustainable partnerships. Despite having lapsed in date, the Complementary Action Plan is still considered to be a relevant and useful framework for guiding AOD service delivery with Aboriginal and Torres Strait Islander communities.
4 Queensland AOD Policy The Queensland Mental Health Commission (QMHC) has responsibility for setting statewide Mental Health, Alcohol and Other Drug strategic direction. The QMHC Whole of Government Strategic Plan released in October 2014 identifies a commitment to developing a Drug and Alcohol Action Plan as a Stage 1 Priority. Due to be released in 2015, the Drug and Alcohol Action Plan will focus on actions to prevent and reduce the adverse impacts of alcohol and drugs on the health and wellbeing of Queenslanders. The Mental Health Alcohol and Other Drugs (MHAOD) Branch within the Department of Health is responsible for setting the state s AOD treatment services policy and investment framework. The Branch also set targets and collects data on public health AOD treatment provision and administers funding of non- government AOD services. Identifying the AOD Treatment Sector in Queensland In Queensland, AOD treatment is provided by: Public health Mental Health and Alcohol, Tobacco and Other Drug Services (MH- ATODS) and public hospitals Non- government organisations (NGOs), including Aboriginal and Torres Strait Islander community controlled organisations General Practitioners and other private healthcare providers Table 1: Key AOD treatment types PREVENTION & EARLY INTERVENTION Harm has not yet occurred Health Promotion & Universal Prevention Selective (at risk) Indicated (high risk) Secondary Prevention INTERVENTION Harm is occurring Standard Intervention Complex / Intensive Intervention MAINTENANCE / AFTERCARE Mitigating further harm Maintenance / Stabilisation Continuing Care Exit / Universal Healthcare Primary healthcare /general community care Specialist Alcohol and Other Drug Services Primary health / general community care GPs / Telephone and Advice lines Community & School Based Education Needle and Syringe Programs (Primary and Secondary) Parent / Carer and Family Services Community & School Based Education Counselling / Casework / Case Management Public Intoxication / Volatile Substance Misuse Services Supported Aftercare Housing Assertive Outreach Services Peer Support Programs (including 12 step ) Opioid Treatment Programs Residential withdrawal, Rehabilitation Centres + Therapeutic Communities Ambulatory / Outpatient Detoxification Specialist & Emergency Hospital Services Statewide Workforce and Sector Development Programs Statewide Policy and Systems Manager 4
5 The AOD Services Spectrum Table 1 locates key AOD treatment types across each domain of health care. It also attempts to match these service types against changing levels of substance- related harm. NB: This table is indicative only. Individual organisations and programs may conceptualise their role differently to what is presented here. As Table 1 suggests, AOD treatment takes many forms, occurs in a variety of settings, has varying levels of intensity and takes varying lengths of time. Together, these services comprise a diverse and comprehensive AOD treatment system bridging the primary health sector, early intervention, acute care, community- based and longer- term rehabilitation service spectrum. For example, treatment can include: opportunistic interventions involving brief, informal interactions by primary health care services, more intensive interventions such as drug withdrawal for severe dependence in a hospital setting, long term counselling and relapse prevention interventions provided on a community outpatient basis, or long term, intensive rehabilitation services including residential rehabilitation and therapeutic communities. Specialist AOD Treatment Services There is an important difference between generalist services who offer some AOD related support as part of their service mix, and specialist AOD treatment services. Due to the complex nature of problematic substance use a distinct standalone treatment services system is essential to ensure clients receive an appropriate and effective treatment response. This type of care is not always able to be provided in primary health care, general practice or mental health care settings. For example, specialist AOD services focus specifically on individuals whose level of substance use exposes them to significant risk (ie Needle and Syringe Programs) through to the provision of specific treatments to address substance dependence or problematic substance use (i.e. detoxification services and therapeutic communities) and to maintenance and stabilisation services (such as Opioid Treatment Programs). Whilst specialist AOD treatment services can respond to a range of issues, addressing the client s substance use is their primary focus and concern. Once the level of risk or harm has been addressed transition to another service or exit usually occurs. Statewide AOD Workforce and Sector Development In Queensland, statewide AOD workforce and sector development services are performed by: The Queensland Network of Alcohol and Other Drug Agencies (QNADA) - a membership based not for profit organisation focusing on non- government AOD service providers; The Queensland Indigenous Substance Misuse Council (QISMC) through Queensland Aboriginal and Islander Health Council which supports community controlled specialist AOD service providers and Aboriginal and Torres Strait Islander health services; and Queensland Health s Statewide Clinical Support Services comprising Insight Training and Education Services, Dovetail Youth AOD Practice Support Unit, Aboriginal and Torres Strait Islander Practice Support Unit and an AOD Research and Development Unit, based within Metro North Mental Health Alcohol and Drug Service, Metro North Hospital and Health Service. 5
6 Sector Mission The provision of effective, evidence- informed prevention, treatment and harm- reduction responses that build a Queensland community with the lowest possible levels of alcohol, tobacco and other drug related harm. Our Values AOD practice with individuals, families and communities in Queensland is characterised by a commitment to the following set of practice values: Harm minimisation Social justice Non- discrimination Respect and dignity Compassion Non- judgment Empowerment Client- centred practice Strengths- based practice Holistic care Inclusivity, accessibility, flexibility and responsiveness Voluntary access AOD treatment providers in Queensland are committed to the following set of sector and workforce values: Being informed by evidence Professionalism Ethical practice Accountability and transparency Confidentiality and privacy Cultural security Collaborative practice Innovation and creativity A commitment to safety A commitment to excellence A commitment to achieving outcomes and results, and A commitment to continuous quality improvement. Aims, Objectives and Anticipated Outcomes of AOD Treatment In Queensland the primary objectives of AOD treatment are: 1) To reduce the client s level of substance use 2) To reduce the client s experience of AOD- related harm 3) To build the client s capacity to better understand and manage their own health and wellbeing. Secondary objectives or outcomes of AOD treatment include: 1) Improved physical and mental health 2) Improved resilience, confidence, self- esteem and sense of self- worth. Other outcomes which may be achieved through AOD treatment include: 1) Improved relationships with partners, family members and friends 2) Improved life skills 3) Improved housing or living conditions 4) Improved education, training and employment- related outcomes 5) Improved legal and justice- related outcomes. Ultimately, an effective AOD treatment is where a client is provided with appropriate information and support to identify their own treatment goals and then assisted to achieve these goals in a safe, effective and timely manner. 6
7 Stages of Change Model The Transtheoretical (or Stages of Change ) Model developed by James Prochaska and Carlo DiClemente in the 1980s is widely used in AOD treatment services as a tool for guiding psycho- social interventions. It proposes that all individuals move through the following series of stages when attempting to change or modify problematic behaviour: pre- contemplation contemplation preparation action maintenance relapse Identifying the client s stage in relation to their readiness or motivation to change determines what types of interventions may best be applied, as well as the range of possible outcomes that may be achieved. 1. Prochaska J O, DiClemente, C C. The transtheoretical approach. In Norcross, J C, Goldfried, M R (eds.) Handbook of psychotherapy integration. 2 nd ed. New York: Oxford University Press; 2005, Recovery in AOD Treatment Settings In the context of Queensland AOD treatment, the term Recovery is used to describe any approach that seeks to identify and achieve goals that are meaningful to the client, which may include safer using practices, reduced use or abstinence. For many people, recovery describes a holistic approach that offers greater opportunity for positive engagement with families, friends and communities. Treatment Types Defined In Queensland, the following treatment types are offered: ACTIVITY Alcohol Pharmacotherapy Ambulatory / Out- client / Home- based withdrawal management and support (detoxification), Assessment only Brief Intervention DEFINITION The use of medication to support abstinence for individuals with alcohol dependence. The provision of short term management or support to people who do not require, or no longer require, inpatient withdrawal management. Suitable for low level, withdrawal with low predicted withdrawal complexity, though in some cases, withdrawal pharmacotherapies may be clinically indicated. Undertaking a stand- alone AOD assessment with the understanding that there will be no subsequent treatment offered (i.e. upon request by other professions / practitioners for court, for external treatment planning or for clients referred by a GP or hospital for an assessment for therapeutic use of prescription opiates) A one- off structured intervention between 5 and 60 mins in length, which involves a brief or basic assessment and provision of information and feedback. 7
8 ACTIVITY Case Management Casework Consultation and liaison Counselling Discharge planning, aftercare/continued care Information and education only for clients individually Information and education only for clients in groups Inpatient / Residential withdrawal management and support (detoxification) Intake and screening Medical Interventions Mentoring programs Needle and Syringe Program Primary Service Needle and Syringe Program Secondary Service Nicotine Replacement / Smoking Cessation Therapy Opioid Treatment Program Peer support groups Police Diversion, Illicit Drugs Court Diversion, and Drug and Alcohol Assessment Referral Courses Queensland Court Referral DEFINITION The planning, coordinating, brokering and monitoring of a treatment plan. The implementation of a treatment plan, driven by both client and practitioner. Provision of advice and support to clients and health professionals at the interface between the AOD sector and the broader health sector, usually in hospital or community health settings. Establishing a professional therapeutic relationship utilising a structured, intentional conversational method to assist clients to identify and resolve personal, social or psychological difficulties. A process of identifying and documenting a client s needs post treatment, generally including relapse prevention and harm reduction information. May include the provision of supported accommodation during the initial transition stage from residential withdrawal or treatment. No treatment provided to an individual client other than information and education. No treatment provided to clients in a group setting other than information and education. The provision of a very high (hospital setting or withdrawal unit) or moderately high (residential settings) level of medically assisted care for clients undertaking an alcohol or other drugs withdrawal process. It is the preferred treatment setting for those assessed as having a risk of complex or severe withdrawal symptoms. A process to determine if engagement with a client is appropriate based on their needs, what treatment and support options are available in the service system, whether the client is voluntary or coerced and whether the client has additional needs related to their age, ability, gender, sexuality or cultural background. The provision of AOD related medical interventions including pharmacotherapies, withdrawal management, BBV screening, Hepatitis vaccination, and medical assessment, intervention and referral for a range of physical and psychological conditions. Non- clinical, personalised support programs that involve matching volunteer mentors with client mentorees for life- skill or interest- based interactions, including cultural men s and women s groups. Provision of a full range of sterile injecting equipment alongside harm reduction interventions such as Blood Borne Virus (BBV), vein care, safe disposal and referral info. Provision of basic sterile injecting equipment only, distributed by non- NSP staff or through vending machines. The administration of either nicotine or a nicotine- receptor- partial- agonist via means other than tobacco to reduce or eliminate withdrawal symptoms and nicotine cravings. Clinically supervised replacement of the drug of dependence with a legally obtained, longer- lasting opioid that is administered to reduce or eliminate withdrawal symptoms and drug cravings. Voluntary, self help groups open to individuals seeking to address their AOD use, or to maintain abstinence (including AA, NA, SMART Recovery). These groups may also support the family and friends of people with AOD issues (e.g. Alanon). Provision of a one- off 1-2 hour assessment and brief intervention session for clients referred by Queensland Police or by a Queensland Magistrates Court. A bail- based program that enables defendants to engage with government agencies and non- government organisations to address the causes of offending behaviour by identifying those defendants who come into contact with the criminal justice system as a result of: drug and/or alcohol dependency; mental illness; intellectual disability; cognitive impairment; and/or homelessness, or risk of homelessness. 8
9 ACTIVITY Queensland Magistrates Early Referral Into Treatment Program Residential Rehabilitation Standalone Client Advocacy Therapeutic Community Therapeutic groups Treatment Planning and review DEFINITION A bail- based diversion program for defendants with illicit drug use issues operating in the Maroochydore and Redcliffe Magistrates Courts. An intensive treatment program conducted in a residential setting typically offering a mixture of one- on- one, group work, peer support and team/community building processes. Provision of direct support to a client in navigating a service system. A residential treatment program that utilises the Community as method approach, incorporating distinct stages of treatment (generally covering assessment/orientation, treatment, transition and re- entry). Structured groups for individuals seeking help with their AOD use, facilitated by a clinician. A process of identifying and documenting a client s goals in relation to their alcohol and drug use to be used to guide their interaction with a treatment service, as well as the periodic review (at least every 90 days) of these goals to ensure continuing relevance of the treatment approach. Service Quality, Standards and Improvements Queensland s AOD treatment services use a range of standards and clinical guidelines where it is relevant to practice and treatment settings. Commonly used tools and guidelines include: Alcohol treatment guidelines for Indigenous Australians (Dept of Health) AOD: A Handbook for Health Professionals (Dept of Health) Australian Therapeutic Community Standards Brief Cognitive Intervention for Regular Amphetamine Users (Dept of Health) Brief Intervention for Substance Use (WHO) Can I Ask?... AOD Clinicians Guide to Addressing Domestic and Family Violence (NCETA) Clinical Guidelines for the care of persons with comorbid mental illness and substance use disorders in acute care settings (NSW Health) Clinical guidelines for the provision of residential treatment (NSW Health) Counselling Guidelines: AOD Issues (WA Drug and Alcohol Office) Dovetail Youth AOD Good Practice Guides Drug and alcohol clinical supervision guidelines (NSW Health) Guidelines for AOD Clinicians (Turning Point) Guidelines for psychosocial interventions (NSW Health) Management of Patients with Psychostimulant Toxicity (NDS) National Clinical Guidelines for Managing Drug use during Pregnancy (NSW Dept of Health) National Comorbidity Clinical Guidelines (NDARC) Protocols for the delivery of social and emotional wellbeing and mental health care in Indigenous settings: Guidelines for health workers, clinicians, consumers and carers. Queensland Alcohol and Drug Withdrawal Clinical Practice Guidelines (May 2012) Queensland Health Dual Diagnosis Clinical Guidelines Queensland Opioid Treatment Program: Clinical Guidelines 2012 The Standard on Culturally Secure Practice (AOD Sector) Therapeutic Practice Frameworks in Youth AOD Services (YSAS) Working Together 2 nd Edition: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principals and Practice 9
10 Key Features of Effective Services Effective AOD treatment services in Queensland are: evidence- informed, targeted to the right clients, timely, responsive and comprehensive, safe, welcoming and non- stigmatising, accessible and easily contactable in terms of location and opening hours, accessible in relation to any physical, environmental or procedural barriers, culturally, religiously, gender, age and developmentally appropriate, and are of adequate standard, staffed by appropriately trained and skilled staff. Effective AOD services also: promote choice and control by clients monitor progress of all clients to ensure that their service is targeted, coordinated and efficient, provide continuity of care not only with other AOD services, but also with other health and welfare systems (eg mental health, disability, housing, homelessness and statutory care services), encourage and enable clients and their carers to provide input and feedback to the service, including opportunities for further engagement where appropriate, regularly monitor and evaluate their own qualitative and quantitative performance, and use this to inform a process of continuous service quality improvement. Case Management and Casework Case management and casework are common models of support offered to clients across a range of AOD treatment settings. While it is acknowledged that many practitioners use these terms differently, even interchangeably, particularly in official job titles and role descriptions, the Queensland AOD Sector considers there to be an operational distinction between the practise of case management and casework, as per the following statement: In the context of AOD treatment, Case Management comprises the planning, coordinating, brokering and monitoring of a treatment plan, whereas Casework is the implementation or actual doing of that plan, and is driven by the client and practitioner Endorsed Counselling Approaches AOD services must offer treatment and counselling approaches that match the individual needs and circumstances identified by each client. Evidence- informed counselling approaches that are commonly utilised in AOD treatment in Queensland include: Motivational enhancement / interviewing Cognitive Behavioural Therapy Mindfulness Acceptance and Commitment Therapy Solution Focussed Therapy Narrative Therapy Emotional Regulation Therapy Contingency Management 10
11 The following approaches, whilst not commonly practised in AOD treatment settings across Queensland, are recognised as valid and appropriate for use in certain contexts: Dialectical Behavioural Therapy Art / Music Therapy Exercise and Healthy Lifestyle Programs Other counselling, therapeutic or experiential approaches not listed here may offer positive benefits to clients, however they are not commonly practised in Queensland. Outreach Many AOD services in Queensland use outreach approaches to locate and/or provide treatment to clients. Importantly, outreach is not an intervention in and of itself. Rather it is a non- agency based approach to working with clients in order to facilitate interventions. The Queensland AOD Sector adopts the following definitions to describe the four main outreach modalities offered: Assertive Street Work: Actively looking for individuals who are not currently in AOD treatment in public space locations such as the streets, malls, parks, shopping centres etc, sometimes after hours. Assertive Community Outreach: Actively looking for individuals who are not currently in AOD treatment at other health, social and accommodation service settings, such as hospital emergency departments, Centrelink offices, boarding houses etc. Clinical Outreach: Structured, planned work with clients in another health or support service s venue, such as a hospital, health service, community centre or youth service. Detached / Mobile Outreach: Structured, planned work with clients in their own homes, workplaces or other agreed settings. Intake, Screening and Assessment Intake, screening and assessment should be conducted in a way that enables a service to successfully determine whether further engagement with an individual is appropriate based on the client s needs and the services available. The process should begin with effective engagement and rapport building so that the client feels safe and welcomed. The client s rights and responsibilities must be clearly explained from the outset, including confidentiality and privacy provisions and how to lodge a complaint. The client should be provided with information on all treatment options available (including those offered by other nearby services) to ensure they are able to make an informed choice of service based on appropriate treatment, matched to their needs. Where the person conducting the assessment believes there is a strong chance the client will not return for further treatment, the session should include a discussion on harm reduction strategies and an exploration of further support options. Screening and Assessment Tools The following screening and assessment tools are most commonly used by the Queensland AOD Sector: Alcohol Use Disorders Identification Test (AUDIT) DASS 21 (Depression, Anxiety, Stress Scales) Kessler 10 (K- 10) Severity of Dependence Scale Self Harming / Suicidal Ideation Indigenous Risk Impact Screen (IRIS) Substance and Choices Scale Folstein Mini Mental State Examination DSM Dependence Rating Aggressive/Homicidal Ideation Fagerström Nicotine Tolerance Questionnaire Psycheck. 11
12 Waiting List Management Where an AOD treatment service is deemed appropriate but not immediately available, service providers should operate a fair, equitable and clearly explained waiting list. If the service is not deemed suitable, service providers should refer the client to the most appropriate service or option available as soon as possible, and offer assistance to make contact with these services. Treatment Planning and Referral Effective treatment planning and referral is essential to maximising client outcomes. Treatment plans should be documented, developed in negotiation with the client and reflect issues identified during the screening and assessment process. The documented plan should clearly articulate the client s treatment goals, strategies in place to achieve these goals and be regularly reviewed and updated (either triggered by a review timeframe or by the client or clinician). Post- treatment referral processes should be documented, ensuring the client is not required to re- tell their story unless they request it. Referrals should only be made once the client has provided informed consent. It is good practice for agencies to follow up their referrals to determine if they were successful and for the receiving agency to provide feedback to the referrer on the process and outcome of the referral. A successful referral is one that results in the client receiving services from the agency to which they were referred. Case coordination between agencies that have a client in common should be conducted with full client knowledge and consent, unless in exceptional circumstances when there is significant or urgent risk of harm to the client or someone else. Case coordination is generally more effective when: A lead agent is identified who ensures competent case management Clear agreements are reached between agencies (e.g. Terms of Reference, MOUs) Coordinated treatment plans are regularly monitored and reviewed A crisis intervention plan is prepared in advance. AOD Treatment in Aboriginal and Torres Strait Islander Communities Community controlled alcohol and other drug services are initiated by local Aboriginal and Torres Strait Islander people and deliver holistic and culturally appropriate care to people within their communities. Aboriginal and Torres Strait Islander issues around AOD misuse are complex and multi causal and addressing these issues requires a comprehensive approach that considers social determinants, prevention, culturally safe care and treatment and support to clients, families and communities. Case Coordination and Service Integration Many individuals seeking AOD treatment also experience a range of co- occurring issues or co- morbidities including poor physical and mental health, relationship breakdown, housing stress, financial strain and legal problems. Effective case coordination is required so that clients experience continuity of care. Indigenous Stages of Change model developed from the Cycle of Behaviour Change, Living With Alcohol Program (2000) Artists: Terry Simmons and Sophia Conway from Titjikala Community [ 12
13 In providing treatment services Aboriginal and Torres Strait Islander community controlled organisations: Provide appropriate assessment and treatment options for clients Address social and emotional wellbeing needs of clients which includes connection to culture, family, land and spirituality Consider implications of family and community in treatment Provide holistic treatment services Provide ongoing support post treatment For non- Indigenous services this includes developing, sustaining and demonstrating cultural competency in service delivery through: Partnering and collaborating with the Aboriginal and Torres Strait Islander AOD sector and communities Participation of Aboriginal and Torres Strait Islander people in governance, management and service delivery levels of the organisation Delivering meaningful outcomes for Aboriginal and Torres Strait Islander people and communities. AOD Practice with Specific Populations The Queensland AOD Sector recognises that specific population groups have particular needs, concerns and barriers that need to be addressed in order to provide fair and accessible AOD treatment. These groups include: Intoxicated clients People who inject People with co- occurring mental health issues People who have a physical disability and/or intellectual impairment People who live in rural and remote areas Criminal justice clients Pregnant women and parents Young people Culturally and linguistically diverse clients Refugees and asylum seekers Lesbian, gay, bisexual, transgender and intersex populations Family members and significant others Queensland AOD Services acknowledge the need for ongoing training, workforce and sector capacity building to improve individual practitioners and service providers ability to work better with these population groups. Engaging Clients and Service Users The Queensland AOD Sector acknowledges the value of meaningful engagement with clients to ensure services meet their needs. Available engagement strategies include a mix of quick, opportunistic tools (such as feedback forms, surveys, questionnaires and suggestion boxes) to deeper engagement options (such as client meetings, focus groups, consumer committees and opportunities to be a member on boards, reference groups and interview panels where appropriate). In order to maximise the benefit of the engagement for both client and agency, the provision of clear, honest communication including a feedback loop from management should be maintained. Clients who participate in service development activities should ideally be paid for their contribution and reimbursed for any outlay or expense they incur. Furthermore clients should be supported to build practical skills and competencies wherever possible. Continuing Care and Exit The Queensland AOD Sector acknowledges that continuing care is just as important as treatment. Providers are therefore committed to high quality post- vention services where necessary alongside well- executed exit processes when treatment is complete or when a client exits treatment earlier than planned. 13
14 The Queensland AOD Sector considers the following practice principles necessary for effective continuing care and/or exit: Commence transition planning in the earlier stages of treatment which may include the preparation of a documented exit plan Explore and regularly revisit relapse prevention strategies in the lead- up to transition Maintain regular communication during transition. Measuring Client Outcomes Measuring the impact of AOD treatment in the lives of clients and communities is essential to ensuring that organisational practice standards continue to improve. Because clients of AOD services often have multiple and complex needs, the same set or types of outcomes are not sought for each and every individual. Nevertheless there is general consensus around a number of outcome domains that can be reasonably expected to be impacted by AOD treatment which could be measured. These are: Changes in amount and/or frequency of substance use Changes in risky behaviour Changes in social and emotional wellbeing Changes in mental health Changes in physical health Increased knowledge of health / AOD risks and harms Increased life skills Changes in self esteem Conversely, it is difficult to measure or reasonably establish the impact of AOD treatment on the following domains: Ability to comply with legal or statutory directives Changes in housing / accommodation Changes to participation in education / training / work Changes in criminal / offending behaviour Developing new and improved outcomes measurement tools that offer a good balance between validity, reliability and utility across treatment settings is a priority for the AOD services sector in Queensland. Conclusion Queensland boasts a vibrant, skilled and dedicated AOD treatment service sector committed to reducing alcohol and drug related harms and increasing the quality of life for the state s residents. Queensland s AOD services are also committed to building their connections with each other and with other health and welfare services in order to provide comprehensive and integrated care to our state s most vulnerable. This framework document is a product of this commitment and serves as a foundation for the future advancement of the AOD treatment sector in Queensland. Date for Review: July
About this document. The Queensland AOD Treatment Service Delivery Framework was officially released in March 2015.
QUEENSLAND ALCOHOL AND OTHER DRUG TREATMENT SERVICE DELIVERY FRAMEWORK March 2015 The aim of Alcohol and Other Drug Treatment Services in Queensland is to provide effective, evidence-informed prevention,More information
Clinical Service Plan. Addiction Services Academic Clinical Unit
Clinical Service Plan Addiction Services Academic Clinical Unit Addiction Services The misuse of alcohol and other drugs has profound impacts on the lives of many Queenslanders. Substance use can damageMore information
Future Service Directions
Alcohol, Tobacco and Other Drug Services Tasmania Future Service Directions A five year plan 2008/09 2012/13 Department of Health and Human Services Contents Foreword... 5 Introduction... 6 AustralianMore information
Queensland Health Policy
Queensland Health Policy Service delivery for people with dual diagnosis (co-occurring mental health and alcohol and other drug problems) September 2008 Policy statement Individuals experiencing dual diagnosisMore information
The Recovery Pathway Service forms a key component of the Sunderland Integrated Substance Misuse Service, as illustrated below:
SERVICE SPECIFICATION LOT 1 RECOVERY PATHWAY 1.0 SERVICE MODEL The Recovery Pathway Service forms a key component of the Sunderland Integrated Substance Misuse Service, as illustrated below: Recovery OutcomesMore information
Submission to the Tasmanian Government. Rethink Mental Health Project Discussion Paper
Submission to the Tasmanian Government Rethink Mental Health Project Discussion Paper February 2015 Alcohol, Tobacco and other Drugs Council of Tas Inc. (ATDC) www.atdc.org.au ABN: 91 912 070 942 Phone:More information
South Eastern Melbourne Partners in Recovery Service System Reform Implementation Plan
South Eastern Melbourne Partners in Recovery Service System Reform Implementation Plan Introduction Partners in Recovery (PIR) is a national program that aims to support people with enduring mental illnessMore information
DUAL DIAGNOSIS POLICY 1. POLICY PURPOSE AND RATIONALE Anglicare Victoria provides services to individuals, young people and families in crisis, including individuals experiencing mental health and alcoholMore information
Senior AOD Clinician - Counselling & Assessment POSCS3029
POSITION DESCRIPTION Senior AOD Clinician - Counselling & Assessment POSCS3029 ISO9001 Approved by Neos Zavrou Next Revision: 02/09/15 Hours: Location: Classification: Reports To: Reports: 1 EFT NorthernMore information
Directory for Substance Misuse Services in Caerphilly
Directory for Substance Misuse s in Caerphilly Background Substance Misuse services use a tiered approach in their approach and delivering of drug/alcohol services. These are as follows: Tier 1 InterventionsMore information
Australian ssociation
Australian ssociation Practice Standards for Social Workers: Achieving Outcomes of Social Workers Australian Association of Social Workers September 2003 Contents Page Introduction... 3 Format of the Standards...More information
CAAPS Alcohol and Other Drug Services. An evidence based approach to providing AOD treatment to Aboriginal people and their families
CAAPS Alcohol and Other Drug Services An evidence based approach to providing AOD treatment to Aboriginal people and their families 1 Contents Introduction 2 CAAPS Services 3 Policy Context 4 GuidelinesMore information
National Standards for Mental Health Services
National Standards for Mental Health Services 2010 Contents Foreword 2 Standard 1. Rights and responsibilities 7 Standard 2. Safety 9 Standard 3. Consumer and carer participation 11 Standard 4. DiversityMore information
Alcohol and Other Drug Youth Clinician. Fixed Term (until 30 June 2015) Part time (0.6 EFT) Negotiable. From $57,500 $63,400
Position Details Position Title Mode of Employment Time Fraction Award/EBA Classification Remuneration Salary Packaging Unit Location Reports to Direct Reports Probationary Period Working with ChildrenMore information
Manchester City Council Report for Information. Report to: Health Scrutiny Committee 23 October The Adult Drug Treatment System in Manchester
Manchester City Council Report for Information Report to: Health Scrutiny Committee 23 October 2014 Subject: Report of: The Adult Drug Treatment System in Manchester Director of Public Health Summary TheMore information
CHC30112 Certificate III in Community Services Work
CHC30112 Certificate III in Community Services Work Course information and vocational outcomes This nationally accredited qualification applies to community work that is delivered through a broad rangeMore information
The National Health Plan for Young Australians An action plan to protect and promote the health of children and young people
The National Health Plan for Young Australians An action plan to protect and promote the health of children and young people Copyright 1997 ISBN 0 642 27200 X This work is copyright. It may be reproducedMore information
ACCESS Placements!!! Apply now and spent 2 weeks in the UK in 2012 alongside service providers in the drugs and criminal justice area!!!!
ACCESS Placements!!! Apply now and spent 2 weeks in the UK in 2012 alongside service providers in the drugs and criminal justice area!!!! Placements outline: The ACCESS project opens opportunities forMore information
Role Description APPLICATIONS WILL NOT BE ACCEPTED BY A THIRD PARTY Job ad reference: MH202794 Closing Date: Monday, 15 February 2016 Role title: Aboriginal and Torres Strait Islander Alcohol and DrugMore information
General Hospital Information
Inpatient Programs General Hospital Information General Information The Melbourne Clinic is a purpose built psychiatric hospital established in 1975, intially privately owned by a group of psychiatristsMore information
People s views on priority areas for change. Paul Farmer Chair, Mental Health Taskforce
People s views on priority areas for change Paul Farmer Chair, Mental Health Taskforce 20k respondents to Mind and Rethink Mental Illness online survey Five groups: People with lived experience FamiliesMore information
DRAFT OPERATIONAL GUIDELINES FOR ACCESS TO ALLIED PSYCHOLOGICAL SERVICES (ATAPS) TIER 2 ABORIGINAL AND TORRES STRAIT ISLANDERS MENTAL HEALTH SERVICES APRIL 2012 Mental Health Services Branch Mental HealthMore information
Learning Disabilities Nursing: Field Specific Competencies
Learning Disabilities Nursing: Field Specific Competencies Page 7 Learning Disabilities Nursing: Field Specific Competencies Competency (Learning disabilities) and application Domain and ESC Suitable itemsMore information
Victorian Alcohol and Other Drug Treatment Services Sector Reform. Frequently Asked Questions
Victorian Alcohol and Other Drug Treatment Services Sector Reform Frequently Asked Questions CONTENTS Why is the Victorian Government reforming the alcohol and drug treatment sector?... 2 How will theseMore information
Practitioner Guidance for Somerset Drug and Alcohol Assessment Tool for Young People. 2nd edition October 2014. Guide
Practitioner Guidance for Somerset Drug and Alcohol Assessment Tool for Young People 2nd edition October 2014 Guide Introduction This document provides practitioners with guidance on using the SomersetMore information
2. The Aims of a Dual Diagnosis Accommodation Based Support Service
SERVICE SPECIFICATION FOR: Dual Diagnosis Mental Health and Substance Misuse Supported Housing Service The specification describes the Service to be delivered under the Steady State Contract for ProvisionMore information
South Australian Women s Health Policy
South Australian Women s Health Policy 1 2 South Australian Women s Health Policy To order copies of this publication, please contact: Department of Health PO Box 287 Rundle Mall Adelaide SA 5000 Telephone:More information
CHC52015 Diploma of Community Services
CHC52015 Diploma of Community Services Release 1 CHC52015 Diploma of Community Services Modification History Release Release 1 Comments This version was released in CHC Community Services Training PackageMore information
EARLY INTERVENTION AND PREVENTION STRATEGY 2012-15 Summary
EARLY INTERVENTION AND PREVENTION STRATEGY 2012-15 Summary Plymouth Children, Young People and Families Partnership INTRODUCTION Why do we need early intervention in Plymouth? We know that effective earlyMore information
Milton Keynes Drug and Alcohol Strategy 2014-17
Health and Wellbeing Board Milton Keynes Drug and Alcohol Strategy 2014-17 www.milton-keynes.gov.uk 2 Contents Foreword 4 Introduction 5 National context 6 Local context 7 Values and principles 9 PrioritiesMore information
Wairarapa Wellness. A brief overview of mental health and addiction services in Wairarapa.
Wairarapa Wellness A brief overview of mental health and addiction services in Wairarapa. This brochure provides a general overview of the services Pathways, CareNZ and Workwise offer in the WairarapaMore information
Consultation Paper: Standards for Effectively Managing Mental Health Complaints
What is the purpose of this paper? The purpose of this paper is to encourage discussion and feedback from people who access, or work in, Western Australia s mental health sector. The paper proposes a draftMore information
Agency of Human Services
Agency of Human Services Practice Guidelines for the Identification and Treatment of Co-occurring Mental Health and Substance Abuse Issues In Children, Youth and Families The Vermont Practice GuidelinesMore information
Queensland Corrective Services Drug and Alcohol Policy
Queensland Corrective Services Drug and Alcohol Policy 2727QCS Commissioner s Foreword Drug and alcohol abuse is a significant issue confronting not only Queensland Corrective Services (QCS), but the entireMore information
1. How would you define vulnerability in terms of a young person (under 24 who is in NOMS custody?
Royal College of Nursing submission to the Independent Review into self- inflicted deaths in National Offender Management Service (NOMS) custody of 18-24 year olds With a membership of more than 410,000More information
Croydon Drug and Alcohol Services. Directory of drug and alcohol services available in Croydon
Croydon Drug and Alcohol Services Directory of drug and alcohol services available in Croydon April 2012 Croydon Treatment & Recovery Partnership Contact details Lantern Hall 190 Church Road Croydon CR0More information
(Health Scrutiny Sub-Committee 9 March 2009)
Somerset County Council Health Scrutiny Sub-Committee 9 March 2009 Drug and Alcohol Treatment Services Author: Amanda Payne Somerset DAAT Co-ordinator Contact Details: firstname.lastname@example.com PaperMore information
Queensland Mental Health Commission Issues Paper
Queensland Mental Health Commission Issues Paper Enhancing Youth Alcohol and Drug Practice in Queensland Prepared by Jeff Buckley and Cameron Francis, Dovetail Metro North Mental Health Alcohol and DrugMore information
UTAH DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH SUBSTANCE USE DISORDER SERVICES MONITORING CHECKLIST (FY 2014) Program Name Reviewer Name Date(s) of Review GENERAL PROGRAM REQUIREMENTS 2014 DivisionMore information
Children, youth and families with co-occurring mental health and substance abuse issues are welcomed in every contact, and in every setting.
Practice Guidelines for the Identification and Treatment of Co-occurring Mental Health and Substance Abuse Issues In Children, Youth and Families June, 2008 This document is adapted from The Vermont PracticeMore information
Integrated drug treatment system Treatment plan 2009/10. Part 1: Strategic summary, needs assessment and key priorities
Establishment: HMP Belmarsh Drugs partnership: Greenwich Primary Care Trust: Greenwich Integrated drug treatment system Treatment plan 2009/10 Part 1: Strategic summary, needs assessment and key prioritiesMore information
DUAL DIAGNOSIS PARTNERSHIP FRAMEWORK Authors Debra Bretherton Howard Thistlethwaite Gary Nichols Roy Butterworth Yvonne Guilfoyle Acknowledgements Leeds Dual Diagnosis Network C) 2009 Lancashire Care NHSMore information
Service Standards for Non-Government Providers of Community Mental Health Services. Department of Health Government of Western Australia
Service Standards for Non-Government Providers of Community Mental Health Services Department of Health Government of Western Australia Office of Mental Health Contents Introduction to the Standards 1More information
MERIT residential treatment guidelines. a guide for MERIT teams and residential treatment providers
MERIT residential treatment guidelines a guide for MERIT teams and residential treatment providers NSW DEPARTMENT OF HEALTH 73 Miller Street NORTH SYDNEY NSW 2060 Tel. (02) 9391 9000 Fax: (02) 9391 9101More information
Wesley Mental Health. Drug and Alcohol Addiction Program. Wesley Hospital Ashfield. Journey together
Wesley Mental Health Drug and Alcohol Addiction Program Wesley Hospital Ashfield Journey together Mission Continuing the work of Jesus Christ in Word and deed Wesley Mission is an organisation with a longMore information
Victorian Purchasing Guide. for. CHC Community Services Training Package. Release 2.1
Victorian Purchasing Guide for CHC Community Services Training Package Release 2.1 December 2015 State of Victoria (Department of Education and Training) 2015. Copyright of this material is reserved toMore information
Bsafe Blackpool Community Safety and Drugs Partnership. Drug and Alcohol treatment planning in the community for Young People and Adults 2012/13
Bsafe Blackpool Community Safety and Drugs Partnership Drug and Alcohol treatment planning in the community for Young People and Adults 2012/13 Planning Framework Treatment plan Planning Framework BsafeMore information
Victorian Alcohol and Other Drug Treatment Services Sector Reform. Frequently Asked Questions
Victorian Alcohol and Other Drug Treatment Services Sector Reform Frequently Asked Questions CONTENTS Why did the Victorian Government reform the alcohol and drug treatment sector?... 2 How will theseMore information
Specialist mental health service components
Specialist mental health service components The specialist public mental health system consists of clinical services and psychiatric disability rehabilitation and support services (PDRSS). Clinical mentalMore information
National Standards for Disability Services. DSS 1504.02.15 Version 0.1. December 2013
National Standards for Disability Services DSS 1504.02.15 Version 0.1. December 2013 National Standards for Disability Services Copyright statement All material is provided under a Creative Commons Attribution-NonCommercial-More information
Aboriginal and Torres Strait Islander. Carers. Education and Training Strategy
Aboriginal and Torres Strait Islander Carers Education and Training Strategy 1 Table of Contents Aboriginal and Torres Strait Islander Carers Education and Training Strategy Table of Contents 1. ContextMore information
3.5 Guidelines, Monitoring and Surveillance of At Risk Groups
3.5 Guidelines, Monitoring and Surveillance of At Risk Groups 3.5.6 Children of Parents who are Affected by Drug and Alcohol Misuse Background There is overwhelming evidence that the misuse of drugs andMore information
TREATMENT MODALITIES. May, 2013
TREATMENT MODALITIES May, 2013 Treatment Modalities New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) regulates the addiction treatment modalities offered in New York State.More information
A - DASH 15 Forest Lane Shenley, Nr Radlett Hertfordshire WD7 9HQ 01923 427 288 email@example.com
A-DASH is commissioned by the Joint Commissioning Group for Young People s Substance Misuse, a sub group of Hertfordshire Children s Trust Partnership. The service is based within Hertfordshire PartnershipMore information
HOSC Report Integrated community drugs and alcohol service retendering options beyond April 2016
HOSC Report Integrated community drugs and alcohol service retendering options beyond April 2016 Meeting Date Sponsor Report author Purpose of report (summary) 12 th May 2015 Margaret Willcox Steve O NeillMore information
Protocol for Accessing Residential Detoxification & Rehabilitation
Protocol for Accessing Residential Detoxification & Rehabilitation Protocol - working group members: Julie Murray, Alcohol & Drugs Partnership Co-ordinator Lynda Mays, Clinical Services Manager, Addictions,More information
WOMEN S ALCOHOL AND OTHER DRUG SERVICES DEVELOPMENT PROGRAM: WOMEN S AOD SERVICE DELIVERY ENHANCEMENT GRANTS APPLICATION FORM Applications close 5pm 7 th February 2014 PLEASE READ THE ACCOMPANYING INFORMATIONMore information
Adult drug treatment plan 2007/08 Part 1 Section A: Strategic summary Section B: National targets Section C: Partnership performance expectations
name Adult drug treatment plan Part 1 Section A: Strategic summary Section B: National targets Section C: expectations Published by NTA: 2 October This strategic summary incorporating national targetsMore information
Community Based Alcohol Services Consultation. Summary
Summary Forty individuals attended the consultation event on 24 June 2010, and 16 individuals returned their views through the consultation response form. Respondents included GPs, practice nurses, serviceMore information
Offenders and their families - making a difference CRISIS CARE COMMITMENT
Offenders and their families - making a difference CRISIS CARE COMMITMENT Red Cross is committed to an inclusive society where all people are valued, their differences are respected and their basic needsMore information
Specialist Alcohol & Drug Services in Lanarkshire
Specialist Alcohol & Drug Services in Lanarkshire This brochure describes what help is available within Lanarkshire s specialist treatment services. These include the North Lanarkshire Integrated AddictionMore information
TABLE OF CONTENTS INTRODUCTION...2 GUIDING PRINCIPLES...3 PURPOSE...3 FRAMEWORK FOR THE DELIVERY OF MENTAL HEALTH AND DISABILITY SERVICES IN QUEENSLAND...4 WHO SHOULD USE THE GUIDELINES...6 COMMUNICATIONMore information
Carers Queensland Inc. Submission for Queensland Health Brain Injury Rehabilitation Planning Project
Carers Queensland Inc. Submission for Queensland Health Brain Injury Rehabilitation Planning Project October 2014 Submission Title: Brain Injury Rehabilitation Planning Project Date: 24 October 2014 Author:More information
Scope of Social Work Practice in Health
in Health Section 1 The unique contribution of social work practice in the health context The social work profession operates at the interface between people and their social, cultural, physical and naturalMore information
THE CREDIT BAIL SUPPORT PROGRAM. A guide to working with the CREDIT Bail Support Program- August 2005
THE CREDIT BAIL SUPPORT PROGRAM A guide to working with the CREDIT Bail Support Program- August 2005 Published by the Victorian Government Department of Human Services Melbourne, Victoria Copyright StateMore information
Human Services Quality Framework. User Guide
Human Services Quality Framework User Guide Purpose The purpose of the user guide is to assist in interpreting and applying the Human Services Quality Standards and associated indicators across all serviceMore information
North Ayrshire Alcohol & Drug Recovery Services
North Ayrshire Alcohol & Drug Recovery Services This table aims to help you identify the most appropriate support service for an individual who has concerns around their alcohol or drug use. Each serviceMore information
Performance Standards
Performance Standards Co-Occurring Disorder Competency Performance Standards are intended to provide a foundation and serve as a tool to promote continuous quality improvement and progression toward bestMore information
Appendix D. Behavioral Health Partnership. Adolescent/Adult Substance Abuse Guidelines
Appendix D Behavioral Health Partnership Adolescent/Adult Substance Abuse Guidelines Handbook for Providers 92 ASAM CRITERIA The CT BHP utilizes the ASAM PPC-2R criteria for rendering decisions regardingMore information
POSITION DESCRIPTION: SECTION A: POSITION CONTEXT Position Title Community Mental Health Practitioner COPES Carer Peer Practitioner Position Reference 11916 Position Type Part time 15.2 hours per weekMore information
CHC50612 Diploma of Community Services Work
CHC50612 Diploma of Community Services Work Release: 1 CHC50612 Diploma of Community Services Work Modification History CHC08 Version 3 CHC08 Version 4 Comments CHC50608 Diploma of Community Services workMore information
CHC42015 Certificate IV in Community Services
CHC42015 Certificate IV in Community Services Release 1 CHC42015 Certificate IV in Community Services Modification History Release Release 1 Comments This version was released in CHC Community ServicesMore information
Management Information. Chief Social Work Officer
Management Information Lead Officer Name: Paul Woolrich Designation: Service Improvement Manager Tel: 58462 (0131 553 8462) Lead Service Area Support to Children & Young People Last Review Date DecemberMore information
Registered Nurse. Position description. Section A: position details. Organisational context
Position Description December 2015 / January 2016 Position description Registered Nurse Section A: position details Position title: Registered Nurse Employment Status: Full Time and Part Time (0.6FTE)More information
Seeing double: meeting the challenge of dual diagnosis. Introduction
briefing september 2009 ISSUE 189 Seeing double: meeting the challenge of dual diagnosis Key points Dual diagnosis affects a third of mental health service users, half of substance misuse service usersMore information
Developing the Guernsey treatment system for substance misusers: Phases One and Two. Helen Baldwin Linda Prickett Adam Marr Jim McVeigh
Developing the Guernsey treatment system for substance misusers: Phases One and Two Helen Baldwin Linda Prickett Adam Marr Jim McVeigh Roles and responsibilities of the LJMU research team Helen BaldwinMore information
WA Strategic Plan for Family and Domestic Violence
WA Strategic Plan for Family and Domestic Violence 2009 2013 1 Message from the Minister WA Strategic Plan for Family and Domestic Violence 2009 2013 Domestic and family violence should not happen to anyone.More information
APPENDIX 3 SERVICES LINKED WITH DUAL DIAGNOSIS TEAM Community Mental Health Teams (CMHTs)- five teams operate across RBKC offering assessment and care management services to people with severe and enduringMore information
CHCAC417A Implement interventions with older people at risk of falls
CHCAC417A Implement interventions with older people at risk of falls Release: 1 CHCAC417A Implement interventions with older people at risk of falls Modification History Not Applicable Unit DescriptorMore information
NATIONAL STANDARDS FOR DISABILITY SERVICES Full version web accessible FOR MORE INFORMATION CONTACT - email@example.com NATIONAL STANDARDS FOR DISABILITY SERVICES Copyright statement All materialMore information
Safer prisons: the challenge of mental ill-health and wider dual diagnosis. Sean Duggan, Chief Executive 21 March 2013
Safer prisons: the challenge of mental ill-health and wider dual diagnosis Sean Duggan, Chief Executive 21 March 2013 Dual diagnosis Dual diagnosis can mean A primary mental health problem that provokesMore information
Do you, or anyone you know, want to be free from drugs or alcohol misuse? We're here to help
Do you, or anyone you know, want to be free from drugs or alcohol misuse? We're here to help If you, or someone you know, wants to be free from alcohol or drugs, we can help. North Yorkshire Horizons offerMore information
Promoting mental health for individuals, families and communities CRISIS CARE COMMITMENT
Promoting mental health for individuals, families and communities CRISIS CARE COMMITMENT Red Cross is committed to an inclusive society where all people are valued, their differences are respected andMore information
Reducing suicide and its impact Queensland Suicide Prevention Action Plan Summary
Queensland Mental Health Commission Reducing suicide and its impact Queensland Suicide Prevention Action Plan 2015-17 Summary Seek help National 24/7 crisis services Lifeline 13 11 14 Suicide Call BackMore information
CHC40412 Certificate IV in Alcohol and Other Drugs
CHC40412 Certificate IV in Alcohol and Other Drugs Release: 1 CHC40412 Certificate IV in Alcohol and Other Drugs Modification History CHC08 Version 3 CHC08 Version 4 Comments CHC40408 Certificate IV inMore information
Joint Submission: May 2014
Joint Submission: Community Services and Health Industry Skills Council (CSHISC) Consultation on Alcohol and Other Drugs (AOD) Units and Qualifications Draft 2 May 2014 Introduction The following jointMore information
Dual Diagnosis. Dual Diagnosis Good Practice Guidance, Dept of Health (2002);
Dual Diagnosis Dual Diagnosis is a challenging problem for both mental health and substance misuse services. People with mental health problems, who also suffer from substance misuse are at an increasedMore information
Supporting Drug & Alcohol Services to Work with Clients with Complex Needs Project
Supporting Drug & Alcohol Services to Work with Clients with Complex Needs Project VAADA Conference 2013 Ciara Donaghy and Heidi Becker, NADA About NADA Peak body for NGO D&A sector in NSW Approx. 110More information
PROTOCOL FOR DUAL DIAGNOSIS WORKING Protocol Details NHFT document reference CLPr021 Version Version 2 March 2015 Date Ratified 19.03.15 Ratified by Trust Protocol Board Implementation Date 20.03.15 ResponsibleMore information
NZQA registered unit standard 27077 version 2 Page 1 of 5
Page 1 of 5 Title Describe approaches to, and models of, addiction intervention, and contribute to the application of one model Level 4 Credits 6 Purpose People credited with this unit standard are ableMore information
Any day is a. good day. to tackle addiction DRUG & ALCOHOL PROGRAMS & SERVICES. Passionate about the possibilities
Any day is a good day to tackle addiction DRUG & ALCOHOL PROGRAMS & SERVICES Passionate about the possibilities How can we help? We help people who are experiencing problems with alcohol or other drugsMore information
Statewide Tenants Advice and Referral Service Program Requirements
Housing Services Statewide Tenants Advice and Referral Service Program Requirements Statewide Tenants Advice and Referral Service: Program Requirements Page 2 of 24 Table of Contents Table of Contents...More information
Aquarius An Overview
Aquarius An Overview Aquarius 2nd Floor 16 Kent Street Birmingham B5 6RD Tel: 0121 622 8181 Fax: 0121 285 2190 firstname.lastname@example.com www.aquarius.org.uk February 2015 1 Who we are Aquarius was establishedMore information
Executive Summary. 1. What is the temporal relationship between problem gambling and other co-occurring disorders?
Executive Summary The issue of ascertaining the temporal relationship between problem gambling and cooccurring disorders is an important one. By understanding the connection between problem gambling andMore information
Getting help for a drug problem A guide to treatment
Getting help for a drug problem A guide to treatment Who we are The National Treatment Agency for Substance Misuse is part of the National Health Service. We were set up in 2001 to increase the numbersMore information
Nurse Practitioner Led Services in Primary Health Care Two Case Studies Frances Barraclough Master of Philosophy (Medicine) USYD
Nurse Practitioner Led Services in Primary Health Care Two Case Studies Frances Barraclough Master of Philosophy (Medicine) USYD National Rural Health Conference Darwin 25 th May 2015 NSW North Coast 2More information
Corl Kerry - Referral and Assessment for Residential Treatment (Tier 4) Introduction Types of Tier 4 Services Services provided at Tier 4
Corl Kerry - Referral and Assessment for Residential Treatment (Tier 4) This document seeks to name the criteria that can guide referrals to residential tier 4 facilities (Part A). It provides guidanceMore information
SOMERSET DUAL DIAGNOSIS PROTOCOL OCTOBER 2011 This document is intended to be used with the Somerset Dual Diagnosis Operational Working guide. This document provides principles governing joint workingMore information
Towards Good Practice: Standards and Guidelines for Suicide Bereavement Support Groups
Towards Good Practice: Standards and Guidelines for Suicide Bereavement Support Groups Towards Good Practice: Standards and Guidelines for Suicide Bereavement Support Groups March 2009 These StandardsMore information
SPECIFICATION FOR THE LOCAL COMMISSIONED SERVICE FOR THE MANAGEMENT OF ALCOHOL MISUSE Date: March 2015 1 1. Introduction Alcohol misuse is a major public health problem in Camden with high rates of hospitalMore information


text:
Position Overview:
The Managing Director will work co-operatively with the Artistic Director in maintaining Presentation House as a vibrant performing arts space and public venue; serve as the administrative lead and implement policy; oversee all finances; work closely with the Board of Directors; and supervise all staff outside of production. The Managing Director will serve as the Presentation House lead liaison with the City North Vancouver.
Day-to-day responsibilities:
- Develop, monitor and maintain administrative procedures
- Manage human resource matters
- Oversee the development and maintenance of annual operating budget
- Develop and maintain organization operating plan
- Oversee the development of annual operating budget for program and building, fund development and the organization's financial operations
- Overall management of Presentation House/Anne MacDonald buildings and grounds
- Lead fund development plans and strategies
- Co-ordinate funding applications for grants from municipal, provincial, national and international funders
- Oversee all marketing materials, sales and initiatives
- Experienced leader in the arts, preferably in theatre
- Effective communicator
- Proven record in fundraising and ability to manage relationships with donors, funders and sponsors
- Experience in the writing of grants and applications
- Proficiency and experience with computer software programs that support finance, operations, marketing and communications
- Experience in venue management and operations

subset: commoncrawl


text:
Physical Infrastructure for start-ups' and members' access to readily available data analytics platform.
For students and working professionals to develop cutting-edge and innovative data analytics and entrepreneurship skills in physical and virtual classrooms.
Work with regional industry players for the betterment of the communities beyond boundaries of seclusion. Set up the data analytics ecosystem.
Aggregating platform to collect and store the data for all sectors. It is to be made accessible and easily shareable open data cultivation stimulating knowledgeably developed growth.


text: You can play Fries: One at a Time free online shooting games at fogames. It has tags: . It has 726 total plays and has been rated 77.3% (0 like and 1 dislike), find the fun and happy day. If you want to play more shooting games, we find some of the game: Zombotron 2 Time Machine, Time Travel Survival 2, Time Travel Survival 3 and Time Travel Survival. To play other games, go to the games page, the mouse games page, or just check out the new games or best games page.


text:
We blog for fun.
Initially, I started this blog as a solo project until my bro Tricc12 joined me on this expedition. And after a while another yet, also a "tech-wizardly person" code-named Rumple007 also decided to join us.
We don't intend to make this into a fancy blog. We are doing this as a hobby. As to do something productive in our lives.
I was always fascinated by the updates and features of certain tech. Both me and Rumple007 are student taking A' levels. Even though Rumple007 and I study science, we are quite interested in tech, especially Android. Tricc12 knows more about tech stuff than me, he works on maintenance while I and Rumple007 try to write stuff as much as we can. (In our part time)
I'm not expecting much from this blog. You're probably reading this either by coming here by a mistake or by random. I'm not a tech wizard. But I do love tech and so does Tricc12 and Rumple007. I always wanted to blog about something. It took me an year to finally decide a topic to blog about and I'm finally doing it. (so excited!!!)
Well that is all about us, if you plan to just read this blog (for no reason at all or because you want some tech news, or reading something fun and entertaining) just follow this blog via your email.
Hardwelling, Tricc12 & Rumple007


text:
Here is my take on the "Oct Counterfeit Kit Challenge".
This month the inspiration kit is
the Hey Little Magpie : Vintage Floral Limited Edition Kit.
Here is my collection kit.
I also added some sequins and washi tape:
I also made my own version of the floral-wood paper. in my version i used a polka dot background and added some flower rub-ons.
i used white gelato for the white flower and i don't like it much. probably will cover it when i scrap a LO. ;)
Thank-u for stopping by :)


text:
Saturday, 14 September 2013
Hot indian muslim Desi Hotties Picture Collection
These pics are taken From Internet and with from visitors.if you have any pics send to me firstname.lastname@example.com. www.indian-online-free--dating-girls.blogspot.com is not responsible any incoviences. contact me for more details email@example.com.( reena.reena19 skype)
No comments:
Subscribe to: Post Comments (Atom)


text:
When we got back after lunch, there were a couple big limos parked outside our hotel.
A wedding!
And I knew exactly where!
My room faces a courtyard so I had a great comfy view of it.
It was quite a foggy day and I bet the rolling fog added more magic of their day.


text:
Filter Articles
June 2013 Songwriting Contest Winners Announced!
We are excited to announce the winners of our June 2013 Songwriting Contest! Huge thanks to our judges, partners, and our contestants for participating!
1ST PLACE WINNER: Jason Houtsma - "Scars"
2ND PLACE WINNER: Daniel Harrison - "Hear Our Praises"
3RD PLACE WINNER: Jaeky Spencer - "I Trust You"
Runners-Up (in alphabetical order):
Alison Brook - "Stars"
Charity Gayle - "Heaven Someday"
Dan Macaulay - "Live Like You're Free"
Drew Ley - "All I Am is Yours"
Gene Ezell - "It Is Finished"
Jaeky Spencer - "Whole in You"
Jason Houtsma - "Song of the Saved"
Klayton Seyler - "Alive in Us"
Marthe De La Torre - "Only You Are Holy"
Sponsored Ads
Subscribe to Our Mailing List
Subscribe to our mailing list for exclusive deals and news! You'll receive one email a week, with an occasional two a week. You may unsubscribe at any time.


text:
"Cavopulmonary Assist Device Development for Fontan Circulatory Support"
This Grant is being funded by the Lauren Elise Memorial Foundation
Children born with single ventricle congenital heart disease are effectively missing half of their hearts, and face lifelong obstacles. Surgical palliation (not cure) is possible, but requires a series of 3 high-risk staged open-heart procedures to reach the final stage of repair. After the final procedure, the patient is left to live the remainder of their life with what is known as a Fontan circulation.
With medical advances, more and more single ventricle children survive surgical repair, and an increasing number are now reaching adulthood. However, this subset of patients constitutes the most rapidly growing and most problematic group of children, and now adults, with congenital heart disease.
A Fontan circulation is identical to a normal 2-ventricle circulation with the exception that it lacks a right-sided power source. Although a Fontan circulation is lifesaving, it has inherent inefficiencies that will eventually lead to circulatory failure. Our work has focused over the past 14 years to replace the missing power source and restore the Fontan circulation to a more efficient 2-ventricle circulation.
To do this requires placing a blood pump into the right-sided circulation in a Fontan patient, which is a tricky and difficult undertaking. We have learned through prior work that a blood pump must be designed specifically for this task: no such pump currently exists. With our effort, we have steadfastly identified the issues and obstacles that must be overcome in order to accomplish assisted Fontan circulation in a way that is safe and reliable.
As a result, we have developed early-stage candidate devices that are capable of performing in this role, either temporarily or permanently. The temporary pump is a catheter-based pump that would be placed by a cardiologist with a needle stick in the neck or groin. It would have an external motor that would drive the pump. The permanent pump has a self-contained motor that will drive rotation of the impeller to provide pumping. The permanent pump would require open-heart surgery for implantation.
If successfully developed for use in humans, the technology would revolutionize the management of patients with single ventricle Fontan circulations. At the current time, there are no therapies that are primarily targeted to support single ventricle patients. This device therapy would constitute a first-ever targeted therapy for Fontan patients. The technology would enable the ultimate treatment strategy for single ventricle heart disease: the restoration and maintenance of 2-ventricle circulatory status.
We seek funding to further develop prototypes of this technology with the goal of getting to a stage sufficient to attract commercialization investment. Funding for device development, especially small-market pediatric devices, is extremely difficult to obtain through more traditional channels. The small market size and complexity of Fontan patients are detractors to potential investors or industry strategic partners. Single ventricle patients are relatively numerous, and deserve better treatment options for their care and long-term health.
The promise that these devices deliver is the restoration of a normal 2-ventricle circulation in patients who are missing one of their ventricles. We seek to further develop these devices toward clinical application, and Children's Heart Foundation funding would bring us much closer to this goal.


text:
Laredo Weather: Current Forecast and Conditions
TAMIU is pleased to welcome you to the 7th Annual Student Research Symposium. Undergraduate and graduate students are encouraged to participate in the poster and oral presentations and to compete for cash prizes for best posters. Come network with students from other TAMU Universities and and enjoy unique cultural entertainment.
Please click on the tabs above to preview the Registration, Check-In Information, Poster Guidelines, Oral Guidelines, Abstract & Poster Registration Information, Schedule of Events, Lodging, Activities and more.
Laredo is 156 miles south of San Antonio, and 158 miles west of Corpus Christi. It is located at an enviable crossroads of international business and life and its history hallmarked by seven sovereign flags.


text:
Compliance: record compliance history
|Action Guide contents
This function should be widely used by compliance officers and will enable them to view, record and update compliance activities undertaken outside of CIS on the contractor scheme or subcontractor record. There will be sections to record details of
- Compliance Investigation Settlement details – This information will include the type of settlement and period covered, details of any settlement obtained and where the enquiry papers are located.
- Deduction details – If unallocated CIS deductions have been traced during an employer compliance review these details can be now be recorded. These are deductions that have not already been recorded on a contractor's monthly return and the individuals to whom they relate have not been identified as registered subcontractors at the time the employer compliance review was undertaken. If however subsequent to this, a subcontractor claims to have suffered CIS deductions from the scheme it may be possible (after completing the normal enquiries) to allocate specific deductions from the unallocated sum to the subcontractor. The officer should then reduce the figure of unallocated deductions by the specified amount allocated to the subcontractor and enter any appropriate 'deduction notes' within the notes field explaining the reason for the action taken.
- Any CIS related manual penalties imposed on the contractor scheme (as a result of incorrect registration information or incorrect returns submitted) and taken directly through SAFE.
- Cases looked at but not taken up for enquiry. These will include details of any 'risk' profiling or employer compliance review considered which was not taken forward at that time for formal compliance action.
There is also a free format notes area within the Investigation, Deduction, and Risk sections where the operator can enter any supplementary notes. The operator's PID should be entered alongside any entries made as the system will record only the date and time of any entries made. All details should be clear and concise and be compliant with the Data Protection Act / Freedom of Information Act. Abbreviations and acronyms should be avoided to ensure the note made will be understandable to others.
To access this functionality you will need to hold the CISR Compliance Officer or CISR Compliance Manager roles. The Authentication function is not required to access 'Record Compliance History' and can be bypassed using 'Internal Enquiry'. For further instructions on entering data see the links below, as appropriate
|Record Investigation Details
|Record Deduction Details
|Record Risk Details
|Record Penalty Details


text:
Here are some interesting views from the European Kampioenschap Pompoenschieten (Pumpkin Shooting Championship) held at Bikschote, Belgium on September 5th.
This is USA Team Carbo with their Onager.
An Onager is a "Wild Asian Ass." It is also the name of a Roman siege engine, which derived its name from the kicking action of the machine, similar to that of an onager (wild ass). Team Carbo was the Delaware Punkin Chunkin World Champions in the Unlimited Torsion Class 2003, 2004, 2005. It took 4 weeks to get their machine shipped to Europe. Reportedly over 7000 spectators attended the Belgian event.
Results from the large torsion machine category:
- Team Bisschop met een schot van 726.4 meter (2383 feet)
- Team Carbo: 648 meter (2125 feet)
- Ypes: 625.3 meter
- L.G. Bikschote: 442.7 meter
Belgian Video News Report: kampioenschap-pompoenschieten
renews.be: Pompoenschieten Bikschote photos
Team Carbo/Onager Online
Spudfiles / EuroForum: Chunkin Europe!


text:
Recently we heard rumors about alleged Nokia plans for re-entering the phone market in 2016. We are happy to report those plans are indeed true and Nokia will be marking its return next year with an Android smartphone.
Nokia sold its device business to Microsoft a year ago and it signed a non-compete clause preventing the company from producing smartphones under the Nokia brand until December 31, 2015 and feature phones under the Nokia brand for a decade.
Nokia used wisely these non-compete clauses and outed the powerful Nokia N1 tablet early this year. The N1 is designed by Nokia, including its Z Launcher for Android, but the rights for the branding, manufacturing, marketing and distributions were licensed to Foxconn.
The President of Nokia China confirmed Nokia is working on Android powered smartphones, which will be probably manufactured in factories in Sichuan, China (after further assessment) and will be launched in 2016. He also sheds some light on company's future - the Nokia's R&D center will permanently relocate to Sichuan, China.
Looking forward to Nokia's next phone chapter? We certainly are.


text:
Here are the basics about our shipping policy. Pricing and options will be available upon checkout. Feel free to contact us with specific questions!
- Free ground shipping on most* orders over $5!
- Next day, 2-day, and 3-day shipping available for an additional fee
- International shipping available for an additional fee
- Orders ship within 3 business days
- Most orders will ship from an Amazon warehouse (they fulfill orders for us)
*Custom printed items (such as Fine Art Cutting Boards) have a ground shipping fee of $7.99.


text:
One Stroke Painting
Homer Glen | Website
This event occurred in the past.
Map | Find Parking
Note, that this is a change of location for the Lemont Artists Guild's meetings. Mona Parry gives a workshop on One Stroke Painting. Participants should bring one or two flat nylon brushes that are ½ or ¼ inch and a small round paint brush. Mona Parry is a very accomplished artist and teacher and has numerous credits and accomplishments to her name. The public is welcome to this class. A donation for the local food pantry is appreciated. For more information call Liz Popp 815-341-1145 or visit the website.


text:
Thursday, September 30, 2010
Wednesday, September 29, 2010
Tuesday, September 28, 2010
Queens Gardens
Quiet time at the bench...
Please hop over to Singapore and congratulate Keropok Man on his significant step in his life. You hadn't heard? It involves knee/s, a ring, and a yes.
Monday, September 27, 2010
Sunday, September 26, 2010
Saturday, September 25, 2010
Cold Air
This is hot (well cold) as out of camera just now.
Friday, September 24, 2010
Thursday, September 23, 2010
Business for Sale (BBB)
This one was not last much. I missed an opportunity to go there..
Wednesday, September 22, 2010
Recycle Bin
If I had a Canon that fit into this case...
Tuesday, September 21, 2010
Just renovated (I think top floor is added as new) govt office building. Next door (court) is almost done.
Monday, September 20, 2010
Craft Beer
Gold variation was sold out when I was at supermarket.
These are new from famous McCashin family. Find more from a news article at Staff.co.nz and their website. Special site seems to be also under construction.
Sunday, September 19, 2010
It does look a tad snug, but the pooch didn't look likes/he was suffering.
Saturday, September 18, 2010
Friday, September 17, 2010
Thursday, September 16, 2010
Wednesday, September 15, 2010
It was little hard to see...
Tuesday, September 14, 2010
Fire in the sky...
I saw a dragon flying over Nelson...
Monday, September 13, 2010
I'm not saying stop voting.
Sunday, September 12, 2010
No KFC Until October
I missed the opportunity to take a shot when their big bucket was sitting on the ground...
Saturday, September 11, 2010
Come Help Break The Guinness World Record For Largest Haka
Ka mate haka at Tahunanui Beach.
Registration start from 12 noon, practice start from 1pm and final haka performed at 3pm.
More info at facebook/rwc2011nelson.
Friday, September 10, 2010
Evening Light
Little early for sunset but it could be spectacular again.
Thursday, September 09, 2010
Maitai River
The right side of previous picture.
Wednesday, September 08, 2010
Tuesday, September 07, 2010
Monday, September 06, 2010
Page & Blackmore
Awarded as the "Independent Bookshop of the Year" !
See them at their Facebook Page.
Sorry, I was bit late for open hours...
Sunday, September 05, 2010
Saturday, September 04, 2010
Going out from airport terminal
[EDIT] Thanks for your concern about the earthquake in Christchurch. We're sufficiently removed from that city that we in fact did not know about it until my parents rang from Japan this morning, and a weaver in Sweden contact me on Facebook! We're OK, and did not notice the shake. But Christchurch has suffered damage, and we're only finding out about it from the radio and the Internet.
Friday, September 03, 2010
Thursday, September 02, 2010
Laura and Tara
Laura and Tara at Nelson Airport.
Better Look!?
Wednesday, September 01, 2010
Theme Day : Open Air Market
Every Saturday, we have open market at one of big car park in CBD. I was bit late for this day but... When the guy at my favourite old tool shop packing the shop, his mascot was greeting the people around.
Have you noticed that table is actually a old door?
Click here to view thumbnails for all participants
Subscribe to: Posts (Atom)


text:
Studio: DDF ProductionsCWMH
Series: Big Tits Love Big Dicks
Approximate Running Time: 02:04:35
Released: 2012
Watch This Movie
Pay Per Minute Streaming Video
Own This Movie
HD Download AvailableLifetime Streaming $9.95
Big tit superstars Jasmine Black, Eva Notty, Sirale, and Katarina Dubrova are front and center in DDF Productions' "Big Tits Love Big Dicks 2"! Forget D's, because we're counting the alphabet all the way up to F! But these ladies sure can't forget the D, because they're hungry for that thick man meat to fuck with their titties, asses, and soaking wet pussies! You're going to need a bigger monitor, because these big tits and dicks are taking over!
Categories: Hd Movies -> Streaming Video International -> Europe Ethnic -> European Appearance -> Big Cocks Appearance -> Big Tits -> Natural Gonzo -> Big Tits


text:
STEPHEN PEARCY – RATT Frontman Smashes Cincy!
March 28, 2017, 2 years ago
With all the drama surrounding the RATT camp; singer Stephen Pearcy released a new solo album, Smash, earlier this year via Frontiers Records. The '80s rocker is on the road supporting the release along with his band and of course he dug tracks "out of the cellar" like "Wanted Man", "Back For More" along with new songs like "Ten Miles Wide" and "I Can't Take It" on the March 24th show in Cincinnati, OH at the M.V.P. Sports Bar.


text:
We've all seen the 'magic spray' soccer trainers use to heal injured soccer players – everyone wonders what it is and given how it often causes a miraculous recovery, it must be magic.
While researching something else in the USSF Advice To Referees and IFAB Memorandums, I came across this section in the USSF 2011-2012 Laws of the Game Memorandum:
5. Vanishing spray
The IFAB approved the use of vanishing spray by CONMEBOL in a trial basis.
USSF Advice to Referees: Except where specifically approved by USSF, the use of vanishing spray is not permitted.
Say what???? Vanishing Spray? You can imagine all the possible scenarios one could come up with for that. I thought it was a joke or a really bad typo. Maybe what we all called Magic Spray , the IAFB called 'Vanishing Spray' since it made injuries 'vanish'.
A little research revealed that it's real. Apparently in CONMEBOL, they're experimenting with vanishing spray paint to ensure players stay 10 yds away during free kicks. Who knew???
Also – if you ever are looking for referee documentation, the GLASA soccer league has an amazing collection of referee information.


text:
Iranian Students: We "Occupied" British Embassy in Support of the 99%
Of course… It all makes sense now.
Iranian regime goons stormed the British Embassy and looted documents and the Queen's portrait during their assault. (ISNA)
Iranian hardliner students announced today that they "occupied" and looted the British Embassy in Tehran this week in support of the 99% .
Fars News reported:
Iranian students in a letter to their peers across the world declared that their recent occupation of the British embassy in Tehran was meant to be a move in support of the world 99 percenters, specially the western people who have revolted against the 1% capital holders ruling the world's unjust system.
"We have occupied the British embassy to voice support for the 99 percenters of the world and in opposition to the policies of the world arrogance," the letter said on Saturday.
"We as the students who have occupied the British embassy in Tehran announce explicitly that we are standing for our historical decision and will humiliate Britain and make it regret," it added.
The Iranian students called on the students, elites and truth-seeking people across the world to attack the interests of Britain in their region and stop London from looting their countries and nations any further.
Thousands of university students who were angry at Britain's growing hostilities towards Iran occupied the British embassy for a couple of hours Tuesday night in a show of protest to London's inimical stances and to demand a full cut of ties with Britain.
The embassy attack was an outpouring of the wrath of the Iranian people who believe Britain is a hostile country seeking to damage and weaken the Islamic Republic.
The students' self-driven move came after Iranian legislators in an open session of the parliament on Sunday approved the bill of a law on downgrading relations with Britain with 179 yes votes, 4 oppositions and 11 abstentions. The 4 oppositions demanded a full cut of ties with London.
The developments in Tehran came a week after the US and Britain targeted Iranian financial sectors with new punitive measures, including sanctions on the Iran's Central Bank and petrochemical industry.
Now it's official.
The #Occupy movement has become synonymous to mass looting, vandalism and destruction… and crapping on cop cars.
As a privately owned web site, we reserve the right to edit or remove comments that contain spam, advertising, vulgarity, threats of violence, racism, anti-Semitism, or personal/abusive attacks on other users. The same applies to trolling, the use of multiple aliases, or just generally being a jerk. Enforcement of this policy is at the sole discretion of the site administrators and repeat offenders may be blocked or permanently banned without warning. Guest posting is disabled for security reasons.


text:
Currently viewing GUEST discoveries
Sign in to save and share your Museum Discoveries.
Not registered yet? Register here.
You have not saved any objects. Why don't you add some?
Wherever you see the "Add to My Discoveries" link, you can click to save the object to your My Discoveries Page.
To discover objects that might intrigue you, why don't you start by exploring the Museum Secrets Object Navigator.
This site provides a My Discoveries page where you can store and view your favorite objects. Wherever you see the "Add to My Discoveries" link, you can click to save the object to your My Discoveries Page.
If you choose to become a registered user, your discoveries will be saved such that you can see then every time you sign in. Registered users can add and edit notes to accompany any discovery, and share their My Discovery page (including notes) with friends via email, Twitter and Facebook.
What happens if you save discoveries without signing in? They will remain on your My Discoveries page, visible to you alone, until you quit your browser.
We would love to hear from you. Raves, flames... we want it all. So please share your thoughts and comments.
» Email Us
Tip 1: Did you know you can add and edit notes to accompany your discoveries? Beneath any discovery click "Write Personal Note" to get started.
Tip 2: If you are logged in, use the share links to share your discoveries (including notes) with your friends via email, Twitter or Facebook.
Are you sure you want to remove this object from your list of discoveries?
» Yes


text:
A NEW EARTH holistic & metaphysical center, Hartamas Shopping Centre @ Plaza Damas 60 Jalan Sri Hartamas 1, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur 50480
Spiritual Full Moon group circle-Manifest your deepest desires
A NEW EARTH holistic & metaphysical center , F-2-12 Plaza Damas Jalan Sri Hartamas 1
NEW MOON Spiritual CIRCLE
A conscious space for one who is ready to work deep within.
ANE supports lightworkers on the divine path to personal mastery within its womb. Whether just stepping in, those with regular practice or master among masters, we hold space for each soul to evolve at your own pace and divine will.
* Holistic Health & Awareness
* Metaphysical Supplies
* Self Empowerment
* Workshops
* Talks
* Readings
* Healings
* Meditation/ Healing Circles
* Support Circle
* Yoga
* Dance
Want to find more groups and events like this?


text:
Estonia is a world leader in e-Health and has niche expertise in biotechnology, genetics and pharmaceuticals. Supported by a collaborative R&D ecosystem, Estonia is applying MedTech to advance science, societal wellbeing and the efficiency of business.
|Collaborative approach between government, academia, health and IT sectors.
|World leader in application of e-Health solutions and services.
|Small but growing R&D capabilities.
|Niche expertise in genetic science and analytics.
|Excellent testbed for development of medtech solutions.
Estonia has a collaborative healthcare cluster spanning government, academia, competence centres, production and IT companies.
A pioneer in e-health for 25 years, today over 95% of data generated by hospitals and doctors is digitised. A person's unified health record and x-rays are available on-demand throughout Estonia, allowing health professionals to make informed decisions. Blockchain technology assures system integrity while patients access their data and prescriptions using Estonia's secure e-ID solutions.
Estonia has an active biotech cluster comprising over 70 companies who, in conjunction with the University of Tartu, research, clinically test and develop innovative science. Areas of expertise include genetics, molecular- and biomarker based testing.
Foreign investors such as Valio and Lallemand trust Estonia to conduct their R&D in food science, including lactose-free, functional molecules and directed evolution.
In pharma, Estonia has a niche production capability for GMP certified pharmaceuticals and life science products such as antibodies, peptides, proteins, enzymes and reagents.
The Estonian Genome Center is a biobank holding data on over 5% of Estonia's adult population. As e-Health and Big Data analytics advance Estonia will emerge as a leader in diagnostic and preventative medicine, with patients empowered to self-service when and where is convenient.
Through the application of medtech and e-health solutions Estonia aims to lead the world in societal wellbeing and the efficient use of resources.
These websites can be useful when interested in healthcare in Estonia:
You are also welcome to send us an enquiry for more specific information.
From multinationals such as Microsoft and Kuehne+Nagel to high growth startups such as TransferWise and Skype, Estonia creates revolutionary consumer, enterprise and government solutions for global markets.
Estonia has unique expertise in developing and managing IT systems and is home to connected networks in transportation, the world's largest blockchain company, the EU's centre of large-scale systems and R&D into 5G telecommunications.
Estonia has a full value chain for R&D, prototyping, and production of precision components and complex systems, and is trusted by ABB, Ericsson and the European Space Agency.
With a highly-qualified workforce and strengths in engineering, electronics and IT, Estonia is at the cutting edge of R&D, production and service for mechatronic solutions with embedded software.
Estonia is one of the first countries to implement smart grid and electric vehicle networks and has strong capabilities in material technologies, big data analytics and IT solutions for the utility and agri sectors.
With over 80 captive, BPO and ITO centres, Estonia is an established location for finance, IT and customer services and has a growing expertise in supply chain, HR and process automation.
The most advanced cyber security country in Europe, Estonia has unique expertise in the development and management of cyber systems. Home to NATO CCDCOE, Guardtime and Malwarebytes, Estonia is trusted to keep the digital economy safe.
Estonia is a world leader in identity cards and mobile and device-independent e-ID solutions. Based on ultra-high encryption and user convenience, e-ID can be used to vote, sign smart contracts, make contactless payments and is being adopted by business and governments globally.
Estonia is the most effective supply chain hub for the Nordic, Baltic and northwest Russian regions thanks to its strategic location, modern infrastructure, multi-modal capabilities and reliable but flexible approach.
Estonia is a world leader in the development and application of digital logistics. Country single windows and electronic queues improve accessibility, automation improves physical and data flows while last mile robotics and apps empower clients.
Estonia has a niche capability in the design and engineering of hardware and software solutions for intelligent transportation, urban planning, tourism and smart homes. Advanced digital infrastructure, skills and consumer adoption provide the ideal R&D testbed.
Estonia is a world leader in e-Health and has niche expertise in biotechnology, genetics and pharmaceuticals. Supported by a collaborative R&D ecosystem, Estonia is applying MedTech to advance science, societal wellbeing and the efficiency of business.
What is it like to run a business in Estonia? How to benefit from the e-solutions and the efficiency of our business culture? What are the opportunities in specific sectors?
The Business in Estonia section helps you prepare for doing business in Estonia. And if you have any further questions, our business advisers are happy to help.