Implementing cognitive remediation therapy : lessons from two public mental health services

Objective: Neurocognitive deficits are a core symptom domain of schizophrenia, occurring in 75 -90 % of people with this diagnosis and influencing long term functional outcomes. This article aims to describe the pilot implementation of cognitive remediation therapy (CRT) in two large public mental health services and detail changes made to the delivery of this therapy after this trial. Conclusions: CRT provides an evidence based approach to targeting cognitive deficits but the translation of this therapy from a research setting to clinical practice has not been well evaluated.

How international entrepreneurship characteristics influence Internet capabilities for the international business processes of the firm

This research explores the relationship between international entrepreneurship characteristics and the use of Internet capabilities for the international business processes of the firm. It has been suggested, that the accumulation of a firms Internet capability can assist international operations, especially when operating in fast changing dynamic Internet environments. However, international entrepreneurship characteristics which are seen as a precursor to leveraging Internet capabilities are still vague. Given this finding, eight case studies of small and medium sized travel and tourism firms were selected to investigate the influence of international entrepreneurship characteristics, and Internet capabilities for international business processes. Based on the eight in-depth case studies, the results signify that successful international entrepreneurial firms which encompass high levels of international innovativeness and proactiveness behaviour integrate Internet capabilities to a greater degree. Our findings also indicate that the prior international business experience, international risk-taking propensity and international networking characteristics are not necessarily precursors to successful integration of Internet capabilities for international business processes. On the contrary, international business experience and international networks actually lead to a reliance on traditional mechanisms of internationalisation and can dilute the development of Internet capabilities for international business processes.

Adding SUGAR : service user and carer collaboration in mental health nursing research

‘SUGAR: Service users and carers group advising on research’ is an exciting initiative established to develop collaborative working in mental health nursing research between mental health service users, carers, researchers and practitioners at City University London, UK. This paper will describe the background to SUGAR and how and why it was established; how the group operates; some of the achievements to date including researcher reflections; and case studies of how this collaboration influences our research. Written reflective narratives of service user and carer experiences of SUGAR were analysed using constant comparative methods by the members. Common themes are presented with illustrative quotes. The article highlights the benefits and possible limitations identified so far by members of SUGAR; outlines future plans and considers the findings in relation to literature on involvement and empowerment. This paper has been written by staff and members of SUGAR and is the first venture into collaborative writing of the group and reflects the shared ethos of collaborative working.

Back to basics: Informing the public of co-morbid physical health problems in those with mental illness

Abstract OBJECTIVE: Those with mental illness are at increased risk of physical health problems. The current study aimed to examine the information available online to the Australian public about the increased risk and consequences of physical illness in those with mental health problems and the services available to address these co-morbidities. METHODS: A structured online search was conducted with the search engine Google Australia (www.google.com.au) using generic search terms 'mental health information Australia', 'mental illness information Australia', 'depression', 'anxiety', and 'psychosis'. The direct content of websites was examined for information on the physical co-morbidities of mental illness. All external links on high-profile websites [the first five websites retrieved under each search term (n = 25)] were examined for information pertaining to physical health. RESULTS: Only 4.2% of websites informing the public about mental health contained direct content information about the increased risk of physical co-morbidities. The Australian Government's Department of Health and Ageing site did not contain any information. Of the high-profile websites, 62% had external links to resources about physical health and 55% had recommendations or resources for physical health. Most recommendations were generic. CONCLUSIONS: Relative to the seriousness of this problem, there is a paucity of information available to the public about the increased physical health risks associated with mental illness. Improved public awareness is the starting point of addressing this health inequity.

Worrying and anxiety are some of the biggest mental health problems facing children today

People often assume children have no worries or nothing to be stressed about. However, children, like adults, do worry about a range of things. There may be times during periods of stress or change when children worry more intensely about things than usual.

Learning processes in creative service teams : towards a dynamic systems theory

The fastest-growing segment of jobs in the creative sector are in those firms that provide creative services to other sectors (Hearn, Goldsmith, Bridgstock, Rodgers 2014, this volume; Cunningham 2014, this volume). There are also a large number of Creative Services (Architecture and Design, Advertising and Marketing, Software and Digital Content occupations) workers embedded in organizations in other industry sectors (Cunningham and Higgs 2009). Ben Goldsmith (2014, this volume) shows, for example, that the Financial Services sector is the largest employer of digital creative talent in Australia. But why should this be? We argue it is because ‘knowledge-based intangibles are increasingly the source of value creation and hence of sustainable competitive advantage (Mudambi 2008, 186). This value creation occurs primarily at the research and development (R and D) and the marketing ends of the supply chain. Both of these areas require strong creative capabilities in order to design for, and to persuade, consumers. It is no surprise that Jess Rodgers (2014, this volume), in a study of Australia’s Manufacturing sector, found designers and advertising and marketing occupations to be the most numerous creative occupations. Greg Hearn and Ruth Bridgstock (2013, forthcoming) suggest ‘the creative heart of the creative economy […] is the social and organisational routines that manage the generation of cultural novelty, both tacit and codified, internal and external, and [cultural novelty’s] combination with other knowledges […] produce and capture value’. 2 Moreover, the main “social and organisational routine” is usually a team (for example, Grabher 2002; 2004).

Secure stream cipher initialisation processes

Stream ciphers are symmetric key cryptosystems that are used commonly to provide confidentiality for a wide range of applications; such as mobile phone, pay TV and Internet data transmissions. This research examines the features and properties of the initialisation processes of existing stream ciphers to identify flaws and weaknesses, then presents recommendations to improve the security of future cipher designs. This research investigates well-known stream ciphers: A5/1, Sfinks and the Common Scrambling Algorithm Stream Cipher (CSA-SC). This research focused on the security of the initialisation process. The recommendations given are based on both the results in the literature and the work in this thesis.

Process mining for clinical processes: A comparative analysis of four Australian hospitals

Business process analysis and process mining, particularly within the health care domain, remain under-utilised. Applied research that employs such techniques to routinely collected, health care data enables stakeholders to empirically investigate care as it is delivered by different health providers. However, cross-organisational mining and the comparative analysis of processes present a set of unique challenges in terms of ensuring population and activity comparability, visualising the mined models and interpreting the results. Without addressing these issues, health providers will find it difficult to use process mining insights, and the potential benefits of evidence-based process improvement within health will remain unrealised. In this paper, we present a brief introduction on the nature of health care processes; a review of the process mining in health literature; and a case study conducted to explore and learn how health care data, and cross-organisational comparisons with process mining techniques may be approached. The case study applies process mining techniques to administrative and clinical data for patients who present with chest pain symptoms at one of four public hospitals in South Australia. We demonstrate an approach that provides detailed insights into clinical (quality of patient health) and fiscal (hospital budget) pressures in health care practice. We conclude by discussing the key lessons learned from our experience in conducting business process analysis and process mining based on the data from four different hospitals.

Design and ethics in digital mental health promotion

This chapter presents a case study of Participatory Design as a design framework for developing interactive digital tools for promoting children’s resilience. The author argues for a participatory methodology as an ethical approach that involves children as co-designers in the process from which they are traditionally excluded, namely the creative design process and the process of mental health promotion.

Screening for risk of later mental health problems : a longitudinal study

Purpose: This is one of the first studies to report that the Achenbach internalising scales were much more effective at identifying those with current comorbid depression and anxiety, rather than individual mood disorder. Introduction: The Achenbach behaviour checklists (YSR,YASR) are widely used, low cost screening tools used to assess problem behaviour. Several studies report good association between the checklists and psychiatric diagnoses; although with varying degrees of agreement. Most are cross-sectional studies involving adolescents referred to mental health services; few are in large community-based studies. This study examined the usefulness of the Achenbach internalising scales in the primary screening (both predictive and concurrent)for depression and anxiety. Methods: The sample was 2400 young adults from an Australian population-based prospective birth cohort study. The association between the empirical anxiety and depression scales were individually assessed against DSM-IV depression and anxiety diagnoses. Odds ratios and diagnostic efficiency tests report the findings. Results: Adolescents with internalising symptoms were twice (OR 2.3, 95%CI 1.7 to 3.1) as likely to be diagnosed with later DSM-IV depression. YASR internalising scale predicted DSM-IV mood disorders (depression OR = 6.9, 95% CI 5.0–9.5; anxiety OR = 5.1, 95% CI 3.8–6.7) in the previous 12 months. The internalising scales were much more effective at identifying those with comorbid depression and anxiety. Conclusions: Adolescence and early adulthood are key risk periods for the onset of anxiety and depression. This study found that young people with internalising behaviour problems were more likely to have comorbid depression and anxiety DSM-IV disorder.

Investigating well-being and mental health in Queensland fire-fighters

This thesis used survey and interview methods to examine how organisational and interpersonal factors impact on the mental health of fire and rescue workers. It was the first published research to assess and predict multiple indicators of mental health; psychological distress, well-being, posttraumatic growth and posttraumatic stress disorder symptoms. The results provide valuable information for supporting fire and rescue workers through psychoeducation and proactive intervention programs.

Self-organization processes in field-invasion team sports

In nature, the interactions between agents in a complex system (fish schools; colonies of ants) are governed by information that is locally created. Each agent self-organizes (adjusts) its behaviour, not through a central command centre, but based on variables that emerge from the interactions with other system agents in the neighbourhood. Self-organization has been proposed as a mechanism to explain the tendencies for individual performers to interact with each other in field-invasion sports teams, displaying functional co-adaptive behaviours, without the need for central control. The relevance of self-organization as a mechanism that explains pattern-forming dynamics within attacker-defender interactions in field-invasion sports has been sustained in the literature. Nonetheless, other levels of interpersonal coordination, such as intra-team interactions, still raise important questions, particularly with reference to the role of leadership or match strategies that have been prescribed in advance by a coach. The existence of key properties of complex systems, such as system degeneracy, nonlinearity or contextual dependency, suggests that self-organization is a functional mechanism to explain the emergence of interpersonal coordination tendencies within intra-team interactions. In this opinion article we propose how leadership may act as a key constraint on the emergent, self-organizational tendencies of performers in field-invasion sports.

Did you see that? Dissociating advanced visual information and ball flight constrains perception and action processes during one-handed catching

The integration of separate, yet complimentary, cortical pathways appears to play a role in visual perception and action when intercepting objects. The ventral system is responsible for object recognition and identification, while the dorsal system facilitates continuous regulation of action. This dual-system model implies that empirically manipulating different visual information sources during performance of an interceptive action might lead to the emergence of distinct gaze and movement pattern profiles. To test this idea, we recorded hand kinematics and eye movements of participants as they attempted to catch balls projected from a novel apparatus that synchronised or de-synchronised accompanying video images of a throwing action and ball trajectory. Results revealed that ball catching performance was less successful when patterns of hand movements and gaze behaviours were constrained by the absence of advanced perceptual information from the thrower's actions. Under these task constraints, participants began tracking the ball later, followed less of its trajectory, and adapted their actions by initiating movements later and moving the hand faster. There were no performance differences when the throwing action image and ball speed were synchronised or de-synchronised since hand movements were closely linked to information from ball trajectory. Results are interpreted relative to the two-visual system hypothesis, demonstrating that accurate interception requires integration of advanced visual information from kinematics of the throwing action and from ball flight trajectory.

Narratives of healing: a case study of a young Liberian refugee settled in Australia

The Tree of Life group program is a narrative-based expressive arts intervention, designed to target the psychological difficulties faced by young people from refugee backgrounds. This study utilised a case study methodology to investigate the experience of a single adolescent from a Liberian background resettled in Australia, who participated in a manualised version of the Tree of Life program. The case study aimed to identify the underlying therapeutic processes that enabled the participant to adopt a preferred self-narrative. The participant was observed to demonstrate positive gains as a result of program participation. Five therapeutic factors were identified as particularly salient to the program’s success: the exploration of alternative stories of self; the fostering of group cohesion; the provision of corrective emotional experiences; the experience of outsider witnesses; and the instillation of hope. These factors were discussed in relation to working with young people from refugee backgrounds. Recommendations for future implementation of the Tree of Life program are provided.

Visualization of predictive distributions for discrete spatial-temporal log Cox processes approximated with MCMC

An important aspect of decision support systems involves applying sophisticated and flexible statistical models to real datasets and communicating these results to decision makers in interpretable ways. An important class of problem is the modelling of incidence such as fire, disease etc. Models of incidence known as point processes or Cox processes are particularly challenging as they are ‘doubly stochastic’ i.e. obtaining the probability mass function of incidents requires two integrals to be evaluated. Existing approaches to the problem either use simple models that obtain predictions using plug-in point estimates and do not distinguish between Cox processes and density estimation but do use sophisticated 3D visualization for interpretation. Alternatively other work employs sophisticated non-parametric Bayesian Cox process models, but do not use visualization to render interpretable complex spatial temporal forecasts. The contribution here is to fill this gap by inferring predictive distributions of Gaussian-log Cox processes and rendering them using state of the art 3D visualization techniques. This requires performing inference on an approximation of the model on a discretized grid of large scale and adapting an existing spatial-diurnal kernel to the log Gaussian Cox process context.