Relationship between vocational status and perceived stress and daily hassles in first-episode psychosis: An exploratory study

PURPOSE Vocational recovery is a primary treatment goal of young people with first-episode psychosis (FEP), yet treatment in this domain is often delayed due to concerns that it might be too stressful. This study aimed to examine whether a relationship exists between vocational status and level of perceived stress and daily hassles in FEP. METHODS Forty-seven FEP participants were recruited upon admission to the Early Psychosis Prevention and Intervention Centre (EPPIC), Melbourne. Demographics, psychopathology, perceived stress (Perceived Stress Scale; PSS) and daily hassles (Hassles Scale; HS) were measured. RESULTS Regarding vocational status, 19 participants were unemployed, 13 were employed, 14 were students, and 1 reported 'home duties'. ANOVAs and post hoc tests comparing the first three groups on perceived stress and daily hassles revealed that the mean PSS Total and mean PSS Distress scores of the employed group were significantly lower than those of the unemployed and student groups. Regarding hassles scores, the employed group had a significantly lower mean Hassles Intensity score than the unemployed group. Results were largely unchanged when covariates were included. There were no significant differences between the three groups in levels of anxiety, negative or positive symptoms. The employed group reported lower depression than the student group, but this finding disappeared after controlling for gender. CONCLUSIONS These results provide preliminary evidence supporting the notion that working or studying is not associated with increased perceived stress or daily hassles in FEP. The findings require replication in larger samples and in different phases of psychosis.

Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD)

BACKGROUND PTSD is an anxiety disorder related to exposure to a severe psychological trauma. Symptoms include re-experiencing the event, avoidance and arousal as well as distress and impairment resulting from these symptoms.Guidelines suggest a combination of both psychological therapy and pharmacotherapy may enhance treatment response, especially in those with more severe PTSD or in those who have not responded to either intervention alone. OBJECTIVES To assess whether the combination of psychological therapy and pharmacotherapy provides a more efficacious treatment for PTSD than either of these interventions delivered separately. SEARCH STRATEGY Searches were conducted on the trial registers kept by the CCDAN group (CCDANCTR-Studies and CCDANCTR-References) to June 2010. The reference sections of included studies and several conference abstracts were also scanned. SELECTION CRITERIA Patients of any age or gender, with chronic or recent onset PTSD arising from any type of event relevant to the diagnostic criteria were included. A combination of any psychological therapy and pharmacotherapy was included and compared to wait list, placebo, standard treatment or either intervention alone. The primary outcome was change in total PTSD symptom severity. Other outcomes included changes in functioning, depression and anxiety symptoms, suicide attempts, substance use, withdrawal and cost. DATA COLLECTION AND ANALYSIS Two or three review authors independently selected trials, assessed their 'risk of bias' and extracted trial and outcome data. We used a fixed-effect model for meta-analysis. The relative risk was used to summarise dichotomous outcomes and the mean difference and standardised mean difference were used to summarise continuous measures. MAIN RESULTS Four trials were eligible for inclusion, one of these trials (n =24) was on children and adolescents. All used an SSRI and prolonged exposure or a cognitive behavioural intervention. Two trials compared combination treatment with pharmacological treatment and two compared combination treatment with psychological treatment. Only two trials reported a total PTSD symptom score and these data could not be combined. There was no strong evidence to show if there were differences between the group receiving combined interventions compared to the group receiving psychological therapy (mean difference 2.44, 95% CI -2.87, 7.35 one study, n=65) or pharmacotherapy (mean difference -4.70, 95% CI -10.84 to 1.44; one study, n = 25). Trialists reported no significant differences between combination and single intervention groups in the other two studies. There were very little data reported for other outcomes, and in no case were significant differences reported. AUTHORS' CONCLUSIONS There is not enough evidence available to support or refute the effectiveness of combined psychological therapy and pharmacotherapy compared to either of these interventions alone. Further large randomised controlled trials are urgently required.

Competitive Smart Cities through Healthy Decision-making

This chapter examines the challenges and opportunities associated with planning for competitive, smart and healthy cities. The chapter is based on the assumptions that a healthy city is an important prerequisite for a competitive city and a fundamental outcome of smart cities. Thus, it is preeminent to understand the planning decision support system based on local determinants of health, economic and social factors. One of the major decision support systems is e-health and this chapter will focus on the role of e-health planning, by utilising web-based geographic decision support systems. The proposed novel decision support system would provide a powerful and effective platform for stakeholders to access online information for a better decision-making while empowering community participation. The chapter also highlights the need for a comprehensive conceptual framework to guide the decision process of planning for healthy cities in association with opportunities and limitations. In summary, this chapter provides the critical insights of using information science-based framework and suggest online decision support methods, as part of a broader e-health approach for creating a healthy, competitive and smart city.

Projecting the new world city: The city as spectacle in an urban light festival

As a precursor to the 2014 G20 Leaders’ Summit held in Brisbane, Australia, the Queensland Government sponsored a program of G20 Cultural Celebrations, designed to showcase the Summit’s host city. The cultural program’s signature event was the Colour Me Brisbane festival, a two-week ‘citywide interactive light and projection installations’ festival that was originally slated to run from 24 October to 9 November, but which was extended due to popular demand to conclude with the G20 Summit itself on 16 November. The Colour Me Brisbane festival comprised a series projection displays that promoted visions of the city’s past, present, and future at landmark sites and iconic buildings throughout the city’s central business district and thus transformed key buildings into forms of media architecture. In some instances the media architecture installations were interactive, allowing the public to control aspects of the projections through a computer interface situated in front of the building; however, the majority of the installations were not interactive in this sense. The festival was supported by a website that included information regarding the different visual and interactive displays and links to social media to support public discussion regarding the festival (Queensland Government 2014). Festival-goers were also encouraged to follow a walking-tour map of the projection sites that would take them on a 2.5 kilometre walk from Brisbane’s cultural precinct, through the city centre, concluding at parliament house. In this paper, we investigate the Colour Me Brisbane festival and the broader G20 Cultural Celebrations as a form of strategic placemaking—designed, on the one hand, to promote Brisbane as a safe, open, and accessible city in line with the City Council’s plan to position Brisbane as a ‘New World City’ (Brisbane City Council 2014). On the other hand, it was deployed to counteract growing local concerns and tensions over the disruptive and politicised nature of the G20 Summit by engaging the public with the city prior to the heightened security and mobility restrictions of the Summit weekend. Harnessing perspectives from media architecture (Brynskov et al. 2013), urban imaginaries (Cinar & Bender 2007), and social media analysis, we take a critical approach to analysing the government-sponsored projections, which literally projected the city onto itself, and public responses to them via the official, and heavily promoted, social media hashtags (#colourmebrisbane and #g20cultural). Our critical framework extends the concepts of urban phantasmagoria and urban imaginaries into the emerging field of media architecture to scrutinise its potential for increased political and civic engagement. Walter Benjamin’s concept of phantasmagoria (Cohen 1989; Duarte, Firmino, & Crestani 2014) provides an understanding of urban space as spectacular projection, implicated in commodity and techno-culture. The concept of urban imaginaries (Cinar & Bender 2007; Kelley 2013)—that is, the ways in which citizens’ experiences of urban environments are transformed into symbolic representations through the use of imagination—similarly provides a useful framing device in thinking about the Colour Me Brisbane projections and their relation to the construction of place. Employing these critical frames enables us to examine the ways in which the installations open up the potential for multiple urban imaginaries—in the sense that they encourage civic engagement via a tangible and imaginative experience of urban space—while, at the same time, supporting a particular vision and way of experiencing the city, promoting a commodified, sanctioned form of urban imaginary. This paper aims to dissect the urban imaginaries intrinsic to the Colour Me Brisbane projections and to examine how those imaginaries were strategically deployed as place-making schemes that choreograph reflections about and engagement with the city.

Futile treatment in hospital: Doctors’ intergroup language

Treatment that will not provide significant net benefit at the end of a person’s life (called futile treatment) is considered by many people to represent a major problem in the health sector, as it can waste resources and raise significant ethical issues. Medical treatment at the end of life involves a complex negotiation that implicates intergroup communication between health professionals, patients, and families, as well as between groups of health professionals. This study, framed by intergroup language theory, analyzed data from a larger project on futile treatment, in order to examine the intergroup language associated with futile treatment. Hospital doctors (N = 96) were interviewed about their understanding of treatment given to adult patients at the end of life that they considered futile. We conducted a discourse analysis on doctors’ descriptions of futile treatment provided by themselves and their in-group and out-group colleagues. Results pointed to an intergroup context, with patients, families, and colleagues as out-groups. In their descriptions, doctors justified their own decisions using the language of logic, ethics, and respect. Patients and families, however, were characterized in terms of wishing and wanting, as were outgroup colleagues. In addition, out-group doctors were described in strongly negative intergroup language.

Becoming bilingual: Children’s insights about making friends in bilingual settings

The majority of the world speaks more than one language yet the impact of learning a second language has rarely been studied from a child’s perspective. This paper describes monolingual children’s insights into becoming bilingual at four time points: two months before moving to another country (while living in Australia), as well as one, six, and twelve months after moving to Germany. The participants were two monolingual English-speaking siblings (a male aged 7- to 8-years and a female aged 9- to 10-years) who subsequently learned to speak German. At each of the four time points, interviews were undertaken with each child using child-friendly drawing and questionnaire techniques. Three themes were identified: (1) the children’s awareness of language competence; (2) inclusion factors, and; (3) exclusion factors that influenced friendship formation. The impact of language ability on making friends was a dominant theme that arose across the four time points and was triangulated across data collection methods. The children made friends with others who had similar language competence in German, even though they were younger, and did not share the same first language. Age-matched peers who were more competent in German were less likely to be described as friends. Across all three themes, the playground was highlighted by both children as the key site where becoming bilingual most strongly impacted initiation and negotiation of friendships. Becoming bilingual impacted the children’s friendship formation and socialization opportunities with more competent language users.

Australia's Biodiversity Conservation Strategy 2010-2020 Submission to the National Biodiversity Strategy Review Taskforce

This submission focuses on “Priority for Change 3: Knowledge for all” and “Priority for Change 5: Involving Indigenous Australians”. Our particular interest lies with ensuring that Indigenous knowledge holders are engaged with in a manner that recognises their prior rights over their own knowledge and intellectual property. As the Preamble of the recently endorsed United Nations Declaration on the Rights of Indigenous Peoples states, we need to; “Recognis[e] that respect for Indigenous Knowledge, cultures and traditional practises contributes to sustainable and equitable development and proper management of the environment”.

Submission on the Hawke Interim Review of the Environment Protection and Biodiversity Conservation Act 1999 (Cth)

There are currently no regulatory mechanisms, laws or policies that specifically provide rights to Indigenous peoples over their Indigenous knowledge and intellectual property. We strongly recommend that the commonwealth take the lead to ensure that national sui generis laws are developed (perhaps to operate initially in areas of Cth jurisdiction, such as IPAs and national parks). The development of such laws should be in tandem with practical guidelines to assist their implementation. A comprehensive, nationally consistent scheme for access to genetic resources, which offers meaningful protection of traditional knowledge and substantive benefit-sharing with Indigenous communities, has to be developed. There are already a range of reports/resources that urge these same reforms and that we direct the Enquiry to again; these include the Voumard Report (2000) – especially Fourmile’s Appendix 10 – “Indigenous Interests”, and Terri Jankes “Our Culture, Our Future (1998).

4D deformation modeling of cortical disease progression in Alzheimer's dementia

This work describes the development of a model of cerebral atrophic changes associated with the progression of Alzheimer's disease (AD). Linear registration, region-of-interest analysis, and voxel-based morphometry methods have all been employed to elucidate the changes observed at discrete intervals during a disease process. In addition to describing the nature of the changes, modeling disease-related changes via deformations can also provide information on temporal characteristics. In order to continuously model changes associated with AD, deformation maps from 21 patients were averaged across a novel z-score disease progression dimension based on Mini Mental State Examination (MMSE) scores. The resulting deformation maps are presented via three metrics: local volume loss (atrophy), volume (CSF) increase, and translation (interpreted as representing collapse of cortical structures). Inspection of the maps revealed significant perturbations in the deformation fields corresponding to the entorhinal cortex (EC) and hippocampus, orbitofrontal and parietal cortex, and regions surrounding the sulci and ventricular spaces, with earlier changes predominantly lateralized to the left hemisphere. These changes are consistent with results from post-mortem studies of AD.

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care services has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

Integration over song classification replicates: song variant analysis in the hihi

Human expert analyses are commonly used in bioacoustic studies and can potentially limit the reproducibility of these results. In this paper, a machine learning method is presented to statistically classify avian vocalizations. Automated approaches were applied to isolate bird songs from long field recordings, assess song similarities, and classify songs into distinct variants. Because no positive controls were available to assess the true classification of variants, multiple replicates of automatic classification of song variants were analyzed to investigate clustering uncertainty. The automatic classifications were more similar to the expert classifications than expected by chance. Application of these methods demonstrated the presence of discrete song variants in an island population of the New Zealand hihi (Notiomystis cincta). The geographic patterns of song variation were then revealed by integrating over classification replicates. Because this automated approach considers variation in song variant classification, it reduces potential human bias and facilitates the reproducibility of the results.

Anthropogenic nitrogen deposition predicts local grassland primary production worldwide

Humans dominate many important Earth system processes including the nitrogen (N) cycle. Atmospheric N deposition affects fundamental processes such as carbon cycling, climate regulation, and biodiversity, and could result in changes to fundamental Earth system processes such as primary production. Both modelling and experimentation have suggested a role for anthropogenically altered N deposition in increasing productivity, nevertheless, current understanding of the relative strength of N deposition with respect to other controls on production such as edaphic conditions and climate is limited. Here we use an international multiscale data set to show that atmospheric N deposition is positively correlated to aboveground net primary production (ANPP) observed at the 1-m2 level across a wide range of herbaceous ecosystems. N deposition was a better predictor than climatic drivers and local soil conditions, explaining 16% of observed variation in ANPP globally with an increase of 1 kg N·ha-1·yr-1 increasing ANPP by 3%. Soil pH explained 8% of observed variation in ANPP while climatic drivers showed no significant relationship. Our results illustrate that the incorporation of global N deposition patterns in Earth system models are likely to substantially improve estimates of primary production in herbaceous systems. In herbaceous systems across the world, humans appear to be partially driving local ANPP through impacts on the N cycle.

Consistent responses of soil microbial communities to elevated nutrient inputs in grasslands across the globe

Soil microorganisms are critical to ecosystem functioning and the maintenance of soil fertility. However, despite global increases in the inputs of nitrogen (N) and phosphorus (P) to ecosystems due to human activities, we lack a predictive understanding of how microbial communities respond to elevated nutrient inputs across environmental gradients. Here we used high-throughput sequencing of marker genes to elucidate the responses of soil fungal, archaeal, and bacterial communities using an N and P addition experiment replicated at 25 globally distributed grassland sites. We also sequenced metagenomes from a subset of the sites to determine how the functional attributes of bacterial communities change in response to elevated nutrients. Despite strong compositional differences across sites, microbial communities shifted in a consistent manner with N or P additions, and the magnitude of these shifts was related to the magnitude of plant community responses to nutrient inputs. Mycorrhizal fungi and methanogenic archaea decreased in relative abundance with nutrient additions, as did the relative abundances of oligotrophic bacterial taxa. The metagenomic data provided additional evidence for this shift in bacterial life history strategies because nutrient additions decreased the average genome sizes of the bacterial community members and elicited changes in the relative abundances of representative functional genes. Our results suggest that elevated N and P inputs lead to predictable shifts in the taxonomic and functional traits of soil microbial communities, including increases in the relative abundances of faster-growing, copiotrophic bacterial taxa, with these shifts likely to impact belowground ecosystems worldwide.

Evaluation of a school-based creative arts therapy programme for adolescents from refugee backgrounds

Creative arts therapy programs have been identified as effective interventions with adolescents affected by adversity. The current study provided a controlled trial of creative arts therapy to address the psychosocial needs of students from refugee backgrounds. Forty-two students participated in a therapy trial, comprising an intervention and control group. Mental health and behavioural difficulties were assessed pre and post intervention. Hopkins Symptoms Checklist-25 (HSCL-25) and the Strengths and Difficulties Questionnaire (SDQ) were used to assess wellbeing. Findings suggested an effect for a reduction in behavioural difficulties for the treatment group. A significant reduction in emotional symptoms was found for the treatment group. Findings provide empirical support for school-based creative arts therapy interventions specific to refugee young people.

Thinking like Disney: Supporting the Disney method using ambient feedback based on group performance

The Disney method is a collaborative creativity technique that uses three roles - dreamer, realist and critic - to facilitate the consideration of different perspectives on a topic. Especially for novices it is important to obtain guidance in applying this method. One way is providing groups with a trained moderator. However, feedback about the group’s behavior might interrupt the flow of the idea finding process. We built and evaluated a system that provides ambient feedback to a group about the distribution of their statements among the three roles. Our preliminary field study indicates that groups supported by the system contribute more and roles are used in a more balanced way while the visualization does not disrupt the group work.