Substance Treatment Options in Psychosis (STOP) : a new intervention for dual diagnosis

Despite the high co-occurrence of psychosis and substance abuse, there is very little research on the development of effective treatments for this problem. This paper describes a new intervention that facilitates reaching functional goals through collaboration between therapists, participants and families. Substance Treatment Options in Psychosis (STOP) integrates pharmacological and psycho-logical treatments for psychotic symptoms, with cognitive-behavioural approaches to substance abuse. STOP is tailored to participants' problems and abilities, and recognises that control of consumption and even engagement may take several attempts. Training in relevant skills is augmented by bibliotherapy, social support and environmental change. A case description illustrates the issues and challenges in implementation.

Shifting the child protection juggernaut to earlier intervention

"For every complex problem there is a solution that is simple, neat and wrong (M.L. Mencken, US writer and social commentator). Nowhere is this quote more apt than when applied to finding over-simplified solutions to the complex problem of looking after the safety and well-being of vulnerable children. The easiest formula is, of course, to ‘rescue children from dysfunctional families’, a line taken recently in the monograph by the right wing think tank, Centre for Independent Studies (Sammut & O’Brien 2009). It is reasoning with fatal flaws. This commentary provides a timely reminder of the strong arguments which lie behind the national and international shift to supporting children and families through universal and specialist community-based services, rather than weighting all resources into statutory child protection interventions. A brief outline of the value of developing the resources to support children in their families, and the problems with 'rescuing' children through the child protection system are discussed.

An intervention for substance abuse in schizophrenia

Describes a cognitive-behavioral intervention for alcohol and cannabis abuse with schizophrenic patients. The intervention integrates substance abuse treatment with other aspects of psychosis management, including assessment, use of anti-psychotic medication, and training in coping skills.

Application of cognitive-behavioural family intervention for schizophrenia in multidisciplinary teams : what can the matter be?

Surveyed 45 therapists who had participated in a family intervention for schizophrenia training program to examine the difficulties they had encountered, their recall of the intervention strategies, and the extent that they thought the approach had become integrated in their everyday work. Between 6 mo and 3 yrs after the family training, Ss reported the number of families they had systematically treated, and the difficulties they had encountered. Allowance of time to undertake the intervention, afterhours scheduling, and illness or holidays presented particular difficulties. Only 4% reported that their knowledge of behavioral techniques was a problem, but in a written test most therapists did not display minimum recall of the material of cognitive therapy, social skills training, or behavioral strategies. The study demonstrated significant problems in disseminating cognitive-behavioral approaches to multidisciplinary settings.

A pilot study utilising cross-age peer tutoring as a method of intervention for anxious adolescents

Anxiety disorders are the most common psychopathology experienced by young people, with up to 18% of adolescents developing an anxiety disorder. The consequences of these disorders, if left untreated, include impaired peer relationships, school absenteeism and self-concept problems. In addition, anxiety disorders may play a causal role in the development of depression in young people, precede eating disorders and predispose adolescents to substance abuse disorders. While the school is often chosen as a place to provide early intervention for this debilitating disorder, the fact that excessive anxiety is often not recognised in school and that young people are reluctant to seek help, makes identifying these adolescents difficult. Even when these young people are identified, there are problems in providing sensitive programs which are not stigmatising to them within a school setting. One method which may engage this adolescent population could be cross-age peer tutoring. This paper reports on a small pilot study using the “Worrybusters” program and a cross-age peer tutoring method to engage the anxious adolescents. These anxious secondary school students planned activities for teacher-referred anxious primary school students for a term in the high school setting and then delivered those activities to the younger students weekly in the next term in the primary school. Although the secondary school students decreased their scores on anxiety self-report measures there were no significant differences for primary school students’ self-reports. However, the primary school parent reports indicated a significant decrease in their child’s anxiety.

Restrung New Chamber Festival : Bridging the Gap Between High Art Music and Popular Sensibilities

The Restrung New Chamber Festival was a practice-led research project which explored the intricacies of musical relationships. Specifically, it investigated the relationships between new music ensembles and pop-oriented bands inspired by the new music genre. The festival, held at the Brisbane Powerhouse (28 February-2 March 2009) comprised 17 diverse groups including the Brodsky Quartet, Topology, Wood, Fourplay and CODA. Restrung used a new and distinctive model which presented new music and syncretic musical genres within an immersive environment. Restrung brought together approaches used in both contemporary classical and popular music festivals, using musical, visual and spatial aspects to engage audiences. Interactivity was encouraged through video and sound installations, workshops and forums. This paper will investigate some of the issues surrounding the conception and design of the Restrung model, within the context of an overview of European new music trends. It includes a discussion of curating such an event in a musically sensitive and effective way, and approaches to identifying new and receptive audiences. As a guide to programming Restrung, I formulated a working definition of new music, further developed by interviews with specialists in Australia and Europe, and this will be outlined below.

Cost-effectiveness of an intervention to reduce emergency re-admissions to hospital among older patients

Background. The objective is to estimate the cost-effectiveness of an intervention that reduces hospital readmission among older people at high risk. A cost-effectiveness model to estimate the costs and health benefits of the intervention was implemented. Methodology/Principal Findings. The model used data from a randomised controlled trial conducted in an Australian tertiary metropolitan hospital. Participants were acute medical admissions aged >65 years with at least one risk factor for readmission: multiple comorbidities, impaired functionality, aged >75 years, 30 recent multiple admissions, poor social support, history of depression. The intervention was a comprehensive nursing and physiotherapy assessment and an individually tailored program of exercise strategies and nurse home visits with telephone follow-up; commencing in hospital and continuing following discharge for 24 weeks. The change to cost outcomes, including the costs of implementing the intervention and all subsequent use of health care services, and, the change to health benefits, represented by quality adjusted life years, were estimated for the intervention as compared to existing practice. The mean change to total costs and quality 38 adjusted life years for an average individual over 24 weeks participating in the intervention were: cost savings of $333 (95% Bayesian credible interval $-1,932:1,282) and 0.118 extra quality adjusted life years (95% Bayesian credible interval 0.1:0.136). The mean net41 monetary-benefit per individual for the intervention group compared to the usual care condition was $7,907 (95% Bayesian credible interval $5,959:$9,995) for the 24 week period. Conclusions/Significance. The estimation model that describes this intervention predicts cost savings and improved health outcomes. A decision to remain with existing practices causes unnecessary costs and reduced health. Decision makers should consider adopting this 46 program for elderly hospitalised patients.

Cost-effectiveness of a telephone-delivered intervention for physical activity and diet

Background: Given escalating rates of chronic disease, broad-reach and cost-effective interventions to increase physical activity and improve dietary intake are needed. The cost-effectiveness of a Telephone Counselling intervention to improve physical activity and diet, targeting adults with established chronic diseases in a low socio-economic area of a major Australian city was examined. Methodology/Principal Findings: A cost-effectiveness modelling study using data collected between February 2005 and November 2007 from a cluster-randomised trial that compared Telephone Counselling with a “Usual Care” (brief intervention) alternative. Economic outcomes were assessed using a state-transition Markov model, which predicted the progress of participants through five health states relating to physical activity and dietary improvement, for ten years after recruitment. The costs and health benefits of Telephone Counselling, Usual Care and an existing practice (Real Control) group were compared. Telephone Counselling compared to Usual Care was not cost-effective ($78,489 per quality adjusted life year gained). However, the Usual Care group did not represent existing practice and is not a useful comparator for decision making. Comparing Telephone Counselling outcomes to existing practice (Real Control), the intervention was found to be cost-effective ($29,375 per quality adjusted life year gained). Usual Care (brief intervention) compared to existing practice (Real Control) was also cost-effective ($12,153 per quality adjusted life year gained). Conclusions/Significance: This modelling study shows that a decision to adopt a Telephone Counselling program over existing practice (Real Control) is likely to be cost-effective. Choosing the ‘Usual Care’ brief intervention over existing practice (Real Control) shows a lower cost per quality adjusted life year, but the lack of supporting evidence for efficacy or sustainability is an important consideration for decision makers. The economics of behavioural approaches to improving health must be made explicit if decision makers are to be convinced that allocating resources toward such programs is worthwhile.

Generative Music editorial

An issue on generative music in Contemporary Music Review allows space to explore many of these controversies, and to explore the rich algorithmic scene in contemporary practice, as well as the diverse origins and manifestations of such a culture. A roster of interesting exponents from both academic and arts practice backgrounds are involved, matching the broad spectrum of current work. Contributed articles range from generative algorithms in live systems, from live coding to interactive music systems to computer games, through algorithmic modelling of longer-term form, evolutionary algorithms, to interfaces between modalities and mediums, in algorithmic choreography. A retrospective on the intensive experimentation into algorithmic music and sound synthesis at the Institute of Sonology in the 1960s and 70s creates a complementary strand, as well as an open paper on the issues raised by open source, as opposed to proprietary, software and operating systems, with consequences in the creation and archiving of algorithmic work.

Performing with grid music systems

Grid music systems provide discrete geometric methods for simplified music-making by providing spatialised input to construct patterned music on a 2D matrix layout. While they are conceptually simple, grid systems may be layered to enable complex and satisfying musical results. Grid music systems have been applied to a range of systems from small portable devices up to larger systems. In this paper we will discuss the use of grid music systems in general and present an overview of the HarmonyGrid system we have developed as a new interactive performance system. We discuss a range of issues related to the design and use of larger-scale grid- based interactive performance systems such as the HarmonyGrid.

Adaptive music techniques

There are many interactive media systems, including computer games and media art works, in which it is desirable for music to vary in response to changes in the environment. In this paper we will outline a range of algorithmic techniques that enable music to adapt to such changes, taking into account the need for the music to vary in its expressiveness or mood while remaining coherent and recognisable. We will discuss the approaches which we have arrived at after experience in a range of adaptive music systems over recent years, and draw upon these experiences to inform discussion of relevant considerations and to illustrate the techniques and their effect.

Soundcipher : a music and sound library for processing

SoundCipher is a software library written in the Java language that adds important music and sound features to the Processing environment that is widely used by media artists and otherwise has an orientation toward computational graphics. This article introduces the SoundCipher library and its features, describes its influences and design intentions, and positions it within the field of computer music programming tools. SoundCipher enables the rich history of algorithmic music techniques to be accessible within one of today’s most popular media art platforms. It also provides an accessible means for learning to create algorithmic music and sound programs.

TraSe algorithm : automatic evolutionary morphing of electronic dance music

The TraSe (Transform-Select) algorithm has been developed to investigate the morphing of electronic music through automatically applying a series of deterministic compositional transformations to the source, guided towards a target by similarity metrics. This is in contrast to other morphing techniques such as interpolation or parameters or probabilistic variation. TraSe allows control over stylistic elements of the music through user-defined weighting of numerous compositional transformations. The formal evaluation of TraSe was mostly qualitative and occurred through nine participants completing an online questionnaire. The music generated by TraSe was generally felt to be less coherent than a human composed benchmark but in some cases judged as more creative.

Barriers to the acceptance of road safety programmes among rural road users : developing a brief intervention

Motorised countries have more fatal road crashes in rural areas than in urban areas. In Australia, over two thirds of the population live in urban areas, yet approximately 55 percent of the road fatalities occur in rural areas (ABS, 2006; Tziotis, Mabbot, Edmonston, Sheehan & Dwyer, 2005). Road and environmental factors increase the challenges of rural driving, but do not fully account for the disparity. Rural drivers are less compliant with recommendations regarding the “fatal four” behaviours of speeding, drink driving, seatbelt non-use and fatigue, and the reasons for their lower apparent receptivity for road safety messages are not well understood. Countermeasures targeting driver behaviour that have been effective in reducing road crashes in urban areas have been less successful in rural areas (FORS, 1995). However, potential barriers to receptivity for road safety information among rural road users have not been systematically investigated. This thesis aims to develop a road safety countermeasure that addresses three areas that potentially affect receptivity to rural road safety information. The first is psychological barriers of road users’ attitudes, including risk evaluation, optimism bias, locus of control and readiness to change. A second area is the timing and method of intervention delivery, which includes the production of a brief intervention and the feasibility of delivering it at a “teachable moment”. The third area under investigation is the content of the brief intervention. This study describes the process of developing an intervention that includes content to address road safety attitudes and improve safety behaviours of rural road users regarding the “fatal four”. The research commences with a review of the literature on rural road crashes, brief interventions, intervention design and implementation, and potential psychological barriers to receptivity. This literature provides a rationale for the development of a brief intervention for rural road safety with a focus on driver attitudes and behaviour. The research is then divided into four studies. The primary aim of Study One and Study Two is to investigate the receptivity of rural drivers to road safety interventions, with a view to identifying barriers to the efficacy of these strategies.