Implementing music therapy on an adolescent inpatient unit: A mixed-methods evaluation of acceptability, experience of participation and perceived impact

Objective: We aimed to assess the feasibility of delivering a music therapy program on adolescent psychiatric wards. Method: We undertook a mixed-methods evaluation of a pilot program. Various active and receptive techniques were employed in group music therapy sessions delivered as part of a structured clinical program. Data collected in interviews with participants and staff and feedback questionnaires were thematically and descriptively analysed and triangulated. Results: Data from 62 questionnaires returned by 43 patients who took part in 16 music therapy sessions, and seven staff, evidenced strong support for music therapy. Patients typically reported experiencing sessions as relaxing, comforting, uplifting, and empowering; >90% would participate by choice and use music therapeutically in the future. Staff endorsed music therapy as valuable therapeutically, reporting that patients engaged enthusiastically and identified sessions as improving their own moods and ward milieu. Conclusions: Integration of music therapy in inpatient treatment of adolescents is feasible and acceptable, and is valued by staff and patients as a complement to ‘talking therapies’. Participation is enjoyed and associated with outcomes including improvement in mood, expression of feelings and social engagement consistent with recovery.

A mixed-methods research approach to the review of competency standards for orthotist/prosthetists in Australia

Aim: The requirement for an allied health workforce is expanding as the global burden of disease increases internationally. To safely meet the demand for an expanded workforce of orthotist/prosthetists in Australia, competency based standards, which are up-to-date and evidence-based, are required. The aims of this study were to determine the minimum level for entry into the orthotic/prosthetic profession; to develop entry level competency standards for the profession; and to validate the developed entry-level competency standards within the profession nationally, using an evidence-based approach. Methods: A mixed-methods research design was applied, using a three-step sequential exploratory design, where step 1 involved collecting and analyzing qualitative data from two focus groups; step 2 involved exploratory instrument development and testing, developing the draft competency standards; and step 3 involved quantitative data collection and analysis – a Delphi survey. In stage 1 (steps 1 and 2), the two focus groups – an expert and a recent graduate group of Australian orthotist/prosthetists – were led by an experienced facilitator, to identify gaps in the current competency standards and then to outline a key purpose, and work roles and tasks for the profession. The resulting domains and activities of the first draft of the competency standards were synthesized using thematic analysis. In stage 2 (step 3), the draft-competency standards were circulated to a purposive sample of the membership of the Australian Orthotic Prosthetic Association, using three rounds of Delphi survey. A project reference group of orthotist/prosthetists reviewed the results of both stages. Results: In stage 1, the expert (n = 10) and the new graduate (n = 8) groups separately identified work roles and tasks, which formed the initial draft of the competency standards. Further drafts were refined and performance criteria added by the project reference group, resulting in the final draft-competency standards. In stage 2, the final draft-competency standards were circulated to 56 members (n = 44 final round) of the Association, who agreed on the key purpose, 6 domains, 18 activities, and 68 performance criteria of the final competency standards. Conclusion: This study outlines a rigorous and evidence-based mixed-methods approach for developing and endorsing professional competency standards, which is representative of the views of the profession of orthotist/prosthetists.

Mixed reality stories: How creative writers integrate virtual and physical realities

Mixed reality stories (MRS) unfold simultaneously in the physical and the virtual world. Advancements in digital technologies, which are now able to capture more contextual information about our physical environments, are enabling novel ways of blending the two worlds. To explore the process of creating stories from this perspective, we conducted a study with creative writers, in which we asked them to write a MRS script for outdoor running. While we saw instances of intentional connections between physical and virtual worlds in their work, we also observed the use of ambiguity or even deliberate contradiction with available contextual information. In this paper we discuss how these approaches can be beneficial for MRS and propose directions for future work.

Being chased by zombies!: Understanding the experience of mixed reality quests

Both researchers and practitioners show increasing interest in exploring mixed reality games: games, where physical environments blend together with digital technologies. In this paper we have extended earlier work by bringing attention to the role of narrative in mixed reality games. For our case study we chose a mobile phone application Zombies Run!, which is designed to support actual running. This application contains a fictional story about a zombie apocalypse and provides runners with various quests (in the form of missions) to complete during their run. We investigated different aspects of participants' experience with the application and how it changed their running. Our findings show how the app changed running in three major ways. Firstly, it changed the way runs were organised. Secondly, it shook up established running routines. And lastly, it shaped the meanings associated with running.

Intuitive interaction in a mixed reality system

Tangible physical systems are more intuitive than Intangible virtual Systems. Mixed reality systems are considered as an alternative to virtual systems, bringing advantages of tangible systems into an interaction. However, past research has mainly focussed on technical aspects of incorporating pervasive-ness and immersive-ness in the virtual systems. This paper reports on an empirical study of intuitive Interaction in a Mixed Reality game system for children and the design aspects that could facilitate intuitive Interaction in such systems. A related samples Friedman’s test showed that the Mixed Reality game system demonstrated more intuitive interactions than non-intuitive Interactions. A linear regression analysis further established that the variation in intuitive Interaction in the Mixed Reality system could be statistically significantly explained primarily by physical affordances offered by the Mixed Reality system and to a lesser extent by the perceived affordances in the system. Design guidelines to develop intuitive Mixed Reality systems are discussed. These guidelines should allow designers to exploit the wonders of advances in technology and at the same time allow users to directly interact with the physical real world. This will allow users to access maximal physical affordances, which are primary contributors to intuitive interaction in Tangible and Mixed Reality systems.

Mixed pixel analysis for flood mapping using extended support vector machine

This paper addresses the challenges of flood mapping using multispectral images. Quantitative flood mapping is critical for flood damage assessment and management. Remote sensing images obtained from various satellite or airborne sensors provide valuable data for this application, from which the information on the extent of flood can be extracted. However the great challenge involved in the data interpretation is to achieve more reliable flood extent mapping including both the fully inundated areas and the 'wet' areas where trees and houses are partly covered by water. This is a typical combined pure pixel and mixed pixel problem. In this paper, an extended Support Vector Machines method for spectral unmixing developed recently has been applied to generate an integrated map showing both pure pixels (fully inundated areas) and mixed pixels (trees and houses partly covered by water). The outputs were compared with the conventional mean based linear spectral mixture model, and better performance was demonstrated with a subset of Landsat ETM+ data recorded at the Daly River Basin, NT, Australia, on 3rd March, 2008, after a flood event.

Mixed pixel analysis and assessment for flood mapping

The most difficult operation in flood inundation mapping using optical flood images is to map the ‘wet’ areas where trees and houses are partly covered by water. This can be referred to as a typical problem of the presence of mixed pixels in the images. A number of automatic information extracting image classification algorithms have been developed over the years for flood mapping using optical remote sensing images, with most labelling a pixel as a particular class. However, they often fail to generate reliable flood inundation mapping because of the presence of mixed pixels in the images. To solve this problem, spectral unmixing methods have been developed. In this thesis, methods for selecting endmembers and the method to model the primary classes for unmixing, the two most important issues in spectral unmixing, are investigated. We conduct comparative studies of three typical spectral unmixing algorithms, Partial Constrained Linear Spectral unmixing, Multiple Endmember Selection Mixture Analysis and spectral unmixing using the Extended Support Vector Machine method. They are analysed and assessed by error analysis in flood mapping using MODIS, Landsat and World View-2 images. The Conventional Root Mean Square Error Assessment is applied to obtain errors for estimated fractions of each primary class. Moreover, a newly developed Fuzzy Error Matrix is used to obtain a clear picture of error distributions at the pixel level. This thesis shows that the Extended Support Vector Machine method is able to provide a more reliable estimation of fractional abundances and allows the use of a complete set of training samples to model a defined pure class. Furthermore, it can be applied to analysis of both pure and mixed pixels to provide integrated hard-soft classification results. Our research also identifies and explores a serious drawback in relation to endmember selections in current spectral unmixing methods which apply fixed sets of endmember classes or pure classes for mixture analysis of every pixel in an entire image. However, as it is not accurate to assume that every pixel in an image must contain all endmember classes, these methods usually cause an over-estimation of the fractional abundances in a particular pixel. In this thesis, a subset of adaptive endmembers in every pixel is derived using the proposed methods to form an endmember index matrix. The experimental results show that using the pixel-dependent endmembers in unmixing significantly improves performance.