Is phase-specific, community-oriented treatment of early psychosis- an economically viable method of improving outcome?

Objective: The Early Psychosis Prevention and Intervention Centre (EPPIC) provides a comprehensive 'real-world' model of early intervention to young people experiencing an emerging psychotic disorder. A prospective study has already provided evidence of improved clinical outcome at 12 months after entry. The present study examined whether the service was also cost-effective.

Method: A cost-effectiveness analysis compared EPPIC with its immediate precursor service, from the perspective of the government funding agency. Only direct costs were included.

Results: EPPIC proved to be more cost-effective. The weighted average cost per patient for the first 12 months was cheaper (by äD 7110 per patient), while treatment outcomes were superior. The savings were due to the marked reduction in in-patient costs outweighing substantial increases in the costs of community care.

Conclusion: These results, while encouraging in terms of the further development of integrated, phase-specific intervention programmes for early psychosis, are not conclusive, and further research is required.

Learning to engage with human rights in heritage

Cultural heritage should not be seen merely as a technical matter or from a narrow visitor management point of view but rather as cultural practice—a form of cultural politics dominated by ruling regimes and social groups in which decisions are made about the future of and access to scarce resources. Several scholars have sought to push this approach further by arguing that heritage studies should take on the protection of human rights as a core consideration in the processes of identifying, inscribing, conserving and interpreting cultural heritage. This paper builds on these previous works to explore what the shift to a rights-based management approach in the World Heritage system might mean for various stakeholders in the heritage protection enterprise as they learn to meet this challenge and to find ways to support people’s right to access, enjoy and maintain cultural heritage. Reaffirming the need to maintain a strong relationship between theory and praxis, the paper draws into the discussion heritage practitioners, decision makers in governments and government agencies, scholars and educators. Of these, the principal emphasis in this paper is on educators who are seen to have a fundamentally important role in developing a critical understanding of the cultural heritage concept, how heritage is created, used and misused and how conservation approaches and programs sit within the broader context of community attitudes and aspirations and governmental responsibilities. A distinction is made between teachers in universities and trainers offering short courses more focused on specific employer needs. The paper focuses on World Heritage but refers to both tangible and intangible aspects. It shows how current moves to establish a rights-based approach to the management of World Heritage sites connects with moves elsewhere in global governance, most notably in the United Nations Permanent Forum on Indigenous Issues and the United Nations Human Rights Commission.

Forgotten histories: ephemeral culture for children and the digital archive

The history of children’s popular culture in Australia is still to be written. This article examines Australian print publication for children from the mid-nineteenth to the early twentieth centuries, together with radio and children’s television programming from the 1950s to the 1970s. It presents new scholarship on the history of children’s magazines and newspapers, sourced from digital archives such as Trove, and documents new sources for early works by Australian children’s writers. The discussion covers early television production for children, mobilising digital resources that have hitherto not informed scholarship in the field.

Using birthing kits to promote clean birth practices in Ethiopia

This article explores three NGO projects that assemble and distribute clean birthing kits in Ethiopia. It contrasts the government's health strategy that aims to increase skilled birth attendance, with local realities as most women in rural and remote settings give birth at home, often in unhygienic conditions, and without skilled assistance. Many health facilities are also unable to provide hygienic conditions for birthing women. The findings indicate that clean birth kits have assisted the NGOs to effectively promote clean delivery at home or in health facilities, and to encourage antenatal care, and early referral to emergency obstetric and new-born care.

Early adoption of mobile devices : a social network perspective

As mobile devices have become the personal information-processing interface of choice, many individuals seem to swiftly follow fashion. Yet, the literature is silent on how early adopters of mobile devices overcome uncertainties related to shifts in technology. Based on purposive sampling, this paper presents detailed insights into why and how five closely related individuals made the decision to adopt the iPhone before it was available through traditional supply chains. Focusing on the role played by social networks, we analyze how adoption threshold, opinion leaders, social contagion, and social learning shaped adoption behaviors and outcomes. The analyses confirm that network structures impact the early decision to accept the iPhone; they show that when facing uncertainty, adoption decisions emerged as a combined result of individual adoption reflections and major influences from the social network as well as behaviors observed within the network, and, they reveal interesting behaviors that differed from expectations. In conclusion, we discuss implications for both theory and practice.

Early adoption of mobile devices : a social network perspective

As mobile devices have become the personal information-processing interface of choice, many individuals seem to swiftly follow fashion. Yet, the literature is silent on how early adopters of mobile devices overcome uncertainties related to shifts in technology. Based on purposive sampling, this paper presents detailed insights into why and how five closely related individuals made the decision to adopt the iPhone before it was available through traditional supply chains. Focusing on the role played by social networks, we analyze how adoption threshold, opinion leaders, social contagion, and social learning shaped adoption behaviors and outcomes. The analyses confirm that network structures impacted the early decision to accept the iPhone; they show that when facing uncertainty, adoption decisions emerged as a combined result of individual adoption reflections and major influences from the social network as well as behaviors observed within the network; and, they reveal interesting behaviors that differed from expectations. In conclusion, we discuss implications for both theory and practice.

Late maturers at a performance disadvantage to their more mature peers in junior Australian football

Children and adolescents mature at different rates such that individuals competing in the same competition may differ in physical and biological maturity despite being of similar chronological age. Whether or not differences translate into on-field performance in competition is relatively unknown. This study investigated the influence of biological maturity on fitness and match running performance in junior Australian football. Eighty-seven under-15 years players were categorised into early (n = 20), average (n = 45) and late (n = 22) maturity groups based on self-reported and anthropometric assessment of biological maturity. Running movements during competition were collected using GPS (5 Hz) technology. Early maturers were heavier and taller than all other boys (P < 0.05), while biological maturity was significantly correlated to 20 m sprint (r = 0.53, P < 0.01). Total distance, high-intensity (>14.4 km · h−1) running distance and number of high-intensity efforts were significantly greater (20.8%, 53.6%, 31.7%, respectively; P < 0.01) in early compared to late maturers. Number of sprints and peak speed in competition were not different. Pubertal development and maturity status partially explained the differences between players in physical size, functional running fitness and match running performance. Late maturing players in this Australian football under-15 age group were at a physical and performance disadvantage to their earlier maturing peers.

Early-developmental stress, repeatability, and canalization in a suite of physiological and behavioral traits in female zebra finches

Adaptive developmental plasticity allows individuals experiencing poor environmental conditions in early life to adjust their life-history strategy in order to prioritize short-term fitness benefits and maximize reproductive output in challenging environments. Much research has been conducted to test whether such adoption of a "faster" life-history strategy is accompanied by concordant changes in behavior and physiology, with mixed results. As research in this field has focused on comparison of mean-level responses of treatment groups, few studies include repeated measures of response variables and the effect that developmental stress may have on repeatability per se. We investigated how early-developmental stress affects the mean expression of (and repeatability in) a variety of behavioral and physiological traits in female zebra finches. We predicted that: (1) individuals subjected to nutritional restriction in the nestling phase would have higher feeding and activity rates, with associated increases in hematocrit and basal metabolic rates (BMRs), (2) nutritional restriction in early life would alter adults' stress-induced corticosterone level, and (3) developmental stress would, respectively, influence the amount of among-individual and within-individual variation in behavioral and physiological traits, hence affecting the repeatability of these traits. In comparison to control females, stressed females did not differ in activity rate or stress-induced corticosterone level, but they did have higher levels of feeding, hematocrit, and BMR. Among-individual variance and repeatability were generally higher in stressed females than in controls. Finally, we found that developmental dietary restriction significantly reduced the amount of within-individual variance both in activity rate in the novel environment and in stress-induced corticosterone level. Our results not only confirm previous findings on the effect of early-developmental stress on BMR, but also extend its effect to feeding rate and hematocrit, suggesting that developmental plasticity in these traits is ontogenetically linked. Early-developmental stress may disable particular genetic canalizing processes, which would release cryptic genetic variation and explain why repeatability and among-individual variance were generally higher in the stressed groups than in controls. For activity rate in the novel environment and with stress-induced corticosterone level, however, early-developmental stress significantly reduced within-individual variance, which may be a consequence of increased canalization of these traits at the micro-environmental level.

Associations between early adrenarche, affective brain function and mental health in children

Early timing of adrenarche, associated with relatively high levels of Dehydroepiandrosterone (DHEA) in children, has been associated with mental health and behavioral problems. However, little is known about effects of adreneracheal timing on brain function. The aim of this study was to investigate the effects of early adrenarche (defined by high DHEA levels independent of age) on affective brain function and symptoms of psychopathology in late childhood (N = 83, 43 females, M age 9.53 years, s.d. 0.34 years). Results showed that higher DHEA levels were associated with decreased affect-related brain activity (i) in the mid-cingulate cortex in the whole sample, and (ii) in a number of cortical and subcortical regions in female but not male children. Higher DHEA levels were also associated with increased externalizing symptoms in females, an association that was partly mediated by posterior insula activation to happy facial expressions. These results suggest that timing of adrenarche is an important moderator of affect-related brain function, and that this may be one mechanism linking early adrenarche to psychopathology.

Use of weekly assessment data to enhance evaluation of a subjective wellbeing intervention

PURPOSE: While intervention effects in target outcomes have typically been tested based on change from baseline to post-intervention, such approaches typically ignore individual differences in change, including time taken to see improvement. The present study demonstrates how weekly patient-reported data may be used to augment traditional pre-post intervention evaluations in order to gain greater insights into treatment efficacy. METHODS: Two hundred and fifty-two adolescent boys and girls (M age = 13.6 years, SD = 0.6 years) from four secondary schools in Victoria, Australia, were assigned by school into control (n = 88) or intervention (n = 164) groups. The intervention group participated in a 6-week course designed to improve subjective wellbeing (SWB) by fostering resilience, coping skills, and self-esteem. In addition to baseline, post-intervention, and 3-month follow-up assessments of SWB, intervention group participants also completed weekly summarise of affective experiences for the duration of the intervention phase. RESULTS: While standard pre-post data showed significant improvement in SWB for the intervention group relative to controls, weekly data showed individual differences in the trajectory of change during this intervention phase; low SWB individuals experienced initial worsening of symptoms followed by improvement in the second half of the intervention phase, whereas high SWB individuals experienced initial gains, followed by a plateau from Week 4 onwards. CONCLUSIONS: Addition of weekly data provided greater insights into intervention effects by: (1) contradicting the notion that early responsiveness to treatment is predictive of level of improvement by post-intervention, and (2) providing data-based insights into ways to enhance the intervention.

Early childhood science exploration: a vehicle for inclusive practices

Social justice and equity are important elements of all educational services and particularly in early childhood where there is an emphasis on including all children in the everyday life of early childhood settings. This emphasis has targeted both the policies and practices in early childhood to meet the needs of a diverse range of learners. An outcome of policy reform is the emphasis on inclusive education that is based on the right of all children to access and participate in general education. A critical pedagogy approach counters discrimination by promoting positive attitudes towards diversity. Science learning is important for all children as it is an approach to thinking and behaving that incorporates aspects of motor, behavioural, sensory, communication and mental functioning. Children from diverse situations can contribute at their own level to the opportunities involved in exploration and investigations. This paper discusses inclusive pedagogy and planning in early childhood centres with a particular focus on science learning through play and child-instigated explorations.

Precarious decencies: negotiating creative (im)mortalities, in life, together

This paper takes up the question of what might hinder the collaborative impulse among artists and specifically poets, and offers—as one possible answer—the complication posed by the urge of an artist for immortality, or for their (individual) name to live on. The paper begins by returning to a moment in Plato, namely that of the Symposium and its observations concerning the connection between poiesis (making) and a questing after immortality. Contrasting with what seems like Plato's broadly positive framing, the paper takes up a second reading of immortality (or the 'will-to-live') found in an early text of the Yogic canon, that of Patanjali's Yoga Sutras. In this second text, written somewhat later than Plato's, the will-to-live is framed otherwise, as one of five afflictions that can be 'made thin' by practice. The paper's wager is that, viewed in this way, as an affliction, the will-to-live (or urge for immortality) deserves consideration as a hindrance to the impulse towards collaboration. Noting, however, that in the poiesis of writing poetry, where there is both the making of things and the action of making things, this creative constellation always contains the tempering solution to its own inherent lures. Writing, although providing fuel for immortal appetites (due to what it makes), also works to temper the worst of this same impulse via the contribution of practice—as dedication, craft and community-as-practice. The practice of writing, therefore, is already at play, and can be emphasised explicitly for any poet or maker who also wants to be able to want to collaborate. The practice of writing, then, and its turn away from investments in identity, works to thin out the more destructive face of an urge for a dubious eternity that can eclipse our ability to work together creatively with others in this life.