Does the addition of integrated cognitive behaviour therapy and motivational interviewing improve the outcomes of standard care for young people with comorbid depression and substance misuse?

Background: The high rates of comorbid depression and substance use in young people have been associated with a range of adverse outcomes. Yet, few treatment studies have been conducted with this population. Objective: To determine if the addition of Motivational Interviewing and Cognitive Behaviour Therapy (MI/CBT) to standard alcohol and other drug (AOD) care improves the outcomes of young people with comorbid depression and substance use. Participants and Setting: Participants comprised 88 young people with comorbid depression (Kessler 10 score of > 17) and substance use (mainly alcohol/cannabis) seeking treatment at two youth AOD services in Melbourne, Australia. Sixty young people received MI/CBT in addition to standard care (SC) and 28 received SC alone. Outcomes Measures: Primary outcome measures were depressive symptoms and drug and alcohol use in the past month. Assessments were conducted at baseline, 3 and 6 months follow up. Results and Conclusions: The addition of MI/CBT to SC was associated with a significantly greater rate of change in depression, cannabis use, motivation to change substance use and social contact in the first 3 months. However, those who received SC had achieved similar improvements on these variables by 6 months follow up. All young people achieved significant improvements in functioning and quality of life variables over time, regardless of the treatment group. No changes in alcohol or other drug use were found in either group. The delivery of MI/CBT in addition to standard AOD care may offer accelerated treatment gains in the short-term.

The effectiveness of energy feedback for conservation and peak demand : a literature review

This paper reviews electricity consumption feedback literature to explore the potential of electricity feedback to affect residential consumers’ electricity usage patterns. The review highlights a substantial amount of literature covering the debate over the effectiveness of different feedback criteria to residential customer acceptance and overall conservation and peak demand reduction. Researchers studying the effects of feedback on everyday energy use have observed substantial variation in effect size, both within and between studies. Although researchers still continue to question the types of feedback that are most effective in encouraging conservation and peak load reduction, some trends have emerged. These include that feedback be received as quickly as possible to the time of consumption; be related to a standard; be clear and meaningful and where possible both direct and indirect feedback be customised to the customer. In general, the literature finds that feedback can reduce electricity consumption in homes by 5 to 20 per cent, but that significant gaps remain in our knowledge of the effectiveness and cost benefit of feedback.

The role of HtrA as a chaperone and protease in bacterial pathogenesis

HtrA (High Temperature Requirement A) is a critical stress response protease and chaperone for many bacteria. HtrA is a multitasking protein which can degrade unfolded proteins, conduct specific proteolysis of some substrates for correct assembly, interact with substrates to ensure correct folding, assembly or localisation, and chaperone unfolded proteins. These functions are critical for the virulence of a number of bacterial pathogens, in some cases not simply due to the broad activities of HtrA in protection against the protein stress conditions which occur during virulence. But also due to the role of HtrA in either specific proteolysis or assembly of key protein substrates which function directly in virulence. Remarkably, these activities are all conducted without any requirement for ATP. The biochemical mechanism of HtrA relies both on the chymotryptic serine protease active site as well as the presence of two PDZ (protein binding) domains. The mechanism is a unique combination of activation by substrate motifs to alter the confirmation of the active site, and assembly into a multimeric complex which has enhanced degradation and may also act as a protective cage for proteins which are not degraded. The role of this protease in the pathogenesis of a number of bacteria and the details of its distinctive biochemical activation and assembly mechanisms are discussed in this chapter.

The role of HtrA as a chaperone and protease in bacterial pathogenisis

HtrA (High Temperature Requirement A) is a critical stress response protease and chaperone for many bacteria. HtrA is a multitasking protein which can degrade unfolded proteins, conduct specific proteolysis of some substrates for correct assembly, interact with substrates to ensure correct folding, assembly or localisation, and chaperone unfolded proteins. These functions are critical for the virulence of a number of bacterial pathogens, in some cases not simply due to the broad activities of HtrA in protection against the protein stress conditions which occur during virulence. But also due to the role of HtrA in either specific proteolysis or assembly of key protein substrates which function directly in virulence. Remarkably, these activities are all conducted without any requirement for ATP. The biochemical mechanism of HtrA relies both on the chymotryptic serine protease active site as well as the presence of two PDZ (protein binding) domains. The mechanism is a unique combination of activation by substrate motifs to alter the confirmation of the active site, and assembly into a multimeric complex which has enhanced degradation and may also act as a protective cage for proteins which are not degraded. The role of this protease in the pathogenesis of a number of bacteria and the details of its distinctive biochemical activation and assembly mechanisms are discussed in this chapter.

Supporting the development of inclusive products : the effects of everyday ambient illumination levels and contrast on older adults' near visual acuity

Current older adult capability data-sets fail to account for the effects of everyday environmental conditions on capability. This article details a study that investigates the effects of everyday ambient illumination conditions (overcast, 6000 lx; in-house lighting, 150 lx and street lighting, 7.5 lx) and contrast (90%, 70%, 50% and 30%) on the near visual acuity (VA) of older adults (n= 38, 65-87 years). VA was measured at a 1-m viewing distance using logarithm of minimum angle of resolution (LogMAR) acuity charts. Results from the study showed that for all contrast levels tested, VA decreased by 0.2 log units between the overcast and street lighting conditions. On average, in overcast conditions, participants could detect detail around 1.6 times smaller on the LogMAR charts compared with street lighting. VA also significantly decreased when contrast was reduced from 70% to 50%, and from 50% to 30% in each of the ambient illumination conditions. Practitioner summary: This article presents an experimental study that investigates the impact of everyday ambient illumination levels and contrast on older adults' VA. Results show that both factors have a significant effect on their VA. Findings suggest that environmental conditions need to be accounted for in older adult capability data-sets/designs.

A new first-order decision-making model for the procurement of public sector infrastructure: Procedures and Testing

Given global demand for new infrastructure, governments face substantial challenges in funding new infrastructure and delivering Value for Money (VfM). As part of the background to this challenge, a critique is given of current practice in the selection of the approach to procure major public sector infrastructure in Australia and which is akin to the Multi-Attribute Utility Approach (MAUA). To contribute towards addressing the key weaknesses of MAUA, a new first-order procurement decision-making model is presented. The model addresses the make-or-buy decision (risk allocation); the bundling decision (property rights incentives), as well as the exchange relationship decision (relational to arms-length exchange) in its novel approach to articulating a procurement strategy designed to yield superior VfM across the whole life of the asset. The aim of this paper is report on the development of this decisionmaking model in terms of the procedural tasks to be followed and the method being used to test the model. The planned approach to testing the model uses a sample of 87 Australian major infrastructure projects in the sum of AUD32 billion and deploys a key proxy for VfM comprising expressions of interest, as an indicator of competition.

Sleepless nights : the effect of socioeconomic status, physical activity, and lifestyle factors on sleep quality in a large cohort of Australian women

The aims of this study were to examine: (1) the association between sociodemographic and lifestyle factors and sleep quality in a population-based cohort of Australian women and (2) possible influence of reproductive status and mental and physical health factors on these associations. Data on 3,655 women (mean age046.6 years, range 34.3–67.4) were obtained from the Mater Hospital University of Queensland Study of Pregnancy for this cross-sectional study. Self-rated sleep quality was assessed using the Pittsburgh Sleep Quality Index. For the purpose of this study, two cutoff points (scores 5 and 10) were used to divide women into three categories: normal (65.2 %), moderately poor (26.4 %), and very poor sleep quality (8.5 %). Other covariates were measured at 21-year follow-up as well. After adjusting for reproductive status, mental and physical health, there were significant associations between moderately poor sleep quality and education and between very poor sleep quality and unemployment, both measures of socioeconomic status. In addition, work-related exertion was associated with increased rates of moderately poor sleep quality, whereas those women undertaking moderate exercise were less likely to experience very poor sleep quality. Independent associations between sociodemographic factors and exercise with moderately poor and very poor sleep quality were identified. These findings demonstrate the dynamic nature of the association between exercise/exertion, socioeconomic status, and sleep quality and highlight the importance of taking these into consideration when dealing with issues of poor sleep quality in women.

Current practice in nutrition assessment for the management of Parkinson’s disease in Australia and Canada

AIM: To document and compare current practice in nutrition assessment of Parkinson’s disease by dietitians in Australia and Canada in order to identify priority areas for review and development of practice guidelines and direct future research. METHODS: An online survey was distributed to DAA members and PEN subscribers through their email newsletters. The survey captured current practice in the phases of the Nutrition Care Plan. The results of the assessment phase are presented here. RESULTS: Eighty-four dietitians responded. Differences in practice existed in the choice of nutrition screening and assessment tools, including appropriate BMI ranges. Nutrition impact symptoms were commonly assessed, but information about Parkinson’s disease medication interactions were not consistently assessed. CONCLUSIONS: he variation in practice related to the use of screening and assessment methods may result in the identification of different goals for subsequent interventions. Even more practice variation was evident for those items more specific to Parkinson’s disease and may be due to the lack of evidence to guide practice. Further research is required to support decisions for nutrition assessment of Parkinson’s disease.

Constructing the shitting citizen : the promise of scatological art as environmental and social activism

Art activism uses visual and performance art to promote social and environmental agendas. In this paper, I explore attempts to raise awareness of sanitation issues at the global, local and personal level using scatological art. I focus on the successes of the open-air public art exhibition set up in the Brisbane (Queensland, Australia) central business district to celebrate World Toilet Day in 2008. The art in this exhibition featured included one hundred toilets decorated to raise awareness of global sanitation issues and the distribution of promotional materials featuring scatological images including postcards and stickers. Given the subject matter and intent, the toilet art and promotional materials presented at the One Hundred Toilet exhibition can be seen as an example of scatological art employed for the purposes of social and environmental activism. Through the One Hundred Toilet exhibition, I consider the political aims and activist potential of using scatological art to progress social and environmental agendas and consider how this kind of ‘shit on show’ approach can contribute to the construction of the shitting citizen; one who is simultaneously responsible for and responsive to managing the waste that they produce and recognising and responding to broader sanitation issues.

The art of being a fan : complicity and criticality in contemporary art and fandom

This practice-led research project aims to use contemporary art processes and concepts of fandom to construct a space for the critical and creative exploration of the relationship between them. Much of the discourse addressing the intersection of these spaces over the last three decades tends to treat art and fan studies as separate areas of critical and theoretical research. There has also been very little consideration of the critical interface that art practice and fandom share in their engagement with one another – or how the artist as fan might creatively exploit this relationship. Approaching these issues through a practice-led methodology that combines studio based explorations and traditional modes of research, the project aims to demonstrate how my 'fannish' engagements with popular culture can generate new responses to, and understandings of, the relationship between fandom, affect and visual art. The research acts as a performative and creative investigation of fandom as I document the complicit tendencies that arise out of my affective relationship with pop cultural artefacts. It does this through appropriating and reconfiguring content from film, television and print media, to create digital video installations aimed at engendering new experiences and critical interpretations of screen culture. This approach promotes new possibilities for creative engagements with art and popular culture, and these are framed through the lens of what I term the digital-bricoleur. The research will be primarily contextualised by examining other artists' practices as well as selected theoretical frameworks that traverse my investigative terrain. The key artists that are discussed include Douglas Gordon, Candice Brietz, Pierre Huyghe, Paul Pfieffer, and Jennifer and Kevin McCoy. The theoretical developments of the project are drawn from a pluralistic range of ideas ranging from Johanna Drucker's discussion of critical complicity in contemporary art, Matt Hills' discussion of subjectivity in fandom and academia, Nicolas Bourriaud's discussion of Postproduction art practices, and Jacques Rancière's ideas about aesthetics and politics. The methodology and artworks developed over the course of this project will also demonstrate how digital-bricolage leads to new understandings of the relationships between contemporary art and entertainment. The research aims to exploit these apparently contradictory positions to generate a productive site for rethinking the relationship between the creative and critical possibilities of art and fandom. The outcomes of the research consists of a body of artworks – 75% – that demonstrate new contributions to knowledge, and an exegetical component – 25% – that acts to reflect on, analyse and critically contextualise the practice-led findings.

The challenge of integrating climate change adaptation and disaster risk management : lessons from bushfire and flood inquiries in an Australian context

Emergency management and climate change adaptation will increasingly challenge all levels of government because of three main factors. First, Australia is extremely vulnerable to the impacts of climate change, particularly through the increasing frequency, duration and/or intensity of disasters such as floods and bushfires. Second, the system of government that divides powers by function and level can often act as a barrier to a well-integrated response. Third, policymaking processes struggle to cope with such complex inter-jurisdictional issues. This paper discusses these factors and explores the nature of the challenge for Australian governments. Investigations into the 2009 Victorian bushfires, the 2011 Perth Hills bushfires, and the 2011 Brisbane floods offer an indication of the challenges ahead and it is argued that there is a need to: improve community engagement and communication; refocus attention on resilience; improve interagency communication and collaboration; and, develop institutional arrangements that support continual improvement and policy learning. These findings offer an opportunity for improving responses as well as a starting point for integrating disaster risk management and climate change adaptation policies. The paper is based on the preliminary findings of an NCCARF funded research project: The Right Tool for the Job: Achieving climate change adaptation outcomes through improved disaster management policies, planning and risk management strategies involving Griffith University and RMIT. It should be noted from the outset that the purpose of this research project is not to criticise the actions of emergency service workers and volunteers who do an incredible job under extreme circumstances, often risking their own lives in the process. The aim is simply to offer emergency management agencies the opportunity to step back and rethink their overall approach to the challenge they face in the light of the impacts of climate change.

The relationship of entrepreneurial orientation, Vincentian values and economic and social performance in social enterprise

This study focuses on the managerial question “should social enterprises become more entrepreneurial?” It adapts the Covin and Slevin (1989) entrepreneurial orientation scale to measure the adoption of entrepreneurship by a social enterprise, and develops a scale that combines a Vincentian based focus to serve the poor with a propensity to take a more entrepreneurial approach toward business as a measure of a social value orientation (SVO).