Mechanisms of change in psychotherapy for people diagnosed with schizophrenia : the role of narrative reflexivity in promoting recovery

Narrative reflexivity was investigated as a potential mechanism of therapeutic change during a 12 - 18 month trial of Metacognitive Narrative Psychotherapy for people diagnosed with schizophrenia. Participants were nine adult clients (8 male, 1 female) aged between 25-65 years (M = 44, SD = 12.76) with a diagnosis of schizophrenia consistent with DSM-IV criteria and seven female provisional psychologists aged between 25-29 years (M = 26.8 years, SD = 1.47 years). Recovery and narrative reflexivity were measured at three time points using the Recovery Assessment Scale (RAS) and the Narrative Processes Coding System (NPCS). Results were reported descriptively due to limited sample size (n = 9). The majority of clients (n = 7) reported an increase in recovery over the course of treatment. For six clients, an overall increase in recovery was associated with an increase in narrative reflexivity. This study provides preliminary support for narrative reflexivity as a potential mechanism of therapeutic change in the psychotherapy of people diagnosed with schizophrenia.

A ramp metering strategy for rapid congestion recovery

Recurrent congestion caused by high commuter traffic is an irritation to motorway users. Ramp metering (RM) is the most effective motorway control means (M Papageorgiou & Kotsialos, 2002) for significantly reducing motorway congestion. However, given field constraints (e.g. limited ramp space and maximum ramp waiting time), RM cannot eliminate recurrent congestion during the increased long peak hours. This paper, therefore, focuses on rapid congestion recovery to further improve RM systems: that is, to quickly clear congestion in recovery periods. The feasibility of using RM for recovery is analyzed, and a zone recovery strategy (ZRS) for RM is proposed. Note that this study assumes no incident and demand management involved, i.e. no re-routing behavior and strategy considered. This strategy is modeled, calibrated and tested in the northbound model of the Pacific Motorway, Brisbane, Australia in a micro-simulation environment for recurrent congestion scenario, and evaluation results have justified its effectiveness.

Post-disaster reconstruction projects : a logical framework for community participation

In a post-disaster environment, housing reconstruction projects frequently face enormous difficulties due to the various, often apparently ill-considered, internal and external factors. Non-Governmental Organisations (NGOs) operating in post-disaster settings such as in Afghanistan continue to face blame over the failure of reconstruction projects, and worse, they are sometimes even viewed as being corrupt entities. While it is not always possible for NGOs to eliminate or reduce the impact of factors that are outside their control, they certainly can increase the chances of project success by placing considerable emphasis on working more effectively with the affected communities. To achieve maximum community participation in reconstruction projects , this research develops a specific logical framework to guide the process of community participation in post-disaster housing reconstruction in Afghanistan.

Modelling total duration of traffic incidents including incident detection and recovery time

Traffic incidents are key contributors to non-recurrent congestion, potentially generating significant delay. Factors that influence the duration of incidents are important to understand so that effective mitigation strategies can be implemented. To identify and quantify the effects of influential factors, a methodology for studying total incident duration based on historical data from an ‘integrated database’ is proposed. Incident duration models are developed using a selected freeway segment in the Southeast Queensland, Australia network. The models include incident detection and recovery time as components of incident duration. A hazard-based duration modelling approach is applied to model incident duration as a function of a variety of factors that influence traffic incident duration. Parametric accelerated failure time survival models are developed to capture heterogeneity as a function of explanatory variables, with both fixed and random parameters specifications. The analysis reveals that factors affecting incident duration include incident characteristics (severity, type, injury, medical requirements, etc.), infrastructure characteristics (roadway shoulder availability), time of day, and traffic characteristics. The results indicate that event type durations are uniquely different, thus requiring different responses to effectively clear them. Furthermore, the results highlight the presence of unobserved incident duration heterogeneity as captured by the random parameter models, suggesting that additional factors need to be considered in future modelling efforts.

The child pose : the role of the nonhuman natural world in recovery from psychological trauma

This thesis by creative work explores relationships among human beings, the nonhuman natural world and language. It addresses the central research question: 'How can a novel embody a narrative of recovery from psychological trauma in which recovery is primarily a function of the character's subjective interaction with nature?' The novel, 'The Child Pose', tells the story of a woman's recovery from psychological trauma. The thesis draws on the psychoanalytic theory of Jacques Lacan, who saw the human subject as fundamentally split and alienated, and therefore inherently vulnerable to being destabilised by trauma. Situating the narrative of recovery within the emerging fields of ecocriticism and ecopsychology, the research constructs psychological recovery through interaction with nature as a transformation of subjectivity: the creation of a new, more stable and connected kind of subject, which Jordan (2012) has called 'the ecological subject'.

Artemisinin induced dormancy in Plasmodium falciparum : duration, recovery rates and implications in treatment failure

Background Despite the remarkable activity of artemisinin and its derivatives, monotherapy with these agents has been associated with high rates of recrudescence. The temporary arrest of the growth of ring-stage parasites (dormancy) after exposure to artemisinin drugs provides a plausible explanation for this phenomenon. Methods Ring-stage parasites of several Plasmodium falciparum lines were exposed to different doses of dihydroartemisinin (DHA) alone or in combination with mefloquine. For each regime, the proportion of recovering parasites was determined daily for 20 days. Results Parasite development was abruptly arrested after a single exposure to DHA, with some parasites being dormant for up to 20 days. Approximately 50% of dormant parasites recovered to resume growth within the first 9 days. The overall proportion of parasites recovering was dose dependent, with recovery rates ranging from 0.044% to 1.313%. Repeated treatment with DHA or with DHA in combination with mefloquine led to a delay in recovery and an ∼10-fold reduction in total recovery. Strains with different genetic backgrounds appeared to vary in their capacity to recover. Conclusions These results imply that artemisinin-induced arrest of growth occurs readily in laboratory-treated parasites and may be a key factor in P. falciparum malaria treatment failure.

Pasture Degradation and Recovery in Australia's Rangelands : Learning from History

"The extended drought periods in each degradation episode have provided a test of the capacity of grazing systems (i.e. land, plants, animals, humans and social structure) to handle stress. Evidence that degradation was already occurring was identified prior to the extended drought sequences. The sequence of dry years, ranging from two to eight years, exposed and/or amplified the degradation processes. The unequivocal evidence was provided by: (a) the physical 'horror' of bare landscapes, erosion scalds and gullies and dust storms; (b) the biological devastation of woody weeds and animal suffering/deaths or forced sales, and; (c) the financial and emotional plight of graziers and their families due to reduced production in some cases leading to abandonment of properties or, sadly, deaths (e.g. McDonald 1991, Ker Conway 1989)."--Publisher website

Proposing and developing the definition and conceptual framework for healthcare resilience to cope with disasters

Building healthcare resilience is an important step towards creating more resilient communities to better cope with future disasters. To date, however, there appears to be little literature on how the concept of healthcare resilience should be defined and operationalized with a conceptual framework. This article aims to build a comprehensive healthcare disaster management approach guided by the concept of resilience. Methods: Google and major health electronic databases were searched to retrieve critical relevant publications. A total of 61 related publications were included, to provide a comprehensive overview of theories and definitions relevant to disaster resilience. Results and Discussions: Resilience is an inherent and adaptive capacity to cope with future uncertainty, through multiple strategies with all hazards approaches, in an attempt to achieve a positive outcome with linkage and cooperation. Healthcare resilience can be defined as the capability of healthcare organisations to resist, absorb, and respond to the shock of disasters while maintaining the most essential functions, then recover to their original state or adapt to a new state. It can be assessed by criteria, namely: robustness, redundancy, resourcefulness; and a complex of key dimensions, namely: vulnerability and safety, disaster resources and preparedness, continuity of essential health services, recovery and adaptation. Conclusions: This new concept places healthcare organisations’ disaster capabilities, management tasks, activities and disaster outcomes together into a comprehensive whole view, using an integrated approach and establishing achievable goals.

Developing an evaluation framework for hospital disaster resilience : tertiary hospitals of Shandong Province, China

This thesis provided a definition and conceptual framework for hospital disaster resilience; it used a mixed-method, including an empirical study in tertiary hospitals of Shandong Province in China, to devise an assessment instrument for measuring hospital resilience. The instrument is the first of its type and will allow hospitals to measure their resilience levels. The concept of disaster resilience has gained prominence in the light of the increased impact of various disasters. The notion of resilience encompasses the qualities that enable the organisation or community to resist, respond to, and recover from the impact of disasters. Hospital resilience is essential as it provides 'lifeline' services which minimize disaster impact. This thesis has provided a framework and instrument to evaluate the level of hospital resilience. Such an instrument could be used to better understand hospital resilience, and also as a decision-support tool for its promoting strategies and policies.

Progress and challenges of disaster health management in China : a scoping review

Background Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. Objective This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. Design A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. Results The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. Conclusions One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

Displaced twice? Talking about resilience with a cohort of men from refugee backgrounds who were affected by the 2011 Queensland floods

What can we learn from people from refugee backgrounds who have been affected by an environmental disaster? This paper presents the first year findings of a study that is investigating the impact of the 2011 Queensland floods on a cohort of men from refugee backgrounds living in Brisbane and the Toowoom- ba–Gatton region of Southeast Queensland. Between 2008 and 2010, the SettleMEN study yielded pre-disaster measures of health and settlement among 233 refugee men. The current 2012−2013 follow-up study offers a rare opportunity to investigate and describe the impact of an environmental disaster on the health and wellbeing of a group of resettled refugee men who were affected by the 2011 Queensland floods. Using a mixed-method approach and a peer interviewer model, this paper reports on the exposure to and impact of the floods on the first 100 respondents who were interviewed between September 2012 and March 2013. Overall, we have found that the floods had a considerable economic and psychosocial impact on this group of men, their families and communities in terms of being forced to evacuate their homes, work disrup- tion, loss of income and personal belongings, and emotional distress. Many of these men reported that their previous refugee experience helped them to cope better during and after the floods, and for some, providing assistance to others during the floods impacted positively on their relationship with their neighbours. These findings challenge the Western deficits model that defines former refugees as traumatised victims. Refugee people’s strengths and capabilities should be taken into consideration when developing disaster response strategies at the neighbourhood and community levels.

A case study in flood fatality : Beijing July 2012 flood

Background The aim of this study is to examine the flood fatality with a view to identifying risks which may inform public policy responses to future flood. On July 21st, 2012, Beijing suffered the heaviest rain since 1963. The average rainfall was 215 mm over a 24 hour period in the central city (301mm in Fangshan District). The rain resulted in a flood that caused severe health, social and financial impact. Results This flood caused 79 deaths. Of the 71 deaths for which a specific cause could be identified, 5 were rescue team members, 42 were killed by drowning (11 in the car), and the others by electricity shock, fallen house, falling items and lightning. The total financial cost was estimated to be US$ 1.7 billion. The causations of the deaths inform the risks associated with the flood. Discussion This flood had a catastrophic impact on Beijing, mainly due to the intensity of the rain (the rain was the heaviest in the modern Beijing history; possibly due to global warming and urban heat island effect), the vulnerability of the infrastructure (poor standards of drainage, disorganized water management systems and decreased permeability of the earth as a result of the city’s rapid development), and the capacity of the response system (mainly dependent on the awareness of the citizens, warning systems and the capacity of the emergency rescue). Implication Many risk management measures have been implemented as a result of this flood, including water level warning marks, flood safety education and warnings sent to mobile phones, a project to move about 74,500 farmers away from the flood-prone areas within 5 years. However, further measures targeted at the fundamental issues identified by this analysis are necessary, especially those targeting at health issues. These may include better planning, improved drainage systems and ecological development to increase permeability etc..

Community engagement for disaster resilience : flood risk management in Jakarta, Indonesia

Understanding dynamics of interactions between community groups and government agencies is crucial to improve community resilience for flood risk reduction through effective community engagement strategies. Overall, a variety of approaches are available, however they are limited in their application. Based on research of a case study in Kampung Melayu Village in Jakarta, further complexity in engaging community emerges in planning policy which requires the relocation of households living in floodplains. This complexity arises in decision-making processes due to barriers to communication. This obstacle highlights the need for a simplified approach for an effective flood risk management which will be further explored in this paper. Qualitative analyses will be undertaken following semi-structured interviews conducted with key actors within government agencies, non-governmental organisations (NGOs), and representatives of communities. The analyses involve investigation of barriers and constraints on community engagement in flood risk management, particularly relevant to collaboration mechanism, perception of risk, and technical literacy to flood risk. These analyses result in potential redirection of community consultation strategies to lead to a more effective collaboration among stakeholders in the decision-making processes. As a result, greater effectiveness in plan implementation of flood risk management potentially improves disaster resilience in the future.

How does Nepal Television (NTV) frame natural disasters? A qualitative content analysis of news scripts using news frames and PPRR cycle

Introduction- This study investigates the prevailing status of Nepalese media portrayal of natural disasters. It is contributing to the development of a disaster management model to improve the effectiveness and efficiency of news production throughout the continuum of prevention, preparedness, response and recovery (PPRR) phases of disaster management. Theoretical framework- Studies of media content often rely on framing as the theoretical underpinning of the study, as it describes how the press crafts the message. However there are additional theoretical perspectives that underline an understanding of the role of the media. This article outlines a conceptual understanding of the role of the media in modern society, the way that this conceptual understanding is used in the crafting of media messages and how those theoretical considerations are applied to the concepts that underpin effective disaster management. (R.M. Entman, 2003; Liu, 2007; Meng & Berger, 2008). Methodology- A qualitative descriptive design is used to analyse the disaster news of Nepal Television (NTV). However, this paper presents the preliminary findings of Nepal Television (a government owned Television station) using qualitative content analysis of 105 natural disaster related news scripts (June 2012-March 2013) based on the framing theory and PPRR cycle. Results- The preliminary results indicate that the media focus while framing natural disasters is dominated by human interest frame followed by responsibility frame. News about response phase was found to be most prominent in terms of PPRR cycle. Limited disaster reporting by NTV has impacted the national disaster management programs and strategies. The findings describe natural disasters are being reported within the limited understanding of the important principles of disaster management and PPRR cycle. Conclusion- This paper describes the current status of the coverage of natural disasters by Nepal Television to identify the frames used in the news content. It contributes to determining the characteristics of effective media reporting of natural disasters in the government owned media outlets, and also leads to including communities and agencies involved in disasters. It suggests the frames which are best suited for news making and how media responds to the different phases of the disaster cycle.