Alternative schooling programs for at risk youth : three case studies

This thesis develops a critical realist explanatory critique of alternative schooling programs for youth at risk taking place at three case study sites. Throughout the thesis the author pursues the question, \Are alternative provisions of schooling working academically and socially for youth at risk?. The academic lens targets literacy learning and associated pedagogies. Social outcomes are posited as positive social behaviours and continued engagement in learning. A four phased analysis, drawing on critical realism, interpretive and subject specific theories is used to elicit explanations for the research question. An overall framework is a critical realist methodology as set out by Danermark, Ekstrom, Jakobsen and Karlsson (2002, p. 129). Consequently phase one describes the phenomena of alternative schooling programs taking place at three case study sites. This is reported first as staff narratives that are resolved into imaginable historical causal components of \generative events., \prior schooling structures., \models of alternative schooling., \purpose., \individual agency., and \relations with linked community organisations.. Then transcendental questions are posed about each component using retroduction to uncover structures, underlying mechanisms and powers, and individual agency. In the second phase the researcher uses modified grounded theory methodology to theoretically redescribe causal categories related to a \needed different teaching and administrative approach. that emerged from the previous critique. A transcendental question is then applied to this redescription. The research phenomena are again theoretically redescribed in the third phase, this time using three theoretically based constructs associated with literacy and literacy pedagogies; the NRS, the 4 Resources Model, and Productive Pedagogies. This redescription is again questioned in terms of its core or \necessary. components. The fourth phase makes an explanatory critique by comparing and critiquing all previous explanations, recontextualising them in a wider macro reality of alternative schooling. Through this critical realist explanatory critiquing process, a response emerges not only to whether alternative provisions of schooling are working, but also how they are working, and how they are not working, with realistically based implications for future improvement.

Moderating drinking by correspondence : an evaluation of a new method of intervention

Recognizing the need to offer alternative methods of brief interventions, this study developed correspondence treatments for low-dependent problem drinkers and evaluated their impact. One hundred and twenty-one problem drinkers were recruited by media advertisements and were randomly allocated to a full cognitive behavioural treatment programme (CBT) or to a minimal intervention condition (MI) that gave information regarding alcohol misuse and instructions to record drinking. As predicted, CBT was more effective than MI in reducing alcohol consumption over the 4-month controlled trial period. CBT produced a 50% fall in consumption, bringing the average intake of subjects within recommended maximum levels. Treatment gains at 6 months were well maintained to 12 months. High levels of consumer satisfaction, a high representation of women and a substantial participation from isolated rural areas attested to the feasibility of the correspondence programme as an alternative treatment. However, some drinking occasions still involved high intake for a significant subgroup of subjects, and this issue will be addressed in future programmes. The results supported the use of correspondence delivery as a means of promoting early engagement and equity of access between city and country areas.

Mechanisms of improvement in treatment for depression : test of a self-efficacy and performance model

Tested D. J. Kavanagh's (1983) depression model's explanation of response to cognitive-behavioral treatment among 19 20–60 yr old Ss who received treatment and 24 age-matched Ss who were assigned to a waiting list. Measures included the Beck Depression Inventory and self-efficacy (SE) and self-monitoring scales. Rises in SE and self-monitored performance of targeted skills were closely associated with the improved depression scores of treated Ss. Improvements in the depression of waiting list Ss occurred through random, uncontrolled events rather than via a systematic increase in specific skills targeted in treatment. SE regarding assertion also predicted depression scores over a 12-wk follow-up.

21st Century politics : new faces/new spaces

Politics has been described as a man’s game and a man’s place. Further, the design of houses of politics also embeds this dominant masculine ethos. Traditional Chambers have been large with only limited seating arrangements ensuring that only privileged elite can participate and both officials and the public are located at some distance and separate from the elected officials. Such a Chamber ensures that Members need to face each other and the dominant interaction is adversarial. Within this system however, women have been able to carve out new spaces, or use existing ones in different ways, to become more involved with the mechanisms of parliament and provide alternative routes to leadership. In doing so, they have introduced elements of the private domain (nurturing, dialogue and inclusion) to the public domain. The way in which space is used is fundamental and its treatment has consequences for individuals, organizations and societies (Clegg and Kornberger 2006). Dale’s (2005) work emphasises the social character of architecture which recognises the impact which it has on the behaviours of individuals and nowhere is this more pertinent than the way the Australian Parliament House operates. This paper draws on the experiences of Australian parliamentarians to examine the way in which the new Australian Parliament House shapes the way in which the Australian political cultural norms and practices are shaped and maintained. It also seeks to explore the way the Members of Parliament (MPs) experience these spaces and how some MPs have been able to bring new ways of utilising the space to ensure it is more accommodating to the men and women who inhabit this building at the apex of Australia’s political life. In doing so, such MPs are seeking to ensure that the practices and processes of Australia’s political system are reflective of the men and women who inhabit this national institution in the beginning of the 21st century.

Measuring episodic memory: A novel approach with an indefinite number of alternative forms

Both clinical practice and clinical research settings can require successive administrations of a memory test, particularly when following the trajectory of suspected memory decline in older adults. However, relatively few verbal episodic memory tests have alternative forms. We set out to create a broad based memory test to allow for the use of an essentially unlimited number of alternative forms. Four tasks for inclusion in such a test were developed. These tasks varied the requirement for recall as opposed to recognition, the need to form an association between unrelated words, and the need to discriminate the most recent list from earlier lists, all of which proved useful. A total of 115 participants completed the battery of tests and were used to show that the test could differentiate between older and younger adults; a sub-sample of 73 participants completed alternative forms of the tests to determine test-retest reliability and the amount of learning to learn.

Effectiveness of current treatment approaches for benzodiazepine discontinuation : a meta-analysis.

Aims: To assess the effectiveness of current treatment approaches to assist benzodiazepine discontinuation. Methods: A systematic review of approaches to benzodiazepine discontinuation in general practice and out-patient settings was undertaken. Routine care was compared with three treatment approaches: brief interventions, gradual dose reduction (GDR) and psychological interventions. GDR was compared with GDR plus psychological interventions or substitutive pharmacotherapies. Results: Inclusion criteria were met by 24 studies, and a further eight were identified by future search. GDR [odds ratio (OR) = 5.96, confidence interval (CI) = 2.08–17.11] and brief interventions (OR = 4.37, CI = 2.28–8.40) provided superior cessation rates at post-treatment to routine care. Psychological treatment plus GDR were superior to both routine care (OR = 3.38, CI = 1.86–6.12) and GDR alone (OR = 1.82, CI = 1.25–2.67). However, substitutive pharmacotherapies did not add to the impact of GDR (OR = 1.30, CI = 0.97– 1.73), and abrupt substitution of benzodiazepines by other pharmacotherapy was less effective than GDR alone (OR = 0.30, CI = 0.14–0.64). Few studies on any technique had significantly greater benzodiazepine discontinuation than controls at follow-up. Conclusions: Providing an intervention is more effective than routine care. Psychological interventions may improve discontinuation above GDR alone. While some substitutive pharmacotherapies may have promise, current evidence is insufficient to support their use.

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.

Eye-movements and visual imagery : a working memory approach to the treatment of post-traumatic stress disorder

It has been claimed that the symptoms of post-traumatic stress disorder (PTSD) can be ameliorated by eye-movement desensitization-reprocessing therapy (EMD-R), a procedure that involves the individual making saccadic eye-movements while imagining the traumatic event. We hypothesized that these eye-movements reduce the vividness of distressing images by disrupting the function of the visuospatial sketchpad (VSSP) of working memory, and that by doing so they reduce the intensity of the emotion associated with the image. This hypothesis was tested by asking non-PTSD participants to form images of neutral and negative pictures under dual task conditions. Their images were less vivid with concurrent eye-movements and with a concurrent spatial tapping task that did not involve eye-movements. In the first three experiments, these secondary tasks did not consistently affect participants' emotional responses to the images. However, Expt 4 used personal recollections as stimuli for the imagery task, and demonstrated a significant reduction in emotional response under the same dual task conditions. These results suggest that, if EMD-R works, it does so by reducing the vividness and emotiveness of traumatic images via the VSSP of working memory. Other visuospatial tasks may also be of therapeutic value.

EMG biofeedback in the treatment of tinnitus : an experimental evaluation

26 tinnitus patients received either electromyogram (EMG) biofeedback with counterdemand instructions, EMG biofeedback with neutral demand instructions, or no treatment. Assessment was conducted on self-report measures of the distress associated with tinnitus, the loudness, annoyance and awareness of tinnitus, sleep-onset difficulties, depression, and anxiety. Audiological assessment of tinnitus was also conducted and EMG levels were measured (the latter only in the 2 treatment groups). No significant treatment effects were found on any of the measures. There was a significant decrease in the ratings of tinnitus awareness over the assessment occasions, but the degree of change was equivalent for treated and untreated groups. Results do not support the assertion that EMG biofeedback is an effective treatment for tinnitus.

Duty of police and ambulance services : what happens when the plaintiff refuses treatment?

In a recent case the New South Wales Court of Appeal considered the duty of care owed by ambulance and police officers, issues concerning breach and causation and the practical effect of the exclusion of the plaintiff's evidence.

Sustainable water provision : alternative strategy and sources in the era of climate change

As a result of rapid urbanisation, population growth, change in lifestyles, pollution and the impacts of climate change, water provision has become a critical challenge for planners and policy-makers. In the wake of increasingly difficult water provision and drought, the notion that freshwater is a finite and vulnerable resources is increasingly being realised. Many city administrations around the World are struggling to provide water security for their residents to maintain lifestyle and economic grouth. This paper review the glocalalternatives to current water sources, including that of desalination, water transfers, recycling, and integrated water management. A comparative study on alternative resources is undertaken and the results are discussed.

What is the future for rimonabant in the treatment of obesity

Orlistat and sibutramine only cause modest reductions in body weight. Rimonabant, a cannabinoid receptor 1 antagonist, is a new approach to weight reduction, but is it safe, efficacious, and better than the existing agents?

Telcagepant is a new oral treatment for migraine

Background : Migraine is a common cause of disability. Many subjects (30 – 40%) do not respond to the 5-HT 1B/1D agonists (the triptans) commonly used in the treatment of migraine attacks. Calcitonin gene-related protein (CGRP) receptor antagonism is a new approach to the treatment of migraine attacks. Objectives/methods : This evaluation is of a Phase III clinical trial comparing telcagepant, an orally active CGRP receptor antagonist, with zolmitriptan in subjects during an attack of migraine. Results : Telcagepant 300 mg has a similar efficacy to zolmitriptan in relieving pain, phonophobia, photophobia, and nausea. Telcagepant was better tolerated than zolmitriptan. Conclusions : The initial Phase III clinical trial results with telcagepant are promising but several further clinical trials are needed to determine the place of telcagepant in the treatment of migraine attacks

Ticagrelor, a platelet aggregation inhibitor for the potential prevention and treatment of arterial thrombosis and acute coronary syndromes

Ticagrelor is an orally active ADP P2Y12 receptor antagonist in development by AstraZeneca plc for the reduction of recurrent ischemic events in patients with acute coronary syndromes (ACS). Prior to the development of ticagrelor, thienopyridine compounds, such as clopidogrel, were the focus of research into therapies for ACS. Although the thienopyridines are effective platelet aggregation inhibitors, they are prodrugs and, consequently, exert a slow onset of action. In addition, the variability in inter-individual metabolism of thienopyridine prodrugs has been associated with reduced efficacy in some patients. Ticagrelor is not a prodrug and exhibits a more rapid onset of action than the thienopyridine prodrugs. In clinical trials conducted to date, ticagrelor was a potent inhibitor of ADP-induced platelet aggregation and demonstrated effects that were comparable to clopidogrel. In a phase II, short-term trial, the bleeding profile of participants treated with ticagrelor was similar to that obtained with clopidogrel; however, an increased incidence of dyspnea was observed - an effect that has not been reported with the thienopyridines. Considering the occurrence of dyspnea, and the apparent non-superiority of ticagrelor to clopidogrel, it is difficult to justify a clear benefit to the continued development of ticagrelor. Outcomes from an ongoing phase III trial comparing ticagrelor with clopidogrel in 18,000 patients with ACS are likely to impact on the future development of ticagrelor.