Current evidence on integrated treatment for serious mental disorder and substance misuse

Substance misuse in people with serious mental disorders is common and has a wideranging negative impact. The multiplicity of problems suggests that this comorbidity is better conceptualized as a type of complex disorder than by ‘dual diagnosis’. Problems with sequential and parallel treatments have led to the development of integrated approaches, with one practitioner or team addressing both the substance use and mental disorder. These treatments are typically characterized by motivation enhancement, minimizing treatment-related stress, emphasizing harm reduction as well as abstinence, and assertive outreach. A review of published randomized trials demonstrates that superior effects to controls are rarely consistent across treatment foci and over time. While motivational interventions assist engagement, more intervention is usually required for integrated treatment programs to improve long-term outcomes more than control conditions. More intensive case management does not consistently improve impact, but extended cognitive-behavioral therapies have promise. Suggestions for maximizing treatment effects and improving research evidence are provided.

Innovative approaches to intervention for problem drinking

Purpose of review: To critique the recent literature on telephone, correspondence-based, and computerized interventions for alcohol problems, which enhance or substitute for practitioner-delivered treatments. Recent findings: There is an unmet need for screening, assessment and intervention for alcohol problems, in part because of the difficulty in accessing such treatment within the current health care system. Research on the efficacy of correspondence or electronic (for example Internet-based) interventions is beginning to emerge. In the period 2003–2004 we identified nine acceptability or feasibility studies of these approaches and seven efficacy trials covering a wide range of settings. These modes of intervention are acceptable to patients and the public, and with careful planning, can be implemented in a variety of settings. Treatment trials demonstrate the efficacy of these interventions in reducing hazardous drinking by university students, in delaying initiation of heavy drinking in children and adolescents, and, intriguingly, in addressing insomnia among recovering alcoholics. Summary: There is strong support among potential users for alcohol interventions that employ telephone assistance, written correspondence, and the Internet. These new technologies offer the prospect of increasing the reach of interventions for problem drinking and being cost- effective alternatives or supplements to face-to-face health service delivery.

Recovery and exercise interventions following breast cancer [Abstract]

Over 13,000 women are diagnosed with breast cancer each year in Australia and approximately 90% of these women will survive longer than 5-years. However, survival following treatment for breast cancer is often associated with adverse physical and psychosocial side effects, which persist beyond treatment cessation. As incidence and survival rates associated with breast cancer continue to rise, there is an imperative need to understand the extent of treatment-related concerns and ways in which these concerns can be minimized and/or overcome. A growing body of scientific evidence demonstrates that extensive quality of life benefits can be attained through exercise during and following breast cancer treatment. Such benefits observed include improvements in psychosocial and physical outcomes, as well as better compliance with treatment regimens and reduced impact of disease symptoms and treatment-related side effects. There is also evidence to suggest that post-diagnosis physical activity can improve survival. However, the majority of women newly diagnosed with breast cancer in Australia are not sufficiently active and the majority experience further declines in their physical activity levels during treatment. Throughout the course of this presentation, which draws on data from cohort studies and randomized trials of exercise interventions conducted in Queensland, the potential benefits of exercising during and following breast cancer treatment, the exercise prescription recommended for breast cancer survivors, the limits of our evidence-based knowledge and the issues faced by clinicians and patients with respect to exercise following a cancer diagnosis will be discussed. The question is no longer whether people with breast cancer should be active during and following their treatment, but is how do health care professionals best assist people to become and stay active in an endeavor to live healthy lives beyond their cancer experience.

Multidisciplinary students on Property core units : comparative analysis of introductory and advanced units

The composition of many professional services firms in the Urban Development area has moved away from a discipline specific ‘silo’ structure to a more multidisciplinary environment. The benefits of multidisciplinarity have been seen in industry by providing synergies across many of the related disciplines. Similarly, the Queensland University of Technology, Bachelor of Urban Development degree has sought to broaden the knowledge base of students and achieve a greater level of synergy between related urban development disciplines through the introduction of generic and multidisciplinary units. This study aims to evaluate the effectiveness of delivering core property units in a multidisciplinary context. A comparative analysis has been undertaken between core property units and more generic units offered in a multidisciplinary context from introductory, intermediate and advanced years within the property program. This analysis was based on data collected from course performance surveys, student performance results, a student focus group and was informed by a reflective process from the student perspective and lecturer/ tutor feedback. The study showed that there are many benefits associated with multidisciplinary unit offerings across the QUT Urban Development program particularly in the more generic units. However, these units require a greater degree of management. It is more difficult to organise, teach and coordinate multidisciplinary student cohorts due to a difference in prior knowledge and experience between each of the discipline groups. In addition, the interaction between lecturers/ tutors and the students frequently becomes more limited. A perception exists within the student body that this more limited face to face contact with academic staff is not valuable which may be exacerbated by the quality of complimentary online teaching materials. For many academics, non-attendance at lectures was coupled with an increase in email communication. From the limited data collected during the study there appears to be no clear correlation between large multidisciplinary student classes and student academic performance or satisfaction.

Choreographing research : supervising the dancing thesis

The dancing doctorate is an interrogative endeavour which can but nurture the art form and forge a beneficial dynamism between those who seek and those who assess the emerging knowledges of dance’. (Vincs, 2009) From 2006-2008 three dance academics from Perth, Brisbane and Melbourne undertook a research project entitled Dancing between Diversity and Consistency: Refining Assessment in Postgraduate Degrees in Dance, funded by the ALTC Priority Projects Program. Although assessment rather than supervision was the primary focus of this research, interviews with 40 examiner/supervisors, 7 research deans and 32 candidates across Australia and across the creative arts, primarily in dance, provide an insight into what might be considered best practice in preparing students for higher research degrees, and the challenges that embodied and experiential knowledges present for supervision. The study also gained the industry perspectives of dance professionals in a series of national forums in 5 cities, based around the value of higher degrees in dance. The qualitative data gathered from these two primary sources was coded and analysed using the NVivo system. Further perspectives were drawn from international consultant and dance researcher Susan Melrose, as well as recent publications in the field. Dance is a young addition to academia and consequently there tends to be a close liaison between the academy and the industry, with a relational fluidity that is both beneficial and problematic. This partially explains why dance research higher degrees are predominantly practice-led (or multi-modal, referring to those theses where practice comprises the substantial examinable component). As a physical, embodied art form, dance engages with the contested territory of legitimising alternative forms of knowledge that do not sit comfortably with accepted norms of research. In supporting research students engaged with dance practice, supervisors traverse the tricky terrain of balancing university academic requirements with studies that are emergent, not only in the practice and attendant theory but in their methodologies and open-ended outcomes; and in an art form in which originality and new knowledge also arises from collaborative creative processes. Formal supervisor accreditation through training is now mandatory in most Australian universities, but it tends to be generic and not address supervisory specificity. This paper offers the kind of alternative proposed by Edwards (2002) that improving postgraduate supervision will be effective if supervisors are empowered to generate their own standards and share best practice; in this case, in ways appropriate to the needs of their discipline and alternative modes of thesis presentation. In order to frame the qualities and processes conducive to this goal, this paper will draw on both the experiences of interviewees and on philosophical premises which underpin the research findings of our study. These include the ongoing challenge of dissolving the binary oppositions of theory and practice, especially in creative arts practice where theory resides in and emerges from the doing as much as in articulating reflection about the doing through what Melrose (2003) terms ‘mixed mode disciplinary practices’. In guiding practitioners through research higher degrees, how do supervisors deal with not only different forms of knowledge but indeed differing modes of knowledge? How can they navigate tensions that occur between the ‘incompatible competencies’ (Candlin, 2000) of the ‘spectating’ academic experts with their ‘irrepressible drive ... to inscribe, interpret, and hence to practise temporal closure’, and practitioner experts who create emergent works of ‘residual unfinishedness’ (Melrose 2006) which are not only embodied but ephemeral, as in the case of live performance?

A news story as big as a doctoral thesis? : deploying journalistic methodology in academic research

The purpose of this paper is to identify and recommend the emergence of an academic research methodology for Journalism the academic discipline, through reviewing various journalistic methods of research – those making up a key element in such methodology. Its focus is on journalistic styles of work employed in academic contexts especially research on mass media issues. It proposes that channelling such activity into disciplined academic forms will enhance both: allowing the former to provide more durable and deeper outcomes, injecting additional energy and intensity of purpose into the latter. It will briefly consider characteristics of research methodologies and methods, generally; characteristics of the Journalism discipline, and its relationship with mass media industries and professions. The model of journalism used here is the Western liberal stream. A proposition is made, that teaching and research in universities focused on professional preparation of journalists, has developed so that it is a mature academic discipline. Its adherents are for the most part academics with background in journalistic practice, and so able to deploy intellectual skills of journalists, while also accredited with Higher Degrees principally in humanities. Research produced in this discipline area stands to show two characteristics: (a) it employs practices used generally in academic research, e.g. qualitative research methods such as ethnographic studies or participant observation, or review of documents including archived media products, and (b) within such contexts it may use more specifically journalistic techniques, e.g. interviewing styles, reflection on practice of journalism, and in creative practice research, journalistic forms of writing – highlighting journalistic / practitioner capabilities of the author. So the Journalism discipline, as a discipline closely allied to a working profession, is described as one where individual professional skills and background preparation for media work will be applicable to academic research. In this connection the core modus operandi will be the directly research-related practices of: insistent establishment of facts, adept crafting of reportage, and economising well with time. Prospective fields for continuing research are described:- work in new media; closer investigation of relations among media producers and audiences; journalism as creative practice, and general publishing by journalists, e.g. writing histories.

Transfer of learning across the globe : pre-service teachers taking the initiative

A continuing challenge for pre-service teacher education is the learning transfer between the university based components and the practical school based components of their training. It is not clear how easily pre-service teachers can transfer university learnings into ‘in school’ practice. Similarly, it is not clear how easily knowledge learned in the school context can be disembedded from this particular context and understood more generally by the pre-service teacher. This paper examines the effect of a community of practice formed specifically to explore learning transfer via collaboration and professional enquiry, in ‘real time’, across the globe. “Activity Theory” (Engestrom, 1999) provided the theoretical framework through which the cognitive, physical and social processes involved could be understood. For the study, three activity systems formed community of practice network. The first activity system involved pre-service teachers at a large university in Queensland, Australia. The second activity system was introduced by the pre-service teachers and involved Year 12 students and teachers at a private secondary school also in Queensland, Australia. The third activity system involved university staff engineers at a large university in Pennsylvania, USA. The common object among the three activity systems was to explore the principles and applications of nanotechnology. The participants in the two Queensland activity systems, controlled laboratory equipment (a high powered Atomic Force Microscope – CPII) in Pennsylvania, USA, with the aim of investigating surface topography and the properties of nano particles. The pre-service teachers were to develop their remote ‘real time’ experience into school classroom tasks, implement these tasks, and later report their findings to other pre-service teachers in the university activity system. As an extension to the project, the pre-service teachers were invited to co-author papers relating to the project. Data were collected from (a) reflective journals; (b) participant field notes – a pre-service teacher initiative; (c) surveys – a pre-service teacher initiative; (d) lesson reflections and digital recordings – a pre-service teacher initiative; and (e) interviews with participants. The findings are reported in terms of the major themes: boundary crossing, the philosophy of teaching, and professional relationships The findings have implications for teacher education. The researchers feel that deliberate planning for networking between activity systems may well be a solution to the apparent theory/practice gap. Proximity of activity systems need not be a hindering issue.

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.

International students using online information resources to learn

This qualitative study views international students as information-using learners, through an information literacy lens. Focusing on the experiences of 25 international students at two Australian universities, the study investigates how international students use online information resources to learn, and identifies associated information literacy learning needs. An expanded critical incident approach provided the methodological framework for the study. Building on critical incident technique, this approach integrated a variety of concepts and research strategies. The investigation centred on real-life critical incidents experienced by the international students whilst using online resources for assignment purposes. Data collection involved semi-structured interviews and an observed online resource-using task. Inductive data analysis and interpretation enabled the creation of a multifaceted word picture of international students using online resources and a set of critical findings about their information literacy learning needs. The study’s key findings reveal: • the complexity of the international students’ experience of using online information resources to learn, which involves an interplay of their interactions with online resources, their affective and reflective responses to using them, and the cultural and linguistic dimensions of their information use. • the array of strengths as well as challenges that the international students experience in their information use and learning. • an apparent information literacy imbalance between the international students’ more developed information skills and less developed critical and strategic approaches to using information • the need for enhanced information literacy education that responds to international students’ identified information literacy needs. Responding to the findings, the study proposes an inclusive informed learning approach to support reflective information use and inclusive information literacy learning in culturally diverse higher education environments.

Dancing the Thesis : Potentials and Pitfalls in Practice-led Research

Practice-led or multi modal theses (describing examinable outcomes of postgraduate study which comprise the practice of dancing/choreography with an accompanying exegesis) are an emerging strength of dance scholarship; a form of enquiry that has been gaining momentum for over a decade, particularly in Australia and the United Kingdom. It has been strongly argued that, in this form of research, legitimate claims to new knowledge are embodied predominantly within the practice itself (Pakes, 2003) and that these findings are emergent, contingent and often interstitial, contained within both the material form of the practice and in the symbolic languages surrounding the form. In a recent study on ‘dancing’ theses Phillips, Stock, Vincs (2009) found that there was general agreement from academics and artists that ‘there could be more flexibility in matching written language with conceptual thought expressed in practice’. The authors discuss how the seemingly intangible nature of danced / embodied research, reliant on what Melrose (2003) terms ‘performance mastery’ by the ‘expert practitioner’ (2006, Point 4) involving ‘expert’ intuition (2006, Point 5), might be accessed, articulated and validated in terms of alternative ways of knowing through exploring an ongoing dialogue in which the danced practice develops emergent theory. They also propose ways in which the danced thesis can be ‘converted’ into the required ‘durable’ artefact which the ephemerality of live performance denies, drawing on the work of Rye’s ‘multi-view’ digital record (2003) and Stapleton’s ‘multi-voiced audio visual document’(2006, 82). Building on a two-year research project (2007-2008) Dancing Between Diversity and Consistency: Refining Assessment in Postgraduate Degrees in Dance, which examined such issues in relation to assessment in an Australian context, the three researchers have further explored issues around interdisciplinarity, cultural differences and documentation through engaging with the following questions:  How do we represent research in which understandings, meanings and findings are situated within the body of the dancer/choreographer?  Do these need a form of ‘translating’ into textual form in order to be accessed as research?  What kind of language structures can be developed to effect this translation: metaphor, allusion, symbol?  How important is contextualising the creative practice?  How do we incorporate differing cultural inflections and practices into our reading and evaluation?  What kind of layered documentation can assist in producing a ‘durable’ research artefact from a non-reproduce-able live event?

Creating and enabling opportunities for increased student participation in experience based learning in professional practice

This paper explores models for enabling increased participation in experience based learning in legal professional practice. Legal placements as part of “for-credit” units offer students the opportunity to develop their professional skills in practice, reflect on their learning and job performance and take responsibility for their career development and planning. In short, work integrated learning (WIL) in law supports students in making the transition from university to practice. Despite its importance, WIL has traditionally taken place in practical legal training courses (after graduation) rather than during undergraduate law courses. Undergraduate WIL in Australian law schools has generally been limited to legal clinics which require intensive academic supervision, partnerships with community legal organisations and government funding. This paper will propose two models of WIL for undergraduate law which may overcome many of the challenges to engaging in WIL in law (which are consistent with those identified generally by the WIL Report). The first is a virtual law placement in which students use technology to complete a real world project in a virtual workplace under the guidance of a workplace supervisor. The second enables students to complete placements in private legal firms, government legal offices, or community legal centres under the supervision of a legal practitioner. The units complement each other by a) creating and enabling placement opportunities for students who may not otherwise have been able to participate in work placement by reason of family responsibilities, financial constraints, visa restrictions, distance etc; and b) enabling students to capitalise on existing work experience. This paper will report on the pilot offering of the units in 2008, the evaluation of the models and changes implemented in 2009. It will conclude that this multi-pronged approach can be successful in creating opportunities for, and overcoming barriers to participation in experiential learning in legal professional practice.

Wellness as higher education curriculum: A comprehensive framework for health education and promotion

A number of studies in relation to the place, impact and purpose of Wellness curricula provide insight into the perceived benefits of Wellness education in university environments. Of particular note is the recommendation by many authors that curriculum design fosters personal experiences, reflective practice and active self-managed learning approaches in order to legitimise (give permission for) the adoption of wellness as a personal lifestyle approach in the frenetic pace of student life. From a broader educational perspective, Wellness education provides opportunities for students to engage in learning self regulation skills both within and beyond the context of the Wellness construct.To realise the suggested potential of Wellness education in higher learning, it is necessary that curricula overlay the principles from the domains of both self-regulation and Wellness, to highlight authentic learning as a means to lifelong approaches. Currently, however, systematic development and empirical examination of the Wellness construct have received limited academic investigation. Despite having a multitude of intended purposes from the educative to the therapy oriented goals of the original authors, most wellness models appear to be limited to the “what” of Wellness. Investigations of the “how” and “why” aspects of Wellness may serve to enhance currently existing models by incorporating behaviour modification and learning approaches in order to create more comprehensive frameworks for health education and promotion.It is also important to note that none of the current Wellness models actually address the educative framework necessary for an individual to learn and thus become aware or understand and make choices about their own Wellness.The literature reviewed within this paper would suggest that learner success is optimised by giving learners authentic opportunities to develop and practice self regulation strategies. Such opportunities include learning experiences that: provide options for self determined outcomes; require skills development; recognise principles of successful learning as outlined by the APA; and are scaffolded according to learner needs rather than in generic ways. Thus, configuring a learner centred curriculum in Wellness Education would potentially benefit from overlaying principles from the domains of both SRL and Wellness to highlight authentic learning as a means to lifelong approaches, triggered by undergraduate experiences.Student perceptions are a rich and significant data base for the measurement of their experiences, activities, practices and behaviours. Wellness undergraduate education, such as the “Fitness, Health and Wellness” unit offered by Queensland University of Technology, offers a context in which to confirm possibilities suggested by the literature reviewed in this paper in a practical, Australian context.

Seeing pedestrians at night : visual clutter does not mask biological motion

Although placing reflective markers on pedestrians’ major joints can make pedestrians more conspicuous to drivers at night, it has been suggested that this “biological motion” effect may be reduced when visual clutter is present. We tested whether extraneous points of light affected the ability of 12 younger and 12 older drivers to see pedestrians as they drove on a closed road at night. Pedestrians wore black clothing alone or with retroreflective markings in four different configurations. One pedestrian walked in place and was surrounded by clutter on half of the trials. Another was always surrounded by visual clutter but either walked in place or stood still. Clothing configuration, pedestrian motion, and driver age influenced conspicuity but clutter did not. The results confirm that even in the presence of visual clutter pedestrians wearing biological motion configurations are recognized more often and at greater distances than when they wear a reflective vest.

Assessing reflection skills in law using criterion-referenced assessment

This paper focuses on the assessment of reflective practice, an issue that has not been fully explored within legal education literature. While the issue of how reflective practice should be taught is one that requires careful consideration, it is beyond the scope of this paper to consider both the teaching and the assessment of reflective practice. Part II of this paper conceptualises reflective practice, and Part III explores the benefits of reflective practice in legal education and the use of reflective writing to assess experiential learning in a legal context. Part IV considers the diverse issues that arise in assessing reflective practice and whether there is an objective method for assessing reflection. Part V of the paper examines the assessment of reflective practice in the context of an exemplar undergraduate law subject that uses a reflective report to assess students’ experiential learning during a court visit.14 Finally, Part VI offers a rubric to facilitate criterion-referenced assessment of reflective practice and thereby provides a framework for assessing reflection skills. It is suggested that the rubric is transferable not only to other law subjects but also to subjects in other disciplines.