Student facilitated PBL - A capstone collaborative learning experience in the Griffith University MBBS program

We report on an innovation in teaching and learning designed to extend the collaborative learning of PBL, that occurs during the first two years of a four year graduate entry medical program, to a capstone learning experience to assist the transition to a hospital based year 3. During the last five weeks of Year 2 the PBL sessions consist of an initial student facilitated session early in the week followed by a large format session for the entire class convened by two clinicians. The new format PBL was perceived positively by the students and staff involved and may have advantages over traditional formats in developing students' clinical reasoning and differential diagnosis skills.

Young love: Romantic concerns and associated mental health issues among adolescent help-seekers

Over 50% of young people have dated by age 15. While romantic relationship concerns are a major reason for adolescent help-seeking from counselling services, we have a limited understanding of what types of relationship issues are most strongly related to mental health issues and suicide risk. This paper used records of 4019 counselling sessions with adolescents (10–18 years) seeking help from a national youth counselling service for a romantic relationship concern to: (i) explore what types and stage (pre, during, post) of romantic concerns adolescents seek help for; (ii) how they are associated with mental health problems, self-harm and suicide risk; and (iii) whether these associations differ by age and gender. In line with developmental-contextual theory, results suggest that concerns about the initiation of relationships are common in early adolescence, while concerns about maintaining and repairing relationships increase with age. Relationship breakups were the most common concern for both male and female adolescents and for all age groups (early, mid, late adolescence). Data relating to a range of mental health issues were available for approximately half of the sample. Post-relationship concerns (including breakups) were also more likely than pre- or during-relationship concerns to be associated with concurrent mental health issues (36.8%), self-harm (22.6%) and suicide (9.9%). Results draw on a staged developmental theory of adolescent romantic relationships to provide a comprehensive assessment of relationship stressors, highlighting post-relationship as a particularly vulnerable time for all stages of adolescence. These findings contribute to the development of targeted intervention and support programs.

Orienting to emotion in computer-mediated Cognitive Behavioural Therapy

Exploring emotions is a defining feature of psychotherapy. This study explores how therapists explore emotions when they cannot see or hear their clients. In analysing 1,279 sessions of online text-based Cognitive Behavioural Therapy (CBT) we focused on therapists’ commiserations (e.g., “I’m sorry to hear that”) and their affective inferences (e.g., “that sounds very scary for you”). Both practices routinely prefaced moves to pursue a range of therapeutic activities, many of which did not prioritise sustained focus on the emotion that had just been oriented to. By separating message composition from message transmission, the modality used for these therapy sessions enabled therapists to combine orientations to emotion with attempts to shift the focus of discussion. Our analysis finds that although physically co-present and computer-mediated psychotherapy share a common focus on emotional experience, the modality used for therapy can be relevant in the design and use of these orientations. Data are in British English.

Asiakassuunnitelma asiakaslähtöistä auttamista tavoitteellistamassa : Kohteen rakentumisen moniääninen menetelmä

The research focuses on client plan in the field of health care and social work on families with children. The purpose of the plan is to create objectives for helping the client and to assist in coordinating the ever-increasing multi-professional work. In general, the plan is understood in terms of assignments and as a contract specifying what to do in client cases. Taking this into consideration, the plan is outsourced into a written document. Instead of understanding the plan as a tool that stabilizes the objectives of action, documents it and facilitates evaluation, the client plan is conceptualized in this study as a practice. This kind of practice mediates client work as being itself also a process of action that focuses on an object whose gradual emergence and definition is the central question in multi-professional collaboration with a client. The plan is examined empirically in a non-stabilized state which leads to the research methodology being based on the dynamics between stabilization and emerging, non-stabilized entities the co-creation and formulation of practice and context. The theoretical approach of the research is the micro analytic approach of activity theory (Engeström R. 1999b). Grounding on this, the research develops a method of qualitative analysis which follows an emerging object with multiple voices. The research data is composed of the videotaped sessions from client meetings with three families, the interviews with the client and the workers as well as client documents that are used to follow up on client processes for at least one year. The research questions are as follows: 1) How is the client plan constructed between the client and different professional agents? 2) How are meanings constructed in a client-centred plan? 3) What are the elements of client-employee relationships that support the co-configuration necessitated by the changes in the client s everyday life? The study shows that the setting of objectives were limited by the palette of institutional services, which caused that the clients interpretations and acts of giving meaning to the kinds of help that was required were left out of the plan. Conceptually, the distinctions between client-centred and client-specific ways of working as well as an action-based working method are addressed. Central to this action-based approach is construing the everyday life of the client, recognizing different meanings and analyzing them together with the client as well as focusing attention on developing the prerequisites for social agency of the clients. The research portrays the elements for creating an action-based client plan. Key words: client plan, user perspective, multi-voiced meaning, multi-professional social work with children and families, agency

Guided respiration mindfulness therapy: Development and evaluation of a brief therapist training program

The present paper describes the development and evaluation of a standardized multi-component therapist training program in guided respiration mindfulness therapy (GRMT). GMRT is a manual-based, experimental clinical intervention involving concentrated focus on sustained self-regulation of breathing, application of mindfulness to emergent somatic experience and relaxation. Therapists (n = 61) new to the approach attended a 2-day experiential workshop and were evaluated pre-post workshop for change in intervention knowledge, as well as change in mindfulness. These trainees also participated in post-workshop focus group sessions to explore perception of the intervention. A subset of 40 therapists participated in a second training component, and 14 of these were rated for competent delivery of the intervention during participation in a clinical trial. During training, therapists personally received the treatment giving the opportunity to assess treatment session (n = 283) impact on sense of wellbeing. Results indicated a brief focused training program can equip therapists with basic knowledge and skills required to deliver the standardized manual-based treatment. Qualitative analysis of focus group sessions showed that therapists endorsed the intervention for clinical use and found it personally beneficial. This research provides a foundation for further evaluation of clinical effectiveness of the intervention.

Water in Action : Encounters among 2- to 3-Year-Old Children, Adults, and Water in Day Care

In line with cultural psychology and developmental theory, a single case approach is applied to construct knowledge on how children s interaction emerge interlinked to historical, social, cultural, and material context. The study focuses on the negotiation of constraints and meaning construction among 2-to 3-year-old children, a preschool teacher, and the researcher in settings with water. Water as an element offers a special case of cultural canalization: adults selectively monitor and guide children s access to it. The work follows the socio-cultural tradition in psychology, particularly the co-constructivist theory of human development and the Network of Meanings perspective developed at the University of São Paulo. Valsiner s concepts of Zone of Free Movement and Zone of Promoted Action are applied together with studies where interactions are seen as spaces of construction where negotiation of constraints for actions, emotions, and conceptions occur. The corpus was derived at a Finnish municipal day care centre. During a seven months period, children s actions were video recorded in small groups twice a month. The teacher and the researcher were present. Four sessions with two children were chosen for qualitative microanalysis; the analysis also addressed the transformations during the months covered by the study. Moreover, the data derivation was analyzed reflectively. The narrowed down arenas for actions were continuously negotiated among the participants both nonverbally and verbally. The adults expectations and intentions were materialized in the arrangements of the setting canalizing the possibilities for actions. Children s co-regulated actions emerged in relation to the adults presence, re-structuring attempts, and the constraints of the setting. Children co-constructed novel movements and meanings in relation to the initiatives and objects offered. Gestures, postures, and verbalizations emerged from the initially random movements and became constructed to have specific meanings and functions; meaning construction became abbreviated. The participants attempted to make sense of the ambiguous (explicit and implicit) intentions and fuzzy boundaries of promoted and possible actions: individualized yet overlapping features were continuously negotiated by all the participants. Throughout the months, children s actions increasingly corresponded adults (re-defined) conceptions of water researchers as an emerging group culture. Water became an instrument and a context for co-regulations. The study contributes to discussions on children as participants in cultural canalization and emphasizes the need for analysis in early childhood education practices on the implicit and explicit constraint structures for actions.

Tuntemattomista vertaistuttaviksi : Esikoisäitien ja -isien perhevalmennusprosessi Espoon uudentyyppisessä perhevalmennuskokeilussa

From Strangers to Peer Acquaintances Mothers and Fathers with a First Born and their Experiences of the New Family Training Process in Espoo This research is composed of two interrelated case studies. The first case was a family training experiment conducted in the City of Espoo during 2003 2005. In the experiment, the content, duration and procedures were modified from the previous family training policy. The new family training system stressed peer group activities and the peer support formed between the participating mothers and fathers. The second case comprised the stories of 14 parents about the family training process. The aim of the research was to find out whether peer group activities and support was demonstrated between the participating parents during the family training process. The second case and its narrative material constituted the main research material. The narrative material was collected by interviews. Eight mothers and six fathers were interviewed twice within a year between their sessions. The parents also filled in questionnaires about their daily life and participated in a drawing exercise, in which they visualized how they experienced the family training during the antenatal period, labour and the postnatal period. A narrative approach was applied to the analysis of the narrative material. The analysis consisted of several stages. In the final stage, the fathers main story was combined with all the participating fathers personal stories. The mothers main story was also constructed from their personal stories. The study implicated that in some parts the mothers and fathers main stories were similar. During the family training, previously unacquainted parents became peer acquaintances. In particular, the first born as a focus created interaction and cooperation among the parents. Parents in similar circumstances became significant to each other. Different figurations formed during the family training. However, the main stories did not always entwine. The mothers were in contact with the other mothers almost daily using mobile phones, email and mother-child activities. The fathers employed outside home met each other only during the family training meetings, but felt being supported by the other fathers. Some families visited one another outside of the family training. This new type of family training had characteristics typical of the project society. The parents peer activities were based on trust, negotiation and contracts between partners. The parents evaluated the benefits of participation in the family training. If they appreciated the activities with peers and peer compassion, they were willing to participate in the family training during the postnatal period. Keywords: family training, parenthood, motherhood, fatherhood, peer, peer group, peer support, social support, social relationships, figurations, the project society, pastoral power, epistolary power

Emotional experience in psychotherapeutic interaction : Conversation analytical study on cognitive psychotherapy

The dissertation examines how emotional experiences are oriented to in the details of psychotherapeutic interaction. The data (57 audio recorded sessions) come from one therapist-patient dyad in cognitive psychotherapy. Conversation analysis is used as method. The dissertation consists of 4 original articles and a summary. The analyses explicate the therapist s practices of responding to the patient s affective expressions. Different types of affiliating responses are identified. It is shown that the affiliating responses are combined with, or build grounds for, more interpretive and challenging actions. The study also includes a case study of a session with strong misalignment between the therapist s and patient s orientations, showing how this misalignment is managed by the therapist. Moreover, through a longitudinal analysis of the transformation of a sequence type, the study suggests that therapeutic change processes can be located to sequential relations of actions. The practices found in this study are compared to earlier research on everyday talk and on medical encounters. It is suggested that in psychotherapeutic interaction, the generic norms of interaction considering affiliation and epistemic access, are modified for the purposes of therapeutic work. The study also shows that the practices of responding to emotional experience in psychotherapy can deviate from the everyday practices of affiliation. The results of the study are also discussed in terms of concepts arising from clinical theory. These include empathy, validation of emotion, therapeutic alliance, interpretation, challenging beliefs, and therapeutic change. The therapist s approach described in this study involves practical integration of different clinical theories. In general terms, the study suggests that in the details of interaction, psychotherapy recurrently performs a dual task of empathy and challenging in relation to the patient s ways of describing their experiences. Methodologically, the study discusses the problem of identifying actions in conversation analysis of psychotherapy and emotional interaction, and the possibility to apply conversation analysis in the study of therapeutic change.

Investigating novelty-outcome relationships in engineering design

Design creativity involves developing novel and useful solutions to design problems The research in this article is an attempt to understand how novelty of a design resulting from a design process is related to the kind of outcomes. described here as constructs, involved in the design process A model of causality, the SAPPhIRE model, is used as the basis of the analysis The analysis is based on previous research that shows that designing involves development and exploration of the seven basic constructs of the SAPPhIRE model that constitute the causal connection between the various levels of abstraction at which a design can be described The constructs am state change, action, parts. phenomenon. input. organs. and effect The following two questions are asked. Is there a relationship between novelty and the constructs? If them is a relationship, what is the degree of this relationship? A hypothesis is developed to answer the questions an increase in the number and variety of ideas explored while designing should enhance the variety of concept space. leading to an increase in the novelty of the concept space Eight existing observational studies of designing sessions are used to empirically validate the hypothesis Each designing session involves an individual designer. experienced or novice. solving a design problem by producing concepts and following a think-aloud protocol. The results indicate dependence of novelty of concept space on variety of concept space and dependence of variety of concept space on variety of idea space. thereby validating the hypothesis The Jesuits also reveal a strong correlation between novelty and the constructs, correlation value decreases as the abstraction level of the constructs reduces. signifying the importance of using constructs at higher abstraction levels for enhancing novelty

An analytical model for capacity evaluation of VoIP on HCCA and TCP file transfers over EDCA in an IEEE 802.11e WLAN

In the context of the IEEE 802.11e standard for WLANs, we provide an analytical model for obtaining the maximum number of VoIP calls that can be supported on HCCA, such that the delay QoS constraint of the accepted calls is met, when TCP downloads are coexistent on EDCA. In this scenario, we derive the TCP download throughput by using an analytical model for the case where only TCP sessions are present in the WLAN. We show that the analytical model for combined voice and TCP transfers provides accurate results in comparison with simulations (using ns-2).

Perceptions Towards Adoption of Mobile Self-services: A Case Study (Available in Hanken intranet only)

This thesis is an exploratory case study that aims to understand the attitudes affecting adoption of mobile self-services. This study used a demo mobile self-service that could be used by consumers for making address changes. The service was branded with a large and trusted Finnish brand. The theoretical framework that was used consisted of adoption theories of technology, adoption theories of self-service and literature concerning mobile services. The reviewed adoption theories of both technology and self-service had their foundation in IDT or TRA/TPB. Based on the reviewed theories an initial framework was created. The empirical data collection was done through three computer aided group interview sessions with a total of 32 respondents. The data analysis started from the premises of the initial framework. Based on the empirical data the framework was constantly reviewed and altered and the data recoded accordingly. The result of this thesis was a list of attitudinal factors that affect the adoption of a mobile self-service either positively or negatively. The factors that were found to affect the attitudes towards adoption of mobile self-services positively were: that the service was time & place independent and saved time. Most respondents, but not all, also had a positive attitude towards adoption due to ease of use and being mentally compatible with the service. Factors that affected adoption negatively were lack of technical compatibility, perceived risk for high costs and risk for malicious software. The identified factors were triangulated in respect to existing literature and general attitudes towards mobile services.

Ilmastonmuutoksen ääri-ilmiöihin liittyvän riskienhallinnan kustannus–hyötyanalyysi osana julkista päätöksentekoa. IRTORISKI-hankkeen loppuraportti.

IRTORISKI-hankkeessa tutkittiin, miten kustannus–hyötyanalyysin käyttöä ilmastonmuutoksen sopeutumissuunnittelussa voitaisiin helpottaa niin, että sitä pystyttäisiin hyödyntämään kustannustehokkaasti sekä ilmastonmuutokseen liittyvien vaarojen priorisoinnissa että ennaltaehkäisevien toimenpiteiden vertailussa. Tutkimuksessa käytettiin esimerkkitapauksina jokitulvaa ja rankkasateiden aiheuttamaa tulvaa kaupunkiolosuhteissa. Tapahtumapuuanalyysia laajennettiin siten, että siitä käyvät ilmi sekä suorat vahingot että lopulliset makrotaloudelliset vaikutukset. Arviot suorista taloudellisista vahingoista perustuivat aikaisempiin tutkimuksiin, kun taas makrotaloudellisia vaikutuksia simuloitiin yleisen tasapainon mallin avulla. Tapaustutkimusten valinnasta, tapahtumapuun käytöstä, sen laajennusosasta sekä lasketuista makrotaloudellisista vaikutuksista keskusteltiin sidosryhmien edustajien kanssa kolmessa asiantuntijaistunnossa.

An Integrated Model of Designing

Current design models and frameworks describe various overlapping fragments of designing. However, little effort exists in consolidating these fragments into an integrated model. We propose a model of designing that integrates product and process facets of designing by combining activities, outcomes, requirements, and solutions. Validation of the model using video protocols of design sessions demonstrates that all the constructs are used naturally by designers but often not to the expected level, which hinders the variety and resulting novelty of the concepts developed in these sessions. To resolve this, a prescriptive framework for supporting design for variety and novelty is proposed and plans for its implementation are created. DOI: 10.1115/1.3467011]

Therapeutic work with the present moment: A conversation analytical study of guidance into immediacy

Therapeutic work with the client’s present moment experience in existential therapy was studied by means of conversation analysis. Using publicly available video recordings of therapy sessions as data, an existential therapist’s practice of guiding a client into immediacy, or refocusing the talk on a client’s immediate experience, was described and compared with a therapist’s corresponding action in cognitive therapy. The study contributes to the description of interactional practice of existential therapy, and involves the first application of conversation analysis to a comparative study of psychotherapy process. The potential utility of this approach and the clinical and empirical implications of the present findings are discussed.

After interpretation.

Using 58 audio recorded sessions of psychoanalysis (coming from two analysts and three patients) as data and conversation analysis as method, this paper shows how psychoanalysts deal with patients’ responses to interpretations. After the analyst offers an interpretation, the patient responds: at that point (in the “third position”), the analysts recurrently modify the tenor of the description from what it was in the patients’ responses. They intensify the emotional valence of the description, or they reveal layers of the patients’ experience other than those that the patient reported. Both are usually accomplished in an implicit, non-marked way, and they discreetly index possible opportunities for the patients to modify their understandings of the initial interpretation. Although the patients usually do not fully endorse these modifications, the data available suggests that during the sessions that follow, the participants do work with the aspects of patients’ experience that the analyst highlighted. In discussion, it is suggested that actions that the psychoanalysts produce in therapy, such as choices of turn design in third position, may be informed by working understanding of the minds and mental conflicts of individual patients, alongside the more general therapeutic model of mind they hold to.