Intensive cognitive-behaviour therapy for depression : preliminary findings with four country residents

Describes a brief intensive program of cognitive therapy for depression that was designed for 4 adult residents of country towns in Australia, who resided some distance from treatment centers. Ss were assessed prior to treatment, at posttreatment, and at 4-wk, 8-wk, and 20-mo follow-ups. Treatments took place over 3 consecutive days for a total period of 15 hrs. Effects were highly consistent with the impact of group treatments delivered on a more traditional schedule. If confirmed in a controlled group study, these results suggest that cognitive therapy may be applied more economically and more widely than was previously realized.

Decision support system for contractor pre-qualification : artificial neural network model

The selection criteria for contractor pre-qualification are characterized by the co-existence of both quantitative and qualitative data. The qualitative data is non-linear, uncertain and imprecise. An ideal decision support system for contractor pre-qualification should have the ability of handling both quantitative and qualitative data, and of mapping the complicated nonlinear relationship of the selection criteria, such that rational and consistent decisions can be made. In this research paper, an artificial neural network model was developed to assist public clients identifying suitable contractors for tendering. The pre-qualification criteria (variables) were identified for the model. One hundred and twelve real pre-qualification cases were collected from civil engineering projects in Hong Kong, and eighty-eight hypothetical pre-qualification cases were also generated according to the “If-then” rules used by professionals in the pre-qualification process. The results of the analysis totally comply with current practice (public developers in Hong Kong). Each pre-qualification case consisted of input ratings for candidate contractors’ attributes and their corresponding pre-qualification decisions. The training of the neural network model was accomplished by using the developed program, in which a conjugate gradient descent algorithm was incorporated for improving the learning performance of the network. Cross-validation was applied to estimate the generalization errors based on the “re-sampling” of training pairs. The case studies show that the artificial neural network model is suitable for mapping the complicated nonlinear relationship between contractors’ attributes and their corresponding pre-qualification (disqualification) decisions. The artificial neural network model can be concluded as an ideal alternative for performing the contractor pre-qualification task.

Primary students' group metacognitive processes in a computer supported collaborative learning environment

The current understanding of students’ group metacognition is limited. The research on metacognition has focused mainly on the individual student. The aim of this study was to address the void by developing a conceptual model to inform the use of scaffolds to facilitate group metacognition during mathematical problem solving in computer supported collaborative learning (CSCL) environments. An initial conceptual framework based on the literature from metacognition, cooperative learning, cooperative group metacognition, and computer supported collaborative learning was used to inform the study. In order to achieve the study aim, a design research methodology incorporating two cycles was used. The first cycle focused on the within-group metacognition for sixteen groups of primary school students working together around the computer; the second cycle included between-group metacognition for six groups of primary school students working together on the Knowledge Forum® CSCL environment. The study found that providing groups with group metacognitive scaffolds resulted in groups planning, monitoring, and evaluating the task and team aspects of their group work. The metacognitive scaffolds allowed students to focus on how their group was completing the problem-solving task and working together as a team. From these findings, a revised conceptual model to inform the use of scaffolds to facilitate group metacognition during mathematical problem solving in computer supported collaborative learning (CSCL) environments was generated.

Cost-effectiveness of an intervention to reduce emergency re-admissions to hospital among older patients

Background. The objective is to estimate the cost-effectiveness of an intervention that reduces hospital readmission among older people at high risk. A cost-effectiveness model to estimate the costs and health benefits of the intervention was implemented. Methodology/Principal Findings. The model used data from a randomised controlled trial conducted in an Australian tertiary metropolitan hospital. Participants were acute medical admissions aged >65 years with at least one risk factor for readmission: multiple comorbidities, impaired functionality, aged >75 years, 30 recent multiple admissions, poor social support, history of depression. The intervention was a comprehensive nursing and physiotherapy assessment and an individually tailored program of exercise strategies and nurse home visits with telephone follow-up; commencing in hospital and continuing following discharge for 24 weeks. The change to cost outcomes, including the costs of implementing the intervention and all subsequent use of health care services, and, the change to health benefits, represented by quality adjusted life years, were estimated for the intervention as compared to existing practice. The mean change to total costs and quality 38 adjusted life years for an average individual over 24 weeks participating in the intervention were: cost savings of $333 (95% Bayesian credible interval $-1,932:1,282) and 0.118 extra quality adjusted life years (95% Bayesian credible interval 0.1:0.136). The mean net41 monetary-benefit per individual for the intervention group compared to the usual care condition was $7,907 (95% Bayesian credible interval $5,959:$9,995) for the 24 week period. Conclusions/Significance. The estimation model that describes this intervention predicts cost savings and improved health outcomes. A decision to remain with existing practices causes unnecessary costs and reduced health. Decision makers should consider adopting this 46 program for elderly hospitalised patients.

Cost-effectiveness of a telephone-delivered intervention for physical activity and diet

Background: Given escalating rates of chronic disease, broad-reach and cost-effective interventions to increase physical activity and improve dietary intake are needed. The cost-effectiveness of a Telephone Counselling intervention to improve physical activity and diet, targeting adults with established chronic diseases in a low socio-economic area of a major Australian city was examined. Methodology/Principal Findings: A cost-effectiveness modelling study using data collected between February 2005 and November 2007 from a cluster-randomised trial that compared Telephone Counselling with a “Usual Care” (brief intervention) alternative. Economic outcomes were assessed using a state-transition Markov model, which predicted the progress of participants through five health states relating to physical activity and dietary improvement, for ten years after recruitment. The costs and health benefits of Telephone Counselling, Usual Care and an existing practice (Real Control) group were compared. Telephone Counselling compared to Usual Care was not cost-effective ($78,489 per quality adjusted life year gained). However, the Usual Care group did not represent existing practice and is not a useful comparator for decision making. Comparing Telephone Counselling outcomes to existing practice (Real Control), the intervention was found to be cost-effective ($29,375 per quality adjusted life year gained). Usual Care (brief intervention) compared to existing practice (Real Control) was also cost-effective ($12,153 per quality adjusted life year gained). Conclusions/Significance: This modelling study shows that a decision to adopt a Telephone Counselling program over existing practice (Real Control) is likely to be cost-effective. Choosing the ‘Usual Care’ brief intervention over existing practice (Real Control) shows a lower cost per quality adjusted life year, but the lack of supporting evidence for efficacy or sustainability is an important consideration for decision makers. The economics of behavioural approaches to improving health must be made explicit if decision makers are to be convinced that allocating resources toward such programs is worthwhile.

Sex offenders in denial : a study into a group of forensic psychologists' attitudes regarding the corresponding impact upon risk assessment calculations and parole eligibility

A considerable proportion of convicted sex offenders maintain a stance of innocence and thus do not engage in recommended treatment programs. As a result, such offenders are often deemed to have outstanding criminogenic needs which may negatively impact upon risk assessment procedures and parole eligibility. This paper reports on a study that aimed to investigate a group of forensic psychologists’ attitudes regarding the impact of denial on risk assessment ratings as well as parole eligibility. Participants completed a confidential open-ended questionnaire. Analysis indicated that considerable variability exists among forensic psychologists in regards to their beliefs about the origins of denial and what impact such denial should have on post-prison release eligibility. In contrast, there was less disparity regarding beliefs about the percentage of innocent yet incarcerated sex offenders. This paper also reviews current understanding regarding the impact of denial on recidivism as well as upon general forensic assessments.

Learning to program : from pear-shaped to pairs

The consistently high failure rate in Queensland University of Technology’s introductory programming subject reflects a similar dilemma facing other universities worldwide. Experiments were conducted to quantify the effectiveness of collaborative learning on introductory level programming students over a number of semesters, replicating previous studies in this area. A selection of workshops in the introductory programming subject required students to problem-solve and program in pairs, mimicking the eXtreme Programming concept of pair programming. The failure rate for the subject fell from what had been an average of 30% since 2003 (with a high of 41% in 2006), to just 5% for those students who worked consistently in pairs.

A comparison of the hazard perception ability of matched groups of healthy drivers aged 35 to 55, 65 to 74, and 75 to 84 years

We examined differences in response latencies obtained during a validated video-based hazard perception driving test between three healthy, community-dwelling groups: 22 mid-aged (35-55 years), 34 young-old (65-74 years), and 23 old-old (75-84 years) current drivers, matched for gender, education level, and vocabulary. We found no significant difference in performance between mid-aged and young-old groups, but the old-old group was significantly slower than the other two groups. The differences between the old-old group and the other groups combined were independently mediated by useful field of view (UFOV), contrast sensitivity, and simple reaction time measures. Given that hazard perception latency has been linked with increased crash risk, these results are consistent with the idea that increased crash risk in older adults could be a function of poorer hazard perception, though this decline does not appear to manifest until age 75+ in healthy drivers.

Emergency department surge capacity : Recommendations of the Australasian surge strategy working group

Background For more than a decade emergency medicine organizations have produced guidelines, training and leadership for disaster management. However to date, there have been limited guidelines for emergency physicians needing to provide a rapid response to a surge in demand. The aim of this study is to identify strategies which may guide surge management in the Emergency Department. Method A working group of individuals experienced in disaster medicine from the Australasian College for Emergency Medicine Disaster Medicine Subcommittee (the Australasian Surge Strategy Working Group) was established to undertake this work. The Working Group used a modified Delphi technique to examine response actions in surge situations. The Working Group identified underlying assumptions from epidemiological and empirical understanding and then identified remedial strategies from literature and from personal experience and collated these within domains of space, staff, supplies, and system operation. Findings These recommendations detail 22 potential actions available to an emergency physician working in the context of surge. The Working Group also provides detailed guidance on surge recognition, triage, patient flow through the emergency department and clinical goals and practices. Discussion These strategies provide guidance to emergency physicians confronting the challenges of a surge in demand. The paper also identifies areas that merit future research including the measurement of surge capacity, constraints to strategy implementation, validation of surge strategies and measurement of strategy impacts on throughput, cost, and quality of care.

Histology challenge : an interactive program for 1st year students

Our students come from diverse backgrounds. They need flexibility in their learning, and opportunities to review aspects of curriculum they are less confident with. An online teaching and learning programme called the Histology Challenge has been developed to supplement learning experiences offered in several first year anatomy and anatomy & physiology units at QUT. The programme is designed to be integrated with the existing Blackboard sites. The Histology Challenge emphasises the foundation concept that a complex system, such as the human body, can be better understood by examining its simpler components. The tutorial allows students to examine the cells and tissues which ultimately determine structural and functional properties of body organs. The program is interactive, asking students to make decisions and choices, demonstrating an integrated understanding of systemic and cellular aspects. It provides users with the ability to progress at their own pace and to test their understanding and knowledge. For the developer the learning activity can be easily controlled and modified via the use of text files. There are several key elements of this programme, designed to promote specific aspects of student learning. Minimum text is used, instead there is a strong emphasis on instructive artwork and original, high quality histology images presented within a framework that reinforces learning and promotes problem solving skills.

Resolving painful emotional experience during psychodrama

Unresolved painful emotional experiences such as bereavement, trauma and disturbances in core relationships, are common presenting problems for clients of psychodrama or psychotherapy more generally. Emotional pain is experienced as a shattering of the sense of self and disconnection from others and, when unresolved, produces avoidant responses which inhibit the healing process. There is agreement across therapeutic modalities that exposure to emotional experience can increase the efficacy of therapeutic interventions. Moreno proposes that the activation of spontaneity is the primary curative factor in psychodrama and that healing occurs when the protagonist (client) engages with his or her wider social system and develops greater flexibility in response to that system. An extensive case-report literature describes the application of the psychodrama method in healing unresolved painful emotional experiences, but there is limited empirical research to verify the efficacy of the method or to identify the processes that are linked to therapeutic change. The purpose of this current research was to construct a model of protagonist change processes that could extend psychodrama theory, inform practitioners’ therapeutic decisions and contribute to understanding the common factors in therapeutic change. Four studies investigated protagonist processes linked to in-session resolution of painful emotional experiences. Significant therapeutic events were analysed using recordings and transcripts of psychodrama enactments, protagonist and director recall interviews and a range of process and outcome measures. A preliminary study (3 cases) identified four themes that were associated with helpful therapeutic events: enactment, the working alliance with the director and with group members, emotional release or relief and social atom repair. The second study (7 cases) used Comprehensive Process Analysis (CPA) to construct a model of protagonists’ processes linked to in-session resolution. This model was then validated across four more cases in Study 3. Five meta-processes were identified: (i) a readiness to engage in the psychodrama process; (ii) re-experiencing and insight; (iii) activating resourcefulness; (iv) social atom repair with emotional release and (v) integration. Social atom repair with emotional release involved deeply experiencing a wished-for interpersonal experience accompanied by a free flowing release of previously restricted emotion and was most clearly linked to protagonists’ reports of reaching resolution and to post session improvements in interpersonal relationships and sense of self. Acceptance of self in the moment increased protagonists’ capacity to generate new responses within each meta-process and, in resolved cases, there was evidence of spontaneity developing over time. The fourth study tested Greenberg’s allowing and accepting painful emotional experience model as an alternative explanation of protagonist change. The findings of this study suggested that while the process of allowing emotional pain was present in resolved cases, Greenberg’s model was not sufficient to explain the processes that lead to in-session resolution. The protagonist’s readiness to engage and activation of resourcefulness appear to facilitate the transition from problem identification to emotional release. Furthermore, experiencing a reparative relationship was found to be central to the healing process. This research verifies that there can be in-session resolution of painful emotional experience during psychodrama and protagonists’ reports suggest that in-session resolution can heal the damage to the sense of self and the interpersonal disconnection that are associated with unresolved emotional pain. A model of protagonist change processes has been constructed that challenges the view of psychodrama as a primarily cathartic therapy, by locating the therapeutic experience of emotional release within the development of new role relationships. The five meta-processes which are described within the model suggest broad change principles which can assist practitioners to make sense of events as they unfold and guide their clinical decision making in the moment. Each meta-process was linked to specific post-session changes, so that the model can inform the development of therapeutic plans for individual clients and can aid communication for practitioners when a psychodrama intervention is used for a specific therapeutic purpose within a comprehensive program of therapy.

Impact of music therapy to promote positive parenting and child development

The effectiveness of a 10-week group music therapy program for marginalized parents and their children aged 0–5 years was examined. Musical activities were used to promote positive parent–child relationships and children’s behavioral, communicative and social development. Participants were 358 parents and children from families facing social disadvantage, young parents or parents of a child with a disability. Significant improvements were found for therapist-observed parent and child behaviors, and parent-reported irritable parenting, educational activities in the home, parent mental health and child communication and social play skills. This study provides evidence of the potential effectiveness of music therapy for early intervention.

A cost-based optimization of a fiberboard pressing plant using Monte-Carlo simulation (a reliability program)

In this research the reliability and availability of fiberboard pressing plant is assessed and a cost-based optimization of the system using the Monte- Carlo simulation method is performed. The woodchip and pulp or engineered wood industry in Australia and around the world is a lucrative industry. One such industry is hardboard. The pressing system is the main system, as it converts the wet pulp to fiberboard. The assessment identified the pressing system has the highest downtime throughout the plant plus it represents the bottleneck in the process. A survey in the late nineties revealed there are over one thousand plants around the world, with the pressing system being a common system among these plants. No work has been done to assess or estimate the reliability of such a pressing system; therefore this assessment can be used for assessing any plant of this type.