A naturalistic inquiry of registered nurses' perspectives and expectations of psychodynamic therapeutic care in acute psychiatric inpatient facilities

Within contemporary inpatient mental health nursing practice, the psychodynamic model of care considered previously to be central to the nurse-patient relationship now seems a radical concept. It appears to exist only within primary care facilities and public health care practice settings. This naturalistic inquiry aimed to explicate mental health nurses' perspectives and expectations of providing psychodynamic therapeutic care in acute inpatient psychiatric facilities. Ten registered nurses working in acute inpatient mental health facilities were interviewed. Five themes emerged: a career for life, relating in a psychodynamic manner, swimming against the current, adopting a position of difference, and hopeful expectancy.

A systematic review of naturalistic interventions in refugee populations

Naturalistic interventions with refugee populations examine outcomes following mental health interventions in existing refugee service organisations. The current review aimed to examine outcomes of naturalistic interventions and quality of the naturalistic intervention literature in refugee populations with the view to highlight the strengths and limitations of naturalistic intervention studies. Database search was conducted using the search terms ‘refugee’, ‘asylum seeker’, ‘treatment’, ‘therapy’ and ‘intervention. No date limitations were applied, but searches were limited to articles written in English. Seven studies were identified that assessed the outcome of naturalistic interventions on adult refugees or asylum seekers in a country of resettlement using quantitative outcome measures. Results showed significant variation in the outcomes of naturalistic intervention studies, with a trend towards showing decreased symptomatology at post-intervention. However, conclusions are limited by methodological problems of the studies reviewed, particularly poor documentation of intervention methods and lack of control in the design of naturalistic intervention studies. Further examination of outcomes following naturalistic interventions is needed with studies which focus on increasing the rigour of the outcome assessment process.

The development of a naturalistic car following model for assessing managed motorway systems' safety effects

This thesis highlights the limitations of the existing car following models to emulate driver behaviour for safety study purposes. It also compares the capabilities of the mainstream car following models emulating driver behaviour precise parameters such as headways and Time to Collisions. The comparison evaluates the robustness of each car following model for safety metric reproductions. A new car following model, based on the personal space concept and fish school model is proposed to simulate more precise traffic metrics. This new model is capable of reflecting changes in the headway distribution after imposing the speed limit form VSL systems. This research facilitates assessing Intelligent Transportation Systems on motorways, using microscopic simulation.

Detection of object onset and offset in naturalistic scenes

The present study was conducted to investigate whether ob- servers are equally prone to overlook any kinds of visual events in change blindness. Capitalizing on the finding from visual search studies that abrupt appearance of an object effectively captures observers' attention, the onset of a new object and the offset of an existing object were contrasted regarding their detectability when they occurred in a naturalistic scene. In an experiment, participants viewed a series of photograph pairs in which layouts of seven or eight objects were depicted. One object either appeared in or disappeared from the layout, and participants tried to detect this change. Results showed that onsets were detected more quickly than offsets, while they were detected with equivalent ac- curacy. This suggests that the primacy of onset over offset is a robust phenomenon that likely makes onsets more resistant to change blindness under natural viewing conditions.

The Australian naturalistic driving study: From beginnings to launch

The Australian Naturalistic Driving Study (ANDS), a ground-breaking study of Australian driver behaviour and performance, was officially launched on April 21st, 2015 at UNSW. The ANDS project will provide a realistic perspective on the causes of vehicle crashes and near miss crash events, along with the roles speeding, distraction and other factors have on such events. A total of 360 volunteer drivers across NSW and Victoria - 180 in NSW and 180 in Victoria - will be monitored by a Data Acquisition System (DAS) recording continuously for 4 months their driving behaviour using a suite of cameras and sensors. Participants’ driving behaviour (e.g. gaze), the behaviour of their vehicle (e.g. speed, lane position) and the behaviour of other road users with whom they interact in normal and safety-critical situations will be recorded. Planning of the ANDS commenced over two years ago in June 2013 when the Multi-Institutional Agreement for a grant supporting the equipment purchase and assembly phase was signed by parties involved in this large scale $4 million study (5 university accident research centres, 3 government regulators, 2 third party insurers and 2 industry partners). The program’s second development phase commenced a year later in June 2014 after a second grant was awarded. This paper presents an insider's view into that two year process leading up to the launch, and outlines issues that arose in the set-up phase of the study and how these were addressed. This information will be useful to other organisations considering setting up an NDS.

Assessment of neuroleptic-induced movement disorders in a naturalistic schizophrenia population

The prevalence and assessment of neuroleptic-induced movement disorders (NIMDs) in a naturalistic schizophrenia population that uses conventional neuroleptics were studied. We recruited 99 chronic schizophrenic institutionalized adult patients from a state nursing home in central Estonia. The total prevalence of NIMDs according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) was 61.6%, and 22.2% had more than one NIMD. We explored the reliability and validity of different instruments for measuring these disorders. First, we compared DSM-IV with the established observer rating scales of Barnes Akathisia Rating Scale (BARS), Simpson-Angus Scale (SAS) (for neuroleptic-induced parkinsonism, NIP) and Abnormal Involuntary Movement Scale (AIMS) (for tardive dyskinesia), all three of which have been used for diagnosing NIMD. We found a good overlap of cases for neuroleptic-induced akathisia (NIA) and tardive dyskinesia (TD) but somewhat poorer overlap for NIP, for which we suggest raising the commonly used threshold value of 0.3 to 0.65. Second, we compared the established observer rating scales with an objective motor measurement, namely controlled rest lower limb activity measured by actometry. Actometry supported the validity of BARS and SAS, but it could not be used alone in this naturalistic population with several co-existing NIMDs. It could not differentiate the disorders from each other. Quantitative actometry may be useful in measuring changes in NIA and NIP severity, in situations where the diagnosis has been made using another method. Third, after the relative failure of quantitative actometry to show diagnostic power in a naturalistic population, we explored descriptive ways of analysing actometric data, and demonstrated diagnostic power pooled NIA and pseudoakathisia (PsA) in our population. A subjective question concerning movement problems was able to discriminate NIA patients from all other subjects. Answers to this question were not selective for other NIMDs. Chronic schizophrenia populations are common worldwide, NIMD affected two-thirds of our study population. Prevention, diagnosis and treatment of NIMDs warrant more attention, especially in countries where typical antipsychotics are frequently used. Our study supported the validity and reliability of DSM-IV diagnostic criteria for NIMD in comparison with established rating scales and actometry. SAS can be used with minor modifications for screening purposes. Controlled rest lower limb actometry was not diagnostically specific in our naturalistic population with several co-morbid NIMDs, but it may be sensitive in measuring changes in NIMDs.

Honesty in the provision of expert services: The effect of naturalistic framings and participants' professions

This thesis studies the incentives and behaviour of providers of expert services, like doctors, financial advisors and mechanics. The focus is in particular on provision of health care using a series of credence goods experiments conducted to investigate undertreatment, overtreatment and overcharging in a medical context. The findings of study one suggest that a medical framing compared to a neutral framing significantly increases pro-social behaviour for standard participants in economic experiments. Study two compares the behaviour of medical practitioners - mainly doctors - to students. It is observed that medical doctors’ undertreat and overcharge significantly less, but at the same time overtreat significantly more than students. The final study compares behaviours for other experts - accountants, engineers and lawyers - using experimental framings drawn from the respective contexts and students from the respective faculties as participants in credence goods experiments.

Naturalistic approaches to sensorimotor control.

Human sensorimotor control has been predominantly studied using fixed tasks performed under laboratory conditions. This approach has greatly advanced our understanding of the mechanisms that integrate sensory information and generate motor commands during voluntary movement. However, experimental tasks necessarily restrict the range of behaviors that are studied. Moreover, the processes studied in the laboratory may not be the same processes that subjects call upon during their everyday lives. Naturalistic approaches thus provide an important adjunct to traditional laboratory-based studies. For example, wearable self-contained tracking systems can allow subjects to be monitored outside the laboratory, where they engage spontaneously in natural everyday behavior. Similarly, advances in virtual reality technology allow laboratory-based tasks to be made more naturalistic. Here, we review naturalistic approaches, including perspectives from psychology and visual neuroscience, as well as studies and technological advances in the field of sensorimotor control.

Near optimal combination of sensory and motor uncertainty in time during a naturalistic perception-action task.

Most behavioral tasks have time constraints for successful completion, such as catching a ball in flight. Many of these tasks require trading off the time allocated to perception and action, especially when only one of the two is possible at any time. In general, the longer we perceive, the smaller the uncertainty in perceptual estimates. However, a longer perception phase leaves less time for action, which results in less precise movements. Here we examine subjects catching a virtual ball. Critically, as soon as subjects began to move, the ball became invisible. We study how subjects trade-off sensory and movement uncertainty by deciding when to initiate their actions. We formulate this task in a probabilistic framework and show that subjects' decisions when to start moving are statistically near optimal given their individual sensory and motor uncertainties. Moreover, we accurately predict individual subject's task performance. Thus we show that subjects in a natural task are quantitatively aware of how sensory and motor variability depend on time and act so as to minimize overall task variability.

Memorabeatlia: a naturalistic study of long-term memory.

Seventy-six undergraduates were given the titles and first lines of Beatles' songs and asked to recall the songs. Seven hundred and four different undergraduates were cued with one line from each of 25 Beatles' songs and asked to recall the title. The probability of recalling a line was best predicted by the number of times a line was repeated in the song and how early the line first appeared in the song. The probability of cuing to the title was best predicted by whether the line shared words with the title. Although the subjects recalled only 21% of the lines, there were very few errors in recall, and the errors rarely violated the rhythmic, poetic, or thematic constraints of the songs. Acting together, these constraints can account for the near verbatim recall observed. Fourteen subjects, who transcribed one song, made fewer and different errors than the subjects who had recalled the song, indicating that the errors in recall were not primarily the result of errors in encoding.