The Use of Computer Based Technology in Art Therapy with Adults who have Severe Physical Disabilities

The following qualitative research paper explores how the computer can be incorporated into an art therapeutic practice as a tool for art making when working with adults who are living with severe physical disabilities. The computer acts as a mediator that helps foster a sense of mastery, offers control over an art making process, and aids in the development of a positive self-concept when working in art therapy with adults who are living with chronic physical illness and limited mobility. Using a theoretical methodology and clinical vignettes, this paper examines how traditional techniques such as drawing, painting, and collage have been adapted using modern technology to meet the needs of clients who are living with physical disabilities. Advancements in new technology offer art therapists the ability to reach more individuals and diverse clinical populations. By incorporating technology into art therapy it has expanded the possibilities for clients who have physical limitations to engage in an art therapeutic process, where the artwork is created not by the therapist, but by the client. Art becomes a mirror, a container, and a witness to many personal struggles for individuals who are living with chronic illnesses

Daily College Student Drinking Patterns Across the First Year of College

Objective: Despite the long recognized importance and well-documented impact of drinking patterns on health and safety, college student drinking patterns are understudied. This study used a daily-level, academic-year-long, multisite sample to identify subpopulations of college student drinking patterns and to describe how these groups differ from one another before, during, and after their first year of college. Method: wo cohorts of first-year college students (n = 588; 59% female) reported daily drinking on a biweekly basis using web-based surveys and completed surveys before and after their first year of college. Results: Cluster analyses based on time series analysis estimates of within-person drinking differences (per weekday, semester, first 6 weeks) and other descriptors of day-to-day drinking identified five drinking patterns: two low (47% and 6%), two medium (24% and 15%), and one high (8%) drinking cluster. Multinomial logistic regression analyses examined cluster differences in pre-college characteristics (i.e., demographics, alcohol outcome expectancies, alcohol problems, depression, other substance use) and first-year college experiences (i.e., academic engagement, alcohol consequences, risky drinking practices, alcohol problems, drinking during academic breaks). Low-drinking students appeared to form a relatively homogeneous group, whereas two distinct patterns were found for medium-drinking students with different weekend and Thursday drinking rates. The Thursday drinking cluster showed lower academic engagement and greater participation in risky drinking practices. Conclusions: These findings highlight quantitative and qualitative differences in day-to-day drinking patterns and suggest a link between motivational differences and drinking patterns, which may be addressed in developing tailored interventional strategies

The efficacy of a web-based gambling intervention program for high school students: A preliminary randomized study

Early onset in adolescent gambling involvement can be a precipitator of later gambling problems. The aim of the present study was to test the preliminary efficacy of a web-based gambling intervention program for students within a high school-based setting. Students attending a high school in Italy (N=168) participated in the present study (58% male–age, M=15.01; SD=0.60). Twelve classes were randomly assigned to one of two conditions: intervention ( N=6; 95 students) and control group (N=6; 73 students). Both groups received personalized feedback and then the intervention group received online training (interactive activities) for three weeks. At a two-month follow-up, students in the intervention group reported a reduction in gambling problems relative to those in the control group. However, there were no differences in gambling frequency, gambling expenditure, and attitudes toward the profitability of gambling between the two groups. In addition, frequent gamblers (i.e., those that gambled at least once a week at baseline) showed reductions in gambling problems and gambling frequency post- intervention. Frequent gamblers that only received personalized feedback showed significantly less realistic attitudes toward the profitability of gambling post-intervention. The present study is the first controlled study to test the preliminary efficacy of a web-based gambling intervention program for students within a high school-based setting. The results indicate that a brief web-based intervention delivered in the school setting may be a potentially promising strategy for a low-threshold, low-cost, preventive tool for at-risk gambling high school students

Therapeutic emails

BACKGROUND: In this paper, we show how counselors and psychologists can use emails for online management of substance abusers, including the anatomy and content of emails that clinicians should send substance abusers. Some investigators have attempted to determine if providing mental health services online is an efficacious delivery of treatment. The question of efficacy is an empirical issue that cannot be settled unless we are explicitly clear about the content and nature of online treatment. We believe that it is not the communications via internet that matters, but the content of these communications. The purpose of this paper is to provide the content of our online counseling services so others can duplicate the work and investigate its efficacy. RESULTS: We have managed nearly 300 clients online for recovery from substance abuse. Treatment included individual counseling (motivational interviewing, cognitive-behavior therapy, relapse prevention assignments), participation in an electronic support group and the development of a recovery team. Our findings of success with these interventions are reported elsewhere. Our experience has led to development of a protocol of care that is described more fully in this paper. This protocol is based on stages of change and relapse prevention theories and follows a Motivational Interviewing method of counseling. CONCLUSION: The use of electronic media in providing mental health treatment remains controversial due to concerns about confidentiality, security and legal considerations. More research is needed to validate and generalize the use of online treatment for mental health problems. If researchers have to build on each others work, it is paramount that we share our protocols of care, as we have done in this paper

Social norms interventions to reduce alcohol misuse in University or College students

Background Drinking is influenced by youth (mis)perceptions of how their peers drink. If misperceptions can be corrected, young people may drink less. Objectives To determine whether social norms feedback reduces alcohol misuse in university or college students. Search strategy Cochrane Drugs and Alcohol Group Register of Trials; Central; MEDLINE; EMBASE; PsyInfo; CINAHL (up to March 2008). Selection criteria RCT or cluster RCT that evaluate social normative intervention with no intervention, alcohol education leaflet or other non-normative feedback intervention Data collection and analysis 2/3 authors extracted data. Included studies were assessed against criteria indicated in the Cochrane Reviewers Handbook version 5.0.0. Main results Twenty-two studies were included (7,275 participants). Alcohol related problems: Significant reduction with Web/computer feedback (WF) (SMD -0.31 95% Cl -0.59 to -0.02), three studies, 278 participants. No significant effect of mailed feedback (MF), individual face-to-face feedback (IFF) or group face-to-face feedback (GFF). Peak Blood Alcohol Content (BAC) : Significant reduction with WF (SMD -0.77 95% Cl -1.25 to -0.28), two studies, 198 participants. No significant effect of MF or IFF. Drinking Frequency: Significant reduction with WF (SMD -0.38 95% Cl -0.63 to -0.13), two studies, 243 participants and IFF (SMD -0.39 95% Cl -0.66 to -0.12), two studies, 217 participants. No significant effect of MF. Drinking Quantity: Significant reduction with WF (SMD -0.35 95% Cl -0.51 to -0.18), five studies, 556 participants and GFF (SMD -0.32 95% Cl -0.63 to -0.02) three studies, 173 participants. No significant effect of MF or IF. Binge drinking: Significant reduction with WF (SMD -0.47 95% Cl -0.92 to -0.03) one study, 80 participants, IFF (SMD -0.25 95% Cl -0.49 to -0.02) three studies, 278 participants and and GFF (SMD -0.38 95% Cl -0.62 to -0.14) four studies, 264 participants. No significant effect for MF. BAC: No significant effect of MF and IFF Drinking norms: Significant reduction with WF (SMD -0.75 95% Cl -0.98 to -0.52 ) three studies, 312 participants. Authors' conclusions WF and IFF are probably effective in reducing alcohol misuse. No direct comparisons of WF against IFF were found, but WF impacted across a broader set of outcomes and is less costly so therefore might be preferred. Significant effects were more apparent for short-term outcomes (up to three months). For mailed and group feedback, and social norms marketing campaigns, the results are on the whole not significant and therefore cannot be recommended

Social norms information for alcohol misuse in university and college students.

To determine whether social norms interventions reduce alcohol-related negative consequences, alcohol misuse or alcohol consumption when compared with a control (ranging from assessment only/no intervention to other educational or psychosocial interventions) among university and college students. Search methods The following electronic databases were searched up to May 2014: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (only to March 2008). Reference lists of included studies and review articles were manually searched. Selection criteria Randomised controlled trials or cluster-randomised controlled trials that compared a social normative intervention versus no intervention, alcohol education leaflet or other 'non-normative feedback' alcohol intervention and reported on alcohol consumption or alcohol-related problems in university or college students. Data collection and analysis We used standard methodological procedures as expected by The Cochrane Collaboration. Each outcome was analysed by mode of delivery: mailed normative feedback (MF); Web/computer normative feedback (WF); individual face-to-face normative feedback (IFF); group face-to-face normative feedback (GFF); and normative marketing campaign (MC). Main results A total of 66 studies (43,125 participants) were included in the review, and 59 studies (40,951 participants) in the meta-analyses. Outcomes at 4+ months post intervention were of particular interest to assess when effects were sustained beyond the immediate short term. We have reported pooled effects across delivery modes only for those analyses for which heterogeneity across delivery modes is not substantial (I2 < 50%). Alcohol-related problems at 4+ months: IFF standardised mean difference (SMD) -0.16, 95% confidence interval (CI) -0.31 to -0.01 (participants = 1065; studies = 7; moderate quality of evidence), equivalent to a decrease of 1.5 points in the 69-point alcohol problems scale score. No effects were found for WF or MF. Binge drinking at 4+ months: results pooled across delivery modes: SMD -0.06, 95% CI -0.11 to -0.02 (participants = 11,292; studies = 16; moderate quality of evidence), equivalent to 2.7% fewer binge drinkers if 30-day prevalence is 43.9%. Drinking quantity at 4+ months: results pooled across delivery modes: SMD -0.08, 95% CI -0.12 to -0.05 (participants = 20,696; studies = 33; moderate quality of evidence), equivalent to a reduction of 0.9 drinks consumed each week, from a baseline of 13.7 drinks per week. Drinking frequency at 4+ months: WF SMD -0.12, 95% CI -0.18 to -0.05 (participants = 9456; studies = 9; moderate quality of evidence), equivalent to a decrease of 0.19 drinking days/wk, from a baseline of 2.74 days/wk; IFF SMD -0.21, 95% CI -0.31 to -0.10 (participants = 1464; studies = 8; moderate quality of evidence), equivalent to a decrease of 0.32 drinking days/wk, from a baseline of 2.74 days/wk. No effects were found for GFF or MC. Estimated blood alcohol concentration (BAC) at 4+ months: peak BAC results pooled across delivery modes: SMD -0.08, 95% CI -0.17 to 0.00 (participants = 7198; studies = 13; low quality of evidence), equivalent to a reduction in peak PAC from an average of 0.144% to 0.135%. No effects were found for typical BAC with IFF. Authors' conclusions The results of this review indicate that no substantive meaningful benefits are associated with social norms interventions for prevention of alcohol misuse among college/university students. Although some significant effects were found, we interpret the effect sizes as too small, given the measurement scales used in the studies included in this review, to be of relevance for policy or practice. Moreover, the statistically significant effects are not consistent for all misuse measures, heterogeneity was a problem in some analyses and bias cannot be discounted as a potential cause of these findings

Incentives for smoking cessation

Background Financial incentives, monetary or vouchers, are widely used in an attempt to precipitate, reinforce and sustain behaviour change, including smoking cessation. They have been used in workplaces, in clinics and hospitals, and within community programmes. Objectives To determine the long‐term effect of incentives and contingency management programmes for smoking cessation. Search methods For this update, we searched the Cochrane Tobacco Addiction Group Specialised Register, clinicaltrials.gov, and the International Clinical Trials Registry Platform (ICTRP). The most recent searches were conducted in July 2018. Selection criteria We considered only randomised controlled trials, allocating individuals, workplaces, groups within workplaces, or communities to smoking cessation incentive schemes or control conditions. We included studies in a mixed‐population setting (e.g. community, work‐, clinic‐ or institution‐based), and also studies in pregnant smokers. Data collection and analysis We used standard Cochrane methods. The primary outcome measure in the mixed‐population studies was abstinence from smoking at longest follow‐up (at least six months from the start of the intervention). In the trials of pregnant women we used abstinence measured at the longest follow‐up, and at least to the end of the pregnancy. Where available, we pooled outcome data using a Mantel‐Haenzel random‐effects model, with results reported as risk ratios (RRs) and 95% confidence intervals (CIs), using adjusted estimates for cluster‐randomised trials. We analysed studies carried out in mixed populations separately from those carried out in pregnant populations. Main results Thirty‐three mixed‐population studies met our inclusion criteria, covering more than 21,600 participants; 16 of these are new to this version of the review. Studies were set in varying locations, including community settings, clinics or health centres, workplaces, and outpatient drug clinics. We judged eight studies to be at low risk of bias, and 10 to be at high risk of bias, with the rest at unclear risk. Twenty‐four of the trials were run in the USA, two in Thailand and one in the Phillipines. The rest were European. Incentives offered included cash payments or vouchers for goods and groceries, offered directly or collected and redeemable online. The pooled RR for quitting with incentives at longest follow‐up (six months or more) compared with controls was 1.49 (95% CI 1.28 to 1.73; 31 RCTs, adjusted N = 20,097; I2 = 33%). Results were not sensitive to the exclusion of six studies where an incentive for cessation was offered at long‐term follow up (result excluding those studies: RR 1.40, 95% CI 1.16 to 1.69; 25 RCTs; adjusted N = 17,058; I2 = 36%), suggesting the impact of incentives continues for at least some time after incentives cease. Although not always clearly reported, the total financial amount of incentives varied considerably between trials, from zero (self‐deposits), to a range of between USD 45 and USD 1185. There was no clear direction of effect between trials offering low or high total value of incentives, nor those encouraging redeemable self‐deposits. We included 10 studies of 2571 pregnant women. We judged two studies to be at low risk of bias, one at high risk of bias, and seven at unclear risk. When pooled, the nine trials with usable data (eight conducted in the USA and one in the UK), delivered an RR at longest follow‐up (up to 24 weeks post‐partum) of 2.38 (95% CI 1.54 to 3.69; N = 2273; I2 = 41%), in favour of incentives. Authors' conclusions Overall there is high‐certainty evidence that incentives improve smoking cessation rates at long‐term follow‐up in mixed population studies. The effectiveness of incentives appears to be sustained even when the last follow‐up occurs after the withdrawal of incentives. There is also moderate‐certainty evidence, limited by some concerns about risks of bias, that incentive schemes conducted among pregnant smokers improve smoking cessation rates, both at the end of pregnancy and post‐partum. Current and future research might explore more precisely differences between trials offering low or high cash incentives and self‐incentives (deposits), within a variety of smoking populations

Expression of the Permo-Triassic Boundary in a High Accommodation, High Southern Paleolatitude Continental Margin Setting

The end-Permian was marked by multiple environmental perturbations that ultimately resulted in the greatest life crisis of the geological record, the end-Permian Extinction (EPE). This paper evaluates the Permo-Triassic boundary (PTB) interval in the high accommodation, high southern paleolatitude paleocontinental margin setting of the northern Sydney Basin, eastern Australia. Recent investigations into the PTB interval in the Sydney Basin place the EPE somewhere above the top of the last Permian coal, which in Sydney’s northern coal field is the Vales Point Coal (VPC). Measured vertical sections and stratigraphic relationships from drill cores, open pits and natural surface exposures, in conjunction with geochemical analyses were used to investigate the expression of the PTB and EPE in the rapidly subsiding foredeep of the Sydney Basin. Our data reveals a coastal to lowland alluvial floodbasin setting proximal to an orogenic hinterland to the east and experienced progressively increasing estuarine influences to the west. Prior to the VPC, alluvial channel bodies are predominantly conglomerate filled, compensationally stacked and lensoid shaped in a direction perpendicular to paleoflow. Vertically separating these channel bodies are thick tuffs, coals, and gray root-penetrated mudrocks that indicate gleyed conditions. Immediately before and after the VPC, channel bodies show reduced bed thickness and a change from conglomerate to pebbly sandstone fill but record no change in fluvial style, stacking pattern, and/or sediment dispersal direction. Coals and tuffs are noticeably absent above the VPC, and mudrocks become more strongly colored but remain indicative of gleyed conditions. The interval immediately above the VPC is highly complex, with some sections preserving up to 18 meters of mudrock in conformable contact with the VPC, whereas others are truncated by fluvial downcutting. Weathering proxies and δ13C values of organic matter through conformable sections suggest periods of intense chemical weathering and at least one pulse of 13C depleted organic matter above the VPC. This study finds that the depositional environment of the northern Sydney Basin did not change significantly in response to climatic perturbations following the top of the VPC, which is substantially different than the traditional view of abrupt, severe alterations to the continental landscape. Advisors: Christopher Fielding & Tracy Fran

Expression of the Permo-Triassic Boundary in a High Accommodation, High Southern Paleolatitude Continental Margin Setting

The end-Permian was marked by multiple environmental perturbations that ultimately resulted in the greatest life crisis of the geological record, the end-Permian Extinction (EPE). This paper evaluates the Permo-Triassic boundary (PTB) interval in the high accommodation, high southern paleolatitude paleocontinental margin setting of the northern Sydney Basin, eastern Australia. Recent investigations into the PTB interval in the Sydney Basin place the EPE somewhere above the top of the last Permian coal, which in Sydney’s northern coal field is the Vales Point Coal (VPC). Measured vertical sections and stratigraphic relationships from drill cores, open pits and natural surface exposures, in conjunction with geochemical analyses were used to investigate the expression of the PTB and EPE in the rapidly subsiding foredeep of the Sydney Basin. Our data reveals a coastal to lowland alluvial floodbasin setting proximal to an orogenic hinterland to the east and experienced progressively increasing estuarine influences to the west. Prior to the VPC, alluvial channel bodies are predominantly conglomerate filled, compensationally stacked and lensoid shaped in a direction perpendicular to paleoflow. Vertically separating these channel bodies are thick tuffs, coals, and gray root-penetrated mudrocks that indicate gleyed conditions. Immediately before and after the VPC, channel bodies show reduced bed thickness and a change from conglomerate to pebbly sandstone fill but record no change in fluvial style, stacking pattern, and/or sediment dispersal direction. Coals and tuffs are noticeably absent above the VPC, and mudrocks become more strongly colored but remain indicative of gleyed conditions. The interval immediately above the VPC is highly complex, with some sections preserving up to 18 meters of mudrock in conformable contact with the VPC, whereas others are truncated by fluvial downcutting. Weathering proxies and δ13C values of organic matter through conformable sections suggest periods of intense chemical weathering and at least one pulse of 13C depleted organic matter above the VPC. This study finds that the depositional environment of the northern Sydney Basin did not change significantly in response to climatic perturbations following the top of the VPC, which is substantially different than the traditional view of abrupt, severe alterations to the continental landscape. Advisors: Christopher Fielding & Tracy Fran

Refined Permian-Triassic floristic timeline reveals early collapse and delayed recovery of south polar terrestrial ecosystems

The collapse of late Permian (Lopingian) Gondwanan floras, characterized by the extinction of glossopterid gymnosperms, heralded the end of one of the most enduring and extensive biomes in Earth’s history. The Sydney Basin, Australia, hosts a near continuous, age-constrained succession of high southern paleolatitude (∼65–75°S) terrestrial strata spanning the end-Permian extinction (EPE) interval. Sedimentological, stable carbon isotopic, palynological, and macrofloral data were collected from two cored coal-exploration wells and correlated. Six palynostratigraphic zones, supported by ordination analyses, were identified within the uppermost Permian to Lower Triassic succession, corresponding to discrete vegetation stages before, during, and after the EPE interval. Collapse of the glossopterid biome marked the onset of the terrestrial EPE and may have significantly predated the marine mass extinctions and conodont-defined Permian–Triassic Boundary. Apart from extinction of the dominant Permian plant taxa, the EPE was characterized by a reduction in primary productivity, and the immediate aftermath was marked by high abundances of opportunistic fungi, algae, and ferns. This transition is coeval with the onset of a gradual global decrease in δ13Corg and the primary extrusive phase of Siberian Traps Large Igneous Province magmatism. The dominant gymnosperm groups of the Gondwanan Mesozoic (peltasperms, conifers, and corystosperms) all appeared soon after the collapse but remained rare throughout the immediate post-EPE succession. Faltering recovery was due to a succession of rapid and severe climatic stressors until at least the late Early Triassic. Immediately prior to the Smithian–Spathian boundary (ca. 249 Ma), indices of increased weathering, thick redbeds, and abundant pleuromeian lycophytes likely signify marked climate change and intensification of the Gondwanan monsoon climate system. This is the first record of the Smithian–Spathian floral overturn event in high southern latitudes.This research was funded by collaborative research grants from the National Science Foundation (EAR-1636625 to CRF and TDF).</p