EMPOWERED trial: protocol for a randomised control trial of digitally supported, highly personalised and measurement-based care to improve functional outcomes in young people with mood disorders

Objectives: Many adolescents and young adults with emerging mood disorders do not achieve substantial improvements in education, employment, or social function after receiving standard youth mental health care. We have developed a new model of care referred to as ‘highly personalised and measurement-based care’ (HP&MBC). HP&MBC involves repeated assessment of multidimensional domains of morbidity to enable continuous and personalised clinical decision-making. Although measurement-based care is common in medical disease management, it is not a standard practice in mental health. This clinical effectiveness trial tests whether HP&MBC, supported by continuous digital feedback, delivers better functional improvements than standard care and digital support. Method and analysis: This controlled implementation trial is a PROBE study (Prospective, Randomised, Open, Blinded End-point) that comprises a multisite 24-month, assessor-blinded, follow-up study of 1500 individuals aged 15–25 years who present for mental health treatment. Eligible participants will be individually randomised (1:1) to 12 months of HP&MBC or standardised clinical care. The primary outcome measure is social and occupational functioning 12 months after trial entry, assessed by the Social and Occupational Functioning Assessment Scale. Clinical and social outcomes for all participants will be monitored for a further 12 months after cessation of active care. Ethics and dissemination: This clinical trial has been reviewed and approved by the Human Research Ethics Committee of the Sydney Local Health District (HREC Approval Number: X22-0042 & 2022/ETH00725, Protocol ID: BMC-YMH-003-2018, protocol version: V.3, 03/08/2022). Research findings will be disseminated through peer-reviewed journals, presentations at scientific conferences, and to user and advocacy groups. Participant data will be deidentified. Trial registration number: ACTRN12622000882729

A rhizomatics of hearing : becoming deaf in the workplace and other affective spaces of hearing

This paper stages a corporeal and affective trail through plateaus of 'Becoming deaf' in the workplace of academia. The paper aims to display the unfamiliarity of deafness in a profession whose ability to speak and hear the written word is all too commonsense. In this piece, Deleuze and Guattari's 'rhizome' acts as sensibility and motif as a body deafens. I make use of photography, poetry and poesis as multi-textual pedagogy for engaging with the disjuncture between advocacy and experience, and to draw attention to the dysphoria of theorising affect and the multidimensionality of experiential relations of affect. The paper argues that deafness/becoming deaf is always a form of hearing and the 'strange label' of disability is brought into question just as it increasingly opens presence, tension, texture, and interdependence.

Affective strategies in the academy: creative methodologies, civic responses and the market

Australian Universities face a 'tough' Federal government of sector deregulation and increased student fees following the Universities Australia policy, A Smarter Australia: An Agenda for Australian Higher Education 2013-2016. New technology, globalisation, productivity driven innovation and scientific method are the contexts through which research outcomes, on tighter budgets, will be made. In this paper, we redraw attention to the complexity of research contexts, including media sites, industry and digital worlds. In particular, we foreground the 'turn to affect'. Recent years have witnessed a complex revision of understandings about lived worlds by considering intangibles: affect, emotion and the senses. Universities have also included the performing arts and the digital arts and sciences. The turn to affect is, then, significant beyond discourse, and universities would be wise to encourage less tangible research strategies that impact and respond to the market and, indeed, allow the market responses to affect

To love-to live: barrow and cart

From the residue of meaning, an ensemble of shadows. From the glint of souvenir, pliable impressions. In this paper, we work a poetics of encounter, of being, keeping, homage, of paying homage to fragility, to object and to interspecies—ways are found to engage motion from within and around co-extensive bodies. With the consolation of images, we follow the terse rhythms of routine and street where dwelling is a case of affective dissent. Zones of departure appear through testimony as well as chance, taking their own form. A footfall brings us as observers into quiet spaces which refuse self-estrangement as we travel by way of an unquiet ground. Breath, respiration, aspiration. Precipitation. Sculptures of mist are also the language of lives, of kinship between object, footfall and air. A language of brackets, questions, ellipses. There may be a man, a dog, a barrow. There may be a woman, a cart. Air. How shall this image be made

“Disability Matters: Pedagogy, Media and Affect”

From the critique of ‘the medical model’ of disability undertaken during the early and mid-1990s, a ‘social model’ emerged, particularly in the caring professions and those trying to shape policy and practice for people with disability. In education and schooling, it was a period of cementing inclusive practices and the ‘integration’ and inclusion of disability into ‘mainstream’. What was lacking in the debates around the social model, however, were the challenges to abledness that were being grappled with in the routine and pragmatics of self-care by people with disabilities, their families, carers and caseworkers. Outside the academy, new forms of activity and new questions were circulating. Challenges to abledness flourished in the arts and constituted the lived experience of many disability activists. Disability Matters engages with the cultural politics of the body, exploring this fascinating and dynamic topic through the arts, teaching, research and varied encounters with ‘disability’ ranging from the very personal to the professional. Chapters in this collection are drawn from scholars responding in various registers and contexts to questions of disability, pedagogy, affect, sensation and education. Questions of embodiment, affect and disability are woven throughout these contributions, and the diverse ways in which these concepts appear emphasize both the utility of these ideas and the timeliness of their application. This book was originally published as a special issue of Discourse: Studies in the Cultural Politics of Education

“Introduction: Disability Matters: Pedagogy, Media and Affect”

This edition of Discourse comes into being after two decades of engagement with the cultural politics of the body – through the arts, teaching, research and varied encounters with ‘disability’ ranging from the very personal to the professional. From the critique of ‘the medical model’ of disability undertaken during the early and mid-1990s, a ‘social model’ emerged, particularly in the caring professions and those trying to shape policy and practice for people with disability. In education and schooling, it was a period of cementing inclusive practices and the ‘integration’ and inclusion of disability into ‘mainstream’ (Northway, 2002; Vincent, Evans, Lunt, & Young, 1996; Vislie, 2003). What was lacking in the debates around the social model, however, were the challenges to abledness that were being grappled with in the routine and pragmatics of self-care by people with disabilities, their families, carers and caseworkers. Outside the academy, new forms of activity and new questions were circulating. Challenges to abledness flourished in the arts and constituted the lived experience of many disability activists. In the early 1990s, for instance, performing arts companies such as the London-based CanDoCo and Restless Dance Theatre in Adelaide, Australia, were making dance and redefining its boundaries as physically based performance sourced in bodily capacity (in preference to disciplining the body into extant genres of ‘the dancing body’)

The clinical education of students with non-native accents

This Professional Issues Statement was developed by a Subcommittee of a former American Speech-Language-Hearing Association Executive Board working group on language proficiency. Members of the group were Catherine J. Crowley, Erika S. Levy, Nidhi Mahendra, and Vicki R. Deal-Williams (ex officio). Julie B. Noel, ASHA vice president for speech-language pathology practice (2009–2011), served as the monitoring officer. This document was approved by the ASHA Board of Directors (BOD 31-2011). ASHA members must consider all applicable local, state, and federal requirements when applying the information in this policy