An Asian perspective of occupational stress coping model : a case study of Sri Lankan employees

Sri Lanka has one of the highest rates of natural disasters and violent conflicts in the world. Yet there is a lack of research on its unique socio-cultural characteristics that determine an individual's cognitive and behavioural responses to distressing encounters. This study extends Goh, Sawang and Oei's (2010) revised transactional model to examine the cognitive and behavioural processes of occupational stress experience in the collectivistic society of Sri Lanka. A time series survey was used to measure the participant's stress-coping process. Using the revised transactional model and path analysis, a unique Sri Lankan model is identified that provides theoretical insights on the revised transactional model, and sheds light on socio-cultural dimensions of occupational stress and coping, thus equipping practitioners with a sound theoretical basis for the development of stress management programs in the workplace.

Contracting for community development : a case study based perspective of a public sector client initiative in Hong Kong

The construction industry is known to be an important contributor towards the gross domestic product of many countries. Moreover, the health of the construction industry is positively correlated to the economic growth of a country and in many economies public sector clients account for a major share of construction works. Given this strength, it is important for public sector clients to initiate innovations aimed at the betterment of the industry. In this context, concern about sustainable development has been a major driver of some innovative initiatives in construction industries worldwide. Furthermore, the Government of Hong Kong regards both sustainability and community development as important criteria when planning and procuring construction projects. This paper is based on a case study of a public sector development project in Hong Kong, and presents the salient features of the procurement and contractual systems adopted in the project, which foster sustainability and community development. The reported interim findings are based on a preliminary document analysis that is part of an ongoing longitudinal case study into the project. The document analysis takes a three-pronged approach in terms of how the procurement and contractual systems foster economic, environmental and social sustainability, and sums up their impact on the community as a whole.

Beneficial effects of exercise : shifting the focus from body weight to other markers of health

Background: Exercise is widely promoted as a method of weight management, while the other health benefits are often ignored. The purpose of this study was to examine whether exercise-induced improvements in health are influenced by changes in body weight. Methods: Fifty-eight sedentary overweight/obese men and women (BMI 31.8 (SD 4.5) kg/m2) participated in a 12-week supervised aerobic exercise intervention (70% heart rate max, five times a week, 500 kcal per session). Body composition, anthropometric parameters, aerobic capacity, blood pressure and acute psychological response to exercise were measured at weeks 0 and 12. Results: The mean reduction in body weight was −3.3 (3.63) kg (p<0.01). However, 26 of the 58 participants failed to attain the predicted weight loss estimated from individuals’ exercise-induced energy expenditure. Their mean weight loss was only −0.9 (1.8) kg (p<0.01). Despite attaining a lower-than-predicted weight reduction, these individuals experienced significant increases in aerobic capacity (6.3 (6.0) ml/kg/min; p<0.01), and a decreased systolic (−6.00 (11.5) mm Hg; p<0.05) and diastolic blood pressure (−3.9 (5.8) mm Hg; p<0.01), waist circumference (−3.7 (2.7) cm; p<0.01) and resting heart rate (−4.8 (8.9) bpm, p<0.001). In addition, these individuals experienced an acute exercise-induced increase in positive mood. Conclusions: These data demonstrate that significant and meaningful health benefits can be achieved even in the presence of lower-than-expected exercise-induced weight loss. A less successful reduction in body weight does not undermine the beneficial effects of aerobic exercise. From a public health perspective, exercise should be encouraged and the emphasis on weight loss reduced.

Workforce indicators of health literacy

The concept of health literacy has evolved over the last forty years from an individual, literacy driven focus in clinical settings to one associated with a contemporary approach to health promotion. The World Health Organization has defined health literacy as ‘the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health’ (World Health Organization, 1998, p. 10). The conceptual evolution of health literacy has seen a shift beyond a functional orientation to also recognise cognitive, behavioural and environmental influences. This more comprehensive view of health literacy acknowledges factors like efficacy, motivation, self-efficacy, autonomy, social support and empowerment. A health literate workforce could present benefits for the employee and employer...

A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare')

Background Coronary heart disease (CHD) and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI) and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL), decrease medication adherence and appropriate utilisation of health services, lead to increased morbidity and suicide risk, and is associated with poorer CHD risk factor profiles and reduced survival. We aim to determine the feasibility of conducting a randomised, multi-centre trial designed to compare a tele-health program (MoodCare) for depression and CHD secondary prevention, with Usual Care (UC). Methods Over 1600 patients admitted after index admission for Acute Coronary Syndrome (ACS) are being screened for depression at six metropolitan hospitals in the Australian states of Victoria and Queensland. Consenting participants are then contacted at two weeks post-discharge for baseline assessment. One hundred eligible participants are to be randomised to an intervention or a usual medical care control group (50 per group). The intervention consists of up to 10 × 30-40 minute structured telephone sessions, delivered by registered psychologists, commencing within two weeks of baseline screening. The intervention focuses on depression management, lifestyle factors (physical activity, healthy eating, smoking cessation, alcohol intake), medication adherence and managing co-morbidities. Data collection occurs at baseline (Time 1), 6 months (post-intervention) (Time 2), 12 months (Time 3) and 24 months follow-up for longer term effects (Time 4). We are comparing depression (Cardiac Depression Scale [CDS]) and HRQOL (Short Form-12 [SF-12]) scores between treatment and UC groups, assessing the feasibility of the program through patient acceptability and exploring long term maintenance effects. A cost-effectiveness analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the government. Discussion This manuscript presents the protocol for a randomised, multi-centre trial to evaluate the feasibility of a tele-based depression management and CHD secondary prevention program for ACS patients. The results of this trial will provide valuable new information about potential psychological and wellbeing benefits, cost-effectiveness and acceptability of an innovative tele-based depression management and secondary prevention program for CHD patients experiencing depression.

Making sense of mental illness as a full human experience : Perspective of illness and recovery held by people with a mental illness living in the community.

Recovery is a highly contextualized concept amid divergent interpretations and unique experiences. There is substantial current interest in building evidence about recovery from mental illness in order to inform best practice founded in the ways people find to live productive and meaningful lives. This paper presents some accounts related to recovery and illness expressed by eight people through a Participatory Action Research project. The research facilitated entry to the subjective experiences of living in the community as an artist with a mental illness. The people in the research shared an integrated understanding of illness, recovery and identity. Their understanding provided insight into mental illness as an inseparable aspect of who they were. Further, specific issue was raised of recovery as a clinical term with a requirement to meet distinct conventions of recovery. This paper emphasizes that being ill and being well, for the person with a mental illness, is a dynamic and complex development not easily explained or transformed into uniform process or outcomes. Attempts to establish an integral or consensual approach to recovery has, to date, disregarded mental illness as a full human experience. This paper argues that broader frameworks for thinking and responding to the dynamic processes of mental illness and recovery are needed and require acknowledgment of competing and contradictory ideas.

The Corio Oval Tribe : a prosopographical perspective of the Geelong Football Club in the nineteenth century

This article analyses the occupational and class status of Geelong footballers in the nineteenth century via the methodology of prosopography. Prosopography is an empirical group biography approach to historical research. The article argues that during the period 1859-78 Geelong's playing group was largely derived from the squattocracy and urban middle class. In the later period 1878-96 the Geelong club recruited more widely from the working class, as in keeping with the increased participation of this class in football from the late 1870s. It can be argued that this more diverse group helped establish Geelong as a footballing power.

Experiencing information across the phenomenon of health information literacy

Interest in the concept of information literacy in different contexts is a topic that has steadily gained increased attention in information literacy discourse and research efforts over recent years. In particular the emergence of the term ‘health information literacy’ attests to this interest and has elevated awareness about the importance and relevance of information literacy in a health context. This paper reports on research that has taken a relational perspective to explore how people experience health information literacy. Initially established by Bruce (1997) the relational perspective draws from an experiential framework that emphasizes the relationship between users and information when learning in different contexts. This approach seeks outcomes that are deeply embedded in users’ informational life worlds and complements experiential phenomenological perspectives that have been used in health research. In keeping with the relational approach this research interprets health information literacy as being the different ways in which people experience using information to learn about health. Using interpretive phenomenography, this research explored variation in the lived experience of how people use information to learn about their health, and variation in what is constituted as information when learning about their health. Participants included 23 males and females aged between 45 and 64 years. All participants were residents from the Greater Brisbane area of Queensland, Australia. The research used semi-structured interviews for data collection. The types of questions posed during interviews included ‘Can you describe a time when you used information to learn about your health?’ and ‘What kinds of information have you used to learn about your health?’. This paper will focus on presenting one element of research findings that concerns the differences in ‘what’ participants experienced as information. Analysis of interview data identified significant variation in the experienced nature of information, specifically the different qualities or elements that comprised the ‘object’ of information, or in other words, what was perceived as ‘informing’. Illustrations of this variation include information experienced as traditional information sources, facts and experiences, something exhibiting particular qualities, physical or psychological changes, other people and role models. These findings provide new insights into what people may experience as information, and build upon existing literature regarding information as a theoretical construct. In addition the potential implications of these findings with respect to the design and delivery of health information literacy education will also be discussed. These research findings contribute to the emergence of information literacy investigations in everyday life and community. Although such settings have long been identified as a significant gap for exploration, research to date in this field has predominantly focused on educational and workplace environments. In this way the knowledge gained from this research has further revealed the contextual nature of information literacy, as well as its complexity as a phenomenon and focus of study.

A wound management education and training needs analysis of health consumers and the relevant health workforce and stocktake of available education and training activities and resources

The goals of this project were to determine the education and training needs of health consumers and the relevant health workforce and to identify and map the available education and training activities and resources. The methods used to collect the data included online surveys and one on one interviews of relevant patients and their carers. The project manager actively sought to engage with the key wound management leaders and advanced clinicians to gain their support and views on the priority education and training issues. The response to all data collection methods was pleasing with almost five hundred responses to the general wound workforce online survey. The data supported the need for more wound management education and training and identified some particular topics of need, such as utilising wound investigations and understanding wound products, pharmaceuticals and devices. The occupational groups with the highest need appear to be those working in primary health care, such as practice nurses and GPs, and those working in residential aged care facilities. The education and training stocktake identified a wide range of activities currently available, the majority being provided in a face to face format. The next stage of the project will be to form some clear and achievable priority action areas based on the available data. An online directory of wound management education and training activities and resources will be developed and further development will be undertaken on a knowledge and skills framework for the wound management workforce. Additionally, transfer of learning factors in the general practice environment will be assessed and strategies will be developed to improve the pre-entry or undergraduate wound management training within relevant higher education programs.

The Fukushima nuclear power plant disaster and percetions of health risk communication : a case study

This case study was conducted to explore the perceptions of health risk messages sent by the Japanese Government following the Fukushima nuclear power plant disaster. The content of health risk messages from the Japanese Government and the Japanese national broadcaster (NHK) were analysed and semi-structured interviews were conducted with a sample of Tokyo residents. Initially, participants trusted these messages but as the crisis unfolded they became sceptical about the messages. Participants felt the messages did not communicate health risk information effectively because the messages were; not supported by evidence, inconsistent, delayed and changed over time. Despite widespread access to the internet, social media and mobile telephones, most participants relied on television news for information about the health risks. The Japanese Government urgently needs to re-build trust by engaging the community in the planning and development phases of health risk communication strategies.

The role of counselling in healing from sexual assault in childhood from the phenomenological perspective of men and women

Serious Childhood Sexual Assault (CSA) has the potential for a wide range of extreme difficulties, not only in childhood but for many years to come. However, the lasting negative impacts are not inevitable and with the right help, those who have experienced CSA can go on to enjoy whole and fulfilling lives. The question posed in this research is “What comprises “the right help”? The present study qualitatively investigated the narratives of men and women with regard to what was deemed important components of counselling which facilitated their healing from childhood sexual assault. Participants consisted of 21 women and 11 men who had sought both individual and group counselling to work through issues stemming from traumatic sexual assault in childhood. Findings presented here describe three superordinate themes which were essential in the healing process, incorporating abuse-specific, client-specific and practitioner-specific components. A final superordinate theme of negative experiences in counselling is also presented, describing unhelpful or negative counselling experiences. Similarities between men and women as to the important components of counselling was remarkable, however important gender differences were also observed.

Safety, courts and crime: occupational safety and health prosecutions in the Magistrates' courts

This paper reports on an empirically based study of occupational safety and health prosecutions in the Magistrates' courts in the State of Victoria, Australia. It examines the way in which the courts construct occupational safety and health issues during prosecutions against alleged offenders, and then theorises the role of the criminal law in health and safety regulation. The paper argues that courts, inspectors, prosecutors and defence counsel are involved in filtering or reshaping occupational safety and health issues during the prosecution process, both pre-trial and in court. An analysis of the pattern of investigation of health and safety offences shows that they are constructed by focusing on 'events', in most cases incidents resulting in injury or death. This 'event focus' ensures that the attention of the parties is drawn to the details of the incident and away from the broader context of the event. This broader context includes the way in which work is organised at the workplace and the quality of occupational safety and health management (the micro context), and the pressures within capitalist production systems for occupational safety and health to be subordinated to production imperatives (the macro context). In particular, during the court-based sentencing process, defence counsel is able to adopt a range of 'isolation' techniques that isolate the incident from its micro and macro contexts, thereby individualising and decontextualising the incident. The paper concludes that the legal system plays a key role in decontextualising and individualising health and safety issues, and that this process is part of the 'architecture' of the legal system, and a direct consequence of the 'form of law'.

Growing demand for emergency department services : associated factors and perspective of patients

This thesis demonstrates how patients' perceived urgency affects their decision to use public hospital emergency departments. The findings inform public health policy solutions aimed at reducing rapid growth in emergency department utilisation which results in congestion and affects the safety, satisfaction, and the quality of care. This research identified that patients attending emergency departments did so based on the perception of their own health status and beliefs that emergency departments were the most suitable location for their care. Blaming patients as "frequent flyers" or "inappropriate users" ignores the complex and multi-factorial nature of the genuine need for urgent medical care felt by patients.

Patient preferences for receiving remote communication support for lifestyle physical activity behaviour change: The perspective of patients with musculoskeletal disorders from three hospital services

This study examined patients’ preference ratings for receiving support via remote communication to increase their lifestyle physical activity. Methods People with musculoskeletal disorders ( n=221 of 296 eligible) accessing one of three clinics provided preference ratings for “how much” they wanted to receive physical activity support via five potential communication modalities. The five ratings were generated on a horizontal analogue rating scale (0 represented “not at all”; 10 represented “very much”). Results Most (n=155, 70%) desired referral to a physical activity promoting intervention. “Print and post” communications had the highest median preference rating (7/10), followed by email and telephone (both 5/10), text messaging (1/10), and private Internet-based social network messages (0/10). Desire to be referred was associated with higher preference for printed materials (coefficient = 2.739, p<0.001), telephone calls (coefficient = 3.000, p<0.001), and email (coefficient = 2.059, p=0.02). Older age was associated with lower preference for email (coefficient = −0.100, p<0.001), texting (coefficient = −0.096, p<0.001), and social network messages (coefficient = −0.065, p<0.001). Conclusion Patients desiring support to be physically active indicated preferences for interventions with communication via print, email, or telephone calls.