Cadmium levels in the lung, liver, kidney cortex, and urine samples from Australians without occupational exposure to metals

The authors undertook this study to assess levels of cadmium exposure in the general population. Samples of lung, liver, and kidney were obtained from 61 cadavers (43 males, 18 females; 2-89 yr of age, mean age = 38.5 yr) who died from accidental causes and who were subject to postmortem examinations at the John Tonge Centre for Forensic Sciences, Queensland Health Scientific Services, Brisbane, Australia, in 1997 and 1998. Samples of bladder urine were also obtained from 22 cadavers. Tissue and urine samples were analyzed for cadmium, zinc, and copper with inductively coupled plasm (ICP) mass spectrometry. The overall mean values for cadmium in the lung, liver, and kidney cortex samples were 0.13, 0.95, and 15.45 mug/gm wet tissue weight. The average renal cadmium level in subjects with high lung-cadmium levels (n = 13) was 6 mug/gm wet tissue weight higher than that of similarly aged subjects who had medium lung-cadmium levels (n = 30). In females, the average level of cadmium in the liver was 74% greater than in males, and the average liver cadmium in females with high lung-cadmium levels was 100% higher than in males in the same age range who had the same high lung-cadmium levels. Renal cadmium accumulation tended to be greater in females than in males who were in the same age range and who had similar lung-cadmium levels, a result that suggested that there was a higher absorption rate of cadmium in females. The mean value for a urinary cadmium excretion of 2.30 mug/gm creatinine was found in a subset of samples that had a mean age of 39 yr and a renal cortex cadmium concentration of 18.6 mug/gm wet tissue weight. Urinary cadmium excretion rates were correlated more strongly with lung and kidney cadmium content than with age or liver cadmium levels. The results suggest that urinary cadmium excretion may be increased in smokers and could provide some estimate of body cadmium burdens in future Australian epidemiological studies.

A survey of Australian mental health occupational therapists

Mental health reform in the western developed world has resulted in new models of care and changed work practices for all mental health professionals. Occupational therapists, as with other mental health professionals, have been required to assume new roles and responsibilities. Literature from the United Kingdom has reflected concern about this new way of working. The aim of this exploratory study was to examine the current work practices of and issues faced by Australian mental health occupational therapists. One hundred and forty-eight respondents (74%) answered an occupational therapy practice in mental health questionnaire. The results from this survey suggest that there are two quite distinct groups of occupational therapists working in mental health settings in Australia. One group works as rehabilitation therapists in traditional activity-focused work roles. The other group works as case manager therapists and employs a much broader spectrum of clinical and support roles. The issues facing therapists include the development and maintenance of a clearly defined role, generic case management versus discipline-specific roles, recruitment and retention, the need for research and evidence-based practice, professional standing, and education and professional development. The concerns over the role of occupational therapy in mental health were similar to those in previous British studies. The implications of these findings include a need for education and training at the undergraduate and postgraduate levels to equip mental health occupational therapists with both discipline-specific and generic skills.

The competence of mental health occupational therapists

This research sought to investigate the self-perceived competence of mental health occupational therapists in Queensland. The research is a post-hoc analysis of survey results that formed part of the 1995 Professional Development Strategy for Adult Mental Health Services for the Queensland Health Mental Health Unit. A sample of 55 occupational therapists was compared with other professionals in relation to both general self-efficacy and efficacy in specific competencies. The devised scale for measuring self-efficacy was found to have a high level of internal reliability. The results indicated that the general self-perceived competence of occupational therapists for the whole sample was comparable to that of other professional groups, but that in the community-based sample it was significantly higher than that of social workers or nurses. In addition, occupational therapists in community settings had significantly higher general self-perceived competence than occupational therapists in hospital locations. Greater length of experience in mental health was strongly predictive of higher levels of competence for occupational therapists than for other professionals. The results suggest that occupational therapists have adapted well to the demands of multidisciplinary community practice. The possible reasons for these results, and the implications for competency-based recruitment and training, are presented.

Mental health: How well are occupational therapists equipped for a changed practice environment?

No Abstract

Risk and protective factors for depressive symptomatology among a community sample of adolescents and young adults

Objectives: The study explores the risk and protective factors for current depressive symptomatology in a large community sample of 15-to-24-year-olds. Methods: The study was designed as a cross-sectional household survey, which used telephone recruitment followed by an anonymous self-report postal questionnaire. The final sample included 3,082 adolescents and young adults from Queensland, Australia. Results: The vast majority of measured risk and protective factors were associated with current depressive symptomatology. Key risk factors included high levels of neuroticism, perceived problems with parents, sexual abuse, relationship breakups, educational failure and sexual identity conflict. A different profile of protective factors was evident for each of these high-risk groups. Of particular note was the importance of well-developed intrapersonal skills as protective for both males and females. The significance of social connectedness as a protective factor for the males overall and across a range of high-risk groups was a central finding. Conclusions and implications: The implications of these findings in relation to a range of mental health promotion and mental illness prevention and early intervention initiatives are discussed. Supported initiatives include parenting programs that consider the realities of modern families, increasing community awareness of the impact on young people of the breakdown of their intimate relationships, initiatives in educational settings and workplaces to increase tolerance of gay/lesbian and bisexual lifestyles and the enhancement of social connectedness.

Perceptions of evidence-based practice: A survey of Australian occupational therapists

Evidence-based practice (EBP) requires clinicians to access, appraise and integrate research literature with clinical experience and clients' perspectives. Currently, little is known about occupational therapists' attitudes to EBP, their perception of implementation barriers or their educational needs. A questionnaire reflecting these issues was sent to a proportionate random sample of 1491 members of the national professional occupational therapy association, OT AUSTRALIA. The questionnaire was completed by 649 (44%) participants. Occupational therapists were positive about EBP with most (96%) agreeing that EBP is important to occupational therapy. Although 56% used research to make clinical decisions, more relied on clinical experience (96%), information from continuing education (82%) and colleagues (80%). Lack of time, evidence and skills were identified as the main barriers to the implementation of EBP. Over half (52%) expressed strong interest in EBP skills training, and most (80%) indicated an interest in the availability of brief summaries of evidence. Targeted educational initiatives, resources and systems are needed to support EBP in occupational therapy.

Occupational therapy assessment of self-awareness following traumatic brain injury

Impaired self-awareness is a common problem following traumatic brain injury. Without adequate self-awareness, a person's motivation to participate in rehabilitation may be limited, which in turn can have an adverse effect on his or her functional outcome. For this reason, it is important that brain injury rehabilitation professionals, including occupational therapists, both understand this phenomenon and use assessment and treatment approaches aimed at improving clients' self-awareness. This article provides an overview of self-awareness, reviewing the distinction between intellectual and online awareness. The current role of occupational therapy in the assessment of self-awareness is highlighted and the guidelines for new assessments of self-awareness suitable for use in occupational therapy are explored.