Actual and preferred work activites of mental health Occupational Therapists: Congruence or Discrepancy

The reform of Australian mental health services has resulted in new models of care and changed work practices for all mental health professionals. Occupational therapists today are as likely to be working in multidisciplinary teams performing a range of generic clinical roles as they are to be working in specialist rehabilitation units. These kinds of changes have taken place in other countries, with anecdotal and some empirical evidence that the changes have resulted in concerns about loss of professional identity and roles. This study sought to identify the current work activities carried out by occupational therapists and to determine whether there was a discrepancy between their actual and desired work activities. It was expected that, overall, they would indicate a preference to do more specialist rehabilitation focused work and less generic case management work. A survey of 196 occupational therapists investigated their actual and preferred work activities in 55 specific roles across four broad categories (senior administration, specialist clinical, general clinical and community development). As expected, the participants indicated that they would prefer to be undertaking more specialist rehabilitation oriented work activities than they were actually doing. Contrary to expectations, they also wished to undertake more rather than less generic clinical work activities, to be more engaged in community development work and to take on more senior and administrative roles. They indicated a preference for less rather than more activity on only 5 of the 55 work roles examined. On examining a subset of 113 participants who reported that 50% or more of their time was spent in case management, there was greater evidence of resistance to generic clinical roles. It was therefore concluded that occupational therapists in Australia are seeking to deploy their specialist skills to a greater degree than the current practice environment permits. They have broadly accepted the generic roles required in multidisciplinary community case management, but those who are actually working in these roles are most likely to have reservations about this kind of work.

Is discrepancy between actual and preferred work activities a factor in work-related stress for mental health occupational therapists and social workers

In the Western developed nations, the changing pattern of mental health care provision has necessitated mental health staff adopting new approaches to service delivery across a diverse and expanding range of service settings. The impact of changed service delivery on Australian mental health professionals is an area that has not been well studied. The aim of the study was to identify the current clinical work activities performed by occupational therapists and social workers and whether there was a discrepancy between the actual and preferred work activities. The study also aimed to identify whether any discrepancy between their actual and preferred clinical work activities was associated with higher levels of stress. A cross-sectional survey of 304 (response rate 76.6%) occupational therapists and social workers in Australian mental health services was conducted. A work activities scale developed specifically for this study and the Mental Health Professionals Stress Scale were used to measure actual and preferred work activities and stress respectively. Both groups experienced a discrepancy between their actual and preferred work activities, with the occupational therapists and the social workers mostly wanting to undertake a diverse range of activities to a significantly greater extent than they currently were. As predicted, stress was associated with the discrepancy between the kind of work that the participants wanted to do and the kind of work that their job actually entailed. Health workers require assistance to adapt to their new work roles and to achieve a balance between generic and discipline-specific competencies. This has implications for education and professional training.

Emergent temporal behaviour and collaborative work

Although collaboration manifestly takes place in time, the role of time in shaping the behaviour of collaborations, and collaborative systems, is not well understood. Time is more than clock-time or the subjective experience of time; its effects on systems include differential rates of change of system elements, temporally non-linear behaviour and phenomena such as entrainment and synchronization. As a system driver, it generates emergent effects shaping systems and their behaviour. In the paper we present a systems view of time, and consider the implications of such a view through the case of collaborative development of a new university timetabling system. Teasing out the key temporal phenomena using the notion of temporal trajectories helps us understand the emergent temporal behaviour and suggests a means for improving outcomes.

Evaluation of a pilot telemedicine network for accident and emergency work

A pilot accident and emergency. teleconsulting service was established in Scotland. It was based at the accident and emergency department of the main hospital in Aberdeen. There were three peripheral sites in rural Grampian (Peterhead, Turriff and Huntly) and one in the Shetland Isles. The videoconferencing equipment used was connected by ISDN at 384 kbit/s. During the 15 months of the study, 1998 videoconference calls were made, of which 402 (20%) calls were made to the accident and emergency department for clinical consultations. The majority of the clinical calls (95%) were made between 09:00 and 17:00, and more than 90% were completed within 20 min. During the majority of calls (87%) one or more X-ray images were transmitted. The majority of patients (89%) received treatment without transportation to the main centre in Aberdeen. The present study demonstrated that accident and emergency teleconsultations can be technically reliable, effective in reducing the number of patient transfers and acceptable to the referring clinicians. As a result, approximately pound1.5 million has been made available by the government to develop a national system for Scotland.

Determination of lifter design, speed and filling effects in AG mills by 3D DEM

The power required to operate large gyratory mills often exceeds 10 MW. Hence, optimisation of the power consumption will have a significant impact on the overall economic performance and environmental impact of the mineral processing plant. In most of the published models of tumbling mills (e.g. [Morrell, S., 1996. Power draw of wet tumbling mills and its relationship to charge dynamics, Part 2: An empirical approach to modelling of mill power draw. Trans. Inst. Mining Metall. (Section C: Mineral Processing Ext. Metall.) 105, C54-C62. Austin, L.G., 1990. A mill power equation for SAG mills. Miner. Metall. Process. 57-62]), the effect of lifter design and its interaction with mill speed and filling are not incorporated. Recent experience suggests that there is an opportunity for improving grinding efficiency by choosing the appropriate combination of these variables. However, it is difficult to experimentally determine the interactions of these variables in a full scale mill. Although some work has recently been published using DEM simulations, it was basically. limited to 2D. The discrete element code, Particle Flow Code 3D (PFC3D), has been used in this work to model the effects of lifter height (525 cm) and mill speed (50-90% of critical) on the power draw and frequency distribution of specific energy (J/kg) of normal impacts in a 5 m diameter autogenous (AG) mill. It was found that the distribution of the impact energy is affected by the number of lifters, lifter height, mill speed and mill filling. Interactions of lifter design, mill speed and mill filling are demonstrated through three dimensional distinct element methods (3D DEM) modelling. The intensity of the induced stresses (shear and normal) on lifters, and hence the lifter wear, is also simulated. (C) 2004 Elsevier Ltd. All rights reserved.

Influence of charge size distribution on net-power draw of tumbling mill based on DEM modelling

Modelling and optimization of the power draw of large SAG/AG mills is important due to the large power draw which modern mills require (5-10 MW). The cost of grinding is the single biggest cost within the entire process of mineral extraction. Traditionally, modelling of the mill power draw has been done using empirical models. Although these models are reliable, they cannot model mills and operating conditions which are not within the model database boundaries. Also, due to its static nature, the impact of the changing conditions within the mill on the power draw cannot be determined using such models. Despite advances in computing power, discrete element method (DEM) modelling of large mills with many thousands of particles could be a time consuming task. The speed of computation is determined principally by two parameters: number of particles involved and material properties. The computational time step is determined by the size of the smallest particle present in the model and material properties (stiffness). In the case of small particles, the computational time step will be short, whilst in the case of large particles; the computation time step will be larger. Hence, from the point of view of time required for modelling (which usually corresponds to time required for 3-4 mill revolutions), it will be advantageous that the smallest particles in the model are not unnecessarily too small. The objective of this work is to compare the net power draw of the mill whose charge is characterised by different size distributions, while preserving the constant mass of the charge and mill speed. (C) 2004 Elsevier Ltd. All rights reserved.

Analysis of stirred mill performance using DEM simulation: Part 2 - Coherent flow structures, liner stress and wear, mixing and transport

Stirred Mills are becoming increasingly used for fine and ultra-fine grinding. This technology is still poorly understood when used in the mineral processing context. This makes process optimisation of such devices problematic. 3D DEM simulations of the flow of grinding media in pilot scale tower mills and pin mills are carried out in order to investigate the relative performance of these stirred mills. In the first part of this paper, media flow patterns and energy absorption rates and distributions were analysed to provide a good understanding of the media flow and the collisional environment in these mills. In this second part we analyse steady state coherent flow structures, liner stress and wear by impact and abrasion. We also examine mixing and transport efficiency. Together these provide a comprehensive understanding of all the key processes operating in these mills and a clear understanding of the relative performance issues. (C) 2006 Elsevier Ltd. All rights reserved.

Analysis of stirred mill performance using DEM simulation: Part 1 - Media motion, energy consumption and collisional environment

Stirred mills are becoming increasingly used for fine and ultra-fine grinding. This technology is still poorly understood when used in the mineral processing context. This makes process optimisation of such devices problematic. 3D DEM simulations of the flow of grinding media in pilot scale tower mills and pin mills are carried out in order to investigate the relative performance of these stirred mills. Media flow patterns and energy absorption rates and distributions are analysed here. In the second part of this paper, coherent flow structures, equipment wear and mixing and transport efficiency are analysed. (C) 2006 Published by Elsevier Ltd.