Dialectical behavior therapy in community mental health settings : an evaluation

Borderline personality disorder causes extreme and enduring suffering. Dialectical Behavior Therapy is a psychological intervention that has been developed to treat the disorder. Two studies were conducted to test the effectiveness of the treatment. Results showed that borderline personality disorder can be treated effectively in the public mental health system. The portfolio presents four case studies to examine the notion that Cognitive Behavior Therapy (CBT) is efficacious in the treatment of anxiety as a comorbid condition.

Utilizing and adapting leisure constraints models to enhance 'short-break' vacations : case study of Melbourne, Australia

Short-break tourism is likely to continue as a popular vacation for time-, income- and special interest conscious tourists. With the competition for visitors, destinations need to consider the constraints and facilitators associated with tourist decision-making for short-break vacations. This study presents the application of a leisure model toward better explaining such vacation choices. This study found key constraints, such as time and awareness, inhibited visitors from visiting attractions. The importance and influence of word-of-mouth recommendations plays a key role in gaining the attention of future visitors.

Emergency department presentations of patients from CALDB receiving chemotherapy in day oncology settings

Objective
The objectives of this research were to compare the emergency department (ED) presentations for cancer patients from culturally and linguistically diverse backgrounds (CALDB) treated with chemotherapy through day oncology units with other cancer patients.

Design
A retrospective audit was conducted. Data collected included demographic factors and ED presentation characteristics. Descriptive statistics and direct logistic regression was used to summarise and compare the ED presentation rates and ED presentation characteristics of patients from CALDB and other patients.

Setting
Primary and secondary care.

Patients
All adult day oncology patients who were treated with chemotherapy and presented to an ED between 1 January and 31 December, 2007. Across the two health sites, 770 day oncology patients attended an ED on at least one occasion. Of these 37.7% were born in a non-English speaking country.

Results
Patients from CALDB were more likely to present (p < 0.001, OR = 1.55, C.I. = 1.29–1.88) and re-present to an ED (p < 0.001, OR = 2.08, C.I. = 1.37–3.16), however there was no association between CALDB and admission to hospital following the ED presentation, triage category or being seen within the clinically recommended time. Patients from CALDB tended to present for potentially preventable conditions such as nausea/vomiting/dehydration and fever.

Conclusions
Our findings suggest that targeted interventions that incorporate education and information to assist with self-care for patients from CALDB may reduce potentially preventable presentations and representations to an ED and the subsequent economic, social and personal costs associated with these ED presentations.

Rediscovering nature in everyday settings : or how to create healthy environments and healthy people

It is estimated that half of the world’s population now live in urban environments. Urban living necessitates a removal from nature, yet evidence indicates that contact with nature is beneficial for human health. In fact, everyday urban places, such as where people live, study, and work, provide opportunities to bring nature back into cities to contribute to positive, healthy environments for people and to foster the human–nature connection. The inclusion of more nature in cities could have additional environmental benefits, such as habitat provision and improving the environmental performance of built environments. In the context of climate change, outcomes such as these assume further importance. This article explores how common urban places can foster links between people and nature, and generate positive health and well-being outcomes. We achieve this by exploring nature in the everyday settings of schools and residential housing.

Scope of practice of occupational therapists working in Victorian community health settings

Background/aim: Current health policy places emphasis on community-based health care and it is expected that there will be an increase in the number of people receiving care in community settings. This study aimed to examine the profile and scope of practice of occupational therapists working in Victorian community health settings and the amount and type of health promotion activity incorporated into their role.
Method:  An anonymous postal questionnaire was sent to 205 community-based Victorian occupational therapists. One hundred and one (49.3% response rate) questionnaires were returned, with 72 respondents (35.1%) meeting study inclusion criteria. A descriptive research design was used to address study aims.
Results:  Results indicate that the majority of community health occupational therapists are experienced practitioners, have a varied scope of practice and report a high level of job satisfaction. Compared with previous studies, there is an increase in new graduate occupational therapists starting their career in community health settings, a greater number of part-time workers and a diversification of clinical and non-clinical roles. Barriers to practice that exist include high demand for service, limited funding and time spent on administrative tasks. Although health promotion was regarded as an important role of community health workers, a large number of therapists were not involved in this activity because of limited knowledge and clinical work taking priority.
Conclusion: Study findings have implications for occupational therapy training, and there is a clear need for input at policy level to address the significant resource allocation issues raised.

The mobile skilled workforce : optimising benefits for rural communities

Many small rural communities with ageing populations and limited opportunities for young people are not attracting skilled workers, but have a flow of skilled people through the community as locums, seasonal workers or contractors. This project investigated the question: how can rural communities capture maximum benefit from professional and other highly skilled workers in the context of an increasingly mobile and transitory workforce? It found that rural communities derive a wide range of benefits from mobile skilled workers. Effectiveness of the integration process determines the nature and extent of mobile skilled worker contribution to the community. Community settings that encourage and support mobile skilled worker integration are identified in terms of culture, leadership and interactional infrastructure. These same settings also influence mobile skilled worker retention in rural communities. Rural communities need to be proactive in matching worker and community characteristics, and this begins with the recruitment process. Mobile skilled workers need assistance and support to develop a primary social contract, and the process needs to be monitored. This is a community-wide responsibility and requires a coordinated, whole-of-community approach. This is the first Australian study to explore how rural communities can capture the advantages from highly skilled mobile workers. Rural communities that make the most of the available pool of skills can increase resilience, identification and uptake of opportunities such as new enterprises, good practice in natural resource management, enhanced social and leisure opportunities, and the quality and range of local services. The importance of this report is that it provides a broad range of strategies for rural communities wanting to know how to optimise the benefits they derive from mobile skilled workers, regardless of their location or rural industry base.

Describing and understanding physical activity in desk-based work settings

This thesis investigated the physical activity behaviours of employees who commonly sit for work tasks. Specifically, this PhD explored the key influences on light-intensity physical activity during work hours and issues associated with subjectively assessing this behaviour. Overall, this PhD provided insights into a novel approach to address the important public health issue of physical inactivity.

Nutrition promotion : theories and methods, systems and settings

An introduction to approaches and techniques used to influence food behaviours and improve nutrition and health.