Roman concept of mental capacity to make end-of-life decisions

When assessing decisional competence of patients, psychiatrists have to balance the patients' right to personal autonomy, their condition and wishes against principles of medical ethics and professional discretion. This article explores the age-old legal and ethical dilemmas posed by refusal of vital medical treatment by patients and their mental capacity to make end-of-life decisions against the background of philosophical, legal and medical approaches to these issues in the time of the Younger Pliny (c62–c113 CE). Classical Roman discourse regarding mental competency and "voluntary death" formed an important theme of the vast corpus of Greco-Roman writings, which was moulded not only by legal permissibility of suicide but also by philosophical (in modern terms, moral or ethical) considerations. Indeed, the legal and ethical issues of evaluating the acceptability of end of life decisions discussed in the Letters are as pertinent today as they were 2000 years ago. We may gain valuable insights about our own methodologies and frames of reference in this area of the law and psychiatry by examining Classical Roman approaches to evaluating acceptability of death-choices as described in Pliny's Letters and the writings of some of his peers.

Study in Roman-Maccabaean relations

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Experiences of engagement in occupations and assertive outreach services

Aim: The purpose of this study was to describe the experience and meaning of engagement for staff and clients of assertive outreach teams.
Method: Interpretative phenomenological analysis was selected for its flexibility and transparency. Data were collected by semi-structured interviews from a sample of five client and five staff participants (n = 10). The interviews were analysed idiographically, inductively and interrogatively.
Findings: Four themes identified by both staff and client participants emerged: engagement as an interpersonal relationship, engagement in and through time, enabling and disabling factors and engagement in occupation. In addition, clients developed a theme around engagement as a means to self-actualisation. Staff also raised a specific theme around the role of engagement in mental health services.
Conclusion: Staff and clients experienced engagement in broadly similar ways, but with differing emphases. Although all participants described it as both an invisible 'means' and a visible 'end', the staff related engagement only to mental health services whereas the clients experienced it in the context of both mental health services and occupations.
Relevance: This study is relevant to all occupational therapists who work with people experiencing mental health problems.

Better access to mental health : mapping the evidence supporting participation in meaningful occupations

Introduction: The purpose of this scoping and mapping project is to assess evidence for the use of focused psychological strategies (FPS) under the Better Access to Mental Health (BAMH) scheme to enable people with mental health problems to increase their functional performance and to participate in meaningful occupations. In particular, it aims to provide an accessible summary of evidence for practitioners who use FPS with their clients.

Methods: Evidence scoping and mapping is a relatively new technique, used to provide an overview of key findings in an area of practice. A five stage process of scoping and mapping was used in this project.

Results: A total of 81 studies which addressed the use of focused psychological strategies to promote functional performance and participation in meaningful occupations were found. Surprisingly, only three were published in occupational therapy journals with one further article being authored by occupational therapists. Three maps are provided showing this evidence by diagnosis, intervention and level of evidence.

Conclusion: Clinicians can say with some confidence that cognitive behavioural therapies are effective functional tools, particularly when working with people with depression or schizophrenia. They can also be confident that good quality evidence exists across a range of diagnoses, although there are many gaps where little to no research has been conducted. Suggestions for further research are provided which take into account the findings of these maps.

Indigenous place-making in the city : dispossessions, occupations and implications for cultural architecture

This paper considers Indigenous place-making practices in light of an idea for a major Victorian Indigenous Cultural Knowledge and Education Centre in central Melbourne as championed by Traditional Owners in Victoria. With only eight Aboriginal architects in the country, collaboration with non-Indigenous architects will be inevitable. Two case studies from the recent past—the Tent Embassy in Canberra and a street corner in Collingwood—reveal that dominant cultures of place-making continue to marginalise Aboriginal people in urban Australia. This paper will contend that delivering spatial justice will require both an opportunity for Indigenous Victorians to build visibility in the centre of the city and a willingness within the dominant culture to be deterritorialised.

Physical inactivity and other health risks among Australian males in less-skilled occupations

Male workers in less-skilled occupations have higher rates of cardiovascular disease, compared with higher-skilled workers. A representative population sample of Australian male workers was used to compare physical activity levels and selected cardiovascular disease risk factors in less-skilled versus professional and skilled workers. Workers in the less-skilled occupational categories reported significantly more vigorous work and home-based activity than did those in the professional and skilled categories. In multivariate comparisons, cigarette smoking was the only factor that discriminated between the less-skilled versus the professional and skilled employees. Although worksites can potentially provide health-promoting physical activity options for higher-risk groups, our findings suggest that smoking and possibly overweight are risk factors that are more strongly present in less-skilled occupations.

Subjective job task analyses for physically demanding occupations : what is best practice?

Workers in physically demanding occupations (PDOs) are frequently subjected to physical selection tests. To avoid legal ramifications, workplaces must be able to show that any personnel selection procedures reflect the inherent requirements of the job. A job task analysis (JTA) is fundamental in determining the work tasks required for employees. To date, there are no published instructions guiding PDO researchers on how to conduct job task analyses. Job task analysis research for non-PDOs offers some insight into the expected reliability and validity of data obtained on the most prevalent task domains in job analysis (importance, frequency, time spent and difficulty). This review critiques such research, and the existing published material on JTA of PDOs, and provides recommendations for future research and practice.

Automatic attribution of ancient Roman imperial coins

Classification of coins is an important but laborious aspect of numismatics - the field that studies coins and currency. It is particularly challenging in the case of ancient coins. Due to the way they were manufactured, as well as wear from use and exposure to chemicals in the soil, the same ancient coin type can exhibit great variability in appearance. We demonstrate that geometry-free models of appearance do not perform better than chance on this task and that only a small improvement is gained by previously proposed models of combined appearance and geometry. Thus, our first major contribution is a new type of feature which is efficient in terms of computational time and storage requirements, and which effectively captures geometric configurations between descriptors corresponding to local features. Our second contribution is a description of a fully automatic system based on the proposed features, which robustly localizes, segments out and classifies coins from cluttered images. We also describe a large database of ancient coins that we collected and which will be made publicly available. Finally, we report the results of empirical comparison of different coin matching techniques. The features proposed in this paper are found to greatly outperform existing methods.