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.

People, places and public health : evaluating the benefits of civic environmentalism in an urban local government context

Recent political, economic and social trends pose threats to the sustainability both of ecosystems and of human health. Australia’s environmental management record is poor, and while by international standards Australians enjoy good health, this is variable (AIHW, 2000). Within developed nations, heart disease, depression, alcohol dependence and stroke are major health issues (Mathers et al. 2002). In Australia, mental disorder is the number one contributor to the disease burden (Vos & Mathers 2000). Recent research has highlighted the role of social capital as a key determinant of health (Kawachi et al., 1997). Despite this, Putnam (1995) observes that social connectedness and civic engagement are in decline. People have less time for leisure and for volunteering, as many juggle paid work and caring for children. Anecdotal evidence suggests that engagement in civic environmentalism has human health benefits, relating to a combination of exposure to natural environments and increased social capital (Maller, Brown, Townsend & St. Leger, 2002). This link is supported by Furnass (1996) who defines well-being as including: satisfactory human relationships, meaningful occupation, opportunities for contact with nature, creative expression, and making a positive contribution to human society. Research conducted by Deakin University confirms the efficacy of linking people and places through civic environmentalism for addressing both ecosystem sustainability and human health and wellbeing. The research has included a pilot study to explore the human health benefits of membership of a local parkland ‘Friends’ group, and a more detailed follow-up study. The aims of the pilot study included:- To identify the range of motivations for joining the Friends group;- To document members’ perceptions of the benefits gained from membership of the group;- To assess the potential for Friends groups to be used as an ‘upstream’ health promotion measure.Face-to-face interviews were conducted with eleven members of a ‘Friends’ group in the eastern suburbs of Melbourne. Data was analysed thematically and key findings included:- Motivations: environmental; social; and pragmatic.- General benefits: community belonging; personal satisfaction; learning opportunities; physical activity; and better environment.- Health benefits: physical health; mental health; and social support. There was unanimous support for the use of ‘Friends’ groups as a tool for health promotion.The follow-up study, in the western suburbs of Melbourne, expanded on the pilot study by measuring the group’s social capital and by collecting self-report data on levels of health service usage. Data was collected through face-to-face interviews and a questionnaire. The findings were similar to the pilot study in relation to the motivations, benefits and the health promotion potential of such groups. However, health service usage data highlighted an apparent anomaly: while respondents perceived significant health benefits, some were nevertheless utilising health services at a relatively high level. This poses some questions requiring further exploration: Is this due to the poorer baseline health of the high health service usage members compared with their fellow members? Does involvement in the group offer health benefits that enable people who would otherwise be too unhealthy to participate in community groups to continue such involvement?If this is the case, then we may do well to look to locally-based mechanisms for promoting ecological sustainability as a tool also for promoting human health. Instead of prescribing a pill, connecting people and places through engagement with a local friends group may address our health problems at the same time as addressing local environmental problems.

Which work characteristics predict employee outcomes for the public-sector employee? An examination of generic and occupation-specific characteristics

The wide-ranging changes that have occurred in the public sector over recent years have placed increasing demands on public-sector employees. A survey of employees within a relatively commercially-oriented public-sector organization in Australia was used to test a demand-oriented generic model of employee well-being and a variety of situation-specific variables. The presence of support at work and the amount of control an employee had over their job were found to be key predictors of employee-level outcomes. Perceptions of pay and the perception of a lack of human resources (HR) were also found to predict employee outcome variables. The results emphasize the impact that middle managers and HR managers can have in terms of reducing the detrimental employee effects that can be caused by the introduction of new public management (NPM) and the potential for a positive impact on employees. In particular, public-sector managers can use the design of jobs and the development of social support mechanisms, such as employee assistance programmes, to maintain, if not improve, the quality of working life experienced by their employees. More broadly, this study has found that the job strain model is a useful tool in a public-sector environment and is likely to be of increasing utility with the continuing introduction or consolidation of NPM over time. Managing these issues in the new public sector could be a key means of protecting the key resource of the Australian public sector - the employees.

Meaningful UDDI web services description

There is a lack of meaningful description of Web Services in UDDI, however, it is necessary for automatic services discovery. In this paper, a language is proposed for semantics description of Web Services which complements the UDDI standards to derive relationships among Web Services. The semantics description can be used to automatically derive relationships among Web Services. We describe how the semantics description of Web Services, based on the proposed language, can be integrated with UDDI.

Reducing latent deprivation during unemployment: the role of meaningful leisure activity

The aim of this study was to investigate the role of meaningful leisure activity in reducing latent deprivation during unemployment. Samples of unemployed (N=201) and employed (N=128) participants were asked to rate their levels of latent deprivation using the Access to Categories of Experience Scale. They were also asked to complete the Profile of Mood States depression subscale, Adult Self-Perception Profile, Meaningful Leisure Activities Questionnaire, and to rate the frequency with which they engaged in social and solitary leisure activities. Results indicate that unemployed participants engaged in social leisure activities less frequently than employed participants and solitary leisure activities more frequently; and they reported higher perceived latent deprivation, higher depressive affect and lower self-esteem. Overall, these findings suggest that participation in leisure activities that are meaningful, rather than simply frequent, may be a constructive and readily achievable coping response during unemployment.

Piazza Vittorio : la transformazione urbanistica : quale identità per i nuovi cittadini? Identity and meaningful place making

Il caso della riqualificazione di Piazza Vittorio, ormai divenuta luogo storico dell'immigrazione a Roma, è un esempio delle sfide che si pongono oggi alle metropoli multietniche ed un'ottima occasione per riflettere sul significato che questo tipo di interventi assume per l'identità culturale della città e dei suoi abitanti, vecchi e nuovi. Lo studio proposto in questo volume chiama in causa la nozione di cultural built heritage, cioè il retaggio culturale di cui è testimone l'architettura, per mostrare quanto e come l'ambiente costruito dagli interventi architettonici ed urbanistici contribuisca a rappresentare, dunque a raccontare ed organizzare, sia lo spazio, sia gli scambi che in esso hanno luogo, sia le identità di coloro che lo abitano. È il primo volume della collana "Squarci. Mobilità dell'uomo, del suo pensiero e delle sue opere", presentata dal curatore Claudio Rossi in un'ampia introduzione. All'interno di "Squarci" si vuole proporre un percorso di studi e ricerche corredati da un dvd. L'occhio della telecamera - attraverso interviste o la realizzazione di docu-film - arricchisce la ricerca con nuove dimensioni d'analisi, che aggiungono elementi di comprensione e talvolta spingono a riconsiderare i risultati stessi delle indagini svolte. È quanto accade per "Mostafa, il mercato trasferito ed altre storie. La trasformazione di Piazza Vittorio a Roma", scritto e diretto da Emanuele Svezia

Canadian therpists' experiences while implementing the model of human occupation remotivation process

This paper presents the results of a qualitative study conducted in Quebec, Canada, with occupational therapists working in mental health. Data were gathered through self-reported narratives of four occupational therapists over the 2 years it took to implement the Remotivation Process (de las Heras, Llerena, & Kielhofner, 2003) and develop a research protocol. Through the descriptive analysis of their narratives, the positive changes this intervention approach had on clients and on occupational therapy practice are highlighted. The experience of the therapists in developing a research protocol is addressed. Finally, the research protocol evaluating the effect of the Remotivation Process on the recovery process of people with depression is presented.

Population norms and meaningful differences for the Assessment of Quality of Life (AQoL) measure

Objective: The Assessment of Quality of Life (AQoL) instrument is widely used in Australian health research. To assist researchers interpret and report their work, this paper reports population and health status norms, general minimal important differences (MIDs) and effect sizes.

Method: Data from the 1998 South Australian Health Omnibus Survey (n=3,010 population-based respondents) were analysed by gender, age group and health status. Data from four other longitudinal studies were analysed to obtain estimated MIDs.

Results: The mean (SD) AQoL utility score was 0.83 (0.20). Gender and age subgroup differences were apparent; the mean scores for women were consistent until their 50s, when scores declined. Greater variability was observed for males whose scores declined more slowly but consistently between 40–80 years. For both genders, those aged 80+ years had the lowest scores When assessed by health status, those reporting excellent health obtained the highest utility scores; progressive declines were observed with decreasing health status. Effect sizes of 0.13 or greater may reflect important differences between groups A difference in AQoL scores of 0.06 utility points over time suggests a general MID.

Conclusions: AQoL population norms, MIDs and effect sizes can be used as reference points for the interpretation of AQoL data. These findings add to the growing evidence that the AQoL is a robust and sensitive measure that has wide applicability.

Implications: The availability of population norms will assist researchers using the AQoL to more easily interpret and report their work.

Fostering meaningful learning by using word problems in post-secondary mathematics

This research is a case study of action research investigating the effects of using word problems with Chinese Malaysian post-secondary students studying mathematics as an enabling science. A variety of word problems, a discussion method, reflective and peer learning, specific values in mathematics, and relevant socio-cultural and language issues were explored.

Correlation between acidic potassium permanganate chemiluminescence and in vitro cell culture assay : physiologically meaningful antioxidant activity

There is great interest in the activity of antioxidant molecules, including polyphenols, from food and plant sources. Acidic potassium permanganate chemiluminescence signal intensity was shown to predict the ability of polyphenols to positively act on cellular redox state and attenuate oxidative stress in cultured skeletal muscle cells.