The employment of people with mental illness

People with a mental illness are among the most socially and economically marginalised members of the community. They experience high levels of unemployment and nonparticipation in the labour force. Unemployment has a number of negative effects including the loss of purpose, structure, roles and status and a sense of identity which employment brings. Employment enables social inclusion in the wider community and is an important way that people with a mental illness can meaningfully participate in the wider community. Australia has a mental health strategy, which guides the ongoing reform of mental health services. However, specific strategies to address the social and economic marginalisation of people with a mental illness have not been addressed. A recovery-oriented approach is recommended, which integrates the key sectors involved. To date there has been little intersectoral collaboration between the various sectors such as mental health services, housing, and vocational services. People require more role-specific assistance to enable them to participate in socially valued roles implicit with citizenship. There is a need to formulate improved pathways to assistance and more evidence-based forms of assistance to re-establish career pathways. This report aims to: 1) collect relevant overseas and Australian evidence about the employment of people with mental illness; 2) identify the potential benefits of employment; 3) describe patterns of labour force participation in Australia among people with mental illness; 4) identify how mental illness can cause barriers to employment; 5) outline the type of employment restrictions reported by people with mental illness; 6) identify the evidence-based ingredients of employment assistance; 7) identify relevant policy implications; and 8) suggest strategies to improve employment outcomes and career prospects for people with mental illness.

Behavioral determinants of healthy aging

With global trends in population aging, many nations are developing and implementing healthy aging policies to promote quality as well as years of healthy life. To broaden the evidence base for such policy development, a review of the literature was conducted to summarize the existing evidence regarding the behavioral determinants of health), aging. Such research is needed so that the efficacy of modes of intervention can be better understood. The Outcome of: healthy or successful aging was selected for this review since this nomenclature dominates the literature describing a global measure of multidimensional functioning at the positive end of the health continuum in older age. Studies published between 1985 and 2003 that reported statistical associations between baseline determinants and healthy aging Outcome were identified from a systematic search of medical, psychological, sociological, and gerontological databases. Eight studies satisfied the search criteria. Modifiable risk factors among the behavioral determinants included smoking status, physical activity level, body mass index, diet, alcohol use, and health practices. On the basis of these findings, effective healthy aging policies need to enhance opportunities across the life span for modification of lifestyle risk factors. Efforts to standardize concepts and terminology will facilitate further research activity in this important area. (Am J Prev Med 2005;28(3):298-304) (c) 2005 American Journal of Preventive Medicine.

Campfire culture and computer culture: Museums of the present

In Australia indigenous peoples have never had a treaty with the dominant cultures; and their on-going marginalisation is some testimony to this. However, they have not languished entirely in a policy free environment: media is one area where some policy advances have been made; but media policy development has experienced a number of problems. It has tended to be monolithic in a situation demanding multi and complex treatments. And funding, as always, never seems sufficient to meet those multi and complex needs. This paper examines a small remote community on the island of Milingimbi off the northern coast of Arnhem Land in Australia's far north. People in East Arnhem Land refer to themselves collectively as Yolngu. This community is not typical of many documented cases of media relations between indigenous and non-indigenous peoples; however, the fact that it tends to overturn much of the conventional scholarship surrounding indigenous peoples and the media, helps shed new light on the inadequacy of not only monolithic media policy, but the inadequacy of media-only approaches to policy. Arguably, the significance of the media in Milingimbi is part of a 'triangulated' relationship between indigenous and dominant cultures. That triangulation also involves appropriate forms of government and education, which coupled with appropriate media appear to offer new ways of seeing self-government alongside relative cultural and economic autonomy.

Regional representations in the EU:between diplomacy and interest mediation

What are regional representations in the European Union? What do they hope to achieve? Since the mid-1980s, sub-state actors in the EU such as county councils, Länder, Autonomous Communities, local, municipal and city authorities have been opening representative offices in Brussels – mini 'embassies' for their territories. Although on the surface these representations might look the same, in practice they operate according to very different dynamics. Whilst some rival national governments for a stake in EU policy development, others have more modest ambitions. This book offers a comprehensive assessment of the burgeoning phenomenon of regional representation in the EU. Considering evidence from old member states as well as those which joined the EU more recently, it looks at where strategies and aims differ, positioning various 'types' of representation closer to the work of embassies or to that carried out by lobbying groups. The author also considers how regional representations contribute to our understanding of multi-level governance in the EU.

A review of barriers to kerbside recycling household waste in the UK

The aim of this work is to use systematic review methodology to answer the question “What are the current barriers to kerbside recycling of household waste in the UK?” A systematic search of electronic databases and journals was undertaken to identify academic published work. A critical scoping review of research published between 2000 – 2008 profiles theory and research design. The systematic review identified twelve relevant papers, of which seven contain original data. To define the current barriers the explanations of barriers were systematically aggregated into four main categories: household / individual behaviour; services / local situation; attitudes / motivation; information and knowledge. The purpose of the work is to inform future marketing campaigns which will assist the UK to reach the statutory targets of waste diversion. The synthesis will be useful to environmental professionals working in waste authorities and researchers and students. The framework offers an opportunity to develop better marketing and communications strategies to help more people recycle more things more often and will inform future recycling policy development.

Aspects of health among an employed population

This survey collected information on aspects of health amongst an employed population, employees in 14 different organisations in the West Midlands Regional Health Authority; and was a stratified sample of senior managers, middle managers and operatives. Nine hundred and sixty questionnaires were distributed asking for both quantitative and qualitative information on 58 questions covering health, work, family, leisure activities and life-style. A response rate of 48% (459 returned questionnaires) came from 290 men (63%), 165 women (36%) and four people (1%) who did not answer the gender question. The initial findings from this study are unique in that there has not been a specific review of the health of people at work. In answer to the main research questions, 92% felt they were healthy. Compared to others of a similar age, 34% felt their health was `above average', 58% `average', and 7&37 `below average'. Thirty two percent of respondents had visited their GP in the past 1-2 months; the highest reason given was disorders of the respiratory system, 20%. People's perceptions on the effects of work on their health were: good effect, 13% fair effect, 20% no effect, 27% poor effect, 27% and bad effect, 7%. The effects of leisure activities on health were thought to be more positive: good effect, 46% fair effect, 20% no effect, 21% poor effect, 3% and bad effect, 2%. The perceptions of effects of life-style on health were considered to be: good effect, 32% fair effect, 32% no effect, 20% poor effect, 9% and bad effect, 1%.  In this survey, leisure and life-style were seen by employees to have more beneficial effects on health than work. Future implications include a review of occupational health as a major policy development area within primary care. There is a need to influence the education and training of health care practitioners in order to affect their ability to practise effectively in this new and challenging area of work.

The European Union and global governance:a handbook

The role of the European Union in global politics has been of growing interest over the past decade. The EU is a key player in global institutions such as the World Trade Organization (WTO) and NATO. It continues to construct an emerging identity and project its values and interests throughout contemporary international relations. The capacity of the EU to both formulate and realise its goals, however, remains contested. Some scholars claim the EU’s `soft power’ attitude rivals that of the USA’s `hard power’ approach to international relations. Others view the EU as insufficiently able to produce a co-ordinated position to project upon global politics. Regardless of the position taken within this debate, the EU’s relationship with its external partners has an increasingly important impact upon economic, political and security concerns on an international level. Trade negotiations, military interventions, democracy promotion, international development and responses to the global economic crisis have all witnessed the EU playing a central role. This has seen the EU become both a major force in contemporary institutions of global governance and a template for supranational governance that might influence other attempts to construct regional and global institutions. This volume brings together a collection of leading EU scholars to provide a state-of-the-art overview covering these and other debates relating to the EU’s role in contemporary global governance. The Handbook is divided into four main sections: Part I: European studies and global governance – provides an overview and critical assessment of the leading theoretical approaches through which the EU’s role in global governance has been addressed within the literature. Part II: Institutions – examines the role played by the key EU institutions in pursuing a role for the EU in contemporary international relations. Part III: Policy and issue areas – explores developments within particular policy sectors, assessing the different impact that the EU has had in different issue areas, including foreign and security policy, environmental policy, common commercial policy, the Common Agricultural Policy, development policy, accession policy, the Neighbourhood Policy and conflict transformation. Part IV: The global multilevel governance complex and the EU – focuses on the relationship between the EU and the institutions, regions and countries with which it forms a global multilevel governance complex, including chapters on the EU’s relationship with the WTO, United Nations, East Asia, Africa and the USA.

Being there:a qualitative interview study with fathers present during the resuscitation of their baby at delivery

Objective: To explore fathers' experiences of the resuscitation of their baby at delivery. Design: A descriptive, retrospective design using tape-recorded semistructured interviews with fathers present during the resuscitation of their baby at delivery. Fathers described what happened, their interactions with healthcare professionals, their feelings at the time and afterwards. Setting: Participants were recruited from a large teaching hospital in the UK. Participants: A purposive sample of 20 fathers whose baby required resuscitation at delivery. Results: Participant responses were analysed using thematic analysis. Four broad themes were identified: 'preparation', 'knowing what happened', 'his response' and 'impact on him'. Fathers had no difficulty recalling their emotions during the resuscitation. These feelings remained vivid and were mostly negative. Most fathers wanted to go to their baby during the resuscitation but did not do so. They felt they should stay with their partner, did not want to impede the resuscitation or felt they were not 'allowed' to go to their baby. The fathers' position in the room and the extent to which they were focusing on their partner had an impact on their recollection of what happened. Fathers had no opportunity to discuss the resuscitation with healthcare professionals afterwards. Several fathers felt they had not yet recovered from the experience and a few had symptoms synonymous with post-traumatic stress disorder. Conclusion: This is the first study to specifically explore fathers' experiences of newborn resuscitation. The findings should inform healthcare education, policy development and the provision of support to fathers.

A simulation analysis of spoke-terminals operating in LTL Hub-and-Spoke freight distribution systems

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT The research presented in this thesis is concerned with Discrete-Event Simulation (DES) modelling as a method to facilitate logistical policy development within the UK Less-than-Truckload (LTL) freight distribution sector which has been typified by “Pallet Networks” operating on a hub-and-spoke philosophy. Current literature relating to LTL hub-and-spoke and cross-dock freight distribution systems traditionally examines a variety of network and hub design configurations. Each is consistent with classical notions of creating process efficiency, improving productivity, reducing costs and generally creating economies of scale through notions of bulk optimisation. Whilst there is a growing abundance of papers discussing both the network design and hub operational components mentioned above, there is a shortcoming in the overall analysis when it comes to discussing the “spoke-terminal” of hub-and-spoke freight distribution systems and their capabilities for handling the diverse and discrete customer profiles of freight that multi-user LTL hub-and-spoke networks typically handle over the “last-mile” of the delivery, in particular, a mix of retail and non-retail customers. A simulation study is undertaken to investigate the impact on operational performance when the current combined spoke-terminal delivery tours are separated by ‘profile-type’ (i.e. retail or nonretail). The results indicate that a potential improvement in delivery performance can be made by separating retail and non-retail delivery runs at the spoke-terminal and that dedicated retail and non-retail delivery tours could be adopted in order to improve customer delivery requirements and adapt hub-deployed policies. The study also leverages key operator experiences to highlight the main practical implementation challenges when integrating the observed simulation results into the real-world. The study concludes that DES be harnessed as an enabling device to develop a ‘guide policy’. This policy needs to be flexible and should be applied in stages, taking into account the growing retail-exposure.

Professionalism within pharmacy – the thoughts of Professional Leaders

To ascertain the thoughts of selected professional leaders on matters relating to pharmacist professionalism. These views will help build a picture of the professional status of pharmacy. Methods - Semi-structured interviews were conducted between July and November 2013 with representatives from eight UK pharmacy leadership bodies. The bodies were selected for their roles in pharmacy policy development, regulation and professional representation. The interviews were recorded and transcribed verbatim. Analysis by constant comparison identified a number of emerging themes. Results - The following emerging themes were identified from the interview data: Influence of the Pharmacy Landscape: Participants highlighted the role that pharmacy plays within the National Health Service and wider society and how future developments may affect the professional status currently afforded to pharmacists. Vocalising Pharmacy: Communication within the profession and also with those external to the profession, including other healthcare professionals and the general public, is important to ensure a high professional standing. The Impact of Commercialism: Professionalism and commercialism were generally seen to be antithetical and a rise in commercialism may adversely impact on external perceptions of the professionalism of pharmacy. Responsibility for Professionalism: The professional image of pharmacy is maintained by the individuals operating within it regardless of their scope of practice. It is the responsibility of all those individuals to ensure that they actively demonstrate ‘professional’ behaviours. The Journey to Professionalism: Acquiring a professional ethos is a continual process but there are stages in a pharmacist’s development that are considered particularly important. These include upbringing, undergraduate education and pre-registration training. Conclusions - Pharmacy’s professional status in the UK remains open to challenge and vital to retaining that status is the public perception of pharmacists. Future research examining pharmacy’s claims to professional status should focus on exploring the attitudes of the general public in addition to the views of pharmacists.

The impact of the juvenile intervention facility on the adjudication of delinquent youth in Broward County

Considerable funds have been allocated in the area of juvenile justice in attempts to reduce and prevent the problem of juvenile delinquency. Much of these funds have been funneled to various community-level intervention programs. This dissertation reports the results of a study that examined the effects of one such program, the Juvenile Intervention Facility (JIF) in Broward County, Florida, on reducing the number of cases handled judicially by the Juvenile Court in that county. ^ Juvenile justice policy, which precipitated the creation of the JIF program, assumed that more structured and integrative efforts at the point of entry into the juvenile justice system would lead to greater diversion from the courts to much needed intervention services. By virtue of this process, the number of juveniles handled judicially by the courts was expected to decrease and future delinquent behavior would be prevented. Archival data from four fiscal years were examined, two years pre-JIF, two years post-JIF, a third-year follow-up, and a concurrent outcome measure corresponding to the first year of JIF operations. Data included all juvenile cases referred during the fiscal years defined for Broward and St. Lucie Counties, the state of Florida, and the United States. The study tested four hypotheses: (a) the JIF would reduce the number of cases handled judicially in Broward County Juvenile Court, (b) the decrease in judicially handled cases would be greater for females than for males, (c) there would be greater decreases in judicially handled cases for whites than non-whites, (d) there would be greater decreases in judicial handling for younger than older offenders. Bivariate analyses were conducted, consisting of chi square tests, to test the hypotheses. ^ Results indicate that the impact of the JIF was in the opposite direction of what was expected in that more juvenile offenders were handled judicially through juvenile court. This fact points to the possibility that the JIF has failed to provide the intended consequences of the policy. In the discussion, these “unintended” consequences are addressed in the context of juvenile justice policy creation and the competing constituencies involved in such policy development. ^

Deprofessionalization of curriculum decision -making

The purpose of this study was to analyze the evolution of Florida state level policy efforts and to assess the responding educational policy development and implementation at the local school district level. The focus of this study was the secondary language arts curriculum in Miami-Dade County Public Schools. ^ Data was collected using document analysis as a source of meaning making out of the language sets proffered by agencies at each level. A matrix was created based on Klein's levels of curriculum decision-making and Functional Process Theory categories of policy formation. The matrix allowed the researcher to code and classify specific information in terms accountability/high-stakes testing; authority; outside influences; and operational/structural organization. ^ Federal policy documents provided a background and impetus for much of what originated at the State level. The State then produced policy directives which were accepted by the District and specific policy directives and guidelines for practice. No evidence was found indicating the involvement of any other agencies in the development, transmission or implementation of the State level initiated policies. ^ After analyzing the evolutionary process, it became clear that state policy directives were never challenged or discussed. Rather, they were accepted as standards to be met and as such, school districts complied. Policy implementation is shown to be a top-down phenomenon. No evidence was found indicating a dialogue between state and local systems, rather the state, as the source of authority, issued specifically worded policy directives and the district complied. Finally, this study recognizes that outside influences play an important role in shaping the education reform policy in the state of Florida. The federal government, through NCLB and other initiatives created a climate which led almost naturally to the creation of the Florida A+ Plan. Similarly, the concern of the business community, always interested in the production of competent workers, continued to support efforts at raising the minimum skill level of Florida high school graduates. ^ Suggestions are made for future research including the examination of local school sites in order to assess the overall nature of the school experience rather than rely upon performance indicators mandated by state policy. ^

Deprofessionalization of curriculum decision-making

The purpose of this study was to analyze the evolution of Florida state level policy efforts and to assess the responding educational policy development and implementation at the local school district level. The focus of this study was the secondary language arts curriculum in Miami-Dade County Public Schools. Data was collected using document analysis as a source of meaning making out of the language sets proffered by agencies at each level. A matrix was created based on Klein's levels of curriculum decision-making and Functional Process Theory categories of policy formation. The matrix allowed the researcher to code and classify specific information in terms accountability/high-stakes testing; authority; outside influences; and operational/structural organization. Federal policy documents provided a background and impetus for much of what originated at the State level. The State then produced policy directives which were accepted by the District and specific policy directives and guidelines for practice. No evidence was found indicating the involvement of any other agencies in the development, transmission or implementation of the State level initiated policies. After analyzing the evolutionary process, it became clear that state policy directives were never challenged or discussed. Rather, they were accepted as standards to be met and as such, school districts complied. Policy implementation is shown to be a top-down phenomenon. No evidence was found indicating a dialogue between state and local systems, rather the state, as the source of authority, issued specifically worded policy directives and the district complied. Finally, this study recognizes that outside influences play an important role in shaping the education reform policy in the state of Florida. The federal government, through NCLB and other initiatives created a climate which led almost naturally to the creation of the Florida A+ Plan. Similarly, the concern of the business community, always interested in the production of competent workers, continued to support efforts at raising the minimum skill level of Florida high school graduates. Suggestions are made for future research including the examination of local school sites in order to assess the overall nature of the school experience rather than rely upon performance indicators mandated by state policy.

Percepção da equipe de saúde, discentes e usuários sobre a comunicação com indivíduos surdos na atenção primária

The study aimed to identify in the professionals and students of health courses that work in a health Basic Unit in the city of Natal/RN their perceptions of the care of deaf patients, and with the population's needs with hearing loss in relation to health care. This is a cross-sectional, exploratory, descriptive study, conducted between April to July 2014, with a population composed of 21 health professionals, 17 students and 8 deaf users. For data collection, we used a structured questionnaire with open and closed questions applied to groups composed of health professionals (doctors, dentists, nurses and health workers) and students of medical schools, nursing, physical education, nutrition and social service. The professionals/students answered a semi-structured questionnaire with open and closed questions concerning the possible difficulties the care of the deaf and hearing impaired. Data collection with deaf users was conducted through filmed interview for the Brazilian Sign Language (Libras) could be interpreted as to the Portuguese by the researcher. With the latter it was conducted a survey of their reactions when looking for a care in the health service. Regarding the profile of identification of the subjects, it was analyzed by simple descriptive statistics (absolute and relative frequencies). The open questions were analyzed through the content analysis technique which allowed the categorization process preserving all the points raised in the discussion so that the lines were representative of the whole. When asked about the professionals and students attitude used to communicate with deaf patients possible the following categories emerged: the "writing", the "gestures" and the "third party assistance". With regard of the deaf, when asked about their experiences in seeking care in health, the elucidated categories were: "quality of care to the hearing impaired", "communication with the hearing impaired adequacy" and "dependence on third parties." The closed questions were measured and adapted to the 5 degrees of variation Likert Scale, which comprised three of these issues: degree of difficulty in communication to meet a patient with hearing loss (minimum to great difficulty); feeling of comfort while using sign language (minimum to severe discomfort); and knowledge of the Law 10.436, which provides for the Brazilian Sign Language (Libras) (low knowledge to entirely clear). The data collected with professionals and students revealed some misunderstanding and discomfort in health care for deaf patients, reality also evidenced in the opinion of the deaf participants. This study revealed problems in communication, resulting in negative consequences in serving this population. This diagnosis may be relevant to public policy development and curriculum guidelines essential to the training of health professionals, inclusion and improving assistance to deaf.

PERSONALIDADE, ESTILOS PARENTAIS E COGNIÇÃO EM MENINOS VÍTIMAS DE ABUSO SEXUAL

Há um consenso na literatura de que a vivência do abuso sexual na infância ocasiona uma série de consequências, tanto físicas quanto psicológicas, às vítimas. O cenário de violência contra crianças e adolescentes está cada vez mais frequente na sociedade contemporânea, tornando-se um problema de saúde pública, de modo a ser necessário um olhar mais atento dos profissionais e elaboração de políticas públicas tanto para a prevenção dos casos como para o tratamento dos problemas deles decorrentes. Nas crianças, há uma associação do aumento de problemas comportamentais e psicológicos, que podem se estender até o período da idade adulta. Outros estudos enfatizam alterações em áreas cerebrais e as relacionam com o surgimento de transtornos mentais na população de crianças vítimas de violência sexual, dentre outros tipos de violência. O objetivo deste trabalho foi verificar a presença de traços de personalidade, os estilos parentais desenvolvidos e o desempenho cognitivo, especificamente as funções executivas, em meninos com histórico de abuso sexual. Foram avaliadas 62 crianças e adolescentes (32 com histórico de abuso sexual e 30 sem), sendo que no grupo de abuso a idade média dos integrantes é de 11,7 anos de idade e seus genitores majoritariamente divorciados, diferentemente do grupo controle, no qual os genitores são, na maior parte, casados. O método constou de questionário sociodemográfico, testes neuropsicológicos que avaliam as funções executivas (Wisconsin Card Sortint Test, Figuras de Ray e Escala de Inteligência Wechsler para Crianças - Terceira Edição (WISC-III)- Semelhanças, Arranjo de Figuras, Compreensão, Cubos, Dígitos e Vocabulário), Questionário de Personalidade para Crianças e Adolescentes (EPQ-J) e Inventário de Estilos Parentais (IEP). Não houve resultados significativos entre o abuso e as funções executivas, tanto nos subtestes dos Escala de Inteligência Wechsler para Crianças - Terceira Edição (WISC-III) quanto no do Wisconsin; porém o grupo apresentou dados significativamente menores na memória do Figuras Complexas de Rey. Com relação ao EPQ-J, os resultados demonstraram maiores índices de neuroticismo, os quais podem ser associados com sintomas de depressão, e apresentaram menores índices em extroversão, trazendo possíveis dificuldades nas relações sociais. Com relação aos estilos parentais, o grupo apresentou dificuldades e prejuízos nas percepções sobre os genitores, especialmente com relação ao genitor, que é o maior abusador estatisticamente. Os dados mostraram uma correlação entre neuroticismo e vocabulário, estilos parentais e vocabulário, e neuroticismo e estilos parentais. Observou-se a importância de maiores estudos com o público masculino, para que possam ser elucidadas, de forma mais abrangente, as questões de abuso sexual e suas interferências nos aspectos neuropsicológicos, estilos parentais e traços de personalidade, visto que a maior parte dos estudos é relacionada ao público feminino. É necessário o desenvolvimento de políticas públicas para o atendimento específico do público masculino que sofre abuso, e que o profissional da saúde esteja preparado para ajudar, fortalecendo os aspectos psíquicos e emocionais.