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.

The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus

Objective: To compare the effects of a 4-month strength training (ST) versus aerobic endurance training (ET) program on metabolic control, muscle strength, and cardiovascular endurance in subjects with type 2 diabetes mellitus (T2D). Design: Randomized controlled trial. Setting: Large public tertiary hospital. Participants: Twenty-two T21) participants (I I men, I I women; mean age +/- standard error, 56.2 +/- 1.1 y; diabetes duration, 8.8 +/- 3.5y) were randomized into a 4-month ST program and 17 T2D participants (9 men, 8 women; mean age, 57.9 +/- 1.4y; diabetes duration, 9.2 +/- 1.7y) into a 4-month ET program. Interventions: ST (up to 6 sets per muscle group per week) and ET (with an intensity of maximal oxygen consumption of 60% and a volume beginning at 15min and advancing to a maximum of 30min 3X/wk) for 4 months. Main Outcome Measures: Laboratory tests included determinations of blood glucose, glycosylated hemoglobin (Hb A(1c)), insulin, and lipid assays. Results: A significant decline in Hb A, was only observed in the ST group (8.3% +/- 1.7% to 7.1% +/- 0.2%, P=.001). Blood glucose (204 +/- 16mg/dL to 147 +/- 8mg/dL, P <.001) and insulin resistance (9.11 +/- 1.51 to 7.15 +/- 1.15, P=.04) improved significantly in the ST group, whereas no significant changes were observed in the ET group. Baseline levels of total cholesterol (207 +/- 8mg/dL to 184 +/- 7mg/dL, P <.001), low-density lipoprotein cholesterol (120 +/- 8mg/dL to 106 +/- 8mg/dL, P=.001), and triglyceride levels (229 +/- 25mg/dL to 150 +/- 15mg/dL, P=.001) were significantly reduced and high-density lipoprotein cholesterol (43 +/- 3mg/dL to 48 +/- 2mg/dL, P=.004) was significantly increased in the ST group; in contrast, no such changes were seen in the ET group. Conclusions: ST was more effective than ET in improving glycemic control. With the added advantage of an improved lipid profile, we conclude that ST may play an important role in the treatment of T2D.

Increased use of emergency services by older people after health screening

Background: evaluation of the 'Keep Well At Home' (KWAH) Project in West London indicated that a programme of screening persons aged 75 and over had not reduced rates of emergency attendances and admissions to hospital. However, coverage of the target population was incomplete. The present analysis addresses 'efficacy'-whether individuals who completed the screening protocol as intended did subsequently use Accident & Emergency (A&E) services less often. Methods: the target population was divided into five groups, depending on whether an individual had completed none, one or both phases of screening, and whether deviations from the protocol related to incomplete coverage or refusal to participate further. We ascertained use of emergency services before screening and for up to 3 years afterwards by linkage of records from KWAH to those of local A&E Departments. Patterns of emergency care were examined as crude races and, via proportional hazards models, after adjustment for available confounders. Results: there was an increase of 51% (95% CI 22-86%) in the crude rate of emergency admissions in the year after first-phase screening compared with the 12 months before assessment. This was most obvious in individuals deemed at high risk who also underwent the second-phase assessment (adjusted hazard ratio relative to individuals not 'at risk'= 2.33; 95% CI 1.59-3.42). Conclusions: the available data do not allow us to distinguish between several possible explanations for the paradoxical increase in use of emergency services. However, what seem to be sensible policies do not necessarily have their intended effects when implemented in practice.

An Internet training intervention for people with traumatic brain injury: Barriers and outcomes

Primary objective: To test whether people with cognitive-linguistic impairments following traumatic brain injury could learn to use the Internet using specialized training materials. Research design: Pre-post test design. Methods and procedures: Seven participants were each matched with a volunteer tutor. Basic Internet skills were taught over six lessons using a tutor's manual and a student manual. Instructions used simple text and graphics based on Microsoft Internet Explorer 5.5. Students underwent Internet skills assessments and interviews pre- and post-training. Tutors completed a post-training questionnaire. Main outcomes and results: Six of seven participants reached moderate-to-high degrees of independence. Literacy impairment was an expected training barrier; however, cognitive impairments affecting concentration, memory and motivation were more significant. Conclusions: Findings suggest that people with cognitive-linguistic impairments can learn Internet skills using specialized training materials. Participants and their carers also reported positive outcomes beyond the acquisition of Internet skills.

Cadmium-induced nephropathy in the development of high blood pressure

In recognition of a central role of the kidney in long-term blood pressure control, we undertook an in-depth analysis of the relationship between blood pressure and kidney damage caused by environmental exposure to the common pollutants cadmium and lead. The subjects were 200 healthy Thais, 16 and 60 years of age (100 female non-smokers, 53 male non-smokers, and 47 male smokers). None of these subjects had been exposed to Cd or Pb in the workplace and their urinary Cd concentrations ranged from 0.4 to 37 nM, whereas their urinary Pb concentrations ranged from 0.1 to 30 nM. The prevalence of high blood pressure was 2%, 8% and 19%, respectively in subjects with low, average and high Cd-burden (linear trend chi(2) = 6.4, P = 0.01). Multiple regression analysis revealed a significant positive association between Cd-burden and blood pressure in male nonsmokers (adjusted beta = 0.31, P = 0.02) and an inverse association between blood pressure and urinary Pb excretion rate in male smokers (adjusted beta = -0.38, P = 0.005). Associations between Cd-burden and nephropathies were evidenced by increases in urinary excretion of beta 2-microglobutin (P = 0.02) and N-acetyl-beta-D-glucosaminidase (P = 0.005) in subjects with high Cd-burden, compared with the subjects with average Cd-burden. In addition, an association between Cd-related nephropathy and high blood pressure was evidenced by a 20% increase in the prevalence of high blood pressure in people with NAG-uria (linear trend chi(2) = 4.3, P = 0.04). Our present study provides first evidence for a possible link between renal tubular damage and dysfunction caused by environmental Cd exposure and increased risk of high blood pressure. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Finding the balance: Living with memory loss

Since the late 1980s, it has been increasingly recognized that the experiences of people with dementia have been omitted from research in the area of dementia and memory loss. More recently, it has been accepted that people with dementia have insight into their condition and, therefore, the ability to contribute to research. A qualitative research project was undertaken with nine participants to explore the experiences and coping strategies of people with dementia. Interviews were undertaken and the data analysed using thematic analysis. Three major themes emerged: coming to terms with memory loss, maintaining control and independence, and the impact of illness on relationships. Understanding the reality for people is essential given that representations of the catastrophic impact of dementia generate high levels of anxiety and depression. Implications for nurses' practice include the need for skilled, well-paced, sensitive and ongoing information about the condition, along with the need to recognize and support the active coping strategies of people with memory loss.

Measuring outcomes of a communication program for older people with hearing impairment using the International Outcome Inventory

The main objective of this study was to describe the outcomes of a communication education program for older people with hearing impairment using the International Outcome Inventory - Alternative Interventions (IOI-AI) and the version for significant others (IOI-AI-SO). Ninety-six people aged 58 to 94 years participated in an interactive group education program for two hours per week for five weeks. The IOI-AI was administered at one to two weeks after the last educational session and 29 significant others also completed the IOI-Al-SO at this time. Overall, positive results were obtained using both questionnaires, and satisfaction with the program was particularly high. Findings also compared favourably to reports of outcomes for other audiological interventions (i.e., another communication training program and hearing aid fitting). Principal components analysis of the IOI-AI revealed a somewhat different factor structure than the original IOI-HA. The two versions of the 101 applied in this study are recommended as simple and effective measures of the outcomes of alternative interventions.

Reduced nephron number and glomerulomegaly in Australian Aborigines: A group at high risk for renal disease and hypertension

Aborigines in remote areas of Australia have much higher rates of renal disease, as well as hypertension and cardiovascular disease, than non-Aboriginal Australians. We compared kidney findings in Aboriginal and non-Aboriginal people in one remote region. Glomerular number and mean glomerular volume were estimated with the disector/fractionator combination in the right kidney of 19 Aborigines and 24 non-Aboriginal people undergoing forensic autopsy for sudden or unexpected death in the Top End of the Northern Territory. Aborigines had 30% fewer glomeruli than non-Aborigines-202000 fewer glomeruli per kidney, or an estimated 404000 fewer per person (P=0.036). Their mean glomerular volume was 27% larger (P=0.016). Glomerular number was significantly correlated with adult height, inferring a relationship with birthweight, which, on average, is much lower in Aboriginal than non-Aboriginal people. Aboriginal people with a history of hypertension had 30% fewer glomeruli than those without-250000 fewer per kidney (P=0.03), or 500000 fewer per person, and their mean glomerular volume was about 25% larger. The lower nephron number in Aboriginal people is compatible with their susceptibility to renal failure. The additional nephron deficit associated with hypertension is compatible with other reports. Lower nephron numbers are probably due in part to reduced nephron endowment, which is related to a suboptimal intrauterine environment. Compensatory glomerular hypertrophy in people with fewer nephrons, while minimizing loss of total filtering surface area, might be exacerbating nephron loss. Optimization of fetal growth should ultimately reduce the florid epidemic of renal disease, hypertension, and cardiovascular disease.

Using fear appeals to promote cancer screening - are we scaring the wrong people?

There is debate regarding the use of fear appeals (emphasizing severe threats to health) in social marketing, to encourage preventive behaviours, such as screening for breast cancer. While it has been found that fear appeals may result in attitude and behaviour change there is also the risk of inciting inappropriate levels of fear, motivating the wrong audience or instigating maladaptive behaviour in the target group such as denial or defensive avoidance. This study examined the impact of an experimental threat manipulation for mammography screening on a group of women in regional Australia. The study found that varying the level of threat had no impact on stated intentions of the women to undergo mammographic screening. However, it also found that high-threat messages resulted in stronger negative emotional reactions and greater perceived susceptibility among younger women who are not the target group for screening in Australia. The results of this study emphasize the importance of limiting the use of high levels of threat in social marketing campaigns, and ensuring that campaigns are appropriately designed to specifically impact upon and motivate the target group. Copyright © 2006 John Wiley & Sons, Ltd.

In the most high and palmy state of Queensland

Peter Beattie's efforts to improve the lives of Indigenous Australians needs support.

ENSINO MÉDIO, LÍNGUA PORTUGUESA E PORTAL EDUCACIONAL: percepções emergentes das narrativas de alunos inseridos em práticas de letramento digital

A educação contemporânea está inserida num contexto de velozes e dinâmicas transformações sociais e culturais, principalmente com o avanço e incorporação das Tecnologias Digitais de Informação e Comunicação (TDIC) no cotidiano das pessoas. Na Sociedade da Informação, na Era do Conhecimento, é preciso ir além do saber ler, escrever e digitar. A escola, por sua vez, de maneira ainda morosa, busca adequar-se às exigências do universo digital do qual participam seus agentes. O Ensino Médio, foco de preocupação e reflexão por todos os envolvidos no processo educativo dessa modalidade, tenta alcançar sua proposta de formação integral dos jovens para o exercício do trabalho e da cidadania. À disciplina Língua Portuguesa reserva-se a missão de conciliar o ensino da norma-culta com os gêneros discursivos de tal forma a promover a inclusão digital dos alunos nas diversas circunstâncias de letramento às quais são submetidos. Nesse âmbito, este trabalho investigou: Que percepções dos processos formativos emergem quando os alunos refletem acerca das práticas pedagógicas e das vivências nas aulas de Língua Portuguesa em atividades mediadas por portal educacional? O objetivo geral da pesquisa é provocar a reflexão nos professores, de tal forma que repensem suas práticas pedagógicas e seu papel no processo educativo a fim de promover uma experiência educativa mais condizente com a realidade dos alunos. A metodologia adotada foi a pesquisa qualitativa de cunho investigativo, na modalidade narrativa, sob a luz de Clandinin e Connelly (2011). Pela inserção no cenário e proximidade afetiva com os participantes, assumiu-se o desafio de desenvolver uma pesquisa-ação, para isso, os instrumentos investigativos adotados foram: entrevista semiestruturada, diário de bordo, atividades realizadas no portal, conversas informais e caderno de campo. A análise dos dados permitiu a elaboração de oito categorias de análise, emergentes das narrativas dos participantes: interação e comunicação; sala de aula ampliada; gestão da aprendizagem; o registro de si e do outro; aprendizagem colaborativa e transformadora; incentivo à pesquisa; estudo autônomo; e, desafios. Os resultados alcançados apontaram para reflexões que não se encerram nas páginas deste trabalho, dentre elas destacam-se: a importância de ouvir o aluno para que as propostas pedagógicas sejam revistas e melhoradas; o testar, nas práticas diárias, é fundamental, é o buscar algo além do tradicional, em prol de um objetivo de aprendizagem definido; o desejo de aprender pode despertar no aluno o interesse pelo conhecimento, tornando-o mais autônomo em suas escolhas e caminhos; as TDIC podem colaborar com o processo de ensino e de aprendizagem, porém exigem envolvimento dos sujeitos, pois elas, enquanto instrumentos, não configuram o conhecimento, são os agentes que ao apropriar-se delas têm condições de obter o melhor de suas potencialidades. Futuros trabalhos poderão dar continuidade a este estudo e trazer grandes acréscimos ao contemplar as influências do uso das TDIC no cotidiano da escola, o que, certamente, será de grande contribuição para o cenário atual da Educação brasileira.

A EDUCAÇÃO PARA AS RELAÇÕES ÉTNICO-RACIAIS NA FORMAÇÃO CONTINUADA DOS PROFESSORES DA BAIXADA SANTISTA: DEZ ANOS APÓS A INSTITUCIONALIZAÇÃO DA LEI 10.639/03

O presente trabalho discute a implementação da Lei Federal 10.639/03, nas escolas estaduais da Região da Baixada Santista, após dez anos de institucionalização. Investigou-se sobre a formação continuada dos professores, relacionando-a como, em sua prática pedagógica, os docentes vêm inserindo os conteúdos da História e Cultura da África e dos Afro-brasileiros que se tornaram obrigatórios pela Lei. A pesquisa realizada com os professores das disciplinas de História, Língua Portuguesa e Artes do Ensino Médio, que lecionam nos municípios de Guarujá, Santos, Cubatão e Bertioga, foi contextualizada com a realidade local e com os cursos de formação continuada para a temática das Relações Étnico-Raciais. Foram levados em consideração os saberes institucionais e não institucionais, implicados na prática reflexiva, no sentido de buscar métodos de ensino como o multiculturalismo que pudesse contemplar todas as etnias que compõem o povo brasileiro, elevando a autoestima dos afrodescendentes, indígenas ou asiáticos e primando por uma valorização da pluralidade cultural e do espírito de cidadania e alteridade. O processo de pesquisa qualitativa envolveu análise bibliográfica e documental, aplicação de: pesquisa-ação, questionários semiestruturados via internet, realização de entrevistas e análise de experiência pedagógica. Os dados empíricos analisados evidenciaram que não obstante algumas experiências exitosas, os professores, em sua maioria, consideram que obtiveram pouca ou quase nenhuma informação a respeito da lei e dos conteúdos que ela implica, nestes dez anos. Esse fato denota a necessidade de maiores investimentos na formação docente, por parte do governo, bem como maiores políticas de incentivo aos docentes que os estimulem a buscar formação continuada e adoção de práticas reflexivas e críticas voltadas para a educação e as relações étnico-raciais, aliando-se à necessidade de uma sociedade contemporânea pluriétnica e multicultural.

High-performance human resource practices, citizenship behaviour and organizational performance:A relational perspective

Taking a relational perspective on the employment relationship, we examined processes (mediation and moderation) linking high-performance human resource practices and productivity and turnover, two indicators of organizational performance. Multilevel analysis of data from hotels in the People's Republic of China revealed that service-oriented organizational citizenship behavior (OCB) partially mediated the relationships between high-performance human resource practices and both performance indicators. Unemployment rate moderated the service-oriented OCB-turnover relationship, and business strategy (service quality) moderated the service-oriented OCB-productivity relationship. Copyright of the Academy of Management, all rights reserved.

People management issues in Indian KPOs

Purpose: The business process outsourcing (BPO) industry in India is evolving rapidly, and one of the key characteristics of this industry is the emergence of high-end services offered by knowledge processing outsourcing (KPO) organizations. These organizations are set to grow at a tremendous pace. Given the people-intensive nature of this industry, efficient employee management is bound to play a critical role. The literature lacks studies offering insights into the HR challenges involved and the ways in which they are addressed by KPOs. The purpose of this paper is to attempt to fill this gap by presenting findings from an in-depth case study of a KPO organization. Design/methodology/ approach: To achieve the research objective we adopted an in-depth case study approach. The research setting was that of a KPO organization in India, which specialises in offering complex analytics, accounting and support services to the real estate and financial services industries. Findings: The results of this study highlight the differences in the nature of work characteristics in such organizations as compared to call centres. The study also highlights some of the key people management challenges that these organizations face like attracting and retaining talent. The case company adopts formal, structured, transparent and innovative human resource practices. The study also highlights that such enlightened human resource practices stand on the foundations laid by an open work environment and facilitative leadership. Research limitations/implications: One of the key limitations is that the analysis is based on primary data from a single case study and only 18 interviews. The analysis contributes to the fields of KPO, HRM and India and has key messages for policy makers. Originality/value: The literature on outsourcing has in general focused on call centres established in the developed world. However, the booming BPO industry in India is also beginning to offer high-end services, which are far above the typical call centres. These KPOs and their people management challenges are relatively unexplored territories in the literature. By conducting this study in an emerging market (India) and focusing on people-related challenges in KPOs, this study attempts to provide a fresh perspective to the extant BPO literature. © Emerald Group Publishing Limited.