Actual and preferred work activites of mental health Occupational Therapists: Congruence or Discrepancy

The reform of Australian mental health services has resulted in new models of care and changed work practices for all mental health professionals. Occupational therapists today are as likely to be working in multidisciplinary teams performing a range of generic clinical roles as they are to be working in specialist rehabilitation units. These kinds of changes have taken place in other countries, with anecdotal and some empirical evidence that the changes have resulted in concerns about loss of professional identity and roles. This study sought to identify the current work activities carried out by occupational therapists and to determine whether there was a discrepancy between their actual and desired work activities. It was expected that, overall, they would indicate a preference to do more specialist rehabilitation focused work and less generic case management work. A survey of 196 occupational therapists investigated their actual and preferred work activities in 55 specific roles across four broad categories (senior administration, specialist clinical, general clinical and community development). As expected, the participants indicated that they would prefer to be undertaking more specialist rehabilitation oriented work activities than they were actually doing. Contrary to expectations, they also wished to undertake more rather than less generic clinical work activities, to be more engaged in community development work and to take on more senior and administrative roles. They indicated a preference for less rather than more activity on only 5 of the 55 work roles examined. On examining a subset of 113 participants who reported that 50% or more of their time was spent in case management, there was greater evidence of resistance to generic clinical roles. It was therefore concluded that occupational therapists in Australia are seeking to deploy their specialist skills to a greater degree than the current practice environment permits. They have broadly accepted the generic roles required in multidisciplinary community case management, but those who are actually working in these roles are most likely to have reservations about this kind of work.

Work activities of occupational therapists in Australian mental health services

The aim of this study was to obtain a profile of occupational therapists’ work activities in contemporary Australian mental health services so as to better understand the specific contribution of this profession. The study also aimed to determine whether or not actual work activity was congruent with the preferred roles of occupational therapists. A cross-sectional survey of 196 occupational therapists working in mental health was conducted. For the purposes of the study, a new instrument was developed that evaluated both actual and preferred work roles in four broad categories: administrative, general clinical skills, specialist clinical skills and community development. Respondents were engaged in a greater proportion of generic than discipline-specific work activities. They reported a preference for higher levels of activity in each of the work categories. These findings suggest that, contrary to some previous reports, not only are occupational therapists in Australia engaged in a broad spectrum of non-specialist mental health work activities, but these activities are mostly congruent with their expectations and wishes.

Who's really hypertensive? - Quality control issues in the assessment of blood pressure for randomized trials

The characterization of blood pressure in treatment trials assessing the benefits of blood pressure lowering regimens is a critical factor for the appropriate interpretation of study results. With numerous operators involved in the measurement of blood pressure in many thousands of patients being screened for entry into clinical trials, it is essential that operators follow pre-defined measurement protocols involving multiple measurements and standardized techniques. Blood pressure measurement protocols have been developed by international societies and emphasize the importance of appropriate choice of cuff size, identification of Korotkoff sounds, and digit preference. Training of operators and auditing of blood pressure measurement may assist in reducing the operator-related errors in measurement. This paper describes the quality control activities adopted for the screening stage of the 2nd Australian National Blood Pressure Study (ANBP2). ANBP2 is cardiovascular outcome trial of the treatment of hypertension in the elderly that was conducted entirely in general practices in Australia. A total of 54 288 subjects were screened; 3688 previously untreated subjects were identified as having blood pressure >140/90 mmHg at the initial screening visit, 898 (24%) were not eligible for study entry after two further visits due to the elevated reading not being sustained. For both systolic and diastolic blood pressure recording, observed digit preference fell within 7 percentage points of the expected frequency. Protocol adherence, in terms of the required minimum blood pressure difference between the last two successive recordings, was 99.8%. These data suggest that adherence to blood pressure recording protocols and elimination of digit preferences can be achieved through appropriate training programs and quality control activities in large multi-centre community-based trials in general practice. Repeated blood pressure measurement prior to initial diagnosis and study entry is essential to appropriately characterize hypertension in these elderly patients.

Two Australian islander communitities as audiences, and their news needs

Many of the 8000 mapped islands within the Australian Exclusive Economic zone are home to full-time but small communities, and many in the far north are home to relatively large Indigenous communities. But small remote communities such as on these islands, and individuals within those communities, become isolated because conventional news media providers regard them as unviable markets. Community development is at risk in such apparently unviable news media markets because individuals an lose touch with each other, others in the community and those in the "outside world".

MODELOS DE AÇÕES SOLIDÁRIAS: UM EXAME MULTICASO

O presente trabalho, busca compreender como ocorre este processo, denominado Desenvolvimento Comunitário (SOUZA, 1991), percebendo-se seu processo histórico, bem como, sua contemporalidade, nas quais contemplam atributos sociais e coletivos, favoráveis à compreensão e aplicabilidade dos conceitos de solidariedade, no qual fazem parte desta categoria social econômica. Para tanto, propõe um diálogo, entre o referencial teórico abordado no presente trabalho, com os relatos das Histórias de Vidas , desenvolvidos na pesquisa de campo, propiciando uma leitura das práticas solidárias, que possam despertar um novo sentido a comunidade, por meios culturais e da participação coletiva. O método de Pesquisa, utilizado foi a Qualitativa , de caráter Exploratório , e a análise dos dados levantados, se procedeu com inspiração Fenomenológica . A técnica de pesquisa utilizada foi a vivencial, por meio da abordagem de histórias de vida , visando compreender como os sujeitos da pesquisa, representados pela Olho Vivo Cooperativa de Confecções e Costura, da cidade de Santo André e da Associação de Promoção Humana e Resgate da Cidadania Padre Léo Comissari, na cidade de São Bernardo do Campo, em São Paulo, percebem o conceito sobre economia solidária, e qual a existência prática da solidariedade, que facilitam, interferem ou propiciam a geração de trabalho e renda, dentro destas comunidades. A análise dos relatos de vida, destes sujeitos da pesquisa, mostrou que a prática da solidariedade ocorre somente entre moradores em situações de extrema necessidade de sobrevivência, mas precisamente na comunidade da Sacadura Cabral. Percebe-se que esta ajuda mútua, dentro desta comunidade, ocorre de forma voluntária, desagregada da compreensão do termo solidariedade. A responsabilidade social das instituições de ensino Superior da região do ABC Paulista incentivou a criação do Corredor Cultural da Economia Solidária do ABC Paulista, cujo comprometimento com a pesquisa, a responsabilidade social e as práticas pedagógicas de ensino superior, apontam para a necessidade de apoio às comunidades locai, visando principalmente o seu desenvolvimento, por meio de instrumentos de capacitação, que visam à geração de trabalho e renda.(AU)

COMUNICAR PARA MUDAR: Estudo das metodologias de desenvolvimento de comunidade e da comunicação para o desenvolvimento e para a mudança social

Estudo sobre as metodologias de comunicação nas propostas de desenvolvimento comunitário. Com base em pesquisa bibliográfica o trabalho objetivou evidenciar os aspectos explícitos e implícitos da comunicação presentes nas metodologias de desenvolvimento de comunidade publicadas no Brasil. Para tal, foi realizada ampla revisão da literatura sobre os conceitos de comunidade, desenvolvimento, pobreza e participação, metodologias de desenvolvimento de comunidade, comunicação para o desenvolvimento e comunicação para a mudança social. Ao final, a pesquisa evidenciou que os conceitos de desenvolvimento e de participação invariavelmente constituem o fundamento a partir dos quais se erigem tanto projetos de desenvolvimento comunitário como de comunicação para o desenvolvimento/mudança social. Um modelo de desenvolvimento necessariamente leva a um modelo de participação, e viceversa, que, em projetos de melhoria das condições de vida comunitária se constituem como elementos catalisadores das demais instâncias do trabalho. Ambas propostas apresentam muitos pontos em comum e diversos espaços para contribuições recíprocas.(AU)

Domestic violence and child abuse: developing sensitive policies

Domestic violence is everywhere and nowhere. No statutory organization or health service has work with either perpetrators or survivors of domestic violence (usually women and children) as the primary focus of their service, yet all agencies will have very significant numbers among their clients/service users. It is therefore crucial that the policy framework is developed both within and between agencies to address the need, and scope, of intervention in this area and particularly the impact on children. Currently, significant steps have been taken by some agencies in the UK to address this previously neglected issue, though the developments are patchy. This paper draws on a UK-wide research study which mapped the extent and range of service provision for families where there is domestic violence and also developed a framework of good practice indicators for ‘Mapped the extent and range of service provision for families where there is domestic violence and also developed a framework of good practice indicators’ provision in this area. This article examines one of the indicators of good practice arising from the research—that of policy development—within social service departments and within the multi-agency arena.

Understanding change in the public sector:a local authority case study

Increasingly managers in the public sector are being required to manage change, but many of the models of change which are available to them have been developed from private sector experience. There is a need to understand more about how the change process unfolds in the public sector. A case study of change in one local authority over the period 1974-87 is provided. The events surrounding housing decentralisation and the introduction of community development are considered in detail. To understand these events a twofold model of change is proposed: a short wave model which explains a change project or event; and a long wave model which considers how these projects or events might be linked together to provide a picture of an organisation over a longer period. The short wave model identifies multiple triggers of change and signals the importance of mediators in recognising these triggers. The extent to which new ideas are implemented and the pace of their adoption is influenced by the balance of power within the organisation and the political tactics which are used. Broad phases in the change process can be identified, but there is not a simple linear passage through these. The long wave model considers the way in which continuity and change feed off one another. It suggests that periods of relative stability may be interspersed with more radical transformations as the dominant paradigm guiding the organisation shifts. However, such paradigmatic shifts in local government may be less obvious than in the private sector due to the diverse nature of the former.

Undergraduate research training and employability

Formal opportunities for Psychology undergraduates to carry out research training are starting to emerge. In spite of the fact that such training programmes would have a high authentic learning component little is known of undergraduate expectations and attitudes towards such programmes. Here 108 undergraduate participants were surveyed in two experiments that recorded both the prospective and retrospective attitudes towards research training participation. Questionnaires and focus groups were employed and the data were triangulated together to converge on an understanding of student expectations towards authentic learning programmes. It was found that while Psychology undergraduates expect to be trained in contemporary research techniques it is the sense of community development that is the prime motivator for participation. These findings are placed within the context of increasing the employability profile of the undergraduate cohort.

An operational research-based integrated approach for mass evacuation planning of a city

Large-scale disasters are constantly occurring around the world, and in many cases evacuation of regions of city is needed. ‘Operational Research/Management Science’ (OR/MS) has been widely used in emergency planning for over five decades. Warning dissemination, evacuee transportation and shelter management are three ‘Evacuation Support Functions’ (ESF) generic to many hazards. This thesis has adopted a case study approach to illustrate the importance of integrated approach of evacuation planning and particularly the role of OR/MS models. In the warning dissemination phase, uncertainty in the household’s behaviour as ‘warning informants’ has been investigated along with uncertainties in the warning system. An agentbased model (ABM) was developed for ESF-1 with households as agents and ‘warning informants’ behaviour as the agent behaviour. The model was used to study warning dissemination effectiveness under various conditions of the official channel. In the transportation phase, uncertainties in the household’s behaviour such as departure time (a function of ESF-1), means of transport and destination have been. Households could evacuate as pedestrians, using car or evacuation buses. An ABM was developed to study the evacuation performance (measured in evacuation travel time). In this thesis, a holistic approach for planning the public evacuation shelters called ‘Shelter Information Management System’ (SIMS) has been developed. A generic allocation framework of was developed to available shelter capacity to the shelter demand by considering the evacuation travel time. This was formulated using integer programming. In the sheltering phase, the uncertainty in household shelter choices (either nearest/allocated/convenient) has been studied for its impact on allocation policies using sensitivity analyses. Using analyses from the models and detailed examination of household states from ‘warning to safety’, it was found that the three ESFs though sequential in time, however have lot of interdependencies from the perspective of evacuation planning. This thesis has illustrated an OR/MS based integrated approach including and beyond single ESF preparedness. The developed approach will help in understanding the inter-linkages of the three evacuation phases and preparing a multi-agency-based evacuation planning evacuation

UK social housing and housing market in England:a statistical review and trends

Around 80% of the 63 million people in the UK live in urban areas where demand for affordable housing is highest. Supply of new dwellings is a long way short of demand and with an average annual replacement rate of 0.5% more than 80% of the existing residential housing stock will still be in use by 2050. A high proportion of owner-occupiers, a weak private rental sector and lack of sustainable financing models render England’s housing market one of the least responsive in the developed world. As an exploratory research the purpose of this paper is to examine the provision of social housing in the United Kingdom with a particular focus on England, and to set out implications for housing associations delivering sustainable community development. The paper is based on an analysis of historical data series (Census data), current macro-economic data and population projections to 2033. The paper identifies a chronic undersupply of affordable housing in England which is likely to be exacerbated by demographic development, changes in household composition and reduced availability of finance to develop new homes. Based on the housing market trends analysed in this paper opportunities are identified for policy makers to remove barriers to the delivery of new affordable homes and for social housing providers to evolve their business models by taking a wider role in sustainable community development.

Undergraduate research training and graduate recruitment

Purpose – Formal opportunities for psychology undergraduates to carry out research training are starting to emerge. In spite of the fact that such training programmes would have a high authentic learning component little is known of undergraduate expectations and attitudes towards such programmes. This paper aims to focus on the issues. Methodology/design/approach – In total, 108 undergraduate participants were surveyed in two experiments that recorded both the prospective and retrospective attitudes towards research training participation. Questionnaires and focus groups were employed and the data were triangulated together to converge on an understanding of student expectations towards authentic learning programmes. Findings – While psychology undergraduates expect to be trained in contemporary research techniques it is the sense of community development that is the prime motivator for participation. Originality/value – The paper places these findings within the context of increasing the employability profile of the undergraduate cohort.

Rebirth of a neighborhood: In streetscape design

This study involves one of the eight neighborhoods in the City of Miami named Little Havana. Little Havana, once a flourishing Hispanic community during the 1960s through the 1980s, is now experiencing housing deterioration, economic disinvestment, and increased social needs. ^ Although the City developed a Community Development Plan for the neighborhood addressing the neighborhood problems, needs, and objectives, it failed to address and take advantage of the area's prominent commercial street, Calle Ocho, as a cultural catalyst for the revitalization of the neighborhood. With an urban study and understanding of the area's needs for transit system improvements, program analysis, and a valuable architectural inventory, an intervention project can be developed. The project will capitalize on the area's historical and cultural assets and serve as a step towards altering the area's decline and revitalizing the street and community to recapture the energy present during the early years of the massive Cuban migration. ^

Vegetation dynamics and their implications for the management of wetlands in the lowlands of Nepal

The maintenance of species richness is often a priority in the management of nature reserves, where consumptive use of resources is generally prohibited. The purpose of this research was to improve management by understanding the vegetation dynamics in the lowlands of Nepal. The objectives were to determine vegetation associations in relation to environments and human-induced disturbances that affect vegetation dynamics on floodplains, where upstream barrages had altered flooding patterns, and consumptive use of plant resources was influencing natural processes. Floodplain vegetation in relation to physical environments and disturbances were studied along transects, perpendicular to the course of the Mahakali River in the western Terai, Nepal. Forest structural changes were studied for three years in ten plots. A randomized split-block experiment with nine burning and grazing treatments was performed in seasonally flooded grasslands. A semi-structured questionnaire was used to assess people's socio-economic status, natural resource use patterns and conservation attitudes. ^ Elevation, soil organic matter, nitrogen, percentage of sand and grazing intensity were significant in delineating herbaceous vegetation assemblages, whereas elevation and livestock grazing were significant in defining forest type boundaries. On the floodplain islands, highly grazed Dalbergia sissoo-Acacia catechu forests were devoid of understory woody vegetation, but the lightly grazed D. sissoo-mixed forests had a well-developed second canopy layer, comprising woody species other than D. sissoo and A. catechu. In grasslands, species richness and biomass production were highest at intermediate disturbance level represented by the lightly grazed and ungrazed early-burned treatments. Ethnicity, education and resource use patterns were important in influencing conservation attitudes. A succession towards the mixed forests would occur in D. sissoo-dominated floodplain forests, where dams and barrages reduce flooding and associated fluvial processes, and if livestock grazing is stopped, as occasionally suggested by nature conservationists. In seasonally flooded grasslands, early burning with moderate grazing would enhance the species diversity and productivity. There is a need to implement a participatory integrated wetland management plan, to include community development, education and off farm income generation, to assure participatory conservation and management of wetlands in Nepal. ^

Predictors of first semester attrition and their relation to retention of generic associate degree nursing students

In community college nursing programs the high rate of attrition was a major concern to faculty and administrators. Since first semester attrition could lead to permanent loss of students and low retention in nursing programs, it was important to identify at-risk students early and develop proactive approaches to assist them to be successful. The goal of nursing programs was to graduate students who were eligible to take the national council licensing examination (RN). This was especially important during a time of critical shortage in the nursing workforce. ^ This study took place at a large, multi-campus community college, and used Tinto's (1975) Student Integration Model of persistence as the framework. A correlational study was conducted to determine whether the independent variables, past academic achievement, English proficiency, achievement tendency, weekly hours of employment and financial resources, could discriminate between the two grade groups, pass and not pass. Establishing the relationship between the selected variables and successful course completion might be used to reduce attrition and improve retention. Three research instruments were used to collect data. A Demographic Information form developed by the researcher was used to obtain academic data, the research questionnaire Measure of Achieving Tendency measured achievement motivation, and the Test of Adult Basic Education (TABE), Form 8, Level A, Tests 1, 4, and 5 measured the level of English proficiency. The Department of Nursing academic policy, requiring a minimum course grade of “C” or better was used to determine the final course outcome. A stepwise discriminant analysis procedure indicated that college language level and pre-semester grade point average were significant predictors of final course outcome. ^ Based on the findings of the study recommendations focused on assessing students' English proficiency prior to admission into the nursing program, an intensive remediation plan in language comprehension for at-risk students, and the selection of alternate textbooks and readings that more closely matched the English proficiency level of the students. A pilot study should be conducted to investigate the benefit of raising the admission grade point average. ^