Evaluation of a mental health service reform program, the Pathways to Community Living Initiative, for people with severe mental illness and complex needs.

OBJECTIVE: The Pathways to Community Living Initiative (PCLI) aims to reform mental health care for people with severe and persistent mental illness (SPMI) and complex needs. This study reports independent evaluation findings on transitions from hospital and practice change in mental health services. METHODS: Data for this mixed-methods evaluation were obtained from administrative collections and semi-structured interviews with PCLI program managers, teams and executive leads; aged care managers; and leaders in inpatient, community and older people's mental health services. RESULTS: Between July 2015 and December 2020, 674 participants (67% of those eligible for the PCLI) were transitioned from hospital to community. Of those transitioned, 21 required subsequent long-stay admissions. The PCLI introduced resources, clearly defined processes, and state-wide networks to guide changes in practice which are becoming embedded in the operations and governance of mental health services across New South Wales. CONCLUSIONS: Severe and persistent mental illness and complex needs can be managed in community settings with highly individualised planning and care, supported by specialised clinical teams in partnership with mental health, aged care and disability services. Evaluation findings highlight the importance of continued investment in rehabilitation psychiatry.

Hand therapists' attitudes, environmental supports, and self-efficacy regarding intimate partner violence in their practice.

STUDY DESIGN: Descriptive, cross-sectional. INTRODUCTION: Intimate partner violence (IPV) may involve physical, psychological, or sexual abuse. Although hand injuries are reported as common sequelae of IPV, there is limited attention to this issue in hand therapy research reports or practice recommendations. PURPOSE OF THE STUDY: The primary aim is to describe the attitudes and beliefs of hand therapists (HTs) about IPV issues. METHODS: A sample of 189 HT completed a standardized survey investigating perceptions regarding issues pertaining to IPV. Areas addressed included self-efficacy (in dealing with IPV), perceived systemic support, victim blaming, professional role responsibility, and safety. Data were analyzed using descriptive statistics while between-group comparisons evaluating the impact of prior IPV experience and demographic variables of gender, country, certified hand therapy, and occupation on questionnaire scores used Mann-Whitney U analysis. RESULTS: The majority of therapists (66%) had some prior experience with IPV. HTs reported neutral perceptions about self-efficacy (M = 2.9/5), client or personal safety (M = 3/5), and support systems available when addressing IPV in practice (M = 3/5). However, therapists considered intervening as part of their professional role (M = 3.8/5) and reported low levels of victim-blaming attitudes (M = 4.4/5). Those with firsthand IPV experience reported lower victim blaming (mdn = 4.9/5 vs 4.6/5, P = .02). Additionally, females were less likely to blame victims of IPV than males (mdn = 4.7/5 vs 4.3/5, P = .003). DISCUSSION: Although Hand Therapists believe their professional role includes addressing IPV, confidence to deal with IPV, access/awareness of resources and perceived safety were substantive barriers. CONCLUSION: Continuing research should identify effective tools to educate and assist therapists to identify and support victims of IPV in hand therapy.

Whole grains and health: from theory to practice--highlights of The Grains for Health Foundation's Whole Grains Summit 2012.

The Grains for Health Foundation's Whole Grains Summit, held May 19-22, 2012 in Minneapolis, was the first meeting of its kind to convene >300 scientists, educators, food technologists, grain breeders, food manufacturers, marketers, health professionals, and regulators from around the world. Its goals were to identify potential avenues for collaborative efforts and formulate new approaches to whole-grains research and health communications that support global public health and business. This paper summarizes some of the challenges and opportunities that researchers and nutrition educators face in expanding the knowledge base on whole grains and health and in translating and disseminating that knowledge to consumers. The consensus of the summit was that effective, long-term, public-private partnerships are needed to reach across the globe and galvanize the whole-grains community to collaborate effectively in translating whole-grains science into strategies that increase the availability and affordability of more healthful, grain-based food products. A prerequisite of that is the need to build trust among diverse multidisciplinary professionals involved in the growing, producing, marketing, and regulating of whole-grain products and between the grain and public health communities.

The sooner, the better: exercise outcome proximity and intrinsic motivation.

BACKGROUND: Despite evidence that outcomes are highly valued when they are expected sooner rather than further into the future (Ainslie, 1975), limited research effort has been devoted to understanding the role of exercise outcome proximity. The purpose of this study was to examine how temporal proximity to positive outcomes influences exercisers' intrinsic motivation. We expected that focusing people on temporally proximal exercise outcomes would increase intrinsic motivation, especially among low-frequency exercisers. METHODS: This online experimental study was completed by 135 community exercisers (Mage = 31.11, SD = 10.29; 62% female) who reported an average of 4.86 exercise bouts per week (SD = 2.12). Participants were randomly assigned to a condition that primed temporally proximal positive exercise outcomes (i.e. experienced during or directly following an exercise bout) or temporally distal outcomes (i.e. experienced after days, months, or years of regular exercise). Participants then reported perceptions of behavioral regulation in exercise. RESULTS: As expected, the proximal exercise outcome condition elicited increased intrinsic regulation among those participants who exercised less frequently (i.e. 1 SD below the mean). CONCLUSIONS: This study reveals the importance of considering proximity as an important dimension of exercise outcomes-particularly when promoting intrinsic motivation among relatively infrequent exercisers.