Cultural diversity and mental health : the relationship between leisure experiences and wellbeing in an ageing Italian community in Australia

One of the population health implications for Australia&rsquo;s ageing population is that a larger proportion of the Australian community will be retired and have more time for leisure pursuits. Meaningful leisure activities for this group are thought to be a factor in promoting positive mental health. However, a search of health literature revealed a paucity of research on how older adults make use of their leisure time, what meaning these pursuits have to them, and whether their chosen leisure activities are health enhancing and promote wellbeing. Australia&rsquo;s population is diverse with many cultures represented. As the population ages, mental health workers will be called upon to provide culturally-appropriate mental health services to clients from a range of ethnic groups. Literature on how people of culturally diverse backgrounds understand leisure activities is also limited. This paper reports on a study carried out in an Italian community in a large regional centre. The participants were selected based on the following criteria; aged 65 years and over, born in Italy, independently living in the community, ambulant, and retired from paid workforce. This study explored how a well-elderly group from an ethnic community derived meaning from their leisure activities and how this impacted on their mental health. Establishing the relationship between leisure and mental health in an ageing ethnic community is important because it sheds light on potential intervention strategies that can be used to maintain the mental health of people living independently in the community. Participants were interviewed using semi-structured questions about their perceptions of leisure, the meanings they derived from these activities, and their perceived impact of these activities on their health. Participant observation was also used to add trustworthiness to the data. Themes arising from the interviews and participant observation will be related to the participants&rsquo; sense of health. Results also revealed how older Italians engaged in leisure activities. Implications of the research findings will be directed towards mental health practice with older ethnic clients in community settings. The promotion of healthy lifestyles and positive mental health for Australia&rsquo;s ageing population will also be discussed.<br /

Estimating the Expected Value of Partial Perfect Information in Health Economic Evaluations using Integrated Nested Laplace Approximation

The Expected Value of Perfect Partial Information (EVPPI) is a decision-theoretic measure of the "cost" of parametric uncertainty in decision making used principally in health economic decision making. Despite this decision-theoretic grounding, the uptake of EVPPI calculations in practice has been slow. This is in part due to the prohibitive computational time required to estimate the EVPPI via Monte Carlo simulations. However, recent developments have demonstrated that the EVPPI can be estimated by non-parametric regression methods, which have significantly decreased the computation time required to approximate the EVPPI. Under certain circumstances, high-dimensional Gaussian Process regression is suggested, but this can still be prohibitively expensive. Applying fast computation methods developed in spatial statistics using Integrated Nested Laplace Approximations (INLA) and projecting from a high-dimensional into a low-dimensional input space allows us to decrease the computation time for fitting these high-dimensional Gaussian Processes, often substantially. We demonstrate that the EVPPI calculated using our method for Gaussian Process regression is in line with the standard Gaussian Process regression method and that despite the apparent methodological complexity of this new method, R functions are available in the package BCEA to implement it simply and efficiently

The impact of shift patterns on junior doctors' perceptions of fatigue, training, work/life balance and the role of social support

Background: The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. Method: Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being. Results: Four main themes were identified. Under "Doctors shift rotas", doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. "Education and training" focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. "Work/life balance" reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. "Social support structures" focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules. Conclusions: The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.4 page(s

The impact of junior doctors’ worktime arrangements on their fatigue and well-being

Objective Many doctors report working excessively demanding schedules that comply with the European Working Time Directive (EWTD). We compared groups of junior doctors working on different schedules in order to identify which features of schedule design most negatively affected their fatigue and well-being in recent weeks.Methods Completed by 336 doctors, the questionnaires focused on the respondents\u27 personal circumstances, work situation, work schedules, sleep, and perceptions of fatigue, work-life balance and psychological strain. Results Working 7 consecutive nights was associated with greater accumulated fatigue and greater work life interference, compared with working just 3 or 4 nights. Having only I rest day after working nights was associated with increased fatigue. Working a weekend on-call between 2 consecutive working weeks was associated with increased work-life interference. Working frequent on-calls (either on weekends or during the week) was associated with increased work-life interference and psychological strain. Inter-shift intervals o

Graph marginalization for rapid assignment in wide-area surveillance

Decentralizing optimization problems across a network can reduce the time required to achieve a solution. We consider a wide-area surveillance sensor network observing an environment by varying the state of each sensor so as to assign it to one or more moving objects. The aim is to maximize an arbitrary utility function related to object tracking or object identification, using graph marginalization in the form of belief propagation. The algorithm performs well in an example application with six heterogeneous sensors. In larger network simulations, the time savings owing to decentralization quickly exceed 90%, with no reduction in optimality. © 2010 Elsevier B.V. All rights reserved

Graph marginalization for rapid assignment in wide-area surveillance

Decentralizing optimization problems across a network can reduce the time required to achieve a solution. We consider a wide-area surveillance sensor network observing an environment by varying the state of each sensor so as to assign it to one or more moving objects. The aim is to maximize an arbitrary utility function related to object tracking or object identification, using graph marginalization in the form of belief propagation. The algorithm performs well in an example application with six heterogeneous sensors. In larger network simulations, the time savings owing to decentralization quickly exceed 90%, with no reduction in optimality. © 2010 Elsevier B.V. All rights reserved

Decentralized Predictive Sensor Allocation

We present a method of dynamic coalition formation (DCF) in sensor networks to achieve well-informed sensor-target allocations. Forecasts of target movements are incorporated when choosing sensor states, as is a memory of target observation. The algorithm can be run in a centralized or decentralized configuration; the latter relies on local message passing in the form of the max-sum algorithm. We show how the DCF algorithm has been applied to synthetic and real data. © 2008 IEEE

Visualizing uncertainty in reliability functions with application to aero engine overhaul

We propose an approach for estimating the date of lost confidence of jet engines, which are devices with multiple components subject to disruption. A mixed Weibull distribution is estimated from a large data set subject to censoring at various times. Parametric uncertainty is derived analytically and mapped visually onto the functions of use in reliability theory, including the hazard function. We demonstrate the use of the method on a database of disruption times for components in 325 jet engines. © 2010 Royal Statistical Society

Decentralized Predictive Sensor Allocation

We present a method of dynamic coalition formation (DCF) in sensor networks to achieve well-informed sensor-target allocations. Forecasts of target movements are incorporated when choosing sensor states, as is a memory of target observation. The algorithm can be run in a centralized or decentralized configuration; the latter relies on local message passing in the form of the max-sum algorithm. We show how the DCF algorithm has been applied to synthetic and real data. © 2008 IEEE