Perceived occupational balance and well-being among people with mental illness living in two types of supported housing

Abstract

Background: People with psychiatric disabilities often struggle with maintaining a satisfying occupational balance. Knowledge about factors of relevance for occupational balance in this group is therefore vital for improving their support.

Aim: The aim was to describe perceptions of occupational balance among people with psychiatric disabilities living in supported housing (SH) or in own flat/house with housing support (OHS). Potential importance of housing context and socio-demographic, well-being and recovery factors for occupational balance was also explored.

Methods: Participants from SH (N?=?155) and OHS (N?=?111) responded to questionnaires about sociodemographic situation, well-being (self-rated health, life satisfaction and self-mastery), personal recovery and occupational balance (work, leisure, home chores, self-care and general balance assessed by SDO-OB).

Results: A majority in both groups reported being in balance regarding all five domains of occupational balance. The OHS group reported being more under-occupied for home chores and self-care. Self-mastery was the most important contributor in both groups in the domains of work, domestic chores and self-care. Day center attendance was vital for general occupational balance.

Conclusion: Both groups generally perceived occupational balance. Control over one’s life situation and possibilities for regularly participating in occupations outside the home environment should receive high priority in housing support.     

Group leader and participant perceptions of Balancing Everyday Life,a group-based lifestyle intervention for mental health service users

Abstract

Background: There exist few recovery and occupation-based interventions for mental health service users. Balancing Everyday Life (BEL) is a new occupation-based lifestyle intervention that was created to fill this need.

Aim: To gain group leaders’ and participants’ perspectives of the BEL intervention content and format, including factors that helped, hindered, and could be improved.

Methods: A constructivist grounded theory method guided data collection and analysis. Interviews took place with 12 BEL group leaders and 19 BEL participants from out-patient psychiatry settings and community-based day centers in Sweden.

Results: BEL’s structure and content were appreciated, yet flexibility was desired to adapt to participant needs. BEL could act as a bridge, helping participants connect with others, and to a more engaged and balanced everyday life. Facilitating factors included a person-focused (versus illness-focused) approach, physical and emotional environments, and connection. Barriers included room resources. More sessions were desired for the intervention.

Conclusion: Group leaders and participants experienced BEL as a useful tool to instigate meaningful change and connection in the participants’ lives. The combination of a positive person-focused approach and group support was appreciated. These results could inform future research, evaluation, and development of occupation-focused lifestyle interventions for mental health service users.     

Dietary Phosphorus Excess: A Risk Factor in Chronic Bone,Kidney, and Cardiovascular Disease?

There is growing evidence in the nephrology literature supporting the deleterious health effect of excess dietary phosphorus intake. This issue has largely escaped the attention of nutrition experts until this symposium, which raised the question of whether the same health concerns should be extended to the general population. The potential hazard of a high phosphorus intake in the healthy population is illustrated by findings from acute and epidemiologic studies. Acute studies in healthy young adults demonstrate that phosphorus intakes in excess of nutrient needs may significantly disrupt the hormonal regulation of phosphorus contributing to disordered mineral metabolism, vascular calcification, bone loss, and impaired kidney function. One of the hormonal factors acutely affected by dietary phosphorus loading is fibroblast growth factor-23, which may be a key factor responsible for many of the cardiovascular disease (CVD) complications of high phosphorus intake. Increasingly, large epidemiological studies suggest that mild elevations of serum phosphorus within the normal range are associated with CVD risk in healthy populations. Few population studies link high dietary phosphorus intake to mild changes in serum phosphorus due to study design issues specific to phosphorus and inaccurate nutrient composition databases. The increasing phosphorus intake due to the use of phosphorus-containing ingredients in processed food and the growing consumption of processed convenience and fast foods is an important factor that needs to be emphasized.     

High Prevelance of Rifampin-Monoresistant Tuberculosis: A Retrospective Analysis among Iranian Pulmonary Tuberculosis Patients

We determined the prevalence of rifampin-monoresistant tuberculosis (RMR-TB) in Iran. Because development of RMR-TB is not common, we also identified the major risk factors associated with RMR-TB reported from different provinces of Iran. Data for 3,020 TB patients who remained or became smear positive after two, four, six, and nine months of standard first-line chemotherapy were retrospectively analyzed. Of 3,020 patients, 1,242 patients (41.1%) were culture and DNA positive for Mycobacterium tuberculosis. Of these patients, 73 (7.4%) patients had monoresistant isolates to rifampin, which was significantly higher than that for multidrug-resistant TB (5.8%). The average rate of RMR-TB in the studied population ranged from 5% to 10%. Classical investigation showed that 33.6% of patients had either a previous or family history of TB. Molecular epidemiology methods (i.e., spoligotyping and Mycobacterium intespersed repetitive unit–variable number tandem repeat), defined transmission link in three clusters (13%). These results outline the urgent need for a comprehensive plan for detection and treatment of RMR-TB cases.