Effectiveness of Suicide Safety Planning Interventions: A Systematic Review Informing Occupational Therapy.

Background. Suicide safety planning (SSP) is a suicide prevention approach that involves developing a collaborative plan between a service provider such as an occupational therapist and a person who is at risk of suicide. Purpose. To synthesize effectiveness studies on SSP. Method. Using the Joanna Briggs Institute methodology, we conducted a systematic review of effectiveness studies including a: (1) title and abstract screening; (2) full-text review; (3) critical appraisal; and (4) narrative synthesis. Findings. We included 22 studies. Critical appraisal scores ranged from 38.5 to 92.3 (m = 63.7). The types of interventions included were: standard and enhanced SSP (n = 11); electronically delivered SSP (n = 5); and SSP integrated with other approaches (n = 6). Only three studies identified meaningful activity as a component of SSP. Evidence across a range of studies indicates that SSP is effective for reducing suicide behavior (SB) and ideation (SI). While some studies have demonstrated effectiveness for reducing symptoms of mental illness, promoting resilience and service use, the number of studies exploring these outcomes is currently limited. Implications. Occupational therapists support individuals expressing SI, and SSP is a necessary skill for practice.

'The Big Island Model': Resident experiences of a novel permanent supportive housing model for responding to rural homelessness.

Research on rural homelessness focuses primarily on describing the experiences and prevalence of homelessness in rural contexts, with little focus on intervention strategies. We conducted a case study of the 'Big Island Model' (BIM), a novel approach to providing housing and support to individuals experiencing homelessness that has been developed for, and reflects, a rural context. We interviewed 13 participants (n = 10 men; n = 3 women) supported by the BIM using mixed interviews including qualitative and quantitative components exploring experiences of living within this model and aspects of psychosocial well-being. Descriptive statistics were calculated to represent demographic data and participants' scores on standardised measures. Wilcoxon signed-rank tests were conducted with threshold scores and population norms derived from existing literature to identify any differences between residents' median scores on each standardised scale and scores derived from published literature. Qualitative data were analysed using thematic analysis. On measures of meaningful activity, residents reported significantly lower levels of boredom (p < 0.01) and a greater degree of engagement in productivity (p < 0.01) compared with participants in other studies. Mental well-being was reported to be higher (p < 0.05) and drug use was significantly lower than a low-moderate range (p < 0.01). Community integration scores revealed significantly lower physical integration (p < 0.05) and significantly higher psychological integration than individuals who had transitioned to housing in another study (p < 0.001). Our analysis of qualitative interviews resulted in the identification of a central essence characterising residents' experiences: 'Becoming Through Belonging'. This essence was represented by four distinct themes: (1) the healing qualities of nature; (2) being meaningfully occupied; (3) living in a mutually supportive environment; and (4) this place is here to help.

Experiences of children growing up with a parent who has military-related post-traumatic stress disorder: a qualitative systematic review.

OBJECTIVE: The objective of this review is to describe the experiences of children growing up in military families with a parent who has military-related post-traumatic stress disorder. INTRODUCTION: Whether serving as a peacekeeper or warrior, military service is both physically and psychologically demanding, increasing exposures to potentially traumatic and morally injurious events and threats to personal safety. Those who have served in the military are at increased risk of developing post-traumatic stress disorder, which includes symptoms such as emotional numbing, withdrawal, and hyperarousal. Research has focused on the experiences of, and impacts on, spouses and partners of military veterans with post-traumatic stress disorder, with quantitative and synthesis studies reporting on measurable impacts on children growing up in military families where a parent is diagnosed with post-traumatic stress disorder. INCLUSION CRITERIA: This review included children who are currently living in, or have grown up in, military families in domestically peaceful nations that deploy their armed forces to global locations of political instability, armed civil conflict, or natural disasters for the purposes of peacekeeping, humanitarian aid, or war. This review also included parents living with post-traumatic stress disorder who speak specifically about the experience of their children. Situations of homeland conflict were excluded. The military families of interest are those with one or more parent with a diagnosis of post-traumatic stress disorder associated with military service. Traumatic experiences leading to post-traumatic stress disorder can be acquired prior to military service or through unrelated experiences, so it cannot be presumed that military service or even combat deployment, in and of itself, causes post-traumatic stress disorder. This review includes the experiences of children currently in childhood as well as adult children of a parent with current or previous military service. METHODS: The following databases were first searched in August 2016 and updated in January 9, 2020: MEDLINE, Embase, Web of Science Core Collection, CINAHL, PsycINFO, AMED, ERIC, and ProQuest Dissertations and Theses Global. This review was conducted in accordance with JBI methodology for systematic reviews of qualitative evidence and with an a priori protocol. RESULTS: Twelve studies were included. The majority of the studies were published after 2006. Elicited through data from adult (n = 65) and adolescent (n = 43) children and/or their parents (n = 65), the review represents the experiences of participants from military families in the United States, Canada, and Australia. There were four synthesized findings: i) Parental post-traumatic stress disorder creates a volatile and distressing climate within the family, eliciting a range of responses from children (87 findings across three categories); ii) Parental post-traumatic stress disorder ripples through the family system, disrupting interpersonal communication and relationships during childhood (57 findings across four categories); iii) Children can experience emotional and psychological difficulties well into adulthood (80 findings across five categories); and iv) Making sense of it all and moving beyond parental post-traumatic stress disorder can take significant time, energy, and support (74 findings across four categories). CONCLUSIONS: The quality of the included studies proved to be high, giving strength to this review. Effective ways of communicating with children about the nature of both the traumatic exposure and the post-traumatic stress disorder itself must be developed. While individuals with post-traumatic stress disorder deserve appropriate interventions to alleviate symptoms and improve functioning, it is not sufficient for recovery from post-traumatic stress disorder either for the individual or for the family who has been deeply affected themselves. Prospective and longitudinal research is needed, ensuring that both the voice of the child and of multiple perspectives within family systems are included and compared.

Promoting Quality Improvement in Long-Term Care: A Multi-Site Collaboration to Improve Outcomes with Pneumonia, Falls, Bacteriuria and Behavioural Issues in Dementia.

The Bridges to Care for Long-Term Care research project aimed to facilitate improvements in outcomes for long-term care residents through the provision of knowledge-to-practice and quality improvement resources by trained facilitators. Point-of-care staff reported improved communication and collaboration, improved use of scope of practice and implementation of best practice knowledge. Overall, participating long-term care homes demonstrated an enhanced capacity for common care issues of the elderly (pneumonia, falls, bacteriuria and behavioural and psychological symptoms of dementia) and the ability to effectively engage in quality improvement processes with efficient and effective use of healthcare resources.

Experiences of children exposed to parental post-traumatic stress disorder while growing up in military and veteran families: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to understand how parental Post-Traumatic Stress Disorder (PTSD) might impact children growing up in military and veteran families. The following question will guide and inform the review: What is the experience of children growing up in military families where the military or veteran parent is living with post-traumatic stress disorder?

Pilot Testing an Intervention on Cultural Safety and Indigenous Health in a Canadian Occupational Therapy Curriculum.

First-year Canadian occupational therapy students (n=27) rated their knowledge of and cultural/emotional responses to cultural safety and Indigenous health prior to and following an educational intervention led by a trained Indigenous educator. At post-intervention, students were also asked to comment on their learning experience. Pilot data of 40% of the class were analyzed using nonparametric approaches proposed by Koller and colleagues; qualitative data were explored using conventional methods. The majority of participant ratings reflected a perceived increase in knowledge and cultural/emotional responses, indicative of positive change following intervention. Student comments about their learning were in keeping with the positive findings. Although our sample size was small and our study examined perceived knowledge acquisition, preliminary results were consistent with related literature.

Promoting quality improvement in long-term care: a multi-site collaboration to improve outcomes with pneumonia, falls, bacteriuria and behavioural issues in dementia.

The Bridges to Care for Long-Term Care research project aimed to facilitate improvements in outcomes for long-term care residents through the provision of knowledge-to-practice and quality improvement resources by trained facilitators. Point-of-care staff reported improved communication and collaboration, improved use of scope of practice and implementation of best practice knowledge. Overall, participating long-term care homes demonstrated an enhanced capacity for common care issues of the elderly (pneumonia, falls, bacteriuria and behavioural and psychological symptoms of dementia) and the ability to effectively engage in quality improvement processes with efficient and effective use of healthcare resources.

The effectiveness of audio-tactile lane-marking in reducing various types of crash: a review of evidence, template for evaluation, and preliminary findings from Australia.

Audio-tactile lane-marking (ATLM) is designed to alert inattentive drivers when they deviate from their lane. Most commonly used previously to mark the edges of divided freeways, it is increasingly used to mark the edge and/or centre of two-lane undivided roads. We present a detailed review of ATLM evaluations to demonstrate that although both edge- and centreline ATLM appear to be effective, evaluations have been flawed insofar as they have (1) often not controlled adequately for variations due to extraneous factors known to affect crash incidence; (2) often focussed on total crashes, or on inattention-related crashes, and failed to address the possibility that ATLM increases some crash-types (particularly crashes involving two-wheeled vehicles, out-of-control crashes, or crashes on the opposite side of the lane to which the ATLM is installed); (3) almost always related to the milled-in "rumble strips" employed in the US rather than the raised profile lane-marking (PLM) that is employed in Australia. The present Empirical Bayes analysis aimed to evaluate PLM by comparing treated and untreated sections of the same roads both before and after the date of treatment in terms a range of crash types (some separately for roads with only edgeline-PLM, with only centreline-PLM, and with both edgeline- and centreline-PLM). Although some of the above issues could not be addressed due to insufficient data, the analysis provides a useful template for future researchers. The results provide evidence that both edgeline and centreline (alone or in combination) reduce targeted (same-side) crashes. Although there is no evidence that edgeline and centreline alone increase opposite side crashes, only edgeline and centreline together produced a net reduction in total crashes. Thus, the present results suggest that installing PLM on both edgeline and centreline is preferable to installing either alone.

Beliefs and behaviours relevant to the road safety effects of profile lane-marking.

Audio-tactile lane-marking (ATLM) is designed to alert inattentive drivers when they deviate from their lane, and appears to reduce crashes. Research into cognitive-behavioural mechanisms underlying, or possibly undermining, the efficacy of ATLM, is limited. We surveyed 775 randomly selected drivers (42% female, up to 75+ years) regarding the profile line-marking (PLM) employed in Australia (and in some European countries). Respondents perceived advantages of PLM in terms of lane-keeping and visibility. Respondents reported avoiding edge-line PLM, so that it may result in driving too close to untreated centre-line. Findings generally allayed concerns, on the basis of risk homeostasis theory, that PLM may increase risky driving. Perceived efficacy of PLM was not associated with increased drink-driving or speeding, but was associated with increased driving while fatigued. Findings suggest that the efficacy of PLM may be increased by employing PLM on both edge- and centre-lines, by exaggerating the audio-tactile effects of PLM that cause drivers to avoid it, and by discouraging the belief that it is safe to drive while fatigued when PLM is present.

The effects of mobile phone use on pedestrian crossing behaviour at signalized and unsignalized intersections.

Research amongst drivers suggests that pedestrians using mobile telephones may behave riskily while crossing the road, and casual observation suggests concerning levels of pedestrian mobile-use. An observational field survey of 270 females and 276 males was conducted to compare the safety of crossing behaviours for pedestrians using, versus not using, a mobile phone. Amongst females, pedestrians who crossed while talking on a mobile phone crossed more slowly, and were less likely to look at traffic before starting to cross, to wait for traffic to stop, or to look at traffic while crossing, compared to matched controls. For males, pedestrians who crossed while talking on a mobile phone crossed more slowly at unsignalized crossings. These effects suggest that talking on a mobile phone is associated with cognitive distraction that may undermine pedestrian safety. Messages explicitly suggesting techniques for avoiding mobile-use while road crossing may benefit pedestrian safety.