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The primary aim of this study was to examine changes in clients' occupational performance and satisfaction with their performance within a community trust setting, using the Canadian Occupational Performance Measure (COPM). Given the rapid throughput of clients and the pressure of limited resources, the authors postulated that occupational therapy interventions were focusing on clients' self-care needs as a matter of priority for clients to be independent at home. Therefore, at a time when services are seeking to be increasingly client-focused, the authors' secondary aim was to explore whether self-care needs were also the clients' highest priorities. Fourteen occupational therapists and 62 clients took part in the study. The therapists used the COPM to assess the client; the clients completed the COPM at initial interview and at the end of the intervention. Inferential statistics were then used to ascertain any change over the intervention period. The findings showed a statistically significant change in clients' occupational performance and satisfaction with their performance, in all settings, following occupational therapy. There were notable differences in occupational performance goals between men and women, in that a higher percentage of self-care goals were identified by the men. Self-care goals were the most frequently cited goals in all of the settings.

Exploring potential mechanisms underpinning the therapeutic effects of surfing" Get in and wrestle with the sea; wing your heels with the skill and power that reside in you, hit the sea's breakers, master them, and ride upon their backs as a king should."Jack LondonFrom its roots in ancient Polynesian and Hawaiian cultures, the twentieth century saw surfing spread around the world to become a popular sport and leisure activity (Finney & Houston, 1996). Despite the popularity of surfing, there has been little scientific research to date investigating motivations for, and benefits from, surfing. However, several cross-sectional studies have found depression and anxiety to be lower in surfers (Amrhein, Barkhoff, & Heiby, 2016;Levin & Taylor, 2011) and surfing has been found to provide a sense of respite from symptoms of trauma in combat veterans (Caddick, Phoenix, & Smith, 2015a;Caddick, Smith, & Phoenix, 2015b). Furthermore, a small but growing number of studies have also investigated the effects of surfing-based mental health interventions. Although there is variation in specific design, surf therapy programs typically involve group-based surfing instruction, and can contain elements of psychoeducation, self-care and wellbeing discussions, creating a safe-space, socialization, and community and rapport building.Although still largely preliminary, the results are promising. For instance, studies have found decreases in anxiety and depression in veterans as a result of these programs (Rogers, Mallinson, & Peppers, 2014;Walter et al., 2019). Surf therapy programs for at-risk youth and youth with disabilities have also reported various benefits such as improvements in behavior, social skills, self-esteem, emotion regulation, and psychological well-being (Cavanaugh & Rademacher,

ObjectiveThe aim of this study was to assess the clinical, economic and personal impacts of the nurse practitioner-led Sydney Adventist Hospital Community Palliative Care Service (SanCPCS) MethodsParallel economic analysis of usual care was conducted prospectively with patients from the enhanced SanCPCS. A convenient retrospective sample from the initial service was used to determine the impact of the enhanced service on patient care. A time series survey was used with patients and carers from within the expanded service group in order to measure patient outcomes and values as they approached death. ResultsPatients of the SanCPCS were less likely to die in hospital and had fewer hospital admissions. In addition, the service halved the estimated hospitalisation cost per patient, but the length of hospital stay was not affected by the service. The SanCPCS was more beneficial for women in terms of fewer hospital admissions and lower costs. Patients’ choices regarding place of care and death and what was ‘important’ to them changed over time. For instance, patients tended to prefer being at home as they approached death, and being pain free doubled in importance. ConclusionsNurse practitioner-led community palliative care services have the potential to result in significant economic and personal benefits for patients and their families in need of such care. What is known about the topic?National trends show an emphasis on community services with the aim of promoting and supporting the choice of dying at home, and this coincides with drives to reduce hospital costs and length of stay. Community-based palliative care services may offer substantial economic and clinical benefits. What does this paper add?The SanCPCS was the first nurse practitioner-led community-based palliative care service in Australia. The expansion of this service led to significantly fewer admissions and deaths in hospital, and halved the estimated hospitalisation cost per patient. What are implications for practitioners?Nurse practitioner-led models for care in the out-patient or community setting are a logical direction for palliative services through the engagement of specialised providers uniquely trained to support, nurture, guide and educate patients and their carers.

Self-transcendent positive emotions play a foundational role in social cognition through binding humans to others. In this article, theoretical and emerging empirical evidence is presented in support of the hypothesis that self-transcendent positive emotions may also facilitate bonds with the natural world. This is suggested to occur due to the ability of self-transcendent emotions to direct attention away from the self, facilitate connections with novel social targets, and reduce defensive distancing from nature caused by death anxiety and disgust. It is concluded that further research is needed to clarify the effects of discrete self-transcendent emotions on connectedness to nature, as well as the magnitude and duration of these effects.

Despite research demonstrating positive outcomes of conscious death reflection, very little research directly examines a core proposition of existential psychologists—that death reflection provides an opportunity for more authentic living. The current study compared individuals chronically exposed to genuine mortality cues (funeral/cemetery workers, n = 107) to a matched control sample ( n = 121) on autonomous motivation. It also assessed the moderating role of six constructs implicated in growth-oriented processing of death reflection: psychological flexibility, curiosity, neutral death acceptance, death anxiety, approach-oriented coping, and avoidant coping. Funeral/cemetery workers were significantly higher on autonomous motivation, and death-related work was found to have a more positive association with autonomous motivation for those higher on flexibility and lower on death anxiety. This has implications for both understanding which individuals are most likely to experience growth motivations when confronting death, and potential avenues for facilitating these motivations to enhance well-being.