bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational Therapy and Multidisciplinary Working on Acute Psychiatric Wards: The Tompkins Acute Ward Study
Authors: Simpson Alan , Bowers Len , Alexander Jane , Ridley Caroline , Warren Jonathan
Published: April 2015

There is limited research into occupational therapy and interprofessional working on acute psychiatric wards. This study aimed to explore relations between occupational therapists and other members of the multidisciplinary team through structured interviews with 47 staff on 14 acute psychiatric wards.

The study found that occupational therapists provided assessments, group activities and individual therapeutic work, with the assessment and development of activities of daily living being central. Linking patients with community resources in preparation for discharge was also important. Severity of illness among patients and speed of discharge were barriers to effective input. Nurses and psychiatrists appreciated occupational therapy input but rarely the breadth of the role. Multidisciplinary relations were generally positive, although some ward teams were disinclined to include occupational therapists in communications and decision making. The occupational therapists appreciated their professional knowledge and opinion being respected and considered.

The study concluded that occupational therapists play an important if often misunderstood role on acute psychiatric wards, but that their involvement could be significantly increased through the employment of more experienced occupational therapists and the provision of interprofessional education. Further research is required to explore the facilities, resources and support required to maximise occupational therapy input and identify areas for increased interprofessional working.
Yoga: An Ancient Occupational Therapy?
Authors: Mailoo Venthan J
Published: April 2015

Yoga is a complete system of occupational regulation, based on complex theories that address occupational risk factors while relating occupation directly to health and wellbeing. Although aspects of yoga have been used in Western occupational therapy settings, some of its underlying theories may have been overlooked. If validated by research, these theories may enrich occupational therapy philosophy. Yogic techniques of potential clinical use include pulse diagnosis, meditation and breath control. These are not described in detail in this opinion piece, but should be the subject of thorough literature reviews and, perhaps, further research.
A Randomised Controlled Trial of Occupational Therapy in Oncology: Challenges in Conducting a Pilot Study
Authors: Harrison-Paul Jane , Drummond Avril E R
Published: April 2015

In order to ascertain whether occupational therapy improved the mood, fatigue management and activities of daily living performance of oncology outpatients, a randomised controlled trial was used to compare an occupational therapy intervention at home with statutory service input. However, there were problems with recruitment and the collection of data, attributable in part to the nature of the disease, and therefore no conclusions regarding the role of occupational therapy could be drawn. Nevertheless, it is believed that this trial is important because it might assist clinicians planning future research in this area and because it counteracts publication bias (ISRCTN71264775).
From Paper to Practice: The Views of Occupational Therapists on the Impact of the National Service Framework for Older People on Practice
Authors: Jacob-Lloyd H , Booth J , Ward G , Dring P , Grant M , Steed A
Published: April 2015

Philp (2003) outlined the fundamental role that occupational therapists could have in implementing the National Service Framework (NSF) for Older People and reforming services for older people (Department of Health 2001). A research project was undertaken, which aimed to investigate the views of occupational therapists about the implementation of the policy in order to identify the key areas and issues that have had an impact on practice. The research design was qualitative and took the form of focus groups.

The focus group data were analysed using a long-table analysis method (Krueger and Casey 2000), which identified five key themes: a raised profile of older people's services, a changing delivery of services, a revisiting of occupational therapy core skills, assessment and resource allocation. The emerging themes suggested that the NSF for Older People has had an impact on the practice of the occupational therapists involved in the focus groups.
Making a Difference, Teamwork and Coping: The Meaning of Practice in Acute Physical Settings
Authors: Robertson Cathy , Finlay Linda
Published: April 2015

Occupational therapists in acute physical settings face challenges and tensions between their holistic professional values and the often reductionist focus of their work. A hermeneutic phenomenological investigation explored the meaning of practice for nine occupational therapists in an acute National Health Service trust in England. Semi-structured interviews were analysed using a framework for interpretive analysis of phenomenological data. Critical reflective evaluation enables readers to judge the quality and relevance of the research.

The three main themes described in this paper – making a difference, gaining strength from the team and coping strategies – illustrate the tensions, stresses and rewards of practice. The occupational therapists wanted to make a difference to their patients' lives. Although they could not always do as much as they would have liked, making an immediate difference by the provision of equipment was rewarding. Relationships with multidisciplinary colleagues generated both stress and satisfaction, but membership of the occupational therapy team enabled the therapists to cope with difficult situations. Effective coping strategies included acknowledging the realities of the acute setting and using reflection to identify those aspects providing value and satisfaction. Overall, the therapists experienced pride, excitement, reward and enjoyment from their work in the acute setting and were convinced of the value and importance of their role.
Occupational Therapy for Children with Acquired Brain Injury: A Survey of Current Practice
Authors: Jones Pru , Drummond Avril , Vella Kristina
Published: April 2015

This survey aimed to describe current occupational therapy practice for children with acquired brain injury in the Trent Region. Forty-three paediatric occupational therapists were sent questionnaires. Information was requested on referral patterns, amount of patient contact time, use of specific care pathways, assessments and the nature of interventions used, as well as contact with educational services.

Eighteen therapists replied and their responses illustrated the difficulties involved in providing a service for this population. The therapists reported low referral rates, service pressures, difficulty in obtaining specialist paediatric equipment and inadequate training. It is suggested that services should provide and network with appropriate training for therapists, and continue the development of care pathways and outcome measures.
The Way We Were: The Ascendance of Rationalism
Authors: Hocking Clare
Published: April 2015

This is the last in a series of three articles that report the findings of a study that explored the history of the ideas that pioneering occupational therapistsin the United Kingdom held about physical objects. Based on an analysis of references to objects in occupational therapy literature published between 1938 and 1962, it revealed the profession's rational and Romantic underpinnings.

The first article described the assumptions rooted in Romanticism and the Arts and Crafts Movement philosophies. The second article explored occupational therapists' rational systematising of knowledge. The focus of this final article is how rationalism came to predominate over Romantic ideals, as the realism of using crafts to transform individuals was pitted against the urgent need to rebuild the nation after World War II. Contributing circumstances, particularly the lack of a research method to explore subjective experiences and outcomes, are identified and the consequences in relation to the balance of the profession's current knowledge base are proposed.
Overseas Placements: Addressing Our Challenges?
Authors: Clampin Anna
Published: April 2015

A project considering overseas practice placements for occupational therapy students was completed by the author on behalf of the education team at the College of Occupational Therapists. The project reviewed the available published literature (both anecdotal and research based) and investigated current practice. This opinion piece raises some key issues arising from the project work. In doing so, it questions whether overseas practice placements can help the occupational therapy profession to embrace the challenges faced from broadening cultural diversity and globalisation, in the contexts of both the higher education and health/social care agendas in the United Kingdom.
Predictive validity of the Montreal Cognitive Assessment (MoCA) as a screening tool for on-road driving performance
Authors: Kwok Jade Chiu Wai , Gélinas Isabelle , Benoit Dana , Chilingaryan Gevorg
Published: April 2015

Introduction

The objectives of this study are to determine (1) the ability of the Montreal Cognitive Assessment to predict on-road driving performance in drivers with a neurological condition and elderly drivers with suspected cognitive decline, and (2) the association between the performance on the Useful Field of View and the performance on the Montreal Cognitive Assessment.

Method

This study used a retrospective design. Clients were included who had completed the Montreal Cognitive Assessment and the on-road driving evaluation from November 2006 to May 2009 ( n = 154) in a driving rehabilitation program in the Montreal Area. Total scores on the Montreal Cognitive Assessment, Useful Field of View risk categories, pass or fail outcomes from an on-road evaluation, as well as demographic and clinical characteristics were recorded from participants’ medical charts.

Results

The Montreal Cognitive Assessment was found to have a sensitivity of 84.5% and a specificity of 50% with a cut-off of ≤25. It was significantly associated with the Useful Field of View risk category.

Conclusion

The Montreal Cognitive Assessment could be a valuable screening tool. However, its predictive validity is not strong enough to recommend its use as the sole instrument for identifying unfit drivers.
Art Therapy
Authors: Champernowne I.
Published: April 2015

“Occupational therapy in psychiatry is a particularly fine art. Emphasis should be placed on constructive projects to awaken new interests and skills, and these must be adapted to the patient's individual needs. The patient emerging from a manic phase requires limited diversional activities, as it may only increase his responsiveness to environmental stimulation. The depressive patient responds better to easy tasks, as complex activities will increase his feelings of inadequacy. The emphasis here should be placed on diversion, which may take the patient out of himself. The schizophrenic requires activities symbolising reality, the neurotic with pent-up tension should be occupied with activities that give him an opportunity for energy release. Many patients will release more energy witnessing an international football match and by concentrating attention upon public affairs than in actual physical work. The patient identifies himself with his favourite player or team of players, political party or leader, etc. and, by projecting himself in real or imaginary actions, he secures a release of tension.

Tension is a sympton of unreleased energy. In the properly selected work and recreations, the psychiatric finds an opportunity to release his unreleased tension, and this is the task of the psychiatric occupational therapist. It goes back to 1913 when the American Psychiatric Association adopted a resolution, namely ‘that occupational therapy marks the standing of a psychiatric organisation, and neglected or omitted the patients are not receiving the adequate care and treatment to which they are entitled.’ After all, occupational therapy is applied physical treatment.— Dr. Z. Wechsler on ‘Physical Therapies in Psychiatry’ in the Australian Association O.T. Bulletin, October, 1951.
First Appointments: A Survey of Influencing Factors
Authors: Toulouse Jane , Williams Sue
Published: April 2015

This article is based on a survey into factors influencing the choice of first appointment in occupational therapy. The questionnaire covered social, personal and work factors, influences during training, and geographical area, as well as job satisfaction and reasons for wishing to change posts. The results showed that, although work considerations were important, the location of a first post was largely determined by personal factors. They also showed that most occupational therapists were happy with their choice of first post. The implications of the survey for district occupational therapists, heads of department, occupational therapy schools, and students are discussed.
Comparing Occupational Therapy with other Services and Therapists' Satisfaction with Occupational Therapy
Authors: Maslin Z B
Published: April 2015

Comparative ratings of occupational therapy were obtained by interviewing patients and therapists. Occupational therapy is seen as equally beneficial in comparison with other services. Results indicate that therapists should endeavour to administer occupational therapy aimed at resolving an individual patient's problems.
Management Training for Occupational Therapists Part 1: Establishing the Need
Authors: Craik Christine
Published: April 2015

This study had two related aims regarding management training for occupational therapists: firstly, to discover if occupational therapists currently employed as heads of department considered that they had sufficient management training to carry out their duties effectively and, secondly, to begin to identify management training needs. A personal interview was carried out on a small sample of head occupational therapists to ascertain their views. The results are discussed and areas for future research are suggested.
An Investigation into the Teaching and Learning of Creative and Constructional Skills
Authors: Robertson Linda
Published: April 2015

This study seeks to identify factors that are important to both staff and students who are involved in teaching or learning the craft-orientated practical skills. The findings indicate that: Students' concerns are often quite different from the concerns of those who teach; students vary from one another as to the primary motivating factors that influence their learning; and there is a difference in attitudes towards the nature of these classes between the various lecturers. It is proposed that such discrepancies should be discussed openly and clarified so that there may be a shared understanding between all staff and students.
Straddle Seating for the Cerebral Palsied Child
Authors: Stewart Pamela C , McQuilton Gordon
Published: April 2015

This paper describes an alternative approach to seating the cerebral palsied child, and presents the development and use of a seating system primarily designed to seat the cerebral palsied child during functional therapy.
A Model for Rotation of Staff from a Health Authority into a Social Services Department
Authors: Rogerson Marion , Murphy Beverley
Published: April 2015

Following the DHSS paper of 1985, ‘Occupational Therapy Service, National Health Service and Local Authority Social Services’,1 which was circulated with the intention of promoting closer working relationships between staff working in health authorities and social services departments, the District Occupational Therapist of Wolverhampton Health Authority and the Head Occupational Therapist of Wolverhampton Social Services resolved to develop closer liaison between their two departments. The result of their resolve was the development of a scheme whereby staff could rotate between the two departments; a précis of the guidelines set out to introduce the scheme is given in this article.
Community Mental Handicap Teams: the Role of the Occupational Therapist
Authors: Newman Jane , Donoghue Karen , Rees Colin
Published: April 2015

This article describes a research project conducted over a 3-week period, which set out to look into the role of the occupational therapist working within a community mental handicap team. It also looks at the preparation that occupational therapists have for such work in terms of their basic training and post-registration experience.
Maximising Occupational Role Performance with the Terminally III Patient
Authors: Lloyd Chris
Published: April 2015

Dying, role relationships and occupational behaviour are key factors in understanding the needs of the terminally ill patient. Assessment and treatment issues are examined from an occupational behaviour perspective. The primary focus is on identifying what it is that the patient would like to accomplish in order to improve the quality of his or her remaining life.
The Participation of Occupational Therapists in the Education of other Professionals about Occupational Therapy
Authors: Fraser-Holland E Naomi
Published: April 2015

The report of a questionnaire study carried out on behalf of the Education and Research Board of the College of Occupational Therapists, supported by a generous grant from the Farrer-Brown Professional Development Fund.
Drinking Equipment: Preparing a DEAP Report
Authors: Pugh Moyra , Stansfield Sharon
Published: April 2015

This article describes the preparation and completion of a Disability Equipment Assessment Programme report on drinking equipment, which included research into difficulties with managing to drink and usage of different cups and straws. Questionnaires were sent out to disabled people and professionals and the results are shown. Brief reviews of the methodology for the trials and the actual users' assessments are given. A knowledge of the range of drinking equipment available and its assessment by users will help therapists in their prescription of equipment most suitable for their patients'/clients' needs.
Improving Engagement Level and Staff-Resident Interaction in a New Therapeutic Day Unit
Authors: Midence Kenny
Published: April 2015

Previous research studies have found evidence of the importance of providing feedback and training to direct care staff. Changes in attitude, support and maximum involvement at all leveis of staff are necessary if activity levels of engagement are to be successfully increased. The ways in which staff encourage residents to participate and give them attention for doing so can influence the things that residents do. This study is an observational research Intended to provide some baseline and 5-month follow-up data on levels of engagement and staff-resident interaction as part of a longer-term programme to develop a high-quality service in a new therapeutic day unit. Baseline and follow-up data were collected by direct observations of the staff-resident interaction and the engagement levels of 14 people with teaming difficulties during seven different activity sessions. The results showed that residents Increased their engagement level Horn 37.5% to 43.2% and staff-resident interaction increased from 36.8% to 64.5% after 5-month follow-up. The implications of these data, the importance of attitude change and the positive effects of staff involvement and participation in organising the day unit are discussed.
Who Owns Quality in the Occupational Therapy Profession and How Do We Assure It?
Authors: Roberts Anne E K
Published: April 2015

This article examines the basic concepts of quality assurance. It explores the ownership of quality assurance within the National Health Service and within the occupational therapy profession. Particular attention is given to the role of the employee as a consumer within the NHS and also to the role of the client as a consumer without. Their respective parts in the assurance of quality are explored. In addition, the need for standards to be set and monitored in current occupational therapy practice is emphasised, with responsibility centred on the profession itself. The increasing need to involve the satisfaction of the client consumer as a measure of outcome is also suggested as part of the assurance of quality.
A Critical Evaluation of the Barthel Index, Part 2
Authors: Murdock Carolyn
Published: April 2015

This is the second of two articles providing a critical evaluation of the Barthel Index as a measure of activities of daily living. Part 2 reviews evidence of the test's standardisation, validity and reliability. It also discusses the usefulness of the test for an occupational therapist in clinical practice and stresses the need for standardised assessment within the profession.
Health Profiles in Physiology Teaching: An Active Learning Experience
Authors: Howells Ken , Butler Jennifer
Published: April 2015

This article describes the background and rationale for using active learning practical classes in the teaching of physiology to occupational therapy students. One such class, a health/fitness profile, is described in detail. The results obtained and the educational value of the sessions are discussed, as are future plans.
Setting up an Occupational Therapy College in the Middle East, Part 2
Authors: Busuttil Joseph
Published: April 2015

The graduation of the pioneering group of students from the Jordanian College of Occupational Therapy in June 1992 marked the successful completion of the first locally produced occupational therapy course. A previous article reviewed the background to the College and the first academic year.1 This article deals with the continuation of the course and concurrent developments.
The First International Congress of the World Federation of Occupational Therapists — Edinburgh, 1954
Authors: Paterson Catherine F
Published: April 2015

This paper gives a brief account of the First International Congress of the World Federation of Occupational Therapists which was held in Edinburgh in 1954, only 2 years after the formation of WFOT. It provides an insight into the organisation of the congress and the subjects that were of relevance to occupational therapists at the time. The prominence of the medical profession in the affairs of occupational therapy is also highlighted.
The Effects of Juvenile Rheumatoid Arthritis on Functional Development: A Literature Review
Authors: Bender Louise , Agnew Patricia J , Black Jamie , Charlton Sheila
Published: April 2015

This literature review examines the condition of Juvenile rheumatoid arthritis (JRA) and its far-reaching effects upon the child, both developmentally and functionally. In particular, the level of functional independence that can be achieved by the child with JRA is discussed in relation to parental perceptions and the phenomenon of maternal overprotection.
Children's Stereotypes of Visibly Physically Impaired Targets: An Empirical Study
Authors: Bracegirdle Hazel
Published: April 2015

Twenty-five primary school aged children with physical impairments from three special schools and matched able-bodied controls from three ordinary primary schools in the Greater Manchester area participated in the study. It was designed to explore the traits that each group would attribute to a visibly physically impaired target. It was assumed that if a set of traits were to be selected consistently then this might reflect an underlying social stereotype. The majority of able-bodied respondents assigned seven traits to the ‘disabled’ target and this finding was in line with that of researchers who suggest that children stereotype those who are physically impaired. Children who themselves had a physical impairment appeared not to hold stereotypical beliefs about those who were ‘handicapped’.
The Professional Portfolio — Purpose, Process and Practice, Part 1: Portfolios and Professional Practice
Authors: Alsop Auldeen
Published: April 2015

This is the first of two articles which together explore the potential for using portfolios in professional practice. Part 1 appraises the practical use of portfolios for students, practitioners and managers. It suggests that individuals might establish and maintain a professional portfolio as a means of demonstrating learning and professional development. Portfolios might also assist practitioners to achieve academic awards and career goals. Part 2 will examine the theory of experiential learning and the process of documenting and accrediting learning in order to build up a portfolio of professional experience.
In Search of a Theoretical Framework for Practice, Part 2
Authors: Jenkins Mary , Brotherton Chris
Published: April 2015

In this work, the position is taken that practice is a knowledge-rich domain where knowledge use and knowledge creation intertwine. This article presents a learning-in-practice model of occupational therapy which anchors occupational therapy theory within the reality of occupational therapy practice, identifying theory and practice as one entity. The model takes issue with the theory/practice paradigm of practical professions and suggests that, in occupational therapy, the real world situation of practice and clients' life-world contexts are the most fitting frames of reference for practitioners.

The model, arising from the thesis ‘Occupational therapy: perspectives on the effectiveness of practice’ (Jenkins, 1994), implies that professional effectiveness is not dependent only on the concept of reflection in and on action as espoused by Schön (1987) but, in effect, hinges on a ‘community of practice’ wherein learning is situated, ongoing and continuous and occurs in action, in discussion and in periods of personal reflection, purposively and incidentally.

Part 1 introduced the work and described Lave's and Wenger's Situated Learning Perspective, from which this practice model is derived; the model's four basic constituents – community, context, access and language – were presented. Part 2 identifies these in the occupational therapy setting and forwards the notion that the model is the kernel of democratic professionalism.
A Scheme of Early Supported Discharge for Elderly Trauma Patients: The Views of Patients, Carers and Community Staff
Authors: Closs S J , Stewart L S P , Brand E , Currie C T
Published: April 2015

This collaborative scheme of Early Supported Discharge, involving hospital and community staff and based in the Orthopaedic Directorate, Royal Infirmary of Edinburgh NHS Trust, has improved early rehabilitation, discharge planning and follow-up for trauma patients aged over 70 and admitted from home and has produced substantial reductions in length of hospital stay. Central to the scheme is a dedicated occupational therapist who coordinates discharge arrangements for eligible patients. An evaluation of the experiences of patients, carers, general practitioners and other community staff indicated that shorter stays in hospital have been achieved without undue problems for patients during the immediate post-discharge period.
Occupational Therapy for Elderly Patients: A New Experience at ‘Policlinico Gemelli, Rome
Authors: Landi F , Bernabei R , Smallwood B , Manigrasso L , Zuccalà G , Cocchi A , Antico L , De Angelis G , Carbonin P U
Published: April 2015

This article considers the importance of rehabilitation in the medical care of elderly patients. It discusses a pilot project being carried out at ‘Policlinico Gemelll’ hospital of Rome, which enables patients to achieve the maximum level of independence and a satisfactory quality of life.

The article is published as part of the College of Occupational Therapists' current focus on ‘Equalising Opportunities’.
Clinical Reasoning in Local Authority Paediatric Occupational Therapy: Planning a Major Adaptation for the Child with a Degenerative Condition, Part 2
Authors: Medhurst Angela , Ryan Susan
Published: April 2015

Part 2 of the article develops the narrative that was described in part 1. The themes that are explored in relation to solving a practical problem are time, adjustment periods, and multiple interpretations of the same story by family members with different roles. What is revealed is the complexity of artistic practice, the dynamic nature of the family members, and the incredible professional sensitivity that is needed in such a situation. The social services occupational therapist reflects on the personal benefits that have been derived from studying and making explicit her clinical reasoning.
An Audit of Occupational Therapy Outpatient Attendance
Authors: Green Andrew
Published: April 2015

An audit of occupational therapy outpatient appointments over a 3-year period demonstrated improved attendance for first appointments in neuropsychiatry when new referral procedures were followed. A substantial number of patients, however, continued to drop out of therapy. The results are discussed in relation to findings of other studies. Speed of referral and personal contact were found to be important factors in reducing non-attendance. Further changes are proposed in an attempt to reduce the number of patients dropping out of therapy, illustrating how audit is a continuous process.
Letters to the Editor: The Last 60 Years
Authors: Kelly Greg
Published: April 2015

A review of the letters published in the British Journal of Occupational Therapy over 60 years.
Two Case Discussions of Ethics: Editing the Truth and the Right to Resources
Authors: Barnitt Rosemary , Warbey Jennifer , Rawlins Sandra
Published: April 2015

Two ethical dilemmas commonly experienced in occupational therapy are presented: whether a terminally ill patient should be told the truth that he or she is dying and how therapists make choices when faced with limited resources. The article commences with an introduction to ethical theories and the use of these with regard to the two dilemmas being discussed. The theories selected are deontology and utilitarianism. A number of ethical principles are described, the major ones being truth telling (veracity), doing good (beneficence) and doing no harm (non-maleficence. The two practice dilemmas are then given with discussion of how ethical theories and principles might help the therapist who is confronted with these difficult issues. The material being discussed is related to the College of Occupational Therapists' Code of Ethics and Professional Conduct at all relevant points. The conclusion is drawn that while there are no easy solutions to these difficult decisions, there are theories and reasoning strategies that can help decisions, there are theories and reasoning strategies that can help.
The Common Problem of Dutch Occupational Therapists in their Intervention with Young Children with Developmental Dyspraxia
Authors: Verkerk Gijs
Published: April 2015

This article presents a qualitative study which aimed to explore the problems that six experienced occupational therapists encountered in their intervention with young children with severe developmental dyspraxia. In-depth interviews revealed that although each case was unique, some commonalities could be deduced. The common problem most of the therapists encountered concerned their doubts about which approach or which techniques to use in their intervention with these children. The use of standardised assessment instruments, continuing education about frames of reference other than sensory integration and mentorship are suggested to relieve this problem.
Applying Phenomenology in Research: Problems, Principles and Practice
Authors: Finlay Linda
Published: April 2015

Interest in phenomenological research has been growing steadily over the last decade as researchers have sought to capture the richness of individual experience. However, the sheer complexity of ideas embedded within phenomenology is challenging. Confusions abound as to what phenomenology means, let alone how to apply it as a research method. Misconceptions and contradictions are apparent in the literature.

This paper starts with a broad review of some current phenomenological literature relevant to occupational therapy. The key principles of the phenomenological approach are then clarified, followed by an exploration of how these might be applied practically in research.
Transcultural Occupational Therapy in the United Kingdom: Concepts and Research
Authors: Howarth Alexandra , Jones Derek
Published: April 2015

The United Kingdom (UK) today is an ethnically diverse society. Legislation and the profession's own code of conduct highlight the need for occupational therapists to engage in culturally sensitive practice. This article comprises a contextual analysis of transcultural occupational therapy in the UK based upon a review of the research published in the British Journal of Occupational Therapy during 1990–1997.

The article focuses initially on terminology to allow a clearer understanding of the issues surrounding transcultural service provision, and the dominant models currently used to conceptualise and implement transcultural practice in health care are also outlined. Discussion of both provides the contextual basis for an analysis of the research. From the material examined, it appears that cultural sensitivity needs to be developed at all levels before occupational therapists can be said to be providing an equitable service to the ethnically diverse communities of the UK.
Political ecology II
Authors: Turner Matthew D.
Published: April 2015

This report provides an update to Peter Walker’s 2005 report that questioned the degree to which political ecologists substantively incorporate ecology in their analyses. Since the publication of this article, a range of scholars have characterized political ecology as unengaged with ecology. This report documents a range of engagements with ecology (or the nonhuman biophysical world more generally) by work strongly influenced by or aligned with political ecology in the realms of environmental politics and the political economy of environmental change. This brief review demonstrates that, while representing a minority of political ecology scholarship, work variously engaging with ecology remains an active and fertile area. The report concludes with a cautionary note that portrayals of political ecology as inhospitable to ecological engagement could actually lead to an erosion of such scholarship. Such an erosion would have severe consequences for the human-and-environment field more generally since political ecology (along with cultural ecology) remains the field’s major place-based approach.
Development of mixed connective tissue disease and Sjögren’s syndrome in a patient with trisomy X
Authors: Fujimoto M , Ikeda K , Nakamura T , Iwamoto T , Furuta S , Nakajima H
Published: April 2015

Increased risk of developing systemic lupus erythematosus (SLE) has been reported in patients with Klinefelter syndrome. Here, we describe a 16-year-old Japanese patient with trisomy X (47,XXX) who developed mixed connective tissue disease (MCTD) and Sjögren’s syndrome. She had polyarthritis, edematous fingers with Raynaud’s phenomenon, sicca syndrome, interstitial lung disease, possible myositis, and was positive for anti-nuclear antibody, anti-nRNP antibody and rheumatoid factor. This is the first report in the literature of a case of MCTD with female polysomy X, which further supports the link between the presence of extra X chromosome(s) and the development of autoimmune diseases.
A statistical method for studying correlated rare events and their risk factors
Authors: Xue Xiaonan , Kim Mimi Y , Wang Tao , Kuniholm Mark H , Strickler Howard D
Published: April 2015

Longitudinal studies of rare events such as cervical high-grade lesions or colorectal polyps that can recur often involve correlated binary data. Risk factor for these events cannot be reliably examined using conventional statistical methods. For example, logistic regression models that incorporate generalized estimating equations often fail to converge or provide inaccurate results when analyzing data of this type. Although exact methods have been reported, they are complex and computationally difficult. The current paper proposes a mathematically straightforward and easy-to-use two-step approach involving (i) an additive model to measure associations between a rare or uncommon correlated binary event and potential risk factors and (ii) a permutation test to estimate the statistical significance of these associations. Simulation studies showed that the proposed method reliably tests and accurately estimates the associations of exposure with correlated binary rare events. This method was then applied to a longitudinal study of human leukocyte antigen (HLA) genotype and risk of cervical high grade squamous intraepithelial lesions (HSIL) among HIV-infected and HIV-uninfected women. Results showed statistically significant associations of two HLA alleles among HIV-negative but not HIV-positive women, suggesting that immune status may modify the HLA and cervical HSIL association. Overall, the proposed method avoids model nonconvergence problems and provides a computationally simple, accurate, and powerful approach for the analysis of risk factor associations with rare/uncommon correlated binary events.
An evaluation of the use of immunoglobulin A antibody response against mycobacterial antigens for the diagnosis of Mycobacterium bovis infection in cattle
Authors: Jeon Haet Sal , Shin A-Rum , Son Yeo-Jin , Kim Jae-Myung , Jang Yunho , Kim Suk , Lee Kang-In , Choi Chul Hee , Park Jeong-Kyu , Kim Hwa-Jung
Published: April 2015

Antibody responses are useful indicators of Mycobacterium bovis infection in cattle. Many studies have evaluated the ability of immunoglobulin G (IgG) to serodiagnose bovine tuberculosis (TB). In the current study, immunoglobulin A (IgA) and IgG responses against the MPB70 and MPB83 antigens of M. bovis, the 38 kDa phosphate-binding lipoprotein (PstS1) that is a well-known serodiagnostic M. tuberculosis antigen, and a newly identified protein, termed Rv1483c, were compared in M. bovis–infected and noninfected cattle as well as in field samples. The diagnostic utility of the IgA antibody to MPB70 and MPB83 for bovine TB was superior or comparable to that of the IgG antibody, and the sensitivity of serodiagnosis increased when the results of antigen binding by IgA and IgG were combined. The sensitivities of the IgG and IgA antibodies to the Rv1483c and PstS1 proteins were significantly lower than those to MPB70 and MPB83, and no diagnostic utility for Rv1483c was observed in field samples. Importantly, the IgA antibody reacted strongly to the MPB70 and MPB83 antigens and differentiated cattle with TB from healthy cattle in a multiantigen printed immunoassay. The results of this study support the feasibility of using IgA antibody against the MPB70 and MPB83 antigens to detect bovine TB. In addition, approaches using assays for both IgA and IgG antibodies may increase detection accuracy.
Barriers to Male Involvement in Antenatal Care in Rural Mozambique
Authors: Audet Carolyn M. , Chire Yazalde Manual , Vaz Lara M. E. , Bechtel Ruth , Carlson-Bremer Daphne , Wester C. William , Amico K. Rivet , Gonzaléz-Calvo Lázaro
Published: April 2015

Low rates of antenatal care (ANC) service uptake limit the potential impact of mother-to-child HIV-prevention strategies. Zambézia province, Mozambique, has one of the lowest proportions of ANC uptake among pregnant women in the country, despite the availability of free services. We sought to identify factors influencing ANC service uptake (including HIV counseling and testing) through qualitative methods. In addition, we encouraged discussion about strategies to improve uptake of services. We conducted 14 focus groups to explore community views on these topics. Based on thematic coding of discourse, two main themes emerged: (a) gender inequality in decision making and responsibility for pregnancy and (b) community beliefs that uptake of ANC services, particularly, if supported by a male partner, reflects a woman’s HIV-positive status. Interventions to promote ANC uptake must work to shift cultural norms through male partner participation. Potential strategies to promote male engagement in ANC services are discussed.
Creating and Maintaining a Safe Space in Experiential Learning
Authors: Kisfalvi Veronika , Oliver David
Published: April 2015

The increasing popularity of experiential learning in management education raises a number of new opportunities and challenges for instructors, particularly with regard to shifting instructor roles and attention to learning through one’s emotions. In this article, we draw on psychodynamics—in particular D. W. Winnicott’s notions of “transitional space” and “holding”—to delineate what a safe space might look like in a management education context. We propose that experiential learning can result in deeper learning when conducted in such a space, which consists of appropriate physical aspects, trust, respect, suspension of judgment and censorship, a willingness to share, and high-quality listening. We further propose that a safe space can be developed and maintained by creating a strong container early on, establishing ground rules, providing lessons in listening and witnessing, teaching by example, and developing a reflexive attitude.
Implementing Functional Behavior Assessment in Thailand
Authors: Opartkiattikul Watinee , Arthur-Kelly Michael , Dempsey Ian
Published: April 2015

Thailand is aiming to improve special education practices, and inclusive education has been introduced and mandated by national laws in the past few years. However, inclusive practices are challenging for many Thai teachers and schools. Many teachers are unprepared to support students with diverse needs and to deal with behavior problems. To successfully support such students, teachers need to apply systematic and effective approaches. Functional behavioral assessment (FBA) is one such approach that may assist teachers in general classrooms. As FBA is a relatively new practice in Thailand, a contextualized approach is required. This article discusses several essential components in FBA implementation processes that need to be considered as well as an example of a research project that involved training Thai teachers in the use of FBA.
Sally Sits on My Shoulder
Authors: Kaff Marilyn , Teagarden James , Zabel Robert H.
Published: April 2015

Beverly (Bev) Johns shares her career as an educator and advocate for children who present challenges in the educational setting. She introduces the reader to “Sally,” who illustrates the continual need for advocacy for children. Bev also offers advice for those just entering the field. Her perspective and experiences enrich us all.
Changes in Adult Behavior to Decrease Disruption From Students in Nonclassroom Settings
Authors: Bohanon Hank
Published: April 2015

Decreasing classroom disruptions that result from hallway-related behavior in high school settings can be very challenging for high school staff. This article presents a case example of preventing problem behavior related to hallway settings in a high school with over 1,200 students. The interventions are described, and the results of the plan are included.
Applying Response to Intervention to Identify Learning Disabilities in Students With Visual Impairments
Authors: Jones Beth A. , Smith Heather Haynes , Hensley-Maloney Lauren , Gansle Kristin A.
Published: April 2015

When visual impairments (VI) and learning disabilities (LD) coexist, it is common for one (i.e., typically LD) to go unidentified. Some school districts may be reluctant to identify students with both VI and LD, potentially causing students to miss out on much-needed services. Child study teams can find support to address this dual diagnosis using a response to intervention (RTI) framework. This article provides guidance and tools for using an RTI framework in the accurate identification of LD in students with VI.
Detective Questions
Authors: Jiménez-Fernández Gracia
Published: April 2015

One of the most frequent problems in reading comprehension is the difficulty in making inferences from the text, especially for students with mild disabilities (i.e., children with learning disabilities or with high-functioning autism). It is essential, therefore, that educators include the teaching of reading strategies to improve their students’ ability to extract inferential information from texts. This article describes one such strategy for improving inference-making called “Detective Questions.” It is a strategy that, in an explicit and scaffolded way, teaches children to discriminate between inferential and literal information and to find the information they need to answer questions on the text. The inclusion of this type of strategy improves children’s reading comprehension in a motivating way and may therefore become an essential part of the teacher’s repertoire of techniques for teaching reading.
Relational Enhancement
Authors: Levin Daniel Z. , Walter Jorge , Appleyard Melissa M. , Cross Rob
Published: April 2015

We propose and test a novel approach to the dilemma that the very network-bridging structure most likely to provide access to novel knowledge may be ill-suited for the cooperation needed to successfully transfer that knowledge. We theorize that the relational dimension of social capital (e.g., tie strength) can act as a substitute for the structural benefits of network closure, and so a network-bridging tie yields more value when it is also strong. We further investigate if it is emotional closeness, interaction frequency, or trust that underlies this “relational enhancement” effect. The results from analyzing a bounded network in a large consulting firm and egocentric networks in the engineering division of a large manufacturer provide support for the relational-enhancement effect of tie strength and further identify trust as the key mechanism allowing network actors to unlock the value embedded in their network-bridging ties.
Edoxaban, a Novel Oral Factor Xa Inhibitor
Authors: Minor Chelsea , Tellor Katie B. , Armbruster Anastasia L.
Published: April 2015

Objective: To evaluate the current literature and potential clinical role of edoxaban (Savaysa) for stroke prevention in nonvalvular atrial fibrillation (NVAF) and treatment of deep-vein thrombosis and pulmonary embolism. Data Sources: A PubMed and Cochrane Central Register of Controlled trials search was conducted in February2015 using the search terms edoxaban (ordu-176b) and atrial fibrillation, deep vein thrombosis, pulmonary embolism, or venous thromboembolism. Bibliographies of all retrieved articles were reviewed. All references included were published between 1998 and 2015. Study Selection/Data Extraction: All studies that included humans and contained data describing the use of edoxaban for either stroke prevention in patients with NVAF or the treatment of venous thromboembolism (VTE) were reviewed. Data Synthesis: Edoxaban is a target-specific oral anticoagulant, specifically a factor Xa inhibitor. It has been studied in 4 major randomized controlled trials for the prevention of stroke and systemic embolism in patients with NVAF. One randomized controlled trial was conducted for the treatment of VTE. Edoxaban demonstrated noninferiority of the primary efficacy end point compared with warfarin for both approved indications. The most common adverse effect is bleeding, similar to other anticoagulants. A dosing limitation exists related to patients treated for NVAF with creatinine clearance >95 mL/min; these patients experienced decreased efficacy. Conclusions: Edoxaban is a safe and effective anticoagulant to reduce the risk of stroke in patients with NVAF and for the treatment of VTE.
Coming “Home”
Authors: Hopkins Justin B.
Published: April 2015

Born in the United States, I grew up in Senegal, West Africa, where my parents worked as missionary linguists. “Coming ‘Home’” tells the story of my return to the United States after graduating from high school. I frame my personal memories, shared in the form of poems (following the methodology outlined by David Hanauer’s Poetry as Research), with reflexive analysis (using the theory of David Pollock and Ruth van Reken’s Third Culture Kids). I examine the difficulty of leaving particular places and people from the “host culture,” as well as the challenge of transition back into the “home” culture.