bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Positive Preparation’: Educational Input on HIV/AIDS in British Occupational Therapy Schools
Authors: Rugg Sue
Published: April 2015

This article presents the results of a national postal survey to determine the type and amount of educational input on HIV/AIDS received by British occupational therapy students. All respondents (18/25 courses, 72%) indicated that they currently provided such input, with an average of 11.9 hours of course time being devoted to it. The majority of presenters were occupational therapists, although colleagues from many other backgrounds were also involved. Much of the material was considered in small group settings, with the content being balanced among a range of aspects. The article concludes that most British occupational therapy students are ‘positively prepared’ to work with clients with HIV/AIDS.
Evaluation of the Uniform Data System for Medical Rehabilitation (including the Functional Independence Measure) by Glenrothes Geriatric Day Hospital Team
Authors: Peter Arthur
Published: April 2015

The need for a patient data collecting system was identified by the geriatric day hospital team in Glenrothes. The Uniform Data System for Medical Rehabilitation (Including the Functional Independence Measure) was selected for this purpose. Its operational acceptability was assessed after using it to collect data on a series of 50 patients. This was done via a questionnaire completed jointly by the team after each patient data sheet had been completed. The team — including an occupational therapist, a physiotherapist, a charge nurse and a doctor — was satisfied overall with the Uniform Data System and the data collected. It identified several operational problems, but these could be overcome through further training, greater familiarity with the system and more appropriate operational definitions.

The results of this study should assist the day hospital team to proceed systematically in selecting a suitable patient data system for day hospital use. The results could also be of interest to other community and hospital care of the elderly staff who are considering the implementation of a patient data collecting system.
Writing for Publication: The Structure of a Journal Article
Authors: Kelly Greg
Published: April 2015

It is very likely that each and every occupational therapist has some information or knowledge worth publishing in a professional Journal. Many clinicians seem to assume that it is only researchers or academics who can write for publication. It may be that all that is preventing some clinicians form submitting their information or ideas for publication is a lack of knowledge about how to structure them. This article is intended as a rough guide and examines the title, the abstract, the introduction, the literature review, the discussion and the conclusion sections of a journal article. It does not deal with method or results as these belong to the structure of a research article, which will be dealt with separately. The article forms part of a symposium entitled ‘An introduction to Writing for Publication in Professional Journals’, prepared by the Editorial Board of BJOT.
Developmental Patterns in Zimbabwean Children with HIV+ Serology: A Guide to Planning a Service Delivery Model
Authors: Kelly Linda
Published: April 2015

The sequelae of AIDS are presenting a worldwide challenge, both in numbers and in the presentation of symptoms, and more children are being affected. Seventy-five children ranging from one month to 4 years were assessed on the Gesell Developmental Schedules in a paediatric clinic for follow-up of children with HIV+ serology in Zimbabwe. When children are deficient in their developmental milestones, it is of concern to their parents. Therapists are involved in the stimulation, adaptation and remediation of the deficits and problems encountered. Combining the parents' concerns with the child's needs can be a challenge with children who, in the long run, will face death.

Four patterns emerged which required different levels of intervention. The levels may be described in a graded sequence that increases with disability, beginning with no developmental delay, then increasing from mild to moderate to severe developmental delays. Handicapping conditions vary within this framework. Within the severe category, there are children who have a range of neurological deficits, including dystonia, hypotonia and tongue thrust. Intervention requires strategies that use a variety of techniques, dependent on the presentation of symptoms. The level of illness in the parents must also be taken into account because they too may need intervention. Intervention strategies are outlined according to the pattern of delay.
The Needs of Physically Disabled People Aged 16–65 Years and Service Usage in Grampian
Authors: Sutherland Anne , Chesson Rosemary
Published: April 2015

The work reported here forms part of a two-phase investigation of disability sponsored by Grampian Regional Council Social Work Committee. Following a questionnaire survey of about one in 40 of the region's households, 212 people with physical disabilities aged 16–65 were interviewed during 1989/90 to obtain an in-depth understanding of their perceptions of current and past service provision. Two-thirds of all those interviewed required some help with self-care across a wide range of activities. Sixty-six (31%) interviewees were found to use 150 items to help with self-care and a further 45 (21%) indicated that they would like equipment. Forty-one per cent of all self-care aids had been self-purchased. Minimal service use was discovered, the most common being dentistry and chiropody. Despite the level of disability, only seven respondents currently had a home help and 10 were in receipt of community occupational therapy. Very low involvement in voluntary organisations was found.

Less than half of interviewees (45%) reported ‘going out’ every day and sedentary leisure activities were more common than visits to clubs or friends. The main reason given for non-participation in other leisure activities was physical difficulty. Only 13 people took part in social activities organised either wholly or partly for people with physical disabilities. In general, those interviewed sought better opportunities for integration into the life of their community. Two case studies are presented in an appendix, which illustrate the multifaceted nature of interviewees' problems and the nature and extent of formal and informal care within two survey households.
An Investigation of the Dimensions of Chronic Low Back Pain: The Patients' Perspectives
Authors: Strong Jenny , Ashton Roderick , Chant David , Cramond Tess
Published: April 2015

This exploratory study investigated the dimensions of pain perceived by seven people with chronic low back pain of non-cancer origin. Using the technique of focus group discussions, the participants gave their perspectives on living with chronic pain. Transcripts from the groups were content analysed to give an indication of the relative importance of the emerging themes. The aspect of family/personal relationships emerged as an important theme, as did affect/emotions (both positive and negative), symptoms/features of pain, mobility, domestic activities and treatment. The extent to which these themes are currently being assessed by health professionals is briefly considered. Recommendations for further research are made.
What Do Psychiatric Inpatients and Ward Staff Think about Occupational Therapy?
Authors: Harries Priscilla , Caan A W
Published: April 2015

In a study of 28 psychiatric inpatients referred to occupational therapy, their understanding about the purposes of this treatment, their initial needs and attendance, the subsequent effects of treatment and their satisfaction with interventions were measured. The perceptions of the therapists involved with these patients were also studied. Patients reported significant benefits from treatment for three specific areas of need which they considered were addressed by occupational therapy. Over all 10 areas of need for which a consensus existed that occupational therapy played a role, patients reported a 13% reduction in need after 4 weeks' treatment.
Empowerment and Enablement: Occupational Therapy 2001
Authors: Stewart Averil
Published: April 2015

The inaugural professorial lecture given by Averil Stewart, Professor of Occupational Therapy at Queen Margaret College, Edinburgh.
Choosing Lever Taps for People with Rheumatoid Arthritis
Authors: Sweeney G M , Catchpool N , Clarke A K
Published: April 2015

This article reports on a Medical Devices Directorate study which set out to evaluate a representative sample of commercially available lever taps for use by individuals who experience difficulty in turning standard taps. Twelve different lever taps were evaluated in terms of ease of use, usefulness and acceptability by a sample of 60 subjects with self-reported difficulty in using taps. Three taps were found to be particularly comfortable and easy to use. The article highlights some of the most important factors to be taken into consideration when selecting lever taps for people with rheumatoid arthritis.
Issues in Contracting Occupational Therapy Services
Authors: Øvretveit John
Published: April 2015

Although most occupational therapy managers have now mastered the basics of contracting, it is important that their junior staff understand the issues. This article summarises issues in contracting, and also shows how occupational therapists can retain their own management structures by contracting services rather than being managed by directorates or localities. It explains why contracting to becoming more Important for occupational therapy, gives an introduction to the concepts underlying contracts, and shows how managers can prepare and negotiate contracts with internal purchasers (for example, directorates) and external purchasers (for example, general practitioners).

This article to adapted with permission from: Øvretveit J. Physiotherapy service contracts and ‘business autonomy’. Physiotherapy 1994; 80(6): 372–376.
Truth Telling in Occupational Therapy and Physiotherapy
Authors: Barnitt Rosemary
Published: April 2015

A study was carried out which looked at ethical dilemmas encountered at work by occupational therapists and physiotherapists. Information about ethical dilemmas was collected through the use of a postal questionnaire to therapists working in the health service in England and Wales. One theme that emerged from content analysis of the dilemmas was telling the truth in the therapeutic relationship. Three main issues emerged: withholding information from patients, usually about diagnosis or prognosis or about services; telling lies to patients for apparently honourable reasons; and telling lies to patients for apparently bad reasons. The present research is related to findings from previous studies in nursing and medicine.
Multidisciplinary Quality Assessment: the Case of a Child Development Team, Part 1
Authors: Howard Lynne M
Published: April 2015

This is the first of three articles reporting research that focused on the increasing attention being paid to measuring the quality of hearth service provision. It addresses the problem of how quality can be measured across a multidisciplinary service and uses a district child development team as an example of such a service, in part 1, the child development team and its origins are examined and a working definition of a quality service in this setting is formulated. The service is broken down into its component parts of structure, process and outcome, according to the model proposed by Donabedian, to examine it more systematically. The following articles will describe the methodology and the results of the research and discuss the findings.
Alcohol Teaching within Occupational Therapy Courses: a Case for Larger Measures
Authors: Booth Peter G , Mulligan Cheryl J
Published: April 2015

The ubiquity of alcohol abuse problems encountered by practising health care workers is not reflected by the scale of training input into professional qualification courses. The present survey found this to be the case within occupational therapy education and training. Practising occupational therapists were aware of basic health information about alcohol. However, they were reluctant and lacked confidence to engage in screening assessment or basic treatment with the problem drinkers, whom they perceived as a significant proportion of their caseload. Enhanced training in alcohol and substance misuse would reinforce both the inevitable involvement with these clients and the legitimate role of the occupational therapist in their management.
Chronic Fatigue Syndrome: A Way Forward
Authors: Pemberton Susan , Hatcher Simon , Stanley Philip , House Allan
Published: April 2015

Chronic fatigue syndrome (CFS) is a condition surrounded by uncertainty and controversy; for example, over whether its cause is physical, psychological or psychosomatic. No doubt this is one reason for the lack of simple rehabilitation programmes to help patients with the syndrome. This article outlines the approach to treating CFS which has been developed at the Fatigue Clinic in Leeds. It is not based upon a particular theory of CFS, but is designed to help patients overcome the common personal and social dysfunctions associated with their condition. As a result it should prove acceptable in wider use, regardless of patients' or therapists' views on the cause of CFS.
The Status and Use of Sensory Integration in the Clinical Setting in Ireland
Authors: Mulcahy Breda
Published: April 2015

The article presents the findings of a survey conducted to determine the status and use of sensory integration in Ireland. The survey questionnaire was distributed to occupational therapists who had completed a Sensory integration International approved course conducted at the School of Occupational Therapy, Trinity College, Dublin. The results are discussed in relation to occupational therapy practice, literature and research.
Unemployment: A Challenge to Occupational Therapy
Authors: Douthwaite Joss
Published: April 2015

When faced with unemployed clients, occupational therapists too frequently treat their symptoms and ignore their joblessness, the net cause of much of their physical and psychological distress. This article suggests that occupational therapists can play a key role in helping unemployed people commit themselves to substitute activities which will protect them front the worst non-financial effects of unemployment. No treatment can be regarded as complete units the client is engaged in these alternative activities.
A Metacognitive Approach to Cognitive Rehabilitation
Authors: Birnboim Smadar
Published: April 2015

This article presents a metacognitive approach to cognitive rehabilitation with people suffering from cognitive disabilities because of brain damage. A theoretical model of four stages of a metacognitive learning process is offered. The four stages serve as guidelines for the therapeutic process. The process is demonstrated in this article by the use of a computer game, but it can be applied in any cognitive activity.
Rehabilitation and Special Education: Measuring Outcomes in Mentally Retarded Children in India
Authors: Sutcliffe Pip
Published: April 2015

A method of measuring and recording change in scored performance (the outcome) is described, based on the Individual Education Programmes of mentally retarded children over time. This method is being piloted at the Tropical Health Foundation of India with children whose handicaps are in the mild to severe categories. (The pilot excludes children with profound handicap.)

This article is adapted from a paper published in ACTIONAID Disability News 1995, Volume 6, Number 1, by kind permission of ACTIONAID, Bangalore, India.
Assessment for the Prescription of Wheelchairs: What Training is Available to Therapists?
Authors: Silcox Lesley
Published: April 2015

The aim of this study was to discover the amount of time spent on and some of the content of the training presently available to therapists, both in colleges and from the wheelchair service. The method was a postal questionnaire, which was sent to all colleges of occupational therapy and physiotherapy and to a geographically selected sample of centres in the wheelchair service.

The results indicated that the mean number of hours of training was statistically significantly higher for colleges of occupational therapy compared with colleges of physiotherapy (OT mean=26.19 hours: PT mean=9.66 hours, t=2.52, df=21, p=0.02) and for colleges of occupational therapy compared with the wheelchair service (OT mean=26.19 hours: WS mean=9.41 hours, t=-2.58, df=20, p=0.02). No statistically significant difference was observed between colleges of physiotherapy and the wheelchair service. The results indicated that the situation has improved slightly since the McColl Report in 1986, which recommended changes within the wheelchair service.
An Evaluation of the Design and Implementation of a National Vocational Qualification in an Occupational Therapy Service
Authors: Reep Judith
Published: April 2015

This article is a study of the implementation of the Self and Environmental Management Skills National Vocational Qualification (NVQ) in an occupational therapy service. The history and reasons for developing NVQs are first described. Semi-structured interviews were used to obtain comments from the four candidates about their perceptions of the assessment process. The discussion incorporates these views, which are of both positive and negative experiences. Recommendations are made in order to improve future NVQ programmes. The article concludes that, in this situation, despite some difficulties, the NVQ has generally improved occupational therapy service provision.
A Different Voice in Occupational Therapy
Authors: Taylor Jackie
Published: April 2015

The majority of occupational therapists are women. The reasons for and the consequences of this situation are reflected upon In this article, in order to achieve a better understanding of the functioning of the profession within health care services. Recent feminist writings, in particular by nurses, psychologists and American occupational therapists, suggest ways in which being female and feminist can have a positive impact on the occupational therapist's work.
In Search of a Theoretical Framework for Practice, Part 1
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 Introduces the work and describes 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 – are presented. Part 2 will identify these in the occupational therapy setting and will forward the notion that the model is the kernel of democratic professionalism.
The Casson Memorial Lecture 1995: An Emergent Profession — A Personal Perspective
Authors: Hagedorn Rosemary
Published: April 2015

The Casson Memorial Lecture 1995, given on 14 July at the 19th Annual Conference of the College of Occupational Therapists, held at Heriot-Watt University, Edinburgh.
The Professional Portfolio — Purpose, Process and Practice, Part 2: Producing a Portfolio from Experiential Learning
Authors: Alsop Auldeen
Published: April 2015

This is the second of two articles that explore the potential for using portfolios in professional practice. Part 1 focused on the practical use of portfolios. Part 2 examines some of the theory relating to experiential learning. It presents strategies for enabling individuals to reflect on experience, identify learning outcomes and document them in some structured way. The article shows how learning outcomes form the basis of portfolios used for professional updating, career enhancement and academic award.
Implications of a Theoretical Framework for Practice
Authors: Jenkins Mary , Brotherton Chris
Published: April 2015

Occupational therapy has been shown to be a profession which, as a consequence of its role in function and enablement, enters clients' life-world situations as a matter of course (Jenkins, 1994a, 1995). Partnership and participation between professional and client occur at practice level, where practitioners and clients learn together of the possibilities and limitations of intervention. In this article, the notion Is advanced that democratic professionalism is the underpinning philosophy of a situated learning model of practice in occupational therapy. The rationale of this proposal is presented and the repercussions of a theoretical framework of practice for educators and practitioners are discussed.
Action Identification May Explain Why the Doing of Activities in Occupational Therapy Effects Positive Changes in Clients
Authors: Dickerson Anne E
Published: April 2015

This article discusses a social cognitive theory called action identification which suggests that the manner in which an action is identified can facilitate behavioural change. Although an action can be identified in many ways, this psychology theory delineates that actions that specify how the action is done are considered a low level identity while actions that signify why the action is performed are at a high level of identity. The level of identification taken by an individual reflects a trade-off between concerns for a comprehensive understanding of the action and how to maintain effective action. Individuals can move between these levels and, in doing so, can change the way in which they view themselves and their world. After a description of the theory and the presentation of two examples of research that document the utility of the theory, application to occupational therapy is suggested. Specifically, action identification theory may explain how the doing in therapy benefits patients more than only verbalisation.
Occupational Therapy: A Critical Overview, Part 1
Authors: Mocellin George
Published: April 2015

This article provides an overview of occupational therapy by analysing those philosophical aspects that are generally held in high regard by the profession. It attempts to demonstrate that current professional beliefs and related models of practice may be flawed and may have a far greater negative Influence on the profession than is generally acknowledged.

Part 1 challenges some of the core philosophical ideas of occupational therapy, in particular concepts related to health through occupation, the meaning of occupation, purposeful activity and occupational dysfunction.
A Comparative Study of the Effectiveness of a Preoperative Education Programme for Total Hip Replacement Patients
Authors: Spalding Nicola J
Published: April 2015

This study examined some effects of providing preoperative education to patients prior to their hospital admission for a total hip replacement. The preoperative education programmes are organised and presented by an occupational therapist with the assistance of a physiotherapist, an anaesthetist, an orthopaedic nurse and a dietician. The content includes information on preparation for surgery, what to expect of admission, surgery and rehabilitation, and how to prepare for discharge.

A quasi-experimental design was used to compare a group of patients who had attended an education programme with, as control, a group of patients who had not. The variables Investigated were length of hospitalisation, morphine usage, mobility independence and discharge preparation.

The results showed that the patients in the experimental group had a mean of 4 days' less hospitalisation than the control group, required less postoperative morphine and achieved mobility independence sooner. The control patients' lack of knowledge of what to expect from their surgery was evident from the lack of preparation for their discharge home. Large financial savings were then calculated as a direct consequence.
Healthy Lifestyles: A Community Programme for Chronically Mentally Ill People
Authors: Lloyd Chris , Samra Pam
Published: April 2015

This article outlines a Healthy Lifestyles Programme (HLP) for chronically mentally ill people in the South Coast Regional Health Authority in Australia, in the area of integrated mental health services. This programme has provided practical community-based experiences for chronically mentally ill people, focusing on functional deficits in daily living skills. Major reforms in service delivery in mental health have resulted in a move to community-based care. The 1994 Queensland Mental Health Plan set out specific objectives and strategies for the implementation of mental health service reform. One of the immediate priorities for Queensland is the establishing of mainstream integrated services to promote continuity of care across service components. The HLP reflects this priority in providing a community-based service in an integrated mental health setting, using the principles of community-based integration, family support, collaboration, rehabilitation and case management, as outlined in the community care model.
Local Authority Occupational Therapy Services and Ethnic Minority Clients
Authors: Johnson Mark R D , Wright Anthea , Jeffcoat Moira-Anne , Petherick Raewyn
Published: April 2015

An audit was conducted of all current cases on the register of a metropolitan district occupational therapy office by the physical disability team. The ethnic origin, language and religion of clients was established from the records and by direct enquiry. An analysis performed of presenting problems, service response and response times demonstrated that there were significant variations between ethnic groups in the use made of the service. No evidence was found of a systematic bias against the interests of ethnic minority groups in general, but a number of questions were raised. In particular, Asian clients were more likely to be referred by certain channels, to require major works and to waft longer for action.

The implications for service providers should be explored. There is also evidence of ethnic-specific needs. The existing literature relating to ethnicity and occupational therapy, most of which is based on the American experience, is of slight value to consideration of the needs of ethnic minority groups or service providers in the United Kingdom. Social factors, including poverty and housing conditions, affect both needs and outcomes. Future research using Improved ethnic monitoring data and the baseline Information of the 1991 census of population will enlarge the debate and permit service Improvements.
Operational Factors in Arranging Fieldwork Education Placements for Occupational Therapy Students, 1993/94
Authors: Maslin Zielfa B
Published: April 2015

A survey of the factors affecting the arrangements of fieldwork education placement programmes for occupational therapy students in the United Kingdom and the Republic of Ireland was conducted for the academic year 1993/94. The results indicate the different types of fieldwork education placement programme that educational institutions are expecting occupational therapy practitioners in the field to accommodate and the multitude of factors affecting the organisation of fieldwork education placements. Organisational factors appear to be the most frequent background to the collapse and delay of fieldwork education placements for students.
Clinical Reasoning, Part 1: The Nature of Problem Solving, a Literature Review
Authors: Robertson Linda J
Published: April 2015

The information-processing literature has been reviewed to identify the component parts of problem solving. The difference between the problem representation and the subsequent solving process is highlighted, as is the role of memory within problem solving. The techniques for searching data and novice/expert differences are outlined. Finally, a model of problem solving in occupational therapy is proposed. The implications of this model for student education will be discussed in part 2 of this article.
Clinical Reasoning in Community Occupational Therapy
Authors: Munroe Heli
Published: April 2015

A qualitative research study was undertaken in order to ascertain the scope and nature of clinical reasoning in community occupational therapy. Thirty occupational therapists based in social work departments in Scotland participated in this study, which required them to describe the content and meaning of their thinking during routine interventions with clients and carers living in their own homes.

The findings indicated that the participants adopted patterns of reasoning that consisted of three elements: reflection, decision making and reasoning. Reflection-in-action was commonplace during the home visits, while decision making was found to be concerned more with interactive than with technical or procedural issues. Reasoning was relativistic or pragmatic in response to contextual influences. In addition, it was found that the respondents tended to use coded meaning when explaining their thinking, which may in part account for the difficulties in articulating the reasoning that underpins clinical action. These issues are discussed in the context of current research on thinking.
Understanding Occupational Therapy: A Hermeneutic Approach
Authors: Kelly Greg
Published: April 2015

The term ‘hermeneutic’ has recently been appearing in the occupational therapy literature related to clinical reasoning but without an adequate definition of its meaning. The purpose of this article, therefore, is to offer a simple introduction to the term and discuss how it applies to clinical reasoning, thus providing occupational therapists with some of the language they will need to understand this relatively new concept fully. Drawing on literature from nursing, physiotherapy, psychology and occupational therapy, this article examines a hermeneutic approach to occupational therapy research and practice and, indeed, to an understanding of the concept of occupational therapy itself.
A Study to Examine the Relationship of the Assessment of Motor and Process Skills (AMPS) to other Tests of Cognition and Function
Authors: Robinson Susanna E , Fisher Anne G
Published: April 2015

In this study, the Assessment of Motor and Process Skills (AMPS), an observational assessment of functional ability, was compared with other tests of function and cognition, namely the Functional Independence Measure (RM), the CAMCOG (the cognitive component of the CAMDEX [Cambridge Examination for Mental Status in the Elderly]) and the Mini-Mental State Examination (MMSE). The subjects were people with diagnosed dementia or mild memory impairment. The results were as expected, revealing significant relationships between AMPS process ability and the CAMCOG, the MMSE and the FIM social/cognition scale, and between AMPS motor ability and the RM physical scale. This supported the validity of the AMPS as an evaluation of the interaction between cognitive impairments and disability in complex activities of daily living.
Registration and Beyond
Authors: Grainger Carol
Published: April 2015

Occupational therapists and other allied health professionals pass entry level examinations and then, in many cases, seek registration through a State Registration Board. Usually, no further establishment of competency is undertaken once entry level qualifications are demonstrated. This article discusses the need to ensure continuing competency after the initial completion of a degree or diploma in occupational therapy, it describes the practices that are being utilised in one Queensland hospital to ensure the competency of private allied health practitioners wishing to provide services to private patients. This process is still undergoing trial, although positive feedback has been received.
Working with Clients with Learning Disabilities and Multiple Physical Handicaps: A Comparison between Hospital and Community Based Therapists
Authors: Pimentel Susan , Ryan Susan
Published: April 2015

This comparative study looked at hospital and community based occupational therapists who worked with clients with learning disabilities and multiple physical handicaps. The factors that were examined were the time spent by occupational therapists with this group, the interventions that were used, and the learning support that was needed for the therapists. Information was gathered from questionnaires and semistructured interviews. The results showed a distinct difference between the two groups of occupational therapists, with remedial activities being the focus in the hospital setting and functional activities in the community. Most of the respondents felt that they had not had either sufficient education at college or sufficient support when they started their service. A change in role from therapist to consultant was found in those working in the community and this group also placed more emphasis on keeping up to date with developments in this specialist field.
Occupation or Therapy? The Attitudes of Mental Health Professionals
Authors: Kaur Daljeet , Seager Martin , Orrell Martin
Published: April 2015

A questionnaire study of mental health staff on a psychiatric unit investigated their views about occupational therapy. The study evaluated the attitudes to the role of the occupational therapist, the referral and assessment process, the importance of therapeutic activities, and communication and feedback between occupational therapists and other disciplines. Sixty-four out of 89 staff responded (72%).

Most respondents thought that occupational therapy should start within a week of admission, even though many referrals took much longer than this to arrive. There was some confusion over who was responsible for getting the patient to attend occupational therapy. Although occupational therapy was felt to increase people's confidence, some staff suggested that patients should not attend until they had gained confidence. There was uncertainty about who should decide on a patient's suitability for occupational therapy. In addition, there was a blurring of rotes between occupational therapists and other disciplines. Many staff were well able to recognise the main functions of occupational therapy. However, they were not confident about this and did not fully apply this knowledge in their clinical practice. Occupational therapists were generally seen in a positive light.

This study emphasises the importance of better communication between occupational therapists and the other professions and, in particular, the need to raise the profile of occupational therapy within local teaching programmes.
Occupational Therapy in the Reformed NHS: The Views of Therapists and Therapy Managers
Authors: Pringle Evelyn
Published: April 2015

This article describes an exploratory study which considered the effect of the recent reforms of the National Health Service on the professional position of occupational therapists working within NHS trusts. The term ‘reforms’ refers to the overall Impact of Government legislation following the Influential Griffiths report of 1983, up to and including the NHS and Community Care Act 1990.

In the absence of any other published empirical data on this subject, an exploratory study was carried out. Sixteen in-depth interviews were conducted over a 2-month period during the summer of 1995 (10 therapists, 6 managers). The sample was drawn from four separate trust sites in the South East of England. The findings suggest that clinical autonomy remains unchanged, although there are fears that it may be under threat in the future. Managerial autonomy appears to have been adversely affected by the loss of the district therapist posts. Managers were concerned about the long-term effects of fragmented services on supervision and support networks and the recognised problems associated with a flat career structure. Job satisfaction was still high among therapists. Both managers and therapists were, however, less secure in their jobs and felt that their morale had been affected by the recent changes.
Fussy Babies: To Treat or Not to Treat?
Authors: DeGangi Georgia A , Sickel Ruth Z , Wiener Andrea S , Kaplan Elizabeth Pirserchia
Published: April 2015

In this prospective study, the developmental outcomes of 39 infants with high irritability and sensory processing problems, also described as regulatory disordered, were examined at 7–30 months and at 3 years using clinical interdisciplinary assessment. Infants with regulatory disorders were defined as being behaviourally difficult with disturbances in sleep, feeding, state control, self-calming, mood regulation and sensory processing. The performance of samples of infants with regulatory disorders, 13 untreated and 26 treated, and 11 normal children were compared at 3 years. All subjects in the clinical sample were offered 12 weeks of Intervention after the initial assessment to address regulatory problems. Of the 39 subjects, 26 chose treatment, thus resulting in a self-selected treated sample.

Post hoc analysis revealed that, at 7–30 months, untreated subjects had more sleep problems and were more irritable whereas treated subjects had more feeding problems and their mothers reported feeling depressed. At 3 years, the children with regulatory disorders differed from their normal counterparts in sensory integration, mood regulation, attention, motor control, sleep and behavioural control. Untreated subjects showed more emotional and behavioural problems than treated subjects. Treated subjects had more motor and sensory integrative problems than untreated subjects but, despite the fact that they had more constitutional problems, they did not show the emotional and behavioural problems that were found in the untreated group. The clinical importance of these findings for occupational therapists is discussed.
The Establishment of Occupational Therapy Clinics within an Educational Setting: A Report
Authors: Ravetz Christine , Granell Celia
Published: April 2015

The establishment of a new facility for occupational therapy education has led to the development of an initiative in fieldwork education and practice. The innovative principle of offering occupational therapy practice within an educational unit has been put into effect. Two clinics, a bathing clinic and a head injury clinic, are now in operation and a third is planned. The innovation was implemented in close cooperation with fieldwork colleagues and as part of the college's mission statement which makes a commitment of service to the community. This article describes the development of the clinics and the running of one of them, the bathing clinic.
Travelling via Delphi: A New Route to the Accreditation of Fieldwork Educators
Authors: Green Sharon
Published: April 2015

The Department of Occupational Therapy, University of Liverpool, has recently developed and introduced a new system of accreditation for fieldwork educators. A team of educators and practitioners used a Delphi technique to determine and refine the system's content and structure. Implementation was preceded by a planned education phase, using formal conferences and informal meetings with staff teams, to ensure familiarity with the new system. Both national and university credit rating has been sought.
Learning Together Apart: The Development of a Distance Learning Course for Occupational Therapy and Physiotherapy Fieldwork Supervisors
Authors: Lunt Aidan , Bracher Maggie , Borrill Wendy
Published: April 2015

This article describes the development of a distance learning course for occupational therapy and physiotherapy fieldwork supervisors by the School of Occupational Therapy and Physiotherapy at the University of Southampton. It is based on a method of practice teacher education (the social work equivalent of fieldwork educator training) developed in the Department of Social Work Studies. The course is designed for a small teaming group of fieldwork supervisors based in the locality of its members, making it particularly useful as a distance learning approach for teaching person-related skills. The group meets at regular intervals for up to 2 years, during which time each course member supervises two different students on placement. The advantages of this concurrent training approach, where supervisors work with students at the same time as developing their own skills, are explored.
Promoting Research in the Clinical Setting: A Local Inquiry and a Complementary Literature Review
Authors: Conroy M Catherine , Pascoe Jennifer A , Roder Gillian B
Published: April 2015

A report on research prospects for occupational therapists employed in Southampton was commissioned by the Director of Occupational Therapy Practice. This article relates the comments gleaned from interviews with 25 people. Obtaining research training and the lack of a career structure were discussed. Acknowledgement was made of the dilemma facing occupational therapists inasmuch as research is required to Justify occupational therapy to purchasers whilst at the same time managing heavy clinical caseloads so that contracts can be met. Occupational therapy managers were concerned that, if research was conducted by existing members of staff, these targets may not be met. The challenge for occupational therapy managers and clinicians is to balance and address these needs skilfully.

Subsequently, the second author reviewed the literature. The complementary literature review relates how others have viewed the relevance of research to occupational therapy, the provision of training, support and a career path for research, and ways of synthesising research and clinical practice.
Focal Points and Relationships: A Study of Clinical Reasoning
Authors: Crabtree Merrill , Lyons Michael
Published: April 2015

This article reports on a single case study of an occupational therapist working in a plastic surgery unit at an Australian public hospital. A phenomenological approach was used to explore the therapist's clinical reasoning in depth. Data were gathered over a 3–week period through semi-structured interviews with the informant and through participant observation of therapy sessions with patients and associated activities engaged in by the informant. The resulting narrative data were analysed inductively. The focus of this discussion is on the aspects of personal interactions that influence clinical reasoning. The article examines how such constructs as power, responsibility, caring and competence combine to influence clinical reasoning.
Occupational Overuse Syndrome/Repetitive Strain Injury: The Occupational Therapist's Role
Authors: McNaughton Anne
Published: April 2015

This article outlines the intervention used in a specialised occupational rehabilitation clinic in New Zealand to treat and manage clients experiencing the symptoms of Occupational Overuse Syndrome (OOS). The government compensation agency accepts the syndrome as genuine and one that can be identified as a work-related injury; it therefore funds the treatment procedures. The article discusses the various explanations of OOS and goes on to outline the work of the clinic, the interventions it uses and the role of the occupational therapist in the treatment of the syndrome.
Developing Integrated Education Programmes for Occupational Therapy: The Problem of Subject Streams in a Problem-Based Course
Authors: Jacobs Tricia
Published: April 2015

Much has been written in the past 15 years by medical educators on problem-based learning (PBL) in medical schools. The other health professions, such as occupational therapy, social work and nursing, have been slow in taking up the challenge and developing PBL programmes to suit their professional needs. The purpose of this article is to summarise previous developments and offer a schema for the preparation of curricula in occupational therapy. No schema for PBL has previously been published, so it is proposed that this attempt will be able to be adapted to a wide range of courses using the acknowledged educational concepts implicit in integrated, problem-based programmes.
Should Occupational Therapists use Simulation Exercises? Using Wheelchair Training as an Example
Authors: Chard Gill
Published: April 2015

The benefits and problems associated with sending occupational therapy students out into the community in wheelchairs, as a simulation exercise during the first year of a full-time undergraduate programme, are explored. Occupational therapy educators themselves have widely divergent views on the best method of student training in this area, and the views of disability awareness groups towards simulation exercises are also considered.

Disabled people, non-disabled people and first-year occupational therapy students were surveyed about wheelchair-simulation exercises and other methods of learning. The results demonstrated that simulation exercises as an appropriate way of learning were supported and that the experiential element of the course should be retained. This article shares the results of the survey and discusses some of the disability awareness issues that they raise for occupational therapy educators, clinicians, students and disabled people themselves.
Integrating Assessment in Problem-Focused Curricula
Authors: Jacobs Tricia
Published: April 2015

The value of traditional assessments, such as examinations and multiple-choice questions, has long been questioned by educationalists. The use of varied, criterion-referenced assessments for the health professions shows advantages for the learning processes of tertiary students. Little has been written in the past 15 years on the assessment strategies compatible with a problem-based learning course. The literature depends on individual academics' experiences and feedback from students. This article outlines a variety of assessment procedures which can be used within occupational therapy courses, enhancing the learning of the students and encouraging a non-competitive, peer-support process of deep learning and assessment.
HIV/AIDS: A New Service Continuum for Occupational Therapy
Authors: Molineux Matthew
Published: April 2015

The first cases of what is now known as AIDS were reported in the USA in June 1981. The first article on occupational therapy for people with HIV/AIDS was published 6 years later in July 1987. Since that time, much has been written about the work of occupational therapists with people affected by HIV or AIDS. This article presents some of the material published on this area of work, and suggests that occupational therapy has much more to offer this group of people than is described in the literature. A new continuum of service provision is outlined and discussed. This includes practice that falls outside what might be considered the traditional role of occupational therapists. Although this article is specific to HIV/AIDS, many of the issues raised are applicable to other areas of practice.
Reducing Neglect in Adult Hemiplegia: Recent Findings and Implications for Treatment
Authors: Roden Paul W
Published: April 2015

Neglect is a disorder of attentional and intentional processes most commonly observed following a cerebrovascular accident. Recent research indicates that neglect can be reduced by priming neural circuits unaffected by cerebral lesions; the more effective remediation strategies are those that prime neural circuits that are under some voluntary control, although new strategies that influence involuntary attentional mechanisms show therapeutic potential. The implications of recent studies involving single-case and group remediation efforts are discussed with respect to treatment and the theoretical context for understanding disorders of attention.