bluuebunny/crossref_metadata_2025 huggingface dataset:
Contracting with Patients Diagnosed with Borderline Personality Disorder
Authors: Calabretta-Caprini Teresa
Published: March 2013

With the evolution of more concrete and definite diagnostic criteria, more individuals are admitted to psychiatric units with the diagnosis of Borderline Personality Disorder. This diagnosis is a distinct one, identifying a certain maladaptive lifestyle — that of “stable instability ”. These individuals are difficult to treat. They have a tendency towards regression in hospital and usually become management problems. Contracting is a technique that has been a useful tool in working with this population. The aim of contracting is to provide structure by setting limits so that regression and dependency in hospital are minimized. This paper will provide an overview of the Borderline Personality and introduce the technique of contracting which is useful in working with this difficult population.
Knowledge and Use of Theory among Occupational Therapists: A Canadian Survey
Authors: Law Mary , McCoII Mary Ann
Published: March 2013

Recent interest in occupational therapy theory has focussed attention on the utility of theory for clinical-practice and for research. However, for many therapists, knowledge and use of theory have changed notably since their educational days, and the process of keeping up to date on theory development may be difficult.

This paper presents the results of a survey aimed at identifying the extent of use of theory and the level of knowledge about theory among practicing therapists in Canada. A random sample of 187 therapists from across the country was surveyed to ascertain their knowledge of authors and ideas in the occupational therapy theory literature. Results indicate that overall knowledge level is moderate. Factors which significantly predict theory knowledge include year of graduation, training in or outside Canada, academic qualification, and self-assessment of theory knowledge. There were no significant differences in theory knowledge according to area of clinical practice.
Using the World Health Organization's International Classification of Impairments, Disabilities, and Handicaps in Occupational Therapy
Authors: Townsend Elizabeth , Ryan Brenda , Law Mary
Published: March 2013

Health status, although commonly defined in terms of the presence or absence of disease, can also be defined in terms of performance or functional status. Loss of performance results in disablement. The authors summarize the conceptual framework and categorization in the World Health Organization's International Classification of Impairments, Disabilities and Handicaps (ICIDH) (1980) and the Model of Occupational Performance in the Guidelines for the Client-Centred Practice of Occupational Therapy (Health and Welfare Canada and the Canadian Association of Occupational Therapists, 1983; 1986). Complementary elements of the ICIDH and the Model of Occupational Performance appear to be recognition that performance is an element of holistic health influenced by the social, physical and cultural environment. Also, the ICIDH categories of disablement appear to be conceptually mirrored in the model's categories of occupational performance. The authors use client and service data to illustrate three uses of the ICIDH in occupational therapy:

communication with other health professionals; program planning and management; and, clinical evaluation and research.
A Survey of Canadian Occupational Therapy Private Practice
Authors: Bridle Mary , Hawkes Bonnie
Published: March 2013

This descriptive study provides an overview of the business structure and function of occupational therapy private practitioners in Canada. Aspects covered include basic demographic information, practice issues defining operational aspects of the business, financial issues including initial investment and fee structures, and other miscellaneous business issues. Some implications for the national and provincial professional organizations arose from the results and are presented in the discussion.
Manage or Be Managed: Where Do You Stand?
Authors: Chilton Heather
Published: March 2013

Proficiency in administration is an essential component for all occupational therapists whether they are managing a caseload or directing the activities of a large department.

However, more attention needs to be paid to preparing therapists for management roles by professional organizations in occupational therapy, at both provincial and national levels. Occupational therapy mangers have a role to play as well. The issues are reviewed briefly and recommendations to improve the situation are made.
The Miller Assessment for Preschoolers: Analysis of Score Patterns for Children with Developmental Delays
Authors: Daniels Linda
Published: March 2013

This paper describes data trends of the Miller Assessment for Preschoolers (MAP) (Miller, 1982) in a clinical sample of children with suspected or confirmed developmental delay. A retrospective chart review was carried out for 95 subjects, 30 girls and 65 boys, aged 34–68 months. The subjects were assigned to one of six groups based on primary medical or developmental diagnosis or to a no-diagnosis group. Analysis of MAP score patterns was performed using Pearson product moment correlations. Descriptive procedures were used to examine MAP score and item performance. The findings suggest that MAP score patterns differ among some categories of medical/developmental diagnoses, and that the patterns differentiate both specific and more generalized delays.
Occupational Performance of Activities of Daily Living among Elderly Canadians in the Community
Authors: McKinnon Allison L.
Published: March 2013

Sociocultural role expectations for occupational performance by individuals and groups differentiated on the basis of age, gender, and other social characteristics are of central interest to occupational therapy practice based on the occupational performance model. Data analysed from the public use microdata file of the 1985 General Social Survey of Canadians reveal important differences in social role expectations and patterns of occupational performance among a representative sample of elderly Canadians (N=3,130), as evidenced by their social support for certain activities of daily living. Significant gender and age differences are identified in the types and sources of social support provided and received, with elderly men much more likely than elderly women to receive help with housework, meal preparation, and grocery shopping. Such information contributes to the development of a broad national context for the client-centred practice of occupational therapy with elderly Canadians, and points to the need for further research on sociocultural influences on occupational performance across the lifespan.
The Community Work Project: An Occupational Therapy Programme
Authors: Vanier Constance , Rivard René
Published: March 2013

The Community Work Project is a work adjustment programme, part of a range of prevocational services offered in the occupational therapy department of the Royal Ottawa Hospital, in Ottawa, Ontario. The special feature of this work adjustment programme is the use of an integrated work environment. Compared to institutionally-based programmes, this work adjustment programme consists of clients undergoing treatment alongside regular competitive employees in a real work setting. Another important feature of this programme is its open length of stay. The Community Work Project is described, with information on programme need, components, referral process and goals/objectives. Data on sex, age, diagnosis, attendance rates, lengths of stay, graduation placements and client satisfaction are also given. The Community Work Project demonstrates how the use of a productive activity in a real work setting assists individuals with psychiatric disabilities to progress in their vocational rehabilitation process. Implications for the vocational rehabilitation of this population are discussed.
Utilization of the Bay Area Functional Performance Evaluation with an Adolescent Psychiatric Population
Authors: Wener-Altman Pam , Wolfe Anita , Staley Douglas
Published: March 2013

A pilot project to evaluate the usefulness of the Bay Area Functional Performance Evaluation (BaFPE) for the adolescent population utilized the assessment results of 48 adolescent psychiatric inpatients over a 30 month period. Scores on the TOA and SIS components of the BaFPE were compared to norms achieved on the original San Francisco adult standardization sample. The TOA was significantly correlated with severity of diagnosis and SIS scores were negatively correlated with length of stay on the adolescent unit. The results also showed that the BaFPE is sensitive to age as older adolescents scored significantly higher on both the TOA and SIS components. The results suggest that the BaFPE, although originally intended for the adult population, may be successfully employed when working with the adolescent population. Furthermore, the BaFPE provides value in identifying adolescents' problem areas thus allowing for appropriate occupational therapy intervention.
Retention Strategy: A Clinical Ladder for Occupational Therapists
Authors: Gage Marie
Published: March 2013

This article explores the issue of retention of occupational therapists and its impact on the facility, client, department and the profession. It also describes the use of a clinical ladder as a retention tool and presents the experience of one clinical facility in developing a clinical ladder. The literature, in association with the experience of the aforementioned clinical facility in the development of a clinical ladder in an occupational therapy department, does not provide conclusive evidence of the efficacy of a clinical ladder as a retention tool. However, it does lend enough support for the concept to encourage its further use in occupational therapy departments. There is a need to be creative in the design of retention methodologies which will decrease turn over and attrition from the profession in order to provide a stable pool of personnel to agencies that employ occupational therapists.
Documentation of Paediatric Assessments using the Occupational Therapy Guidelines for Client-Centred Practice
Authors: Watson Diane
Published: March 2013

Although documentation is required in occupational therapy, there is little uniformity in content or format between therapists or facilities. The purpose of this article is to present a format that reflects the Canadian Guidelines for the Client-Centred approach to assessment and to share the experience of implementing this format at the Arbutus Society for Children in Victoria, British Columbia. It is hoped that client-centred documentation will facilitate role clarification, service promotion, and quality assurance. As the format reflects the conceptual framework described in the Occupational Therapy Guidelines for Client-Centred Practice (Canadian Association of Occupational Therapists, 1991b), it should be appropriate for use in other areas of practice.
A Theoretical Model of Functional Performance in Persons with Alzheimer Disease
Authors: Carswell Anne , Carson Lorie J. , Walop Wikke , Zgola Jitka
Published: March 2013

This paper reports on a qualitative study that defined a theoretical model as a first step in the development of a functional performance measure for clients with Alzheimer disease. A consensus panel of caregivers used the grounded theory approach to identify the basic sub-components of functional performance that are affected by Alzheimer disease. A model of functional performance which can be applied to any basic activity of daily living was derived from these data. The model comprised three axes: behavioural, environmental and quality of performance. A second panel of caregivers validated the model. This study provided the framework for the Functional Performance Measure to be tested in a subsequent study.
Reasons for Participating in Occupational Therapy Groups: Perceptions of Adult Psychiatric Inpatients and Occupational Therapists
Authors: Poumeni-Walker Isabella , Wilson Keith G. , Jewers Robin
Published: March 2013

Little is known about the attitudes of psychiatric patients towards the specific role of occupational therapy within the overall context of hospital-based treatment. The present study examined this issue by asking 102 adult psychiatric inpatients to indicate their reasons for participating in an occupational therapy group programme, and comparing their responses to those of 31 occupational therapists. Both groups gave high ratings to “reasons for participation” that were related to the achievement of positive therapeutic outcomes, although therapists rated these items significantly higher. The patients, on the other hand, gave higher ratings than therapists to items related to escaping the hospital routine (e.g., “to decrease boredom”), and to achieving “secondary gains” (e.g., to get passes to leave the hospital). The results emphasize the importance of preparing patients for participation in therapy groups in order to enhance the therapeutic value of these experiences.
Predictors of Burnout for Psychiatric Occupational Therapy Personnel
Authors: Brown G. Ted , Pranger Tina
Published: March 2013

Burnout is inherent in many health care professions. This research investigation was conducted to determine if burnout existed at significant levels and if a relationship between burnout, work environment factors and demographic characteristics existed among a group of psychiatric occupational therapy personnel. The study design was a descriptive survey format utilizing mailed questionnaires. Eighty-nine respondents completed the Maslach Burnout Inventory, the Work Environment Scale and a demographic questionnaire. A series of regression analyses were performed. The results indicated that the following were significant predictors of burnout: work involvement, a large percentage of clients on one's caseload diagnosed with schizophrenia, work pressure, age, income level, the length of time working in psychiatric occupational therapy, caseload size and the amount of overtime performed on a weekly basis. Implications for psychiatric occupational therapy practice are discussed and recommendations for future research are made.
Adaptive Computer Education — More than “High Tech”
Authors: Lysaght Rosemary , Lloyd Mary
Published: March 2013

Advances in technology have greatly broadened the range of occupational opportunities available to persons with disabilities. While technical devices help in making participation in computer-based work functions possible, a variety of strategies are required to help individuals with special needs prepare for, acquire, and maintain employment. The experience of the Centre for Adaptive Computer Education, a vocational training programme for adults with disabilities, highlights several strategies that have proven effective in helping persons with disabilities to access work training and employment. Techniques used embrace a number of structural and behavioural approaches to training, including extended training time, individualized curricula, individual tutoring, stress management training, behaviour management, supportive counselling, and promotion in the workplace.
Effectiveness of a Custom-Made below Elbow Lateral Counterforce Splint in the Treatment of Lateral Epicondylitis (Tennis Elbow)
Authors: Clements Linda G. , Chow Susanna
Published: March 2013

The purpose of the study was to determine the effectiveness of a custom-made below elbow lateral counterforce splint along with standard physiotherapy compared with physiotherapy alone, for the treatment of lateral epicondylitis. It was hypothesized that the recovery from lateral epicondylitis is greater following four weeks of standard physiotherapy and the use of the splint, than following four weeks of standard physiotherapy alone. The experimental group (with the splint and physiotherapy) demonstrated a significant improvement in pain (p = 0.05) and maximum grip strength (p = 0.025) of the affected arm compared to the control group. The experimental group showed a greater improvement in function approaching but not reaching significance. The results indicate that this custom-made splint is of value in facilitating the recovery from lateral epicondylitis.
Involving Clients in Programme Evaluation and Research: A New Methodology for Occupational Therapy
Authors: Clark Carrie , Scott Elizabeth , Krupa Terry
Published: March 2013

Eliciting client satisfaction with services has become common in mental health settings and in the planning of service delivery systems. It is also compatible with the client-centred practice of occupational therapy. The traditional approach to collecting satisfaction information involves staff interviewing clients using questionnaires developed by staff. However, there is often a lack of variability in responses and the vast majority of clients report being satisfied. A review of the literature reveals that these favourable reports may be a result of social desirability and of clients being interviewed by treatment providers who have the power to give or withhold care. This paper reviews the relationship between occupational therapy and client involvement, examines the rationale for involving clients in programme evaluation and research, reviews the limitations with traditional methods of collecting information about client satisfaction, and discusses how clients are involved in evaluation and research in today's mental health care setting.
Considering Spirituality in Occupational Therapy Practice
Authors: Egan Mary , Delaat M. Denise
Published: March 2013

Despite its prominent place in the Occupational Therapy Guidelines for client-centred practice, the exact role of spirituality in clinical practice has been difficult to delineate. In this paper current concepts of spirituality are outlined and ways in which these concepts have been applied in health care are described. To illustrate these spiritual concepts, the experiences of individuals whom the authors have met in their clinical practice are outlined in a series of vignettes. Finally, a revision of the model of occupational performance which enhances consideration of spirituality in occupational therapy practice is proposed, and some guidelines for occupational therapists wishing to incorporate spiritual concerns in therapy are suggested.
Le processus d attribution des aides techniques: La perception des obstacles selon la perspective des ergothérapeutes.
Authors: Vincent Claude , Weiss-Lambrou Rhoda , Levy Ron
Published: March 2013

Au Québec, le système d'attribution des aides techniques s'effectue par le biais d'un réseau complexe d'acteurs et de structures, lequel est présentement confronté à des problèmes d'ordre financier, administratif et organisationnel. Ces problèmes, tout comme le nombre croissant des aides techniques disponibles, ont eu un impact sur la pratique des ergothérapeutes oeuvrant dans ce domaine. Afin de mieux comprendre la pratique du point de vue des cliniciens, une étude qualitative a été menée auprès de sept ergothérapeutes. La cueillette des données a été effectuée à. l'aide d'entrevues semi-dirigées. L'analyse de contenu du discours des participants a généré divers thèmes reflétant la perception des ergothérapeutes. Cet article décrit un des thèmes émergeant de l'étude, soit les “obstacles” perçus et vécus par les ergothérapeutes. La formulation de trois affirmations théoriques résultant de cette recherche complétera le texte.
Evaluation of the Cost Effectiveness of Therapist Computerized Entry of Occupational Therapy Workload Measurement Data
Authors: Edwards Mary , Law Mary , Worth Barb , Baptiste Sue
Published: March 2013

A study was conducted to examine the cost effectiveness of two methods of managing occupational therapy workload measurement data. The computer entry of statistical data by a clerk in a central location was compared to multi-site direct input of data by therapists. Cost effectiveness, efficiency and accuracy of each method were the primary outcomes. Ease of coordination and level of computer comfort were secondary outcomes. It was clear that clerk entry of data was more cost effective, efficient and accurate than therapist entry of data. The monitoring of monthly data entry was best facilitated by clerk entry. Therapists had a positive attitude towards direct entry but were unable to approximate the speed and accuracy of the data entry clerk. Therapists' comfort with computers increased slightly during the study. Since the prime purpose of the study was to examine cost effectiveness, it was concluded that clerk entry of workload data is the best use of resources.
Professional Expertise of Occupational Therapists in Community Practice: Results of an Ontario Survey
Authors: Lysack Catherine , Stadnyk Robyn , Paterson Margo , McLeod Kerryellen , Krefting Laura
Published: March 2013

This paper presents findings of a study, The Community Practice Project, that examined the situation of occupational therapists practising in community based settings in the province of Ontario, Canada in 1992. In addition to providing a profile of the typical community based therapist, the study considered issues relating to: the principal roles in places of employment; specific job skills and areas of professional expertise utilized in the community; and how well occupational therapists' formal training prepared them for their community oriented roles and tasks. Results indicate that great opportunities exist and job satisfaction is high in community settings. Nonetheless, therapists feel inadequately prepared for the new role of consultant and its concomitant skills in a field that has re-oriented itself toward the client and is increasingly focused on health promotion and disability prevention.
Conception d'un modèle dynamique de la déglutition: Un outil pédagogique et clinique
Authors: Babin Anne Sophie , Tétreault Sylvie
Published: March 2013

RÉSUMÉ L'alimentation demeure une des activités de la vie quotidienne les plus importantes pour l'humain. Afin de mieux visualiser les composantes de la déglutition et d'en comprendre la physiologie, un modèle dynamique de déglutition a été conçu par trois étudiantes en ergothérapie à l'Université Laval. Le but de ce prototype en trois dimensions est de simplifier la compréhension et la visualisation du processus de déglutition. Présentement, très peu de matériels pédagogiques permettent de voir d'une façon dynamique les mouvements survenant lors de la déglutition. Dans un premier temps, le présent article décrit brièvement les trois phases de la déglutition. Par la suite, il fournit des informations techniques quant à la fabrication du modèle de déglutition afin de permettre aux lecteurs de le reproduire. Pour terminer, des suggestions se rapportant à l'application pédagogique et clinique du modèle sont proposées.
Strategic Planning: Positioning Occupational Therapy to Be Proactive in the New Health Care Paradigm
Authors: Shackleton Teri L. , Gage Marie
Published: March 2013

Strategic planning can be a powerful tool for occupational therapists seeking to position themselves to be leaders in the rapidly changing health care environment. The philosophical base and values of occupational therapy are consistent with those embraced by the emerging health care paradigm. However, occupational therapy staff at Victoria Hospital, an acute care university-affiliated health care institution, identified obstacles to seizing the opportunities offered by this shift in health care. In reviewing the literature, it was discovered that these obstacles were not unique to one particular facility, but were in fact common issues faced by the profession. The strategic planning process described in this paper provided a framework for addressing the identified barriers and positioning occupational therapists to play a proactive role in the evolving health care paradigm.
Handwriting Error Patterns of Children with Mild Motor Difficulties
Authors: Malloy-Miller Theresa , Polatajko Helene , Anstett Bev
Published: March 2013

A large proportion of children referred to school-based occupational therapists experience difficulty with handwriting. Illegible handwriting is found to have secondary effects on school achievement and self-esteem. The purpose of this study was to identify handwriting error patterns of children with mild motor difficulties and to examine the relationship between handwriting error patterns and perceptual-motor abilities. Sixty-six children aged 7 to 12 years old with mild motor difficulties were involved in the study. The results indicated three possible handwriting error patterns: (1) Execution Factor; (2) Aiming Factor; (3) Visual-Spatial Factor. The Execution Factor was associated with visual-motor skill and sensory discrimination; the Aiming Factor was correlated with visual-motor and fine-motor performance. There were no significant associations with perceptual-motor abilities for the Visual-Spatial Factor.
The Person-Environment-Occupation Model: A Transactive Approach to Occupational Performance
Authors: Law Mary , Cooper Barbara , Strong Susan , Stewart Debra , Rigby Patricia , Letts Lori
Published: March 2013

Occupational therapy theory, practice and research has increasingly emphasized the transactional relationship between person, environment and occupation. Occupational performance results from the dynamic relationship between people, their occupations and roles, and the environments in which they live, work and play. There have, however, been few models of practice in the occupational therapy literature which discuss the theoretical and clinical applications of person-environment interaction. This paper proposes a Person-Environment-Occupation Model of occupational performance which builds on concepts from the Occupational Therapy Guidelines for Client Centered Practice and from environment-behaviour theories. The model describes interactions between person, occupation and environment, outlines major concepts and assumptions, and is applied to a practice situation.
Development of an Occupational Therapy Practice Perspective in a Homeless Shelter: A Fieldwork Experience
Authors: Heubner Joanne , Tryssenaar Joyce
Published: March 2013

This paper describes the lived experience of a student occupational therapist at a homeless shelter. This phenomenological experience was captured through journal entries, used initially as a communication tool with the supervising therapist. Retrospective content analysis of the journal revealed a dual search for meaning: by the residents, as they sought for meaning in their chaotic lives; and the student as she searched for meaning in the role of the occupational therapist. Key themes included the importance of rapport, and the residents' innate drive towards purposeful activity. The student developed activity opportunities for people identified as lower functioning, with concommitant psychiatric difficulties. The restraints of the physical setting did not discourage people with significant dysfunction from involvement. Positive changes in psychosocial functioning also were observed. This lived experience indicates the potential of occupational therapy as an ideal profession for addressing the myriad of problems associated with the shelter population.
Ethics, Moral Reasoning and Professional Virtue in Occupational Therapy Education
Authors: Brockett Margaret
Published: March 2013

Concerns about the right ways of behaving towards others have been around for centuries and are clearly influenced by social and historical contexts. The feminist concept of health-care ethics as a commitment to fostering health empowerment *** still in its infancy but is especially appropriate to the practice of occupational therapy. It calls for a much wider interpretation of ethics than is common in bioethics literature but one that clearly affects all professional relationships because of their inherently moral nature. Replicating a study in the United Kingdom (UK), a survey of the occupational therapy educational programmes in Canada was undertaken to determine what is being taught about ethics. As in the UK, the picture is quite confused. This paper outlines the results of the Canadian study and discusses the concerns that arise for the practice of occupational therapy as a moral endeavour.
Functional Consequences of Bipolar Affective Disorder: An Occupational Therapy Perspective
Authors: Kusznir Alice , Scott Elizabeth , Cooke Robert G. , Young L. Trevor
Published: March 2013

An investigation into the functional consequences for an outpatient group of euthymic clients with the diagnosis of bipolar disorder(N=62) was conducted at the Bipolar Clinic at the Clarke Institute of Psychiatry. Participants completed a questionnaire that was based on the Role Checklist and that measured their level of involvement, satisfaction, and functioning in various life roles. The questionnaire also included criteria for adaptive level of functioning. Approximately one third of the sample did not meet the criteria for adaptive level of functioning. Furthermore the self-care, productivity and leisure problems identified in the open-ended questions suggest that the functional consequences of bipolar affective disorder are substantial for this euthymic outpatient group of clients. The implications of these results are discussed in the context of the Occupational Therapy Guidelines for Client-Centred Mental Health Practice.
Inclusiveness: A Community Dimension of Spirituality
Authors: Townsend Elizabeth
Published: March 2013

Personal dimensions of spirituality are important but insufficient for understanding the full transformative potential in spirituality. Communities which extend equal respect and opportunities to people of differing abilities and characteristics create an energizing interconnected-ness based on a community spirituality of inclusiveness. This paper offers a critical analysis of inclusiveness as a community dimension of spirituality. Inclusiveness emerged as an implicit yet practical component of everyday practice during an ethnographic study of occupational therapy in adult, mental health day programmes. There were no explicit goals to foster a spirituality of community inclusiveness, yet occupational therapists continually emphasized the worth of everyone's contributions to chores and other occupations which turn day programmes into inclusive communities. Nevertheless, occupational therapy is constrained by organizational processes which control what can be done in everyday practice. Two organizational constraints, medical classification and individualized accountability, are highlighted and shown to interact with risk management, confidentiality, management information, workload measurement, and other policies which form a ruling apparatus that emphasizes the safe management of individual cases or patients. In light of this analysis, occupational therapists are encouraged to make spirituality, inclusiveness and community activism an explicit and accountable part of practice.
Occupational Therapy Students' First Year Fieldwork Experiences: Discovering the Complexity of Culture
Authors: Dyck Isabel , Forwell Sue
Published: March 2013

Although culture is important to the process of occupational therapy, little is known about how culturally-sensitive practice develops. This paper reports findings from the first year of a three year study following a cohort of occupational therapy students. The study was designed to explore students' perceptions of the development of cultural competencies over the course of their programme. Data were collected through in-depth interviews and fieldwork journals. Two themes emerging from the data are discussed here. These relate to definitional issues concerning the concept of culture, and students' own identification within a culturally complex society. A sense of Canadian-ness informed how students defined cultural difference in the clinical setting, while their own reflections on the concept of culture shaped their response to differences. Interpreting client situations in terms of culture was sometimes useful to students, but there was also resistance to the use of culture as an explanation due to the danger of stereotyping. Implications of the study for curriculum development are discussed.
The Minnesota Manual Dexterity Test: Reliability, Validity and Reference Values Studies with Healthy Elderly People
Authors: Desrosiers Johanne , Rochette Annie , Hébert Réjean , Bravo Gina
Published: March 2013

Several dexterity tests have been developed, including the Minnesota Rate of Manipulation Test (MRMT) and a new version, the Minnesota Manual Dexterity Test (MMDT). The objectives of the study were: a) to verify the test-retest reliability of the MMDT; b) to compare the MRMT and the MMDT; c) to study the concurrent validity of the MMDT; and d) to establish reference values for elderly people with the MMDT. Two hundred and forty-seven community-living healthy elderly were evaluated with the MMDT, and two other dexterity tests, the Box and Block Test (BBT) and the Purdue Pegboard (PP). Thirty-five of them were evaluated twice with the MMDT and 44 were evaluated with both the MMDT and MRMT. The results show that the test-retest reliability of the MMDT is acceptable to high (intraclass correlation coefficients of 0.79 to 0.87, depending on the subtest) and the validity of the test is demonstrated by significant correlations between the MMDT, the BBT and the PP (0.63 to 0.67). There is a high correlation (0.85 to 0.95) between the MMDT and the MMRT in spite of different results. The reference values will help occupational therapists to differentiate better between real dexterity difficulties and those that may be attributed to normal aging.
Étude descriptive sur l'intégration au travail de jeunes adultes présentant une infirmité motrice cérébrale
Authors: Bouchard Anne , Bourbonnais Renée , Tétreault Sylvie
Published: March 2013

Le travail joue un rôle primordial dans la vie de tous les individus. Toutefois, il demeure inaccessible pour certains jeunes adultes vivant avec une déficience physique.

Les données recueillies lors de cette recherche ont permis de décrire 67 jeunes adultes présentant une infirmité motrice cérébrale. Les variables socio-démographiques, l'état de santé, le niveau d'autonomie dans les activités de la vie quotidienne et le statut de travail ont été examinés. Des proportions ont été calculées et ont été comparées pour chacune des catégories de ces variables. De plus, les variables ayant un lien avec le statut de travail ont été mises en évidence. Ces variables, soit l'âge, l'âge au premier emploi, le type d'école fréquentée, la capacité de remplir soi-même le questionnaire, la présence de problèmes de santé et la majorité des activités de la vie quotidienne, semblent toutes reliées à l'autonomie de la personne. Enfin, il apparaît que les résultats obtenus concordent en général avec ceux retrouvés dans la littérature c'est-à-dire que les mêmes variables montrent un lien avec le travail.
Flow and Occupation: A Review of the Literature
Authors: Emerson Heather
Published: March 2013

Flow is a subjective psychological state which occurs when one is totally involved in an activity. Elements of the flow experience include the focusing of attention on a clear goal, a loss of self-consciousness, an altered sense of time, and a sense that the activity in itself is rewarding. Through a review of the literature, the author presents conditions linked to the experience of flow that pertain to traits of the person, properties of the activity, and the interaction between the two. The relevance of flow theory to occupational therapy and occupational science is discussed. Considerations for research on flow and occupation are outlined.
Evidence-Based Occupational Therapy
Authors: Law Mary , Baum Carolyn
Published: March 2013

“Is evidence-based health care just a passing fad, promoted by managers and purchasers enjoying their influence over clinical practice, but doomed to fail as a far too cumbersome method for dealing with the complexity and imprecision of real-life clinical decisions? ”
Economic Evaluation of Occupational Therapy: Where are We at?
Authors: Landry Diane Watson , Mathews Maria
Published: March 2013

Policy makers, health administrators, and practitioners are under pressure to justify resource allocation decisions through an analysis of need, value, and choice. Economic evaluations are increasingly being used to assess the value of health programmes and services. A search of three literature databases revealed that whereas assessments of outcomes and effectiveness are common in the rehabilitation disciplines, comparatively few studies attempt to link costs with outcomes. The purpose of this paper is to familiarize practitioners with the basic concepts and methods used to conduct economic evaluations by describing the different types of analysis, and critiquing research publications to illustrate how this approach has been used to assess the value of various domains of health service relevant to most occupational therapists. By participating in outcomes research to link the costs and consequences of services, occupational therapists will be better able to demonstrate the value of their contribution to the health of Canadians. It is hoped that this paper will stimulate evaluative efforts and enhance the practice of evidence-based decision making in resource allocations.
Voluntarism as Occupation
Authors: Rebeiro Karen L. , Allen John
Published: March 2013

An exploratory, single-case design was conducted to explore and describe the personal experience of a voluntarism occupation for one individual with schizophrenia who resides within the community. Non-participant observation and in-depth interviewing were utilized to explore the voluntarism experience of this individual. The findings suggest that voluntarism is both a meaningful and purposeful occupation for this individual. Volunteering is perceived to be a valued and socially acceptable occupation which allows for the individual to contribute to, and be a productive member of society. In addition, John (a pseudonym) perceived that his participation in a voluntarism occupation helped him to construct a socially acceptable identity and to maintain his preferred view of himself, as a competent individual, not as a mental health consumer. These findings suggest that participation in a voluntarism occupation may benefit some consumers of mental health services. While these findings were based upon the experiences of one person, occupational therapists are encouraged to consider voluntarism as therapy and as a means of enabling the occupational performance of their clients. Implications for further research are suggested.
A Comparison of Interface Pressure Readings to Wheelchair Cushions and Positioning: A Pilot Study
Authors: Pellow Tanya Rose
Published: March 2013

Occupational therapists are often involved in assessing the seating needs of clients who have quadriplegia. One component of this process involves determining the appropriate use of wheelchair cushions and pressure relieving techniques in the prevention of pressure sores. The purpose of this study was to assess the effect of tilt and recline positioning and various wheelchair cushions on interface pressures at the ischial tuberosities and the sacrum of two subjects with C5 quadriplegia. In addition, interface pressures under bony prominences were assessed in the personal driving position (when the subject enters), neutral, 35 degree tilt, 45 degree tilt, and maximum recline (150 degrees).

The results of this study indicate that for the two subjects evaluated, higher average interface pressures at the ischial tuberosities were obtained when using one of the three cushions under scrutiny. Futhermore, the general trend observed with both subjects is a reduction of pressure readings at the ischial tuberosities with tilt and recline positioning (especially with 45 degree tilt and 150 degree recline). The findings of this study are in keeping with previous studies which identified that individual and ongoing assessment is essential in providing the best cushion and pressure relief techniques for individuals.
Improving the Driver–Automation Interaction
Authors: Beller Johannes , Heesen Matthias , Vollrath Mark
Published: March 2013

Objective:

The aim of this study was to evaluate whether communicating automation uncertainty improves the driver–automation interaction.

Background:

A false system understanding of infallibility may provoke automation misuse and can lead to severe consequences in case of automation failure. The presentation of automation uncertainty may prevent this false system understanding and, as was shown by previous studies, may have numerous benefits. Few studies, however, have clearly shown the potential of communicating uncertainty information in driving. The current study fills this gap.

Method:

We conducted a driving simulator experiment, varying the presented uncertainty information between participants (no uncertainty information vs. uncertainty information) and the automation reliability (high vs. low) within participants. Participants interacted with a highly automated driving system while engaging in secondary tasks and were required to cooperate with the automation to drive safely.

Results:

Quantile regressions and multilevel modeling showed that the presentation of uncertainty information increases the time to collision in the case of automation failure. Furthermore, the data indicated improved situation awareness and better knowledge of fallibility for the experimental group. Consequently, the automation with the uncertainty symbol received higher trust ratings and increased acceptance.

Conclusion:

The presentation of automation uncertainty through a symbol improves overall driver–automation cooperation.

Application:

Most automated systems in driving could benefit from displaying reliability information. This display might improve the acceptance of fallible systems and further enhances driver–automation cooperation.
The sea as place in Derek Walcott’s poetry
Authors: Jefferson Ben Thomas
Published: March 2013

Throughout his career, the Saint Lucian poet Derek Walcott has celebrated the Caribbean Sea. From his early writings that pay homage to the importance of the sea in the Caribbean literary voice, Walcott has developed a complex notion of the sea as a place that can be known phenomenologically, and that defies or complicates hegemonic definitions of place and country.
Response and damage propagation of polymer-matrix fibre-reinforced composites: Predictions for WWFE-III Part A
Authors: Pinho ST , Vyas GM , Robinson P
Published: March 2013

This paper showcases the authors’ predictions for the 13 challenging test cases of the third World Wide Failure Exercise. The cases involve the prediction of lamina biaxial stress–strain curves, matrix cracking and delamination in various cross-ply and quasi-isotropic laminates under uniaxial loading, variation of thermal expansion coefficient of a laminate with matrix cracking, bending of a general laminate, loading-unloading behaviour and the strength of various thin and thick laminates containing an open hole. The laminates were made of various glass and carbon fibre/epoxy materials. The constitutive model is based on plasticity theory, includes hydrostatic pressure effects and accounts for multiaxial load combination effects. The failure criteria distinguish between matrix failure, fibre kinking and fibre tensile failure. In-situ strengths are used for matrix failure. Propagation of failure takes into consideration the fracture energy associated with each failure mode and, for matrix failure, the accumulation of cracks in the plies. The model is used to make blind predictions of all test cases from the third World-Wide Failure Exercise.
The Civil–Military Divide in Protracted Small War
Authors: Cochran Shawn T.
Published: March 2013

This article examines the basis of military leadership preferences toward war termination, and thus the basis of the associated civil–military divide, within the context of protracted small war. The conventional wisdom posits military leadership preferences as a near-constant in favor of persistence and thus expects a dominant pattern of military obstructionism. However, such a pattern does not hold empirically across the population of small wars. This gap between expectation and evidence derives at least in part from the limits of the bureaucratic–organizational model, focused on the military’s desire for resources, autonomy, and influence, that underlies the conventional wisdom. In contrast, this article suggests an alternative model privileging the demands of institutional legitimacy. The legitimacy motive as conceptualized here is particularly salient to the small war context. It accordingly provides a foundation for better understanding variation in military leadership preferences toward war termination and thus variation in the direction and intensity of the civil–military divide.
Collective Identity and Promotion Prospects in the South Korean Army
Authors: Kim Insoo , Crabb Tyler
Published: March 2013

This study examines how collective identity based around military school ties influences an individual officer’s achievement in the military. The central premise of this study is that if collective identity can form the basis for fragmented social networks in the South Korean officer corps, it can result in different opportunities for members within different networks. The results presented here demonstrate that collective identities are important explanatory factors to account for this exchange of social resources. All else being equal, the exchange of instrumental and material resources is more likely between military officers who graduated from the same civilian or military school.
Lessons From a Buried Past
Authors: Gabriele Kathryn R.
Published: March 2013

Networks are developing alongside traditional bureaucracies as viable entities for addressing wicked problems. This alternate organizational model requires that administrators learn to manage and lead in more horizontal power-sharing structures. Public administration scholars trace the rise of networks in the United States back to the 1990s, yet the settlement women of the Progressive Era established a managerial and organizational precedent for using democratically anchored governance networks to affect social change. This article examines the work of the settlement women and explores how contemporary network managers can adapt and apply valuable but frequently overlooked managerial lessons from the field’s history.
Distancing Disease in the Un-black Han Chinese Politic
Authors: Hood Johanna
Published: March 2013

This article seeks to understand the meanings associated with HIV/AIDS in China’s media and examine how the “distance” many urban Chinese people feel toward HIV/AIDS is sustained, despite major changes in public health campaigns that indicate otherwise. It draws on evidence from China’s press and public health media, which remain overlooked in studies on attitudes toward HIV even though 90 percent of urban Chinese learn about HIV from the media, making it supremely important in informing urban understandings of the virus. In particular, the article examines how susceptibility to infection has become associated with racial and gender characteristics through the early portrayal of Africans in China’s media reports on HIV/AIDS. It suggests that the geographical and corporeal signification of Africa and Africans establishes an understanding that connects the “dark” consequences of HIV with skin color and a supposed lack of sociomoral and economic development, thus enabling Chinese audiences to perceive themselves as distant from or even immune to the virus. Finally, the article suggests that if attitudes toward HIV/AIDS are to be addressed, then the racialized attitudes in media toward HIV need to be analyzed, challenged, and changed.