bluuebunny/crossref_metadata_2025 huggingface dataset:
Macular Thinning Associated with Unilateral Optic Nerve Hypoplasia
Authors: Hoang Quan V. , Chau Felix Y. , Shahidi Mahnaz , Miller Marilyn T. , Blair Michael P.
Published: April 2011

The authors present the case of an 8-year-old boy with a long-term diagnosis of unilateral optic nerve hypoplasia (ONH) of unknown cause in the right eye. Spectral-domain optical coherence tomography (SD-OCT) of the central macula was consistent with hypoplasia greatest in the inner retinal layers, but also involving the outer retinal layers when compared with the unaffected contralateral eye. Although ONH is commonly associated with hypoplasia of the nerve fiber and ganglion cell layers, it can also be associated with hypoplasia of other layers in the inner and outer retina, including the outer nuclear and photoreceptor inner/outer segment layers, as evidenced by SD-OCT.
Presentación. Literatura y cine o “el Cine Soñado”
Authors: García-Abad García M. Teresa
Published: April 2011

No disponible.
La puesta en escena de la autenticidad. Andalucía, un siglo de fascinación, de Basilio Martín Patino, y el “materialismo histórico” en Walter Benjamin
Authors: Cornago Bernal Óscar
Published: April 2011

Este artículo explora las estrategias teatrales desarrolladas por el género documental para crear un efecto de realidad. Con este objetivo se analizará la producción para televisión de Basilio Martín Patino Andalucía, un siglo de fascinación, una serie de cinco documentales filmados entre 1992 y 1996 para la cadena pública Canal Sur Televisión. Estas películas serán comparadas con trabajos anteriores de Martín Patino y con el punto de vista de críticos y directores en relación a las prácticas documentales y la creación de un efecto de objetividad en los medios audiovisuales. Como metodología se aplicará el concepto de “historia material” desarrollado por Walter Benjamin.
Mito, identidad y poestética en Carmen la de Ronda (1959), una idea de Alfonso Sastre
Authors: García-Abad García M.ª Teresa
Published: April 2011

A través del estudio de la película Carmen la de Ronda (Tulio Demicheli, 1959) se plantean las disfunciones promovidas entre la idea de Alfonso Sastre que le sirve de origen y la disolución final de un mito por el que transitar la más abierta paradoja; un complejo recorrido capaz de revelar los desencuentros originados por la interacción entre la producción y la recepción de los artefactos culturales.
El mito de Don Juan en el cine: De Molière a Jacques Weber
Authors: Becerra Suárez Carmen
Published: April 2011

Desde su nacimiento en el siglo XVII español, el mito de Don Juan ha sido vertido en diferentes géneros, abordado por numerosos creadores, desde perspectivas y expresiones artísticas diversas, interpretado por filósofos y estudiado por científicos. Este artículo analiza las modificaciones que el escenario mítico presenta en la versión cinematográfica de Jacques Weber, teniendo en cuenta, además de otras causas de semejante interés, las relacionadas con el cambio de lenguaje: de la literatura al cine. Pero además, como el film estudiado es el resultado de la transposición fílmica de un texto literario particular, en este caso la versión donjuanesca de Molière, se analiza, en primer lugar, la adecuación al discurso mítico del texto literario de partida.
El principe destronado (Miguel Delibes, 1973)/ La guerra de papá (Antonio Mercero, 1977) y la tercera vía del cine español
Authors: Faulkner Sally
Published: April 2011

Este artículo examina La guerra de papá como ejemplo de la Tercera Vía, y considera las razones de su éxito de taquilla. Mediante el análisis comparado de la novela original de Delibes y la versión cinematográfica de Mercero, se detiene en el uso del punto de vista infantil (subrayado en el título de Delibes) y el tratamiento de la Guerra Civil (focalizado en el título de Mercero). Tras analizar La guerra de papá en el contexto del cine de autor y cine comercial contemporáneos españoles, concluye que Mercero encuentra un punto de encuentro entre ambas tendencias que explica su éxito de público como un ejemplo de la cultura media española. Por último, el estudio considera los vínculos entre la novela de Delibes, el cine de Mercero, y la televisión española de momento.
Las determinaciones genéricas en los procesos adaptativos
Authors: Pérez Bowie José Antonio
Published: April 2011

El traslado de un texto literario a la pantalla suele estar condicionado por diversos factores derivados del nuevo contexto en el que el título adaptado debe funcionar. Entre ellos están los condicionamientos que ejerce sobre la obra originaria el género cinematográfico que sirve de modelo para el proceso adaptador. En el presente trabajo se reflexiona sobre esas determinaciones y se analizan tres ejemplos del cine español de postguerra en los cuales la obra literaria sufre una transformación considerable para adecuarse a las exigencias del modelo cinematográfico elegido.
La Ninnette de Miguel Mihura vuelve al cine
Authors: Ríos Carratalá Juan A.
Published: April 2011

Ninette (2005), de José Luis Garci, es la segunda adaptación cinematográfica de la exitosa comedia Ninette y un señor de Murcia (1964), de Miguel Mihura. El artículo analiza los criterios seguidos por el director y su guionista habitual, Horacio Valcárcel, en su adaptación, que se considera poco fiel al espíritu original de la obra teatral y contradictorio con la presentación de la película como homenaje a Miguel Mihura.
Flor de otoño: ejemplo de una obra de teatro adaptada a una película incluso antes de ser representada
Authors: Zatlin Phyllis
Published: April 2011

En general, la adaptación fílmica de obras de teatro suele poner de manifiesto tensiones entre la fidelidad a puestas en escena previas y el deseo de evitar el “teatro enlatado”. Menos frecuente es el caso de una cronología inversa como el representado por Flor de Otoño, de José M.ª Rodríguez Méndez, en el que un texto escrito para el teatro llega antes al público de cine. Escrita en 1972, la pieza de Rodríguez Méndez no se estrena hasta 1982, después de pasar por la pantalla en una adaptación fílmica dirigida por Pedro Olea en 1978. El análisis de esta versión cinematográfica de una obra teatral se detiene en las estrategias adaptativas que moviliza a la vez que considera la ausencia de puesta en escena previa como una solución que favorece la libertad creativa en dicho proceso.
Más allá de la cinefilia y la mitomanía. Las escritoras españolas ante el cine
Authors: Peña Ardid Carmen
Published: April 2011

Este artículo estudia la presencia del cine en la obra de varias escritoras españolas del siglo XX, atendiendo no sólo a las formas que ha adoptado su impacto estético –manifiesto en temas y recursos de inspiración fílmica–, sino al modo en que dichas escritoras, en tanto espectadoras “femeninas” con identidades complejas y muy diferenciadas, se sirven de los espacios de la literatura para dejar constancia crítica de su posición ambivalente hacia la representación cinematográfica y la influencia de sus configuraciones culturales.
De Ella a Él: caras y máscaras en la “novela” de Mercedes Pinto (1926) y en la película de Luis Buñuel (1952)
Authors: Heitz Françoise
Published: April 2011

Mercedes Pinto, cuya trayectoria se desarrolló desde Canarias, su tierra de nacimiento, hasta México, pasando por Uruguay, conoció el éxito por sus escritos y actividades culturales y luego quedó sumida en el olvido. Sin embargo, la adaptación de su “novela” autobiográfica Él (Montevideo, 1926) a la gran pantalla por Luis Buñuel en 1952, le deparó otra vida al libro. Si en la obra literaria prevalece la autoficción y su claro compromiso feminista a favor del divorcio, adquiere nueva complejidad en la película mexicana de Buñuel el estudio del caso clínico de la paranoia. Al ataque a una burguesía parasitaria se une una subversión del género del melodrama, cuyo falso final feliz pervierte los códigos establecidos, dejando que se imponga el principio de duda. Asimismo, la exploración de los roles sexuales, heredera de la corriente surrealista, rehúye toda simplificación maniquea y se afirma como objeto fascinante para toda labor hermenéutica.
La flor de mi secreto (Almodóvar, 1995): La literatura como seducción
Authors: Martínez-Carazo Cristina
Published: April 2011

Las múltiples referencias a la escritura presentes en La flor de mi secreto (1995) han llevado a etiquetar esta película como la más literaria de Pedro Almodóvar. La lectura y la escritura funcionan como hilo conductor de la película en la medida en que articulan la existencia de la protagonista, Leo/Amanda Gris. Pero más allá de este despliegue de alusiones literarias, lo que en realidad determina la literaridad del film es, por un lado, la construcción de dicho personaje a partir de modelos literarios y por otro la exploración de su subjetividad a partir de la escritura. Leo se perfila como réplica de las escritoras “atormentadas” a las que admira; alcohólica como ellas, adicta a los tranquilizantes, suicida, abrumada por la soledad e instalada en la escritura como espacio de supervivencia. Además, el espectador accede a su subjetividad a partir de su trayectoria como escritora ya que su melodramática existencia se funde/confunde con su escritura. Almodóvar proyecta en La flor de mi secreto sus fantasmas literarios y subvierte en el proceso los parámetros de la literatura, el valor del canon, las categorías genéricas, tanto literarias como sexuales, las leyes del mercado y las cuestiones de autoría. Opone además una clara resistencia a una definición estable del fenómeno literario al insertarlo en el cinematográfico, activando con ello un complejo juego de intertextualidades que en última instancia contribuyen a disolver las fronteras entre la alta y baja cultura y a abrir un espacio de convergencia entre las artes.
Escenificar la presencia: O. Welles y F. Kafka, El Proceso
Authors: González de Ávila Manuel
Published: April 2011

La semiótica de la presencia ha cambiado el modo en el que la teoría del sentido considera las obras de arte y los documentos de cultura. Este artículo explora sus posibilidades y límites a partir del análisis del filme de O. Welles El proceso, adaptado de la novela homónima de F. Kafka.
El pensamiento cinematográfico de Roman Jakobson
Authors: Puyal Alfonso
Published: April 2011

El artículo versa sobre la teoría cinematográfica esbozada por el lingüista ruso a partir de tres aportaciones: el ensayo “¿Decadencia del cine?” (1933); la entrevista sobre cine realizada en 1967; y algunos comentarios diseminados en sus escritos. La hipótesis que plantea Jakobson es la transposición de los recursos literarios al medio cinematográfico, hasta levantar lo que los formalistas denominaron “poética del cine” (Poetika kino). En este sentido, la aportación más reveladora es el estudio de las funciones metonímicas y metafóricas que el cine despliega a partir de la planificación y el montaje. Una panorámica por las relaciones que mantuvo Jakobson con los poetas y pintores de la vanguardia rusa y checa, su cultura en materia cinematográfica (películas, cineastas), o las referencias teóricas que manejó en materia fílmica son algunos de los temas abordados con el fin contextualizar la visión que Jakobson tenía del medio cinematográfico. El grueso del artículo estará centrado en su artículo de 1933 sobre cine, escrito a raíz de las consecuencias del sonido en el lenguaje cinematográfico, así como de una pequeña experiencia en el oficio del cine durante su estancia en la república checa.
Pediatric Patients with Intravascular Devices: Polymicrobial Bloodstream Infections and Risk Factors
Authors: Onland Wes , Pajkrt Dasja , Shin Cathy , Fustar Stana , Rushing Teresa , Wong Wing-Yen
Published: April 2011

A retrospective study was conducted, including 61 patients with long-term intravascular devices (IVDs) admitted to the Childrens Hospital Los Angeles with diverse underlying diseases, different types of catheters, and culture-proven catheter-related bloodstream infections (BSIs). Within these patients, 125 catheter-related BSIs occurred, and the incidence of monomicrobial and polymicrobial BSIs was evaluated. Risk factors for polymicrobial BSIs were determined. Forty-two BSIs contained more than one pathogen. These polymicrobial BSIs were observed more often in younger patients (<4.1 years versus ≥4.1 years) and less in patients using venous implanted ports. No other associations were found between the occurrences of polymicrobial BSIs and underlying diseases, other types of catheters, host defense status, parenteral nutrition, recurrences, or catheter removal. Patients with long-term IVDs at a younger age have a higher risk of developing a polymicrobial BSI. Future prospective studies should address the issue of polymicrobial infection in IVDs in more detail.
Experiences of Engagement in Occupations and Assertive Outreach Services
Authors: Hitch Danielle
Published: April 2011

Aim:

The purpose of this study was to describe the experience and meaning of engagement for staff and clients of assertive outreach teams.

Method:

Interpretative phenomenological analysis was selected for its flexibility and transparency. Data were collected by semi-structured interviews from a sample of five client and five staff participants (n = 10). The interviews were analysed idiographically, inductively and interrogatively.

Findings:

Four themes identified by both staff and client participants emerged: engagement as an interpersonal relationship, engagement in and through time, enabling and disabling factors and engagement in occupation. In addition, clients developed a theme around engagement as a means to self-actualisation. Staff also raised a specific theme around the role of engagement in mental health services.

Conclusion:

Staff and clients experienced engagement in broadly similar ways, but with differing emphases. Although all participants described it as both an invisible ‘means’ and a visible ‘end’, the staff related engagement only to mental health services whereas the clients experienced it in the context of both mental health services and occupations.

Relevance:

This study is relevant to all occupational therapists who work with people experiencing mental health problems.
Occupational Therapists' Perceptions of Their Role with People Who are Homeless
Authors: Grandisson Marie , Mitchell-Carvalho Morag , Tang Victoria , Korner-Bitensky Nicol
Published: April 2011

Introduction:

The needs of individuals who are homeless are often unmet. This study identifies the potential role of occupational therapy with adults who are homeless.

Method:

This was a qualitative study of occupational therapists working in Montreal, Québec, Canada, consisting of two survey modes: focus group and self-administered questionnaires. A moderate inductive strategy was used in the analysis of the responses.

Findings:

Twenty-two occupational therapists participated. The traditional roles of assessing, treating and conducting research were discussed, as well as the emerging role of occupational therapists as case managers, outreach workers and advocates. The challenges to implementing services included health care structures and processes. The potential facilitators included active leadership and advocacy by occupational therapists regarding the needs of those who are homeless.

Implications:

There is a clear and pertinent role for occupational therapy services with those who are homeless. The traditional process of service delivery presents challenges that must be addressed. The topic of homelessness and role-emerging practice placements with this population should be included in the occupational therapy curriculum.
Contextual Factors That Have an Impact on the Transitional Experience of Newly Qualified Occupational Therapists
Authors: Morley Mary
Published: April 2011

Many newly qualified occupational therapists (NQOTs) experience difficulties when moving into practice, with limited opportunities to co-work with colleagues. In 2005, a preceptorship programme designed to ease these transitional challenges was piloted.

The programme was evaluated using mixed methods within a realist framework in order to understand the contextual factors that have an impact on the transitional experience of NQOTs and their engagement with the programme. Semi-structured interviews were carried out with four pairs of NQOTs and supervisors at 6 and 12 months into the programme. The findings suggest that the demands placed on new practitioners are increasing, with early expectations of autonomy within an interprofessional context. Strategies that assist transition include co-working, role modelling and informal support. The preceptorship programme facilitates the provision of these.

The study highlights the importance of situated learning theories and communities of practice as frameworks to prepare therapists to analyse the complexities of the workplace and to facilitate negotiated access to the multidisciplinary communities.
Supervision Models in a 2:1 Acute Care Placement
Authors: Blakely Christine , Rigg Jessica , Joynson Katherine , Oldfield Sara
Published: April 2011

Internationally, occupational therapy is experiencing increasing difficulty in establishing sufficient placements for students. In order to provide additional placements, the 2:1 model (two students with one practice placement educator) was introduced to the orthopaedic setting of an acute hospital. Different supervision formats were used in the placement and included individual, group and peer supervision. This was the students' first practice placement and their first experience of supervision in the clinical setting. The students identified the advantages of using a range of supervision models to consolidate learning. The students also stated that having a peer to share experiences benefited their personal learning experience within the placement.
Occupational Therapy Risk Assessment in Forensic Mental Health Practice: An Exploration
Authors: Cordingley Kevin , Ryan Susan
Published: April 2011

Forensic occupational therapists are one of the members of the multidisciplinary team who participate in the risk assessment process. However, the forensic occupational therapy risk assessment literature is largely descriptive and experience based, with little empirical research.

This study investigated forensic occupational therapists' ideas about risk assessment and what risks they assess. A qualitative approach, using three focus groups of therapists working in different forensic settings, provided the data. The analysis of the data found that four themes emerged: risk perceptions and interpretations, fundamental information, risk behaviours and occupations, and environments.

These themes support a number of aspects of risk assessment in the forensic occupational therapy literature and could be categorised under the components of the person, the environment and occupational performance and participation. There was, however, limited evidence in the literature and in this study about the risks associated with occupations and about client-centred approaches to risk assessment. Further research of these aspects, and a comparison between forensic occupational therapy risk assessment and multidisciplinary risk assessment, is recommended.
Activity and Social Participation in the Period following a First Episode of Psychosis and Implications for Occupational Therapy
Authors: Krupa Terry , Woodside Harriet , Pocock Karen
Published: April 2011

Purpose:

The study advances a conceptual understanding of activity and social participation in the period following the first episode of psychosis.

Method:

A constructivist, grounded theory approach was used. Data were collected from 25 primary participants who had experienced a first episode of psychosis in the previous 5 years; 15 secondary participants, such as family and friends, with knowledge of the activity and social experiences of primary participants, personal records and documents; and six key informants.

Findings:

The first episode of psychosis was highly disruptive and even damaging to activity and social participation. Recovering from this fall-out, to maintain engagement in activities and social participation, included the need to create new plans, adjust to affective disconnection, develop balanced lifestyles, match participation to abilities, learn new skills, and participate under new and constraining social conditions.

Conclusion:

The period following the first episode of psychosis is a time of high risk for disengagement from activity and social participation. Occupational therapists have an important role to play in enabling activity and social engagement. The findings offer examples of how occupational therapy services might address critical tasks for activity and social engagement.
Peer Interactions and Their Benefits during Occupational Therapy Practice Placement Education
Authors: Daniels Nikki
Published: April 2011

Peer collaboration is believed to assist in the development of critical thinking and reflection skills. However, collaboration may be difficult to achieve in the practice placement environment because students often experience placements away from peers. This study aimed to establish the frequency and types of peer contact experienced by first year occupational therapy students during practice placement education, in order to identify any benefits from interactions during this time and to establish any unmet needs that may arise from restricted peer contact.

The data from responses to a survey by 53 of a cohort of 121 students demonstrated the diversity and disparity in the opportunities available. Many interactions provided support and reassurance and made a positive contribution to learning. Return-to-university days during practice placements and regional support groups to facilitate collaboration were suggested.

The analysis of an online discussion board made available to all 121 students showed that only 12 students contributed to the discussions. The perceived benefits included contact with peers and practical support from tutors. Improved education and increased input from tutors were suggested as methods to encourage more effective use of this tool, in order to meet the learning and social needs of students with limited opportunities for peer interaction during placement modules.
Is There a Role for Occupational Therapy within a Specialist Child and Adolescent Mental Health Eating Disorder Service?
Authors: Gardiner Clare , Brown Naomi
Published: April 2011

In Northern Ireland, only two occupational therapists work within the specialist field of child and adolescent mental health (CAMH). This is despite recommendations made by the Bamford Review of Mental Health and Learning Disability (Northern Ireland) that occupational therapy should be a core element of CAMH provision. The College of Occupational Therapists has urged practitioners to challenge inequalities in health and social care provision and to use occupational language to reinforce the relationship between occupation, recovery and wellbeing. This opinion piece highlights occupational therapy core skills and occupational therapy frames of reference or modalities, underlining the application of both to eating disorders. The treatment models discussed are the Model of Human Occupation, the Canadian Model of Occupational Performance and sensory integration. Evidence reinforces that the models discussed are applicable, appropriate and valuable when treating children and adolescents with an eating disorder.

It is argued that the valuable and unique role of occupational therapy must be recognised by health and social care commissioners and CAMH providers and be vocalised by occupational therapists. CAMH teams are advised to embrace the unique skills that occupational therapists have to offer children and adolescents with eating disorders in order to ensure that clients receive truly multidisciplinary and client-centred evidence-based services.
Screening for Depression after Stroke: Developing Protocols for the Occupational Therapist
Authors: Kneebone Ian , Baker Julia , O'Malley Heather
Published: April 2011

Depression after stroke is common and can have a substantial effect on rehabilitation outcome. Despite this, the routine screening that has been recommended is only taking place around half the time. Occupational therapists have training that well positions them to provide screening. In a local stroke unit, the psychology and occupational therapy departments worked together, considering relevant research, clinical considerations (such as identifying suicidal ideas) and practical issues (such as ease of administration and patient compliance) to determine screening protocols that could be enacted by occupational therapists. Two protocols were developed, one for people under 65 years of age and one for people aged 65 years or older.
Interrater Reliability of the Clock Drawing Task in the Occupational Therapy Adult Perceptual Screening Test
Authors: Eggins Wendy , Gustafsson Louise , Cooke Deirdre
Published: April 2011

The clock drawing item in the Occupational Therapy Adult Perceptual Screening Test (OT-APST) screens for unilateral neglect and impairments in constructional skills. The purpose of this study was to re-evaluate the interrater reliability of the clock drawing item in the OT-APST following the addition of example clock drawings to the manual. This study also compared the interrater reliability for occupational therapy clinicians with that for final year occupational therapy students and examined clocks with poor interrater reliability for the individual scoring criteria.

Sixteen occupational therapy students and 15 practising occupational therapists scored 50 clocks drawn by people with stroke, using the OT-APST clock drawing criteria. Interrater reliability was determined for each rater in comparison to the gold standard, using intraclass correlation (ICC) and kappa statistics. Student and clinician interrater reliability were compared using t-tests. The scoring of clocks with poor agreement was examined further in order to identify disparities.

The student and clinician groups demonstrated excellent reliability for ICC (0.83 and 0.84 respectively) and moderate reliability for kappa statistics (0.58 and 0.59). The differences between the groups were not significant (p > 0.05). Scoring disparities were seen in the formation of the circle or in the placement of the numbers. The results support reliable scoring for the clock drawing item in the OT-APST.
Promoting Mental Wellbeing through Activity in a Mental Health Hospital
Authors: Hutcheson Catriona , Ferguson Hazel , Nish George , Gill Lesley
Published: April 2011

Studies have indicated widespread inactivity in psychiatric wards, although the occupational therapy and mental health journals support the therapeutic benefits of participation in activity. A service evaluation was conducted to explore activity provision and identify gaps in service within a 13-ward psychiatric hospital. The results of the initial exploration were that staff and patients indicated a lack of structured and accessible activity. An activity programme was introduced offering a minimum of 17 groups weekly, including functional, leisure, art and sport groups. Six months after the introduction of the programme, 63 patients participated in one week, which was a considerable increase from 6 inpatients taking part in activity prior to the introduction of the programme. The results of a service evaluation conducted by questionnaire identified positive feedback from over 90% of patients and 100% of staff. The main recommendation was the continuous provision of an inpatient activity programme within the hospital. A further recommendation was to build closer links with community resources to enable continued participation after discharge from hospital.
The Conceptualisation of Residential Home Environments: Implications for Occupational Therapy
Authors: Robertson Linda , Fitzgerald Ruth
Published: April 2011

This paper examines the views of staff about the environments of two residential homes: one representative of a homely environment and the other more reminiscent of a hotel. A qualitative study using in-depth semi-structured interviews was conducted with a purposive sample of 21 staff. Emerging themes in the data from the first facility related to kinship, recognition of history, individuality and meaningful relationships in the homely environment. This contrasted with a more conscious awareness of the tone of the second facility, the need for correct behaviours and a bureaucratic organisation in the hotel-like home.

The findings showed that the meanings attached to a residential home and its press for occupational behaviours are shaped by cultural, social and historical experiences. Such meanings are strongly influenced by management, with staff and residents adjusting to expectations as indicated by the social and physical environment. There is very little in the literature that reflects how one should conceptualise a residential home, yet it is the very nature of this perception that is crucial to the development of an atmosphere that indicates expectations for actions – for both staff and residents.
Using a Card Sort to Structure and Promote Enquiry-Based Learning
Authors: Moores Alis , Akhurst Jacqui , Powell Janneke
Published: April 2011

An occupational therapy card sort was developed as part of an enquiry-based learning initiative to enable students to evaluate their skill development. The online card sort comprises modified playing cards that students deal to assess their skill development. The card items reflect standards of proficiency for occupational therapists.

The card sort was evaluated to determine whether it was effective in measuring changes in skills over time and to see whether students found it useful to identify their skill levels and plan their learning needs. Data were collected from second-year occupational therapy students, both by using questionnaires and by collecting completed card sorts from 35 students at two intervals in their studies for comparison.

The card sort was found to be sensitive to changes in students' perceived skill levels over time and to detecting differences between categories of skills. The students found the card sort effective as a means to promote the active learning skills necessary for enquiry-based learning. The card sort was identified as a useful tool for planning professional development needs and for engaging in continuing professional development.
Is Clinical Updating a Valuable Mechanism for Enhancing the Student Experience?
Authors: Tickle Ellen , Davys Deborah , McKenna Jacqui
Published: April 2011

This opinion piece aims to clarify the concepts of the theory-practice and practice-theory gaps, and to begin to explore the impact of these gaps on efficacious occupational therapy practice. Any perceived gaps between theoretical knowledge and practice skills may have a detrimental effect on the student experience and, ultimately, upon the production of graduates who are fit for practice and purpose.

A number of issues are raised. One significant issue is the value of clinical updating for academic staff and its impact upon the student experience. Another issue is the need for further clarification of the definitions of theory-practice/practice-theory gaps and consideration of the impact of these perceived gaps. A need for further research is identified to explore staff perceptions of these issues.
Self-Identified Occupational Competencies, Limitations and Priorities for Change in the Occupational Lives of People with Drug Misuse Problems
Authors: Davies Rachel , Cameron Josh
Published: April 2011

This study investigated self-identified competencies, limitations and priorities for change in the occupational lives of people with drug misuse problems. Thirty people undergoing inpatient drug detoxification completed the Occupational Self Assessment (OSA) version 2.2. Six of these participated in semi-structured interviews focusing on their priorities for change, identified using the OSA.

The OSA results found that the participants identified the greatest occupational limitations with the following OSA items: managing finances; making decisions based on what they think is important; getting done what they need to do; having a satisfying routine; and working towards goals. The items considered most important were taking care of others; being involved as a student, worker, volunteer, and/or family member; and working towards goals. The items prioritised for change were the ability to manage finances; work towards goals; take care of the place where they live; and take care of themselves. The interview participants maintained that a focus on drug use had stopped them from achieving goals and making changes in their lives.

The findings from both the OSA and the interviews drew particular attention to self-care and financial management needs and suggest a rationale for occupational therapy to give meaning, purpose and structure to clients' abstinence-related goals, aimed at reclaiming their lives.
Experience and Meaning of Group Altruistic Activities among Long-Term Care Residents
Authors: Cipriani Joseph , Haley Rachel , Moravec Erin , Young Holly
Published: April 2011

Purpose:

A phenomenological investigation was conducted of the experiences of long-term care residents as they planned, participated and reflected on their engagement in an altruistic activity.

Procedures:

Eight residents planned and engaged in the creation of flower arrangements and greeting cards for local hospice patients. Data were collected via in-depth group and individual interviews, as well as field notes. The process of data analysis was guided by the empirical, phenomenological and psychological method.

Findings:

A grand theme of ‘connectedness’ emerged and was supported by four underlying subthemes: (a) creative and thoughtful activity, (b) sense of community, (c) facilitation of reminiscence and (d) reciprocity.

Conclusion:

Through engagement in an altruistic activity, the participants developed a sense of connection with their pasts, the others in the group, the recipients and the activity itself. The findings suggest that occupational therapy services should include altruistic activities to help to facilitate a greater sense of connection for their clients.
The Elizabeth Casson Memorial Lecture 2010: ‘Jack of All Trades and Master of None’: The Future of Occupational Therapy?
Authors: Drummond Avril
Published: April 2011

The Elizabeth Casson Memorial Lecture 2010, given on 24 June at the 34th Annual Conference and Exhibition of the College of Occupational Therapists, held at the Brighton Centre, Brighton, Sussex.
Can Disability Studies Contribute to Client-Centred Occupational Therapy Practice?
Authors: McCormack Cathy , Collins Bethan
Published: April 2011

Occupational therapists frequently cite a ‘client-centred’ approach as a fundamental aspect of their practice. However, there are many examples in the narratives of disabled people that suggest that the health and social care services they experience do not quite meet this aspiration. The authors propose that an understanding of disability from disabled people's perspectives is elemental to client-centred practice and that knowledge of the academic discipline of disability studies can contribute to authentic client-centred occupational therapy.
How do Computer Assistive Technologies Enhance Participation in Childhood Occupations for Children with Multiple and Complex Disabilities? A Review of the Current Literature
Authors: Chantry Jane , Dunford Carolyn
Published: April 2011

Functional impairments can limit the participation of children with disabilities in childhood occupations, which can be detrimental to their overall development and social and emotional wellbeing. The primary goal of occupational therapy for children with disabilities is to facilitate and enable active participation in meaningful occupations. Computer-based assistive technologies can be used as an enabler, allowing children with severe disabilities access to a variety of activities. The aim of this study was to establish how computer assistive technologies can have an impact on the participation of children with complex and multiple disabilities in childhood occupations and in the development of their occupational roles.

A comprehensive and systematic search and review of contemporary literature pertaining to computer use by children with severe and complex disabilities and its impact on a child's participation was undertaken. Articles included were critically appraised and analysed using a conceptual model of occupational therapy, with findings relating to the occupational performance areas of productivity, self-maintenance and leisure (a summary table is included). The findings supported the use of computer technologies for participation to a varying degree in all occupational performance areas, but were particularly positive in the areas of education, communication and play activities for children with disabilities.
Survey of Paediatric Occupational Therapists' Understanding of Developmental Coordination Disorder, Joint Hypermobility Syndrome and Attention Deficit Hyperactivity Disorder
Authors: Baudinette Karina , Sparks Jennie , Kirby Amanda
Published: April 2011

Evidence suggests that developmental coordination disorder (DCD) co-occurs with attention deficit hyperactivity disorder (ADHD) and joint hypermobility syndrome (JHS). Paediatric occupational therapists working with children with DCD need to consider the impact of co-occurring conditions on the children they assess and treat. A survey investigating the knowledge base and understanding relating to these conditions was conducted. The results showed that therapists (n = 225, response rate 23%) have an understanding of DCD; however, a more detailed knowledge of ADHD and JHS would allow them to consider the impact of the overlapping nature of these conditions. This highlights a training need to ensure understanding of these conditions and appropriate management.
Service Users' Perceptions and Experiences of Goal Setting Theory and Practice in an Inpatient Neurorehabilitation Unit
Authors: Baird Tess , Tempest Stephanie , Warland Alyson
Published: April 2011

Goal setting is a key component in the rehabilitation process and clinical guidelines recommend collaboration between health care professionals, service users and their families. This qualitative preliminary study (n = 6) used semi-structured interviews to explore the perceptions and experiences of the goal setting process with service users on a neurorehabilitation unit. Two overall themes emerged: the components of goal setting and the factors that helped to guide the process. The participants reported experiencing varying levels of collaboration and concluded that goals should be achievable, realistic and negotiated, yet challenging. Short-term goals were seen as particularly valuable.
Facilitating Technology Use in Older Adulthood: The Person-Environment-Occupation Model Revisited
Authors: Vrkljan Brenda
Published: April 2011

This mixed methods study used a cross-comparative case study design to explore how previous experiences with technology can influence collaboration between older married couples during first-time use of technology, namely an in-vehicle navigation system.

Previous research suggests that, with age, collaboration with a married partner can maintain or, in some cases, even improve performance on cognitive-based, memory retrieval tasks. However, few studies have evaluated how older adults problem solve collaboratively through such tasks. Driving a car has been identified as a context in which older drivers and copilots (that is, spouse) work together to get to the places they need to go safely. With the advent of vehicular technology, including navigation systems, older drivers expect to share the cognitive load with their copilot.

Using the Person-Environment-Occupation Model, this investigation highlights key factors that influence the shared adoption and use of technology in later life. For occupational therapists, the results from this study can guide clinical decision-making when prescribing technology and considering collaborative training strategies that facilitate occupational performance in older adulthood.
Older Adults' Experiences and Perceptions of Dual Tasking
Authors: Muhaidat Jennifer , Skelton Dawn , Kerr Andrew , Evans Jonathan , Ballinger Claire
Published: April 2011

There is no consensus on which dual task (DT) test best assesses mobility or balance deficits in older adults. This study aimed to explore older adults' experiences and perceptions of dual tasking to identify DTs relevant to their everyday life and that they perceive as difficult or risky.

Two gender-specific focus groups were conducted. Six males and nine females, aged 70 years or above, participated. The topics posed to the groups included structured and open questions designed to explore experiences of combining two activities and the consequences of that for balance. The results were subjected to content analysis to identify DT examples, task difficulty levels and balance-threatening tasks.

Most participants were able to identify DT examples and some identified a concurrent impact on balance. There were gender differences in the examples: the females focused more on household tasks and the males more on outdoor activities. Many tasks that were considered difficult or risky by the participants do not feature sufficiently in the literature, such as stair negotiation and avoiding moving obstacles accompanied by secondary tasks.

The views of older adults should be taken into consideration to help to develop tests that are more sensitive and have face validity.
Broadening the Vision: The Education and Training Needs of Occupational Therapists Working with People with Sight Loss
Authors: Campion Carol , Awang Darren , Ward Gill
Published: April 2011

This study aimed to identify the continuing professional development needs of occupational therapists in the area of sight loss and to identify the ways in which these needs could be met through pre-registration and post-registration education. A two-stage survey was carried out: an online survey was used to explore the education experience of occupational therapists who were members of two of the College of Occupational Therapists Specialist Sections – Older People and Housing, and a telephone survey was used to gather information from higher education institutions involved in the pre-registration education of occupational therapists regarding the current content of the curriculum relating to sight loss. The results of the study revealed low confidence levels among therapists in assessing and giving advice to people with sight loss, along with a varied approach to the inclusion of sight loss in pre-registration occupational therapy curricula.

A need for the development of appropriate education and training for working with people with sight loss was identified for occupational therapists at both pre-registration and post-registration stages, in order to enable the profession to seize the opportunity for prioritising this area of emerging practice and to make a more significant contribution to improving outcomes for people with sight loss.
Spirituality, Occupation and Occupational Therapy Revisited: Ongoing Consideration of the Issues for Occupational Therapists
Authors: Wilson Lesley
Published: April 2011

This opinion piece revisits and considers the spiritual dimensions of occupation and occupational therapy practice. It discusses the dilemmas inherent in such an exploration and suggests ways of looking at different aspects, drawing from some of the literature on this topic. Views are put forward as to whether or not spirituality is a legitimate sphere in which occupational therapists should engage and issues of ongoing debate are highlighted.
Patients' Perceptions of Preoperative Home-Based Occupational Therapy and/or Physiotherapy Interventions Prior to Total Hip Replacement
Authors: Orpen Nicola , Harris Janet
Published: April 2011

This study focused on patients' accounts of perceptions and experience of preoperative home-based interventions to increase health professionals' understanding of what is important or not when supporting patients preparing for hip replacements.

Method:

A phenomenological approach helped to develop insights into what patients found useful or not about preoperative interventions, thus developing an understanding of the value of the service from patients' perspectives. Data were gathered from 10 participants, using semi-structured interviews. Analysis used a seven-step framework for phenomenological data analysis.

Findings:

Five main themes emerged: preoperative equipment use increases independence, progress and confidence; individual needs are better met through timely visits; competent therapist home intervention offers reassurance regarding surgery; knowing one's home environment is suitable increases confidence in planning hospital discharge after surgery; and levels of social support require preoperative assessment. The participants identified preoperative home visits as valuable in helping to prepare for surgery. Home visits can alleviate preoperative anxiety and may contribute to more streamlined discharge planning. Visits may help to cut the costs of erroneous equipment provision or last-minute equipment deliveries and decrease length of stay.

Conclusion:

This research offers clinicians and managers relevant insight into patients' perceptions of home-based services and could work alongside quantitative research findings to inform best practice within National Health Service resource restrictions.
From Artist to Writer to Reader and Back Again: The Odyssey of an Occupational Artist
Authors: Kelly Greg
Published: April 2011

This paper sketches my personal odyssey from artist to occupational therapist. I call it an odyssey because it traces a journey home to where it all began: a love of drawing and story-telling. It focuses on my progress as an author and how this has informed my development as an occupational therapist. It begins with my stalled attempt to find the true meaning of art and ends with a quest to find the true meaning of occupation. As an occupational therapist, I also envisage myself as a guide for others on a continuous quest for knowledge and I hope that this brief reflection inspires others to find meaning in their everyday practice and, perhaps, share it with others.
A Practice Development Programme to Promote the Use of the Model of Human Occupation: Contexts, Influential Mechanisms and Levels of Engagement Amongst Occupational Therapists
Authors: Melton Jane , Forsyth Kirsty , Freeth Della
Published: April 2011

This study evaluated a multifaceted, organisation-wide practice development (PD) programme in one National Health Service mental health and learning disabilities trust.

Method:

Individual differences in integrating the Model of Human Occupation in occupational therapists' daily practice were examined through in-depth qualitative, multimethod realistic evaluation. A stratified sample of all occupational therapists (n = 74) was achieved using a self-report survey. Semi-structured interviews at three time points, practice observation and documentation audit continued until saturation appeared highly likely and categories were well elaborated (n = 10).

Findings:

The findings indicated that environmental contexts, particularly the support of the immediate team, and the therapist's personal circumstances influenced MOHO use. The mechanisms that acted as catalysts for practice change were Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Know-how and Channelling Time. Four stages of MOHO integration, characterised as In the Hangar, On the Runway, Take-off and In the Air, were identified.

Conclusion:

Most studies of the uptake of PD treat people as relatively homogeneous, but they are not. Greater attention to individual differences, the mechanisms underpinning successful engagement and influencing contexts may result in better outcomes from PD investments. A degree of tailoring PD approaches to individual circumstances would be beneficial.