bluuebunny/crossref_metadata_2025 huggingface dataset:
Current Trends in Assessing Children's Play
Authors: Sturgess J L
Published: April 2015

Occupational therapists often assess children's play both formally and informally. A critical review of play assessments from occupational therapy and other disciplines is presented. Many of the assessments available were found to be limited by incomplete psychometric development in regard to validity and reliability and by factors relating to clinical usefulness, such as the artificial context of many play observations.

The need for a range of types of play assessment to choose from is argued and a checklist for helping to select a suitable play assessment is presented. Finally, the suggestion is made that occupational therapists continue to develop more play assessments.
‘Why are You doing That?’ A Project to Look for Evidence of Efficacy within Occupational Therapy
Authors: Conroy M Catherine
Published: April 2015

Nine occupational therapists working with children agreed to participate in a project designed to extend their awareness of evidence of efficacy in their clinical practice. Successful procedures would be developed for use in other areas of the occupational therapy service in Southampton.

The occupational therapists divided themselves into three groups – those working with children whose needs were primarily physical, those working with children with emotional and behavioural problems and those working in mainstream schools with children with special needs – and used the following process to develop the project. They devised a statement related to their clinical practice. Electronic databases were used to search for relevant articles. Papers published during the past 10 years and available locally were distributed to the participating therapists. They reviewed the articles, using an agreed format. The articles were discussed by the therapists at regular meetings, culminating in a summary of the research findings, how they related to clinical practice and priorities for future research.

There is evidence of increased research-related activity beyond that required by the project. Requests have been made by occupational therapists in other clinical areas to be included in this process.
The Evolution of a Partnership to Meet the Special Needs of Children
Authors: Graham Jackie , Maze Mary K
Published: April 2015

Being mindful of the importance of a multiprofessional approach to meeting complex needs, an advisory teacher together with occupational therapists and physiotherapists developed a successful working partnership. This began in their work with preschool children and developed into the services the team offered to pupils in mainstream schools and their parents.

In this article, the working practice that evolved, in a shire county in England, is outlined. The key elements and the benefits of such an approach are identified.
Problem-Based Learning, Part 2: Understanding Learner Stances
Authors: Savin-Baden Maggi
Published: April 2015

This is the second of three papers which explores the growing influence of problem-based learning (PBL) within professional curricula. Part 2 presents an overview of a study undertaken over 5 years (Savin-Baden, 1996), which sought to explore the expectations and experience of staff and students in different universities within the United Kingdom on diverse professional courses. It is argued here that PBL appears to promote many of the abilities currently high on the agenda in British higher education in the 1990s, yet the wider implications of its implementation are more complex and far-reaching. This study found that the way in which PBL was played out in practice was less coherent, more varied and more complex than the literature and personal experience implied. Part 2 documents the rationale for the study, the methodology undertaken and the evolution of the model of Dimensions of Learner Experience; part 3 will discuss the findings of this study.
The Impact of the Manual Handling Operations Regulations 1992 on the Use of Hoists in the Home: The Patient's Perspective
Authors: Conneeley Anne Louise
Published: April 2015

This article describes a qualitative study which aimed to explore the implications of the implementation of the Manual Handling Operations Regulations (MHOR) 1992 for the patient. Ten participants, where the use of a hoist was indicated in view of the MHOR 1992, were interviewed individually in their own homes. Through this method, those aspects influencing acceptance or rejection of the use of a hoist were established and the meanings of the experiences for those individuals were clarified. The results of the study have implications for practice. For some participants, the use of a hoist involved physical, social and psychological levels of response. To implement MHOR 1992 successfully, these issues must be acknowledged and addressed.
The Rivermead Perceptual Assessment Battery: Its Relationship to Selected Functional Activities
Authors: Donnelly Sharon M , Hextell Donna , Matthey Stephen
Published: April 2015

Thirty-five stroke patients were assessed on the Rivermead Perceptual Assessment Battery (RPAB) and three functional activities. The activities chosen had reported constructional components. A checklist was developed to measure a person's performance on the constructional components of each activity objectively. The RPAB results were correlated with those of making a sandwich and packing a lunchbox, putting on a cardigan and setting a table. A statistically significant relationship was found between the RPAB and the selected functional tasks. The results also suggest that a clinical relationship exists between performance on the RPAB and the three tasks, therefore assumptions can be made about a person's performance on these tasks using the results from the RPAB.
The Rey Figure Copy as a Screening Instrument for Perceptual Deficits after Stroke
Authors: Lincoln N B , Drummond A E R , Edmans J A , Yeo D , Willis D
Published: April 2015

The aim of the study was to investigate the use of the Rey figure for screening patients for perceptual impairment following stroke. Stroke patients in a trial of a stroke unit were assessed using the Rey figure copy at entry to the study. Those admitted to the stroke unit were also assessed on the Rivermead Perceptual Assessment Battery (RPAB). In 61 patients assessed consecutively on both tests, using conventional clinical cut-off points the Rey figure copy was impaired in 31 out of 32 patients who were impaired on the RPAB. Fifteen patients who failed the Rey figure did not have perceptual problems on the RPAB, indicating that deficits on the Rey figure are not only due to perceptual problems. A receiver operating characteristic curve was plotted to compare different cut-off points. The Rey figure may be used as a brief screening assessment for perceptual deficits following stroke.
Do Occupational Therapists Feel Equipped to Deal with the Adult Legacy of Childhood Sexual Abuse?
Authors: Abrahamson Vanessa
Published: April 2015

Research findings are consistent in showing a strong, specific and coherent association between childhood sexual abuse (CSA) and long-term psychiatric problems. Occupational therapists working in mental health services must therefore have contact with survivors of abuse, yet the literature reveals a paucity of research on their role.

Semi-structured interviews were conducted with nine occupational therapists to explore their knowledge and practice concerning this issue. All respondents considered that awareness of CSA was pertinent to their profession and should be taught during education and training. None of them had received teaching in this area. Most respondents thought that it was not their role to deal with CSA in depth. However, the context in which they worked provided an opportunity for initial disclosure which might not happen elsewhere and needed to be handled skilfully. Occupational therapy techniques, including creative methods, link in well with other approaches, especially counselling, in treating the long-term effects of CSA. Continuing educational requirements and the role of occupational therapy with this client group need to be addressed by the profession.
The Educational Needs of Occupational Therapists Who Work with Adult Survivors of Childhood Sexual Abuse
Authors: Foulder-Hughes Lynda
Published: April 2015

This study aimed to examine the education and training needs of occupational therapists who work with adult survivors of childhood sexual abuse (CSA). Two sample groups were used: occupational therapy pre-registration courses and occupational therapists working in mental health settings. Two postal surveys were designed in order to elicit both quantitative and qualitative data. Seventeen courses and 43 occupational therapists responded from around the United Kingdom.

The results indicated that although most of the occupational therapy courses offered some form of education around CSA issues, this had been available for a relatively short period of time (generally for less than 5 years). However, the majority of occupational therapists who responded were senior staff with more than 5 years' clinical experience who had not received such education as students. Consequently, the education offered differed greatly from that of 5 years ago. All the occupational therapists felt that their current level of knowledge could be improved. Recommendations regarding prospective educational requirements and further research are made.
How do Clients with Learning Disabilities Evaluate their Experience of Cooking with the Occupational Therapist?
Authors: Melton Jane
Published: April 2015

This research study set out to establish the views of five clients with mild learning disabilities. Qualitative methodology was employed, with particular focus given to occupational therapy and the activity of cooking. Semi-structured interviews were carried out in the clients' own environment. Following analysis, the data revealed that clients have powerful individual views regarding the meaning of cooking. The individual's role and routine in this activity was seen to vary greatly. The occupational therapists were perceived as being sensitive to individual circumstances and assistive in developing clients' skills and confidence in the tasks.

The empowering style used by the occupational therapists was highlighted as an important element in the clients' development of control over the activity. The therapists were perceived as having a number of different roles according to the stage of intervention, including supporter, teacher and facilitator. A respectful attitude towards the client was determined as being a vital element of the therapy.

The study concludes that occupational therapy is valuable for teaching skills to and empowering clients with mild learning disabilities. The recommendations suggest that individualised treatment programmes are required for successful intervention. Furthermore, subsequent research into the meaning of other occupations to clients with learning disabilities would provide greater understanding of the needs of this client group in relation to occupational therapy.
Shared Learning, Joint Training or Dual Qualification in Occupational Therapy and Social Work: A Feasibility Study
Authors: Alsop Auldeen , Vigars Christine
Published: April 2015

A small-scale research project was undertaken to explore the feasibility of shared learning, joint training or dual qualification for occupational therapists and social workers in their professional qualifying programmes. A two-stage process examined the curricular requirements of the two professions and the working practices of occupational therapists and social workers in selected authorities. Similarities were found in both curriculum content and working practices, suggesting that a partly shared curriculum between the two professions at qualifying level was both feasible and desirable. However, structural differences in the two professional programmes could place restrictions on the development of joint programmes. Professional expectations and expressed concerns indicated that a dual qualifying programme was not a desirable option at this time.
The Therapeutic Value of Activity in Child Psychiatry
Authors: Ainscough Kerry
Published: April 2015

This paper seeks to identify those children in psychiatry who cannot make use of the standard combination of non-directive play therapy and psychodynamic thought as a method of treatment. It proposes that integrating therapeutic activity into this formula might hold the key to success and seeks to substantiate this claim. The question then arises: is it the occupational therapist or the activity that makes the crucial difference?
Personal Injury Litigation and the College of Occupational Therapists' Code of Ethics and Professional Conduct
Authors: Sterry Mary
Published: April 2015

Increasing numbers of occupational therapists are engaging in writing expert witness reports in personal injury cases. This article airs some of the conflicts and ethical dilemmas that may arise when working in this field, and considers the position of the occupational therapist in relation to the widely accepted legal view of the role of the expert witness and the College of Occupational Therapists' Code of Ethics and Professional Conduct.

The article follows the order of the College of Occupational Therapists' Code of Ethics and Professional Conduct and a number of potential difficulties are highlighted, although by no means all. Where possible, an attempt is made to offer a solution that would enable the occupational therapist to maintain professional integrity. Above all, the article is intended to stimulate discussion and debate which will be of benefit to people already working in this field and to those entering it In the future.
Understanding and Using Descriptive Statistics
Authors: Gissane Conor
Published: April 2015

There is sometimes confusion over the correct statistical techniques that should be used in a particular setting. This paper outlines some methods that can be applied both to display information graphically and to summarise data numerically. The relative strengths and weaknesses of a number of diagrams and summary measures are examined. The particular method(s) that is used depends upon a number of factors. These are, firstly, the level of measurement of the data that have been collected; secondly, the overall distribution of the data being investigated; and, finally, the overall strategy of the plan of investigation. The reasons as to why a particular technique should be used are not always apparent and some methods for making a decision are discussed. Investigators should consider their choice carefully and be in a position to justify that choice.
Introduction to Challenging Behaviour
Authors: Pimm Paul L
Published: April 2015

This paper is an introduction to a topic that most health professionals are likely to encounter at some time in their career. It has been derived from a review of the relevant literature and from work with people with cerebral palsy who challenge services. Challenging behaviour is relatively common among people with learning disabilities, particularly when the learning disability is severe in nature. It also occurs, although less frequently, in other groups where there may be severe physical disability involving deficits in social and expressive language skills or additional sensory impairment.

There are potentially serious consequences for the person who displays challenging behaviour, not least of which are the possibilities of limited learning experiences and social isolation. Unless the behaviour of people displaying challenging behaviour is properly understood and addressed, it will be difficult to involve them in structured activities. Their quality of life will, as a consequence, be seriously impaired. For those who self-abuse causing repeated physical injury to themselves, there may be permanent physical damage and disfigurement. Understanding challenging behaviour is the first step to a recognition that all people, regardless of disability, have a right to be included in the structure of mainstream society.
A Fieldwork Award: Rewarding Excellence in Practice
Authors: Knight Judith
Published: April 2015

Fieldwork is a substantial and compulsory component of a first-degree programme in occupational therapy. A student must demonstrate competence in fieldwork in order to practise. This vital element of the course receives little recognition. Fieldwork is either marked on a pass/fall basis or included in the degree classification. This is hardly satisfactory because neither student nor prospective employer has a clear indication about competence to practise, other than that the student has attained the minimum level to graduate.

This article seeks to show how the occupational therapy course at Nene-University College in Northampton has addressed the problem. Students are now able to demonstrate excellence in fieldwork with a separate fieldwork award in addition to the normal degree classification.
What is Cultural Competency?
Authors: MacDonald Ruth
Published: April 2015

The concept of cultural competency has been discussed in recent United Kingdom occupational therapy literature. It is suggested that there is an additional competency that the practitioner requires in order to ensure effective practice. Wells's (1996) model of multicultural competency education, consisting of knowledge, self-exploration and skills, is proposed as a tool to develop this competency. Strategies are used within the Discipline of Occupational Therapy at the University College of Ripon and York St John and these are presented within the Wells model.

Using the model of multicultural competency education, Wells (1996) provides a clear framework for curriculum development and assessment. It is suggested that educational establishments are best equipped to assess the knowledge and self-exploration components of the model and that the skills component is best assessed while on fieldwork.
Mechanisms for Recovery of Hand and Arm Function after Stroke: A Review of Evidence from Studies Using Non-Invasive Investigative Techniques
Authors: Turton Ailie
Published: April 2015

The mechanisms for recovery of motor function after stroke are largely unknown. New non-invasive techniques of Positron Emission Tomography (PET) and Transcranial Magnetic Stimulation (TMS) have provided evidence for changes within the cortical motor areas and descending pathways after stroke in adult subjects. Reorganisation of the corticospinal tract originating from the damaged hemisphere is important for recovery of hand function. Some implications for occupational therapy are discussed.
Rehabilitation Schemes for Elderly Patients with a Hip Fracture
Authors: Stewart Lisa S P , McMillan Ian R
Published: April 2015

This article focuses on the rehabilitation services that have developed as a result of the rising incidence of hip fracture and the clinical challenge that it presents. The background to rehabilitation developments for elderly orthopaedic patients and the way in which different schemes have been initiated in accordance with local needs and resources are described.
The Management of Chronic Fatigue Syndrome in an Inpatient Setting: Presentation of an Approach and Perceived Outcome
Authors: Cox Diane L , Findley Leslie J
Published: April 2015

This paper describes chronic fatigue syndrome (CFS) and methods of management in a National Health Service Neurological Sciences Facility. A retrospective postal survey was carried out to determine the perceived level of ability of CFS inpatients 6 months following discharge from an inpatient programme of CFS treatment and management. One hundred and ninety-nine patients were admitted into the CFS inpatient programme, aged 16–68 years and with a mean age of 39 years. A specifically designed self-report questionnaire was used to ascertain duration of fatigue, change in work pattern and current level of ability (6 months following the inpatient programme).

One hundred and nine patients fulfilled the Centre for Disease Control 1994 criteria for CFS. At 6 months post-discharge, 89 (82%) patients had a perceived increase in level of ability compared with prior to their admission to hospital. The duration of symptoms appeared to affect outcome. A further controlled trial using published rating scales is currently under way to substantiate the findings.
Research Pathways for Occupational Therapists: Taking Our Own Road
Authors: Wright Ruth
Published: April 2015

The nature of qualitative research is examined through a review of the literature. The resonances between qualitative research and the practice and philosophy of occupational therapy are suggested. Particular attention is paid to the parallels in the areas of client-centred practice, holism, adult learning, gender issues, use of language and reflection. It is suggested that qualitative research is an appropriate methodology for research undertaken by occupational therapists and one for which they are well equipped by the nature of their core skills and philosophy.
What Attracts Mature Students to Occupational Therapy?
Authors: Craik Christine , Alderman Julie J
Published: April 2015

Over the past 36 years, there have been many studies in North America on the factors that attract recruits to occupational therapy, but often they are combined with similar professions and do not distinguish the characteristics of mature recruits. There is no similar literature in the United Kingdom.

A semi-structured postal questionnaire gathered data from students aged 30 and over in their second and third year at Brunel University, London. Thirty-seven mature students responded and Identified previous occupational therapy experiences and the role of practitioners in encouraging recruitment. The three most important reasons for choosing occupational therapy as a career were job satisfaction, helping people and job security.

A third of respondents would not have been ready emotionally to commence their education straight from school, while a quarter felt that maturity would make them better therapists. Promotion prospects were seen as similar or better than those of younger colleagues, but financial constraints would deter future mature students from considering the profession. This study, although small, may have implications for the recruitment and education of similar students and adds to the body of knowledge about the profession.
Occupational Therapy for the Management of Fatigue in Multiple Sclerosis
Authors: Bowcher Heidi , May Miriam
Published: April 2015

A fatigue management programme for clients with multiple sclerosis has been developed as part of the occupational therapy service at the National Hospital for Neurology and Neurosurgery.* A single case study approach was used to evaluate the effectiveness of the fatigue management programme during a 3-week period of inpatient rehabilitation.

The assessments used were, first, objective measures of productivity and, secondly, client rating of performance, satisfaction and level of fatigue, associated with the performance of a keyboard activity chosen by the client. The activity was performed and the assessments were made during four sessions in the baseline phase (first week) and repeated in the third week. The fatigue management programme was carried out in the second week.

The ratings of performance and satisfaction after the task were initially varied but became more consistent when fatigue management was applied. Also, a downwards trend (more exhausted) in the level of fatigue ratings recorded in the baseline was reversed (less tired). Productivity improved up to 100% of the task.

The main conclusion was an overall change to more consistent levels of task performance which had a positive impact on the experience of fatigue. Further work is required to evaluate generalisation to other tasks and the carry-over to the community setting.
Occupation and Disability: A Role for Occupational Therapists in Developing Countries
Authors: Yeoman Susanna
Published: April 2015

Disability issues are rarely priorities for action in developing countries. Prejudicial attitudes against disabled people among the wider community are common and opportunities for empowerment are few. As a result, disabled people are frequently marginalised within their communities and have limited access to education and employment.

Farming is a basic means of livelihood for many people in developing countries and for disabled people, unlikely to be able to secure other employment, farming is of particular relevance. Yet disabled people are often excluded from opportunities to develop farming skills, resulting in further disadvantage and reinforcing the notion of dependence on others.

A qualitative study was carried out in the Brong Ahafo Region of Ghana in 1996 to examine the position of disabled people in local society, particularly in relation to the range of occupations available to them. The research highlighted a number of pressing needs for disabled people in Ghana. Analysis of these needs showed that, through application of basic occupational therapy philosophy and skills, occupational therapists have a unique contribution to make in improving the quality of life of disabled people in developing countries.
Designing a Questionnaire: An Overview
Authors: Ballinger Claire , Davey Christine
Published: April 2015

Survey design using questionnaire is a popular methodology employed by occupational therapists in both research and clinical practice. A misconception sometimes encountered is that it is relatively easy to produce a questionnaire and that no special preparation or training is perceived as necessary’ (Chesson 1993, p711). This paper guides the reader through the process of designing and using a questionnaire and highlights some of the potential pitfalls. It is intended to provide an overview and the reader is directed to other texts which explore some of the issues in more detail.
Developing Student Autonomy in Education: The Independent Option
Authors: Carnall Linda
Published: April 2015

The article focuses upon the ‘Independent Option’, introduced into the third-year occupational therapy student programme at Sheffield Hallam University in 1996. The option aims to develop autonomous learning and reflective practice within an explicit theoretical framework. A portfolio of work compiled by each student is submitted for assessment.

One students experience (of facilitating the health education of clients in an acute psychiatric day hospital) is explored, by examining reflective processes and the development of student autonomy. This is evaluated against set objectives agreed prior to commencing the option. Theoretical perspectives in respect of student-centred teaching, principles of adult learning and reflective practice are discussed against a backdrop of client-centred therapy.
Auditory Integration Training and Autism: Two Case Studies
Authors: Brown Mark Morgan
Published: April 2015

Auditory integration training, a specific auditory sensory intervention, was applied to two autistic children. The results of the procedure were associated with improvements in balance, arousal and sensory modulation, speech and language, sequencing, eye control and attention. A number of hypotheses are given that may help to explain the effect of the process.
Children's Computer Access: Analysis of the Visual-Motor Demands of Software Designed for Children
Authors: Lane Alison , Ziviani Jenny
Published: April 2015

As technology access becomes an increasingly important activity of daily living, debate persists as to the manner in which computers are best able to assist children in educational and recreational settings. In particular, information regarding the suitability of commonly used child-computer interfaces is required. Occupational therapists are uniquely qualified to assess and problem-solve computer access issues but, to date, have limited the application of this skill to the areas of rehabilitation and disability.

This paper describes a process where the traditional occupational therapy tool of task analysis was used to identify the visual-motor demands of the children's computer game packages that use the mouse for operation. The first author examined 12 game packages comprising 45 separate games and applications and recorded information on the types of movement, task design features and recommended ages for all games. The results of the analysis are discussed in terms of the degree of visual-motor development that is required of children accessing these games and the implications for game designers producing developmentally sensitive software.
Sexual Issues within Occupational Therapy, Part 2: Implications for Education and Practice
Authors: Couldrick Lorna
Published: April 2015

Part 2 of this article considers the implications of a study which asked if a client's sexual expression was a legitimate domain of concern of the occupational therapist. The majority of practitioners interviewed believed that it was compatible with the values of the profession and should be part of practice, but views differed about the scope and limits of the role. In reality, only half the respondents included sexual expression of the client within their practice, either routinely or occasionally.

The results demonstrated disparity between ideology and practice. There was evidence of powerful emotive forces, encompassing cultural, contextual and personal issues, which explained why sexual activity was not regarded like other activities of daily living. The majority of participants did not feel adequately prepared to address this aspect of human function. Further research is required but the study has implications for both professional education and practice.
Rising from Sitting in Elderly People, Part 2: Strategies to Facilitate Rising
Authors: Chan Donna , Laporte Diane M , Sveistrup Heidi
Published: April 2015

Rising from a sitting position is an important component of activities of daily living. Although not meaningful in itself, it is a precursor to mobility and other meaningful activities. As such, a difficulty in rising due to gradual age-related changes must be addressed by occupational therapists working in community or institutional settings.

This literature review is in two parts. Part 1 discussed the functional implications and importance of rising from sitting and provided a biomechanical analysis of sit-to-stand that focused on balance and momentum. It considered the dynamic relationship between the centre of mass and the centre of pressure, phases of rising and factors that affect ease of rising, such as Initial body position, speed of rising and age-related physiological changes. Part 2 addresses this Issue and provides movement, environmental and motivational strategies that may be appropriate for elderly clients. By using knowledge from biomechanics, environmental influences and learning strategies, the occupational therapist can provide various strategies to facilitate rising.
The Funding Agencies' Perspective on the Provision of Electronic Assistive Technology: Equipping for Life?
Authors: Cowan Donna M , Turner-Smith Alan R
Published: April 2015

Electronic assistive technology (EAT) — powered wheelchairs, communication equipment and environmental control systems — can greatly improve the user's and carers' quality of life if prescription is timely and appropriate. Despite the benefits that this equipment can bring, the provision of EAT is a highly confused area because different funding agencies with different remits are involved.

As part of a larger research project, a survey was carried out to investigate the remit of and the range of equipment supplied through three funding sources within a given geographical area. This paper gives the results of this survey and presents a snapshot of provision, showing the differences that can occur. It was found that a wide range of equipment was available through these agencies but that the variation in provision was great. Provision was affected adversely by differences in eligibility criteria, referral mechanisms and funding management.

The paper concludes that professionals working in this field should be aware of the level of services provided by all agencies throughout their areas. Solutions such as the Joint funding of equipment are suggested for users who live in areas with services that have stringent criteria and are hence perhaps denied the independence that they could achieve.
The Joint Protection Knowledge Assessment (JPKA): Reliability and Validity
Authors: Hammond Alison , Lincoln Nadina
Published: April 2015

The aim of this study was to design and test a multiple-choice questionnaire to assess the joint protection knowledge of people with rheumatoid arthritis. The questionnaire content was generated from a literature review and face validity was established. The correct answers for the items included in the Joint Protection Knowledge Questionnaire (JPKA) were identified in an inter-rater agreement study with 31 rheumatology occupational therapists. All the questions achieved significant agreement using Kendall's coefficient of concordance (p<0.01 for all items). The content validity was partially established using a panel of 18 rheumatology occupational therapists. A test-retest reliability study with 20 people with rheumatoid arthritis showed no significant difference on two tests at 2 month intervals (median JPKA score test 1 = 78.75%; test 2 = 85%: z = 1.39; p = 0.16). The JPKA is a reliable and valid assessment which can be used to evaluate the effectiveness of joint protection education programmes.
Introducing New Learning Technologies into the Occupational Therapy Curriculum: Evaluation of a Hypermedia Teaching Package
Authors: Seale Jane K
Published: April 2015

There is a growing acceptance that information technology has a place in the occupational therapy curriculum. This has led to an increasing focus on the role of new learning technologies, such as hypermedia, in occupational therapy education. This paper describes a new hypermedia-based application called ‘Computer Applications in Therapy’ and reports the results of two case studies designed to assess its educational value and the potential influence that prior information technology experience might have on its use.

A discussion of the results focuses on the three themes of self-directed learning, orientation and navigation, and skills and experience, and leads to three main conclusions. There is a need to explore the relationship between learning styles and use of learning technologies; develop and evaluate user-friendly interfaces and resource bases that have a strong sense of narrative; and cater for novices and experts.
The Doris Sym Memorial Lecture: Developing a Philosophy of Occupation for Health
Authors: Wilcock Ann A
Published: April 2015

The Third Caledonian Health Lecture, held on 3 March 1999, was dedicated to the memory of Doris Sym. MBE, Fellow of Glasgow Caledonian University, and founder and first Principal of the Glasgow School of Occupational Therapy. Professor Gordon Dickson, Dean of the Faculty of Health at Glasgow Caledonian University, hosted the event, which was attended by a wide range of people including Doris's family, friends, ex-colleagues, practising occupational therapists, retired occupational therapists and academics from other disciplines within the Faculty of Health.

In 1997, the year of the diamond jubilee of occupational therapy education in Scotland. I had the honour of presenting Doris Sym for the award of honorary fellow of Glasgow Caledonian University. Resplendent in her academic robes, Doris gave a feisty speech recalling the challenges involved in setting up a new educational establishment and looking forward to her future participation in University events. Her death early in 1998 came as a shock to us all.

The University was pleased and honoured to welcome Dr Ann Wilcock, founding editor of the Journal of Occupational Science: Australia and historian of the College of Occupational Therapists, to give her lecture — ‘Developing a philosophy of occupation for health’ — in memory of a pioneer and visionary woman who led the development of her profession and established the school teaching it in the West of Scotland.

Ann Carnduff, Head. Division of Occupational Therapy, Glasgow Caledonian University.
Conducting a Service Review
Authors: Howard Lynne , Leeson Janet
Published: April 2015

This article describes how a review was planned, executed and progressed in an occupational therapy children's service. It indicates how the terms of reference were drawn up, the methods used to gain the information required and how the review was written up in order to present it to management and other relevant personnel. It documents what the review achieved in terms of changes to the service and staff development and suggests future directions for the service.
Clinical Governance: An Information Guide for Occupational Therapists
Authors: Sealey Christine
Published: April 2015

Clinical governance is a framework for combining a full range of quality activities, building first upon what is already being carried out. It is being implemented in the National Health Service from April 1999. What is it? What will it mean for occupational therapists working not only in health but also in all other sectors?

This paper has been written to explain this new Government initiative and to coincide with the publication of the College of Occupational Therapists' Position Statement on Clinical Governance (COT 1999a). Government policy on quality is explained in brief, along with the responsibilities of occupational therapy practitioners and managers. A table is provided to help therapists clarify what is already in place and what areas need to be addressed.
Clinical Placements for the Professions Allied to Medicine, Part 2: Placement Shortages? Two Models that can Solve the Problem
Authors: Huddleston Rosalind
Published: April 2015

Traditional models of fieldwork education are unable to provide for the increasing numbers of student placements required to cope with the growing demand for qualified staff. Part 1 of this article summarised the recent research carried out in the North West Region which explored many clinical placement issues. It highlighted the need for occupational therapists to use different approaches to fieldwork education and to utilise non-traditional placement models which have the potential to increase the numbers of appropriate learning experiences without compromising the placement quality.

Willingness to test new placement models is the key issue. Part 2 of the article looks at current placement provision and describes the advantages and disadvantages of two fieldwork education models identified in the North West Region research: the collaborative and the role-emerging models. These models have the potential to increase the numbers of good quality placements available to occupational therapy students while preparing them for working in a changing and challenging health care environment.
The Benefits of Environmental Control Systems as Perceived by Disabled Users and their Carers
Authors: Harmer Jenny , Bakheit A M O
Published: April 2015

The primary objective of this study was to examine the effects of the provision of environmental control systems (ECSs)on the user's functional independence and the amount of care he or she needed. A secondary objective was to establish whether accessibility, acceptability and reliability of ECSsand training in their use have increased the benefits derived from them. A questionnaire and semi-structured interview were used to obtain the responses of users of ECSsand their carers in the County of Dorset, England.

Sixteen users of ECSs and 13 carers were recruited for the study. All users lived at home and were frequently left alone for periods of up to 13 hours per day. Functional gains were reported in all aspects of function that were studied, but statistically significant improvement was found in 7 out of the 17 functions evaluated. The maximum benefit appeared to be in the functions relating to home security needs. There was also evidence that the provision of ECSshad reduced the amount of care needed by disabled users. There was strong agreement between the responses of users and carers. No conclusion could be reached regarding the secondary objective of the study. The provision of ECSsappears to have increased the functional independence of disabled users and their sense of wellbeing and reduced the burden of their care.
The Use of Standardised and Non-Standardised Assessments in a Social Services Setting: Implications for Practice
Authors: Stewart Sandra
Published: April 2015

The increasing demand for occupational therapists to justify their practice and their clinical judgements stimulated consideration of the importance of the psychometric properties of the tools used by professionals in making clinical judgements. In social services settings a variety of procedures are used to establish a client's entitlement to services, some of which are more rigorous than others. In this study, a non-standardised assessment tool to measure severity of disability was compared with a standardised tool to assesswhether there were differences in outcomes and what, if any, were the consequences for service entitlement. The conclusion was that the use of non-standardised tools may unfairly disadvantage some client groups when being assessedfor services.
A System for Determining the Priority of Referrals within a Multidisciplinary Community Mental Health Team
Authors: Job Teresa
Published: April 2015

The high level of demand for community mental health services implies a need for allocating priority to referrals. Pressure to achieve this has been apparent in the British national health and social services since reorganisation in 1991. What has been less clear Is how this could be carried out within individual services.

The project arose in response to increasing referrals to a local community mental health team from general practitioner fund holders, leading to unacceptable waiting times for clients. A questionnaire was sent to all 49 general practitioners serving the area, of whom 35 responded. The survey was designed to gain information about the factors influencing referral to the service and the levels of satisfaction with the intervention provided. The results highlighted an urgent need to reduce waiting times and to target clients with greatest need more effectively. This information led to the development of a system to assess priority of referral.

The system, still in use, assesses five components: level of distress, level of functioning, suicidal intent, motivation and contact with other services. Scores are allocated to each section. An overall score determines the client's starting point on the waiting list. Additional points are accrued during waiting times ensuring that movement up the list is continuous.
The Housing Enabler: An Objective Tool for Assessing Accessibility
Authors: Iwarsson Susanne
Published: April 2015

This paper describes an instrument — the Housing Enabler — used in the assessment of housing accessibility. The tool was developed from the original Enabler idea by Steinfeld et al (1979), resulting in an instrument for reliable assessment of the accessibility of the housing environment and the immediate outdoor environment in terms of occupational therapy. Apart from a description of the instrument itself, this paper presents theoretical bases, studies completed, and current, and future considerations of importance for occupational therapy practice and research. The outcome of a Housing Enabler assessment makes the concept of accessibility concrete and allows for individual as well as group analyses. In conclusion, the Housing Enabler is a useful and reliable instrument for research, practice and education. It offers a wide range of applications and is well suited for the current development of community-based occupational therapy.
The Impact of Restructuring Mental Health Services on Occupational Therapy
Authors: Lloyd Chris , King Robert , Maas Frikkie
Published: April 2015

Major reform of mental health services in Australia has been taking place. In Queensland, the Queensland Mental Health Plan set out specific objectives and strategies for implementing mental health services reform which have had an impact on the professional role of staff working in those services. A pilot study, using a qualitative design, was conducted to examine the impact of restructuring mental health services on occupational therapy. The results of this study indicate a commitment to the profession of occupational therapy, enthusiasm, and a highly perceived sense of competence in and contributions to mental health.
Bending resistance and energy-absorbing effectiveness of empty and foam-filled thin-walled tubes
Authors: Li Zhibin , Lu Fangyun
Published: April 2015

A comparative study on the crashworthiness characteristics of different cylindrical tubular structures under quasi-static three-point bending, such as thin-walled empty tube, foam-filled single tube structure and foam-filled double tube structure was carried out. The load–deformation characteristics, failure modes and energy absorption capacity of different structures were investigated. Typical characteristic parameters to measure crashworthiness of a structure, namely energy absorption, specific energy absorption (SEA) and energy-absorbing effectiveness factor were systematically studied and compared to identify a potential structural component for vehicle engineering applications. The experimental results confirmed that when subjected to bending, the total energy absorption, SEA and energy-absorbing effectiveness of foam-filled double structures were relatively higher than those of the empty and foam-filled single structures. Foam-filled double square and circular tube structures are recommended as crashworthy structures due to their high bending resistance and energy-absorbing effectiveness.
Understanding Practitioner Perceptions of Responsiveness to Intervention
Authors: Regan Kelley S. , Berkeley Sheri L. , Hughes Melissa , Brady Kelly K.
Published: April 2015

This mixed methods study explored elementary and secondary educators’ perceptions of their school district’s responsiveness to intervention (RTI) initiative. Teachers and administrators were surveyed regarding (a) the perceived feasibility and effectiveness of educational practices that are inherent within RTI models, (b) perceived knowledge of basic RTI concepts, and (c) perceived preparedness to implement specific components of RTI within their district. A majority of respondents reported that educational practices common to RTI models (e.g., progress monitoring, evidence-based instruction) were both feasible for the classroom and effectively implemented at their school. In addition, most understood the basic principles of RTI. However, responses indicated that educators need more specific guidance about how to implement. Lack of understanding of RTI and need for guidance for implementation were particularly pronounced at the high school level. Findings from the current study are consistent with the existing RTI literature. We conclude with recommendations for professional development of RTI and implications for practice specifically at the secondary level.