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Introduction: Animal-assisted and nature-based interventions in psychosocial treatment for various groups of clients have been studied internationally. However, there is little knowledge about how young adults with autism experience participation in such types of interventions. This clinical study aimed to describe the feasibility of animal-assisted and nature-based activities on a farm as a complementary intervention for young adults with autism and social withdrawal., Methods: The participants were aged 18-30 years, diagnosed with autism and social withdrawal, with no organised occupation during the previous year. Eleven of 13 participants completed a 12-week intervention in small groups. They took part in interviews before and after, which focused on their current life situation and expectations about, and experiences of the intervention. The feasibility was described in terms of participants' characteristics, attendance, and their experiences of participating in the activity. Data were analysed with descriptive statistics and qualitative content analysis., Consumer and Community Involvement: The intervention was formed in collaboration with participating supervisors, ordinary clinical staff, and a young woman with a user perspective., Findings: The level of feasibility was found to be high. The mean participation rate during the activity days was 75% and varied from 50 to 100%. The analysis of the participants' experiences from the activity generated three categories, "Being in a meaningful context", "Creating a comfort zone" and "Developing structure in everyday life", and each of these included sub-categories., Conclusion: The main categories revealed a dynamic process based in meaningfulness, comfort and structure in everyday life. The positive experiences of undemanding activities, emotional relationships and non-verbal communication with the horses were prominent and might facilitate the development of social interaction. However, the intervention's timeframe of 12 weeks was experienced as too short for long-lasting change., (© 2024 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Background: Including Aboriginal and Torres Strait Islander people and communities through consultation has been a key feature of policy implementation throughout the Australian Government's "Closing the Gap" (CTG) strategy. However, consultation often reinforces power imbalances between government and local community and can undervalue or marginalise Indigenous knowledge and leadership. Occupational therapy has a short history of examining colonial power structures within the profession, but there has been limited progress to decolonise consultation and practice., Methods: Drawing on decolonising research methodology and positioned at the interface of knowledge, comparative case studies were used to understand policy implementation in two regions. In Shepparton, Victoria, CTG policy was implemented predominately through an Aboriginal Community Controlled Health Organisation, and in Southern Adelaide, South Australia, CTG policy was implemented through mainstream state government and non-government providers in the absence of a local Aboriginal-controlled organisation. Findings were examined critically to identify implications for occupational therapy., Results: Our case studies showed that policy stakeholders perceived consultation to be tokenistic and partnerships were viewed differently by Aboriginal and non-Indigenous participants. Participants identified the need to move beyond a rhetoric of "working with" Aboriginal and Torres Strait Islander people, to promote Aboriginal leadership and really listen to community so that policy can respond to local need. The findings of this research show that Aboriginal-controlled services are best positioned to conduct and respond to community consultation., Conclusion: A decolonising approach to consultation would shift the status quo in policy implementation in ways that realign power away from colonial structures towards collaboration with Indigenous leadership and the promotion of Aboriginal-controlled services. There are lessons for occupational therapy from this research on policy implementation on authentic, decolonised consultation as a key feature of policy implementation. Shifting power imbalances through prioritising Indigenous leadership and honouring what is shared can drive change in CTG policy implementation processes and outcomes., (© 2024 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

The occupational therapy doctorate degree requires a capstone experience and project to be completed within a specific occupational therapy (OT)-related setting. The doctoral capstone experience and project can be difficult to complete in the highly specialized Neonatal Intensive Care Unit (NICU). This paper provides a sample outline of the doctoral capstone experience and project in the NICU. The NANT Core Competencies, written by the National Association of Neonatal Therapists Professional Collaborative, were utilized as a guideline to track student progress and ensure understanding of neonatal therapy topics. This paper follows one student's doctoral capstone experience and project in the NICU while mentored by an occupational therapist. Learning objectives related to utilizing the NANT Core Competencies, gaining clinical skills, and participating in program development were created. The site mentor trained, supported, and educated the student in the NICU while monitoring her progress during the fourteen weeks. Overall, the student successfully completed all objectives. This paper provides an example of the doctoral capstone experience and project in the NICU utilizing the NANT Core Competencies to support the mentor-student relationship and student learning with educational topics provided in the competencies guiding the capstone experience. With details including student progress, weekly mentor-student meetings, and roles/responsibilities of the student and mentor, this paper serves as a resource and guideline for OT faculty as well as potential mentors of occupational therapy doctorate students in the NICU setting. Additionally, this paper highlights the feasibility of the completion of the OT doctoral capstone in the NICU.

An objective structured clinical examination (OSCE) has been recognised as a reliable but workload-intensive assessment method across health sciences studies. Though a variety of digital marking tools have been employed to improve marking and feedback provision for OSCEs, many of these require specialist software or maintenance. This pilot study examines the development and trialling of Microsoft Forms as a marking and feedback instrument for an OSCE within a Sport and Exercise Therapy module. This study aims to assess whether the use of a non-specialist digital tool, such as Microsoft Forms, might be able overcome limitations in current assessment procedures and ultimately provide a more effective method for marking and feedback provision for an OSCE. Results from OSCE examiners (N = 8) and students (N = 30) who participated in the pilot indicate that Microsoft Forms does have the potential to provide a more effective experience for examiners and ultimately improve upon feedback provision for students when compared with a paper-based marking tool. However, concerns around the form's ease-of-use may ultimately influence its adoption as a marking instrument above current paper-based methods.

This article is an analysis of the ways in which creative assessment in Latin American literature, particularly sewing textiles, led to positive well-being benefits for students during the early stages of the Covid-19 lockdown. Through the lens of research coming out of occupational therapy, health-based arts therapies, and the Conflict Textiles collection, it explores general student feedback and two case studies of the visual and written elements of an assessment submitted in 2020 in a Latin American literature course in Spanish and Portuguese Studies, Queen's University Belfast, to show the potential eudaimonic well-being effects of creative projects. [ABSTRACT FROM AUTHOR]

Introduction: Participation in work and employment is a milestone of adulthood. People returning to work after burn injury may have physical, psychological, social, and environmental barriers to overcome in order to resume their pre-injury employment. The aim of this paper is to evaluate qualitative findings regarding return-to-employment after burn injury., Methods: A qualitative synthesis was conducted based on the qualitative findings of an earlier mixed methods review. A pre-determined scoping review protocol was used in the earlier review to search MEDLINE, CINAHL, Embase, PsycINFO, PubMed, Scopus, CCRCT, and CDSR databases between 2000 and Aug 2021. Any papers presenting qualitative data from previously employed adults with cutaneous burn injuries were included., Findings: A total of 20 papers with qualitative data on return-to-employment after burn injury were found. Only six included studies focused on return-to-employment outcomes and the remaining studies reporting on quality of life and life experiences after burn injury. Common themes included impairments that develop and change over time; occupational identity and meaning; temporal aspects of burn recovery; burn rehabilitation services and interventions; attitudes, knowledge and support of service providers; workplace environments supporting work re-engagement after burn injury; usefulness of work accommodations; family and social supports, individuals attributes that influence re-engaging in employment; and accepting and rebuilding., Conclusion: Resumption of work after burn injury is regarded as a key marker of recovery for working-aged adults by burn survivors and burn care professionals. Support at transition points during the burn recovery process and peer-led programmes were important. However, limited information currently exists regarding clinical practices, service gaps, and understanding of return-to-employment outcomes after burn injury., (© 2023 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Introduction: Evidence-based practice supports clinical decision-making by using multiple sources of evidence arising from research and practice. Research evidence develops through empirical study while practice evidence arises through clinical experience, client preferences, and the practice context. Although occupational therapists have embraced the paradigm of evidence-based practice, some studies have identified limits in the availability and use of research, which can lead to reliance on other forms of evidence. This study aimed to understand how Australian occupational therapists use practice evidence, manage potential bias, and enhance trustworthiness. Potential use of a critical appraisal tool for practice evidence was also explored., Methods: A 42-item questionnaire was developed to address the study aims. It consisted of a 7-point Likert scale, ordinal and free text questions. Likert scales were collapsed into binary scales and analysed using SPSS. Ordinal data were graphed and free text responses were analysed using manifest content analysis., Results: Most respondents (82%) indicated that practice evidence was an important informant of practice and is used alongside research evidence. Almost all respondents (98%) expressed confusion when reconciling discrepancies between research and practice evidence. There was general acknowledgement that practice evidence is prone to bias (82%), yet 92% were confident in trusting their own practice evidence. Most respondents (74.5%) undertook some measures to appraise practice evidence, and almost all respondents (90%) agreed they would refer to a critical appraisal tool that helped them evaluate practice evidence., Conclusion: Occupational therapists in this study routinely use practice evidence arising from their own experience, client perspectives, and their practice context to inform clinical decision-making. While they agreed that practice evidence was prone to bias and misinterpretation, they generally trusted their own practice evidence. Participants indicated they needed guidance to critically appraise their practice evidence and supported the development of a critical appraisal tool for this purpose., (© 2024 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Introduction: This review aimed to synthesize and review computerized cognitive rehabilitation studies on children with disabilities to confirm their effectiveness. Methods: In 2021, an electronic search of academic articles was performed using PubMed, CINAHL, Science Direct, and Cochrane databases. Results: First, two experienced researchers selected 325 papers. 85 non-SCI studies published before 2017 were excluded. Further, duplicate studies were removed, remaining with 71 papers. After reviewing the title and abstract, 14 studies were selected. Finally, after performing a full text review, 7 studies were selected. All studies on computerized cognitive rehabilitation in children were randomized clinical trials that showed a positive impact to this therapy. Computerized cognitive rehabilitation targeting children with various diseases improved their memory, math ability, and activities of daily living. Conclusion: Computerized cognitive rehabilitation can be effectively used in clinical practice in line with non-face-to-face treatment of children with various difficulties caused by the coronavirus pandemic.

Existing research evidence pertaining to the occupational therapy (OT) role with adventure-based outdoor activities for military veterans and the authors' positive experience serving members of a non-profit veteran-run organization that promotes rehabilitation archeology suggest that outdoor rehabilitation for this client population is a promising avenue for the profession. Moreover, students' exposure to outdoor experiences designed for military veterans as well as other populations presenting with physical and mental health conditions has the potential to significantly augment OT curriculum by impacting both the learning trajectory and personal transformation of the students. This paper describes a unique service-learning experience involving graduate OT students who engaged with and provided services to veterans participating in archeological fieldwork, as well as the impact of this experience on the students.

Students often find learning and applying theory difficult and potentially disconnected from practice. Using theory to guide occupational therapy assessment and intervention preserves the distinct value of occupational therapy. One way students develop professional reasoning is by learning how to use theory. Theoretical knowledge guides the professional reasoning questions that students and practitioners seek to answer. Teaching occupational therapy theory needs to involve clear, engaging, and meaningful activities that foster an explicit focus on occupation. This paper presents an innovative way of teaching theory in occupational therapy. We explain a thinking cap analogy to organize the theoretical knowledge that guides professional reasoning. This analogy involves the instructor wearing a hat as a thinking cap to represent an occupation-centered model of practice on which objects (frames of reference) can be added as flair. We describe the thinking cap analogy in detail and how this analogy builds on Ikiugu's framework for combining theoretical conceptual models. Multiple years of student course feedback demonstrate the usefulness of this analogy as a teaching innovation. This method for teaching theory can advance how students use theoretical knowledge to guide professional reasoning in practice and value occupation, performance, and participation as central to occupational therapy.

Background: Home hazard removal programs are effective in reducing falls among older adults, but delivery in the United States is limited., Objectives: We completed a process evaluation of the Home Hazard Removal Program (HARP), an intervention delivered by occupational therapists., Methods: Using the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance), we examined outcomes using descriptive statistics and frequency distribution. We examined differences between covariates using Pearson correlation coefficients and two-sample t tests., Results: 79.1% of eligible older adults participated (reach); they experienced a 38% reduction in fall rates (effectiveness). Ninety percent of recommended strategies were completed (adoption), 99% of intervention elements were delivered (implementation), and 91% of strategies were still used at 12 months (maintenance). Participants received an average of 258.6 minutes of occupational therapy. An average of US$765.83 was spent per participant to deliver the intervention., Conclusions: HARP has good reach, effectiveness, adherence, implementation, and maintenance and is a low-cost intervention., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Despite the growing diversity among students in higher education, nonprogression to postsecondary education persists for many students with intellectual disabilities with low completion rates for those who do progress. Research suggests that occupational therapy (OT) support can be extremely beneficial in assisting students. Less is known however about the impact of OT in higher education. This study aims to examine the use of OT embedded in a postsecondary programme for students with intellectual disabilities. Methods: This study uses a scoping review of relevant literature and a qualitative analysis of OT working in a higher education programme specifically designed for students with intellectual disabilities in Ireland. Findings: This paper highlights how the OT support within this programme uses a four-fold collaborative approach supporting students, staff, business partners and wider organisational structures in the university. Conclusion: The analysis highlights the opportunities for collaboration between OT and curriculum developers, teaching and ancillary staff and students in higher education along with the significant OT input into work placements and internships with business partner mentors. Challenges in educating stakeholders to understand OT in the higher education environment would suggest a substantial need for further research.

Introduction: Telehealth interventions have the potential to enhance access to care and improve efficiency while reducing the burden on patients. Although telehealth interventions are well accepted and adopted in physical therapy, their usage in occupational therapy for older adults is less common, and limited information exists regarding their setting and context., Objective: To provide an inventory and synthesis of telehealth interventions in occupational therapy for older adults., Method: For published studies on telehealth-based occupational therapy interventions in older adults between 2000 and 2022, six databases were reviewed. Data extraction and analysis were guided by the taxonomies developed by Tulu, McColl and Law and informed by the Canadian Model of Occupational Performance and Engagement., Findings: Twenty-three studies on telehealth interventions in occupational therapy for older adults were identified, mostly from North American authors (n = 11; 47.8%) and randomised clinical trials (n = 9; 39.1%). Most participants had a health problem (n = 20; 87.0%), mainly stroke (n = 9; 39.1%). Interventions focussed primarily on symptom management education (n = 12; 52.2%) of community-dwelling adults with health conditions, using videoconferencing systems or applications (n = 14; 60.7%). Interventions were delivered from the healthcare centre (n = 6; 26.1%) to the person's home (n = 18; 78.3%) synchronously (n = 19; 82.6%). About one third (n = 8; 34.8%) of the studies specified the therapist's location., Conclusion: Published studies on telehealth interventions in occupational therapy with older adults have mainly focussed on the synchronous training and education of participants using videoconferencing systems or applications. According to these studies, the scope of interventions is limited and could be expanded, for example, through occupational development and environmental modification. To better understand and describe best practices in the use of telehealth in occupational therapy, future studies should provide more details about the interventions performed, the technology used and the environmental settings of the therapist., (© 2023 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Introduction: Retirement, being a major life event and a focus of healthy ageing in society, creates the opportunity for occupational therapists to support people transitioning from work to retirement. Little is known about the scope of practice of occupational therapy in the work-to-retirement transition. The aim of this study was to, in Australia, (1) explore the potential scope of practice and factors influencing the potential scope of practice of occupational therapy in the work-to-retirement transition and (2) map findings to occupational therapy theoretical frameworks to assist in articulating scope of practice., Methods: A qualitative study (thematic analysis as an independent approach within a qualitative descriptive methodology) was undertaken using semi-structured interviews with Australian occupational therapists., Findings: Australian occupational therapists (n = 14) were interviewed. Four themes were identified which related to the potential scope of occupational therapy practice in the work-to-retirement transition: finding meaningful occupation; modifying lifestyles and homes for better living; work engagement; and application of occupational therapy skills. Six themes were identified which related to contextual factors influencing the potential scope of occupational therapy practice in the work-to-retirement transition: right time; valuing our expertise; promoting occupation(al therapy); finding the money; life, work and retirement longevity; and social responsibility., Conclusion: The work-to-retirement transition can be incorporated into other practice areas or can be a unique practice area allowing for a more targeted service. The frameworks of who, what, when, and where and enablement skills assist in articulating occupational therapy scope of practice in the work-to-retirement transition. A number of contextual factors can be barriers and/or facilitators to occupational therapy practice. More clearly articulating occupational therapy practice in the work-to-retirement transition will enable the profession to promote their scope of practice assisting in obtaining professional and public recognition and overcoming barriers such as funding to enable provision of services within this area., (© 2022 Occupational Therapy Australia.)

Art and movement are motivating forces in, through, and beyond education. As populations age, there is an increasing need to support physical and social well-being. Yet, since the onset of the COVID-19 pandemic, there has been a reported exponential increase in feelings of loneliness across generations. Complex challenges require trans-disciplinary solutions, and this paper represents a joint effort within and across disciplines, communities and cultures to find ways to ameliorate this silent epidemic. In this paper, we propose a cross-disciplinary conceptual framework where Aboriginal Artists and Knowledge Holders, Teacher Educators, and Physical and Occupational Therapists come together to explore theoretical and pedagogical insights that encompass intergenerational art-moving-well-being practices, reducing feelings of loneliness and improving social connections across generations. There are two main aims of this paper; first, to better understand current studies that report on integrating art-moving-well-being practices, and the effect this has on health and well-being of intergenerational participants (under 10-year-olds, 20+ year olds and 50+ year olds). Second, based on community needs, the long-term aim is to propose a flexible art-moving-well-being conceptual model that is scalable, sustainable and based on social and relational support systems. We propose a model that is flexible and adaptable within and across our local community and beyond. We argue that feelings of loneliness are unique to each individual, and there is a need to connect specific intergenerational programmes with art-moving-well-being practices that readily engage and integrate varied communities and cultures in sustainable ways and thus, contribute to thriving communities.

This paper describes the application of an integrated theoretical framework that consists of behavioral change models to plan preventative educational programs and target interventions to facilitate parent implementation of tummy time (prone positioning) to promote infant development and prevent flattening of the infant's skull. A qualitative study design was used to explore tummy time barriers and facilitators and to gain an in-depth understanding of the behaviors that influence tummy time implementation. Twenty-three parent participants completed an open-ended survey designed to gain information on parental perspectives related to tummy time. Data were analyzed using thematic analysis. Physical Capability of the infant and Psychological Capability of the parent, Physical and Social Opportunity, Reflective Motivation, Automatic Motivation, Emotion, Memory, Attention, & Decision Processes, Skills, Environmental Context & Resources, Social Influences, Beliefs about Consequences, Beliefs about Capabilities, and Knowledge are components to target during intervention. Occupational therapists and other healthcare providers can use the comprehensive behavioral change models described in this paper to develop evidence-informed, theory-based interventions to promote parental implementation of tummy time.

Purpose: The study investigates meaningful learning among higher education students using concept maps (CM) as a learning strategy. The main goals were to understand whether the introduction of CM produced changes in students' academic achievement and intrinsic motivation (IM). Design/methodology/approach: In this quasi-experimental study, academic achievement was collected using achievement tests made in-class, IM through a self-reported questionnaire and the usefulness of CM using an interview. The research sample consisted of 60 undergraduate students enrolled in the first year of an undergraduate occupational therapy (OT) program of a Portuguese polytechnic institute in two different consecutive academic years. Students were assigned to 2 groups (experimental group (EG) -- 23 and control group -- 37). CM were introduced in the pedagogical process of the EG. Findings: CM produced better academic achievement in the EG. Nevertheless, groups presented a decrease in the levels of IM over time. Practical implications: The paper includes implications for the development of CM as a learning strategy to improve students' learning and academic achievement. Originality/value: This paper fulfills an identified need to investigate the double impact of CM on academic achievement and IM in higher education students.

Background/aim: Although sensory approaches are recommended to relieve distress and agitation and reduce the use of seclusion and restraint, many Australian psychiatric units have struggled to sustain their practice. The aim of this study was to investigate the barriers and enablers influencing the use of different sensory approaches across one health region in Australia and to obtain recommendations for strategies to improve their use., Method: This cross-sectional survey was informed by the Theoretical Domain Framework. Likert scale questions considered barriers and enablers to the use of non-weighted sensory interventions, weighted modalities, sensory rooms, and sensory assessments/plans. Open-ended questions explored participant concerns and recommendations to improve the use of sensory approaches., Results: Participants (n = 211) were from nursing, allied health, medical, and peer support staff across inpatient psychiatric units. Factors most frequently identified as enablers for using sensory approaches were beliefs of positive benefits to consumers (e.g. decreasing distress and agitation); belief it was within the staff's role; and knowledge of the approaches. Limited time was the most common identified barrier. Factors statistically associated with more frequent use were knowledge, skills, confidence, availability, and easy access to sensory tools/equipment. Only 30% of participants were concerned about potential risks of sensory approaches, with this risk mitigated through adequate supervision and thorough risk assessment. Recommendations to improve practice included improved access to, and maintenance of, equipment, more training, and increased staffing., Conclusion: This study revealed how barriers and enablers vary for different sensory approaches and how these factors impact their frequency of use in psychiatric units. It provides insights into staff recommendations to improve the use of sensory approaches in one health region in Australia. This knowledge will lead to the development of implementation strategies to address identified barriers and improve the use of sensory approaches in psychiatric units., (© 2023 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

The organisational, physical and social environment within residential aged care settings greatly influence its residents' sense of autonomy, choice and control and their ability to engage in meaningful occupations. Identifying to what extent these environmental contexts are supportive and well-coordinated could assist with promoting meaningful engagement of residents. The Residential Environment Impact Scale (REIS) was developed to measure the impact of the physical and social environment on residents. This study examined the benefits and barriers to implementing the REIS in four Australian Residential Aged Care Facilities (RACFs) and factors to consider during implementation., Method: A multisite sequential mixed-methods study was conducted. Research participants included occupational therapists conducting the REIS and leadership staff examining the REIS reports in four facilities. Data consisted of formal observations of the REIS assessment process, an online survey of all participants and two research consensus groups. Qualitative findings were generated from field notes, open-ended survey questions and group discussions. Close-ended survey questions provided quantitative data., Findings: The REIS was considered a useful audit tool, generating a holistic overview of the RACF. It highlighted the quality of person-centred care and the potential role of occupational therapists to promote opportunities for meaningful occupational engagement. Barriers included administration time, personal characteristics of residents and limited resources to action recommendations., Conclusion: The REIS has potential to be an audit tool for a whole-environment approach to facility assessment of residents' sense of autonomy, occupational choice and meaningful engagement. As such, it provides occupational therapists with scope to support RACFs meeting national quality standards., (© 2021 Occupational Therapy Australia.)

Person-centered approaches to measurement are needed to more fully reach the goals of person-centered practice. Keyform maps, derived from Rasch analysis and principles of person-centered measurement, are thought to be an important tool for translating person-centered measurement into clinical practice. The purpose of this study was to understand the impact of keyform map use in a variety of learning activities embedded across multiple courses in an entry-level occupational therapy curriculum. This paper includes a description of 3 keyform map learning activities and corresponding results. The effects of keyform maps as a signature instructional strategy within entry-level occupational therapy education and implications for future studies are also discussed.

Facilitated communication (FC) has been a heavily debated and documented topic across multiple disciplines, including sociology, education, psychology, pediatrics, speech-language pathology, and disability studies. Although many professionals from various disciplines and advocates have offered opinions, suggestions, and research on the topic, there has been minimal input from the occupational therapy (OT) profession. The lack of OT input is noteworthy as OTs are experts in enabling upper extremity performance and independence through a variety of training, adaptation and modification strategies, and use of external supports. Because of their professional code of ethics and a specific knowledge base, OTs are uniquely positioned to provide a host of ethical and evidence-based strategies that enable independent access to communication technology. The consideration of multiple access options is contrary to the typical facilitated encounter where facilitators exclusively choose to manipulate an upper extremity in order for letters to be selected on a display or keyboard. The purpose of this paper is threefold: (a) To offer insight into the standard of care by OTs including their ethical standards; (b) to identify varied accommodations that enable access using a feature-matching standard of care that eliminates the need for a facilitator; and (c) to highlight how to increase independent assistive technology/augmentative and alternative communication access, thus dissuading the need or use of facilitated access to letters.

This paper explores the reflections of occupational therapy academics about the experience of kindness in academic and professional life. Data were derived from a reflective group conversation in the context of a larger overarching research project exploring occupational therapy academic development. The findings elaborate how kindness and care played out for us as participant-researcher academics, including how it was mediated by expression of values and behaviours in our roles, and how we experienced the values and behaviours of others in the academy. We found that degrees of kindness and care were distributed along a continuum from more kind to less kind. A notable aspect of our conceptualisation of kindness involves recognising others' potential and a willingness to work collectively. We argue that it is critical to create and maintain communities that value and are capable of acting with authentic care and kindness. Prioritising our time to engage in emotion-based, relational work beyond 'duty of care' is vital to support collective success and longevity in the academy. Recognition of, and action to challenge, the forces that erode kindness and care are vital next steps in creating academic and professional contexts that will support our flourishing.

Speech problems affect about 66% of children with classic galactosemia (CG), but limited evidence is reported on early motor and sensory motor development in this at-risk population. Research has been focused on speech and language development, leaving a paucity of data on motor and sensory differences. This paper describes preliminary data regarding sensory motor and motor development patterns in young children with CG. Babble Boot Camp© (BBC) is an NIH-funded randomized control trial (RCT) implementing proactive interventions designed to support the speech language development of infants with CG. Cases were randomly assigned to a motor-first group (Motor Milestones), receiving virtual occupational therapy through 14 months, or a speech-first group, receiving virtual speech therapy through 14 months. All cases received speech and language therapy from 15 to 24 months. Controls, typically developing infants, did not receive occupational therapy or speech therapy. Participants were recruited through social media, advertisements, metabolic clinics, and the Galactosemia Foundation. Infants in the motor milestones group were assessed with the Developmental Assessment of Young Children and Sensory Profile-2 pre-enrollment (<6 months of age) and post-treatment follow-up at 2.5, 3.5, and 4.5 years of age. Results show that 17.5% of participants with CG had delays in gross motor, 22.5% in fine motor, and 45% in sensory processing. Data from the Motor Milestones portion of BBC are important emerging evidence for occupational therapy in early intervention, preschool, and outpatient settings. This research supports the need for occupational therapy services during early intervention to minimize or prevent long-term motor and sensorimotor delays in infants with CG. Understanding patterns and addressing literature gaps helps support the need for occupational therapists to address motor delays, improve activities of daily living, play, promote functional independence, and provide caregiver education to best support the occupational performance of children with CG.

Objective: There is an increased risk of occupational imbalance and poor quality of life (QoL) if one has schizophrenia. Although evidence suggests a relationship between psychopathology and QoL, the association of occupational balance (OB) with QoL in schizophrenia is unclear. This study aimed to investigate the associations among psychopathology, occupational balance, and QoL in schizophrenia., Methods: This was a cross-sectional study carried out in a Community Mental Health Center (CMHC). Ninety-five individuals aged 18 years or older with the diagnosis of schizophrenia participated in the study. All participants completed a sociodemographic form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale in Schizophrenia (CDSS), Occupational Balance Questionnaire-11 Turkish Version (OBQ11-T), and the World Health Organisation Quality of Life Assessment Instrument (WHOQOL-100-TR). Relationships among clinical and depressive symptoms, OB, and QoL variables were examined through correlation analysis, and then multiple linear regression analysis was performed to determine the variables that have influences on QOL., Results: The study participants had low OB scores and the lowest mean in the WHOQOL-social relationships subscale. WHOQOL-overall QoL score demonstrated a moderate negative correlation with the PANSS-total score and PANSS-general psychopathology subscale score (r = -0.422, r = -0.463, P < 0.001) and a mild negative correlation with the CDSS-total score (r = -0.390, P < 0.001). OBQ11-T total score showed a moderate positive correlation with the WHOQOL-overall score (r = 0.549; P < 0.001). Findings from the multiple linear regression analysis revealed that OBQ11-T (β = -0.467, P = 0.000) and PANSS-general psychopathology (β = -0.221, P = 0.045) were significant predictors of the overall QoL, explaining 48% of the variance in the overall QoL (adjusted R 2  = .43, P < 0.001)., Conclusion: Our study findings showed that OB and general psychopathology are determinants that should be considered in improving the QoL in individuals with schizophrenia. Thereby, addressing the symptoms of general psychopathology and occupational factors to improve the QoL may be achieved with the incorporation of occupation-based programmes to routine treatment. However, further research is required., (© 2022 Occupational Therapy Australia.)

Introduction: Occupational therapists working in community aged care play a key role in service provision because of their expertise in considering the person, their occupations, and environmental context. To further understand occupational therapy practice in community aged care, this study aimed to explore the approaches, models, frames of reference, assessments, interventions, and outcome evaluation methods being used by Australian occupational therapists in aged care., Methods: An online questionnaire was developed, piloted, and delivered to occupational therapists working in community aged care in Australia. Responses to closed-ended questions were analysed using descriptive statistics, and a summative approach to content analysis was applied to open-ended questions., Results: Seventy-one occupational therapists employed in community aged care across Australia participated in the questionnaire. Almost half of the respondents were employed in private practice. All respondents used a compensatory approach to practice, whereas just over three-quarters used a restorative approach. The Person-Environment-Occupation (PEO) model was the most frequently used occupation-focused model (n = 45). The biomechanical and rehabilitative frames of reference were each used by over two thirds of respondents. Cognitive assessments were most common, followed by functional and environmental assessments. The interventions of equipment and home modifications were very common followed by remedial therapy., Conclusion: Community aged care occupational therapists show coherence in theory-to-practice application, but there is wide diversity in practice decisions and possibly gaps in practice. Occupational therapists remain firmly client centred but apply compensatory approaches more than reablement approaches. This trend may be due to the influence of aged care funding models and limits on time. In addition to reacting to crisis, there is scope for occupational therapists to have a greater focus on early intervention to support dementia care and prevent falls., (© 2023 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

»: Iatrogenic nerve injuries may occur after any intervention of the upper extremity., »: Causes of iatrogenic nerve lesions include direct sharp or thermal injury, retraction, compression from implants or compartment syndrome, injection, patient positioning, radiation, and cast/splint application, among others., »: Optimal treatment of iatrogenic peripheral nerve lesions relies on early and accurate diagnosis., »: Advanced imaging modalities (e.g., ultrasound and magnetic resonance imaging) and electrodiagnostic studies aid and assist in preoperative planning., »: Optimal treatment of iatrogenic injuries is situation-dependent and depends on the feasibility of direct repair, grafting, and functional transfers., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A897)., (Copyright © 2023 by The Journal of Bone and Joint Surgery, Incorporated.)

General community occupational therapists (OTs) work with clients experiencing chronic and complex conditions, some living with one or more comorbid common mental health issues (such as anxiety, depression or distress). This study aimed to describe the perspectives of general community OTs of their engagement with clients experiencing mental health issues; their perceptions of the implementation of routine screening in their practice, and the knowledge, skills and support they need to identify and support their clients' mental health needs. Six focus groups were undertaken with general community OTs (n = 21) from three Australian health services in rural, regional and metropolitan settings, between December 2020 and January 2021. Data were analysed using a team-based framework approach. Three key themes were identified: (1) OTs' experiences working with people with mental health issues; (2) impacts of engaging with clients experiencing mental health issues on OTs; and (3) implementing routine mental health screening in general community OT practice. The latter had two sub-themes: (i) identified considerations and (ii) education and system-level support needs. General community OTs frequently work with clients with mental health issues. These experiences impact their practice in multiple ways. This study highlights opportunities for integrating routine mental health screening into general community OT practice and identifies the system and educational development required to support this enhancement to practice. Supporting general community OTs to routinely screen for mental health issues will enhance collaborative client-centred care. Our findings may also have implications for other community-based health professionals and services, particularly those delivered in clients' homes., (© 2022 John Wiley & Sons Ltd.)

Describing how occupation is used in practice can be challenging for occupational therapists. Occupation-centred, occupation-based, and occupation-focussed terminology are frequently used interchangeably and ambiguously to describe practice. However, ambiguous language creates confusion and inadequately demonstrates the value of occupation. This scoping review aimed to identify how occupation-centred, occupation-based, and occupation-focussed terminology are defined and represented in occupational therapy literature. A five-step scoping review included papers published between 2014 and 2019 from four databases. Extracted data were summarised to outline how the terms were being used within the literature. Initial searching yielded 819 articles and 35 papers met inclusion/exclusion criteria. Within current literature, occupation-focussed and occupation-based terminology were inconsistently described. A limited number of articles used occupation-centred and occupation-focussed terminology to describe practice, whilst occupation-based was more prominent. Occupation-based terminology was represented in numerous ways to describe assessments, practice tools, interventions, research, and theory. Discrepancies between the description and implementation of occupation-based practice were most prominent within interventions. Findings demonstrated that occupation-based and occupation-focussed terminology were used interchangeably and inconsistently in literature. It is timely to consider how this is problematic for our professional identity and perceptions of occupation in practice. [ABSTRACT FROM AUTHOR]

Introduction: Telehealth is widely proposed to improve access and equity in provision of rehabilitation, including wheelchair assessment, yet the design requirements of telehealth wheelchair assessment that will be accepted and utilised at scale are unclear. Service design that addresses the existing inequities in outcomes for indigenous populations, such as Māori will be critical. The aim of this study was to examine the design requirements of a telehealth wheelchair assessment service from the perspectives of key stakeholders such as wheelchair users and their families, including indigenous (Māori) and health professionals including occupational therapist, and physiotherapist assessors and technicians., Methods: Within a wider mixed methods design, inductive thematic analysis was applied to focus group and interview data from 23 assessors (19 occupational therapists and four physiotherapist assessors, one of whom was Māori) and 19 wheelchair users (three of whom were Māori)., Results: Eight themes were discerned with the final three themes emphasising the experiences of particular concern to Māori: (1) At the mercy of the system; (2) The hurdle of technology; (3) More efficient for all; (4) Lost information and connection; (5) Rights and the right way forward; (6) Cultural safety; (7) Whanaungatanga (relationship building); and (8) Summative disadvantage for Tāngata whaikaha (Māori with disabilities). Themes reflected a recognition of risks and uncertainty associated with tele-delivered assessment. Conversely, advantages in access, equity, and professional competency were reimagined. Perspectives of Māori included both risks and advantages as perceived by Māori., Conclusion: Substantial dissatisfaction with current wheelchair assessment services among wheelchair users provides context to the impetus for a successful design of a telehealth assessment service. Training in conducting telehealth wheelchair assessment is essential incorporating culturally safe communication practices and support of wheelchair user autonomy while identifying solutions that achieve wheelchair user goals., (© 2022 Occupational Therapy Australia.)

Introduction: Palliative Care Australia suggests current needs (emotional wellbeing, understanding of cancers impact on relationships, everyday activities, and life milestones) for adolescent and young adults in palliative care are unmet due to a lack of age-specific palliative care facilities in Australia. This includes the provision of occupational therapy that can impact these unmet needs. Although the occupational therapy role in palliative care has been documented, little is known about existing occupational therapy services or occupational needs for young people with palliative care needs. The aims of this study were to obtain occupational therapists insights of working with this population in Australia regarding (1) gaps in palliative care services for this population; (2) facilitators and challenges to providing occupational therapy for this group; and (3) perceived occupational needs of young people living with a life-limiting cancer diagnosis., Methods: Using snowball sampling, an online survey was distributed to occupational therapists with experience working in palliative cancer care with adolescents and young adults. Available for 6 weeks, the survey included demographic, work history, and service delivery questions. Forced-choice questions were summarised descriptively, and content analysis was used to analyse free-text data., Results: Eleven completed surveys were returned. Overall, therapists perceived current palliative care services for this population within Australia to be lacking. Two gaps emerged: age-appropriate facilities and gaps in provision of psycho-social and occupational therapy services. Funding, lack of knowledge of the occupational therapy role, and professional confidence were highlighted as challenges to practice. Main occupational needs related to maintenance of as "normal" a life as possible: maintaining occupational role engagement, continuing connection with others, and being heard regarding their occupational needs., Conclusion: Findings suggest a need for service changes, including custom-designed facilities, improved funding, training and mentoring, to support age-appropriate and occupation-focussed care for the young person in cancer-specific palliative care., (© 2021 Occupational Therapy Australia.)

Feedback is powerful for learning in education, and the workplace. Work-integrated learning bridges these two settings, but how prepared students are to use feedback strategies as they enter the workplace remains unknown. This paper documents an exploratory, mixed-methods, study involving final-year occupational therapy students. The students were undertaking work-integrated learning to develop project management skills. The specific research questions addressed were; how feedback literate are final-year students; and, can feedback literacy (FL) education improve FL in preparation for the workplace? Likert scales, open response questions, and assessment rubrics were utilised. Opportunities for FL education were provided. Statistically significant differences between pre- and post-test survey responses were evident. Four qualitative themes were identified; enacting feedback, choice of feedback, emotional impact of feedback and value of the outsider perspective. Some students demonstrated sophisticated feedback capabilities. Others engaged tokenistically with feedback. Tentative support for the effectiveness of one FL intervention was demonstrated.

Integrating theory-into-practice is an important skill for professionals to master during their university education; however, students and educators find learning and teaching about theory-into-practice challenging. To address these difficulties 'Transition Workshops' were implemented within a Bachelor of Occupational Therapy. A mixed methods evaluation was conducted using pre- and post-workshop surveys and focus groups. Qualitative findings, the focus of this paper, were that team teaching helped educators feel more confident in teaching theory-into-practice as it was more enlivening than solo teaching, it provided opportunity for professional development, it enabled better understanding of the whole curriculum, and it modelled a consolidated professional identity. Team teaching assisted students by providing them with multiple role-models. This study highlighted that some of the challenge in supporting students to learn how to integrate theory-into-practice may be addressed using team teaching.

Disparities in academic performance have been found in students from underserved districts. This is especially prevalent in students with disabilities. Technology use can help to narrow this divide. Mainstream software packages are readily available to most districts and increasingly include accessibility features (AF) to enable students to complete academic tasks at relatively low cost. Occupational therapy practitioners (OTPs) can support student success through the use of AF available to all students, including assistive technology (AT) for students with disabilities. Students' successful use of technology is often contingent on help from their teachers, however, teachers may need support to facilitate this process. This study describes the results of a pilot training program for teachers in an underserved school district designed to facilitate sustained use of AF that are readily available for implementation in the classroom. This paper discusses the lessons learned from provision of this training program to inform the OTP role in support of processes with similar objectives. Factors that influence teachers' perceptions of the utility and comfort with the features are reported.

Introduction: Parenting is a valued, common and challenging adult role. Many parents, including some living with disability or difficult social circumstances, experience barriers to fulfilling their parenting roles. Yet, occupational therapy involvement in parenting is rarely documented. Current understandings about 'doing' parenting lack cohesion and are dispersed in occupational therapy literature. This study aims to map and synthesise occupational therapy literature on 'doing' parenting to describe the state of the existing knowledge base, and develop a conceptual framework of parenting occupations as portrayed in occupational therapy literature., Methods: A scoping review was conducted. Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science were searched on 28 October 2019 and updated on 18 February 2021. Journal articles and book chapters were screened for eligibility. Included texts' publication characteristics, methodological characteristics, and areas of focus were summarised. Interpretive content analysis was conducted., Results: From 5945 unique records, 105 texts were included. These discussed general parenting, parents with disabilities, and parenting in challenging social situations. Most texts focussed on mothers caring for young children in Western cultural contexts. The analysis culminated in the development of a conceptual framework: the Parenting Occupations and Purposes (POP) Framework. This comprises 10 interrelated areas of parenting occupations, which are performed for the purposes of addressing the child's basic, developmental and social needs. Parenting occupations were also found to be influenced by additional, underlying occupations that build parenting capacity - Continuous Parental Development (CPD) occupations., Conclusion: These findings provide an overview of current occupational therapy conceptualisations of parenting. Unlike most of the existing literature on parenting, the POP Framework is parent-centric rather than child-centric. More research on parenting occupations is needed, especially with more diverse representation (fathers, ages of children, parental disability and sociocultural background). Further research is required to examine the POP Framework's usefulness in guiding research and practice, particularly among parents with diverse characteristics., (© 2021 Occupational Therapy Australia.)

Introduction: Advances in cancer treatment over the last decade have led to increased survival rates. As a result, survivors are living longer with and beyond cancer, often with greater levels of morbidity. Occupational therapists, with their focus on remedial and compensatory strategies to improve function and participation, are well suited to assess and intervene with this population. Despite this, little research exists to demonstrate the efficacy of interventions and value of the occupational therapy role. This systematic review aimed to review how and when occupational therapists provide services for adult patients with cancer and identify where they add the most value., Methods: A systematic search was conducted of six electronic databases. Eligible studies reported on occupational therapy interventions targeting management of cancer symptoms, rehabilitation or environmental modifications for adult cancer patients discharged from acute hospital services. Data extraction and quality assessment were undertaken by two reviewers. Narrative synthesis summarised the attributes and treatment outcomes of each intervention., Results: Nine articles were included from a total of 309 articles retrieved. Eight different interventions were reported for people with cancer (n = 531). Small sample sizes and methodological quality precluded any formal analysis; however, intervention components that showed positive results were person-centred, individualised and included regular monitoring and flexibility in care, with input from multidisciplinary health professionals. Therapists also need to reflect upon the optimal duration of interventions and selection of outcome measures that specifically match intervention components., Conclusion: Despite inconclusive support of any particular type of intervention, this systematic review identified several successful intervention components for occupational therapists working with people with or beyond cancer. Overall, findings suggest that monitored tailored programmes compensating for fluctuations in a patient's condition have efficacy to improve patient outcomes and should be considered when delivering intervention with patients post hospital discharge., (© 2021 Occupational Therapy Australia.)