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Introduction: Occupational therapists require research and evaluation skills to deliver evidence-based care, making research education integral to their training. We aimed to develop a student and staff-informed strategy to further embed research into the occupational therapy programmes and enhance the research culture at a United Kingdom Higher Education Institution. Method: We used group concept mapping to gather ideas from students and staff on how to embed research and improve research culture within the occupational therapy programmes at a United Kingdom Higher Education Institution. Participants generated, sorted and rated ideas for importance and success. We analysed the data to create a concept map and identified rating values for the themed clusters and their ideas. Results: The concept map contained four themed clusters of ideas: Wider research community, Integration of research into the core programme, Advanced research support and capacity building and Research awareness. Successes and improvement targets were identified within each cluster. Conclusion: Group concept mapping provided a structured and comprehensive method to develop a strategy for embedding research and fostering a research culture in occupational therapy programmes at a higher education institution. The four-themed concept map and identified priority targets serve as a foundation for implementing the strategy and improving research integration in occupational therapy education. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and MethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONTo explore fatigue and physical activity behavior experiences and management, with an emphasis on activity pacing among adults with chronic conditions.Semi-structured interviews were conducted with 15 adults with chronic conditions and the symptoms of chronic fatigue who had either received or not received fatigue management advice. Interviews were audio-recorded and transcribed verbatim, then analyzed using reflexive thematic analysis.Participants reported barriers to fatigue management such as overactivity, mental health issues, and workplace challenges. Additionally, they highlighted rest, restful activities, and supportive social environment as facilitators of effective fatigue management, along with the importance of nutrition and physical activity. In some cases, there were conflicting experiences with social environment and physical activity. Activity pacing was identified as a promising solution and participants recommended several strategies for future consideration.Participants identified fatigue as a significant denominator in daily living and recognized the importance of activity pacing in fatigue management. Through reflective processes, they uncovered crucial factors for effective fatigue management, highlighting a multidimensional, interdisciplinary, and tailored approach to activity pacing as a promising solution. Further research should explore clinicians’ perspectives of a multidimensional fatigue management approach to further support optimal intervention design.Fatigue was perceived commonly across various chronic conditions, extending beyond mere tiredness and diminishing individuals’ capacity to perform daily activities.Rehabilitation professionals might incorporate activity pacing strategies tailored to each individual’s needs to effectively manage fatigue across chronic conditions.A multidimensional approach, including physical, psychological, and social interventions, is suggested for comprehensive fatigue management in rehabilitation.Facilitating rest and fostering a supportive social environment might be integral components of rehabilitation process to enhance the effectiveness of fatigue managementFatigue was perceived commonly across various chronic conditions, extending beyond mere tiredness and diminishing individuals’ capacity to perform daily activities.Rehabilitation professionals might incorporate activity pacing strategies tailored to each individual’s needs to effectively manage fatigue across chronic conditions.A multidimensional approach, including physical, psychological, and social interventions, is suggested for comprehensive fatigue management in rehabilitation.Facilitating rest and fostering a supportive social environment might be integral components of rehabilitation process to enhance the effectiveness of fatigue management [ABSTRACT FROM AUTHOR]

In the UK, the proliferation of voluntary and community organisations (VCOs) providing emergency food aid has been the subject of critical scrutiny. Analysis has called for further work to understand and act upon the diverse practices taking place within and across food banks. We consider how co-ordinators of food banks in the county of Northumberland have responded to interlocking crises and rising demand, and how they reflect upon their practices. We embed their views and experiences within a critical, contextualised analysis of a core tension: how to provide food in a minimally stigmatising manner, while simultaneously arguing and acting for the end of such activities. We consider the implications of such tensions for approaches to local development, focusing on two key elements of a 'transformative social innovation' approach: system innovation and narratives of change. We argue that without significant change in, and challenges to, these 'shades of change', enacting (empowering) transformative social innovation in relation to food insecurity will be difficult. In doing so, we consider the potential of community wealth building (CWB) and universal basic services (UBS) to enable innovative change in social and system practices and enhance social infrastructure. [ABSTRACT FROM AUTHOR]

Fatigue is a disabling and prevalent feature of many long-term conditions. Orthostatic dizziness is a commonly experienced by those with fatigue. The purpose was; to evaluate factors contributing to successful delivery of a novel group exercise program designed for people with chronic fatigue and orthostatic symptoms and identify targets to improve future program content and delivery. We used group concept mapping methodology. Participants of the exercise program with a long-term physical health condition and chronic fatigue- contributed ideas in response to a focus question. They sorted these ideas into themed piles and rated them for importance and success of the program delivery. Multidimensional scaling and cluster analysis were applied to the sort data to produce ideas clusters within a concept map. Value ratings were compared to evaluate the success of the program. The resulting concept map depicted seven key themed clusters of ideas: Exercises, Group atmosphere, Physical benefits, Self-management of symptoms, Acceptance and Education. Value plots of the rating data identified important and successful conceptual ideas. The concept maps have depicted key concepts relating to the successful delivery of a novel exercise program for people with fatigue and identified specific targets for future program enhancements. Orthostatic symptoms are common in those with fatigue and might be a target for group-based exercise programs. People with fatigue value a group-based exercise program that targets orthostatic symptoms. The key concepts of a group-based exercise program valued by those with fatigue are the exercises, group atmosphere, physical benefits, self-management support, acceptance, education and support with looking forwards following the program. [ABSTRACT FROM AUTHOR]

Rationale, Aims, and Objectives: The reorganization of acute major trauma pathways in England has increased survival following traumatic injury, resulting in an increased patient population with diverse and complex needs requiring specialist rehabilitation. However, national audit data indicate that only 5% of patients with traumatic injuries have access to specialist rehabilitation, and there are limited guidelines or standards to inform the delivery of rehabilitation interventions for individuals following major trauma. This group concept mapping project aimed to identify the clinical service needs of individuals accessing our major trauma rehabilitation service, prioritize these needs, determine whether each of these needs is currently being met, and plan targeted service enhancements. Methods: Participants contributed towards a statement generation exercise to identify the key components of rehabilitation following major trauma, and individually sorted these statements into themes. Each statement was rated based on importance and current success. Multi‐dimensional scaling and hierarchical cluster analysis were applied to the sorted data to produce themed clusters of ideas within concept maps. Priority values were applied to these maps to identify key areas for targeted service enhancement. Results: Fifty‐eight patients and health care professionals participated in the ideas generation activity, 34 in the sorting, and 49 in the rating activity. A 7‐item cluster map was agreed upon, containing the following named clusters: Communication and Coordination; Emotional and psychological wellbeing; Rehabilitation environment; Early rehabilitation; Structured therapy input; Planning for home; and Long‐term support. Areas for targeted service enhancement included access to timely and adequate information provision, collaborative goal setting, and specialist pain management across the rehabilitation pathway. Conclusion: The conceptual framework presented in this article illustrates the importance of a continuum of rehabilitation provision across the injury trajectory, and provides a platform to track future service changes and facilitate the codesign of new rehabilitation interventions for individuals following major trauma. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To recognise why timely medicines reconciliation is important in the emergency assessment unit (EAU) • To understand the barriers to timely medicines reconciliation in the EAU • To identify potential methods of improving medicines reconciliation in the EAU Background: Medicines reconciliation is the process of creating and maintaining the most accurate list possible of all medicines a patient is taking. If medicines reconciliation cannot be completed in a timely manner in hospital emergency assessment units (EAUs), delays in treatment can occur, potentially leading to deterioration of long-term and acute conditions, patient distress and complaints. Aim: To obtain the perspectives of staff working on an EAU regarding the time patients wait for their medicines to be prescribed, including their awareness of practice and protocols. To determine the time from admission to the EAU until medicines reconciliation, and to identify if there was any time difference in medicines reconciliation according to the day of admission. Method: This was a service evaluation in which staff working in one EAU in a teaching hospital in the north east of England were asked to complete a survey in December 2017. The staff survey aimed to ascertain: whether staff were aware of any guidance relating to medicines reconciliation times; how long they thought the average waiting time was for medicines reconciliation; and if they thought there were implications for patients or staff as a result of time spent waiting for medicines reconciliation. In addition, an audit was performed analysing medicines reconciliation times for all patients admitted to the EAU during the month of December 2017. Results: A total of 30 staff members responded to the survey. While 40% (n=12) of respondents believed that the EAU had an efficient system in place for timely medicines reconciliation, 90% (n=27) believed the unit could still improve. Almost half the respondents (47%, n=14) perceived a delay in medicines reconciliation could result in exacerbation of patients' physical conditions. The clinical audit identified considerable variation in medicines reconciliation times, ranging from seven minutes to almost 24 hours. However, most medicines (82%) were reconciled within six hours. Conclusion: This service evaluation found that the median time after arrival in the EAU until completion of medicines reconciliation was two hours 48 minutes. However, almost one fifth of patients had to wait for more than six hours, and in one instance almost 24 hours. One potential solution could be increasing the involvement of hospital pharmacists or pharmacy technicians in medicines reconciliation. [ABSTRACT FROM AUTHOR]

Objectives. To identify whether sleep disturbances are more prevalent in primary SS (pSS) patients compared with the general population and to recognize which specific sleep symptoms are particularly problematic in this population. Methods. Electronic searches of the literature were conducted in PubMed, Medline (Ovid), Embase (Ovid), PsychINFO (Ovid) and Web of Science and the search strategy registered a priori. Titles and abstracts were reviewed by two authors independently against a set of prespecified inclusion/exclusion criteria, reference lists were examined and a narrative synthesis of the included articles was conducted. Results. Eight whole-text papers containing nine separate studies met the inclusion criteria and were included in the narrative analysis. Few of these studies met all of the quality assessment criteria. The studies used a range of self-reported measures and objective measures, including polysomnography. Mixed evidence was obtained for some of the individual sleep outcomes, but overall compared with controls, pSS patients reported greater subjective sleep disturbances and daytime somnolence and demonstrated more night awakenings and pre-existing obstructive sleep apnoea. Conclusions. A range of sleep disturbances are commonly reported in pSS patients. Further polysomnography studies are recommended to confirm the increased prevalence of night awakenings and obstructive sleep apnoea in this patient group. pSS patients with excessive daytime somnolence should be screened for co-morbid sleep disorders and treated appropriately. Interventions targeted at sleep difficulties in pSS, such as cognitive behavioural therapy for insomnia and nocturnal humidification devices, have the potential to improve quality of life in this patient group and warrant further investigation. [ABSTRACT FROM AUTHOR]