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Mild traumatic brain injury (mTBI) or concussion is prevalent among trauma patients, but symptoms vary. Assessing discharge safety is not standardized. At our institution, occupational therapy (OT) performs cognitive assessments for mTBI to determine discharge readiness, potentially increasing resource utilization. We aimed to describe characteristics and outcomes in mTBI trauma patients and hypothesized that OT consultation was associated with increased length of stay (LOS). This is a retrospective study at a level 1 trauma center over 17 mo. All patients with mTBI, without significant concomitant injuries, were included. We collected data regarding OT assessment, LOS, mechanism of injury, Glasgow coma score, injury severity score (ISS), concussion symptoms, and patient disposition. Statistical analysis was performed, and significance was determined when P < 0.05. Two hundred thirty three patients were included. Median LOS was 1 d and ISS 5. Ninety percent were discharged home. The most common presenting symptom was loss of consciousness (85%). No symptoms were associated with differences in LOS or discharge disposition (P > 0.05). OT consult (n = 114, 49%) was associated with longer LOS and higher ISS (P < 0.01). Representation with concussive symptoms, discharge disposition, mechanism of injury, and patient demographics were no different regardless of OT consultation (P > 0.05). mTBI is common and assessment for discharge safety is not standardized. OT cognitive assessment was associated with longer LOS and higher injury severity. Despite institutional culture, OT consultation was variable and not associated with improved concussion-related outcomes. Our data suggest that OT is not required for mTBI discharge readiness assessment. To improve resource utilization, more selective OT consultation should be considered. Further prospective data are needed to identify which patients would most benefit. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effects of the cluster nursing strategy applied to traumatic brain injury (TBI) patients. Ninety-eight TBI patients admitted to the hospital were selected as the study subjects. They were randomized into two groups, the control group and the cluster group, with 49 cases in each group. The control group received routine nursing methods, while the cluster group received cluster nursing strategy. The intervention effects were compared between the two groups. After 3 months, the total occurrence of complications in the cluster group was significantly lower than that in the control group. Postintervention, the cluster group had a significantly lower National Institutes of Health Stroke Scale score and significantly higher Fugl–Meyer score and Loewenstein Occupational Therapy Cognitive Assessment score compared with the control group. The serum level of glial fibrillary acidic protein in the control group was significantly higher than that in the cluster group, while the serum level of brain-derived neurotrophic factor was significantly lower. The application of the cluster nursing strategy in the care of patients with TBI could effectively reduce the risk of complications and improve neurological, motor, and cognitive functions. [ABSTRACT FROM AUTHOR]

Background and Objective: Transcranial magnetic stimulation (TMS) is considered as a promising treatment option for post-stroke cognitive impairment (PSCI).Some meta-analyses have indicated that TMS can be effective in treating cognitive decline in stroke patients, but the quality of the studies included and the methodologies employed were less than satisfactory. Thus, this meta-analysis aimed to evaluate the efficacy and safety of TMS for treating post-stroke cognitive impairment. Methods: We searched online databases like PubMed, Embase, Cochrane Library, and Web of Science to retrieve randomized controlled trials (RCTs) of TMS for the treatment of patients with PSCI. Two independent reviewers identified relevant literature, extracted purpose-specific data, and the Cochrane Risk of Bias Assessment Scale was utilized to assess the potential for bias in the literature included in this study. Stata 17.0 software was used for data analysis. Results: A total of 10 studies involving 414 patients were included. The results of the meta-analysis showed that TMS was significantly superior to the control group for improving the overall cognitive function of stroke patients (SMD = 1.17, 95% CI [0.59, 1.75], I2 = 86.1%, P < 0.001). Subgroup analyses revealed that high-frequency rTMS (HF-rTMS), low-frequency rTMS (LF-rTMS), and intermittent theta burst stimulation (iTBS) all have a beneficial effect on the overall cognitive function of stroke patients. However, another subgroup analysis failed to demonstrate any significant advantage of TMS over the control group in terms of enhancing scores on the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and Rivermead Behavioral Memory Test (RBMT) scales. Nonetheless, TMS demonstrated the potential to enhance the recovery of activities of daily living in stroke patients, as indicated by the Modified Barthel Index (MBI) (SMD = 0.76; 95% CI [0.22, 1.30], I2 = 52.6%, P = 0.121). Conclusion: This meta-analysis presents evidence supporting the safety and efficacy of TMS as a non-invasive neural modulation tool for improving global cognitive abilities and activities of daily living in stroke patients. However, given the limited number of included studies, further validation of these findings is warranted through large-scale, multi-center, double-blind, high-quality randomized controlled trials. PROSPERO registration number: CRD42022381034. [ABSTRACT FROM AUTHOR]

Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program and illustrate how research evidence from systematic reviews can be used to inform and guide clinical decision-making. Each article in this series summarizes the evidence from published systematic review briefs on a given topic and presents an application of the evidence to a related clinical case. This Evidence Connection article presents a case report of a person with dementia who is transitioning to a new setting. The occupational therapy evaluation and intervention process is described. Systematic review briefs on interventions for people with Alzheimer's disease and related dementias were published in Volume 77 (Supplement 1) of the American Journal of Occupational Therapy. This Evidence Connection article presents a case report of a person with dementia who is transitioning to a new setting, including a description of the occupational therapy evaluation and intervention process. [ABSTRACT FROM AUTHOR]

Importance: Since the first descriptions of autism, difficulties with affective contact (e.g., interpersonal exchanges of feelings between individuals) have been considered a common feature of autism spectrum disorder, and these difficulties frequently manifest in occupational therapy interventions. Objective: To (1) explore how autistic young adults describe their emotions and (2) suggest ways to improve the affective contact between autistic clients and their therapists. Design: Virtual focus group interviews. Setting: Online (Qualtrics) survey and Zoom focus groups. Participants: Autistic adults (N = 24) who met the following inclusion criteria: self-reported diagnosis of autism spectrum disorder or Asperger syndrome, age 18–35 yr, able to understand English, and able to participate in a focus group or individual interview using verbal or written communication. Results: Two themes were noted and are presented in this article: (1) Autistic people experience complex emotions and (2) autistic people's emotions are often (mis)measured and (mis)understood. Conclusions and Relevance: The findings indicate that autistic people experience diverse, complex, and intense emotions and that these are connected to occupation. This suggests that occupational therapists must be attuned to the emotional dimension of occupation when working with autistic clients and that autistic clients may benefit from the use of embodied language to reference their emotions. Occupational therapists can help autistic clients recognize their bodily changes when experiencing emotions and to better identify and regulate their emotions. The results also show that there were many cases nonautistic people misinterpreted the emotions of autistic people on the basis of their facial expressions or words. Plain-Language Summary: This article provides information about the emotional experiences of autistic people. The study found that autistic people experience complex emotions and that those emotions are often misinterpreted or misunderstood. The author provides information on how occupational therapists can use a neurodiversity-affirming and person-centered approach to support the emotional experiences of people in the autism community. Positionality Statement: In this article, identity-first language is used when referring to autistic adults. This deliberate choice aligns with the principles of the neurodiversity-affirming movement. Autistic self-advocates have indicated a preference for this style of language over person-first language. The author would also like to acknowledge their positionality. As both a neurodivergent researcher and a self-advocate for the disabled community, this style of language aligns with their own experiences of and beliefs about their disability. This study explored how autistic young adults describe their emotions and suggests ways that occupational therapists can be more attuned to the emotional dimension of occupation when working with autistic clients. [ABSTRACT FROM AUTHOR]

Background: Entrustable Professional Activities (EPA)-based assessment is easily and intuitively used in evaluating the learning outcomes of competency-based medical education (CBME). This study aimed to develop an EPA for occupational therapy focused on providing health education and consultation (TP-EPA3) and examine its validity. Methods: Nineteen occupational therapists who had completed online training on the EQual rubric evaluation participated in this study. An expert committee identified six core EPAs for pediatric occupational therapy. TP-EPA3 was developed following the EPA template and refined through consensus meetings. The EQual rubric, a 14-item, five-point criterion-based anchor system, encompassing discrete units of work (DU), entrustable, essential, and important tasks of the profession (EEIT), and curricular role (CR), was used to evaluate the quality of TP-EPA3. Overall scores below 4.07, or scores for DU, EEIT, and CR domains below 4.17. 4.00, and 4.00, respectively, indicate the need for modifications. Results: The TP-EPA3 demonstrated good validity, surpassing the required cut-off score with an average overall EQual score of 4.21 (SD = 0.41). Specific domain scores for DU, EEIT, and CR were 3.90 (SD = 0.69), 4.46 (SD = 0.44), and 4.42 (SD = 0.45), respectively. Subsequent revisions clarified observation contexts, enhancing specificity and focus. Further validation of the revised TP-EPA3 and a thorough examination of its reliability and validity are needed. Conclusion: The successful validation of TP-EPA3 suggests its potential as a valid assessment tool in occupational therapy education, offering a structured approach for developing competency in providing health education and consultation. This process model for EPA development and validation can guide occupational therapists in creating tailored EPAs for diverse specialties and settings. [ABSTRACT FROM AUTHOR]

To critically review the evidence for occupation-based interventions in improving occupational performance and participation outcomes in the hospital setting. Five databases were searched from 2000–2022. Peer-reviewed studies of any design investigating the impact of occupation-based interventions in the hospital setting were included. Methodological quality was assessed using the appropriate tool for each study design. Following data extraction, a narrative synthesis was conducted. Thirty-three studies comprising of 26 experimental, five non-experimental, and two mixed methods studies were included (n = 1646 participants). Results indicate good evidence to support occupation-based interventions to improve occupational performance and participation outcomes in inpatient rehabilitation; it is unclear whether they are more effective than any control/alternative intervention. Research in the acute and mental health hospital settings were scarcer. Understanding the benefits of occupation-based interventions was enhanced through qualitative results including improving independence and confidence to discharge home, increasing motivation for therapy, connecting with others, and peer-based learning. Heterogeneity and methodological weaknesses across existing studies limits the conclusions that can be drawn on the impact of occupation-based interventions in the hospital setting. More rigorous research should be conducted with better reporting of intervention design and the use of robust measures of occupational performance. The use of occupation-based interventions should be considered to improve occupational performance and participation outcomes in the hospital setting. There is good evidence to support the impact of occupation-based interventions on improving occupational performance and participation outcomes in the inpatient rehabilitation setting; evidence in the acute and mental health settings is scarcer. Occupation-based interventions are valued by both patients and clinicians for their impact on patient outcomes and the patient experience. [ABSTRACT FROM AUTHOR]

Introduction: Pre-discharge home assessments by occupational therapists facilitate safe and timely discharge from hospital and are associated with better health outcomes. Digital technology offers the potential to reduce duplication of documentation and improve communication and sharing of home assessment findings. Objective: This quality improvement project evaluated time-cost; clinician satisfaction and confidence; and acceptability of the use of a digital approach to home assessments. Methods: A prospective, cross-sectional design was used to compare usual practice with the digital approach across two sub-acute wards in a large metropolitan hospital in Queensland, Australia. Time to document and conduct home assessments as well as clinician satisfaction and confidence were compared using descriptive statistics. Clinician perspectives about the home assessment approaches were collected through a survey and analyzed using content analysis. Results: Home assessment and documentation time were significantly lower for the home assessments conducted using the digital approach compared with usual practice assessments. Clinician satisfaction with using digital technology was higher. Conclusions: The introduction of this simple technology reduced clinicians' time to conduct home assessments and document home assessment reports. The project was well received by occupational therapy clinicians. http://links.lww.com/IJEBH/A187 [ABSTRACT FROM AUTHOR]

The objective was to identify the AT demands of para-athletes in para-badminton and present the process of prescription, and follow-up of the AT devices. Also, to evaluate the expectations and the level of satisfaction with the service provided and the AT device. Case study with 3 professional para-badminton athletes, that had as baseline the Matching Person and Technology (MPT) model, the Para-athlete Questionnaire, the AT Device Predisposition Assessment (ATD PA-Br), the Quebec User Evaluation of Satisfaction with AT (B-QUEST) and an Observation Script. The data were analyzed using absolute frequency statistics, and the qualitative data were grouped according to the categories of the MPT model. 4 AT demands were identified: 1 insole, 1 wheelchair footrest adaptation, 1 armband, and 1 lower-limb strap, with prescription, and AT follow-up by the occupational therapist. The quantitative analysis showed a gain in athletes' satisfaction with the AT devices, and in the expectations achieved with the use of the device. The role of the occupational therapist in parasports, based on a theoretical model, can contribute to the successful use of AT and therefore better performance of para-athletes. Studies with different populations are necessary to improve knowledge in the area. Understanding the Assistive Technology (AT) intervention, considering the use AT guidelines and the Matching Person and Technology (MPT). Presenting the intervention of an occupational therapist (OT) with paralympic athletes, more specifically in the area of AT in with relation to Para-badminton; Identifying the AT used and customized in para-badminton and their objectives; Identifying personal, contextual and technological factors that can interfere with the use of AT in parasports; Presenting the satisfaction with the AT device in the parasport, such as: insole, wheelchair footrest adaptation, armband and, lower-limb strap; before and after OT intervention in the area of AT; Knowing the satisfaction with the AT service provided by the occupational therapist based on the MPT model; Comprehending the use of the MPT conceptual model and application of the AT Device Predisposition Assessment (ATD PA-BR) for prescribing and monitoring AT use in the para-athlete population; [ABSTRACT FROM AUTHOR]

Objective: In this study, it was explored whether the efficacy on applying transcranial direct current stimulation (tDCS) combined with motor-cognitive intervention for post-stroke cognitive impairment (PSCI) was greater than that on applying each method alone. Methods: A total of 90 patients with PSCI admitted to Zhejiang Provincial People's Hospital, China, from April 2021 to June 2022 were randomly divided into a tDCS group (n = 30), a motor-cognitive intervention group (n = 30), and a combination group (n = 30). All three groups received conventional rehabilitation therapy. The tDCS group was given tDCS therapy. The motor-cognitive intervention group received motor-cognitive intervention, whereas the combination group received tDCS combined with motor-cognitive intervention. The treatment duration was 4 weeks. The general data of patients were recorded before treatment. The Montreal Cognitive Assessment (MoCA) Scale and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) Scale were used to evaluate the cognitive function of patients in three groups before and after treatment. Further, within- and between-groups comparisons were performed to determine differences in cognitive function. Results: Before treatment, there was no significant difference between the baseline scores of the three groups (P > 0.05). After 4 weeks of treatment, except for the score for the LOTCA motor praxis subtest of the tDCS group, the MoCA and LOTCA scores of the three groups significantly improved compared with the corresponding scores before treatment (P < 0.05), and there was no drop-out case. After treatment, the MoCA and LOTCA scores of the three groups were compared in pairs. The results showed that except for the attention domain in MoCA, the method used for the combination group had more efficacy than those used for the other two groups (P < 0.05). Further, there was no statistical difference in efficacy between the tDCS and the motor-cognitive intervention groups (P > 0.05). Conclusion: The combination of tDCS and motor-cognitive intervention is safe and can help improve the cognitive function of patients with PSCI. [ABSTRACT FROM AUTHOR]

Introduction: Measures of participation restrictions in daily life occupations are not typically used and may aid discharge planning and demonstrate the impact of occupational therapy services in inpatient settings. The overall aim of this mixed‐methods study was to test the feasibility of relevant outcome measures by (1) investigating which of the three identified measures—the Home Support Needs Assessment, the Personal Care Participation Assessment and Resource Tool, and the Functional Autonomy Measurement System—best identifies meaningful changes in participation restrictions in daily life occupations required for community life; and (2) investigating the acceptability, usefulness, and feasibility of each measure to support inpatient practice. Methods: Occupational therapists (n = 3) completed the three measures with patient participants (n = 12) at admission and discharge. Each occupational therapist participated in a semi‐structured interview. Outcome measure responses were summarised statistically. Qualitative data were analysed using reflexive thematic analysis. Findings: Total scores on all three measures changed significantly between admission and discharge (P < 0.002). Three themes reflected the occupational therapist participants' perceptions of the acceptability, usefulness, and feasibility of the outcome measures: 'Clinically and Professionally Meaningful Tools', 'Becoming Familiar', and 'Fostering My Daily Work'. Conclusion: Each measure demonstrated a meaningful change. Selection and successful implementation of an outcome measure depends on its local acceptability to occupational therapists and organisational practices. All three measures are promising tools to address a measurement gap in occupational therapy practice. Future research could embed one measure into practice using knowledge translation methods, with a large‐scale evaluation of the value of occupational therapy. Key Points for Occupational Therapy: Routine use of standardised measures may improve patient outcomes and demonstrate the benefits of occupational therapy.The Functional Autonomy Measurement System (SMAF), Personal Care Participation Assessment and Resource Tool (PC‐PART), and Home Support Needs Assessment (HSNA) are promising tools for inpatient settings, subject to occupational therapists' acceptability.Outcome measures can be integrated within the practice context using knowledge translation principles. [ABSTRACT FROM AUTHOR]

Interdisciplinary collaboration between health and education professionals is one of the principles of inclusive education. This study aimed to describe the practices and service delivery by pediatric occupational therapists (OTs) in schools in Spain. Data came from a convenience sample of pediatric OTs recruited through Spanish professional colleges and associations for a web-based survey, mixed-method research study. Thirty-five respondents were excluded because they didn't meet the eligibility criteria. Ninety-two responses were obtained for data analysis. Twenty-nine OTs (31.5%) work in schools (school-OTs), and sixty-three participants (68.5%) don't work there but collaborate with schools (non-school OTs). Participants support students with and without a medical diagnosis. Services provided by OTs external to the educational system are mainly funded by families or only partially covered. Findings show that most participants use standardized assessments and apply several intervention approaches. They believe there are barriers to the collaboration and implementation of occupational therapy services in schools. This preliminary study shows a need for changes in Spain's State and Regional Education legislation and provides recommendations to improve school service delivery. Pediatric OTs are encouraged to reflect on and identify opportunities for changes to enhance school-based occupational therapy practice in Spain. [ABSTRACT FROM AUTHOR]

Objectives: Short child occupational profile (SCOPE) screening tool is used to assess different factors of functional abilities and record the progress levels of individuals in occupational therapy interventions. This study aimed to validate a Persian version of the SCOPE test. Methods: This methodological research was conducted in two stages, including translation... [ABSTRACT FROM AUTHOR]

Background/aim: Occupational therapists use different models and measurements for assessing children with attention-deficit/hyperactivity disorder (ADHD). One of those measurements is the Child Occupational Self-Assessment. In this study, concurrent validity of the Child Occupational Self-Assessment with Pediatric Quality of Life was tested in children with ADHD. Methods: A correlational study was conducted. The Child Occupational Self-Assessment and Pediatric Quality of Life were filled by 128 children with ADHD aged between 8 and 11 years. Findings: The results indicated that in competency subscale the highest correlation coefficient was for the total score of Pediatric Quality of Life (r = 0.56, p < 0.01) and the lowest was for social performance (r = −0.44, p < 0.01). The highest and lowest correlation coefficient in value subscale were for the total score (r = −0.46, p < 0.01) and emotional performance of Pediatric Quality of Life (r = −0.34, p < 0.01), respectively. Conclusions: The Child Occupational Self-Assessment has an acceptable concurrent validity with Pediatric Quality of Life. It can be a suitable measurement for assessing of children with ADHD. [ABSTRACT FROM AUTHOR]

Importance: Children with unilateral cerebral palsy (UCP) have poor strength and movement control on one side of their body, leading to impaired bimanual coordination skills. Objective: To compare duration and intensity of all-day habitual movement of the dominant and nondominant upper extremities (UEs) in typically developing (TD) children and children with UCP. Design: Two-group observational study. Setting: Children's naturalistic settings. Participants: Convenience sample of 9 TD children and 9 children with UCP. Intervention: Children wore accelerometers on both wrists all day and night for 1 wk. Outcomes and Measures: We compared the extent of asymmetry in bilateral arm use (intensity and duration) between the 2 groups. Results: Compared with TD children who use both UEs equally, children with UCP were more likely to use their dominant or unaffected UE than their nondominant or affected UE during daily activities. There were no differences between groups in dominant UE activity. However, children with UCP engaged in lower levels of moderate to vigorous activity and greater levels of light activity with their nondominant or affected UE than their TD peers. Conclusions and Relevance: Wrist-worn accelerometry can provide objective information on real-world habitual activity with both arms in children. Accelerometers are nonintrusive, easy to use, and well tolerated by children, and they allow prolonged monitoring of UE activity outside therapeutic contexts. Occupational therapists can use wrist-worn accelerometers as sensitive tools to assess asymmetries in UE use at baseline and as an outcome measure to assess the efficacy of behavioral interventions and carryover into real-world settings among children with UCP. Plain-Language Summary: This pilot study provides promising evidence that supports the use of wrist-worn accelerometry as an accurate, easy-to-use, and objective assessment tool for children with unilateral cerebral palsy (UCP) to detect asymmetries in bilateral real-world arm activity at baseline and after intensive occupational therapy interventions to improve arm function. The authors used wrist-worn accelerometry for one week with 9 typically developing (TD) children and 9 children with UCP to compare dominant or unaffected versus nondominant or affected upper extremity (UE) use for intensity and duration of activity. Compared with TD children, children with UCP had lower relative intensity of activity in the nondominant UE than the dominant UE. Wrist-worn accelerometers seem to be a sensitive measure to detect asymmetries in bilateral all-day UE use in children with UCP. The findings have implications for the use of wrist-worn accelerometers as an outcome measure to assess the efficacy of intensive therapies to improve real-world affected UE activity and bimanual function among children with UCP. The findings of this pilot study support the use of wrist-worn accelerometry as an accurate, easy-to-use, and objective assessment tool for children with unilateral cerebral palsy to detect asymmetries in bilateral real-world arm activity and to use at baseline and after intensive occupational therapy interventions to improve arm function. [ABSTRACT FROM AUTHOR]

Although occupational therapy has its roots in mental health practice, the profession has not been able to adequately and consistently address mental health issues that face society today. As we continue to experience both the protracted coronavirus disease 2019 pandemic and political and social unrest, occupational therapy professionals must take action at individual, state, and national levels to assist in mitigating the current mental health tsunami and improving a fractured mental health care system. In this column, we define and explore issues facing the mental health care system and the different roles and perspectives that are relevant to occupational therapy professionals. Recommendations for the future are provided: actions that can be facilitated at the individual level, in practice, education, and research; at the state level, through state organizations and strategic partnerships; and at the national level, through the American Occupational Therapy Association and other means of advocacy. We want to honor Mary Reilly's vision that occupational therapy become one of the greatest ideas of our time. In this column, the authors define and explore issues facing the U.S. mental health care system and the different roles and perspectives that are relevant to occupational therapy professionals. [ABSTRACT FROM AUTHOR]

Musicians are a distinct population with a high rate of developing musculoskeletal and neurological disorders affecting their ability to participate in music-based occupations. These injuries negatively affect the musician's health and well-being in physical, financial, psychosocial, and emotional dimensions. Given music's complex and integrated role in the musicians' life, treatment must be multi-dimensional, considering aspects of the person, the type of instrument, environment, context, and social obligations. Occupational therapy providers are uniquely qualified to treat musicians because of their focuse on holistic, occupation-based, and client-centered care. This manuscript describes the role of occupational therapy in this client population based on the best available evidence. It discusses the literature regarding the upper-extremity health challenges in musicians and the associated physical and psychosocial risk factors. Furthermore, the manuscript elucidates the foundational elements of occupational therapy in relation to musician-clients supporting this profession's profound role in musician health care. In addition, the manuscript employs the Person-Environment-Occupation-Performance model and the Occupational Adaptation frame of reference to promote an occupation-based and client-centered approach to musician-client care. With this information, occupational therapy providers will recognize the importance of client-centered and evidence-based care in this population and their role in caring for musicians with hand and upper extremity disorders. [ABSTRACT FROM AUTHOR]

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Background: The demand for employment of standardized evaluations is increasing. In Denmark, approximately 25% of all occupational therapists (OTs) are trained to use the standardized occupational therapy instrument Assessment of Motor and Process Skills (AMPS). Aims: To investigate the use of AMPS within Danish occupational therapy practice and determine factors supporting or hindering the use. Material and methods: An online cross-sectional survey was conducted among OTs from various settings. Results: Overall, 844 calibrated OTs participated in the survey. Of these, 540 (64%) met the inclusion criteria and 486 (90%) completed the questionnaire. Forty percent of the participants used the AMPS in a standardized way during a one-month period and 56% reported being dissatisfied with the low number of AMPS evaluations completed. Five supporting and nine hindering factors were found to significantly influence the use of standardized AMPS evaluations. Conclusions/Significance: Despite demands for standardized evaluations, the AMPS is not regularly used in a standardized way within Danish occupational therapy practice. Use of AMPS in clinical practice seems to be facilitated by an acknowledgement from the management and the OT's ability to develop habits and routines. Time restraints were reported, however, time to conduct evaluations was not a statistically significant influencing factor. [ABSTRACT FROM AUTHOR]

Background: Family communication about pain is an important therapeutic target when a parent lives with chronic pain. Occupational therapy literature about communication in families affected by parental chronic pain is currently lacking. Aims/Objectives: To bring an occupational perspective to communication within families affected by parental chronic pain, to generate insights for practice. Materials and Methods: Five families (total n=19 family members) were recruited into this collective case study. The gathered data included interviews, observations, and personal documents/artefacts. A cross-case analysis of similarities and differences between families was conducted to distil insights about the relationship between occupation and communication about parental pain. Results: Each family develops its own style of communicating about a parent's pain. On a day-to-day basis, pain-related communication is prompted by experienced, observed and/or anticipated occupational disruption brought about by parental pain. Conclusions: Occupational disruption and occupational responses need to be components of interest, when designing assessments and interventions targeted at communication in families affected by parental chronic pain. Significance: The findings from this study point to the importance of communication through occupation in families affected by parental chronic pain and suggest novel targets for occupational therapy intervention. [ABSTRACT FROM AUTHOR]

Importance: Cortical or cerebral visual impairment (CVI), a leading cause of visual dysfunction in children across the globe, can result in delayed development of fine and gross motor skills, functional mobility, and socialization, which affects all areas of occupation. No assessments are recommended for occupational therapy practitioners working with children with CVI. Objective: To appraise the measurement properties and clinical utility of CVI assessments appropriate for use by occupational therapy practitioners. Data Sources: MEDLINE via PubMed, Scopus, and Web of Science. Study Selection and Data Collection: We followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines for systematic reviews of patient-reported outcome measures for relevant studies. Findings: A total of 590 records yielded 15 studies of the measurement properties of 12 assessment tools, 8 patient-reported outcome measures and 4 clinician-reported or performance-based outcome measures. We report on the quality of measurement properties of 10 of the 12 outcome measures. None had high-quality evidence of content validity, structural validity, or test–retest reliability. Most had indeterminate internal consistency as a result of a lack of confirmatory factor analysis. Three instruments demonstrated high quality and sufficient construct validity. Conclusions and Relevance: On the basis of the COSMIN guidelines, all 12 outcome measures have the potential to be recommended but require further study before definitive recommendations can be made. What This Article Adds: This is the first systematic review of assessments of CVI feasible for use by occupational therapy practitioners. High-quality studies of measurement properties are lacking. Further examination of the measurement properties of outcome measures is required. This is the first systematic review of assessments of cortical or cerebral visual impairment (CVI) feasible for use by occupational therapy practitioners. [ABSTRACT FROM AUTHOR]

The need to support a healthy lifestyle among the population has become increasingly apparent in recent years. The National Board of Health and Welfare in Sweden has published national guidelines regarding unhealthy lifestyle habits since 2011. An instrument based on the practical and theoretical foundations of occupational therapy was developed to support the profession's unique contribution to implementing these guidelines. The aim was to examine the utility of the instrument by investigating its implementation potential and clinical relevance. Sixteen occupational therapists used the instrument in practice together with 60 clients. Afterwards, they completed a questionnaire covering questions of utility. The instrument demonstrated mostly positive dimensions of utility. The results show that the instrument seems to have a high implementation potential and is clinically relevant. It seems, for example, to support implementation of the national guidelines and to capture how a person's lifestyle habits are expressed in everyday occupations. The instrument further seems to promote people's participation in treatment. The instrument 'Diary-based survey of lifestyle habits in everyday activities and support for the process of change' seems promising in terms of utility. However, the scientific merit of the instrument will need to be further established. [ABSTRACT FROM AUTHOR]

Kluding et al., created The Kansas University Sitting and Standing Balance Scales (KUSSBS) in 2006 to meet the need for objective documentation of balance and for a tool without a floor effect. Rater reliabilities were established by Kluding for the standing scale, but not for the sitting balance scale (KUSitBS). The aim of this study was to establish inter- and intra-rater reliability for the KUSitBS. Four occupational therapists were recruited to rate a videotaped performance of a simulated patient. Resulting inter-rater reliability inter-class coefficients (ICC) are good, ICC =.877, p <.01, suggesting that sitting balance on the KUSitBS was rated similarly across coders. Intra-rater reliability ICC are excellent, ICC =.914, indicating that each occupational therapist rated sitting balance on the KUSitBS similarly at initial assessment and then again two weeks later. In order to have confidence in using any assessment tool, intra- and inter-rater reliability must be established. This study's results advance the use of the KUSitBS with adult populations. [ABSTRACT FROM AUTHOR]

There is mounting evidence that the vascular manifestations associated with COVID-19 are linked to ischemic strokes. The emergence of patients with both COVID-19 and cerebrovascular accidents (COV-CVA) has created a need to adjust occupational therapy service delivery for inpatients with this dual diagnosis. This clinical perspective paper conceptualizes COV-CVA as a health condition using the International Classification of Functioning, Disability and Health Framework (ICF). The Occupational Therapy Practice Framework-4 was used to guide clinical considerations and recommendations for the evaluation, intervention, and discharge planning of patients with COV-CVA. [ABSTRACT FROM AUTHOR]

Aims: This study describes the knowledge and tool needs identified by occupational therapists to improve their evaluation of older adults facing cognitive impairments and identify their preferred strategies for knowledge translation. Methods: A descriptive qualitative study design was used. Four focus groups were conducted with 16 occupational therapists working with cognitively impaired older adults in institutional and community care settings. An inductive approach was used to analyze the thematic content of the interviews. Results: Occupational therapists identified a need for up-to-date knowledge of cognitive systems and disorders and knowledge related to legal capacity and protection regimes. A need for short standardized performance-based tests was also identified. Preferred knowledge translation strategies included a combination of formal learning activities and peer interactions. Conclusion: Occupational therapists require an up-to-date knowledge base and specialized tools to assess this population. Strategies to translate existing standardized performance-based instruments into practice may contribute to meeting these needs. [ABSTRACT FROM AUTHOR]

Objectives: Providing optimal support for carers of people with advanced cancer is critical to facilitating discharge home from hospital. Carer Support Needs Assessment Tool–Intervention (CSNAT‐I) has shown promise in supporting carers' needs in this context. This study aimed to explore patient and carers experiences with and views on the acceptability of the CSNAT‐I delivered by occupational therapists in an acute oncology setting. Methods: People with advanced cancer and their carers who had previously received the CSNAT‐I as part of usual care while admitted to an Australian specialist cancer centre or acute hospital were invited to participate in interviews exploring their perceptions of the intervention. Data were analysed thematically. Results: Two patients and 10 carers participated in semi‐structured interviews. Three themes were constructed from the data: Carers viewed the CSNAT‐I as comprehensive process that (1) 'covered everything' related to discharge planning; (2) generated an 'increased awareness of needs' for themselves, patients, and clinicians; and (3) triggered an emotional response of feeling 'wrapped up in care' that was maintained as they moved from hospital to home. Conclusion: This study has demonstrated that the CSNAT‐I was highly acceptable to carers as part of existing discharge processes supporting them through the transition from hospital to home and can be delivered by occupational therapists and other clinicians with a natural synergy to discharge planning. These findings will inform further development and testing of the delivery model of the CSNAT‐I in future trials. [ABSTRACT FROM AUTHOR]

Background: To better understand the current practice trends of ASD treatment globally and promote practitioner collaboration, it is important to complete studies in countries where little is known about the diagnosis and treatment of ASD through an occupational lens. The aim of this study was to gain an insight into how occupational therapists in the Dominican Republic evaluate and treat children diagnosed with ASD. Method: This qualitative descriptive study explored the perception of occupational therapists (n = 6) and caregivers of children with ASD (n = 28) through a questionnaire and focus group. Interview transcripts and questionnaire text were analyzed using thematic analysis. Trustworthiness was established through member checking, an audit trail, triangulation, reflexivity, and a thick description. Results: Three themes emerged: caregiver ability to access quality services, importance of caregiver involvement in the treatment process, and value of client-centered care. Conclusion: Promoting cultural humility, which focuses on continuous critical self-reflection and lifelong learning, can lead to improved outcomes for this population from initial diagnosis to the overall treatment process. [ABSTRACT FROM AUTHOR]

Importance: Occupational therapy practice is intended to reflect the core construct of occupation throughout all aspects of service delivery. In pediatric occupational therapy, the evidence examining regularly selected assessment tools and the occupational constructs of those assessment tools is insufficient. Objective: To examine the assessment tools regularly selected by practicing pediatric occupational therapists and the therapists' classification of assessment tools as occupation-based. Design: A cross-sectional quantitative design through the dissemination of an anonymous, close-ended assessment tool inventory with completion of descriptive statistics. Setting: Pediatric occupational therapist practice specific to the assessments used. Participants: There were 337 pediatric occupational therapists recruited through targeted sampling via social media. The participants were included if they had provided direct client care to individuals ages of 0 to 21 yr during their career. Results: The assessment tools most commonly used by pediatric occupational therapists are the Sensory Profile (86.4%) and the Beery–Buktenica Developmental Test of Visual–Motor Integration (85.2%). The primary assessment tools selected by pediatric occupational therapists were skill-based regardless of years of practice or practice setting. Therapists were unable to correctly classify assessment tools as occupation-based. Conclusions and Relevance: The limited use of occupation-based assessments in conjunction with decreased recognition of the occupational nature of assessment tools hinders the integration of occupation-based assessment tools across pediatric clinical practice. Pediatric occupational therapists' integration of occupation-based assessment tools is needed to promote the occupational constructs of the profession. What This Article Adds: This article identifies the common assessment tools utilized by pediatric occupational therapists. Additionally, this article brings awareness to the inconsistent identification and integration of occupation-based assessment tools within pediatric clinical practice. This article identifies the common assessment tools utilized by pediatric occupational therapists and brings awareness to the inconsistent identification and integration of occupation-based assessment tools within pediatric clinical practice. [ABSTRACT FROM AUTHOR]

The Occupational Self-Assessment (OSA) is a self-report measure of occupational competence and values used to identify goals and assess outcomes. The Icelandic version of the OSA (OSA-IS) has been through several developmental stages to evaluate its psychometric properties. Through each stage, revisions have been made. To investigate the psychometric properties of the fourth revised version of OSA-IS. Retrospective data from 291 rehabilitation clients with a range of conditions were analysed using Rasch analysis of unidimensionality and descriptive statistics. All statistics were compared to established criteria. Analyses suggest the OSA-IS items define unidimensional constructs of occupational competence and values. Most (89%) participants completed the assessment in a reliable manner and no association was observed between demographic variables and fit status. Differences in the item hierarchies were observed between the original OSA and the OSA-IS, suggesting that Icelandic clients responded differently due to cultural, linguistic and/or sample differences. OSA-IS is a psychometrically sound instrument that may be used to support identification of client-centred goals and for intervention development. Clinicians should use score tables specifically developed for the OSA-IS to measure outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Culturally safe and meaningful cognitive assessment methods for use with Aboriginal and Torres Strait Islander peoples are scarce. Concerns are raised regarding the efficacy of existing methods in cross‐cultural contexts. The Perceive, Recall, Plan and Perform (PRPP) Assessment offers a person‐centred alternative whereby cognitive strategy application is examined during performance of culturally relevant everyday tasks. This paper explores its use with Aboriginal and Torres Strait Islander peoples in Australia. Methods: A critical case study design was applied to examine the effectiveness and relevance of the PRPP Assessment with two Aboriginal Australian people in the Northern Territory of Australia. 'Ivan' and 'Jean' were each receiving occupational therapy through a rehabilitation service over a 6‐month period following acquired brain injuries. Ivan and Jean were assessed performing everyday tasks of interest and importance to them as part of routine care. A partnership approach was adopted throughout the process, and both consented to their stories being told. Results: The PRPP Assessment was able to measure changes in Ivan's and Jean's cognitive strategy use and its impact on performance of meaningful tasks. Ivan demonstrated a 46% increase in performance mastery and a 29% increase in cognitive strategy use with most improvements identified in his ability to sense information, initiate action, and continue performance. Jean demonstrated a 71% increase in performance mastery and a 32% increase in cognitive strategy use. Her greatest improvements were in the ability to recall schemes, self‐evaluate, and initiate action. Conclusion: The two critical case stories shared in this study suggest that the PRPP Assessment has emerging evidence of clinical utility when used with Aboriginal people with acquired brain impairment. The information gained revealed strengths in performance; it was effective in measuring change in cognitive strategy use, was able to inform the goal setting process, and guided intervention to support cognitive strategy use during task performance. [ABSTRACT FROM AUTHOR]

Background: Developmental coordination disorder (DCD), a prevalent neurodevelopmental disorder with motor and psychosocial consequences, can significantly impact children's quality of life. In Australia, most children with diagnosed/suspected DCD have received occupational therapy services, more so than any other health service. As such, occupational therapists are key in identification and treatment and require a sound knowledge of diagnostic criteria and the best evidence for practice. This study explored current occupational therapy services for children with DCD. Areas for development are identified to improve the identification of, and subsequent intervention for, children with DCD. Methods: In this cross‐sectional study, an online survey was completed in September and October 2020 by 175 occupational therapists working in Australia. Results: Although all therapists worked with children who met the criteria for DCD diagnosis, 70% worked with children with no specific diagnosis and 50% worked with children with outdated diagnostic labels. Australian occupational therapists used similar models/frameworks (commonly a multisensory/sensory processing approach) to guide practice with children with DCD, regardless of therapist characteristics, practice setting (clinic/community, rural/urban), how therapy is funded, or the state where the therapists completed their training/currently practiced. Although assessment practices did not differ significantly, therapists with greater years of paediatric practice and those who studied and/or practiced in Western Australia were more likely to assess to identify DCD. Half of the therapists did not assess to identify DCD; however, 60% of assessing therapists reported best practice methods in assessment for DCD, indicating emerging best practices in the Australian context. Conclusion: The findings from this study suggest that small adaptations to current occupational therapy practice may enhance the early identification of children with DCD in Australia. The existing gaps in evidence to practice must be addressed to improve current Australian practice and increase access to appropriate services and ultimately improve the quality of life for children with DCD. [ABSTRACT FROM AUTHOR]

Background: An estimated 25% of the homeless population has a mental illness, which means that many experience cognitive problems that adversely impact basic and instrumental activities of daily living and goal attainment. This case report focused on the experience of an individual living in transitional housing who was evaluated with a performance-based occupational therapy assessment in the context of community-based interdisciplinary psychosocial care provided by a robust occupational therapy fieldwork program. Method: This case report generally followed the CARE Case Report Guidelines and highlights the use of a standardized performance-based assessment and follow-up care suggested by test outcomes. Results: This assessment confirmed that the client did not have executive function problems, rather his performance was impeded by social anxiety and agoraphobia. It also identified his occupational strengths, including a passion for art and his desire to reconnect with his family and take steps toward more independent housing. Conclusion: The standardized performance-based occupational therapy assessment of executive function carried out in a natural group setting confirmed its value in a psychosocial rehabilitative transitional housing program. Comments The authors declare that they have no competing financial, professional, or personal interest that might have influenced the performance or presentation of the work described in this manuscript. [ABSTRACT FROM AUTHOR]

Medication management is a national patient safety goal for home care practice. Medication management is an occupation within the scope of occupational therapy. Occupational therapists are able to assess and provide intervention for cognitive, visual, motor, process, environmental and personal factors that impact an individual's ability to manage their medication independently. This quality improvement project describes a program developed to promote medication management competence in occupational therapists practicing in a large, academic home health agency. The quality improvement project consisted of an online module providing education on the Performance Assessment of Self-Care Skills (PASS) and a 1-hour training session combining didactic education with case-based learning. Pre-post assessment surveys revealed a 25% increase in perceived medication management competence after the intervention. Occupational therapists identified 4 barriers to medication management practice: role ambiguity, documentation challenges, pharmacology knowledge deficit, and reconciliation process barriers. [ABSTRACT FROM AUTHOR]

This article describes the development and preliminary psychometric properties of the TeleWrite, a handwriting assessment tool designed to measure the rate, accuracy, and fluency of children's handwriting for children in first through third grade administered via telehealth. A series of three pilot studies were completed to determine initial interrater reliability, content validity, and clinical utility of the TeleWrite. A study with eight children was used to determine preliminary interrater reliability testing using a beta version of the TeleWrite with (n = 9) raters. The reliability coefficient was obtained using intraclass correlation (ICC) and yielded α = 0.92 for total scores, CI [0.815, 0.983] and the Cronbach's α measure for internal consistency was α = 0.95 (excellent). A clinical utility survey of (n = 55) pediatric occupational therapists was used to obtain their clinical impression regarding the usefulness and accuracy. Representing twelve different countries and twenty-two U.S. states, the respondents indicated that 61% (n = 33) are quite or extremely likely to use the TeleWrite in their practice and most participants (64%; n = 35) indicated that TeleWrite was quite/extremely accurate in measuring handwriting performance. Third, a content validity study with nine handwriting experts reviewed and concluded that all ten subtests of the TeleWrite tool are considered essential. All preliminary studies strengthen the development of the TeleWrite assessment to advance to construct validation of the tool. [ABSTRACT FROM AUTHOR]

Observation is an important method for occupational therapists (OTs) to gather information on people's occupational performance; yet, not much research has been conducted on OTs' descriptions of doing observations in their practices. This study aimed to explore community OTs descriptions of doing observations during the assessment of persons with cognitive impairments. Nineteen OTs participated in focus group interviews. Thematic analysis with an inductive approach was performed. Three themes were revealed during analysis, the value of doing unstructured observations, the importance of doing observations in familiar contexts, and the importance of experience, structure and competence when doing observation. This study showed that the participants regarded observation as one of OTs' core competencies, and they described doing observations in different ways. The results emphasised the importance of doing unstructured observations in persons' familiar contexts when assessing persons with cognitive impairments. However, the participants highlighted the need for increasing OTs structure and competence through implementing more occupation-based standardised assessment tools for OTs in community services to facilitate evidence-based practice. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francophone de Recherche en Ergotherapie is the property of Communaute Pour l Avancement de la Recherche Appliquee Francophone en Ergotherapie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Changes in the social environment in this digital era will cause different stimulation patterns for language development and social interaction skills in children. This study's goal is to look into how to improve language ability in the digital age. Data were collected through observation, interviews, reviewing medical history, and conducting a specific assessment of occupational therapy, and then analyzed to identify performance and limitations related to the issues. This study found that the digital environment could bring a good impact if children are given assistance by adults when exposed to various audio-visual technologies. [ABSTRACT FROM AUTHOR]

The occurrence of visuospatial neglect acts as a key predictor of recovery outcome following stroke. However, the specific behavioural profiles associated with various neglect subtypes are not well understood. This study aims to identify real-world functional impairments associated with neglect, to determine whether functional impairment profiles differ across patients with egocentric and allocentric neglect, and to investigate how neglect severity predicts functional impairments. Notes from 290 stroke patients' occupational therapy functional assessments were qualitatively and quantitatively analysed in the context of neglect type and severity as reported by the OCS Cancellation Task. Overall, neglect patients had more references to having difficulty initiating tasks, finding items, exhibiting spatial inattention, and having difficulty using both arms than patients without neglect. The proportion of theme references did not differ significantly across patients with egocentric and allocentric neglect. The quantitative severity of egocentric neglect was acted as a significant predictor of reference occurrence over and above stroke severity within difficulty finding items, spatial inattention, body inattention, and upper limb use. This study expands on previous findings by identifying real-world functional impairments differentiating patients with and without neglect. This data provides novel insight into the impact of neglect on functional abilities. [ABSTRACT FROM AUTHOR]

Copyright of Ergoscience is the property of Schulz-Kirchner Verlag Gmbh and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: While most children have developed effective handwriting by secondary school age, some have handwriting difficulties that hamper academic progress. Occupational therapists play a role in assessment and planning support, which may include introducing typing as an alternative. However, there is limited understanding regarding how decisions are made about recommending typing. This study explored the support provided to adolescents with handwriting difficulties by occupational therapists, and the contextual factors that influence their decision-making. Method: Semi-structured interviews were conducted with 13 occupational therapists and analysed using thematic analysis. Findings: Although there was shared practice underpinned by occupational therapy philosophy, there was also divergent practice due to different approaches. Roles and responsibilities, resources, and evidence and experience influenced occupational therapists' practice. Understanding the adolescent's motivation, the effect of handwriting difficulties on well-being and the need for a functional method to record schoolwork, was central to occupational therapists' decision-making to recommend typing. Conclusion: Strategies are needed to address the knowledge-practice gap, including evidence-based guidelines. Closer collaboration between occupational therapists and school staff could increase understanding of roles and highlight the unique occupational therapy contribution. Further research examining whether, when and how to introduce typing as an alternative to handwriting would support best practice. [ABSTRACT FROM AUTHOR]

To appraise the literature evaluating psychometric properties and clinical utility of cognitive assessments available for use by occupational therapists in acute and subacute hospital contexts with children aged 4–18 years diagnosed with an acquired brain injury. Scoping review. Assessments and associated studies were evaluated for their methodologic quality using the COnsensus-based standard for the Selection of health Measurement INstruments (COSMIN) strategy. Forty-one studies evaluated 49 different assessments and reported on assessment psychometrics (n = 40), clinical utility (n = 1) and five reported on both. Fourteen assessments with the strongest psychometric properties and clinical utility were shortlisted. A gold standard assessment was not identified. Instead, a shortlist of functional, performance-based, technology-based, and self-report assessments were identified as relevant for the setting and population, but requiring further investigation. Future development of a cognitive assessment in partnership with therapists working in tertiary pediatric settings will ensure optimal clinical utility and validity. [ABSTRACT FROM AUTHOR]

Introduction: Low implementation rates of occupational therapy home assessment recommendations have previously been reported. The objective was to identify and describe the barriers and facilitating factors that influence implementation of home assessment recommendations. Methods: A mixed methods systematic review consisting of studies involving adults living in the community who received an occupational therapy home assessment was conducted. Seven databases were last searched in August 2021. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools (SUMARI) dependent on study design. Data synthesis followed the convergent integrated approach. Findings were mapped to the theoretical Capability Opportunity Motivation Behaviour (COM‐B) model of health behaviour change. Results: From 5,540 citations, 22 articles met the criteria for the systematic review. Implementation of occupational therapy home assessment recommendations ranged between 55% and 90%. Six synthesised findings were identified. Capability barriers included a patient's cognitive and physical ability. Motivation barriers included a perceived lack of need and stigma; patient reported decreased involvement and lack of choice. Opportunity barriers included limited family or carer involvement, carer stress, level of service provision available, including funding, therapy dosage and timing and environmental restrictions. Overall facilitators included patient‐centred care, including choice and understanding need, individualised tailored recommendations, involvement of families and carers, provision of written record and strategies to support implementation. Results were limited by methodological weaknesses in identified studies and heterogeneity in the definition and measurement of implementation impacting on comparison. Specific intervention components were often poorly described. Conclusion: The theoretical model elucidates priority factors to address for promoting implementation of home assessment recommendations. Future high‐quality research clearly defining intervention components is required to support short‐ and long‐term implementation of recommendations in the home environment. Behaviour change techniques could be utilised to support home assessment practices in future research. [ABSTRACT FROM AUTHOR]

With the development of the Internet era, the application of smartphones in life is quite useful, and the penetration rate of smartphones will be further increased in the future, making teenagers increasingly dependent on mobile phones. Teenagers are under great academic pressure, and excessive reliance on mobile phones will inevitably affect the formation of normal values. Teenagers, as a special group, deserve our attention. Mobile phone dependence has become a social problem. In this paper, the Pittsburgh Sleep Quality Index was used to evaluate the sleep quality of adolescents, and the factors affecting the sleep quality of adolescents were explored from three dimensions of behaviour, physiology, and emotion based on the sleep quality model. In this study, structural equation modelling was used to test the multiple mediating effects and analyze the relationship between mobile phone anxiety and sleep quality. Through the analysis of the internal mechanism of the two, the results show that the average score of adolescents' anxiety about mobile phone use is 32.87, and the standard deviation is 10.67. The difference between mobile phone anxiety and sleep quality was statistically significant (P < 0.001); good sleep quality can alleviate the prediction effect of mobile phone anxiety on anxiety and provide reference for promoting the physical and mental health development of adolescents. [ABSTRACT FROM AUTHOR]

Olfactory dysfunction can indicate early cognitive decline and is associated with dementia symptoms. We developed an olfactory-based sensory stimulation program and investigated its effects on cognition and emotion, and board game training were used as a comparison. In this parallel design pilot study, 30 participants with mild to moderate dementia were equal randomly assigned to the control (CONT), olfactory stimulation with cognitive training (OS), and board game (BG) groups. Two participants were withdrawn from CONT and OS groups, respectively. The intervention was a 12-week program with one 30-min session twice a week. We employed a bloodbased biomarker technique and several cognitive and psychological tests to measure basal and after-intervention values. No significant differences were observed between the groups after intervention, as measured using the Mini-Mental State Examination, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Top International Biotech Smell Identification Test, and Geriatric Depression Scale (GDS). The results showed that the OS group had a lower plasma Tau level than the other groups following intervention, whereas the CONT group had a significantly increased plasma amyloid ß1-42 level. OS participants had a lower concentration ratio of plasma Tau and amyloid Aß1-42 and showed more stable or improved cognition, olfactory function, and mood state. Both the OS and BG groups had a higher percentage of participants with stable or improved cognition and emotion. Taken together, these results suggest that olfactory-based sensory stimulation can be a beneficial intervention for patients with dementia. [ABSTRACT FROM AUTHOR]

Background: There is a large gap between the needs of individuals diagnosed with autism spectrum disorder (ASD) and the currently available services in Saudi Arabia. Services are often difficult to access, inconsistent in quality, incomplete, unsatisfactory, and costly. As such, there is a national need for expert consensus on the appropriate standards for the assessment and management of children on the autism spectrum. Methodology: A guideline development group (GDC) was formed by professionals representing all related specialties and institutions involved in the management of individuals on the autism spectrum in Saudi Arabia. They met on a regular basis over 21 months. The guideline development process consisted of five steps starting from reviewing existing guidelines and ending with discussing and writing this manuscript. A formal voting process was utilized and recommendations were discussed until a consensus was reached. Results: There was consensus on the following: A specialized diagnostic assessment needs to be carried out by an experienced multidisciplinary team for children referred to assess for ASD. They should be assessed for medical etiology, their behavioral history carefully reviewed, and symptoms directly observed. Longitudinal assessments are encouraged to reflect the effects of symptoms on the individual's ability to function while with their family, among peers, and in school settings. An additional formal assessment of language, cognitive, and adaptive abilities as well as sensory status is essential to complete the diagnostic process. Interventions should be individualized, developmentally appropriate, and intensive, with performance data relevant to intervention goals to evaluate and adjust interventions. Target symptoms must be identified to address and develop monitoring systems to track change. Conclusion: ASD is a complex condition with widely varying clinical manifestations, thus requiring evaluation and intervention by a range of professionals working in coordination. Behavioral and environmental interventions are the key to optimal outcomes, in conjunction with medications when indicated for specific symptoms. Parental involvement in interventions is vital to sustaining therapeutic gains. [ABSTRACT FROM AUTHOR]