Search

Background: To fulfil the desire for evidence-based practice, there is impetus for occupational therapy (OT) to make research a priority and to encourage research engagement. Purpose: This study’s aim was to explore occupational therapists’ reasons for and for not getting involved in research and to determine potential barriers and enablers to engaging in research. Methods: Three focus groups were conducted with five participants each. Data were thematically analysed. Findings: Occupational therapists’ reasons for expressing interest in getting involved in research were having an interest in the condition and/or the symptoms being studied; promoting client support and service development; and ‘upskilling’. Three themes emerged from the thematic analysis: (1) motivation to get involved in research can be influenced; (2) ‘firefighting’: barriers and organisational culture; and (3) The nature of research needs consideration from an occupational therapist perspective. Implications: Findings suggest that though occupational therapists are able to get involved in research, it remains that there are difficulties in doing so (e.g., organisational culture); and such difficulties may outweigh both reasons and enablers to such involvement. Reasons for expressing interest, enablers, barriers and the relationships among them warrant further investigation and consideration with respect to involving occupational therapists in research.

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. Main objective To assess the benefits and harms of occupational therapy interventions for improving daily functioning, participation, and quality of life in people with multiple sclerosis. Secondary objectives To assess whether the effects of occupational therapy interventions differ according to the format of intervention delivery (individually versus group) and to the location of service delivery (outpatient, inpatient, or home-based therapy).

The current study-within-a-trial explored individuals’ decisions to decline participation in research trialling a chronic illness-focused therapy (i.e. multiple sclerosis). Four themes were identified from seven semi-structured interviews with participation decliners and were confirmed by the host trial’s Patient & Public Involvement (PPI) panel: acknowledgement of the value of research; ‘fit’ of the study; misinterpretation of participant information; and ‘ignorance is bliss’ – discussed in light of theory and research. This study-within-a-trial extends research on trial recruitment and participation decline; while also suggesting that PPI can be utilised in both a practical and impactful manner. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study-within-a-trial was conducted within research funded by the Health Research Board (Ireland) under a Definitive Interventions and Feasibility Award (DIFA-FA-2018-027). peer-reviewed

Background: With an average age of onset of about 20-40 years, MS usually manifests during early adulthood, which is considered to be a critical period for the development and maintenance of relationships particularly dating and romantic relationships. People with MS can experience sexual dysfunction, fatigue, pain, reduced mood and bladder/bowel dysfunction. These difficulties can affect a person s ability to participate in many meaningful activities, including those that affect relationships dating, preparing meals, engaging in sexual intercourse and others. Research in the area has explored the experiences of people with MS in long-term relationships or in marriage. However, an increasing number of people are not in long-term relationships in their 20 s, 30 s and beyond. It is known that dating or entering romantic relationships has been shown to be difficult for those with physical disabilities who face stigma, negative societal attitudes and the fear of requiring care from potential partners. The experience of those with a progressive, complex condition like MS has not been explored in detail to date. Objectives: To develop a rich understanding of the impact of MS on romantic relationships and occupations related to dating. To better understand how living with a progressive, early-onset condition such as MS, interacts with/influences developing romantic relationships. Methods: This study used a descriptive phenomenological design. Data were collected through two online focus group. A purposive sampling strategy was implemented to identify participants that have relevant knowledge or experience to address the research topic. Participants self-recruited by contacting the authors. Participants were excluded if they (i) were co-habiting with a partner or married (ii) had a comorbid diagnosis of a neurological disorder or (iii) were not able to provide informed consent. The authors used Colaizzi s (1978) descriptive phenomenological method to analyse the data. Results: Six females and two males participated in the focus groups. Participants were aged between 23-37 years and had a diagnosis of relapsing-remitting multiple sclerosis. Years since MS diagnosis ranged from 4-16 years. Dating with a diagnosis of MS is a highly personal phenomenon, characterised by many individual differences in values and experiences. Core to the phenomenon were the process of personal decision-making about disclosure of the diagnosis, considerations about dating and couple-focused activities that were limited by pain or fatigue and ongoing adaptation to the fluctuating nature of the condition with partners in new/developing relationships. Planning for and engaging in dating was considered by some participants to be emotionally exhausting. Conclusions: There were a range of experiences of dating and relationships across the participants in the study. Participants discussed the most salient issues specific to dating with MS including diagnosis non-peer-reviewed

Introduction For occupational therapy students, international experiences and access to a global curriculum develops understanding of broad cultural and contextual determinants of health and wellbeing. International placements or study abroad opportunities are not possible for many students and many universities are developing alternative internationalisation opportunities. The aim of this review was to determine what is known from the existing literature on the use of online international student collaboration in occupational therapy curricula. Method A scoping review design was used to search relevant literature on online international student collaboration in occupational therapy education, following a methodological framework for conducting scoping reviews. Seven databases were searched. Search included all articles published up until November 2020. Findings The database searches yielded a total of 2011 results. Following screening and review of articles ten papers met the inclusion criteria and were included in the review. The studies were charted and discussed in the areas of format of the online interactions, reported outcomes of the online interactions, barriers and facilitators in implementation. Conclusion Findings inform curricula designers establishing online international learning and those conducting research in this area. Outcomes indicate the breadth of student learning including culture, diversity, as well as the social determinants of occupational engagement and participation. Registration Protocol Registered: 2020-07-06, available on Open Science Framework (OSF) at https://osf.io/wfkjy

INTRODUCTION: The challenges that transgender people face, which are caused by a multitude of factors, have been well documented. However, changes in occupational participation are less well known. This research explored changes in the occupational participation of transgender people. METHODS: The study used a phenomenological research design. Data were collected through semi-structured interviews with five participants. Data were analyzed with an interpretative phenomenological approach. RESULTS: Three themes were identified: work, self-presentation, and role change. Positive reports of transitioning were described as well as ongoing challenges in occupational participation. Various effects on work and life roles were reported. The study did not include either an emic perspective or member checking, limiting the usefulness of the findings. CONCLUSION: The findings showed that gender transitions can affect occupational participation both positively and negatively. A gender transition has the potential to foster a renewed sense of meaning and enjoyment in the everyday lives of people who identify as transgender. For clinicians, it is important to support people who are transgender and those undergoing a gender transition to maximize their occupational participation. [ peer-reviewed 2021-03-12

Since the beginning of the COVID-19 pandemic, there has been limited research on why people choose to volunteer or what the benefits and challenges of volunteering are, has been conducted in the context of the COVID-19 pandemic. This study aimed to investigate the motivations, benefits, challenges, and concerns associated with volunteering during the COVID-19 pandemic in Ireland. A cross-sectional design assessed the motivations, benefits, challenges, and concerns associated with volunteering during the COVID-19 pandemic. Purposive sampling was used, gathering 254 valid participants. Descriptive statistics, inferential statistics and content analysis were employed to analyse the data. Altruistic motivations, social benefits, and concerns about COVID-19 infection were among the most highly rated motivations, benefits, and concerns. Positive and negative aspects of volunteering during the COVID-19 pandemic were also identified. This study is the first of its kind to explore motivations, benefits, and challenges associated with volunteering during the COVID-19 pandemic in Ireland.

Reliable remote cognitive testing could provide a safer assessment of cognitive impairment in multiple sclerosis (MS) during the COVID-19 pandemic and thereafter. Here we aimed to investigate the reliability and feasibility of administering Brief International Cognitive Assessment for MS (BICAMS) and the Trail-Making Test (TMT) to people with MS online. Between-group differences on BICAMS and the TMT were examined in a sample of 68 participants. Group 1 (N = 34) was tested in-person pre-pandemic. Group 2 was tested remotely. Within-group differences for in-person and virtual administrations were examined for Group 1. No significant differences between virtual and in-person administrations of the CVLT-II and SDMT were detected. BVMT-R scores were significantly higher for virtual administrations (M = 20.59, SD = 6.65) compared to in-person administrations (M = 16.35, SD = 6.05), possibly indicating inter-rater differences. Strong positive correlations were found for in-person and virtual scores within Group 1 on the CVLT-II (r = .84), SDMT (r = .85), TMT-A (r = .88), TMT-B (r = .76) and BVMT-R (r = .72). No significant differences between in-person and remote administrations of CVLT-II and SDMT in people living with MS were detected. Recommendations for future studies employing the TMT and BVMT-R online are provided. This study-within-a-trial was conducted within a trial funded by the Health Research Board (Ireland) under a Definitive Interventions and Feasibility Award [grant number DIFA-FA-2018-027]. peer-reviewed

BACKGROUND: Currently, outcomes of Multiple Sclerosis (MS) are not standardized and it is unclear which outcomes matter most to people living with MS. A consensus between patients and healthcare professionals on which outcomes to measure and how, would facilitate a move towards value-based MS care. OBJECTIVE: to develop an internationally accepted, patient-relevant Standard Outcome Set for MS (S.O.S.MS). METHODS: A mixed-method design was used, including a systematic literature review, four patient focus groups (n=30) and a RAND-modified Delphi process with seventeen MS experts of five disciplines from seven countries (the Netherlands, United States of America, Portugal, Ireland, India, New Zealand, Switzerland and Turkey). RESULTS: A standard outcome set for MS was defined, consisting of fourteen outcomes divided in four domains: disease activity (n=3), symptoms (n=4), functional status (n=6), and quality of life (n=1). For each outcome, an outcome measure was selected and the measurement protocol was defined. In addition, seven case-mix variables were selected. CONCLUSION: This standard outcome set provides a guideline for measuring outcomes of MS in clinical practice and research. Using this set to monitor and (inter)nationally benchmark real-world outcomes of MS can support improvement of patient value and ultimately guide the transition towards value-based MS care.

Background The COVID-19 pandemic has likely had a negative impact on rehabilitation and quality of life (QoL) research in multiple sclerosis (MS). Method We explored perceived barriers to research among 87 researchers, representing 18 countries, both prior to and since COVID-19. Results A Wilcoxon signed-rank test found that significantly more researchers reported experiencing barriers to research since the onset of the pandemic compared to pre-COVID-19 (p Conclusions Implications for the future landscape of rehabilitation research in MS are discussed.

Objective: The objective of this longitudinal study examined, first, whether people with multiple sclerosis who previously advocated for angioplasty to treat chronic cerebral spinal venous insufficiency (CCSVI) through YouTube continued reporting benefits. Second, it examined a new cohort reporting on CCSVI treatment, and third, whether perspectives have changed. Method: YouTube videos from August 2011 to January 2019 related to CCSVI were retrieved. Once retrieved, all videos were compiled, classified and analyzed. Categorical data were reported and a pre-determined code-book was used to code videos. Data from the videos were extracted and analyzed using discourse analysis. Results: 1293 videos related to CCSVI were uploaded by 54 people with multiple sclerosis who met the inclusion criteria. YouTube videos uploaded by people with multiple sclerosis have shifted in volume and message. The initial surge in interest in CCSVI treatment has diminished, but there still exists strong advocates for its use. There appears to be an inconsistency between positive results, actual improvements in symptoms, and the overall messages reported. Very little long-term data was available as the procedure is relatively new. Conclusion: Practitioners may be faced with pressure to provide unproven treatments in the future and should be understanding but evidence-driven when supporting multiple sclerosis therapies. This research is funded in part by a National MS Society Post-doctoral Fellowship Award No. MB 0016. peer-reviewed 2020-03-26

This article describes an innovative transnational education project involving three European universities, funded through ERASMUS+. One of its aims was to develop and provide a curriculum to facilitate students’ understanding and identification of occupational (in)justice by exposing them to marginalised people living in three European communities with differing cultural, social, and political systems. Occupational injustice is an ongoing deprivation or patterns of disruption that creates health burdens, barriers to educational and social opportunities, and risk to the individual’s lifespan. We describe how a transnational educational collaboration offered a new way of facilitating learning of occupational (in)justice in a practical way to stimulate the application of concepts to discipline specific thinking and engage students in debate about new areas of potential practice which are transformational. The educational theory underpinning the project is discussed, together with a description of how authentic learning experiences supported the development of occupational justice knowledge and justice-focused practice. The team are grateful to all the community partners who supported the project, offered new sights, and readily engaged with the students throughout the 3 years. The team are thankful for co-funding by the ERASMUS+ programme of the European Union (Grant no. 2016-1-SE01-KA203-022102) to support the development and delivery of this project. peer-reviewed 2022-02-09

In this Open Letter we present reflections from three different perspectives on the integration of public and patient involvement (PPI) in a research trial. We reflect on the experience of having a patient employed as a contract researcher, with no prior research experience, on a feasibility trial of cognitive rehabilitation in multiple sclerosis. This Open Letter is written by the PPI research team member with reflections from a researcher on the trial and the principle investigator. We will discuss some of the changes made and the impacts that have been resulted from of PPI input into the trial. We focus on PPI involvement in participant recruitment, the development of trial material, integration of PPI along the research cycle, and collaboration. We hope that this Open Letter will encourage principle investigators and groups to include PPI members as part of the research team and help patients and members of the public understand what the experience of PPI members is like We would like to thank the wider PPI advisory group to the COB-MS trial and PPI Ignite at NUI Galway for their ongoing support throughout the trial. Thank you also to MS Ireland for their continued support throughout. peer-reviewed

Background We aimed to estimate the clinical effectiveness of Community Occupational Therapy for people with dementia and family carers–UK version (Community Occupational Therapy in Dementia–UK version [COTiD-UK]) relative to treatment as usual (TAU). We hypothesised that COTiD-UK would improve the ability of people with dementia to perform activities of daily living (ADL), and family carers’ sense of competence, compared with TAU. Methods and findings The study design was a multicentre, 2-arm, parallel-group, assessor-masked, individually randomised controlled trial (RCT) with internal pilot. It was conducted in 15 sites across England from September 2014 to January 2018. People with a diagnosis of mild to moderate dementia living in their own home were recruited in pairs with a family carer who provided domestic or personal support for at least 4 hours per week. Pairs were randomised to either receive COTiD-UK, which comprised 10 hours of occupational therapy delivered over 10 weeks in the person with dementia’s home or TAU, which comprised the usual local service provision that may or may not include standard occupational therapy. The primary outcome was the Bristol Activities of Daily Living Scale (BADLS) score at 26 weeks. Secondary outcomes for the person with dementia included the following: the BADLS scores at 52 and 78 weeks, cognition, quality of life, and mood; and for the family carer: sense of competence and mood; plus the number of social contacts and leisure activities for both partners. Participants were analysed by treatment allocated. A total of 468 pairs were recruited: people with dementia ranged from 55 to 97 years with a mean age of 78.6 and family carers ranged from 29 to 94 with a mean of 69.1 years. Of the people with dementia, 74.8% were married and 19.2% lived alone. Of the family carers, 72.6% were spouses, and 22.2% were adult children. On randomisation, 249 pairs were assigned to COTiD-UK (62% people with dementia and 23% carers were male) and 219 to TAU (52% people with dementia and 32% carers were male). At the 26 weeks follow-up, data were available for 364 pairs (77.8%). The BADLS score at 26 weeks did not differ significantly between groups (adjusted mean difference estimate 0.35, 95% CI −0.81 to 1.51; p = 0.55). Secondary outcomes did not differ between the groups. In total, 91% of the activity-based goals set by the pairs taking part in the COTiD-UK intervention were fully or partially achieved by the final COTiD-UK session. Study limitations include the following: Intervention fidelity was moderate but varied across and within sites, and the reliance on primarily proxy data focused on measuring the level of functional or cognitive impairment which may not truly reflect the actual performance and views of the person living with dementia. Conclusions Providing community occupational therapy as delivered in this study did not improve ADL performance, cognition, quality of life, or mood in people with dementia nor sense of competence or mood in family carers. Future research should consider measuring person-centred outcomes that are more meaningful and closely aligned to participants’ priorities, such as goal achievement or the quantity and quality of activity engagement and participation. Trial Registration Current Controlled Trials ISRCTN10748953., Jennifer Wenborn and colleagues investigate the effectiveness of community occupational therapy program in improving activities of daily living, cognition, and mood for people with dementia., Author summary Why was this study done? Maintaining everyday and pleasurable activities can be difficult for a person with dementia, as well as their family carer who often feels increasingly stressed as they need to give more and more support. Occupational therapists assist people to improve their health and well-being through carrying on with the activities they need and want to do. It is therefore important to develop effective strategies to deliver occupational therapy to people with dementia and their family carers who support them. What did the researchers do and find? We tested the effectiveness of the Community Occupational Therapy in Dementia–UK version (COTiD-UK) programme compared to the care that people with mild to moderate dementia and their family carers usually receive, through a clinical trial. We recruited 468 pairs comprising a person with dementia and a family carer across England who were randomly allocated to either take part in the COTiD-UK programme or to continue with their usual care. We found no statistical evidence that COTiD-UK gave more benefit to people with dementia or their carers than the usual care provided in terms of the people with dementia being able to carry out activities or their mood or quality of life nor their family carers’ sense of competence or mood. The pairs who took part in the COTiD-UK intervention set an average of 4.09 goals each, of which 91% were fully or partially achieved by the final COTiD-UK session. What do these findings mean? We did not find evidence to support commissioning the COTiD-UK intervention for people with mild to moderate dementia and their family carers. Future studies need to develop more realistic methods of measuring the effectiveness of programmes such as this, particularly to focus on the outcomes that most matter to the individuals taking part and to truly reflect the actual performance, experience, and views of the person living with dementia.

Background Cognitive difficulties experienced by people with multiple sclerosis (MS) impact their quality of life and daily functioning, from childcare and work, to social and self-care activities. Despite the high prevalence of cognitive difficulties seen in MS, there is a lack of developed programmes that target cognition, while also supporting patients by helping them to function well in everyday life. The Cognitive Occupation-Based programme for people with MS (COB-MS) was developed as a holistic, individualised cognitive rehabilitation intervention. It addresses the wide-ranging symptoms and functional difficulties that present in MS, including the ability to maintain employment, social activities, home management and self-care. The aim of the current research is to evaluate the feasibility and preliminary efficacy of COB-MS for people with MS. The focus is on feasibility outcomes as well as functioning associated with cognitive difficulty and secondary outcomes related to cognition, fatigue and quality of life. Methods One hundred and twenty people with MS will be assigned to participate in either the COB-MS programme or a treatment as usual, wait-list control group as part of this single-blind, cluster-randomised controlled feasibility and preliminary efficacy trial of the COB-MS programme. The COB-MS group will participate in an eight-session occupational-based cognitive rehabilitation programme over 9 weeks. The primary outcome measure is the goal attainment scaling at 12 weeks. Participants will be assessed pre-intervention, post-intervention and at 12 weeks post-intervention and 6 months post-intervention. Qualitative evaluations of participants’ perspectives will also be examined as part of the feasibility study. Discussion Results will provide recommendations for a future definitive trial of COB-MS, with respect to both feasibility and preliminary, clinical efficacy. In the event that results indicate efficacy, study findings will suggest that COB-MS requires consideration as a means of enhancing cognitive and daily functioning in people living with MS. Trial registration ISRCTN: ISRCTN11462710. Registered on 9 September 2019.

Background: This protocol describes a double-blind, randomised non-inferiority study-within-a-trial (SWAT), comparing the effects of a patient-designed-and-informed participant information sheet with a standard, researcher-designed participant information sheet on recruitment, retention, decision certainty, participant information sheet understanding and likeability. The SWAT is part of a larger trial that aims to evaluate the feasibility and preliminary efficacy of a cognitive occupation-based programme for people with MS (COB-MS) on cognitive and daily functioning for people with multiple sclerosis. Methods: During the study, 120 people with multiple sclerosis will be randomly allocated to one of the two groups, where they will either receive a standard participant information sheet or a patient-designed participant information sheet. Recruitment and retention will be analysed, as well as decision certainty, likability and understanding. Discussion: Results will provide recommendations for recruitment, consent and retention for future trials, as well as shed some light on the factors influencing the understanding and likeability of a trial’s participant information sheet. Recommendations will also be made regarding patient and public involvement in developing and/or aiding the development of participant information sheets. Registration: SWAT: Northern Ireland Hub for Trials Methodology Research SWAT Repository Store (SWAT105). COB-MS trial: ISRCTN11462710.

Background: Part-time PhD students are often neglected in research and policy. Clinicians who decide to undertake a PhD usually do so on a part-time basis. It is important that supervisors are aware of the unique challenges that part-time students face. Aim: The aim is to advise supervisors on the best ways to support clinicians who are completing, undertaking, or beginning a PhD. Methods: Literature on the topic, as well as critical reflection and feedback from students was used to develop these tips. Results: Practical tips are presented here to help when supporting part-time PhD students. Conclusion: Clinicians are skilled in many areas but may require additional supports in managing time, integrating into the research environment and developing an academic identity. Supervisors have a key role in supporting their development and advocating on behalf of students when required. peer-reviewed

Background: Early withdrawal from the workforce is associated with a diagnosis of multiple sclerosis (MS), with employment retention rates also lower than in the general population. Despite legal requirements, equality in the workplace for people with MS has not been achieved. Disclosure of multiple sclerosis at work is essential for the implementation of accommodations enabling employment retention. Method: An interpretive descriptive study explored participants’ decision to disclose or not disclose their diagnosis of multiple sclerosis and the implications this had on work participation and working relationships. Semistructured interviews were used to collect data from 6 participants. Results: Three themes were identified, using a reflective approach to analysis, from the data: (a) Accommodations; (b) Workplace Relationships; and (c) Balancing Work and Home Life. Participants had mixed experiences of disclosing their diagnosis. Findings supported the implementation of workplace accommodations including physical, cognitive, and structural supports. Concealment of MS was associated with fear of workplace stigmatisation. Conclusion: Disclosure is multidimensional and subjective. It is based on personal, systematic, and social factors. This study was limited by the small number of participants and not including stakeholders in the creation of the topic guide. The results are important for those involved in supporting people with multiple sclerosis to remain in the workplace.

Introduction Cognitive difficulties have been reported to have the greatest effect on function and quality of life in people with multiple sclerosis, affecting 50–60% of people. To date, few interventions have been developed to treat cognitive issues in multiple sclerosis. Here we report on a Cognitive Occupation-Based programme (COB-MS) for people with Multiple Sclerosis an evidence-based intervention to address everyday problems encountered due to cognitive difficulties. The aim of this research was to explore the views of people with multiple sclerosis and occupational therapists on the programme and its potential implementation in practice. Methods Data were elicited from a purposive sample of 12 people from two stakeholder groups, people with multiple sclerosis (n = 5) and occupational therapists (n = 7), through focus groups and interviews. The programme and related materials were presented, and contributions recorded, transcribed and thematically analysed. Results Two main themes were identified from analysis of the data: response to the intervention and challenges to implementing the programme. Occupational therapists agreed that the COB-MS is client-centred. People with multiple sclerosis thought that it was a validating intervention. The overall format was viewed to be useful and feasible. Conclusion The COB-MS for people with Multiple Sclerosis is the first known cognitive intervention using an occupation frame of reference to address difficulties faced among persons with multiple sclerosis and was found to be timely and relevant to the needs of the population.

Introduction A national survey was conducted with United Kingdom (UK) occupational therapists to scope occupational therapy service provision for people with dementia and their family carers in the community. Method This was an online questionnaire with topics on occupational therapists’ roles, service provision, referral, assistive technology and assessment tools. Recruitment was through direct invitation, and promotion via occupational therapy networks, websites and newsletters. Results A total of 197 responded. Occupational therapy referrals most commonly came from the multidisciplinary team. Over half primarily undertook profession-specific work, with occupational therapy assessments the most common profession-specific task. Two-thirds of referrals for initial assessments were for people with mild-to-moderate dementia. A median of 2.5 hours for assessment/intervention was spent for each person with dementia. Almost two-thirds used the Model of Human Occupation Screening Tool. Most could prescribe personal activities of daily living equipment and Telecare, with few able to prescribe equipment for reminiscence or leisure. Conclusion This national survey increases knowledge of UK community occupational therapy practice and service provision for people with dementia and their family carers. It informs occupational therapists about national trends within this practice area, and development of the community occupational therapy intervention (COTiD-UK) as part of the Valuing Active Life in Dementia research programme.

Executive function is best measured in loosely structured, multi-component tasks that reflect real-life demands. These tasks require participants to develop a strategy, keep a plan in mind and monitor time. Errors include ignoring stated goals (‘goal neglect’), over-allocation of time to one task and violating rules. Teasing apart such errors can be complicated and these assessments can be difficult to control and time-consuming to administer. This paper reports an evaluation of a new, easy-to-administer computer-based multiple component test, the Computerised Multiple Elements Test (CMET). In Study 1 20 older adults (55–70 years) completed the task under different conditions. Study 2 examines the relationships between CMET and performance on measures of related constructs. The results show that poor CMET performance correlated with self-reported frequency of everyday cognitive lapses. There is a reasonable basis for further exploration of the CMET as a quick, practical and potentially sensitive measure of organisational skills.

Introduction: To develop occupational therapy s evidence base and improve its clinical outcomes, occupational therapists must increase their research involvement. Barriers to research consumption and leadership are well documented, but those relating to delivering research interventions, less so. Yet, interventions need to be researched within practice to demonstrate their clinical effectiveness. This study aims to improve understanding of challenges and enablers experienced by occupational therapists who deliver interventions within research programmes. Method: Twenty-eight occupational therapists who participated in the Valuing Active Life in Dementia (VALID) research programme reported their experiences in five focus groups. Data were analysed thematically to identify key and subthemes. Results: Occupational therapists reported that overwhelming paperwork, use of videos, recruitment and introducing a new intervention challenged their research involvement, whereas support, protected time and a positive attitude enabled it. The impact of these challenges and enablers varied between therapists and organisations. Conclusion: Challenges and enablers to research involvement can be identified but must be addressed within individual and organisational contexts. Multifaceted collective action to minimise challenges and maximise enablers can facilitate clinicians involvement in research. Using this approach should enable occupational therapists to increase their research involvement, thus demonstrating the clinical effectiveness of their interventions. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article:This manuscript presents independent research funded by the National Institute for Health Research’s Programme Grants for Applied Research Programme (RP-PG-0610-10108). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. peer-reviewed

Computerised training has been shown to benefit cognitive function in older adults but rarely, if ever, enhances performance in everyday life. This study examines how an entirely internet-based cognitive programme can generalise to daily functioning. This is an exploratory study (n = 25) of computer and video-based strategy training with older adults that was conducted over the internet to facilitate generalisation. Results found no evidence of gains to measures in daily functioning. The only training benefits were on tasks that had been trained. The results suggest that not all training procedures produce benefits and a lack of transfer to daily life was evident here. Caution should be taken in interpretation due to the small sample under investigation. This research may be useful for the design and conduct of future rehabilitation studies.

Objectives: In the Netherlands, Graff et al. found Community Occupational Therapy in Dementia (COTiD) demonstrated benefits to people with dementia and family carers. In this study, focus groups took place with people with dementia and family carers to explore how to make COTiD relevant to the UK context. Method: Six focus groups (three with people living with dementia (n = 18) and three with family carers (n = 21)) took place. Participants were asked for their impressions of the intervention, the extent to which it could meet their needs, and what modifications were needed. Audio-recordings of the groups were transcribed and analysed. Results: Three key themes emerged covering ‘loss and living with dementia’, ‘what helped us’, and ‘consistency and continuity’. People with dementia and family carers spoke about the impact of their diagnosis on them and their family and what strategies helped. Issues such as timing, follow-up, and the importance of an early intervention in preventing crises were highlighted. There was some concern over the length of the intervention and the disruption it might cause to current schedules. Conclusion: Overall, participants were optimistic about COTiD being used in the United Kingdom if it was to be introduced in a flexible and timely manner, incorporating the needs and existing strategies of the person with dementia. These outcomes have led to changes, such as incorporating more flexibility into COTiD, being made to the intervention prior to its implementation in the United Kingdom. National Institute for Health Research (NIHR) in the UK under its Programme Grants for Applied Research scheme (RP-PG-0610-10108) peer-reviewed 2016-05-01

BACKGROUND: Multitasking measures, in which a series of tasks must be completed within a naturalistic setting not fully under the experimenter’s control, have been shown to be more sensitive than traditional measures in detecting organisational problems in people with difficulties in executive functioning. There are a number of drawbacks to such tasks however. They can take considerable time to administer and are demanding in terms of examiners noting and recording all relevant aspects of performance. This potentially leaves them more open to subtle bias. One method that could offset these limitations is to video record performance. OBJECTIVES: The practicality and outcome of using video ratings to accurately score performance off-line is investigated here. METHODS: Nineteen participants completed a Multiple Errands Task (MET) while wearing a body-worn camera. Their performance was scored “live” and by an independent rater who had only access to video footage of the task. RESULTS: Significant relationships were seen on all variables of the MET between the live and video ratings. The inter-rater reliability of the measure appears strong. CONCLUSION: We provide initial support for the use of a video rater when assessing performance on an MET. peer-reviewed

Recent reports suggest that intensive, progressive training on working memory tasks can lead to generalized cognitive gains.A patient, following hypoxic brain damage, showed significant difficulties in working memory and time-perception. This study examined the impact and specificity of any benefits resulting from automated working memory training (AWMT) in comparison with the effects of an equivalent programme that emphasized automated novel problem-solving (APST) which served as an active control. Following initial assessment, the patient trained for 4 weeks (20 days), 20-30 minutes a day on the APST tasks before repeating key outcome measures. He then trained for an identical period on AWMT.There were no cognitive gains apparent following APST. Furthermore, there were no disproportionate gains on digit span following AWMT. AWMT was, however, associated with improvement in time-perception that had previously been resistant to rehabilitation. In line with previous reports, AWMT was also followed by gains on a measure of planning.The results provide encouraging evidence that AWMT may have generalized benefits in the context of impaired WM capacity following brain injury.

To the Editor,In its current form, computerised cognitive training should not be used in occupational therapy practice. The evidence of effectiveness is just not convincing. Recent years have seen ...