The use of evidence based practice by occupational therapists who treat adult stroke patients

The study identified the extent to which members of the National Association of Neurological Occupational Therapists (NANOT) who treated adult stroke patients used evidence-based practice (EBP). A random sample of NANOT members (n = 200) was surveyed by a postal questionnaire on the use of EBP and the results were analysed for the 125 therapists who worked with adult stroke patients. The principal factor that `greatly’ influenced the choice of intervention of three-quarters of the respondents was working with other therapists, followed by attendance at postgraduate courses; gaining postgraduate qualifications had the least influence. Although over 90% of the respondents considered that they used EBP at some time, the most frequently reported levels of evidence used were custom and practice and expert opinion, which were at the lower end of the hierarchy. Therefore, although the respondents who treated adult stroke patients did use EBP, they did not use the higher levels recommended. The respondents who used the higher levels of evidence were those who were most recently qualified. The factors influencing the use of EBP were the relevance of research to practice, time, lack of therapists’ knowledge and lack of support

The career choice of first year occupational therapy students: A follow up study

This study replicated a survey of first-year occupational therapy students at Brunel University (Craik et al 2001) and 114 students (91.2%) responded. Their profile was similar to that of the students in the previous study, with 90% being female, 65% being over 21 years of age and 20% coming from minority ethnic groups. The most frequent way that the students had heard about occupational therapy remained through informal means, with variety and challenge continuing to be the most important factors in attracting potential students to the profession. The results of this study, taken with those of Craik et al (2001), provide data on 444 first-year students and further emphasise the importance of occupational therapists in encouraging recruitment to the professio

Unbalanced instabilities of rapidly rotating stratified shear flows

The linear stability of a rotating, stratified, inviscid horizontal plane Couette flow in a channel is studied in the limit of strong rotation and stratification. An energy argument is used to show that unstable perturbations must have large wavenumbers. This motivates the use of a WKB-approach which, in the first instance, provides an approximation for the dispersion relation of the various waves that can propagate in the flow. These are Kelvin waves, trapped near the channel walls, and inertia-gravity waves with or without turning points. Although, the wave phase speeds are found to be real to all algebraic orders in the Rossby number, we establish that the flow, whether cyclonic or anticyclonic, is unconditionally unstable. This is the result of linear resonances between waves with oppositely signed wave momenta. We derive asymptotic estimates for the instability growth rates, which are exponentially small in the Rossby number, and confirm them by numerical computations. Our results, which extend those of Kushner et al (1998) and Yavneh et al (2001), highlight the limitations of the so-called balanced models, widely used in geophysical fluid dynamics, which filter out Kelvin and inertia-gravity waves and hence predict the stability of the Couette flow. They are also relevant to the stability of Taylor-Couette flows and of astrophysical accretion discs.Comment: 6 figure

Inpatients’ perspectives of occupational therapy in acute mental health

Background Research into service users’ views of occupational therapy in acute mental health is extremely limited. This collaborative study between South West London and St George’s Mental Health NHS Trust and Brunel University (UK) obtained inpatients’ perspectives of occupational therapy. Methods Service users and occupational therapists were involved in designing a self-report questionnaire and, following training, in recruiting participants and collecting data. Results Sixty-four (28.6%) inpatients responded and most had met an occupational therapist who had explained the purpose of their intervention. The most frequent group interventions were arts and crafts, relaxation, community meetings, cookery, sports and gym, with the latter two rated as most beneficial. There was much less choice about individual goals and interventions. A highly significant and positive correlation was found between occupational therapy meeting the needs of individuals and it improving their daily functioning and quality of their admission. Conclusions Occupational therapists need to provide more individual interventions and more fully involve inpatients in deciding on individual goals. Group interventions, which are meaningful, relevant and with an occupational focus, are most beneficial. Further research examining the effectiveness of cookery and sport and gym and establishing the benefits of engaging in group and individual intervention on acute wards is warranted

Mental health clients confirm the value of occupation in building competence and self-identity

Engagement in occupation is proposed to enhance health and wellbeing. To date, few studies have demonstrated this in relation to people with mental health problems. This study aimed to evaluate occupational therapy’s beliefs in the restorative powers of occupation from the perspective of people with enduring mental health problems living in the community. Qualitative research methods were used in two mental health day service settings: a workshop, where woodwork was provided as a medium for creative therapy, and a drop-in facility. Participant observation was undertaken over 10 sessions and, during six in-depth interviews, the clients were asked about their occupational experiences and whether they had perceived any benefits from engagement in occupation. Content and inductive analysis as well as concept mapping of the data resulted in emergent themes and subthemes. Occupation was identified both as a means for building competence through the acquisition of skills, coping with challenges and achieving success and as a medium for developing self-identity through the drive to create, feelings of usefulness and engendering a sense of self. These themes help to support the need for an increase in the provision of meaningful occupation for people with enduring mental health problems. However, further research is required to develop and corroborate the findings

A survey of occupational therapy practitioners in mental health

As part of the College of Occupational Therapists’ Mental Health Project, a survey of occupational therapists practising in mental health in the UK was conducted. A questionnaire was sent to 200 members of the Association of Occupational Therapists in Mental Health and achieved a 68.5% response rate. The majority of the 137 respondents were female, with Senior I staff between 20 and 30 years of age who were unlikely to have worked in another area forming the largest group. Although most had received additional training, they identified the need for more training, especially in aspects of occupational therapy. Most were managed by an occupational therapist and 96% received supervision. Community mental health was the most frequently reported area of work with leisure, counselling, anxiety management and creative activities the most frequently used interventions. Respondents were committed to the core principles of occupational therapy and the need to develop outcome measures and evidence based practice, and were concerned about moves to generic working. This study has provided data, not only for the position paper on the way ahead for occupational therapy in mental health but also for individual occupational therapists and managers

Occupational therapists' perceptions of predischarge home assessments with older adults in acute care

Predischarge occupational therapy home assessments are routinely performed with older adults in Europe, Australia and North America. Their primary aim is to facilitate a timely and safe discharge from hospital. However, there is a lack of published research on this topic, especially studies exploring occupational therapists' perceptions of home assessments. The paper aims to redress this by describing occupational therapists' perceptions of predischarge occupational therapy home assessments with older adults in acute care. All occupational therapists who undertook home assessments in an acute care hospital with older adults during the duration of the study period were invited to complete a reflective diary. In total, 15 reflective diaries were completed by six therapists. The data were analysed using thematic content analysis. The findings suggest that home assessments were carried out because of mobility or environmental concerns. Satisfaction and dissatisfaction with the outcome of the home assessment were related to the incidents that occurred during the assessment. Some of the occupational therapists' anxieties were related to the older adults' level of functioning or ill health, and the older adults' own concerns did have an impact upon the therapists' expectations of the home assessment process

College of occupational therapists: Position paper on the way ahead for research, education and practice in mental health

The future of occupational therapy in mental health has been a topic of reflection and debate. The Education and Research Board (now the Education and Practice Board) of the College of Occupational Therapists created a Working Group to develop a position paper on the way ahead for research, education and practice in mental health. Following consultation, the Working Group reviewed literature, examined current research and surveyed practitioners, managers and educators. From these findings, recommendations have been made which will lead to a firmer evidence base for the practice of occupational therapy in mental health, leading to a more effective use of the expertise of occupational therapists and an improved service for users

Magnetic nanowires as permanent magnet materials

We present the fabrication of metallic magnetic nanowires using a low temperature chemical process. We show that pressed powders and magnetically oriented samples exhibit a very high coercivity (6.5 kOe at 140 K and 4.8 kOe at 300 K). We discuss the magnetic properties of these metamaterials and show that they have the suitable properties to realize "high temperature magnets" competitive with AlNiCo or SmCo permanent magnets. They could also be used as recording media for high density magnetic recording.Comment: 5 pages, 5 figure

Enhancement of the Benjamin-Feir instability with dissipation

It is shown that there is an overlooked mechanism whereby some kinds of dissipation can enhance the Benjamin-Feir instability of water waves. This observation is new, and although it is counterintuitive, it is due to the fact that the Benjamin-Feir instability involves the collision of modes with opposite energy sign (relative to the carrier wave), and it is the negative energy perturbations which are enhanced.Comment: 15 pages, 2 figures To download more papers, go to http://www.cmla.ens-cachan.fr/~dias. Physics of Fluids (2007) to appea