Subtle Realism and Occupational Therapy: an Alternative Approach to Knowledge Generation and Evaluation

Occupational therapists are increasingly engaging in research. As this occurs, important and challenging questions are being asked about the most appropriate research approaches to use. Strongly held perspectives of what best constitutes evidence often conflict with influential hierarchies of research. The British Journal of Occupational Therapy has, in recent years, published a variety of papers and letters that have presented and defended effectively the differing perspectives of research approaches. Each of these has presented challenges to occupational therapy research. This opinion piece supports a combinist approach to research. It presents and defends such an approach from a subtle realist perspective

Factors that constitute a good cognitive behavioural treatment manual: A Delphi study

Cognitive behavioural treatment manuals have increased in frequency, purpose and impact over the last 40 years. Despite numerous papers on the topic, few empirical studies regarding the constitution of treatment manuals have been conducted. A Delphi study examining the factors that constitute a good cognitive behavioural treatment manual is presented. This study generated a consensus of opinion of factors that therapists and researchers should consider when developing and appraising treatment manuals for cognitive behavioural interventions. Limitations of the study and the potential relevance of the research are discussed

“100 Years of University Nursing Education”: The Significance of a Baccalaureate Nursing Degree and Its Public Health Origins for Nursing Now

Abstract The 100-year milestone of university nursing education at the University of British Columbia (UBC) in 2019 offers a pause for reflection and inquiry. History assists us to illuminate current issues and debates in light of past events. An examination of the legacy of Ethel Johns and others who held the vision of why nursing education should enter the university in 1919 sheds light on its historical significance, then and now. The first Director, Ethel Johns, referred to the establishment of the University of British Columbia Department of Nursing and the degree program it offered as “the experiment” (Johns, 1936). Reflections on “the experiment” provides a standpoint to consider how this courageous and visionary leader might have viewed the way “the experiment” is faring within the 21st century landscape of Canadian university nursing education. This reflection on the history of university nursing education and its public health origins is all the more pressing in the World Health Organization (WHO) declared International Year of the Nurse and the Midwife and, unprecedented over the last century, the emergence of a global COVID-19 pandemic and related public health crisis. The initiation of university education in 1919 was in part spurred by the Influenza epidemic of 1918 amidst a realization of the need for a breadth and depth of nursing education in public health and leadership, which was argued to be best situated within the regular post-secondary education system. We contend that this reflection is once again needed in nursing education programs. We offer a critique of how the pandemic of 2020 can illuminate current shortcomings in the baccalaureate preparation of nurses. The present context of the pandemic might prompt efforts to ensure nursing capacity is sufficient to engage with a public health crisis and provide the leadership – needed now, as it was then. Résumé Les 100 ans de formation universitaire en sciences infirmières à la University of British Columbia (UBC) en 2019 ont permis un temps de pause pour une réflexion et une évaluation. L’histoire nous aide à éclairer les problèmes et les débats actuels à la lumière des évènements passés. Un examen de l’héritage d’Ethel Johns et d’autres qui ont partagé une vision de la raison pour laquelle la formation en sciences infirmières devrait être offerte à l’université en 1919 fait la lumière sur son importance historique passée et présente. La première directrice, Ethel Johns, fait référence à la création du département des sciences infirmières de la University of British Columbia et le programme alors offert comme étant « l’expérience » (Johns, 1936). Les réflexions sur « l’expérience » offrent un point de vue pour considérer comment cette chef de file courageuse et visionnaire pourrait avoir vu la façon dont « l’expérience » se porte dans le contexte de la formation en sciences infirmières dans les universités canadiennes au 21e siècle. Cette réflexion sur l’histoire de la formation universitaire en sciences infirmières et ses origines de santé publique est d’autant plus pressante depuis que l’Organisation mondiale de la Santé (OMS) a déclaré cette année comme l’Année internationale des sages-femmes et du personnel infirmier, et suite à l’émergence d’une pandémie mondiale de COVID-19 et la crise de santé publique qui y est liée. Le commencement de la formation universitaire en 1919 a été en partie stimulée par l’épidémie de grippe de 1918 et la constatation du besoin d’une formation en sciences infirmières en santé publique et leadership, dont le meilleur endroit a été déterminé comme étant dans le système régulier d’études supérieures. Nous maintenons que cette réflexion est nécessaire une fois de plus dans les programmes de formation en sciences infirmières. Nous offrons une critique de la façon dont la pandémie de 2020 peut éclaircir les lacunes actuelles dans la préparation des infirmières au baccalauréat. Le contexte actuel de la pandémie pourrait susciter des efforts pour s’assurer que la capacité des services infirmiers est suffisante pour gérer une crise de santé publique et offrir le leadership qui est maintenant nécessaire, comme il l’a été à cette époque

Environmental pollutants from the Scott and Shackleton expeditions during the ‘Heroic Age’ of Antarctic exploration

Early explorers to Antarctica built wooden huts and brought huge quantities of supplies and equipment to support their geographical and scientific studies for several years. When the expeditions ended and relief ships arrived, a rapid exodus frequently allowed only essential items to be taken north. The huts and thousands of items were left behind. Fuel depots with unused containers of petroleum products, asbestos materials, and diverse chemicals were also left at the huts. This investigation found high concentrations of polyaromatic hydrocarbons in soils under and around the historic fuel depots, including anthracene, benzo[b]fluoranthene, benzo[k]fluoranthene, chrysene, fluorene, and pyrene, as well as benzo[a]anthracene, benzo[a]pyrene, and fluoranthene, which are recognized carcinogens. Asbestos materials within the huts have been identified and extensive amounts of fragmented asbestos were found littering the ground around the Cape Evans hut. These materials are continually abraded and fragmented as tourists walk over them and the coarse scoria breaks and grinds down the materials. A chemical spill, within the Cape Evans hut, apparently from caustic substances from one of the scientific experiments, has caused an unusual deterioration and defibration on affected woods. Although these areas are important historic sites protected by international treaties, the hazardous waste materials left by the early explorers should be removed and remedial action taken to restore the site to as pristine a condition as possible. Recommendations are discussed for international efforts to study and clean up these areas, where the earliest environmental pollution in Antarctica was produced

The involvement/exclusion paradox of spontaneous volunteering:new lessons from winter flood episodes in England

This article focuses on the involvement and management of spontaneous volunteers (SVs). It develops a new theory—which we call the “involvement/exclusion” paradox—about a situation which is frequently manifested when SVs converge in times of disaster. After reviewing research and policy guidance relating to spontaneous volunteering, we present findings from a study of responses to winter flood episodes in England. Taking together the empirical findings and the literature, the article analyzes elements inherent in the involvement/exclusion paradox and develops a conceptual model to illustrate and explain the paradox. Implications for managers and future research are discussed

Screening fungi isolated from historic Discovery Hut on Ross Island, Antarctica for cellulose degradation

To survive in Antarctica, early explorers of Antarctica's Heroic Age erected wooden buildings and brought in large quantities of supplies. The introduction of wood and other organic materials may have provided new nutrient sources for fungi that were indigenous to Antarctica or were brought in with the materials. From 30 samples taken from Discovery Hut, 156 filamentous fungi were isolated on selective media. Of these, 108 were screened for hydrolytic activity on carboxymethyl cellulose, of which 29 demonstrated activities. Endo-1, 4-β-glucanase activity was confirmed in the extracellular supernatant from seven isolates when grown at 4°C, and also when they were grown at 15°C. Cladosporium oxysporum and Geomyces sp. were shown to grow on a variety of synthetic cellulose substrates and to use cellulose as a nutrient source at temperate and cold temperatures. The research findings from the present study demonstrate that Antarctic filamentous fungi isolated from a variety of substrates (wood, straw, and food stuffs) are capable of cellulose degradation and can grow well at low temperatures

Attitudes of small animal practitioners toward participation in veterinary clinical trials

To determine attitudes of small animal practitioners toward veterinary clinical trials and variables influencing their likelihood of participating in such trials

Pain sensitivity differs between dog breeds but not in the way veterinarians believe

BackgroundVeterinarians hold distinct breed-specific pain sensitivity beliefs that differ from the general public but are highly consistent with one another. This is remarkable as there is no current scientific evidence for biological differences in pain sensitivity across dog breeds. Therefore, the present study evaluated whether pain sensitivity thresholds differ across a set of dog breeds and, if so, whether veterinarians’ pain sensitivity ratings explain these differences or whether these ratings are attributed to behavioral characteristics.MethodsPain sensitivity thresholds [using quantitative sensory testing (QST) methods] and canine behaviors (using owner questionnaires and emotional reactivity tests) were prospectively measured across selected dog breeds. Adult, healthy dogs from 10 dog breeds/breed types were recruited, representing breeds subjectively rated by veterinarians as high (chihuahua, German shepherd, Maltese, Siberian husky), average (border collie, Boston terrier, Jack Russell terrier), or low (golden retriever, pitbull, Labrador retriever) pain sensitivity. A final sample of 149 dogs was included in statistical analyses.ResultsVeterinarians’ pain sensitivity ratings provided a minimal explanation for pain sensitivity thresholds measured using QST in dogs; however, dog breeds did differ in their pain sensitivity thresholds across the QST methods evaluated. Breed differences were observed for some aspects of emotional reactivity tests; however, these behavioral differences did not explain the differences in pain sensitivity thresholds found. Veterinarians’ pain sensitivity ratings were positively associated with dog approach scores for the disgruntled stranger test suggesting that the way dogs greet strangers may be a factor influencing veterinarians’ ratings of pain sensitivity across dog breeds.Conclusions and clinical relevanceOverall, these findings highlight a need to investigate biological mechanisms that may explain breed differences in pain sensitivity because this may inform pain management recommendations. Further, future research should focus on when and how these breed-specific pain sensitivity beliefs developed in veterinarians, as veterinarians’ beliefs could impact the recognition and treatment of pain for canine patients

Non-prescription medicine misuse, abuse and dependence : a cross-sectional survey of the UK general population

BACKGROUND: Non-prescription medicines (NPMs) can be misused, abused or lead to dependence, but the prevalence of these problems within the UK general population was unknown. The aim of this study was to estimate the prevalence of self-reported misuse, abuse and dependence to NPMs.METHODS: A cross-sectional postal survey was sent to 1000 individuals aged ≥18 randomly drawn from the UK Edited Electoral Register.RESULTS: A response rate of 43.4% was achieved. The lifetime prevalence of NPM misuse was 19.3%. Lifetime prevalence of abuse was 4.1%. Younger age, having a long-standing illness requiring regular NPM use and ever having used illicit drugs or legal highs were predictive of misuse/abuse of NPMs. In terms of dependence, lifetime prevalence was 2% with 0.8% currently dependent and 1.3% dependent in the past. Dependence was reported with analgesics (with and without codeine), sleep aids and nicotine products.CONCLUSION: Given the increasing emphasis on self-care and empowering the public to manage their health with NPMs, the findings highlight the need for improved pharmacovigilance of these medicines to maximize benefits with minimal risk. Healthcare providers need to be aware of the potential for misuse, abuse and dependence, particularly in patients with long-term illness

Airway glucose concentrations and effect on growth of respiratory pathogens in cystic fibrosis

AbstractBackgroundPulmonary decline accelerates in cystic fibrosis-related diabetes (CFRD) proportional to severity of glucose intolerance, but mechanisms are unclear. In people without CF, airway glucose (AG) concentrations are elevated when blood glucose (BG)≥8 mmol L−1 (airway threshold), and are associated with acquisition of respiratory infection.MethodsTo determine the relationship between BG and AG, 40 CF patients underwent paired BG and AG (nasal) measurements. Daily time with BG>airway threshold was compared in 10 CFRD, 10 CF patients with normal glucose tolerance (CF-NGT) and 10 healthy volunteers by continuous BG monitoring. The effect of glucose at airway concentrations on bacterial growth was determined in vitro by optical densitometry.ResultsAG was present more frequently (85%-vs.-19%, p<0.0001) and at higher concentrations (0.5–3 mmol L−1-vs.-0.5–1 mmol L−1, p<0.0001) when BG was ≥8 mmol L−1-vs.-<8 mmol L−1. Daily time with BG≥8 mmol L−1 was CFRD (49±25%), CF-NGT (6±5%), healthy volunteers (1±3%), p<0.0001. Staphylococcus aureus growth increased at ≥0.5 mmol L−1 (p=0.006) and Pseudomonas aeruginosa growth above 1–4 mmol L−1 glucose (p=0.039).ConclusionsBG≥8 mmol L−1 predicted elevated AG concentrations in CF, at least in nasal secretions. CFRD patients spent ∼ 50% day with BG>airway threshold, implying persistently elevated AG concentrations. Further studies are required to determine whether elevated airway glucose concentrations contribute to accelerated pulmonary decline in CFRD