Occupational balance: What tips the scales for new students?

The open question, ‘What prevents you from reaching occupational balance?’, was posed within a questionnaire aimed at exploring the meanings of occupation, health and wellbeing with a cohort of first-year occupational therapy students during their initial few weeks at university. Their written responses to the question about occupational balance were analysed and are discussed in this paper. Not surprisingly, occupational balance appeared to be achieved by only a few and more by chance than design. People, time and money factors were identified as the main impediments to achieving occupational balance, with psychological and emotional pressures being at the forefront. Interestingly, despite these barriers, the overall educational benefit of considering the occupational balance question in this way raised the students’ awareness of its relationship to health and wellbeing. This increased awareness might have longer-term health benefits, both personally and professionally, which would be worthy of further research

Using historical documentary methods to explore the history of occupational therapy

peer-reviewed.Introduction: Historical research can benefit health professions by providing a basis for understanding how current beliefs and practices developed over time. From an occupational therapy perspective, a need for deeper critical understandings of the profession has been identified; historical research can facilitate this process. Documentary research is a significant methodology in historical inquiry, but there is a dearth of guidance for occupational therapists wishing to employ this method. Method: A conceptual literature review was conducted to describe how to use documentary sources to understand the development of the profession, drawing on literature from the disciplines of history and occupational therapy. Results: The stages of historical documentary research are described: choosing a topic, sourcing and selecting evidence, and managing sources. How to consider the authenticity, credibility and representativeness of historical material is discussed. Various means to determine the meaning of historical evidence are considered, with chronological, thematic and theoretical approaches proposed. Conclusion: Methodological transparency is central to the process of historical documentary research. To enhance understanding of the quality of historical source material, adoption of the guidelines outlined is recommended. Adopting a clearly defined questioning perspective promotes more substantial conclusions and professional understandingspeer-reviewe

Collaborative research exploring mental health service user perspectives on acute inpatient occupational therapy

Introduction:User perspectives are important for understanding why people engage with occupational therapy during an admission for acute mental health issues, and can be used to inform service provision and development. Method: Twenty-two recent and current inpatients participated in six semi-structured individual interviews and three focus groups. Data from the two methods were initially subject to separate thematic analysis. Then a further stage of constant comparative analysis, of both data sets, generated the findings presented here. Findings: Three themes were identified: (1) ‘A tiny sort of world’ expressed experiences of being restricted; (2) ‘Relief’ indicated how occupational therapy offered relief from the ward and experiences of mental ill-health; and (3) ‘Something to do’ suggested specific purposes for engaging in occupation. These themes indicate how service users experience and value occupational therapy for different reasons at different times. The approach of occupational therapists to service users, valuing them as occupational beings, is a key aspect of their experience. Conclusion: The profession is challenged to design flexible opportunities for occupational engagement which simultaneously provide relief and distraction, address diverse occupational needs, and are feasible within the resource restrictions of acute mental health services

The Lived Experience of People with Mental Health and Substance Misuse Problems: Dimensions of Belonging

Introduction: People with co-occurring mental health and substance misuse problems are among the most excluded in society. A need to feel connected to others has been articulated in the occupational science literature although the concept of belonging itself has not been extensively explored within this paradigm. This paper reports findings from research that explored the meaning and experience of belonging for four people living with dual diagnosis in the United Kingdom. Method: Researchers employed an interpretative phenomenological approach to the study. Four semi-structured interviews were carried out. The interviews were guided by questions around the meaning of belonging, barriers to belonging and how belonging and not belonging impacted on participants’ lives. Data analysis facilitated the identification of themes across individual accounts and enabled comparisons. Findings: Data analysis identified four themes – belonging in family, belonging in place, embodied understandings of belonging and barriers to belonging. Conclusion: The findings add further insights into the mutable nature of belonging. A link between sense of belonging and attachment theory has been proposed, along with a way to understand the changeable and dependent nature of belonging through ‘dimensions of belonging’

Immune complex formation impairs the elimination of solutes from the brain: implications for immunotherapy in Alzheimer's disease

Background: Basement membranes in the walls of cerebral capillaries and arteries form a major lymphatic drainage pathway for fluid and solutes from the brain. Amyloid-β (Aβ) draining from the brain is deposited in such perivascular pathways as cerebral amyloid angiopathy (CAA) in Alzheimer's disease (AD). CAA increases in severity when Aβ is removed from the brain parenchyma by immunotherapy for AD. In this study we investigated the consequences of immune complexes in artery walls upon drainage of solutes similar to soluble Aβ. We tested the hypothesis that, following active immunization with ovalbumin, immune complexes form within the walls of cerebral arteries and impair the perivascular drainage of solutes from the brain. Mice were immunized against ovalbumin and then challenged by intracerebral microinjection of ovalbumin. Perivascular drainage of solutes was quantified following intracerebral microinjection of soluble fluorescent 3kDa dextran into the brain at different time intervals after intracerebral challenge with ovalbumin. Results: Ovalbumin, IgG and complement C3 co-localized in basement membranes of artery walls 24 hrs after challenge with antigen; this was associated with significantly reduced drainage of dextran in immunized mice. Conclusions: Perivascular drainage along artery walls returned to normal by 7 days. These results indicate that immune complexes form in association with basement membranes of cerebral arteries and interfere transiently with perivascular drainage of solutes from the brain. Immune complexes formed during immunotherapy for AD may similarly impair perivascular drainage of soluble Aβ and increase severity of CAA

Do Characteristics of Faces That Convey Trustworthiness and Dominance Underlie Perceptions of Criminality?

BACKGROUND: This study tested whether the 2D face evaluation model proposed by Oosterhof and Todorov can parsimoniously account for why some faces are perceived as more criminal-looking than others. The 2D model proposes that trust and dominance are spontaneously evaluated from features of faces. These evaluations have adaptive significance from an evolutionary standpoint because they indicate whether someone should be approached or avoided. METHOD: Participants rated the emotional state, personality traits, and criminal appearance of faces shown in photographs. The photographs were of males and females taken under naturalistic conditions (i.e., police mugshots) and highly controlled conditions. In the controlled photographs, the emotion display of the actor was systematically varied (happy expression, emotionally neutral expression, or angry expression). RESULTS: Both male and female faces rated high in criminal appearance were perceived as less trustworthy and more dominant in police mugshots as well as in photographs taken under highly controlled conditions. Additionally, emotionally neutral faces were deemed as less trustworthy if they were perceived as angry, and more dominant if they were morphologically mature. Systematically varying emotion displays also affected criminality ratings, with angry faces perceived as the most criminal, followed by neutral faces and then happy faces. CONCLUSION: The 2D model parsimoniously accounts for criminality perceptions. This study extends past research by demonstrating that morphological features that signal high dominance and low trustworthiness can also signal high criminality. Spontaneous evaluations regarding criminal propensity may have adaptive value in that they may help us to avoid someone who is physically threatening. On the other hand, such evaluations could inappropriately influence decision making in criminal identification lineups. Hence, additional research is needed to discover whether and how people can avoid making evaluations regarding criminality from a person's facial appearance

Expressing care in narratives about occupations

Introduction: Engagement in occupations impacts on wellbeing, but this relationship needs to be better understood by occupational therapists. A focus on the meanings of occupations, rather then their purpose, might help further this understanding. Being meaningful, an occupation enables the individual to participate in society in a way that reflects personal and societal values. This paper explores how people can express personal values and caring in the narratives that they tell about leisure occupations. Method: Seventeen serious leisure enthusiasts were interviewed and encouraged to talk about their chosen occupation. Narratives were extracted from the transcripts and analysed, giving attention to content, structure and interaction. Those narratives that appeared to have a meaning associated with caring were examined further in order to establish the types of caring that they revealed. Findings: Thirty-one narratives were found to have a meaning associated with values or caring, relating either to a moral struggle, caring close to home or caring further afield. Conclusion: For some individuals, the meaningfulness of their leisure occupations lies, in part, in using them as a vehicle to express care towards themself, towards others or towards the environment. This has implications for the uses of occupations in therapy

Community participation and recovery for mental health service users: An action research inquiry

Introduction: The social inclusion of individuals with mental health problems is an issue for mental health services, for the individuals who experience stigma, discrimination and exclusion, and for society at large. To develop community-orientated services that are capable of promoting inclusion it will, therefore, be advantageous to all parties to understand what service users find most helpful. Method: A 2-year action research project explored the recovery journeys of a group of assertive outreach service users who had progressed from being socially excluded and occupationally deprived to being participants in their local communities. The research aimed to understand how these outcomes were produced and to use this knowledge to inform local service development. Findings: This paper focuses on eight qualitative interviews, where service users recounted their stories of community participation and inclusion. The findings show how assertive outreach practitioners harnessed occupation as a basis for building relationships between practitioners and service users, and how this became a conduit towards participation in the mainstream community. Conclusion: Facilitating engagement in community-based occupations through creative collaboration helped participants reconnect with cherished roles, achieve long-standing goals and develop feelings of self-efficacy, belonging and wellbeing.© The College of Occupational Therapists Ltd

Enacting social transformation through occupation: A narrative literature review

Background: In occupational therapy and occupational science there is a drive to confront social and health injustices through occupation-based practices with social transformation as a goal. However, scholars acknowledge a lack of theory to support this developing area of practice. Aim: To explore how occupations have been used to enact social transformation for disadvantaged communities and to elucidate socially transformative outcomes. Methods: A narrative literature review was carried out, focussing specifically on arts-based occupations, using seven databases. Thirty-eight items were included. Results: Three overarching themes emerged: experiences related to giving voice; levels of change and arts-based occupations influence social change. Conclusions: Art forms as a means of expression can support people to make demands for change. This was true whether the art form was adopted at grass roots level, or via formalized projects run by researchers or Non-Government Organizations. Whilst personal change and small scale social change outcomes were achievable, larger scale structural change was not evident. Unintended outcomes in the form of risks to participants were reported. How and why change came about was not clearly articulated; leaving a need for further exploration of the mechanisms and contexts supporting change in the growing field of social transformation through occupation

The Winchcombe meteorite, a unique and pristine witness from the outer solar system.

Direct links between carbonaceous chondrites and their parent bodies in the solar system are rare. The Winchcombe meteorite is the most accurately recorded carbonaceous chondrite fall. Its pre-atmospheric orbit and cosmic-ray exposure age confirm that it arrived on Earth shortly after ejection from a primitive asteroid. Recovered only hours after falling, the composition of the Winchcombe meteorite is largely unmodified by the terrestrial environment. It contains abundant hydrated silicates formed during fluid-rock reactions, and carbon- and nitrogen-bearing organic matter including soluble protein amino acids. The near-pristine hydrogen isotopic composition of the Winchcombe meteorite is comparable to the terrestrial hydrosphere, providing further evidence that volatile-rich carbonaceous asteroids played an important role in the origin of Earth's water