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

Ethics, occupational therapy and discharge planning: four broken principles

Occupational therapists play a significant role in the discharge process and are often exposed to ethically challenging decision-making. This paper examines the moral basis of discharge planning, relating it to the four fundamental bio-ethical principles of respect for autonomy, beneficence, non-maleficence and justice. Using a case study design, data was collected from 10 occupational therapists and two elder care patients using the critical incident approach, as part of a wider study to determine their perceptions of discharge planning and multidisciplinary teamwork. Direct observation of interaction within multidisciplinary teams was also undertaken. The findings from the research suggest that occupational therapists are unintentionally breaching these four principles and therefore their code of ethics and professional conduct. It is suggested that further research is needed to determine how occupational therapists overcome these challenges. Furthermore, this research has important implications for education establishments regarding the teaching of ethics to occupational therapists

Do all health and social care professionals interact equally: A study of interactions in multidisciplinary teams in the United Kingdom.

Problems around deficits in interprofessional collaboration have been identified since the National Health Service (NHS) was introduced. It is within the context of the current policy focus on improving collaborative working that this study was undertaken. A direct observational study using the Bales’ Interaction Process Analysis tool was carried out in two older persons teams to explore patterns of interaction in the multidisciplinary team meetings. Analysis revealed some key differences in the way in which different professions interacted. Occupational therapists, physiotherapists, social workers (SW) and nurses rarely asked for opinions and for orientation. The consultant (the individual in charge of the medical team) tended to have high rates for asking for orientation, giving opinions and giving orientation. Although some nurses did have high individual rates for the giving of orientation. The data from the research has highlighted that therapists, SWs and nurses are reluctance to voice their opinions in multidisciplinary teams and thus conformity may dominate its culture. It is suggested that therapists, SWs and nurses need to cite their opinions in teams more effectively if they are to be competent and committed patient-centred practitioners

Perceptions of Black and Minoritised Ethnic (BME) Occupational Therapists experiences on mentoring

Introduction: Mentorship is perceived as a mechanism to enhance career progression. Within occupational therapy, there is little research to demonstrate the effectiveness of mentoring on career success and no research has explored its relevance for black and minoritised ethnic (BME) occupational therapists. This research explored the experience of mentoring for career progression from a BME perspective using a survey. Methods: An online survey was conducted with occupational therapists in the United Kingdom who identified as BME. The primary recruitment method was a convenience sample via a BME network and through its other links. Content analysis and descriptive statistics were used to analyse and report the data. Findings: In all, 54 BME occupational therapists completed the survey. Most BME therapists had never requested a BME mentor, but most wanted a BME mentor. Active allyship was viewed as an important part of mentorship when mentored by a white therapist. Conclusion: This research is the first study in occupational therapy to examine the mentoring experiences and needs of BME therapists. It is a call for action to recognise and reorient the approach and understanding of the structures and experiences of BME mentorship

Making a difference: Belonging, diversity and inclusion in occupational therapy

Over the past year, COVID-19 has been causing death and adding to grief across the world; during this time, an equally important issue – #blacklivesmatter – has been filling our minds and awakening our hearts to confront misery, enable equity and champion social justice. The events unfolding globally have provided a space for what have been difficult conversations to begin in the occupational therapy profession. The purpose of this editorial is twofold: First, to share conversations with occupational therapists (OTs) in the United Kingdom, around racism, support for ethnic minorities and career progression; Second, to stimulate debate and dialogue with the wider occupational therapy profession alongside multi-professional groups. Individuals, teams and organisations often discuss conversation regarding equality and diversity, but they are seldom spoken of as race and race-based discrimination or societal equality

Understanding the difference, makes the difference: perceptions of Black and Minoritised ethnic occupational therapists on mentoring

Introduction Black and Minoritised Ethnicity (BME) occupational therapists face lower career progression opportunities and mentoring is one possible intervention that may offer support. BME persons may have different expectations and experiences from their mentor, and research exploring their perceptions of mentoring is important. In Occupational Therapy there is a growing awareness of the need to be true to the values of social justice. The aim of this research is to learn about BME occupational therapists’ experiences and perceptions of mentoring for career progression. Methods Four online focus groups involving 19 participants from the UK were held, discussions were facilitated by researchers using a topic guide. Participants responses were analysed, and codes were brought together to create Themes including career progression and role models, mentoring relationship, similarity with the mentor and outcomes from mentoring. Results The study highlighted that trust is integral to effective mentoring relationships and BME occupational therapists want mentors who they can trust with their experiences and stories. Compatibility between mentors and mentees in terms of personality, values, and working styles is crucial for effective mentoring relationships. Providing opportunities for networking, acknowledging good work and giving permission were all seen as outcomes from good mentoring. The absence of BME role models and ingroup bias were also reported as issues to be addressed. Conclusion This study explores the perception of mentorship as a mechanism for career advancement in occupational therapists from BME backgrounds, with these results transferable to other health and care professional groups. We recommend the creation of a mentoring charter for BME healthcare workers in the United Kingdom to ensure that those from BME backgrounds feel supported, mentored, and provided with equitable access to resources, including adequate mentoring and networking opportunitie

How to design and set up a clinical trial part 1 : the research question

Data from clinical trials involving human participants are essential in establishing an evidence base about the safety and effectiveness of our treatments. This first article describes the steps involved in designing and setting up a clinical trial, from establishing the research question(s) to searching the literature. Acquiring some knowledge about how to set up a clinical trial will allow the conscientious clinician to use the most relevant information to provide the highest possible standards of clinical care for his/her patients. CPD/Clinical Relevance: Even if a clinician is not, has never been, nor is ever planning to be involved in research, he/she should understand and be able to interpret the data from clinical trials

Polio survivors' perceptions of the meaning of quality of life and strategies used to promote participation in everyday activitie

INTRODUCTION: The term 'post-polio syndrome' (PPS) is used to describe new and late manifestations of poliomyelitis that occur later in life. Research in this area has focused upon health status rather than its effect on quality of life. AIM: To gain an in-depth understanding of the meaning of quality of life for polio survivors and to determine the type of strategies that are used by people with PPS and the support that they consider as important to facilitate participation in everyday life activities that have an impact on their quality of life. METHOD: Six focus groups were conducted with 51 participants from two regions in England. Data were audio-taped and analysed using thematic analysis. RESULTS: Our research found that polio survivors used terms used to describe quality of life which could be associated with that of happiness. Our research has identified resolvable factors that influence quality of life namely inaccessible environments, attitudes of health-care professionals and societal attitudes. Polio survivors have tried alternative therapies, chiefly acupuncture and massage, and found them to be effective in enhancing their quality of life. CONCLUSION: It is suggested that health-care professionals should consider factors which influence happiness and implement a person-centred approach with the views of the polio survivor being listened to. The three factors that influenced quality of life could be resolved by health-care professionals and by society. With regard to strategies used, we suggest that polio survivors should have access to the treatments that they perceive as important, although further research is required to design optimal interventions for this client group

Effect of food and temperature on the development and silk production of Bombyx mori Linnaeus (Lepidoptera: Bombycidae).

Larven von Bombyx mori Linnaeus wurden mit verschiedenartiger Nahrung bei unterschiedlichen Temperaturen aufgezogen. Es wurde festgestellt, daß die Entwicklung bei 30°C am schnellsten und bei 20°C am langsamsten verlief, daß aber die ausgereiften Larven und Puppen bei 25°C am meisten wogen. Der Wassergehalt der gezogenen Puppen war bei 20°C höher als bei den beiden anderen Temperaturen. Auf Blättern von Maulbeersämlingen gezogene Larven entwickelten sich schneller als auf Blättern von gepfropften Varietäten gezogene. Die Puppenperiode war jedoch bei der ersteren Nahrung länger als bei der letzteren. Die langsamere Larvenentwicklung auf den gepfropften Varietäten war mit geringerem Larven- und Puppengewicht verbunden. Unabhängig von der Temperatur und der Güte der Nahrung waren Larven und Puppen von Weibchen immer schwerer als von Männchen. Die Überlebensquote der Raupen war bei 30°C niedriger als bei 20°C oder 25°C. Sie war ferner bei gepfropftem M. alba niedriger als bei jeder anderen Nahrung. Die Seidenproduktion der Raupen war bei 25°C am höchsten und bei 30°C am geringsten. Wenn die Larven auf Blättern von Maulbeersämlingen gezogen wurden, erzeugten sie mehr Seide als bei Aufzucht auf Blättern der gepfropften Varietäten. Weibliche Raupen erzeugten stets schwerere grüne Kokons als männliche. Die Seidenhülsen der schwereren weiblichen Kokons wogen jedoch nicht mehr als die der leichteren männlichen Kokons, außer bei der ungünstigen Temperatur von 30°C bei Nahrung von Sämlingen. Die Insekten legten die größte Anzahl von Eiern, wenn sie bei 25°C gezogen wurden, und die geringste Anzahl bei 30°C. Das Gewicht der Larven und Puppen bei 20°C unterschied sich nicht von dem bei 30°C, aber die bei 30°C geringere Fruchtbarkeit als bei 20°C hängt eindeutig damit zusammen, daß das Leben der Motten bei der ersteren Temperatur kürzer ist als bei der letzteren. Auf Blättern von Maulbeersämlingen gezogene Insekten legten signifikant mehr Eier als auf Blättern von gepfropften Varietäten gezogene. Das Leben im Reifestadium war auf gepfropftem M. alba kürzer als bei jeder anderen Nahrung. Im allgemeinen lebten die Männchen länger als die Weibchen.Larvae of Bambyx mari Linnaeus were reared on food of different qualities at different temperatures. - It was found that although the rate of development was highest at 30°C and lowest at 20°C, mature larvae and pupae weighed more at 25°C. Water content of pupae reared at 20°C was higher than that at the other two temperatures. Larvae reared on leaves from seedling varieties of mulbeny developed more quickly than those reared on leaves from grafted varieties. The pupal period, however, was longer on the former than on the latter food. The lower rate of larval development on grafted varieties was associated with decreased larval and pupal weights. Irrespective of temperature and quality of food, larvae and pupae of females were always heavier than those of males. The rate of survival among caterpillars was lower at 30°C than at 20°C or 25°C. It was also lower on grafted M. alba than on any other food. Silk production by caterpillars was highest at 25°C and lowest at 30°C. When larvae were reared on leaves from seedling varieties of mulberry, they produced more silk than those reared on leaves from graf ted varieties. Female caterpillars always produced heavier green cocoons than males. Silk shells from heavier female cocoons, however, did not weigh more chan those from lighter male cocoons, except at the unfavourable temperature of 30°C on seedling foods. Insects laid the highest number of eggs when reared at 25°C and the smallest number at 30°C. There was no difference in larval and pupal weights at 20°C and 30°C, but lower fecundity at 30°C than at 20°C was definitely associated with the fact that the life of the moths was shorter at the former than at the latter temperature. Insects reared on leaves from seedling mulberry laid significantly more eggs than those reared on leaves from grafted varieties. Adult life was shorter on grafted M. alba than on any other food. Generally the males lived longer than the females

Food activities and identity maintenance among community-living older adults: A grounded theory study

OBJECTIVE. Engaging in food activities and maintaining identity are each important for productive aging. This study explored the role of food activities in identity maintenance among community-living older adults. METHOD. We used a grounded theory approach to analyze data collected in semistructured interviews with 39 predominantly White, British older adults living in West London. RESULTS. Two lifelong food identities "food lover" and "nonfoodie" were maintained in the processes of participation and maintenance and threat and compensation. The process change in meaning and identity explained the development of a third food identity"not bothered" when participants experienced being alone at the table, deteriorating health, and worry about the cost of food. CONCLUSION. Food activities that are a pleasurable and important part of daily life contribute to the maintenance of important identities and mental well-being in older adults.British Geriatrics Society/Dunhill Medical Trust Research Fellowship held by the first autho