Showing papers on "Occupational therapy published in 2004"

Effects of Augmented Exercise Therapy Time After Stroke A Meta-Analysis

Abstract: Background and Purpose— To present a systematic review of studies that addresses the effects of intensity of augmented exercise therapy time (AETT) on activities of daily living (ADL), walking, and dexterity in patients with stroke. Summary of Review— A database of articles published from 1966 to November 2003 was compiled from MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, PEDro, DARE, and PiCarta using combinations of the following key words: stroke, cerebrovascular disorders, physical therapy, physiotherapy, occupational therapy, exercise therapy, rehabilitation, intensity, dose–response relationship, effectiveness, and randomized controlled trial. References presented in relevant publications were examined as well as abstracts in proceedings. Studies that satisfied the following selection criteria were included: (1) patients had a diagnosis of stroke; (2) effects of intensity of exercise training were investigated; and (3) design of the study was a randomized controlled trial (RCT). ...

The Canadian Occupational Performance Measure: A research and clinical literature review.

Abstract: Backround. It has been 13 years since the Canadian Occupational Performance Measure (COPM) was published. In that time there has been a remarkable growth in its acceptance as an outcome measure within the occupational therapy practice and research. Purpose. The purpose of this paper is to review the emerging research and clinical literature related to the COPM since 1994 and to document its impact upon occupational therapy practice and research throughout the world. Method. A systematic search was conducted to the professional and research literature in English publications (primarily occupational therapy). Eighty-eight papers that met the inclusion criteria were reviewed, 86% of which examined the COPM in relation to its psychometric properties (19 papers), research outcomes (33 papers) or practice (33 papers). Results. Overall, although there are a few limitations discussed in the review, the conclusion is that the COPM is a valid, reliable, clinically useful and responsive outcome measure acceptable fo...

Dimensions of Meaning in the Occupations of Daily Life

Abstract: Background According to the existential philosophers, meaning, purpose and choice are necessary for quality of life. Qualitative researchers exploring the perspectives of people who have experienced health crises have also identified the need for meaning, purpose and choice following life disruptions. Although espousing the importance of meaning in occupation, occupational therapy theory has been primarily preoccupied with purposeful occupations and thus appears inadequate to address issues of meaning within people's lives. Purpose This paper proposes that the fundamental orientation of occupational therapy should be the contributions that occupation makes to meaning in people's lives, furthering the suggestion that occupation might be viewed as comprising dimensions of meaning: doing, being, belonging and becoming. Drawing upon perspectives and research from philosophers, social scientists and occupational therapists, this paper will argue for a renewed understanding of occupation in terms of dimensions of meaning rather than as divisible activities of self-care, productivity and leisure. Practice implications Focusing on meaningful, rather than purposeful occupations more closely aligns the profession with its espoused aspiration to enable the enhancement of quality of life.

Occupational justice and client-centred practice: A dialogue in progress

Abstract: Background. This paper describes an ongoing, international dialogue about the relationship between occupation, justice, and client-centred practice, prompted by the question: How do occupational therapists work for justice? Methods. The authors critically reflect on their own dialogue and culturally situated interests, dialogues with workshop participants, and a literature review. Results. Four cases of occupational injustice are proposed: occupational alienation, occupational deprivation, occupational marginalization, and occupational imbalance. The naming of these occupational injustices suggests four occupational rights: to experience meaning and enrichment in one's occupations; to participate in a range of occupations for health and social inclusion; to make choices and share decision-making power in daily life; and to receive equal privileges for diverse participation in occupations. Practice Implications. Since silence implies compliance with the status quo, the authors encourage occupational therap...

Validity of the Canadian Occupational Performance Measure: a client-centred outcome measurement:

Abstract: Objective: To study the convergent and divergent validity of the Canadian Occupational Performance Measure (COPM). Design: Cross-sectional study. Setting: The occupational therapy departments of two university hospitals in Amsterdam. Subjects: One hundred and five consecutive outpatients. Outcome measures: The COPM is a measure of a client's self-perception of occupational performance in the areas of self-care, productivity and leisure. Outcome measures of the COPM are: the client's most important problems in occupational performance and a total score for performance and a total score for satisfaction for these problems. Problems reported in the COPM were compared with the Sickness Impact Profile (SIP68), the Disability and Impact Profile (DIP) and an open-ended question. Results: Complete data were obtained for 99 clients. The identification of occupational performance problems with the COPM surpassed the items reported in the SIP68, the DIP and the open-ended question, which confirms the surplus value of the COPM. Divergent validity was further demonstrated by the low correlation coefficients between the total SIP68 scores and the COPM. Seventy-four per cent of the occupational performance problems reported in the COPM had a corresponding item in the DIP and 49% had a corresponding item in the SIP68. Convergent validity was supported by the fact that 63% of the corresponding problems in the DIP were reported to be a disruption of quality of life and 74% of the corresponding problems in the SIP68 were identified as a disability. Conclusion: The results of this study provide supportive evidence for the convergent and divergent validity of the COPM. The data support the assumption that the COPM provides information that cannot be obtained with current standardized instruments to measure health.

Interprofessional training in the context of clinical practice: goals and students' perceptions on clinical education wards.

Abstract: AIMS: This paper describes the context of interprofessional training on clinical education wards (CEWs) and reports students' perceptions of this type of interprofessional and professional training. CONTEXT: A 2-week interprofessional clinical course was designed for medical students in their surgical eighth term, and nursing, occupational therapy and physiotherapy students, all in their sixth term. Clinical tutors were responsible for the patients and also supervised the students. The goals for the students included: to provide the patients with good medical care, nursing and rehabilitation; to develop their own professional roles; to enhance their level of understanding of the other professions; to stress the importance of good communication for teamwork and for patient care; to enhance understanding of the role of the patient, and to become more aware of ethical aspects of health care. MATERIAL AND METHODS: A questionnaire developed by teachers from the 4 educational departments was used. A total of 962 students responded (78%). RESULTS: The CEWs provided the students with good clinical practice in terms of training in their own professions as well in learning more about the other professions. The importance of good communication for teamwork and for patient care was recognised. The quality of supervision and students' perception of their own professional roles were important factors regarding satisfaction with the CEW course. CONCLUSIONS: The CEW course seemed to provide the students with an opportunity to develop their own professional roles and their functions as team members.

Collaborative learning for collaborative working? Initial findings from a longitudinal study of health and social care students.

Abstract: This paper presents the initial findings from a longitudinal quantitative study of two cohorts of students who entered the 10 pre-qualifying programmes of the Faculty of Health and Social Care, University of the West of England (UWE), Bristol, UK. The overall aim of the study is to explore students' attitudes to collaborative learning and collaborative working, both before and after qualification. On entry to the faculty, 852 students from all 10 programmes completed the UWE Entry Level Interprofessional Questionnaire, which gathered baseline data concerning their self-assessment of communication and teamwork skills, and their attitudes towards interprofessional learning and interprofessional interaction. Comparative analysis of these data was undertaken in terms of demographic variables such as age (i.e. older or younger than 21 years), experience of higher education, prior work experience and choice of professional programme. The results indicate that most students rated their communication and teamwork skills positively, and were favourably inclined towards interprofessional learning, but held negative opinions about interprofessional interaction. Some student groups differed in their responses to some sections of the questionnaire. Mature students, and those with experience of higher education or of working in health or social care settings, displayed relatively negative opinions about interprofessional interaction; social work and occupational therapy students were particularly negative in their responses, even after adjustment for confounding demographic variables. The paper concludes by considering the implications of the findings for interprofessional educational initiatives and for professional practice.

Participation of children with physical disabilities: relationships with diagnosis, physical function, and demographic variables

Abstract: The primary goal of occupational therapy intervention for children with disabilities is enabling participation in the daily activities of childhood. The World Health Organization conceptualizes chronic health conditions and disability as two distinct aspects of health, with the primary concern on the level of health condition being with diagnosis rather than function. Participation, within the International Classification of Functioning, Disability and Health (ICF), is characterized by the interactions between a child, its family, and other personal and environmental factors. Few studies have examined the relationships between diagnosis, function, and participation in children with disabilities. Using the results of a study of the participation of 427 children with physical disabilities in activities outside mandated school, the authors examined the relative influence of diagnostic category on participation. When adjusted for age, sex, and physical function, diagnostic category does not significantly affe...

Occupational therapy for community dwelling elderly people: a systematic review

Abstract: Objective: occupational therapy might play an important role in maintaining independent living for community dwelling elderly people. The aim of this systematic review is to determine whether occupational therapy improves outcome for people who are ≥60 years and are living independently. Methods: an extensive search in MEDLINE, CINAHL, EMBASE, AMED and SCISEARCH until July 2002 was performed. Studies with controlled and uncontrolled designs were included. Six intervention categories were distinguished and individually analysed using a best-evidence synthesis, based on the type of design, the methodological quality, type of outcome measures and statistical significance of findings. Results: 17 studies were included, ten of which were randomised clinical trials. Six randomised clinical trials had a high methodological quality. Strong evidence is present for the efficacy of advising on assistive devices as part of a home hazards assessment on functional ability. There is some evidence for the efficacy of training of skills combined with a home hazard assessment in decreasing the incidence of falls in elderly people at high risk of falling. Some evidence is available for the efficacy of comprehensive occupational therapy on functional ability, social participation and quality of life. Insufficient evidence is present for the efficacy of counselling the primary caregiver of dementia patients about maintaining the patient’s functional abilities. Conclusion: this review shows that occupational therapy interventions for community dwelling elderly people results in positive outcomes. Future research in the efficacy of occupational therapy in elderly patient groups such as people with dementia is recommended. Furthermore, research into tailoring interventions to the needs of elderly patients is recommended.

An integrated undergraduate pain curriculum, based on IASP curricula, for six health science faculties.

Abstract: Pain education, especially for undergraduates, has been identified as important to changing problematic pain practices, yet, no published data were found describing an integrated, interprofessional pain curriculum for undergraduate students. Therefore, this project aimed to develop, implement, and evaluate an integrated pain curriculum, based on the International Association for the Study of Pain curricula [http:// www.iasp-pain.org/curropen.html], for 540 students from six Health Science Faculties/Departments. Over an 18-month period, the University of Toronto Centre for the Study of Pain’s Interfaculty Pain Education Committee developed a 20-h undergraduate pain curriculum to be delivered during a 1-week period. Students from Dentistry, Medicine, Nursing, Pharmacy, Physical Therapy, and Occupational Therapy participated as part of their 2nd or 3rd year program. Teaching strategies included large and small groups, Standardized Patients, and 63 facilitators. Evaluation methods included: (a) pre- and post-tests of the Pain Knowledge and Beliefs Questionnaire (PKBQ) and (b) Daily Content and Process Questionnaire (DCPQ) to obtain feedback about process, content, and format across the curriculum’s 5 days. A significant improvement in pain knowledge and beliefs was demonstrated (t ¼ 181:28; P , 0:001), although non-responders were problematic at the post-test. DCPQ overall ratings of ‘exceeding or meeting expectations’ ranged from 74 to 92%. Ratings were highest for the patient-related content and panel, and the small-group discussions with Standardized Patients. Overall evaluations were positive, and statistically significant changes were demonstrated in students’ pain knowledge and beliefs. This unique and valuable learning opportunity will be repeated with some modifications next year. q 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Occupational balance: exploring the relationships among daily occupations and their influence on well-being.

Abstract: In this lecture, I have reviewed theoretical discussions and definitions of occupational balance, findings from selected studies, and highlighted some methods for measuring aspects of occupational balance. Are any of these ideas directly applicable to occupational therapy practice, education and research? Consider the hassles of everyday life, and add the complicating factors of illness, injury, disability, and limited income. Life, and the pursuit of necessary, desirable and obligatory occupations, can become overwhelming. Given that occupational therapists aim to enable individuals, regardless of ability, to successfully engage in a range of occupations, the answer to the question is yes. Furthering our understanding of occupational balance can improve our ability to serve individual clients and society. In 2001, Fearing stated in her Muriel Driver Memorial Lecture: We will not only recognize and value the skill of maintaining balance, our own and that of our clients, but we will live it. Balance will not be viewed as a set of scales that has equal parts such as work on one side and play on the other but rather the kind of balance that comes from being centred so that we act from a stable base. From that stable base, we will gain a keen sensitivity to rhythm--knowing when to move and when to let go. (Fearing, 2001 pp. 214-215) Perhaps these reflections have added a little coherence to the study of occupational balance. Occupational balance is a relative state, recognizable by a happy or pleasant integration of life activities and demands. There are indicators of imbalance, more so than tangible ways to measure it, and once recognized occupational therapists have the strategies to help restore a sense of occupational balance. Given our collective history and skill in client-centred practice, occupational therapists are capable of both advancing this line of inquiry and attaining occupational balance for ourselves and our clients.

Effects of functional restoration versus 3 hours per week physical therapy: a randomized controlled study.

Abstract: Study design Randomized parallel-group comparative trial with a 6-month follow-up period. Objective To compare, in chronic low back pain patients, the effectiveness of a functional restoration program, including intensive physical training, occupational therapy, and psychological support to an active individual therapy consisting of 3 hours physical therapy per week during 5 weeks. Summary of background data Controlled studies conducted in the United States showed a benefit of functional restoration in patients with low back pain, especially on return to work. Randomized Canadian and European trials had less favorable results. In France, there has been up to now no randomized study. Controlled studies suggested a positive effect of functional restoration programs. Methods Eighty-six patients with low back pain were randomized to either the functional restoration (44 patients) or the active individual therapy (42 patients) program. One person in each group never started the program. Two patients did not complete the functional restoration program, and one was lost to follow-up at 6 months. The mean number of sick-leave days in the 2 previous years was 6 months. Results After adjustment on the variable "workplace enrolled in an ergonomic program", the mean number of sick-leave days was significantly lower in the functional restoration group. Physical criteria and treatment appreciation were also better. There was no significant difference in the intensity of pain, the quality of life and functional indexes, the psychological characteristics, the number of contacts with the medical system, and the drug intake. Conclusions This study demonstrates the effectiveness of a functional restoration program on important outcome measures, such as sick leave, in a country that has a social system that protects people facing difficulties at work.

Rehabilitation for Parkinson's disease: a systematic review of available evidence

Abstract: Objective: To systematically review the available evidence on the effectiveness of nonpharmacological rehabilitation interventions for people with Parkinson's disease, and identify future research needs.Design: Electronic searches of four databases (CINAHL, Cochrane Library, MEDLINE, PsychLIT) 1980-2002; examination of reference lists of relevant papers. Controlled trials and observational studies were included. Data extraction and quality assessment of papers by two independent reviewers. A narrative review.Setting: Rehabilitation interventions delivered either in subjects' own homes, or in clinical settings as outpatients.Subjects: Community-living adults with Parkinson's disease.Interventions: Physiotherapy, occupational therapy, speech and language therapy, psychological counselling and support, and education.Main measures: A range of outcomes: mobility, functional status, speech, swallowing, psychological well-being, as determined by the studies included in the review.Results: Forty-four different st...

Time use and occupational performance among persons with schizophrenia

Abstract: Schizophrenia is a complex disorder with a heavy impact on daily life. Since the human occupational pattern is a product of person-occupation-environment interaction, it is of importance to explore all these factors to understand the daily occupational pattern among persons with schizophrenia. This study aimed to describe the time use of 10 persons with schizophrenia, reflecting the participants' daily occupations, social and geographical environments, and emotional reaction and reflection on their occupational performance. The results showed stagnation in the participants' occupational pattern and time use. Most activities were not triggered by a facilitating environment but from within the person by basic, immediate life needs, or wanting to escape reality. Occupational therapists could assist this group in reshaping the environment and regaining roles that involve interacting with the outside world.

Occupational therapy for rheumatoid arthritis

Abstract: Background For persons with rheumatoid arthritis (RA) the physical, personal, familial, social and vocational consequences are extensive. Occupational therapy (OT), with the aim to facilitate task performance and to decrease the consequences of rheumatoid arthritis for daily life activities, is considered to be a cornerstone in the management of rheumatoid arthritis. Till now the efficacy of occupational therapy for patients with rheumatoid arthritis on functional performance and social participation has not been systematically reviewed. Objectives To determine whether OT interventions (classified as comprehensive therapy, training of motor function, training of skills, instruction on joint protection and energy conservation, counseling, instruction about assistive devices and provision of splints) for rheumatoid arthritis patients improve outcome on functional ability, social participation and/or health related quality of life. Search methods Relevant full length articles were identified by electronic searches in Medline, Cinahl, Embase, Amed, Scisearch and the Cochrane Musculoskeletal group Specialised Register. The reference list of identified studies and reviews were examined for additional references. Date of last search: December 2002. Selection criteria Controlled (randomized and non-randomized) and other than controlled studies (OD) addressing OT for RA patients were eligible for inclusion. Data collection and analysis The methodological quality of the included trials was independently assessed by two reviewers. Disagreements were resolved by discussion. A list proposed by Van Tulder et al. () was used to assess the methodological quality. For outcome measures, standardized mean differences were calculated. The results were analysed using a best evidence synthesis based on type of design, methodological quality and the significant findings of outcome and/or process measures. Main results Thirty-eight out of 58 identified occupational therapy studies fulfilled all inclusion criteria. Six controlled studies had a high methodological quality. Given the methodological constraints of uncontrolled studies, nine of these studies were judged to be of sufficient methodological quality. The results of the best evidence synthesis shows that there is strong evidence for the efficacy of "instruction on joint protection" (an absolute benefit of 17.5 to 22.5, relative benefit of 100%) and that limited evidence exists for comprehensive occupational therapy in improving functional ability (an absolute benefit of 8.7, relative benefit of 20%). Indicative findings for evidence that "provision of splints" decreases pain are found (absolute benefit of 1.0, relative benefit of 19%). Authors' conclusions There is evidence that occupational therapy has a positive effect on functional ability in patients with rheumatoid arthritis.

Reflections on: “So… What Do You Do?” Occupation and the Construction of Identity

Abstract: Background. What we do has always played a leading part in social conversations about who we are. In part, these social questions are about occupational identity. Purpose and method. Occupational identity is an emerging concept in the occupational therapy literature. In this paper, the concept of occupational identity is examined through the observations of a former research participant in a previous study on the meaning of gardens and gardening in daily life, and the recent work of researchers in occupational therapy and occupational science. Results. Three themes are examined in these reflections. They are occupation and continuity of occupational identity, the contributions of productivity, leisure and self-care to occupational identity and, the public and private aspects of occupational identity. Practice Implications. Exploration with a client about what occupations are most meaningful in her or his life may be a means to understanding the person's construction of an occupational identity. Understand...

Understanding play: The Implications for play assessment

Abstract: This article reviews the current literature on play and play assessment in occupational therapy. The concept of play and play theories are examined and reasons are investigated for the low use of play assessment in paediatric occupational therapy practice. Within contemporary occupational therapy practice, the concept of play is being readdressed and play behaviour is understood to be important in child development. Available assessments of play in occupational therapy assess the child in a familiar environment to the child. Since many paediatric occupational therapists work in clinical settings, it is concluded that a clinically viable assessment of observation of play behaviour is required within occupational therapy. Parameters for such an assessment are proposed.

Home Health Care Utilization:A Review of the Research for Social Work

Abstract: The author reviewed the literature to identify the variables associated with home health care utilization using the Andersen-Newman model as a framework for analysis. Sixty-four studies published between 1985 and 2000 were identified through PUBMED, Sociofile, and PsycINFO databases. Home health care was defined as in-home skilled nursing, homemaker, mobile meals, home health aide, physical therapy, occupational therapy, or social work services. The review indicates that the client most likely to use home health care is elderly, has a high number of ADL/IADL impairments, lives alone, has a low level of informal support, and has Medicaid coverage. In the presence of informal support or when care recipients live with others, the initiation of formal services may be delayed until physical impairment of the care recipient is severe or caregiver burden is high. Implications for social work practice and research are discussed.

Activity-Focused Motor Interventions for Children with Neurological Conditions

Abstract: This article presents a model to guide activity-focused physical therapy and occupational therapy interventions for children with neurological conditions. Activity-focused interventions involve structured practice and repetition of functional actions and are directed toward the learning of motor tasks that will increase independence and participation in daily routines. According to this model, the pediatric therapist: (1) develops activity-related goals in collaboration with the child and the family; (2) plans activity-focused interventions by adapting knowledge of motor learning to the child's individual learning strengths and needs; and (3) integrates impairment-focused intervention with activity-focused intervention.

Individual Patient Data Meta-Analysis of Randomized Controlled Trials of Community Occupational Therapy for Stroke Patients

Abstract: Background and Purpose— Trials of occupational therapy for stroke patients living in the community have varied in their findings. It is unclear why these discrepancies have occurred. Methods— Trials were identified from searches of the Cochrane Library and other sources. The primary outcome measure was the Nottingham Extended Activities of Daily Living (NEADL) score at the end of intervention. Secondary outcome measures included the Barthel Index or the Rivermead ADL (Personal ADL), General Health Questionnaire (GHQ), Nottingham Leisure Questionnaire (NLQ), and death. Data were analyzed using linear or logistic regression with a random effect for trial and adjustment for age, gender, baseline dependency, and method of follow-up. Subgroup analyses compared any occupational therapy intervention with control. Results— We included 8 single-blind randomized controlled trials incorporating 1143 patients. Occupational therapy was associated with higher NEADL scores at the end of intervention (weighted mean diffe...

Randomised controlled trial of an occupational therapy intervention to increase outdoor mobility after stroke

Abstract: Objective To evaluate an occupational therapy intervention to improve outdoor mobility after stroke. Design Randomised controlled trial. Setting General practice registers, social services departments, a primary care rehabilitation service, and a geriatric day hospital. Participants 168 community dwelling people with a clinical diagnosis of stroke in previous 36 months: 86 were allocated to the intervention group and 82 to the control group. Interventions Leaflets describing local transport services for disabled people (control group) and leaflets with assessment and up to seven intervention sessions by an occupational therapist (intervention group). Main outcome measures Responses to postal questionnaires at four and 10 months: primary outcome measure was response to whether participant got out of the house as much as he or she would like, and secondary outcome measures were response to how many journeys outdoors had been made in the past month and scores on the Nottingham extended activities of daily living scale, Nottingham leisure questionnaire, and general health questionnaire. Results Participants in the treatment group were more likely to get out of the house as often as they wanted at both four months (relative risk 1.72, 95% confidence interval 1.25 to 2.37) and 10 months (1.74, 1.24 to 2.44). The treatment group reported more journeys outdoors in the month before assessment at both four months (median 37 in intervention group, 14 in control group: P Conclusion A targeted occupational therapy intervention at home increases outdoor mobility in people after stroke.

Teachers’ Survey on Problems With Handwriting: Referral, Evaluation, and Outcomes

Abstract: Objective The purpose of this study was to describe the factors that led elementary school teachers to refer students with handwriting difficulties to occupational therapy, the criteria they used to determine acceptable handwriting, and the handwriting outcomes they looked for after occupational therapy services Method A paper questionnaire composed of 31 close-ended questions was mailed to 400 first- through fourth-grade regular education teachers from 32 states to collect data from the 2000-2001 school year The data were analyzed descriptively using frequency counts and converted to percentages Results Information was obtained from 314 teachers The main factor for handwriting referral to occupational therapy was that the student was not improving with classroom assistance alone Teachers chose not being able to read student's writing as the main criterion they used to determine if the student's handwriting was acceptable, and increased legibility was the most important outcome they desired following occupational therapy services for handwriting remediation Conclusion The perceptions of regular education teachers on problems with handwriting can provide valuable information to occupational therapy practitioners when providing consultation and direct services related to handwriting in schools

What's new in stroke rehabilitation.

Abstract: Stroke rehabilitation has been revolutionized in the last decade through a combination of new imaging techniques looking at brain recovery and clinical trials into what is working in stroke rehabilitation. The fear that rehabilitation was a long way from being rooted in science1 has been overcome by an increasing understanding of neuronal recovery processes and their modulation by various physical and pharmacological interventions. More than 300 randomized controlled trials provide a sound foundation for evidence-based practice in stroke rehabilitation, supplementing and often confirming decades of clinical experience. This growing body of knowledge has been enriched by several studies in 2003. Advances in basic sciences and clinical research are beginning to merge and show that the human brain is capable of significant recovery after stroke, provided that the appropriate treatments and stimuli are applied in adequate amounts and at the right time. What is particularly exciting is the introductions of new technologies such as robotic enhancement of therapies and virtual reality to further enhance that recovery. Stroke rehabilitation is therapy intensive and one of the unresolved debates has been around the issues of quality and quantity. Evidence is building that intensity of therapy is important. This is particularly true for language recovery. Bhogal et al2 identified 8 randomized controlled trials (RCTs), which compared the intensity of speech and language therapy (SLT) delivered by a trained therapist versus a non-therapist or a non-SLT control. Four of the studies were positive and these studies provided a mean of 8.8 hours of therapy per week for 11.2 weeks when compared with the 4 negative trials that provide approximately 2 hours of therapy per week for a total of 22.9 weeks. On average, positive RCTs provided 98.4 hours of therapy over half the time that the negative RCTs provided 43.6 hours. Intensive therapy …

Learning in two communities: the challenge for universities and workplaces

Abstract: This article reports on a longitudinal study of school‐to‐work transitions in four professions: education, social work, physiotherapy, and occupational therapy. Each of these professions is characterized by the need for an undergraduate degree for certification; extensive, supervised internships before graduation; and, to a greater or lesser extent, supervision for beginning professionals after graduation. Students in their last years of university, beginning professionals in their first years of practice, and the experienced practitioners who supervise both these groups were interviewed. The article draws on theory and data to help explain why the move from classroom to workplace is often so difficult, and make recommendations to stakeholders in the training and induction of new practitioners in these professions. The recommendations may be extrapolated to other workplaces.