OBJECTIVES: To identify ethical dilemmas experienced by occupational and physical therapists working in the UK National Health Service (NHS). To compare ethical contexts, themes and principles across the two groups. DESIGN: A structured questionnaire was circulated to the managers of occupational and physical therapy services in England and Wales. SUBJECTS: The questionnaires were given to 238 occupational and 249 physical therapists who conformed to set criteria. RESULTS: Ethical dilemmas experienced during the previous six months were reported (...) by 118 occupational and 107 physical therapists. The two groups were similar in age, grade, and years of experience. Fifty of the occupational therapy dilemmas occurred in mental health settings but no equivalent setting emerged for physical therapy. Different ethical themes emerged between the two groups, with the most common in occupational therapy being difficult/dangerous behaviour in patients and unprofessional staff behaviour, and for physical therapists resource limitations and treatment effectiveness. No differences were found in the ethical principles used. CONCLUSION: The ethical dilemmas reported by the therapists were primarily concerned with health care ethics, rather than the more dramatic ethics reported in much of the biomedical ethics literature. Differences were found between the two professional groups when ethical contexts and themes were compared but not when ethical principles were compared. This suggests that educators and researchers need to be aware of work settings and the interdisciplinary nature of employment as well as ethical principles held by individual therapists. (shrink)

Philosophy and Occupational Therapy: Informing Education, Research, and Practice provides an overview of the most influential philosophical movements from past to present and shows how these philosophies are a foundational, yet underutilized, element of occupational therapy education, research, and practice. Each chapter offers a basic description of a philosophy, outlines major thinkers and concepts, and ultimately summarizes the implications for occupational therapy education, research, and practice.

Reagon, Bellin and Boniface argue that traditional models of evidence-based practice focus too much on randomised controlled trials and neglect 'the multiple truths of occupational therapy'. This opinion piece points out several flaws in their argument, and suggests that it is unethical to rely on weaker evidence sources when higher quality evidence exists. Ironically, the evidence that they provide to support their argument regarding different types of evidence is itself very weak.

Resumen: En el presente trabajo intentaremos destacar la necesidad que existe hoy, para la terapia ocupacional, de entablar un diálogo con la filosofía, enfatizando la relevancia de plantear la pregunta concerniente al ser humano en cuanto ocupación. Se plantea que la terapia ocupacional se encontraría en una situación de crisis de los fundamentos que la orientan y le brindan sentido a su práctica, proponiendo como posible solución una revisión de los aspectos principales de la analítica del Dasein de Martin Heidegger, (...) con el objeto de clarificar por qué y cómo el fenómeno de la ocupación puede ser considerado como un momento constitutivo de cada existencia humana.: This paper aims to emphasize the current need for occupational therapy to have a dialogue with philosophy, to highlight the question concerning the human being as occupation. The article argues that occupational therapy could be in a crisis concerning its fundamental grounds that, on the one hand, guide it and, on the other hand, give it sense to its own practice, proposing as a possible answer following Martin Heidegger’s analytics of Dasein. In this context, we will try to clarify why and how the phenomenon of occupation can be considered as an essential and constitutive moment of each human person. (shrink)

The armed forces of World War II employed unprecedented numbers of mechanical transport vehicles, precipitating a spike in demand for automotive manufactures. Eager to capture a share of the less certain postwar automobile marketplace, defense contractors such as Willys-Overland pursued a diverse range of product development and advertising strategies, based on the foundation of their military output. This article considers the cultural significance of Willys-Overland’s 1/4-ton truck (“jeep”), one of the most widely recognized transport artifacts of World War II. Working (...) from a Canadian perspective, the discussion traces the jeep’s transformation from a versatile front line utility truck into an enduring icon of the postwar auto age. (shrink)

Occupational therapy often uses craft activities as therapeutic tools, but their therapeutic effectiveness has not yet been adequately demonstrated. The aim of this study was to examine changes in frontal midline theta rhythm and autonomic nervous responses during craft activities, and to explore the physiological mechanisms underlying the therapeutic effectiveness of occupational therapy. To achieve this, we employed a simple craft activity as a task to induce Fmθ and performed simultaneous EEG and ECG recordings. For participants (...) in which Fmθ activities were provoked, parasympathetic and sympathetic activities were evaluated during the appearance of Fmθ and rest periods using the Lorenz plot analysis. Both parasympathetic and sympathetic indices increased with the appearance of Fmθ compared to during resting periods. This suggests that a relaxed-concentration state is achieved by concentrating on craft activities. Furthermore, the appearance of Fmθ positively correlated with parasympathetic activity, and theta band activity in the frontal area were associated with sympathetic activity. This suggests that there is a close relationship between cardiac autonomic function and Fmθ activity. (shrink)

How does law effect well-being? Can school rules influence the feel-good factor among children? If a self-perception of being ‘good’ improves well-being, people would prefer to be good—even children. But traditional school rules are often contrary to the principles of well-being, and create ‘good criminals’. Starting from the seemingly absurd truth—‘crime is caused by the law’— the paper proposes that children should learn to view law critically and creatively. Then, through a novel application of Occupational Therapy , and (...) using ‘law’ to focus social agency, a case study develops ‘The law of school dress’ as a public good. The result reflects Jeremy Bentham’s Principle of Utility. Philosophy of OT reminds us that the ultimate purpose of education is not just to learn: it is to improve well-being through learning as meaningful ‘occupation’. And ‘law’ has a part to play. (shrink)

This book is organized around six theorists and offers a biographical perspective of each theorist, An objective review of the theory, and recommendations for using each theory in day-to-day practice.

Introduction: Resilience is a multidimensional and dynamic construct associated with positive growth and the capacity to transform stressful and negative factors into opportunities of personal development and self-improvement when faced with difficult experiences. The resilience process of each individual integrates multiple analysis levels, which range from genetic-environmental interactions to a complex process of adaptation between the individual and his/her family, friends, co-workers, society, and culture.Objective: To determine whether resilience improves in students of occupational therapy when exposed for the (...) first time to practice placement education.Methodology: Quasi-experimental, prospective, observational, multi-center study with a sample composed of students from the Degree of Occupational Therapy of the public universities of Málaga and Castilla-La Mancha. Two weeks prior to the beginning of the practice education period, the participants completed a questionnaire that included sociodemographic data and the area of their internships. They were also given the Spanish version of the Connor-Davidson's resilience scale. All these instruments were also completed 1 week after the end of the clinical practice.Results: There were statistically significant differences between the variables that make up resilience and the different internship areas. On the other hand, there was a significant improvement of global resilience after the clinical practice period, in both women and men, when the internship area was not considered.Conclusions: The results show that resilient students are more optimistic and work to improve a situation beyond doing simply what is expected of them, knowing how to control their feelings. This is beneficial for students in practice education, since, during these, they face difficult situations that require a resilient pattern, which helps reduce stress and the burnout syndrome. (shrink)

Compared to other health care professions such as medicine, nursing and pharmacy, few studies have been conducted to examine the nature of practice errors in occupational and physical therapy. In an ongoing study to determine root causes, typographies and impact of occupational and physical therapy error on patients, focus group interviews have been conducted across the United States. A substantial number of harmful practice errors and/or other patient safety events (deviations or accidents) have been identified. Often (...) these events have had moral dimensions that troubled the therapist involved. In this article, six of these transcribed cases are analyzed, using predominant bioethical theories, ethical principles and professional codes of ethics. The cases and their analyses are intended to be exemplary, improving the readers’ ability to discern and critically address similar such events. Several patient safety strategies are suggested that might have prevented the events described in these cases. (shrink)

Sensory processing problems and related dysfunctions are among the most common conditions in children with autism spectrum disorder. This study examined the effect of sensory integration therapy on different aspects of occupational performance in children with ASD. The study was conducted on an intervention group receiving SIT and a control group with 3- to 8-year-old children with ASD. The Short Child Occupational Profile was used to compare the two groups in terms of the changes in their (...) class='Hi'>occupational performance and the Sensory Profile was used to assess sensory problems. The intervention group showed significantly greater improvement in all the SCOPE domains, as well as in all the SP domains, except for the “emotional reactions” and “emotional/social responses” domains,. The effectiveness of SIT in improving occupational performance in children with ASD as a health-related factor is supported by our findings. (shrink)

In this article we explore how Swedish welfare politics within health‐care and rehabilitation has opened up a space for nurses’ and occupational therapists’ professional projects. Using historical data, an analysis of the policy‐making process behind welfare programs central to the professionalization of nursing and occupational therapy is presented. The time period covered is, in the case of nurses, the larger part of the twentieth century, while the modern history of occupational therapists first began in the 1940s. (...) Special emphasis is placed on the corporative nature of the Swedish welfare state and the professional strategies utilized by nurses and occupational therapists in their struggle for jurisdiction. In the article, politicization is identified as a core strategy by which female‐dominated welfare state occupations in Sweden have tried to gain influence over the welfare policy‐making process and their occupations’ jurisdiction. (shrink)

ABSTRACT This article will examine the career of weaver and occupational therapist Mary E. Black by using her life as a lens through which to explore the intersection of arts and crafts revivalism with occupational therapy in early twentiethcentury northeastern North America. Born in Massachusetts, Black grew up in and was educated in Wolfville, Nova Scotia. She trained as ward's aide in Montreal in 1919 and worked in a string of hospitals and sanitariums throughout the United States (...) and Nova Scotia. Indeed, Black understood her work as an occupational therapist and what she described as “the therapeutics of weaving” to be intertwined. Like many arts and crafts revivalists of her period, Black saw the teaching of skilled craftmaking as a means to generate self-sufficiency, since it provided a way for displaced and injured people to make salable goods in the face of industrialization, war, and inadequate medical care. In Black's case, the utopian social mission of the new professional field of occupational therapy provided just the institutional means to disseminate the remunerative qualities of craftwork on a broad scale. (shrink)

Cet article propose une réflexion sur les liens fraternels dans le cadre d’une thérapie familiale à partir des conceptions théoriques sur le fraternel de R. Kaës, sur l’illusion groupale de D. Anzieu et sur les notions de transgénérationnel dans une famille. L’objectif est de montrer la pertinence d’une approche de thérapie familiale psychanalytique à partir d’un cas d’une fratrie de quatre garçons dont l’aîné est le porteur des traumatismes parentaux et considéré comme le « bouc émissaire » de la famille. (...) Plusieurs hypothèses sont proposées qui permettent de comprendre l’importance du traumatisme en fonction de la place qu’occupe chacun des enfants de la fratrie, un « pacte dénégatif » pouvant s’être instauré comme organisateur des liens entre les frères. La thérapie familiale souligne la nécessité du travail de métabolisation de la famille et de différenciation entre les frères, au prix dans le cas présenté, d’une autonomisation réelle d’un des membres de la fratrie. (shrink)

Background Occupational therapists may be encountered with a variety of ethical issues. The aim of this study was to explore ethical issues of Occupational therapist’s practice in adult physical dysfunction field. Methods Ten graduated Occupational therapists were selected by purposive sampling method. Data were gathered by semi-structured interview. Data were analyzed by content analysis approach. Results Data analysis ultimately leads to the emergence of three themes which reflects Ethical issues in Occupational Therapy. These themes include: (...) unethical practice of Occupational therapists, factors influencing ethical practice and Strategies to improving ethical practice. Conclusion The findings show that occupational therapists have various ethical problems related to client’s rights in addition to their clinical practice, that according to the participants in this study, lack of awareness about professional ethics related to the occupational therapy and also lack of comprehensive monitoring rules in this field are the major causes of unethical practice. (shrink)

Professional ethics has currently raised its public profile in the UK as part of social anxiety around governance of health and social care, fuelled by catastrophically bad practice identified in particular healthcare facilities. Professional ethics is regulated by compliance with abstracted, normative codes but experienced as contextualised exercise of personal qualities, understanding and engagement. This study examined how practitioners from one speciality of occupational therapy, an Allied Health Profession, develop ethical practice through dialogical engagement in local OT communities (...) of practice, supporting and modifying understanding of and approaches to specific situations experienced as ethically difficult and individual reflection on the personal bildungsroman underpinning their own professional practice. Engagement in community of practice and personal reflection contributed to ethical development for participating OTs. Opportunities to engage in peer OT groups and professional reflection should be considered by employers as integral to productive practice and not a distraction from it. (shrink)

This paper argues that Sulmasy and Sugarman have not succeeded in showing a moral difference between withholding and withdrawing treatment. In particular, they have misunderstood historical entitlement theory, which does not automatically prefer a first occupant by just acquisition.

Jean Ayres invented Sensory Integration for children experiencing learning and social difficulties because, according to Ayres, they could not adequately integrate information from multiple sensory modalities. She established a scientific basis for her identification of children with sensory integrative difficulties, using statistical techniques to identify symptoms and neuroscience to determine a cause. She was an unusually reflective practitioner who catalyzed a community of practice around SI without becoming a guru—indeed, she encouraged her students to come up with their own ideas (...) and test them empirically. She felt isolated from the growing field of Occupational Therapy yet is viewed as one of its greatest pioneers. After her death in 1988, the SI community gradually began to argue about fundamental issues like what should constitute an appropriate diagnosis and set of tests for SI. At present, the network is fragmented to the point where some of the opposing positions may be incommensurable with each other, which would require a trading zone. (shrink)

Background: Electroconvulsive therapy is one of the most effective treatments for major depressive disorder. Recently, there has been increasing attention to evaluate the effect of ECT on resting-state functional magnetic resonance imaging. This study aims to compare rs-fMRI of depressive disorder patients with healthy participants, investigate whether pre-ECT dynamic functional network connectivity network estimated from patients rs-fMRI is associated with an eventual ECT outcome, and explore the effect of ECT on brain network states.Method: Resting-state functional magnetic resonance imaging data (...) were collected from 119 patients with depression or depressive disorder, and 61 healthy participants, with an age mean of 52.25 years old. The pre-ECT and post-ECT Hamilton Depression Rating Scale were 25.59 ± 6.14 and 11.48 ± 9.07, respectively. Twenty-four independent components from default mode and cognitive control network were extracted, using group-independent component analysis from pre-ECT and post-ECT rs-fMRI. Then, the sliding window approach was used to estimate the pre-and post-ECT dFNC of each subject. Next, k-means clustering was separately applied to pre-ECT dFNC and post-ECT dFNC to assess three distinct states from each participant. We calculated the amount of time each subject spends in each state, which is called “occupancy rate” or OCR. Next, we compared OCR values between HC and DEP participants. We also calculated the partial correlation between pre-ECT OCRs and HDRS change while controlling for age, gender, and site. Finally, we evaluated the effectiveness of ECT by comparing pre- and post-ECT OCR of DEP and HC participants.Results: The main findings include depressive disorder patients had significantly lower OCR values than the HC group in state 2, where connectivity between cognitive control network and default mode network was relatively higher than other states, Pre-ECT OCR of state, with more negative connectivity between CCN and DMN components, is linked with the HDRS changes. This means that those DEP patients who spent less time in this state showed more HDRS change, and The post-ECT OCR analysis suggested that ECT increased the amount of time DEP patients spent in state 2.Conclusion: Our finding suggests that dynamic functional network connectivity features, estimated from CCN and DMN, show promise as a predictive biomarker of the ECT outcome of DEP patients. Also, this study identifies a possible underlying mechanism associated with the ECT effect on DEP patients. (shrink)

Rationale, aims and objectives: Appropriate use of diagnostic and treatment modalities are essential for rational use of resources. The aim of this study is to evaluate the use of diagnostic modalities and different treatment options and their economic impacts following an acute ankle distortion resulting from an occupational accident. We evaluated the type-of-treatment impact on the victims' course of recovery as well as its impact on the associated accident costs. Research was carried out in Belgium. Methods: An ankle distortion (...) victims' database consisting of 200 cases of (Belgian) occupational accidents during the period 2005-2007 was analysed. Results: Patients who were prescribed immobilization or the use of adjuvant support or physical therapy (118 cases) were not employed during a period of 37 days on average, with a mean total cost of 3140.14 Euros caused by the ankle sprain. Patients without any adjuvant therapy (82 cases) were characterized by an unemployment rate of 15 days on average, and a total cost of 1077.86 Euros. Cast immobilization, although its application is not supported by evidence-based literature, was still applied in 36% of the population studied and resulted in the longest average absence of work of 42 days with an obvious significant increase in medical and total costs. Conclusions: Our results show a high rate of inappropriate use of cast immobilizations for ankle distortions. From an economic point of view and for the same clinical endpoint (being full resumption of the occupational activities), simple conventional treatment, consisting of rest, ice, compression and elevation at diagnosis with allowance of early weight bearing in the further clinical course, leads to the quickest full resumption of activities in combination with the lowest medical costs, if compared with any other kind of treatment. (shrink)

An adaptation of an occupational therapy journal has been set up to support trainees in the development of their reflective competencies. A suggestion had been made to write a reflexive statement during their clinical experience. However, the implementation of this pedagogical reflexive approach proved difficult to implement given that it depended on the student’s initiative or the supervisor’s willingness to use them. Following this observation, an evaluation of the project was carried out. This article presents the results of (...) this evaluation process. This approach intended to 1. describe the rationale for using reflective journals in occupational therapy; 2. document the impact of reflective writing in occupational therapy; 3. briefly assess the use of reflective statements; 4. describe elements to be considered in assessing the quality of reflections. The evaluation process made possible to retain several elements from the research and theoretical concepts to support the assessment of the reflection. (shrink)

The Tidal Model represents a significant alternative to mainstream mental health theories, emphasizing how those suffering from mental health problems can benefit from taking a more active role in their own treatment. Based on extensive research, The Tidal Model charts the development of this approach, outlining the theoretical basis of the model to illustrate the benefits of a holistic model of care which promotes self-management and recovery. Clinical examples are also employed to show how, by exploring rather than ignoring a (...) client's narrative, practitioners can encourage the individual's greater involvement in the decisions affecting their assessment and treatment. The Tidal Model 's comprehensive coverage of the theory and practice of this model will be of great use to a range of mental health professionals and those in training in the fields of mental health nursing, social work, psychotherapy, clinical psychology and occupational therapy. (shrink)

From industrial psychology and occupational therapy to the laboratory bench and scenes of “heroic” fieldwork, there are important connections between the science of labor and the labor of science. Participants in the 2022 Gordon Cain Conference explored how greater attention to these connections might deepen historical understanding of what constitutes “science” and what counts as “labor.” Our conversations circled around themes of vulnerability (of systems, individual bodies, historical testimony), affect (pertaining to historical actors and ourselves), and interdependence (e.g. (...) across human groups, species, political boundaries, and time). For the members of this group, which grew out of a panel discussion, these themes and motivations coalesced around a topical focus on invisibility, which helped us to articulate – in the form of a co-created syllabus – research questions about science and labor from multiple angles pertaining to practice, archival preservation, and scholarly representation. This syllabus is organized into six thematic modules that aim to challenge and historicize the concept of invisible labor by facilitating comparisons across geographic, temporal, conceptual, and disciplinary boundaries. The goals of this collaborative syllabus, in sum, are manifold: we seek to facilitate more inclusive histories of science through critical engagement with “invisibility” and thereby promote a more expansive understanding of what constitutes scientific labor; to highlight the constitutive role of gendered labor practices in the scientific enterprise; to draw attention to interdependencies that make all forms of production (knowledge or material) possible; to elucidate systems of remuneration for scientific labor over the longue durée and through pointed comparisons; and, finally, to promote self-reflexivity about the methods we use to narrate the history of science and make sense of our own labors. (shrink)

Is positive thinking really so healthy that, as Martin Seligman (2000) and Mihaly Csikszentmihalyi passionately thus argued, "we believe that a psychology of positive human functioning will arise, which achieves a scientific understanding and effective interventions to build thriving individuals, families, and communities"? This optimistic view on positive thinking for health can be contrasted with an opposing view by Barbara Ehrenreich (2009), who "extensively critiqued 'positive psychology'" and showed "how obsessive positive thinking impedes productive action, causes delusional assessments of situations, (...) and people are then blamed for not visualising hard enough and thus 'attracting' failure even in situations when 'masses of lives were lost'." (WK 2013; R Byrne 2006) Contrary to these opposing views (and other ones as will be discussed in the book), health care (in relation to mental health and physical health in the context of mind and body) are neither possible (or impossible) nor desirable (or undesirable) to the extent that the respective ideologues (on different sides) would like us to believe. Surely, this questioning of the opposing views on health care does not suggest that the study of health care is worthless, or that those fields (related to health care) like medicine, chiropractic, health system, dentistry, health info tech, nursing, psychiatrics, clinical psychology, occupational therapy, pharmacy, allied health, and so on are unimportant. Needless to say, neither of these extreme views is reasonable. Instead, this book offers an alternative (better) way to understand the future of health care, especially in the dialectic relationships between mental health and physical health in the context of mind and body -- while learning from different approaches in the literature but without favouring any one of them (nor integrating them, since they are not necessarily compatible with each other). More specifically, this book offers a new theory (that is, the interconnected theory of health care) to go beyond the existing approaches in a novel way and is organised in four chapters. (shrink)

The debate about health insurance coverage and the related issue of unequal access to health care turn on fundamental questions of justice, but for an individual patient like DM, the abstract question about who is deserving of health insurance becomes a very concrete problem that has a profound impact on care and livelihood. DM's circumstances left him stuck in the hospital. A satisfactory discharge plan remained elusive; his insurance coverage severely limited the number and type of facilities that would accept (...) him; and his inadequate engagement in his own rehabilitation process limited discharge options even further. Despite extensive involvement with the psychiatry, social work, physical therapy, and occupational therapy teams, DM consistently made “bad” decisions. He repeatedly refused antibiotics and did not consistently work with rehab services to improve his strength and mobility. Although the clinicians wanted to provide him with the best care possible, he often seemed unwilling to do the things necessary to achieve this care—or perhaps his depression rendered him unable to do so. He also tended to take out his frustration on staff members caring for him. All of this was, in turn, very frustrating for the staff. It may be easy, however, to make too much of DM's role, to see his choices as more important than his circumstances. A major goal of the ethics consultants was to reframe DM's predicament for the staff members involved in his care. (shrink)

Talking about ‘suffering’ in relation to ‘old age’ implies reflecting on its semantic fields, its various references and the relationship between the two in a dynamic way. We therefore propose to reflect first of all, in a philosophical way, on ‘suffering’ and its specificity in relation to other terms such as ‘pain’; then we will look at the meaning of ‘old age’ and its semantic field: ‘old age’, ‘third age’, ‘senectitude’; we will continue with the question of the relationship between (...) suffering and elderly people to detect if there is a determination and connection between both realities; to, finally, propose, in continuity with our conclusions, a practical look from the human activity in a humanistic paradigm of Occupational Therapy. (shrink)

There are currently no instruments available to measure ethical sensitivity in the therapeutic sciences. This study therefore aimed to develop and implement a measure of ethical sensitivity that would be applicable to four therapeutic professions, namely audiology, occupational therapy, physiotherapy, and speech-language pathology. The study followed a two-phase, sequential exploratory mixed-methods design. Phase One, the qualitative development phase, employed six stages and focused on developing an instrument based on a systematic review: an analysis of professional ethical codes, focus (...) group discussions, in-depth interviews, a review of public complaints websites, and an expert panel review. The development phase culminated in the Measuring Instrument for Ethical Sensitivity in the Therapeutic Sciences (MIEST), a pen-and-paper measure for studying ethical sensitivity in the therapeutic sciences.Phase Two, the quantitative stage, focused on implementing the MIEST in two different stages. A total of 100 participants completed the instrument. MIEST scores were found to be comparable for all four professions, which confirmed the multidisciplinary usability of the instrument. Participants tended to base decisions on the ethical principle of beneficence. The MIEST is effective to assess and describe the ethical sensitivity of professionals in the four specified therapeutic sciences. The constructed vignettes also make the MIEST appropriate for use in problem-based learning programs. (shrink)

Due to the prevalence, severity, and costs associated with autism spectrum disorders, it has become a public health issue. In response, state governments have adopted ASD-specific private insurance mandates requiring coverage of ASD screening, diagnosis, and treatment. Despite rapid uptake of these laws, differences exist in the type and levels of coverage, especially for allied health services including occupational therapy. We piloted a structured legal research methodology to code ASD insurance mandates that impact allied health service provisions. State (...) private insurance mandates were obtained from WestlawNext. A coding methodology was piloted on 14 states and included variables for age and service limits, treatments covered, and medical necessity. Coding methods were feasible and highly reliable among raters. Ten of 12 states had a coverage mandate, many with specific provisions for allied health providers. A full analysis of all 50 states is warranted to identify provisions affecting allied health providers serving individuals with ASD. (shrink)

The purpose of the article is to elaborate on the scholarly debate on affect. We consider the site of affect to be the activities of embodied, socioculturally and spatially situated participants: “Affective activity is a form of social practice” (Wetherell, 2015, p. 147). By studying affect as a social phenomenon, we treat affect as a social ontology. Social practices are constituted through participation in social interaction, which makes it possible to study affect empirically. Moreover, we suggest that to consider affect (...) a social ontology connects affect to agency. We regard affect as a participants’ phenomenon where emotions and knowledge are not separated, i.e. as a social epistemology. To capture the complexity of affective activity, the study of situated participation requires video data. We collected data at a centre for persons with acquired brain injury (ABI), which highlights research ethics. The International Classification of Functioning, Disability and Health (ICF) framework defines participation as involvement in life situations. ICF focuses on two broader perspectives: the body and the individual in society. We turn ICF’s abstract societal perspective on participation to meaningful local accomplishments in lived social practices. Our focus is, in line with a critical social ontology in disability studies, on how-ability, the communicative abilities of the residents (Hughes, 2007). To get closer to life situations as they unfold, we analyse participation in its details as embodied actions during activities in the material environment of the centre. To conclude, we demonstrate a resident’s competent participation in an occupational therapy session through a fine-grained analysis of affective activity. Interaction, practices and phenomena are complex theoretical and practical issues. In the analysis of the encounters as complex multimodal and -sensorial situations, we use an extended version of Ethnomethodological Conversation Analysis (EMCA) that incorporates the body and material environment with the interconnectedness of interactional episodes. To do this, we enlarge the scope of analysis from the complexity of local occasions of affective activity to connections between consecutive affective entanglements. In the indicated work we draw on theoretical (lamination) and methodological (nexus analysis) suggestions in order to best pursue the sociocultural nature of situated interactions. (shrink)

Drawing on the author’s experience carrying out qualitative research in the field of occupational therapy with people with intellectual disabilities, this article explores ethical issues inherent in ethnographic and case study research, where study designs can evolve over time. Such qualitative methodologies can enable deep understanding of research topics, but detailed description of methods and of the range of potential experiences participants may have is necessary to ensure that they are fully informed and ethics committees satisfied. Thorough consideration (...) is required of ethical issues related to topic relevance and design, recruitment, collection of data and portrayal of participants in the eventual case report. The article illustrates a way in which research of this type can be explained and justified, including how recruitment can be achieved of participants likely to lack capacity to consent to participation themselves. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Adolph Meyer’s Psychobiology in Historical Context, and Its Relationship to George Engel’s Biopsychosocial ModelEdwin R. Wallace IV (bio)Keywordspsychobiology, integrative models of psychiatry, biopsychosocial modelBefore addressing the importance of Adolf Meyer and the question of his impact on the biopsychosocial model of the psychoanalytical internist George Engel, let us tersely sketch the history of functionalism in medicine/psychiatry, and of the nineteenth/early twentieth century’s progressive abandonment of it in favor of (...) basic science reductive models of “disease,” not illness.FunctionalismWhereas Hippocratic physicians diagnosed diatheses in terms of humoral excesses or deficiencies, their primary emphasis was on the ill person. They began with careful histories of the patient’s complaints and his or her daily life course, customary activities, typical foods and beverages imbibed, and the exacerbation or relief of symptoms associated with any or all of these. They also asked questions about his physical and social environment. They carefully looked for any clinically pertinent signs, and might physically examine the patient or his excretions. When they arrived at a diagnosis (say, an excess of yellow or black bile, or of blood or phlegm), they would educate the patient about it and discuss possible approaches. Although leeching, emetics, or purgatives might be prescribed, “dietetics” was the core of the treatment. Much more than recommendations about dietary intake, this involved conversations about “lifestyle” management in general: exercise, fresh air, habit changes, and perhaps bathing in mineral waters or spas. If the patient were “melancholic” (which then included what we would now consider a variety of psychiatric disorders), he or she might be prescribed daily swimming and other forms of vigorous exercise, conversations with a philosopher, [End Page 347] attendance at theatrical comedies, or even referral to an Asklepian temple for “incubation sleep” and priestly dream interpretation. Often doctors worked closely with physical trainers, to whom they sent their patients. In short, their orientation was holistic (“mind”/”body” integration), directed first and foremost toward an individual ill person.In the second century, C.E. Galen, despite his humoral and anatomical pathologies, was similarly holistic or functionalist. He resorted to a variety of physical examinational methods while also attending to the patient’s mental/emotional status. He described one case where he was attending a woman for syncopal episodes. His examinations of her included his customary attention to the pulse. During one evening session, a servant entered and happened to mention that he had just seen the handsome Pylades dancing. Suddenly her pulse became irregular and she fainted straight away. This led Galen to consider love sickness, and perhaps not humoral or organ pathology. He tested his hypothesis during subsequent visits. Whenever another dancer or actor was mentioned, her pulse remained regular and her sensorium alert, but when Pylades was mentioned the irregular pulse and fainting recurred. Because she was married, Galen realized her insoluble conflict, and treated her accordingly.From the fall of Rome until the rise of University Medicine in the later Middle Ages, medical lore and doctoring was in monastic hands—each monastery had its clerical medic, who might also attend outsiders. They were attuned to the traditional triad of major mental disorders—mania, melancholia, and phrenitis—which they explained somatically. However, they also encountered lesser mental/emotional disorders for which they developed their own nosology. “Scrupulosity,” for example, characterized a committed monk with an unrealistic sense of sinfulness and guilt—which often drove him to self-mortification such as flagellation, hair shirts with chains underneath, and so forth, for which the remedy was kindly pastoral counseling. “Accedia” was akin to our “dysthymia,” whose sufferer was affected by sadness, lassitude, and impaired capacity to carry out the monastic routine. This was viewed as straddling the boundary between sickness and sin. Routine physical labor (“occupational therapy”) and prayers, confession, penance, and “pep talks” were prescribed.When universities with medical schools arose in the latter Middle Ages, students’ educations were mostly bookish and theoretical. Hippocratic and Galenic somatic orientations were still preeminent. (Vesalius would not publish his illustrated anatomical text until 1543.) Dietetics and purgatives, bloodletting, and so on were still favored treatments. Nevertheless, doctors gave considerable time and attention to their patients as ill... (shrink)

In an age of pressing global issues such as climate change, the necessity for countries to work together to resolve problems affecting multiple nations has never been more important. Interdisciplinarity in higher education is a key to meeting these challenges. Universities need to produce graduates, and leaders, who understand issues from different perspectives, and who can communicate with others outside the confines of their own disciplines. -/- Drawing on contributions from 37 scholars from Australia, New Zealand, Hong Kong, Malaysia, the (...) Netherlands and the United Kingdom, this volume examines issues inherent in providing interdisciplinary education within the structures of universities and proposes ways in which these issues might be best managed. -/- The book has a dual focus on perspectives and practicalities. Themes covered include: the need for graduates who can work within and across multi-disciplinary and multi-professional teams; interdisciplinary leadership; the critical importance of interdisciplinary thinking to meet global challenges; collaboration in interdisciplinary approaches to teaching and learning; the role of institutional and other systems to support interdisciplinary endeavours; the centrality of disciplines; balancing disciplinarity and interdisciplinarity; and the place of interdisciplinarity in graduate outcomes and attributes. Definitional aspects of interdisciplinary higher education and current interdisciplinary practice across a range of contexts are also examined. -/- Contributors represent a wide range of discipline areas, including accounting, academic development, agriculture, food and wine science, biotechnology, employment relations, environmental science, the health sciences, higher education, land and environment, languages and cultures, occupational therapy, science communication, social work and social policy. (shrink)

Background During the first wave of the new coronavirus (COVID-19) pandemic, the sudden increase in hospitalised patients put medical facilities in southern Switzerland under severe pressure. During this time, bachelor’s degree programs in nursing, physiotherapy and occupational therapy were disrupted, and students in their second year were displaced. Students experienced the continuous reorganisation of their traineeship as healthcare facilities adapted to a climate of uncertainty. Purpose The aim of this study was to investigate the degree of moral distress (...) and the ethical issues most often encountered by physiotherapy, nursing and occupational therapy students enrolled in a traineeship during the first wave of the COVID-19 pandemic in southern Switzerland. Participants and research context The sample consisted of 102 participants, and the response rate was 81.6%. Research design Based on a pragmatic approach, a mixed-method with a convergent design was adopted. Data were collected between 30 April 2020 and 14 May 2020, via a survey administered to all occupational therapy, physiotherapy and nursing students in their fourth semester. Ethical considerations Given that no vulnerable persons were involved, the Ethics Committee of Southern Switzerland waived authorisation. However, all measures were put into place to protect participants by guaranteeing their anonymity and confidentiality. Results and discussion The data analysis showed that the main source for moral distress was ‘poor teamwork’ and that the moral issues encountered most often by students were related to the appropriateness of care and working conditions, with a clear reference to students’ own safety and that of their loved ones; the other concerns reported included the loss of learning opportunities and the perceived lack of technical knowledge and skills. Conclusions This survey offers a faithful overview of physiotherapy, nursing and occupational therapy students’ experience during the first pandemic wave. This study also identifies some key recommendations for healthcare professions’ education. (shrink)