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Issue 171 - 2 March 2011

Our sympathy and support go out to the people of Canterbury after the devastating earthquake and ongoing aftershocks.

If you have accommodation you can offer, or you are looking for help with accommodation: 0800 HELP 00 (0800435700),

Healthline: 0800 611116.

Business-owners' helpline: 0800 424946.

Information on the Earthquake Commission's insurance cover, cleaning up and making an EQC claim, call 0800 DAMAGE (0800 326243).

Government Helpline
0800 779 997

Red Cross Person Enquiry Line
0800 733 276 or 0800 RED CROSS

Articles - Australian Occupational Therapy Journal

1. Occupational therapy, a central role in the future health and wellbeing of an ageing Australia
By Kendig, Hal. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p1
: In this article, the author presents his viewpoint on the major issues faced by occupational therapists with ageing clients and offers suggestions on how occupational therapists' core principles can make greater contributions to the successful rehabilitation of older people in Australia. He adds that occupational therapy is well positioned to address major issues related to unsuspected population ageing in the country..

2. Navigating ethical discharge planning: A case study in older adult rehabilitation
By Durocher, Evelyne & Gibson, Barbara E. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p2-7
Ethical issues are becoming more complex as individuals live longer with increased disability and medical needs. This article elucidates common ethical issues encountered in discharge planning with older adults.
Methods: We conducted normative ethical analysis of a clinical case using methods of philosophical inquiry, including thick description, reflexivity, conceptual clarification and examination of competing arguments for internal consistency.
Results: The analysis demonstrates how health-care teams struggle to balance protection from harm while honouring informed choices. We argue that ethical discharge planning requires judicious identification of client values, even if these conflict with team determinations of best interests.
Conclusion: Dialogue is needed to identify risks, help clients determine their personal level of acceptable risk and determine provisions to minimise risks. [ABSTRACT FROM AUTHOR].

3. Retirement: What will you do? A narrative inquiry of occupation-based planning for retirement: Implications for practice
By Hewitt, Alana et al. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p8-16

4. Happy and healthy only if occupied? Perceptions of health sciences students on occupation in later life
By Zecevic, Aleksandra et al. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p17-23
In this study, we bring attention to the university education of health science students with respect to occupation in later life. Our goal was to provide descriptive data from narratives of a group of undergraduate students and initiate discussion about the place of occupation in the context of ageing to answer the following questions: (i) How young people perceive successful ageing in relation to occupation? and (ii) can spirituality-related activities be considered occupations in later life?
Methods: Based on a thematic selection, the quality of photographs and reflective narratives, 60 Photovoice assignments created by health sciences students were analysed using content analysis.
 Results: The findings of this study indicate that students seem to neglect the benefits of ‘being’ through spiritual engagement, and instead emphasise the importance of ‘doing’, and perpetuate pervasive successful ageing discourses in Western societies. Conclusions: Occupational therapists have potential to take an active role in undergraduate health science education and to inform the development of holistic models that would include spirituality as an avenue to live late life to its fullest potential. Photovoice emerged as a powerful teaching method to increase awareness, empathy and compassion of young adults towards ageing. [ABSTRACT FROM AUTHOR].

5. Investigation into the occupational lives of healthy older people through their use of time
By Chilvers, Rachel et al. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p24-33
Older people are one of the largest groups using health-care services; therefore, it is important for occupational therapists to have an understanding of their occupational lives. Temporality is a key element of occupation, yet little research exists regarding older people and time use, despite the considerable temporal adjustments taking place at this lifestage. The aim of this study was to identify the occupational lives of healthy older people through the activities they undertake in a 24-hour period.
Method: Data analysis of time-use diaries from 90 older UK residents (aged 60–85 years) who considered themselves to be healthy was undertaken, using 15 activity codes and three pre-coded terms: necessary, enjoyable and personal.
Results: The participants spent most of their time sleeping and resting (34%), followed by performing domestic activities (13%), watching television, listening to the radio or music, or using computers (11%), eating and drinking (9%) and socialising (6%). Enjoyable activities occupied most of their time (42% of the day), followed by necessary (34%) and personal activities (16%).
Conclusion: These data contribute to the growing evidence base regarding older people as occupational beings, indicating that they are a diverse group of individuals who are meeting their needs with dynamic, positive activities. This highlights the importance of a client-centred approach to occupational therapy, as it enables the clients to have choice, control and diversity in their activities when meeting their needs. [ABSTRACT FROM AUTHOR].

6. Impact of fatigue on everyday life among older people with chronic heart failure
By Norberg, Eva-Britt et al. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p34-41
To explore the relationship between fatigue and performance of activities of daily living (ADL), use of assistive devices, home-help service and community mobility services in older clients with chronic heart failure.
Methods: A cross-sectional descriptive study of 40 patients was performed using the Multidimensional Fatigue Inventory, the Staircase of ADL, Assessment of Motor and Process Skills and a demographic checklist.
Results: We found high levels of general fatigue, physical fatigue and reduced activity. Greater fatigue was associated significantly with increased dependence and decreased quality of ADL, but not for shopping. Use of community mobility services and assistive devices was frequent and home help less frequent. Use of assistive devices and home help were associated significantly with greater fatigue, but not the use of community mobility services. Conclusions: Fatigue had a negative impact on ADL mainly from physical rather than from mental causes. Improved energy conservation strategies to reduce the consequences of fatigue are needed. [ABSTRACT FROM AUTHOR].

7. LiFE Pilot Study: A randomised trial of balance and strength training embedded in daily life activity to reduce falls in older adults
By Clemson, Lindy et al. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p42-50
: Exercise as a falls prevention strategy is more complex with people at risk than with the general population. The Lifestyle approach to reducing Falls through Exercise (LiFE) involves embedding balance and lower limb strength training in habitual daily routines.
Methods: A total of 34 community-residing people aged ≥70 years were randomised either into the LiFE programme or into a no-intervention control group and followed up for six months. Inclusion criteria were two or more falls or an injurious fall in the past year.
Results: There were 12 falls in the intervention group and 35 in the control group. The relative risk (RR) analysis demonstrated a significant reduction in falls (RR = 0.23; 0.07–0.83). There were indications that dynamic balance ( P = 0.04 at three months) and efficacy beliefs ( P = 0.04 at six months) improved for the LiFE programme participants. In general, secondary physical and health status outcomes, which were hypothesised as potential mediators of fall risk, improved minimally and inconsistently.
Conclusions: LiFE was effective in reducing recurrent falls in this at-risk sample. However, there were minimal changes in secondary measures. The study was feasible in terms of recruitment, randomisation, blinding and data collection. A larger randomised trial is needed to investigate long-term efficacy, mechanisms of benefit and clinical significance of this new intervention. [ABSTRACT FROM AUTHOR].

8. The physical environment as a fall risk factor in older adults: Systematic review and meta-analysis of cross-sectional and cohort studies
By Letts, Lori et al. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p51-64
Evidence that the physical environment is a fall risk factor in older adults is inconsistent. The study evaluated and summarised evidence of the physical environment as a fall risk factor.
Methods: Eight databases (1985–2006) were searched. Investigators evaluated quality of two categories (cross-sectional and cohort) of studies, extracted and analysed data.
Results: Cross-sectional: falls occur in a variety of environments; gait aids were present in approximately 30% of falls. Cohort: Home hazards increased fall risk (odds ratio (OR) = 1.15; 95% confidence interval (CI): 0.97–1.36) although not significantly. When only the high quality studies were included, the OR = 1.38 (95% CI: 1.03–1.87), which was statistically significant. Use of mobility aids significantly increased fall risk in community (OR = 2.07; 95% CI: 1.59–2.71) and institutional (OR = 1.77; 95% CI: 1.66–1.89) settings.
Conclusions: Home hazards appear to be a significant risk factor in older community-dwelling adults, although they may present the greatest risk for persons who fall repeatedly. Future research should examine relationships between mobility impairments, use of mobility aids and falls. [ABSTRACT FROM AUTHOR].

9. Can this patient go home? Assessment of decision-making capacity
By Darzins, Peteris. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p65-67
The article offers author's view on the role of occupational therapists in decision making in context to inpatient's return to home. He opines that therapists must consider if their patients have the decision-making capacity to choose to live at risk. A six-step capacity assessment process is also discussed.

10. Hand exercise leads to modest improvement in grip and pinch strength, but no difference in hand function, pain, stiffness or dexterity in older people with hand osteoarthritis
By Ballinger, Claire & Adams, Jo. Australian Occupational Therapy Journal, Feb 2010, Vol. 57 Issue 1: p68-69
In this article, the author comments on the article "Exercise and hand osteoarthritis symptomatology: A controlled crossover trial" published in the previous issue of the journal. He adds that conventions in the study used, best evidence available for exercise and placebo programmes. He further adds that therapy consultation and the use of a sham hand cream is equally effective compared to therapy consultation and mobility and strengthening exercises for patients with hand osteoarthritis..

Journals - Table of Contents

11. From JONA (The Journal of Nursing Administration), February 2011, Volume 41, Number 2
. Ergonomics in Healthcare Facility Design, Part 1: Patient Care Areas
11B. Staying Afloat in a Sea of Digital Waves
11C. The Emergence of Nurse Executive Influence in Practice: An Interview With Joyce Clifford
11D. Sustaining a Successful RN Compensation Model Through Transparency and Communication
11E. The Association of Shift-Level Nurse Staffing With Adverse Patient Events
11F. Work-Related Burnout, Job Satisfaction, Intent to Leave, and Nurse-Assessed Quality of Care Among Travel Nurses
11G. Feasibility of a Multi-institution Collaborative to Improve Patient-Nurse Relationship Quality
11H. Decreasing Pressure Ulcers Across a Healthcare System: Moving Beneath the Tip of the Iceberg
11I. Use of Outsourced Nurses in Long-term Acute Care Hospitals: Outcomes and Leadership Preferences

12. From Australian Journal of Forensic Sciences, 01/12/2009, Vol. 41 Issue 2
. DNA profiles from flip-open cell phones
12B. The persistence of animal hairs in a forensic context
12C. Trust me - I'm an expert: forensic evidence and witness immunity
12D. Graphical evidence: forensic animations and virtual reconstructions
12E. The value of death scene examination in the recognition of unsafe sleeping conditions in the young
12F. Comments on Coulthard & Johnson's (2007) portrayal of the likelihood-ratio framework
12G. Disposition of Toxic Drugs and Chemicals in Man
12H. Scientific Protocols for Fire Investigation
12I. Animal Investigators - How the World's First Wildlife Forensics Lab is Solving Crimes and Saving Endangered Species
12J. Forensic Victimology: Examining Violent Crime Victims in Investigative and Legal Contexts


2011 PHC Research Conference
Inspirations, collaborations, solutions
13-15 July 2011
Venue: Brisbane
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