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Introduction: Evidence‐based practice supports clinical decision‐making by using multiple sources of evidence arising from research and practice. Research evidence develops through empirical study while practice evidence arises through clinical experience, client preferences, and the practice context. Although occupational therapists have embraced the paradigm of evidence‐based practice, some studies have identified limits in the availability and use of research, which can lead to reliance on other forms of evidence. This study aimed to understand how Australian occupational therapists use practice evidence, manage potential bias, and enhance trustworthiness. Potential use of a critical appraisal tool for practice evidence was also explored. Methods: A 42‐item questionnaire was developed to address the study aims. It consisted of a 7‐point Likert scale, ordinal and free text questions. Likert scales were collapsed into binary scales and analysed using SPSS. Ordinal data were graphed and free text responses were analysed using manifest content analysis. Results: Most respondents (82%) indicated that practice evidence was an important informant of practice and is used alongside research evidence. Almost all respondents (98%) expressed confusion when reconciling discrepancies between research and practice evidence. There was general acknowledgement that practice evidence is prone to bias (82%), yet 92% were confident in trusting their own practice evidence. Most respondents (74.5%) undertook some measures to appraise practice evidence, and almost all respondents (90%) agreed they would refer to a critical appraisal tool that helped them evaluate practice evidence. Conclusion: Occupational therapists in this study routinely use practice evidence arising from their own experience, client perspectives, and their practice context to inform clinical decision‐making. While they agreed that practice evidence was prone to bias and misinterpretation, they generally trusted their own practice evidence. Participants indicated they needed guidance to critically appraise their practice evidence and supported the development of a critical appraisal tool for this purpose. [ABSTRACT FROM AUTHOR]

Intergenerational programs in residential aged care may improve well-being and combat loneliness and social isolation in older people with cognitive impairment. This pilot study investigated the effects of a semi-structured intergenerational group, including children from a co-located early learning centre and people living in residential aged care with cognitive impairment. This 9-week study used a mixed methods pre- and post-program design. Sessions were designed and delivered once per week by Occupational Therapists and took into account residents' interests and children's developmental needs and interests, identified in pre-program interviews. Nine older people with cognitive impairment and 13 children participated. The program was well attended despite disruptions and complications caused by COVID-19 and weather conditions. Older people valued the opportunity to engage with the children. Children were observed to gain confidence in communicating and forming friendships with older people with different levels of ability. There did not appear to be any change in loneliness or neuropsychiatric symptoms. The intergenerational program benefited participants and received strong support from family members and staff of the early learning centre and aged care home. [ABSTRACT FROM AUTHOR]

People living in residential aged care homes in Australia often have limited opportunities for meaningful social engagement. The present study aimed to characterize the state of intergenerational programs in residential aged care within a nationwide Australian sample. A total of 572 valid survey responses were received. A large number of aged care homes had existing programs, but only 18.2% had active programs; 44.4% reported their programs as temporarily suspended, predominantly due to COVID-19. The most common activities included singing (67.8%), games (56.8%), reading (51.1%) and craft (41.5%). Mental health and wellbeing, opportunity to socialize, and connection with the community were considered as the main benefits. There is consensus on the benefits of well-placed programming and engagement. Several barriers and challenges to engagement exist, including the COVID-19 pandemic. Aged care homes need adequate information and support to increase their ability to offer intergenerational programs between residents and community members. The survey provides insight into intergenerational programs in Australian aged care homes during the COVID-19 pandemic Staff completing the survey reported positive views of the benefits of the programs to both old and young participants The findings highlight the diversity of participants' ages, places, mode of delivery and types of activities – frequently singing, games, reading and craft, but also dancing and reminiscence, and even robotics. While COVID-19 posed significant challenges, there were creative solutions including written letters and shared journals, virtual interaction and simple strategies such as access to areas where residents could observe children at play or in passing. [ABSTRACT FROM AUTHOR]

To critically review the evidence for occupation-based interventions in improving occupational performance and participation outcomes in the hospital setting. Five databases were searched from 2000–2022. Peer-reviewed studies of any design investigating the impact of occupation-based interventions in the hospital setting were included. Methodological quality was assessed using the appropriate tool for each study design. Following data extraction, a narrative synthesis was conducted. Thirty-three studies comprising of 26 experimental, five non-experimental, and two mixed methods studies were included (n = 1646 participants). Results indicate good evidence to support occupation-based interventions to improve occupational performance and participation outcomes in inpatient rehabilitation; it is unclear whether they are more effective than any control/alternative intervention. Research in the acute and mental health hospital settings were scarcer. Understanding the benefits of occupation-based interventions was enhanced through qualitative results including improving independence and confidence to discharge home, increasing motivation for therapy, connecting with others, and peer-based learning. Heterogeneity and methodological weaknesses across existing studies limits the conclusions that can be drawn on the impact of occupation-based interventions in the hospital setting. More rigorous research should be conducted with better reporting of intervention design and the use of robust measures of occupational performance. The use of occupation-based interventions should be considered to improve occupational performance and participation outcomes in the hospital setting. There is good evidence to support the impact of occupation-based interventions on improving occupational performance and participation outcomes in the inpatient rehabilitation setting; evidence in the acute and mental health settings is scarcer. Occupation-based interventions are valued by both patients and clinicians for their impact on patient outcomes and the patient experience. [ABSTRACT FROM AUTHOR]

Objective: A feasibility study to test the proposed methodology for a larger randomised control trial was conducted, investigating the comparative effectiveness of the two types of pressure management support surfaces with regards to healing pressure injuries (PI). A secondary objective was to provide insights into the user acceptability of the two types of pressure management support surfaces. Method: A randomised control feasibility study was conducted in a community health setting in Canberra, Australia. Patients aged ≥65 years with an existing Stage 2 PI who slept in a bed were eligible. Participants were randomised to either the active mattress group or the reactive mattress group for use on their bed. All participants received standard wound care by community nursing staff and were provided an air-flotation cushion for use when not in bed. Photographs were taken and used for blind assessment of wound healing. Secondary information was gathered through a survey regarding user acceptability of the support surfaces and changes in habits regarding PI prevention strategies. Results: In total, five patients were recruited, with one passing away prior to mattress allocation. Results were inconclusive with regards to comparative effectiveness and user acceptability due to the small sample size; however, secondary data indicated an increasing implementation of PI prevention strategies. Conclusion: This study confirmed the need for further high quality research comparing reactive and active pressure mattresses. Trends indicate the importance of including education on PI prevention strategies to promote changes in behaviour. Changes to the proposed methodology will be made to increase recruitment in the primary study. [ABSTRACT FROM AUTHOR]

Introduction: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. The purpose of this paper is to review these recommendations and the Australian Government's policy responses and explore the emerging changes in allied health service provision in residential aged care. Methods: Data from the four available Quarterly Financial Reports from the 2022–2023 financial year were extracted and analysed in relation to staff costs and time per person per day across personal care, nursing, and allied health workers. Supplementary data sources including the 2020 Aged Care Workforce Census were accessed to provide contextual data relating to individual allied health professions, including occupational therapy. Results: The analysis shows a modest increase in median registered nurse minutes per person per day, and cost per person per day, from the first to second quarter, and again in the third and fourth. By contrast, median time and cost for allied health declined. From 5.6 minutes per person per day in the first quarter, reported allied health minutes fell to 4.6 minutes per person per day in the second quarter, an 18% decrease, and by the fourth quarter was 4.3 minutes per person per day. This is just over half the Australian average of 8 minutes reported to the RCACQS in 2019. Conclusion: Under recent residential aged care reforms, aged care providers have regulatory incentives to concentrate their financial resources on meeting the mandated care hours for registered nurses, enrolled nurses, personal care workers, and assistants in nursing. These same reforms do not mandate minutes of allied health services. Although providers of residential aged care in Australia continue to employ and value allied health, we argue that mandating care minutes for personal and nursing care without mandating the provision of allied health creates a perverse incentive whereby access to allied health services is unintentionally reduced. PLAIN LANGUAGE SUMMARY: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. In this paper, we argue that despite the positive intentions of some of the reforms following the Royal Commission, there have been unintended consequences that have reduced the spending on allied health in residential aged care and reduced the minutes residents receive of allied health. Consideration to mandating allied health care minutes in residential aged care should be considered. [ABSTRACT FROM AUTHOR]

The article offers information on the formation of Occupational Therapy Australia Limited and its role in advocacy and policy influence. Topics include the association's efforts in lobbying against the introduction of independent assessments for NDIS funding, advocating for increased fees for occupational therapy services to veterans, and addressing the societal issue of loneliness among older adults through submissions to the Royal Commission in Aged Care Quality and Safety.

Objectives: Social isolation is recognised as a risk factor in the inflammatory process. This study explored the association between social isolation and the Dietary Inflammatory Index (DII) in community-dwelling older persons. Methods: This cross-sectional pilot study recruited 107 community-dwelling people aged over 55 years living in the Australian Capital Territory. Participants completed an extensive food frequency questionnaire and provided anthropometric and sociodemographic data. Social isolation was evaluated using the Lubben Social Network Scale (LSNS). Diet quality was assessed using DII. Results: Average age was 70.1 (±8.61) years and 62.8% were female. The average DII score was −1.10 (±1.21), indicating an anti-inflammatory diet. Higher LSNS was associated with lower DII (b (95% CI) = −0.041 (−0.066, −0.17); p < 0.01) and was positively influenced by the number of people in household (b (95% CI) = 5.731 (2.336, 9.127); p = 0.001). Conclusion: Increased risk of social isolation was associated with an increased tendency towards a more inflammatory diet. Reducing social isolation may decrease the inflammatory component of dietary intake for older persons living independently in the community. [ABSTRACT FROM AUTHOR]

This communication reports a four-step protocol to produce 3-allyl-2-(allyloxy)-5-bromoaniline 5 from commercially available 2-allylphenol. The synthetic steps used were nitration, selective bromination, allylation, and reduction of the nitro group. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify educational, technological, and professional consequences of ePortfolio use that were intended, unintended, positive and negative. Ethical approval was obtained from seven universities in accordance with institutional guidelines established in accordance with Australia's National Statement on Ethical Conduct in Human Research. A mixed methods design was employed to survey staff and invite them to participate in a focus group or interview. Online questionnaires were distributed across seven universities to 22 volunteer respondents drawn from academic teachers in both disciplines. Following completion and quantification of questionnaire data, respondents were invited to participate in a either a focus group or interview with one of the researchers. Merton's sociological model was adopted in the study as it informed a conceptual framework used to examine the impact of unintended consequences that emerged when building a professional online presence. This theory was used to identify the full range of ePortfolio learning and teaching practices emerging as a multi-function, complex system, within domains and purpose of ePortfolios such as information systems, health or education disciplines. Results indicated a significant challenge, namely there is no single set of guidelines that would support teachers and students when engaging in learning and teaching activities to improve protection of private data relating to vulnerable people. Digital literacy of academics and students is variable and may impact on data privacy. Data gathered will be used to inform development of guidelines on the use and publication of information collected in ePortfolios to protect vulnerable people. [ABSTRACT FROM AUTHOR]

Art activities for people with dementia have a range of therapeutic benefits including psychosocial wellbeing and enhanced quality of life. Successful art programs promote social engagement, are inclusive and empowering, and enable opportunity for people with dementia to express themselves verbally and non-verbally. The COVID-19 pandemic and associated social distancing precautions have impacted the capacity of art galleries and museums to deliver in-person programs. However, they have also provided a new opportunity. This paper explores the potential benefits, challenges, and future directions for research relating to the online delivery of gallery-facilitated art activities for people with dementia. The evidence revealed that increased digitisation of programs increased access for participants, however, the majority of the research was published before the pandemic. Nevertheless, COVID-19 has necessitated many museums and galleries to engage with people with dementia online. Future research is needed to improve the usability of online delivery platforms and a comparison of online and onsite delivery is recommended, particularly to evaluate benefits to people living in rural and remote areas where access to museums and galleries may be limited. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of residents, families and staff in the establishment of a new small‐scale home model of care for people living with dementia. Background: New and innovative small‐scale models of care have the potential to improve outcomes for older people, especially those with dementia, who experience high rates of cognitive impairment in traditional residential aged care homes in Australia. Design: A qualitative descriptive study. Methods: Semi‐structured interviews with 14 guests, family and staff of a new small‐scale dementia home named 'Kambera House' in the Australian Capital Territory were conducted between July 2021 when the home opened and August 2022. Data were analysed using reflexive thematic analysis and reported according to the COREQ guidelines. Results: Two guests with mild‐to‐moderate dementia, five family and seven staff members participated in the study. The data revealed high satisfaction with Kambera House, generating five themes. Falls detection technology in the home provided a sense of safety, enabling more time for person‐centred care. Free, everyday technology connected the home with families as part of an overall community of care where staff were empowered to maximize choice and dignity of risk of guests living in the home. This contributed to the sense of community, rather than an institution, where the conditions of work supported the conditions of care, and were embedded in a culture of responsiveness, change and flexibility. Conclusion: Kambera House represents a successful example of a new small‐scale dementia home. Technology played an important background role in improving overall safety and flexibility as part of a model of care which demonstrated positive experiences for guests and families by being responsive to their individual needs. Impacts: Small‐scale homes for people with dementia offer an alternative model that may provide more individualized, person‐centred care compared with the traditional institutionalized care. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Sulfones are fascinating and highly used functional groups, but current syntheses still have limitations. Here, a regiodivergent transition metal-free approach towards sulfones [(E)-allylic sulfones and α-sulfonylmethyl styrenes] is reported. The method employs commercially available olefins, bases, additives, solvents, and sodium sulfinates (RSO2Na) and produces adducts in good yields. Considering that up to 4 reactions (bromination, dearomative rearrangement, E2, and SN2) are happening, this approach is very efficient. The structures of key adducts were confirmed by X-ray crystallography. [ABSTRACT FROM AUTHOR]

There is a growing interest in developing more efficient synthetic alternatives for the synthesis of nitrogen-containing allylic compounds. This article presents a straightforward two-step protocol to produce 5-(3-azidoprop-1-en-2-yl)benzo[d][1,3]dioxole 4 from the natural product safrole. The method yielded the expected α-azidomethyl styrene 4, in good yield, via a dearomative rearrangement. [ABSTRACT FROM AUTHOR]

There is a need for integrated and effective postdiagnostic rehabilitation programs for community-dwelling people with dementia and their carers to promote their quality of life and management of dementia. Here, we report on preliminary findings of the Sustainable Personalised Interventions for Cognition, Care, and Engagement (SPICE) Program conducted in Canberra, Australia. Over twelve weeks, six people with dementia and their carers completed five hours of weekly small group activities and separate individual appointments. SPICE is an active therapeutic intervention with five components delivered by allied health professionals: (1) cognitive stimulation therapy; (2) carer education, support, and capacity building; (3) physical activity; (4) Care Of People with dementia in their Environments (COPE) program; and (5) dietary assessment and advice. Participants completed questionnaires pre- and post-intervention and a program evaluation interview which was analysed by qualitative thematic analysis. The program demonstrated high program satisfaction ratings and program adherence (94% people with dementia and 92% carers) which supports intervention feasibility. The results of quantitative outcome measures suggest positive effects, but inferences cannot be drawn due to small sample size. Qualitative themes from participant experiences highlighted the following: (1) social connection, engagement, and interaction were key drivers of the success of the program; (2) clinicians fostered a positive and respectful culture; (3) carers were supported with strategies and skills to reframe dementia; and (4) reablement can be fun. The new combination of evidence-based interventions was feasible and considered valuable. Further results are required to confirm these findings and support a longer-term trial. [ABSTRACT FROM AUTHOR]

Background: Small-scale models of dementia care are a potential solution to deinstitutionalize residential aged care and have been associated with improved resident outcomes, including quality of life and reduced hospitalizations for people living with dementia. Objective: This study aimed to generate strategies and ideas on how homes for people living with dementia in a village setting within a suburban community, could be designed and function without external boundaries. In particular, how could residents of the village and members of the surrounding community access and engage safely and equitably so that interpersonal connections might be fostered? Methods: Twenty-one participants provided an idea for discussion at three Nominal Group Technique workshops, including people living with dementia, carers or former carers, academics, researchers, and clinicians. Discussion and ranking of ideas were facilitated in each workshop, and qualitative data were analyzed thematically. Results: All three workshops highlighted the importance of a surrounding community invested in the village; education and dementia awareness training for staff, families, services, and the community; and the necessity for adequately and appropriately trained staff. An appropriate mission, vision, and values of the organization providing care were deemed essential to facilitate an inclusive culture that promotes dignity of risk and meaningful activities. Conclusion: These principles can be used to develop an improved model of residential aged care for people living with dementia. In particular, inclusivity, enablement, and dignity of risk are essential principles for residents to live meaningful lives free from stigma in a village without external boundaries. [ABSTRACT FROM AUTHOR]

Students more than ever are completing their university studies online. At the onset of the Covid-19 pandemic, most higher education providers were required to move to exclusively deliver online curriculum. It is therefore imperative that educators have access to psychometrically sound measures of students' online learning experiences. The reliability and validity properties of the Distance Education Learning Environments Scale (DELES) and Student Engagement in the e-Learning Environment Scale (SELES) were examined. A sample of 151 Australian undergraduate students completed the DELES and SELES after completing their studies online during 2020 due to Covid-19. Cronbach alpha coefficients, subscale item correlations and linear regression analyses were completed with bootstrapping. Cronbach alpha coefficients for the SELES subscales ranged from.68 to.93 and.75 to.96 for the DELES subscales. The within subscale correlations ranged from.29 to.66 for the SELES (p <.001) and.30 to.68 for the DELES (p <.001) and the between subscale correlations ranged from.18 to.75 (p <.001) respectively. Regression findings indicated that the SELES and DELES subscale models each accounted for 56.6% and 22.2% of the unique variance of the DELES Enjoyment, respectively. These findings present important psychometric evidence about the DELES and SELES. [ABSTRACT FROM AUTHOR]

The rapid switch to online learning in response to the Covid-19 pandemic affected occupational therapy students' education delivery. It is, therefore, important to investigate these impacts. This study investigated the potential predictors of academic performance in undergraduate occupational therapy students after moving to online or blended learning post-Covid-19. A total of 208 students from three Australian universities completed a demographic questionnaire and the Distance Education Learning Environment Scale (DELES). Hierarchical linear regression analyses were completed to identify significant students' academic performance predictors. Hierarchical regression explained a cumulative total variance of 24.6% of students' academic performance. The following independent variables were significant predictors: DELES student autonomy (p = 0.033), number of hours per semester week dedicated to indirect online study (p = 0.003), number of hours per semester week dedicated to indirect offline study time (p = 0.034), gender (p = 0.005) and English as a first language (p = 0.045). The findings add to the knowledge base on the range of factors that have impacted occupational therapy students' academic performance during the Covid-19 pandemic. The outcomes will assist faculty in developing supportive and pedagogically sound learning modes across online, hybrid and traditional forms of instruction within occupational therapy curricula. [ABSTRACT FROM AUTHOR]

Polypropionate units are a common structural feature of many of the natural products in polyketides, some of which have shown a broad range of antimicrobial and therapeutic potential. Polypropionates are composed of a carbon skeleton with alternating methyl and hydroxy groups with a specific configuration. Different approaches have been developed for the synthesis of polypropionates and herein we include, for the first time, all of the epoxide-based methodologies that have been reported over the years by several research groups such as Kishi, Katsuki, Marashall, Miyashita, Prieto, Sarabia, Jung, McDonald, etc. Several syntheses of polypropionate fragments and natural products that employed epoxides as key intermediates have been described and summarized in this review. These synthetic approaches involve enatio- and diastereoselective synthesis of epoxides (epoxy-alcohols, epoxy-amides, and epoxy-esters) and their regioselective cleavage with carbon and/or hydride nucleophiles. In addition, we included a description of the isolation and biological activities of the polypropionates and related natural products that have been synthetized using epoxide-based approaches. In conclusion, the epoxide-based methodologies are a non-aldol alternative approach for the construction of polypropionate. [ABSTRACT FROM AUTHOR]

Portfolios have been used in health professions for many decades as a means of documenting reflective practice that inform change, supports the understanding of professionals' development needs and changing care options for clients. Electronic versions of one's portfolio of evidence or E-Portfolios became more prevalent in the early 2000s as a repository to store evidence and reflections. However, in recent years E-Portfolios have evolved from a repository to an articulation of authentic learning and development. Introduction of a range of E-Portfolio technology options, hosting systems and increasing professional/ethical standards, has resulted in challenges and opportunities for academics and professionals to meet increasing requirements for teaching and support of students training for health professions. This paper explores twelve tips explained and justified in a Health Science context, designed to support students developing and using E-Portfolios to fulfil professional standards, show evidence of reflective practice and culminate in securing a job in their field. [ABSTRACT FROM AUTHOR]

Introduction: Collaborating with consumers in designing, delivering, and evaluating curricula is an ongoing initiative within occupational therapy tertiary courses in Australia. Within the Australian educational context, consumers are involved in on‐campus educational activities. Student occupational therapists must complete 1000 hours of practice placements as part of their education. To date, no research has explored how consumers could contribute to student occupational therapists' learning during practice placements. This study aimed to explore Australian occupational therapists' perceptions of consumers providing feedback to students during practice placements. Methods: A qualitative descriptive approach was adopted to engage with the diversity of practice contexts and gain a rich dataset from the occupational therapy profession. A qualitative questionnaire was developed and distributed using snowballing techniques. The questionnaire asked recipients to reflect on the risks, challenges, and benefits of consumers providing feedback to student occupational therapists from all stakeholders' perspectives. Demographic data were collated, and reflexive thematic analysis was used to construct themes. Findings: Responses were received from 81 participants. Most respondents identified as experienced occupational therapists from metropolitan locations across Australia. Reflective thematic analysis was used to construct three themes: Personal capability of consumers and students will enable, inhibit, and be developed by engaging in a feedback process; an educator‐controlled process to ensure safety for all stakeholders is required for time‐poor practice contexts; and us versus them: Shifting control to consumers can disempower practice educators. Conclusion: Engaging with consumers throughout all aspects of student occupational therapists' educational programme is required, including practice placements. New educational initiatives need to consider all stakeholders' concerns to ensure that authentic contribution from consumers is made within the various practice contexts. A co‐design approach that involves all stakeholders to develop a feedback process may result in high‐quality learning experiences that assist students to become safer, consumer‐centred health professionals. [ABSTRACT FROM AUTHOR]

Microbial infection is a leading cause of death worldwide, resulting in around 1.2 million deaths annually. Due to this, medicinal chemists are continuously searching for new or improved alternatives to combat microbial infections. Among many nitrogen-containing heterocycles, carbazole derivatives have shown significant biological activities, of which its antimicrobial and antifungal activities are the most studied. In this review, miscellaneous carbazole derivatives and their antimicrobial activity are discussed (articles published from 1999 to 2022). [ABSTRACT FROM AUTHOR]

The article presents the discussion on process of reflection about diversity, equity, and inclusion in publishing. Topics include recognising the systemic racism, biases, injustices, and prejudices experienced by Aboriginal and/or Torres Strait Islander Peoples in research; and current journal processes support bias, assumptions, injustices, and prejudices.

When older adults' driving abilities decline, automated driving technologies may improve community mobility, engagement, and independence. Most previous research has focused on older persons' attitudes rather than their use of automated driving technologies. This study examined older Australians' perceptions and experience of automated vehicle technologies before, during, and after a real-life driving experience, focusing on ease of use, usefulness, safety, acceptance, trust, and confidence. This mixed-methods study included observation of a 6-km test drive using a partially automated vehicle, pre- and post-drive questionnaires, and a post-drive semi-structured interview. Most participants reported positive perceptions and experiences before, during, and after the test drive. Visual analysis of pre/postresponses revealed divergent reactions to the test drive, consistent with the heterogeneity of the older population. Automated driving technologies have potential to contribute to mobility at older ages. Larger-scale studies including actual driving experiences are recommended. [ABSTRACT FROM AUTHOR]

Introduction: In many countries, the COVID‐19 pandemic resulted in sudden changes to the delivery of health professions education in response to local and national lockdowns. Within occupational therapy, university education programs traditionally delivered in face‐to‐face classroom, and clinical settings, the transition to online learning presented unique issues and challenges for faculty and students. This study compared the experiences and perceptions of learning in two groups of occupational therapy students during the pandemic: one group converted to online learning only and the other had a blended approach that combined face‐to‐face on‐campus learning with some online lecture content delivery. Methods: Two hundred and eight (n = 208) undergraduate occupational therapy students from three Australian universities completed an online self‐report demographic questionnaire and two standardised instruments: the Student Engagement in the e‐Learning Environment Scale and the Distance Education Learning Environment Scale. An independent‐samples t test with bootstrapping was completed to examine differences in students' scores. Results: Statistically significant differences were observed between the online and blended learning groups across a range of the SELES and DELES subscales. The strongest findings related to psychological motivation (p = 0.001), personal relevance (p = 0.001), interactions with instructors (p = 0.002), instructor support (p = 0.001), student interaction & collaboration (p = 0.001), and cognitive problem solving (p = 0.001). Conclusion: Occupational therapy students who transitioned to online‐only learning experienced higher levels of motivation, interactions with instructors and peers, and self‐directed learning than students who experienced a blended education delivery approach of face‐to‐face and online learning. The findings extend educators' understanding of the matrix of factors that have impacted students' education during COVID‐19 and support the development of contemporary and pedagogically sound online and traditional modes of occupational therapy instruction. The results provide evidence of the importance of well‐structured programs that facilitate active and flexible learning, provide meaningful and positive experiences, and promote initiatives safeguarding social and personal well‐being. Further research in this area is recommended. [ABSTRACT FROM AUTHOR]

Rationale: People with stroke experience falls at more than twice the rate of the general older population resulting in high fall-related injuries. However, there are currently no effective interventions that prevent falls after stroke. Aims: To determine the effect and cost-benefit of an innovative, home-based, tailored intervention to reduce falls after stroke. Sample size estimate: A total of 370 participants will be recruited in order to be able to detect a clinically important between-group difference of a 30% lower rate of falls with 80% power at a two-tailed significance level of 0.05. Methods and design: F alls a fter s troke t rial (FAST) is a multistate, Phase III randomized trial with concealed allocation, blinded assessment, and intention-to-treat analysis. Ambulatory stroke survivors within five years of stroke who have been discharged from formal rehabilitation to the community and who have no significant language impairment will be randomly allocated to receive habit-forming exercise, home safety, and community mobility training or usual care. Study outcomes: The primary outcome is the rate of falls over the previous 12 months. Secondary outcomes are the risk of falling (proportion of fallers), community participation, self-efficacy, balance, mobility, physical activity, depression, and health-related quality of life. Health care utilization will be collected retrospectively at baseline and prospectively to 6 and 12 months. Discussion: The results of FAST are anticipated to directly influence intervention for stroke survivors in the community. Trial Registration: ANZCTR 12619001114134 [ABSTRACT FROM AUTHOR]

Social isolation and sedentary behaviour are common in residential aged care facilities (also known as nursing homes or long-term care). Use of new technologies such as virtual and augmented reality are currently under investigation for their potential to provide exciting and engaging activities for older people in residential aged care facilities. However, there is limited evidence on whether these technologies can promote physical activity in a small group setting for people with cognitive impairment. Using mixed methods, we examined the use of a virtual cycling experience in a sample of 10 participants with cognitive impairment living in residential aged care facilities. In a randomised crossover design, participants engaged in a 25-minute, self-paced, facilitated seated virtual cycling experience and a time-matched seated physical activity session in groups of five. All participants completed a brief pre- and post-intervention mood questionnaire. Video analysis was used for both conditions to compare levels of environmental stimulation, apathy and engagement using both the Person–Environment Apathy Rating Scale and the Engagement of a Person with Dementia Scale. A thematic analysis of semi-structured interviews following the virtual cycling experience was also performed. No differences were observed between conditions for all outcomes except for environmental stimulation, where there was a lower response in the intervention than the control condition (p = 0.032). This was primarily driven by lower scores for the virtual cycling experience than control in physical accessibility (p = 0.012). Participants reported the virtual cycling experience to be immersive and challenging and reminisced about cycling earlier in life. The activity manager observed that the virtual cycling experience was an overall positive experience and emphasised benefits of safety screening and preparation prior to the activities. The findings of this study support the use of the virtual cycling experience as an immersive and engaging alternative to usual activities, which might encourage higher levels of physical activity in residential aged care facilities. [ABSTRACT FROM AUTHOR]

Arthritis is a significant cause of chronic pain and disability, affecting around 3.5 million Australians. However, little is known regarding the overall diet quality of those living with arthritis. This study aimed to assess the dietary quality of Australians living in the Australian Capital Territory region with arthritis. This cross-sectional study analysed dietary intake data of individuals living with arthritis using a validated food frequency questionnaire. Dietary quality was assessed using the Healthy Eating Index-2015 (HEI-2015) to examine associations between diet composition, age, income and arthritis impact using the short form of the Arthritis Impact Measurement Scales 2 (AIMS2-SF). Participants, predominantly female (82.6%), were grouped by age: 18–50 years (n = 32), 50–64 years (n = 31), and 65 + years (n = 23). Significant correlations were observed between age and HEI-2015 (rs = 0.337, p = 0.002) and income and AIMS2-SF (rs = − 0.353, p < 0.001). The mean HEI-2015 score for the 18–49 years group was fair (72.1 ± 12.3), lower than both the 50–64 years group score of good (81.5 ± 9.72) (p = 0.004), and the 65 + years group score of good (81.8 ± 12.1) (p = 0.007). Dietary fibre, seafood and plant protein, fatty acids, and refined grains were identified as dietary components of concern for the 18–49 years group, and total fruit and added sugar were components of concern for people in the worst tertile for the AIMS2-SF. People aged between 18 and 49 years are consuming a lower quality diet compared to people aged 50 years and over. Further research is needed to understand why this association is occurring in this high socioeconomic region of Australia (a high-income country). [ABSTRACT FROM AUTHOR]

Introduction: Practice education is a fundamental component of health professional students' education and many personal, social and professional factors impact on students' performance. This study investigated the relationship between measures of resilience and practice education performance in occupational therapy students. Methods: A quantitative cross‐sectional study was used to collect the data. In all, 149 occupational therapy students completed a self‐report questionnaire comprised of demographic questions and two standardised scales: Resilience at University (RAU) and Resilience Scale for Adults (RSA). Students' practice education performance was measured by the Student Practice Evaluation Form–Revised (SPEF–R). Multi‐linear regression analyses with bootstrapping were completed to identify resilience factors that were predictive of occupational therapy students' practice performance. Results: Overall, occupational therapy students reported high levels of resilience based on the RAU and RSA subscale scores. "Managing Stress," "Find Your Calling" and "Living Authentically" were strong predictors of a range of key fieldwork performance SPEF–R factors, including "Professional Behaviours," "Self‐management Skills," "Co‐worker Communication" and "Communication Skills." Conclusion: The resilience factors identified as being significant predictors of practice education performance outcomes in occupational therapy students represent notable findings. They suggest that students' capabilities in managing their stress levels, finding meaning in their chosen profession, and engaging self‐care daily activities outside of the work environment that are meaningful, authentic and fit with one's personal values and beliefs can act as buffers against the challenges experienced by students who are completing practice education placements. The findings will assist academic and practice educators in identifying and targeting vulnerable students and strengthening resilience strategies through proactive pre‐practice placement initiatives. Qualitative studies are recommended to further explore the relationship between resilience and practice education performance in occupational therapy students. [ABSTRACT FROM AUTHOR]

The use of existing public spaces by people living with dementia, such as museums and art galleries, are becoming popular due to their ability to facilitate programs which promote social engagement and inclusion. However, few studies have investigated physiological outcomes of art gallery-based programs. Using a quasi-experimental design, the present study aimed to investigate the levels of salivary biomarkers of cortisol and interleukin-6, quality of life (QoL), depressive symptoms, cognition, and wellbeing, after attending the National Gallery of Australia (NGA) Art and Dementia program. Twenty-eight people living with dementia, each supported by a carer or family member, were recruited for a six-week program and were followed up at twelve weeks. In total, 25 participants (17 female; mean age 84.6±7.27 years) completed the study, and 22 provided viable saliva samples. The waking to evening salivary cortisol ratio was higher post-intervention (p = 0.033), and returned to baseline levels at follow-up (p = 1.00), indicating a more dynamic salivary cortisol rhythm in response to the six-week program. Interleukin-6 levels remained unchanged (p = 0.664). No improvements in QoL (DEMQOL-Carer) were observed between baseline and post-intervention (p = 0.076). However, self-reported depressive symptoms decreased post-intervention compared with baseline (p = 0.015), and memory (immediate recall) (p = 0.009) and verbal fluency (p = 0.027) improved between the same timepoints. The NGA Art and Dementia program appears to have quantifiable benefits, including improved hypothalamic-pituitary-adrenal axis function, justifying a need for longer controlled trial inclusive of physiological outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The call for occupational therapists to embrace occupation-based practice has increased in recent decades. Little is known about how occupational therapists perceive and implement occupation-based practice. This study aims to uncover the experiences of new and recent graduates using occupation in their practice. Method: A phenomenological design guided the development of semi-structured interviews. New and recent Australian occupational therapy graduates were interviewed about their experiences of occupation in their practice. Interview transcripts formed the data and themes were developed by thematic analysis. Findings: Eighteen occupational therapists were interviewed. Three main themes emerged from the data. Overall, graduates found it challenging to embrace occupation in their everyday practice, deciding it is more pressing to remediate impairments than to enable occupations. Some participants stated that occupation-based practice was unrealistic given the efficiency pressures of their practice environments. However, graduates felt that with more experience they would be able to implement occupation in their daily practice. Conclusion: Recently graduated occupational therapists in Australia find it challenging to consistently implement occupation in their daily practice. Confidence to apply occupation-based skills is an important factor for implementing occupation in practice. Some recent graduates are choosing impairment-based techniques over occupation-based practice. [ABSTRACT FROM AUTHOR]

Assistive technology including virtual reality and augmented reality has gained interest as a novel intervention in a range of clinical settings. This technology has the potential to provide mental stimulation, a connection to autobiographical memory through reminiscence, and enhanced quality of life (QoL) to people living with dementia (PLWD) and mild cognitive impairment (MCI). In this mini-review, we examine the available evidence from studies reporting on the potential benefits of virtual and augmented reality to provide enjoyable, leisurely activities that may promote QoL and psychological well-being and facilitate social interaction. In total, 10 studies of varying study designs and durations (5 min to 6 months) using virtual (n = 9) and augmented reality (n = 1) were examined in PLWD (n = 6) and MCI (n= 3), in addition to 1 study that included participants with both conditions. Overall, the virtual experiences were enjoyed by the participants, improved their mood and apathy, and were preferred when compared with nonvirtual experiences. However, small sample sizes and variations in study design limit the generalizability of the results. Nevertheless, the use of virtual and augmented reality technology for PLWD and MCI is a novel and emerging method which may provide cognitive stimulation and improve well-being. Future research should explore the potential application of this technology to promote social interaction in both the community and aged care settings. We suggest future studies in PLWD and MCI assess the effects of more sustained use of virtual and augmented reality technology on psychological outcomes including QoL, apathy, and depressive symptoms, with the incorporation of physiological biomarker outcomes. [ABSTRACT FROM AUTHOR]

Background: Research into the prevalence of dishonest academic behaviors suggests that such behaviors may be extensive in higher education. This study investigated the academic integrity of Australian occupational therapy students and compared the perspectives of undergraduate (UG) and graduate-entry master's (GEMs) students. Method: Students from five Australian universities (701; response rate 35%; 72.5% female) completed five standardized scales: (a) Academic Dishonesty Scale; (b) Academic Dishonesty in the Classroom Setting Scale; (c) Academic Dishonesty in the Clinical/Practice Education Setting Scale; (d) Academic Dishonesty Tendency Scale; and (e) Perceived Academic Sources of Stress. One-way analyses of variance were conducted to compare the scores of the UG and GEMs students. Results: No significant differences were found on the UG (n = 609) and GEMs (n = 92) students' self-reported scores in academic dishonesty in the classroom and practice education settings. Significant differences were noted between the UG and GEMs students on self-reported tendency toward dishonesty in providing appropriate references, on workload and examinations, and self-perception. Overall, low rates of academic integrity breaches were reported by occupational therapy UG and GEMs students, but they are still present. Conclusion: Occupational therapy UG and GEMs students report good levels of academic integrity in the classroom and practice education settings, although areas of concern in academic integrity were identified. Educators should facilitate the development and awareness of academic integrity among UG and GEMs occupational therapy students. [ABSTRACT FROM AUTHOR]

Background/aim: Occupation and an occupational perspective of health and wellbeing are required to be taught in accredited occupational therapy programmes internationally. Current research into occupational therapy education has commonly focused on curriculum design and the experience of students and their developing skills for practice. Little research has focused on the perspectives of educators and in particular their own reflections and beliefs on the use of occupation in occupational therapy education. The aim of this study was to uncover Australian educator perspectives of occupation in occupational therapy education. Method: This study utilised a qualitative research framework. Eight occupational therapy educators and practice education coordinators completed semi‐structured interviews. Educators ranged in experience from two to over 20 years in the university sector. The interview transcripts were transcribed verbatim, forming the data for analysis. Braun and Clarke's thematic analysis was used to analyse the dataset. Results: Three themes emerged from the data: occupation is our framework; the balance between practice education and occupation‐centred education; and educators changing the focus. Overall, educators believed that the 'occupation for health' philosophy and its application are important foundations for education. However, educators provided varied responses on how to teach these concepts to students. Conclusion: Gaining educators' opinions on the importance of occupation in education is beneficial for ensuring consistency throughout occupational therapy curricula. Theoretical models were endorsed by educators to foster occupation‐based practice. Educators must continue to innovate within the profession for occupation‐based approaches in practice and education to be strengthened in the future. [ABSTRACT FROM AUTHOR]

Objective: Changes in technology have resulted in a lack of clarity regarding the comparative effectiveness between active and reactive support surfaces in the prevention and treatment of pressure ulcers (PUs). The purpose of this literature review was to evaluate the comparative effectiveness of active and reactive mattresses for prevention and treatment of PUs. Method: A literature search was completed using CINAHL, Medline Plus, Scopus, Cochrane Library and PubMed databases, as well as reference lists. A temporal limiter was placed excluding studies published before 2000 due to changes in care standards and support surface technology. Results: Of the 33 articles included, nine were systematic/literature reviews and 24 were randomised controlled trials (RCTs). There was a consensus that pressure mattresses are an effective prevention and treatment strategy, however comparisons of the two types were often inconclusive or conflicting. Studies were conducted in acute, sub-acute or residential facilities, with no studies in a domiciliary setting. The majority of studies were rated as moderate quality with significant methodological limitations. Conclusion: Further research is needed to investigate the use of support surfaces in a domiciliary setting with an appropriate methodology aimed at minimising the limitations described in the existing literature. [ABSTRACT FROM AUTHOR]

Background: Academic integrity is the moral code of academia. Students who demonstrate trustworthiness in an academic setting are more likely to be dependable in a clinical setting. It is, therefore, important for occupational therapy academic and fieldwork educators to know the academic integrity profile of their students and to address any areas of academic dishonesty in curriculum design and delivery. To date, there has been no baseline description of the academic honesty profile of Australian occupational therapy students. Aim: To establish a baseline of academic integrity and academic dishonesty among occupational therapy undergraduate and graduate‐entry masters students in a cohort of Australian students. Methods: Seven hundred and one students from five Australian universities completed a self‐report questionnaire comprising demographic questions and six standardised scales measuring academic integrity. Results: Overall, occupational therapy students reported high levels of academic and fieldwork integrity; however, some areas of concerns exist. Students report copying material without citations at least once during their studies (55%), obtaining test questions at least once during their studies (42.6%) or padding out a bibliography (39.5%). Conclusion: Occupational therapy education needs to continue to emphasise the importance of academic and fieldwork integrity. Students need to be explicitly taught what academic honesty and dishonesty is and be provided with the resources and time to complete academic work to reduce the risk of academic dishonesty. [ABSTRACT FROM AUTHOR]

The literature reports that rehabilitation for elderly patients with mild-to-moderate dementia who have a hip fracture improves functional outcomes. However, access to rehabilitation may be difficult due to misconceptions about the ability of these patients to engage in and benefit from rehabilitation. Additionally, people who are admitted from residential care may not have the same options for rehabilitation as those admitted from home. This study sought to understand from expert clinicians how and why decisions are made to accept a person with dementia post-fracture for rehabilitation. In this Australian-based qualitative study, 12 health professionals across a state and territory were interviewed. These clinicians were the primary decision makers in accepting or rejecting elderly patients with dementia post-fracture into rehabilitation. Three key themes emerged from the data: criteria for accessing rehabilitation, what works well and challenges to rehabilitation. The participants were unanimous in the view that access to rehabilitation should be based on the ability of the patient to engage in a rehabilitation programme and not assessed solely on cognition. In terms of clinical care, a coherent rehabilitation pathway with integration of geriatric and ortho-geriatric services was reported as ideal. Challenges remain, importantly, the perception of some health care staff that people with dementia have limited capability to benefit from rehabilitation. Rehabilitation for this growing group of patients requires multiple resources, including skilled practitioners, integrated clinical systems and staff education regarding the capabilities of people with dementia. Future research in this area with patients with moderate-to-severe dementia in residential care is warranted. [ABSTRACT FROM AUTHOR]

With hip fracture and dementia increasing in incidence in the global ageing population, there is a need for the development of specific procedures targeting optimal treatment outcomes for these patients. This paper looks primarily at the factors that limit access to subacute rehabilitation services as a growing body of evidence suggests that access to timely inpatient rehabilitation increases functional outcomes for patients both with dementia and without. Information was gathered by searching electronic data bases (SCOPUS, Medline, CINAHL, Health Source Nursing/Academic Addition, Psychinfo and the Cochrane Library) for relevant articles using the search terms dementia OR Alzheimer* AND hip fracture AND subacute rehabilitation OR convalescence for the period 2005–2015. Abstracts were scanned to identify articles discussing eligibility and access. A total of nine papers were identified that directly addressed this topic. Other papers discussing success or failure of rehabilitation and improved models of care were also reviewed. Barriers to access discussed in the literature include information management, management of comorbidities, attitudes, resource availability, and the quality of evidence and education. By identifying these factors we can identify strategic points of intervention across the trajectory of prevention, treatment and rehabilitation that may improve outcomes for this growing group of vulnerable patients. Emerging best practice for these patients is also discussed. [ABSTRACT FROM AUTHOR]

Background/aim The World Federation of Occupational Therapists' minimum standards state occupation and its relationship with health must be concepts covered in occupational therapy education. Therefore, it is assumed that Australian graduates have sound knowledge of the principles of occupation-based practice. In some practice settings, the link to occupation may not be explicit and graduates could face challenges to being occupation-based. The aims of this pilot study were to explore graduates' perceptions of occupation in their practice and to investigate whether graduates felt sufficiently prepared for occupation-based practice. Methods Two focus groups with eight therapists in total were employed to uncover experiences and perceptions of occupation. Themes were synthesised using Braun and Clarke's method of thematic analysis, where line by line coding was employed to inductively build themes. Results Participants believed that occupation-based practice was important but did not necessarily need to be implemented as a means of intervention. From the participants' perspective, simply striving for occupation as the end goal of therapy was acceptable. A strong focus on impairment-based practice hindered some therapists from exploring the use of occupation-based practice. For recent graduates, workplace culture was pervasive and inhibited the use of occupation. In addition, participants felt university educators did not provide an integrated or consistent approach when teaching how to apply occupation in practice. Conclusion Workplace expectations and limited power to influence practice are impeding graduates from authentically applying occupation in practice. Insights from recently graduated therapists about occupation have the potential to inform future directions of occupation-based practice. [ABSTRACT FROM AUTHOR]

The article offers information on contribution of professor Sylvia Rodger on professional issues, opportunities identification and challenges faced by occupational therapists and discusses process of clinical decision-making. Topics discussed include Australian Competency Standards for Entry Level Occupational Therapists; evidence-based process helps to guide clinical decision-making; and effective teamwork enhances the quality of care.

A letter to the editor in response to an article on challenges in implementing occupation-focused practice is presented.