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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., (© 2024 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

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., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Consumer contribution to occupational therapy student learning is mandated for Australian educational programs. However, there is limited research about how consumers contribute to student learning during practice placements. A scoping review was completed to explore the concepts of existing feedback systems for consumers to authentically contribute to student learning during practice placements., Methods: Five databases were searched for all articles up to and including July 2023. All publications were included if they described and investigated authentic contribution to student learning during a practice placement experience. Data from the results and discussion sections of the papers were transformed into qualitative data and thematically analysed to develop a conceptual understanding of consumer feedback systems., Results: Forty-six papers met the eligibility criteria. Most articles originated from Medicine (30%) and Nursing (45%) education. Feedback systems were primarily designed to critique student communication and professional behaviours using a variety of standardised and non-standardised methods. Five interconnected themes were created that addressed the concepts of consumer feedback systems. The themes were (1) creating value specific for each stakeholder is essential, (2) preparation is required and nuanced; (3) consumers do engage and provide critical feedback when the system is supportive of all stakeholders; (4) gathering approaches need to be responsive to the diversity of practice and learning; (5) processing feedback with a trusted mentor is critical for learning., Conclusions: Consumers, academics, practice educators, and students recognised that consumers have an important role in contributing to student learning during practice placements. Future consumer feedback systems need to be co-produced to create an optimal mode for consumers to authentically contribute to student learning constructively and safely., Consumer and Community Involvement: A consumer consultant was a member of the advisory panel for the larger research project that this review is part of and provided advice to the research team at all stages of the project., Plain Language Summary: In Australia, occupational therapy training programs require input from consumers to help students learn. However, there is not much research on how consumers help occupational therapy students during their practical training. We did a review to see how existing feedback systems let consumers genuinely help students during their training. We searched five databases for research up to July 2023. We included research that talked about how consumers help all health students learn during practical training. We found 46 articles, mostly from Medicine and Nursing education. We analysed them to understand how consumer feedback systems work and found five main themes: (1) making sure everyone involved gets value out of it, (2) being prepared is important, (3) consumers give useful feedback when the system supports everyone involved, (4) different approaches are needed because practices and learning vary, and (5) discussing feedback with other people helps students learn. Current feedback systems mostly focused on how students communicate and behave professionally. Consumers, educators, and students all agree that consumers play a vital role in helping students learn during practical training. In the future, we need to work together to make feedback systems that let consumers help students in the best way possible, making sure it is constructive and safe for everyone., (© 2024 The Author(s). Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

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.

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., (© 2024 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Purpose: To critically review the evidence for occupation-based interventions in improving occupational performance and participation outcomes in the hospital setting., Methods: 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., Results: 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., Conclusions: 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.Implications For RehabilitationThe 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.

Objective: Virtual reality (VR) has been used to improve upper limb function after stroke but there is little to guide product developers in building experiences that engage users in the sustained, repetitive training required. This research sought to understand the characteristics of VR scenarios best suited to engaging someone with a stroke during recovery to achieve therapeutic outcomes., Methods: Five creative immersive VR scenarios were designed by an experienced VR content creator containing unique combinations of VR characteristics. The usefulness of the scenarios was reviewed by expert clinicians experienced in stroke rehabilitation. Following this review, seven stroke survivors participated in each experience and reported on their engagement and motivation. Outcome measures were the User Satisfaction Evaluation Questionnaire and the modified Intrinsic Motivation Inventory. Semi-structured interviews were conducted with five participants following their immersive VR experience and analysed thematically., Results: Expert clinicians reported potential therapeutic value in the immersive VR scenarios by providing opportunities for repeated and graded practice of upper limb movements. Stroke survivors reported varied levels of enjoyment and engagement for each scenario. They recommended changes to the experiences, primarily relating to the tailoring of the scenarios to match varied upper limb capacities., Conclusion: This study highlights the characteristics of immersive VR scenarios that are important in sustaining motivation and providing high-repetition task-specific movement experiences. Differences in the experience and preferences of stroke participants regarding the characteristics of immersive VR experiences indicate that a variety of experiences are necessary to engage and sustain participation in an immersive VR-related therapy programme., Competing Interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: CD owns Recovery VR who provided the VR headsets and co-funded the research. CD was not involved in the data collection or analysis., (© The Author(s) 2024.)

Introduction: Occupation-based interventions use engagement in a person's daily activities to achieve change. There is growing research into the use of occupation-based group interventions in the inpatient rehabilitation setting. It remains unclear whether occupation-based groups offer comparable outcomes to occupation-based interventions delivered individually; this research will precede a clinical trial aimed at comparing these two approaches for improving occupational performance outcomes. This study details the process of co-designing the intervention. Partnering with clinicians and patients in the design of healthcare interventions can promote patient-centred care, enhance uptake, and improve applicability and sustainability of the intervention to that setting., Methods: A modified nominal group technique (NGT) design was applied to facilitate two meetings and an electronic survey with an expert panel of clinicians and patients. Twelve participants (n = 4 occupational therapists, n = 1 registered nurse, n = 1 physiotherapist, n = 1 occupational therapy assistant, n = 1 occupational therapy manager, and n = 4 patients) were purposively recruited. A modified approach to the technique's four stages was used: silent generation, round robin, clarification, and voting. Consensus was set at >50%. Qualitative data from group discussions were analysed thematically., Findings: All participants agreed the intervention should include patient-centred, goal-directed, practice of daily activities, including breakfast and lunch preparation, domestic tasks, and laundry. Other components that were agreed included where the groups could run, group size, eligibility criteria, and frequency. Key themes from clinicians included needing a goal-directed intervention, focused on progressing towards hospital discharge; time and resource requirements were also discussed. Patients emphasised the importance of building social connections, opportunity to engage in meaningful activity, and the importance of linking participation to patient goals., Conclusion: Through collaboration with clinicians and patients, an occupation-based group intervention considering the available evidence, alongside clinical, experiential, and contextual sources of knowledge was developed; this resulted in an evidence-based, patient-centred, and contextually relevant intervention., (© 2024 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Objective: Sustaining the health and well-being of older people living in residential aged care (RAC) requires new means of providing safe and stimulating recreational and therapeutic programs such as using virtual reality (VR). The aim of the scoping review was to investigate the utility of immersive VR interventions using head-mounted display technology to promote the health and well-being of people without cognitive impairment living in RAC., Method: The following databases were searched from inception until January 2024: PubMed, PsycINFO, Scopus, Cochrane and CINAHL. The eligibility criteria were quantitative, qualitative or mixed methods studies published in English, conducted in RAC, using VR with head-mounted display with people without cognitive impairment., Results: Of the 274 articles identified, 9 articles with a total of 310 residents and 50 staff met the inclusion criteria. Seven factors to either impede or enable the use of VR with head-mounted displays in RAC were: residents' agency; the nature of the VR experience; the content of the experience; the ease of use and comfort of the technology; the role of RAC staff; and the role of residents' family members., Conclusion: Immersive VR has potential as a tool to promote the health and well-being of people without cognitive impairment living in RAC. Small sample sizes, variations in study design, and selection bias mean that generalisability of the results is limited. Further research is recommended to inform the design and implementation of immersive VR programs tailored specifically for this population., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

NHCs ( N -heterocyclic carbenes) are generally used as organic ligands that can coordinate with metal ions like silver to form stable complexes. These complexes have shown enhanced antimicrobial properties compared to silver alone. This document provides an overview of the reported NHC-based silver derivatives (acetates, chlorides, bromides, and iodides) who possess antimicrobial activity. This review covers articles published between the first report (2006) and 2023.

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.

Importance: Evidence for the positive effects of occupation-based interventions on occupational performance is increasing; however, little is known about the impacts of occupation-based interventions on older adults living in long-term care., Objective: To consolidate the evidence on the effectiveness of occupation-based interventions for improving occupational performance among older adults living in long-term care., Data Sources: MEDLINE, CINAHL, PsycINFO, SCOPUS, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from journal-database inception to February 2023., Study Selection and Data Collection: This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles were peer-reviewed studies published in English that evaluated occupation-based interventions for older adults living in long-term care and used validated tools to measure occupational performance., Findings: Seventeen articles, with 2,974 participants, were identified. The reviewed studies included 6 Level 1b randomized controlled trials, 5 Level 2b studies of various study designs, and 5 Level 3b studies with quasi-experimental designs. Across studies, heterogeneous measures were used to assess occupational performance. All studies implemented client-centered, occupation-based interventions designed and/or delivered by occupational therapists. Interventions were tailored to residents' goals, interests, or abilities to improve occupational performance and participation, and inconsistent effects were reported., Conclusions and Relevance: Moderate evidence supports the use of occupation-based interventions tailored to individual residents and incorporation of physical activities for improving the occupational performance of older adults living in long-term care. Currently, evidence for care partner involvement and multilevel occupation-based interventions is limited. Plain-Language Summary: This study adds to the evidence base indicating that occupation-based interventions have the potential to promote the occupational performance of older adults living in long-term care. High-quality randomized controlled trials with longer term follow-up and assessment of clinically meaningful outcomes are critical for developing the evidence base in this practice setting., (Copyright © 2024 by the American Occupational Therapy Association, Inc.)

In this work, we have provided mechanistic insight into the addition of bromine to an allylic double bond of allylaryl derivatives using experimental and DFT-based electronic structure methods. The experimental yields indicate the influence of the functional group on the aryl ring on the ratio of 1,2-dibromo and 1,3-dibromo adducts formed in the reaction. The optimized geometry and the electron density maps of the allylaryls and their cationic intermediates from DFT simulations revealed that electron-rich aryl rings promoted formation of cationic spiro[2.5] intermediate II , whereas electron-poor aryl rings resulted in formation of bromonium intermediate I . It was observed that electron-rich allylaryls promoted the 1,2-shift of the aryl ring that resulted in bond formation between the carbon atom (C1) on the aryl ring and the central carbon atom (C3) in the allylic double bond and formed spiro[2.5] intermediate II , a trend which was confirmed by harmonic oscillator model of aromaticity index. Also, Wiberg bond order analysis is in good agreement with the experimental work. Thermochemical analysis indicates that smaller C1···C3 distance resulted in favorable values for the difference in free energy change (ΔΔ G ). The favorable ΔΔ G values are a result of higher electron density on the aryl ring, making it more nucleophilic toward C3 carbon and promoting 1,2-shift that led to formation of the spiro[2.5] intermediate. Thus, the underlying mechanism indicates that the electron-rich allylaryls promote the formation of 1,3-dibromo compounds through formation and stabilization of the spiro[2.5] intermediate II ., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

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., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

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-sulfonyl-methyl styrenes] is reported. The method employs commercially available olefins, bases, additives, solvents, and sodium sulfinates (RSO 2 Na) and produces adducts in good yields. Considering that up to 4 reactions (bromination, dearomative rearrangement, E2, and S N 2) are happening, this approach is very efficient. The structures of key adducts were confirmed by X-ray crystallography., Competing Interests: Conflicts of interest There are no conflicts to declare.

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., Competing Interests: Conflicts of Interest: The authors declare no conflict of interest.

Nutrition knowledge is a primary factor influencing food choices and the ability to identify nutritional risk for carers of people with dementia. Acquiring nutrition knowledge helps carers monitor changes in food intake and micronutrient intake, and whether a healthy and balanced diet is being consumed. This study aimed to assess the nutrition knowledge of carers in the Australian community and their experiences with nutrition education. Using a mixed-methods approach, the nutrition knowledge of informal carers was assessed using the revised General Nutrition Knowledge Questionnaire (AUS-R-NKQ), and interviews of informal carers were used to explore the perspectives in a sub-sample. A total of 57 carers (44 females; mean age of 63.0 ± 13.1) completed the survey, and 11 carers participated in follow-up interviews. The total sample scored 22.9 (±4.57) out of 38 on the AUS-R-NKQ, suggesting basic nutrition knowledge. The interviewed carers acknowledged the importance of healthy nutrition but viewed the provision of a healthy diet for a person with dementia as challenging. In both the survey and interviews, carers reported limited use and availability of dementia-specific nutrition resources. Carers were unsatisfied with the advice and number of referrals provided to improve the nutrition of the person with dementia and desired less confusing nutrition education materials adapted to their level of knowledge. The present study highlights the need for informal carers to be supported to acquire adequate nutrition knowledge.

Background: 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., Aims/objectives: This study investigated the potential predictors of academic performance in undergraduate occupational therapy students after moving to online or blended learning post-Covid-19., Material and Methods: 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., Results: 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)., Conclusions: 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., Significance: 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.

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.

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.

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.

Objectives: Access to assistive technologies (ATs) is a human right for people with disabilities, but there are a range of barriers, including lack of adequate information. This review aimed to explore the implications of information asymmetry on the delivery of AT and to investigate if there are effective and equitable ways of providing AT brokerage services to people needing AT., Design: Scoping review., Data Sources: EBSCO Medline, EBSCO Cinahl, Academic Search Ultimate, Business Source Ultimate, Proquest Central, Scopus, Web of Science, PsychINFO, EconLit and JSTOR were searched through 18 July 2021., Eligibility Criteria: Intervention and observational studies and articles directly related to information asymmetry and brokerage in the context of AT were included. In addition, a scan of web-based resources and services was undertaken., Data Extraction and Synthesis: Four authors independently screened the articles for inclusion and performed a narrative synthesis., Results: Thirty-three articles were identified. The narrative synthesis showed that: (1) AT users want access to impartial information sources; (2) users want to be involved in AT selection; (3) users benefit from access to demonstration sites; (4) users want access to training and ongoing support in their use of AT; and (5) users want access to information on new and emerging technologies. Access to information and user engagement, we produced better outcomes and satisfaction. Web-based repositories are valuable for user research and peer feedback, while demonstration sites address the need for expert advice, trial use of equipment, training and support in equipment use and maintenance., Conclusions: Access to impartial information brokerage is critical to optimise AT selection. The implications of information asymmetry include lower user satisfaction, equipment underutilisation or abandonment. Aspects such as access to demonstration sites and web-based resources were also important., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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., (© 2022 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

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).

Background: Identifying dietary patterns that promote healthy aging has become increasingly important due to changes in food processing and consumption of processed foods. Recently, the effects of these foods and unhealthy dietary patterns on cognitive function have become more widely recognized. Aim: The aim of this review is to discuss the association between various dietary patterns and cognition in older age, while also highlighting growing evidence that ultra processed food (UPF) may negatively impact healthy aging. Methods: We have performed a non-systematic literature review searches in Google Scholar electronic database with pre-defined terms relating to UPF, diet, dietary patterns, cognition and ageing. Results: The most prevalent diets in the literature include the Western, Mediterranean, Dietary Approach to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurogenerative Delay (MIND), Japanese, Nordic, and plant-based diets. Based on the findings, higher intakes of fresh fruit and vegetables, wholegrains and oily fish are common components of dietary patterns that are positively associated with better cognitive function. In contrast, the characteristics of a Western style dietary pattern, consisting of high amounts of UPF's, are increasing in many countries even where the staple dietary pattern was identified as healthy (i.e. Japan). Conclusion: The consumption of UPF, classified by the NOVA food classification system as industrially manufactured foods containing high levels of starches, vegetable oils, sugar, emulsifiers, and foods additives, has a negative impact on the overall nutritional quality of individual diets.

The promotion of physical activity (PA) by health professionals is a key strategy to increase PA levels in the population. In this study, we investigated PA promotion, preparedness, and knowledge among university nursing and allied health students and staff, as well as PA resource usage within curricula, before and after an educational intervention. Students and staff from 13 health disciplines at one Australian university were invited to complete an online survey, and a curriculum audits were conducted before and after PA teaching resources were promoted by academic PA champions (n = 14). A total of 299 students and 43 staff responded to the survey pre-intervention, and 363 and 32 responded to the post-intervention, respectively. PA promotion role perception (≥93%) and confidence to provide general PA advice (≥70%) were high throughout the study. Knowledge of PA guidelines was poor (3−10%). Students of physiotherapy, sport and exercise science, as well as more active students, were more likely to be aware of the PA guidelines (p < 0.05). Over 12 months, PA promotion preparedness and knowledge did not change significantly, nor was there a change in the amount of PA content delivered, despite a significant increase in the use of the teaching resources across a number of disciplines (p = 0.007). Future research should be carried out to investigate the implementation of the resources over time and to develop additional strategies for PA promotion and education scaffolded across curricula.

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.

Purpose: To investigate differences between domestic and international occupational therapy students in their perceptions and experiences of online learning during the COVID-19 pandemic., Methods: Cross-sectional study of 151 occupational therapy students enrolled in the 4-year Bachelor of Occupational Therapy (Honours) courses at the University of Canberra and Monash University in Australia. Students completed the Student Engagement in the e-Learning Environment Scale (SELES) and the Distance Education Learning Environment Scale (DELES). Both instruments have established validity and reliability. ANOVA analysis with bootstrapping was completed to examine potential differences in domestic and international students' experiences and perceptions of online learning., Results: Statistically significant differences were observed between domestic and international students' scores on the DELES Student Autonomy (p=0.001), Personal Relevance (p=0.001) and Student Interaction and Collaboration (p=0.037) subscales., Conclusion: International students experienced greater difficulties during online learning in relation to taking control of their own learning, connecting acquired knowledge with real-world settings, and forging collaborative and interactive working relationships with their peers. Academic, technological, and social support measures are recommended to strengthen students' self-directed learning skills, facilitate them to link what they have learned beyond online settings, and encourage active and collaborative engagement with peers and instructors.

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., (© 2022 Occupational Therapy Australia.)

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.

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.

Background: Academic integrity is viewed as honest and responsible scholarship and the moral code of academia. Reported incidences of academic dishonesty among health professional students are widespread and may be an indicator of future unprofessional behaviour in the workplace. Aim: This study investigated the potential predictors of academic integrity in undergraduate and graduate-entry masters occupational therapy students. Method: Occupational therapy students from five universities ( n  = 701 participants; 609 undergraduates; 92 graduate-entry masters) were recruited. Data were collected via a two-part self-report questionnaire that included six standardised scales: Academic Dishonesty Scale; Academic Dishonesty in the Classroom Setting Scale; Academic Dishonesty in the Clinical/Practice Education Setting Scale; Moral Development Scale for Professionals; Academic Dishonesty Tendency Scale; and Perceived Academic Sources of Stress. Data analysis involved multi-linear regression analyses with bootstrapping. Result: Significant predictors of academic integrity in occupational therapy students included age, gender, grade point average, public meaning, moral practice, general tendency towards cheating, tendency towards dishonesty in the conduct and reporting of research findings, tendency towards not providing appropriate references and acknowledgements and pressures to perform well academically. Conclusion: These findings will assist educators in identifying vulnerable students potentially prone to academic integrity infringements and implementing proactive strategies with them. Further studies are recommended to explore further predictors of students' academic integrity., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

Objectives: To summarise the evidence from interventions investigating the effects of out of care setting activities on people with dementia living in residential aged care., Design: A systematic review., Methods: A systematic search of electronic databases (PubMed, PsycINFO, Scopus, Web of Science and the Cochrane Library) was performed to identify intervention trials published from journal inception to January 2020. Controlled trials, or quasi-experimental trials, which measured pre-intervention, post-intervention or during-intervention outcomes, where the participants were required to leave the care setting to participate in an intervention, were eligible for inclusion. Quality appraisal of the studies was performed following the Cochrane Collaboration's Risk of Bias or Newcastle-Ottawa Scale tools., Results: Of the 4155 articles screened, 11 articles met the inclusion criteria from 9 different studies. The number of participants in the studies ranged from 6 to 70 people living with dementia and lasted for 3 weeks up to 5 months. The interventions were aquatic exercise, wheelchair cycling, art gallery discussion groups, an intergenerational mentorship programme, horse riding, walking and outdoor gardening. Overall, the studies indicated preliminary evidence of psychological (n=7), physical (n=4) and physiological (n=1) benefits, and all interventions were feasible to conduct away from the aged care facilities. However, the low number of participants in the included studies (n=177), the absence of a control group in all but three studies, and potential for selection bias, limits the generalisability of the findings., Conclusions: Activities outside of the residential aged care setting have the potential to be effective at providing a range of benefits for people living with dementia. Higher quality studies are required to encourage care providers to implement these type of activities in dementia care settings., Prospero Registration Number: CRD42020166518., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Malnutrition poses a significant problem for oncology patients, resulting in fatalities within this population. Patients with head and neck cancer (HNC) are at high risk, with up to 90% developing malnutrition. Common treatments used for HNC can often lead to adverse side effects, including oral health conditions, gastrointestinal upsets, and several metabolic changes. Consequently, treatments can cause inadequate nutritional intake, resulting in a reduction in energy consumption, and alterations in energy utilization, contributing to the development of malnutrition. Furthermore, the presence of these treatment toxicities, and the related malnutrition can lead to reduced quality of life, weight loss, and psychological distress. There are interventions available (nutritional, medicinal, and physical therapies) that have demonstrated potential effectiveness in reducing the severity of symptomatic toxicities, reducing the risk of malnutrition, and improving survival outcomes of patients with HNC. Based on the findings of this review, there is an urgent need for the implementation or continuation of multi-disciplinary strategies, as well as updated and improved guidelines to assist in the prevention and treatment of malnutrition caused by treatment-related toxicities in patients with HNC.

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 (r s  = 0.337, p = 0.002) and income and AIMS2-SF (r s  = - 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).

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., (© 2019 Occupational Therapy Australia.)

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., (© 2018 Occupational Therapy Australia.)

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.

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., (© 2019 S. Karger AG, Basel.)

Background: Research into the prevalence of dishonest academic behaviours suggests that such behaviours may be extensive among international students in higher education., Objective: To compare the academic integrity of domestic and international occupational therapy students and identify possible contributors to students' engagement in dishonest academic behaviours., Design: A quantitative cross-sectional study using a survey containing several standardised scales was used to collect the data., Settings: Five Australian universities., Participants: 701 occupational therapy students., Methods: Students completed a self-report questionnaire comprising demographic questions and six standardised scales: Academic Dishonesty Scale; Academic Dishonesty in the Classroom Setting Scale (ADCS); Academic Dishonesty in the Clinical/Practice Education Setting Scale; Moral Development Scale for Professionals; Academic Dishonesty Tendency Scale; and Perceived Academic Sources of Stress. One-way analysis of variance (ANOVA) was conducted to compare the scores of domestic and international students on academic dishonesty factors, moral development, and perceived sources of academic stress., Results: Significant differences between domestic and international students were observed on age; grade point average; hours per week spent in paid work; moral practice; tendency towards cheating; tendency towards cheating in research assignments; pressures to perform; and self-perception. No significant differences were found on students' self-reported scores on academic dishonesty in academic classroom education contexts, fieldwork practice education settings or perceived stresses of workload and examinations and time restraints., Conclusions: The reported incidences of dishonest academic behaviours in the classroom and fieldwork settings were low for all occupational therapy students, irrespective of origin and were comparable to findings from cohorts of other health professional students. However, concomitant with existing research, international students were found to have a greater tendency to engage in dishonest behaviours particularly on research assignments. This may be reflective the socio-cultural issues and external pressures that international students experience. Further study in this area is recommended., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

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.

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., (© 2018 Occupational Therapy Australia.)

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.

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.

Background: Digital story telling (DST) is an innovative way to allow students to assess the care needs of an older adult and creates an opportunity for interdisciplinary involvement. Traditionally, a single healthcare discipline approach is used by higher education institutions for preclinical training in the care of the older adult. Interprofessional learning (IPL) is generally not integrated well into the health professional curricula of Australian Universities., Aim: To explore the use of Mask-Ed as a way of eliciting students understanding of their roles in patient care and to determine readiness for IPL in a cohort of health students prior to clinical placement., Method: An online survey of students prior to their first clinical placement was undertaken. The survey incorporated a digital story of a Mask-Ed character and the readiness for IPL scale., Results: Students recognised the importance of IPL. However, only 25% of students had an advanced understanding of their own roles and no student showed an advanced understanding of the other disciplines roles in the care of the older adult., Conclusions: In this study, DST using Mask-Ed assisted with students' understanding of interprofessional roles in the care of the older adult. Our findings demonstrated that IPL is important, and this was further enhanced by the use of Mask-Ed simulation., Competing Interests: Competing interests: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

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., (© 2016 Occupational Therapy Australia.)