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Background: Assessing medical fitness to drive (FTD) can include both off- and on-road testing, although consistency of practice is unclear., Purpose: To examine actual practices being used to assess FTD at driver assessment centres (DACs) across Canada., Method: Surveys e-mailed to 90 DACs were returned by 47 assessors., Findings: The majority of respondents (89%) were occupational therapists. Assessors reported doing an average of eight FTD assessments per month (range = I to 40) at an average cost of $366 (SD = $225; range = $40 to $985). Referrals came from physicians (96%), other health professionals (70%), and licensing authorities (66%). Clients with stroke, dementia, traumatic brain injury, mild cognitive impairment, and multiple sclerosis composed 62% of estimated caseloads. Assessments took 3 hr on average (range = 1.24 to 4.5 hr); 64% reported they always took clients on road regardless of clinic results., Implications: Evidence-based guidelines for training and assessment are clearly needed given the inconsistency in practice.

Background: State anxiety can result from a variety of life situations. This type of anxiety can disrupt occupational engagement and performance, thereby affecting rehabilitation and recovery. Occupational therapists need to address the connection between mind-body-spirit and its relationship to performance and engagement in meaningful occupations. Yoga, when used as an adjunct to therapy, has the potential to address state anxiety., Purpose: The aim was to systematically review the evidence concerning the effectiveness of yoga as a treatment approach for state anxiety., Methods: Six electronic databases, the authors' own files, and the references of included studies from 1990 to July 2011 were searched., Findings: A total of 25 unique studies represented by 26 publications made up the sample: two systematic reviews; 16 randomized controlled trials, and seven prospective, controlled, non-randomized studies. Evidence suggests yoga can be a viable therapeutic option for reducing state anxiety in certain situations., Implications: In making the determination to recommend yoga as an intervention, occupational therapists should consider the client's circumstances and values as well as the type and intensity of the yoga program.

Background: Many office-based assessment tools are used by occupational therapists to predict fitness to drive., Purpose: To appraise psychometric properties of such tools, specifically predictive validity for on-road performance., Methods: A literature search was conducted to identify assessment tools and studies involving on-road outcomes (behind-the-wheel evaluation, crashes, traffic violations). Using a standardized appraisal process, reviewers rated each tool's psychometric properties, including its predictive validity with on-road performance., Findings: Seventeen measures met the inclusion criteria. Evidence suggests many tools do not have cutoff scores linked with on-road outcomes, although some had stronger evidence than others. Implications. When making a determination regarding driver fitness, clinicians should consider the psychometric properties of the tool as well as existing evidence concerning its utility in predicting on-road performance. Caution is warranted in using any one office-based tool to predict driving fitness; rather, a multifactorial-based assessment approach that includes physical, cognitive, and visual-perceptual components, is recommended.

Background: Participation in occupations of everyday life, such as self-care, work, and leisure, contribute to health and well-being. Obesity has been shown to influence health-related quality of life, but it is unclear how obesity influences participation in specific occupations., Purpose: To describe the lived experience of adults with class III obesity and the associated impact on participation in occupations of daily living., Methods: Ten adults enrolled in an obesity treatment program were interviewed. Data were interpreted using descriptive phenomenological methods., Findings: Participants underscored the tensions, barriers, and coping strategies across and within specific occupations. Although participation across occupations of daily living was described, the quality and diversity of occupations was influenced by real and perceived barriers within the environment., Implications: Participation in daily occupations is limited for persons with class III obesity. Intervention approaches should address health-related concerns and consider environmental adaptations that facilitate meaningful engagement in everyday life.

Background: The notion of universalism was introduced to me during my first year of PhD studies in Rehabilitation Science. During a class discussion, we debated the merits of two theoretical perspectives that offered contradicting views as to the most effective means to facilitating a shift in societal perceptions of disability. As exemplified by the World Health Organization's current model of health, the International Classification of Functioning, Disability and Health (ICF), there has been a shift from a minority group analysis towards a universalistic perspective of disablement., Purpose: This paper introduces readers to the underlying concepts of both minority group analysis and universalism and, in doing so, proposes that universalism is closely aligned with the underlying constructs of occupational therapy. Universalism provides a comprehensive framework that can be utilized by occupational therapists to encourage the development of health and social-related policies that promote inclusiveness, yet still the respect the differences that exist among individuals. PRACTICE IMPLICATIONS By improving their familiarity with such theories, occupational therapists may be better positioned to contribute to policy development within their respective treatment and/or community settings.