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Introduction The periods of lockdown during 2020 led to changes in daily occupations. As participation relies on dynamic interactions between the person, his/her occupations and his/her environment, we wondered whether people from different generations shared the same perception of occupational disruptions during the lockdown. Methods We performed an online survey based on the Canadian Occupational Performance Measure (COPM) of adults in 27 European Union countries, the United Kingdom and Switzerland. Three groups were compared: young adults (YAs, aged 18–39), middle-aged adults (MAs, aged 40–59) and older adults (OAs, aged 60 and over). Results 2865 participants (YAs: 47%; MAs: 33%; OAs: 20%) reported a total of 6549 disrupted occupations. The most frequently disrupted domain was leisure (83%), followed by productivity (16%) and self-care (2%); there were no significant intergroup differences ( p = 0.18). In a multivariate analysis, socializing disruptions were more likely to be associated with younger age (adjusted odds ratio (OR) [95% confidence interval (CI)] = 0.62 [0.50–0.76] for YAs versus MAs and 0.46 [0.30–0.71] for YAs versus OAs. Conclusion With the exception of socializing, the main disrupted occupations were similar from one generation to another. Our findings might enable the more accurate assessment of the risk of occupational disruption in a restrictive environment.

Further consolidation and clarity regarding occupation as a means to foster change in interventions are needed. The study aimed to utilize the knowledge of occupational scholars to systematically determine what is required to use occupation as means to foster change within occupation-based interventions and to generate a conceptual model from those results. Group Concept Mapping involved the following: preparation, generation of ideas, structuring of statements, data analysis, interpretation of maps, and development of conceptual model. Fifty-two international occupational scholars brainstormed 125 ideas. A cluster rating map with nine clusters posed the foundation for a conceptual model with seven themes, namely, artful use of occupation, evidence-based use of occupation, collaboration to promote occupation, coordinating intervention fit, client factors, sociocultural context, and structural influences. The conceptual model, capturing dimensions and dynamics required for using occupation to foster change, may guide future research into occupation-based interventions.

Temporality, occupation, and relationships are identified as discrete factors that impact quality of life for individuals at the end of life and those around them. However, scholars, practitioners, and educators require insights regarding whether and how interactions between these factors shape this quality of life. This study is framed by an understanding that meaning is negotiated between people through social interaction and occupational engagement in temporal contexts. We conducted in-depth interviews with 9 patients and 10 family members, incorporating the Pictor visual elicitation technique. Analysis was conducted through an iterative process involving open and selective coding. Findings are described as three main processes: (a) experiences of temporal rupture, (b) diminished significance of clock time, and (c) shifts in occupational priorities. Participants’ perspectives may help carers understand how to foster positive temporal experiences and quality of life for patients and those who love them.

Introduction As life expectancy grows so does the need for mental health services for older people. Occupational science and therapy literature demonstrates how occupation supports older adults' wellbeing, but there has been little research into the relationship between occupation and health for those with anxiety and depression. The aim of this study was to understand the occupational experience of Irish older adults with anxiety and depression so as to inform therapeutic programmes. Method A qualitative research design with a phenomenological framework was adopted. A total of five community-dwelling people with diagnoses of anxiety and/or depression were purposively selected to participate in semi-structured interviews. The interviews were analysed using thematic analysis. Findings The themes which emerged – ‘Occupation as a marker for wellness’ and ‘Sustaining a sense of occupational identity’ – support existing literature and reveal new information about interactions between occupational identity crisis and mental health. Personally meaningful occupation which connects a person to their life worlds and sense of self has the potential to consolidate recovery from anxiety and depression. Conclusion The study contributes to knowledge on how occupation supports an older person's wellbeing and identity in the face of life changes, and has implications for occupational therapists working with older adults.

Research has reported on traditional methods of assessing interrater reliability but, currently, no such standard protocol exists for selection of alternative methods of assessing interrater reliability, such as wearable video cameras. The professions of occupational therapy and occupational science take a unique ecological perspective when evaluating individuals, which focuses on the naturalistic perspective of an individual, ideally resulting in optimal performance. Given current advancements in technology, wearable, low-cost, unobtrusive, first-person view digital video cameras are readily available for use in research. The researchers generated an original rubric for critiquing cameras, then trialed four cameras for use in a future interrater reliability study. This standardized protocol fills a gap in the field and can be used by future researchers searching for a standardized method of camera selection.

Introduction Cognitive difficulties have been reported to have the greatest effect on function and quality of life in people with multiple sclerosis, affecting 50–60% of people. To date, few interventions have been developed to treat cognitive issues in multiple sclerosis. Here we report on a Cognitive Occupation-Based programme (COB-MS) for people with Multiple Sclerosis an evidence-based intervention to address everyday problems encountered due to cognitive difficulties. The aim of this research was to explore the views of people with multiple sclerosis and occupational therapists on the programme and its potential implementation in practice. Methods Data were elicited from a purposive sample of 12 people from two stakeholder groups, people with multiple sclerosis (n = 5) and occupational therapists (n = 7), through focus groups and interviews. The programme and related materials were presented, and contributions recorded, transcribed and thematically analysed. Results Two main themes were identified from analysis of the data: response to the intervention and challenges to implementing the programme. Occupational therapists agreed that the COB-MS is client-centred. People with multiple sclerosis thought that it was a validating intervention. The overall format was viewed to be useful and feasible. Conclusion The COB-MS for people with Multiple Sclerosis is the first known cognitive intervention using an occupation frame of reference to address difficulties faced among persons with multiple sclerosis and was found to be timely and relevant to the needs of the population.

The values of occupational therapy are grounded in justice, and its origins in activism and advocacy. Enabling individuals to participate in meaningful occupations to enhance health and well-being was the genesis of the profession that answered a call to justice. Occupational science brought focus to understand humans as occupational beings and made justice more visible in the discourse. A systematic mapping review was undertaken to deconstruct how notions of occupational justice (OJ) have been woven in the literature. The ideas of OJ were dominant in 40 out of the 120 articles that met the study’s inclusion criteria. OJ was represented mainly in the context of disadvantaged groups and dissonance in practice. For OJ to influence policy, the focus on the individuals’ experiences of occupational injustices must be seen as transacting with systems and policies that contribute to participation inequities in groups and populations.

There is a growing body of scholarly literature about occupational justice, human rights, and power redistribution ready to be integrated into occupational science and occupational therapy education. As students around the world become familiar with the concepts and intents underlying occupational justice, it will be important to investigate their translation of occupational justice understandings into actions outside the classroom. This exploratory single case study describes curricular, university, and regional factors related to one former student’s engagement in social protests following her occupational justice education. Based on her reflections, we emphasize the need to provide classroom opportunities where students can apply and critically reflect on (a) knowledge about occupational justice and (b) unintended consequences and potential professional tensions that may arise in relation to pursuing occupational justice. Future research will benefit from broader comparative studies that analyze personal, contextual, and programmatic differences among instances of occupational justice education and students’ engagement in occupational reconstructions.

Background. Occupational justice is cited throughout the occupational science and occupational therapy literatures despite little scholarly attention either to its definition or to how situations of occupational justice are identifiable. Purpose. This paper aims to contribute a critique of occupational justice, explore the concepts of justice and (occupational) rights, and support a capabilities approach to inform rights-based occupational therapy practices. Key Issues. No clear definition of occupational justice or differentiation from social justice exists despite the longevity of the concept, and theorists frequently confuse the concepts of justice and rights. A rights-based focus provides an unambiguous mandate for occupational therapists, with the capabilities approach offering a cross-disciplinary framework to inform rights-based practices. Implications. The concept of occupational rights is consistent with the rights-based focus advocated by the disabled people’s movement, articulated by the United Nations’ Convention on the Rights of Persons With Disabilities, and affirmed by the World Federation of Occupational Therapists’ position on the centrality of occupation to health, well-being, and human rights.

The study of human occupation requires a variety of methods to fully elucidate its complex, multifaceted nature. Although qualitative approaches have commonly been used within occupational therapy and occupational science, we contend that such qualitative research must extend beyond the sole use of interviews. Drawing on qualitative methodological literature, we discuss the limits of interview methods and outline other methods, particularly visual methods, as productive means to enhance qualitative research. We then provide an overview of our critical ethnographic study that used narrative, visual, and observational methods to explore the occupational transitions experienced by immigrants to Canada. We describe our use of occupational mapping and participatory occupation methods and the contributions of these combined methods. We conclude that adopting a variety of methods can enable a deeper understanding of the tacit nature of everyday occupation, and is key to advancing knowledge regarding occupation and to informing occupational therapy practice.

Background. The concept of occupational balance has always been important to occupational therapists and occupational scientists, but it is often interpreted differently by professionals, particularly in relation to practice. Purpose. This study focused on the understanding of occupational balance of a group of experienced occupational therapists who held positions at the time in Iran. Method. A preliminary qualitative study from within an interpretive paradigm was employed. A focus group was used for data collection, and the data were analyzed using thematic networks analysis in relation to occupational science concepts. Findings. Four organizing themes were uncovered: integrity in being, equilibrium in doing, contentedness in becoming, and harmony in belonging. The global theme of “fluidity” describes the dynamic nature of occupational balance. Implications. The concept of occupational balance needs to be further explored in different communities. Identifying similarities and differences in its meaning and application will inform culturally relevant client-centred education and practice.

Introduction Occupational balance is an important and widely used concept in occupational therapy and occupational science. There is, however, not one unified definition in use, but several different ones, and thus instruments that measure the concept in research studies are diverse as well. Consequently, it is unclear how instruments and definitions correspond. The purpose of this study was to examine the coverage of occupational balance definitions by occupational balance instruments. Method Within a mixed-methods design we conducted a qualitative and quantitative content analysis of definitions and items of existing instruments. Definitions and items were extracted from articles identified in a systematic literature search. The extent of congruence and coverage between definitions and instruments was examined. Results The definitions used in 47 articles were structured into 19 categories. The categories which were found in most definitions were a balance of ‘various occupational patterns and areas’ (42; 89%) and ‘occupational accomplishment, performance, roles and responsibilities’ (35; 75%); 20 instruments were explored. Together they covered 16 (84%) of the 19 categories. Conclusion Knowing which instruments cover which dimensions of occupational balance can support occupational therapists, other health professionals and health researchers in their selection of an instrument to measure occupational balance.

Background. Scrutiny regarding the typological categorization of occupation (e.g., occupation as work, rest, or leisure) has prompted interest in experiential categories as a less exclusionary alternative. Empirical research can extend the dialogue about categorization by demonstrating how people in particular situations apply and generate occupational categories. Purpose. This article explores how adults without work utilized typological and experiential categorizations when discussing their occupations. Method. Data were generated via a secondary analysis of interview transcripts from three ethnographic case studies. Findings. Study consultants gravitated toward experiential rather than typological categorizations, emphasizing the social, chosen, purposeful, and temporal qualities of their occupational engagement. Implications. Occupational therapy practitioners and researchers must explicitly state how and why they categorize occupations with clients and research participants. Whereas typological categories can be used to initiate discussions about occupation, open questions paired with consultant-generated experiential categories may better capture occupational engagement and reveal potential injustices in situations like unemployment.

Background. The concept “everyday” appears unchallenged and problematic when applied to people who experience disrupted lives through illness or disability. Purpose. This study draws upon social and philosophical theory to review the relevance of the concept “everyday” when applied to contemporary occupational therapy and the lives of individuals who experience biographical disruption. Method. A literature review guided by a scoping framework was undertaken followed by a critical analysis drawing on Bauman to determine the frequency and meaning of the concept “everyday” used in the occupational therapy and occupational science literature. Findings. Definitions of the “everyday” are used infrequently despite recurrent use of the concept. A large proportion of literature reviewed in this manuscript does not acknowledge or discuss the philosophical and sociological influences that contribute to an understanding of the “everyday,” leaving the reader to make her or his own interpretations. Implications. Reconceptualizing lived “everyday” experience within the contextual “here and now” provides a postmodern “episodic” lens for occupational therapists working with individuals who experience biographical disruption.

Introduction: Occupations are recognised in occupational therapy and occupational science literature as vehicles to meaning and wellbeing. Yet, the question of how they are used to create meaning has not been investigated exhaustively. In this study, the researchers explored the life histories of worker-writers in the United Kingdom. These writers considered themselves as representatives of the most numerous but marginalised social class. The researchers considered how the worker-writers derived life meaning from their occupations and occupational roles. Method: Using heuristic research methods, 34 published autobiographies were analysed to elicit themes illuminating how meaning was created by the worker-writers through occupations and occupational roles. Results: Five themes emerged from the analysis. Worker-writers created meaning by engaging in occupations and occupational roles that fostered family life and other meaningful relationships; a sense of control over their lives; meaningful leisure pursuits; a contribution to or connection to greater causes; and a sense of wellbeing. Conclusion: No claims are being made in this study about the generalisability of the findings to clinical practice. However, occupational therapists may consider exploring ways of helping clients engage in occupations reflecting themes that emerged from the study, as a way of helping them to reconstruct their lives following life-changing events or conditions.

Performers with disabilities in the entertainment industry of Southern California work together as a cohesive force for change, challenging common misconceptions about disability reflected in television and movies. This qualitative study was based on videotaped interviews with a cohort of actors and media activists with physical disabilities working in television and film. Narratives, field notes, and reflexive journal entries were coded, analyzed, and interpreted using qualitative methods. Ethnography and grounded theory approaches were combined, offering a conceptual framework suggesting that, for the participants in this study, performance is a transformative occupation or of such primary importance as to substantially organize their lives. A love of acting appears to inspire the creativity, adaptiveness, and motivation necessary to advance their careers despite significant personal challenges and social barriers inhibiting participation within the industry. This study provides evidence of the potential for occupational engagement to change people's lives while also changing society.

Background. Occupational therapists propose that occupation is a basic human need across the lifespan. However, there is limited understanding of how occupation contributes to the end-of-life experience. Purpose. The purpose of this study was to examine the embodied nature of occupation at end of life from the perspectives of Canadians 60 years of age or older who are diagnosed with a terminal illness. Methods. The study adopted a phenomenological methodological approach to conduct semi-structured interviews with eight participants. Findings. Six themes were identified. Participants described orientations toward occupations that involved: living with death, reworking everyday life, being guided by the will of the body, giving priority to relationships, attending to the small things, and engaging existential orientations. Implications. This study contributes to knowledge about occupation at end of life and offers a starting point to guide practice that is attentive to the lived dimensions of occupation at end of life.

Health policy requires occupational therapy to demonstrate evidence-based clinical outcomes and efficiency in order to survive. This has significant implications for occupational therapy researchers and managers and suggests a re-evaluation of the profession's priorities for research. This opinion piece aims to stimulate debate regarding the impact of occupational science on occupational therapy and the need for research that evaluates the effectiveness of occupational therapy interventions. This is achieved by reflecting on a personal experience of evaluating research evidence for clinical guidelines and by exploring current and future challenges.

This short evaluation report discusses the development of a creative project that encourages student-centred learning. Year 3 occupational therapy students are given the opportunity to explore occupational science theories, applied to an area of human activity through creative media, such as film making, poetry, textiles, animation and photography. Student evaluation of the project identified its value as a highly stimulating learning encounter. The article outlines the educational underpinnings for the project and how the use of creativity enables students to develop their understanding of human occupation, which informs their professional socialisation and identity.

Background: Claiming that the degree of consensus within an academic discipline is a marker of sustainability, some occupational scientists have challenged members of their discipline to work towards philosophical and conceptual consensus. However, because dominant theories of occupation reflect specific Western perspectives, proposing consensus suggests either that the global majority ought to conform to Western perspectives or that Western perspectives are assumed to be universal. Method: Issues confronting occupational theorists (scientists and therapists) are not unique. Accordingly, this paper employs illustrative examples from feminist theory displaying the assumption of universal perspectives and propensity to theoretical imperialism. “These examples are used to highlight the necessity and value of incorporating cultural diversity within theory. Discussion: Dominant feminists' theories were challenged by women of colour, third world and colonised women, lesbians, and disabled, working class, older and poor women, and their underlying universal assumptions were exposed as heterosexist, classist, ableist, racist and an inadequate basis for theory. This review suggests that knowledge is partial and situated, and that theories prevail due not to their intrinsic superiority but to superior power. Conclusion: Occupational scientists and occupational therapy's theorists are exhorted to draw from a diversity of cultural perspectives, such that theories are inclusive rather than exclusive.

Rest is often acknowledged as an integral part of occupational therapy and occupational science, yet little is known about the experience of rest. This article arose from a question posed by the researchers during an earlier phenomenological study of women's experiences of adapting to osteoarthritis. A secondary analysis of the interview and focus group data from the initial study was conducted to answer the question, “How is rest experienced by these women with hip and knee osteoarthritis?” For these 11 women between the ages of 60 and 75 years, rest is a meaningful occupation that contributes to well-being and the achievement of occupational balance. Rest sometimes requires adaptation and is often enfolded with other occupations. Rest is described as different from sleep, which diverges from many classifications of rest in health frameworks. These findings suggest that rest is an important occupational experience and belongs in models of occupational therapy.

In order to look across three cultures at the meanings of celebratory food preparation for older women, researchers in Thailand, America and New Zealand collaboratively designed a derived etic method that respected each culture while allowing cultural comparison of food-related occupations. Anticipating differences in practices at each site, the inquiry broadly addressed who was involved, the tasks of preparing, sharing and offering food, and the physical and social contexts in which the tasks were performed. A seven-step process emerged with alternating collaborative action to design the study and advance analysis, undertake site-specific data collection and analysis of emic and later, conduct etic interpretation. Strategies to support collaboration, address issues relating to translation of data and analysis, and minimize domination of the western researchers are reported, along with critical examination of the method as enacted. Challenges and benefits of working as an international collaboration are identified.

This study examined the impact of participation in a wellness assignment on healthy habit changes in pre-professional undergraduate students. Participants consisted of 58 students enrolled in an undergraduate occupational science health and wellness course. Students were given an assignment to alter three to five habits that would improve their wellness over the semester, and follow-up surveys tracked their adherence to the changes. The assignment and outcomes were retrospectively analyzed using social cognitive and self-determination theories. Students believed that participation in the assignment increased (1) their own wellness status, (2) their understanding of how to impact their own wellness, and (3) their ability to understand client and therapist perspectives on making habit changes. The outcomes suggest that using the principles of social cognitive and self-determination theories appears to support the success of and adherence to healthy habit changes. Implications for occupational therapy educators and practitioners in the use of these theoretical models to support behavior changes are discussed.

The overall aim of this thesis was to contribute to an understanding of the everyday life of women with chronic rheumatic conditions with an emphasis on how they relate to narrative meaning in their everyday activities. The design conveys an ethnographic approach, including a thorough consideration of conceptual and empirical resources. Narrative traditions were explored as well as existing knowledge of everyday activities. Following on from this exploration, an epistemology and methodology was traced to study ‘meaning in action’ for women living with chronic rheumatic conditions in their local cultures. The findings further show how meaning in action happens in the everyday activities of the participating women. By engaging in their local cultures the women enabled themselves to communicate significant issues of meaning through everyday activities. This thesis contributes to the existing knowledge of everyday living with chronic rheumatic conditions by that it has established a conceptual framework of ‘narrative in action’ and subsequent methodology to study the phenomenon. Further it has shown how everyday action provides interpretative possibilities that enable the women to manage, adjust and negotiate their meanings. The concept of ‘enacted ordinariness’ is established and it is shown how questions of moral worth is embedded in everyday action and how society’s labelling tradition impacts the women’s everyday living. Participation in everyday activities in local cultures is found to be of great value for the women but several contradictions are embedded. Processes of meaning are managed in their everyday action, and they do not set their condition apart from themselves and their way of living. Suggesting that activities produce interaction and communication between individual practices and cultural practices, this thesis also contributes to the ongoing exploration of the concept of occupation/activity. For occupational therapy and occupational science this thesis adds to existing basic knowledge of the temporal quality of activities and their relatedness to narrative and meaning.

A sense of belonging is a key element in enabling social inclusion through meaningful occupations. This is evident in occupational science and social and therapeutic horticulture (STH) literature. How these theories interact in practice was explored at Thrive's STH project in Battersea in London. A workshop conducted with Thrive Battersea's therapists examined how gardening may facilitate health and wellbeing through belonging. The authors reflect on themes of belonging from the workshop. The implications for occupational therapy from this apparently rich synergy of occupational science, STH and social inclusion are considered.

The authors discuss the use of psychobiological measures (i.e., biomarkers) for furthering understanding of the biological foundations supporting human occupational behavior. They explore the possible applications of psychobiological measures in research relevant to occupational therapy practice and occupational science, including the documentation of outcomes following occupational therapy intervention. Common psychobiological measures that are available and of particular interest to occupational scientists and therapists are described based on a review of research that has applied psychobiological measures. Psychobiological measures have rarely been reported in the occupational science and occupational therapy literature to date, although such measures are beginning to emerge as researchers expand their questions and methods related to occupational engagement. Psychobiological measures may provide promising insights into the effectiveness of interventions designed to improve self-regulation and more effectively manage stressors for enhancing occupational performance. These measures also may be used to increase understanding of how participation in desired occupations influences arousal levels, stress response, and overall states of well-being and productivity.

Growing awareness of the Western perspectives underpinning occupational science and occupational therapy's values, theories, and evaluation tools has given rise to questions about culturally relevant knowledge and practice with non-Western populations. To make sense of attempts to develop cross-cultural knowledge taking place within the profession and discipline, the authors review epistemological perspectives and methodological advances in anthropology and psychology. Thus informed, they both summarize and critique constructivist and positivist approaches to knowledge development and practice that cross or resist the crossing of cultures. The authors outline a multicultural collaborative research method that supports extending and refining the profession's knowledge in a way that both honors local perspectives and reveals concepts that cross cultures. Insights from a study that explored the meaning of food preparation to older Thai, American, and New Zealand women provide illustrative examples.

Social inclusion and occupational science sit well together and there is a strong case for occupational therapists to take more of a lead with socially inclusive practice. The implications and challenges for occupational therapy roles in mental health services are explored and inclusive practice is discussed in the light of policy that is designed to broaden professional roles. It is argued that if occupational therapists in mental health are going to meet the social inclusion agenda with an occupational focus, they need a political and social awareness in their work with service users and mental health teams.

This article proposes that the idea of meaningful occupations can be used by occupational therapists and occupational scientists to create organizational development interventions to help build sustainable business organizations. Review of recent organizational development literature indicates a trend toward an increasing lack of concern for individual employee needs. A conceptual model of organizational development that reinstates focus on the well-being of the individual as a basis for building sustainable organizations in which employee and organizational goals match is proposed for use by occupational therapists and occupational scientists who may be interested in contributing to this area of human endeavor. An occupation-based worker evaluation formula based on participation in occupations that are meaningful to an employee is suggested.

The European Cooperation in Occupational Therapy Research and Occupational Science (ECOTROS) aims to bring together occupational therapists interested in research in order to promote and facilitate international cooperation. In 2005/06, a survey was undertaken to identify the occupational therapists and institutions that were undertaking research in each country in Europe and to discover the topic, range and type of research. Responses to questionnaires were obtained from 113 individuals and information was given about 143 studies being undertaken within 7 countries. The results of the survey state the academic qualifications, work areas and research topics of the participants; the professions of the supervisors; and the sources of the funding.

This paper explains the interdisciplinary narrative research method of psychobiography, using examples from the author's psychobiographical work about Dian Fossey. Dr Fossey was the primatologist and occupational therapist famous for saving the highland mountain gorillas from extinction. She is known worldwide from her popular book, Gorillas in the Mist, and from the 1987 film of the same name. She sustained her research centre in Rwanda successfully for 18 years before her murder in 1985. Prior to her primatology career, Fossey graduated from an occupational therapy programme in the United States and worked with children for 10 years. The paper details the steps to write a psychobiography, the strategies for analysis and the markers of a good psychobiography. It is suggested that psychobiography is a method that can find a home in occupational therapy and occupational science. The reasons that psychobiography can mesh with occupational therapy are discussed. A second paper, a psychobiographical study of Dian Fossey, is in press.

Children with autism characteristically prefer routinization, yet their mothers seem to experience greater parenting stress orchestrating family life than mothers parenting children with other disabilities. This qualitative study examined the development and use of routines for nine mothers parenting children with autism spectrum diagnoses. Interview transcripts were coded by sorting data into categories and searching for variations within the category and the relationships between categories. Findings describe: (1) development of routines, (2) child's comfort or discontent in routines, (3) child's fluctuations in participation in routines, (4) effects of irregular routines on participation, (5) maternal strategies to manage irregular routines, (6) mothers' selective modification of routines, and (7) alterations in family activities and rituals. The implications of these findings for practice are discussed.

Background. Occupational deprivation as a concept has been presented and discussed in the occupational therapy and occupational science literature for the past several years. The discussion to date, however, has been largely exploratory and theoretical in nature. Purpose. This article represents the author's attempt to further understandings of occupational deprivation as a lived experience through research undertaken with Kosovar refugees living in Australia. Method and Result. The article focuses on the story of one of the participants of the study which is presented as a case study to illuminate aspects of occupational deprivation as a process occurring over time. The case study is interwoven with interpretive commentary, which serves to highlight key issues as to how occupational deprivation may be experienced by groups of people in different cultural, historic and societal contexts and how it may therefore be addressed by occupational therapists. Practice Implications. The article concludes with reflections on future directions with respect to both further research and professional action. In particular, the focus of professional action is oriented to a population-based approach.

Background. The paper is based on a keynote address delivered at the 2004 CAOT Conference in Charlottetown, Prince Edward Island Occupational therapists are widely associated with a medical model of health care in which recognition of how engagement in occupation contributes to health status is poorly understood. Occupational science as the study of people as occupational beings has the potential to increase such understanding. Purpose. This paper considers some aspects of the relationship between health and the occupations of older people to highlight avenues for change and the research required to support them. Method. The paper is structured around a simple verse of dialogue between a healthy old man and an occupational therapist. Explanation of the dialogue draws upon historical and current literature as well as occupational science research to provide a rationale for future practice based on broader concepts of occupation for health. Results and Practice Suggestions. The dialogue promotes the need for discussion about health and about the health notion of Active Ageing. It highlights professional language as one impediment to change and suggests that research concerning occupation as it relates to population health is a primary requirement for the future of occupational therapy.

Background. This paper describes an ongoing, international dialogue about the relationship between occupation, justice, and client-centred practice, prompted by the question: How do occupational therapists work for justice? Methods. The authors critically reflect on their own dialogue and culturally situated interests, dialogues with workshop participants, and a literature review. Results. Four cases of occupational injustice are proposed: occupational alienation, occupational deprivation, occupational marginalization, and occupational imbalance. The naming of these occupational injustices suggests four occupational rights: to experience meaning and enrichment in one's occupations; to participate in a range of occupations for health and social inclusion; to make choices and share decision-making power in daily life; and to receive equal privileges for diverse participation in occupations. Practice Implications. Since silence implies compliance with the status quo, the authors encourage occupational therapists to develop their own dialogue about occupational injustices in order to address them openly with others. Dialogue about occupational justice is timely as occupational therapists around the world articulate what distinguishes this numerically small, rather invisible profession and its contributions to individuals, populations, and societies.

This opinion piece aims to further the discussion of violence that Twinley and Addidle (2012) and Morris (2012) have initiated. Using occupational therapy, occupational science and criminological literature, it is argued that violence itself is not an occupation but, rather, an instrument of certain occupations, such as crime. Investigation of the situations in which violent occupations become ‘occupational possibilities’ is advocated, with the suggestion that practitioners and scholars must direct their attention to both perpetrators and victims of violent occupations. It is further argued that a better understanding of violent occupations will more adequately frame occupational repertoires in disadvantaged communities.

The profession of occupational therapy aims to recognise and value cultural diversity. The purpose of this review is to examine occupational therapy in Western multicultural contexts. First, culturally competent practice is discussed. Secondly, concepts relating to culture in two occupational therapy models (the Model of Human Occupation and the Occupational Performance Model) and in occupational science are examined. Thirdly, occupational therapy in Western multicultural contexts is examined in relation to immigrant cultural groups and indigenous cultural groups: issues, cultural variations and strategies are identified. Fourthly, the implications for occupational therapy education are discussed. In conclusion, the implications for the profession of occupational therapy are identified.

Occupational therapy possesses few mid-range substantive theories, particularly those that have been derived empirically or generated within the profession. Grounded theory offers a systematic and well recognised approach to study the richness and diversity of human experience, in order to generate relevant theory. This paper describes grounded theory, its theoretical orientation and its elements, and offers a critique of the approach. A selection of grounded theory studies related to occupational therapy and occupational science are reviewed to demonstrate the contribution that the approach has begun to make to, and the potential that the approach offers for, developing empirically derived occupational therapy theories.

Time use is of enduring interest to occupational therapists and occupational scientists. However, occupational researchers have yet to exploit fully the potential of large population-level time use datasets. A brief overview of the historical development and current activities within time use research internationally is presented. Whilst acknowledging the challenging nature of this type of research, the authors explore some of the opportunities offered by the secondary analysis of large time use datasets for occupational therapy and occupational science researchers who seek to advance knowledge of human activity, participation and health.

This opinion piece discusses current thinking on, and approaches to, violence from the fields of occupational therapy, occupational science and criminology. A change in how occupation is both defined and examined is anticipated, rather than considering only prosocial occupations. The authors propose the need for an increase in work that explores the impact of antisocial occupations upon other occupations and upon health and wellbeing; occupational therapists and scientists must, therefore, develop their theory, practice and research to include due consideration of antisocial occupations. Owing to the primary author's interests, there is a focus upon the antisocial occupation of violence.

With the emergence of occupational science, there has been renewed interest in the health benefits of occupational engagement and a call for more research into the occupational nature of humans. Engaging in occupations is known to have a positive effect on an individual's health and sense of wellbeing. A common feature of people with schizophrenia, however, is a decrease in volition and a reduction in the occupations performed. This study explored some of the influences on occupational engagement for people with schizophrenia living in the community. A qualitative approach was chosen, using semi-structured interviews. Four male and four female participants, aged 23 to 49 years, described the influences on their occupational engagement. Content analysis, primarily using coding and memoing, was employed to categorise the data. Four main themes emerged: health, routine, external factors and internal factors. Some specific factors identified within these themes were medication, daily schedules, staff, family, work, self-concept and challenges. The implications of the results are discussed, with particular reference to assisting occupational therapists to enable clients with schizophrenia to engage more successfully in occupations.

In this study, the cognitive performance, specifically visuomotor organization and thinking operations, of new immigrant children (Ethiopian) and children from a minority group (Bedouin) was compared to the performance of mainstream Israeli children in two age groups. By assessing the cognitive performance of children from different cultural contexts, a more basic understanding can be gained of the child's ability to perform in school, in daily self-care, and in play/leisure tasks. Furthermore, knowledge of information-processing development that influences occupation in different cultures will advance occupational science. The findings suggest that cultural context as well as schooling have a powerful impact on children's cognitive performance. The findings may have implications for various diverse populations, and therefore it is recommended to study the cognitive performance of school-age children in other populations and to use a dynamic assessment to explore the learning potential of children. It is recommended to develop preventive intervention programs in populations from diverse cultural contexts.

Habits, rather than being mundane or trivial, are significant learned behaviors embedded in an ecocultural context (of time, place, and society) with which they engage in a dialectical relationship. Habits enable or frustrate adaptation to environmental challenges. In a positive mode, habits relate to personal meaning, identity, competence, satisfaction, and self-expression. The study of habits requires adoption of an ethical, scholarly, and holistic approach. Occupational science needs to continue its investigation and synthesis of interdisciplinary knowledge about habits, including identification of the environmental conditions that further occupation; the “affordances” (environmental potentials for action) that provide occupational resources; the habit patterns that contribute to health, and to identification and reclamation of people's strengths, capabilities, and interests; the process of learning of new habits; reconstruction of the self through habit change; and the relationship of engagement in occupation to being in place in one's ecoculture. Such study may require that occupational scientists critically assess their epistemological assumptions and research approaches.

In this paper, I will consider occupational science as a key to broadening horizons in occupational therapy. I start by clarifying and defining what occupational science is, and discuss the benefits that rigorous study of humans as occupational beings may bring to occupational therapy. I suggest that adopting occupational science will assist occupational therapists to think in occupational rather than medical terms. This alone would extend the profession's domain of concern considerably, because it becomes clear that it is not only the people with disorder of body or mind who are occupationally handicapped. Humans have ‘occupational needs’ which are related to maintaining health, and many health outcomes, either good or bad, can be traced back to basic occupational determinants that people have created over time. Our twentieth century founders recognised that we needed such a science and, even earlier, social philosophers wrote of its importance. If occupational therapists work as agents of change according to a sound knowledge base built upon the unique aspect of life and health which is their domain, they will be able to respond and develop according to rapidly changing economies and values. This keynote address was given on 4 July 2001 at the 25th Annual Conference of the College of Occupational Therapists, held at the University of Wales, Swansea.

This article seeks to examine the nature and experience of transitions in life. It explores pertinent theoretical underpinning and considers the ways in which people manage and adapt to change. In particular, it attempts to synthesise the ideas from the psychology of transition with those from occupational science. Throughout, the article is informed by the contributions both from experiential workshops over the last 5 years (including one held at the Inaugural United Kingdom Occupational Science Symposium in York in 1999) and from students who have chosen an elective level 3 module entitled ‘Adult Development — Life Transitions and Crisis' in a BSc/BSc(Hons) Occupational Therapy programme. Among the conclusions from those experiences is the acknowledgement of the centrality and personal meaning of occupation at the point of transition.

Occupational science and occupational therapy suggest that people engage in occupations that are meaningful and relevant to them on personal and cultural levels. Sexual orientation is one theme of meaning in a person's life which influences his or her choice of occupations and the meaning and relevance those occupations hold. Sexual orientation, as it is conceptualised here, encompasses far more than a person's choice of sexual partner and is, therefore, an important area for an occupational therapist to consider. It is, however, an often neglected area in both curricula and the literature.This paper presents the results of a qualitative study which investigated the perspectives of basic grade occupational therapists regarding working with clients of gay, lesbian or bisexual sexual orientation. Six basic grade occupational therapists were interviewed using a semi-structured format and four themes emerged. The findings included that the basic grade occupational therapists interviewed did not consider occupation in its complexity and so did not appreciate how sexual orientation might be expressed in a person's occupations. The interviews also indicated that the subject of sexuality is still taboo in occupational therapy.

This article offers an overview of Wilcock's theories, from the field of occupational science, and relates them to the community care of people with severe mental health problems. Wilcock's occupational risk factors — imbalance, deprivation and alienation — are described and are seen to be reinforced both by the adaptive nature of this client group's problems and by the difficulties experienced by community-based services as they evolve to address the unfolding complexity of clients' needs. The potential for chronicity to be compounded and deepened in this way is highlighted, with particular reference to vocational and social disability, and the possible implications of a wider acknowledgement of occupational risk factors are discussed in relation to day-to-day practice and service configuration.