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Introduction Canadian occupational therapists are employed as case managers on assertive community treatment (ACT) teams to support community living for individuals with severe and persistent mental illnesses. In this position, occupational therapists act primarily as generalists, typically attending appointments with clients, supervising medication adherence, supporting basic living needs, and managing client crises. Occupational therapists may also provide psychotherapy and coping skill groups, as well as profession-specific practices, such as skills training. Exploring how ACT occupational therapists describe their perceived ideal practice may support transformation in long-standing, occupational therapy practices on ACT teams. Method This qualitative, interpretive description study involved 11 Canadian ACT team occupational therapists in one individual, semi-structured in-depth interview using an interview guide containing open-ended questions. Interview transcripts were analyzed to identify themes pertaining to therapists’ descriptions of their perceived ideal occupational therapy practice on ACT teams. Results Three themes emerged: (a) Engaging in practice “with intention”; (b) Finding the space for occupational therapy practice; and (c) Supporting clients in their recovery to find their best occupational self. Conclusions The findings highlight practice possibilities for occupational therapist working on ACT teams and provide a foundation for advocating for better use of specific occupational therapy practices within community mental health settings.

BACKGROUND Physician assistants (PAs) and NPs have expanded roles in nephrology as both the patient load and acuity of care needed for this population have increased. PURPOSE To evaluate the workforce patterns of PAs and NPs working in nephrology over the past decade. METHODS Using the biannual survey from the National Kidney Foundation Council of Advanced Practitioners, data were collected and analyzed over the past decade. RESULTS Surveys of nephrology practitioners show the evolution of the dialysis-focused practitioner to one encompassing all aspects of nephrology: hospital, ICU, research, office, and all types of dialysis. Salaries and benefits have increased to compensate for the expansion of responsibilities. CONCLUSIONS PAs and NPs in nephrology have the opportunity to use their skills and training in caring for this high-risk population.

This article presents an unusual case of appendicitis in pregnancy complicated by the novel coronavirus (SARS-CoV-2). The novel coronavirus has affected the way medicine is practised across most parts of the world with over 160 000 000 global cases to date. Tackling management of these cases is more complex when other pathological processes are ongoing. Appendicitis is a common occurrence in pregnancy, with most obstetric centres seeing about one or two cases a year. Though maternal morbidity and mortality are relatively unimpacted by this event, fetal loss and preterm labour are common sequelae. This case involves a 35-year-old woman presenting in her third trimester with abdominal pain and who went on to be diagnosed with concurrent appendicitis and SARS-CoV-2 infection. Although spinal anaesthesia would be most appropriate as it avoids aerosol generation, general anaesthetic techniques were indicated due to thrombocytopenia in this case. She underwent a successful appendicectomy, although preterm delivery was indicated as a result of maternal and fetal concerns.

A small scale qualitative project, undertaken by an interdisciplinary domestic violence research group involving academic researchers and research assistants, with colleagues from Independent Domestic Abuse Services (IDAS), investigated youth aggression and violence against parents. Following the literature review, data was generated through several research conversations with young people (n = 2), through semi-structured interviews with mothers (n = 3) and practitioners (n = 5), and through a practitioner focus group (n = 8). Thematic analysis and triangulation of the data from parents, practitioners and young people, elicited interconnected and complex overarching themes. Young people could be both victim and perpetrator. The witnessing or experiencing of domestic aggression and violence raised the concept of ‘bystander children’. The impact of young people experiencing familial violence was underestimated by parents. For practitioners, the effects of working with domestic violence was shown to be significant - both positively and negatively.

Aging of the population in the United States and increasing incidence of chronic diseases such as diabetes, hypertension, and CKD have contributed to a growing demand for healthcare services. Increasingly, healthcare organizations employ Physician Assistants (PAs) and Nurse Practitioners (NPs)

Introduction: The primary Brazilian occupational therapists goal is to enable their clients to participate in the activities of everyday life. Thus, it is important that therapists have tools that capture their clients’ activities repertoires. The Paediatric Activity Card Sort (PACS) is a client-centred tool designed to capture the activity repertoire of children. However, the PACS is based on the activities of Canadian children, leading to questions regarding its use in other countries. Objective: To determine the acceptability and applicability of the PACS with Brazilian children. Method: Sixty children between 5 and 14 years participated in a descriptive cross-sectional study. A questionnaire was used to gather sociodemographic information. Behavioural observations were used to judge the acceptability of the PACS. Item responses and their relation to sociodemographic variables were used to examine applicability. Descriptive statistics were used to describe demographics and item responses. Differencesin the PACS scores between gender, race, presence of siblings, parents’ educational levels and marital status were assessed using non-parametric statistics. Results: Reported participation in PACS activities ranged from 95.7% (personal care) to 15.1% (sports). Eleven PACS activities had a participation rate of less than 10% and a number of new activities, not included in the PACS, were identified. Differences were found among gender and presence of siblings. Conclusion: With adjustments for the Brazilian context the PACS can be a useful tool to capture children activity suggesting the potential usefulness of a Brazilian PACS.

En effet, la communaute mondiale en ergotherapie peut et doit travailler en collaboration afin de promouvoir les valeurs communes sous-jacentes de la profession; par exemple, le droit de tous les individus, communautes, groupes et populations a s’engager dans des occupations signifiantes ou a l’habilitation de leur participation occupationnelle en ayant acces a des services justes et equitables et en evoluant dans des milieux justes et equitables (p. ex., Townsend et Polatajko, 2013). Pour etre indexees, ce qui est requis pour faire une demande de facteur d’impact au Journal Citation Reports, ces revues doivent demontrer que les articles qu’elles publient sont largement cites, et ce, dans des revues publiees en anglais. Toutefois, recemment, ces revues sont passees a la publication bilingue en ajoutant des manuscrits en langue anglaise et, dans certaines situations, comme pour le Brazilian Journal of Occupational Therapy (BrJOT; http://www.cadernosdeterapiaocupacional.ufscar.br), en publiant des articles dans trois langues. (Ont.), OTR, OT(C) Redactrice en chef adjointe / Coredactrice Revue canadienne d’ergotherapie Ana Ana Paula Serrata Malfitano, PhD, OT (Bresil) Redactrice en chef, Brazilian Journal of Occupational Therapy Professeure, Federal University of Sao Carlos, UFSCar, Sao Carlos, Sao Paulo, Bresil

Vision : Promouvoir l’ergotherapie a travers le monde Mission : Offrir une tribune a la recherche de pointe axee sur la pratique, l’enseignement et la politique dans le domaine de l’ergotherapie Priorites strategiques (PS) : PS1. Accroitre chez les auteurs le desir de soumettre a la RCE des articles influents/de calibre superieur. PS2. Rehausser la rigueur scientifique des revisions. PS3. Veuillez a ce que les ressources et les processus appropries soient mis en place pour soutenir la revue. PS4. Promouvoir la revue afin de favoriser l’avancement de l’ergotherapie. PS5. Favoriser une communication transparente et complete.

Aim This methodological paper outlines a participatory and reflexive research approach in the context of in‐depth, small‐scale and preliminary qualitative research conversations with a vulnerable population. Developing a participatory and reflexive methodology The project involved developing in‐depth research conversations with three mothers and their children who had experienced domestic violence. Underpinned by poststructural feminism and relational ethics, a participatory approach to facilitate informal, nondefensive, participant‐centred conversational spaces for the women and children was developed. Creating both the relational medium and the dialogical processes through which to engage with the women and children prompted multiple and complex challenges for the research team. Some members of the research team had prior experience of domestic violence, generating implications for ethical and reflexive research practice. Implications for research practice The study highlights the complexities and challenges of developing a participatory approach with vulnerable populations including the quandaries faced, the importance of critical reflexivity during in‐depth qualitative inquiry and the value of utilising a project steering group to support research governance. All members of the research team were emotionally impacted by the research work and the relational engagement with participants. A collaborative, peer‐supervisory approach to support the researchers, the research processes – and, ultimately, the participants – was essential. Two case vignettes are included to exemplify researcher experiences.

The purpose of this study was to explore children's everyday outdoor occupations in context. A naturalistic observational approach was employed to record the observed outdoor occupations of children in Mbarara, Uganda. Thematic analysis, through pattern formation and constant comparative analysis, was used to uncover categories and themes in the data. Patterns emerged from the data revealing two overarching categories containing three themes: 1) types of occupations: play, work and nothing in particular and 2) characteristics of occupational engagement: being in peer groups, having fun and using materials in the environment. The themes reveal that children's occupations are both similar and different across minority and majority world cultures and that children's occupations are contextually situated and flexible in nature. A limitation of the study was that the observational approach made identification of children's ages subjective. Subsequent studies should explore children's experiences of occupational engagement using interviews and focus groups. Copyright © 2010 John Wiley & Sons, Ltd.

ephrology advanced practitio-ners are involved in every aspect of renal medicine, and what they do is as unique as they are. Advanced practitioners (AP) include nurse practitioners (NP), physician assistants (PA), and clinical nurse specialists (CNS).Surveys by the National Kidney Foundation (NKF), the Renal PhysiciansAssociation (RPA), and the Academy of Nephrology Physicians Association that looked at AP job descriptions revealed the diverse scope of their practice. While all participate in caring for renal patients, their individual duties cover the entire spectrum of nephrology. Depending on the practice needs, an AP may perform history and physicals, dictate discharge summaries, make hospital rounds, and take after-hours calls. Many APs are providers in chron-ic kidney disease (CKD) clinics and in nephrology clinics. In addition, they round in hemodialysis and peritoneal dialysis clinics. Their duties here include writing and modifying dialysis prescriptions and providing for patient needs. They are also involved in transplantation, often seeing patients and potential donors in transplant evaluation and following the patient after transplant in the hospital and clinic. In addition, some APs are utilized as surgi-cal fi rst assistants. Advanced practitioners are actively involved in research and often direct research studies.

Teachers who differentiate learning with meaningful tasks for students at all levels can keep their entire class engaged.

Nous avons besoin de savoir « Quelles habiletes d'habilitation sont utilisees?»«A quoi ressemblent les habiletes d'habilitation en action? » « Qu'est-ce qui rend l'habilitation efficace ou inefficace? » Dans son allocution, Dre Kirsh (2015) enoncait clairement que la progression de notre comprehension de l'habilitation a l'occupation devait inclure une attention particuliere du niveau auquel l'habilitation doit se produire afin que des changements occupationnels substantiels se produisent. Ainsi, les ergotherapeutes doivent collaborer avec les individus presentant des incapacites, leurs familles et les organismes venant en aide aux personnes en situation de handicap afin de revendiquer des changements au plan politique; par exemple, reduire la stigmatisation et la discrimination a l'endroit des accidentes du travail a Toronto, faire valoir et appliquer les principes de design universel a Port-au-Prince et changer la culture organisationnelle a Largo.

[...]in February 2011, the CJOT editorial board articulated a vision and mission for the journal and identified five strategic priorities: [...]the decision at the strategic review was to undertake a course correction and focus our attention on issues of quality and reach. New Vision: To be a high-quality scholarly journal that is at the forefront of the science of occupational therapy and a destination journal for the top scholars in the field, globally New Mission: To provide a forum for leading-edge occupational therapy scholarship that advances theory, practice, research, and policy Over the next year, a number of initiatives will be undertaken to strengthen the quality of the journal and focus its reach.

Intradialytic exercise is both safe and beneficial for patients; however, worldwide, despite evidence to support its efficacy, it is underutilized. A pilot project in a large inner city hemodialysis unit demonstrated the benefits of introducing a program to improve physical function among the participants.

[...]we thought it was time to issue a call to advance our scholarship on enablement, globally. [...]in all three countries, the right to fair and equitable employment is guaranteed at the system level; however, in all three countries, many examples can be found where these laws are not translated into policy or the policy is not adhered to by the organization. [...]there is a need for occupational therapists to collaborate with persons with disabilities, their families, and disabled persons' organizations to advocate for change at the policy level, for example, to reduce stigma and discrimination directed toward injured workers in Toronto, to enforce the use of universal design principles in Port-auPrince, and to change organizational culture in Largo.

Individuals who have made a direct intellectual contribution to the development of the new ideas and findings are distinguished by being listed as an author of the new work. [...]ethical writing involves clear attributions to the authors of the previous work that was used in creating the new knowledge through citation and to individuals who contributed to the new work in significant ways through authorship. Flowchart: What to do if you suspect plagiarism: (a) Suspected plagiarism in a submitted manuscript.Telechargeau http://publicationethics.org/files/u7140/plagiarism%20A.pdf International Committee of Medical Journal Editors.

It has been observed repeatedly that risk factors for cardiovascular diseases tend to co-occur within individuals (1, 2). Typically, disturbances of glucose metabolism, dyslipidemias, central obesity, and elevated blood pressure are among the metabolic and hemodynamic components considered. These observations have been made both on the individual level and at the population level as associations between these risk factors. Since each of these conditions is highly prevalent in adulthood, it is reasonable to expect clusters due to chance alone. However, it has been speculated for some time that co-occurrence of these conditions is due to a common underlying process. Several terms have been proposed to describe the clustering of metabolic disorders, among them syndrome X, the insulin resistance syndrome, and the multiple metabolic syndrome (table 1) (3-13). For the purposes of this review, the latter terminology, the multiple metabolic syndrome, will be adopted since it does not rely on assumptions about underlying etiologic mechanisms and retains a certain neutrality. The term "multiple metabolic" implies primarily more than one metabolic abnormality, but does not preclude the interpretation that several syndromes may, in fact, be subsumed under this heading. This review will focus on the multiple metabolic syndrome largely from an epidemiologic perspective. There are several excellent review papers that have concentrated on the physiologic or clinical perspectives (3, 12, 14).

The mission of this journal is “to provide a forum for leading edge scholarship that advances occupational therapy practice, education, and policy.” While all three are equally meritorious, in this editorial we will focus on advancing practice. We do so because we believe that without advancing our practice the advancement of our education and policy become moot. Further, as editors, we are struck by the paucity of submissions related to practice and would like to encourage occupational therapy scholars to consider work in this area, in particular, in the rhetoric of the 2007 Enabling Occupation II guidelines, to consider work in advancing occupation-based practice (Townsend & Polatajko, 2007). The rhetoric in Enabling Occupation II suggests that occupation-based practice has great potential to broaden the scope of our practice, and we would like to encourage the scholarship necessary to realize that potential. Unfortunately, a divide appears to be emerging between the rhetoric and practice; the perception seems to be that occupation-based enablement restricts practice and that there are many forms of practice that are not consistent with the ideas subtending occupation-based enablement. We believe this divide emanates from a misinterpretation of the rhetoric. The rhetoric offered in Enabling Occupation II is that occupation-based enablement involves “the full range

Family business consultants, whatever their profession of origin, can make use of the distinction between what people say (content) and how they say it (process). This article summarizes some key concepts that process experts draw from family systems, organization development, and conflict resolution/negotiation theories to formulate a process/content framework. We suggest guidelines, illustrated with case examples, that can help family business consultants who are content experts move more thoughtfully and effectively between these two ways of viewing a family business. These guidelines can also help family businesses choose between the process or content experts they may need in different situations.

AIMS: The aim of this review was to assess whether restraint and seclusion are safe and effective interventions for the short-term management of disturbed/violent behaviour. Staff and service user perspectives on the use of these interventions were also considered. The review was undertaken as part of the development process for a national guideline on the short-term management of disturbed/violent behaviour in adult psychiatric inpatient settings and emergency departments in the United Kingdom. METHOD: An exhaustive literature search was undertaken. Systematic reviews, before and after studies, as well as qualitative studies were included. Searches were run from 1985 to 2002. FINDINGS: Thirty-six eligible studies were identified. However, none were randomised controlled trials. Most of the included studies had many limitations, such as small sample sizes, confounders not adequately accounted for, potential selection bias, poorly reported results, and lack of clarity as to whether mechanical restraints were used. This review must therefore be viewed as a mapping exercise, which illustrates the range and quality of studies that have been undertaken in this area to date. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Insufficient evidence is available to determine whether seclusion and restraint are safe and/or effective interventions for the short-term management of disturbed/violent behaviour in adult psychiatric inpatient settings. These interventions should therefore be used with caution and only as a last resort once other methods of calming a situation and/or service user have failed.

Question remains regarding endurance training and changes in resting heart rate (HR) among older individuals. The objective of this meta-analysis was to determine the effects of controlled aerobic training on resting HR among sedentary older adults.Studies were identified by a systematic computer database search, hand article search, and cross-reference. The inclusion criteria were (i) controlled clinical trials, (ii) endurance exercise as the only intervention, (iii) a nonexercise control group, (iv) within-group mean ages of subjectsor = 60 yr, (v) a measure of changes in resting HR, (vi) studies published in English journals.Outcome was derived from 13 studies with a total of 651 individuals in 14 control (N = 241) and 16 exercise groups (N = 410). The pooled standardized effect size by a fixed-effect model showed an upper moderate effect of -0.58 +/- 0.08 (mean +/- SEM, 95% CI = -0.74 to -0.42). This homogeneity effect was statistically significant (P = 0.001). The magnitude of net change averaged -6 bpm (-2 to -12 bpm), representing an 8.4% reduction. Greater and statistically significant decrease of resting HR among the elderly was found in the studies with training length more than 30 wk.This meta-analytic investigation supports the efficacy of endurance exercise training in decreasing HR at rest in older adults. This training induced adaptation may have protective benefits for cardiovascular aging. A longer exercise training length, probably more than 30 wk, may be needed for older individuals to be more effective in terms of resting HR reduction.

[...]CAOT reviewed the production and distribution of CJOT and considered how best to engage readers, advance the dissemination of occupational therapy research, and consequently, profile the work of Canadian occupational therapy, nationally and internationally. First and foremost, SAGE is a leading publisher with an impeccable reputation.

Because of the broad nature of occupational therapy practice, research questions can arise from many different elements and dimensions of practice, leading many occupational therapy researchers to ask questions based on assumptions that fit within different paradigms.