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Since 2015, nearly 45,000 Syrian refugees who fled the civil war have resettled in Canada. This forced migration can present significant disruptions for Syrian refugees’ everyday lives. Refugee you...

INTRODUCTION Persons who become displaced due to situations such as war and natural disasters face extreme challenges in maintaining their occupational repertoires. This study aimed to explore the occupational lives of Syrians under temporary protection in Turkey. METHODS This mixed method study used a cross-sectional design with a predominantly qualitative focus. Syrians living under temporary protection in Turkey were interviewed using the Canadian Occupational Performance Measure (COPM) to identify their perceived performance problems in the areas of self-care, productivity, and leisure. Additional probes were used to explore participants' reasoning for the choice of occupations and scoring, and occupational changes since arriving in Turkey. Socio-demographics were collected on the participants' age, gender, educational level, marital status, monthly house budget, social security, and number of persons within the household. Thematic analysis was used to undercover themes from the qualitative data. RESULTS Thirty Syrians living under temporary protection in Turkey in Hatay province participated in this study (mean age: 29.66 ± 7.97 years [range = 18 to 50 years]): 16 women (mean age: 28.64 ± 8.04 years) and 14 men (mean age: 30.56 ± 8.05 years). Participants identified more significant problems in their performance of productive and leisure occupations than in self-care occupations. The following themes emerged: (a) having a house of our own: meeting basic needs and completing activities of daily living; (b) no money for shopping: past everyday occupations now luxuries; (c) feeling valued and important: having the ability but no job; (d) living day to day: Education, career, and marriage on hold; and (e) enjoyment in life: leaving behind family, friends, and occupational spaces. CONCLUSION Syrians living in temporary protection in Turkey experience uncertainty within their occupational lives. Participants were able to meet their basic needs; however, precarity of employment limited their participation in previous occupations contracting their repertoires.

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.

Estimated glomerular filtration rate (eGFR) calculators have included a race adjustment to help approximate measured GFR. Over the past several years, as more attention has been directed toward uncovering racial bias, the appropriateness of including race in these calculators has been called into question. The American Society of Nephrology and the National Kidney Foundation convened an expert task force to review the inclusion of race in eGFR. The deliberative review showed that race can be removed from eGFR calculators without causing adverse reactions in any group of patients. This new, refitted CKD-EPI equation can be used immediately by all laboratories in the United States. The task force also recommended greater use of cystatin C nationally in eGFR calculations. This would enable the new CKD-EPI equation to incorporate both creatinine and cystatin C without race and would yield better accuracy than a calculator that uses creatinine alone.

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.

Background Physician assistants (PAs) and nurse practitioners (NPs) have expanded roles in nephrology as both the patient load and acuity of care needed for this population have increased. Purpose To evaluate 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-centralized practitioner to one encompassing all aspects of nephrology: hospital, intensive care unit, research, office, and all types of dialysis. Salaries and benefits have increased to compensate for the expansion of responsibilities. Implications for practice Physician assistants and NPs in nephrology have the opportunity to use their skills and training in caring for this high-risk population.

Introduction Children with mobility difficulties are thought to share similar participation repertoires due to the impact of their physical impairments. However, with these children, as with all others, individual differences and contexts should mediate occupational repertoires and experiences, resulting in participation differences, at least in part. This study aimed to explore the occupational repertoires of children with mobility difficulties and their view of their occupational participation. Methods Five children with mobility difficulties were assessed using the paediatric activity card sort, to establish their occupational repertoires. Semi-structured interviews were used to understand the children’s occupational participation. Findings Our findings suggest that children with mobility issues are more likely to participate in quiet occupations, but not exclusively. The children defined participation in their own way. Conclusion The knowledge about how children with mobility difficulties understand participation in occupation can help occupational therapists to establish goals with their clients and personalise interventions.

Background. In 2012, the World Federation of Occupational Therapists released a position statement on sustainability and sustainable practice, urging occupational therapists to address the global e...

Introduction An occupational repertoire is the array of occupations that an individual has the perceived capacity to perform at a specific point in time. The Occupational Repertoire Development Measure – Parent is a new tool that uses parent report to identify the occupations children can and do perform and their interests in and opportunities for doing them. This study aimed to test the face validity, comprehensiveness, and internal consistency of the Occupational Repertoire Development Measure – Parent as a tool to measure the occupational repertoire of children aged between 2 and 12 years. Method Twenty-nine occupational therapists completed an online questionnaire about the Occupational Repertoire Development Measure – Parent, and 27 parents completed it and then provided feedback via a structured interview. Descriptive statistics, content analysis, and the content validity index guided data analysis. Results Participants view the Occupational Repertoire Development Measure – Parent as practical, simple, and supportive of occupation-centred practice to optimize children’s development of a meaningful repertoire. Overall, self-care occupations were rated highly relevant. Lower-scoring occupations were those perceived as performed only by older children, nonessential for children with disabilities, or culturally unimportant. Conclusion Results indicate value in the further development of the Occupational Repertoire Development Measure – Parent and validate that it asks relevant questions to understand a child’s performance, engagement, and opportunities, leading to optimal repertoire development.

Background Personal Energy Planning is a problem-solving based programme that guides people receiving maintenance haemodialysis treatment to use energy management strategies to address life participation challenges. The feasibility of training dialysis clinicians to become Personal Energy Planning coaches (i.e., programme administrators) is currently unknown. Objectives To explore the feasibility of training dialysis clinicians to administer the Personal Energy Planning programme. Design Feasibility study involving an adherence evaluation of two trained dialysis clinician coaches' problem-solving facilitation skills, and one qualitative interview with each coach. Participants Two Personal Energy Planning coaches with nursing backgrounds who administered the programme to 10 patients receiving maintenance haemodialysis treatment over a total of 34 sessions. Approach Audio recordings of one session per treatment recipient (n = 10) were evaluated using an established treatment adherence checklist. The proportion of treatment sessions where the item was observed by two adherence raters was calculated. In addition, coaches were interviewed about their experiences learning and administering the programme; interviews were analysed using inductive thematic analysis. Findings Some core facilitation skills (e.g., patient-centred goal setting and analysis of performance breakdowns) were consistently used; however, other facilitation skills (e.g., guided discovery and global problem-solving strategy) were not regularly implemented. The coaches discussed challenges (e.g., supporting patient problem-solving and fluctuating patient health) with administering the intervention. Certain training resources (e.g., coaching handbook and expert consultation) were identified as valuable to their learning. Conclusions With modifications to training materials, it might be feasible to train dialysis clinicians to administer Personal Energy Planning with people receiving maintenance haemodialysis treatment.

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.

Introduction: Many models of human occupation are predicated on the notion that environments or contexts influence occupational performance and engagement. By extension, it can be considered that c...

Introducao: Muitos modelos de ocupacao humana sao baseados na nocao de que ambientes ou contextos influenciam o desempenho ocupacional e o engajamento. Por extensao, pode-se considerar que os conte...

Social distancing, a critical measure to manage COVID-19 transmission, is consistently associated with social isolation, a major health issue. Social isolation negatively impacts mental and physical health, particularly among older adults. A pre-post comparison study examined changes in cognitive function and perceived health among 36 community-dwelling Brazilian older adults, assessed pre and post social distancing measures enacted due to COVID-19. A significant increase in cognitive function was found 1 month into social distancing ( M = 16.3, p = .002, power = 0.88), with declining scores for vitality ( M = −29.3, p < .001, power = 0.99) and mental health ( M = −38.1, p < .001, power = 0.99), particularly among participants who lived alone ( t = −3.8, p = .001). Older adults exhibit rapid changes in perceived health when excluded from participation in social activities. Health care professionals should consider holistic approaches when addressing the impacts of social isolation on this population.

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)

Background. Foundational to the occupational therapy profession is the belief that engagement in occupation is health promoting; however, this belief fails to account for occupational engagement that may be risky or illness producing. Consensus regarding the nature of the relationship between occupation and health has yet to be achieved. Purpose. The purpose of this study is to provide a comprehensive description of how the relationship between occupation and health and well-being is discussed within the occupational therapy and occupational science literature. Method. The methodological framework outlined by Arksey and O’Malley served as the basis for this scoping review of the occupational therapy and occupational science literature. Findings. One hundred and twelve articles were identified as meeting the criteria for inclusion. The dominant discourse portrays the relationship between occupation and health as positive. Implications. The broader literature suggests that occupational engagement can have both positive and negative effects on health and well-being. As such, the reconceptualization of the relationship between occupation and health and well-being is warranted to enable occupational therapists to practise in a more client-centred manner.

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.

There is currently little research concerning occupations that may be detrimental rather than beneficial to health and well-being. This study used interpretative phenomenological analysis (Smith & Osborn, 2003) to explore one young man's experience of binge drinking; an occupation typically associated with varying health risks. Viewing his subjective account of binge drinking through the lens of Wilcock's (1993) theory of the human need for occupation, it could be regarded as an occupation to maintain aspects of health and well-being and therefore have some constructive elements. This study lends qualified support to Wilcock's hypothesis, suggesting that the relationship between occupation, health and well-being is far more complex than much of the earlier occupational science research proposed.

Management of patients with chronic kidney disease has evolved since the last Kidney Disease Improving Global Outcomes clinical practice guideline was published in 2012. This article reviews the most recent guidelines, common management issues in primary care, kidney risk and outcome calculators, and over-the-counter medications that may cause community-acquired acute kidney injury.

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