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Introduction: This study compares the experiences of high school students with visual impairments (that is, those who are blind or have low vision) in and out of school. Methods: Twelve visually impaired high school students completed the same in-the-moment survey seven times daily for seven consecutive days. The frequencies of their activities, interactions, and ratings of internal variables (fitting in, acceptance, loneliness, and enjoyment) were compared across three contexts: home, school, and other (neither home nor school) contexts. Results: Participants spent much of their time out of school alone at home. They rated leisure and structured recreation in "other" locations as their most enjoyable activities. Doing nothing at school was the least positively rated activity. Participants fitted in significantly less and felt significantly less accepted at school than elsewhere. A large proportion of school interactions involved receiving help; few involved giving help. Participants with additional disabilities reported more school social challenges than their peers who were only visually impaired. Discussion and implications for practitioners: This study highlights the subjective dimensions of choice in everyday life. The social impact of doing nothing at school provides an imperative for staff members to ensure that adolescents with visual impairments can participate in lessons. Staff may also need to facilitate opportunities for these students to reciprocate with peers. Adolescents with visual impairments highly value activities with friends out of home and, as with most adolescents, may need to lean on their families for assistance in this area until they can participate in such activities independently.

Introduction: This study explores the social experiences in high school of students with visual impairments. Methods: Experience sampling methodology was used to examine (a) how socially included students with visual impairments feel, (b) the internal qualities of their activities, and (c) the factors that influence a sense of inclusion. Twelve students, including three with additional disabilities, completed the Psychological Sense of School Membership (PSSM) questionnaire as a measure of inclusion. They were subsequently asked to complete an in-the-moment survey seven times daily for one week using an iOS device. This survey asked about activities and ratings of internal variables: fitting in, acceptance, loneliness, awareness, and enjoyment. Each student was also interviewed. Z-scores were created for internal variables and correlations calculated to examine relationships between experiences, PSSM, and demographic variables. Results: This group felt included as measured by the PSSM (m = 4.24, SD = 0.67). Students' most frequent activity was classwork. Doing nothing rated most negatively and was described as time wasting. Out-of-class activities were rated most positively. In the three participants with additional disabilities, it appeared that the presence of this additional disability negatively influenced a sense of inclusion (rb = -0.67, p < 0.05), fitting in (rb = -0.86, p < 0.05), enjoyment (rb = -0.65, p < 0.05), and loneliness (rb = 0.88, p < 0.05). Interviews revealed a lack of common ground between adolescents with both visual impairments and additional disabilities and their peers. Discussion and implications for practitioners: These students worked hard to maintain parity with peers and found school more enjoyable if they fit in. It is important to provide discreet and timely access to the curriculum. Friendships require time, common interests, and reciprocity. There may be potential to further explore out-of-class clubs as a means of supporting friendship development. In addition, findings suggest that students with additional disabilities are not likely to feel included. Because this population comprises the majority of visually impaired students, this result has serious implications for practitioners and should be examined in future research.

Background: We assessed the effectiveness of a simple intervention for increasing children's physical activity, play, perceived competence/social acceptance, and social skills. Methods: A cluster-randomized controlled trial was conducted, in which schools were the clusters. Twelve Sydney (Australia) primary schools were randomly allocated to intervention or control conditions, with 226 children (5-7 years old) selected randomly to participate. Data were collected at baseline and after 13 weeks. The intervention consisted of introducing recycled materials without an obvious play purpose into school playgrounds and a risk-reframing workshop for parents and teachers. Results: Children from the intervention schools increased physical activity and reduced sedentary time while control schools decreased physical activity and increased sedentary time. The intervention yielded increases in total accelerometer counts (ß = 9350 counts, 95% CI 3490-1522, p = 0.002), minutes of moderate/vigorous physical activity (MVPA) (ß = 1.8 min, 95% CI 0.52-3.12, p = 0.006), and reductions in sedentary time (ß = -2.1 min, 95% CI -3.77-(-0.51), p = 0.01). Although the changes in time spent in play and nonplay were not statistically different (p = 0.08) the effect size (d = 0.27) indicates clinical significance. Conclusions: This intervention was effective for increasing MVPA during recess and demonstrated capacity to improve play opportunities in school playgrounds.

Background and Objectives: Residents in aged care homes often report lack of life purpose and meaning and limited opportunities to contribute to their community. The JAVA Memory Care program is designed to facilitate engagement for older adults with advanced dementia. This study explored whether JAVA Memory Care engaged such adults meaningfully, on social and occupational levels, within one Australian residential care home. Methods: A mixed method design guided this exploration. Trained staff facilitated six JAVA groups over 2 months. Three sources of data were utilised. Observational data (qualitative and quantitative) were obtained using a narratively enhanced Assessment Tool for Social and Occupational Engagement (ATOSE). The other two data sources were qualitative and analysed thematically: reflections by the lead JAVA facilitator and data generated by a research discussion group. Results: The quantitative data comprised 564 ATOSE behaviour markers. Participants were categorised as being engaged in 93% of these markers. Two of the three qualitative themes focused on the collective and self‐expressive nature of participant engagement. The third theme focused on practicalities such as time pressures, facilitator training, resident selection, and resource preparation. For residents, the groups provided a context for relating meaningfully to others. Conclusion: The JAVA program achieved a high level of engagement. However, it was a time intensive intervention and required a person‐centred philosophy, appropriate staff training, organisational support, and a suitable quiet space. The program had positive benefits, but practical issues identified needed to be considered before implementation. [ABSTRACT FROM AUTHOR]

Background and objectives: Global migration and an increased life expectancy led to a growing number of people with dementia from Culturally and Linguistically Diverse (CaLD) backgrounds living in long‐term residential care settings. These minority groups' wellbeing may be negatively impacted due to poor culturally appropriate care that fails to honour valued cultural traditions. This study considered culturally appropriate dementia care for older adults with an Indian heritage living in Sydney‐based residential aged care facilities. Research design and methods: The Nominal Group Technique was employed to collect data from three groups of stakeholders of Indian heritage over a period of 6 months: care staff (n = 8), family of residential care recipients (n = 8), and community‐dwelling older adults (n = 7). Results: Perspectives highlighted six concepts for consideration: (1) embracing a person‐centred approach to promote culturally appropriate dementia care; (2) training staff in culturally appropriate forms of respect; (3) the impact of staff ratios on care; (4) the importance of familiarity to meaningful engagement; (5) the importance of food; and (6) the necessity of engaging family and the wider Indian community in residential care activities. Conclusions: Culturally appropriate dementia care for older adults with an Indian heritage is an area in need of further development. To ensure that residents with an Indian heritage are respected as an ethnic minority, it remains crucial that research is generated to inform policy development on each CaLD group as a separate entity. [ABSTRACT FROM AUTHOR]

Because leisure activities are often viewed as optional, their value to people with disabilities may not be recognized. This study explored the benefits of leisure activities for eight young people who are blind. These activities provided them with supportive relationships, a desirable identity, experiences of power and control, and experiences of social justice. They enabled the young people we studied to thrive despite adversity. (Contains 1 table.)

The organisational, physical and social environment within residential aged care settings greatly influence its residents' sense of autonomy, choice and control and their ability to engage in meaningful occupations. Identifying to what extent these environmental contexts are supportive and well‐coordinated could assist with promoting meaningful engagement of residents. The Residential Environment Impact Scale (REIS) was developed to measure the impact of the physical and social environment on residents. This study examined the benefits and barriers to implementing the REIS in four Australian Residential Aged Care Facilities (RACFs) and factors to consider during implementation. Method: A multisite sequential mixed‐methods study was conducted. Research participants included occupational therapists conducting the REIS and leadership staff examining the REIS reports in four facilities. Data consisted of formal observations of the REIS assessment process, an online survey of all participants and two research consensus groups. Qualitative findings were generated from field notes, open‐ended survey questions and group discussions. Close‐ended survey questions provided quantitative data. Findings The REIS was considered a useful audit tool, generating a holistic overview of the RACF. It highlighted the quality of person‐centred care and the potential role of occupational therapists to promote opportunities for meaningful occupational engagement. Barriers included administration time, personal characteristics of residents and limited resources to action recommendations. Conclusion: The REIS has potential to be an audit tool for a whole‐environment approach to facility assessment of residents' sense of autonomy, occupational choice and meaningful engagement. As such, it provides occupational therapists with scope to support RACFs meeting national quality standards. [ABSTRACT FROM AUTHOR]

Abstract Background In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills. Methods/Design This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT), in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention), with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1) Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2) Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers) are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment. Discussion These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health. Trial registration Australian and New Zealand Clinical Trials Registration Number ACTRN12611000089932.

Background: Person-centred care (PCC) is regarded as best practice within dementia care, however there is a gap between the understanding and the implementation of this type of care practice. The Peer Enablement Program (PEP) incorporates a group problem solving model for promoting PCC of residents with moderate to advanced dementia living in care facilities. Objective: Trained PEP facilitators introduced the program to selected staff from an organisation with 99 facilities across Australia. The objective of this study was to identify what particular aspects of the PEP these facilitators valued for advancing PCC and care culture change. Method: An embedded mixed methods study design guided this investigation. The qualitative component of the study focussed on the insights of the nine PEP facilitators who presented the workshops. This information was supported and contrasted with descriptive data generated from 322 workshop feedback forms by attendees over the course of the three workshops presented nationally. Results: Facilitators identified peer support as the most valued aspect of the PEP. It promoted collaboration among attendees; supported development of their occupational identities as transformational leaders; and created communities of practice with potential to sustain advances in PCC. Conclusions: The PEP has the potential to advance PCC. Further research is needed to evaluate the long-term sustainability of these advances and to determine if this program can be utilised more widely, both in a national and international context. [ABSTRACT FROM AUTHOR]