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SHORT REPORT Education and research in Africa: Identifying and meeting the needs.

The development and promotion of occupational therapy in the Sub-Saharan continent of Africa is seen as a challenge for the World Federation of Occupational Therapists. It is also a challenge for pioneering occupational therapists, mostly ex-patriates, who have started occupational therapy services in many new countries of Africa over the past few years. This report identifies and addresses the problems. It is important that existing training centres for occupational therapists are maintained by attracting permanent, indigenous teaching staff and clinical supervisors, by promoting continuing support and development of existing occupational therapy services and by promoting the development of more rehabilitation and educational facilities. A priority is to help government departments to develop job structures for occupational therapists. Research is seen as being vital to this process. The report concludes by emphasizing the importance of developing confidence in the profession of occupational therapy by ongoing education, personal achievement and positive thinking.

Journal Article↗

[Rotator cuff tear--an occupational disease? An epidemiological analysis].

BACKGROUND: In literature there are only few data which describe the influence of occupation on the development of rotator cuff disease. METHODS: In a retrospective study, 760 open rotator cuff repairs were analysed and related to the profession and occupational load. Exclusion criteria were traumatic tears and sports injuries. All male persons were statistically analysed and the data compared with occupational patterns of the region, obtained from the Federal Statistical State Office. RESULTS: Rotator cuff repairs were performed in 472 males who had no evidence for a traumatic origin. After statistical analysis (p < 0.001) we found significantly more patients working in agriculture and forestry (6.38% versus 1.07% in Bavaria) and in the building industry (35.11% versus 13.40% in Bavaria). CONCLUSIONS: Our data suggest that working exposure increases the risk or leads to the clinical manifestation of rotator cuff tears. Although a detailed analysis of individual physical exposure is not available yet, the statistical results indicate that rotator cuff tears must be taken into consideration as a result of ergonomic exposure.

Adult↗

The manpower shortage in occupational therapy: implications for Ontario.

A consistently increasing imbalance between the supply of and demand for occupational therapists has led to a critical manpower shortage in occupational therapy. Based on a review of various government reports and related literature, this paper provides an overview of the extent of this manpower problem, identifies factors affecting retention and attrition of occupational therapists and discusses strategies to improve retention and reduce attrition. To address the supply-demand imbalance, recommendations in relation to education, employment, immigration and service delivery for the occupational therapy profession in Ontario are proposed.

Forecasting↗

The social context of occupational stress in a caring profession.

This paper examines the relationship between the structure and ideology of the psychiatric system and the actions, worldview and subjective experiences of psychiatric nurses working within both the hospital and the community settings. In contrast to previous occupational stress research, which has tended to concentrate on the perspective of staff without interpreting either the interrelationships between the experiences of caregiver and recipients or the ways in which the social context of care influences all participants' interpretations of their situation, this paper will argue that the occupational stresses facing psychiatric professionals cannot be fully understood without a clear understanding of the ambivalent role of welfare institutions within our society. This necessitates moving beyond the decontextualized, micro-level analyses advocated within the traditional occupational stress literature and drawing on alternative theoretical traditions which facilitate richer interpretations of the complex interplay between the structure and ideology of Western psychiatric systems and the motives, understandings, actions and emotions of different players within the system. With these considerations in mind, this article seeks to forge new links between the theoretical analysis of psychiatry's role within our society and the empirical investigation of occupational stress in psychiatric nursing by elucidating the interpersonal processes which enable the structural contradictions of psychiatry to find concrete expression within the fragmented understanding and inconsistent actions of the various players within the system. As the empirical research will reveal, staff attempts to ameliorate the chronic personal insecurities engendered by these contradictions often have the paradoxical effect of augmenting the problems of the psychiatric system and intensifying the very feelings they are struggling to avoid.

Hospitals, Psychiatric↗

"And teach agony to sing": an afternoon with Eleanor Clarke Slagle.

Using published works, archival correspondence, interviews with contemporaries, and historical commentary, an imagined conversation is presented between Eleanor Clarke Slagle (1871-1942) and three of her actual contemporaries. As a founder of the National Society for the Promotion of Occupational Therapy (later to become the American Occupational Therapy Association [AOTA] and a past-president and executive secretary of AOTA for 21 years, Slagle came in contact with a host of therapists as well as men and women who influenced her and the occupational therapy profession, most particularly Julia Lathrop, Adolf Meyer, William Rush Dunton, Jr., and Ida Sands. Emphasis is placed on some of her early life experiences; Hull House; and the evolution of the occupational therapy belief system, including occupations, curative work, and spiritual rehabilitation (i.e., self-respect, interests, ambition, happiness, economic usefulness, success). Special attention was taken to reflect Slagle's typical use of language and the vernacular of the mid-1930s. Extensive study was undertaken, through reading Slagle's published works, to remain true to her use of language.

Drama↗

[Health status of adolescents and modern approaches to holding medical professional consultations].

Due to unfavorable trends in the health state of contemporary children and teenagers, the total number of young males and females, who have health-related limitations in educational and occupational spheres, went up to 80%. A medical professional consultation belongs to a system of measures, whose purpose is to assist the young males and females with impaired health to choose professions or occupations, which would maintain their health intact and promote successfully their adaptation to professional training conditions and subsequently to actual occupational conditions. A timely and high-skilled implementation of medical professional consultations with a subsequent rational employment of teenagers and youth with impaired health should be regarded as a secondary prevention of pathologies. The holding of such medical professional consultations for teenagers is reasonable both at the stage, when a teenager makes his or her choice of a job (i.e. at school), and at the stage of receiving a professional education, so that the schoolchildren and students could get a job in line with their health status and that they could be employed with respect to doctor's recommendations. The Research Institute for Children's Health elaborated a number of methodological and regulating documents to promote the efficiency of the medical professional consultations; an automated assessment system is in the process of construction at the above institution.

Adolescent↗

Postmodernism and its application to the field of occupational therapy.

This article presents both the general concept of postmodernism and its reflection in a wide array of fields of interest. In particular, the paper reviews the postmodernist perspective as it appears in healthcare and medicine. This leads to a postmodernist analysis of the profession of occupational therapy, the main conclusion being that occupational therapy combines elements of modernism and postmodernism. This gives occupational therapy clinicians the luxury of enjoying the best of both worlds.

Culture↗

Ability to solve problems, professionalism, management, empathy, and working capacity in occupational therapy--the professional self description form.

The majority of occupational therapists in Sweden previously worked on large occupational therapy wards. Health care policy has changed over the years and the system has been reorganized accordingly. The employment situation for occupational therapists has also changed. This paper focuses on the perception of professional self among occupational therapists. The objective was to explore the professional self and to suggest components important to the occupational therapist profession. The Professional Self Description Form (PSDF) was used for the exploration of self. The 19 items in the PSDF cover areas relevant to professional functioning and activity. Sixty-eight employed occupational therapists participated. The results of the PSDF were subjected to factor analysis and five factors were obtained; Ability to solve problems, Professionalism, Management, Empathy, and Working capacity. We believe that these five factors can function as improving domains of the role of the professional occupational therapist in Sweden.

Adult↗

Health law in 1985--implications for the optometric profession.

In conclusion, I believe that you should seek to expand the scope of optometry into areas now regarded as exclusively medical practice, and devote less time and effort to protecting your rear from the encroachment of the opticians. I suggest this because it follows a seemingly natural process of expanding upward that one finds in other professions and occupations in the health field. Second, I have suggested that, to achieve an expanded scope of optometry, there may have to be some sacrifice of the concept of the independent, entrepreneurial practitioner in optometry. Even the medical profession is recognizing that the individual entrepreneurial physician is becoming less of a factor than he was before, and the future is not particularly bright for him further down the road. Third, to the extent you can influence the forum where the struggle over the expanded practice of optometry takes place, you may increase the likelihood that the expanded role will be recognized by law sooner. I have already alluded to the idea that costs of health services and funding mechanisms are intimately tied to the law related to optometric practice in the future. As you know from the legislative struggles in many states over inclusion of optometric services within state Medicaid programs, and freedom of choice legislation that required an insurer to pay any legally recognized practitioner who could provide the service, rather than physicians exclusively, the optometric profession is well aware how closely the success of a profession is linked to access to third party payment.(ABSTRACT TRUNCATED AT 250 WORDS)

Health Services Accessibility↗

Rethinking disability and what to do about it: disability studies and its implications for occupational therapy.

Disability studies seeks to reframe rehabilitation's understanding and responses to disability. Disability scholars point out that rehabilitation's perspectives and practices are not objective, but instead reflect particular historical and ideological forces. By demonstrating how rehabilitation practitioners can unintentionally do things that are unhelpful or even harmful, disability scholars challenge the profession of occupational therapy to reconsider aspects of practice, education, and research. In order to provide a context for a special issue devoted to disability studies, this paper examines disability studies' major critiques of rehabilitation and considers their implications for occupational therapy. The paper identifies ways that occupational therapy can continue to respond reflectively to the themes of disability studies. It also identifies a number of questions raised by disability studies that will need to be addressed in practice, education, and research.

Disability Evaluation↗

Minority workers and communities.

Environmental and occupational hazards do not affect all communities equally. Members of ethnic and racial minorities, whether as working people or as community residents, sustain disproportionate risks from chemical, physical, and biological hazards. This paper reviews the nature of these disproportionate risks, focusing primarily on the workplace, but considering general environmental exposures as well. It discusses three principal mechanisms of increased risk: excessive hazardous exposures in both the workplace and the general environment, increased susceptibility, and inferior healthcare. It presents evidence that, as the result of these factors, members of minority groups display elevated rates of work-related illness, injury, fatality, and disability. Finally, it offers recommendations with regard to research, primary prevention, minority recruitment into the occupational health professions, and treatment and compensation for injured and ill minority workers.

Career Choice↗

[Cancer mortality according to occupation].

The 55 profession groups, fully enclosing the male population of Switzerland, can be adjoined to a cancer risk category, according to their absolute and proportional mortality rate from 1979 to 1983 (age standardized for 35- to 74-years old). Lung-cancer mortality is for all building trade professions, even for building engineer and truck drivers, three times higher as for professions asking school-leaving examination. The carcinoma of the superior digestion tract and the bladder follow this falling incidence, while the opposite, profession specific falling incidence being shown by colon and rectum cancers and by the tumours of the lymphatic tissue and the prostata. Deduction of the results is cancer prevention: this should be carried out by a general, profession-orientated furtherance.

Adult↗

[Occupational-demographic analysis of employment of the population of USSR, RSFSR and Ukrainian SSR according to the general census].

Aging of the manpower resources is still continuing in this country as a whole and in individual republics, the average age approaching 40 years thus stepping on the verge of the older age group. The aging people are being 'pushed away' from most professions and occupations. Judging from the results of the recent general census of the population, in the USSR the portion of the 'pushed away' manpower has amounted to 80.7%. The growing discrepancy between the aging manpower resources and the modern industry demands are expressed in terms of increased morbidity and mortality among the productive age-groups.

Adult↗

Competence in scientific inquiry and research.

The survival and expansion of the profession of occupational therapy depends on its ability to respond to continually changing environments. One of the most current and critical factors in this adaptation is the capacity of therapists to achieve competence in scientific inquiry and research. Competence in the role of researcher is necessary because it contributes to the development of the individual therapist, the profession, and the organization within which the therapist functions. The aim of this article is to review and elaborate on the competencies associated with the role of researcher and to propose a reconceptualization of the knowledge, skills, and attitudes that shape competence in scientific inquiry.

Evidence-Based Medicine↗

Skill acquisition and competency testing for physical agent modality use.

OBJECTIVE: The use of physical agent modalities is not considered an entry-level skill and requires postprofessional education, according to the American Occupational Therapy Association. The purpose of this survey was to determine how occupational therapy practitioners who use physical agents modalities are trained. METHOD: Two hundred fifty occupational therapists were randomly selected from the American Occupational Therapy Association's Physical Disabilities Special Interest Section. The practitioners were surveyed about their use of, education in, competency testing for, and opinions on eight physical agent modalities. RESULTS: Results were based on 100 responses (40% response rate). Of the eight modalities, the most commonly used were hot and cold packs, and the least were transcutaneous electrical nerve stimulators. The most common means of education was on-the-job training, and the least common was higher level accredited education. A majority (71) of respondents reported that no competency testing was being performed at their facilities. In the remaining facilities (29), the majority performed competency tests with no routine frequency, using no particular guidelines for testing and no formal methods for maintaining standards for physical agent modality use. Eighty-five respondents indicated they would be interested in attending continuing education programs on the use of physical agent modalities, and 88 believed that functional activities should follow the use of physical agent modalities within the same treatment session. CONCLUSION: The occupational therapy profession may need specific educational and competency guidelines to assure the qualifications of therapists using physical agent modalities.

Accreditation↗

"Profession": a working definition for medical educators.

PURPOSE: To provide a working definition of professionalism for medical educators. SUMMARY: Thus far, the literature has not provided a concise and inclusive definition of the word profession. There appears to be a need for one as a basis for teaching the cognitive aspects of the subject and for evaluating behaviors characteristic of professionals. Furthermore, a knowledge of the meaning of the word is important as it serves as the basis of the contract between medicine and society, and hence, of the obligations required of medicine to sustain the contract. A definition is proposed based on the Oxford English Dictionary and the literature on the subject. It is suggested that this can be useful to medical educators with responsibilities for teaching about the professions, professional responsibilities, and professional behavior. CONCLUSIONS: The proposed definition is as follows: Profession: An occupation whose core element is work based upon the mastery of a complex body of knowledge and skills. It is a vocation in which knowledge of some department of science or learning or the practice of an art founded upon it is used in the service of others. Its members are governed by codes of ethics and profess a commitment to competence, integrity and morality, altruism, and the promotion of the public good within their domain. These commitments form the basis of a social contract between a profession and society, which in return grants the profession a monopoly over the use of its knowledge base, the right to considerable autonomy in practice and the privilege of self-regulation. Professions and their members are accountable to those served and to society.

Canada↗

Heuristic walkthrough evaluation of a prototype computer network service for occupational therapists.

AIM: To identify utility and design criteria for a computer network service for occupational therapists. DESIGN: Heuristic walkthrough evaluation. The evaluators explored a prototype and then commented upon the design in plenary sessions. SUBJECTS: One group of information system design experts and one of occupational therapists. RESULTS: The central utility criteria were the possibility to organize dynamic work groups for development of the occupational therapy profession and access to databases on assistive technologies. The main system design criteria identified were navigation, structure, tools, and content. CONCLUSION: A computer network service can support the development of the therapy professions. Generic issues exist which need to be considered in the detailed design. The heuristic walkthrough method is useful for identifying these.

Computer Communication Networks↗

Occupational health surveillance. We're making progress, but is it enough?

1. Surveillance data are used in the development of health strategies and policies. 2. The Sensor program bridges the gap that exists between the reporting of occupational disorders and infectious disease. 3. A shortage of health care professionals experienced in health surveillance has been a hindrance to the occupational health profession over the years. However, this is changing as more individuals seek advanced degrees. 4. As the ability to collect and analyze data improves, the health and safety of employees also should improve.

Databases, Factual↗