Librarian and Researcher Assessments of Search Result Relevance: How Well Do They Align?

Conducting comprehensive but efficient literature searches for complex evidence syntheses involves selecting databases that will retrieve the greatest number of relevant results on the question. Lack of a comprehensive single database on allied health educational topics challenges those seeking such literature. In this study, six participants contributed research questions on instructional methods and materials for allied health patients, caregivers, and future health professionals. Two health sciences librarians created search strategies for these questions and searched eleven databases. Both the librarians and the six participants evaluated the search results using a rubric based on PICO to assess extent of alignment between the librarians' and requestors' relevance judgments. Intervention, Outcome, and Assessment Method constituted the most frequent bases for assessments of relevance by both librarians and participants. The librarians were more restrictive in all of their assessments except in a preliminary search yielding twelve citations without abstracts. The study's results could be used to identify effective techniques for reference interviewing, selecting databases, and weeding search results.

Predictors of clinical experience performance in occupational therapy and physiotherapy: A scoping review.

INTRODUCTION: Successful completion of clinical education experiences is a graduation requirement for students in occupational therapy and physical therapy programmes. A scoping review was conducted to determine what is known about possible clinical experience performance predictors and to find associated research gaps. METHODS: The search included one hand-searched journal and seven databases, which were used to identify related relevant studies: CINAHL, Education Database, Education Source, Education Resources Information Center (ERIC), PubMed, REHABDATA, and Web of Science. A research librarian guided the search process, and the review's reporting is structured by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Studies were included if they contained predictors of clinical experience success indicated by validated performance evaluation tools that were scored by clinical instructors. A multidisciplinary team reviewed the title, abstract, and full text for inclusion and conducted thematic data synthesis to categorise findings. FINDINGS: Twenty-six articles met the inclusion criteria. The majority of articles were of correlational design and included single institutions. Seventeen articles included occupational therapy, eight included physical therapy, with only one article including both programmes. Four categories of predictors of clinical experience success were identified: pre-admission variables, academic preparation, learner characteristics, and demographics. Each of the main categories included three to six subcategories. Key findings included the following: (a) The most common cited predictors in clinical experiences are academic preparation and learner characteristics, (b) more experimental design studies are needed to determine the causal relationship between predictors and clinical experience success, and (c) future research is needed on ethnic disparities and clinical experience success. CONCLUSION: Findings from this review show that possible predictors of clinical experience success include a wide range of factors when correlating success with a standardised tool. Academic preparation and learner characteristics were the most investigated predictors. There were only a small number of studies that found a correlation with pre-admission variables. The findings of this study suggest that students' academic achievement may be a critical element of clinical experience preparation. Future research using experimental designs and across institutions is needed to determine the main predictors for student success.

A Scoping Review of Grasp and Handwriting Performance in School-Age Children.

OBJECTIVE: Handwriting is a critical functional skill that impacts academic participation and progress. Occupational therapists address components of grasp in their handwriting intervention as it is commonly assumed that grasp affects legibility, fluency, and endurance, yet research studies examining this relationship are limited. METHOD: We used scoping review methodology to map existing research on grasp and handwriting performance in school-age children and to identify gaps in the literature. RESULTS: Thirteen articles met search criteria and were categorized by grasp patterns and handwriting performance, and grasp force and handwriting performance. Findings suggest an inefficient grasp can lead to decreased handwriting legibility and fatigue. The current literature is inconclusive and several gaps were identified. CONCLUSION: Additional studies should address research gaps through inclusion of children with special needs and interventions including lengthier handwriting tasks representative of a typical school day.

Occupational Therapists' Perceptions of Online Competence Assessment and Evidence-Based Resources.

OBJECTIVE: This study explored U.S. occupational therapists' perceptions of online competence assessment and associated evidence-based resources. METHOD: The study used a cross-sectional design with a survey. Respondents were occupational therapists certifying or recertifying with the National Board for Certification in Occupational Therapy in March 2016. RESULTS: The response rate was 88.6%, with 58.5% indicating they had used the online competence assessment platform. A majority agreed that the platform's tools helped them identify clinical knowledge (n = 211; 79.9%) and skill needs (n = 160; 60.8%). Of those who obtained copies of the evidence-based resources (n = 98; 45.6%), 72.5% (n = 71) read at least one. Chi-square analysis demonstrated negative relationships between years as an occupational therapist and clinical skills assessment and between highest degree and use of evidence-based practices. CONCLUSION: Online competence assessment assisted participants in identifying competence needs and evidence-based resources for improving clinical knowledge and skills.

Occupational Therapists' Self-Reported Research Utilization and Use of Online Evidence Sources.

Research utilization of occupational therapists may positively influence the quality and cost-effectiveness of service delivery; however, previous studies suggest that therapists' overall use of research in clinical practice is limited. This cross-sectional study used survey methodology to investigate the research utilization behaviors of occupational therapists and examine the differences in behaviors between those who had and had not used the Navigator®. The Navigator® online competence assessment platform supports research utilization through recommended readings and access to online databases with full-text articles. Findings showed a low level of research utilization overall, with Navigator® users more likely to use online databases than non-users. Future research should examine if access to online platforms, such as the Navigator®, combined with context-specific training that integrates active learning approaches could improve occupational therapists' research utilization for increased implementation of evidence-based practice.

Continuing competence assessment and maintenance in occupational therapy: Scoping review with stakeholder consultation.

BACKGROUND/AIM: Continuing competence activities hold the promise of improving health-care service quality, especially given concerns about system inefficiencies and fragmentation. The aim of this scoping review was to describe the assessment and maintenance of occupational therapists' continuing competence and identify knowledge gaps for future research. A secondary aim was comparing scoping review findings with those from other health-care fields and considering possible impact of varying international regulations. METHODS: A series of database searches retrieved peer-reviewed and grey literature on assessment and maintenance of occupational therapy continuing competence from 1995 to 2015. Themes were developed and findings shared with stakeholders, whose comments drove a second phase: searching for reviews related to continuing competence from allied health, medicine, and nursing, and reviewing websites and documents concerning regulatory requirements for occupational therapy continuing competence in seven English-speaking nations. RESULTS: Twenty-seven sources from the scoping review search met inclusion criteria. Stakeholder consultation validated the themes and preliminary knowledge gaps. Research into other health-care specialties corresponded to findings from the scoping review. The website/document review of occupational therapy regulatory requirements revealed wide variation on both the state/province and national levels. CONCLUSIONS: This scoping review highlights gaps in research on effective methods and assessment of occupational therapy continuing competence. Findings suggest a need for research on approaches to continuing competence that incorporate the translation of evidence to practice and address the influence of external factors. Regulatory agencies may address the quality of occupational therapy services by incorporating a variety of professional development options into requirements.

Practitioner Training for Use of Evidence-Based Practice in Occupational Therapy.

The purpose of this integrative review was to examine the evidence-based practice (EBP) training literature for occupational therapy practitioners in order to describe the relationships between EBP use in practice and practitioner training for EBP. A systematic search of literature related to EBP training in occupational therapy was followed by a research evaluation, review of case examples, and qualitative content analysis. Findings suggest that comprehensive, contextually-relevant, and collaborative training approaches are necessary for practitioners to address implementation of EBP. Research investigating the mechanisms of practitioner training and ways to measure the relationships between training, changes in how practitioners use evidence-based practices, and client outcomes and other quality indicators is recommended.

A Century of Therapeutic Use of the Physical Environment.

In this article, we describe the use of the objects and spaces of the physical environment by occupational therapy practitioners in the United States over the profession's first 100 years. Using professional literature selected by decade from the years 1917 through 2016 to obtain data, we applied grounded theory methods to complete a detailed description. Team-based analysis over four coding schemes yielded a theoretical description of the profession's therapeutic use of the physical environment. Study findings included descriptions across occupational therapy's history of (1) treatment spaces, (2) the concepts of adapting and grading, and (3) a typology of constructive and nonconstructive applications of objects and activities by occupational therapy clients and practitioners. This extended historical perspective on trajectories of change in intervention space, the role of physical products in intervention, therapist repertoire, and the enduring role of adaptation suggests how the physical environment may be used in future practice.

Social Participation in Schools: A Survey of Occupational Therapy Practitioners.

OBJECTIVE: We sought to identify strategies and practices that school-based occupational therapy practitioners use in addressing social participation, their perceptions of competence, and factors influencing their strategies and practices. METHOD: Surveys were sent to 500 randomly selected members of the American Occupational Therapy Association's Early Intervention and School Special Interest Section; 112 usable surveys were received from 36 states. RESULTS: Respondents reported focusing on internal client factors when addressing social participation. Fewer than half (46.5%) indicated that they understood their role (mean [M] = 4.23, standard deviation [SD] = 1.22), and 57.1% desired greater understanding or ability (M = 4.64, SD = 1.29). Differences were found based on years of experience, service delivery model used, and services provided by diagnosis category. CONCLUSION: School-based occupational therapy practitioners may need to expand their current practices in addressing student social participation. Findings may be used to develop interventions to address this area of practice.

Teaching interprofessional collaboration: using online education across institutions.

Interdisciplinary courses among students in occupational therapy, physical therapy, and speech-language pathology are important for addressing teamwork, communication, and understanding of professional roles, especially in pre-service training for early intervention and school-based practice where collaboration is essential. Although interprofessional education (IPE) as a part of higher education in the health sciences has been strongly encouraged, IPE courses are difficult to schedule and implement. This article discusses the challenges of developing and delivering two IPE courses in an online format, specifically the innovation that addresses logistics, time factors, and social presence for the IPE courses across two institutions.

Prevention of tracheostomy-related pressure ulcers in children.

BACKGROUND AND OBJECTIVES: Pressure ulcers are commonly acquired in pediatric institutions, and they are a key indicator of the standard and effectiveness of care. We recognized a high rate of tracheostomy-related pressure ulcers (TRPUs) in our ventilator unit and instituted a quality improvement program to develop and test potential interventions for TRPU prevention, condensed them into a clinical bundle, and then implemented the bundle into our standard practice. METHODS: The intervention model used a rapid-cycle, Plan-Do-Study-Act (PDSA), framework for improvement research. All tracheostomy-dependent patients admitted to our 18-bed ventilator unit from July 2008 through December 2010 were included. TRPU stage and description, number of days each TRPU persisted, and bundle compliance were recorded in real time. All TRPUs were staged by a wound-care expert within 24 hours. The interventions incorporated into the TRPU-prevention bundle included frequent skin and device assessments, moisture-reducing device interface, and pressure-free device interface. RESULTS: There was a significant decrease in the rate of patients who developed a TRPU from 8.1% during the preintervention period, to 2.6% during bundle development, to 0.3% after bundle implementation. There was a marked difference between standard and extended tracheostomy tubes in TRPU occurrence (3.4% vs 0%, P = .007) and days affected by a TRPU (5.2% vs 0.1%, P < .0001). CONCLUSIONS: Education and ongoing assessment of skin integrity and the use of devices that minimize pressure at the tracheostomy-skin interface effectively reduce TRPU even among a population of children at high risk. These interventions can be integrated into daily workflow and result in sustained effect.

Factors influencing physical therapists' involvement in preschool transitions.

BACKGROUND: Families and children receiving early intervention services benefit from service provider involvement during the transition to preschool special education services. OBJECTIVES: This study sought to determine the factors that physical therapists working in early intervention services and/or preschools identified as supportive of their involvement, and associated with their perceived involvement, in transition planning for young children with disabilities moving from early intervention to preschool services. DESIGN: A cross-sectional survey was used. METHODS: A survey was mailed to a random sample of 600 members of the American Physical Therapy Association's Section on Pediatrics. Physical therapists working with children transitioning out of early intervention and into preschool participated. Data from physical therapists providing services in preschools were included in this study. RESULTS: The response rate was 56.3%. The highest- and lowest-ranked facilitators of transition planning were: "Staff at my preschool program value my participation in transition planning activities" (highest ranked) (X=5.02, SD=1.36, n=142) and "I am encouraged to participate in transition planning activities by the early intervention service coordinator" (lowest ranked) (X=1.91, SD=3.50, n=143). Multivariate regression models demonstrated that physical therapists' perceived value and expertise in providing transition planning services were significantly associated with collaboration with professionals from early intervention programs (F(1,129)=207) and support of families during the transition process (F(1,134)=48). CONCLUSIONS: Physical therapists who identified implementing practices that supported communication, collaboration, and strong, positive relationships between early intervention and preschool programs had greater involvement in the transition planning process.

Factors associated with therapists' involvement in children's transition to preschool.

We identified factors associated with occupational therapists' involvement as children receiving early intervention services transition into preschool. A survey was sent to members of the American Occupational Therapy Association's School System Special Interest Section. The highest ranked factor for respondents in early intervention was understanding their role (mean [M]= 4.96, standard deviation [SD] = 1.26, n = 78) and for respondents in preschool programs it was having preschool staff value their participation (M = 4.84, SD = 1.46, n = 248). Preschool occupational therapists' relationship with early intervention providers, employer-based supports, and knowledge of the transition process were significantly associated with their involvement in two transition planning areas: collaboration with early intervention programs (p < .001) and family support (p < .001). Findings suggest that practices that enhance relationships among programs influence occupational therapist involvement. Implications for formal training to support involvement in the transition process are discussed.

Informing early intervention through an occupational science description of infant-toddler interactions with home space.

OBJECTIVE: The study provides a substantive description of infant and toddler play with everyday objects and independent negotiation of home space. METHOD: A grounded theory approach was used to study 18 typically developing children longitudinally from ages 1 to 18 months. Data from 133 home visits included videotaped self-directed play sessions with usual objects, maternal interviews, and observation records. RESULTS: Infant Space Theory is a substantive theory of infant-toddler interactions with the spaces and objects of the home. This contextualized view of the infant-toddler describes progressions in gaze and visual play, in mapping and ranging home space, in stationary object play, and in the little-described development of mobile object play. CONCLUSION: Therapists providing early intervention services within the home environment may benefit from the theory in their creation and modeling of naturalistic interventions with infants and families.

Parenteral nutrition in neonatal foals: clinical description, complications and outcome in 53 foals (1995-2005).

This retrospective study describes the use of and complications associated with parenteral nutrition (PN) administration to 53 equine neonates at the University of California Veterinary Medical Teaching Hospital. Medical records were examined and information obtained on signalment, physical examination, clinical diagnosis, outcome, total hospitalization time, insulin administration, microbiology culture results, other complications (i.e. thrombophlebitis) and necropsy findings. Complete blood count and serum biochemistry analytes, venous blood gas, serum electrolyte and glucose concentrations, and blood lactate concentration results were compared before and during PN administration in all foals. Seventeen foals (32%) developed hypertriglyceridemia (>200mg/dL). Triglyceride concentrations >200mg/dL were significantly (P=0.049) associated with non-survival. Forty-seven foals (89%) developed hyperglycemia (blood glucose >120mg/dL) and eight (15%) developed catheter-related complications (thrombosis or local sepsis). Packed cell volume, total protein, creatinine, blood urea nitrogen, and sorbitol dehydrogenase concentrations decreased while foals were on PN, while serum chloride concentration increased. This study highlighted that hypertriglyceridemia during the acute phase of neonatal illness may be detrimental to outcome, and that the safety of lipid-containing solutions in foals warrants further study.

Descriptive study of occupational therapists' participation in early childhood transitions.

OBJECTIVE: The study describes the current role of occupational therapists in the transition of young children with special needs from early intervention to preschool and from preschool to kindergarten. METHOD: Questionnaires were mailed to a random sample of 500 pediatric occupational therapists who are members of the American Occupational Therapy Association's School System Special Interest Section. RESULTS: The response rate was 44.3%, with 173 usable surveys. Approximately 40% of therapists working in the early-intervention-to-preschool transition and 32% of therapists working in the preschool-to-kindergarten transition reported not participating fully in the process. The primary barrier to full participation was "not enough time." Evaluation was identified as the most frequently used strategy for participation. Only 23% of respondents reported receiving specialized transition training. CONCLUSIONS: Although limited by a small sample, the study provides an initial description of occupational therapists' participation in early childhood transitions.

Electronegative LDLs from familial hypercholesterolemic patients are physicochemically heterogeneous but uniformly proapoptotic.

A highly electronegative fraction of human plasma LDLs, designated L5, has distinctive biological activity that includes induction of apoptosis in bovine aortic endothelial cells (BAECs). This study was performed to identify a relationship between LDL density, electronegativity, and biological activity, namely, the induction of apoptosis in BAECs. Plasma LDLs from normolipidemic subjects and homozygotic familial hypercholesterolemia subjects were separated into five subfractions, with increasing electronegativity from L1 to L5, and into seven subfractions according to increasing density, D1 to D7. L1 to L5 were also separated according to density, and D1 to D7 were separated according to charge. The density profiles of L1 to L5 were similar (maximum density = 1.030 +/- 0.002 g/ml). Induction of apoptosis by all seven density subfractions was confined to the highly electronegative fraction, L5, and within each density subfraction the magnitude of apoptosis correlated with the L5 content. Electronegative LDL is heterogeneous with respect to density and composition, and induction of apoptosis is more strongly associated with LDL electronegativity than with LDL size or density.

The use of infant seating devices in child care centers.

OBJECTIVE: The purpose of this study was to compare the duration of time that infants in child care centers were placed in infant seating devices to the duration of time spent on the floor or being held by child care providers. METHOD: Thirty-eight infants who were typically developing (mean age = 4.5 months) from eight child care centers were observed minute-by-minute for a consecutive 120 min, targeting the amount of time each infant spent in seating devices, on the floor, or being held by child care providers. RESULTS: The amount of time the infants spent in seating devices was significantly longer than on the floor (p= .0001) or being held by child care providers (p= .0001). CONCLUSION: All infants spent more time in seating devices than on the floor or being held by child care providers. Future research should explore seating device use in infants identified as at-risk or as having special needs, particularly how child care routines for these infants may influence seating device use, as well as the impact of this practice on these infants' motor development.

Exploring occupational therapy and transitions for young children with special needs.

Young children with special needs typically experience many transitions between services. As part of a larger family system, each of these transitions and the myriad of factors involved affect the life of the child and the lives of their families. Occupational therapists have a unique, yet insufficiently explored, perspective that may contribute to the support and planning for families and children during the transition process. The purpose of this paper is to explore the Ecology of Human Performance (EHP) framework (Dunn, Brown & McGuigan, 1994) and apply it to occupational therapy and early childhood transitions. A description of the transition process and potential occupational therapy interventions using the EHP framework is developed.