Dr Eamon O'Sullivan: psychiatrist and forgotten pioneer of occupational therapy.

OBJECTIVES: This paper provides a brief overview of the history of occupational therapy in psychiatry in Ireland and explores why the contribution of an early Irish psychiatrist and proponent of occupational therapy, Dr Eamon O'Sullivan (1897-1966), was not fully recognised in the decades after his retirement in 1962. METHODS: A review of selected key reports, papers and publications related to the history of occupational therapy was undertaken. RESULTS: Eamon O'Sullivan was appointed Resident Medical Superintendent at Killarney Mental Hospital Co. Kerry in 1933 and developed an occupational therapy department at the hospital from the 1930s until his retirement in 1962. He wrote one of the first textbooks of occupational therapy published in 1955. His occupational therapy philosophy reflects the early decades after the formalisation of the profession in 1917 when beliefs about the curative properties of occupation flourished and professional education programmes were scarce. By the time O'Sullivan's textbook was published it received a lukewarm reception within occupational therapy as it did not reflect 1950s practice and professional philosophy. The professionalisation of occupational therapy in Ireland in the 1960s was also a factor in the lack of acknowledgement of O'Sullivan's contribution to the profession. CONCLUSION: Practice and professional philosophy change and the paper concludes by considering O'Sullivan's work in light of contemporary occupational therapy which once again places occupation at its centre and emphasises the importance of balance, health and wellbeing.

Exploring the co-involvement of disabled adolescents in participatory action research; protocol for a critical interpretative synthesis.

Background: Participatory action research (PAR) provides an opportunity for academic researchers and adolescents to co-conduct research within an area of shared interest. Reciprocal learning occurs as co-researchers acquire research skills and knowledge, and academic researchers gain understanding of the issue being examined, from the perspective of those with lived experience. All members of the research team have a shared responsibility for the research and decision-making processes. PAR has predominantly involved adults as co-researchers. However, in recent years more effort has been made to co-conduct research with adolescents. The aim of this review is to interrogate the practices of academic researchers employing a PAR approach when working along-side disabled adolescents. Methods/design: A critical interpretive synthesis (CIS) will be conducted, allowing for a diverse range of evidence to be drawn from. A systematic search of nine databases, from 1990 onwards, will be conducted first. Reference checking will occur to elicit further relevant data. Following screening, further purposive sampling will be completed to facilitate the development of concepts and theory in line with the on-going analysis and synthesis of findings. Data analysis will involve interpretation of included papers in relation to the principles of PAR and a 'best-practice' framework will be developed. During analysis particular emphasis will be given to the identification of potential social barriers to the participation of disabled adolescents in PAR.    Discussion: PAR is widely employed but little is known about its use when working with disabled adolescents. This current CIS will critically question the current practices of academic researchers employing PAR when working along-side disabled adolescents and future research through the best practice framework we will develop.

Eamon O'Sullivan: 20th-century Irish psychiatrist and occupational therapy patron.

The profession of occupational therapy was formalized in the USA in 1917. Many of its earliest proponents were psychiatrists, yet their role in the development of the profession has received limited attention. This paper addresses this gap by considering one of the earliest Irish psychiatrist patrons of occupational therapy: Dr Eamon O'Sullivan (1897-1966) of Killarney Mental Hospital, Co Kerry, who developed an occupational therapy department in 1934. A textbook written by O'Sullivan reflects core philosophies articulated by occupational therapy's founders, and these philosophies were evident in practice at his hospital. Some inconsistencies between O'Sullivan's writings and practice are identified. In the absence of patient testimonies, it is not possible to resolve questions about the potential exploitation of patients through work as therapy.

Safety first: Factors affecting preceptor midwives experiences of competency assessment failure among midwifery students.

BACKGROUND: Assessment of clinical practice is a core component of midwifery education. Clinical assessment is challenging and affected by a number of factors. Preceptor midwives are reported to be reluctant to fail students in clinical assessments. This is worrying as preceptor midwives are gatekeepers to the profession of midwifery and need to ensure midwifery students are safe and competent practitioners of midwifery on completion of their programmes. METHODS: This qualitative descriptive study explores preceptor midwives experiences of clinical assessment of midwifery students in four maternity units in the Republic of Ireland. Following ethical approval, twenty-nine preceptor midwives were interviewed. Content analysis was used to analyse the data and two themes with associated subthemes identified. FINDINGS: Competency assessment in practice was supported by a robust, clearly delineated process, considered vital to ensure effective and fair assessment of midwifery students. The process in place had many advantages but attracted some criticism too, most notably language, documentation and lack of continuity of the preceptor. The challenges of clinical assessment were multifaceted but the most pressing concern was dealing with students who were struggling in practice where the outcome of an assessment was potentially a fail. Preceptor midwives expressed reluctance to fail students but balanced this with ensuring safety for women and their babies. A number of other challenges hampered decisions in clinical assessments. These included the confidence of the preceptor, juggling the competing demands of clinical practice with effective assessment in an increasingly complex and fiscally challenging environment, operationalising the competency assessment process and the emotional toll associated with failing a student. CONCLUSION: Preceptors' primary focus is on ensuring that graduate midwives are safe and competent practitioners and it is this which guides their decision making on the outcome of clinical assessments. However, more support is required for the onerous responsibility of clinical assessment, particularly for less experienced midwives but also when failure of clinical assessment is a potential outcome. Preceptorship needs to be valued more at a strategic level.

The Transition to Retirement Experiences of Academics in "Higher Education": A Meta-Ethnography.

BACKGROUND AND OBJECTIVES: There are increasing numbers of older academics working in Higher Education Institutions worldwide. It is essential that academics' retirement experiences are clearly understood as they tend to have different retirement trajectories than other occupational groups. This meta-ethnography aims to answer the research question "what are the experiences of academics transitioning to retirement" by identifying and synthesizing qualitative research using a meta-ethnographic approach. RESEARCH DESIGN AND METHODS: A systematic literature search was conducted from January 2000 to September 2016 to identify qualitative studies focusing on academics' experiences of retirement. Two reviewers independently assessed the methodological quality of included papers. Concepts from each study were translated into each other to form theories, which were then combined through a "line-of-argument" synthesis. RESULTS: Twenty papers were included. Five themes were identified: (a) continuing to work in retirement, (b) the impact of the retirement transition on the academics' identity, (c) changing relationships through the retirement transition, (d) experiencing aging processes, and (e) planning for retirement. For most, retirement is characterized by continuing to work in aspects of their role, maintaining associated relationships, with gradual disengagement from academic activities. For another smaller group, the retirement pathway is experienced as an event, with complete detachment from academic activities. DISCUSSION AND IMPLICATIONS: The review highlights that academics transitioning to retirement experience varying retirement pathways. Awareness of the benefits of comprehensive retirement planning programs could enable academics to choose a retirement pathway that facilitates a smooth transition to retirement.

The Bluebirds: World War I Soldiers' Experiences of Occupational Therapy.

OBJECTIVE: More is known about the experience of occupational therapists than the experience of patients during the profession's early years. We examined soldiers' experiences of occupational therapy in American Base Hospital 9 in France during World War I through analysis of a 53-line poem by Corporal Frank Wren contained in the unpublished memoir of occupational therapy reconstruction aide Lena Hitchcock. METHOD: Historical documentary research methods and thematic analysis were used to analyze the poem, the memoir, and the hospital's published history. RESULTS: The poem describes the activities engaged in during occupational therapy, equipment used, and the context of therapy. It articulates positive dimensions of the experience of engaging in activities, including emotional benefits, diversion, and orthopedic benefits. CONCLUSION: Previous historical research has identified core philosophical premises about the use of occupational therapy; in this article, the enactment of these principles is established through the analysis of a soldier's account of receiving occupational therapy.

An integrative review of social and occupational factors influencing health and wellbeing.

Therapeutic approaches to health and wellbeing have traditionally assumed that meaningful activity or occupation contributes to health and quality of life. Within social psychology, everyday activities and practices that fill our lives are believed to be shaped by structural and systemic factors and in turn these practices can form the basis of social identities. In occupational therapy these everyday activities are called occupations. Occupations can be understood as a contextually bound synthesis of meaningful doing, being, belonging and becoming that influence health and wellbeing. We contend that an integrative review of occupational therapy and social psychology literature will enhance our ability to understand the relationship between social structures, identity and dimensions of occupation by elucidating how they inform one another, and how taken together they augment our understanding of health and wellbeing This review incorporates theoretical and empirical works purposively sampled from databases within EBSCO including CINAHL, psychINFO, psychArticles, and Web of Science. Search terms included: occupation, therapy, social psychology, occupational science, health, wellbeing, identity, structures and combinations of these terms. In presenting this review, we argue that doing, being and belonging may act as an important link to widely acknowledged relationships between social factors and health and wellbeing, and that interventions targeting individual change may be problematic.

Nouns and verbs in Chintang: children's usage and surrounding adult speech.

Analyzing the development of the noun-to-verb ratio in a longitudinal corpus of four Chintang (Sino-Tibetan) children, we find that up to about age four, children have a significantly higher ratio than adults. Previous cross-linguistic research rules out an explanation of this in terms of a universal noun bias; instead, a likely cause is that Chintang verb morphology is polysynthetic and difficult to learn. This hypothesis is supported by the fact that the development of Chintang children's noun-to-verb ratio correlates significantly with the extent to which they show a similar flexibility with verbal morphology to that of the surrounding adults, as measured by morphological paradigm entropy. While this development levels off around age three, children continue to have a higher overall noun-to-verb ratio than adults. A likely explanation lies in the kinds of activities that children are engaged in and that are almost completely separate from adults' activities in this culture.

Political violence and mental health: a multi-disciplinary review of the literature on Nepal.

Implementation of current international consensus guidelines regarding mental health and psychosocial support in emergencies requires the consideration of findings from both the medical and social sciences. This paper presents a multi-disciplinary review of reported findings regarding the relations between political violence, mental health and psychosocial wellbeing in Nepal. A systematic search of six databases resulted in the identification of 572 studies, of which 44 were included in the review. These studies investigated the influence of political violence on contextual variables that shape mental health and psychosocial wellbeing, and examined psychological distress and mental disorders in the context of political violence. The majority of studies addressed the mental health of Bhutanese refugees in Nepal and the impact of the Maoist People's War. Based upon these results from Nepal, we discuss a number of issues of concern to international researchers and practitioners and present policy and research recommendations. Specifically, we consider (a) the need for longitudinal multi-disciplinary research into protective and risk factors, including agency, of psychological distress and mental disorders in situations of political violence, (b) the continuing controversy regarding the PTSD construct, and (c) the lack of robust findings regarding the effectiveness of mental health and psychosocial support.

The influence of culture on diabetes self-management: perspectives of Gujarati Muslim men who reside in northwest England.

AIM: To present the findings of a study which explored the influence of culture on (type 2) diabetes self-management in Gujarati Muslim men who reside in northwest England. BACKGROUND: This study was informed by an embodied perspective of culture, in which culture is grounded in the body and self. This contrasts with some contemporary health research and policy which adopts an oversimplified perspective, portraying culture as static and deterministic and being responsible for non-adherent self-management behaviours. METHOD: A case-study approach was used, which combined interview and participant observation methods. Data were collected from Gujarati Muslim men about their lived experiences of diabetes self-management. These accounts, along with further narrative data from 'significant other' participants, were analysed over several cycles. RESULTS: Two central concepts guide the results: embodied culture and dynamic culture. These concepts reflect the subjective and contextual nature of culture and are illustrated in the themes 'past experiences and socio-economic factors', 'social and gendered roles' and 'personal choice and contextual factors'. The findings highlight that the complexity of life means that culture never exists in isolation, but is one of the many factors that a man negotiates to inform his diabetes self-management. CONCLUSION: We draw attention to the dissonance between the way culture is presented in some government policy and research, and the way it is understood in an embodied approach. The National Service Framework for Diabetes advocates the provision of individualized culturally appropriate care, and in this paper, we make suggestions as to how an embodied approach can be incorporated within the framework. RELEVANCE TO CLINICAL PRACTICE: Nurses have an integral role in implementing the National Service Framework for Diabetes. This paper contributes to the debate about how nurses can best deliver this framework to a diverse patient population.