Greg Kelly

Smart Home Technologies for Health and Social Care Support.

BACKGROUNDnThe integration of smart home technology to support health and social care is acquiring an increasing global significance. Provision is framed within the context of a rapidly changing population profile, which is impacting on the number of people requiring health and social care, workforce availability and the funding of healthcare systems.nnnOBJECTIVESnTo explore the effectiveness of smart home technologies as an intervention for people with physical disability, cognitive impairment or learning disability, who are living at home, and to consider the impact on the individuals health status and on the financial resources of health care.nnnSEARCH STRATEGYnWe searched the following databases for primary studies: (a) the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register, (b) the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, issue 1, 2007), and (c) bibliographic databases, including MEDLINE (1966 to March 2007), EMBASE (1980 to March 2007) and CINAHL (1982 to March 2007). We also searched the Database of Abstracts of Reviews of Effectiveness (DARE). We searched the electronic databases using a strategy developed by the EPOC Trials Search Co-ordinator.nnnSELECTION CRITERIAnWe included randomised controlled trials (RCTs), quasi-experimental studies, controlled before and after studies (CBAs) and interrupted time series analyses (ITS). Participants included adults over the age of 18, living in their home in a community setting. Participants with a physical disability, dementia or a learning disability were included. The included interventions were social alarms, electronic assistive devices, telecare social alert platforms, environmental control systems, automated home environments and ubiquitous homes. Outcome measures included any objective measure that records an impact on a participants quality of life, healthcare professional workload, economic outcomes, costs to healthcare provider or costs to participant. We included measures of service satisfaction, device satisfaction and healthcare professional attitudes or satisfaction.nnnDATA COLLECTION AND ANALYSISnOne review author completed the search strategy with the support of a life and health sciences librarian. Two review authors independently screened titles and abstracts of results.nnnMAIN RESULTSnNo studies were identified which met the inclusion criteria.nnnAUTHORS CONCLUSIONSnThis review highlights the current lack of empirical evidence to support or refute the use of smart home technologies within health and social care, which is significant for practitioners and healthcare consumers.

Zen in the Art of Occupational Therapy, Part One:

In recent years, rapid changes have occurred within the health care system. Economic, political, scientific and social forces are transforming our view of health and, with the awakened interest in unconventional models of treatment, it is Important to assess the new set of demands placed on occupational therapy in relation to this change. Now that a greater emphasis is being placed on integrated methods of treatment, it is appropriate that we should consider the concepts of our own profession and their application to current changes of thought. The holistic approach to occupational therapy still has a valid contribution to make in the treatment process but perhaps a fresher application of this concept, including alternative Eastern philosophies, would promote a more balanced, dynamic outlook for occupational therapy, encour aging principles of self-help and creating a more challenging and more integrated practice of treatment. The article attempts to explain the principles of Eastern philosophy with reference to the Chinese ‘Book of Changes’ — the ‘I Ching’ — and to illustrate its relevance to new technology and scientific research.

Understanding Occupational Therapy: A Hermeneutic Approach

The term ‘hermeneutic’ has recently been appearing in the occupational therapy literature related to clinical reasoning but without an adequate definition of its meaning. The purpose of this article, therefore, is to offer a simple introduction to the term and discuss how it applies to clinical reasoning, thus providing occupational therapists with some of the language they will need to understand this relatively new concept fully. Drawing on literature from nursing, physiotherapy, psychology and occupational therapy, this article examines a hermeneutic approach to occupational therapy research and practice and, indeed, to an understanding of the concept of occupational therapy itself.

Feminist or Feminine? The Feminine Principle in Occupational Therapy

Recently, there has been renewed interest in the relationship between feminism and occupational therapy, but does occupational therapy continue to operate on the feminine principle which underlies the philosophical basis of the profession? There is a strong tendency by some occupational therapists to emulate the masculine principle which drives the medical model but this, in fact, places occupational therapy at a disadvantage in the prevailing male culture. Drawing on a wide range of recent literature related to education, professionalism, management, research, clinical reasoning and complementary therapies, this article argues that the feminine principle is very much alive in the theory and practice of occupational therapy today.

Writing for Publication: The Structure of a Journal Article

It is very likely that each and every occupational therapist has some information or knowledge worth publishing in a professional Journal. Many clinicians seem to assume that it is only researchers or academics who can write for publication. It may be that all that is preventing some clinicians form submitting their information or ideas for publication is a lack of knowledge about how to structure them. This article is intended as a rough guide and examines the title, the abstract, the introduction, the literature review, the discussion and the conclusion sections of a journal article. It does not deal with method or results as these belong to the structure of a research article, which will be dealt with separately. The article forms part of a symposium entitled ‘An introduction to Writing for Publication in Professional Journals’, prepared by the Editorial Board of BJOT.

Children's Drawings as a Means of Nonverbal Communication: An Introduction

Childrens drawings have often been used by adults to help them to communicate with children who, for whatever reason, do not express themselves verbally. Sometimes this seems to be the only method which appears to be effective. However, examination of the literature suggests that adults interpretation of the drawings made by children may not be as reliable as it could be. The concept of childrens drawings as a means of nonverbal communication is examined and suggestions are made to enable adults to use the medium of drawing more effectively in order to understand a childs graphic language.

Occupational Therapy for Speech and Language Disordered Children: A Sensory Integrative Approach

The treatment of children with speech and language disorders is normally carried out by speech therapists but, due to the fact that they also present with a variety of perceptual-motor problems, an occupational therapist may be involved in the treatment. Recent research from the USA suggests that occupational therapy, using a sensory integrative (SI) approach, can have a direct, beneficial effect on speech and language development. In some cases, the child may initially benefit more from occupational therapy than from speech therapy. This article examines the theoretical implications of using an SI approach to treatment, with particular emphasis being given to vestibular stimulation. It is, primarily, intended to be a literature review in preparation for a research project currently being carried out by the author

Keeping up with the Journals: The Strange Case of the Disappearing Asymmetrical Tonic Neck Reflex

The history of the research into the asymmetrical tonic neck reflex (ATNR) and the subsequent changes in methods of evaluation which have resulted from this research are traced from the early 1930s to the present day. This brief overview serves as a reminder that we must constantly re-evaluate our store of knowledge in the light of new evidence if we are to maintain effective and efficient treatment practices. Inevitably, this means reading current journal articles, especially if we are unable to carry out research ourselves.

Occupational therapy: the use of complementary therapies in occupational therapy. Part 2

Abstract In Part 1 of this article, it was argued that the philosophy of occupational therapy has more in common with the complementary therapies than it does with Western allopathic medicine. Part 2 examines the current use of complementary therapies, such as aromatherapy, in occupational therapy. Suggestions are made as to how the relationship between occupational therapy and the complementary therapies might develop in the future.

Motivation in Learning Disabled Children

It is generally thought that children with learning disabilities are poorly motivated to learn. However, the reasons usually given are very vague and the causes are, more often than not, attributed to symptoms of learning disability such as ‘hyperactivity’ and ‘short attention span’. This article proposes that such symptoms may be misleading in the search for the true causes of learning disability and that lack of motivation may be the result of the education system rather than an inherent fault in the child himself. Methods of dealing with motivational problems using social, environmental and physiological approaches are outlined.