Dr Daniel Cezar Da Cruz

Introduction: Hemiparesis is the main sensorimotor deficit after stroke. It can result in limitations in Activities of Daily Living (ADL) and social participation. Hemiparesis can be treated with behavioral techniques of intensive use of the affected arm, such as constraint-induced movement therapy (CIMT), however, it remains unclear whether motor improvement can lead to increases in the domains of activity and participation. Objective: Identify whether CIMT is superior to usual techniques to enhance activity and participation outcomes in stroke survivors. Methods: A systematic review with meta-analysis was conducted, based on the PRISMA guidelines. Search databases were: PubMed, LILACS, Embase, SciELO, Cochrane Library, Scopus, Medline, and Web of Science, with no language restriction. Meta-analysis was performed with Review Manager (version 5.3), significance level p ≤ 0.05. Results: A total of 21 articles were included for analysis. Superior effects were observed on motor function and performance in activities of daily living of individuals treated with CIMT. The outcomes measures utilized were: Fugl-Meyer Assessment (p = 0.00001); Wolf motor function test (p = 0.01); Modified Barthel Index (p = 0.00001); Motor Activity log (MAL) Amount of use (AOU) (p = 0.01); MAL Quality of movement (QOM) (p = 0.00001); Action Research Arm Test-ARAT (p = 0.00001); and FIM (p = 0.0007). Conclusion: Our results show that CIMT results in more significant gains in the functional use of the upper limb in ADL and functional independence, demonstrating superior activity and participation results in stroke survivors when compared to conventional therapies.

Practical text and online assets link theory with day-to-day practice Collaborative-relationship-focused, inclusive and strengths-based language Summaries and key points for each chapter make navigation easy Focus on working with groups, ...

Occupational Therapy for People Experiencing Illness, Injury or Impairment is a seminal textbook that has been used in preregistration occupational therapy education for more than 40 years. Now in its eighth edition, it reflects significant developments within the occupational profession and the contexts of the delivery of health and social care when working with people who experience illness, injury or impairment to promote occupational participation. It is highly regarded for its level of detail, its practical approach, and the breadth of its content, with input from multiple authors from around the world. Fully updated and built around the professional concepts and processes to promote occupational participation this invaluable resource will enable occupational therapists link theory with day-to-day practice, reflect on the knowledge, expertise and attitudes that inform their work and practice in a critically reflexive way.

Purpose: to explore the changes in occupations experienced by individuals with Lyme Disease (LD), their strategies to engage in their current occupations, and their aspirations for future occupations to better understand their occupational participation and the factors influencing their engagement. Methodology: a qualitative descriptive survey was distributed online, achieving 35 responses. Data was analysed using Reflexive Thematic Analysis (RTA). Findings: Three main themes were generated: 1) Living with the effects of the unknown, 2) Experiencing occupational losses and changes, and 3) ‘I know my limits’: adapting lives. participants experienced occupational disruption and deprivation that possibly affected their dimensions of occupation: doing, being, belonging, and becoming. Implications for occupational science: this is the first study conducted with individuals with LD from an occupational perspective. Our study is the first to identify how the condition impacts occupations and how participants developed strategies to engage in occupations. Therefore, our study holds worth in contributing new knowledge to occupational science, beyond the disease and illuminating the occupational perspective of human beings.

Artificial intelligence (AI) is increasingly shaping how we live, influencing human occupations at individual and global levels. Despite growing debate, the impact of AI has not been extensively examined from an occupational perspective. This study, part of the Global Occupational Therapy Think Tank (GOTTT), critically reflects on themes from AI literature regarding its influence on what people want to, need to, and are expected to do, as well as its impact on their environments. To support our reflective piece, we conducted a literature review covering January 2023 to December 2024, using keywords such as "AI" combined with terms like "human occupations," "daily life," "work," "leisure," "social relationships," "play," "study," and "rest." Searches in Google Scholar yielded 54 articles meeting the inclusion criteria. Information was extracted, charted, and analysed collaboratively by coauthors, who formulated critical reflections shared during team meetings to interpret findings through an occupational lens. Analyses reveal that AI's influence on human occupations is most frequently framed within work and study contexts. The findings underscore the need for qualitative investigations into how AI impacts individuals, groups, and populations, highlighting the interplay between AI and the digital divide in shaping participation and reducing tensions in daily life. This study contributes to occupational science by offering insights into AI’s growing role in shaping occupations and its broader implications for participation and engagement in various life domains.

The theme of this special issue is leadership and knowledge innovation in occupational therapy. We understand leadership beyond and away from the capitalistic values that include but are not limited to productivity, quantitative measures, managerial roles, and “value for the money” that govern most of the systems and services we work or should access in society. Aligning with Backman (2022), we agree that leadership is not about having a title, being perceived by others as an authority, possessing power and some specific features and personal attributes. Still, its focus relies on social changes and recognizing the role of teams and collectives. Therefore, having an outcome or need for action opens the doors of leadership to each of us, and citing an outcome or reason for action encourages leadership to everyone acting in their circle of influence that goes from our micro, meso and macro levels (Backman, 2022).

The Royal College of Occupational Therapists (RCOT) campaign on the ‘Complexity of Occupation’, part of its Workforce Strategy, promotes occupation-centred practice as the profession’s distinct contribution to health and social care. Research shows this approach strengthens professional identity, enhances health outcomes and clarifies roles (Phillips et al., 2023). Fisher and Marterella (2019) describe occupation-centred practice as a profession-specific way of thinking that keeps occupation at the heart of reasoning. Translating theory into action requires therapists to apply occupational knowledge meaningfully (Hitch and Pepin, 2020). This editorial reflects on these ideas and explores practical ways to embed the dimensions of doing, being, belonging and becoming into occupational therapy.

Hand function assessment is essential for upper limb rehabilitation of stroke survivors. Conventional acquisition devices have inherent and restrictive difficulties for their clinical usage. Data gloves are limited for applications outside the medical environment, and motion tracking systems setup are time and personnel demanding. We propose a novel instrument designed as a replica of a glass, equipped with an omnidirectional vision system to capture hand images and an inertial measurement unit for movements kinematic data acquisition. Four stroke survivors were invited as volunteers in pre and post-treatment experiments for its evaluating. The exercise of drinking water from a glass was elected for the trails. Before treatment, subjects used their contralesional and ipsilateral hands to perform them. Two main functional features were found in the data analysis. There were differences between limbs in the grasping hand postures, mainly in the index and thumb abduction angle, and in the task timing. After treatment, two volunteers repeated the protocol with their contralesional hands. Changes in the features were observed, index and thumb abduction angles were greater in both cases, and tasks timing were altered in distinct ways. These preliminary results suggest the instrument can be used both in evaluation of hand functional deficit and rehabilitation progress. Improvements and future work are also presented.

Objective: To perform cross-cultural adaptation of the Wheelchair Skills Test of manual wheelchair users and their caregivers into the Brazilian Portuguese language. Methods: The study was composed of translation, synthesis of translations, back-translation, review by an expert committee and pre-test, when the test was applied in the target population. Included were translators, subject specialists and coordinators to carry out the cross-cultural adaptation process, and manual wheelchair users and their caregivers with at least six months of wheelchair experience for the pre-test. Results: Forty-three people participated in the study, 30 for the pre-test and 13 for the stages that preceded the pre-test. The mean age of manual wheelchair users was 40.2 (±10.7) years and of caregivers was 44.2 (±15.7) years. Of the 47 phrases translated in the first stage, 36 discrepancies were found and resolved. During the analysis by the committee of experts the instrument underwent 13 modifications in order to achieve the best possible equivalence between the original version and the final version and was understandable by the people evaluated. The total pre-test scores of wheelchair users and their caregivers were 66.2 (±24.6) and 88.7 (±14.2), respectively. Conclusions: This instrument was able to evaluate the abilities of wheelchair users and their caregivers in Brazil, as well as being useful for training in rehabilitation programs.Implications for rehabilitation The need to use wheelchair (WC) properly has made clinicians and rehabilitation professionals more concerned with assessing and training users' abilities with their WC. Cross-cultural adaptation allows for the linguistic modification of the original language of the evaluation tool into a new language and enables the comparison of research results in different countries. Immediate use of the instrument for WC users and caregivers in Brazil, both for evaluation and for training, is necessary and may be a means for rehabilitation professionals to improve their evaluations, their treatments and optimize the skills that aim at independence.

Introduction: In occupational therapy, scientific journals have been the object of studies in order to understand the trajectories and characteristics of the production of knowledge of the profession. In Brazil, the evaluation of the bibliographical production disseminated in journals has been a prerequisite for the insertion and permanence of researchers in graduate programs. Objective: To characterize the publications on occupational therapy in non-specific journals of the profession classified in strata A1 and A2 by the WebQualis list of the Coordination of Personal Improvement of Higher Education (CAPES) in Physical Education, Speech Language, Physiotherapy and Occupational Therapy areas as to the origin of journals and articles published, as well as the themes, objectives, methods and people addressed. Method: This is a descriptive study of articles and journals published in the period from 2004 to 2015. Data were analyzed by simple descriptive statistics. Results: There was an increase in publications on occupational therapy in these vehicles from 30 articles published in 2004 to 82 in 2015, although it is concentrated in certain journals in European and American countries. A higher frequency of articles with authors related to the universities and countries of North America and Europe was observed, as well as articles with an intervention approach and quantitative methodological approach. Conclusion: Although an increase in publication on occupational therapy has been observed, it has been observed that there is a numerical, thematic and methodological restriction of non-specific occupational therapy journals that publish articles related to the profession.

Introduction: In Brazil, there is a gap of assessment, encompassing the use of assistive technology and functional mobility of wheelchairs users and caregivers. The Wheelchair Skills Program (WSP) is an integrated system that includes elements for testing and training wheelchair users, clinicians and/or their caregivers. Objective: Cross-cultural adaptation of the Portuguese-Brazil version of the Wheelchair Skill Test Questionnaire (WST-Q Version 4.3), a component of the WSP, and to examine its face validity. Method: Interactive steps were applied to produce Portuguese-Brazil versions of the WST-Q. The Cultural, Idiomatic, Semantic and Conceptual Equivalences were evaluated by a Committee of Specialists. Fifteen informal caregivers were evaluated with the WST-Q Brazil. Results: Twenty-eight of the 131 sentences were modified for further understanding. Subsequent semantic analysis reached 96.18% agreement, and language equivalence (100%), cultural (99.2%) and conceptual (100%) agreement. The questionnaire was easily understood between caregivers and the expert committee judged the Brazilian version equivalent to Canadian original. Conclusion: Success was achieved in cross-cultural adaptation of the tool, members of the expert committee judged the Brazilian version equivalent to the original Canadian. The WST-Q Brazil version 4.3 for caregivers contemplated 33 wheelchair transfer skills, mobility outdoor and indoor. Keywords: Wheelchair, Assessment, Assistive Technology, Translations.

Background and purpose Overuse injuries and painful symptoms in athletes and dancers (especially classical ballerinas) may lead to reduced functional performance. However, laser application may reduce pain and increase physical conditioning. The aim of the current study was to evaluate the immediate and long-term effects of infrared laser on classical ballerinas’ feet. Methods Eight female adults who perform classical ballet training and feel pain in their foot, but report no injuries in the last 6 months participated in the study. Infrared laser (808 nm) was applied on ballerina's feet twice a week during three months. The laser parameters utilized were 100 mW average optical power and spot size of 0.04 cm2 applied during 1 min, leading to 6 J and 125 J/cm2 per point. Thermography, algometry and unipodal static standing balance test were performed. Results There was a significant increase in plantar arch temperature (1.6 °C for center and 2.3 °C for border, p < 0.05) immediately after laser treatment for all ballerinas. The pressure pain thresholds (PPT) were significantly increased for 5 of 7 analyzed sites (p < 0.05). Regarding to the static standing balance, the time on one-foot showed a significant increases (from 23 ± 12 s to 34 ± 13 s, p < 0.05) only when the test was performed on the left foot (support foot). Conclusion Then, there were pain relief and improvement of functional performance in ballerinas. The possible mechanism of laser action in reducing pain and thus enhancing performance, like higher blood flow of foot due to an increase of cutaneous temperature, will be discussed.

RESUMO A Comunicação Suplementar e/ou Alternativa para crianças (CSA) com paralisia cerebral é essencial para o seu envolvimento em diferentes contextos. Assim sendo, o objetivo deste artigo foi verificar os efeitos de um programa individualizado de CSA para uma criança com paralisia cerebral não verbal em três contextos da vida cotidiana: escola, casa e ambientes clínicos. Este estudo utilizou o delineamento experimental de múltiplas sondagens. Os participantes foram uma criança com paralisia cerebral e três parceiros de comunicação em seus respectivos contextos: professor, mãe e terapeuta ocupacional. A intervenção consistiu no processo individualizado de formação teórica e prática dirigida aos parceiros de comunicação e implementação da CSA. Após a implementação do programa de intervenção, os resultados demonstraram que a criança e os parceiros de comunicação usaram com sucesso os recursos da CSA. Os resultados apontam que as estratégias adotadas nos três contextos foram eficazes e proporcionaram aprendizado sobre o uso de CSA para a criança e seus parceiros de comunicação.

Background: Stroke is a chronic disease responsible for changes in the functional capacity of the patients. Patient care is usually provided by family caregivers, but with great burden and negative impact on their quality of life. Objectives: (1) To investigate whether a correlation existed between the levels of independence and cognition in stroke patients and the burden and quality of life of their caregivers; (2) to assess whether periods of injury, rehabilitation and care, and age of the stroke patients interfered with these correlations. Methods: This was a cross-sectional and correlational study that included 60 participants, of which 30 were post-stroke patients and 30 were their caregivers. The data collection instruments were the Mini Mental State Examination and the Functional Independence Measure for the post-stroke participants, and the Zarit Burden Interview Scale and the World Health Organization Quality of Life-BREF, for the caregivers. The Pearson’s product-moment correlation was used for the data analysis. Results: Independence and cognition showed no correlation with the burden and quality of life of the caregivers. We identified a strong positive correlation between independence and cognition (r = 0.882), and a moderate negative correlation between independence and rehabilitation period (r = −0.398) and between burden and quality of life of the caregivers (r = −0.414). Conclusions: Our data suggest the need for health interventions aimed not only at stroke patients, but also at their family caregivers, given the association between the burden and the low levels of quality of life of the caregivers.

Wheelchairs skills training is fundamental in the rehabilitation of disabled people and is considered an essential step in wheelchair prescription/dispensing services. The objective of this study was: (1) to map the interventions for manual wheelchairs skills training available in the literature of the last 10 years (2008-2018); and (2) identify the best levels of scientific evidence on this practice. This was an integrative review of the literature in the Virtual Electronic Library Online (SciELO) and in the Biblioteca Virtual em Saúde (BVS), Literatura Latino-Americana e do Caribe de Ciências da Saúde (LILACS), and PubMed / MEDLINE, with articles in English, Spanish and Portuguese between 2006 and 2018. We found seven randomized controlled trials, all available in the English language and most of Canadian affiliation. The protocol of the Wheelchair Skills Training Program - WSTP presented the largest number of studies (n=4) with proven efficacy and confidence in wheelchair skills and attainment of training goals. This protocol has also proved to be effective in individual and group approaches, in contexts of specialized rehabilitation and community services, with a diversified public and a variable training time between two and 24 hours. It is concluded that WSTP has been shown to be a strategy with high levels of evidence on wheelchair skills training, and further research is needed to evaluate the effectiveness of this practice in aspects not yet investigated.

Background: Falls are the most serious and frequent household accidents occurring in the elderly; their prevention is important in decreasing morbidity, mortality, and medical costs. This study aimed to identify and correlate factors such as gender, level of independence in daily activities, balance, physical activity, and function of the upper limbs within the elderly population. Methods: This was a correlational and cross-sectional study with a quantitative approach. Forty-three elderly participants were selected from a Primary Health Care Unit in the city of São Carlos, São Paulo, Brazil. Collection instruments included a questionnaire, the Berg Balance Scale, the Functional Independence Measure, and the Box and Blocks Test. Data were analysed using Pearson correlation. Results: Most participants were women (46.5%) between 60 and 70 years old being 58% of the sample. The total number of falls for older women was 31. The number of falls increased proportionally with the increasing age of the participant (r = 0.41) (p = 0.0063). The greater the number of falls, the lower the performance in balance (r = −0.47) (p = 0.0015) and independence (r = −0.63) (p ≤ 0.0001). Conclusion: This study resulted in evidence that can strengthen the development of preventative strategies, focusing on physical activity and its importance in the prevention of falls.

The Wheelchair Skills Test-Questionnaire form for Manual Wheelchairs Operated by Wheelchair Users (WSTQ-M-WCU 4.3) assesses wheelchair skills that may influence users’ occupational performance in their daily activities. The purpose of this study was to cross-culturally adapt the WSTQ-M-WCU 4.3 to Brazilian Portuguese and to examine the inter-rater and test-retest reliabilities. This is a methodological study of cross-cultural adaptation and psychometric properties of reliability. The agreement achieved in the cross-cultural adaptation concerning idiomatic, cultural, conceptual and semantic aspects was 100%, 99.2%, 100% and 96.18%, respectively. We analyzed the test-retest and inter-rater reliabilities in a convenience sample of 46 manual wheelchair users using Cronbach’s Alpha and Bland-Altman plots. The Brazilian version has excellent internal consistency (α > 0.9) and strong inter-rater reliability (p < .05). This instrument can guide practitioners in training wheelchair skills, thus contributing to the planning of interventions and for evidence-based practice in Assistive Technology.

Mobility is essential for activities of daily living and therapists should give priority to evaluate its effects in their client’s performance. We aimed to ascertain the intra- and inter-rater reliability of Functional Mobility Assessment (FMA) and to identify correlations among satisfaction, independence, and skills in 44 users of manual wheelchairs and three users of powered wheelchairs. We analyzed the test-retest and inter-rater reliability of the FMA in a sample of 47 wheelchair users using the Cronbach’s Alpha. For correlations with FMA were used the Quebec User Evaluation of Satisfaction with Assistive Technology, Functional Independence Measure, and Wheelchair Skills Test Questionnaire (manual and powered forms). The test-retest reliability showed good internal consistency (α > 0.9). Associations between functional independence, wheelchair skills, and functional mobility were significant (p < .05). The Brazilian version of the FMA is reliable for use among wheelchair users, and its correlation with other measurements suggests cohesion among assessments related to mobility devices.

O acidente vascular cerebral é uma doença crônica que causa sequelas motoras e cognitivas e possíveis alterações na capacidade funcional. Este estudo objetivou identificar os níveis de independência funcional e cognição em homens com acidente vascular cerebral e verificar a presença de correlações entre essas variáveis. Para tanto, adotou-se um estudo transversal descritivo-correlacional com amostra de conveniência composta por trinta (n=30) homens adultos. Para a coleta de dados foram aplicados a Medida de Independência Funcional e o Mini Exame do Estado Mental. Para a análise dos dados adotou-se a análise descritiva simples e o coeficiente de correlação de Pearson. Os resultados demonstraram o predomínio de sujeitos dependentes e com altos índices de alterações cognitivas bem como correlações positivas fortes entre a cognição e a independência motora (r=0,827 p=0,000), cognitiva (r=0,912 p=0,000) e total (r=0,882 p=0,000). Esses dados demonstram o impacto das alterações cognitivas na independência funcional de sujeitos pós-AVC e sugerem a necessidade de intervenções específicas em terapia ocupacional destinadas a esses.

Introduction: The quantity and quality of papers published in journals are often considered as research trends indicators in several fields of study. In the case of occupational therapy (OT) there are few studies addressing this issue.Objective: To describe the characteristics of occupational therapy electronic journals, including year of creation, publication frequency, peer review process, language of publication, and content access policies. Materials and methods: A descriptive, quantitative study was carried out based on a search conducted in the following databases by using the term “occupational therapy”: Web of Science, Scopus, SciELO, CINAHL, OTDBASE, Ulrich’s International Periodical Directory, NCBI Databases, CINAHL-EBSCOhost, ProQuest, Medline, and Directory of Open Access Journals. Simple descriptive statistics was used to analyze data. Results: After the search was conducted, 39 journals were included for analysis, of these 85% had been created after 1990. All journals were indexed in different databases, but most of them were in Journal Citation Reports, CINAHL, Medline, Science Citation Index Expanded, OTDBase, and PsycINFO. Likewise, approximately 36% publish an issue every three months, and mainly in English. Conclusion: A more comprehensive understanding of the characteristics of these journals may help OT researchers choosing the best option to submit their works for publication, and contribute to achieving higher rates of production and dissemination of knowledge on OT by said journals.

Internet of things (IoT) is a designation given to a technological system that can enhance possibilities of connectivity between people and things and has been showing to be an opportunity for developing and improving smart rehabilitation systems and helps in the e-Health area. Objective: to identify works involving IoT that deal with the development, architecture, application, implementation, use of technological equipment in the area of patient rehabilitation. Technology or Method: A systematic review based on Kitchenham's suggestions combined to the PRISMA protocol. The search strategy was carried out comprehensively in the IEEE Xplore Digital Library, Web of Science and Scopus databases with the data extraction method for assessment and analysis consist only of primary studies articles related to the IoT and Rehabilitation of patients. Results: We found 29 studies that addressed the research question, and all were classified based on scientific evidence. Conclusions: This systematic review presents the current state of the art on the IoT in health rehabilitation and identifies findings in interdisciplinary researches in different clinical cases with technological systems including wearable devices and cloud computing. The gaps in IoT for rehabilitation include the need for more clinical randomized controlled trials and longitudinal studies. Clinical Impact: This paper has an interdisciplinary feature and includes areas such as Internet of Things Information and Communication Technology with their application to the medical and rehabilitation domains.

Introduction. The Functional Mobility Assessment (FMA) measures satisfaction with mobility devices in daily life. However, in Brazil, there is a lack of instruments which measure functional mobility. Objective: We aim to report the cross-cultural adaptation process and face validity of the FMA for use in Brazil. Methods: Two international guidelines were used in the cross-cultural adaptation process. Two independent translators translated the instrument from English to Brazilian Portuguese, and the two versions were reconciled. Two different translators back translated this reconciled version, and an expert committee analysed the resulting synthesis. For face validity, the FMA was applied with 24 participants, divided into two groups, users with disabilities (n = 12) and occupational therapy students (n = 12) and occupational therapy students (. Results: The cross-cultural adaptation of the FMA was concluded, and its face validity presented that both groups understood most or completely all instrument items. Conclusion: The Brazilian version of FMA is now available in Brazilian Portuguese and has face validation. Further studies should test its psychometric properties.

Purpose: Pressure injuries are a complication due to spinal cord injury. The objective of the study is to compare the pressure distribution in the wheelchair seat of subjects with spinal cord injury using 3 pads (Roho

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Nos dias atuais, a empregabilidade das pessoas com deficiência é um debate crescente e as dificuldades no trabalho precisam ser compreendidas a partir daqueles que vivenciam esse processo. Objetiva-se identificar os aspectos que facilitam e/ou dificultam a inclusão de pessoas com deficiência em atividades laborais e entender a contribuição da tecnologia assistiva no desempenho do papel ocupacional de trabalho. Trata-se de uma pesquisa qualitativa. Participaram 30 sujeitos, com idade entre 18 e 60 anos. Foi desenvolvida entrevista semiestruturada e a análise dos dados foi feita a partir da análise de conteúdo temática. O trabalho apresentou-se como importante meio de realização pessoal e profissional na vida dos entrevistados, além de forma de reconhecimento pela sociedade. A tecnologia assistiva apareceu como um facilitador tanto no ambiente de trabalho quanto em relação à acessibilidade para se chegar a ele. A escolaridade e o preconceito foram pontuados como as principais barreiras ao processo de inclusão. Destaca-se a importância de ações afirmativas e de incentivo ao debate de políticas públicas pelo acesso aos direitos das pessoas com deficiência, garantidos na Lei brasileira.

Abstract

Date Presented 3/30/2017

This session describes the importance for professional practice of thinking about the development of a different approach focused on stroke patients and family caregivers.

Primary Author and Speaker: Daniel Cruz

Additional Authors and Speakers: Camila Caro

Este ensaio tem como objetivo refletir sobre os resultados da pesquisa sobre estupro no Brasildivulgada pelo Instituto de Pesquisa Econômica Aplicada (IPEA), em março de 2014. Sãoabordados os conceitos sobre patriarcalismo, machismo, moral e papéis, especialmente osocupacionais. O modelo de família patriarcal era comum na Idade Média, devido à estruturaeconômica agrícola do período, e foi muito diferente do patriarcado burguês do século XIX. Omachismo, por sua vez, surgiu com a decadência da Moral Cristã na sociedade burguesagestada ao fim da era medieval e se infiltrou facilmente na burguesia. A perda de uma moralnorteadora e a ascensão de ideias liberais e relativistas fez o homem moderno perder seusreferenciais e, muitas vezes, seu próprio papel no mundo.Descritores: Terapia ocupacional; Papel (figurativo); Sexismo; Moral.

Este estudo teve por objetivo descrever e discutir a vivência curricular com “Grupos Reflexivos da Prática”na formação, a partir da perspectiva de docentes e alunos de um curso de graduação em TerapiaOcupacional. Esta é uma pesquisa qualitativa, realizada com 26 alunos e dois docentes numa universidadepública, em 2011. A análise temática categorial possibilitou três categorias: o Grupo Reflexivo como espaçode aprendizagem: construção coletiva e desenvolvimento profissional, O processo de aprender a aprendere, O papel do facilitador e o sentido do “Grupo de Reflexão da Prática. Verificou-se que a atividade educativaem questão indica potencial positivo da estratégia metodológica utilizada com pequenos grupos paradiscussão da prática. O grupo apresentou-se como um espaço dinâmico e significativo, em que impressões,vivências, dúvidas e angústias referentes à prática puderam ser relatadas, refletidas, discutidas ecompartilhadas entre os alunos e docentes, com os fundamentos teóricos pertinentes aos temas.Descritores: Educação; Terapia ocupacional; Aprendizagem baseada em problemas.

Introduction: Post-stroke limitations may cause problems and lead to dependency in daily activities, which requires the use of mobility assistive devices. Objective: Identify the level of functional independence and the use of mobility assistive devices among men as well as to check the relationship between these variables. Method: It is a descriptive, correlational research using convenience sampling carried at medical centers specialized in physical rehabilitation in a medium size town of São Paulo state. Then, a Data Form of the patient with stroke and the Functional Independence Measure were used. The data were sent to a simple descriptive analysis and biserial test. Results: It showed predominance of stroke subjects dependent for the activities of daily life (63%), and those using mobility assistive devices (66.6%). The devices were wheelchairs (10), shower chairs (9), and canes (7). Moderate positive correlations between the use of mobility device and the motor functional independence (p<0.05 and r=0.617), and the total functional independence (p<0.05 and r=0.590) was also identified. Conclusion: Data demonstrate the possible impact in preventing mobility during daily activities, in particular motor activities among stroke subjects. That increases the need of occupational therapy interventions aiming at the mobility improvement among these subjects.

INTRODUÇÃO: Por vários anos, a formação do terapeuta ocupacional esteve voltada para a assistência, mas com as mudanças no mercado de trabalho, nas políticas sociais e de saúde, diferentes espaços e cargos tornaram-se possíveis para esse profi ssional, dentre eles o de gestor. No entanto, a produção de conhecimento em Terapia Ocupacional na área de Gestão é escassa e traz uma lacuna ao longo de sua história no Brasil. OBJETIVO: investigar sobre a formação de terapeutas ocupacionais para a prática de gestão. MÉTODO: trata-se de uma pesquisa descritiva e transversal cuja amostra foi composta por 278 terapeutas ocupacionais de diferentes instituições do Brasil. O instrumento de coleta foi um questionário com perguntas abertas e fechadas. Os dados da pesquisa foram analisados através de estatística descritiva simples e pelo programa IBM – Many Eyes. RESULTADOS: a importância do conteúdo sobre gestão durante a formação acadêmica foi apontada pelos participantes. Cerca de 86% (n=239) dos profi ssionais relataram difi culdades em relação ao conhecimento do conteúdo de gestão em sua formação. CONCLUSÃO: acredita-se que os resultados obtidos com essa investigação possam servir para a formulação de propostas curriculares que contemplem a formação para a gestão, uma vez que, pelas respostas identifi cadas, tal formação ainda se mostra bastante incipiente.

Background: Handwriting is a fundamental skill needed for the development of daily-life activities during lifetime and can be performed using different forms to hold the writing object. In this study, we monitored the sEMG activity of trapezius, biceps brachii, extensor carpi radialis brevis and flexor digitorum superficialis during a handwriting task with two groups of subjects using different grasp patterns. Subjects and methods: Twenty-four university students (thirteen males and eleven females; mean age of 22.04 ± 2.8. years) were included in this study. We randomly invited 12 subjects that used the Dynamic Tripod grasp and 12 subjects that used the Static Tripod grasp. Results: The static tripod group showed statistically significant changes in the sEMG activity of trapezium and biceps brachii muscles during handwriting when compared to dynamic tripod group's subjects. No significant differences were found in extensor carpi radialis brevis and flexor digitorum superficialis activities among the two groups. Conclusion: The findings in this study suggest an increased activity of proximal muscles among subjects using a transitional grasp, indicating potential higher energy expenditure and muscular harm with the maintenance of this motor pattern in handwriting tasks, especially during the progression in academic life. © 2013 Elsevier Ltd.

Resumen Introducción La literatura en cuanto al contexto laboral de los profesores ha documentado las condiciones de trabajo y sus efectos en la salud, sin embargo, existe escasa evidencia de los efectos de la Carga Mental de Trabajo (CMT) en este grupo, pese a tratarse de un riesgo psicosocial que se construye a partir de factores propios del quehacer docente. Objetivo Explorar la literatura respecto a la CMT percibida por profesores y su relación con condiciones de trabajo y efectos en su salud. Método Se realizó revisión integrativa en bases de datos Web of Science, CINAHL Complete, PubMed y Scielo utilizando descriptores en inglés y español considerándose como criterios de inclusión estudios cuantitativos, cualitativos y mixtos; estudios publicados desde 2013 al 2019. Además, se realizó búsqueda manual, rescatando un estudio de relevancia para el abordaje de la temática. Los estudios fueron sometidos a evaluación según niveles de evidencia desarrollados por el Oxford Centre forEvidence-Based Medicine. Resultados Se localizaron 20 artículos y se formularon categorías de análisis: condiciones laborales de profesores, efectos del trabajo en la salud, carga mental percibida por los mismos, además de establecerse sugerencias para la salud ocupacional. Conclusión Las características del contexto docente incluyen factores propios de la CMT, entre ellos la intensidad laboral y tiempos de trabajo extenuante, ruido, alta cantidad de estudiantes, mala calidad de relaciones interpersonales, inestabilidad laboral y falta de recursos.

Introduction: The Model of Human Occupation Screening Tool (MOHOST) was developed in the UK and measures the occupational participation. Until its translation, there were no standardised instruments in Brazil of a similar nature. Objectives: To describe the translation and cross-cultural adaptation process of the MOHOST for Brazil, its face validity and test-retest reliability among occupational therapists. Method: A translation agreement was established allowing the assessment to be translated and honed after a back translation. An expert committee was formed of ten occupational therapists to test face validity of the instrument with 50 occupational therapists. Statistical analysis was employed to investigate whether the occupational therapists' understanding of the MOHOST was linked to their length of clinical experience. The test-retest reliability was examined among a sample of eight adults with physical disabilities. Results: The cross-cultural adaptation of the Brazilian MOHOST has been completed. A significant correlation (p=0.04) was found between years of professional experience and greater understanding of the MOHOST items. The MOHOST presented very high reliability in the test-retest (r>0.900). Conclusion: A Brazilian translation of the MOHOST has face validation and test-retest reliability. Future studies addressing this instrument's psychometric properties of validity and inter-rater reliability are recommended.

RESUMO: A participação ocupacional é uma questão crucial para a atenção à pessoa com deficiência e caracteriza-se pelo grau de participação de uma pessoa em várias ocupações, tais como as de autocuidado, trabalho, escola, lazer, dentre outras. O objetivo deste estudo foi, assim, verificar se a participação ocupacional avaliada pelo Model of Human Occupation Screening Tool (MOHOST Brasil) apresenta correlações com as medidas de independência funcional e de cognição em adultos com deficiências. Foram avaliadas 41 pessoas com deficiência física usando o MOHOST Brasil, a Medida de Independência Funcional (MIF) e o Mini Exame do Estado Mental (MEEM). A subescala motora da MIF apresentou correlação moderada com o fator de habilidades motoras MOHOST (r 0,586 p = 0,001). O item "Linguagem e práxis" do MEEM apresentou correlação moderada com o fator "habilidades de processo" do MOHOST (r 0,573 p = 0,001). As correlações entre o MOHOST e a MIF e entre o MOHOST e o MEEM mostram que há relação entre as dimensões de participação, desempenho e habilidades, confirmando que o MOHOST é útil para avaliar a participação ocupacional de pessoas com deficiências físicas. Conclui-se também que o MOHOST pode fornecer dados que possam contribuir para o planejamento de intervenções que estimulem a participação ocupacional em diferentes papéis no âmbito da Terapia Ocupacional e na sua inferface com a Educação Especial.

Occupational engagement was first described in 1980 by Elizabeth Yerxa. Forty years later, the concept has no consensual definition in the literature. Despite a lack of common agreement, occupational engagement has been used to describe the ultimate goal of occupational therapy in several documents of associations and research articles. The opinion piece discusses the importance and implications of a lack of consensual concept definition for the profession of occupational therapy and focuses on five descriptions of occupational engagement in the literature. The word "promise" expresses the message occupational therapists send through their organizations, institutions, clinical practice, and research to society and stakeholders that can benefit from occupational therapy services. The descriptions of occupational engagement are presented to illustrate how the literature understands the phenomenon differently. The literature presents definitions that diverge in four meanings: (a) occupational performance; (b) occupational participation; (c) occupational balance, routine and skills; and (e) beyond performance. As a final consideration, this opinion piece highlights the need for action in exploring the concept of occupational engagement in the profession of occupational therapy and in the discipline of occupational science.

Objective: Describe the profile of students in the health and exact undergraduate courses of a public university in the Midwest region of Brazil, determine the prevalence of Common Mental Disorders (CMD) among these students, and verify the sociodemographic and course-related factors associated with their occurrence. Method: A cross-sectional and relational study was carried out from May to September 2020 with a sample of 493 students who answered a survey on sociodemographic variables and the Self-reporting Questionnaire (SRQ 20). We conducted descriptive analyses of the variables and logistic regression, using the Statistical Package for Social Sciences (SPSS), version 21.0. A cutoff point ≥7 was adopted in the SRQ-20 for suspected CMD. Results: The prevalence of CMD in the sample was 66.1%. Comparison between the groups (with or without CMD) showed that the highest prevalence rates were linked to the female gender (p<0.001) and undergoing health care treatment (p<0.001). Regression analysis indicated significant predictors for CMD being female (p<0.001) and being enrolled in exact science courses (p=0.050). Conclusion: The high prevalence of CMD reinforces the need to invest in the creation of care spaces that pay special attention to women and exact sciences students, in addition to discussing student assistance policies aimed at promoting the health, well-being, and care of university students.

Understanding the history of occupational therapy in Brazil through individual and collective trajectories is fundamental, both for the advancement of knowledge production and for professional training and development in the field. This article is based on the life story of Milton Carlos Mariotti, occupational therapist, Senior Professor at the Federal University of Paraná (UFPR). The objective is to document his professional narrative, the legacy of his leadership and his ethical commitment to the development of occupational therapy in Brazil. For that, four occupational therapist professors got together to formulate a semi-structured interview script composed of 34 questions. Based on the responses, the text was organized into four thematic axes: 1) Educational background, 2) Work as an occupational therapist, 3) Academic trajectory and 4) Political militancy. As a result, a historical narrative is presented that documents the history of the teacher's professional life and his contribution to the institutionalization of occupational therapy in the State of Paraná, southern Brazil.

Occupational engagement has been conflated with other concepts, such as participation, active occupational performance, and therapeutic engagement. This critical review will discuss occupational engagement as a unique concept that describes a form of involvement in doing that does not require performance and foregrounds the subjective-affective and cognitive experiences of doing. We present some attributes of occupational engagement and the implications for the lack of clarity of this concept within the literature. The difference between occupational engagement and therapeutic engagement is discussed by comparing the foundational tenets of the Model of Human Occupation (MOHO) and the Canadian Model of Occupational Performance and Engagement (CMOP-E). Through one illustrative narrative, we discuss how occupational engagement can be understood as a phenomenon that is not performance-dependent and has different levels of engagement. To conclude, we point out some assumptions about occupational engagement that can inform occupational therapy research and practice.

The Occupational Therapy evaluation is the first step in determining the intervention path and ensuring that the client has the greatest possible occupational participation. Te assessment Te Short Child Occupational Profile (SCOPE) is a tool that makes it possible to systematically assess factors that facilitate or restrict participation in the occupations of children and adolescents, and these factors are based on the Model of Human Occupation (MOHO). Te aim of the present study was to describe the methodological study of the cross-cultural adaptation of SCOPE to Brazilian Portuguese. Te methodological procedures involved the translation of the assessment into Portuguese and back-translation to English; analysis of semantic, idiomatic, conceptual and experiential equivalences by the Expert Committee; verification of clarity and understanding of the instrument through a Pre-Test to consolidate the final version and approval by the main author of the original assessment. Te translation and back-translation processes showed few discrepancies between the terms, obtaining good resolution among the translators for the preparation of the synthesis. All suggestions for changes by the Expert Committee were analyzed and duly incorporated into the preliminary version of the instrument, which, in the Pre-Test stage, showed good or excellent understanding of sentences by the participants. Te Brazilian version of SCOPE was approved by the main author of the original assessment. Success was achieved in the process of cross-cultural adaptation of the assessment tool for Brazil, currently entitled: Initial Occupational Profile of Children and Adolescents (SCOPE-Brasil), being able to undergo further studies to obtain psychometric validation measures with the Brazilian population.

Abstract Objective Describe the profile of students in the health and exact undergraduate courses of a public university in the Midwest region of Brazil, determine the prevalence of Common Mental Disorders (CMD) among these students, and verify the sociodemographic and course-related factors associated with their occurrence. Method A cross-sectional and relational study was carried out from May to September 2020 with a sample of 493 students who answered a survey on sociodemographic variables and the Self-reporting Questionnaire (SRQ 20). We conducted descriptive analyses of the variables and logistic regression, using the Statistical Package for Social Sciences (SPSS), version 21.0. A cutoff point ≥7 was adopted in the SRQ-20 for suspected CMD. Results The prevalence of CMD in the sample was 66.1%. Comparison between the groups (with or without CMD) showed that the highest prevalence rates were linked to the female gender (p<0.001) and undergoing health care treatment (p<0.001). Regression analysis indicated significant predictors for CMD being female (p<0.001) and being enrolled in exact science courses (p=0.050). Conclusion The high prevalence of CMD reinforces the need to invest in the creation of care spaces that pay special attention to women and exact sciences students, in addition to discussing student assistance policies aimed at promoting the health, well-being, and care of university students.

The Brazilian Practice Guidelines for Stroke Rehabilitation – Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

Rationale: occupational engagement was firstly mentioned in the literature in 1980 by Elizabeth Yerxa. After more than forty years, this concept is still not clear or consensual of definition among researchers and practitioners. In spite of a common agreement, occupational engagement has been used to describe the ultimate goal of occupational therapy in several documents of associations and research articles. Objective: to review how occupational engagement has been described in occupational therapy and occupational science literature. Methods: this is an integrative review about the concept of occupational engagement in publications (articles and books) and documents of associations published between 1980-2000. Search was conducted during three months in DOAJ, PubMed, Web of Science, Scopus, Medline databases and manual search in books, book chapters and occupational therapy websites. Data analysis was performed in qualitative themes by its content. Results: three categories emerged and were discussed based on literature: 1) Occupational engagement and the subjective experience; 2) Occupational presence and engagement, and 3) Health, well-being and quality of life through occupational engagement. Conclusion: however occupational participation and occupational performance are important concepts for occupational therapy, it is only through occupational engagement that this profession can achieve the promise of health, well-being and quality of life.

Background: In 2020, the world was surprised by the spread and mass contamination of the new Coronavirus (COVID-19). COVID-19 produces symptoms ranging from a common cold to severe symptoms that can lead to death. Several strategies have been implemented to improve the well-being of patients during their hospitalization, and virtual reality (VR) has been used. However, whether patients hospitalized for COVID-19 can benefit from this intervention remains unclear. Therefore, this study aimed to investigate whether VR contributes to the control of pain symptoms, the sensation of dyspnea, perception of well-being, anxiety, and depression in patients hospitalized with COVID-19. Methods: A randomized, double-blind clinical trial was designed. Patients underwent a single session of VR and usual care. The experimental group (n = 22) received VR content to promote relaxation, distraction, and stress relief, whereas the control group (n = 22) received non-specific VR content. Results: The experimental group reported a significant decrease in tiredness, shortness of breath, anxiety, and an increase in the feeling of well-being, whereas the control group showed improvement only in the tiredness and anxiety. Conclusions: VR is a resource that may improve the symptoms of tiredness, shortness of breath, anxiety, and depression in patients hospitalized with COVID-19. Future studies should investigate the effect of multiple VR sessions on individuals with COVID-19.

The Occupational Self-Assessment version 2.2 (OSA) is a self-assessment of the client’s occupational competence and values. To describe the process of cross-cultural adaptation of OSA into Brazilian Portuguese (OSA-Brazil) and examine its reliability and validity for use with the Brazilian population. Assessment translation was guided by two international guidelines for cross-cultural adaptation of standardized instruments. Face validity was tested with 24 participants. Internal consistency, test–retest reliability, and convergent validity were tested with a convenience sample of 40 participants. The cross-cultural adaptation process concluded with a consensus among the expert panel review (r > 80%) and evidence of strong face validity. The OSA-Brazil demonstrated appropriate test–retest reliability (r > 0.70) and convergent validity with the 36-Item Short-Form Health Survey (SF-36) (p < .05). The OSA-Brazil has good face validity, test–retest reliability, and convergent validity. The assessment can be used by the Brazilian occupational therapists to assess client’s occupational competence.

Abstract Introduction The physical, social and occupational restrictions imposed by the COVID-19 pandemic have affected the health and well-being of the world population. Objective To identify the repercussions of the pandemic on the occupational participation of students, lecturers and technicians from three public universities in Northern Brazil, to compare the changes reported by participants in occupational participation before and during the pandemic, and to identify symptoms of depression, anxiety and stress self-reported. Method This is a Cross-sectional, descriptive and comparative study with a quantitative approach. One hundred and ninety-nine (n = 199) participants (students, lecturers and technicians) responded to an online questionnaire, the “Occupational Participation Checklist” and the Anxiety, Stress and Depression Scale (DASS-21). Data analysis were descriptive and also performed by applying the Wilcoxon and Mann-Whitney tests. Results During the pandemic, an increase in occupational participation was identified for all participants in domestic activities (p <0.001) and a decrease in work and study face to face (p <0.001). Students reported more symptoms of depression, anxiety and stress when compared to lecturers (p<0.001). Most students did not organise their time to fulfil their occupations with satisfaction. Such difficulties were associated with symptoms of depression, anxiety and stress, especially among the student's group (p<0.001). Conclusion This study provided preliminary evidence about differences in occupational participation before and during the Covid-19 pandemic. The organization of time and difficulties in occupational participation were associated to levels of anxiety, depression and stress, especially in the sample of students.

Resumo Estudos de perfil sociodemográfico são importantes para o planejamento e análise das necessidades de uma população. No campo da saúde mental, pesquisas sobre o perfil de usuários desses serviços ainda são incipientes no Brasil. Objetivou-se descrever o perfil sociodemográfico de usuários de um Centro de Atenção Psicossocial (CAPS) e verificar se existem associações entre a variável escolaridade com as demais variáveis sociodemográficas. Trata-se de estudo transversal descritivo e associativo, do tipo retrospectivo, com coleta a partir de prontuários, protocolo de acolhimento, relatório social e anamnese psiquiátrica. A análise de dados foi descritiva e com testes de associação. Identificou-se uma proporção usuários do sexo feminino no CAPS (n=324). Os usuários eram oriundos majoritariamente da Região Centro-Oeste do país (n=239), seguida da Nordeste (n=144). Os resultados indicaram um alto número de desemprego (n=130) e níveis elevados para baixa escolaridade (n=264). As variáveis: trabalho (p=0.0005), ocupação (p=0.0005), renda (p<0.0001), quantidade de filhos (p<0.007) e receber benefício (p=0.02) apresentaram correlações positivas com o nível de escolaridade. Conclui-se que pesquisas de correlação entre dados sociodemográficos e indicadores da saúde mental podem fornecer evidências para a criação de políticas públicas nesse campo e desdobramentos para a inclusão social dos usuários.

A lesão medular provoca alterações físicas, psicológicas e emocionais que repercutem na alteração de papéisocupacionais. No Brasil, há uma escassez de pesquisas sobre esse assunto, o que levanta a necessidade de investigaçõesna área. Teve-se por objetivos descrever os papéis ocupacionais e avaliar a independência de sujeitoscom lesão medular em processo de reabilitação e verificar se há relação entre as variáveis nível de independência,papéis ocupacionais e o grau de importância atribuído a estes. A pesquisa transversal foi realizada em um centrode reabilitação da cidade de São Paulo-SP, com 33 usuários em processo de reabilitação e com mais de seis mesesde lesão. Os instrumentos utilizados foram a Lista de Identificação de Papéis Ocupacionais, o Critério de ClassificaçãoEconômica Brasil-CCEB e o Índice de Barthel-IB. O procedimento para análise dos dados abrangeu cálculosnão-paramétricos e o teste de correlação de Spearman. Foram identificados quinze sujeitos paraplégicos e dezoitotetraplégicos. O nível mais prevalente no IB foi a “dependência moderada”. Para o CCEB, 42% se encontravam naclasse B2 de poder aquisitivo. Os sujeitos com lesão medular (n=33) perderam papéis sociais do passado para opresente, entretanto, manifestaram o desejo em aumentá-los no futuro. Foi identificada correlação positiva entreos papéis ocupacionais e independência (p<0,01) e dos papéis ocupacionais com o grau de importância (p<0,05).A partir dos dados obtidos sugere-se a pertinência da investigação dos efeitos das intervenções em reabilitação emrelação aos papéis ocupacionais, no sentido de favorecer a reinserção social desses sujeitos em todos os domíniosdas atividades sociais. Spinal Cord Injury (SCI) causes physical, psychological and emotional changes that impact on occupational roles. In Brazil,there is a lack of research on this subject, which raises the need for further research in this field. The aim of this studyis to describe the occupational roles and independence of individuals with SCI within the rehabilitation process and toverify if there is a relationship among the variable levels of independence, occupational roles and the degree of importanceassigned to these. A cross-sectional survey was conducted in a rehabilitation center of the city of São Paulo, Brazil, with 33users in rehabilitation process, with more than six months of injury. The instruments used were the Role Checklist, the EconomicClassification Criterion Brazil-CCEB and Barthel Index-IB. The procedure for data analysis included non-parametricand Spearman Correlation Test. We identified fifteen subjects with paraplegia and eighteen with tetraplegia. The IB levelmore prevalent was the “moderate dependence”. For CCEB, 42% of the participants were in class B2 of purchasing power.All individuals with SCI (n = 33) lost occupational roles from past to present, however, they expressed a desire to increasethem in the future. A positive correlation was found between the occupational roles and independence (p<0.01) and alsothe occupational roles with the degree of importance (p<0.05). From data obtained we suggest the relevance of researchon the effects of interventions in rehabilitation as regards occupational roles, in order to promote the social reintegrationof these individuals in all areas of activities and social participation.

Com o aumento da população idosa tem-se um expressivo crescimento das doenças crônicas, uma delas é o Acidente Vascular Cerebral. A lesão provoca, dentre suas várias sequelas, a hemiplegia, a qual dificulta a mobilização do membro superior e inferior de um hemicorpo, diminuindo a funcionalidade e a qualidade de vida do indivíduo acometido pelo Acidente Vascular Cerebral. A Terapia por Contensão Induzida é uma das diversas terapias, utilizadas para reduzir as incapacidades que prejudicam a funcionalidade do membro afetado. Esta revisão de literatura teve como objetivo identificar se a Terapia por Contensão Induzida, aplicada ao membro superior de indivíduos hemiplégicos, por Acidente Vascular Cerebral, manteve seus resultados em longo prazo. Foram analisados seis artigos que aplicaram este tipo de terapia em seus sujeitos e os observaram durante pelo menos um mês após o pós-teste. Como resultado, identificou-se que foram utilizados diferentes tipos de avaliações, as quais calculavam o tempo de realização das atividades, quantidade e qualidade de uso dos membros superior comprometido. A revisão mostrou que a terapia por contensão induzida tende a manter seu resultado positivo, porém com algumas quedas dos escores das avaliações utilizadas sem, no entanto, haver uma regressão da pontuação inicial dos sujeitos no nível do pré-teste.

Objetivo: O ensaio fotográfico propõe, a partir do conceito de Nomofobia, refletir sobre o aspecto negativo da tecnologia móvel nas ocupações humanas. Descrição da imagem: É contextualizado brevemente o desenvolvimento da tecnologia de modo geral e suas diferentes consequências para os sujeitos na sociedade. A partir de quatro imagens ilustra-se a des-conexão com o mundo real, a contradição do estar em grupo, mas solitariamente, a dependência e o uso do tempo com a tecnologia móvel. Por fim, aponta-se a necessidade de pesquisas e de intervenções na terapia ocupacional, referindo-se à tecnologia móvel dentro do conceito de engajamento e desengajamento ocupacional. Palavras-chave: Telefone Celular. Ocupações Relacionadas com Saúde. Tempo de Tela. Terapia Ocupacional. AbstractObjective: From a photographic perspective, this essay proposes reflections based on the concept of Nomophobia, considering the negative side of mobile technology in human doings. Picture descripition: The development of technology in general and its different consequences for man in the society is briefly contextualized. Four photos illustrate the dis-connection with the real world, the contradiction of being in a group, but alone, the dependence and use of time with cell phones. Finally, the need for research and interventions in occupational therapy is pointed out, referring to mobile technology within the concept of occupational engagement and disengagement.Keywords: Cell Phone. Allied Health Occupations. Screen Time. Occupational Therapy. ResumenObjetivo: Desde una perspectiva fotográfica, este ensayo propone, desde el concepto de Nomofobia, considerar el lado negativo de la tecnología móvil en las actividades humanas. Descripción de la imagen: El desarrollo de la tecnología en general y sus diferentes consecuencias para el hombre se contextualiza brevemente. Cuatro fotos ilustran la desconexión con el mundo real, la contradicción de estar en un grupo, pero solo, la dependencia y el uso del tiempo con los teléfonos celulares. Finalmente, se señala la necesidad de investigación e intervenciones en terapia ocupacional, refiriéndose a la tecnología móvil dentro del concepto de involucración y desinvolucración ocupacional.Palabras clave: Teléfono Celular. Empleos Relacionados con Salud. Tiempo de Pantalla. Terapia Ocupacional.

Purpose This study aims to explore the changes in occupations experienced by individuals with Lyme Disease, their strategies to re-engage in their meaningful occupations and future aspirations to better understand their occupational participation and engagement. Design/methodology/approach This is a qualitative descriptive survey. A form with four questions was distributed online on three social media platforms, achieving 27 full responses. Data were analysed using Reflexive Thematic Analysis. Findings Three main themes were generated: 1) Living with the effects of the unknown, 2) Experiencing occupational losses and changes and 3) “I know my limits”: adapting lives. Originality/value To the best of the authors knowledge, this is the first study conducted with individuals with Lyme Disease from an occupational perspective. Their study is a pioneer in identifying how the condition impacts individuals’ occupations, revealing their strategies to re-engage in meaningful occupations. Therefore, this study contributes to producing evidence for occupational science and future occupational therapy interventions.

Background. The core concepts of occupational performance, occupational engagement, and occupational participation are unique to the occupational therapy profession. However, their definitions and applications are inconsistently presented across conceptual models of practice and have been challenged within the occupational therapy and occupational science literature. Objective. This study aimed to describe the discursive controversies presented within the occupational therapy literature for the inclusion or exclusion of the three core concepts within occupational therapy. Methods. A conceptual review of the literature was undertaken to uncover applications and controversies of the three core occupational concepts. Each concept was analysed based on its features, attributes, and characteristics (Podsakoff, 2016) through an anti-oppressive lens. An anti-oppressive lens within occupational therapy focuses on minimizing discourses and practices that exclude or limit certain social groups from achieving occupational equity and rights through autonomous informed decision making about their occupational lives. Results. The applications of the three core concepts appeared to be distinct, yet, related, and covered the breadth of occupational outcomes desired across social groups. Removing core concepts would lead to occupational inequities. Conclusions. The inclusion of all three concepts as core outcomes of occupation-centred practice ensures the professions focus on occupational equity across diverse social groups.

As occupational therapy is increasingly recognized as an important healthcare profession worldwide, the time is suitable to develop a Global Occupational Therapy Think Tank (GOTTT) for promoting international collaboration, advancing the profession globally, and addressing global challenges in an inclusive manner. The global COVID-19 pandemic raised the importance of establishing a platform for exchange, so a group of occupational therapy scholars and practitioners from around the world formed the GOTTT in 2021. The group intentionally sought members from all continents. Members collectively formulated the mission and vision of the GOTTT, seeking to reflect knowledge, experience, and best practices of occupational therapy worldwide. The actions of GOTTT are aimed toward increased recognition, support, and resources for the profession, ultimately benefiting the individuals, groups, and communities served by occupational therapy. As its first project, the think tank examined the global occupational therapy response to COVID-19 by synthesizing medical research findings, intervention case studies, and international OT practice stories. We present the GOTTT and its goals with some reflections about the global response of OT in regard to the COVID-19 Pandemic.

Com o aumento da população idosa tem-se um expressivo crescimento das doenças crônicas, uma delas é o Acidente Vascular Cerebral. A lesão provoca, dentre suas várias sequelas, a hemiplegia, a qual dificulta a mobilização do membro superior e inferior de um hemicorpo, diminuindo a funcionalidade e a qualidade de vida do indivíduo acometido pelo Acidente Vascular Cerebral. A Terapia por Contensão Induzida é uma das diversas terapias, utilizadas para reduzir as incapacidades que prejudicam a funcionalidade do membro afetado. Esta revisão de literatura teve como objetivo identificar se a Terapia por Contensão Induzida, aplicada ao membro superior de indivíduos hemiplégicos, por Acidente Vascular Cerebral, manteve seus resultados em longo prazo. Foram analisados seis artigos que aplicaram este tipo de terapia em seus sujeitos e os observaram durante pelo menos um mês após o pós-teste. Como resultado, identificou-se que foram utilizados diferentes tipos de avaliações, as quais calculavam o tempo de realização das atividades, quantidade e qualidade de uso dos membros superior comprometido. A revisão mostrou que a terapia por contensão induzida tende a manter seu resultado positivo, porém com algumas quedas dos escores das avaliações utilizadas sem, no entanto, haver uma regressão da pontuação inicial dos sujeitos no nível do pré-teste.

Introduction: Functional mobility is a common aspect involved in spinal cord injured patients, requiring the use of a wheelchair. Although this resource is fundamental in the rehabilitation of these individuals, several aspects related to the physical environment can interfere with the levels of functional mobility. Objective: To describe aspects related to functional mobility with a wheelchair in patients with spinal cord injury. Method: This is a descriptive study with samples composed of 11 patients with spinal cord injuries from an association of people with disabilities in a medium-sized city of São Paulo State. For data collection, a Spinal Cord Injury Identification Form was used. Data were analyzed through simple descriptive analysis. Results: Most of the sample used a motorized wheelchair (63.63%; n = 7) and reported barriers in the home environment (81.81%; n = 9), on the sidewalk (90.90%; n = 10) and in the block of the household (90.90%; n = 10). Despite these barriers, 100% (n = 11) reported independence for mobility at home and 90.90% (n = 10) outside. Among the reported mobility difficulties, there were limitations for transfers to the car (54.54%; n = 6), transfers to surfaces of the same height (36.36%; n = 4), and transportation of the wheelchair in own vehicle (63.63%; n = 7). Conclusion: The findings demonstrate the relevance of interventions aimed at promoting functional mobility in individuals with spinal cord injury with an emphasis on the physical environment and assistive technology resources.

BACKGROUND: Working part-time or full-time is a persistent dilemma for women, especially mothers, as they strive to manage their time across various roles. However, the existing literature remains unclear on whether part-time work contributes more to life satisfaction than full-time work. OBJECTIVE: This study aims to describe and compare time-use patterns in different occupational roles and levels of life satisfaction among 795 mothers in Brazil who are employed either part-time or full-time. METHODS: Data was collected through an online survey and the snowball technique. Regression and correlation analyses were performed on the data obtained from the following instruments: the Role Checklist for assessing time-use within occupational roles, the Satisfaction with Life Scale, and demographic information. RESULTS: Our analysis revealed no significant differences in life satisfaction between mothers working full-time and those working part-time (t (793)=1.160, p = 0.24). However, life satisfaction scores were positively correlated with the number of occupational roles performed (r = 0.222, p <  0.01), higher family income (P <  0.001), and engagement in social roles such as Friend (r = 0.106, p = 0.003), Hobbyist/Amateur (r = 0.08, p = 0.018), and Caregiver (r = 0.07, p = 0.026). CONCLUSION: While our society places significant emphasis on time spent at work, our findings highlight that life satisfaction extends far beyond the dichotomy of working part-time or full-time. There are deeper dimensions to consider, including the number of occupational roles, family income, and engagement in social roles, which have a more substantial impact on overall life satisfaction.

Abstract This Opinion in the Profession is based on the enduring legacy of Elizabeth June Yerxa, a pioneering leader in occupational therapy and occupational science, following her passing in December 2024. Rather than a traditional "in memoriam," the author uses the present tense to emphasize Yerxa's ongoing influence. The paper highlights four key themes from Yerxa’s work: the commitment of occupational therapy to social change, the importance of an occupation-centered education, the term “engaging in occupation”, and the establishment of occupational science as a foundational discipline. Yerxa’s advocacy for critical thinking, holistic perspectives, and the integration of diverse fields in occupational therapy education is explored, alongside her challenges to conventional approaches in the profession. Central to her vision was the recognition of occupation as a vital force in human life, transcending the medical model and focusing on personal and societal well-being. The piece urges current occupational therapists to draw inspiration from Yerxa’s work, particularly in times of societal uncertainty, and to continue her advocacy for a more inclusive, compassionate world. Yerxa’s leadership, based on personcentered care and social justice, remains a beacon for the future of occupational therapy and science. Comments The author declares that they have no competing financial, professional, or personal interest that might have influenced the performance or presentation of the work described in this manuscript. Keywords occupational science, occupational therapy, leadership, occupational engagement

"Philosophy and Occupational Therapy: Informing Education, Research, and Practice provides an overview of the most influential philosophical movements from past to present and shows how these philosophies are a foundational, yet ...

"Perspectives on Occupational Therapy Education: Past, Present, and Future outlines a path forward for occupational therapy educators, incorporating the impact of historical context, contemporary issues and trends, and international ...

Background Dementia is among the most common chronic noncommunicable neurodegenerative diseases. In the long term, it causes disability and loss of autonomy and independence. It is estimated that there are 35.6 million people with Alzheimer’s disease worldwide. Several clinical aspects of this disease have been widely studied, but the main focus of study has been memory loss, which is one of the first symptoms. The present study proposes an innovative intervention that combines cognitive training and multisite transcranial direct current stimulation, which interferes with other clinical aspects of the subject. Case presentation In this study, we present two subjects diagnosed with mild Alzheimer’s disease. Subject 1 is an 82-year-old Brazilian Latin American woman with a high school education who was diagnosed with Alzheimer’s disease 8 years ago and uses an Exelon patch. Subject 2 is an 88-year-old Brazilian Latin American woman with an incomplete primary education who was diagnosed with Alzheimer’s disease 1 year ago and received medical orientation to temporarily discontinue medications for Alzheimer’s disease. Both participants were subjected to intermittent cognitive training sessions and concomitant transcranial stimulation in three weekly 30-minute sessions in which a brain area was stimulated every 10 minutes for a total of 24 sessions, with a 2-month follow-up. Transcranial stimulation was applied to six different regions of the cortex: the dorsolateral prefrontal cortex bilaterally, the somatosensory association cortex bilaterally and Broca’s and Wernicke’s areas. Comparing the results of tests performed before and after the treatment period, a 1-point improvement was observed for both subjects on the Word Recall task of the Alzheimer Disease Assessment Scale, which evaluates symptoms related to the decline of episodic memory. Improvement in the executive functions domain was also observed through the results of the Stroop test, Victoria version. Conclusions The results from the two presented cases show that multisite transcranial stimulation associated with cognitive training is an effective adjuvant method for the treatment of patients diagnosed with mild Alzheimer’s disease. Its effects can benefit patients’ daily routines by reducing cognitive deficits by keeping intact areas active and/or compensating for lost functions.

OBJECTIVE: to verify whether there are associations among occupational roles, independence to perform Activities of Daily Living, purchasing power, and assistive technology for individuals with physical disabilities. METHOD: 91 individuals with physical disabilities participated in the study. The instruments used were: Role Checklist, Brazilian Economic Classification Criterion, Barthel Index, and a Questionnaire to characterize the subjects. RESULTS: an association with a greater number of roles was found among more independent individuals using a lower number of technological devices. Higher purchasing power was associated with a lower functional status of dependence. CONCLUSION: even though technology was not directly associated with independence, the latter was associated with a greater number of occupational roles, which requires reflection upon independence issues when considering the participation in occupational roles. These findings support interdisciplinary actions designed to promote occupational roles in individuals with physical disabilities.

INTRODUÇÃO: Dentre as preensões utilizadas para a escrita a trípode dinâmica apresenta a maior prevalência entre a população. Apesar de considerada padrão para a escrita manual, são escassos estudos que envolvam a análise da amplitude articular das mãos durante esta atividade. OBJETIVO: Obter as variações das amplitudes de movimento das articulações distais do membro superior durante a atividade de escrita manual em adultos. METODOLOGIA: 50 adultos jovens, destros e sem comprometimento no membro superior tiveram suas mãos fotografadas durante a escrita e posteriormente analisadas através do Software de Avaliação Postural (SAPO). RESULTADOS: Foi observado um padrão comum de pronação de antebraço, abdução entre I e II metacarpianos e fl exão de metacarpofalangeana e interfalangeana proximal do II dedo, similar às descrições encontradas na literatura. CONCLUSÃO: Foi possível estabelecer um padrão postural por meio da análise fotogramétrica, demonstrando a aplicabilidade deste método para a análise da motora do membro superior durante a atividade de escrita manual.

A  Estrutura da Prática da Terapia Ocupacional: Domínio e Processo  é um documento oficial da Associação Americana de Terapia Ocupacional (AOTA). Com a intenção de consultas internas e externas, este documento apresenta um sumário de idéias inter-relacionadas que definem e guiam a prática da terapia ocupacional6. A Estrutura  foi desenvolvida para articular a contribuição da terapia ocupacional na promoção de saúde e participação de pessoas, organizações e populações através do  envolvimento7  na  ocupação.

A partir de um relato de caso tem-se por objetivo apresentar o efeito da tecnologia assistiva na independência para Atividades de Vida Diária-AVDs, pós lesão da medula espinal. São apresentadas as adaptações e órteses prescritas e confeccionadas para uma paciente com tetraplegia C6 (ASIA A), ao longo de sete meses de reabilitação em terapia ocupacional hospitalar. O instrumento utilizado para a coleta de dados foi a Medida de Independência Funcional-MIF. Embora a classificação de dependência modificada não tenha sido alterada, os resultados mensurados em valores quantitativos no escore total da MIF aumentaram de 50 para 64 e permitem discutir a melhora na independência para os itens de alimentação e autocuidado, a partir do treino com adaptações. As AVDs instrumentais:uso do computador, leitura e escrita também foram promovidas com o uso de tecnologia assistiva. Por fim, a importância da pesquisa em tecnologia assistiva é destacada a fim de favorecer indicadores de melhora na reabilitação e, no sentido clínico, maior possibilidade de independência no desempenho ocupacional desses pacientes.

Diante as diversas pesquisas acerca da violência realizada em diferentes áreas, o objetivo deste artigo é discutir o fenômeno da violência e suas relações com a deficiência no desenvolvimento humano. Enquanto metodologia foi realizada uma revisão de literatura nos últimos dois anos, destacando-se alguns tipos de violência e suas relações com a deficiência. Como considerações, sugere-se o fomento de pesquisas nesta linha de investigação e a necessidade de maior proximidade de profissionais da área da saúde e educação, com a comunidade, no contexto da prevenção e promoção do desenvolvimento infantil.

Occupation-centred practice positions occupation as the primary content of intervention, the intended outcome, or both (Fisher, 2013; Polatajko & Davis, 2019). This perspective requires occupational therapy students to understand the variations and complexities of occupation to enable occupational performance and participation in future practice. Although occupation-centred practice has been the philosophically foundation of occupational therapy for over a quarter century, its uptake across practice settings and with novice practitioners has been limited (e.g., Jewell et al., 2016; Jones et al., 2022). However, workplace interventions have resulted in a shift in occupational therapists’ thinking and use of occupation in practice (Bennetts et al., 2025; Colquhoun et al., 2012). In this symposium, a critical overview will be provided of empirical theories, models, and frames of reference that support occupational therapy students in developing a mental model of the complexity of occupation. Using this information, attendees will identify and map the pedagogical approaches, practice tools, and learning activities they use, or would like to use, to teach occupation in their curricula. A collective action plan will be generated to encourage the use of critical pedagogies in teaching the complexities of occupation to support diverse competencies required for occupation-centred practice uptake in occupational therapy

Occupational therapy curricula are designed to develop students’ knowledge, skills, and attitudes that will support future practice. Although educational programs often assume that learning the curricular content will lead to doing, replicated evidence suggests that increasing knowledge, skills, and attitudes alone does not lead to their application in real-world situations (Benfield & Jeffery, 2022; Jones et al., 2022). Accordingly, habits of doing must be developed. Evidence supports the use of occupational therapy theory and evidence-based practice in habit development and modification with clients, and researchers have demonstrated that teaching habits of doing can be effective with occupational therapy students (Cohn et al., 2014; Dutra et al., 2018; Hilton, et al., 2010). This symposium will describe essential learning activities (e.g., evidence-based practice, curiosity, critical reflection, self-regulated learning) that have been targeted for developing habits of doing by students. Participants will be asked to analyse the educational activities that they use to develop habits of doing and identify practical strategies for their own curriculum. Participants will be encouraged to share learning activities and instructional strategies used to foster student engagement and identify feasible actions that can be incorporated into their current educational activities to ensure habits of doing that support diversity competence.

Every day, occupational therapy practitioners, students, and educators encounter uncertainty: “the dynamic, subjective perception of not knowing what to think, feel, or do” (Lee et al., 2021, p. 1195). Practitioner uncertainty arises from clients’ complex diverse needs within unique contexts that require novel and innovative, individualized solutions. As such, the ability to manage uncertainty has been positioned as an occupational therapy competency (Galvaan et al., 2021) that must be explicitly taught in health professions education (Stephens & Lazarus, 2024). Leveraging uncertainty can lead to opportunities for self-regulated learning and creativity. This workshop will provide opportunities for critical reflection of experiences of uncertainty and dialogue about educational strategies to support learning from a pedagogy of uncertainty. A brief literature review will provide a foundation for small group dialogue of educators’ experiences in navigating uncertainty in occupational therapy. Each group will discuss strategies for teaching uncertainty and how it can be leveraged to increase competency and innovation. Humility and uncertainty tolerance can be supported by applying effective strategies for discovery of information, curiosity of learning, and creativity in identifying interventions to support clients’ goals. Educators will create an action plan for applying strategies for leveraging uncertainty to foster humility through their teaching

In tribute to Elizabeth Yerxa, this reflective piece revisits her foundational vision for occupational science as a transformative, inclusive, and ethically grounded discipline. Anchored in her assertion that occupational science offers “a significant, viable, fresh way of thinking about the occupational human,” we explore four interrelated themes: Significant, Viable and fresh, For all, and A way of thinking. We argue that significance lies not only in practical application but in the discipline’s capacity to challenge epistemic and social exclusions. Viability and freshness are framed as commitments to methodological pluralism and epistemological sustainability, embracing interpretive, participatory, and culturally situated approaches. The call to serve ‘all people’ demands a reconfiguration of who is recognized as a knowledge producer, supporting occupational science to engage with historically marginalized voices and knowledges. Finally, we position occupational science as a way of thinking, an ethical and political praxis that links knowledge production to social transformation. As scholars navigating multiple epistemic traditions, we reflect on the internationalization of the field and its potential to foster dialogue across differences. In the spirit of Yerxa and Freire, we conclude with questions to provoke collective dialogue (reflection and action) toward a more just and inclusive occupational science.

Purpose The purpose of this study is to critically examine how artificial intelligence (AI) influences and is influenced by human occupation through a critical occupational lens. Design/methodology/approach Using a critical occupational perspective, this study examines the reciprocal relationship between AI and human occupation. Interdisciplinary literature and reflective analysis are integrated to explore ethical, social, and contextual implications. Findings Emphasising that AI is not neutral but embedded in socio-technical systems, this paper urges occupational therapy practitioners and scholars to engage with AI critically, ethically and contextually. Research limitations/implications The piece has final considerations with reflective questions and recommendations for embedding human dignity, sustainability and equity at the centre of AI development and use in occupational therapy practice. Originality/value Occupational therapy practitioners and scholars are called to recognise its potential to both enable and constrain occupational justice.

Introduction:Assistive equipment and technology (AE&T) is often part of occupational therapy practice for individuals with multiple sclerosis (MS). We aim to explore the acceptability and usability of AE&T by people with MS from the perspective of occupational therapists. Methods:Our study applied a qualitative descriptive design, using semi-structured interviews conducted with five qualified occupational therapists with at least 6 months of experience in providing occupational therapy to adults with MS. Reflexive thematic analysis was used for data analysis. Findings:Three developed themes describe the occupational therapists’ experiences: ‘The cognitive impact of the illness rather than the physical’, ‘There’s a drive to not let the MS win’ and ‘They have to experience it by doing’. Therapists perceive cognitive changes, the meaning of technology and a person-centred approach as elements influencing the acceptability and usability of AE&T. Conclusion:Our findings highlight the importance of using core occupational therapy principles and approaches to best support people with MS in using AE&T effectively.

Introduction: Premenstrual syndrome is commonly experienced by women of reproductive age and encompasses somatic, psychological and behavioural symptoms that recur during the luteal stage of menstrual cycle and resolves during or after menstruation. Although premenstrual syndrome has gained growing interest in recent years, the experience of women living with premenstrual syndrome has not yet been explored from an occupational perspective. Method: This qualitative study an used exploratory and descriptive design to gain a deeper understanding of the lived experience of women with premenstrual syndrome through an occupational lens. Data were collected using semi-structured interviews with four women living with premenstrual syndrome symptoms. Each interview was transcribed verbatim and thematically analysed. Findings: Three themes were identified: (1) occupational disturbance, (2) social impairment and occupational disengagement, and (3) the importance of self-awareness to engage in occupations. Women with premenstrual syndrome symptoms experienced difficulties that impacted their ability to engage in occupations including self-care, productivity and leisure, interfering with their occupational routine and interpersonal relationships. A level of awareness was considered important to manage premenstrual syndrome symptoms. Conclusion: The findings of this study are relevant to understanding the impact of premenstrual symptoms on daily living and for tailoring future interventions to address the occupational needs in women with premenstrual syndrome.

Introduction The COVID-19 pandemic has significantly impacted on service provision for adults who have a learning disability, resulting in reduced occupational activities, routine, and social contact. Objective To analyse referrals received for Occupational Therapy intervention for adults who have a learning disability pre-COVID-19 (2019) and during COVID-19 (2020). Method This is a descriptive study conducted as a service evaluation with an NHS Trust Clinical Effectiveness Team in a city in the North of England. The data source was obtained from referral documentation. Quantitative and qualitative data were extracted from a data Performa and analysed using descriptive statistics (mean, median, mode, and standard deviation) performed by the Software Microsoft Excel. Results The total number of cases used in this evaluation was 274. There was an increase in referrals during the COVID-19 pandemic, the greatest increase was for Occupational Therapy intervention focusing on engagement in meaningful occupation. Over both years the predominant referrals were for equipment reviews. Conclusion Data collected captures a broad range of information regarding Occupational Therapy service provision pre and during the COVID-19 pandemic and puts this in the context of future considerations regarding the Occupational Therapy services for adults who have a learning disability.

Many autistic women without an intellectual disability receive their diagnoses later in life. Little is understood about how gender, autism, and a late diagnosis intersect to impact the occupational identity of these individuals. Purpose: the current study aimed to explore how autistic women who received a diagnosis in adulthood describe key areas that influence the development of occupational identity. Methods: eight participants recruited from social media were interviewed through semi-structured interviews, and a reflexive thematic analysis was conducted on the rich accounts of their lived experiences. Results: three major overlapping themes included experiencing disconnection from one’s own volition, striving for occupational balance, and acceptance as a protective factor within these women's lives. Subthemes were in relation to personal reconciliation around difference and the dynamic between the person, environment, and the dominant socio-cultural context. The political, social, and economic landscape perpetuating neoliberal, individualistic and ableist ideals within practice is criticised considering the lived experiences presented in the findings. Conclusion: the necessity for collective health promotion through improving the basic standard of living according to the social determinants of health is highlighted.

Alopecia Areata (AA) is a chronic condition that causes unpredictable hair loss, often leading to significant psychological distress. While the social and medical implications of AA have been explored, the occupational impact has not been considered. This scoping review aimed to explore the lived experiences of individuals with AA from an occupational perspective. A five-stage methodological framework was followed, with a search conducted across three databases (2003–2023), identifying key terms related to AA and its effects on both children and adults. Eleven qualitative studies were selected from an initial 265 results, including 989 participants aged 10-79, mainly from North America and the UK. Data were analysed thematically, identifying three key themes: 1) Navigating AA through occupations across the lifespan, 2) Occupational Engagement in Self-Care is not Always Pleasurable, and 3) The connection between the meaning of hair and its loss with daily occupations. The review concluded that AA affects various aspects of life, including work, study, self-care, and physical activities. While the condition can be distressing, it sometimes leads to the development of new, meaningful occupations. These findings highlight the potential role of occupational therapists in supporting individuals with AA.

Introduction: Belonging has been explored in higher education research, focusing on student engagement, performance, and psychological impacts on learning. However, few studies examine the experiences of underrepresented students. This study explores the lived experiences of belonging among occupational therapy students, including their practice placement experiences. Methods: Using a phenomenological approach, semi-structured interviews were conducted with six occupational therapy students from the United Kingdom. Data were analysed using Reflexive Thematic Analysis (RTA). Findings: Three themes were created: "Representation and Belonging" – Participants highlighted experiences of underrepresentation, with one noting, “I was the only non-white person in the room.” "Navigating Between Being and Doing" – Students expressed frustration with limited action following discussions on inclusion, asking, “We’ve done a lot of talking, what are we going to do? "Institutional Oppression" – Participants questioned whether institutions fully recognise systemic barriers, with one student stating, “Are they even aware?”. The research illustrates how doing, being, becoming, and belonging interact at individual, regional, and national levels. The collective voices of students from a public university in Northern England reflect broader systemic dynamics within UK higher education. Implications for Occupational Science: The sense of belonging fluctuates based on individual, cultural, and environmental factors. Findings highlight the need for occupational therapy education to implement effective strategies that foster belonging and promote inclusive practices. These insights contribute to a deeper understanding of how higher education can better support diverse student populations.

Belonging has been explored in research in higher education with a focus on student engagement or performance and the impact of psychological aspects on individuals' learning. Few studies focused on underrepresented occupational therapy students’ belonging. Our research aimed to explore the lived experience of occupational therapy students regarding belonging at university. This phenomenological study was conducted with six occupational therapy students from the United Kingdom who volunteered to participate in semi-structured interviews. Data analysis was carried out through Reflexive Thematic Analysis (RTA). Three themes were constructed: Theme 1: Representation and belonging - “I was the only non-white person in the room”; Theme 2: Navigating between being and doing - “we've done a lot of talking, what are we going to do?”, and Theme 3: Societal and Institutional Oppression - “Are they even aware?”. The sense of belonging appeared to fluctuate according to individuals, places, and cultures. Our analysis suggests considerations for further occupational therapy education regarding effective strategies to enable belonging, as well as inclusive practices in higher education.

Introduction Increasingly occupational therapy programmes have complemented traditional practice placements with Role Emerging Placements (REPs) in settings with no existing occupational therapy provision. Previous research has predominantly explored the student experience of such placements with largely favorable findings. However, there is a lack of understanding regarding the professional practice-based skills students develop within REPs. Objective To measure and compare students’ competencies for occupational therapy practice developed within Role Emerging Placements (REP) to those in ‘traditional’ practice placements. Method A retrospective cohort study design was used to analyze data extracted from the Competency Based Fieldwork Evaluation for Occupational Therapists (CBFE-OT) of MSc pre-registration occupational therapy UK students (n=181). Descriptive and inferential statistical analysis measured and compared student fieldwork competency scores between four placements, one of which was a Role Emerging Placement (REP). Results Students scored significantly higher in ‘Communication’ and ‘Professional Interactions’ compared to all other practice competencies but scored significantly less well in ‘Clinical Reasoning’ and ‘Practice Knowledge’ regardless of placement model. However, in a REP, students scored significantly higher in ‘Performance Management’ compared to traditional placements (z=-2.222 p=0.026). Conclusion Students can develop similar skills of competence to practise in a REP as traditional placements and may better develop leadership and time management skills. These additional skills may advantage students in developing their careers and scoping the profession.

Background: COVID-19 and long COVID have had an impact worldwide on people’s participation in occupations. Occupational therapists play a role in supporting individuals' recovery and participation in daily life. Objective: The present study undertook a scoping review of research on COVID-19 and long COVID to map the occupational therapy process with this population, including evaluation, intervention, and outcomes. Methodology: Three online databases were searched to identify research papers published between 2020-2023 from all countries, published in English, Portuguese, or Spanish. From 455 texts, 25 studies were selected for this review. Results: Studies were conducted across varied healthcare settings, mainly inpatient hospitals. Participants ranged from children to older adults, with adults being the most represented group. Standardised assessments included occupational history, activities, body functions, cognition, and emotional regulation. Interventions were educational, compensatory, restorative, or acquisitional, with outcomes focused on daily living activities, performance skills, and client factors.

Introduction: The number of women surviving after breast cancer is increasing, along with the length of time they are living with the after-effects of treatment. Although the treatment’s effects are known to impact occupational participation, little is known about how breast cancer could affect occupational identity. This study aims to illuminate the lived experience of women long-term after breast cancer treatment through an occupational perspective in order to explore how they perceive their occupational identity. Methods: A qualitative study with semi-structured interviews was conducted with six women, who had all received a diagnosis of breast cancer and treatment for longer than a year. Reflexive Thematic Analysis was used to analyse the data. Findings: Three intertwined themes describe the participants’ experience. (1) ‘Disruptions in daily life and Environmental support’, (2) ‘Be able to do’ and identity, and (3) ‘Doing what matters and is possible’. Findings revealed that the occupational identities of the participants were maintained. Cancer treatment effects appear to impact occupational competence that corresponded to participants’ occupational identities, suggesting difficulties in the order of occupational adaptation. Conclusion: Our findings contribute to understanding the challenges to occupational participation related to the occupational identity of women following breast cancer and treatment.

The purpose of this study was to identify the level of burden and quality of life of family caregivers of stroke patients and to investigate the correlation between burden, quality of life (including physical, social, psychological, and environmental domains), age of caregivers, and the care period. A descriptive correlational cross-sectional study was performed, with a convenience sample of family caregivers (n = 30) of stroke patients in São Paulo, Brazil. Data were collected using a questionnaire on participants’ characteristics, the Zarit Burden Interview Scale (ZBIS), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) instrument. A descriptive analysis was performed, and correlations between variables were analyzed using Pearson's product-moment correlation coefficient. The average burden score on the ZBIS was 29.6, representing a moderate burden, and the average overall quality of life score on the WHOQOL-BREF was 62.06%, which indicates moderate quality of life. A significant weak negative correlation was observed between burden and environmental domains (r = −0.470; p =.009), quality of life (r = −0.414; p =.023), and physical domains (r = −0.394; p =.031). No significant correlations were found between burden and quality of life, and variables in the psychological and social domains, age of caregivers, or care period. Caregivers for stroke patients presented with moderate levels of burden and reduction in quality of life. Levels of burden correlated negatively with environmental domains, quality of life levels, and physical domains; however, these correlations were weak, indicating the possible interference of other factors.

Introduction: The first occupational therapy (OT) undergraduate programme in Brazil opened in 1956 in Rio de Janeiro by the "Associa§£o Brasileira Beneficente de Reabilita§£o", as a technical educational course. It became a university undergraduate programme only in 1969. The aim of this article is to provide a comprehensive overview of the development of OT undergraduate programmes in Brazil. In addition, a mapping of the distribution of existing educational courses in Brazil will be reported through an historical overview. From 1958 until 1986, 15 undergraduate programmes were identified. Between 1987 and 1999, this number increased to 24 and finally between 2000 and 2011 this number was raised to 75 across the whole country. There are some significant differences between the OT courses, depending on the region of the country. The lecturing laboratory spaces that drew the most attention were the Assistive Technology Laboratories, which only began to appear in the middle of the 2000s.  Conclusion: There was a marked increase throughout the last decade in the number and the quality of OT undergraduate programmes in Brazil, which consequently enhanced the number of occupational therapists in the country, improved standards within the profession and brought advances in the field of practice. In order to understand the role of the practitioners in the contemporary world a dialogue between different countries and continents plays an important role when reflecting on the OT undergraduate programmes.  Keywords: occupational therapy, undergraduate programmes, educational institutions.  

There are few correlational studies comparing family-work reconciliation between groups of women. OBJECTIVE: We intend to correlate and compare the use of time, purchasing power, and job satisfaction between two groups of working women, women with children and women without children. METHODS: This is a correlational and comparative study. The following instruments were used: Activities Diary; Brazilian Criteria for Economic Classification; and the short version of the Quality of Working Life Questionnaire. A total of 171 women participated in the study: one group was composed of 78 women with children and the other group was composed of 93 women without children. Data were analyzed using the Shapiro-Wilk test, Wilcoxon test, Student's t-test and the Kolmogorov Smirnov test. RESULTS: Women with children spent more hours/day on hygiene, taking care of elderly individuals, practicing their religion, and studying (p = 0.001), but they presented no statistical differences in job satisfaction from those women without children (p = 0.2362). Women with children belonged to a higher economic classification and had greater purchasing power than women without children. CONCLUSIONS: Having children is a variable that influences time use, purchasing power, and job satisfaction among women and the presence of children is a factor that may increase the purchasing power of a woman.

For handwriting, mature grasps are considered the most effi cient and recommended by educators and therapists, as they demand less energy loss and less tension in the proximal region of the upper limb. Some people use other grasps patterns that are also functional, however it is unknown what problems that may arise from use of these grasps. Knowing the types of grasp in young adults can support researches that relates the grasp used during functional activities with its implications. This study, quantitative, descriptive, cross-sectional, population- based, identifi ed the types and prevalence of pencil grasps used by 806 adults university students, all right handed, of both genders, without functional impairment of the upper limbs. The handwriting activity was fi lmed, and the images were analyzed and identifi ed. The results revealed the most frequent pattern was the dynamic tripod grasp, followed by lateral tripod, both mature grasps. The transition grasps and variations was identifi ed in 34,86% of the sample. Future researches could include excessive use of body structures and injuries in the upper limb, helping to provide suitable guidelines for the prevention and rehabilitation treatments of injuries.

A lesão medular provoca alterações físicas, psicológicas e emocionais que repercutem na alteração de papéisocupacionais. No Brasil, há uma escassez de pesquisas sobre esse assunto, o que levanta a necessidade de investigaçõesna área. Teve-se por objetivos descrever os papéis ocupacionais e avaliar a independência de sujeitoscom lesão medular em processo de reabilitação e verificar se há relação entre as variáveis nível de independência,papéis ocupacionais e o grau de importância atribuído a estes. A pesquisa transversal foi realizada em um centrode reabilitação da cidade de São Paulo-SP, com 33 usuários em processo de reabilitação e com mais de seis mesesde lesão. Os instrumentos utilizados foram a Lista de Identificação de Papéis Ocupacionais, o Critério de ClassificaçãoEconômica Brasil-CCEB e o Índice de Barthel-IB. O procedimento para análise dos dados abrangeu cálculosnão-paramétricos e o teste de correlação de Spearman. Foram identificados quinze sujeitos paraplégicos e dezoitotetraplégicos. O nível mais prevalente no IB foi a “dependência moderada”. Para o CCEB, 42% se encontravam naclasse B2 de poder aquisitivo. Os sujeitos com lesão medular (n=33) perderam papéis sociais do passado para opresente, entretanto, manifestaram o desejo em aumentá-los no futuro. Foi identificada correlação positiva entreos papéis ocupacionais e independência (p<0,01) e dos papéis ocupacionais com o grau de importância (p<0,05).A partir dos dados obtidos sugere-se a pertinência da investigação dos efeitos das intervenções em reabilitação emrelação aos papéis ocupacionais, no sentido de favorecer a reinserção social desses sujeitos em todos os domíniosdas atividades sociais.