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Article ; Online: The use of practice evidence by Australian occupational therapists: Perspectives and actions.

Greber, Craig / Isbel, Stephen

2024

Abstract: Introduction: Evidence-based practice supports clinical decision-making by using multiple sources of evidence arising from research and practice. Research evidence develops through empirical study while practice evidence arises through clinical ... ...

Abstract	Introduction: Evidence-based practice supports clinical decision-making by using multiple sources of evidence arising from research and practice. Research evidence develops through empirical study while practice evidence arises through clinical experience, client preferences, and the practice context. Although occupational therapists have embraced the paradigm of evidence-based practice, some studies have identified limits in the availability and use of research, which can lead to reliance on other forms of evidence. This study aimed to understand how Australian occupational therapists use practice evidence, manage potential bias, and enhance trustworthiness. Potential use of a critical appraisal tool for practice evidence was also explored. Methods: A 42-item questionnaire was developed to address the study aims. It consisted of a 7-point Likert scale, ordinal and free text questions. Likert scales were collapsed into binary scales and analysed using SPSS. Ordinal data were graphed and free text responses were analysed using manifest content analysis. Results: Most respondents (82%) indicated that practice evidence was an important informant of practice and is used alongside research evidence. Almost all respondents (98%) expressed confusion when reconciling discrepancies between research and practice evidence. There was general acknowledgement that practice evidence is prone to bias (82%), yet 92% were confident in trusting their own practice evidence. Most respondents (74.5%) undertook some measures to appraise practice evidence, and almost all respondents (90%) agreed they would refer to a critical appraisal tool that helped them evaluate practice evidence. Conclusion: Occupational therapists in this study routinely use practice evidence arising from their own experience, client perspectives, and their practice context to inform clinical decision-making. While they agreed that practice evidence was prone to bias and misinterpretation, they generally trusted their own practice evidence. Participants indicated they needed guidance to critically appraise their practice evidence and supported the development of a critical appraisal tool for this purpose.
Language	English
Publishing date	2024-03-12
Publishing country	Australia
Document type	Journal Article
ZDB-ID	604554-6
ISSN	1440-1630 ; 0045-0766
ISSN (online)	1440-1630
ISSN	0045-0766
DOI	10.1111/1440-1630.12941
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Article ; Online: Reform and reverberation: Australian aged care policy changes and the unintended consequences for allied health.

Gibson, Diane / Isbel, Stephen

Australian occupational therapy journal

2024

Abstract: Introduction: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal ... ...

Abstract	Introduction: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. The purpose of this paper is to review these recommendations and the Australian Government's policy responses and explore the emerging changes in allied health service provision in residential aged care. Methods: Data from the four available Quarterly Financial Reports from the 2022-2023 financial year were extracted and analysed in relation to staff costs and time per person per day across personal care, nursing, and allied health workers. Supplementary data sources including the 2020 Aged Care Workforce Census were accessed to provide contextual data relating to individual allied health professions, including occupational therapy. Results: The analysis shows a modest increase in median registered nurse minutes per person per day, and cost per person per day, from the first to second quarter, and again in the third and fourth. By contrast, median time and cost for allied health declined. From 5.6 minutes per person per day in the first quarter, reported allied health minutes fell to 4.6 minutes per person per day in the second quarter, an 18% decrease, and by the fourth quarter was 4.3 minutes per person per day. This is just over half the Australian average of 8 minutes reported to the RCACQS in 2019. Conclusion: Under recent residential aged care reforms, aged care providers have regulatory incentives to concentrate their financial resources on meeting the mandated care hours for registered nurses, enrolled nurses, personal care workers, and assistants in nursing. These same reforms do not mandate minutes of allied health services. Although providers of residential aged care in Australia continue to employ and value allied health, we argue that mandating care minutes for personal and nursing care without mandating the provision of allied health creates a perverse incentive whereby access to allied health services is unintentionally reduced.
Language	English
Publishing date	2024-05-07
Publishing country	Australia
Document type	Journal Article
ZDB-ID	604554-6
ISSN	1440-1630 ; 0045-0766
ISSN (online)	1440-1630
ISSN	0045-0766
DOI	10.1111/1440-1630.12953
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Article: Synthesis of a New α-Azidomethyl Styrene from Safrole via a Dearomative Rearrangement.

Isbel, Stephen R / Bugarin, Alejandro

Molbank

2023 Volume 2023, Issue 3

Abstract: There is a growing interest in developing more efficient synthetic alternatives for the synthesis of nitrogen-containing allylic compounds. This article presents a straightforward two-step protocol to produce 5-(3-azidoprop-1-en-2-yl)benzo[ ...

Abstract	There is a growing interest in developing more efficient synthetic alternatives for the synthesis of nitrogen-containing allylic compounds. This article presents a straightforward two-step protocol to produce 5-(3-azidoprop-1-en-2-yl)benzo[
Language	English
Publishing date	2023-08-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2170280-9
ISSN	1422-8599
ISSN	1422-8599
DOI	10.3390/m1713
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Article: Occupation-Based Interventions to Improve Occupational Performance Among Older Adults Living in Long-Term Care: A Systematic Review.

Mitterfellner, Rachael / D'Cunha, Nathan M / Isbel, Stephen

The American journal of occupational therapy : official publication of the American Occupational Therapy Association

2024 Volume 78, Issue 1

Abstract: Importance: Evidence for the positive effects of occupation-based interventions on occupational performance is increasing; however, little is known about the impacts of occupation-based interventions on older adults living in long-term care.: ... ...

Abstract	Importance: Evidence for the positive effects of occupation-based interventions on occupational performance is increasing; however, little is known about the impacts of occupation-based interventions on older adults living in long-term care. Objective: To consolidate the evidence on the effectiveness of occupation-based interventions for improving occupational performance among older adults living in long-term care. Data sources: MEDLINE, CINAHL, PsycINFO, SCOPUS, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from journal-database inception to February 2023. Study selection and data collection: This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles were peer-reviewed studies published in English that evaluated occupation-based interventions for older adults living in long-term care and used validated tools to measure occupational performance. Findings: Seventeen articles, with 2,974 participants, were identified. The reviewed studies included 6 Level 1b randomized controlled trials, 5 Level 2b studies of various study designs, and 5 Level 3b studies with quasi-experimental designs. Across studies, heterogeneous measures were used to assess occupational performance. All studies implemented client-centered, occupation-based interventions designed and/or delivered by occupational therapists. Interventions were tailored to residents' goals, interests, or abilities to improve occupational performance and participation, and inconsistent effects were reported. Conclusions and relevance: Moderate evidence supports the use of occupation-based interventions tailored to individual residents and incorporation of physical activities for improving the occupational performance of older adults living in long-term care. Currently, evidence for care partner involvement and multilevel occupation-based interventions is limited. Plain-Language Summary: This study adds to the evidence base indicating that occupation-based interventions have the potential to promote the occupational performance of older adults living in long-term care. High-quality randomized controlled trials with longer term follow-up and assessment of clinically meaningful outcomes are critical for developing the evidence base in this practice setting.
MeSH term(s)	Aged ; Humans ; Exercise ; Language ; Long-Term Care ; Peer Review ; Occupational Therapy
Language	English
Publishing date	2024-01-17
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	219403-x
ISSN	1943-7676 ; 0272-9490 ; 0161-326X
ISSN (online)	1943-7676
ISSN	0272-9490 ; 0161-326X
DOI	10.5014/ajot.2024.050441
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Article ; Online: Being present and heard: The pivotal role of leadership, responsiveness, and future-focussed thinking in policy advocacy.

Murray, Carolyn M / Isbel, Stephen / McKinstry, Carol

Australian occupational therapy journal

2024

Language	English
Publishing date	2024-04-28
Publishing country	Australia
Document type	Editorial
ZDB-ID	604554-6
ISSN	1440-1630 ; 0045-0766
ISSN (online)	1440-1630
ISSN	0045-0766
DOI	10.1111/1440-1630.12955
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Article ; Online: Designing an occupation-based group intervention for adult inpatient rehabilitation: Partnering with clinicians and patients using a nominal group technique design.

Wall, Gemma / Pearce, Claire / Gustafsson, Louise / Isbel, Stephen

Australian occupational therapy journal

2024

Abstract: Introduction: Occupation-based interventions use engagement in a person's daily activities to achieve change. There is growing research into the use of occupation-based group interventions in the inpatient rehabilitation setting. It remains unclear ... ...

Abstract	Introduction: Occupation-based interventions use engagement in a person's daily activities to achieve change. There is growing research into the use of occupation-based group interventions in the inpatient rehabilitation setting. It remains unclear whether occupation-based groups offer comparable outcomes to occupation-based interventions delivered individually; this research will precede a clinical trial aimed at comparing these two approaches for improving occupational performance outcomes. This study details the process of co-designing the intervention. Partnering with clinicians and patients in the design of healthcare interventions can promote patient-centred care, enhance uptake, and improve applicability and sustainability of the intervention to that setting. Methods: A modified nominal group technique (NGT) design was applied to facilitate two meetings and an electronic survey with an expert panel of clinicians and patients. Twelve participants (n = 4 occupational therapists, n = 1 registered nurse, n = 1 physiotherapist, n = 1 occupational therapy assistant, n = 1 occupational therapy manager, and n = 4 patients) were purposively recruited. A modified approach to the technique's four stages was used: silent generation, round robin, clarification, and voting. Consensus was set at >50%. Qualitative data from group discussions were analysed thematically. Findings: All participants agreed the intervention should include patient-centred, goal-directed, practice of daily activities, including breakfast and lunch preparation, domestic tasks, and laundry. Other components that were agreed included where the groups could run, group size, eligibility criteria, and frequency. Key themes from clinicians included needing a goal-directed intervention, focused on progressing towards hospital discharge; time and resource requirements were also discussed. Patients emphasised the importance of building social connections, opportunity to engage in meaningful activity, and the importance of linking participation to patient goals. Conclusion: Through collaboration with clinicians and patients, an occupation-based group intervention considering the available evidence, alongside clinical, experiential, and contextual sources of knowledge was developed; this resulted in an evidence-based, patient-centred, and contextually relevant intervention.
Language	English
Publishing date	2024-04-30
Publishing country	Australia
Document type	Journal Article
ZDB-ID	604554-6
ISSN	1440-1630 ; 0045-0766
ISSN (online)	1440-1630
ISSN	0045-0766
DOI	10.1111/1440-1630.12950
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Article: Immersive virtual reality in the promotion of health and well-being for people in residential aged care without cognitive impairment: A scoping review.

Holloway, Helen / Conroy, Brenda / Isbel, Stephen / D'Cunha, Nathan M

Digital health

2024 Volume 10, Page(s) 20552076241249568

Abstract: Objective: Sustaining the health and well-being of older people living in residential aged care (RAC) requires new means of providing safe and stimulating recreational and therapeutic programs such as using virtual reality (VR). The aim of the scoping ... ...

Abstract	Objective: Sustaining the health and well-being of older people living in residential aged care (RAC) requires new means of providing safe and stimulating recreational and therapeutic programs such as using virtual reality (VR). The aim of the scoping review was to investigate the utility of immersive VR interventions using head-mounted display technology to promote the health and well-being of people without cognitive impairment living in RAC. Method: The following databases were searched from inception until January 2024: PubMed, PsycINFO, Scopus, Cochrane and CINAHL. The eligibility criteria were quantitative, qualitative or mixed methods studies published in English, conducted in RAC, using VR with head-mounted display with people without cognitive impairment. Results: Of the 274 articles identified, 9 articles with a total of 310 residents and 50 staff met the inclusion criteria. Seven factors to either impede or enable the use of VR with head-mounted displays in RAC were: residents' agency; the nature of the VR experience; the content of the experience; the ease of use and comfort of the technology; the role of RAC staff; and the role of residents' family members. Conclusion: Immersive VR has potential as a tool to promote the health and well-being of people without cognitive impairment living in RAC. Small sample sizes, variations in study design, and selection bias mean that generalisability of the results is limited. Further research is recommended to inform the design and implementation of immersive VR programs tailored specifically for this population.
Language	English
Publishing date	2024-04-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2819396-9
ISSN	2055-2076
ISSN	2055-2076
DOI	10.1177/20552076241249568
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Article ; Online: Epoxide-Based Synthetic Approaches toward Polypropionates and Related Bioactive Natural Products.

Rodríguez-Berríos, Raúl R / Isbel, Stephen R / Bugarin, Alejandro

International journal of molecular sciences

2023 Volume 24, Issue 7

Abstract: Polypropionate units are a common structural feature of many of the natural products in polyketides, some of which have shown a broad range of antimicrobial and therapeutic potential. Polypropionates are composed of a carbon skeleton with alternating ... ...

Abstract	Polypropionate units are a common structural feature of many of the natural products in polyketides, some of which have shown a broad range of antimicrobial and therapeutic potential. Polypropionates are composed of a carbon skeleton with alternating methyl and hydroxy groups with a specific configuration. Different approaches have been developed for the synthesis of polypropionates and herein we include, for the first time, all of the epoxide-based methodologies that have been reported over the years by several research groups such as Kishi, Katsuki, Marashall, Miyashita, Prieto, Sarabia, Jung, McDonald, etc. Several syntheses of polypropionate fragments and natural products that employed epoxides as key intermediates have been described and summarized in this review. These synthetic approaches involve enatio- and diastereoselective synthesis of epoxides (epoxy-alcohols, epoxy-amides, and epoxy-esters) and their regioselective cleavage with carbon and/or hydride nucleophiles. In addition, we included a description of the isolation and biological activities of the polypropionates and related natural products that have been synthetized using epoxide-based approaches. In conclusion, the epoxide-based methodologies are a non-aldol alternative approach for the construction of polypropionate.
MeSH term(s)	Epoxy Compounds/chemistry ; Biological Products/pharmacology ; Stereoisomerism ; Carbon/chemistry ; Alcohols/chemistry
Chemical Substances	Epoxy Compounds ; Biological Products ; Carbon (7440-44-0) ; Alcohols
Language	English
Publishing date	2023-03-24
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24076195
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Article ; Online: Occupation-based interventions to improve occupational performance and participation in the hospital setting: a systematic review.

Wall, Gemma / Isbel, Stephen / Gustafsson, Louise / Pearce, Claire

Disability and rehabilitation

2023 , Page(s) 1–22

Abstract: Purpose: To critically review the evidence for occupation-based interventions in improving occupational performance and participation outcomes in the hospital setting.: Methods: Five databases were searched from 2000-2022. Peer-reviewed studies of ... ...

Abstract	Purpose: To critically review the evidence for occupation-based interventions in improving occupational performance and participation outcomes in the hospital setting. Methods: Five databases were searched from 2000-2022. Peer-reviewed studies of any design investigating the impact of occupation-based interventions in the hospital setting were included. Methodological quality was assessed using the appropriate tool for each study design. Following data extraction, a narrative synthesis was conducted. Results: Thirty-three studies comprising of 26 experimental, five non-experimental, and two mixed methods studies were included ( Conclusions: Heterogeneity and methodological weaknesses across existing studies limits the conclusions that can be drawn on the impact of occupation-based interventions in the hospital setting. More rigorous research should be conducted with better reporting of intervention design and the use of robust measures of occupational performance.Implications For RehabilitationThe use of occupation-based interventions should be considered to improve occupational performance and participation outcomes in the hospital setting.There is good evidence to support the impact of occupation-based interventions on improving occupational performance and participation outcomes in the inpatient rehabilitation setting; evidence in the acute and mental health settings is scarcer.Occupation-based interventions are valued by both patients and clinicians for their impact on patient outcomes and the patient experience.
Language	English
Publishing date	2023-07-31
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1104775-6
ISSN	1464-5165 ; 0963-8288
ISSN (online)	1464-5165
ISSN	0963-8288
DOI	10.1080/09638288.2023.2236021
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Article ; Online: Professional issues, challenges and opportunities: Professor Sylvia Rodger's contribution.

Isbel, Stephen

Australian occupational therapy journal

2017 Volume 64 Suppl 1, Page(s) 14–16

MeSH term(s)	Australia ; Clinical Decision-Making ; Evidence-Based Practice ; Female ; History, 21st Century ; Humans ; Leadership ; Male ; Occupational Therapy/education ; Occupational Therapy/organization & administration ; Patient Care Team/organization & administration ; Physician's Role ; Quality Assurance, Health Care
Language	English
Publishing date	2017-07-17
Publishing country	Australia
Document type	Biography ; Historical Article ; Journal Article ; Review
ZDB-ID	604554-6
ISSN	1440-1630 ; 0045-0766
ISSN (online)	1440-1630
ISSN	0045-0766
DOI	10.1111/1440-1630.12373
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