List of Titles

A 3D measurement and computerized meshing study to promote bus ridership among people using powered mobility aids

- Unsworth, Carolyn, Chua, Julian, Gudimetla, Prasad

Authors: Unsworth, Carolyn , Chua, Julian , Gudimetla, Prasad
Date: 2020
Type: Text , Journal article
Relation: Frontiers in Built Environment Vol. 6, no. (2020), p.
Full Text:
Reviewed:
Description: People who use powered mobility aids such as wheelchairs and scooters need and want to use public transport. Buses are the most affordable and efficient form of public transport, capable of connecting people across local communities. However, with curbside rather than platform boarding and internal space limitations, buses also present many accessibility challenges for people using mobility aids during ingress, egress, and interior maneuverability. In Australia, people using mobility aids board low floor buses that are required to comply with the national bus accessibility standard, using the front doors. A new standard was recently created to provide a Blue Label identification for powered mobility aids suitable to access public transport. The accuracy of this standard to identify mobility aids suitable to use on buses has not been verified. This research used a world-first methodology that included 3-Dimensional (3D) scanning of 35 mobility aids and 21 buses. The resulting 735 scan combinations were efficiently meshed using Meshlab, an open-source software. The research demonstrated that (i) although none of the buses were compliant with the relevant standard in 3D, many could still facilitate the boarding of a variety of mobility aids, and (ii) the Blue Label, while a valuable guide, did not accurately identifying all mobility aids that would and would not be able to board buses. This research has shortlisted nine mobility aids that can be recommended to consumers as being able to fit all the full-size buses tested. The dimensions of mobility aids that appear to enable access on most buses were also identified for consumers to consider when purchasing a mobility aid. The novel 3D meshing methodology used in this research also revealed that most collision points between mobility aids and buses occur in the curved-corridor entry of the buses. To minimize this entry problem, future bus boarding designs should consider the option of double-door entry/exit in the middle of the bus, which is common in many other countries. Adoption of this strategy would mitigate some of the challenges that people using mobility aids encounter when accessing buses, thereby increasing public transport ridership among this group. © Copyright © 2020 Unsworth, Chua and Gudimetla.

A randomised controlled trial to test the effectiveness of decision training on assessors' ability to determine optimal fitness-to-drive recommendations for older or disabled drivers

- Harries, Priscilla, Unsworth, Carolyn, Gokalp, Hulya, Davies, Miranda, Tomlinson, Christopher, Harries, Luke

Authors: Harries, Priscilla , Unsworth, Carolyn , Gokalp, Hulya , Davies, Miranda , Tomlinson, Christopher , Harries, Luke
Date: 2018
Type: Text , Journal article
Relation: BMC Medical Education Vol. 18, no. 1 (2018), p.
Full Text:
Reviewed:
Description: Background: Driving licensing jurisdictions require detailed assessments of fitness-to-drive from occupational therapy driver assessors (OTDAs). We developed decision training based on the recommendations of expert OTDAs, to enhance novices' capacity to make optimal fitness-to-drive decisions. The aim of this research was to determine effectiveness of training on novice occupational therapists' ability to make fitness-to-drive decisions. Methods: A double blind, parallel, randomised controlled trial was conducted to test the effectiveness of decision training on novices' fitness-to-drive recommendations. Both groups made recommendations on a series of 64 case scenarios with the intervention group receiving training after reviewing two thirds of the cases; the control group, at this same point, just received a message of encouragement to continue. Participants were occupational therapy students on UK and Australian pre-registration programmes who individually took part online, following the website instructions. The main outcome of training was the reduction in mean difference between novice and expert recommendations on the cases. Results: Two hundred eighty-nine novices were randomised into intervention; 166 completed the trial (70 in intervention; 96 in control). No statistical differences in scores were found pre-training. Post training, the control group showed no significant change in recommendations compared to the experts (t(96) = -.69; p =.5), whereas the intervention group exhibited a significant change (t(69) = 6.89; p < 0.001). For the intervention group, the mean difference compared with the experts' recommendations reduced with 95% CI from -.13 to.09. Effect size calculated at the post-training demonstrated a moderate effect (d =.69, r =.32). Conclusions: Novices who received the decision training were able to change their recommendations whereas those who did not receive training did not. Those receiving training became more able to identify drivers who were not fit-to-drive, as measured against experts' decisions on the same cases. This research demonstrated that novice occupational therapists can be trained to make decisions more aligned to those of expert OTDAs. The decision training and cases have been launched as a free training resource at www.fitnesstodrive.com. This can be used by novice driver assessors to increase their skill to identify drivers who are, and are not fit-to-drive, potentially increasing international workforce capacity in this growing field of practice. © 2018 The Author(s).

A randomized controlled trial protocol investigating effectiveness of an activity-pacing program for deconditioned older adults

- Timmer, Amanda, Unsworth, Carolyn, Browne, Matthew

Authors: Timmer, Amanda , Unsworth, Carolyn , Browne, Matthew
Date: 2019
Type: Text , Journal article
Relation: Canadian Journal of Occupational Therapy Vol. 86, no. 2 (2019), p. 136-147
Full Text: false
Reviewed:
Description: Background.: Acute hospitalization of older adults can lead to deconditioning and the need for rehabilitation to facilitate a return to home and previous lifestyle. An occupational therapy intervention to combat deconditioning is activity pacing, an active self-management strategy where individuals learn to modify how and when activities are completed with the aim of improving participation in occupation. Purpose.: This study will examine the effectiveness of occupational therapy with activity pacing during rehabilitation for deconditioned older adults. Method.: A randomized controlled trial is proposed with inclusion criteria of older adults, 65+ years old, living independently in the community prior to admission, with adequate cognition and language to participate in the intervention. Participation, health status, self-efficacy in daily activities, self-efficacy in activity pacing techniques, and symptom management (pain and fatigue) will be measured at admission, discharge, and 3 months postdischarge. Implications.: Determining if an activity-pacing program is effective will provide occupational therapists with evidence to support service delivery. © CAOT 2019.

Quick View

A systematic review of evidence for fitness-to-drive among people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder

- Unsworth, Carolyn, Baker, Anne, So, Man, Harries, Priscilla, O'Neill, Desmond

Authors: Unsworth, Carolyn , Baker, Anne , So, Man , Harries, Priscilla , O'Neill, Desmond
Date: 2017
Type: Text , Journal article
Relation: BMC Psychiatry Vol. 17, no. 1 (2017), p.
Full Text:
Reviewed:
Description: Background: Limited evidence exists regarding fitness-to-drive for people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder (herein simply referred to as 'mental health conditions'). The aim of this paper was to systematically search and classify all published studies regarding driving for this population, and then critically appraise papers addressing assessment of fitness-to-drive where the focus was not on the impact of medication on driving. Methods: A systematic search of three databases (CINAHL, PSYCHINFO, EMBASE) was completed from inception to May 2016 to identify all articles on driving and mental health conditions. Papers meeting the eligibility criteria of including data relating to assessment of fitness-to-drive were critically appraised using the American Academy of Neurology and Centre for Evidence-Based Medicine protocols. Results: A total of 58 articles met the inclusion criteria of driving among people with mental health conditions studied, and of these, 16 contained data and an explicit focus on assessment of fitness-to-drive. Assessment of fitness-to-drive was reported in three ways: 1) factors impacting on the ability to drive safely among people with mental health conditions, 2) capability and perception of health professionals assessing fitness-to-drive of people with mental health conditions, and 3) crash rates. The level of evidence of the published studies was low due to the absence of controls, and the inability to pool data from different diagnostic groups. Evidence supporting fitness-to-drive is conflicting. Conclusions: There is a relatively small literature in the area of driving with mental health conditions, and the overall quality of studies examining fitness-to-drive is low. Large-scale longitudinal studies with age-matched controls are urgently needed in order to determine the effects of different conditions on fitness-to-drive. © 2017 The Author(s).

A systematic review of professional reasoning literature in occupational therapy

- Unsworth, Carolyn, Baker, Anne

Authors: Unsworth, Carolyn , Baker, Anne
Date: 2016
Type: Text , Journal article , Review
Relation: British Journal of Occupational Therapy Vol. 79, no. 1 (2016), p. 5-16
Full Text: false
Reviewed:
Description: Introduction: Over the past 33 years, theoretical and empirical articles have been published on professional reasoning in occupational therapy. This systematic review sought to answer two questions: (1) What is the nature and volume of professional reasoning literature; and (2) What do we know about the development of professional reasoning in students through literature exploring novice and expert differences? Method: A systematic review of the peer-reviewed literature with narrative and critical analysis. Findings: A total of 140 articles were classified into six topic areas: what is professional reasoning, ethics and moral reasoning?, methods of studying professional reasoning, novice-expert differences, professional reasoning of assistants, and advancing specific fields of practice using professional reasoning. Of these, 68% included analysis of data, and the remainder were discussions. Fourteen articles examining novice-expert differences were critiqued but only eight were rated as strong. Research findings prompt the need for reflection, extended fieldwork, and development of protocols to facilitate reasoning. Conclusion: This is the first systematic review of the professional reasoning literature, and provides a foundation for more detailed critiques of specific topics to be undertaken. While research strengths have been identified, gaps include the use of standardised measures of professional reasoning and identification of educational approaches that promote professional reasoning. © The Author(s) 2015.

A systematic review of public transport accessibility for people using mobility devices

- Unsworth, Carolyn, So, Man, Chua, Julian, Gudimetla, Prasad, Naweed, Anjum

Authors: Unsworth, Carolyn , So, Man , Chua, Julian , Gudimetla, Prasad , Naweed, Anjum
Date: 2021
Type: Text , Journal article , Review
Relation: Disability and Rehabilitation Vol. 43, no. 16 (2021), p. 2253-2267
Full Text: false
Reviewed:
Description: Purpose: Being able to access public transport is vital for mobility device users as this is an affordable way of maintaining community connections and participating in activities that promote quality of life. This systematic review investigated literature on public transport access for people using mobility devices, excluding transit restraint and securement literature. Materials and methods: A systematic review of the peer-reviewed literature in English from 1995 to 2019, with critical appraisal and narrative synthesis. Results: Twenty-six articles were identified, including 14 studies investigating user experiences, seven examining bus formats and floor layouts, and five focusing on bus ramp incidents and optimal design. Studies were generally observational and descriptive, with 12 including analysis of video data. Conclusion: This is the first systematic review of literature related to the accessibility of public transport for people using mobility devices. Topics such as ramp access have been relatively well-researched, as have the experiences of users. However, many gaps remain and there is a need for research to; address the barriers identified through user experiences, discern the best access to stations and stops, as well as floor formats for people to ingress, manoeuvre and egress from a variety of transport modes, and promote universal design principles in the transport sector. Rehabilitation professionals can use the findings of this review to advocate for, and support people using mobility devices to successfully negotiate public transport.Implications for Rehabilitation Accessible public transport is vital to enable people using mobility devices to remain connected in their communities. Despite increased international awareness and adoption of accessibility features by the public transport sector to improve getting to a stop, ingress, manoeuvrability within and egress from conveyances, access for people using wheeled mobility devices cannot be assumed. When prescribing new wheeled mobility devices with clients, rehabilitation professionals and users need to consider public transport access and the suitability of different devices for this purpose. Rehabilitation professionals can undertake skills training with people using wheeled mobility devices to test out access prior to independent travel on public transport and develop strategies to overcome any barriers. © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Analysing and interpreting outcomes data to support evidence-based practice using the example of AusTOMs-OT

- Unsworth, Carolyn

Authors: Unsworth, Carolyn
Date: 2017
Type: Text , Journal article
Relation: British Journal of Occupational Therapy Vol. 80, no. 10 (2017), p. 631-637
Full Text: false
Reviewed:
Description: Statement of context: Occupational therapists working with clients who have neurological impairments routinely collect outcomes data. However, data cannot inform practice unless it is routinely reviewed. The aim of this paper was to show how outcomes data collected on the Australian Therapy Outcome Measures – Occupational Therapy scale were analysed and interpreted. Although the example pertains to clients with neurological problems, the approach can be applied to all areas of practice. Critical reflection on practice: When outcomes data are routinely analysed and findings reviewed, occupational therapists have an increased understanding of practice strengths and limitations. Implications for practice: Incorporating analysis and interpretation of outcomes data for clients with neurological problems into practice contributes evidence to support therapy and ensures clinicians retain control of their data. © 2017, © The Author(s) 2017.

Anti-vaccination and pro-CAM attitudes both reflect magical beliefs about health

- Bryden, Gabrielle, Browne, Matthew, Rockloff, Matthew, Unsworth, Carolyn

Authors: Bryden, Gabrielle , Browne, Matthew , Rockloff, Matthew , Unsworth, Carolyn
Date: 2018
Type: Text , Journal article
Relation: Vaccine Vol. 36, no. 9 (2018), p. 1227-1234
Full Text: false
Reviewed:
Description: We examined the relationship between complementary and alternative medicine (CAM) use and vaccination scepticism; and specifically whether a person's more general health-related worldview might explain this relationship. A cross-sectional online survey of adult Australians (N = 2697) included demographic, CAM, and vaccination measures, as well as the holistic and magical health belief scales (HHB, MHB). HHB emphasises links between mind and body health, and the impact of general ‘wellness’ on specific ailments or resistance to disease, whilst MHB specifically taps ontological confusions and cognitive errors about health. CAM and anti-vaccination were found to be linked primarily at the attitudinal level (r = −0.437). We did not find evidence that this was due to CAM practitioners influencing their clients. Applying a path-analytic approach, we found that individuals’ health worldview (HHB and MHB) accounted for a significant proportion (43.1%) of the covariance between CAM and vaccination attitudes. MHB was by far the strongest predictor of both CAM and vaccination attitudes in regressions including demographic predictors. We conclude that vaccination scepticism reflects part of a broader health worldview that discounts scientific knowledge in favour of magical or superstitious thinking. Therefore, persuasive messages reflecting this worldview may be more effective than fact-based campaigns in influencing vaccine sceptics. © 2017 Elsevier Ltd

Barriers and enablers to aligning rehabilitation goals to patient life roles following acquired brain injury

- Sansonetti, Danielle, Nicks, Rebecca, Unsworth, Carolyn

Authors: Sansonetti, Danielle , Nicks, Rebecca , Unsworth, Carolyn
Date: 2018
Type: Text , Journal article
Relation: Australian Occupational Therapy Journal Vol. 65, no. 6 (2018), p. 512-522
Full Text: false
Reviewed:
Description: Background/aim: Life roles are integral to occupational therapy practice. Goal setting is a method of establishing priorities to measure outcomes. While acquired brain injury can impact a person's ability to fulfil meaningful life roles, the alignment of goals set in rehabilitation to life roles, is unclear. This study aimed to (i) explore the alignment of goals with life roles for people with an acquired brain injury participating in inpatient rehabilitation; and (ii) identify barriers and enablers to life role discussions within a patient-directed goal setting framework. Method: A mixed-methods study was conducted on an inpatient rehabilitation unit in Victoria, Australia. Quantitative data were obtained from a retrospective file audit of randomly selected medical records. Qualitative data were collected through: a) interviews with patients and their families; and b) A focus group with occupational therapists. Thematic analysis of both audit data and narrative data was undertaken. Results: Thirty files were examined and demonstrated 33% alignment between goals and life roles. Four interviews were completed with patients, with a family member participating in two of these. Themes identified were: readiness, role concept, recovery concept and goal review. Five therapists attended the focus group. Themes identified were: Patient factors, goal review, expectations, role change and environment. Interview and focus group data identified that barriers to life role discussions included: lack of patient and family readiness, patients’ difficulty understanding role concept, focus on impairments and lack of family/ significant others support. Enablers included: having early conversations involving family, regular goal review and use of standardised tools. Conclusion: Goal setting in alignment with life roles is important in acquired brain injury rehabilitation, but may be limited. This process can be enhanced by including patients and their significant others in early goal setting conversations, along with regular goal review across the rehabilitation process. © 2018 Occupational Therapy Australia

Quick View

Burden and preparedness amongst informal caregivers of adults with moderate to severe traumatic brain injury

- Lieshout, Kirsten, Oates, Joanne, Baker, Anne, Unsworth, Carolyn, Cameron, Ian, Schmidt, Julia, Lannin, Natasha

Authors: Lieshout, Kirsten , Oates, Joanne , Baker, Anne , Unsworth, Carolyn , Cameron, Ian , Schmidt, Julia , Lannin, Natasha
Date: 2020
Type: Text , Journal article
Relation: International Journal of Environmental Research and Public Health Vol. 17, no. 17 (2020), p. 1-12
Full Text:
Reviewed:
Description: This study examined the patterns of informal (unpaid) caregiving provided to people after moderate to severe traumatic brain injury (TBI), explore the self-reported burden and preparedness for the caregiving role, and identify factors predictive of caregiver burden and preparedness. A cross-sectional cohort design was used. Informal caregivers completed the Demand and Difficulty subscales of the Caregiving Burden Scale; and the Mutuality, Preparedness, and Global Strain subscales of the Family Care Inventory. Chi-square tests and logistic regression were used to examine the relationships between caregiver and care recipient variables and preparedness for caregiving. Twenty-nine informal caregivers who reported data on themselves and people with a moderate to severe TBI were recruited (referred to as a dyad). Most caregivers were female (n = 21, 72%), lived with the care recipient (n = 20, 69%), and reported high levels of burden on both scales. While most caregivers (n = 21, 72%) felt “pretty well” or “very well” prepared for caregiving, they were least prepared to get help or information from the health system, and to deal with the stress of caregiving. No significant relationships or predictors for caregiver burden or preparedness were identified. While caregivers reported the provision of care as both highly difficult and demanding, further research is required to better understand the reasons for the variability in caregiver experience, and ultimately how to best prepare caregivers for this long-term role. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Description: Data collection for this project was supported by the NSW Lifetime Care and Support Scheme (now iCare Foundation). N.A.L. is supported by a Future Leader Fellowship (Award ID 102055) from the National Heart Foundation of Australia.

Determining client cognitive status following mild traumatic brain injury

- Hobson, Elizabeth, Lannin, Natasha, Taylor, Amelia, Farquhar, Michelle, Morarty, Jacqui, Unsworth, Carolyn

Authors: Hobson, Elizabeth , Lannin, Natasha , Taylor, Amelia , Farquhar, Michelle , Morarty, Jacqui , Unsworth, Carolyn
Date: 2016
Type: Text , Journal article
Relation: Scandinavian Journal of Occupational Therapy Vol. 23, no. 2 (2016), p. 138-146
Full Text: false
Reviewed:
Description: Background People with mild traumatic brain injury (mTBI) commonly experience cognitive impairments. Occupational therapists working in acute general hospitals in Australia routinely access client Glasgow Coma Scale (GCS) scores, and assess cognitive status using standardized tools and by observing basic activity of daily living (ADL) performance. However, limited evidence exists to identify the best assessment(s) to determine client cognitive status. Aim/objectives To determine whether cognitive status assessed by GCS score and the Cognistat are predictive of basic ADL performance among clients with mTBI in an acute general hospital and make inferences concerning the clinical utility of these assessment tools. Material and methods Retrospective analysis of medical record data on demographics, Cognistat, GCS, and modified Barthel Index (MBI) using descriptive statistics, chi-square tests and linear regression. Results Data analysis of 166 participants demonstrated that no associations exist between GCS and Cognistat scores, or Cognistat scores and MBI dependency level. The presence of co-morbid multi-trauma injuries and length of stay were the only variables that significantly predicted MBI dependency level. Conclusion and significance While the MBI scores are of value in identifying clients with difficulty in basic ADLs, Cognistat and GCS scores are of limited use in differentiating client levels of cognitive impairment and the authors caution against the routine administration of the Cognistat following mTBI. Further research is required to identify more suitable assessments for use with a mTBI population. © 2015 Taylor & Francis.

Determining fitness to drive among drivers with alzheimer's disease or cognitive decline

- Unsworth, Carolyn, Chan, Siew-Pang

Authors: Unsworth, Carolyn , Chan, Siew-Pang
Date: 2016
Type: Text , Journal article
Relation: British Journal of Occupational Therapy Vol. 79, no. 2 (2016), p. 102-110
Full Text: false
Reviewed:
Description: Introduction: Fitness to drive skills progressively deteriorate following a diagnosis of Alzheimer's disease/cognitive decline. Occupational therapists require standardised assessments to help them make recommendations to clients and licensing authorities regarding client fitness to drive. This research aimed to determine whether drivers in the early stages of Alzheimer's disease/cognitive decline can drive safely, and if this could be predicted using the occupational therapy - driver off-road assessment battery (OT-DORA Battery). Method: Drivers with Alzheimer's disease/cognitive decline were assessed by one of nine driver assessors over 18 months. Client data were collected on the OT-DORA Battery and following on-road assessment; the outcome was recorded as pass, pass with conditions, or fail. Results: A total of 63 clients were assessed, and n = 40 (63.5%) were passed as fit to drive, of whom 33(83%) had at least one condition placed on their licence. Client age and scores on four subtests of the OT-DORA Battery were predictive of outcome. Conclusion: A diagnosis of Alzheimer's disease/cognitive decline should not automatically preclude driving. Scores on four of the subtests from the OT-DORA Battery may be used to help determine whether a client is fit to drive or not fit to drive, or whether a client should be referred for specialist occupational therapy driver assessment. © The Author(s) 2015.

Effect of contamination and purity priming on attitudes to vaccination and other health interventions : a randomised controlled experiment

- Bryden, Gabrielle, Rockloff, Matthew, Browne, Matthew, Unsworth, Carolyn

Authors: Bryden, Gabrielle , Rockloff, Matthew , Browne, Matthew , Unsworth, Carolyn
Date: 2021
Type: Text , Journal article
Relation: Vaccine Vol. 39, no. 45 (2021), p. 6653-6659
Full Text: false
Reviewed:
Description: The objective of this experiment is to assess whether priming for contamination and purity causes a change in attitudes to health interventions, including vaccination, and complementary and alternative medicines (CAMs). An online priming experiment was conducted with four between-subject experimental conditions including photos of: 1) biological contamination, 2) chemical contamination, 3) pure environments, such as pristine landscapes, and 4) hazard signs/icons indicating physical threats. Two control conditions included photos of neutral scenes and neutral icons, whereby experimental groups were compared against the related control groups (photograph for conditions 1–3 and neutral icons for condition 4). Subjects were randomly assigned to one of the six conditions, and after exposure to the images they were asked to rate 10 conventional and alternative health interventions for effectiveness and safety, as well being assessed for disgust sensitivity using the reduced-item DPSS-R [10]. A total of 642 adults completed the experiment. Exposure to primes did not cause a differential change in ratings of health interventions. Nevertheless, higher levels of sensitivity to disgust were associated with lower ratings of the effectiveness of MMR vaccination, tetanus injection, antibiotics, and surgery; and higher levels of sensitivity to disgust were associated with higher ratings of effectiveness of vitamins/minerals. In conclusion, this online experiment did not find an experimental effect of priming for contamination and purity on subjects’ ratings of the safety and effectiveness of conventional and alternative health interventions. This indicates that attitudes to these health interventions are not influenced by a temporary increase in the salience of feelings of contamination or purity. However, individual differences in disgust sensitivity are related to their attitudes to vaccination and CAM interventions. © 2021 Elsevier Ltd

Effect of navigation problems, assessment location, and a practice test on driving assessment performance for people with alzheimer's disease

- Unsworth, Carolyn, Russell, Kay, Lovell, Robin, Woodward, Michael, Browne, Matthew

Authors: Unsworth, Carolyn , Russell, Kay , Lovell, Robin , Woodward, Michael , Browne, Matthew
Date: 2019
Type: Text , Journal article
Relation: Journal of Alzheimer's Disease Vol. 67, no. 3 (2019), p. 1035-1043
Full Text: false
Reviewed:
Description: Background: People with Alzheimer's disease may be required to undertake clinical and on-road assessments to determine fitness to drive. The manner in which on-road assessments are conducted with drivers who do and do not have navigational problems may affect the outcome. Objectives: Investigate the effect of 1) navigational difficulties, 2) location of assessment (un/familiar area) and assessment order, and 3) undertaking a second assessment (practice), on passing an on-road driving assessment. Methods: Forty-three drivers undertook an Occupational Therapy-Driver Assessment Off Road Assessment (OT-DORA) Battery which included the Drive Home Maze Test (DHMT). Participants with/without a history of navigational problems were randomly allocated into three groups: 1) Unfamiliar/then familiar area assessment; 2) Unfamiliar/unfamiliar; 3) familiar/unfamiliar. An on-road assessment protocol was used including over 100 expected behaviors at nominated points along the directed route. For familiar area assessments, the driver self-navigated from their home to shops and services. A pass/fail decision was made for each assessment. Results: A generalized linear mixed effects model showed neither location, nor practice affected passing the on-road assessment. Participants with navigational problems were six times less likely to pass regardless of route familiarity and direction method, and the DHMT was a significant negative predictor of passing. Conclusion: Drivers with Alzheimer's disease who have navigational problems and are slow to complete the DHMT are unlikely to pass an on-road assessment. However, navigation and maze completion skills may be a proxy for an underlying cognitive skill underpinning driving performance. © 2019 - IOS Press and the authors. All rights reserved.

Engaging patients with moderate to severe acquired brain injury in goal setting

- D’Cruz, Kate, Unsworth, Carolyn, Roberts, Karen, Morarty, Jacqui, Turner-Stokes, Lynne

Authors: D’Cruz, Kate , Unsworth, Carolyn , Roberts, Karen , Morarty, Jacqui , Turner-Stokes, Lynne
Date: 2016
Type: Text , Journal article
Relation: International Journal of Therapy and Rehabilitation Vol. 23, no. 1 (2016), p. 20-31
Full Text: false
Reviewed:
Description: Background/Aims: An exploratory study of a novel approach to using the Goal Engagement Scale to examine patients’, families’ and health professionals’ perceptions of patient engagement in goal setting. Methods: This mixed methods study was conducted from September 2013 to April 2014 in both inpatient trauma and rehabilitation units at an Australian health care service. Participants were 22triads (patients with moderate to severe traumatic brain injury or stroke, their family member(s) and a treating health professional) participating in routine goal setting interviews. Goal setting interviews were audio recorded, transcribed and thematically analysed, drawing upon an iterative process of qualitative data analysis, while the Goal Engagement Scale scores were analysed descriptively, drawing comparison between triad participant findings. Findings: Perception of patient’s level of engagement in goal setting differed between health professionals, patients and families. Health professionals’ views dominated the goal setting process. Goal setting interview data revealed four main themes, highlighting the importance of reflective listening skills to build a trusting relationship with patients and families to support engagement in goal setting. Conclusions: The findings of this exploratory study both affirm the suitability of future research into goal setting engagement and provide clinically useful strategies to support engagement of patients and families in goal setting. © 2016 MA Healthcare Ltd. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Carolyn Unsworth” is provided in this record**

Feasibility of modifying the hospital environment to reduce the length of amnesia after traumatic brain injury : a pilot randomized controlled trial

- Lannin, Natasha, Galea, Claire, Coulter, Megan, Gruen, Russell, Jolliffe, Laura, Ownsworth, Tamara, Schmidt, Julia, Unsworth, Carolyn

Authors: Lannin, Natasha , Galea, Claire , Coulter, Megan , Gruen, Russell , Jolliffe, Laura , Ownsworth, Tamara , Schmidt, Julia , Unsworth, Carolyn
Date: 2021
Type: Text , Journal article
Relation: International journal for quality in health care : journal of the International Society for Quality in Health Care Vol. 33, no. 1 (2021), p.
Full Text: false
Reviewed:
Description: BACKGROUND: Reorientation programmes have been an important component of neurotrauma rehabilitation for adults who suffer from post-traumatic amnesia (PTA) after traumatic brain injury (TBI); however, research testing the efficacy of acute programmes is limited. OBJECTIVE: This study aimed to determine if it is feasible to provide a standardized environmental reorientation programme to adults suffering from PTA after TBI in an acute care hospital setting, and whether it is likely to be beneficial. METHODS: We conducted a randomized controlled trial with concealed allocation and intention-to-treat analysis. A total of 40 participants suffering from PTA after TBI were included. The control group received usual care; the experimental group received usual care plus a standardized orientation programme inclusive of environmental cues. The primary outcome measure was time to emergence from PTA measured by the Westmead PTA Scale, assessed daily from hospital admission or on regaining consciousness. RESULTS: Adherence to the orientation programme was high, and there were no study-related adverse responses to the environmental orientation programme. Although there were no statistically significant between-group differences in time to emergence, the median time to emergence was shorter for those who received the standardized reorientation programme (9.0 (6.4-11.6) versus 13.0 (4.5-21.5) days). Multivariate analysis showed that the Glasgow Coma Scale (GCS) at scene (P = 0.041) and GCS at arrival at hospital (P = 0.0001) were significant factors contributing to the longer length of PTA. CONCLUSION: Providing an orientation programme in acute care is feasible for adults suffering from PTA after TBI. A future efficacy trial would require 216 participants to detect a between-group difference of 5 days with an alpha of 0.05 and a power of 80%. © The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved.
Description: BACKGROUND: Reorientation programmes have been an important component of neurotrauma rehabilitation for adults who suffer from post-traumatic amnesia (PTA) after traumatic brain injury (TBI); however, research testing the efficacy of acute programmes is limited. OBJECTIVE: This study aimed to determine if it is feasible to provide a standardized environmental reorientation programme to adults suffering from PTA after TBI in an acute care hospital setting, and whether it is likely to be beneficial. METHODS: We conducted a randomized controlled trial with concealed allocation and intention-to-treat analysis. A total of 40 participants suffering from PTA after TBI were included. The control group received usual care; the experimental group received usual care plus a standardized orientation programme inclusive of environmental cues. The primary outcome measure was time to emergence from PTA measured by the Westmead PTA Scale, assessed daily from hospital admission or on regaining consciousness. RESULTS: Adherence to the orientation programme was high, and there were no study-related adverse responses to the environmental orientation programme. Although there were no statistically significant between-group differences in time to emergence, the median time to emergence was shorter for those who received the standardized reorientation programme (9.0 (6.4-11.6) versus 13.0 (4.5-21.5) days). Multivariate analysis showed that the Glasgow Coma Scale (GCS) at scene (P = 0.041) and GCS at arrival at hospital (P = 0.0001) were significant factors contributing to the longer length of PTA. CONCLUSION: Providing an orientation programme in acute care is feasible for adults suffering from PTA after TBI. A future efficacy trial would require 216 participants to detect a between-group difference of 5 days with an alpha of 0.05 and a power of 80%. © The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Hazard perception skills of young drivers with Attention Deficit Hyperactivity Disorder (ADHD) can be improved with computer based driver training : an exploratory randomised controlled trial

- Bruce, C., Unsworth, Carolyn, Dillon, M., Tay, R., Falkmer, T., Bird, P., Carey, L.

Authors: Bruce, C. , Unsworth, Carolyn , Dillon, M. , Tay, R. , Falkmer, T. , Bird, P. , Carey, L.
Date: 2017
Type: Text , Journal article
Relation: Accident Analysis and Prevention Vol. 109, no. (2017), p. 70-77
Full Text: false
Reviewed:
Description: Background: Young drivers with Attention Deficit Hyperactivity Disorder (ADHD) are at higher risk of road traffic injuries than their peers. Increased risk correlates with poor hazard perception skill. Few studies have investigated hazard perception training using computer technology with this group of drivers. Objectives: *Determine the presence and magnitude of the between-group and within- subject change in hazard perception skills in young drivers with ADHD who receive Drive Smart training. *Determine whether training-facilitated change in hazard perception is maintained over time. Methods: This was a feasibility study, randomised control trial conducted in Australia. The design included a delayed treatment for the control group. Twenty-five drivers with a diagnosis of ADHD were randomised to the Immediate Intervention or Delayed Intervention group.The Immediate Intervention group received a training session using a computer application entitled Drive Smart. The Delayed Intervention group watched a documentary video initially (control condition), followed by the Drive Smart computer training session. The participant's hazard perception skill was measured using the Hazard Perception Test (HPT). Findings: After adjusting for baseline scores, there was a significant betweengroup difference in post-intervention HPT change scores in favour of the Immediate Intervention group. The magnitude of the effect was large. There was no significant within-group delayed intervention effect. A significant maintenance effect was found at 6-week follow-up for the Immediate Intervention group. Conclusions: The hazard perception skills of participants improved following training with large effect size and some maintenance of gain. A multimodal approach to training is indicated to facilitate maintenance. A full-scale trial is feasible. © 2017 Elsevier Ltd

Quick View

Injury by design : a thematic networks and system dynamics analysis of work-related musculoskeletal disorders in tram drivers

- Naweed, Anjum, Bowditch, Lorelle, Trigg, Joshua, Unsworth, Carolyn

Authors: Naweed, Anjum , Bowditch, Lorelle , Trigg, Joshua , Unsworth, Carolyn
Date: 2022
Type: Text , Journal article
Relation: Applied Ergonomics Vol. 100, no. (2022), p.
Full Text:
Reviewed:
Description: Tram driving is a safety critical task where work-related musculoskeletal disorders (WRMSDs) and injuries are associated with interacting occupational design factors over time. These interactions then carry implications for workforce retention, public safety, workplace relations and supports. To better understand such interactions, this study used thematic networks and system dynamics (causal loop diagrams) analysis with the aim to unearth a global theme underscoring occurrence of WRMSDs, and describe the factors influencing the system dynamics of WRMSD occurrence in tram drivers. Building on earlier work focused on occupational participation, secondary analysis of driver interviews (n = 13) and driving observations (n = 11) produced thematic network and causal loop models of risk factors that highlighted an Injury by Design problem structure as a global theme. Research targeting organisational culture, human factors, and design standards is needed to minimise WRMSDs risk in tram drivers. © 2021 The Authors

Quick View

Linking people and activities through community mobility : an international comparison of the mobility patterns of older drivers and non-drivers

- Unsworth, Carolyn, Dickerson, Anne, Gélinas, Isabelle, Harries, Priscilla, Margot-Cattin, Isabel, Mazer, Barbara, Stapleton, Tadhg, Swanepoel, Lizette, Timmer, Amanda, Niekerk, Lana, Vrkljan, Brenda

Authors: Unsworth, Carolyn , Dickerson, Anne , Gélinas, Isabelle , Harries, Priscilla , Margot-Cattin, Isabel , Mazer, Barbara , Stapleton, Tadhg , Swanepoel, Lizette , Timmer, Amanda , Niekerk, Lana , Vrkljan, Brenda
Date: 2022
Type: Text , Journal article
Relation: Ageing and Society Vol. 42, no. 8 (2022), p. 1938-1963
Full Text:
Reviewed:
Description: Community mobility using private and public transportation is important for maintaining health, social participation and living well in later life. This international cross-sectional cohort study (N = 246) reported on the health and driving status of older adults from seven countries where the mobility patterns of drivers and non-drivers were compared in terms of city and rural areas, weather, as well as their respective differences in the number of out-of-home places accessed and quality of life. Older adults participated in a semi-structured interview and completed four standardised instruments: the EQ-5D-5L, modified PULSES health profile, modified Transportation Questionnaire, and the Transport - Participation in Activities and Places Outside the Home. Results suggested inclement weather and place of residence negatively impacted out-of-home activities but did not increase use of public transportation. Drivers accessed more out-of-home activities than non-drivers, suggesting higher community participation among this group, and quality of life was generally high among all participants, but slightly higher for drivers. Findings indicate that a complex myriad of factors can influence community mobility in older adults and further investigations are needed to understand patterns of transport in later life, particularly with regard to those factors that promote and maintain transport mobility, and relationships between transport mobility, community participation and quality of life. Copyright © The Author(s), 2021. Published by Cambridge University Press.

Showing items 1 - 20 of 36