The tuatara genome reveals ancient features of amniote evolution.

The tuatara (Sphenodon punctatus)-the only living member of the reptilian order Rhynchocephalia (Sphenodontia), once widespread across Gondwana1,2-is an iconic species that is endemic to New Zealand2,3. A key link to the now-extinct stem reptiles (from which dinosaurs, modern reptiles, birds and mammals evolved), the tuatara provides key insights into the ancestral amniotes2,4. Here we analyse the genome of the tuatara, which-at approximately 5 Gb-is among the largest of the vertebrate genomes yet assembled. Our analyses of this genome, along with comparisons with other vertebrate genomes, reinforce the uniqueness of the tuatara. Phylogenetic analyses indicate that the tuatara lineage diverged from that of snakes and lizards around 250 million years ago. This lineage also shows moderate rates of molecular evolution, with instances of punctuated evolution. Our genome sequence analysis identifies expansions of proteins, non-protein-coding RNA families and repeat elements, the latter of which show an amalgam of reptilian and mammalian features. The sequencing of the tuatara genome provides a valuable resource for deep comparative analyses of tetrapods, as well as for tuatara biology and conservation. Our study also provides important insights into both the technical challenges and the cultural obligations that are associated with genome sequencing.

Publisher Correction: The tuatara genome reveals ancient features of amniote evolution.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The experiences of families of children with cerebral palsy and complex disability after three years accessing the National Disability Insurance Scheme.

INTRODUCTION: In Australia, children with cerebral palsy and complex disability receive funded supports through the National Disability Insurance Scheme (NDIS). This individualised funding scheme requires parents to navigate and advocate on behalf of their child, supported by expert reports, recommendations, and allied health services. Supports aim to enable participation in all areas of daily life, which may be otherwise largely inaccessible to children with complex disability and their families. This study aimed to explore the experiences of families of children with complex disability after 3 years accessing the NDIS. METHODS: A qualitative research design with a demographic questionnaire and in-depth interview was undertaken. Purposive sampling was used to recruit participants from one organisation providing occupational therapy and other allied health services. Data analysis implemented Braun and Clarke's thematic approach to examine the experiences of participants. CONSUMER AND COMMUNITY INVOLVEMENT: This research was conducted with a registered National Disability Insurance Scheme provider to give voice to parent consumers who raise children with complex disability. FINDINGS: Seven mothers and one father (N = 8) of children with complex disability were interviewed. Most parents reported increased success and satisfaction navigating the scheme. Five overall themes were generated from the data: pivotal roles of families, parental empowerment, life-changing equipment, the fallibility of the scheme, and a critical scheme. CONCLUSION: Parents reported reliance on the scheme for their child's basic daily care and a more enriched life for their child and family. Parents were grateful for the scheme but experienced inconsistencies, navigation difficulties, and variable choice and control. Most parents had fears about the sustainability of the scheme, translating into uncertainty about their child's future. Allied health professionals, including occupational therapists, are key advocates for children with complex disability and their families. Collaboration through sharing knowledge and skills to support children, their families, and carers is key to empowering parents to navigate the NDIS. PLAIN LANGUAGE SUMMARY: The National Disability Insurance Scheme (NDIS) provides funding for people with permanent and significant disability. Children with cerebral palsy (and other complex disability) are lifetime users of the NDIS. For children with complex disability, their families are crucial to ensuring that their daily needs are being met, including providing medication. Previous research indicated that parents rely on the NDIS to support their children; however, there have been various challenges such as long wait times for equipment and difficulty understanding how to use the scheme. This study explored the experiences of families of children with complex disability, after more than 3 years of being an NDIS participant. Eight parents from one therapy service provider completed a short questionnaire about themselves, their child, and their family, followed by an interview with the first author. Four authors (occupational therapists) worked together to design and implement this study. The findings highlighted several key points: the important role of parents as caregivers; parents became more knowledgeable and confident to navigate the NDIS with time; equipment funded by the NDIS was life-changing; the NDIS has ongoing issues; and the crucial nature of the NDIS. Occupational therapists can be extremely important to families, including with supporting families to navigate the NDIS and advocating for them. Occupational therapists must stay current with their knowledge of the NDIS as they provide lifetime support, including prescribing equipment, technology, and home modifications.

Occupational Therapy Observation Tool-Adjustment Support Details for autistic children: Investigation of content validity and clinical utility.

INTRODUCTION: Standardised testing is crucial for autistic children to receive appropriate interventions, necessary services, and funding. Behaviours associated with autism can hinder children's test performance and participation. The 18-item, two-page Occupational Therapy Observation Tool-Adjustment Support Details (OTOT-ASD) is used in conjunction with standardised assessments. The OTOT-ASD enables the recording of autism-related behaviours and the reasonable assessment accommodations made to support participation in testing. The current study aims to investigate the content validity and clinical utility of the OTOT-ASD from occupational therapists' perspectives. METHOD: A specifically designed online questionnaire was distributed Victoria-wide to occupational therapists with clinical experience with autistic children. The questionnaire was designed in line with the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN), including relevance, comprehensiveness, and comprehensibility of items evaluated for content validity. Applicability and clinical usefulness were also investigated. Quantitative data were analysed using descriptive statistics. RESULTS: Seventy-one occupational therapists responded to the questionnaire and 46 provided a full dataset. Over 96% of the respondents considered documenting behaviours and testing accommodations as important, yet less than 45% reported having resources to record this information. Ninety-five percent of the respondents perceived the OTOT-ASD to be useful in clinical practice. Over 70% agreed that OTOT-ASD items were significantly relevant to practice and comprehensive. To improve comprehensibility, identified items were altered following feedback. CONCLUSION: The findings suggest that the OTOT-ASD is clinically useful and content validity is sound. Further research on other psychometric properties of the OTOT-ASD and users' qualitative experiences in utilising the tool is recommended.

Feasibility of Health Promoting Activity Coaching for Mothers of Children With Disabilities: Pilot Nonrandomized Controlled Trial.

IMPORTANCE: Mothers of children with disabilities experience health disparity. Interventions targeting maternal mental health need to be developed. OBJECTIVE: To determine the feasibility and preliminary effectiveness of the Healthy Mothers Healthy Families-Health Promoting Activities Coaching (HMHF-HPAC) intervention for mothers to improve participation in healthy activities and mental health and to evaluate outcome measures. DESIGN: Nonrandomized controlled pilot feasibility study with one group who received HMHF-HPAC and a control group. SETTING: Pediatric occupational therapy service; on site or telehealth. PARTICIPANTS: Twenty-three mothers completed prequestionnaires; of those, 11 mothers participated in the intervention, and 5 did not (7 withdrew). INTERVENTION: Eleven pediatric occupational therapists were trained to deliver six 10-min sessions of HMHF-HPAC to mothers, integrated into their child's therapy session or separately via telehealth. OUTCOMES AND MEASURES: Mixed-design analysis of variance explored changes in scores on the Depression Anxiety Stress Scale-21 Items and the Health Promoting Activities Scale. RESULTS: The intervention group reported, on average, significant reductions in depressive symptoms and stress symptoms and significant increases in participation in health-promoting activity. No significant main effect of time was found for these variables in the control group. CONCLUSIONS AND RELEVANCE: The HMHF-HPAC program is a viable occupational therapy coaching intervention that can be embedded in existing services for families of children with disabilities. Future trials that evaluate the effectiveness of the HMHF-HPAC intervention for mothers of children with disabilities are warranted. What This Article Adds: This article provides support for the feasibility of appropriate and sensitive outcome measures and program content and delivery to implement the novel HMHF-HPAC intervention in further research. Mothers of children with disabilities benefited from integrated HMHF-HPAC delivered by pediatric occupational therapists within the family's existing services.

Identifying support mechanisms to overcome barriers to food safety scheme certification in the food and drink manufacturing industry in Wales, UK.

Obtaining food safety certification is essential for food manufacturers. Potential barriers to obtaining certification are complex, interrelated and broadly relate to, 'knowledge and skills', 'time, cost and resources', and 'communication and access to information'. This study aimed to explore requirements for support to enable food manufacturers in Wales to overcome identified barriers. Food manufacturers (n = 37) participated in group discussions (n = 2) and completed online-questionnaires (n = 29). Support mechanisms, perceived necessary to obtain food safety certification included; funding for training and audit-fees, support for implementing food safety scheme documentation, on-site support through mentoring/coaching and pre-audits. Findings identify the need for a food safety scheme certification support package pathway incorporating online, off-site, on-site and financial support to assist food and drink manufacturers obtain third-party food safety certification. Such assistance would support three critical areas. Findings may inform development of support mechanisms to increase uptake of food safety certification and accelerate food-sector growth.

Initial Development and Evaluation of the My Family's Accessibility and Community Engagement (MyFACE) Tool for Families of Children With Disabilities.

IMPORTANCE: Parental perceptions and experiences of community inclusion influence the community participation of families and children with a disability, although no measurement tools exist. OBJECTIVE: To describe the initial development of the My Family's Accessibility and Community Engagement (MyFACE) tool. DESIGN: MyFACE measures parental perceptions of community accessibility and engagement of families raising a child with a disability. Items represent common community activities rated on a 5-point Likert scale. COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guided content validity, construct validity, and internal reliability testing. SETTING: Australia. PARTICIPANTS: Seventy-seven mothers of children with a disability provided data, with 69 complete data sets. RESULTS: The nine-item MyFACE had excellent content and construct validity and good internal reliability (Cronbach's α = .85). Hypothesis testing correlated MyFACE with maternal factors (mental health and healthy behavior) and child factors (psychosocial issues). Three predictors together explained 27% of the variance in a significant model, F(3, 61) = 7.09, p < .001. The most important predictor was maternal depressive symptoms. CONCLUSIONS AND RELEVANCE: Initial evaluation of the MyFACE tool suggests sound psychometric properties warranting further development. What This Article Adds: The MyFACE tool provides clinicians and researchers with a way to measure parental perceptions of community inclusion. Maternal depressive symptoms were predictive of MyFACE scores, indicating that to be effective, family participation may require clinicians to address maternal mental health and children's participation restrictions.

Cross-Cultural Validation of the Chinese Version of the Health Promoting Activities Scale.

IMPORTANCE: The Health Promoting Activities Scale (HPAS) measures the frequency of participation in health-promoting activities of mothers of children with disabilities. Translation of the HPAS into Chinese and validation of the Chinese version will enable its use with Chinese-speaking mothers of children with disabilities. OBJECTIVE: To translate the HPAS into Chinese and assess its construct validity in relation to measures of well-being, mental health, and activity satisfaction. DESIGN: Cross-cultural validation. SETTING: Community. PARTICIPANTS: Eight bilingual Chinese speakers were involved in the translation. Ethnic Chinese mothers of children with disabilities living in Australia, Singapore, or Taiwan (N = 89) were recruited via purposive snowball sampling. Participants self-selected to complete the Chinese e-survey. OUTCOMES AND MEASURES: Translation was guided by recommended frameworks. The Chinese versions of the Warwick-Edinburgh Mental Well-being Scale (WEMWS), Personal Well-being Index (PWI), and Kessler Psychological Distress Scale-10 (K10) were used to determine construct validity. Internal reliability was investigated. RESULTS: The Chinese version of the HPAS correlated significantly with satisfaction ratings (r = .45, p < .001; n = 87), WEMWS Total score (r = .61, p < .001; n = 85), PWI mean score (r = .44, p < .001; n = 84), and K10 total score (r = -.33, p = .002; n = 81). Internal reliability was moderate (Cronbach's α = .74). CONCLUSIONS AND RELEVANCE: The Chinese version of the HPAS was found to be cross-culturally equivalent to the original HPAS and psychometrically sound for use with Chinese-speaking mothers of children with disabilities. What This Article Adds: This study provides an example of the cross-cultural validation process. The Chinese version of the HPAS is psychometrically sound and could be used as an outcome measure of Chinese mothers' participation in health-promoting activities.

Contact experiences and needs of children of prisoners before and during COVID-19: Findings from an Australian survey.

Most of the research examining children visiting a parent in prison indicates that visits have a positive impact on children's well-being, their connection to the imprisoned parent and the parent themselves. However, the COVID-19 pandemic brought about a significant change to prison visits worldwide, with limits or bans on face-to-face contact. Understanding the experiences and needs of children during this period remains limited. This paper presents the findings of a survey of 84 carers of 184 children across Australia, investigating children's experiences of contact with their imprisoned parent both before and during COVID-19 restrictions. Although most carers reported maintaining contact during restrictions, a range of difficulties were noted: reduced availability; the effect of prison-based issues, including lockdowns; and the suitability of video/telephone visits for young children. Some described the benefits of videoconferencing, including reduced travel time and cost, and not needing to take children into a prison environment. Despite this, respondents typically described the negative impact of restrictions, and lack of physical contact, on children's emotional well-being. Our findings suggest that, for video visiting to be successful, it should be complementary to in-person visits, tailored to the needs of children, with support offered to families.

Healthy Mothers Healthy Families, Health Promoting Activity Coaching for mothers of children with a disability: Exploring mothers' perspectives of programme feasibility.

BACKGROUND: Health Promoting Activity Coaching, an intervention within the Healthy Mothers Healthy Families programme (HMHF-HPAC), was delivered by occupational therapists in a project that assessed feasibility of this new intervention. The HMHF-HPAC promotes the health and well-being of mothers of children with disabilities and is a six-session programme with website, workbook, and one-on-one coaching. Consumer experiences of this novel health-promoting intervention were sought to enable consumer-informed feedback for future modifications and improvements prior to further development. METHODS: This qualitative study explored the experiences of mothers who participated in the HMHF-HPAC and their perspectives on the service delivery, content and impact. This study was embedded within an overarching feasibility study and was conducted parallel to a quantitative component. Seven mothers who completed the HMHF-HPAC participated in semi-structured interviews. Data were analysed thematically using a six-stage thematic approach. FINDINGS: Four key themes emerged: Recognising Mothers; From Vulnerability to Empowerment; A Goal for Me; and Perspectives on Content and Delivery. Mothers reported increased participation in health-promoting activities over the duration of HMHF-HPAC, reflective of their individual needs. Mothers described improved mood and energy levels, reduced stress and anxiety, greater self-awareness, and increased engagement in leisure activities with their children. Health-promoting goals identified by mothers' pertained to improving physical activity levels, healthy dietary changes, sleep quality and duration, community engagement, and mindfulness activities. Mothers reported that their child's occupational therapists, the website, and workbook were acceptable and viable. CONCLUSIONS: Mothers' experiences support the feasibility of embedding the HMHF-HPAC programme into occupational therapy services directed towards child and family-focused interventions. Mothers found occupational therapists to be acceptable facilitators of the HMHF-HPAC, given the frequent interactions and rapport with mothers and the occupational underpinnings of the programme. The HMHF-HPAC is an accessible intervention that promotes family-oriented practice.

Healthy ageing through participation in community situated activities: A scoping review of assessment instruments to support occupational therapy practice.

INTRODUCTION: The occupational therapy profession has an essential role to play in healthy ageing that includes enabling participation, a construct that according to The International Classification of Functioning, Disability and Health (ICF), incorporates an environmental context. Environmental barriers and enablers of participation in community-situated activities for people over the age of 65 have been identified. To support practice, occupational therapists require assessments with demonstrated content validity including comprehensive coverage of the construct. The purpose of this scoping review study was to investigate what instruments are available to assess community participation for people over the age of 65 that included environmental factors. METHODS: A scoping review of the literature was conducted, utilising the Joanna Briggs Institute (JBI) scoping review methodology. The evidence source was review articles and inclusion criteria were that they reviewed instruments to assess participation that could be used for people over the age of 65. Items extracted from included instruments were evaluated against a preset list of community-participation and environment categories that had been developed from the ICF. RESULTS: Twenty-three review studies met inclusion criteria and from these 240 instruments were extracted. Twenty instruments were retained after exclusions and from these, 540 instrument items were extracted. Of these, 280 (47%) were coded as community-participation, and only 20 (3.4%) as environment items. Fourteen of the instruments included no environment items. CONCLUSIONS: No instrument was identified that comprehensively assessed community participation including the related environmental factors. Such an instrument is required to enable occupational therapy practitioners to support healthy ageing. The development of such an instrument will strengthen the profession's capacity to develop new ways of delivering services to older adults in line with emerging ways that aged care will be delivered and to advance its essential role in healthy ageing.

Peer mentor training: Pathway to competency for facilitators of Healthy Mothers Healthy Families workshops.

BACKGROUND: Healthy Mothers Healthy Families (HMHF) is a women's health and empowerment programme designed to promote the health and well-being of mothers of children with a disability. An ongoing need to extend the reach of HMHF to more mothers, and increase scalability, resulted in development of a training programme based in principles of adult and transformative learning, to credential mothers as HMHF facilitators. The current study evaluated the process and outcomes of the competency training programme for new facilitators. METHODS: A pretest and posttest design with midway data collection point was implemented to evaluate the facilitators' competence following the training programme. Surveys contained specifically designed demographic questions, open-ended questions, self-report of competency and estimation of need for education/training. Fifteen predetermined criteria enabled self-ratings. Training of facilitators occurred alongside delivery of 23-day HMHF workshops. Workshop participants provided anonymous objective evaluation of the facilitators' competencies. Triangulation enabled comparison of self-ratings, workshop participant ratings and author evaluation of new facilitators. RESULTS: Facilitators (N = 7) completed all theory and practical elements of the HMHF facilitator education package and were successfully credentialed in May 2020. Overall, facilitators' competency ratings were highest at Time 3, which followed successful co-facilitation of at least three HMHF workshops. As expected, facilitators rated their highest need for education/training at baseline. At Time 3, facilitators self-reported a lower need for education/training for all competency criteria. All facilitators received mean anonymous competency ratings from workshop participants (N = 294), above the predetermined benchmark that was required to become credentialled. CONCLUSIONS: The HMHF competency training programme, based on principles of adult and transformative learning, was effective in training seven HMHF facilitators who were mothers and had suitable professional backgrounds to deliver HMHF workshops. Training supports the fidelity of the HMHF intervention. Further research to evaluate maternal outcomes for participants attending the facilitator-lead workshops is warranted.

Understanding the barriers to food safety scheme certification in the food and drink manufacturing industry in Wales, UK.

It is increasingly essential for food manufacturers to have food safety certification. Little is known about certification in the Welsh food industry. This study aimed to explore perceptions of Welsh manufacturers regarding the drivers, benefits and barriers to obtaining certification. Focus groups with manufacturers and stakeholders (n = 68) were conducted. 'Customer requirement' and 'product safety' were drivers for obtaining certification. Benefits related to 'food safety culture', 'supply chain security', 'brand protection', 'due diligence', 'business growth' and 'job security'. Barriers were complex, often interrelated and were broadly defined as, 'knowledge and skills', 'time, cost and resources', and 'communication and access to information'. The research identifies the need to explore requirements for support to enable food manufacturers in Wales to overcome identified barriers. Such data may inform the design and development of support mechanisms to increase uptake of food safety certification and accelerate food sector growth in-line with Welsh Government aspirations.

Controlled choice, not choice and control: Families' reflections after one year using the National Disability Insurance Scheme.

INTRODUCTION: At least 40 percent of children with cerebral palsy and their families rely on access to allied health services, assistive technology, and require funding and expertise to achieve skills and participate in daily life. Implementation of the National Disability Insurance Scheme (NDIS) has resulted in a shift to public funding and emphasis on choice and control of services, support and assistive technology to promote social and economic participation. Families of children with cerebral palsy are invested in scheme success and their subjective experiences require consideration if the NDIS is to meet participation targets. OBJECTIVE: The aim of this research was to explore the experiences of families with a child with cerebral palsy, who have been in receipt of the NDIS for 12 months, comparisons to previous funding systems, and recommendations for the NDIS going forward. METHODS: Purposive sampling was utilised within one specialised paediatric setting. All families received occupational therapy intervention for their child. A qualitative approach using semi structured interviews was employed. Braun and Clarke's six phases of thematic analysis was utilised to analyse the data and explore participants lived experiences. FINDINGS: Eight (n = 8) mothers of children with cerebral palsy were interviewed. Three overarching themes were derived from the data: Equipment impacts on all areas of life; Frustration navigating the National Disability Insurance Scheme; and Gratitude, hope and suggestions. CONCLUSION: Families reported challenges navigating the NDIS including administrative challenges and extensive wait times for assistive technology, as well as gratefulness for increased opportunities for support. Occupational therapists and other allied health professionals can assist by: being proactive in service delivery and advocating for the needs of individual families and children; and finding ways to increase the preparedness of the NDIS to better understand the needs of children with cerebral palsy and their families.

Initial psychometric evaluation of the Hartley Knows Writing Shapes Assessment Version 2 with typically developing children between the ages of 4 and 8.

INTRODUCTION: Despite advances in technology, handwriting still remains an important part of the school curriculum. Especially during the early years of schooling, handwriting difficulties have been shown to negatively affect academic success. Consequently, occupational therapists rely on sound psychometric tools to assess a child's visual motor abilities and implement appropriate strategies to facilitate their handwriting outcomes. The Hartley Knows Writing Shapes Assessment Version 2 (HKWSA-V2) evaluates knowledge of writing shapes, ability to replicate writing shapes and knowledge of handwriting concepts used in the Hartley Knows Writing Program (HKWP). The current study describes the initial development and psychometric evaluation of the HKWSA-V2. METHOD: Typically developing children (N = 50) between 4 and 8 years old, completed two visual motor assessments: the HKWSA-V2 and the Beery Buktenica Developmental Test of Visual Motor Integration 6th Ed. (Beery VMI). Guided by the COnsensus-based standards for the Selection of health Measurement INstruments, statistical analysis was conducted using various non-parametric tests to assess the internal consistency, construct, and criterion validity of the HKWSA-V2. RESULTS: The internal consistency of the HKWSA-V2 ranged between adequate and excellent (Cronbach's α = 0.61-0.88). Construct validity as hypothesised, was supported with strong correlations found between groups of children who had and had not been involved in the HKWP. Statistically significant differences were also found in HKWSA-V2 scores based on the child's chronological age (r = .51, p < .01; r = .34, p < .05) and year level (p = .00). Criterion validity was substantiated with moderate to strong correlations found between all HKWSA-V2 scales and subscales and the Beery VMI subscales (ρ = 0.06-0.53). CONCLUSION: Evaluation of the tool provides promising initial psychometric findings. The tool allows professionals and clinicians to evaluate a child's visual motor abilities according to concepts learnt within the HKWP. Further development of the HKWSA-V2 is warranted.

Dunnock social status correlates with sperm speed, but fast sperm does not always equal high fitness.

Sperm competition theory predicts that males should modulate sperm investment according to their social status. Sperm speed, one proxy of sperm quality, also influences the outcome of sperm competition because fast sperm cells may fertilize eggs before slow sperm cells. We evaluated whether the social status of males predicted their sperm speed in a wild population of dunnocks (Prunella modularis). In addition to the traditional analysis of the average speed of sperm cells per sample, we also analysed subsamples of the fastest sperm cells per sample. In other words, we systematically evaluated the effects of including different numbers of the fastest sperm in our analyses, ranging from the 5-fastest sperm cells to the 100-fastest sperm cells in a sample. We further evaluated whether fitness, defined here as the number of chicks sired per male per breeding season, relates to the sperm speed in the same population. We found that males in monogamous pairings (i.e. low levels of sperm competition), produced the slowest sperm cells, whereas subordinate males in polyandrous male-male coalitions (i.e. high levels of sperm competition) produced the fastest sperm cells. This result was consistent regardless of the number of fastest sperm included in our analyses, but statistical support was conditional on the number of sperm cells included in the analysis. Interestingly, we found no significant relationship between fitness and sperm speed, which suggests that it is possible that the differential mating opportunities across social status levelled out any possible difference. Our study also suggests that it is important to identify biologically meaningful subsets of fastest sperm and cut-offs for inclusions for assessing sperm competition via sperm speed.

The impact of carer status on participation in healthy activity and self-reported health among Australian women over 50 years.

BACKGROUND/AIM: Occupational therapists frequently work with carers and their family member who requires direct services. In Australia, women provide the majority of informal care. Carer status is determined by the provision of informal help or supervision to an older person, or a person with a disability or long-term health condition. Caregiving responsibilities can impact mental and physical health and reduce women's participation in leisure activities and the labour force. The aim of the study was to examine differences in the participation of Australian women, aged 50 years and over, with and without caregiving responsibilities, in self-selected health promoting activities, self-reported mental health and participation in physical activity. METHODS: This cross-sectional study investigated Australian women (N = 157) who completed a survey comprising demographic questions, the Depression Anxiety Stress Scales-21 (DASS-21), International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Health Promoting Activities Scale (HPAS). Differences between carers and non-carers in participation in health promoting activities, mental health, physical activity and labour force participation were investigated using Mann-Whitney U and Kruskal-Wallis tests. RESULTS: Carers reported significantly lower participation in health promoting activities (P < 0.001), vigorous physical activity (P = 0.001) and moderate physical activity (P = 0.009). Carers also reported significantly higher responses than non-carers, in symptoms of depression, anxiety and stress (P < 0.001). Carers were significantly more likely than non-carers to be engaged in part-time employment, with 37% of carers employed part-time and 44% of carers not working. CONCLUSION: These findings indicate significant differences between women with and without caregiving responsibilities and their participation in health promoting activities, self-reported mental health, participation in physical activity and the labour force. Carers may benefit from occupational therapy that recognises the important role of carers in the life of their family member and supports carer's health and participation in health promoting activities.

Recovery in the first six months after hand and upper limb burns: A prospective cohort study.

BACKGROUND/AIM: Hands are commonly involved in burn trauma. Occupational therapy in the acute phase aims to reduce the risk of deformities and facilitate return to usual occupations. This study aimed to describe usual occupational therapy care at a major adult burns service, and measure recovery from hand burns in the first six months post-acute hospital discharge. METHOD: To describe usual occupational therapy care, an audit of patient contact statistics over six months was undertaken, and occupational therapy staff were interviewed. To measure recovery, a prospective cohort study recruited adults hospitalised with hand/upper limb burns at the Victorian Adult Burns Service. Recruitment occurred over a four month period. Functional recovery was measured at three time points: discharge, three and six months post-discharge. Instruments included the Quick Disabilities of the Arm, Shoulder and Hand and the Functional Assessment for Burns. RESULTS: Usual care was calculated to be one 30 minute session of daily occupational therapy. Interventions were described using the Template for Intervention Description and Replication. Participants (N = 10) were aged 22-65 years and were treated for burns ranging from 2% to 40% total body surface area. Scores on the Functional Assessment for Burns suggested high functional independence at discharge. Quick Disabilities of the Arm, Shoulder and Hand scores improved significantly at each time point, with most substantial improvement occurring between discharge and three months. Involvement of the first web-space was associated with poorer recovery in the first three months post-discharge (P = 0.04). Six participants (60%) had returned to work at the three month follow-up, and seven (70%) at six months. CONCLUSION: The Quick Disabilities of the Arm, Shoulder and Hand was responsive to recovery in the post-discharge period. Further research into upper limb recovery following burns is needed, including exploration of the relationship between recovery and first web space hand burns.

The experiences of social and community participation of people with non-traumatic spinal cord injury.

BACKGROUND/AIM: Incidence of non-traumatic spinal cord injury in Australia is increasing, which will result in more occupational therapists being involved in the rehabilitation of this group in the future. The profile of people with non-traumatic spinal cord injury differs from people with traumatically acquired spinal cord injuries, and their long-term health and well-being outcomes are not known. The aim of this study was to explore the experience of returning to social and community participation following non-traumatic spinal cord injury. METHODS: Qualitative methods were used for this study. Semi-structured interviews were conducted with seventeen people with non-traumatic spinal cord injury who had returned home. Data were analysed inductively utilising the thematic analysis method. RESULTS: The process of returning to social and community participation following non-traumatic spinal cord injury was identified as occurring in three main stages: withdrawal; re-emergence into society; and stability. Each stage consisted of adjustment and adaptation in a number of areas, including: the loss of independence; the experience of being out in public; social networks; participation in productivity roles; and expectations regarding satisfactory social and community participation. Many of the participants had developed or were developing strategies to adapt to the changes experienced in these stages. CONCLUSION: By using a qualitative approach, this study adds to the understanding of the adjustment process experienced by people following non-traumatic spinal cord injury when they return to living in the community. Although findings parallel those of studies conducted with people with TSCI, there are some differences that may warrant alternative approaches from occupational therapists working with people with NTSCI. Such approaches include assisting people with NTSCI to modify their expectations regarding how they will participate in the community, assisting them to find new meaningful roles, and facilitating the development of new social networks to replace lost ones.

Criterion Validity of the Child's Challenging Behavior Scale, Version 2 (CCBS-2).

OBJECTIVE: The Child's Challenging Behavior Scale, Version 2 (CCBS-2), measures maternal rating of a child's challenging behaviors that compromise maternal mental health. The CCBS-2, the Child Behavior Checklist (CBCL), and the Strengths and Difficulties Questionnaire (SDQ) were compared in a sample of typically developing young Australian children. METHOD: Criterion validity was investigated by correlating the CCBS-2 with "gold standard" measures (CBCL and SDQ subscales). Data were collected in a cross-sectional survey of mothers (N = 336) of children ages 3-9 yr. RESULTS: Correlations with the CBCL externalizing subscales demonstrated moderate (ρ = .46) to strong (ρ = .66) correlations. Correlations with the SDQ externalizing behaviors subscales were moderate (ρ = .35) to strong (ρ = .60). CONCLUSION: The criterion validity established in this study strengthens the psychometric properties that support ongoing development of the CCBS-2 as an efficient tool that may identify children in need of further evaluation.