Suchergebnisse

Including the client and user perspective is more and more in the focus of health care and community Services (Chu et al., 2016). Teaching examples and research projects of the Zürich University of Applied Sciences (ZHAW), illustrate and explore possibilities including client perspective and client specific skills in different ways. In the "enable-it skill laboratory" clients present their occupational performance difficulties and teach students specific skills based on the enablement skills of the CMOP-E. The structure and content of this teaching unit aims to facilitate a deeper understanding of client centeredness. "Learning from clients" in this "hands on" interaction, clients teach students different skill such as repairing electric appliances. Beforehand the student's interview the clients to their occupational history and relate theoretical aspects to practical experiences. Inclusive education: this course teaches influences of political and socio-cultural aspects and gives insight of personal experiences of a child and her family pioneering inclusive education. A young woman and wheelchair user co-lectures with a lecturer from the ZHAW. With a selection of running research projects such as the "playgrounds for all", we show how the perspective of children is included in research and how children`s voices need to be heard to remove play barriers.

Betätigungsfokussierte Instrumente auszuwählen und gleichzeitig den verordnenden Ärzten oder der Einrichtungspolitik gerecht zu werden, kann zum Dilemma führen. In diesen Fällen leitet das Klinische Reasoning zusammen mit einem Top-down-Vorgehen durch die Auswahl: Welche Instrumente liefern spezifische Informationen, die es für eine betätigungsorientierte und gezielte Therapieplanung braucht?

Background: Children with and without disabilities consider playgrounds as significant places in their life, which offer opportunities for play and social interactions. Playgrounds are especially important in times when opportunities to meet are restricted, for example, due to the Covid-19 pandemic. Even though the primary purpose of playgrounds is to be a place for children to play, playground design is mainly determined by adults. Children`s voices regarding their use of playgrounds, and their wishes and needs to enhance participation on playgrounds are seldom addressed. In particularly perspectives of children with disabilities are often absent. The aim of this presentation is to give insight into how the perspectives of children with disabilities may contribute to playground design. Method: The presentation draws on an international project that explores children's perspectives through literature reviews and semi-structured interviews. Results: Children make important contributions to playground design. For example, children with disabilities show a unique understanding of their own situation and propose inclusive playground adjustments. Their unique perspectives on play could help playground providers to adapt playgrounds to their needs and wishes to ensure participation in play including opportunities for social interactions and challenges according to their abilities. Discussion: Children are the main user group of playgrounds. Child-focused participatory methods that include children with different abilities and a variety of needs and backgrounds should be included in processes of playground planning, evaluating, and monitoring to enhance playground design. This project has received funding from the European Union & Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 861257.

Background: Inclusive playgrounds aim to enable all children to participate and be socially included on playgrounds through the way they are designed. However, knowledge is lacking about how children with and without disabilities perceive playing on inclusive playgrounds and whether these playgrounds lead to more social inclusion. Aims/Objectives: The study explores the experiences of children, with and without disabilities, of playing on inclusive playgrounds. Material and methods: Semi-structured interviews and observations were conducted on six inclusive playgrounds in Switzerland. Overall, 32 children aged 7–12 years participated; 14 children had a disability while 18 children did not. A qualitative content analysis was used for data analysis. Results: The children's experiences of playing on an inclusive playground resulted in the creation of three categories describing: how children with and without disabilities experience play activities on inclusive playgrounds; invisible barriers on inclusive playgrounds; and the fact that children with disabilities have recommendations for the design of inclusive playgrounds. Conclusions and significance: The results showed that achieving inclusion on a playground is complex and must be considered as a transaction among different environments. For occupational therapists, this could mean that, to support play as an activity on inclusive playgrounds, intervention is necessary at the community and political levels.

In Switzerland, recent changes in legislation have reformed special needs education; more children with special needs are now integrated into mainstream schools. Health professionals such as occupational therapists are not embedded in the Swiss education system, but pediatric occupational therapists are starting to work at schools, with the aim of enabling children's full participation as school students. This is bringing a change to the practice of pediatric occupational therapists. Cultural, political, and social factors differ in many ways from those of other countries where most of the current research on pediatric occupational therapists in mainstream education has been conducted. The need for school-based research that is situated within the political, structural, and cultural context of a country has been stressed in different studies. This qualitative study employed narrative analysis to explore the practice experiences and clinical reasoning of Swiss pediatric occupational therapists when working with children with special needs in the school context. Three main themes were identified in the narratives: "bringing in an occupational therapy perspective," "focusing on school-related occupations," and "collaborating with different inclusion players." These represent three different aspects of the therapists' emerging practice. The participants highlight different approaches for children with special needs to enable their participation in everyday life at school through learning, playing, and being with their peers. The findings are discussed in relation to current international research and with respect to European countries with a similar political and structural context, thus complementing approaches to school-based occupational therapy.

Introduction: Recent changes in legislation reformed special need education in Switzerland, subsequently more and more children with special needs are integrated in mainstream schools. Health professionals such as occupational therapists are not politically and structurally embedded in the education context. To enable children's full participation in different aspects of being a student such as learning, playing or doing arts and crafts, paediatric occupational therapists have started to work in mainstream schools. This has brought about a change of their practice context. Objectives: Cultural, political and social factors differ in many ways from countries, where most research has been conducted. The need for school-based research that is situated within the political, and cultural context of a country has been stressed in different studies and is objective of this study. Method: In a paradigmatic narrative approach five occupational therapists working in mainstream schools participated in semi-structured interviews. Their accounts of their stories and reflections of their work in this emerging context, were thematically analysed. Results: Three main themes were identified: "bringing in an occupational therapy perspective", "focusing on school related occupations" and "developing collaboration with different inclusion players". The findings demonstrate that occupational therapists found different avenues to contribute in enabling children to participate in everyday life at school learning, playing and being with their peers. Conclusion: The findings are discussed in relation to current international research and in regard to European countries with a similar political and structural context thus complementing approaches and guiding practice implications to school based occupational therapy.

In Switzerland, recent changes in legislation have reformed special needs education; more children with special needs are now integrated into mainstream schools. Health professionals such as occupational therapists are not embedded in the Swiss education system, but pediatric occupational therapists are starting to work at schools, with the aim of enabling children's full participation as school students. This is bringing a change to the practice of pediatric occupational therapists. Cultural, political, and social factors differ in many ways from those of other countries where most of the current research on pediatric occupational therapists in mainstream education has been conducted. The need for school-based research that is situated within the political, structural, and cultural context of a country has been stressed in different studies. This qualitative study employed narrative analysis to explore the practice experiences and clinical reasoning of Swiss pediatric occupational therapists when working with children with special needs in the school context. Three main themes were identified in the narratives: "bringing in an occupational therapy perspective," "focusing on school-related occupations," and "collaborating with different inclusion players." These represent three different aspects of the therapists' emerging practice. The participants highlight different approaches for children with special needs to enable their participation in everyday life at school through learning, playing, and being with their peers. The findings are discussed in relation to current international research and with respect to European countries with a similar political and structural context, thus complementing approaches to school-based occupational therapy. ; publishedVersion ; Copyright © 2019 Angelika Echsel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 861257. ; Introduction: The P4Play Marie Sklodowska-Curie (MSC) Training Network is an innovative European Joint Doctorate (EJD) programme in Occupational Science for Occupational Therapists. This EJD was established in 2020 when 2.2 m was awarded to a consortium of researchers and play advocates, in the highly competitive Horizon2020 scheme. P4play is a collaboration between 4 academic universities in Ireland, Sweden, Scotland, and Switzerland, and 15 partner organisations in Europe and the USA. The P4play programme adopts a child's rights-based perspective and aims to investigate the nature of play through the lens of People, Place, Policy and Practice (P4Play). Background: After extensive scientific research, scholarly exploration, and discourse on play, a refocus on play as a right requires further study as a central concern (or occupation) in children's lives. Occupational Science, a science dedicated to the study of humans as doers or as occupational beings, offers a unique lens to explore play as an occupation. From this perspective, the P4Play proposal was developed and submitted for funding to the MSC programme, in 2019 and was successful on first submission. P4play intends to amplify children's voices and explore the intersectionality of diverse childhood experiences of play, within families, communities, and cultures, drawing from pragmatism, complexity theories, childhood studies and anthropology among others. Methods: implementing the P4play programme The P4Play research programme has employed 8 early-stage researchers dedicated to exploring the complex and situated nature of play, e.g., social-spatial inclusion, play deprivation, and policy. and the development of solutions to address barriers to play provision in diverse community settings. Eight PhD research projects are being designed and implemented to examine play from diverse ...

This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 861257 ; In this poster session two research projects of P4Play in the area of practice are described. Introduction: The P4Play Marie Sklodowska-Curie (MSC) Training Network is an innovative European Joint Doctorate (EJD) programme in Occupational Science for Occupational Therapists. This EJD was established in 2020 when 2.2 m was awarded to a consortium of researchers and play advocates, in the highly competitive Horizon2020 scheme. P4play is a collaboration between 4 academic universities in Ireland, Sweden, Scotland, and Switzerland, and 15 partner organisations in Europe and the USA. The P4play programme adopts a child's rights-based perspective and aims to investigate the nature of play through the lens of People, Place, Policy and Practice (P4Play). Background: After extensive scientific research, scholarly exploration, and discourse on play, a refocus on play as a right requires further study as a central concern (or occupation) in children's lives. Occupational Science, a science dedicated to the study of humans as doers or as occupational beings, offers a unique lens to explore play as an occupation. From this perspective, the P4Play proposal was developed and submitted for funding to the MSC programme, in 2019 and was successful on first submission. P4play intends to amplify children's voices and explore the intersectionality of diverse childhood experiences of play, within families, communities, and cultures, drawing from pragmatism, complexity theories, childhood studies and anthropology among others. Methods: The P4Play research programme has employed 8 early-stage researchers dedicated to exploring the complex and situated nature of play, e.g., social-spatial inclusion, play deprivation, and policy. and the development of solutions to address barriers to play provision in diverse community settings. Eight PhD research projects are being ...

The shift towards inclusive education in many European countries has led to structural changes that affect both schools and their related professionals aiming to support children's participation. While most European countries acknowledge inclusive education and its need, serious challenges exist to its implementation at a national and local community level. Interdisciplinary collaboration, including health and educational professionals, is seen as an imperative key principle for inclusive education services. To learn about the occupational therapist's contribution to inclusive education, the aim of this study was to describe the state of the art of occupational therapists' collaboration and services delivery in Swiss schools. Using an exploratory, cross-sectional study design, a web-based survey was sent to 509 occupational therapists in Switzerland resulting in 302 responses for data analysis using descriptive statistics. Findings show that nearly all participants (97%) collaborate with schools, and 49% of participants provided direct services within a mainstream school setting. These services were mainly funded by health insurance and focused on physical and social environmental adaptations. Despite reported collaboration between occupational therapists and schools, this study shows a need for changes in federal health and education legislation as well as innovative solutions for service delivery in schools.

Introduction: Legionella spp. is a potential pneumonia causing pathogen, which can be transmitted to humans from water-supplying systems. Immunocompromised but also healthy individuals can be vitally threatened. Both, hot and cold-water supplying systems must be considered as transmission sources and therefore a periodic surveillance has to be performed in public buildings according to local legislations. During a routine surveillance, a hazardous colonization was detected within the cold-water supplying system at University Hospital Knappschaftskrankenhaus Bochum, Germany. Applied architectural measures remained unsatisfying in the reduction of legionella contamination of the cold-water distributing system. Methods: Adapted to an analysis of risks, effort and benefit, the superheat and flush procedure was applied twice with a time interval of 6 months. Results were evaluated concerning the efficiency and the sustainability and statistically analyzed. Results: While 33 out of 70 samples had a higher legionella count than the legal threshold of 100 CFU/100 mL (CFU - Colony Forming Units) before the first disinfection was carried out, this number could be reduced to 1 out of 202 samples after the first intervention. Additionally, in contrast to previously published studies, the effect was long-lasting, as no relevant limit exceedance occurred during the following observation period of more than two years. Conclusion: The superheat and flush disinfection can provide an economic and highly effective measure in case of legionella contamination and should be shortlisted for an eradication attempt of affected water-supplying systems in hospitals.

IntroductionCardiovascular diseases are increasing in aging HIV‐positive patients (HIV+). Impact of traditional cardiovascular risk factors, HIV‐specific parameters and antiretroviral therapy (ART) on the incidence of cardiovascular events (CVE) and on the mortality rate are investigated in different HIV+ cohorts.MethodsThe HIV HEART (HIVH) study is an ongoing prospective observational cohort study in the German Ruhr area to assess the frequency and clinical course of cardiac disorders in 1481 HIV+ by standardized non‐invasive cardiovascular screening. CVE were defined as diagnosed or documented myocardial infarction, coronary heart disease, arterial coronary intervention, stent implantation, bypass operation and stroke.Results1481 HIV+ subjects (mean age: 49.3±10.7 years (y), female: 15.6%) were included. 130 CVE and 90 deaths were documented until the end of 7, 5 year follow‐up of HIVH. Mean duration of the HIV‐infection was 12.9±6.8 y. HIV+ were treated with ART on average for 8.6±6.8 y. According to the CDC classification of the HIV‐infection, HIV+ were distributed over the clinical categories (A:34.6%; B:31.4% and C:33.9%) while more than the half had an advanced immunodeficiency (I:8.3%; II:41.1%; III:50.7%). Advanced clinical and immunological stages were significantly (p<0.001) associated with higher incidences of deaths (A:16.7%; B:26.7%; C:56.7% and I:6.7%; II:27.7%; III:65.6%) and CVE (A:17.7%; B:33.1%; C:49.2% and I:3.1%; II:32.3%; III:64.6%) but not with the duration of HIV‐infection (per y: Hazard ratio (HR): 0.91 [0.88–0.94]) and ART (per y: HR: 0.81 [0.79–0.84]) adjusted for age. The proportion of deceased HIV+ with HIV‐RNA ≥50 copies/mL and lower CD4‐cell counts at their last visit is significantly higher compared with living HIV+ without CVE (HIV‐RNA ≥50 copies/mL: 25.6% vs 14.7%). Median CD4‐cells: 286.5 cells/µL (IQR: 168.8–482.8) versus 574 cells/µL (IQR: 406–786). 96.1% of the living HIV+ with CVE had HIV‐RNA<50 copies/mL and median CD4‐cells 542.5 cells/µL (IQR: 370–793.5).ConclusionsAdvanced clinical and immunological stages of HIV‐infection, but not the duration of ART, were associated with higher incidences of CVE and deaths in the HIVH cohort. These observations support an earlier initiation of ART in HIV+. Special cardiovascular risk calculations for HIV+ should consider immunological and clinical categories of the HIV‐infection.