It has recently been suggested that yogic philosophy provides a model for occupational therapy and that meditation and pranayama (yogic breathing exercises) can facilitate occupational performance. This literature review was undertaken to determine whether there is any evidence to support the use of pranayama to facilitate occupational performance. A literature search using AMED, BNI, CINAHL, HMIC, Medline and Old Medline for the term `pranayama', limited to English language human research uncovered seven articles clinically applicable to occupational performance. The evidence suggests pranayama can influence, arousal, metabolism and exercise tolerance. Slow alternate nostril breathing should be considered when anxiety impairs occupational performance, and right nostril breathing should be considered for obesity, lethargy, and symptoms of hypothyroidism or similar metabolic disorders that inhibit function. Further research is required for evidence-based application of other pranayama techniques.
Teamwork in health care settings is assumed to be beneficial for the client since it allows for a more holistic, comprehensive, co-ordinated approach. It is essential, therefore, for team members to have an adequate knowledge of, and respect for one another's professions. Traditionally, the different health care professions know little about each others specific skill-set and their roles as health care practitioners, whereas in interprofessional education (IPE), clinicians and/or students become familiar with the knowledge, skills and attitudes of each other to be effective team members. Changes in the current health care environment require well-versed, flexible, collaborative clinicians who work for the client's best interests. Traditional professional silos are no longer viable. IPE both at the undergraduate/pre-employment level and postgraduate/post-employment level is seen as one means to foster effective cross-professional communication, collaboration and client-centred care. IPE assists students to increase their knowledge of the roles and functions of other related professionals and enable an integrated approach to both in the workplace and in collaborative practice. Given that IPE is resource intensive, a question that can be posed is "how effective is IPE?" Many evaluation studies examining the effectiveness of IPE in health care contexts (mainly with physicians and nurses) have been completed. Only a few investigations have included other health professions such as occupational therapy, pharmacy, social work or physiotherapy. All of the IPE effectiveness studies report some form of positive benefit or outcome, but none of the studies are definitive or have been replicated. Many of the published health science IPE evaluation studies lack adequate rigor in terms of poor or unclear research design used, small sample size, non-randomisation of participants, lack of comparison control group, lack of acknowledgement of bias, non-standardised instruments used and/or statistical analyses completed. Several systematic reviews have been completed dealing with the published health science IPE evaluation literature, but the results have been largely inconclusive. Ongoing evaluation of the effectiveness of IPE in the health sciences is required.
Can a work setting with its organizational, cultural, and practical considerations influence the way occupational therapists make decisions regarding client interventions? There is currently a paucity of evidence available to answer this question. This study aimed to investigate the influence of work setting on therapists' clinical reasoning in the management of clients with cerebral palsy and upper limb hypertonicity. Specifically the study aimed to examine therapists' objective and stated policies, and their intervention decisions using Social Judgement Theory methodology. Participants were 18 occupational therapists with more than five years experience with clients with cerebral palsy who were asked to make intervention decisions for clients represented by 90 case vignettes. They worked in three settings, hospitals (5), schools (6), and community (6). One participant from private setting was not included in the analysis because of lack of participants in this setting. The results indicated that therapy settings did influence therapists' decisions about intervention choices but not their objective and subjective policy decisions.