Background: Call centres are thriving and expanding commercial enterprises providing cost-effective ways for organisations to connect with new and existing clients through telecommunication channels. Call centre agents perform this function telephonically for 75% of the day in large open-plan office environments characterised by workloads that are demanding, repetitive and highly scripted. Verbal abuse by clients is prevalent adding to a work experience that is potentially emotionally draining and stressful. Agents are under constant surveillance and monitoring to abide with commercial regulations but also to ensure high call volume and quality engagement with clients, these being the most important performance indicators. High staff absenteeism and attrition levels account for large financial losses in the industry. To date no studies have been found considering the impact of sensory processing of call centre agents on their performance, absenteeism and attrition. Sensory processing considers the neuro-physiological and behavioural components of individuals in the interactions with their daily work occupations and life environments. Although predominantly applied in paediatric clinical populations in occupational therapy, sensory processing provides universal truths about human behaviour which can add value to promoting wellness amongst healthy adults in work environments. Design: A quantitative, non-experimental and correlational study design was used to measure and compare demographic, sensory processing and performance data from 459 call centre staff within four fully operational call centres, which varied in type of operation, employer and geographical area in South Africa. The standardised and validated 60-item Adolescent/Adult Sensory Profile (Brown, Tollefson, Dunn, Cromwell & Fillion, 2001) was used to measure sensory processing as neurological thresholds and potential propensity for individuals to cope with high sensory stimulating work environments. Agent performance data in each of the four centres were recorded daily, in real time, using sophisticated information technology systems, and included details about absenteeism. Attrition data were collected after the initial data intake to reflect true attrition. Results: Data were analysed using statistical methods to obtain locality (e.g. means, medians), dispersion (e.g. standard deviations and interquartile ranges) and associations (e.g. Spearman Rank correlations). Results showed strong, consistent and significant correlations between agents who displayed sensation avoiding processing and poor performance. Agents who exhibited sensation seeking processing had higher performance ratings. To a lesser, yet still significant, degree agents with low registration and sensory sensitivity also had lower performance ratings. Sensory sensitive agents were absent less often than other workers and sensation seeking agents showed a tendency for higher attrition. Results differed between service inbound call centres to sales and collections outbound ones. Team leaders, who are high performing agents promoted into these positions, had less sensory sensitive and sensation avoiding processing styles. A novel subset structure was designed to account for the multidimensional capacity of the AASP, and this was correlated with all the performance data. It provided a preliminary method for use in further research studies. The study strengths were the innovative sample in measuring sensory processing of healthy populations at work and the compilation of performance data through sophisticated computerised systems, which minimised the margin of error. Study limitations were the use of a self-questionnaire format for profile data collection and small sample sizes in subsequent data collection stages. Recommendations: The AASP has the potential to be used by call centre human resource practitioners for recruitment and performance management. Improved sensory environmental considerations and adaptations supportive of a more successful and healthier agent-job-environment fit are provided. The study findings support knowledge transfer into other general human resource management, education and training, occupational health management and occupational therapy practises. It expands the application of sensory processing theories and informs future research.

Prue and Fairbank (1981) have identified parameters on which feedback procedures should be analyzed. This study investigated one parameter, the source of feedback. It was expected that feedback from supervisors would exert more control over paraprofessionals' behavior than feedback from non-supervisors. Paraprofessionals from six residences at a state school for mentally retarded persons were trained to work in pairs to teach their clients to leave the residence when a fire alarm sounded. Twenty-eight paraprofessionals participated; their ages ranged from 21 to 55, thirteen were women and fifteen men. Subjects were taught how to conduct fire-evacuation training, given the equipment they needed, and specific schedules. The dependent variable was the number of training trials each team did. The independent variable was a feedback memo on the team's performance from one of the two sources. The research design was a multiple-baseline across teams with the order of presentation of feedback sources counterbalanced. Training sessions were scheduled twice a week, but were only conducted when there was enough staff, about two-thirds of the time. A methodological refinement was made during the intervention; feedback on a team's performance began to be sent to each member rather than the team as one. Data were analyzed graphically and statistically. Results showed that each team did more training after feedback was introduced, but there were no differences across feedback sources. Delivering feedback to individuals improved several teams' performances. All clients who received feedback made progress. Four conclusions were drawn: (1) Feedback from different sources can control the behavior of paraprofessionals working in an institution for mentally retarded persons; (2) written feedback is more effective if delivered in a manner that ensures that each subject always sees it; (3) it is not effective to rely on antecedents to manage paraprofessionals' behavior; and (4) much work remains to be done on teaching mentally retarded persons fire-evacuation skills.

Two schedules of performance feedback were examined to determine their effects on the endurance of work habits. Three health-care routines (feeding, positioning, and transferring physically disabled clients) were task-analyzed and four direct service providers' actual performances were measured weekly. Concurrent schedules and multiple baselines across subjects and response classes were used to evaluate the effects of written instruction and intensive and intermittent feedback schedules. Results showed that instructions led to, at best, slight and usually brief change. Marked improvements in performances were noted after feedback, regardless of schedule. Follow-up measures indicated that performances maintained above baseline levels after both schedules. Subjects favorably rated the feedback program and recommended provision of this service to co-workers. Cost estimates indicate that while considerable time was spent developing the observational system used to assess work performances, the feedback procedure was easy to use and did not interfere with patient care.

Bibliography: leaves 120-126.

Magister Scientiae (Occupational Therapy) - MSc(OT) / Occupational justice empowers individuals, especially the previously disadvantaged, to have their basic needs met, as well as turn their potential into reality, through human rights and labour legislation, which provides access to equal opportunities. However, with the amount of different choices, in terms of occupational roles, facing the individual to fill their time with, effective management thereof to preserve one’s health and well-being on a daily basis, is not necessarily guaranteed. Occupational science, and more specifically, occupational therapy education imparts the importance of occupational balance, a concept which denotes a balance between the person, their environment and their occupations, some of which are strenuous and others relaxing. Occupational balance can be achieved by adapting the physical, mental, social and rests occupations.

Includes bibliographical references. / Substance abuse is a rising global health and social problem that is associated with serious medical, psychiatric, family, occupational, legal, financial and spiritual problems. While recovery from substance abuse is possible, it is a subjective and contested process. To date, the recovery process has not been explored from an occupational perspective in Zimbabwe, where as many as 60% of all readmissions at Zimbabwe’s psychiatric referral centre during the period from January 2010 to December 2011 were secondary to substance-induced disorders, and less than three percent of these patients moved into long-term recovery or sustained sobriety with rehabilitation follow-up. This qualitative narrative inquiry explores the journey of recovery from substance abuse among young adult Zimbabwean men. The aim of the study was to investigate how occupations played a role in the recovery journeys of each of these men. Three young adult men identified as former substance abusers were purposively selected for the study. Data generation occurred through in-depth narrative interviews with each participant. Principles of trustworthiness and validation emphasising the persuasiveness, coherence and pragmatic use of the narratives were applied throughout the research process, and ethical issues in narrative research were upheld. Ethical clearance was applied for and granted by the University of Cape Town’s Human Ethics Research Committee and permission to do the research was sought and given by the Medical Research Council of Zimbabwe. The findings of the study — explanatory stories — were produced through narrative analysis. These stories revealed substance abuse to be an occupation associated with both positive and negative consequences. Recovery from such abuse emerged as an ongoing occupational transition negotiated through participation in other occupations, and influenced by both personal and environmental factors. The way in which occupations were abandoned, modified and newly adopted during the process of this occupational transition is discussed. The construction and reconstruction of a positive occupational identity was seen as central to the process of occupational transition. The study concluded that engagement and participation in ‘engaging occupations’ was an intricate contributor to the recovery journey for young adult Zimbabwean men, and that narrative interviews should be used in generating data to explore the occupational nature of life and its events.

Introduction and aim Tobacco farmers are exposed to toxic workplace hazards such as nicotine and pesticides in addition to known agriculture related hazards like dust, and ergonomic factors. Nicotine and pesticide exposure have been linked to the development of chronic respiratory diseases. This study was aimed at determining the prevalence of obstructive lung disease among tobacco farmers in Malawi and its association to nicotine and pesticide exposure. Methods A cross-sectional study was conducted comprising of 279 current workers across four flue-cured tobacco farms in rural Zomba district of Malawi during a tobacco growing season. The assessment involved the use of a modified ECRHS questionnaire and questions on pesticides and nicotine exposure. Voluntary HIV testing was offered to individuals who did not know their HIV status. Health outcomes assessment involved the use of both symptom and spirometry-based diagnoses of obstructive lung disease. The data was analyzed using STATA 14 computer software and included bivariate and multivariate logistic regression analysis. Results The study had predominantly male participants (68%) with a total mean age of 37.7 years, majority (73%) of whom had attained primary education or higher, with 20% being current smokers. Participants had a mean employment duration of 7.3 years and 62% indicated that they worked mainly with tobacco while 57% were involved in pesticides application. HIV prevalence was 16%. The prevalence of current asthma (ECRHS) was 20% whilst for asthma score≥2 it was 23%. The prevalence of chronic bronchitis, work related ocular nasal symptoms and work- related chest symptoms were 17%, 20% and 29%, respectively. Airflow Limitation measured as FEV1 < LLN was 14% (NHANES and sample reference). The prevalence of moderate to severe obstruction was 4%. The prevalence of green tobacco sickness (a proxy for nicotine exposure) in the past year was 26% with an average of 3 episodes within that period. Most workers were exposed to pesticides with 72% reporting exposure during spraying of pesticides while 83% reported re-entry into fields soon after spraying. The main pesticide in use was organophosphates (18%). The majority (51%) of participants reported use of organophosphate pesticides at home. In multivariate analysis nicotine exposure and associated tasks were significantly associated with all respiratory outcomes (OR range 1.78-7.26). Pesticide application was positively associated with all the symptom-based respiratory outcomes (OR 1.96- 2.62) except for work related chest symptoms. Exposure during spraying was significantly associated with asthma score≥2 (OR 2.09, CI 1.01-4.31), current asthma (OR 2.57, CI 1.22-5.40), and work related ocular nasal symptoms (OR 2.43, CI 1.17- 5.04) while pesticide drift was associated with current asthma (OR 2.62, CI 1.00-6.86) and work related ocular nasal symptoms (OR 3.00, CI 1.18-7.62). In spirometry-based outcomes duration of pesticide exposure was significantly associated with FEV1/FVC< LLN (OR 5.11, CI 1.57-16.66), FEV1/FVC< 70% (OR 4.58, CI 1.17-17.98) and moderate to severe obstruction (OR 13.25, CI 1.69-103.93). Nicotine exposure was not significantly associated with spirometry-based outcomes. Conclusion In conclusion, this study showed that tobacco farmers in Malawi have a higher prevalence of asthma and chronic bronchitis compared to the general population or tobacco farmers in other settings. Additionally, exposure to nicotine and pesticides is strongly associated with the prevalence of obstructive lung diseases among these farmers.

South Africa is one of the most violent nations in the world and has an extremely high incidence of road accidents and work place injuries. The precise effect of this on upper limb injury statistics is not known as the incidence and prevalence of these conditions has yet to be determined. Hand injuries are, however, common worldwide and, in South Africa, may be complex in nature. This places a demand on occupational therapy services to provide comprehensive upper limb rehabilitation, a responsibility that inevitably falls on novice occupational therapists at some point. Occupational therapists in South Africa are required to complete a year of compulsory Community Service after graduating before they are permitted to practice independently. These placements are often in rural, under-resourced areas and graduates are faced with multiple new roles while negotiating the transition into practice. No published research to date has described the general experience of Community Service occupational therapists in South Africa or the extent to which these therapists are equipped to treat patients with upper limb injuries and conditions. The study sought to determine the extent to which Community Service occupational therapists are equipped to treat patients with upper limb injuries and conditions.

No description available.

Background: There is a high worldwide prevalence of cerebral palsy, a neurological condition which impacts most areas of life of children and their families. Evidence shows that occupational therapy is effective in enhancing the child's function, participation and quality of life, especially when provided at a young age and with high intensity. Literature provides additional recommendations for occupational therapy to follow a holistic and family-centred approach, considering participation in context, rather than an individual medical focus. These notions place pressure on the strained South African healthcare system, where human and physical resources, as well as contextually-relevant evidence for practice, are limited. The aim of this research was, therefore, to obtain a baseline description of the occupational therapy services being provided to children with severe cerebral palsy, across all government healthcare facilities of the Western Cape province. Methods: A quantitative, cross-sectional descriptive study was conducted, using a selfdesigned questionnaire. The questionnaire was developed using recognised survey principles in order to maintain research rigour, reliability and validity of results, and guidelines from previousstudies of a similar nature. The questionnaire was available to participants in duplicate online and hard copy formats. The anonymous, self-report questionnaire obtained profiles of the participating occupational therapists and their departments, descriptions of current service provision (assessments, goal-setting and interventions), perceived factors influencing service selection, and an understanding of services therapists felt they should be providing more of. No sampling took place and responses were invited from all occupational therapists employed by the provincial health department. All recruitment and correspondence took place via email or telephone. Recruitment and data collection took place over a period of 16 weeks, with each participant having a maximum of two weeks to submit their responses, after which a maximum of three reminders were sent. Numerical data were analysed using non-parametric descriptive statistics and categorical data were presented in terms of frequencies and percentages. Ethical principles adhered to included respect, confidentiality, anonymity, beneficence, non-maleficence and justice. Results: There was a response rate of 53%, with all provincial health districts and levels of care represented amongst participants. Assessments frequently involved observations of the child in activities(85%) and interviews with their caregiver (98%). Goals formulated, with some input of caregivers, related to occupational performance components (91%) more often than occupational performance (77%), and largely aimed to maintain the child's condition (68%), rather than improve development or functional participation (47%). A range of interventions were provided, but appointments were infrequent (median: 1 per month), mainly took place in clinical environments (100%), and waiting periods for assistive devices and orthotics were common. Opportunities for direct therapy and interventions in the child's daily context were limited, and home programmes and caregiver education were heavily relied upon indirect intervention methods, frequently implemented by 100% and 91% of participants respectively. Key factors influencing the selection of services included resource availability (62%), therapists' training (62%) and the level of care at which they worked (59%). Therapists felt they were meeting some of the children's needs, and required the support of the multidisciplinary team to meet more of their needs effectively. Conclusion: This study provides insight into occupational therapists' roles in the government healthcare sector in the Western Cape province, and highlights the degree of alignment of services with policy and elements of best practice. Some merits are clear, in terms of the combination of direct and indirect services provided and the involvement of families in therapy processes. However, there remains a shortfall in terms of effective holistic, evidence-based, family-centred, and early and intensive approaches. This study, therefore prompts revision of strategies to implement existing policies promoting quality services for people with disabilities and align occupational therapists' training with evidence-based practice and holistic frameworks and approaches. Further research is recommended, particularly a qualitative consideration of the contextual factors influencing service provision, in order to better understand and address the barriers to meaningful and effective services for this population within the context of Primary Healthcare. With these recommendations, quality service provision, leading to participation and quality of life outcomes for children with severe cerebral palsy and their families, may be enhanced.