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Introduction:The clinical practice patterns and use of research evidence by Australian occupational therapists working with clients experiencing neurocognitive impairments has not been surveyed for nearly 10 years. This survey aimed to evaluate the current status of occupational therapy practice and evidence use and provide recommendations for ongoing evidence translation. Methods: An online survey of occupational therapists working in Australia was conducted over four months targeting registered clinicians working with adults experiencing neurocognitive impairments. Results: 191 occupational therapists from a wide range of clinical practice areas, with a significant level of experience completed the survey. Functional retraining (n = 180, 94%), compensatory training (n = 173, 91%) and task/environmental modifications (n = 161, 84%) were the most commonly reported intervention techniques, while more targeted interventions such as context-sensitive training (n = 54, 28%), positive behaviour supports (n = 42, 22%) and metacognitive strategy training (n = 37, 19%) were used less frequently. Half the respondents were aware of current research evidence and suggested a wide range of strategies supporting evidence translation. Traditional barriers of limited time, access and skills to interpret research were also reported. Conclusion: Consistent with earlier surveys most occupational therapists continue to use a functional/compensatory approach to cognitive rehabilitation, with an increasing number of therapists using specialist cognitive interventions. The current challenge for occupational therapists is embedding specialist techniques into occupation-based intervention. Knowledge translation and implementation strategies will be a critical component to achieving this. K E Y W O R D S acquired brain injury , evidence based practice, knowledge translation , metacognitive strategy training, occupational therapy | 75 NOTT eT al.

Introduction: Few ecologically valid assessment tools are available for occupational therapists to evaluate the cognitive demands and performance of women with breast cancer in the workplace. This study aims to identify difficulties in work-related cognitive strategy use experienced by women with breast cancer using the Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis. Method: Deductive content analysis was used to code secondary data from 10 interview transcripts involving women who had breast cancer and experienced difficulties in everyday cognitive functioning after treatment. Thirty-four PRPP cognitive strategy items were used as predetermined codes in a secondary analysis to identify and quantify specific cognitive difficulties described by the women. Results: The 10 women experienced problems with work tasks that required the cognitive strategies related to the 'programming', 'continuing', and 'attending' processing categories of the PRPP system. In addition, the women demonstrated strengths in their capacity to evaluate their own thinking and performance. Conclusion: This pilot study indicated the need for further research to determine how cognitive impairments which may occur after breast cancer treatment impact on occupational performance in a complex work environment. The PRPP System of Task Analysis was identified as a potentially useful measurement and interview tool for this purpose.

Objectives: The purpose of this paper is to review what is known about return to productivity roles for people who have HIV/AIDS and HIV Associated Neurocognitive Disorder (HAND), to highlight gaps in knowledge and practice for assisting people with HAND to engage in productivity roles, to describe an occupational therapy assessment system that overcomes some of the limitations of current research and practice, and to demonstrate the clinical utility of this instrument for use with clients who have HAND. Participants: The participant in this study is a man with HIV Associated Dementia (HAD), one sub-type of HAND. Methods: The real-world impact of HAD on productivity role participation was assessed using the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis, an ecological assessment method. Productivity tasks assessed were those associated with this man's desire to become a volunteer grocery shopper. The assessment took place under naturalistic conditions in a grocery store. Results: The participant demonstrated 28.6% mastery of the grocery shopping task. Performance was impacted on primarily by errors of accuracy and timing. Reasons for these errors centered on the participant's difficulties in applying cognitive strategies to perceive, recall, plan and perform the task. Conclusions: The PRPP System of Task Analysis shows promise in being able to identify errors in task mastery and the underlying cognitive strategy application errors that impact on mastery in people with HAND.

When considering the impact of contextual factors on paid employment for people with a dual diagnosis of spinal cord injury/traumatic brain injury, personal factors may be of greater influence than environmental factors. Study participants experienced few physical or attitudinal barriers and reported highly supportive interpersonal relationships.