The greater number of older people in communities is reflected in their increasing demands on the services of accident and emergency (A&E) departments. Recognition of the complex needs of older adults attending A&E departments has resulted in many National Health Service trusts employing occupational therapists in these departments. The occupational therapists are required to assess and evaluate a patient's functional status and, using a team approach, to make decisions about his or her wider needs, including therapeutic requirements and social provision. In order to audit the provision of the occupational therapy service in an A&E department, data were collected monthly over a 3-year period in a single district general hospital on the referrals made by medical and nursing staff. The mean age of the patients referred was 80 years. The majority of the patients were female and living alone. The most common presenting problem was that of a fall, with a resulting fracture in half of the patients. The occupational therapy input in the A&E department was demonstrated in this study to save admissions to acute hospital care, amounting to an equivalent of two beds saved in each of the years covered by the audit.

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In order to test the hypothesis that monolinguals differ from bilinguals in their pattern of language lateralisation and to examine the relative merits of language-acquisitional versus language-specific factors, two experiments involving divided screen presentation of two languages were conducted using Welsh/English speaking participants. In the first experiment 80 monolingual teenagers were compared to 80 bilingual teenagers on a tachistoscopic "visual half-field" test of Welsh and English nouns and verbs. ANOVA revealed a greater left hemisphere advantage for Welsh-English bilinguals as compared to English monolinguals. Thus, in contrast to previous studies, in our bilinguals there was evidence of greater left hemisphere involvement in the processing of language. In the second experiment, four separate groups of 40 teenagers, varying in the age and manner of acquisition of their languages, were compared on the same test of Welsh and English words. These groups can be viewed as graded from the early to late bilinguals. ANOVA revealed a greater left hemisphere advantage when processing Welsh as compared to English words for all four groups. However no significant difference was observed between the four groups in respect of laterality for Welsh and English, indicating an equally greater left hemisphere bias for all four groups when processing Welsh words. We discuss these results in terms of a language-specific effect and suggest the specific orthography of the Welsh language (for individually presented nouns and verbs) promotes a left hemisphere advantage over and above language-acquisitional factors.