bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual Reality Exposure Therapy Does Not Provide Any Additional Value in Agoraphobic Patients: A Randomized Controlled Trial
Authors: Meyerbroeker K. , Morina N. , Kerkhof G.A. , Emmelkamp P.M.G.
Published: March 2013

Background: A number of studies have demonstrated the efficacy of virtual reality exposure therapy (VRET) in specific phobias, but research in seriously impaired patients with agoraphobia is lacking. In this randomized controlled trial with patients with agoraphobia and panic disorder, VRET and exposure in vivo were compared in terms of outcome and processes involved. Methods: Patients with panic disorder with agoraphobia (n = 55) were randomly assigned to receive 4 sessions of cognitive behavioral therapy (CBT) followed by either 6 sessions of VRET or 6 sessions of exposure in vivo or to a waiting list control condition. Results: Analyses showed that both active treatment packages were significantly more effective than no treatment and that no differences between VRET and exposure in vivo were found in three out of four outcome measures. On the panic disorder severity scale, however, CBT plus exposure in vivo was more effective than CBT plus VRET. The results show clear synchrony of temporal processes involved in VRET and exposure in vivo on weekly avoidance measures and cognitive measures. Further, it was shown that initial changes in agoraphobic cognitions during the CBT phase predicted later changes in agoraphobic avoidance behavior. Conclusion: These data support the notion that therapeutic processes involved might be the same in VRET and exposure in vivo. However, given the slight superiority of exposure in vivo above VRET, the costs involved in the implementation of VRET and the lack of long-term follow-up, VRET cannot yet be recommended for patients with agoraphobia.
Memory Awareness Profiles Differentiate Mild Cognitive Impairment from Early-Stage Dementia: Evidence from Assessments of Performance Monitoring and Evaluative Judgement
Authors: Clare Linda , Whitaker Christopher J. , Roberts Judith L. , Nelis Sharon M. , Martyr Anthony , Marková Ivana S. , Roth Ilona , Woods Robert T. , Morris Robin G.
Published: March 2013

Background: Measures of memory awareness based on evaluative judgement and performance monitoring are often regarded as equivalent, but the Levels of Awareness Framework suggests they reflect different awareness phenomena. Examination of memory awareness among groups with differing degrees of impairment provides a test of this proposition. Method: Ninety-nine people with dementia (PwD), 30 people with mild cognitive impairment (PwMCI), and their relatives completed isomorphic performance monitoring and evaluative judgement measures of memory awareness and were followed up at 12 and (PwD only) 20 months. In addition to the resulting awareness indices, comparative accuracy scores were calculated using the relatives' data to establish whether any inaccuracy was specific to self-ratings. Results: When making evaluative judgements about their memory in general, both PwD and PwMCI tended to overestimate their own functioning relative to informant ratings made by relatives. When monitoring performance on memory tests, PwD again overestimated performance relative to test scores, but PwMCI were much more accurate. Comparative accuracy scores indicated that, unlike PwD, PwMCI do not show a specific inaccuracy in self-related appraisals. Conclusions: The results support the proposition that awareness indices at the levels of evaluative judgement and performance monitoring should be regarded as reflecting distinct awareness phenomena.
The Impact of Self-Reported Psychological Stress Levels on Changes to Peripheral Blood Immune Biomarkers in Recreational Marathon Runners during Training and Recovery
Authors: Rehm Kristina E. , Elci Okan U. , Hahn Kathryn , Marshall,Jr. Gailen D.
Published: March 2013

Objective: Marathon training is both physically and psychologically stressful, both of which can lead to altered immunity. The purpose of this study was to determine if the overall immunoregulatory changes associated with the physical stress of marathon training are affected by psychological stress. Methods: Nineteen recreational marathoners completed the Perceived Stress Scale (PSS), State-Trait Anxiety Inventory (STAI) and Penn State Worry Questionnaire (PSWQ), and had levels of T cell subpopulations and cytokine (IFNγ, IL4 and IL10) production determined 4 weeks before (baseline), 24-48 h before (prerace) and 1 week after (recovery) participation in a marathon. Results: PSS scores decreased at the prerace visit compared to baseline and remained low at recovery. Compared to baseline, there were significant changes to numerous immune measures at the prerace visit, including decreases in Th1/Th2 ratio, Tc1/Tc2 ratio, Tr1 and Th3 cell populations as well as decreases in IFNγ/IL4 cytokine ratio and IL10 production. Most immune parameters had returned to near baseline values at the recovery visit. Higher levels of perceived stress, anxiety and worry exacerbated many of the alterations in immunity that were observed at the prerace visit. Higher levels of perceived stress and worry had significant effects on changes to Treg, IL4 production and the IFNγ/IL4 cytokine ratio. Stress had an additional impact on changes in IL10 production. High anxiety levels resulted in significant changes to Treg, Tr1 and Th3. Conclusion: These data suggest that recreational marathon runners with higher levels of psychological stress may be more at risk for the immune alterations that are common during periods of prolonged physical training.
Prenatal Hypoxia Downregulates the Expression of Pulmonary Vascular Endothelial Growth Factor and Its Receptors in Fetal Mice
Authors: Tsao Po-Nien , Wei Shu-Chen
Published: March 2013

Background: Previous reports showed that prenatal hypoxia delays the process of lung maturation. Vascular endothelial growth factor (VEGF) and its receptors were important for lung development. However, the role of VEGF and VEGF receptors in altered fetal lung development and maturation induced by prenatal hypoxia remains unknown. Objectives: To elucidate the role of VEGF and VEGF receptors in altered fetal lung development and maturation induced by prenatal hypoxia. Methods: Lung sections of control and maternal hypoxic fetal mice were used for the determination of lung development and total RNA isolated from lung homogenates were used for determination of the expression patterns of VEGF, Flt-1, Flk-1, hypoxia-inducible factor (HIF)-1α, HIF-2α, surfactant protein (SP)-A, SP-B, SP-C, and SP-D by quantitative real-time RT-PCR. Results: Prenatal hypoxia resulted in fetal mice body weight gain impairment, delayed fetal pulmonary aeration and maturation. Pulmonary SP-A, SP-B, SP-C, and SP-D mRNA were all decreased in the prenatal hypoxia group. In addition, we demonstrated that prenatal hypoxia inhibited the developmental increase of pulmonary HIF-1α and HIF-2α expression and resulted in decreasing VEGF and its receptors (Flt-1 and Flk-1) at the mRNA expression level and VEGF protein level in fetal lungs. These inhibitory effects persisted and progressed even when the dams were returned to air. Conclusions: We suggest that prenatal hypoxia insults, at least in late gestation, influence pulmonary VEGF and VEGF receptor expression through the down-regulation of HIF pathways and impair fetal lung growth and maturation.
Genotypes and Phenotypes of 162 Families with a Glomulin Mutation
Authors: Brouillard P. , Boon L.M. , Revencu N. , Berg J. , Dompmartin A. , Dubois J. , Garzon M. , Holden S. , Kangesu L. , Labrèze C. , Lynch S.A. , McKeown C. , Meskauskas R. , Quere I. , Syed S. , Vabres P. , Wassef M. , Mulliken J.B. , Vikkula M. ,   GVM Study Group
Published: March 2013

A decade ago, we identified a novel gene, glomulin (GLMN) in which mutations cause glomuvenous malformations (GVMs). GVMs are bluish-purple cutaneous vascular lesions with characteristic glomus cells in the walls of distended venous channels. The discovery of the genetic basis for GVMs allowed the definition of clinical features to distinguish GVMs from other venous anomalies. The variation in phenotype was also highlighted: from a single punctate blue dot to a large plaque-like lesion. In this study, we screened GLMN in a large cohort of patients to broaden the spectrum of mutations, define their frequency and search for possible genotype-phenotype correlations. Taking into account 6 families published by others, a mutation in GLMN has been found in 162 families. This represents 40 different mutations; the most frequent one being present in almost 45% of them. Expressivity varies largely, without a genotype/phenotype relationship. Among 381 individuals with a mutation, we discovered 37 unaffected carriers, implying a penetrance of 90%. As nonpenetrant individuals may transmit the disease to their descendants, knowledge on the mutational status is needed for appropriate genetic counseling.
Experimental Designs for Array Comparative Genomic Hybridization Technology
Authors: McDonnell S.K. , Riska S.M. , Klee E.W. , Thorland E.C. , Kay N.E. , Thibodeau S.N. , Parker A.S. , Eckel-Passow J.E.
Published: March 2013

Array comparative genomic hybridization (aCGH) technology is commonly used to estimate genome-wide copy-number variation and to evaluate associations between copy number and disease. Although aCGH technology is well developed and there are numerous algorithms available for estimating copy number, little attention has been paid to the important issue of the statistical experimental design. Herein, we review classical statistical experimental designs and discuss their relevance to aCGH technology as well as their importance for downstream statistical analyses. Furthermore, we provide experimental design guidance for various study objectives.
Urinary Protein Excretion Is Associated with Left Ventricular Hypertrophy in Treatment-Naïve Hypertensive Patients in an African Hospital Setting
Authors: Forlemu Arnold , Menanga Alain , Ashuntantang Gloria , Kingue Samuel
Published: March 2013

Background: Left ventricular hypertrophy (LVH) is an independent predictor of fatal and non-fatal cardiovascular events in hypertensive patients. Current guidelines for the management of hypertension are based on cardiovascular risk stratification. This study evaluated the possibility that an inexpensive, simple random, single-void urinary protein-to-creatinine ratio (UPCR) would be associated to left ventricular (LV) mass in a black African setting, and therefore direct appropriate management of these patients. Methods: We measured echocardiographic LV mass and a random spot UPCR in 34 untreated newly diagnosed hypertensive patients attending the cardiology consultation unit at the Yaoundé General Hospital. LV mass was indexed to height (in m2.7) to obtain the LV mass index (LVMI). A regression model was used to verify the independent association between UPCR and LVMI. Results: The mean age of our patients was 52.65 years, and the mean systolic and diastolic blood pressures were 152.44 and 92.84 mm Hg, respectively. The prevalence of LVH was 41.2%. UPCR was higher in patients with LVH compared to those without (p = 0.043). There was a significant correlation between UPCR and LVMI (r = 0.581, p < 0.001). In the multiple linear regression model, UPCR was associated with LVMI independent of systolic blood pressure (p < 0.001). Conclusion: Random spot UPCR is associated with an increased LV mass and may be very useful in screening and guiding appropriate management of high-risk untreated hypertensive patients.
Correlation between Biological Marker Expression and 18F-Fluorodeoxyglucose Uptake in Cervical Cancer Measured by Positron Emission Tomography
Authors: Park Sang I. , Suh Dong S. , Kim Seong-Jang , Choi Kyung U. , Yoon Man-Soo
Published: March 2013

Background: This study aimed to determine whether several biologic markers were associated with 18fluorine-fluorodeoxyglucose (18F-FDG) uptake in patients with carcinoma of the cervix. Patients and Methods: 60 patients with International Federation of Gynecology and Obstetrics (FIGO) stages IA2 to IIB cervical cancer, who underwent 18FDG positron emission tomography/computed tomography (PET/CT), were included in the current study. All patients underwent radical hysterectomy. Tumor sections were stained by immunohistochemistry for glucose transporter 1 (GLUT1), carbonic anhydrase-IX (CA-IX), vascular endothelial growth factor (VEGF), hexokinase type I (HK-I), hexokinase type II (HK-II), and cytoplasmic and nuclear hypoxia-inducible factor (HIF) 1α. Results: The expression of GLUT1 (p = 0.005), VEGF (p = 0.021), HK-II (p = 0.009), and cytoplasmic HIF1α (p = 0.024) was significantly associated with a higher median standardized uptake value (SUVmax). There was a positive correlation between 18F-FDG uptake and GLUT1 (p = 0.008), CA-IX (p = 0.030), HK-II (p < 0.001) as well as cytoplasmic HIF1α (p = 0.016), whereas this relationship was not observed among the VEGF, HK-I and nuclear HIF1α. Conclusion: The data presented in this study indicate that 18F-FDG uptake is associated with the presence of GLUT1, VEGF, nuclear HK-II, and cytoplasmic HIF1α. There was also a significant correlation among the rate of expression of GLUT1, HK-II, cytoplasmic HIF1α, and CAIX in carcinomas of the cervix.
ECRG1 and Its Relationship with Esophageal Cancer: A Brief Review
Authors: Rasool Sabha , Khan Tanzeela , Qazi Falak , Ganai Bashir A.
Published: March 2013

Esophageal cancer ranks 8th among the most frequently occurring cancers of the world. The exact cause of esophageal squamous cell carcinoma (ESCC) is unknown; however, some factors like smoking, alcohol intake, consumption of fungal-contaminated, spicy, or nitrosamine-containing foodstuffs and hot beverages, together with various genetic factors, have been found associated with the occurrence of this disease in various parts of the world. Much work has been carried out to elucidate the role of various gene mutations and polymorphisms in esophageal mucosal cancer. Previous studies have suggested that esophageal cancer-related gene 1 (ECRG1), as a novel candidate of the tumor suppressor gene family, is expressed in normal esophagus, liver, colon and lung tissues, but the expression is seen to be down-regulated in tumors, especially in ESCC, and in adjacent tissues. The Arg290Gln polymorphism in exon 8 of the ECRG1 gene has been studied in particular in a number of cases and has been observed to play an active role in the development of ESCC. This suggests that substitution of the arginine in the conserved catalytic domain of the ECRG1 protein might reduce its catalytic capacity by impacting its 3-dimensional conformation, thereby causing the genetic susceptibility to ESCC.
Relevance of Incidental Colorectal FDG-PET/CT-Enhanced Lesions
Authors: Putora Paul M. , Müller Joachim , Borovicka Jan , Plasswilm Ludwig , Schmidt Felix
Published: March 2013

Introduction: Positron emission tomography/computed tomographies (PET/CTs) may result in incidental findings of fluorodeoxyglucose (FDG)-avid lesions in the colon. The aim of this study was to assess the relevance of a colonoscopic workup of such lesions. Patients and Methods: We retrospectively analysed all PET/CT reports (n = 4,973) generated in our nuclear medicine department between May 2006 and May 2011; in 69 cases a colonoscopic evaluation was recommended for incidental FDG-avid lesions. Results: Of these 69 cases, 51 underwent colonoscopy because of the potential need for further treatment. The maximum standardized uptake values (SUVmax) ranged from 5.0 to 42.0 with an average of 10.9. In 44 of the 51 patients, a histopathological abnormality was found on colonoscopy, 44 in the location described by PET/CT. A further 38 lesions were identified that were not visible on PET/CT. The histopathological evaluation in the 51 patients revealed 14 hyperplastic polyps, 27 adenomas with low-grade and 4 with high-grade dysplasia, 3 adenocarcinomas and 1 neuro-endocrine tumour. Conclusion: Incidental findings of focal colorectal FDG uptake should lead to further workup with colonoscopy. The SUVmax was not predictive for higher grade histologies. With an SUV of 5 the yield was high for colonic premalignant and malignant lesions. However, malignancy cannot be ruled out in focal lesions with an SUV of less than 5, and for individual patients a colonoscopy should not be ruled out.
Repeat Coronary Revascularization After Coronary Artery Bypass Surgery in Older Adults
Authors: Fosbøl Emil L. , Zhao Yue , Shahian David M. , Grover Frederick L. , Edwards Fred H. , Peterson Eric D.
Published: March 2013

Background—

A major advantage of coronary artery bypass graft surgery (CABG) relative to percutaneous coronary intervention is its durability, yet there is a paucity of information on rates and predictors of repeat coronary revascularization after CABG in the modern era.

Methods and Results—

We included patients ≥65 years from the Society of Thoracic Surgeons’ National Adult Cardiac Surgery Database who were undergoing first-time isolated CABG from 1991 to 2007 (n=723 134, median age 73 years). After linking to Medicare claims data, long-term outcomes of CABG (up to 18 years after surgery) were examined by use of cumulative incidence curves. Multivariable Cox proportional hazard analysis was used to identify factors associated with 1- and 5-year repeat revascularization trends and variability. We found that the overall 18-year survival rate was 20%. Cumulative incidences of any repeat revascularization (percutaneous coronary intervention or CABG, yet most often percutaneous coronary intervention) were 2%, 7%, 13%, and 16% at 1, 5, 10, and 18 years after surgery, respectively. The rates of repeat CABG procedures were quite low for all time points (0.1%, 0.6%, 1.3%, and 1.7%, respectively). Female sex, disease severity represented by a history of percutaneous coronary intervention, preoperative dialysis, and partial revascularization were strongly associated with a higher revascularization rate, whereas advanced age, left main disease, and smoking were associated with a lower rate. There was approximately a 2-fold variation in repeat revascularization rates across centers at 1 year (interquartile range 1.7–3.6%) and 5 years (interquartile range 6.7–12.0%).

Conclusions—

Repeat revascularization is performed infrequently among older patients who undergo CABG; however, these rates vary substantially by patient subgroups and among providers.
Risk Factors for Intracerebral Hemorrhage
Authors: Howard George , Cushman Mary , Howard Virginia J. , Kissela Brett M. , Kleindorfer Dawn O. , Moy Claudia S. , Switzer Jeffery , Woo Daniel
Published: March 2013

Background and Purpose—

Risk factors for intracerebral hemorrhage (ICH) have been largely identified in case–control studies, with few longitudinal studies available.

Methods—

Predictors of incident ICH among 27 760 black and white participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study were assessed.

Results—

There were 62 incident ICH events during an average follow-up of 5.7 years. The increase in risk with age differed substantially between blacks and whites (
P
=0.006), with a 2.25-fold (95% confidence interval, 1.63–3.12) increase per decade in whites, but no age association with ICH risk in blacks (hazard ratio=1.09; 95% confidence interval, 0.70–1.68). We observed increased risk among men, those with higher systolic blood pressure, and warfarin users.

Conclusions—

The racial differences in the impact of age contributed to a risk of ICH that was >5 times higher for blacks than whites at age 45, but only about one third as great by age 85. Confirming findings from other studies, men participants with elevated systolic blood pressure and warfarin users were also at greater risk. The contributors to the racial differences in ICH risk require additional investigation.
Malignant Emboli on Transcranial Doppler During Carotid Stenting Predict Postprocedure Diffusion-Weighted Imaging Lesions
Authors: Almekhlafi Mohammed A. , Demchuk Andrew M. , Mishra Sachin , Bal Simerpreet , Menon Bijoy K. , Wiebe Samuel , Clement Fiona M. , Wong John H. , Hill Michael D. , Goyal Mayank
Published: March 2013

Background and Purpose—

Carotid angioplasty and stenting (CAS) has a higher incidence of periprocedural stroke compared with endarterectomy. Identifying CAS steps with the highest likelihood of embolization may have important implications. We evaluated CAS safety by correlating the findings of procedural transcranial Doppler with postprocedure diffusion-weighted imaging (DWI) lesions.

Methods—

In this prospective study, transcranial Doppler monitoring was performed during CAS procedures, which were divided into 11 steps. Embolic signals on transcranial Doppler were counted and classified based on the relative energy index of microembolic signals into microemboli ≤1 or malignant macroemboli >1. Poststenting MRI was performed in all cases. A negative binomial regression model was used to evaluate the predictive value of transcranial Doppler emboli for new DWI lesions.

Results—

Thirty subjects were enrolled. Seven of 30 subjects (23.3%) were asymptomatic. The median embolic signal count was 212.5 (108 microemboli and 80 malignant macroemboli). Stent deployment phase showed the highest median embolic signals count at 58, followed by protection device deployment at 30 (
P
=0.0006). Twenty-four of 30 (80%) had new DWI lesions on post-CAS MRI. The median DWI count was 4 (interquartile range 7). Two of 30 (6.7%) had new or worsening clinical deficits post-CAS. For every malignant embolus, the expected count of DWI lesions increases by 1% ( 95% confidence interval, 0%–2%;
P
=0.032).

Conclusions—

We observed a high incidence of embolic signals during CAS procedure, especially, when devices were deployed. Most subjects developed new DWI lesions, but only 6.7% had deficits. Malignant macroemboli predicted new DWI lesions.
Two new Oxalis (Oxalidaceae) species from the Richtersveld National Park, South Africa
Authors: DREYER LÉANNE L. , ROETS FRANCOIS , OBERLANDER KENNETH C.
Published: March 2013

Two new Oxalis species from the Richtersveld National Park (South Africa) are described and typified. Both species show strong morphological resemblance to members of the South African Oxalis section Cernuae. Oxalis nivea sp. nov. closely resembles the well-known weed O. pes-caprae, but it bears white flowers, and has a very restricted distribution range north of the northernmost known locality of O. pes-caprae. Oxalis rosettifolia sp. nov. is distinguished from all other species by a combination of a flat basal rosette of leaves, terete petioles, flask-shaped floral tubes and at least some enlarged, spathulate bracts at the terminal articulation of the peduncle. Phylogenetic analyses based on nuclear ITS and plastid trnSG data confirmed the placement of both of these species within a clade containing O. pes-caprae. The exact placement of these two species differs between ITS- and trnSG-based trees, but both analyses confirm a close relationship between the two new species and O. copiosa and O. cf. haedulipes.
QIU, Z.J., WANG, X.L., LIU, Z.Y., YANG, J.F. & ZHANG, S.Z. (2012) Cytological and phylogenetic study of Petrocosmea hexiensis (Gesneriaceae), a new species from Chongqing, China. Phytotaxa, 74, 30–38.
Authors: QIU Z.J. , WANG X.L. , LIU Z.Y. , YANG J.F. , ZHANG S.Z.
Published: March 2013

Please note the following information should be added to the author:XIAO-LING WANG1,3,††Equal contributor
A taxonomic revision of the Meranoplus F. Smith of Madagascar (Hymenoptera: Formicidae: Myrmicinae) with keys to species and diagnosis of the males
Authors: BOUDINOT BRENDON E. , FISHER BRIAN L.
Published: March 2013

The species-level taxonomy of the ant genus Meranoplus F. Smith from Madagascar is revised. Two new species, M. cryptomys sp. n. and sylvarius sp. n. are described from workers and queens; M. mayri Forel, 1910, and M. radamae Forel, 1891, are redescribed, and queens and males for these two species are described for the first time. The first diagnosis of Meranoplus males for any biogeographic region is provided based on Malagasy species. Illustrated keys to all known Malagasy castes and species are presented. Diagnoses are given for two species groups: the M. mayri group and the M. nanus group. The diagnosis of the M. nanus species group from Bolton (1981) is thereby expanded with six new characters. Two species are known from the M. mayri species group and seven described species are known for the M. nanus species group, including the two new species described herein. The mouthparts, genitalia, and all castes, where known, of Malagasy Meranoplus are illustrated.
The tadpole of Pleurodema cordobae Valetti, Salas & Martino, 2009 (Anura: Leiuperidae) from Córdoba, Argentina
Authors: OTERO MANUEL A. , GRENAT PABLO R. , VALETTI JULIAN A. , SALAS NANCY E. , MARTINO ADOLFO L.
Published: March 2013

The frog genus Pleurodema Tschudi, 1838 is distributed from Panama throughout South America to southern Chile and Argentina and currently is represented by 15 species, of which 10 have been recorded in Argentina (Faivovich et al. 2012). Recently, Valetti et al. (2009) re-described the tetraploid species P. kriegi and described a related cryptic species, the octoploid Pleurodema cordobae. These species are endemic of the Sierra Grande of Córdoba (Ferraro & Casagranda 2009; Valetti et al. 2009; Valetti et al. 2011) and together with the tetraploid P. bibrioni comprise a clade of polyploid cryptic species within the genus (Faivovich et al. 2012). The external morphology has been described for the tadpoles of P. bibrioni and P. kriegi by Kolenc et al. (2009), but the tadpole of P. cordobae remains undescribed. The aim of this work is to describe the larval external morphology and oral disc of new species P. cordobae.
Description of the male of Architis catuaba Santos & Nogueira, 2008 and new records of Architis capricorna Carico, 1981 (Araneae: Pisauridae)
Authors: SILVA ESTEVAM L. CRUZ DA
Published: March 2013

The genus Architis Simon, 1898 currently includes 21 described species distributed in the Neotropical region, from Panama to Argentina (Platnick 2012). Santos (2007b) provided the latest revision, describing eight new species and synonymizing A. nitidopilosa Simon, 1898 with A. tenuis Simon, 1898 (the type species of the genus), A. suarez Carico, 1989 with A. cymatilis Carico, 1981 and A. paulistana Mello-Leitão, 1917 with Aglaoctenus lagotis (Holmberg, 1876). Recently, three new species were described by Santos & Nogueira (2008) from the Amazonian region, inNorthern Brazil.
Exploration of a Group Model in Fieldwork Education
Authors: Farrow Susan , Gaiptman Barbara , Rudman Deborah
Published: March 2013

Objective. Organizational changes, such as program management and managed care, and fluctuations in resources present challenges to the effective provision of fieldwork placements. This study compared an innovative group model with a traditional 1:1 supervision model to determine their effect on students and supervisors.

Method: The two models were implemented at an urban clinical facility in several areas of practice over a 2 year period. Questionnaires were used to assess student skill development, student and supervising therapist satisfaction, and impact on supervising therapists' use of time. Focus groups were used to explore the advantages and disadvantages of each model.

Results. There were few statistically significant differences in students' (n=26) and supervising therapists' (n=28) ratings when the two models were compared. The qualitative findings suggest that the advantages of one model often relate to the disadvantages of the other model. In addition, supervising therapists and students offered several suggestions for how to improve implementation of the group model.

Conclusion: When the results of the study are compared to the objectives established for the group model, it appears that many of the objectives outlined for the model were partially achieved. Several issues, such as the student-supervisor relationship and the evaluation process, need to be addressed with participants to ensure successful implementation of the group model.
Perceived and Valued Roles of Adults with Severe Mental Health Problems
Authors: Hachey Raymonde , Boyer Geneviève , Mercier Céline
Published: March 2013

The purpose of this article is to convey the findings of two studies related to the perception of past, present and future roles, the value attributed to these roles as well as the role patterns. Both studies were conducted with adults who have schizophrenia and are involved in a rehabilitation or work program. Data were collected from two sources: 1) secondary analysis of a study related to the methodology for validating the French translation (Hachey, Jumoorty, & Mercier, 1995) of the “Role Checklist”, (Barris, Oakley, & Kielhofner, 1988) and 2) a research project on the perception of roles and quality of life. Results showed that the dominant roles assumed by participants regardless of time were family member, friend, home maintainer and hobbyist. The most valued roles were those of friend, worker, and family member. The discussion will address the questions asked and elucidate the role patterns. The conclusion underlines the importance, for occupational therapists and health professionals, of including roles in the daily lives of their clients, taking into consideration the ones they value most highly.
Issues in Bidding for Contracts for Occupational Therapy Services
Authors: Harms Sheila , Law Mary
Published: March 2013

There is an increasing number of occupational therapists in Canada who are involved in bidding for contracts to deliver occupational therapy services. Occupational therapists working in an institutional or community-based setting may not have had the responsibility of developing a proposal or a marketing plan for bidding purposes. However, the responsibility of developing a bid to compete for a service delivery contract often rests on occupational therapists who are sole practitioners in a private practice setting. The purpose of this paper is to highlight issues in the literature such as service delivery plans, marketing strategies and costing of services that can assist the occupational therapist in the development of a contractual bid. A specific clinical example, school therapy services, has been used to illustrate how these strategies can be applied to practice. Success in contractual bids appears to be primarily influenced by cost of the service, the expertise of the service provider, ability to provide coordinated care, ease of access for clients, and inclusion of methods to measure client outcome.
Reflections on Reflective Practice
Authors: Kinsella Elizabeth Anne
Published: March 2013

In recent years, a wide range of professions have adopted ‘reflective practice’ as an approach to professional development, and many professions have made it a mandatory dimension of their membership credentialling process. Despite the fact that it has been widely taken up in the professional world, there are many different conceptualizations and ideas about what it is. In this paper, six theoretical underpinnings of reflective practice are considered, and suggestions are made about how we can begin to incorporate reflection into our own practices.
L'évolution de notre perspective sur l'occupation: un périple passant de la thérapie récréative à l'utilisation thérapeutique de l'activité, jusqu'à la promotion de l'occupation
Authors: Polatajko Helene
Published: March 2013

La thérapie occupationnelle, dans le sens large du terme, est devenue la préoccupation la plus sérieuse à laquelle doivent faire face les hommes d'état du monde entier en ce moment. Dans tous les pays du globe, la propagation du chômage (manque d'occupations) monopolise l'attention des parlements nationaux et des congrès mondiaux. Dans le monde entier, on tente de remédier à l'insatisfaction humaine et aux troubles mentaux en demandant aux gens d'accomplir des tâches quotidiennes pour occuper leur esprit, garder leur corps en santé et leur permettre de trouver un moyen de subsistance (Howland, 1933, p. 4).
Meaning of Occupational Engagement in Life-Threatening Illness: A Qualitative Pilot Project
Authors: Vrkljan Brenda , Miller-Polgar Janice
Published: March 2013

INTRODUCTION: The onset of a personal crisis combined with the resultant disruption in occupational routines may challenge a person's identity as a capable and healthy individual. However, it remains unclear how individuals regain a sense of health and well-being in the period following a personal crisis.

RESEARCH OBJECTIVE: To explore occupational engagement and its meaning to individuals following a life-threatening diagnosis.

METHOD: Semi-structured interviews were conducted with three women diagnosed with breast cancer. The data were analyzed using a constant-comparative approach to identify common themes.

RESULTS: The primary theme that emerged was “Doing = Living.” This theme and the underlying themes illustrated the connection between meaningful occupational engagement and one's self-perception as capable and healthy. These findings suggest that occupational engagement may provide the medium through which ‘deconstructive’ or ‘reconstructive’ messages concerning the self are relayed between persons and their environment.

IMPLICATIONS: In a period of personal crisis, such as a life-threatening diagnosis, individuals may turn to those occupations that are meaningful to regain a sense of control and normalcy in their lives.
Culture and Occupation: A Comparison of Weaving in Two Traditions
Authors: Bonder Bette R.
Published: March 2013

The ways in which cultural beliefs are reflected in the enactment of specific occupations are not well described. A comparison of weaving in the Guatemala Highlands and in Northeast Ohio was completed using interview and observation to provide detailed information about the enactment of weaving, and its meaning to women in the two cultures. Findings demonstrate that there are significant differences in content, context, pattern, affect, and meaning of the occupation. However, weavers also express similar experiences of connection with others, maintenance of tradition, and creative and spiritual expression. Findings also suggest that interventions to maintain the important meanings of the occupation must be tailored to the specific cultural beliefs of the two different groups.
Participatory Action Research: Integrating Community Occupational Therapy Practice and Research
Authors: Cockburn Lynn , Trentham Barry
Published: March 2013

Participatory action research (PAR) is a form of collaborative research particularly concerned with power inequities of marginalized communities. With this approach, occupational therapists can work with clients and communities to address issues of access, inclusion, equity and collaboration in practice and research. This paper begins with a summary of key concepts and controversies related to participatory action research. Two examples from occupational therapy experience are used to demonstrate the initial steps and key principles of PAR projects and to highlight the conceptual links between PAR and community-based, client-centred occupational therapy. One project involved a group of mental health consumers, the other a community group of older adults. Several challenges and potential outcomes in PAR projects are highlighted in this examination of the complexity of PAR processes. The paper concludes by identifying possibilities and obstacles to the further use of PAR in occupational therapy.
La signification des activités quotidiennes chez les personnes souffrant de troubles mentaux graves
Authors: Aubin Ginette , Hachey Raymonde , Mercier Céline
Published: March 2013

Les troubles mentaux graves affectent les occupations quotidiennes et le mode de vie des personnes qui en souffrent. Une étude descriptive a été menée ayant pour but d'étudier quelle signification les personnes souffrant de troubles mentaux graves donnent à leurs activités quotidiennes. Dans cette étude, la signification des activités a été définie à partir du Modèle de l'occupation humaine de Kielhofner, et ce, par trois déterminants, soient: le sentiment de compétence, l'importance et le plaisir. Ceux-ci ont été mesurés pour chaque activité quotidienne à l'aide du Questionnaire occupationnel lors d'une entrevue semi-structurée effectuée auprès de 45 personnes souffrant de troubles mentaux graves. De façon générale, les activités incluses dans les catégories de l'hygiène et des soins, des repas et du sommeil ont obtenu les moyennes les plus élevées pour chaque déterminant, soit le sentiment de compétence, l'importance et le plaisir. Toutefois, le travail se distingue quant à l'importance accordée à l'activité tandis que les activités sociales sont mises en valeur par leur association au plaisir. L'analyse des résultats souligne l'importance pour les ergothérapeutes de mieux connaître le sens accordé aux activités quotidiennes par les personnes souffrant de troubles mentaux graves afin de soutenir les efforts de ces personnes à développer une perception plus positive de leur occupation du temps.
Impact of Wheeled Seated Mobility Devices on Adult Users' and Their Caregivers' Occupational Performance: A Critical Literature Review
Authors: Reid Denise , Laliberte-Rudman Deborah , Hebert Deborah
Published: March 2013

The prescription of wheeled seated mobility devices for clients with mobility impairment is a growing area in occupational therapy practice. The goal is to enhance client participation in occupation through technical intervention. This critical review examines the body of knowledge concerning the impact and effectiveness of the provision of wheeled seated mobility on the occupational performance of wheelchair users and their caregivers. The scope and gaps in the literature are defined to identify areas for future research. While the focus is on the methodological issues of the research reports, the relevance of findings to occupational therapy practice will also be reviewed. The results of the 46 studies in this review indicate that the majority of research conducted thus far have methodological limitations, which limits the extent to which this body of research can be drawn upon to provide evidence for the effectiveness of wheeled mobility systems. While most of the studies reviewed addressed constructs of relevance to occupational therapy practice, there was an emphasis on performance components and inadequate attention to engagement in occupations. This review is an important first step in building the ability of occupational therapists to demonstrate effectiveness in wheeled seating interventions.
Learning from Today's Clinicians in Vocational Practice to Educate Tomorrow's Therapists
Authors: Strong Susan , Baptiste Sue , Salvatori Penny
Published: March 2013

Background. In response to the demand for therapists and changes in vocational practice, a needs assessment was conducted to update an occupational therapy educational program. Method. Employing focus groups, interviews and questionnaires, 66 therapists from a wide range of graduating institutions working in vocational practice were asked to: a) identify the essential knowledge, skills and professional behaviours required for vocational practice; b) determine to what extent training is preparing students for vocational practice; and c) make recommendations for curriculum revision and/or for additional curriculum development. Participants and their jobs were profiled together with the challenges and issues of vocational practice. Results. There was strong agreement among participants regarding what is required to practice effectively but disparate views concerning the extent they were prepared for practice. Clinical Implications. Recommendations were given for entry and postgraduate level curricula. Findings were compared to a past community practice survey. Implications for practicums, professional integrity and ethical issues were discussed.
Well-Being and Older People: A Review of the Literature
Authors: Stanley Mandy , Cheek Julianne
Published: March 2013

Background. Most countries in the world are experiencing an expansion in their population of older people. As people now expect to live longer, they also seek continuing health and well-being throughout their extended old age. Occupational therapists are involved in working towards the attainment of well-being with their older clients. However, their understandings of what well-being for older people entails seems varied, as this examination of the occupational therapy and related gerontological literature reveals. Results. Three key points emerge from the literature review: first, the definition of well-being is usually assumed, or is lacking in clarity, and a range of similar terms, such as happiness and life satisfaction, are used interchangeably; second, well-being has been measured in research using various scales, which may not capture the complexity of the concept; and third, the perspective of the older person is often missing in discussions of well-being. Clinical Implications. It is suggested that one way of moving occupational therapists' understanding of well-being forward is to conduct research into what older people themselves understand or perceive well-being to be.
Pressure Relief Splinting for an Infant: A Systemic Approach
Authors: Denys Adelle
Published: March 2013

Background. This case report describes a unique splinting design used on a 6 month-old infant with a grade II heel pressure sore. Traditional methods of attaining pressure relief such as gel pads and repositioning may benefit an inactive, relatively healthy child. However, a 6 month-old infant who is actively at the developmental age of reciprocal kicking is less likely to respond to these interventions. Furthermore, children with multiple systemic diagnosis may demonstrate a rapid deterioration of their pressure sore when the most effective intervention is not initially chosen. Method. This paper reviews the multiple systems which impact wound healing to assist the occupational therapist in choosing efficient methods of pressure relief. The splint design described was chosen due to the age and the complex medical history of the infant. Practice Implications. The effectiveness of total pressure relief initiated early in the infant's treatment resulted in complete visual healing within one month. It was worn for six weeks to avoid recurrence on an already susceptible area of skin.
Lorsque l'enseignement supérieur s'intéresse au renouvellement des pratiques en réadaptation: étude de besoins
Authors: Durand Marie-José , Falardeau Marlène
Published: March 2013

Description générale et but. Afin de répondre aux nouveaux défis que pose la pratique professionnelle en réadaptation, une étude a été effectuée au Québec auprès d'intervenants du domaine pour évaluer leurs besoins de formation continue au 2e cycle universitaire. Méthodologie. Au total, 99 personnes ont participé à des groupes de discussion et à des entrevues téléphoniques. Une analyse de contenu des discours a été réalisée. Résultats. Deux grandes catégories de compétences à acquérir ont été dégagées : le développement du « soi-outil », c'est-à-dire de l'amélioration de la capacité d'introspection de l'intervenant dans sa pratique professionnelle et le “ soi-producteur de services », à savoir l'acquisition de connaissances dans le domaine cognitif reliée à l'amélioration de la qualité des services. Par ailleurs, les participants ont favorisé une variété de modes pédagogiques dont des enseignements intensifs offerts de préférence les fins de semaine et des programmes courts de formation (9 à 15 crédits). Conséquences pour la pratique. Cette étude a permis de cibler les besoins particuliers des cliniciens pour faire face aux transformations actuelles des services de santé. La nécessité de créer un programme de 2e cycle en réadaptation a été mise en évidence et beaucoup d'enthousiasme face à la création d'un tel programme a été manifesté.
Occupationaljustice and Client-Centred Practice: A Dialogue in Progress
Authors: Townsend Elizabeth , A.Wilcock Ann
Published: March 2013

Background. This paper describes an ongoing, international dialogue about the relationship between occupation, justice, and client-centred practice, prompted by the question: How do occupational therapists work for justice? Methods. The authors critically reflect on their own dialogue and culturally situated interests, dialogues with workshop participants, and a literature review. Results. Four cases of occupational injustice are proposed: occupational alienation, occupational deprivation, occupational marginalization, and occupational imbalance. The naming of these occupational injustices suggests four occupational rights: to experience meaning and enrichment in one's occupations; to participate in a range of occupations for health and social inclusion; to make choices and share decision-making power in daily life; and to receive equal privileges for diverse participation in occupations. Practice Implications. Since silence implies compliance with the status quo, the authors encourage occupational therapists to develop their own dialogue about occupational injustices in order to address them openly with others. Dialogue about occupational justice is timely as occupational therapists around the world articulate what distinguishes this numerically small, rather invisible profession and its contributions to individuals, populations, and societies.
Can I Play Too? Physical Activity Engagement of Children with Developmental Coordination Disorders
Authors: Poulsen Anne A. , Ziviani Jenny M.
Published: March 2013

Background. Children with developmental coordination disorders (DCD) are less physically active and have significantly different patterns of social and physical play than their well-coordinated peers. Factors. The impact of motor incoordination on physical activity engagements throughout life is influenced by a multitude of factors. External factors such as the social, cultural and physical environment may act as either supports or barriers to active physical involvement. Individual characteristics including the unique physical and psychological attributes of the child with motor coordination difficulties also impact on engagement in physically active occupations. Result. A model is proposed that conceptualizes the multiple dimensions which impinge on the decisions to select, engage and persist in physical activities for children with developmental coordination disorders. Practice Implications. The occupational therapist's role in promoting a balanced and physically active lifestyle is explored. Interventions to increase physical activity participation for children with DCD are dependent on a full understanding of the complex, multi-dimensional correlates of occupational engagement.
Occupational Performance Challenges for Children with Congenital Heart Disease: A Literature Review
Authors: Imms Christine
Published: March 2013

Backround. Paediatric specialists have advocated for exercise training programs for children with congenital heart disease without addressing other common deficits, such as behavioural and psychological problems. Despite evidence of the role of occupational therapy in rehabilitation for adults with cardiac disease, there has been little published about occupational therapy for children with congenital heart disease. Purpose. This literature review on the outcomes of congenital heart disease, guided by the Canadian Model of Occupational Performance, highlights the comprehensive needs of these children. Results. The findings of the review are that congenital heart disease can have wide-ranging neurological and psychosocial implications. This suggests that occupational therapists should be concerned about limitations in the participation of these children in age-appropriate childhood occupations related to self-care, productivity or leisure. Practice Implications. As cardiac rehabilitation program planning becomes more commonplace for children, comprehensive programs that promote optimal occupational performance need to be developed, implemented and evaluated.