bluuebunny/crossref_metadata_2025 huggingface dataset:
B and T Lymphocyte Attenuator Restricts the Protective Immune Response against Experimental Malaria
Authors: Adler Guido , Steeg Christiane , Pfeffer Klaus , Murphy Theresa L. , Murphy Kenneth M. , Langhorne Jean , Jacobs Thomas
Published: October 2011

The immune response against the blood stage of malaria has to be tightly regulated to allow for vigorous antiplasmodial activity while restraining potentially lethal immunopathologic damage to the host like cerebral malaria. Coinhibitory cell surface receptors are important modulators of immune activation. B and T lymphocyte attenuator (BTLA) (CD272) is a coinhibitory receptor expressed by most leukocytes, with the highest expression levels on T and B cells, and is involved in the maintenance of peripheral tolerance by dampening the activation of lymphocytes. The function of BTLA is described in several models of inflammatory disorders and autoimmunity, but its function in infectious diseases is less well characterized. Also, little is known about the influence of BTLA on non-T cells. In this study, we analyzed the function of BTLA during blood-stage malaria infection with the nonlethal Plasmodium yoelii strain 17NL. We show that BTLA knockout mice exhibit strongly reduced parasitemia and clear the infection earlier compared with wild-type mice. This increased resistance was seen before the onset of adaptive immune mechanisms and even in the absence of T and B cells but was more pronounced at later time points when activation of T and B cells was observed. We demonstrate that BTLA regulates production of proinflammatory cytokines in a T cell-intrinsic way and B cell intrinsically regulates the production of P. yoelii 17NL-specific Abs. These results indicate that the coinhibitory receptor BTLA plays a critical role during experimental malaria and attenuates the innate as well as the subsequent adaptive immune response.
Ex Vivo IL-1 Receptor Type I Expression in Human CD4+ T Cells Identifies an Early Intermediate in the Differentiation of Th17 from FOXP3+ Naive Regulatory T Cells
Authors: Raffin Caroline , Raimbaud Isabelle , Valmori Danila , Ayyoub Maha
Published: October 2011

IL-17–producing CD4+ Th (Th17) cells are a unique subset of proinflammatory cells expressing the retinoic acid-related orphan receptor γt and associated with different forms of inflammatory autoimmune pathologies. The development of Th17 cells, mediated by TGF-β and IL-1, is closely related to that of FOXP3+ suppressor/regulatory T cells (Treg). In this study, we report that ex vivo expression of IL-1RI in human circulating CD4+ T cells identifies a subpopulation of FOXP3+ Treg that coexpress retinoic acid-related orphan receptor γt, secrete IL-17, and are highly enriched among CCR7+ central memory cells. Consistent with the concept that IL-1RI expression in Treg identifies a subpopulation at an early stage of differentiation, we show that, in Th17 populations differentiated in vitro from natural naive FOXP3+ Treg, IL-1RI+ IL-17–secreting cells are central memory cells, whereas IL-1RI− cells secreting IL-17 are effector memory cells. Together with the absence of detectable IL-1RI and IL-17 expression in resting naive CD4+ T cells, these data identify circulating CCR7+ Treg expressing IL-1RI ex vivo as early intermediates along an IL-1–controlled differentiation pathway leading from naive FOXP3+ Treg to Th17 effectors. We further show that, whereas IL-1RI+ central memory Treg respond to stimulation in the presence of IL-1 by generating IL-17–secreting effectors, a significant fraction of them maintain FOXP3 expression, consistent with an important role of this population in maintaining the Treg/Th17 memory pool in vivo.
Enrichment of Functionally Distinct Mouse Hematopoietic Progenitor Cell Populations Using CD62L
Authors: Cho Scott , Spangrude Gerald J.
Published: October 2011

The details of the bifurcation of the lymphoid and myeloid lineages following commitment by multipotent progenitor cells (MPP) remain a topic of controversy. We report that the surface glycoprotein CD62L can be characterized as a novel marker of this and other stages of early hematopoietic differentiation. Cell isolation and transplant studies demonstrated CD62Lneg/low long-term hematopoietic stem cells and CD62Lhigh MPP within the traditionally defined c-kitposLinneg/lowSca-1pos stem/progenitor cell population. Within the MPP population, previously defined as c-kitposLinneg/lowSca-1pos–Thy-1.1negFlt3pos, Sca-1 and CD62L resolved four populations and segregated Sca-1highCD62Lneg/low MPP from Sca-1highCD62Lhigh leukocyte-biased progenitors. Using a novel transplantation method that allows tracking of erythroid and platelet engraftment as an alternative to the classical method of in vitro colony formation, we characterized Sca-1highCD62Lneg/low cells as MPP, based on transient engraftment of these lineages. These data establish CD62L as a useful tool in the study of early hematopoiesis and emphasize the power of trilineage-engraftment studies in establishing the lineage potential of MPP subsets.
A Disintegrin and Metalloproteinase 10 Regulates Antibody Production and Maintenance of Lymphoid Architecture
Authors: Chaimowitz Natalia S. , Martin Rebecca K. , Cichy Joanna , Gibb David R. , Patil Pooja , Kang Dae-Joong , Farnsworth Julie , Butcher Eugene C. , McCright Brent , Conrad Daniel H.
Published: October 2011

A disintegrin and metalloproteinase 10 (ADAM10) is a zinc-dependent proteinase related to matrix metalloproteinases. ADAM10 has emerged as a key regulator of cellular processes by cleaving and shedding extracellular domains of multiple transmembrane receptors and ligands. We have developed B cell-specific ADAM10-deficient mice (ADAM10B−/−). In this study, we show that ADAM10 levels are significantly enhanced on germinal center B cells. Moreover, ADAM10B−/− mice had severely diminished primary and secondary responses after T-dependent immunization. ADAM10B−/− displayed impaired germinal center formation, had fewer follicular Th cells, decreased follicular dendritic cell networks, and altered chemokine expression in draining lymph nodes (LNs). Interestingly, when spleen and LN structures from immunized mice were analyzed for B and T cell localization, tissues structure was aberrant in ADAM10B−/− mice. Importantly, when ADAM10-deficient B cells were stimulated in vitro, they produced comparable Ab as wild type B cells. This result demonstrates that the defects in humoral responses in vivo result from inadequate B cell activation, likely because of the decrease in follicular Th cells and the changes in structure. Thus, ADAM10 is essential for the maintenance of lymphoid structure after Ag challenge.
Therapist–Child Interaction in the Middle Minutes of Sensory Integration Treatment
Authors: Dunkerley Erin , Tickle-Degnen Linda , Coster Wendy J.
Published: October 2011

The purpose of this study was to describe the management of challenge during therapist-child interaction in sensory integration treatment. This descriptive and relational study of the middle minutes of treatment sessions partially replicated an earlier study of the beginning minutes. One minute Videotape clips taken from the middle minutes of 38 treatment sessions were shown to therapist judges who rated qualities of therapist and child behavior. Two patterns emerged from the correlations of ratings: work and playfulness. Work for the child involved trying hard, cooperating, and seeking assistance, whereas work for the therapist involved assisting and guiding the child. Play for the child included enjoying the activity, being successful and confident, and trying hard. For the therapist, play involved being creative and behaving playfully. Patterns of work and play were different across different levels of challenge to the child.
Jewish Spirituality Through Actions in Time: Daily Occupations of Young Orthodox Jewish Couples in Los Angeles
Authors: Frank Gelya , Bernardo Carol Sue , Tropper Shonna , Noguchi Frank , Lipman Carey , Maulhardt Beth , Weitze Laura
Published: October 2011

Ethnographic methods were used to study daily occupations and weekly routines of four young Orthodox Jewish couples living in Los Angeles. Data from interviews and participant observation demonstrate the importance to the couples of fulfilling God’s commandments [Hebrew, mitzvot], which organize and sanctify the otherwise mundane activities of daily living, such as eating, bathing, sleeping, and rising. The article focuses on the couples’ experiences in (a) observing the Sabbath, (b) studying and praying, and (c) keeping a kosher home. Orthodox Jewish ritual, practice, and spirituality are time bound and action oriented. Occupational therapists can benefit from understanding how Orthodox Jews invest and experience spiritual meaning in seemingly mundane occupations and routines.
Competency Beliefs and Occupational Role Behavior Among Adolescents: Explication of the Personal Causation Construct
Authors: Henry Alexis D. , Coster Wendy J.
Published: October 2011

According to the Model of Human Occupation (MOHO), beliefs regarding competency can influence whether a person’s occupational role behavior is adaptive or maladaptive. Such beliefs are considered to be part of a person’s sense of “personal causation.” This article reviews some of the theoretical underpinnings of the personal causation construct. Issues addressed are the distinction between competency beliefs and locus of control (another aspect of personal causation according to the MOHO); the domain-specific nature of competency beliefs; and, in particular, the evidence for a relationship between competency beliefs and actual behavior. The article focuses on competency beliefs and their relationship to three domains of occupational behavior that have relevance for adolescents: academic ability, social competence, and physical competence. Implications for clinical practice with adolescents with psychiatric disorders are addressed.
Occupational Therapy Practice: Focusing on Occupational Performance
Authors: Baum Carolyn M. , Law Mary
Published: October 2011

Changes in the health system require occupational therapy practitioners to focus their concerns on the long-term health needs of people and to help them develop healthy behaviors not only to improve their health, but also to minimize the health care costs associated with dysfunction. Occupational therapy practitioners must initiate efforts in the community to integrate a range of services that promote, protect, and improve the health of the public. This article shares the experiences of Canadian occupational therapy practitioners, who were challenged by their government nearly 15 years ago to establish a system that demonstrates effectiveness by improving the health of occupational therapy clients.

By focusing on occupational performance, occupational therapy practitioners assist clients in becoming actively engaged in their life activities. This requires client-centered and family-centered practice and services that span from the agency or institution to the community. Occupational therapy practitioners must work collaboratively with persons in the client’s environment (e.g., family members, teachers, independent living specialists, employers, neighbors, friends) to assist the client in obtaining skills and to make modifications to remove barriers that create a social disadvantage. A focus on occupational performance requires occupational therapy personnel to reframe how we think about occupational therapy to a sociomedical context and to take an active role in building healthy communities.
Off-Road Driving Evaluations for Persons With Cerebral Injury: A Factor Analytic Study of Predriver and Simulator Testing
Authors: Galski Thomas , Ehle Holly T. , Williams J. Bradley
Published: October 2011

Objectives. Off-road evaluations composed of psychometric testing and simulator driving are commonly used in rehabilitation settings to assess a person's fitness to resume driving after a cerebral injury. Although the results of these evaluation methods separately provide information about ability to drive, there is no clear understanding about what is measured in comprehensive off-road evaluations as a whole. This study explored the interrelationship of perceptual, cognitive, behavioral, and operational variables that form the basic for off-road evaluations in order to determine whether there are basic dimensions underlying performance in these evaluations and to derive a small set of variables that could help in refining methods for evaluating persons with cerebral injuries.

Methods. One-hundred six persons with cerebral damage due to brain injury or cerebrovascular accident were administered a predriver evaluation that consisted of selected neuropsychometric tests. Subjects were also evaluated in a driving simulator that measured their operational responses to filmed driving situations and assessed their behaviors. Principal component analysis was used to identify manifest and latent variables contributing to the results of the evaluations.

Results. The analysis produced a model with five independent (orthogonal) eigenvectors, or factors, for this population: Higher Order Visuospatial Abilities, Basic Visual Recognition and Responding, Anticipatory Braking, Defensive Steering, and Behavioral Manifestations of Complex Attention. These factors accounted for 66.14% of the total variance in the subjects’ responses to comprehensive off-road evaluations.

Conclusion. These factors were useful in understanding driving performance and the role of predriver and simulator testing in driver evaluations.
Comparison of the Test–Retest Reliability of the Work Box™ Using Three Administrative Methods
Authors: Speller Loucretia , Trollinger Judith A. , Maurer Patti A. , Nelson Craig E. , Bauer David F.
Published: October 2011

Objective. The purpose of this study was to compare the test–retest reliability of three administrative methods of the Work Box™: (a) the original instructions, (b) a revised version of the original instructions, and (c) another revised version that was based on suggestions made by authors of the first two versions of the instructions.

Method. Sixty subjects without disabilities were randomly grouped so that 20 subjects were tested per administrative method. The assessment was administered to each subject on two occasions, with a 7-day to 14-day period between tests. Scores were recorded as time in seconds, and intraclass correlation coefficients (ICCs) were used to calculate the reliability.

Results. The ICCs for assembly, disassembly, and total scores were .589, .604, and .654, respectively, for the original instructions; .424, .572, and .545 for the revised instructions; and .781, .579, and .717 for the second revised instructions. Reliability was found to be higher for men than for women and for subjects who claimed to have more rather than less experience in similar manual dexterity tasks.

Conclusions. On the basis of the reliability of each administrative method and comments made by subjects about their understanding of the instructions, the second revised version of the instructions is recommended as the standard method. The results also indicate that the assessment is most appropriate for a population of men with manual dexterity experience. With further standardization, the Work Box could be a valuable assessment tool for therapists working in industrial rehabilitation settings.
A Comparison of the Performance of Children With and Without Autism on the Sensory Profile
Authors: Kientz Mary Alhage , Dunn Winnie
Published: October 2011

Objectives. The purpose of this study was to determine whether the Sensory Profile discriminates between children with and without autism and which items on the profile best discriminate between these groups.

Method. Parents of 32 children with autism aged 3 to 13 years and of 64 children without autism aged 3 to 10 years completed the Sensory Profile. A descriptive analysis of the data set of children with autism identified the distribution of responses on each item. A multivariate analysis of covariance (MANCOVA) on each category of the Sensory Profile identified possible differences among subjects without autism, with mild or moderate autism, and with severe autism. Follow-up univariate analyses were conducted for any category that yielded a significant result on the MANCOVA.

Results. Eighty-four of 99 items (85%) on the Sensory Profile differentiated the sensory processing skills of subjects with autism from those of subjects without autism. There were no group differences between subjects with mild or moderate autism and subjects with severe autism.

Conclusion. The Sensory Profile can provide information about the sensory processing skills of children with autism to assist occupational therapists in assessing and planning intervention for these children.
Job Analysis in Occupational Therapy: Stepping Into the Complex World of Business and Industry
Authors: Lysaght Rosemary
Published: October 2011

Job analysis is used in a variety of fields to identify the nature of work performed. Occupational therapists use job analysis as a basis for evaluating injured workers, planning rehabilitative programs, structuring preemployment screening protocols, developing transitional work plans, and conducting environmental modification and risk management programs. There is little evidence in the literature of a theoretical basis or practical framework for job analysis in occupational therapy, although the theory that underlies occupational therapy provides a general foundation. Current job analysis methods appear inadequate for the wide range of practice applications and for responding to the changing nature of the labor market. A need is identified for further investigation of methods derived from occupational therapy and other disciplines, development of documentation approaches suited to a variety of job types, and attention to validity and reliability of results.
Role Perceptions of Mothers With Young Children: The Impact of a Child’s Disability
Authors: Crowe Terry K. , VanLeit Betsy , Berghmans Kirsten K. , Mann Paul
Published: October 2011

Objective. The purpose of this study was to examine and compare the perceived past, present, and future occupational roles of mothers of young children. Awareness of the role demands placed on mothers will assist occupational therapists in addressing the needs of children with disabilities within the family context.

Method. One hundred and thirty-five mothers of children 6 months to 5 years of age completed the Role Checklist, which examines participants’ perceptions of past, present, and future occupational roles. Forty-five participants had children with multiple disabilities and major functional limitations, 45 had children with Down’s syndrome, and 45 had children who were typically developing.

Results. The group of mothers of children who were typically developing was found to have significantly more present roles than the other two groups. All three groups lost significant numbers of roles from past (before birth of child) to present and anticipated adding significant numbers of future roles. There were no significant differences among the three groups in value placed on occupational roles.

Conclusion. Role demands of caring for a young child were high for all participants, particularly if the child had a disability. Participants seemed to respond to these demands by giving up other discretionary roles in order to meet their caregiving obligations. Thus, asking mothers of children with disabilities to take on therapy-related caregiving tasks may contribute to role strain.
Understanding Professional Behavior: Experiences of Occupational Therapy Students in Mental Health Settings
Authors: Lyons Michael
Published: October 2011

A phenomenological study explored occupational therapy students’ experiences in psychiatric fieldwork. Of particular interest was students’ understanding of professional behavior toward persons who use mental health services. Data were gathered from 16 informants via in-depth interviews and participant observation on multiple occasions during fieldwork affiliations. Emerging from informants’ views of professional behavior were difficulties in their reconciling conflicting expectations with regard to emotional and social distance from persons who use mental health services. Additionally, the informants experienced a need to assume authority and maintain control in their dealings with service users. Students’ encounters with such issues during fieldwork are indicative of challenges they may face as health professionals in a changing climate of mental health services. These data are stimuli for reflection on features of professional relationships with service users, particularly in response to expectations of persons with disabilities regarding control over their lives.
Giving a Deposition: Some Helpful Tips for the Occupational Therapy Practitioner
Authors: Ranke Beth A. Ekelman
Published: October 2011

Occupational therapy practitioners frequently are asked to testify at depositions. Some may be intimidated by the legal process and not know what to do when subpoenaed to appear at a deposition. This article describes the deposition process, explains how one should prepare for a deposition, and provides helpful suggestions on how to tackle the deposition itself. This information can make the experience less threatening to those professionals asked to testify.
A Task for Assessing Vertigo Elicited by Repetitive Head Movements
Authors: Cohen Helen S. , Gavia Jacob A.
Published: October 2011

Objective. We developed a simple, inexpensive test for assessing vertigo in persons with peripheral vestibular disorders.

Method. The test was administered to 16 asymptomatic adults and 16 patients with chronic vertigo caused by peripheral vestibular disorders. Participants sat in a chair and as rapidly as possible transferred 25 beanbags one at a time from a basket placed on the floor to a basket held .91 m up in the air. The task was timed, and the participants rated the level of vertigo elicited on a 10-point scale.

Results. Patients took significantly more time to perform the task and reported significantly greater levels of vertigo than did the asymptomatic adults. Test scores did not differ significantly across test sessions or raters.

Conclusion. Performance on this task reliably differentiated patients with vestibular disorders from asymptomatic adults. The test is inexpensive, takes less than 1 min to perform, and has minimal technical requirements, making it suitable for a variety of facilities and levels of staff expertise.
Tracing Research Methodology in Occupational Therapy
Authors: Custard Cheryl
Published: October 2011

As a profession, occupational therapy has been repeatedly confronted with the challenge to prove the value of occupation as a therapeutic medium. The types of research pursued by occupational therapists have evolved in response to societal trends, external pressures, and the priorities of individual practitioners. Although many therapists have reconciled the pursuit of research with the roots of occupational therapy through an adherence to naturalistic methods, others continue to value experimental research designs. This article explores the rise of qualitative research methods in occupational therapy and addresses the current dilemma between naturalistic and positivistic designs.
Reliability and Validity of a Videotape Method To Describe Expressive Behavior in Persons With Parkinson’s Disease
Authors: Lyons Kathleen Doyle , Tickle-Degnen Linda
Published: October 2011

The ability to effectively communicate thoughts, feelings, and identity to others is an important aspect of occupational performance. The symptoms of Parkinson’s disease can impair a person’s ability to verbally and non-verbally communicate with others. In order to better understand issues of communication functioning for this population, research tools to describe expressive and communicative behavior during occupation and social interaction are needed. In this study, six persons with Parkinson’s disease participated in individual, videotaped interviews focused on problem solving during daily activities. Three trained graduate students viewed edited clips from the videotapes and completed a rating scale of expressive behavior designed by the authors. Data support the reliability and construct validity of the behavioral rating scale, suggesting that measures of expressive behavior of persons with Parkinson’s disease can be effectively derived using short segments of videotaped activity.
The Role of the School-Based Occupational Therapist in Secondary Education Transition Planning: A Pilot Survey Study
Authors: Kardos Margaret , White Barbara Prudhomme
Published: October 2011

OBJECTIVE. The purpose of this study was to investigate school-based occupational therapists’ knowledge of transition planning, their degree of participation in assessment and intervention of students requiring transition services, and to identify potential barriers limiting therapists’ participation in transition services.

METHOD. Using survey methods, a questionnaire was mailed to a random sample of therapists listed as members of the School System Special Interest Section of the American Occupational Therapy Association. Eighty therapists from all geographical regions within the continental United States and who identified themselves as working with students 13–21 years of age in an educational setting, participated in the study. The response rate was 20%.

RESULTS. The majority of participants reported that they understood the terminology associated with the Individuals with Disabilities Education Act (IDEA) of 1990 and the 1997 IDEA amendments definitions of transition planning at the secondary level, but were less likely to apply that knowledge to the transition planning process. The majority of therapists reported minimal participation in secondary education transition planning assessment and intervention for students with disabilities. Most respondents believed that they were not contributing to the transition planning process in a manner that maximized their skills, and identified several barriers that they believed hindered greater participation.

CONCLUSION. This pilot study suggests that occupational therapists may not be participating in transition services to their fullest potential. While the low response rate in this study precludes generalization, this information is important to guide further study as well as to shape efforts to increase occupational therapy’s role in this important service area within school-based practice.
Professional Strategies in Work-Related Practice: An Exploration of Occupational and Physical Therapy Roles and Approaches
Authors: Lysaght Rosemary , Wright JoAnne
Published: October 2011

Both occupational and physical therapy have historical roots in worker rehabilitation; however, the core philosophies and areas of expertise of these professions suggest there may be inherent differences in the ways each approaches therapeutic intervention. This study surveyed 600 occupational and physical therapists in the United States to determine the nature and scope of work-related practice, and the degree to which occupation-based strategies are used by either profession. The overall response rate was 54% (n = 324), and 76% of respondents (n = 246) were actively engaged in providing work-related services. Results indicate that both professions provide all services commonly associated with work-related therapy in almost equal proportions. Few significant differences were identified between the professions in terms of approaches to therapy, and findings did not reveal the use of occupation-based interventions to any greater degree by occupational therapists.
Vision, Visual-Information Processing, and Academic Performance Among Seventh-Grade Schoolchildren: A More Significant Relationship Than We Thought?
Authors: Goldstand Sarina , Koslowe Kenneth C. , Parush Shula
Published: October 2011

OBJECTIVE. To compare visual and visual-information processing skills between children with and without mild reading and academic problems and examine the incidence of visual deficits among them.

METHOD. Seventy-one seventh graders classified as proficient (n = 46) and nonproficient (n = 25) readers were compared with respect to scores on an accepted vision screening, on tests of visual-perception, visual-motor integration, and academic performance. Further, academic performance and visual-information processing were compared between children who failed and passed the vision screening.

RESULTS. Visual deficits were found in 68% of the participants, and among significantly more boys than girls. Nonproficient readers had significantly poorer academic performance and vision-screening scores than the proficient readers. Participants who passed the visual screening performed significantly better in visual perception than those who failed.

CONCLUSION. Visual function significantly distinguishes between children with and without mild academic problems, as well as on visual-perception scores. The high occurrence of visual deficits among participants warrants consideration of vision deficits among schoolchildren with academic performance difficulties.
Behavioral and Physiologic Response Measures of Occupational Task Performance: A Preliminary Comparison Between Typical Children and Children With Attention Disorder
Authors: Prudhomme White Barbara , Mulligan Shelley E.
Published: October 2011

OBJECTIVE. To compare performance on the Assessment of Motor and Process Skills (AMPS), a measure of functional task performance and physiological responses (salivary cortisol levels) during AMPS administration, between typically developing children and children diagnosed with attention deficit hyperactivity disorder (ADHD).

METHOD. In this quasi-experimental study, independent t tests, and mixed, repeated measures analysis of variance were conducted to compare a group of typically developing children (n = 21) with a group of children with ADHD (n = 12) on two dependent measures: (a) the AMPS and (b) salivary cortisol. Salivary cortisol, a stress hormone, was taken at three time points, baseline, mid-way through AMPS administration, and 20 min following AMPS administration.

RESULTS. Significant differences were found on the activities of daily living (ADL) process ability measure of the AMPS (p = .001) and the ADL motor ability measure (p = .04), with the ADHD group performing more poorly than typical children. There was no significant group (ADHD vs. control) by time period interaction effect on cortisol levels. Overall, the cortisol levels of the ADHD group were higher than the levels of those in the control group (p = .02). Cortisol levels tended to drop significantly over time (p = .01) for both groups, however the patterns differed somewhat between groups. Cortisol levels of the typical children dropped at the final time period (20 min post-AMPS administration) whereas the levels of the children in the ADHD remained higher during this time period. This interaction effect approached, but did not reach, statistical significance (p = .15).

CONCLUSION. The results of this investigation suggest that the AMPS is sensitive to detecting functional performance concerns, and both motor and process skill deficits, associated with ADHD, and therefore may be a useful assessment tool with this population. Data also suggests that cortisol expression to a well-known ADL task may be lower if the task is not overly challenging for the individual, and provides support for further study of the role of cortisol with disorders of attention.
Can the Social Model Explain All of Disability Experience? Perspectives of Persons With Chronic Fatigue Syndrome
Authors: Taylor Renee R.
Published: October 2011

OBJECTIVE. The social model of disability has had a major influence on the academic field of disability studies and on contemporary understandings of the causes and experience of disability. The purpose of this study was to examine the adequacy of the social model for explaining the disability experience of persons with chronic fatigue syndrome (CFS).

METHODS. This qualitative study examined the experiences of 47 adults with CFS participating in a research project that aimed to evaluate a participant-designed rehabilitation program. Data were aggregated from focus group interviews, open-ended questionnaires, progress notes, and from a program evaluation questionnaire. Data analysis was based on a grounded theory approach and used triangulation of multiple data sources and member checks to assure dependability of findings.

RESULTS. Four themes emerged from the analysis: (1) minimization and mistrust of the disability; (2) negative experiences of impairment; (3) lack of identification with the disability community; and (4) the focus on advocacy as a quest for legitimacy. These themes varied in the extent to which they conformed to the principles set forth by the social model.

CONCLUSIONS. Although the social model has important contributions to lend to occupational therapy practice, it is important to recognize that it may not capture the full reality of disability. In particular, the social model has serious limitations in describing the disability experience of individuals with disabilities who do not have visibly obvious disabilities and whose impairments do not conform to the traditional viewpoint of disability.
Evaluating the Quality of Reporting Occupational Therapy Randomized Controlled Trials by Expanding the CONSORT Criteria
Authors: Moberg-Mogren Emily , Nelson David L.
Published: October 2011

CONTEXT. Well-reported randomized controlled trials (RCTs) are necessary for evidenced-based practice in the field of occupational therapy.

OBJECTIVE. The primary purpose of this study was to analyze the quality of reporting in selected RCTs relevant to occupational therapy by using the Nelson-Moberg Expanded CONSORT Instrument (NMECI). The interrater reliability of the NMECI was also tested.

METHOD. The 201-sub-item NMECI was developed by the authors to clarify the 22-item CONSORT Statement, each item of which raises several issues. Fourteen RCTs obtained through the OTseeker database were analyzed independently by the authors.

RESULTS. The 14 articles complied with slightly more than half of the sub-items of the NMECI (M = 104.2, SD = 32.9 for the main rater). The only area of full compliance involved reporting of objectives and hypotheses; areas of frequent noncompliance included reporting of adverse events, randomization, and blinding. The intraclass correlation coefficient assessing level of interrater agreement on the total NMECI score was .95, indicating strong agreement overall. For the 176 kappas that could be computed on individual sub-items, the median kappa was .85, with an inter-quartile range from .58 to 1, indicating high levels of agreement for most items. However, 29 kappas fell below the moderate level of agreement (.40).

CONCLUSIONS. The field of occupational therapy needs increased sophistication in conducting and reporting RCTs. The NMECI shows promise in evaluating the quality of RCTs, given refinements to some items.
A Case Report on the Collaboration of Health Care Professionals in Fitting and Training Seven Iraqi Clients With Right Wrist Disarticulations 9 Years Postamputation
Authors: Krenek Suzanne M. , Vasquez Myra
Published: October 2011

In 1995, seven men from Iraq had their right hands surgically amputated under the regime of Saddam Hussein. The men have lived with the shame, that is associated with missing a right hand in their culture, since that time. Recently, the media and a team of health care providers collaborated to bring these seven men to Houston, Texas, for surgical revisions, prosthetic hands, and occupational therapy services. The preprosthetic, interim-prosthetic, and postprosthetic interventions are discussed, as well as the typical time frames for each. This case report outlines the time restrictions that were placed on the health care team and demonstrates the continuous collaborative approach between occupational therapists, prosthetists, and other health care professionals, which contributed to the initial successful outcomes for these men.
Responses to the Acquisition and Use of Power Mobility by Individuals Who Have Multiple Sclerosis and Their Families
Authors: Boss Terri M. , Finlayson Marcia
Published: October 2011

PURPOSE. To develop an understanding of family members’ reactions to the acquisition of power mobility by persons with multiple sclerosis (MS) from the perspectives of the end users and their family members.

METHODS. Data were obtained through semistructured interviews with seven persons with MS using or considering power mobility and four of their family members.

RESULTS. Three major themes emerged from the data. Recognizing the Need for Power Mobility resulted from the interaction between multiple sclerosis progression and the participants’ desired performance. Family decision making and communication, insurance funding and approval, and the physical and social environment were just some of the factors affecting the process of Deciding and Obtaining the Power Mobility. Using Power Mobility resulted in positive, negative, and neutral outcomes.

CONCLUSIONS. This study uncovered an overall lack of resources and some issues within the family environment, such as communication and decision making, both of which can negatively impact the acquisition and use of power mobility for persons with MS. Understanding these challenges may assist occupational therapists to facilitate this transition with their clients.
Psychometric Testing of the McGill Ingestive Skills Assessment
Authors: Lambert Heather C. , Gisel Erika G. , Groher Michael E. , Abrahamowicz Michal , Wood-Dauphinee Sharon
Published: October 2011

The goal of this study was to determine the psychometric properties of the McGill Ingestive Skills Assessment. Interrater and intrarater reliability and score stability were tested using repeated administration of this test. The Functional Independence Measure and Modified Mini-Mental State Examination, as well as patient characteristics, were used to determine the validity of the assessment. One hundred and two persons with ingestive skill loss of neurologic origin were evaluated. Intraclass correlations for interrater, intrarater reliability and stability reached or surpassed 0.80 for most subscales. In validity testing, significant relationships were found between McGill Ingestive scores and Functional Independence Measure and Mini-Mental scores, as well as with patient characteristics. It is concluded that the McGill Ingestive Skills Assessment approaches or meets levels of reliability necessary for assessing patients and is valid for adults with neurogenic feeding difficulties residing in tertiary care facilities.
Driving Evaluation Practices of Clinicians Working in the United States and Canada
Authors: Korner-Bitensky Nicol , Bitensky Jamie , Sofer Susan , Man-Son-Hing Malcolm , Gelinas Isabelle
Published: October 2011

OBJECTIVE. To determine off-road and on-road driving evaluation practices of clinicians in the United States and Canada who assess individuals with disabilities for fitness to drive.

PARTICIPANTS. Participants were 114 clinician attendees at the 2003 annual Association of Driver Educators for the Disabled with driving assessment experience ranging from 1 month to 25 years.

MEASURES. Information was elicited regarding the clinician, clientele, referral practices, and off-road and on-road driving evaluation practices and retraining practices using a self-administered questionnaire.

RESULTS. Participants were largely occupational therapists (68%) who worked in 42 different states and provinces. The most prevalent clientele were persons with traumatic brain injury (97%) and stroke (96%). Testing times greater than 60 min were common for both the off-road (61%) and on-road (49%) evaluations. Commonly performed off-road assessments included the Brake Reaction Timer; Trail Making Test, Parts A and B; and the Motor Free Visual Perception Test, used by 73%, 72%, and 66%, respectively; comprehensive computer-based driving evaluation was rare. Sixty-one percent indicated that all clients underwent on-road evaluation regardless of the off-road results. Finally, 78% used a standard driving route, whereas 24% used a scoring system to evaluate on-road driving.

CONCLUSION. Driving assessment in Canada and the United States is multidimensional and time-intensive. Although the domains being assessed are similar across clincians, specific off-road and on-road assessment practices vary greatly. The majority use nonstandardized on-road assessments.
Effectiveness of a Work-Related Stress Management Program in Patients With Chronic Schizophrenia
Authors: Lee Hui-Ling , Tan Happy Kuy-Lok , Ma Hui-Ing , Tsai Chia-Yu , Liu Yung-Kung
Published: October 2011

OBJECTIVE. The purpose of this study was to examine the effect of a work-related stress management program on perceived work-related stress in patients with chronic schizophrenia.

METHOD. A single-blind, randomized crossover design was used. Twenty-nine patients undergoing vocational training while working at paid part-time jobs in a psychiatric center were randomly assigned to receive 12 weeks of a work-related stress management program followed by 12 weeks of no treatment, or the reverse. The Work-Related Stress Questionnaire for Chronic Psychiatric Patients (WSQP) was developed for this study and used to examine the treatment effect.

RESULTS. The decrease in stress was significantly greater when the participants were undergoing the program compared to the decrease of stress when they were not (t = 2.93, p = .0034, r = .49).

CONCLUSION. The results show that the work-related stress management program had large short-term positive effects on the patients’ perceived work-related stress. These findings support providing this type of program to employed patients with chronic schizophrenia.
Critiquing the Logic of the Domain Section of the Occupational Therapy Practice Framework: Domain and Process
Authors: Nelson David L.
Published: October 2011

The Occupational Therapy Practice Framework: Domain and Process (also known as the Framework), an official document of the American Occupational Therapy Association, advocates terminology and a classification system for concepts that are central to the profession of occupational therapy. Its use has been advocated in practice, research, education, and communications with those who wish to know more about occupational therapy. Given its importance to the profession and to society, the Framework deserves intense scrutiny and sustained scholarly inquiry.

This article investigates the logic of Occupational Therapy Practice Framework: Domain and Process, with a focus on domain. Are definitions and classifications within the domain logically coherent?

The Framework repeatedly violates two rules of logical definitions: (a) a unique term must be applicable to certain particulars and must not be applicable to others (the rule of precision); and (b) the particulars assigned to one term must not be assignable to another term unless there is a logical explanation (the rule of parsimony). The Framework also repeatedly violates two rules of logical classification: (a) a lower-level category must be classifiable only within its assigned higher-level category (the rule of exclusivity); and (b) all relevant particulars must be classifiable (the rule of exhaustiveness).

The profession of occupational therapy needs one or more logically coherent conceptual frameworks, but the Framework is not recommended as a logical basis for practice, education, research, and external communications. Specific recommendations are made in support of the development of a logical framework and the refinement of existing frameworks.
Beyond Active Learning: A Case Study of Teaching Practices in an Occupation-Centered Curriculum
Authors: Hooper Barbara
Published: October 2011

Although occupation-centered curricula are highly promoted, the teaching processes that convey such designs remain unclear. This case study elucidated occupation-centered teaching practices. Interview and observational data were collected over 8 weeks, and analysis involved coding transcriptions, data matrices, concept maps, journaling, and writing. Participants augmented active learning strategies with strategies that linked course topics to the subject of occupation. The use of linking strategies suggested that: (a) course content was treated as two-tiered; (b) neither content nor instructional processes were inherently occupation-centered; and (c) subject-centered education strengthens social learning theories. Although curricula may appear occupation-centered based on a curriculum description and course content, ultimately “linking opportunities” in the classroom constitute an essential feature that demarcates a program as occupation-centered.
The World of Everyday Occupation: Real People, Real Lives
Authors: Hasselkus Betty Risteen
Published: October 2011

Everyday occupation is a primary means by which we organize the worlds in which we live. The phenomenological experiences of day-to-day life build meaning and community in our lives; yet everyday occupation is often “seen but unnoticed.” Cultural tendencies and invisible social forces contribute to the obscurity of the everyday and, in severe situations, to occupational deprivation. The purpose of this Slagle lecture is to raise awareness of the complexity and “delicate layerings” of everyday occupation, its theoretical and conceptual underpinnings, the consequences of severe occupational constraints to health and well-being, and the essential relevance of everyday occupation to occupational therapy and occupational science. Everyday occupation related to food is probed in depth to illustrate the richness of day-to-day living. Occupational therapy personnel are encouraged to gain deeper understandings of the importance and meaning of everyday occupation in the lives of clients and the general public, thereby helping people find value in their everyday practices.
The Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA–Ch): A New Instrument for Assessing Learning Potential
Authors: Katz Noomi , Golstand Sarina , Bar-Ilan Ruthie Traub , Parush Shula
Published: October 2011

OBJECTIVE. To describe the development and psychometric properties of the Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA–Ch), a dynamic criterion-referenced assessment of cognitive abilities and learning potential for children with cognitive and learning difficulties.

METHOD. A series of studies analyzed the age standards, criterion cutoff scores, and percentage of mediation cues required for typically developing children 6–12 years of age, as well as reliability and validity.

RESULTS. MANOVA analyses determined four age groups that best fit the outcome data: 6–6.11, 7–8.11, 9–10.11, and 11–12 years. Criterion cutoff scores of 25% for at-risk and under 10% for deficient performance were obtained for each age group. Dynamic percentage scores were determined. Significant high interrater reliability and moderate to high internal consistency reliability were found. Construct validity was supported by comparing children with traumatic brain injury and learning disabilities to typically developing children, and ecological validity of children with attention deficit hyperactivity disorder by comparing performance on the DOTCA–Ch to the School Function Assessment.

CONCLUSIONS. The DOTCA–Ch is a reliable and valid assessment that provides learning potential and can facilitate intervention for cognitive difficulties that manifest themselves in daily functions among school-age children.
A Case Report of Evidence-Based Practice: From Academia to Clinic
Authors: Bailey Diana M. , Bornstein Jodi , Ryan Sarah
Published: October 2011

The purpose of this article is to present activities that can be used to integrate evidence-based practice (EBP) into clinicians’ daily work so that they may be better informed when planning intervention with their clients. The article includes a short history of EBP, a description of an eight-step EBP process taught in an academic setting using a student project as an example, and suggestions for ways in which individual practitioners and occupational therapy managers can promote the implementation of EBP in daily practice.