bluuebunny/crossref_metadata_2025 huggingface dataset:
Enabling Empowerment: Using Simulations versus Real Occupations
Authors: Townsend Elizabeth
Published: March 2013

This study shows how the organization of occupational therapy determines occupational therapists' potential and limits for enabling the empowerment of adults who attend mental health day programmes. Drawing from the full ethnography, this paper shows how the organization of practice determines invisibly whether occupational therapists are more likely to involve people in simulations or in the real occupations of their everyday world. The study explores the use of simulations versus real occupations by tracing everyday practice to the locations, facilities, and scheduling context in which practice occurs. Practice is further traced to the philosophic and funding context of programmes. The final part of the analysis outlines how the use of simulations versus real occupations is shaped by particular ideas about mental health, professional practice, health services, welfare, and the market place. The analysis of an institutional ethnography offers a blueprint for change.
Being Client-Centred When the Client is Cognitively Impaired
Authors: Hobson Sandra
Published: March 2013

Canadian occupational therapists aspire to be client-centred. As a profession we continue to debate what this means. The question of how to be client-centred becomes more acute when the client has cognitive deficits, and capacity, including the legal right to consent to treatment, is called into question. Further, in current literature and law, capacity is described as situational (i.e., specific to the time, circumstances and question being asked) and thus, difficult to determine. In this discussion, the author will explore two strategies, graded decision-making and advocacy, for practicing in a client-centred manner with cognitively impaired clients.
A Description of Grip and Pinch Strength in Children Aged 6 to 11 Years Using the Martin Vigorimeter
Authors: Backman Catherine , Daniels Linda E.
Published: March 2013

The vigorimeter is potentially a useful instrument for measuring grip and pinch strength in children. However, no normative or comparative data are supplied by the manufacturer, and only two previous studies using it to test children's hand strength could be found in the literature. The purpose of this study was to collect preliminary hand strength data in children aged 6 to 11 years. Spherical grip, tip pinch and tripod pinch strength were measured in 134 children. Graphs displaying the results suggest that, on average, strength increases with age, boys are stronger than girls, and the right hand is often (but not always) stronger than the left. While far from producing norms, this study did demonstrate that the vigorimeter has utility as an instrument for measuring grip and pinch strength in children, and provided some preliminary baseline data to assist clinicians in judging the results of hand strength tests.

Le vigorimètre peut être un instrument utile pour mesurer la force de préhension grossière et la force de préhension fine chez les enfants. Cependant, le fabricant ne fournit pas de données normatives ou comparatives et on ne trouve dans la littérature que deux études dans lesquelles l'instrument a été utilisé pour évaluer la force de prehension des enfants. Le but de cette étude était de recueillir des données préliminaires sur la force de préhension des enfants âgés de 6 à 11 ans. La force de la prise palmaire sphérique, des prises digitales et des prises tridigitales a été mesurée chez 134 enfants. Les résultats présentés dans les graphiques suggèrent qu'en général la force augmente avec l'âge, les garçons sont plus forts que les filles et la main droite est souvent (mais ce n'est pas toujours le cas) plus forte que la gauche. Loin de produire des normes, cette étude a toutefois démontré que le vigorimètre est un instrument utile pour mesurer la force de préhension grossière et la force de préhension fine chez les enfants. L'étude fournit également quelques données de base préliminaires qui aideront les cliniciens à apprécier les résultats des tests sur la force de préhension.
L'apprentissage expérientiel et l'ergothérapie: Compatibilité théorique et pratique
Authors: Guitard Paulette
Published: March 2013

Pour favoriser l'adaptation du client, l'ergothérapeute doit souvent avoir recours à l'enseignement. La relation ergothérapeute-client est alors modifiée et définie comme le processus enseignement-apprentissage. L'ergothérapie reconnaît le processus enseignement-apprentissage comme un outil d'intervention fort précieux, mais il demeure néanmoins méconnu des ergothérapeutes. La littérature mentionne peu de modèles éducatifs ou pédagogiques utilisés en ergothérapie. Un des modèles cités est celui de l'apprentissage expérientiel. Ce modèle est un processus cyclique qui se base sur l'activité, l'expérience concrète de l'apprenant pour favoriser l'apprentissage. L'apprentissage est alors plus significatif pour l'apprenant et mieux intégré à sa réalité quotidienne. Le présent article définit ce modèle d'apprentissage et présente une analyse comparative de ses principes de base et des croyances fondamentales de l'ergothérapie. L'analyse démontre que l'approche expérientielle est tout à fait compatible avec la philosophie et la pratique de l'ergothérapie.
Aspects of Motor Performance and Preacademic Learning
Authors: Feder Katya , Kerr Robert
Published: March 2013

This study examined preschool children's performance on a pursuit tracking task in relation to specific performance on motor and cognitive measures of preacademic skill development. Fifty children, ages 4.3 to 5.8 years were tested using the Miller Assessment for Preschoolers (MAP)and number/counting items. High and low performance groups were designated based on performance on the MAP, individual MAP spatial items as well as number/counting items. Groups were compared based on their performance on a pursuit tracking task. Results indicated that the low performance number/counting concept group demonstrated a significantly slower average response time, overshoot movement time and reaction time. These findings offer support for an underlying perceptual-motor difficulty in children exhibiting low scores on preacademic tasks of mathematical concepts. The low MAP and spatial groups demonstrated a significantly higher rate of overshoots, suggesting difficulty in processing visual spatial information.
Objectifs d'intervention: Comment les formuler en ergothérapie
Authors: Dubouloz Claire-Jehanne , Tremblay Manon
Published: March 2013

Cet article propose un cadre de référence pour l'élaboration d'un objectif d'intervention à court terme en ergothérapie. Il a pour but de clarifier la définition d'un objectif, sa nature et ses caractéristiques. Trois différentes taxonomies développées dans les sciences de l'éducation sont décrites. Elles sont, pour le domaine cognitif, la taxonomie de Bloom, Engelhart, Furst, Hill, et Krathwohl, pour le domaine affectif, celle de Krathwohl, Bloom et Bertram et, pour le domaine sensorimoteur, celle de Harrow. À partir de ces taxonomies, des applications illustrant des objectifs de traitement en situation ergothérapique sont présentées. Ce cadre de référence facilitera la tâche des cliniciens et des cliniciennes lors de la planification du traitement. Il favorisera également l'apprentissage des étudiants et étudiantes par rapport à l'élaboration des objectifs d'intervention.
Spirituality in a Refugee Camp
Authors: Algado Salvador Simo , Gregori Jose Maria Rodriguez , Egan Mary
Published: March 2013

Occupational therapy intervention guided by clients' spiritual beliefs can be a powerful force for change. This paper describes an occupational therapy project with Maya Indian families returning to Guatemala after 14 years refuge in Mexico. The project was designed and carried out over a 12 month period. Its aim was to assist the families to re-adapt to village life and to establish roles and habits which would ensure a better quality of life.

Mayan cosmovision was used to guide the project. The needs of the community were assessed using the model of human occupation. Community enablement was used to guide the intervention. Different problems were faced by the different age groups in the community, i.e. the children, adolescents, adults and older adults, and the project was tailored to meet the needs of each group. Outcomes of the project demonstrate the utility of occupational therapy intervention guided by client spirituality.
Investigation of Cross-Cultural Practice: Implications for Curriculum Development
Authors: Scott Roxanne
Published: March 2013

A study was conducted to explore British occupational therapists' perceptions of cross-cultural practice. A qualitative research approach was used to explore both the concerns and difficulties therapists experience in cross-cultural clinical encounters, and the attitudes, skills and knowledge they feel are essential for the provision of culturally sensitive practice. One of the most significant study findings was the identified need for a phenomenological approach during initial assessment and ongoing service provision. This approach requires that therapists engage in a process of introspective analysis of their own cultural and socio-economic background and belief systems. Therapists need to understand the influence these systems have on their clinical perceptions and interactions. Based on the analysis of the data, recommendations for professional education and development in cultural awareness have been made.
Test-Retest Reliability of a Tutor Evaluation Form Used in a Problem-Based Curriculum
Authors: Hay John A.
Published: March 2013

This paper reports an investigation of the test-retest reliability of student evaluations of tutors in a Problem-Based Learning curricula at McMaster University. Thirty first-year Occupational Therapy students in five tutorial groups completed a 19 item tutor evaluation scale. To examine test-retest reliability they completed the scale on two occasions separated by a three day interval. Fourteen items had test-retest generalizability coefficients greater than .70. Student evaluations appear to have promising reliability. Suggestions for the improvement of reliability include familiarization with the form and ensuring that administration occurred separately from formal student evaluations.
On Scaling Methodology and Environmental Influences in Disability Assessments: The Cumulative Structure of Personal and Instrumental ADL among Older Adults in a Swedish Rural District
Authors: Iwarsson Susanne , Isacsson Åke
Published: March 2013

The ADL Staircase is a hierarchical instrument for assessment of independence/dependence in personal and instrumental activities of daily living (P-ADL and I-ADL). Its development was based on Katz's ADL-Index, applying the same assessment principles. The cumulativity among the items has previously been confirmed in Swedish urban elderly population samples. The purpose of this study was to test the instrument in a rural setting. Due to local environmental conditions, the authors developed alternative definitions for the “transportation” item. Data collected using 133 respondents suggested a different cumulative order among the I-ADL items from that identified in urban samples, and significant gender differences were found. The scale's cumulativity was analysed in-depth, and it revealed different results depending on which scaling analyses were used. Environmental factors highlighted the methodological difficulties inherent in I-ADL assessments, and the results revealed a higher prevalence of disability compared to previous gerontological studies. In clinical practice, awareness of the consequences of I-ADL assessments' limited generalizability between settings is strongly recommended. The study also has theoretical implications for further understanding of the complexity of disablement.
Occupation-as-Means to Mental Health: A Review of the Literature, and a Call for Research
Authors: Rebeiro Karen L.
Published: March 2013

Occupational therapy is a profession which is based upon many beliefs about occupation. One belief is that engagement in occupation can promote physical and mental health. This belief appears to support the profession's jurisdictional claim to the use and application of occupation in psychosocial practice. A review of the psychosocial occupational therapy literature yielded few empirical studies which addressed the use of occupation-as-means to mental health. A discrepancy exists between what the profession theoretically advances about occupation and the research conducted in this area. This discrepancy is highlighted as a possible explanation for the lack of recognition of the value of occupational therapy in mental health and is forwarded as a potential risk to the profession's jurisdictional claim to the use and application of occupation. A call to research is advanced to develop a knowledge base on occupation, to empirically support the use of occupation as therapy, and to secure a unique role for occupational therapy in psychosocial practice.
La pratique de l'ergothérapie fondée sur l'évidence scientifique
Authors: Law Mary , Baum Carolyn
Published: March 2013

«Le concept d'un système de santé fondé sur l'évidence scientifique ne représente-t-il qu'une mode transitoire, défendue par des gestionnaires et des clients exer♣ant une influence sur la pratique clinique? Un concept voué à l'échec parce qu'il constitue une méthode par trop encombrante pour aborder la complexité et l'imprécision des décisions cliniques dans des situations réelles? »
Evidence-Based Practice: The Cochrane Collaboration, and Occupational Therapy
Authors: Hayes Robyn L. , McGrath John J.
Published: March 2013

This paper describes how occupational therapists can become involved in the Cochrane Collaboration — a well-developed tool for facilitating the involvement of health professionals and lay people in evidence-based practice. The Cochrane Collaboration is a growing international project intended to systematically locate, conduct systematic reviews (including metaanalyses) of, and disseminate information on all available randomised controlled trials of interventions in any area of health. In particular, occupational therapists can use the Cochrane Collaboration to become better informed about best practice and evaluate research in their areas of interest, and learn skills related to conducting randomised controlled trials, systematic reviews, and meta-analyses.
The Cochrane Collaboration
Authors: Pollock Nancy
Published: March 2013

One of the elements of best practice is the use of evidence in decision-making with clients. It is often very difficult for clinicians to access the latest research evidence, to synthesize the findings and to apply the evidence to the practice situation. A recent innovation, The Cochrane Collaboration represents an important step forward in making evidence available in a usable form for busy clinicians. This paper describes the Cochrane Collaboration and suggests ways that occupational therapists can both benefit from and contribute to the Collaboration.
Mediational Techniques: Origins and Application to Occupational Therapy in Paediatrics
Authors: Missiuna Cheryl , Malloy-Miller Theresa , Mandich Angela
Published: March 2013

For a variety of reasons, occupational therapists are beginning to explore the use of cognitive, or “top-down” approaches during intervention. While these approaches have a long history within education and psychology, the steps involved in problem-solving and the techniques that are used to mediate a child's occupational performance are unfamiliar to most therapists. In this paper, the historical underpinnings of cognitive approaches and mediational techniques are reviewed and the steps involved in teaching a child to problem solve are outlined. As each is described from the literature, it is interpreted and applied to paediatric occupational therapy practice. Finally, the problem-solving steps and techniques are combined to demonstrate usage of a cognitive approach in order to address a common occupational performance issue in childhood.
Reliability of Perceived Competence Measures for Young School-Aged Children
Authors: Klein Sheryl , Magill-Evans Joyce
Published: March 2013

Client perceptions of competence provide the occupational therapist with information relevant to intervention goals and performance outcomes. The Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PCSA) (Harter & Pike, 1983) and the All About Me (AAM) (Missiuna, 1992) measure perceptions of competence in young school-aged children. Test-retest reliability of scores on the PCSA and AAM was examined using a sample of 24 Grade 1 and 2 children with motor and/or language delays. For intervals of 10 to 22 days, the PCSA and AAM had moderate to good reliability. Competence perceptions were more reliable than acceptance perceptions on the PCSA. The AAM, a measure of perceived physical competence, was correlated more highly to the PCSA physical subscale and competence factor score than to other PCSA subscales. In general, young children view themselves as being highly competent.
Secondary Analysis of Survey Data: A Research Method with Potential for Occupational Therapists
Authors: Finlayson Marcia , Egan Mary , Black Charlyn
Published: March 2013

The secondary analysis of previously collected survey data can assist occupational therapists to focus research, make policy decisions and test theory. In this paper the authors outline the process of carrying out a secondary analysis using existing survey data. Steps include selecting the research question, and then locating, appraising, acquiring and analysing the data. To illustrate this process, the authors examined the relationships between accidents and mobility impairments among older adults using data previously collected in the National Population Health Survey. Finally, some further examples of occupational therapy research carried out using secondary analysis of survey data are considered.
Shoulder Supports Revisited: A Canadian Follow-Up Survey
Authors: Boyd Elizabeth A. , Pepin Penny , Szabo-Hartin Janine
Published: March 2013

This paper investigates the use of shoulder supports with stroke patients in Canada and compares the results of two survey questionnaires carried out in 1984 and 1994. It describes which shoulder supports therapists are using with stroke patients and which goals they hope to achieve with specific supports. The Lapboard, Cuff Type Sling, and Arm Trough Support were the most frequently used supports at both time periods. The most frequent goal chosen for each of these three most frequently chosen supports was the same at both time periods but were chosen significantly less frequently in 1994. There was a significant decrease in the use of the Bobath Axial Roll over the ten year period. This follow up questionnaire documents the limited changes which have occurred in the last ten years in the management of the shoulder following stroke, raises some questions about this area of practice, and outlines some solutions including the need to base occupational therapy practice on more evidence.
The Art of Observation: Reflecting on a Spiritual Moment
Authors: Toomey Moira A.
Published: March 2013

Spiritual moments can occur at unexpected times and it is often upon reflection that the significance of the moment is understood. The author tells a personal story about her daughter and herself engaged in the activity of drawing flowers. The reflection which follows highlights both the process and outcomes of the experience. Exploring spiritual issues using this narrative medium assists health care workers to recognize better and understand spirituality in relation to the occupation of visual art.
Parental perceptions of adolescent health behaviours: Experiences from Croatian high schools
Authors: Burusic Josip , Sakic Marija , Koprtla Natalija
Published: March 2013

Objective:

The aim of this study was to explore parental perceptions of adolescent health behaviours and to examine to what extent parents’ perceptions of their children’s health behaviours are determined by the family’s socio-demographic characteristics.

Method:

Participants in the study were 605 parents. They completed questionnaires in which they rated whether different health-risk behaviours were present in their children (i.e. smoking, alcohol consumption, drug use, risky sexual behaviour, insufficient physical activity, unhealthy eating habits and obesity). Parents also provided information on the family’s socio-demographic characteristics.

Results:

The results show that parents rate insufficient physical activity and unhealthy eating habits as the most pronounced problems in their children, while they rate risky sexual behaviour and drug use as the least pronounced. Parents estimate that insufficient physical activity and unhealthy eating habits are significantly more pronounced among girls than among boys. The results of factor analysis reveal that, from the parents’ perspective, adolescent health-risk behaviours can be grouped into those pertaining to unhealthy habits and those connected to addictive and risk behaviours. Parents rate that behaviours reflecting unhealthy lifestyle are significantly more present among girls than among boys. Regression analyses showed that a family’s living standard is the only significant predictor of unhealthy habits and addictive and risk behaviours.

Conclusion:

When observed from a parental perspective, adolescent health-risk behaviours can be grouped into different categories, and parents claim to observe certain differences in these behaviours between boys and girls. The most important determinant of adolescent health behaviours is a family’s living standard.
The associations between health literacy, reasons for seeking health information, and information sources utilized by Taiwanese adults
Authors: Wei Mi-Hsiu
Published: March 2013

Objective:

To determine the associations between health literacy, the reasons for seeking health information, and the information sources utilized by Taiwanese adults.

Method:

A cross-sectional survey of 752 adults residing in rural and urban areas of Taiwan was conducted via questionnaires. Chi-squared tests and logistic regression were used for data analysis.

Results:

Health literacy was found to be lower among adults who were older, with lower educational attainment, with lower household income, with blue-collar occupation, and living in rural areas. After socio-demographic characteristics were controlled for, adults with adequate health literacy were significantly more likely than adults with inadequate or marginal health literacy to report desires for health-related information, autonomous medical decision making, and finding information on their own, as reasons for seeking health information. Adults with inadequate or marginal health literacy were more likely to cite recommendations from medical professionals and hesitation to ask medical professionals questions as their reasons for seeking health information. Adults with adequate health literacy were significantly more likely than those with inadequate or marginal health literacy to obtain health information from the Internet, books, newspapers, and magazines, and were less likely to seek health information from alternative care providers.

Conclusion:

The findings suggest the need to consider target groups’ health literacy when developing health education programmes. More attention must be focused on providing interventions that motivate information seeking and improve information-seeking skills for adults with limited health literacy.
What Is Missiology?
Authors: Langmead Ross
Published: March 2013

Should missiology seek the status of a theological discipline? After a brief account of the history of academic missiology it is argued here that a trinitarian missiology is at the heart of all of theology. Missiology should both permeate theology and exist as a subject area to accompany missionary praxis, making theological education at least missiological to the core, if not itself missional. Missiology is part of practical theology, praxis-based and oriented to specific contexts. It draws on both theological and other disciplines (particularly the social sciences) as an interdisciplinary enterprise rather than as a discipline in its own right.
God’s Holistic Mission: Fullness of Parts, Participants, and Places
Authors: George Sherron
Published: March 2013

God’s holistic mission includes a fullness of parts, participants, and places. Holism integrates. Ephesians provides a conceptual framework for understanding God’s cosmic mission of salvation and reconciliation in the world. Fullness of spiritual, material, social, and planetary life comes through God’s multidimensional mission action that includes evangelism, compassion, and social justice. Because there is one body, one faith, one baptism, one God, we all participate in one common mission. God’s mission is local, global, cosmic, and ecumenical. Each baptized Christian and local congregation is a primary agent. Our participation in local or global mission is part of the bigger picture of missio Dei. This article will reflect on the integration and relationships of the parts, participants, and places of mission. How do we bring together local and global mission in a holistic vision? An ongoing missionary dialogue can lead to a dynamic creative integration and expanding partnerships.
The Contribution to Missiology by United Methodist Scholarship on Evangelism
Authors: Teasdale Mark R.
Published: March 2013

United Methodist scholars have contributed significantly to the emerging critical study of evangelism. In doing so, they have also contributed to the study of mission. This is because the Methodist approach to the study of evangelism allows for a broad set of definitions for evangelism, multiple methodologies for considering evangelism, and a wide array of activities that can fall under the rubric of evangelism. This essay demonstrates the breadth of this contribution by reviewing texts authored by United Methodist scholars of evangelism from the 1970s to the present.
Toward a Dose-Response Account of Media Priming
Authors: Arendt Florian
Published: March 2013

We present a dose-response (DR) account of media priming. DR concepts describe the relationship between a dose and the elicited response and, thus, allow us to study dose-dependent media priming effects. We report empirical evidence from an experiment ( N = 351) for the DR relationship between exposure to stereotypic newspaper content and readers’ stereotypic social reality estimates. We investigated the change in the media priming effect size by utilizing nine experimentally manipulated dose-conditions (i.e., frequency of the media prime). The empirical data appeared in the form of a Gaussian distribution function: We were able to document (1) a threshold dose, which generally allows us to specify the acceptable daily intake of potentially harmful media content. Furthermore, (2) we found a decline in the effect size at very high dose levels. We argue that a DR account as a supplement to contemporary approaches can be beneficial for media priming research.
Mothers’ complex talk when sharing books with their toddlers: Book genre matters
Authors: Nyhout Angela , O’Neill Daniela K.
Published: March 2013

This study investigated the influence of book genre (narrative or didactic) on mothers’ language use during a book sharing interaction with their 18- to 25-month-olds. Mother–child dyads were videotaped sharing both a narrative and a didactic book, adapted from two commercially available books, and matched in terms of length, quantity of text, and target content. A greater proportion of mothers’ talk was complex (i.e., predictions, text-to-life comparisons) during narrative book sharing than during didactic book sharing. Mothers also used a greater variety of verb tenses and referenced more mental states during narrative book sharing. These results differ from findings from previous studies with older children where it has been concluded that didactic books offer greater opportunities for complex talk than narrative books. The results also highlight the importance of taking situational factors into account when investigating parent–child communicative interactions.
Different Pathways of Constitutive Androstane Receptor–mediated Liver Hypertrophy and Hepatocarcinogenesis in Mice Treated with Piperonyl Butoxide or Decabromodiphenyl Ether
Authors: Sakamoto Yohei , Inoue Kaoru , Takahashi Miwa , Taketa Yoshikazu , Kodama Yukio , Nemoto Kiyomitsu , Degawa Masakuni , Gamou Toshie , Ozawa Shogo , Nishikawa Akiyoshi , Yoshida Midori
Published: March 2013

The constitutive androstane receptor (CAR) is essential for Cyp2b induction, liver hypertrophy, and hepatocarcinogenesis in response to phenobarbital (PB). Liver hypertrophy with Cyp2b induction is a major mode of action of hepatocarcinogenesis in rodents. However, it remains unclear whether CAR is involved in the response to many other nongenotoxic hepatocarcinogens besides PB. In this study, we investigated CAR involvement in liver hypertrophy and hepatocarcinogenesis of Cyp2b-inducing nongenotoxic hepatocarcinogens, piperonyl butoxide (PBO), and decabromodiphenyl ether (DBDE), using wild-type and CAR knockout (CARKO) male mice. PB was used as the positive control. In the wild-type mice, 4-week treatment with PBO, DBDE, or PB induced hepatocellular hypertrophy with increased Cyp2b10 messenger RNA and Cyp2b protein expression. In CARKO mice, only PBO showed liver hypertrophy with Cyp2b10 and Cyp3a11 induction. After 27-week treatment following diethylnitrosamine initiation, PBO and PB generated many eosinophilic altered foci/adenomas in wild-type mice; however, the lesions were far less frequent in CARKO mice. DBDE increased the multiplicity of basophilic altered foci/adenomas in wild-type and CARKO mice. Our findings indicate that murine CAR plays major roles in hepatocarcinogenesis but not in liver hypertrophy of PBO. DBDE may act via CAR-independent pathways during hepatocarcinogenesis.
The Placenta in Toxicology. Part II
Authors: Svensson-Arvelund Judit , Ernerudh Jan , Buse Eberhard , Cline J. Mark , Haeger Jan-Dirk , Dixon Darlene , Markert Udo R. , Pfarrer Christiane , Vos Paul De , Faas Marijke M.
Published: March 2013

During pregnancy, the maternal immune system is challenged by the semiallogeneic fetus, which must be tolerated without compromising fetal or maternal health. This review updates the systemic and local immune changes taking place during human pregnancy, including some examples in rodents. Systemic changes are induced by contact of maternal blood with placental factors and include enhanced innate immunity with increased activation of granulocytes and nonclassical monocytes. Although a bias toward T helper (Th2) and regulatory T cell (Treg) immunity has been associated with healthy pregnancy, the relationship between different circulating Th cell subsets is not straightforward. Instead, these adaptations appear most evidently at the fetal–maternal interface, where for instance Tregs are enriched and promote fetal tolerance. Also innate immune cells, that is, natural killer cells and macrophages, are enriched, constituting the majority of decidual leukocytes. These cells not only contribute to immune regulation but also aid in establishing the placenta by promoting trophoblast recruitment and angiogenesis. Thus, proper interaction between leukocytes and placental trophoblasts is necessary for normal placentation and immune adaptation. Consequently, spontaneous maladaptation or interference of the immune system with toxic substances may be important contributing factors for the development of pregnancy complications such as preeclampsia, preterm labor, and recurrent miscarriages.
Panel 5: Microbiology and Immunology Panel
Authors: Murphy Timothy F. , Chonmaitree Tasnee , Barenkamp Stephen , Kyd Jennelle , Nokso‐Koivisto Johanna , Patel Janak A. , Heikkinen Terho , Yamanaka Noboru , Ogra Pearay , Swords W. Edward , Sih Tania , Pettigrew Melinda M.
Published: March 2013

Objective

The objective is to perform a comprehensive review of the literature from January 2007 through June 2011 on the virology, bacteriology, and immunology related to otitis media.

Data Sources

PubMed database of the National Library of Medicine.

Review Methods

Three subpanels with co‐chairs comprising experts in the virology, bacteriology, and immunology of otitis media were formed. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a second draft was created. The entire panel met at the 10th International Symposium on Recent Advances in Otitis Media in June 2011 and discussed the review and refined the content further. A final draft was created, circulated, and approved by the panel.

Conclusion

Excellent progress has been made in the past 4 years in advancing an understanding of the microbiology and immunology of otitis media. Advances include laboratory‐based basic studies, cell‐based assays, work in animal models, and clinical studies.

Implications for Practice

The advances of the past 4 years formed the basis of a series of short‐term and long‐term research goals in an effort to guide the field. Accomplishing these goals will provide opportunities for the development of novel interventions, including new ways to better treat and prevent otitis media.
Panel 7: Treatment and Comparative Effectiveness Research
Authors: Marchisio Paola , Chonmaitree Tasnee , Leibovitz Eugene , Lieberthal Allan , Lous Jorgen , Mandel Ellen , McCormick David , Morris Peter , Ruohola Aino
Published: March 2013

Background and Objectives

Otitis media (OM) is one of the most common reasons for antibiotic treatment in children. Controversies regarding antibiotic treatment for OM have accumulated in the past decade, and there seem to be more dilemmas than certainties. The objectives of this article are to provide the state‐of‐the art review on achievements in treatment of all different stages of OM, including acute otitis media (AOM), otitis media with effusion (OME), and chronic suppurative otitis media, and to outline the future research areas.

Data Sources

PubMed, Ovid Medline, the Cochrane Database, and Clinical Evidence (BMJ Publishing).

Review Methods

All types of articles related to OM treatment published in English between January 2007 and June 2011 were identified. A total of 286 articles related to OM treatment were reviewed by the panel members; 114 relevant quality articles were identified and summarized.

Results

New evidence emerged on beneficial results of antibiotic treatment, compared with observation of AOM in young children who were diagnosed based on stringent criteria. In OME, the main results were related to a nonsignificant benefit of adenoidectomy versus tympanostomy tube placement alone in the treatment of chronic OME in younger children. Other modalities of OM treatment were studied and described herein.

Conclusions and Implications for Practice

Significant progress has been made in advancing the knowledge on the treatment of OM. Areas of potential future research have been identified and outlined.
Panel 6: Vaccines
Authors: Pelton Stephen I. , Pettigrew Melinda M. , Barenkamp Stephen J. , Godfroid Fabrice , Grijalva Carlos G. , Leach Amanda , Patel Janak , Murphy Timothy F. , Selak Sanja , Bakaletz Lauren O.
Published: March 2013

Objective

To update progress on the effectiveness of vaccine for prevention of acute otitis media (AOM) and identification of promising candidate antigens againstStreptococcus pneumoniae, nontypeableHaemophilus influenzae, andMoraxella catarrhalis.

Review Methods

Literature searches were performed in OvidSP and PubMed restricted to articles published between June 2007 and September 2011. Search terms includedotitis media, vaccines, vaccine antigens, and each of the otitis pathogens and candidate antigens identified in the ninth conference report.

Conclusions

The current report provides further evidence for the effectiveness of pneumococcal conjugate vaccines (PCVs) in the prevention of otitis media. Observational studies demonstrate a greater decline in AOM episodes than reported in clinical efficacy trials. Unmet challenges include extending protection to additional serotypes and additional pathogens, the need to prevent early episodes, the development of correlates of protection for protein antigens, and the need to define where an otitis media vaccine strategy fits with priorities for child health.

Implications for Practice

Acute otitis media continues to be a burden on children and families, especially those who suffer from frequent recurrences. The 7‐valent PCV (PCV7) has reduced the burden of disease as well as shifted the pneumococcal serotypes and the distribution of otopathogens currently reported in children with AOM. Antibiotic resistance remains an ongoing challenge. Multiple candidate antigens have demonstrated the necessary requirements of conservation, surface exposure, immunogenicity, and protection in animal models. Further research on the role of each antigen in pathogenesis, in the development of correlates of protection in animal models, and in new adjuvants to elicit responses in the youngest infants is likely to be productive and permit more antigens to move into human clinical trials.
Panel 3: Recent Advances in Anatomy, Pathology, and Cell Biology in Relation to Otitis Media Pathogenesis
Authors: Cayé‐Thomasen Per , Hermansson Ann , Bakaletz Lauren , Hellstrøm Sten , Kanzaki Sho , Kerschner Joseph , Lim David , Lin Jizhen , Mason Kevin , Spratley Jorge
Published: March 2013

Background and Objectives

The pathogenesis of otitis media (OM) involves a number of factors related to the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx. Although some issues of pathogenesis are fairly well established, others are only marginally indicated by current knowledge, and yet others remain undisclosed. The objective of this article is to provide a state‐of‐the‐art review on recent scientific achievements in the pathogenesis of OM, as related to anatomy, pathology, and cell biology.

Data Sources

PubMed, Ovid Medline, and Cochrane Library.

Review Methods

Articles published on the pathogenesis of OM and the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx between January 2007 and June 2011 were identified. Among almost 1900 abstracts, the authors selected 130 articles for full article review and inclusion in this report.

Results

New knowledge on a number of issues emerged, including cell‐specific expression and function of fluid transportation and innate immune system molecules, mucous cell metaplasia, mucin expression, bacterial adherence, and epithelial internalization, as well as the occurrence, composition, dynamics, and potential role of bacterial biofilm. In addition, the potential role of gastroesophageal reflux disease and cigarette smoke exposure has been explored further.

Conclusions and Implications for Practice

Over the past 4 years, considerable scientific progress has been made on the pathogenesis of OM, as related to issues of anatomy, pathology, and cell biology. Based on these new achievements and a sustained lack of essential knowledge, suggestions for future research are outlined.
Panel 4: Recent Advances in Otitis Media in Molecular Biology, Biochemistry, Genetics, and Animal Models
Authors: Li Jian‐Dong , Hermansson Ann , Ryan Allen F. , Bakaletz Lauren O. , Brown Steve D. , Cheeseman Michael T. , Juhn Steven K. , Jung Timothy T. K. , Lim David J. , Lim Jae Hyang , Lin Jizhen , Moon Sung‐Kyun , Post J. Christopher
Published: March 2013

Background

Otitis media (OM) is the most common childhood bacterial infection and also the leading cause of conductive hearing loss in children. Currently, there is an urgent need for developing novel therapeutic agents for treating OM based on full understanding of molecular pathogenesis in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM.

Objective

To provide a state‐of‐the‐art review concerning recent advances in OM in the areas of molecular biology, biochemistry, genetics, and animal model studies and to discuss the future directions of OM studies in these areas.

Data Sources and Review Methods

A structured search of the current literature (since June 2007). The authors searched PubMed for published literature in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM.

Results

Over the past 4 years, significant progress has been made in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. These studies brought new insights into our understanding of the molecular and biochemical mechanisms underlying the molecular pathogenesis of OM and helped identify novel therapeutic targets for OM.

Conclusions and Implications for Practice

Our understanding of the molecular pathogenesis of OM has been significantly advanced, particularly in the areas of inflammation, innate immunity, mucus overproduction, mucosal hyperplasia, middle ear and inner ear interaction, genetics, genome sequencing, and animal model studies. Although these studies are still in their experimental stages, they help identify new potential therapeutic targets. Future preclinical and clinical studies will help to translate these exciting experimental research findings into clinical applications.
Oral Tongue Squamous Cell Carcinoma in Never‐Smokers: Analysis of Clinicopathologic Characteristics and Survival
Authors: Durr Megan L. , van Zante Annemieke , Li David , Kezirian Eric J. , Wang Steven J.
Published: March 2013

Objectives

(1) To compare clinical characteristics, survival, and recurrence between never‐smokers and ever‐smokers with oral tongue squamous cell carcinoma (OTSCC). (2) To assess the relationship between clinicopathologic characteristics and survival/recurrence in OTSCC.

Study Design

Historical cohort study.

Setting

Academic university medical center.

Subjects and Methods

This is a study of 120 patients with OTSCC who were treated from January 1999 to February 2010. Clinicopathologic factors were compared between never‐smokers and ever‐smokers using t tests and χ2 tests. Cox regression analyses examined their association with survival and recurrence.

Results

Of 120 subjects, 66 (55%) were prior or current smokers. There were no significant differences in clinicopathologic factors between ever‐smokers and never‐smokers. After adjustment for clinicopathologic factors, multivariate Cox regression analysis demonstrated decreased overall survival for never‐smokers, but this difference was not significant (hazard ratio [HR], 2.84; P =. 056). Increased depth of tumor invasion (HR per millimter invasion, 1.09; P =. 005), nodal metastasis (HR, 7.1; P =. 025), and stage III or IV disease (HR, 9.45 and 7.31; P =. 026 and. 029, respectively) were associated with decreased overall survival. Perineural invasion (HR, 8.56; P =. 005) and lymphovascular invasion (HR, 6.01; P =. 011) were associated with disease recurrence.

Conclusion

Overall survival may be decreased in never‐smokers with OTSCC. Greater depth of tumor invasion and more advanced stage disease are associated with decreased survival. Perineural invasion and lymphovascular invasion are associated with disease recurrence.
Anachronism and Morality: Israeli Settlement, Palestinian Nationalism, and Human Liberation
Authors: Dalsheim Joyce
Published: March 2013

This article is concerned with how the idea of anachronism can interfere with our thinking about social justice, peace, and human liberation. In the case of Israel/Palestine the idea of anachronism is deployed among liberals, progressives and radical theorists, and activists seeking peace and social justice who express animosity toward religiously motivated settlers and their settlement project. One of the ways in which they differentiate themselves from these settlers is by suggesting that settler actions belong to the past. They also pity Palestinians conceived of as stuck in an oppressive system of settler colonialism that also belongs to the past, preventing them from moving forward. Both perceptions of anachronism limit the ways we can think about human liberation and peace. This article sheds light on a conundrum about who or what belongs to the past, and how thinking in such terms can contribute to the production of a particular moral collective and to the production of enmity. Both perceptions of anachronism frame history as a kind of progress in which peoples or groups might be ranked according to their levels of civilizational attainment, an idea we abandoned long ago as an analytical tool, but seem to have retained as a matter of practical political sympathy and judgment. This temporal conditioning can interfere with the thinking of even some of the most progressive social theorists, and mimics a colonial impulse.
Tuberculosis in CBA/J Mice
Authors: Major S. , Turner J. , Beamer G.
Published: March 2013

Tuberculosis (TB) develops in 5% to 10% of people infected with Mycobacterium tuberculosis ( M.tb), but we do not understand how TB develops. CBA/J mice may model these events, as sick mice share features with TB patients, including weight loss, M.tb growth, extensive granulomatous infiltrates, neutrophils, necrosis, and fibrosis. Here, M.tb-infected CBA/J mice were categorized clinically: those with no signs or those with 10% weight loss to determine whether clinical state was associated with lung lesions. The type and distribution of infiltrates (granulomatous with lymphoid aggregates and scattered neutrophils) were similar in mice with weight loss and in mice with no signs. The amount of infiltration and neutrophil foci were higher in mice with weight loss than in mice with no clinical signs. Necrosis and fibrosis were only identified in mice that lost weight. Our results suggest that CBA/J mice may be useful to determine if and how neutrophils contribute to TB disease progression in mouse models.
Under the Guardians’ Supervision
Authors: Frost Ginger
Published: March 2013

This article explores how Cambridge and Cardiff poor law unions “found” families for illegitimate children between 1870 and 1930, even when doing so meant coming into conflict with national regulations. Both unions pursued support from fathers, stepfathers, maternal kin, and others. They also recognized cohabiting relationships in outrelief, and they used creative fostering and adoption schemes involving wider kin. As time went by, guardians formally took the place of some families, but failed to remove children entirely from kin who were determined to stay in contact. Ironically, then, the poor law acknowledged the relationships between illegitimate children and their families well before the Legitimacy Act of 1926.
Headache and Physical and Sexual Abuse Among Jewish and Arab Adolescents in Israel
Authors: Genizi Jacob , Srugo Isaac , Kerem Nogah C.
Published: March 2013

The purpose of the present study was to evaluate the relationship between headaches and physical and sexual abuse. A self-administered, anonymous questionnaire was presented to 2088 tenth grade students in Northern Israel. Participants were Jews and Arabs between the ages of 15 to 16 years. Arab adolescents comprised 55% of the analyzed sample and adolescent Jews 45%. With regard to gender, 56% of participants were females. Of the Arab participants, 18.6% reported having frequent headaches, less than that reported in the Jewish group (27.9%). Jewish girls who were physically abused during childhood had a higher prevalence of frequent headaches (55% vs 33% P < .001). Jewish students who reported being sexually abused had higher headache prevalence as well (44.4% vs 27.3% P = .05). In conclusion, adolescents who reported to have been physically or sexually abused report a higher prevalence of headache compared to their peers.