bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epithelial Thickness Up to 26 Years After Radial Keratotomy: Three-dimensional Display With Artemis Very High-frequency Digital Ultrasound
Authors: Reinstein Dan Z. , Archer Timothy J. , Gobbe Marine 
Published: April 2011

PURPOSE:
To characterize the epithelial thickness profile in a population of eyes after radial keratotomy for myopia.

METHODS:
The epithelial thickness profile was measured in vivo by Artemis very high-frequency digital ultrasound arc-scanning (ArcScan Inc) across the central 10-mm diameter of the cornea on 14 eyes after radial keratotomy for myopia. Maps of the mean and standard deviation of epithelial thickness were plotted and compared to the epithelial thickness of a previously published population of normal untreated eyes.

RESULTS:
Ultrasound scanning using the Artemis was performed a mean 16.7±5.8 years (range: 1.6 to 26.3 years) after radial keratotomy. The mean epithelial thickness profile showed the epithelium to be thicker centrally and thinner paracentrally, which was different from the population of normal eyes. The mean thickest epithelial thickness was 78.8±6.0 μm (range: 64.8 to 89.6 μm) and the mean thinnest epithelial thickness was 43.7±4.3 μm (range: 36.1 to 49.3 μm), which were statistically significantly different from the epithelial thickness at these locations in the population of normal eyes.

CONCLUSIONS:
Three-dimensional thickness mapping of the epithelial thickness profile demonstrated epithelial changes that compensated in part for the central corneal flattening induced by the radial keratotomy incisions. The fact that epithelial changes were consistent across eyes from approximately 2 to 26 years after radial keratotomy suggests that epithelial changes are a permanent response to corneal curvature changes.
Artisan Iris-supported Phakic IOL Implantation in Patients With Keratoconus: A Review of 16 Eyes
Authors: Sedaghat Mohamadreza , Ansari-Astaneh Mohammad-Reza , Zarei-Ghanavati Mehran , Davis Scott W. , Sikder Shameema 
Published: April 2011

PURPOSE:
To evaluate the clinical outcomes of Artisan phakic intraocular lens (PIOL; Ophtec BV) implantation in patients with stable keratoconus.

METHODS:
In a prospective, nonrandomized case series, 14 Artisan PIOLs and 2 toric Artisan PIOLs were implanted in 13 patients (16 eyes) with stable keratoconus who had contact lens intolerance. Pre- and postoperative data were collected.

RESULTS:

Mean follow-up was 14.2±7.8 months. Preoperative uncorrected distance visual acuity (UDVA) was counting fingers in all patients. Mean final logMAR (Snellen equivalent) UDVA and corrected distance visual acuity (CDVA) were 0.15(20/28)±0.13 and 0.11(20/26)±0.10, respectively. The improvements in UDVA and CDVA were statistically significant (
P
<.0001 and
P
<.002, respectively). All patients achieved a final UDVA of 20/40 or better, and 84.6% had a final CDVA of 20/32 or better. No postoperative complications occurred except for two cases of sterile uveitis.

CONCLUSIONS:
Implantation of the Artisan PIOL is effective in improving visual acuity in patients with stable keratoconus. Long-term safety remains to be established as no postoperative endothelial cell counts were performed.
Toric Intraocular Lens Misalignment Inducing Astigmatism After Refractive Surgery
Authors: Forseto Adriana S. , Nosé Ricardo M. , Nosé Walton 
Published: April 2011

PURPOSE:
To report the unexpected induction of astigmatism after phacoemulsification and toric intraocular lens (IOL) implantation in an eye with previous corneal refractive surgery.

METHODS:
Case report of a 46-year-old man with bilateral nuclear cataract and previous photorefractive keratectomy. Because corneal topography identified regular corneal astigmatism at the central optical zone, phacoemulsification and implantation of a one-piece hydrophobic acrylic toric IOL were performed.

RESULTS:
Unexpected induction of astigmatism occurred in the first operated eye despite proper alignment of the IOL according to the preoperative calculations using simulated K values to determine toric IOL power and alignment. A retrospective qualitative analysis of corneal topography showed mismatching of the steepest meridian, leading to an off-axis IOL. Secondary IOL rotation improved both uncorrected and corrected distance visual acuity.

CONCLUSIONS:
Qualitative analysis of the corneal topography is mandatory during the assessment of toric IOL alignment in eyes with previous corneal refractive surgery to identify the actual location of the steepest meridian.
A comparison of Methods for Data-Driven Cancer Outlier Discovery, and An Application Scheme to Semisupervised Predictive Biomarker Discovery
Authors: Karrila Seppo , Lee Julian Hock Ean , Tucker-Kellogg Greg 
Published: April 2011

A core component in translational cancer research is biomarker discovery using gene expression profiling for clinical tumors. This is often based on cell line experiments; one population is sampled for inference in another. We disclose a semisupervised workflow focusing on binary (switch-like, bimodal) informative genes that are likely cancer relevant, to mitigate this non-statistical problem. Outlier detection is a key enabling technology of the workflow, and aids in identifying the focus genes. We compare outlier detection techniques MOST, LSOSS, COPA, ORT, OS, and t-test, using a publicly available NSCLC dataset. Removing genes with Gaussian distribution is computationally efficient and matches MOST particularly well, while also COPA and OS pick prognostically relevant genes in their top ranks. Also our stability assessment is in favour of both MOST and COPA; the latter does not pair well with prefiltering for non-Gaussianity, but can handle data sets lacking non-cancer cases. We provide R code for replicating our approach or extending it.
The Impact of Intersection Design on the Driving Performance of Adults in the Recovery Phase of a Turn
Authors: Classen Sherrilene , Shechtman Orit , Stephens Burton , Davis Ethan , Lanford Desiree , Mann William 
Published: April 2011

Driving, an instrumental activity of daily living, requires safe person-environment interactions. The effectiveness (safety) of four United States Federal Highway Administration intersection design guidelines in the recovery phase of a turn was tested on older and younger adults. Using kinematics measures from an instrumented vehicle, drivers negotiating improved and unimproved intersections were examined in Gainesville, Florida. The findings from a 2 × 2 repeated measures ANOVA (within-subject variable = intersection condition: improved versus unimproved; between-subject variable = age: young versus old) yield support for three manoeuvres: extended receiving lane, right-turn channelisation with acceleration lane and left-turn offset, but not for no acute turn angle. One interaction effect (age x intersection) existed and age effects (favouring older drivers) appeared for three manoeuvres, yet showed little practical significance, suggesting that these design guidelines benefit older and younger drivers alike. This study informs occupational therapists that enhancements in the environment have an impact on safer driving, particularly at urban intersections. A replication of the concept of this study, that is, testing intersection design guidelines in the United Kingdom, may generate valuable information on the plausibility of environmental design guidelines and their effects on the driving performance of older and younger adults.
‘I Feel So Much Safer’: Unravelling Community Equipment Outcomes
Authors: Sainty Mandy , Lambkin Christopher , Maile Louise 
Published: April 2011

Health and wellbeing outcomes are the new currency of health and social care commissioning. To explore the extent to which community equipment had an impact on the health and wellbeing outcomes of choice and control, quality of life and personal dignity, a postal survey was carried out among a sample of adults who had been prescribed community equipment by social or primary care services to meet mobility, domestic, personal care or sensory needs. A response rate of 52% (251) was achieved. Seventy-eight per cent of respondents reported that they were using all the equipment prescribed. Bathing equipment tended to be either very successful or not used at all. Of those who had used all or some of the equipment prescribed, 91% reported feeling safer and over 80% said that it made a positive difference to their independence, quality of life or ability to do things when they wanted. The provision of equipment had less of an impact on reducing the need for assistance at home, particularly from paid carers. The practice implications highlighted by the findings focus on the need to review the opportunities available for maximising effective use of bathing equipment.
Measuring Social Inclusion: A Staff Survey of Mental Health Service Users' Participation in Community Occupations
Authors: Dorer Gemma , Harries Priscilla , Marston Louise 
Published: April 2011

Mental health service users frequently experience social exclusion and limited occupational engagement. A survey was conducted to gather staff reports of 199 service users' levels of engagement and social inclusion across eight domains of community occupation. The staff reported that the majority of service users (54%) engaged in two or fewer of the community occupation domains over a 7-day period, the most common being the use of local facilities (92%) and contact with family and friends (61%). The staff reports suggested that far fewer service users were engaged in the other domains: day centres (25%), education (14%), sport (13%), arts (12%), employment (11%) and faith (8%). With regard to social inclusion, activities occurred most frequently in mainstream settings for the domains of faith (100%), use of local facilities (98%), sport (80%), and family and friends (79%). Lower levels of social inclusion were reported for the other domains. Statistical analysis revealed that service users' occupational engagement related to their accommodation type, age and gender, but not to ethnicity. These findings indicate that further research is needed to explore service users' views on social inclusion and what they feel would support them to engage in community occupations at a level that suits their individual needs.
Night-Time Positioning for Children with Postural Needs: What is the Evidence to Inform Best Practice?
Authors: Wynn Nicky , Wickham Jill 
Published: April 2011

This paper presents the findings of a review of the literature concerning the assessment and provision of night-time positioning for children with postural needs. The aim of the review was to source and evaluate the evidence available for the efficacy of current treatments and to establish best practice. There is a small but growing body of evidence demonstrating that night-time positioning is beneficial to children with postural needs when used within a child and family centred 24-hour postural management programme. Children and families need timely assessment and provision of equipment, together with appropriate training and support to learn to use night-time positioning equipment effectively. Occupational therapists have a distinct role in the assessment and provision of night-time positioning equipment and need to be both skilled in assessment and knowledgeable about postural management and the equipment available. This review of literature suggests that further research is required to strengthen the evidence for the efficacy of night-time positioning equipment and to guide therapists in best practice.
Does the Use of a Sensory Re-Education Programme Improve the Somatosensory and Motor Function of the Upper Limb in Subacute Stroke? A Single Case Experimental Design
Authors: Helliwell Suzanne 
Published: April 2011

Purpose: The purpose was to evaluate the effects of a sensory re-education programme on the somatosensory and motor function of the upper limb in subacute stroke. Participant: The participant was a subacute stroke patient with radiological evidence of first unilateral stroke, with motor and sensory impairments. Procedures: Following a baseline period to establish a pattern of sensory function, a sensory re-education programme was delivered over 10 sessions. The treatment occurred three times a week on set days and was administered by a trained assistant. Main outcome measures: The Rivermead Assessment of Somatosensory Performance (RASP) and the Upper Limb — Motor Assessment Scale (UL-MAS) were completed throughout the baseline phase and then at weekly intervals until the final day of the study. The Functional Independence Measure was completed at the start and end of the intervention phase. Results: Surface pressure touch and surface localisation were the most impaired during the baseline phase. Proprioceptive movement and proprioceptive direction showed gradual improvement throughout the intervention phase. Conclusion: The results suggest that there may have been an effect on proprioception in the upper limb following intervention. The inconsistency during the baseline phase makes definitive conclusions difficult to draw. The change in proprioception did not have any effect on motor recovery. Further discussion is needed on the implementation of sensory re-education in the subacute stroke population.
Meeting the Challenge: OT and IT
Authors: Morley Mary , Aveling Patricia 
Published: April 2011

Government policy requires occupational therapists to provide evidence for the clinical effectiveness of services using information management systems. However, their engagement in the Information Management and Technology programme has been limited. The benefits of engaging in this agenda are explored and the risks of non-involvement are discussed. Strategies to assist occupational therapists and managers to implement information systems are highlighted. It is concluded that unless occupational therapists engage collectively in the short term, the opportunities to influence information systems will diminish and the unique occupational therapy contribution will be at risk of becoming invisible.
Learning in International Practice Placement Education: A Grounded Theory Study
Authors: Barker Alison , Kinsella Elizabeth Anne , Bossers Ann 
Published: April 2011

Objective: There is a growing trend towards international practice placement education in occupational therapy, yet little research documents the learning that individuals who participate in such experiences report. The purpose of this study was to examine the process of learning that arises through engagement with occupational therapy practice placement education in an international context. Method: A constructivist grounded theory methodology was employed. In-depth, semi-structured interviews were conducted with eight individuals who had completed an international practice placement during their tenure as an occupational therapy student. Findings: The core category of learning identified by participants was personal and professional development. The subcategories included thinking outside the box, adaptability/flexibility, cultural sensitivity, recognition of the value of interpersonal relationships, and gaining confidence through moving beyond one's comfort zone and through increasing autonomy. The comments from participants also invoke critical reflection on the appropriateness of the transfer of North American occupational therapy practice into resource-poor countries. Conclusion: This research documents the process of learning described by a group of individuals who participated in international practice placement education as part of their occupational therapy education. The research contributes to knowledge about international practice placement education in occupational therapy.
Feasibility of the Canadian Occupational Performance Measure for Routine Use
Authors: Colquhoun Heather , Letts Lori , Law Mary , MacDermid Joy , Edwards Mary 
Published: April 2011

Purpose: Despite encouragement, routine outcome measurement is not standard practice in occupational therapy. This applies across most practice areas and outcome measures, including occupational therapy measures such as the Canadian Occupational Performance Measure. Barriers to using outcome measures have been proposed, but are gathered from therapists not measuring outcomes routinely. This study gathered therapists' perceptions on outcome measurement following a period of routine outcome measure use. A secondary aim was to propose a therapist-driven template for summarising outcome data routinely. Procedures: Using a process evaluation, a short answer survey was used with three occupational therapists following 5 months of Canadian Occupational Performance Measure use in older people's rehabilitation. The data were summarised descriptively, using a proposed template based on therapist feedback. Findings: The therapists perceived that the measure facilitated treatment for both therapists and clients but they experienced challenges related to client cognition and sustaining use. Template creation indicated that the therapists placed more importance on individual than group level data. Conclusion: The therapists perceived benefit in routine Canadian Occupational Performance Measure use. The instrument appears feasible for meaningful and routine use but not necessarily for sustained use. Increasing outcome measure use is complex, requiring more knowledge on barriers, expectations of value and methods of data utilisation.
Understanding Parenting Occupations in Neonatal Intensive Care: Application of the Person-Environment-Occupation Model
Authors: Gibbs Deanna , Boshoff Kobie , Lane Alison 
Published: April 2011

The adoption of family-centred care principles within neonatal intensive care, including support for the development of the parental role, has been increasing in profile over the past decade. During this period, occupational therapy has also had an emerging role in the provision of services within neonatal intensive care. However, there has been limited exploration of the concept of parenting as an occupation as a means of supporting parental role development within the neonatal intensive care unit (NICU). In accordance with the philosophy of family-centred care, opportunities exist to determine how the occupational efforts of parents and preterm infants can best be supported. This paper provides a review of the current literature and its application to the Person-Environment-Occupation (PEO) Model as a framework for illuminating the acquisition of parenting occupations in the NICU. Illustration is provided of how the application of the PEO Model can be used to direct occupational therapy practice to incorporate a focus on family-centred care and the development of an occupation-based approach through which practice can be enhanced, ensuring that both the infant's and the family's needs are recognised and addressed.
‘Rip That Book up, I've Changed’: Unveiling the Experiences of Women Living with and Surviving Enduring Mental Illness
Authors: McKay Elizabeth Anne 
Published: April 2011

The lives of women with an enduring mental illness have been little researched within occupational therapy. This study explored the experiences of five women living with enduring mental illness in their communities. The women were interviewed over a 2-year period using the life history method. Data were recorded and transcribed verbatim. The data set was analysed in two ways. First, from the narrative analysis, an individual unique narrative of each woman's life was created. Secondly, the data were analysed using the constant comparative method. This paper presents the findings from the constant comparative analysis. Six themes were identified, which lifted the veil on the experience of living with and surviving enduring mental illness. Each theme represented a section of the women's lived experiences: a specific frame of the bigger picture of their lives. The themes were present life, life roles, relationships, illness transitions, help and cultural context. The findings highlighted the complex life roles and needs of the women over time. They unveiled how the women became agents in creating a better life for themselves and others. Practitioners have a role to play in creating meaningful and safe environments that encourage social inclusion and recovery.
Exploring Occupational Adaptation through the Lives of Women with Multiple Sclerosis
Authors: Cahill Mairead , Connolly Deirdre , Stapleton Tadhg 
Published: April 2011

Multiple sclerosis (MS) affects people's physical capabilities and the lives of people with MS are constantly changing (Finlayson et al 2005), yet how people adapt to the disease from an occupational perspective has received little attention. This study explored the occupational adaptation of women with MS. Seven women with MS were recruited from the Multiple Sclerosis Society of Ireland. Each participant completed the Modified Interest Checklist (Kielhofner and Neville 1983), the Role Checklist (Oakley et al 1985) and the Occupational Questionnaire (Smith et al 1986). Qualitative data were also collected, using the Occupational Performance History Interview – II (Kielhofner et al 2004). The findings from all four tools were amalgamated and analysed. Three main themes emerged: the impact of MS on (i) performance capacity, (ii) roles and (iii) interests. The participants adapted by performing interests and roles differently and developing new meaningful interests and roles that were congruent with their performance capacity. The findings highlight the importance of having an understanding of the impact of different types of MS on the occupational adaptation process. A greater understanding will facilitate occupational therapists in enabling people with MS to adapt to their condition by engaging in meaningful occupations throughout the lifespan.
Spirituality within Dementia Care: Perceptions of Health Professionals
Authors: Bursell Jennifer , Mayers Christine A 
Published: April 2011

There is an increasing awareness that people with dementia should have their spiritual needs addressed. The aim of this study was to investigate health professionals' understanding of spirituality within dementia care and their perceptions of how patients' spiritual needs are met and by whom. A phenomenological approach was used, with semi-structured interviews undertaken with four nurses, two occupational therapists, two physiotherapists, two doctors and one speech and language therapist (n = 11). All the health professionals found defining ‘spirituality’ difficult, although common terminology was used. They agreed that spirituality was not solely related to religion. Chaplaincy staff were associated with the provision of spiritual care, but 10 of the health professionals identified themselves as staff who should address such spiritual needs. The majority (n = 10), however, reported a lack of confidence with spiritual care and agreed that training would be valuable. The findings indicate that all health professionals should address the spiritual needs of patients with dementia. A working definition of ‘spirituality’ is needed and further research is also warranted into the type of training needed by health professionals with regard to the spiritual care of patients.