bluuebunny/crossref_metadata_2025_split huggingface dataset:
NADPH Oxidase Deficiency Regulates Th Lineage Commitment and Modulates Autoimmunity
Authors: Tse Hubert M. , Thayer Terri C. , Steele Chad , Cuda Carla M. , Morel Laurence , Piganelli Jon D. , Mathews Clayton E. 
Published: September 2010

AbstractReactive oxygen species are used by the immune system to eliminate infections; however, they may also serve as signaling intermediates to coordinate the efforts of the innate and adaptive immune systems. In this study, we show that by eliminating macrophage and T cell superoxide production through the NADPH oxidase (NOX), T cell polarization was altered. After stimulation with immobilized anti-CD3 and anti-CD28 or priming recall, T cells from NOX-deficient mice exhibited a skewed Th17 phenotype, whereas NOX-intact cells produced cytokines indicative of a Th1 response. These findings were corroborated in vivo by studying two different autoimmune diseases mediated by Th17 or Th1 pathogenic T cell responses. NOX-deficient NOD mice were Th17 prone with a concomitant susceptibility to experimental allergic encephalomyelitis and significant protection against type 1 diabetes. These data validate the role of superoxide in shaping Th responses and as a signaling intermediate to modulate Th17 and Th1 T cell responses.
Does Cytolysis by CD8+ T Cells Drive Immune Escape in HIV Infection?
Authors: Balamurali Mehala , Petravic Janka , Loh Liyen , Alcantara Sheilajen , Kent Stephen J. , Davenport Miles P. 
Published: September 2010

AbstractCD8+ “cytotoxic” T cells are important for the immune control of HIV and the closely related simian models SIV and chimeric simian–human immunodeficiency virus (SHIV), although the mechanisms of this control are unclear. One effect of CD8+ T cell-mediated recognition of virus-infected cells is the rapid selection of escape mutant (EM) virus that is not recognized. To investigate the mechanisms of virus-specific CD8+ T cell control during immune escape in vivo, we used a real-time PCR assay to study the dynamics of immune escape in early SHIV infection of pigtail macaques. For immune escape mediated by cytolysis, we would expect that the death rate of wild type (WT) infected cells should be faster than that of EM-infected cells. In addition, escape should be fastest during periods when the total viral load is declining. However, we find that there is no significant difference in the rate of decay of WT virus compared with EM virus. Further, immune escape is often fastest during periods of viral growth, rather than viral decline. These dynamics are consistent with an epitope-specific, MHC class I-restricted, noncytolytic mechanism of CD8+ T cell control of SHIV that specifically inhibits the growth of WT virus in vivo.
Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System
Authors: Villanueva R. , Knudson K. M. , Harvey E. M. , Langle J. M. , Paul W. , Del Beccaro M. A. 
Published: September 2010

Summary
Objective: We sought to determine the frequency and type of decision support alerts by location and ordering provider role during Computerized Provider Order Entry (CPOE) medication ordering. Using these data we adjusted the decision support tools to reduce the number of alerts.
Design: Retrospective analyses were performed of dose range checks (DRC), drug-drug interaction and drug-allergy alerts from our electronic medical record. During seven sampling periods (each two weeks long) between April 2006 and October 2008 all alerts in these categories were analyzed. Another audit was performed of all DRC alerts by ordering provider role from November 2008 through January 2009. Medication ordering error counts were obtained from a voluntary error reporting system.
Measurement/Results: Between April 2006 and October 2008 the percent of medication orders that triggered a dose range alert decreased from 23.9% to 7.4%. The relative risk (RR) for getting an alert was higher at the start of the interventions versus later (RR= 2.40, 95% CI 2.28-2.52; p< 0.0001). The percentage of medication orders that triggered alerts for drug-drug interactions also decreased from 13.5% to 4.8%. The RR for getting a drug interaction alert at the start was 1.63, 95% CI 1.60-1.66; p< 0.0001. Alerts decreased in all clinical areas without an increase in reported medication errors.
Conclusion: We reduced the quantity of decision support alerts in CPOE using a systematic approach without an increase in reported medication errors
Development and Evaluation of the University of Michigan’s Practice-Oriented Research Training (PORT) Program
Authors: Murphy Susan L. , Kalpakjian Claire Z. , Mullan Patricia B. , Clauw Daniel J. 
Published: September 2010

Abstract
We describe the development and evaluation of a clinical research training program designed specifically for such health professionals as occupational and physical therapists. Outcomes of program success included trainees’ self-rating of research skills before and after the program, as well as submission of a formal grant application to a grant competition for program participants. At program completion, participants reported improvements in their research skills, with the most gain in formulating research questions and writing a testable hypothesis and the least gain in understanding statistics. Of the 21 participants, 43% submitted a grant proposal to a competitive intramural grant program. In the next year, grantees of the program will continue to be mentored by the program mentors while conducting their research projects. Given the initial successes, this program represents a promising model for providing research training to practicing clinicians.
Use of Mental Practice to Improve Upper-Limb Recovery After Stroke: A Systematic Review
Authors: Nilsen Dawn M. , Gillen Glen , Gordon Andrew M. 
Published: September 2010

AbstractOBJECTIVE. We sought to determine whether mental practice is an effective intervention to improve upper-limb recovery after stroke.METHOD. We conducted a systematic review of the literature, searching electronic databases for the years 1985 to February 2009. We selected studies according to specified criteria, rated each study for level of evidence, and summarized study elements.RESULTS. Studies differed with respect to design, patient characteristics, intervention protocols, and outcome measures. All studies used imagery of tasks involving movement of the impaired limb. The length of the interventions and number of practice hours varied. Results suggest that mental practice combined with physical practice improves upper-limb recovery.CONCLUSION. When added to physical practice, mental practice is an effective intervention. However, generalizations are difficult to make. Further research is warranted to determine who will benefit from training, the dosing needed, the most effective protocols, whether improvements are retained, and whether mental practice affects perceived occupational performance.
Cross-Regional Validation of the School Version of the Assessment of Motor and Process Skills
Authors: Munkholm Michaela , Berg Brett , Löfgren Britta , Fisher Anne G. 
Published: September 2010

Abstract
OBJECTIVE. The objective was to determine whether the School Version of the Assessment of Motor and Process Skills (School AMPS) is valid when used to evaluate students in different world regions.
METHOD. Participants were 984 students, ages 3–13 yr, from North America, Australia and New Zealand, United Kingdom, and the Nordic countries, matched for age and diagnoses. We used FACETS many-faceted Rasch analyses to generate item difficulty calibrations by region and evaluate for significant differential item functioning (DIF) and differential test functioning (DTF).
RESULTS. Four School AMPS items demonstrated DIF but resulted in no DTF.
CONCLUSION. This study provided support for occupational therapists using the School AMPS to evaluate students’ quality of schoolwork task performances across regions because the School AMPS measures are free of bias associated with world region.
Occupational Therapy and Participatory Research: A Partnership Worth Pursuing
Authors: Letts Lori 
Published: September 2010

Abstract
This paper argues that participatory research is an approach to developing knowledge that can make significant contributions to occupational therapy. One project, working with older adults in Toronto to organize a new seniors’ organization, is used to illustrate the ways in which this approach is participatory and how it can be understood as research. Other examples of participatory research from the occupational therapy literature are then presented. These include research among occupational therapists and research with participants who are typically clients of occupational therapy services. The examples are used to illustrate the conceptual links between client-centered, occupation-based occupational therapy and participatory research. Challenges of adopting a participatory research approach in occupational therapy are discussed, although many of these can be addressed through open discussions with participants. The paper concludes that participatory research is an approach to research that should be pursued more actively in occupational therapy.
Establishing Worker Identity: A Study of People in Craft Work
Authors: Dickie Virginia Allen 
Published: September 2010

Abstract
Having a work-related identity is central to being an adult in America. Going to work and engaging in prescribed work behaviors in the workplace is the usual or typical way that adults achieve worker identities. The purpose of this study, developed from an ethnography of people who make crafts at home and sell their work at craft fairs, was to examine how worker identity is constructed when individuals do not have the external markers of a socially identified job and workplace. I used participant observation of craft fairs and other craft venues, and interviews of people who do this work, as major sources of data. Results of the analysis of the data related to worker identity demonstrated that these crafters followed basic steps, or rules, to achieve such a worker identity. These rules, some for work at home and some for other social contexts, encompassed complex behaviors learned through the process of doing the work as well as from other crafters. The conclusions of the study are first, that individual and social identity formation as a worker involves complex processes for which rules and guidelines do exist. Second, these rules are often discovered through the process of doing the work. Third, the meaning of work and the individual and social identities of being a worker are individual, and finally, knowledge of worker identity formation is gained through the study of both those who successfully achieve such an identity and those who do not.
Effects of an Energy Conservation Course on Fatigue Impact for Persons With Progressive Multiple Sclerosis
Authors: Vanage Susan M. , Gilbertson Kirsten Kay , Mathiowetz Virgil 
Published: September 2010

Abstract
OBJECTIVE. Fatigue is a common, troublesome symptom for persons with multiple sclerosis. This study evaluated the effects of an energy conservation course on fatigue impact for persons with multiple sclerosis whose symptoms cause moderate to severe disability.
METHODS. Thirty-seven persons with progressive multiple sclerosis participated in an 8-week experimental energy conservation course treatment and an 8-week control period of traditional treatment using a crossover design. The Fatigue Impact Scale (FIS) was used to assess fatigue impact before and after the experimental and control periods, and 8 weeks post-energy conservation course.
RESULTS. After participation in the energy conservation course, the average FIS total score and physical, cognitive, and psychosocial subscale scores decreased significantly, whereas the total and subscale scores did not change significantly during the control period. Additionally, decreased fatigue impact was maintained 8 weeks after course completion for evaluated participants.
CONCLUSION. This study provides evidence that this energy conservation course can be a beneficial intervention for persons with progressive multiple sclerosis.
The Development of an Assessment To Evaluate Behavioral Factors Associated With Falling
Authors: Clemson Lindy , Cumming Robert G. , Heard Robert 
Published: September 2010

Abstract
The purpose of this study was to report the development of the Falls Behavioral (FaB) Scale for Older People, an assessment designed to evaluate behavioral factors that could potentially protect against falling. Instrument development included content analysis, expert review, and factor analysis. Ten behavioral dimensions were identified including Cognitive Adaptations, Protective Mobility, Avoidance, Awareness, Pace, Practical Strategies, Displacing Activities, Being Observant, Changes in Level, and Getting to the Phone. The final 30item scale had a Content Validity Index of 0.93. Test–retest reliability was ICC = 0.94 (p &lt; .01). Construct validity was established by showing that, as expected, scale scores were positively associated with increasing age (rs = 0.46, p &lt; .01) and negatively associated with greater physical mobility (rs = −0.68, p &lt; .01). People who had fallen utilized safer behaviors than those who had not reported a fall (p &lt; .05) providing a benchmark for using the scale in future studies. The FaB is an easily completed, reliable, and valid tool for determining the presence or absence of protective behaviors. It has potential to assist in goal setting for falls prevention and to evaluate behavioral outcomes of fall prevention programs.
Environmental Effects on the Assessment of People With Dementia: A Pilot Study
Authors: Hoppes Steve , Davis Lori A. , Thompson David 
Published: September 2010

Abstract
OBJECTIVE. The purpose of this pilot study was to use a standardized assessment of independent living skills to explore the effects of environment on functional performance of individuals with dementia.
METHODS. Twelve participants (6 males, 6 females), diagnosed with dementia, were given the Structured Assessment of Independent Living Skills (SAILS), a standardized assessment of functional motor, cognitive, instrumental, and social performance. Participants were assessed in their homes, in an adult day-services facility they regularly attended, and in an occupational therapy clinic.
RESULTS. Data were analyzed using repeated measures analysis of variance (ANOVA). There was no evidence of a learning effect from repeated assessments. Participants’ performances did not differ among the home, clinic, and adult day-services settings on the total SAILS score (F = 1.22; df = 2,20; p = 0.3176), nor on three of its subscales: cognitive score (F = 0.80; df = 2,20; p = 0.4648), instrumental activities (F = 1.37; df = 2,20; p = 0.2777), and social interaction (F = 0.34; df = 2,20; p = 0.7147). However, participants’ performance on the SAILS motor score was significantly higher in the home than in the clinic (t = 2.925, df = 11, p = 0.0138).
CONCLUSION. Participants’ motor performance was significantly better at home than in an unfamiliar environment. Effects of environment on motor performance, and absence of effects on cognitive, instrumental, and social performances, can be explained through ecological theory. These results suggest that the ability to adapt movement to an unfamiliar environment may decline with the onset and progression of dementia.
Clara: A Phenomenology of Disability
Authors: Padilla René 
Published: September 2010

Abstract
A phenomenological approach was used to describe the lived experience of disability of a woman who sustained a head injury 21 years ago. Data were collected through 11 face-to-face interviews and 72 e-mail messages over the period of 11 weeks. An iterative, fluid process of questioning, information-giving, analysis, and verification was characteristic of the whole study, alternating between analysis of the particular and analysis of the general. Through a process of phenomenological reduction, each interview transcript and e-mail message was divided into meaning units that denoted shifts of meaning. Similar meaning units within a transcript or message were then grouped and summarized in a phrase or word. As new meaning units emerged, additional interviews and e-mail exchanges took place in order to obtain an exhaustive description of the experience of disability. All meaning units obtained from this iterative process finally were “horizonalized” into meaning clusters of nonrepetitive themes. The themes of nostalgia, abandonment, and hope emerged through this collaborative process. A shift in view of life was noted in the participant as the reflective process of this study unfolded, suggesting a phenomenological collaboration between patient and therapist may engender a more genuine connection in which personal meaning is authentically the cornerstone of occupation-centered treatment.
Relationship Between Visual-Motor Integration and Handwriting Skills of Children in Kindergarten: A Modified Replication Study
Authors: Daly Christopher J. , Kelley Gail T. , Krauss Andrea 
Published: September 2010

Abstract
OBJECTIVE. The purpose of this study was to examine the relationship of performance on the Developmental Test of Visual-Motor Integration (VMI; Beery, 1997) to handwriting legibility in children attending kindergarten. The relationship of using lined versus unlined paper on letter legibility, based on a modified version of the Scale of Children’s Readiness in PrinTing (Modified SCRIPT; Weil & Cunningham Amundson, 1994) was also investigated.
METHOD. Fifty-four typically developing kindergarten students were administered the VMI; 30 students completed the Modified SCRIPT with unlined paper, 24 students completed the Modified SCRIPT with lined paper. Students were assessed in the first quarter of the kindergarten school year and scores were analyzed using correlational and nonparametric statistical measures.
RESULTS. Strong positive relationships were found between VMI assessment scores and student’s ability to legibly copy letterforms. Students who could copy the first nine forms on the VMI performed significantly better than students who could not correctly copy the first nine VMI forms on both versions of the Modified SCRIPT.
CONCLUSION. Visual-motor integration skills were shown to be related to the ability to copy letters legibly. These findings support the research of Weil and Cunningham Amundson. Findings from this study also support the conclusion that there is no significant difference in letter writing legibility between students who use paper with or without lines.
Spirituality as Experienced by Occupational Therapists in Practice
Authors: Egan Mary , Swedersky Jill 
Published: September 2010

Abstract
Despite considerable literature describing the potential place of spirituality in occupational therapy, surveys repeatedly demonstrate that therapists are uncomfortable with this concept in practice. To gain a better understanding of how spirituality might inform practice, we interviewed eight occupational therapists who stated that they considered spirituality while working with patients.
Participants defined spirituality as one’s beliefs about the world and one’s place in it and how one lives out these beliefs, through reflection and conscious actions. Four themes of consideration of spirituality in practice emerged. In the first, addressing religious concerns, therapists dealt with patients’ religious questions and issues. In the second, addressing suffering, therapists assisted patients to deal with their feelings related to loss and pain, attempted to relieve patients’ distress and helped patients move towards increased functioning. In the third, encouraging the self, therapists worked to assist patients to acknowledge their own worth and to use their unique gifts and interests. In the fourth, growing as a person, therapists themselves were transformed as a result of the therapeutic encounter.
This study represents an early attempt to determine what occupational therapists who consider spirituality actually do in practice. Future research should go deeper into the experience of such therapists, to gain a richer understanding of the phenomenon.
Classroom Seating for Children With Attention Deficit Hyperactivity Disorder: Therapy Balls Versus Chairs
Authors: Schilling Denise Lynn , Washington Kathleen , Billingsley Felix F. , Deitz Jean 
Published: September 2010

Abstract
OBJECTIVE. The purpose of this study was to investigate the effects of therapy balls as seating on in-seat behavior and legible word productivity of students with attention deficit hyperactivity disorder (ADHD). Additionally, social validity was assessed to evaluate teacher and student opinions regarding the intervention.
METHOD. A single subject, A-B-A-B interrupted time series design was employed across 3 students (2 males, 1 female) with ADHD. The study was conducted in a 4th grade inclusive classroom during daily language arts. During phases 1 and 3, the 3 participants and all other class members sat on chairs (in-seat on chair); during phases 2 and 4, everyone sat on therapy balls (in-seat on ball). Dependent variables were in-seat behavior and legible word productivity. Data were graphed and visually analyzed for differences between phases.
RESULTS. Results demonstrated increases in in-seat behavior and legible word productivity for the students with ADHD when seated on therapy balls. Social validity findings indicated that generally the teacher and students preferred therapy balls.
CONCLUSION. This study provides evidence that use of therapy balls for students with ADHD may facilitate in-seat behavior and legible word productivity.
Occupational Therapy Effects on Visual-Motor Skills in Preschool Children
Authors: Dankert Heather L. , Davies Patricia L. , Gavin William J. 
Published: September 2010

Abstract
OBJECTIVE. The purpose of this study was to evaluate the assumption that preschool children who receive occupational therapy will demonstrate significant improvement in their visual-motor skills as measured on the Developmental Test of Visual-Motor Integration (VMI) and the two supplemental Visual Perception and Motor Coordination tests.
METHOD. Preschool children with developmental delays (n = 12) received occupational therapy a minimum of one individual 30-minute session, and one group 30-minute session per week for 1 school year. Their performance was compared to that of two control groups; preschool students without disabilities who received occupational therapy (n = 16) for one 30-minute group session per week and students without disabilities (n = 15) who received no occupational therapy. The VMI and two supplemental tests were administered three times to each student, at the beginning, middle, and end of school year.
RESULTS. Planned comparison tests showed that students with developmental delays demonstrated statistically significant improvement in visual-motor skills and developed skills at a rate faster than expected when compared to typically developing peers on the VMI. The effect size for preschool students without disabilities who received occupational therapy exceeded the effect size for the VMI and Visual Perception supplemental test for the preschool students without disabilities who received no therapy, although, the difference in the posttest performance of these two groups was not statistically significant.
DISCUSSION. The results of this study demonstrate that intervention, including occupational therapy, can effectively improve visual-motor skills in preschool-aged children.