The role of occupational therapy for individuals living with sickle cell disease

The purpose of the research study was to determine the role occupational therapy plays in the management of sickle cell disease (SCD). A descriptive survey was administered to 39 persons living with or caring for persons living with SCD. This survey was administered at two sickle cell foundations and one hospital. ^ The research study determined that none of the 10.3% of the sample who had rehabilitative therapy received occupational therapy. Furthermore, at least 50% of persons surveyed agreed that SCD affected their activities of daily living; at least 38.5% agreed that work and productive activities were hampered; and at least 18% agreed that play/leisure activities were affected. No one within the sample received gene therapy. ^ It was concluded that occupational therapy is relevant for persons who are disabled by SCD. It is recommended that occupational therapists realize the importance of treating patients with SCD from a more holistic perspective. ^

The conflict resolution behaviors of occupational therapy students as a function of the personality types, demographic characteristics and contextual factors

Interpersonal conflicts have the potential for detrimental consequences if not managed successfully. Understanding the factors that contribute to conflict resolution has implications for interpersonal relationships and the workplace. Researchers have suggested that personality plays an important and predictable role in conflict resolution behaviors (Chanin & Schneer, 1984; Kilmann & Thomas, 1975; Mills, Robey & Smith, 1985). However, other investigators have contended that contextual factors are important contributors in triggering the behavioral responses (Shoda & Mischel, 2000; Mischel & Shoda, 1995). The purpose of this study was to investigate the relationships among personality types, demographic characteristics and contextual factors on the conflict resolution behaviors reported by graduate occupational therapy students (n = 125). ^ The study design was correlational. The Myers Briggs Type Indicator (MBTI) and the Thomas-Kilmann (MODE) Instrument were used to establish the personality types and the context independent conflict resolution behaviors respectively. The effects of contextual factors of task vs. relationship and power were measured with the Conflict Case Scenarios Questionnaire (CCSQ). One-way ANOVA and linear regression procedures were used to test the relationships between personality types and demographic characteristics with the context independent conflict behaviors. Chi-Square procedures of the personality types by contextual conditions ascertained the effects of contexts in modifying the resolution modes. Descriptive statistics established a profile of the sample. ^ The results of the hypotheses tests revealed significant relationships between the personality types of feeling-thinking and sensing-intuition with the conflict resolution behaviors. The contextual attributes of task vs. relationship orientation and of peer vs. supervisor relationships were shown to modify the conflict behaviors. Furthermore, demographic characteristics of age, gender, GPA and educational background were shown to have an effect on the conflict resolution behaviors. The knowledge gained has implications for students' training, specifically understanding their styles and use of effective conflict resolution strategies. It also contributes to the knowledge on management approaches and interpersonal competencies and how this might facilitate the students' transition to the clinical role. ^

Attitudes towards the marine environment and implications for marine resource management in Seward, Alaska

This research, conducted in 2006-2008, examines the ways in which various groups involved with the marine resources of Seward, Alaska construct attitudes towards the environment. Participant observation and semi-structured interviews are used to assess how commercial halibut fishers, tour boat operators, local residents and government officials understand the marine environment based on their previous experiences. This study also explores how ideologies relate to the current practices of each group. Two theories orient the analyses: The first, cultural modeling provided a theoretical and methodological framework for pursuing a more comprehensive analysis of resource management. The second, Theory of Reasoned Action (Ajzen and Fishbein 1980), guided the analysis of the ways in which each participant’s ideology towards the marine environment relates to their practice. Aside from contributing to a better understanding of a coastal community’s ideologies and practices, this dissertation sought to better understand the role of ecological ideologies and behaviors in fisheries management. The research illustrates certain domains where ideologies and practices concerning Pacific halibut and the marine environment differ among commercial fishers, government, and management officials, tour boat operators and residents of Seward, AK. These differences offer insights into how future collaborative efforts between government officials, managers and local marine resource users might better incorporate local ideology into management, and provide ecological information to local marine resource users in culturally appropriate ways.

Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States

Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Quality of life and application of the transtheoretical model to diabetes self -management behaviors in older adults with type 2 diabetes

One in five adults 65 years and older has diabetes. Coping with diabetes is a lifelong task, and much of the responsibility for managing the disease falls upon the individual. Reports of non-adherence to recommended treatments are high. Understanding the additive impact of diabetes on quality of life issues is important. The purpose of this study was to investigate the quality of life and diabetes self-management behaviors in ethnically diverse older adults with type 2 diabetes. The SF-12v2 was used to measure physical and mental health quality of life. Scores were compared to general, age sub-groups, and diabetes-specific norms. The Transtheoretical Model (TTM) was applied to assess perceived versus actual behavior for three diabetes self-management tasks: dietary management, medication management, and blood glucose self-monitoring. Dietary intake and hemoglobin A1c values were measured as outcome variables. Utilizing a cross-sectional research design, participants were recruited from Elderly Nutrition Program congregate meal sites (n = 148, mean age 75). ^ Results showed that mean scores of the SF-12v2 were significantly lower in the study sample than the general norms for physical health (p < .001), mental health (p < .01), age sub-group norms (p < .05), and diabetes-specific norms for physical health (p < .001). A multiple regression analysis found that adherence to an exercise plan was significantly associated with better physical health (p < .001). Transtheoretical Model multiple regression analyses explained 68% of the variance for % Kcal from fat, 41% for fiber, 70% for % Kcal from carbohydrate, and 7% for hemoglobin A 1c values. Significant associations were found between TTM stage of change and dietary fiber intake (p < .01). Other significant associations related to diet included gender (p < .01), ethnicity (p < .05), employment (p < .05), type of insurance (p < .05), adherence to an exercise plan (p < .05), number of doctor visits/year ( p < .01), and physical health (p < .05). Significant associations were found between hemoglobin A1c values and age ( p < .05), being non-Hispanic Black (p < .01), income (p < .01), and eye problems (p < .05). ^ The study highlights the importance of the beneficial effects of exercise on quality of life issues. Furthermore, application of the Transtheoretical Model in conjunction with an assessment of dietary intake may be valuable in helping individuals make lifestyle changes. ^

Evaluation of a mentored self -help intervention for the management of psychotic symptoms

Cognitive behavioral therapy has been shown to be promising for the treatment of individuals experiencing psychotic symptoms, who are often diagnosed with schizophrenia. Using a non-random non-equivalent comparison group design (n = 26), this study explores whether an individually mentored self-help and self-paced intervention based upon cognitive behavioral approaches to auditory hallucinations or "hearing voices" makes a significant positive difference for individuals with major mental disorder diagnoses and psychotic symptoms who are residing in the community and receiving community mental health services. The mentored self-help intervention uses a workbook (Coleman & Smith, 1997) that stemmed from the British psychiatric survivor and "voice hearers"' movements and from cognitive behavioral approaches to treating psychotic symptoms. Thirty individuals entered the study. Pre- and post-intervention assessments of 15 participants in the intervention group and 11 participants in the comparison group were carried out using standardized instruments, including the Rosenberg Self-Esteem Scale, the Brief Psychiatric Rating Scale, and the Hoosier Assurance Plan Inventory - Adult. Four specific research questions address whether levels of self-esteem, overall psychotic symptoms, depression-anxiety, and disruption in life improved in the intervention group, relative to the comparison group. Pre- and post-assessment scores were analyzed using repeated measures analysis of variance. Results showed no significant difference on any measure, with the exception of the Brief Psychiatric Rating subscale for Anxious Depression, which showed a statistically significant pre-post difference with a strong effect size. A conservative interpretation of this single positive result is that it is due to chance. An alternative interpretation is that the mentored self-help intervention made an actual improvement in the level of depression-anxiety experienced by participants. If so, this is particularly important given high levels of depression and suicide among individuals diagnosed with schizophrenia. This alternative interpretation supports further research on the intervention utilized in this study. ^

A Systematic Review of Internet-Based Worksite Wellness Approaches for Cardiovascular Disease Risk Management: Outcomes, Challenges & Opportunities

Context The internet is gaining popularity as a means of delivering employee-based cardiovascular (CV) wellness interventions though little is known about the cardiovascular health outcomes of these programs. In this review, we examined the effectiveness of internet-based employee cardiovascular wellness and prevention programs. Evidence Acquisition We conducted a systematic review by searching PubMed, Web of Science and Cochrane library for all published studies on internet-based programs aimed at improving CV health among employees up to November 2012. We grouped the outcomes according to the American Heart Association (AHA) indicators of cardiovascular wellbeing – weight, BP, lipids, smoking, physical activity, diet, and blood glucose. Evidence Synthesis A total of 18 randomized trials and 11 follow-up studies met our inclusion/exclusion criteria. Follow-up duration ranged from 6 – 24 months. There were significant differences in intervention types and number of components in each intervention. Modest improvements were observed in more than half of the studies with weight related outcomes while no improvement was seen in virtually all the studies with physical activity outcome. In general, internet-based programs were more successful if the interventions also included some physical contact and environmental modification, and if they were targeted at specific disease entities such as hypertension. Only a few of the studies were conducted in persons at-risk for CVD, none in blue-collar workers or low-income earners. Conclusion Internet based programs hold promise for improving the cardiovascular wellness among employees however much work is required to fully understand its utility and long term impact especially in special/at-risk populations.

The Effectiveness of an Online Workshop on Behavior Management as a Professional Development Tool for Teachers

The current study examines the effects of an online workshop pertaining to classroom behavior management on teacher self-efficacy, attitudes, motivation, knowledge, and practices. In addition, information about teacher utilization of the Internet, their opinions about professional development, and experiences with classroom management were collected. Participants included 57 1st through 5th grade special and regular education teachers. Eligible teachers were those who teach an academic subject and had at least one child in the classroom they considered as disruptive. Teachers were randomized to either a training or waitlist group. Classroom observations of teacher practices and questionnaires were utilized. Teachers in the training group participated in two assessment points, baseline and post-workshop, and received access to the online course immediately following the baseline assessment. Teachers in the waitlist group participated in three assessment points, baseline, post-workshop, and follow-up, and received access to the online course immediately following the post-workshop assessment. Findings show that all teachers had access to the Internet at home and at school and used it on a daily basis. The majority of teachers indicated having some past training on all the techniques that were presented in the online workshop. All teachers expressed satisfaction with the workshop, indicating that it should be offered again. Post-workshop, findings showed significant group differences in knowledge with a large effect for the training group scoring higher than the waitlist group on a quiz. Secondly, group differences in self-efficacy, knowledge, and attitudes with teachers’ past-training as a moderator, was examined. Past-training was not found to be a significant moderator of self-efficacy, knowledge, or attitudes. However, the main effect for training group was significant for attitudes. In addition, teacher attitudes, but not knowledge and self-efficacy, significantly predicted motivation to implement. Next, the moderating effect of barriers on motivation and classroom management skill implementation was examined. Barriers were not found to be a significant moderator. Lastly, the training group was observed to be significantly more effective at giving commands compared to the waitlist group. The current study demonstrates the potential of a low-intensity online workshop on classroom management to enhance the accessibility of teacher professional development.

Sex offender risk assessment and management in Ireland

This research examined sex offender risk assessment and management in Ireland. It focused on the statutory agencies with primary responsibility (Garda Síochána and the Probation Service). The goal was to document the historical, contextual and current systems, in addition to identifying areas of concern/improvements. The research was a mixed-methods approach. Eight studies were conducted. This incorporated documentary reviews of four Commission to Inquire Reports, qualitative interviews/focus groups with Garda staff, Probation Service staff, statutory agencies, community stakeholders, various Non-Governmental Organisations (NGOs) and sex offenders. Quantitative questionnaires were also administered to Garda staff. In all over 70 interviews were conducted and questionnaires were forwarded to 270 Garda members. The overall findings are: •Sex offender management in Ireland has become formal only since 2001. Knowledge, skills and expertise is in its infancy and is still evolving. •Mixed reviews and questions regarding fitness for purpose of currently used risk assessments tools were noted. •The Sex Offender Act 2001 requires additional elements to ensure safe sex offender monitoring and public protection. A judicial review of the Sex Offender Act 2001 was recommended by many respondents. •Interagency working under SORAM was hugely welcomed. The sharing of information has been welcomed by managing agencies as the key benefit to improving sex offender management. •Respondents reported that in practice, sex offender management in Ireland is fragmented and unevenly implemented. The research concluded that an independent National Sex Offender Authority should be established as an oversight and regulatory body for policy, strategy and direction in sex offender management. Further areas of research were also highlighted: ongoing evaluation and audits of the joint agency process and systems in place; recidivism studies tracking the risk assessment ratings and subsequent offending; and an evaluation of the current status of sex offender housing in Ireland.

Social-Cognitive Determinants of Success in Online Communities for Weight Management

Background: Online communities may be an effective, convenient, and relatively inexpensive intervention platform for individuals seeking assistance with weight management. Recent research suggests that these communities may be as effective as in-person treatments for weight management; however, very little is known about the characteristics that predict weight loss amongst those using an online community. Methods: Within a social-cognitive framework, we sought to identify the psychosocial characteristics that are associated with successful weight management for users of MyFitnessPal, a popular online community for weight management. We recruited participants who were new to the online community and asked them to complete 2 surveys (one at baseline and one 3 months later) that assessed various psychosocial constructs as well as self-reported height and weight. Results: Participants in our sample reported losing, on average, 4.55 kg during the 3-month time period. We found that engaging in weight control behaviors (e.g., monitoring food intake, weighing oneself, etc.) fully mediated the relationship between several of our variables of interest (i.e., baseline self-efficacy and perceived social support within the community) and weight loss. We also found that participants who expected to lose more weight at baseline were significantly more likely to have lost more weight at follow-up. Conclusions: On average, participants in our study lost a clinically meaningful amount of weight. Predictors of weight loss within this community included perceived support within the community (mediated by weight control behaviors), baseline self-efficacy (mediated by weight control behaviors), and baseline outcome expectations. Results of this study can ultimately serve to inform the design of future eHealth interventions for weight management.

An integrated psychology virtual research ethics committee

Research and professional ethics are an integral part of every Psychology degree, as this is seen as a key graduate learning outcome for students leaving to become clinicians working with clients and patients. The development of these skills is embedded in teaching, but they culminate in the final year of a degree when final year students must gain formal ethical approval for their final research project. Decision as to the ethical appropriateness of research are made by a Departmental Research Ethics Committee, which considers all research project proposals submitted by staff and students within the department. One of the challenges of this practice is the scale of work involved for committee members (Doyle & Buckley, 2014) who are all faculty members, and the tracking of applications and decisions, alongside the quality assurance required to ensure that all applications are treated fairly and equally. The time involved in performing this work is often underestimated by Universities, and the variety and complexity of decisions requires extensive discussion and negotiation. Traditionally, these decisions are reached by committee discussions, however this presents logistical difficulties as it requires meetings with quorate attendance. The University of Westminster launched a virtual tool in 2014 to facilitate the management of the Research Ethics Committee, to help track the progress of applications and to allow discussions to occur and be managed virtually. The Department of Psychology adopted the tools in September 2014 to deal with all ethics applications. Here we report on how this virtual committee has affected the role and practices of a working committee that deals with over 300 applications per year, and how an online ethics procedure has facilitated an integrated developmental approach to ethical education.

Psychological factors associated with self-management among adolescents with Type 1 diabetes: a review

This review aims to synthesise the literature examining the psychosocial variables related to self-management (insulin adherence, non-adherence and administration, blood sugar monitoring, dietary behaviour, exercise behaviour) in adolescents with type 1 diabetes.
A systematic search of three electronic databases was carried out and, after the application of eligibility criteria, 21 articles were assessed for quality prior to data extraction. Numerous psychological factors were found to be associated with self-management; however, correlations were typically small to moderate. The strongest associations were found between social anxiety and diet (among males); greater intrinsic motivation, conscientiousness and diet; and extraversion and exercise.

Does Emotional Intelligence have a “Dark” Side? A Review of the Literature

Emotional intelligence (EI) was once touted as the ‘panacea’ for a satisfying and successful life. Consequently, there has been much emphasis on developing interventions to promote this personal resource in applied settings. Despite this, a growing body of research has begun to identify particular contexts when EI does not appear helpful and may even be deleterious to a person, or those they have contact with, suggesting a ‘dark’ side to the construct. This paper provides a review of emergent literature to examine when, why and how trait and ability EI may contribute to negative intrapersonal (psychological ill-health; stress reactivity) and interpersonal outcomes (emotional manipulation; antisocial behaviour). Negative effects were found to operate across multiple contexts (health, academic, occupational) however these were often indirect, suggesting that outcomes depend on pre-existing qualities of the person. Literature also points to the possibility of ‘optimal’ levels of EI – both within and across EI constructs. Uneven profiles of self-perceptions (trait facets) or actual emotional skills contribute to poorer outcomes, particularly emotional awareness and management. Moreover, individuals who possess high levels of skill but have lower self-perceptions of their abilities fare worse that those with more balanced profiles. Future research must now improve methodological and statistical practices to better capture EI in context and the negative corollary associated with high levels.

An Interdisciplinary Approach to the Management of Vocal Cord Dysfunction in an Elite Female Swimmer: a Case Study

Acute pulmonary disorders are commonplace within the athletic population, with exercise induced bronchoconstriction (EIB), and vocal cord dysfunction (VCD) common diagnoses. VCD is a condition that causes the adduction of the vocal folds during inhalation, causing obstruction at the larynx and thereby a severely impaired sporting performance. VCD can be brought on by laryngeal irritants, emotional and psychological stress and asthma. The gold standard of treatment for VCD centres on an interdisciplinary approach from specialists that often include a respiratory consultant, speech and language therapist (SLT) and a psychologist. The present case study details the interdisciplinary approach to the treatment of an elite female swimmer with VCD with an intervention programme that lasted nine weeks, instigated by a local general practitioner (G.P.) who chose to engage a Sport Psychology Consultant (SPC) due to the sport-specific nature of the psychological stress experienced by the individual. The steps involved in the design of the sport psychology interventions are outlined and the relationship of those interventions to the work of the other specialists is discussed. The 9 week intervention programme was aimed at reducing perfectionist tendencies and competitive state anxiety using a combination of cognitive behavioural therapy (CBT), goal-setting and imagery. Overall, the treatment programme was deemed a success as perfectionism and competitive state anxiety levels reduced over time along with the frequency of VCD occurrence. This case study demonstrates the breadth of roles that can be undertaken by a SPC and raises awareness of a complex respiratory disorder that is not yet fully understood.

Co-exposure to mycotoxins: the case of waste management workers

Introduction - Occupational exposures are characterized by being complex and associated to co-exposure to several contaminants by different exposure routes. Even if exposure occurs to only a chemical agent, it can have different exposure routes and can result in different health effects. The waste management setting is recognized by the presence of several chemical and biologic agents in the workplaces. Recently, it was reported occupational exposure to Aflatoxin B1 (AFB1) in one Portuguese waste management industry. However, data regarding to fungal burden showed that exposure to other mycotoxins should be expected. Aim of the study - The aim of the present work was to know if workers from this waste management industry were exposed to other mycotoxins besides AFB1.