The use of treatment theories and procedures for postural control in adult with hemiplegia: A national survey

This study investigated the use of treatment theories and procedures for postural control training used by Occupational Therapists (OTs) when working with hemiplegic adults who have had cerebrovascular accident (CVA) or traumatic brain injury (TBI). The method of data collection was a national survey of 400 randomly selected physical disability OTs with 127 usable surveys returned. Results showed that the most common used treatment theory was neurodevelopmental treatment (NDT), followed by motor relearning program (MRP), proprioceptive neuromuscular facilitation (PNF), Brunnstrom's approach, and the approach of Rood. The most common treatment posture used was sitting, followed by standing, mat activity, equilibrium reaction training, and walking. The factors affecting the use of various treatment theories procedures were years certified, years of clinical experience, work situation and work status. Pearson correlation coefficient analyses found significant positive relationships between treatment theories and postures. There were significant high correlations between usage of all pairs of treatment procedures. ^

Valued occupational roles and life satisfaction among south Florida HIV-infected and non-infected homosexual males: An exploratory study

A study was conducted in order to describe and understand the occupational role behavior of gay men with particular interest on understanding the impact of an HIV diagnosis on their roles and life satisfaction. A 137-item questionnaire was developed for this study and distributed through various gay community groups in south Florida. The process resulted in ranked description of 24 valued occupational roles of gay men (n = 80) along with a general understanding of potential shifts that may occur in those roles as a result of becoming infected with HIV. The study concludes that a diagnosis of HIV infection impacts gay men both by altering their value for particular roles and by darkening the images they hold of their future. The study also identified key factors which may contribute to the greater life satisfaction of gay men including greater confidence in personal knowledge of HIV, a more optimistic outlook an life, the use of stronger coping styles, and perceiving stronger social support and lower stress. ^

A comparison of breathing patterns of normal full term infants in supine versus right side-lying during quiet and active behavioral sleep states

This study investigated the effect of sleep position on breathing patterns of normal full term infants during quiet and active behavioral sleep states. Tidal volume, percent contribution of rib cage to tidal volume, and respiration rate were measured via respiratory inductive plethysmography (RIP) and pneumotachograph (PNT) in ten infants sleeping in supine versus right side-lying. Data was collected immediately following two consecutive feedings. Paired t tests and ANOVA comparisons showed no significant differences between the two postures (p $<$.05) in mean tidal volume (supine, M = 19.16, right side, M = 22.45), percent contribution of rib cage to tidal volume (supine, M = 30.55, right side M = 33.20), or respiration rate (supine, M = 49.13, right side, M = 49.37) during quiet sleep. Comparisons also showed no significant differences between the two postures (p $<$.05) in mean tidal volume (supine, M = 18.89, right side, M = 20.12), percent contribution of rib cage to tidal volume (supine, M = 6.43, right side, M = 6.97) or respiration rate (supine, M = 62.18, right side, M = 61.04) during active sleep. Therefore, no differences were found in the three respiratory variables measured between the supine and right side-lying positions. These findings suggest that infants may be positioned in either sleep position without detriment to respiratory function. This information may benefit occupational therapists and other health professionals involved in the education of parents on infant positioning and their respective advantages. ^

Education and training in the use of physical agent modalities by occupational therapists practicing in the physical disabilities area

This study was conducted to examine how occupational therapists (OTs) practicing in the physical disabilities area received their training in the use of physical agent modalities (PAMs); to determine the frequency of PAMs usage by those therapists; and to obtain their opinions regarding the training of OTs and OT students in the administration of PAMs. Three hundred OTs practicing in physical diabilities (n = 194 returned) were surveyed. The most frequently used modalities were hot and cold packs, paraffin, and ultrasound. The least frequently used modalities were transcutaneous electrical stimulation (TENS) and whirlpool. On-the-job training was the most common educational method received by the respondents for PAMs usage. The respondents considered a combination of undergraduate education, fieldwork, continuing education and on-the-job training as the most appropriate educational setting for training in modalities. While few of the respondents received preparation in PAMs during entry-level academic programs, the majority felt that OT students should be trained in PAMs usage as part of their education curriculum. ^

Optimization of pavement maintenance and rehabilitation programming using shuffled complex evolution algorithm

The major barrier to practical optimization of pavement preservation programming has always been that for formulations where the identity of individual projects is preserved, the solution space grows exponentially with the problem size to an extent where it can become unmanageable by the traditional analytical optimization techniques within reasonable limit. This has been attributed to the problem of combinatorial explosion that is, exponential growth of the number of combinations. The relatively large number of constraints often presents in a real-life pavement preservation programming problems and the trade-off considerations required between preventive maintenance, rehabilitation and reconstruction, present yet another factor that contributes to the solution complexity. In this research study, a new integrated multi-year optimization procedure was developed to solve network level pavement preservation programming problems, through cost-effectiveness based evolutionary programming analysis, using the Shuffled Complex Evolution (SCE) algorithm.^ A case study problem was analyzed to illustrate the robustness and consistency of the SCE technique in solving network level pavement preservation problems. The output from this program is a list of maintenance and rehabilitation treatment (M&R) strategies for each identified segment of the network in each programming year, and the impact on the overall performance of the network, in terms of the performance levels of the recommended optimal M&R strategy. ^ The results show that the SCE is very efficient and consistent in the simultaneous consideration of the trade-off between various pavement preservation strategies, while preserving the identity of the individual network segments. The flexibility of the technique is also demonstrated, in the sense that, by suitably coding the problem parameters, it can be used to solve several forms of pavement management programming problems. It is recommended that for large networks, some sort of decomposition technique should be applied to aggregate sections, which exhibit similar performance characteristics into links, such that whatever M&R alternative is recommended for a link can be applied to all the sections connected to it. In this way the problem size, and hence the solution time, can be greatly reduced to a more manageable solution space. ^ The study concludes that the robust search characteristics of SCE are well suited for solving the combinatorial problems in long-term network level pavement M&R programming and provides a rich area for future research. ^

An Exploration of Auditory Brainstem Encoding of Stop Consonants in Infants and Implications for Language Outcomes

Current trends in speech-language pathology focus on early intervention as the preferred tool for promoting the best possible outcomes in children with language disorders. Neuroimaging techniques are being studied as promising tools for flagging at-risk infants. In this study, the auditory brainstem response (ABR) to the syllables /ba/ and /ga/ was examined in 41 infants between 3 and 12 months of age as a possible tool to predict language development in toddlerhood. The MacArthur-Bates Communicative Development Inventory (MCDI) was used to assess language development at 18 months of age. The current study compared the periodicity of the responses to the stop consonants and phase differences between /ba/ and /ga/ in both at-risk and low-risk groups. The study also examined whether there are correlations among ABR measures (periodicity and phase differentiation) and language development. The study found that these measures predict language development at 18 months.

Place, policy and practitioners: on rehabilitation, independence and the therapeutic landscape in the changing geography of care provision to older people in the United Kingdom

A growing body of literature in geography and other social sciences considers the role of place in the provision of healthcare. Authors have focused on various aspects of place and care, with particular interests emerging around the role of the psychological, social and cultural aspects of place in care provision. As healthcare stretches increasingly beyond the traditional four walls of the hospital, so questions of the role of place in practices of care become ever more pertinent. In this paper, we examine the relationship between place and practice in the care and rehabilitation of older people across a range of settings, using qualitative material obtained from interviews and focus groups with nursing, care and rehabilitation staff working in hospitals, clients’ homes and other sites. By analysing their testimony on the characteristics of different settings, the aspects of place which facilitate or inhibit rehabilitation and the ways in which place mediates and is mediated by social interaction, we consider how various dimensions of place relate to the power-inscribed relationships between service users, informal carers and professionals as they negotiate the goals of the rehabilitation process. We seek to demonstrate how the physical, psychological and social meanings of place and the social processes engendered by the rehabilitation encounter interact to produce landscapes that are more or less therapeutic, considering in particular the structuring role of state policy and formal healthcare provision in this dynamic.

Prosthetic Architecture: Enabling Connection, Movement, and Empowerment

This thesis explores the relationship between body and architecture through a metaphorical and literal analysis of prosthetic devices. The thesis questions how the relationship between prosthetics and architecture can inform the design of a building that enables connection, movement and empowerment for its occupants. Driving questions of investigation include: How can a building enable growth, healing and wellbeing? , How can a building embody and reflect human growth and transformation? , and, How can a building enable equivalence between its users? The program of an inpatient prosthetic rehabilitation facility allows for the exploration of these questions and a study for how we can create spaces that influence rehabilitation and growth. Through body and prosthetics analysis the thesis explores what spaces are best for one to grow and develop in and study how concepts, such as connection, movement and empowerment can enable one and enhance one’s quality of life.

Terapêutica interdisciplinar para fratura cominutiva de côndilo por projétil de arma de fogo: enfoque miofuncional

TEMA: ferimentos causados por projéteis de arma de fogo apresentam alta incidência na região da cabeça e face. A articulação temporomandibular pode estar envolvida, além de estruturas anatômicas importantes como o nervo facial, necessitando de equipe multidisciplinar para efetuar tratamento adequado. PROCEDIMENTOS: apresentação de caso clínico de fratura condilar cominutiva causada por projétil de arma de fogo tratado de forma não-cirúrgica associado à terapia miofuncional orofacial. Paciente encaminhado para avaliação e procedimentos fonoaudiológicos após conduta da equipe de cirurgia bucomaxilofacial, sem remoção do projétil, alojado superficialmente, próximo da origem do músculo esternocleidomastóideo à direita, com fratura condilar cominutiva e lesão do nervo facial. Foram aspectos observados em avaliação: mordida aberta anterior, importante redução da amplitude dos movimentos mandibulares com desvios para o lado acometido, ausência de lateralidade contralateral, dor muscular, paralisia e parestesia em terço médio e superior da hemiface direita. Realizadas sessões de terapia miofuncional seguindo protocolo específico para traumas de face constando de: drenagem de edema; manipulações na musculatura levantadora da mandíbula ipsilateral; ampliação e correção dos movimentos mandibulares; procedimentos específicos referentes à paralisia facial e reorganização funcional direcionada. RESULTADOS: após oito semanas de terapia os resultados obtidos mostram restabelecimento de amplitude e da simetria dos movimentos mandibulares, reorganização da mastigação, adequação da deglutição e fala, remissão da sintomatologia dolorosa e remissão da paralisia do terço médio. CONCLUSÃO: o tratamento conservador da fratura por meio da terapia miofuncional orofacial resultou na reabilitação funcional da mandíbula e face dirigindo os movimentos e estimulando a adequação das funções estomatognáticas.