Occupational Performance Issues of Children with Hemiplegia after Acquired Brain Injury.

Aims: This retrospective, exploratory study aimed to examine the categories and frequency of occupational performance issues (OPIs) identified by children (or their caregivers), who participated in a two-week, group-based modified constraint induced movement therapy program, Helping Hand. The effect of participant age on the OPIs identified was also explored.Methods: OPIs were identified using the Canadian Occupational Performance Measure for 46 Helping Hand participants, prior to program participation. Descriptive statistics including the frequency of identified OPIs were used to categorize the 236 OPIs into occupational areas. Descriptive statistics were also used to determine how the categories of OPIs and relative frequencies differed based on participant age.Results: The identified OPIs were diverse, and differed in frequency of identification and level of specificity. The OPIs identified varied based on participant age, with age groups showing developmentally appropriate differences in OPIs.Conclusions: Identification of OPIs should balance client-centredness with probing for specificity, in order for OPIs to be understood by clinicians. This will guide future program development and interventions that target age-appropriate occupational priorities.

Action plan co-optimization reveals the parallel encoding of competing reach movements.

Several influential cognitive theories propose that in situations affording more than one possible target of action, we prepare multiple competing movements before selecting one. Here we provide direct evidence for this provocative but largely untested idea and demonstrate why preparing multiple movements is computationally advantageous. Using a reaching task in which movements are initiated after one of two potential targets is cued, we show that the movement generated for the cued target borrows components of the movement that would have been required for the other, competing target. This interaction can only arise if multiple potential movements are fully specified in advance and we demonstrate that it reduces the time required to launch a given action plan. Our findings suggest that this co-optimization of motor plans is highly automatic and largely occurs outside conscious awareness.

Building Medical Schools Around Social Missions: The Case of the University of California, Riverside.

Abstract-The University of California recently created the first new public medical school on the West Coast of the United States in nearly 50 years. It was built in a region of California with significant health challenges, including a marked physician shortage and very poor overall health outcomes. The region's population is racially and ethnically diverse and rapidly growing, with a particularly large population of Mexican American residents. It is also an area with high unemployment, low college-going rates compared to most other areas of California, and a large undocumented immigrant population. When the University of California Board of Regents authorized the creation of this new medical school, it charted unique social missions for the school that have particular relevance to the needs of its immediate region. This article presents a single case study of how the school was designed to accomplish these social missions and, ultimately, to improve the health of the people living in the region it serves. Many of the strategies used were adopted from developing countries that have far more serious workforce issues and health challenges. The authors believe these strategies and missions are unique among the 17 new medical schools created in the United States in the last decade. Furthermore, this model could have broader implications for the development of health policies and health system reform in other nations, such as Mexico.