Occupational Therapy in the Promotion of Health and Well-Being.

A balanced pattern of occupations enhances the health and fulfills the needs of individuals, families, communities, and populations (American Occupational Therapy Association [AOTA], 2014b; Hocking, 2019; Meyer, 1922). Occupations are personalized "everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life" (World Federation of Occupational Therapists, 2012, para. 2). The purpose of this statement is to describe occupational therapy's role and contribution in the areas of health promotion and prevention for internal and external audiences. AOTA supports and promotes the involvement of occupational therapy practitioners¹ in the development and delivery of programs and services that promote health, well-being, and social participation of all people.

Characterization of the transient middle cerebral artery occlusion model of ischemic stroke in a HuR transgenic mouse line.

This set of experiments characterizes a model of transient cerebral ischemic stroke in a transgenic (Tg) mouse line in which the glial fibrillary acidic protein (GFAP) promoter is utilized to drive expression of a human RNA-binding protein, HuR. Additionally, the effect of cerebral ischemia on the expression of endogenous Hu proteins is presented.

Testing different ICA algorithms and connectivity analyses on MS patients.

Multiple sclerosis (MS) is a progressive neurological disorder that affects the central nervous system. Functional magnetic resonance imaging (fMRI) has been employed to track the course and disease progression in patients with MS. The two main aims of this study were to apply in a data-driven approach the independent component analysis (ICA) in the spatial domain to depict the active sources and to look at the effective connectivity between the identified spatial sources. Several ICA algorithms have been proposed for fMRI data analysis. In this study, we aimed to test two well characterized algorithms, namely, the fast ICA and the complex infomax algorithms, followed by two effective connectivity algorithms, namely, Granger causality (GC) and generalized partial directed coherence (GPDC), to illustrate the connections between the spatial sources in patients with MS. The results obtained from the ICA analyses showed the involvement of the default mode network sources. The connectivity analyses depicted significant changes between the two applied algorithms. The significance of this study was to demonstrate the robustness of the analyzed algorithms in patients with MS and to validate them before applying them on larger datasets of patients with MS.

The centers for medicare & medicaid services diabetes health disparities reduction program.

The Centers for Medicare & Medicaid Services has implemented 3 prevention interventions programs to bring diabetes self-management education to vulnerable populations via Medicare's Quality Improvement Organizations. The programs and the lessons derived from a Federal initiative geared to closing the health disparities gap are described.

Challenges of preparing allied health professionals for interdisciplinary practice in rural areas.

Meeting the health needs of individuals in rural communities involves addressing the challenges of complex multifaceted health problems, limited local health resources and services, isolation, and distance. Interdisciplinary collaboration can create solutions to health care problems that transcend conventional, discipline-specific methods, procedures, and techniques. This paper reports on the four-pronged approach of the Western Maryland Area Health Education Center used to prepare allied health students to be interdisciplinary team members in rural areas. It describes the development of four interdisciplinary instructional team member training venues (in-class instruction, Web-based modules, service-learning programs, and faculty development workshops) that integrate opportunities to develop and practice interdisciplinary health promotion skills in rural communities. Challenges to implementing the model are described, including developing faculty and student training participation, integrating training venues into existing programs at participating institutions, and designing a unified program evaluation.

The resolution of Californian populations of Liriomyza huidobrensis and Liriomyza trifolii (Diptera: Agromyzidae) using PCR.

Liriomyza trifolii (Burgess) and Liriomyza huidobrensis (Blanchard) are important vegetable pests in California. Populations of each species differ in their impact in central and southern regions. This difference may be explained by geographical or host plant differences in each of the regions. We used random amplified polymorphic DNA polymerase chain reactions to assess genetic differences between two laboratory populations of each species collected from central and southern California. Individual L. trifolii from the two regions could be discriminated by the presence/absence of PCR products. No such qualitative differences were apparent in PCR products amplified from L. huidobrensis individuals, but the origins of individuals could be differentiated using a bootstrap analysis of marker frequencies. Marker primers were used to compare field and laboratory individuals. No evidence was found for the existence of further populations or of hybrid populations in central and southern California. The distribution of populations of L. huidobrensis was explained completely by geographical differences. As a consequence of the absence of leafminer infestations on the same host plant varieties in both regions, factors governing L. trifolii population distribution differences were less apparent. The presence of the same host plant varieties at both sites suggests that the two L. trifolii populations differ in host plant preference.

Pharmacokinetic evaluation of two theophylline dosing methods for infants.

Theophylline is often used in infants, yet few studies have evaluated the serum concentrations achieved with currently recommended dosing guidelines. Two theophylline dosing regimens, a postnatal age (PNA) equation and the Federal Drug Administration (FDA) dosing guidelines, were retrospectively evaluated in a group of infants, postconceptional age (PCA) 31-96 weeks, with known theophylline clearances. Large variations in theophylline concentrations were observed for both dosing regimens. Mean +/- SD projected steady-state theophylline serum concentrations, Css, were 17.7 +/- 7.6 micrograms/ml with the PNA equation (n = 40) and 5.6 +/- 2.9 micrograms/ml with the FDA guidelines (n = 52). Over one-third of Css with the PNA equation were > 20 micrograms/ml. Using the FDA guidelines, 40% of Css were < 5 micrograms/ml. The majority of infants < 40 weeks PCA attained projected Css > 20 micrograms/ml (21.7 +/- 5.1 micrograms/ml) with the PNA equation, but < 5 micrograms/ml (4.3 +/- 1.4 micrograms/ml) with FDA guidelines. An age-related bias was also observed for each dosing method. For the PNA equation, projected Css were significantly higher in infants < 40 weeks versus > or = 40 weeks PCA (21.7 +/- 5.1 versus 15.8 +/- 7.9 micrograms/ml, p < 0.01). For FDA guidelines, projected Css were significantly lower in infants < 40 weeks PCA versus older infants (4.3 +/- 1.4 versus 8.5 +/- 4.3 micrograms/ml, p < 0.001). Clinical application of currently accepted theophylline dosing guidelines for infants results in a high frequency of Css, which are potentially toxic or subtherapeutic.(ABSTRACT TRUNCATED AT 250 WORDS)

Alterations in theophylline metabolism during the first year of life.

Maturational changes in theophylline disposition were evaluated in 52 infants (gestational age, 24 to 40 weeks; postnatal age, 2 to 69 weeks) receiving maintenance theophylline therapy. Theophylline and metabolites were measured in serum and urine at steady state, and the influence of clinical parameters on the maturational changes was analyzed by multiple stepwise linear regression. Theophylline clearance and urine metabolite pattern reached adult values at 55 weeks' postconceptional age. Serum caffeine concentrations greater than 1 microgram/ml occurred in infants up to 50 weeks' postconceptional age. Disappearance of serum caffeine concentrations and maturation of theophylline clearance were primarily related (p < 0.001) to development of the demethylation pathway to 3-methylxanthine. Postconceptional age was the major factor (p < 0.001) explaining the interpatient variability in theophylline clearance (r2 = 0.57), serum caffeine to theophylline ratio (r2 = 0.46), and urinary excretion of theophylline (r2 = 0.51), caffeine (r2 = 0.49), 1,3-methyluric acid (r2 = 0.32), 1-methyluric acid (r2 = 0.53), and 3-methylxanthine (r2 = 0.58). Our findings indicate that postconceptional age rather than postnatal age should be used as a maturational marker during theophylline therapy in infancy.

[Medulloblastomas--the results after postoperative radiotherapy with and without adjuvant chemotherapy]. / Medulloblastome--Ergebnisse nach postoperativer Radiotherapie mit und ohne adjuvante Chemotherapie.

Between 1975 and 1991, 40 patients with newly diagnosed medulloblastoma were treated at the authors' institutions. After aggressive surgical resection 39/40 (98%) received craniospinal radiation therapy with a local boost to the posterior fossa and other macroscopically involved areas. A group of 29 patients was treated with adjuvant chemotherapy. The five-year actuarial survival and event-free survival were 75% and 65%, respectively. Survival was significantly better for patients treated after 1981 as compared to those treated between 1975 and 1980 (p = .02). Younger age (two to four years) was associated with a better prognosis (p = .02). The extend of resection, Chang-stage, radiation dose to posterior fossa and the use of chemotherapy did not significantly impact on survival and relapse-free survival.

Creating the "spirit of service".

What does it take for a hospital to achieve excellence in the area of customer service? How can customer service be improved within a large and complex healthcare facility? Many hospitals are currently seeking answers to these questions.

A historical review of occupational therapy's role in preventive health and wellness.

The public is becoming increasingly cognizant of the importance of proactive health behavior and is seeking assistance from health care professionals in their pursuit of wellness. As occupational therapy strives to meet this growing consumer demand, a historical review of the profession's involvement in proactive health activities can enhance its response. Since its inception, occupational therapy has recognized the importance of both preventive action and the promotion of wellness. In this paper, the significant historical events in this area are discussed to stimulate future research and clinical application in health promotion.

The effect of amygdalectomy on orienting and classical conditioning in monkeys.

The basic findings of these two studies are as follows: a failure of orientating and conditioning of viscero-autonomic responses, but essentially normal orienting and conditioning of a temporal muscle response in amygdalectomized animals. Small procedural differences exist between the two studies,and a possible order effect exists as a result of the use of the same subjects consecutively. However, we fell that the difference between the responses of the viscero-autonomic system and the skeletal system would still be found were all of the measures gathered simultaneously in an optimal conditioning situation. The definitive study--simultaneous viscero-autonomic and skeletal (behavioral) recording--remains to be done. Trial-by-trial analysis of the correlations or lack of correlations between these responses in such a study should be highly informative. These two studies offer substantial information relevant to the original questions. When behavior is modified by simple repetition of experience the effect of amygdalectomy is restricted to the viscero-autonomic components of orienting and classical conditioning, not to the entire spectrum of responses. The issue raised, therefore, is the significance of the viscero-autonomic components of orienting and classical conditioning. The suggestion has been proposed (Pribram, 1969) that these components serve as mechanisms of internal rehearsal necessary to the registration (as novel or familiar) of the orienting and conditioning experience. This proposal requires further testing.