Sensory Integrative Dysfunction

Parental participation in the occuational therapy program for the child with sensory integrative dysfunction may significantly improve the achievement of therapy goals, as well as adaptive behaviors within the home. An individual plan for effective parent involvement is developed with consideration given to levels of parent/child interaction and to the parents' ability to accept their child's difficulties. Purposes of parental participation are outlined in conjunction with an existing model for evaluation and intervention. A case presentation is presented which illustrates optimal parental involvement and the resulting positive outcomes.     

A Psychometric Study of the Chinese Version of the Assessment of Communication and Interaction Skills

This study examined the dependability of the Assessment of Communication and Interaction Skills—Chinese version (ACIS-C) with psychiatric participants in Taiwan. A convenience sample of 101 participants diagnosed with psychiatric illness were recruited from four day-care wards in northern and eastern Taiwan. The results of the Rasch analysis showed that the ACIS-C items coalesced to form a measure of communication/interaction and the 4-point rating scale functioned as intended. The ACIS-C differentiated participants into six levels of communication and interaction skills. The findings support the conclusion that the ACIS-C is a valid and sensitive tool when used with Chinese clients. Moreover the study supports the generalizability of the Model of Human Occupation concept of communication and interaction skills to an Eastern context.     

Psychometric evaluation of the Finnish translation of the assessment of communication and interaction skills (ACIS-FI)

Abstract

Background: The Model of Human Occupation (MOHO) is a widely used conceptual practice model in Finland. Therefore, Finnish translations of valid and reliable MOHO assessments are needed.

Objective: The primary objective of this study was to examine the psychometric properties of the Finnish translation of the Assessment of Communication and Interaction Skills (ACIS-FI) using the many-facet Rasch model approach.

Methods and Materials: Twenty-eight occupational therapists completed an in-person training workshop on the ACIS-FI and participated as raters in this study. One hundred and forty-eight clients were rated using the ACIS-FI. Rating scale functioning, unidimensionality, person validity and rater severity, item targeting, and item and person separation statistics were examined.

Results: The rating scales demonstrated adequate functioning; the rating category ‘deficit’ was infrequently adopted by the raters. The ACIS-FI had satisfactory construct validity, as confirmed by all items exhibiting unidimensionality within a single construct (i.e. communication and interaction skills), and appropriate item fit. Validity was further confirmed through low person misfit (6%) and low rater misfit (3.6%). No ceiling or floor effects were found. The ACIS-FI was able to separate clients into four levels of communication and interaction skills.

Conclusions: This study offers evidence for the validity of the ACIS-FI as a measure of communication and interaction skills in occupational therapy.

Significance: The ACIS-FI offers Finnish practitioners and researchers a valid tool to measure communication and interactions skills that is theoretically grounded in the MOHO.     

Assessing Employment Needs of Bulgarian Youths with Intellectual Impairments

This paper illustrates how the Model of Human Occupation provided a conceptual framework to inform the development of a work-related program for Bulgarian youths with intellectual impairments who are also socially disadvantaged. The paper describes the process of conducting a needs assessment guided by this model. Information was gathered on participants from the target group to create a holistic profile of their strengths and challenges/barriers. This information, in turn, was used to identify key needs which will guide next steps in program development.     

Utilization and Content Validity of the Swedish Version of the Volitional Questionnaire (VQ-S)

The aim of this study was to examine the utility and content validity of the Swedish version of the Volitional Questionnaire (VQ-S). The participants in this study were thirteen occupational therapists selected because they worked with clients for whom the VQ-S is appropriate (in this case, adults with intellectual impairments) and because they had knowledge of the Model of Human Occupation. These participants completed a demographic questionnaire at the beginning of the study. Each therapist then used the VQ-S a total of six times and after each time they completed a questionnaire concerning the utility and content validity of the instrument. After having administered the instrument six times they completed a third questionnaire that assessed their perceptions of the VQ-S based on their total experience. Data from these questionnaires and the six assessment forms with the actual client ratings were analyzed using both quantitative and qualitative procedures. The findings indicate that the VQ-S has clinical relevance and potential for implementation with adults with intellectual impairments. They also support the content validity of the VQ-S.     

The Framework of Occupational Gradation (FOG) to Treat Upper Extremity Impairments in Persons With Central Nervous System Impairments

Occupational therapists providing treatment of persons with central nervous system (CNS) impairments now embrace a motor control approach based on principles of strength training and practice of meaningful occupations. This paper describes the Framework of Occupational Gradation (FOG), which was developed to assist occupational therapists to systematically challenge upper extremity function by manipulating the degrees of freedom of active motion in a person's extremity. Clients may be able to perform occupations under several or all levels within the framework. However, the person, task, or object properties and the environment can also be manipulated by the occupational therapist to optimize or challenge a person's performance at each level. Application of the FOG is presented through case studies.     

Validity of the Swedish Version of the Worker Role Interview

The Worker Role Interview (WRI) was developed as an assessment of psychosocial factors which influence work success and return to work following an injury. The instrument has been translated and adapted for Swedish culture. This article presents the findings from a study of the validity of the Swedish Worker Role Interview (SWRI) with a psychiatric population. Results indicate that the Swedish instrument is a valid measure of psychosocial capacity for work. Comparison of findings from the SWRI with research on the WRI indicates that the instrument is valid across both cultures and languages and can be used effectively with both physically and psychiatrically disabled clients.     

Bivalent human papillomavirus vaccine and the risk of fatigue syndromes in girls in the UK

Introduction

Over 70% of cervical cancers are related to human papillomavirus types 16 and 18. In 2008, the vaccine Cervarix, protecting against these two strains, was introduced into the routine UK immunisation programme for girls aged 12–13 years, with a catch-up in girls aged up to 18 years. As part of the risk management planning for this new campaign, the Medicines and Healthcare products Regulatory Agency (MHRA) anticipated a range of conditions, including chronic fatigue syndrome, which might be reported as adverse events in temporal association with the vaccine.

Methods

Near-real time ‘observed vs. expected’ analyses were conducted comparing the number of reports of fatigue syndromes submitted via the MHRA's Yellow Card passive surveillance scheme to the expected number, using background rates calculated from the Clinical Practice Research Datalink (CPRD) and estimates of vaccination coverage. Subsequently, an ecological analysis and a self-controlled case series (SCCS), both using CPRD, compared the incidence rate of fatigue syndromes in girls before and after the start of the vaccination campaign and the risk in the year post-vaccination compared to other periods.

Results

The number of spontaneous reports of chronic fatigue following Cervarix vaccination was consistent with estimated background rates even assuming low reporting. Ecological analyses suggested that there had been no change in the incidence of fatigue syndromes in girls aged 12–20 years after the introduction of the vaccination despite high uptake (IRR: 0.94, 95% CI: 0.78–1.14). The SCCS, including 187 girls, also showed no evidence of an increased risk of fatigue syndromes in the year post first vaccination (IRR: 1.07, 95% CI: 0.57–2.00, p = 0.84).

Discussion

The successful implementation of an enhanced pharmacovigilance plan provided immediate reassuring evidence that there was no association between vaccination with Cervarix and an increased risk of chronic fatigue syndromes. This has now also been further demonstrated in more comprehensive epidemiological studies.     

应用人体能量监测仪评估公职人员健康状态的研究

目的：探讨公职人员亚健康常见表现及健康危险因素。方法使用人体能量监测仪对2776名公职人员进行检测,比较男、女健康危险因素分值和中度以上（含中度）风险检出率的差异。结果12种健康危险因素分值由高到低依次为精力不足（1.11±1.01）、易感疲劳（1.09±1.26）、鼻塞不通（0.95±1.59）、胸闷气短（0.94±0.91）、睡眠障碍（0.89±1.59）、饮食不振（0.76±0.76）、焦虑不安（0.75±1.16）、口腔炎症（0.75±1.21）、呼吸障碍（0.69±0.83）、眼部疲劳（0.61±0.72）、腰酸腿胀（0.60±0.72）和肠胃不适（0.48±0.65）。除男、女焦虑不安分值差异无统计学意义（P＞0.05）外,其余11项健康危险因素分值女性均高于男性（P＜0.01）。女性在精力不足、易感疲劳、鼻塞不通、口腔炎症和腰酸腿胀5个方面的中度以上（含中度）风险检出率明显高于男性（P＜0.01）。结论慢性疲劳综合征是公职人员亚健康的常见表现,且女性更易出现亚健康问题。     

Occupational identity of adolescents with ADHD: A mixed methods study

Background: Occupational identity (OI) is shaped by occupational experiences over time and has been studied among individuals with a variety of health conditions. Adolescents with ADHD face numerous challenges in their occupational performance that may threaten their OI.

Objective: This study sought to compare the occupational identities of adolescents with and without ADHD and to gain a deeper understanding of the characteristics of OI among adolescents with ADHD.

Methods: Sixty-four adolescents with (n?=?21) and without ADHD (n?=?43) were interviewed using the Occupational Performance History Interview (OPHI-II). A mixed methodology was applied, using quantitative and subsequent qualitative content analyses of 10 interviews, with a directed approach.

Results: OPHI-II OI interval scores and 7/11 items of the OI scale were significantly lower in the ADHD group compared to controls. In the qualitative content analyses, three major themes were found: (i) the meaning of success in academic participation, (ii) the consequences of not succeeding in academic participation and (iii) self-explanations for not succeeding in academic participation.

Conclusion: Findings demonstrate the presence of OI challenges among adolescents with ADHD. Occupational therapy intervention may be needed in order to promote occupational adaptation.     

慢性疲劳综合征精神情志症状的文献研究

目的通过文献研究分析慢性疲劳综合征精神情志特点与预后转归的关系。方法对慢性疲劳综合征(chronic fa-tigue syndrome,CFS)的基本概念、诊断标准、流行病学特征的文献资料以及精神情志因素与慢性疲劳综合征病程及预后的文献资料进行研究整理,评价常用的几种CFS症状测评量表,分析这些量表在评估CFS患者精神情志特点上的异同。结果文献研究发现,CFS患者普遍存在大量精神情志症状。结论有必要进行临床大样本调查,系统分析慢性疲劳综合征精神情志特点与预后转归的相关性,为进一步明确CFS情志疗法提供理论和临床依据。     

Reliability and validity of the Self-Efficacy for Performing Energy Conservation Strategies Assessment for persons with multiple sclerosis

The purpose of the study was to determine the test-retest reliability, internal consistency, and construct validity of the Self-Efficacy for Performing Energy Conservation Strategies Assessment (SEPECSA) for persons with multiple sclerosis (MS). The current study was part of a larger study (Mathiowetz et al., in review) to determine the effects of the Packer et al. (1995) energy conservation course. Thirty-six individuals were recruited from the local MS society. Participants completed the SEPECSA three times with a six-week control period between the first two assessments and the six-week Packer course between the second and third assessments. The test and retest correlation was high (r = .776, ICC = .771) indicating good reliability of the SEPECSA. Construct validity was supported by the significant increase in SEPECSA score after the Packer et al. course. The results of the study demonstrated that the SEPECSA is a reliable and valid assessment for individuals diagnosed with MS. Limitations of this study included its confinement within a larger study and the eight individuals who did not complete this study in its entirety. Future research will include a follow-up study of individuals who completed the course to determine the use and effectiveness of the energy conservation strategies.     

The Influences of Obesity and Age on Functional Performance During Intermittent Upper Extremity Tasks

In this study, the main and interactive effects of obesity and age on functional performance were assessed during intermittent exertions involving the upper extremity. The prevalence of obesity has doubled over the past 30 years and this increase is associated with higher health care costs, rates of workplace injury, and lost workdays. Obesity and aging can modify job demands and affect worker capacity in terms of muscular and psychomotor function. However, there is a lack of empirical studies quantifying the work-relevant (or ergonomic) impacts related to task demands, capacities, and their potential imbalance. Eight obese and eight non-obese participants from each of two age groups (18–25 and 50–65 years) completed three endurance tasks involving fixed levels of task demands: hand grip, shoulder flexion, and a simulated assembly task using the upper extremity. Measures of functional performance including endurance, discomfort, motor control, and task performance were recorded for each of the task conditions. Endurance times were ～60% longer for the non-obese group, and older participants had longer endurance times; however there was no evidence of interactive effects of obesity and age. Obesity also impaired functional performance, as indicated by higher rates of strength loss, increases in discomfort, and declines in task performance. These observed impairments may reflect underlying physiological differences among individuals who are obese, but that are independent of age. Obesity-related impairments may have implications for the design of work duration and demand level to prevent fatigue development for workers who are obese.     

An examination of the psychometric properties of the occupational identity questionnaire for community-living elderly who require care

IntroductionAuthors created an Occupational Identity Questionnaire Provisional version (OIQ-P) to assess occupational identity for elderly individuals. The purpose of this study was to examine the psychometric properties of the OIQ-P.MethodsParticipants included 135 (42 males) elderly who lived locally and required care or support. OIQ-P was evaluated in terms of structural validity, criterion validity and internal consistency.ResultsBased on the results of an exploratory factor analysis and confirmatory factor analysis, an OIQ with a factor structure of 3 factors and 14 items was created. Rasch rating scale model revealed that 14 participants and 1 item did not fit the goodness of fit, nevertheless, the overall result was good. Spearman''s rank correlation coefficient indicates that there was a law correlation between OIQ and the occupational identity scale of the Occupational Performance History Interview Version 2. In terms of internal consistency, the person separation index and person separation reliability coefficient were 2.30 and 0.84, respectively.ConclusionThis study confirmed the structural validity, criterion validity and internal consistency for the OIQ. To enhance the clinical utility of the OIQ, it is necessary to examine the interpretability and conduct an intervention study using the OIQ.     

Vaccination as teenagers against meningococcal disease and the risk of the chronic fatigue syndrome

The etiology of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is unknown. In Norway, a vaccine against Neisseria meningitides group B was administered to teenagers in 1988--1989 in a protection trial. In order to estimate the relative risk of CFS/ME according to vaccine history, we conducted a case-control study in 2007, with 201 cases diagnosed at one of two hospitals and 389 controls. The adjusted odds ratio for CFS/ME was 1.06 (95% CI: 0.67-1.66) for subjects who received the active vaccine contrasted to subjects who did not. Using this design, no statistically significant association between vaccination against meningococcal disease in teenagers and occurrence of CFS/ME could be observed.     

Pre- and Postsurgical Approaches to the Treatment of the Adult with Hemiplegia Having Motor Balancing Surgery of the Upper Extremity

This paper describes both the pre and post surgical treatment of the adult hemiplegic who has a disabling spasticity in the upper extremity. This includes discussion of general criteria for selection used y the therapist as well as guidelines for therapy after surgery. Emphasis is on close collaboration with the surgeon and in meeting the daily functional needs of the patient.     

早期康复干预对老年急性期脑卒中偏瘫患者上下肢功能及日常生活能力恢复的影响

目的评价早期康复干预对于改善脑卒中偏瘫患者肢体功能及日常生活能力的作用。方法选取2012年3月至2013年8月间于我院神经内科住院治疗的首次发病的脑卒中并偏瘫患者120例,随机分为对照组和观察组,分别采用常规护理和早期康复干预,对比分析早期康复干预对于患者肢体功能及日常生活能力的影响。结果两组患者在护理干预后Barthel指数、FegMevyer积分均较干预前显著升高,且差异具有统计学意义(P<0.05);而观察组患者经过8周的康复训练后,其Barthel指数、Feg-Mevyer积分与对照组患者相比,显著升高(P<0.01)。结论对于急性脑卒中偏瘫患者而言,实施早期康复干预护理能够显著提高患者肢体运动能力和日常生活能力,对于改善患者的生活质量具有重要意义。     

浙江省疾病预防控制系统慢性非传染性疾病预防控制能力评估

目的了解浙江省疾病预防控制系统慢性病预防控制能力,为推进慢病领域的能力建设提供依据。方法通过全国慢性病预防控制能力调查系统调查浙江省、市和县三级疾病预防控制中心（CDC）慢性非传染性疾病（慢性病）防控的资源、执行能力等基本情况。结果浙江省共有246人在岗在编从事慢性病防控工作,占CDC总人数的5．14％;省、市和县三级防控经费占同级CDC总经费的比例分别为2．71％、2．50％和3．83％;市和县CDC设有专门慢性病防控科所的比例分别为45．45％、14．77％;在慢性病防控工作人员中,97．56％具有医学背景,78．45％接受过本科及以上教育,高级职称占15．85％;2011年省、市和县级年平均继续教育人次数分别为10．00、13．36和8．57人次;全省100．00％的县级CDC开展了慢性病监测工作,其中有67．05％的CDC开展了行为危险因素监测;54．41％的市级和46．71％的县级CDC对慢性病监测进行过评估。结论浙江省疾控系统慢性病防控资源与“十二五”规划目标仍有一定差距,慢性病防控能力有待进一步提高。     

慢性疲劳综合征常见病因及干预措施

近年来慢性疲劳综合征(CFS)已经引起医学界广泛关注。从其病因、发病机制和干预措施方面综述最新研究进展。研究CFS以利于临床医生对该疾病足够重视,以便正确诊断,早期干预,促进CFS患者早日康复。CFS发病机制复杂,病因尚不明确,目前认为该病与心理因素、病毒感染、疲劳毒素、免疫功能失调、遗传等因素有关。