Egg Consumption in Relation to Glioma: A Case–Control Study

Background and Aims: Data on the link between egg consumption and brain tumors are limited. The objective of this study was to investigate the association between egg consumption and odds of glioma in Iranian adults.

Methods: In this hospital-based case–control study, 128 newly-diagnosed cases of glioma and 256 age- and sex-matched controls were enrolled from hospitals. Patients with pathologically confirmed glioma (without any other cancers) were considered eligible. We collected data on dietary intakes, including egg consumption, using a 126-item validated FFQ. Egg consumption was computed from all foods containing this food as their ingredients. Participants were categorized into tertiles of egg consumption. Conditional logistic regression was used to examine the association between egg consumption and glioma.

Results: After adjustment for age, sex and energy intake, individuals in the middle tertile of egg consumption were 58% (OR 0.42; 95% CI 0.24, 0.73) less likely to have glioma compared with those in the lowest tertile. Further adjustment for other potential confounders strengthened the association; such that participants with the greatest consumption of egg intake were 62% (0.38; 0.18, 0.76) less likely to have glioma compared with those with the lowest consumption. Additional controlling for dietary intakes did not change the association significantly (0.39; 0.18, 0.85).

Conclusion: We found an inverse association between egg consumption at the amount of almost 2 eggs/week and odds of glioma. Further studies are required to examine this association.     

A Multicentre and stratified study of the attitude of medical students towards organ donation in Spain

Introduction: Medical students represent a new generation of medical thought, and if they have a favourable attitude towards organ donation this will greatly encourage its promotion.

Objective: To analyse the attitude of medical students in Spanish universities towards the donation of their own organs and to determine the factors affecting this attitude.

Material and Methods: Type of study: A sociological, interdisciplinary, multicentre, and observational study in Spain. Study population: Students studying a degree in medicine enrolled in Spain (n?=?34,000). Sample size: A sample of 9598 students (confidence of 99% and precision of ±1%), stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ donation and transplantation (PCID-DTO RIOS) was self-administered and completed anonymously.

Results: The questionnaire completion rate was 95.7% (n?=?9.275). 80% were in favour of donation, 2% against and 18% were undecided. The following main variables were related to a favourable attitude: being of the female sex (Odds Ratio?=?1.739); being in the sixth year of the degree (OR?=?2.506); knowing a donor (OR?=?1.346); having spoken about the subject with one’s family (OR?=?2.132) and friends (OR?=?1.333); having a family circle that is in favour, more specifically, having a father (OR?=?1.841), mother (OR?=?2.538) or partner in favour (OR?=?2.192); being a blood donor (OR?=?2.824); acceptance of the mutilation of the body if it were necessary (OR?=?2.958); and being an atheist or an agnostic (OR?=?1.766).

Conclusions: Spanish medical students generally have a favourable attitude towards organ donation, although 20% are not in favour.     

Viewpoints on how students with autism can best navigate university

Background: Despite recognition of the challenges faced by students with autism spectrum disorders (ASD) there is limited understanding of the barriers and facilitators to participation in major life areas, such as being a university student.

Aim/Objective: This research aimed to examine viewpoints on what affects the success of Australian university students with ASD.

Material and Method: Q-methodology was used to describe the viewpoints of university students with ASD, their parents and their mentors, on success at university for students with ASD. A total of 57 participants completed the Q-sort.

Results/Findings: Three viewpoints emerged; Individualised Support, Contextual Support and Social Support.

Conclusions: This study highlighted that supports need to be individualized to the barriers and facilitators faced by Australian students with ASD. Supports also need to be contextualized to the built and social environments of universities.

Significance: This study supports the premise that environmental interventions can be effective in facilitating participation in major life areas, such as university education. Peer mentoring for students with ASD may have utility for this group, but should be extended to include social, emotional and psychological support.     

Effects of dog-assisted intervention on quality of life in nursing home residents with dementia

Background: People with dementia often have a poor quality of life. Therefore, methods that can improve their life situation must be identified. One promising method is dog-assisted intervention.

Aim: This study aimed to investigate the effects of dog-assisted intervention on quality of life in nursing home residents with dementia.

Materials and methods: A one-group, pretest post-test study design was used. Quality of life was measured using the QUALID in 59 nursing home residents prior to and after a dog-assisted intervention. Non-parametric tests were used to analyze the data, and effect sizes were calculated.

Results: The participants’ total scores improved significantly between baseline and post-test 1 (p?=?<?0.001) and worsened significantly at post-test 2 (p?=?0.025). The largest effect size was found for the item ‘Verbalization suggests discomfort’ (p?=?0.001).

Conclusion: The results indicate that dog-assisted interventions can have positive effects on quality of life in nursing home residents with moderate to severe dementia.

Significance: The results contribute to a growing knowledge base about non-pharmacological methods that can be used in dementia care. Occupational therapists should consider dog-assisted interventions when planning activities that can reduce the illness burden and improve the quality of life for people with dementia.     

Re-imagining occupational therapy clients as communities: Presenting the community-centred practice framework

Background: Occupational therapists’ are increasingly working with communities and providing services at the community level. There is, however, a lack of conceptual frameworks to guide this work.

Aim: The aim of this article is to present a new conceptual framework for community-centered practice in occupational therapy.

Material and Method: The conceptual framework was developed from qualitative multi-case research on exemplars of community participation. The first was, a network of Canadian food security programs, and the second, a rural Australian community banking initiative. Key themes were identified from across the case studies, and cross-case findings interpreted using occupational therapy and occupational science knowledge, and relevant social theory. The outcome is a four-stage, occupation-focused, community-centered practice framework.

Findings: The Community-Centred Practice Framework can be used by occupational therapists to understand and apply a community-centered practice approach. The four stages are: (1) Community Identity, (2) Community Occupations, (3) Community Resources and Barriers, and (4) Participation Enablement.

Conclusions: Further research is needed to trial and critically evaluate the framework, to assess its usefulness as a robust, occupation-focused, frame of reference to guide community-centered practice in occupational therapy.

Significance: The proposed framework should assist occupational therapists to conceptualize community-centered practice, and to utilize and apply theory.     

The Norwegian Occupational Balance Questionnaire (OBQ11-N) – development and pilot study

Background: The concept occupational balance has been linked with health and well-being, and it is therefore viewed as an important concept for occupational therapy practice, theory and research. To operationalize and measure occupational balance, the Occupational Balance Questionnaire (OBQ) was developed in Sweden. To date, no Norwegian translations of the OBQ exists.

Aim: To describe the process of developing a Norwegian version of the 11-items Occupational Balance Questionnaire (OBQ11-N) and to evaluate its feasibility and face validity.

Methods: The development process followed a predetermined series of steps, including forward and back translation and cognitive interviews with a pilot sample.

Results: The pilot study sample (n?=?8) varied with respect to age, gender and education level. There was high level of agreement between the participants with regard to their understanding of the content of the items. Three of the items were slightly modified in terms of words and phrasing.

Conclusion: The OBQ11-N was developed according to established translation guidelines and appears to be feasible and have good face validity.

Significance: The OBQ11-N may prove useful for assessing occupational balance and associated factors in Norwegian population groups. However, more research is needed to establish the Norwegian version of the questionnaire as psychometrically valid.     

Exploring the lived experience of homelessness from an occupational perspective

Background: Working in homelessness is a growing area of practice for occupational therapists, however, there is limited literature on the lived experiences of homelessness and occupational engagement

Study aim: To explore the lived experience of homeless men in relation to how they engaged in day-to-day occupations when sleeping rough or hostel dwelling

Methods: Data were gathered from five men residing in a homeless hostel in the UK. Data collection included semi-structured interviews and photographic diaries. Data were analyzed using Interpretative Phenomenological Analysis

Results: Participants described their experiences of occupational engagement whilst sleeping on the streets which included engaging in survival occupations, the significance of apparently ordinary occupations and moving beyond survival occupations. The homeless hostel provided opportunities for occupational engagement that the men perceived in an idiosyncratic manner. The men described benefits of engaging in novel occupations and reengaging in known occupations. Occupational injustices were a common theme that occurred throughout participants experiences

Conclusion: This study has highlighted the diversity of occupational engagement for ‘roofless’ or ‘houseless’ participants and how different individuals experience occupational adaption

Significance: This study has furthered understandings of the concept of ‘survival occupations’ and the importance of community resources to facilitate occupational engagement whilst homeless.     

Understanding the experiences of married Southern African women in protecting themselves from HIV/AIDS: a systematic review and meta-synthesis

Background: Whilst marriage has been repeatedly identified in the literature as an HIV risk factor amongst Southern African women, not much is known about women’s perception of their role, experiences and strategies used to address HIV risks in the context of a marriage.

Aims: The aim of the study was to synthesise perceptions, experiences and strategies of married Southern African women in the prevention of HIV.

Methods: A systematic review of qualitative studies was conducted. Three electronic databases (Medline, Cinahl and PsycINFO) were systematically searched to identify relevant literature. The meta-synthesis process followed Sandelowski and Barroso’s [2007. Handbook for Synthesizing Qualitative Research. Springer Publishing Company] recommendations.

Results: Of 7 609 papers, 15 were included in the review. The quality of the included studies was variable. In the final synthesis stage, three broad analytic themes emerged: contextual background, cues to preventive behaviour, and HIV prevention strategies.

Implications: Findings were used to develop a conceptual framework for studying HIV/AIDS prevention experiences of married Southern African women.     

Body Mass Index (BMI) and Infectious/Febrile Episodes in Children with Intermediate Risk Acute Lymphoblastic Leukemia (IR ALL)

The incidence of treatment related mortality in children with acute lymphoblastic leukemia (ALL) is reported to be between 2% and 4% with infections being the leading cause.

Aim: To establish a relationship between body mass index at diagnosis (BMI 0), after protocol I therapy completion (BMI I) and the incidence rate ratio (IRR) of infectious/febrile episodes in children with ALL intermediate risk.

Methods: Thirty one consecutive patients (2–18 years old, with a male to female ratio of 19/12) with newly diagnosed ALL that were treated uniformly according to ALL IC 2009 protocol were included in this analysis.

Results: A BMI decrease of at least 5% during protocol I therapy and BMI 1 under 15th percentile score corresponds significantly with higher IRR (with P-values 0.04 and 0.006 respectively) during the whole intensive therapy.

Conclusion: Some relationships between BMI reduction and higher IRR in ALL patients were found, but their significance is limited by the size of the group analyzed.     

Identifying,organizing and prioritizing ideas on how to enhance ADL ability

Background: There is a need to develop evidence-based occupational therapy programs aiming at enhancing the ability to perform Activities of Daily Living (ADL) among persons living with chronic conditions. Information from different sources is to be integrated in the development process. Thus, it is necessary to engage both occupational therapists and persons living with chronic conditions in suggesting ideas on how to enhance the ADL ability.

Objective: To identify, organize and prioritize ideas on how to enhance ability to perform ADL in persons with chronic conditions.

Material and method: Group Concept Mapping, involving brainstorming, sorting, labeling, rating and validation of ideas, was applied among persons with chronic conditions (n?=?≤?18) and occupational therapists (n?=?≤?23). Multidimensional scaling analysis and cluster analyzes were applied.

Results: 149 ideas were identified and organized into seven clusters related to applying new adaptational strategies, personal factors, social surroundings and relevant services and opportunities. Each cluster contained ideas of high priority to persons with chronic conditions and/or occupational therapists.

Conclusion: A span of highly relevant themes, illustrated the complexity of enhancing ADL ability. This should be considered in the development of interventions aiming at enhancing ADL ability in persons with chronic conditions.     

Occupation as marker of self: Occupation in relation to self among people with advanced cancer

Background: Living with advanced cancer can have a profound impact on the person’s self. A person’s self is influenced by various aspects of daily life, including engagement in occupation. From an occupational perspective, little research has been done to explore how the self of people with advanced cancer is formed through their engagement in occupation.

Aim: The purpose of this study was to explore how people with advanced cancer experience that their sense of self is formed through engagement in occupation.

Methods: A total of 28 interviews were conducted with 22 people with advanced cancer. Grounded theory guided the collection and analysis of data.

Results: ‘Occupation as marker of self’ was identified as the core category. Occupations served as markers of the participants’ self (1) by mirroring their abilities and positioning of their self in the illness trajectory; and (2) as means of expressing their self. The core category provided explanations about how the participants’ experiences of occupation influenced their self-perceptions, as explained in the sub-categories ‘defining the self through occupation’ and ‘reassessing self and accepting limitations’.

Conclusions: For people with advanced cancer, engagement in occupation influences their self as current abilities become apparent and positions of their self can be created and expressed.     

‘It’s like being a slave to your own body in a way’: a qualitative study of adolescents with chronic fatigue syndrome

Background: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a relatively common disabling illness in adolescents that may limit participation in daily life.

Aim: This study explored interactions between the illness experiences of adolescents with CFS/ME, their occupational lives and expectations for the future.

Methods: Seven adolescents with CFS/ME were interviewed. The interviews were analyzed using thematic analysis.

Results: Three themes were developed. ‘Being ruled by an unfamiliar and inexplicable body’, which illustrated that altered and strange bodies seemed to separate and disrupt the participants from their former occupational lives. ‘On the sideline of life with peers’, which demonstrated that the informants spent time at home, doing undemanding activities instead of participating in activities with peers. ‘A coherent connection between present and future life’, which was reflected by how the participants eventually accepted their situation and rebuilt a meaningful occupational life and value of self.

Conclusion: CFS/ME made the body unfamiliar and disconnected informants from participating in their usual daily occupations. A coherent interaction between body, occupational life and social self was achieved by taking their new body into account and adjusting their occupations accordingly. This practice enabled the participants to hope for a better future life.     

Prerequisites and driving forces behind an extended working life among older workers

Background: Reforms are changing pension systems in many European countries, in order to both restrict early retirement and force people to extend their working life. From occupational therapy and occupational science perspectives, studies focusing on aspects of working life that motivate the older worker is urgent.

Aim: The aim was to describe incentives behind an extended working life among people over age 65.

Method: Focus group methodology was used, with participants ages 66–71, from varying work fields: construction and technical companies and the municipal elderly care sector.

Findings: Work was considered important and valuable to the degree of how challenging work was, the possibilities for inclusion in a team of colleagues and the chances for better personal finances. Amongst all, the participants expressed a feeling of a strengthened identity by being challenged and having the opportunity to manage working tasks.

Conclusion: The finding showed the actual reasons behind an extended working life among older workers. However, a risk of rising social inequity may appear with increased working life if older people are forced to extend their working life due to a difficult financial situation as a pensioner. A variety of retirement options and initiatives in order to support older workers are justified.     

Perceptions of occupational therapy students and clinical tutors on the attributes of a good role model

Background: Occupational therapy students learn in different environments, where role modelling takes place. Nevertheless, little is known about student and tutors perceptions on model´s characteristics.

Objectives: The aims of this study were to investigate the perceptions of occupational therapy students on the most important attributes of role models and to confront their views with those of clinical tutors.

Methods: A sample of 61 students completed a structured, standardized online questionnaire. Ten clinical tutors regarded by students as good models underwent a semi-structured individual interview. Data were analyzed quantitatively and qualitatively (thematic content analysis).

Results: The most important attributes of a good role model according to student perception were: good relationship with patients, integrity and ethical behaviour, respectful relationships with colleagues, patient management skills, commitment to personal and professional growth and enthusiasm for the profession. Clinical tutors believed that they were nominated as good role models because they demonstrated empathy towards patients, good relationships with students and enthusiasm for their profession.

Conclusions and Significance: Perceptions of occupational therapy students and clinical tutors about role models characteristics were similar. Identification of attributes of good role models may inform teacher training and faculty development in occupational therapy.     

Understanding the characteristics of friendship quality,activity participation,and emotional well-being in Taiwanese adolescents with autism spectrum disorder

Background: Autism spectrum disorder (ASD) is a lifelong developmental disability characterized by deficits in social communication and social interaction across multiple contexts. Existing literature on social relationships and well-being among adolescents with ASD in Asian countries is scant.

Aims: This study compared the perceptions of adolescents with ASD with those of their neurotypical peers toward their friendship quality, activity participation, and emotional well-being, and examined the relationships between friendship quality, activity participation, and emotional well-being.

Methods: The study participants—101 adolescents with ASD and 101 neurotypical peers, aged 10–19 years—completed the following self-administered questionnaires: the Friendship Quality Questionnaire, the Child and Adolescent Scale of Participation, the Beck Anxiety Inventory, and the short-form UCLA loneliness scale.

Results: Adolescents with ASD reported lower friendship quality, lower school participation, and higher levels of anxiety and loneliness compared to their neurotypical peers. Loneliness correlated negatively with friendship quality and school participation and positively with anxiety. Adolescents with ASD experienced increased levels of anxiety when low friendship quality was accompanied by greater loneliness.

Conclusions and significance: These findings reveal that friendship quality, school participation, and loneliness have a considerable effect on the emotional well-being of adolescents with ASD, thus indicating the need for therapeutic interventions that address interpersonal relationships and emotional well-being.     

Empowerment,self and engagement in day center occupations: A longitudinal study among people with long-term mental illness

Background: Day centers are a common form of mental health service internationally. They are aimed at enhancing occupational engagement and social relations, but there is a need to clarify the outcomes of day center programs, including the impact on important aspects of recovery such as empowerment.

Aims: The aim of this study was to explore whether perceived empowerment changed over time among Swedish day center users and whether self-esteem, quality of life, socio-demographic data and self-reported diagnosis, type of program and level of engagement in day center occupations could predict future empowerment.

Method: The study involved a re-analysis of longitudinal data from 14?day centers, where measures of perceived empowerment and other individual factors were collected over a 15-month period. Non-parametric statistics were used, including Wilcoxon’s signed-rank test and logistic regression analysis.

Results: There were no significant changes in day center attendee empowerment scores. Self-esteem and level of engagement in day center occupations were found to be predictors of empowerment, together explaining 34% of the variation.

Conclusions: Developing empowerment in the day center context involves a complex interaction of individual, social and material factors. Potential barriers to empowerment are discussed along with considerations related to measuring empowerment as an outcome of day center programs.     

Factors associated with routine screening for the early detection of breast cancer in cultural-ethnic and faith-based communities

Objectives: Studies have shown a lower adherence to health behaviors among women in cultural-ethnic minorities and faith-based communities, especially lower screening attendance for the early detection of breast cancer. This study compares factors related to cancer screening adherence in two distinct cultural-ethnic minorities in Israel: Arab women as a cultural-ethnic minority and Jewish ultra-Orthodox women as a cultural-ethnic faith-based minority.

Design: During the year 2014, a total of 398 Jewish ultra-Orthodox women and 401 Arab women between the ages of 40–60, were randomly selected using population-based registries. These women answered questionnaires regarding adherence to mammography and clinical breast examination (CBE), health beliefs and cultural barriers.

Results: Arab women adhered more than ultra-Orthodox women to mammography (p?<?.001) and CBE exams (p?<?.01). Religious beliefs, exposure barriers and perceived risk were higher among the ultra-Orthodox women, while social barriers, accessibility barriers and perceived severity were higher among the Arab women (p?<?.01). Adjusting for background factors, higher adherence to CBE and mammography were associated with lower levels of religious beliefs (AOR?=?0.90, 95% CI?=?0.69–1.17 AOR?=?0.62, 95% CI?=?0.39–0.82, respectively), perceiving a higher risk of cancer (AOR?=?1.93, 95% CI?=?1.23–3.04 and AOR?=?3.22, 95% CI?=?1.53–6.61), and having more fears related to cancer-related losses (AOR?=?1.51, 95% CI?=?1.19–3.00 and AOR?=?1.24, 95% CI?=?0.63–1.22). In addition, perceiving greater advantages of CBE was associated with higher adherence to CBE (AOR?=?1.82, 95% CI?=?1.45–2.29), while not receiving a physician’s recommendation was associated with lower adherence to mammography (AOR?=?1.82, 95% CI?=?1.45–2.29).

Conclusion: This study addressed a lacuna in screening behaviors of women from cultural-ethnic and faith-based communities. In order to increase adherence, health care professionals and policymakers should direct their attention to the specific nature of each community.     

Assessment of dietary factors,dietary practices and exercise on mental distress in young adults versus matured adults: A cross-sectional study

The importance of the diet in modulating mental health is uncovering as many dietary factors have been described to alter brain chemistry. Brain maturation may not complete until the age of 30 which may explain the differential emotional control, mindset, and resilience between young adults and matured adults. As a result, dietary factors may influence mental health differently in these two populations.

Objectives: To study dietary intake, dietary practices and exercise in young adults (YA) (18–29 years) versus matured adults (MA) (30 years and older) in relation to mental distress. Another aim was to assess whether mental well-being potentially stimulates healthy eating, healthy practices, and exercising.

Methods: An anonymous internet-based survey was sent through social media platforms to different professional and social group networks. Best-fit models were constructed using the backward regression analysis to assess the relationship between dietary variables, exercise, and mental distress in YA versus MA.

Results: YA mood seems to be dependent on food that increases availability of neurotransmitter precursors and concentrations in the brain (such as frequent meat consumption and exercise, respectively). However, MA mood may be more reliant on food that increases availability of antioxidants (fruits) and abstinence of food that inappropriately activates the sympathetic nervous system (coffee, high glycemic index, and skipping breakfast).

Discussion and conclusion: Level of brain maturation and age-related changes in brain morphology and functions may necessitate dietary adjustments for improving mental well-being.