Use of the Perceive, Recall, Plan and Perform System of Task Analysis for persons with schizophrenia: A preliminary study

Background/aim:  Task analysis that targets information processing skills is an essential tool to understanding difficulties encountered by people with schizophrenia in their daily activities. The purpose of this preliminary study was to explore the use of the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis for this clientele. The specific objectives were to describe information processing difficulties as measured by the PRPP and to examine preliminary evidence of construct validity and interrater reliability.
Methods:  In the first part of this study, 10 participants with schizophrenia living in the community were assessed using the PRPP during both a simple and a complex meal preparation task. Community functioning was measured using the Independent Living Skills Survey. In the second part, interrater reliability was appraised using three trained raters, who scored 15 participants preparing the complex meal preparation task.
Results:  Analysis of performance demonstrates that people with schizophrenia have difficulties especially in the Perceive and Plan quadrants of the PRPP and are more challenged in the complex task. The PRPP total score for the complex task is strongly related to the community functioning score. Results indicate good interrater reliability for the PRPP total score and moderate interrater reliability for the quadrant scores.
Conclusion:  Despite the small sample size, results from this preliminary study support the use of the PRPP System of Task Analysis to further explore the impact cognitive deficits have on daily task performance and thus on community functioning in people with schizophrenia.     

Student Recruitment and Selection for Occupational Therapy

The School of Occupational Therapy at the Cumberland College of Health Sciences has attempted to integrate the student recruitment and selection process with the curriculum objectives of a training programme for occupational therapists. This approach is based on the view that student selection is one component of a total interacting system of manpower development. The primary role of the occupational therapist and the skills required to fit that role were defined and used to rationalise a selection process aimed at producing an effective practitioner. There is a focus on increasing self selection by applicants. It is suggested that compulsory attendance at information sessions, personal/social factors assessed at interview and past academic record are effective measures for identifying students who would succeed in the occupational therapy curriculum. There is a need for further research in this area and the development of this selection process generates questions which may determine the direction of that research.     

Homelessness: Perspectives,Misconceptions, and Considerations for Occupational Therapy

SUMMARY

Like poverty, the problem of homelessness has been with us to varying degrees since the founding of our nation. Attempts to explain homelessness have an equally long history. Hence, the literature and popular media are home to divergent perspectives, explanations, and characterizations of homelessness. The objectives of this paper are to present a unifying taxonomy of prominent perspectives on homelessness, and to illustrate how various perspectives lead to particular characterizations of persons who become homeless. The taxonomy traces the connection between perspectives and interpretations of the problem and helps to illuminate implicit and often unexamined assumptions about who becomes homeless and why. Critical examination of these perspectives is vital because our individual and collective understanding of homelessness is a powerful determinant of how we approach occupational therapy practice with this population. Implications for community practice and program planning for individuals and families in homeless shelters are also discussed.     

超声造影微泡:敏锐成像、定点给药与治疗

超声造影剂是一种具有稳定壳层结构的微米级气泡。当受到超声激励时,微泡会随着声波周期性压力变化发生有规律的收缩与膨胀。超声造影剂的引入使得超声成像的分辨力、敏感性和特异性得到极大提升。通过将特异性抗体或配体连接到超声造影剂表面构筑靶向超声造影剂,使超声造影剂主动结合到靶标组织可以实现对病变组织的分子成像。而且,通过在靶向微泡上携带药物或基因可以实现靶向定点治疗。本文首先对超声造影剂的发展历程及制备方法进行了介绍,对超声激励下微泡的声学特性以及新型超声微泡成像方法进行了概述,接着对超声分子影像的原理、靶向微泡制备以及超声分子影像的应用进行了阐述,最后介绍和展望了超声微泡在给药与治疗方面的应用。     

图像引导放疗治疗颈段、胸上段食管癌疗效观察

目的：观察颈段、胸上段食管癌行图像引导放射治疗（image-guided radiation therapy,IGRT）的疗效和不良反应。方法：回顾性分析32例颈段、胸上段食管癌患者接受图像引导放射治疗的疗效,局部区域控制率和总生存率用Kaplan-Meier法计算,并评价其毒副反应。结果：近期总有效率（CR＋PR）为93.7%,1、2年局部控制率分别为84.3%、71.8%。1、2年生存率分别为75.0%、62.5%。急性放射反应主要是1、2度急性放射性食管炎,放射性气管炎,白细胞减少。结论：颈段胸上段食管癌行IGRT治疗疗效肯定,副反应小,临床值得推广。     

Boron neutron capture therapy outcomes for advanced or recurrent head and neck cancer

We retrospectively review outcomes of applying boron neutron capture therapy (BNCT) to unresectable advanced or recurrent head and neck cancers. Patients who were treated with BNCT for either local recurrent or newly diagnosed unresectable head or neck cancers between December 2001 and September 2007 were included. Clinicopathological characteristics and clinical outcomes were retrieved from hospital records. Either a combination of borocaptate sodium and boronophenylalanine (BPA) or BPA alone were used as boron compounds. In all the treatment cases, the dose constraint was set to deliver a dose <10–12 Gy-eq to the skin or oral mucosa. There was a patient cohort of 62, with a median follow-up of 18.7 months (range, 0.7–40.8). A total of 87 BNCT procedures were performed. The overall response rate was 58% within 6 months after BNCT. The median survival time was 10.1 months from the time of BNCT. The 1- and 2-year overall survival (OS) rates were 43.1% and 24.2%, respectively. The major acute Grade 3 or 4 toxicities were hyperamylasemia (38.6%), fatigue (6.5%), mucositis/stomatitis (9.7%) and pain (9.7%), all of which were manageable. Three patients died of treatment-related toxicity. Three patients experienced carotid artery hemorrhage, two of whom had coexistent infection of the carotid artery. This study confirmed the feasibility of our dose-estimation method and that controlled trials are warranted.     

Quality of Life after Subarachnoid Haemorrhage,and its Relationship to Impairments,Disabilities and Depression

This investigation addresses the subjectively experienced Quality of Life (QoL) in long-term survivors (n104) of subarachnoid haemorrhage (SAH). QoL in terms of increase/no—negligible change/decrease was related to prevalence of impairments, disabilities and to occurrence of depression. The perceived QoL had increased for 14% of the sample, was unaltered for 48% and had decreased for 38%. Impairments were neither significantly related to QoL nor to depression. Decreased QoL appeared mainly to reflect decreased ability to socialise while depression was closely associated with disabilities in numerous instrumental activities of daily living, particularly within the domestic and social sphere, and also with work- and leisure disabilities.     

Comorbidity-Related Treatment Outcomes among HIV-Infected Adults in the Bronx,NY

Aging, HIV infection, and antiretroviral therapy have been associated with increasing rates of chronic comorbidities in patients with HIV. Urban minority populations in particular are affected by both the HIV/AIDS and chronic disease epidemics. Our objectives were to estimate the prevalence of and risk factors for hypertension, dyslipidemia, and diabetes among HIV-infected adults in the Bronx and describe comorbidity-related treatment outcomes. This was a cross-sectional study of 854 HIV-positive adults receiving care at 11 clinics which provide HIV primary care services; clinics were affiliated with a large urban academic medical center. Data on blood pressure (BP), cholesterol, and glycemic control were collected through standardized chart review of outpatient medical records. We found prevalence rates of 26%, 48%, and 13% for hypertension, dyslipidemia, and diabetes, respectively. Older age, obesity, family history, and current protease inhibitor use were consistently associated with comorbidity. Diabetes treatment goals were achieved less often than BP and lipid goals, and concurrent diabetes was a significant predictor for BP and lipid control. In conclusion, major cardiovascular-related comorbidities are prevalent among HIV-positive adults in the Bronx, especially older and obese individuals. Differences exist in comorbidity-related treatment outcomes, especially for patients with concurrent diabetes. Because cardiovascular risk is modifiable, effective treatment of related comorbidities may improve morbidity and mortality in HIV-infected patients.     

Self-Discrepancy Theory,Standards for Body Evaluation,and Eating Disorder Symptomatology Among College Women

This 1865 Harris/Burroughs trial marked the first time that the paroxysmal [temporary] insanity plea was supported by expert medical testimony in a U.S. courtroom. Jurors agreed that the female defendant was insane at the time of the shooting due to being "crossed in love and suffering from painful dysmenorrhea." Attitudinal stances of the legal system, health professionals, newspapers and the public are illustrated. By merely changing the antebellum language, the reactions could be recycled into our current tabloid newspapers and titillating TV programs as if the tragedy occurred yesterday.     

The Construction of Motherhood: Tasks,Relational Connection,and Gender Equality*

Abstract: This qualitative analysis of 50 couples explored how gender equality is related to the construction of motherhood in their day‐to‐day interactions. Results identified two models of mothering: (a) mothering as a gendered talent and (b) mothering as conscious collaboration. The first model perpetuated gender inequality through a recursive task‐relationship cycle between mothers and children. More equal couples consciously collaborated to create a task‐relationship spiral for fathers as well as mothers. Processes involved in each view of mothering were discussed relative to the distribution of parenting tasks. The findings suggest that families would benefit from education and clinical approaches that address gender and power, encourage open discussion regarding how child care choices are made, and develop new skills for both genders.     

Sex therapy for erectile dysfunction: Characteristics of couples,treatment outcome,and prognostic factors

Outcome and prognostic factors were studied in 36 couples who entered sex therapy because of the male partners' erectile dysfunction. Treatment was completed by two thirds. Noncompletion was associated with lower socioeconomic status, the female partner having a history of psychiatric treatment, pretreatment poorer motivation of the male partner, poor communication in the general relationship, and less sexual pleasure experienced by the female. A positive treatment outcome occurred in 69.4%, and was associated with better pretreatment communication and general sexual adjustment, especially the female partner's interest and enjoyment of sex, absence of a positive psychiatric history in the female partner, and a couple's early engagement in homework assignments. Results highlight important aspects of the initial assessment, indicate couples for whom the initial phase of treatment should be prolonged and modified or an alternative approach considered, and have implications for assignment of couples to treatment groups in evaluative studies of therapy.     

68例甲状腺功能减退症患者的激素补充替代治疗情况调查分析

目的:调查甲状腺功能减退症患者的激素补充替代治疗情况,为治疗保健工作提供依据。方法:对68例已诊断为甲状腺功能减退症的患者的治疗情况,从甲状腺功能化验(T3、T4、TSH值)和以问卷的形式,从是否有记忆力智力的下降,是否意识到需要长期的服药治疗,是否选择最佳药物,是否自行停药及原因,是否有医务人员的明确指导等情况进行了调查。结果:34%的被调查人甲状腺功能(T3、T4、TSH)未能在理想的数值。90%的被调查人在甲减治疗之前有记忆力智力的下降。46%的被调查人未意识到需要长期的服药治疗,47%的被调查人未能选择最佳药物。35%的被调查人自行停药。31%的被调查人未能得到医务人员的明确指导。结论:通过甲状腺功能减退症患者的激素补充替代治疗情况调查证明该病患者的激素补充替代治疗情况不够理想。有近1/2的被调查人对甲低的终生治疗不明确,有近1/2的被调查人不能选择最佳药物,有近1/3的被调查人自行停药。其原因与患者有记忆力智力的下降和未能得到医务人员的明确指导有关。有关的医疗保健人员有必要提高相关知识,加强耐心,除患者外对其亲友也有必要进行相关知识的交代,进一步提高此类疾病患者的治疗水平。     

穴位贴敷治疗妇科术后恶心呕吐的疗效观察

目的观察穴位贴敷疗法治疗术后病人恶心呕吐的临床疗效。方法选择2013年6月到2014年1月全麻腹式手术患者90例,随机分为两组各45例。对照组常规术后给予消炎、营养支持等治疗,治疗组在常规治疗的基础上加用穴位贴敷,贴敷中脘穴、双足三里、双内关。比较两组的治疗效果。结果治疗组总有效率为95.56%,明显高于对照组的77.78%,差异具有统计学意义(P<0.05)。治疗组平均呕吐次数、平均恶心次数明显少于对照组,差异具有统计学意义(P<0.05)。结论穴位贴敷可改善妇科术后恶心呕吐症状,具有穴位的刺激与调节作用及药物吸收后的药效作用,值得临床应用。     

真菌性关节炎的临床特征及诊疗现状

骨关节真菌感染是较为罕见的疾病,但近年来,由于皮质类固醇或其他免疫抑制药物滥用,此类感染的风险也在逐年增加。骨关节真菌感染对于骨科医生来说无疑是一个挑战,基于国内外文献,将真菌性关节炎的临床特征以及目前诊疗现状进行综述,以提高临床医生对真菌性关节炎的发病机制及相关因素的认识,采取积极有效措施加强对真菌性关节炎的早期诊断及治疗。     

Philosophy,science and ideology: a proposed relationship for occupational science and occupational therapy

This paper explores the interaction between the philosophy of occupational therapy, the science of occupation and the regional ideology of a specific geographical area, and proposes two models to depict the relationship. One model focuses on the interaction between daily occupational therapy practice in a specific geographical region and the international influences on that practice. The international influences include the effect of occupational science. The second model focuses on the relationship between the philosophy of occupational therapy, occupational science and regional ideology. It concludes by showing the importance of developing a global identity through the importation of knowledge from evolving sciences in industrialized countries at the same time as basic and applied knowledge is developed in the scientific community of a geographic region. Copyright © 2000 Whurr Publishers Ltd.