Goal attainment scaling: Clinical implications for paediatric occupational therapy practice

Children with disabilities pose unique challenges for occupational therapists when the value of therapy programmes and the child's individual progress are being evaluated. Children whose development is atypical may make progress through a course of intervention and/or maturation, yet standardised tests frequently used by occupational therapists are often not sensitive enough to detect these changes. In this current climate of economic rationalism and accountability, providing documentary evidence of occupational therapy programme benefits is essential. This paper addresses the utility of goal attainment scaling for objectively and systematically documenting the outcomes of occupational therapy intervention. Goal attainment scaling provides a direct, reliable and accurate method of assessing treatment-induced client change. The process of goal attainment scaling is described and the literature on goal attainment scaling in paediatrics is reviewed. It is concluded that goal attainment scaling is a useful clinical process and measure of therapy programme outcomes for children with disabilities.     

Antibody-mediated adherence of rat eosinophils to schistosomula of Schistoma mansoni in vitro.

Eosinophils from the peritoneal washings of normal rats adhered to live or formalin-fixed schistosomula of Schistosoma mansoni in vitro, in the presence of heat-inactivated serum from infected rats. Eosinophil adherence caused permeability changes in the schistosomula as revealed by 51Cr release and methylene blue uptake. The serum factor which mediated adherence resided in the 7S fraction after Sephadex G-200 gel filtration. Protein A from Staphylococcus aureus which binds specifically to the Fc piece of IgG inhibited adherence, thereby demonstrating that IgG was the antibody responsible for this reaction and that the Fc portion was the site of interaction between eosinophil and antibody; rat eosinophils were shown to possess Fc receptors. The antibody mediating adherence reached high titres in the sera of rats 5-8 weeks after exposure to 500 cercariae, but thereafter there was a gradual decline in titre. Surface membrane from adult S. mansoni inhibited adherence, indicating the presence of cross-reacting antigens in adult worms and schistosomula.     

Serodiagnosis of human Schistosoma mansoni infections: enhanced sensitivity and specificity in ELISA using a fraction containing S. mansoni egg antigens omega 1 and alpha 1

Six fractions of Schistosoma mansoni egg homogenate obtained by cation exchange chromatography were tested in an enzyme-linked immunosorbent assay (ELISA) for their efficacy in serodiagnosis of human S. mansoni infections. One cationic fraction (CEF6) containing egg antigens omega 1 and alpha 1, was found to be highly reactive with a S. mansoni positive reference serum pool. 94 of 95 sera from individuals infected with S. mansoni gave a positive reaction with CEF6, and no cross reactivity was obtained with this antigenic fraction and sera from donors infected with heterologous non-schistosome parasites and cases of avian cercarial dermatitis. Only 10 of 165 sera from patients with S. haematobium and three of 10 sera from patients with S. japonicum were positive with S. mansoni egg CEF6. In one group of patients from West Africa, examined both serologically and parasitologically at a six-monthly interval, the measurement of antibody to CEF6 provided a more sensitive diagnostic aid than stool examination.