Gender bias in an occupational therapy text

Willard and Spackman's Occupational Therapy does not create an awareness and understanding of the role of women in the field of occupational therapy. Nor does the text include general policy statements or reflections on how gender bias affects our work. What is our true consciousness as women therapists? Maria Mies (1983) wrote that women consent to their own oppression or subordination through silence. "Only when there is a rupture in the 'normal' life of a woman, a divorce, an end of a relationship, is there a chance for her to become conscious of her true condition which had been unconsciously submerged in a patriarchal system" (p. 125). True consciousness occurs in occupational therapy when practitioners avoid the use of activities or occupation in therapy. This is our "rupture". I believe the profession needs to develop a policy statement discussing gender concerns in our theory and practice linked to the progress made by women scientists in anthropology, psychology, sociology, history, and literature. It is critical to good treatment that the gender role factor be included in our research on the generic impact of activity on the individual and small group. As female occupational therapists we have the opportunity to make a significant imprint on a gender-based understanding of the health value of activities in our daily lives.     

The topography of expanded uncrossed retinal projections following neonatal enucleation of one eye: differing effects in dorsal lateral geniculate nucleus and superior colliculus

The topographic organization of the uncrossed retinal projections to the dorsal lateral geniculate nucleus (dLGN) and superior colliculus (SC) was studied in normal adult hooded rats and in rats subjected to unilateral ocular enucleation on the day of birth. Sections were stained for anterograde degeneration products following discrete retinal lesions at various locations. The projection from the temporal crescent to the dLGN in neonatally enucleated rats had an expanded but topographically normal organization, with the nasotemporal and dorsoventral retinal axes displaying polarities identical to those in normal adults. Neonatal enucleation permits the remaining uncrossed retinogeniculate projection to extend primarily along the "lines of projection" into neuropil normally recipient of binocularly conjugate crossed projections. In the SC, the dorsoventral axis of the temporal crescent showed a normal polarity, but the nasotemporal axis failed to display any topographic organization. Retinal loci in the temporal crescent projected throughout the rostrocaudal extent of the ipsilateral SC. Retinal lesions placed outside the temporal crescent failed to produce any substantial degeneration in ipsilateral dLGN or SC. These topographically distinct effects in dLGN and SC following unilateral eye removal on the day of birth are discussed in the context of differing constraints upon axonal ingrowth and connectivity during early development, which may normally bring about the characteristically distinct features of retinogeniculate and retinocollicular organization.     

Hyperbaric oxygen therapy in chronic stable multiple sclerosis: double-blind study

We carried out a randomized, double-blind, placebo-controlled trial of hyperbaric oxygen therapy (HBO) in patients with chronic stable MS. Eighty-two patients were treated in a multiplace hyperbaric chamber with gas supplied by mask. Forty-one patients received 20 consecutive daily treatments of 100% O2 followed by 7 "booster" treatments in the next 6 months; 41 control patients received "air" (12.5% O2 at 1.75 atmospheres absolute). There was no significant difference in treatment and control groups in the Extended Kurtzke Disability scores, Kurtzke Functional scores, magnetic resonance imaging, or evoked potentials after the initial 20 treatments or after the boosters. HBO is not effective in treating chronic stable MS.     

Magnetic resonance imaging for detecting lesions of multiple sclerosis: comparison with computed tomography and clinical assessment.

Eighty-two patients with known or suspected multiple sclerosis (MS) were examined by means of magnetic resonance imaging (MRI) with a 0.15-T resistive scanner. The diagnosis could be made by MRI in 34 (97%) of the 35 patients with chronic, well-documented, stable MS and by high-volume delayed x-ray computed tomography (HVD CT) in only 6 (54%) of 11 patients in this group. The stage of the disease as judged from the MRI scans correlated poorly with the clinical status of the patient and with the known duration of the disease. MRI identified 28 (88%) of the 32 patients in whom MS was subsequently diagnosed by a neurologist, whereas regular contrast or HVD CT identified only 11 (52%) of 21 such patients. MRI is the most sensitive imaging modality for MS but is of little value in assessing the severity of the disease: many of the lesions seen on MRI scans are clinically "silent", and MRI does not usually detect small lesions in the brainstem, cerebellum or spinal cord that may be clinically significant.     

Management of sports-induced skin wounds

Skin wounds are common in sports but are rarely documented by the certified athletic trainer. The literature is unclear about wound types, and none of the articles reviewed reported frequencies. The purpose of this paper is to discuss the frequency of common athletic skin wounds and their specific management. Management of skin wounds can sometimes be problematic. Hydrogen peroxide has been used on wounds since 1947, yet some researchers report that hydrogen peroxide and iodophor solution can delay or interfere with wound healing, or cause damage to the wounded area if use is intense and prolonged. Occlusive dressings have been reported to have considerable advantage in maintaining a moist wound bed and in decreasing healing time. Infection rates beneath occlusive dressings, however, are similar to those associated with other types of dressings. Complications to wounds, with or without the use of occlusive dressings, such as keloids and seborrheic dermatitis, occur in low frequencies. Due to a lack of specific information about sports-induced skin wounds and their management, we recommend that standardized documentation for common wounds be developed along with further study of techniques for management.     

The Influence of Dirithromycin on the Pharmacokinetics of Cyclosporine in Healthy Subjects and in Renal Transplant Patients

The effect of a standard regimen of the investigational macrolide antibiotic, dirithromycin, on the single-dose kinetics of orally administered cyclosporine (CSA) was investigated in healthy young males and on the steady-state disposition kinetics of cyclosporine in a panel of renal transplant patients. Eight male volunteers participated after giving informed consent. CSA was administered in three single doses (15 mg kg(minus sign1) p.o. each) in each of three phases: (1) prior to a 14-day regimen of dirithromycin; (2) at the end of a 14-day regimen of dirithromycin (500 mg p.o. qAM); and (3) 2 weeks after the last dose of a 14-day regimen of dirithromycin. Pharmacokinetic parameters of CSA were estimated, and the differences among treatments were assessed by analysis of variation. No significant differences among treatment (phase) means were detected (p < 0.05). We conclude that a typical 14-day regimen of dirithromycin failed to alter the disposition kinetics of CSA when taken orally healthy young adult males. The effect of a standard regimen of dirithromycin on the steady-state disposition kinetics of orally administered CSA was investigated in a panel of 15 stable renal transplant patients. Pharmacokinetic parameters for CSA were evaluated prior to, during, and 2 weeks after discontinuing a 14-day (500 mg day(minus sign1)) oral regimen of dirithromycin. Dirithromycin elicited small but significant changes in the following parameters: C(av) was increased by 16% during dirithromycin treatment, and the changes in normalized C(av) were comparable. Likewise, C(SS,min) and normalized C(SS,min) were increased by 19% and 20%, respectively, during dirithromycin treatment. CSA oral clearance, CL/F(SS), decreased by 17% during dirithromycin treatment. C(SS,max) and normalized C(SS,max) were increased by 13% and 17%, respectively, during dirithromycin treatment but were not significantly different from those either before or after dirithromycin. The magnitude of the pharmacokinetic changes for CSA during dirithromycin treatment (<15% in normal subjects and 15--20% in renal transplant patients) when considered in the context of the therapeutic range of cyclosporine concentrations was relatively small, and not likely to warrant special attention to the dosing of CSA in such patients beyond routine whole-blood CSA and serum creatinine monitoring.