An Investigation of Occupation-based Practice in Upper Extremity Intervention - A Pilot Study

The primary purpose of this study was to explore the extent to which therapists focused on functional occupation-based performance in both assessments and goals, and whether this was related to client satisfaction and perceived self-efficacy. Researchers found that while most therapists demonstrated inconsistent occupation-based practices, therapists were most occupation-focused during goal writing and in their clinical reasoning. Results also suggest that clients responded well to client-centered practices

Student Perceptions and Grade Comparisons after Exposure to Instructor-Made Skills Videos in a Kinesiology Course

The purpose of this mixed method, descriptive case study was to determine whether the use of pre-recorded instructor-made videos (PRIMVs) in a kinesiology course, along with curricular design changes, facilitated increased conceptual and practical student learning. The study examined three student cohorts in one occupational therapy program. Two of the student cohorts had unrestricted access to the PRIMVs designed to support student learning of bone and muscle palpation and joint actions. Students from the two cohorts completed a survey about their experience of having access to the videos. Exam data from the student cohorts who had access to the videos was compared to exam data from an earlier cohort who had not been exposed to the videos. While no significant differences in the lab exam grades were noted, quantitative and qualitative data collected from the surveys revealed that students perceived that their overall course grade was higher and they were better prepared for clinical fieldwork as a result of having access to the videos. This study adds to the growing body of evidence that supports video technology as a supplemental learning tool in occupational therapy education

Medical treatment of endometriosis-related pain

Available medical treatments for symptomatic endometriosis act by inhibiting ovulation, reducing serum oestradiol levels, and suppressing uterine blood flows. To this aim, several drugs can be used, with a similar magnitude of effect, in term of pain relief, independently of the mechanism of action. Conversely, safety, tolerability, and cost differ. Medications for endometriosis can be categorised into low-cost drugs, including OCs and most progestogens, and high cost drugs, including dienogest and GnRH agonists. As the individual response to different drugs is variable, a stepwise approach is suggested, starting with OCs or low-cost progestogens, and stepping up to high-cost drugs only in case of inefficacy or intolerance. Oral contraceptives may be used in women with dysmenorrhoea as their main complaint, and when only superficial peritoneal implants or ovarian endometriomas < 5 cm are present, while progestogens should be preferred in women with severe deep dyspareunia and when infiltrating lesions are identified

Early Home Therapies against Covid-19. An Italian Case of Politicisation of Science?

Since February 2020, strategies aimed at containing and managing the Covid-19 syndemic have been developed by the governments of European countries. Among these measures, the possibility of an early treatment of the disease has been considered of fundamental importance, both for curing the disease and governing the syndemic. Despite their potential, early therapies received a somehow unexpected treatment in Italy and the debate around them gave rise to a very evident conflict between proponents and opponents of those treatments, to the point that some of the former organised a properly political movement in order to promote the integration of early home therapies in the official health protocols. Not surprisingly, the issue of early therapies has been considered an exemplary case of politicisation of science. However, the assimilation of the early therapy controversy to the frame of politicisation of science cannot fully explain why these protocols were discarded by political and health authorities. Rather, the consideration of health protocols as socio-technical objects shifts the attention on the vast range of cultural, political and economic factors that contributed to the general resistance towards those treatments. Therefore, we aim to analyse the media coverage of the phenomenon, and investigate the protocols of home treatment of Covid-19, paying attention to the interaction of the factors that contributed to the exclusion of home therapies into national guidelines

Using antiepileptic drugs in children : recent developments and recommendations

Epilepsy is one of the most common neurological disorders, with approximately 45 per 100,000 children developing new-onset epilepsy every year. Children are a vulnerable population with unique health needs and a correct diagnosis and thus correct treatment of epilepsy in children, particularly a diagnosis of early onset epilepsy, is important in order to ensure better quality of life, neurodevelopmental outcomes, cognition, education, improved level of function and future employment. Therapy with antiepileptic drugs (AEDs) aims to minimize the frequency of epileptic seizures with minimal side effects. The first generation AEDs (such as phenytoin, carbamazepine and valproic acid) are still widely used, although they are associated with serious side effects and pharmacokinetic problems (narrow therapeutic indices, nonlinear kinetics, and drug-drug interactions due to enzyme inhibition and enzyme induction properties). The novel AEDs (such as lamotrigine, levetiracetam, rufinamide, and zonisamide) have expanded the treatment options of epilepsy, however they are also associated with severe pharmacokinetic shortcomings, especially for paediatric populations. This educational article will discuss how the correct use of these drugs can lead to improved quality of life measures. This paper also provides an overview of ongoing research on the use of population pharmacokinetics in addressing the challenges paediatric populations offer to drug and dose individualisation.peer-reviewe

Early Home Therapies against Covid-19. An Italian Case of Politicisation of Science?

Since February 2020, strategies aimed at containing and managing the Covid-19 syndemic have been developed by the governments of European countries. Among these measures, the possibility of an early treatment of the disease has been considered of fundamental importance, both for curing the disease and governing the syndemic. Despite their potential, early therapies received a somehow unexpected treatment in Italy and the debate around them gave rise to a very evident conflict between proponents and opponents of those treatments, to the point that some of the former organised a properly political movement in order to promote the integration of early home therapies in the official health protocols. Not surprisingly, the issue of early therapies has been considered an exemplary case of politicisation of science. However, the assimilation of the early therapy controversy to the frame of politicisation of science cannot fully explain why these protocols were discarded by political and health authorities. Rather, the consideration of health protocols as socio-technical objects shifts the attention on the vast range of cultural, political and economic factors that contributed to the general resistance towards those treatments. Therefore, we aim to analyse the media coverage of the phenomenon, and investigate the protocols of home treatment of Covid-19, paying attention to the interaction of the factors that contributed to the exclusion of home therapies into national guidelines

Universal cures for idiosyncratic illnesses: a genealogy of therapeutic reasoning in the mental health field

Over the past decades, there has been a significant increase in prescriptions of psychotropic drugs for mental disorders. So far, most of the explanations of the phenomenon have focused on the process of medicalization, but little attention has been cast towards physicians' day-to-day clinical reasoning, and the way it affects therapeutic decision-making. This article addresses the complex relationship between aetiology, diagnosis and drug treatment by examining the style of reasoning underlying prescribing practices through an historical lens. A genealogy of contemporary prescribing practices is proposed, that draws significant comparisons between 19th-century medicine and modern psychiatry. Tensions between specific, standardized cures and specific, idiosyncratic patients have been historically at play in clinical reasoning - and still are today. This inquiry into the epistemological foundations of contemporary drug prescription reveals an underlying search for scientific legitimacy

Perceived Stress and Burnout in Athletic Training Students

Athletic training students can experience stress and symptoms of burnout and there is empirical support for a relationship between stress and burnout in health professions students in fields such as medicine and nursing. 1-3 However, prior research on the relationship between stress and burnout has been limited in athletic training students. The purpose of the present study was to examine the relationship between perceived stress and symptoms of burnout in athletic training students. Two hundred thirty athletic training students from 61 institutions completed an online questionnaire consisting of the Perceived Stress Scale (PSS), the Burnout Clinical Subtype Questionnaire - Student Survey (BCSQ-12-SS), and answered questions related to their athletic training student experience and stress management. Higher perceived stress scores were positively correlated to higher reported symptoms in all three burnout subtypes (overload, lack of development, and neglect), with the strongest relationship between perceived stress and symptoms of the overload burnout subtype. Number of classes, number of credit hours, and clinical site placements were unrelated to perceived stress or burnout symptoms. Students reporting that stress management was addressed in the athletic training curriculum had lower levels of perceived stress compared to students who reported that stress management was unaddressed. Students who reported use of a self-care stress management strategy (such as breaks, exercise, or time for themselves) had lower perceived stress scales compared to students who did not report using a self-care strategy. The findings suggest that how students respond to and manage stressors may be more important to the athletic training student experience than the size or type of workload

Crisis in Education: A Call to ACT

The current education system in the United States is riddled with difficulties which include an increasing demand for qualified teachers and persistently high attrition rates. Teachers are prone to low job satisfaction, low self-efficacy, as well as increased stress and burnout. Although these problems are widely discussed in the literature, scant intervention research is available. Additionally, existing interventions miss two key elements that may be especially relevant to the challenges faced by educators: acceptance and values. The current study examined the efficacy of acceptance and commitment therapy (ACT) for reducing teacher burnout through a day-long professional development workshop. Thirty-five teachers were assigned to either an experimental (n=20) or waitlist control group (n=15). At three months followup, burnout levels significantly decreased for the ACT group and increased for the control group. Additionally, changes in burnout were mediated by the acceptance of undesirable thoughts and feelings. The current study supports ACT as an effective method for reducing burnout in teachers

Encountering stereotype threat in the workplace : how lesbian, gay, bisexual, and transgender employees meet the challenge of negative stereotyping.

Employee retention continues to be a major drain on the resources of organizations, especially in terms of personnel, productivity, and financial resources. One of the primary motivators of employee turnovers established by research is the issue of unfairness in the workplace. This study investigated the dimensions of unfairness related to being a lesbian, gay, bisexual, or transgender employee. Specifically, the issue of stereotype threat and its effect on job performance was explored. Using an on-line survey, members of LGBT labor union caucuses and LGBT employee resource groups were asked to complete a questionnaire that assessed demographic differences and responses to issues of self-monitoring, concern for appropriateness, and self-efficacy as they related to the employee\u27s experience of stereotype and job performance. Hierarchical regression analyses and structural equation modeling were used to ascertain the effect and systemic relationships between the variables. This study documented the presence of stereotype threat in the workplace. It was also found that self-efficacy completely mediates the effect of stereotype threat on job performance. Furthermore, more subtle indirect effects of stereotype threat were found. Additionally, mechanisms that affect how the employee adapts to his/her situation were explored. It was concluded that stereotyping of lesbian, gay, bisexual, and transgender employees can directly and indirectly affect the levels of job performance in the workplace. In short, when an employee feels unfairly treated the likelihood of employee turnovers increases