Parental Perspectives of Occupational Therapy Home Instruction Programs for Their Children with Special Needs

In this changing age of health care it has become even more important to reevaluate the effectiveness and relevance of patient education. Traditionally, patients have been given extensive occupational therapy home instruction programs with little thought to the patient\u27s perspective or ability to comply. Among pediatric occupational therapists there continues to be some debate as to whether it is even beneficial for parents to perform activities at home with their children. The purpose of this study was to use a qualitative research approach with focus group methodology to 1) gain a better understanding of the life experiences and perceptions of parents regarding occupational therapy home instruction programs for their children with special needs, and 2) identify the facilitators and barriers to the delivery of occupational therapy home instruction programs. A focus group of seven mothers of children with special needs was conducted. The written transcription of the group was analyzed for emerging content, clusters and categories. Four themes emerged related to the life experiences and perceptions of parents in regard to their home instruction programs. It was concluded from these themes that the parents of children with special needs have a strong desire to be involved in home instruction programs that provide direction, hope and control; despite the isolation, depression and overwhelming life style demands that are a part of the lived experience. Two themes emerged related to the barriers and facilitators of home instruction programs. It was concluded from these themes that parents of children with special needs perceive a variety of emotive and cognitive factors as both barriers and facilitators to the delivery of the home instruction program for their child with special needs. The results from this study offer insight and direction for the provision of quality occupational therapy home instruction programs that will ultimately improve overall patient care

3d metal complexes with the perfluoro-tert-butoxide and perfluoropinacolate ligands: dioxygen reduction and intermolecular substrate oxidation

A CuI fully fluorinated O-donor monodentate alkoxide complex, K[Cu(OC4F9)2] (1), was previously shown to form a trinuclear copper–dioxygen species with a {Cu3(3-O)2} core, TOC4F9, upon reactivity with O2 at low temperature. A significantly expanded kinetic and mechanistic study of TOC4F9 formation is reported using stopped-flow spectroscopy. The TOC4F9 complex performed catalytic oxidase conversion of para-hydroquinone (H2Q) to para-benzoquinone (BQ) and hydroxylation of 2,4-di-tert-butylphenolate (DBP) to catecholate, making TOC4F9 the first tri-copper species to perform tyrosinase (both monooxygenase and oxidase) chemistry. As opposed to 1, when K+ is fully encapsulated in {K(18C6)}[Cu(OC4F9)2] (4), O2 was not reduced under identical conditions. To study the effects of both alkali cation and the degree of encapsulation on reduction of O2, derivative complexes were synthesized with Na+ (16), {Na(DME)}+ (17), {Na(15C5)}+ (18), {K(15C5)}+ (19), {K(15C5)2}+ (20), Cs+ (21), {Cs(18C6)}+ (22), and {Cs(18C6)2}+ (23). Reduction of O2 was found to be encapsulation-dependent, and cation size was also determined to affect the chromophore observed. These results suggest that cation…F/O interactions between the CuI complexes assemble aggregates that are required to form reactive {Cun−O2} species. However, catalytic oxidation of H2Q to BQ and sub-stoichiometric oxidation of DBP to catecholate occurred regardless of whether a {Cun−O2} intermediate was detected, suggesting that a reactive species may self-assemble in the presence of substrate in all complex derivatives unable to reduce O2. A series of heteroleptic mixed phosphine/alkoxide 3d complexes was designed to evaluate PPh3 as a protecting group. Complexes of the form [(Ph3P)2M(OC4F9)2] (M= Fe (24), Co (25), Ni (26), Zn (27)) and [(Ph3P)2M(pinF)] (M= Co (31), Ni (32), Zn (33)) were prepared and characterized, along with related complexes with non-reactive L-donors for comparison, [(DME)Fe(OC4F9)2] (28) and [(Ph3PO)2M(OC4F9)2] (M= Fe (29), Ni (30)). Dimeric [Fe2(-O)(OPPh3)2(OC4F9)4] (36) was isolated after O2 reactivity with 24, and 28 and 29 were able to generate intermediate species capable of both oxidation of H2Q to BQ and oxygen atom transfer of thioanisole to methyl phenyl sulfoxide. The choice of fluorinated ligand influences O2 reactivity with CoII (25, 31), but not for NiII (26, 32). Related dimeric compounds [Co2(pinF)2(THF)4)] (34) and [Zn2(pinF)2(THF)2)] (35) were also isolated

Open Access: Is OA Ok?

Open Access (OA) publishing is growing exponentially across many disciplines. What do UNE students and faculty need to know about it? UNE Librarian Beth Dyer presents its opportunities and pitfalls, with advice on how to approach OA both as an author and a consumer. UNE College of Pharmacy’s Dr. Dan Brazeau talks about his experiences with OA publishing. UNE Librarian Bethany Kenyon discusses UNE\u27s open access digital repository, DUNE: Digital UNE, where UNE community members can deposit and share original content

A protein interaction map for cell polarity development

Many genes required for cell polarity development in budding yeast have been identified and arranged into a functional hierarchy. Core elements of the hierarchy are widely conserved, underlying cell polarity development in diverse eukaryotes. To enumerate more fully the protein–protein interactions that mediate cell polarity development, and to uncover novel mechanisms that coordinate the numerous events involved, we carried out a large-scale two-hybrid experiment. 68 Gal4 DNA binding domain fusions of yeast proteins associated with the actin cytoskeleton, septins, the secretory apparatus, and Rho-type GTPases were used to screen an array of yeast transformants that express ∼90% of the predicted Saccharomyces cerevisiae open reading frames as Gal4 activation domain fusions. 191 protein–protein interactions were detected, of which 128 had not been described previously. 44 interactions implicated 20 previously uncharacterized proteins in cell polarity development. Further insights into possible roles of 13 of these proteins were revealed by their multiple two-hybrid interactions and by subcellular localization. Included in the interaction network were associations of Cdc42 and Rho1 pathways with proteins involved in exocytosis, septin organization, actin assembly, microtubule organization, autophagy, cytokinesis, and cell wall synthesis. Other interactions suggested direct connections between Rho1- and Cdc42-regulated pathways; the secretory apparatus and regulators of polarity establishment; actin assembly and the morphogenesis checkpoint; and the exocytic and endocytic machinery. In total, a network of interactions that provide an integrated response of signaling proteins, the cytoskeleton, and organelles to the spatial cues that direct polarity development was revealed

Moral Distress Amongst American Physician Trainees Regarding Futile Treatments at the End of Life: A Qualitative Study.

BACKGROUND: Ethical challenges are common in end of life care; the uncertainty of prognosis and the ethically permissible boundaries of treatment create confusion and conflict about the balance between benefits and burdens experienced by patients. OBJECTIVE: We asked physician trainees in internal medicine how they reacted and responded to ethical challenges arising in the context of perceived futile treatments at the end of life and how these challenges contribute to moral distress. DESIGN: Semi-structured in-depth qualitative interviews. PARTICIPANTS: Twenty-two internal medicine residents and fellows across three American academic medical centers. APPROACH: This study uses systematic qualitative methods of data gathering, analysis and interpretation. KEY RESULTS: Physician trainees experienced significant moral distress when they felt obligated to provide treatments at or near the end of life that they believed to be futile. Some trainees developed detached and dehumanizing attitudes towards patients as a coping mechanism, which may contribute to a loss of empathy. Successful coping strategies included formal and informal conversations with colleagues and superiors about the emotional and ethical challenges of providing care at the end of life. CONCLUSIONS: Moral distress amongst physician trainees may occur when they feel obligated to provide treatments at the end of life that they believe to be futile or harmful.This study was funded by the Health Resources and Service Administration T32 HP10025-20 Training Grant, the Gates Cambridge Scholarship, Society of General Internal Medicine Founders Grant, and the Ho-Chiang Palliative Care Research Fellowship at the Johns Hopkins School of Medicine.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s11606-015-3505-

The Evolving Role of the Chief Wellness Officer in the Management of Crises by Health Care Systems: Lessons from the Covid-19 Pandemic

Even before the onset of the Covid-19 pandemic, clinician burnout was a recognized occupational syndrome and a driver of suboptimal patient care. National calls for system-level interventions to improve clinician well-being led some health care organizations (HCOs) to appoint a Chief Wellness Officer (CWO). By incorporating CWOs into the emergency command structure, these HCOs were equipped to identify and address health care worker needs throughout the pandemic. CWOs learned important lessons regarding how HCOs can best address workforce well-being in the midst of a crisis. Key CWO contributions include identifying evolving sources of worker anxiety, deploying support resources, participating in operational decision-making, and assessing the impact of fluid pandemic protocols on clinician well-being. As HCOs seek to promote posttraumatic growth, attention to the well-being of the workforce should be incorporated into emergency management protocols with the goal of sustaining a resilient health care workforce

Oshkosh Scholar

A journal of UW Oshkosh undergraduate researc

Navigating Minority & Gender Discrimination, Substance Use Disorder, Financial Distress & Workplace Politics: Lessons For Work-Life Wellness in Academic Medicine: Part 2 of 3: Wellness in Academic Medicine

In this second of three manuscripts addressing a range of complex work and personal issues, the authors explore case scenarios with characters who work in the fields of general surgery, orthopedic surgery, anesthesiology, neurology, radiology, and otolaryngology. The medical specialty identifiers help inform some baseline understanding of the demands of that particular profession but are less pertinent than the specifics of each case. In this manuscript, the authors dive into the topics of navigating a lawsuit and professional burnout, personal finances, substance use disorder, demands of clinical work and workplace politics, diversity and inclusion, and dealing with major personal illness. The authors provide practical steps to help the readers deal with similar situations and provide insight to support persons on how to improve support structures