Life History of Maggie Lesher, MA, OTR/L

This life history is one of 29 life history interviews which are a part of a larger project, Life Histories of Individuals Who Have Been Influential in Developing Occupational Therapy (OT) in North Dakota and Wyoming. The purpose of this project is to gather information about the history and evolution of occupational therapy (OT) practice in North Dakota and Wyoming through life histories of individuals who have been influential in developing OT in these two states. It is anticipated that the life history process will be a powerful way to gather this information. This study is intended to provide current and future generations of occupational therapists a view of the history and how occupational therapy practice has evolved from its inception to current practice in North Dakota and Wyoming. An in-depth phone interview with Maggie Lesher, MA, OTR/L was conducted by two student researchers and both the student researchers and Maggie Lesher were in their homes at the time the phone interview took place. Maggie Lesher is a highly successful occupational therapist and is the founder of Children’s Theraplay – a home based agency with locations in Plymouth and Maplewood MN. Maggie has worked in multiple states and practice areas making the interview rich with information regarding occupational therapy practice. The findings of this study will be archived and made available on the University of North Dakota (UND) OT website. Informed consent was obtained by the student researchers prior to completing the interview with Maggie Lesher. Careful consideration of the Kawa Model was kept by the researchers throughout this process to root the focus of the study on the overall life experiences of the participant (Teah & Iwama, 2015). Emphasis was placed on the barriers the participant experienced, her personal attributes, and the physical and social environments that surrounded Maggie Lesher (Teah & Iwama, 2015).https://commons.und.edu/ot-oral-histories-posters/1018/thumbnail.jp

Evolution of Occupational Therapy Practice: Life History of Maggie Lesher

This life history is one of 29 life history interviews which are a part of a larger project, Life Histories of Individuals Who Have Been Influential in Developing Occupational Therapy (OT) in North Dakota and Wyoming. The purpose of this project is to gather information about the history and evolution of occupational therapy (OT) practice in North Dakota and Wyoming through life histories of individuals who have been influential in developing OT in these two states. It is anticipated that the life history process will be a powerful way to gather this information. This study is intended to provide current and future generations of occupational therapists a view of the history and how occupational therapy practice has evolved from its inception to current practice in North Dakota and Wyoming. An in-depth phone interview with Maggie Lesher, MA, OTR/L was conducted by two student researchers and both the student researchers and Maggie Lesher were in their homes at the time the phone interview took place. Maggie Lesher is a highly successful occupational therapist and is the founder of Children’s Theraplay – a home based agency with locations in Plymouth and Maplewood MN. Maggie has worked in multiple states and practice areas making the interview rich with information regarding occupational therapy practice. The findings of this study will be archived and made available on the University of North Dakota (UND) OT website. Informed consent was obtained by the student researchers prior to completing the interview with Maggie Lesher. Careful consideration of the Kawa Model was kept by the researchers throughout this process to root the focus of the study on the overall life experiences of the participant (Teah & Iwama, 2015). Emphasis was placed on the barriers the participant experienced, her personal attributes, and the physical and social environments that surrounded Maggie Lesher (Teah & Iwama, 2015)

Therapeutic Use of Self: A Guide to Integrate the 5 Love Languages into Practice

Healthcare institutions have become businesses and, subsequently, these institutions are oftentimes structured to maximize profits consequently leading to a sacrifice in quality of care (Beltrán-Salazar, 2014). The emphasis on business in healthcare results in a push for productivity and reimbursement consequently decreasing attention to the therapeutic relationship. There are many definitions that offer a better understanding to the idea of therapeutic use of self, but they offer little to guide therapists in what using therapeutic use of self looks like in everyday practice (Solman & Clouston, 2016). Additionally, a vast majority of occupational therapists perceive the therapeutic relationship to be vital elements to engagement in therapy, however, only half of therapists feel they sufficient knowledge about use of self beyond the basics he or she learned during their education (Taylor, Lee, Kielhofner, & Ketkar, 2009). A literature review was conducted on the current state of healthcare, topics relating to the 5 Love Languages (Chapman, 1992), lack of humanized client-centered care, therapeutic use of self, and the influence of use of self on therapy outcomes and client satisfaction. Concepts from the Canadian Model of Client Centered Enablement (CMCE) (Townsend et al., 2013), the framework of the 5 Love Languages, and information obtained from the literature review were used to guide development of the product. The final product is a guidebook that is intended to be used by occupational therapists, occupational therapy assistants or the healthcare team. We believe the application of the 5 Love Languages to the therapeutic relationship will improve the therapy process for both the practitioner and the client and result in improved therapy outcomes

Implementation of a screening program for patients at risk for posttraumatic stress disorder

Introduction Implantable cardioverter defibrillator (ICD) recipients who suffer from posttraumatic stress disorder (PTSD) are known to be associated with significant cardiac-specific mortality. Clinical observations suggest that PTSD is frequently undetected in ICD recipients followed up at electrophysiology (EP) outpatient clinics. Early recognition of PTSD is important to reduce the risk of serious manifestations on patient outcomes. Methods All ICD recipients aged 19 years or older at the Washington University School of Medicine (WASHU) EP clinic, a large urban EP clinic, were invited to participate in the project. An informed consent letter with an attached primary care: posttraumatic stress disorder (PC: PTSD) survey was offered to the participants who met the inclusion criteria. Those who completed the survey were included in the project. Individuals with positive survey result were offered a referral to mental health services. Comparisons between PTSD and non-PTSD patients were done using a two-sample t -test for continuous variables. Using Fisher's exact test, PTSD prevalence was compared to the study by Ladwig et al in which prevalence was determined as the proportion of patients with positive findings of PTSD ( n = 38/147). All analyses were conducted using SAS v9.4. The proportion of patients having PTSD was determined and an exact 95% confidence interval was evaluated based on the binomial distribution. Results Using a convenience sample, 50 ICD recipients (33 males and 17 females) were enrolled. The project had a 30-day outcome period. Nine (18%) of the 50 participants had positive PC: PTSD findings and all these nine participants were referred to a mental health specialist. The current project demonstrated an 18% (9/50) PTSD prevalence rate when compared to a 26% (38/147) prevalence rate in the study by Ladwig et al ( P = 0.34). Although this project did not demonstrate 20% PTSD prevalence rate, as hypothesized, the 18% PTSD prevalence rate is consistent with previous research. Conclusion The prevalence of PTSD noted in the current project is consistent with previous research and validates underrecognition of PTSD in ICD patients. Offering a referral to all ICD recipients at EP clinic visits with a positive PC: PTSD screening to a mental health specialist is an important step in reducing the risk of serious manifestations on patient outcomes

A Mental Health Self-Screening Tool for Graduate Students

Background: Excessive perceived stress and mental health crises are escalating among college students. About 50% meet mental health disorder criteria, and half of them receive inadequate treatment. Aim: This study aimed to evaluate the feasibility and outcomes of a 15-20 minute online, anonymous, mental health self-screening survey and resource tool for graduate students across a large midwestern university campus. Methods: A descriptive, correlational design addressed the study's aims. Recruitment occurred through multiple campus communication mechanisms and included a brief study description, quick reference (QR) code, and weblink to access the tool and survey. Data collected with the tool included demographic items and scores from standardized screening instruments measuring burnout, perceived stress, depression, anxiety, post-traumatic stress disorder (PTSD), alcohol misuse, and health behavior practices. Descriptive and correlational statistics were computed. Results: Among 778 graduate students who accessed and completed the survey, nearly 60% met the burnout threshold, 58% scored 8 (of 16) on the stress scale, 32% met the depression threshold, 47% met the anxiety threshold, 54% reported one or more symptoms of PTSD, and 38% reported poor health behaviors. Significant positive correlations (r = 0.184 to 0.615) were found between burnout, perceived stress, depression, and anxiety. Health behavior scores were significantly negatively correlated (r = -0.151 to -0.283) with burnout, perceived stress, depression, and anxiety. Scores differed by gender, race, and graduate student status (part-time vs. full-time). Female identifying students, age, and hours worked per week were associated with various outcome scores. Students commented that the tool needed more specific resources tailored to their scores. Conclusions: The data support the need for tailored coping resources based on student self-reported data. Video-based micromodules guiding individuals through coping skills (breathing, mindfulness, identifying negative thoughts, gratitude exercises) have since been developed and will be studied as a tailored resource for students

Radiation Testing of Electronics for the CMS Endcap Muon System

The electronics used in the data readout and triggering system for the Compact Muon Solenoid (CMS) experiment at the Large Hadron Collider (LHC) particle accelerator at CERN are exposed to high radiation levels. This radiation can cause permanent damage to the electronic circuitry, as well as temporary effects such as data corruption induced by Single Event Upsets. Once the High Luminosity LHC (HL-LHC) accelerator upgrades are completed it will have five times higher instantaneous luminosity than LHC, allowing for detection of rare physics processes, new particles and interactions. Tests have been performed to determine the effects of radiation on the electronic components to be used for the Endcap Muon electronics project currently being designed for installation in the CMS experiment in 2013. During these tests the digital components on the test boards were operating with active data readout while being irradiated with 55 MeV protons. In reactor tests, components were exposed to 30 years equivalent levels of neutron radiation expected at the HL-LHC. The highest total ionizing dose (TID) for the muon system is expected at the inner-most portion of the CMS detector, with 8900 rad over ten years. Our results show that Commercial Off-The-Shelf (COTS) components selected for the new electronics will operate reliably in the CMS radiation environment

Reactivity of neodymium carriers in deep sea sediments: Implications for boundary exchange and paleoceanography

The dissolved neodymium (Nd) isotopic distribution in the deep oceans is determined by continental weathering inputs, water mass advection, and boundary exchange between particulate and dissolved fractions. Reconstructions of past Nd isotopic variability may therefore provide evidence on temporal changes in continental weathering inputs and/or ocean circulation patterns over a range of timescales. However, such an approach is limited by uncertainty in the mechanisms and importance of the boundary exchange process, and the challenge in reliably recovering past seawater Nd isotopic composition (εNd) from deep sea sediments. This study addresses these questions by investigating the processes involved in particulate–solution interactions and their impact on Nd isotopes. A better understanding of boundary exchange also has wider implications for the oceanic cycling and budgets of other particle-reactive elements. Sequential acid-reductive leaching experiments at pH ∼2–5 on deep sea sediments from the western Indian Ocean enable us to investigate natural boundary exchange processes over a timescale appropriate to laboratory experiments. We provide evidence that both the dissolution of solid phases and exchange processes influence the εNd of leachates, which suggests that both processes may contribute to boundary exchange. We use major element and rare earth element (REE) data to investigate the pools of Nd that are accessed and demonstrate that sediment leachate εNd values cannot always be explained by admixture between an authigenic component and the bulk detrital component. For example, in core WIND 24B, acid-reductive leaching generates εNd values between −11 and −6 as a function of solution/solid ratios and leaching times, whereas the authigenic components have εNd ≈ −11 and the bulk detrital component has εNd ≈ −15. We infer that leaching in the Mascarene Basin accesses authigenic components and a minor radiogenic volcanic component that is more reactive than Madagascan-derived clays. The preferential mobilisation of such a minor component demonstrates that the Nd released by boundary exchange could often have a significantly different εNd composition than the bulk detrital sediment. These experiments further demonstrate certain limitations on the use of acid-reductive leaching to extract the εNd composition of the authigenic fraction of bulk deep sea sediments. For example, the detrital component may contain a reactive fraction which is also acid-extractible, while the incongruent nature of this dissolution suggests that it is often inappropriate to use the bulk detrital sediment elemental chemistry and/or εNd composition when assessing possible detrital contamination of leachates. Based on the highly systematic controls observed, and evidence from REE patterns on the phases extracted, we suggest two approaches that lead to the most reliable extraction of the authigenic εNd component and good agreement with foraminiferal-based approaches; either (i) leaching of sediments without a prior decarbonation step, or (ii) the use of short leaching times and low solution/solid ratios throughout

Stroke Induces Prolonged Changes in Lipid Metabolism, the Liver and Body Composition in Mice

Acknowledgements We would like to thank the Biological Services Facility at the University of Manchester for expert animal husbandry and Karen Davies who helped with the MRI. The Histology Facility equipment that was used in this study was purchased by the University of Manchester Strategic Fund. Special thanks goes to Peter Walker for their help with the histology. Funding information This work was supported by the Kohn Foundation, an Edward Bonham Carter Doctoral Scholarship, an EPSRC/MRC Centre for Doctoral Training in Regenerative Medicine studentship grant (EP/L014904/1), and the Medical Research Council (MR/K501311/1).Peer reviewedPublisher PD

Radiation testing of electronics for the CMS endcap muon system

The electronics used in the data readout and triggering system for the Compact Muon Solenoid (CMS) experiment at the Large Hadron Collider (LHC) particle accelerator at CERN are exposed to high radiation levels. This radiation can cause permanent damage to the electronic circuitry, as well as temporary effects such as data corruption induced by Single Event Upsets. Once the High Luminosity LHC (HL-LHC) accelerator upgrades are completed it will have five times higher instantaneous luminosity than LHC, allowing for detection of rare physics processes, new particles and interactions. Tests have been performed to determine the effects of radiation on the electronic components to be used for the Endcap Muon electronics project currently being designed for installation in the CMS experiment in 2013. During these tests the digital components on the test boards were operating with active data readout while being irradiated with 55 MeV protons. In reactor tests, components were exposed to 30 years equivalent levels of neutron radiation expected at the HL-LHC. The highest total ionizing dose (TID) for the muon system is expected at the innermost portion of the CMS detector, with 8900 rad over 10 years. Our results show that Commercial Off-The-Shelf (COTS) components selected for the new electronics will operate reliably in the CMS radiation environment.Physic