First Year Occupational Therapy Students’ Clinical Reasoning Approach to Addressing Challenging Behaviors Related to Sensory Processing Using a Simulated Case Study

Occupational therapy students must be prepared to use clinical reasoning to select appropriate interventions for children with sensory processing disorders (SPDs). Although these interventions are typically taught in entry-level occupational therapy programs, there is little information regarding the method by which occupational therapy students are taught a clinical reasoning process to determine which sensory processing intervention to use with pediatric clients. A problem-solving framework called A SECRET was used to teach students clinical reasoning for children with SPDs, via an online, module-based course. Following the module, the students were tested with an online assessment tool regarding their ability to discriminate between appropriate and inappropriate intervention strategies, and to articulate their rationale to demonstrate how they clinically reasoned through a complex client case. Eight students participated in a focus group to provide their perceptions of the online delivery of the content and the A SECRET reasoning process. Five descriptive representations emerged from the qualitative data analysis: the A SECRET Process, Self-Regulation, the Occupational Therapy Practice Framework, Participation, and Safety/Security. The findings suggest an inherent value for online learning to assist occupational therapy students in their program’s first year to learn the A SECRET process and then clinically reason through a simulated case study

Early childhood chronic illness: comparability of maternal reports and medical records

[Jane E. Miller, Dorothy Gaboda, and Diane Davis].Also available via the World Wide Web.Includes bibliographical references (p. 9-10)

Highly productive polar forests from the Permian of Antarctica

Two stratigraphically closely spaced bedding planes exposed at Lamping Peak in the Upper Buckley Formation, Beardmore Glacier area, Antarctica contain abundant in situ stumps (n=53, n=21) and other plant fossils that allow reconstruction of forest structure and biomass of Glossopteris forests that thrived at ~ 75o S paleolatitude in the Permian. Mean trunk diameter is 14 and 25 cm, corresponding to estimated mean maximum heights of 12 and 19 m. Basal areas are 65 and 80 m2ha- 1. The above ground biomass was calculated using allometric equations for Ginkgo biloba, yielding biomasses of 147 and 178 Mg ha- 1. Biomass estimates based on comparison with biomass of modern forests with equivalent basal areas are higher (225 – 400 Mg ha- 1). The amount of above ground biomass added each year (Annual Net Primary Productivity), based on biomass estimates and growth rings in silicified plant material from the Buckley Formation nearby, is poorly constrained, ranging from ~ 100 – 2000 g m- 2 yr- 1. Compared to modern forests at all latitudes, the Permian forests have high basal areas and high biomass, exceeded in both only by forests of the U.S. Pacific northwest and Sequoia forests. The estimated range of productivity (ANPP) is within that of many very productive modern forests. The Lamping Peak forests’ basal areas and calculated biomass are also larger than younger high paleolatitude fossil forests except for Arctic Cenozoic forests. Presence of these highly productive fossil forests at high paleolatitude is consistent with hothouse conditions during the Late Permian, prior to the eruption of the Siberian flood basalts

Hydrogeology and Geochemistry of Glacial Deposits in Northeastern Kansas

Twelve counties (Atchison, Brown, Doniphan, Douglas, Jackson, Jefferson, Johnson, Leavenworth, Nemaha, Shawnee, Wabaunsee, and Wyandotte) in northeastern Kansas were glaciated during the Pleistocene Epoch. The glacial deposits consist of till, fluvial, loess, and lacustrine deposits locally totalling thicknesses of 400 ft (120 m). A major buried valley 3 mi (5 km) wide, 400 ft (120 m) deep, and 75 mi (120 km) long trends eastward across southern Nemaha, northern Jackson, and central Atchison counties. Several smaller tributary valleys can be identified in Atchison, Nemaha, Brown, Jackson, and Jefferson counties. Other buried valleys generally trend southward to the Kansas River valley or northward into Nebraska and Missouri. The glacial deposits filling the buried valleys locally are clayey. However, most valleys contain at least some water-bearing sand and gravel. Wells drilled into the best water-bearing sand and gravel deposits may yield as much as 900 gallons per minute (gpm; 0.06 m3/sm3/s), but less than 500 gpm (0.03 m3/s) is more common. The alluvial deposits of the Kansas and Missouri river valleys are the major sources of ground water in northeastern Kansas. Wells in these aquifers may have yields of 5,000 gpm (0.3 m3/s), but yields are more commonly less than 3,000 gpm (0.2 m3/s). We analyzed data from 80 pump tests using computer programs to find the best fit for transmissivity (1) and storage (S) values on glacial, alluvial, and bedrock aquifers. Transmissivities in the Missouri River valley alluvium ranged from 200,000 gallons per day per foot (gpd/ft) to 600,000 gpd/ft (2,000-7,000 m2/d), and storage values were between 0.001 and 0.0004. Tests in the Kansas River valley alluvium indicated transmissivities in the range 50,000-600,000 gpd/ft (600-7,000 m2/d) and storage values of 0.03. In the main buried valley across northeastern Kansas, the glacial deposits had T and S values of 2,500-25,600 gpd/ft (31.0-318 m2/d) and 0.00002-0.002, respectively. In the smaller buried valleys the glacial deposits had T values ranging from 1,500 gpd/ft to 100,000 gpd/ft (19-1,200 m2/d). Because of increasing population size in northeastern Kansas, appropriations of water for public and industrial water supplies have been increasing. Most of the pumpage comes from wells in the Kansas and Missouri river valleys. However, in 1981 the Division of Water Resources reported allocations of 1,466 acre-ft of water from wells tapping glacial aquifers associated with the main buried channel across Nemaha, Jackson, and Atchison counties and an additional 837 acre-ft from tributaries associated with the main buried channel. Nemaha County has the largest appropriation of water from the glacial aquifer (1,549 acre-ft/yr in 1983), and Wyandotte County has the largest appropriation of water from the alluvial aquifers (54,250 acre-ft/yr in 1983). Shawnee County has the largest number of ground-water appropriation rights (217). In 1981, for the 12-county study area, the Division of Water Resources found that 773 wells have ground-water appropriation rights. These 773 wells have appropriation rights for 140,484 acre-ft of water from alluvial aquifers, 5,290 acre-ft from glacial aquifers, and 2,146 acre-ft from Pennsylvanian and Permian rock aquifers. Maps for each county show the depth to bedrock, total thickness of Pleistocene sand and gravel deposits, estimated yield of wells, depth to water in wells and test holes, and the saturated thickness of Pleistocene deposits. A bedrock topographic map for the twelve counties was prepared from outcrop data and information from more than 5,000 water well, oil and gas, and test-hole logs. Ground waters from alluvial deposits are hard calcium bicarbonate waters that may have iron concentrations of several milligrams per liter. Sand and gravel associated with the glacial deposits generally yield hard calcium bicarbonate waters and may contain appreciable amounts of iron, manganese, sulfate, and chloride locally. Nitrate concentrations above 45 mg/L are noted in a number of wells of varying depth and aquifer source

Gender-specific associations of short sleep duration with prevalent and incident hypertension : the Whitehall II Study

Sleep deprivation (5 hour per night) was associated with a higher risk of hypertension in middle-aged American adults but not among older individuals. However, the outcome was based on self-reported diagnosis of incident hypertension, and no gender-specific analyses were included. We examined cross-sectional and prospective associations of sleep duration with prevalent and incident hypertension in a cohort of 10 308 British civil servants aged 35 to 55 years at baseline (phase 1: 1985-1988). Data were gathered from phase 5 (1997-1999) and phase 7 (2003-2004). Sleep duration and other covariates were assessed at phase 5. At both examinations, hypertension was defined as blood pressure 140/90 mm Hg or regular use of antihypertensive medications. In cross-sectional analyses at phase 5 (n5766), short duration of sleep (5 hour per night) was associated with higher risk of hypertension compared with the group sleeping 7 hours, among women (odds ratio: 2.01; 95% CI: 1.13 to 3.58), independent of confounders, with an inverse linear trend across decreasing hours of sleep (P0.003). No association was detected in men. In prospective analyses (mean follow-up: 5 years), the cumulative incidence of hypertension was 20.0% (n740) among 3691 normotensive individuals at phase 5. In women, short duration of sleep was associated with a higher risk of hypertension in a reduced model (age and employment) (6 hours per night: odds ratio: 1.56 [95% CI: 1.07 to 2.27]; 5 hour per night: odds ratio: 1.94 [95% CI: 1.08 to 3.50] versus 7 hours). The associations were attenuated after accounting for cardiovascular risk factors and psychiatric comorbidities (odds ratio: 1.42 [95% CI: 0.94 to 2.16]; odds ratio: 1.31 [95% CI: 0.65 to 2.63], respectively). Sleep deprivation may produce detrimental cardiovascular effects among women. (Hypertension. 2007;50:694-701.) Key Words: sleep duration blood pressure hypertension gender differences confounders comorbiditie

Hydrogeology and Geochemistry of Glacial Deposits in Northeastern Kansas

Twelve counties (Atchison, Brown, Doniphan, Douglas, Jackson, Jefferson, Johnson, Leavenworth, Nemaha, Shawnee, Wabaunsee, and Wyandotte) in northeastern Kansas were glaciated during the Pleistocene Epoch. The glacial deposits consist of till, fluvial, loess, and lacustrine deposits locally totalling thicknesses of 400 ft (120 m). A major buried valley 3 mi (5 km) wide, 400 ft (120 m) deep, and 75 mi (120 km) long trends eastward across southern Nemaha, northern Jackson, and central Atchison counties. Several smaller tributary valleys can be identified in Atchison, Nemaha, Brown, Jackson, and Jefferson counties. Other buried valleys generally trend southward to the Kansas River valley or northward into Nebraska and Missouri. The glacial deposits filling the buried valleys locally are clayey. However, most valleys contain at least some water-bearing sand and gravel. Wells drilled into the best water-bearing sand and gravel deposits may yield as much as 900 gallons per minute (gpm; 0.06 m3/sm3/s), but less than 500 gpm (0.03 m3/s) is more common. The alluvial deposits of the Kansas and Missouri river valleys are the major sources of ground water in northeastern Kansas. Wells in these aquifers may have yields of 5,000 gpm (0.3 m3/s), but yields are more commonly less than 3,000 gpm (0.2 m3/s). We analyzed data from 80 pump tests using computer programs to find the best fit for transmissivity (1) and storage (S) values on glacial, alluvial, and bedrock aquifers. Transmissivities in the Missouri River valley alluvium ranged from 200,000 gallons per day per foot (gpd/ft) to 600,000 gpd/ft (2,000-7,000 m2/d), and storage values were between 0.001 and 0.0004. Tests in the Kansas River valley alluvium indicated transmissivities in the range 50,000-600,000 gpd/ft (600-7,000 m2/d) and storage values of 0.03. In the main buried valley across northeastern Kansas, the glacial deposits had T and S values of 2,500-25,600 gpd/ft (31.0-318 m2/d) and 0.00002-0.002, respectively. In the smaller buried valleys the glacial deposits had T values ranging from 1,500 gpd/ft to 100,000 gpd/ft (19-1,200 m2/d). Because of increasing population size in northeastern Kansas, appropriations of water for public and industrial water supplies have been increasing. Most of the pumpage comes from wells in the Kansas and Missouri river valleys. However, in 1981 the Division of Water Resources reported allocations of 1,466 acre-ft of water from wells tapping glacial aquifers associated with the main buried channel across Nemaha, Jackson, and Atchison counties and an additional 837 acre-ft from tributaries associated with the main buried channel. Nemaha County has the largest appropriation of water from the glacial aquifer (1,549 acre-ft/yr in 1983), and Wyandotte County has the largest appropriation of water from the alluvial aquifers (54,250 acre-ft/yr in 1983). Shawnee County has the largest number of ground-water appropriation rights (217). In 1981, for the 12-county study area, the Division of Water Resources found that 773 wells have ground-water appropriation rights. These 773 wells have appropriation rights for 140,484 acre-ft of water from alluvial aquifers, 5,290 acre-ft from glacial aquifers, and 2,146 acre-ft from Pennsylvanian and Permian rock aquifers. Maps for each county show the depth to bedrock, total thickness of Pleistocene sand and gravel deposits, estimated yield of wells, depth to water in wells and test holes, and the saturated thickness of Pleistocene deposits. A bedrock topographic map for the twelve counties was prepared from outcrop data and information from more than 5,000 water well, oil and gas, and test-hole logs. Ground waters from alluvial deposits are hard calcium bicarbonate waters that may have iron concentrations of several milligrams per liter. Sand and gravel associated with the glacial deposits generally yield hard calcium bicarbonate waters and may contain appreciable amounts of iron, manganese, sulfate, and chloride locally. Nitrate concentrations above 45 mg/L are noted in a number of wells of varying depth and aquifer source

Waiting for child developmental and rehabilitation services: an overview of issues and needs

Concern about the length of time that children, young people, and families may have to wait to access assessment, diagnostic, interventional, therapeutic, and supportive child developmental and rehabilitation (CDR) services is widespread, but adequate data collection and research on this issue remain limited. We review key concepts and issues relevant to waiting for CDR services from the published literature, a national workshop devoted to this topic, and international experience. We conclude that gaps in data, evidence, and consensus challenge our ability to address the issue of waiting for CDR services in a systematic way. A program of research coupled with actions based on consensus-building is required. Research priorities include acquiring evidence of the appropriateness and effectiveness of different models of intervention and rehabilitation services, and documenting the experience and expectations of waiting families. Consensus-building processes are critical to identify, categorize, and prioritize \u27sentinel\u27 components of CDR service pathways: (1) to reduce the inherent complexity of the field; (2) to create benchmarks for waiting for these respective services; and (3) to develop definitions for wait-time subcomponents in CDR services. Collection of accurate and replicable data on wait times for CDR services can be used to document baseline realities, to monitor and improve system performance, and to conduct comparative and analytic research in the field of CDR services