Occupational Therapy\u27s Role in Matching Handlers and Assistance Dogs with Occupational Needs

In the past two decades, there has been an increase in the use of assistance dogs to improve health, function, and companionship (Walther et al., 2017). Although assistance dogs offer a variety of benefits for individuals with different needs, matching a person with a suitable dog is not always successful the first time. Optimal matches can be achieved by adding occupational therapy to strengthen the evaluation process. The two major purposes of this project were: 1) to observe and assess the current matching process of assistance dog programs and 2) identifying occupational therapy’s role in aiding the evaluation process. This project included three assistance dog programs in California: Guide Dogs for the Blind (GDB), Canine Companions for Independence (CCI), and Canine Support Teams, Incorporated (CST). A total of 25 participants were recruited for interviews from early February to late March 2020. Interview questions were closed and open-ended, examining the participant’s life (routines and tasks associated with new occupations), their need for an assistance dog, tasks in which the dogs will aid, disability (if comfortable), need for additional support, costs of obtaining/maintaining a dog, adaptive tools needed, and home environment. Three themes were identified: routines, tasks associated with new occupations, and physical environment (successor versus the first-time handler). Several key findings from this project revealed a need for occupational therapy within the evaluation process and two-week team training. Although participants subsequently continued with successful matches, enhancing the programs could increase the quality of life and ease of information attainment for participants. Doing so will help clients overcome barriers before, during, and after the placement process (Winkle et al., 2012)

Amiodarone-Induced Pulmonary Toxicity - A Frequently Missed Complication.

IntroductionAmiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5-15% and is correlated to dosage, age of the patient, and preexisting lung disease.DescriptionA 56-year-old male with a past medical history of coronary artery disease and chronic obstructive pulmonary disease was admitted for a coronary artery bypass graft. Post-operatively, the patient was admitted to the ICU for ventilator management and continued to receive his home dose of amiodarone 400 mg orally twice daily, which he had been taking for the past 3 months. The patient was found to be hypoxemic with a PaO2 52 mmHg and bilateral infiltrates on chest x-ray. Patient also complained of new onset dyspnea. Physical exam found bilateral rhonchi with bibasilar crackles and subcutaneous emphysema along the left anterior chest wall. Daily chest x-rays showed worsening of bilateral interstitial infiltrates and pleural effusions. A chest high-resolution computed tomography on post-operative day 3 showed extensive and severe bilateral ground glass opacities. APT was suspected and amiodarone was discontinued. A course of oral prednisone without antibiotics was initiated, and after one week of treatment the chest film cleared, the PaO2 value normalized and dyspnea resolved.DiscussionAPT occurs via cytotoxic T cells and indirectly by immunological reaction. Typically the lungs manifest a diffuse interstitial pneumonitis with varying degrees of fibrosis. Infiltrates with a 'ground-glass' appearance appreciated on HRCT are more definitive than chest x-ray. Pulmonary nodules can be seen, frequently in the upper lobes. These are postulated to be accumulations of amiodarone in areas of previous inflammation. Those undergoing major cardiothoracic surgery are known to be predisposed to APT. Some elements require consideration: a baseline pulmonary function test (PFT) did not exist prior. APT would manifest a restrictive pattern of PFTs. In APT diffusing capacity (DLCO) is generally >20 percent from baseline. A DLCO was not done in this patient. Therefore, not every type of interstitial lung disease could be ruled out. Key features support a clinical diagnosis: (1) new dyspnea, (2) exclusion of lung infection, (3) exclusion of heart failure, (4) new radiographic features, (5) improvement with withdrawal of amiodarone. Our case illustrates consideration of APT in patients who have extensive use of amiodarone and new onset dyspnea

Quantitative analysis, distributional pattern and species diversity of woody plant species of Lamberi Forest Range, Rajouri, J&K, India

Quantitative analysis, distributional pattern and species diversity of woody plant species of Lamberi Range of Rajouri Forest division, J&K, has been carried out by laying 50 quadrats (10m X 10m size) for trees and 100 quadrats (5m X 5m size) for shrubs. Various phytosociological parameters like frequency, density, abundance, importance value index IVI and diversity indices for trees and shrubs has been used to reveal the plant community structure of the area. The abundance to frequency ratio (A/F) for different species was determined to assess the distribution pattern of the species (regular <0.025, random 0.025-0.05 and contagious >0.05) which indicated the contagious distribution for all the species. Survey of the area revealed presence of 63 woody plant species from the study area comprising of 43 trees and 20 shrubs. Pinus roxburghii (IVI 49.7, Abundance 81.1) and Carissa opaca (IVI 81.12 abundance 7.05) have been recorded as the dominant tree and shrub, respectively, of the area. The computation of diversity indices showed that species richness and evenness i.e Shannon- Weiner’s, Margalef’s and Menhinick’s remained high for trees and low for shrubs. Simpson’s index of dominance was also high for trees. Species which needs priorities for conservation and protection and also required to be monitored have also been highlighted

A novel secure routing scheme using probabilistic modelling for better resistivity against lethal attacks

Study towards Wireless Adhoc Network dates two decades back with various researchers evolving up with new solutions towards addressing its problems. Irrespective of various other problems, the issues related to the secure routing is yet unsolved owing to massively increasing fatal strategies of the adversary. Review of existing literature shows that the existing secure routing scheme can only govern over the stated attacks reducing the applicability in case of dynamic attacks. Therefore, this manuscript introduces a novel probabilistic model which offers the capability to wireless nodes to identify the malicious behavior and react accordingly. Different from existing intrusion prevention system, the proposed system allows the malicious node to participate in the data forwarding process and exhaust its resources with no chance of launching an attack. The simulated outcome of the study shows that the proposed secure routing scheme offers better data forwarding characteristic in contrast to the existing system in the aspect of intrusion detection and secure data transmission