Occupational therapy for children with severe cerebral palsy in government healthcare facilities in the Western Cape: an overview of current services

Background: There is a high worldwide prevalence of cerebral palsy, a neurological condition which impacts most areas of life of children and their families. Evidence shows that occupational therapy is effective in enhancing the child's function, participation and quality of life, especially when provided at a young age and with high intensity. Literature provides additional recommendations for occupational therapy to follow a holistic and family-centred approach, considering participation in context, rather than an individual medical focus. These notions place pressure on the strained South African healthcare system, where human and physical resources, as well as contextually-relevant evidence for practice, are limited. The aim of this research was, therefore, to obtain a baseline description of the occupational therapy services being provided to children with severe cerebral palsy, across all government healthcare facilities of the Western Cape province. Methods: A quantitative, cross-sectional descriptive study was conducted, using a selfdesigned questionnaire. The questionnaire was developed using recognised survey principles in order to maintain research rigour, reliability and validity of results, and guidelines from previousstudies of a similar nature. The questionnaire was available to participants in duplicate online and hard copy formats. The anonymous, self-report questionnaire obtained profiles of the participating occupational therapists and their departments, descriptions of current service provision (assessments, goal-setting and interventions), perceived factors influencing service selection, and an understanding of services therapists felt they should be providing more of. No sampling took place and responses were invited from all occupational therapists employed by the provincial health department. All recruitment and correspondence took place via email or telephone. Recruitment and data collection took place over a period of 16 weeks, with each participant having a maximum of two weeks to submit their responses, after which a maximum of three reminders were sent. Numerical data were analysed using non-parametric descriptive statistics and categorical data were presented in terms of frequencies and percentages. Ethical principles adhered to included respect, confidentiality, anonymity, beneficence, non-maleficence and justice. Results: There was a response rate of 53%, with all provincial health districts and levels of care represented amongst participants. Assessments frequently involved observations of the child in activities(85%) and interviews with their caregiver (98%). Goals formulated, with some input of caregivers, related to occupational performance components (91%) more often than occupational performance (77%), and largely aimed to maintain the child's condition (68%), rather than improve development or functional participation (47%). A range of interventions were provided, but appointments were infrequent (median: 1 per month), mainly took place in clinical environments (100%), and waiting periods for assistive devices and orthotics were common. Opportunities for direct therapy and interventions in the child's daily context were limited, and home programmes and caregiver education were heavily relied upon indirect intervention methods, frequently implemented by 100% and 91% of participants respectively. Key factors influencing the selection of services included resource availability (62%), therapists' training (62%) and the level of care at which they worked (59%). Therapists felt they were meeting some of the children's needs, and required the support of the multidisciplinary team to meet more of their needs effectively. Conclusion: This study provides insight into occupational therapists' roles in the government healthcare sector in the Western Cape province, and highlights the degree of alignment of services with policy and elements of best practice. Some merits are clear, in terms of the combination of direct and indirect services provided and the involvement of families in therapy processes. However, there remains a shortfall in terms of effective holistic, evidence-based, family-centred, and early and intensive approaches. This study, therefore prompts revision of strategies to implement existing policies promoting quality services for people with disabilities and align occupational therapists' training with evidence-based practice and holistic frameworks and approaches. Further research is recommended, particularly a qualitative consideration of the contextual factors influencing service provision, in order to better understand and address the barriers to meaningful and effective services for this population within the context of Primary Healthcare. With these recommendations, quality service provision, leading to participation and quality of life outcomes for children with severe cerebral palsy and their families, may be enhanced

Quantification of Neurite Degeneration through use of an Optimized and Automated Method

Neurite degeneration is a cellular dysfunction commonly associated with neurodegenerative pathologies such as Alzheimer’s disease and Parkinson’s disease (PD). One common method of scoring neurite degeneration in micrographs involves calculation of a degeneration index (DI) using neurite fragment measurements obtained via the particle analyzer plugin of FIJI software. However, this method can be time consuming and subject to inaccuracies related to inadequate contrast. Here we describe a modified method for performing DI measurements with enhanced efficiency, accessibility, and accuracy compared to existing techniques. We developed a macro to automate the analysis process, enabling rapid and objective measurements of multiple images. We have also increased the accuracy of measurements by modifying selection criteria for neurite fragments, as well as by determining optimal procedures for contrast enhancement and removal of non-neurite materials from images. Moreover, we demonstrate how this method may be applied to measure neurite degeneration in an in vitro model of PD. To model neurite degeneration associated with PD, we treated Lund Human Mesencephalic (LUHMES) cells with 4-hydroxynonenal or 6-hydroxydopamine, compounds that induce oxidative stress. We describe culture methods, cell densities, and drug concentrations that yield consistent and accurate measurements of neurite degeneration, and we demonstrate use of our optimized method in an experiment assessing the effects of c-Jun N-terminal Kinase (JNK) on neurite degeneration. Since neurite degeneration is a key, early-stage event associated with PD, this optimized and automated method may be used to gain novel insights into molecular interactions underlying PD progression

Description and alleviation of the stress response in Atlantic sharpnose sharks (rhizoprionodon terraenovae), white-spotted bamboo sharks (chiloscyllium plagiosum), and golden shiners (notemigonus crysoleucas)

Sharks are an essential component of many marine ecosystems; however they have experienced population declines mainly attributed to overfishing and capture of sharks as bycatch. Despite sharks often being released when captured as bycatch the act of capture can result in a stress response which may cause severe physiological perturbations. Studies have investigated the physiological impacts of capture stress on elasmobranchs but most have primarily focused on the secondary stress response. I conducted a series of studies to further describe the primary stress response through quantification of adrenocorticotropic hormone (ACTH) while also investigating methods such as sedation and limiting air exposure to reduce the magnitude of the stress response to capture. Results implicated ACTH as a reliable indicator of the primary stress response in elasmobranchs which I suggest as an additional measurement to go along with the suite of physiological stress indicators that are commonly measured in elasmobranchs. I also demonstrated the severe effect of air exposure on elasmobranch physiology and suggest that fishers limit sharks to no more than five minutes of air exposure during catch-and-release fishing. Lastly I show the potential of iso-eugenol sedation at reducing levels of stress indicators. These studies have combined the disciplines of conservation and physiology in an effort to provide methods and results that can be utilized in conservation management of shark populations

The Effects Of Leisure Satisfaction And Perfectionism On Academic Burnout

The present study examined the impact of three variables on academic burnout: perfectionism, depression, and leisure satisfaction. Participants included male and female college students enrolled in a four year university in the Midwest. Participants completed a variety of demographic questions and surveys through an internet survey on Survey Gizmo. The Almost Perfect Scale Revised was used to assess an individual\u27s perfectionism, The Patient Health Questionnaire 2 measured depression, The Leisure Satisfaction Scale Short Form was included to measure students\u27 leisure satisfaction, and the Maslach Burnout Inventory Student measured academic burnout. The study found that perfectionism and depression were significant predictors of burnout, while leisure satisfaction was only a significant predictor for the burnout variable of efficacy. Also, perfectionism did not moderate the relationship between leisure satisfaction and burnout. This study provides important information for counselors at university counseling centers who wish to design effective interventions for combating academic burnout in college students

Resilience and tree health: a basis for implementation in sustainable forest management

Resilience is rapidly becoming a prominent concept in research, policy and practice. However, it is apparent that there is no consistent meaning of resilience being used by those involved in governing and managing forests and tree health. We aimed to (1) identify how the concept of resilience is defined in a range of decision-making contexts, (2) develop an understanding of resilience, which will be useful in the context of tree health and forestry and (3) suggest how managers could use this understanding more broadly as a framework for decision-making on resilience within the forestry sector. Implementation of resilience for tree health needs to encompass a range of functions and services, management objectives and threats, all present at a variety of scales. We conclude that, due to the complexity of the resilience concept and forest systems, no single definition of resilience can be sufficient and it is more appropriate to explicitly consider four resilience components: resistance, recovery, transformation and adaptation. We propose a set of decision steps which stakeholders can use to develop a Resilience Implementation Framework to guide management for their system of interest

Assessment of protected area coverage of threatened ground beetles (Coleoptera: Carabidae): a new analysis for New Zealand

Gap analysis is a tool that allows conservationists to quantify the effectiveness of protected areas at representing species diversity, but the lack of distribution maps for invertebrates has precluded its application to the world’s most diverse animal groups. Here, we overcome this limitation and conduct a gap analysis, using niche modelling, on the Pterostichini (Coleoptera: Carabidae) of New Zealand, one of the most diverse and most threatened tribes of ground beetles in the nation. Niche modelling uses data on abiotic parameters to model predicted species ranges based on records of their known distribution, and is a useful tool for conservation planning. This method is widely applicable where there is good taxonomical knowledge of the group in question and distribution records are available. We obtained sample localities from museum records for 67 species of Pterostichini, including 10 species listed as threatened, and modelled their spatial distributions based on climate, landforms and soil properties. Most species had small spatial distributions, with 48–75% of species having ranges of less than 100 000 ha. We found the areas with highest species richness fell largely outside of the protected area network, as did the distribution of most individual species, with just 20–25% of species having more than 30% of their range falling within a protected area. In terms of percent land area, New Zealand has one of the world’s largest protected area networks, but the spatial distribution of that network affords little protection to this group of invertebrates. This analysis provides support for the creation of new reserves to increase the value and efficacy of the protected areas network

Plasticity or local adaptation?: Survival of L. parva larvae in varying salinity

As environmental stressors continue to amplify, Lucania parva, or Rainwater Killifish, are expected to outlast other species in unpredictably fast changing environments, as they are unique in their ability to tolerate multiple salinities. The objective of this research is to understand what affects L. parva’s ability to tolerate salinity and discover the limitations the species might have to tolerating it. Understanding this fish’s biology will help with the conservation of aquatic ecosystems in Florida. Preliminary data and early trends suggest that during early larval stages, L. parva are plastic but the extent of their plasticity is limited as they cannot survive as well in extreme salinities

Invertebrate diversity in Irish and British forests

Ireland and Britain were once covered in natural forest, but extensive anthropogenic deforestation reduced forest cover to less than 1% and 5 %, respectively, by the beginning of the 20th century. Large-scale afforestation has since increased the level of forest cover to 11% in Ireland and 12% in Britain, with the majority of planted forests comprising small monoculture plantations, many of which are of non - native conifer tree species. At present the forest cover of Ireland and Britain generally consists of small areas of remnant semi-natural woodland and pockets of these plantation forests within a predominantly agricultural landscape. Invertebrates comprise a large proportion of the biodiversity found within forested habitats. In particular, spiders and carabid beetles play an important role in food webs as both predators and prey and respond to small-scale changes in habitat structure, meaning they are particularly sensitive to forest management. Hoverflies play an important role in control and pollination and have been successfully used as indicators of habitat disturbance and quality. This research addressed a number of topics pertinent to the forest types present in the contemporary Irish and British landscapes and aimed to investigate the invertebrate diversity of these forests. Spiders and carabid beetles were sampled using pitfall trapping and hoverflies were sampled using Malaise net trapping. Topics included the impacts of afforestation, the importance of open space, the choice of tree species, and the use of indicators for biodiversity assessment, as well as rare native woodlands and the effect of grazing on invertebrate diversity. The results are discussed and evidence-based recommendations are made for forest policy and management to protect and enhance invertebrate biodiversity in order to promote sustainable forest management in Ireland and Britain

Pop-Up Library

Lane Library held a Pop-Up Library outside The Galley entrance on February 27, 2018. Books and DVDs were available to check out, and librarians provided answers to questions as well as outreach to inform the campus of library services