Development of the Occupational Performance Inventory of Sexuality and Intimacy (OPISI): Phase One

Background: The occupational therapy profession needs a framework to guide understanding of the occupational nature of sexuality and intimacy, assessment, intervention design, and measurement of outcomes. This study aimed to define the occupational nature of sexuality and intimacy and develop a theoretical and occupation-based screen, in-depth self-assessment, and performance measure. Method: The Occupational Performance Inventory of Sexuality and Intimacy (OPISI) was developed following DeVellis’s (2017) guidelines for scale development that involved mapping the construct, generating an item pool, determining the format for measurement, and reviewing the initial item pool. Results: The Occupational Therapy Sexual Assessment Framework (OTSAF) was developed to define the occupational nature of sexuality and intimacy, depict how the theoretical constructs intertwine with the domain of occupational therapy, and guide scale development. The OPISI includes a self-screen, in-depth self-assessment, and an individualized measure to establish baseline performance and detect self-perceived change in ability, satisfaction, understanding, and confidence in skills and ability to improve occupational performance associated with sexuality and intimacy over time. Conclusion: The OTSAF defines the occupational nature of sexuality and intimacy and informs the occupational therapy scope of practice. The OPISI includes theoretical and occupation-based tools to adequately screen, assess, and measure performance related to the complex occupational nature of sexuality and intimacy. Formal validation is needed prior to releasing the OPISI for clinical use

Supporting Healthy Lifestyles of Liver Transplant Candidates and Recipients

Background: Currently, liver transplant (LTx) recipients do not receive occupational therapy services post discharge. Literature addresses post-LTx issues, many within the scope of occupational therapy practice including physical quality of life (sleep, pain, mobility, sexual functioning, nutrition, physical fatigue and physical activity), physiological quality of life (anxiety and depression, self-image, coping style, fear of graft rejection, noncompliance, and physiological fatigue), and role return. Therefore, implementing an occupational therapy intervention addressing common post-LTx issues could facilitate return to valued roles and occupations. Purpose: The purpose of this study is to examine the feasibility of an educational and supportive intervention to assist LTx recipients in return to valued roles and daily activities. Method: Evaluation of a program based on translation of data from a longitudinal recovery study. The basis of evaluation was a patient satisfaction survey from session content and environment. The goal was to assess feasibility of our occupational therapist led post-LTx intervention program. Results: Based on survey results from the Spring-Fall 2013 education sessions, 100% of responses would recommend the sessions for others, and the average numerical response for “how helpful did you find the manual” was 3.44 (Likert scale 1-4 with 4 being very helpful). When asked what would you improve, responses ranged from "being more structured" to "increasing the number of participants”. Results following program modification showed 100% of participants would recommended the session for others, and 100% found the location and time of sessions convenient. The average response for “how helpful did you find the manual” was 3.38, with 54% of participants finding the manual very helpful. Implications for Practice: This research contributes evidence for the content of an educational intervention post -LTx. Our research identified benefits of the program and improvements to maximize participant satisfaction. This study highlights the need for occupational therapy interventions and patient education post-LTx

Le climat futur des régions méditerranéennes françaises : quelles tendances ? -

La forte sensibilité climatique de la région méditerranéenne, notamment celle des espaces forestiers, nécessite une meilleure prise en compte des projections climatiques pour le siècle à venir. Pour ce faire, l'information climatique mise à disposition doit être à haute résolution spatiale. D'une part pour prendre en compte de manière plus réaliste que les simulations globales, les contraintes et processus physiques d'échelle fine. Et, d'autre part, pour permettre à certaines communautés d'alimenter des modèles d'impacts par des variables atmosphériques scalairement cohérentes. Les méthodes de régionalisation statistiques et dynamiques sont les deux grandes approches méthodologiques permettant de produire une information climatique régionalisée, allant de 50 à 8 km de résolution horizontale en fonction de la méthode et de la région prise en compte. Les résultats de ces méthodes obtenues par la communauté climatique française mettent en évidence pour la fin de siècle une augmentation (diminution) des températures (précipitations) en été. En hiver une incertitude persiste sur l'amplitude du réchauffement, alors qu'aucune tendance sur les précipitations ne se dégage

Examining the Effects of an Outpatient Palliative Care Consultation on Symptom Burden, Depression, and Quality of Life in Patients With Symptomatic Heart Failure

BACKGROUND: We conducted this prospective comparative study to examine the feasibility and effectiveness of a palliative care consultation along with standard heart failure care in an outpatient setting regarding symptom burden, depression, and quality of life (QOL). METHODS AND RESULTS: Thirty-six patients (53.6 ± 8.3 years old) were referred for an outpatient palliative care consultation after discharge. Changes in symptom burden, depression, and QOL at 3 months were compared with 36 patients with symptomatic heart failure matched on age, sex, race, and New York Heart Association functional class. Improvements were observed in symptom burden, depression, and QOL in both groups over time (all P <.005), but were more pronounced in patients receiving a palliative care consultation (all P <.035). CONCLUSIONS: A palliative care consultation may reduce symptom burden and depression and enhance QOL in patients with symptomatic heart failure. Larger-scale randomized controlled trials sufficiently powered to assess clinical outcomes are warranted to determine the efficacy of palliative care services in outpatient settings regarding symptom distress, depression, and QOL in patients with symptomatic heart failure

Synchronous computer-mediated team-based learning in the Spanish foreign language classroom

textThis study presents an Activity Theoretical (Cole 1996; Engeström 1987) examination of team-based computer-mediated communication (CMC) in Spanish. The use of team “chat” activities, where the teacher is absent, provided socially-based opportunities for language practice and afforded social support for learners throughout the semester. The team chats created opportunities for social interaction that encouraged learners to bridge the gap between what they could do alone and what they could accomplish collaboratively with others, thus promoting the emergence of a Zone of Proximal Development (Vygotsky 1962). This study analyzed the quantity of speech and the quantity and type of speech actions produced by the learners. The chats were characterized by equal participation. The absence of the teacher in the chats encouraged learners to take on teacher roles and to divide the labor in order to construct knowledge collaboratively. Generally, two learners in each team were found to assume teacher roles. They produced higher percentages of discussion maintenance actions, on-topic moves, and elicits, and offered more linguistic support and scaffolding than their teammates. Learners overall tended to avoid the L1 and they produced high percentages of socializing actions, suggesting that the team- based chats generally fostered team solidarity. In interviews, learners confirmed that teams provided emotional as well as linguistic support and noted increased confidence and proficiency in Spanish, citing the team-chats as the cause. Although the chats were characterized by intense social interaction, negotiation routines rarely occurred. Some evidence, however, of the incorporation of pragmatic, lexical and grammatical features was found, in addition to a unique form of negotiation, which evolved as a result of the collaborative team effort. This collaboration pushed learners to focus on form and to “output” (Swain 1995), perhaps causing interlanguage modification. Although AT offers a valuable descriptive tool for the contextualized examination of language use in the chats, the fact that it does not make any predictions for language learning illustrates its limitations for an examination of language acquisition. This study proposes that AT be combined with a more predictive framework, such as the Pushed-Output Hypothesis (Swain 1995) to provide a more productive and fruitful examination of team-based language use and acquisition.Spanish and Portugues

Bleeding Green: On the Socioeconomic Polity of Women's Healthcare

In March of 2017, House Republicans shook the nation by proposing the American Health Care Act (AHCA) as a supposed alternative to President Obama’s highly controversial Affordable Care Act (ACA). Citing Obamacare as a costly, restrictive program, House Republicans fought against the majority of its central aims, many of which had proven beneficial to American women. While Obamacare expanded women’s coverage through Medicaid, Planned Parenthood, and “essential health mandates” the AHCA withdrew federal funding from such programs while eliminating the requirements that guaranteed women’s access to basic primary, preventative, and reproductive care (including maternity and newborn care). Though the AHCA was ultimately pulled before being put to the vote, its implications still reverberate throughout the nation: women are scared for their rights and scared for a future in which their health care needs are ignored. The unfortunate reality, however, is that the AHCA is not novel in its marginalization of women and their needs. By examining history, we can see that modern events are merely an extension of underlying issues that persist within an inherently exploitive framework. With modern issues in mind, this paper interests itself in three primary endeavors: discerning the factors that continuously undermine women’s relationship with the system, examining the failure of efforts to address these factors, and suggesting ways to remedy these issues going forwards. By mapping women’s healthcare over time and with both social and financial lenses, I will demonstrate that our nation needs to reform its ideological attitudes before undertaking procedural and structural reforms.Englis

La composition de la CJUE

La Cour de justice de l 'Union européenne (CJUE) est l ’ instance juridique suprême de l 'Union européenne. Elle joue un rôle décisif pour le développement et le respect du droit européen à travers la mission qui lui a été confiée , mission qui consiste à «assurer le respect du droit dans l 'interprétation et l’application des Traités ». Comme toutes les juridictions , la Cour de justice de l’Union européenne ne peut échapper à l’exigence inéluctable d’un tribunal indépendant et impartial, dictée par le droit à un procès équitable. Notre investigation a donc pour objet d’esquisser une «bonne » composition pour une «bonne » justice. La composition de la Cour de justice de l ’Union européenne garantit-elle le droit à un procès équitable ? Pour y répondre, nous aborderons en premier lieu le droit à un juge compétent. Puis nous évoquerons en second lieu le droit à un juge indépendant et impartial.Lemond Sophie. La composition de la CJUE. In: Revue juridique de l'Ouest, 2017-3. pp. 97-109

A Critical Evaluation of Eight Series of Music Books for Grades Four, Five and Six

This study is an evaluation of individual music textbooks from eight series for grades four, five, and six, by a definite criterion basis. It seems very worthwhile to have an evaluation of such books: (a) to aid in the wise selection of music books, and (b) to become familiar with the contributions of each series