INVESTIGATING THE EFFECT OF STRESS, WETTING, AND COMPACTION ON SETTLEMENT POTENTIAL OF MINE SPOILS

Strip mining in Kentucky has left large areas of land that could potentially be used for business and housing developments. However, the mine spoils underlying these areas are prone to severe differential settlement due to a variety of factors. Mine spoil from the Gateway Business Park in Jenkins, Kentucky was used for a series of laboratory tests to develop relationships between shear wave velocity, confining stress, compaction energy, and dry unit weight to develop a method to assess settlement potential. It was found that a stress-corrected shear wave velocity of greater than 275 ft/s/psi0.25 typically indicated dry mine spoil, and less than 275 ft/s/psi0.25 typically indicated wet mine spoil. Equations were developed to predict the amount of settlement of a mine spoil profile based on the load, the mine spoil lithology, and the shear wave velocity of the mine spoil. With regards to compaction, it was found that if the mine spoil was compacted to at least 120 pcf (18.8 kN/m3), or a void ratio of 0.45 or less, the mine spoil would suffer little to no volume change when wetted. The results provided herein form the basis of a methodology for screening mine spoil sites for development based on settlement potential

Home and community activities: dimensions and associations with patterns of sensory response among children with autism spectrum disorders

Activity participation is integral to the study of occupational science. Children's participation in activities provides them with learning opportunities that positively impact their development; however, children with autism spectrum disorders (ASD) experience decreased activity participation as compared to children with typical development. Among children with ASD, four sensory response patterns (hyporesponsiveness, hyperresponsiveness, sensory seeking, enhanced perception) characterize the extreme behavioral responses to the sensory elements of activities, which potentially impact the frequency of activity participation. Research has not yet investigated the home and community activities in which children with ASD participate, or examined the differential effects of sensory response patterns on activity participation. The purpose of this study was to empirically derive dimensions of home and community activities that characterized the participation of a large sample of school-aged children with ASD (n=713). This study also examined the link between the sensory response patterns and dimensions of activity participation among children with ASD, as moderated by child characteristics (i.e., chronological age, developmental age, autism severity). In order to derive dimensions of activity participation, exploratory factor analysis was utilized on a measure of children's activity participation, the Home and Community Activities Scale (HCAS; adapted from Dunst, Hamby, Trivette, Raab, & Bruder, 2002). The associations with dimensions of activity participation and children's sensory response patterns, as moderated by child characteristics, were analyzed using mixed model regression. The results suggested that a six factor model characterized the activity participation among school-aged children with ASD, and included: Parent-Child Household Activities; Community Activities; Routine Errands; Neighborhood Social Activities; Outdoor Activities; and Faith-based Activities. Hyperresponsiveness was negatively associated with each dimension of activity participation, while enhanced perception supported participation in each activity dimension. Hyporesponsiveness and sensory seeking differentially impacted activity participation based on children's chronological age. The findings have implications for an occupational science conceptualization of how activities are categorized, as well as demonstrate that the sensory response patterns among children with ASD play a key role in their home and community activity participation. Implications for occupational therapy research and future research directions are discussed

Early Intervention Service Delivery via Telehealth During COVID-19: A Research-Practice Partnership

Coaching has been identified as a best practice for early intervention (EI) services provided through the Individuals with Disabilities Education Act (IDEA) Part C. The current study describes the establishment and progress of a research-relationship partnership to deliver coaching via telehealth during the COVID-19 pandemic. Community-based EI providers implemented 9-weeks of telehealth coaching and evaluated the extent to which child and caregiver outcomes differed between families that had previously received in-person services versus telehealth only. Four EI providers completed the intervention with n=17 families of children aged 6-34 months during the pandemic (April-August 2020). We used the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) to collect outcomes on caregiver identified goals; we used Wilcoxon Signed Rank Tests to examine pre- to post-intervention data. Results showed significant improvements in parent satisfaction, child performance, and goal attainment (all p<.01). Findings suggest that telehealth coaching procedures implemented by community-based EI providers resulted in improvements in caregiver identified goals for young children

Keeping PACE With 21st Century Healthcare: A Framework for Telehealth Research, Practice, and Program Evaluation in Occupational Therapy

The use of telehealth to deliver occupational therapy services rapidly expanded during the COVID-19 pandemic. There are frameworks to evaluate services delivered through telehealth; however, none are specific to occupational therapy. Therefore, occupational therapy would benefit from a framework to systematically evaluate components of telehealth service delivery and build evidence to demonstrate the distinct value of occupational therapy.  The PACE Framework outlines four priority domains to address areas of need: (1) Population and Health Outcomes; (2) Access for All Clients; (3) Costs and Cost Effectiveness; and (4) Experiences of Clients and Occupational Therapy Practitioners. This article describes the development and expert reviewer evaluation of the PACE Framework. In addition, the PACE Framework’s domains, subdomains, and outcome measure examples are described along with future directions for implementation in occupational therapy research, practice, and program evaluation.&nbsp

Telehealth Competency Questionnaire-Consumer: Psychometric Validation of a Client-centered Measure

To effectively access telehealth services, individuals must possess certain competencies; yet, telehealth consumer focused measures are limited. The purpose of this study was to describe the development and validation of the Telehealth Competency Questionnaire – Consumer (TCQ-C). Among a sample of adults with chronic health conditions (n=134), findings showed that the TCQ-C is comprised of one factor that accounts for 66.6% of the variance, and internal consistency of subscales are good (range α = 0.80-0.87) and may be used for clinical or research purposes. The TCQ-C demonstrated moderate concurrent validity with the Telehealth Usability Questionnaire-Usability subscale (r = 0.728, p<.001), and significantly discriminates between adults >65 years and those younger as well as those with and without previous telehealth experience. The TCQ-C is a psychometrically sound instrument to evaluate baseline competencies among telehealth consumers so that education, research, and clinical practices are tailored to increase effective engagement between clients and providers

Development and Pilot of the Caregiver Strategies Inventory

Children with autism spectrum disorder often demonstrate unusual behavioral responses to sensory stimuli (i.e., sensory features). To manage everyday activities, caregivers may implement strategies to address these features during family routines. However, investigation of specific strategies used by caregivers is limited by the lack of empirically developed measures. In this study, we describe the development and pilot results of the Caregiver Strategies Inventory (CSI), a supplement to the Sensory Experiences Questionnaire Version 3.0 (SEQ 3.0; Baranek, 2009) that measures caregivers’ strategies in response to their children’s sensory features. Three conceptually derived and empirically grounded strategy types were tested: cognitive–behavioral, sensory–perceptual, and avoidance. Results indicated that the CSI demonstrated good internal consistency and that strategy use was related to child age and cognition. Moreover, parent feedback after completing the CSI supported its utility and social validity. The CSI may be used alongside the SEQ 3.0 to facilitate a family-centered approach to assessment and intervention planning

Observational Characterization of Sensory Interests, Repetitions, and Seeking Behaviors

Sensory interests, repetitions, and seeking behaviors (SIRS) are common among children with autism spectrum disorder (ASD) and other developmental disabilities (DD) and involve unusual actions that intensify or reinforce a sensory experience. Researchers and practitioners typically use parent-report measures or informal clinical observations to understand the presence and nature of SIRS. In this study, we used a scoring supplement to the Sensory Processing Assessment for Young Children, an observational measure, to characterize SIRS across three groups of children—those with ASD (n = 40), DD (n = 37), and typical development (n = 39). Group differences were identified in frequency and intensity of overall SIRS, complexity of SIRS, and incidence of particular types of SIRS (i.e., posturing, sighting, proprioceptive seeking, spinning). Facial affect was also explored and found to be primarily neutral during engagement in SIRS across groups. Implications for practice and future research are discussed

Prognostic value of National Early Warning Scores (NEWS2) and component physiology in hospitalised patients with COVID-19:a multicentre study

BACKGROUND: National Early Warning Scores (NEWS2) are used to detect all-cause deterioration. While studies have looked at NEWS2, the use of virtual consultation and remote monitoring of patients with COVID-19 mean there is a need to know which physiological observations are important. AIM: To investigate the relationship between outcome and NEWS2, change in NEWS2 and component physiology in COVID-19 inpatients. METHODS: A multi-centre retrospective study of electronically recorded, routinely collected physiological measurements between March and June 2020. First and maximum NEWS2, component scores and outcomes were recorded. Areas under the curve (AUCs) for 2-day, 7-day and 30-day mortality were calculated. RESULTS: Of 1263 patients, 26% died, 7% were admitted to intensive care units (ICUs) before discharge and 67% were discharged without ICU. Of 1071 patients with initial NEWS2, most values were low: 50% NEWS2=0–2, 27% NEWS2=3–4, 14% NEWS2=5–6 and 9% NEWS2=7+. Maximum scores were: 14% NEWS2=0–2, 22% NEWS2=3–4, 17% NEWS2=5–6 and 47% NEWS2=7+. Higher first and maximum scores were predictive of mortality, ICU admission and longer length of stay. AUCs based on 2-day, 7-day, 30-day and any hospital mortality were 0.77 (95% CI 0.70 to 0.84), 0.70 (0.65 to 0.74), 0.65 (0.61 to 0.68) and 0.65 (0.61 to 0.68), respectively. The AUCs for 2-day mortality were 0.71 (0.65 to 0.77) for supplemental oxygen, 0.65 (0.56 to 0.73) oxygen saturation and 0.64 (0.56 to 0.73) respiratory rate. CONCLUSION: While respiratory parameters were most predictive, no individual parameter was as good as a full NEWS2, which is an acceptable predictor of short-term mortality in patients with COVID-19. This supports recommendation to use NEWS2 alongside clinical judgement to assess patients with COVID-19

A collagen-hydroxyapatite scaffold allows for binding and co-delivery of recombinant bone morphogenetic proteins and bisphosphonates.

An emerging paradigm in orthopedics is that a bone-healing outcome is the product of the anabolic (bone-forming) and catabolic (bone-resorbing) outcomes. Recently, surgical and tissue engineering strategies have emerged that combine recombinant human bone morphogenetic proteins (rhBMPs) and bisphosphonates (BPs) in order to maximize anabolism and minimize catabolism. Collagen-based scaffolds that are the current surgical standard can bind rhBMPs, but not BPs. We hypothesized that a biomimetic collagen-hydroxyapatite (CHA) scaffold would bind both agents and produce superior in vivo outcomes. Consistent with this concept, in vitro elution studies utilizing rhBMP-2 ELISA assays and scintillation counting of (14)C-radiolabeled zoledronic acid (ZA) confirmed delayed release of both agents from the CHA scaffold. Next, scaffolds were tested for their capacity to form ectopic bone after surgical implantation into the rat hind limb. Using CHA, a significant 6-fold increase in bone volume was seen in rhBMP-2/ZA groups compared to rhBMP-2 alone, confirming the ability of ZA to enhance rhBMP-2 bone formation. CHA scaffolds were found to be capable of generating mineralized tissue in the absence of rhBMP-2. This study has implications for future clinical treatments of critical bone defects. It demonstrates the relative advantages of co-delivering anabolic and anti-catabolic agents using a multicomponent scaffold system