Parent Perceived Facilitators and Barriers to Implementation of Ayres Sensory Integration® (ASI) Parent Education Modules for Autistic Children

Introduction: Ayres Sensory Integration® (ASI) is an evidence-based intervention for children with challenges in sensory integration. Parent education is an integral part of ASI (Parham et al., 2011). To address parent education, researchers developed the ASI Parent Education Modules, developed by a team of researchers (Schaaf et al., 2015) and embellished by others (Roan et al., 2022) designed to educate parents about their child’s sensory integrative challenges, ideas for addressing these at home, and to promote collaboration between therapists and parents. Objective: To examine parental perceptions of the facilitators and barriers impacting the implementation of ASI Parent Education Modules for autistic children experiencing sensory integration challenges. Methods: A qualitative, phenomenological approach using a reflexive thematic analysis approach (Braun and Clarke 2006, 2022) was used to better understand parents\u27 experiences with the modules and their perceived facilitators and barriers when using the ASI parent education modules. Results: Three themes resulted from use of the analytic approach related to parents’ experiences learning about ASI, their child’s underlying sensory integration challenges, and activities they could do at home with their child: Challenges of Raising an Autistic Child as a Neurotypical Parent, Making the Connection, and Testing Limits and Pushing Boundaries. Conclusion: Themes highlight the importance of ASI parent education and collaboration between occupational therapists and parents to promote client participation. Parents may have a limited understanding of ASI concepts and the rationale of sensory-rich activities in the clinic and at home. The results of the study indicate parents desire to understand their child’s sensory integrative challenges, the rationale behind the intervention, and how to implement sensorimotor activities at home. The results further support parent education to improve therapeutic outcomes and promote children with sensory integrative challenges’ participation in daily routines. References Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3. 77-101. DOI: 10.1191/1478088706 Braun, V. & Clarke, V. (2022). Thematic Analysis: A Practical Guide. Sage Publications. Parham, D.L., Roley, S.S., May-Benson, T.A., Koomar, J., Brett-Green, B., Burke, J.P., Cohn, E.S., Mailloux, Z., Miller, L.J., & Schaaf, R.C. (2011). Development of a fidelity measure for research on the effectiveness of the Ayres Sensory IntegrationÒ intervention. American Journal of Occupational Therapy, 65(2). 133–142. DOI: 10.5014/ajot.2011.000745 Roan, C., Mailloux, Z., Carroll, A., & Schaaf, R.C. (2022). Brief report– A parent guidebook for occupational therapy using Ayres Sensory Integration. American Journal of Occupational Therapy, 76, 7605345020. DOI: 10.5014/ajot.2022.049419 Schaaf, R., Mailloux Z., Koester, A., & Dumont, R. (2015). ASI parent education modules [Unpublished manuscript]. Autism Center of Excellence, Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University Synopsis: This study utilized one-to-one virtual interviews to examine parents’ perceptions of the facilitators and barriers to implementation of the ASI Parent Education Modules. Findings indicate that parents have limited knowledge of how help their children with sensory integrative challenges participate in their daily routines prior to using the ASI Parent Education Modules. After using the ASI Parent Education Modules, parents developed an understanding of their child’s sensory integrative differences and felt more comfortable implementing sensory-rich activities. Parents discussed the benefits of using sensory-rich activities at home to promote their child’s participation in valued occupations. Acknowledgments: Maclain Capron, Elke van Hooydonk, OTD, OTR/L, Joanne Hunt, OTD, OTR/L, Patti Faller, OTD, OTR/L, Erin Harvey, M.S. OTR/L, and Regina Freeman M.S., OTR/L

Weatherability and Leach Resistance of Wood Impregnated with Nano-Zinc Oxide

Southern pine specimens vacuum-treated with nano-zinc oxide (nano-ZnO) dispersions were evaluated for leach resistance and UV protection. Virtually, no leaching occurred in any of the nano-ZnO–treated specimens in a laboratory leach test, even at the highest retention of 13 kg/m3. However, specimens treated with high concentrations of nano-ZnO showed 58–65% chemical depletion after 12 months of outdoor exposure. Protection from UV damage after 12 months exposure is visibly obvious on both exposed and unexposed surfaces compared to untreated controls. Graying was markedly diminished, although checking occurred in all specimens. Nano-zinc oxide treatment at a concentration of 2.5% or greater provided substantial resistance to water absorption following 12 months of outdoor exposure compared to untreated and unweathered southern pine. We conclude that nano-zinc oxide can be utilized in new wood preservative formulations to impart resistance to leaching, water absorption and UV damage of wood

Rapid Enzymatic Response to Compensate UV Radiation in Copepods

Ultraviolet radiation (UVR) causes physical damage to DNA, carboxylation of proteins and peroxidation of lipids in copepod crustaceans, ubiquitous and abundant secondary producers in most aquatic ecosystems. Copepod adaptations for long duration exposures include changes in behaviour, changes in pigmentation and ultimately changes in morphology. Adaptations to short-term exposures are little studied. Here we show that short-duration exposure to UVR causes the freshwater calanoid copepod, Eudiaptomus gracilis, to rapidly activate production of enzymes that prevent widespread collateral peroxidation (glutathione S-transferase, GST), that regulate apoptosis cell death (Caspase-3, Casp-3), and that facilitate neurotransmissions (cholinesterase-ChE). None of these enzyme systems is alone sufficient, but they act in concert to reduce the stress level of the organism. The interplay among enzymatic responses provides useful information on how organisms respond to environmental stressors acting on short time scales

Long term hemodialysis aggravates lipolytic activity reduction and very low density, low density lipoproteins composition in chronic renal failure patients

<p>Abstract</p> <p>Background</p> <p>Dyslipidemia, particularly hypertriglyceridemia is common in uremia, and represents an independent risk factor for atherosclerosis.</p> <p>Methods</p> <p>To investigate the effects of hemodialysis (HD) duration on very low density lipoprotein (VLDL) and low density lipoprotein (LDL) compositions and lipopolytic activities, 20 patients on 5 to 7 years hemodialysis were followed-up during 9 years. Blood samples were drawn at T0 (beginning of the study), T1 (3 years after initiating study), T2 (6 years after initiating study) and T3 (9 years after initiating study). T0 was taken as reference.</p> <p>Results</p> <p>Triacylglycerols (TG) values were correlated with HD duration (r = 0.70, P < 0.05). An increase of total cholesterol was noted at T2 and T3. Lowered activity was observed for lipoprotein lipase (LPL) (-44%) at T3 and hepatic lipase (HL) (-29%) at T1, (-64%) at T2 and (-73%) at T3. Inverse relationships were found between HD duration and LPL activity (r = -0.63, P < 0.05), and HL activity (r = -0.71, P < 0.01). At T1, T2 and T3, high VLDL-amounts and VLDL-TG and decreased VLDL-phospholipids values were noted. Increased LDL-cholesteryl esters values were noted at T1 and T2 and in LDL-unesterified cholesterol at T2 and T3.</p> <p>Conclusion</p> <p>Despite hemodialysis duration, VLDL-LDL metabolism alterations are aggravated submitting patients to a greater risk of atherosclerosis.</p

Literacy and blood pressure – do healthcare systems influence this relationship? A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Limited literacy is common among patients with chronic conditions and is associated with poor health outcomes. We sought to determine the association between literacy and blood pressure in primary care patients with hypertension and to determine if this relationship was consistent across distinct systems of healthcare delivery.</p> <p>Methods</p> <p>We conducted a cross-sectional study of 1224 patients with hypertension utilizing baseline data from two separate, but similar randomized controlled trials. Patients were enrolled from primary care clinics in the Veterans Affairs healthcare system (VAHS) and a university healthcare system (UHS) in Durham, North Carolina. We compared the association between literacy and the primary outcome systolic blood pressure (SBP) and secondary outcomes of diastolic blood pressure (DBP) and blood pressure (BP) control across the two different healthcare systems.</p> <p>Results</p> <p>Patients who read below a 9^thgrade level comprised 38.4% of patients in the VAHS and 27.5% of the patients in the UHS. There was a significant interaction between literacy and healthcare system for SBP. In adjusted analyses, SBP for patients with limited literacy was 1.2 mmHg lower than patients with adequate literacy in the VAHS (95% CI, -4.8 to 2.3), but 6.1 mmHg higher than patients with adequate literacy in the UHS (95% CI, 2.1 to 10.1); (p = 0.003 for test of interaction). This literacy by healthcare system interaction was not statistically significant for DBP or BP control.</p> <p>Conclusion</p> <p>The relationship between patient literacy and systolic blood pressure varied significantly across different models of healthcare delivery. The attributes of the healthcare delivery system may influence the relationship between literacy and health outcomes.</p

An outbreak of post-acupuncture cutaneous infection due to Mycobacterium abscessus

BACKGROUND: Despite the increasing popularity of acupuncture, the importance of infection control is not adequately emphasized in Oriental medicine. In December 2001, an Oriental medical doctor in Seoul, South Korea, encountered several patients with persistent, culture-negative skin lesions on the trunk and extremities at the sites of prior acupuncture treatment. We identified and investigated an outbreak of Mycobacterium abscessus cutaneous infection among the patients who attended this Oriental medicine clinic. METHODS: Patients were defined as clinic patients with persistent cutaneous infections at the acupuncture sites. Medical records for the previous 7 months were reviewed. Clinical specimens were obtained from the patients and an environmental investigation was performed. M. abscessus isolates, cultured from patients, were compared by pulsed-field gel electrophoresis (PFGE). RESULTS: Forty patients who attended the Oriental medicine clinic and experienced persistent cutaneous wound infections were identified. Cultures from five of these patients proved positive, and all other diagnoses were based on clinical and histopathologic examinations. All environmental objects tested were negative for M. abscessus, however, most were contaminated by various nosocomial pathogens. Molecular analysis using PFGE found all wound isolates to be identical. CONCLUSION: We have identified a large outbreak of rapidly growing mycobacterial infection among patients who received acupuncture at a single Oriental medicine clinic. Physicians should suspect mycobacterial infections in patients with persistent cutaneous infections following acupuncture, and infection control education including hygienic practice, should be emphasized for Oriental medical doctors practicing acupuncture

Identification of a sheath-associated protein involved in phosphate transport in Sphaerotilus natans

Sphaerotilus natans was shown to have a fourfold lower K′ m of phosphate transport when grown in medium containing 0.1 m m phosphate, compared to cells grown in 10.0 m m phosphate. Analysis of sheath proteins from cells grown at these two phosphate levels revealed a protein of 53 kDa present in the sheath of cells grown at a phosphate concentration of 0.1 m m . This sheath-associated, phosphate-regulated protein, designated SapP, was gel purified and used to raise a polyclonal antibody. Enzyme-linked immunosorbent assay was used to localize this protein to the surface of the sheathed cells. Phosphate uptake assays done in the presence of the antibody also showed a rise in the K′ m of phosphate transport in cells grown in 0.1 m m phosphate, indicating that this protein is involved in high-affinity phosphate transport.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46762/1/253_2004_Article_BF00166797.pd

Anticholinergic drug burden tools/scales and adverse outcomes in different clinical settings: a systematic review of reviews

Background: Cumulative anticholinergic exposure (anticholinergic burden) has been linked to a number of adverse outcomes. To conduct research in this area, an agreed approach to describing anticholinergic burden is needed. Objective: This review set out to identify anticholinergic burden scales, to describe their rationale, the settings in which they have been used and the outcomes associated with them. Methods: A search was performed using the Healthcare Databases Advanced Search of MEDLINE, EMBASE, Cochrane, CINAHL and PsycINFO from inception to October 2016 to identify systematic reviews describing anticholinergic burden scales or tools. Abstracts and titles were reviewed to determine eligibility for review with eligible articles read in full. The final selection of reviews was critically appraised using the ROBIS tool and pre-defined data were extracted; the primary data of interest were the anticholinergic burden scales or tools used. Results: Five reviews were identified for analysis containing a total of 62 original articles. Eighteen anticholinergic burden scales or tools were identified with variation in their derivation, content and how they quantified the anticholinergic activity of medications. The Drug Burden Index was the most commonly used scale or tool in community and database studies, while the Anticholinergic Risk Scale was used more frequently in care homes and hospital settings. The association between anticholinergic burden and clinical outcomes varied by index and study. Falls and hospitalisation were consistently found to be associated with anticholinergic burden. Mortality, delirium, physical function and cognition were not consistently associated. Conclusions: Anticholinergic burden scales vary in their rationale, use and association with outcomes. This review showed that the concept of anticholinergic burden has been variably defined and inconsistently described using a number of indices with different content and scoring. The association between adverse outcomes and anticholinergic burden varies between scores and has not been conclusively established