Serving High-Risk Youth in Context: Perspectives from Hong Kong

Background: High-risk youth are often defined in occupational therapy terminology as adolescents and young adults who experience personal, contextual, or environmental barriers to effective participation in healthy, age-appropriate occupations. Without assistance for participation, these youth may acquiesce to daily routines of unhealthy risk-taking or isolation, failing to achieve developmental milestones needed for successful transition to adulthood. There are known therapeutic services targeting this population, but occupational therapy involvements have been sparsely documented. Method: Having been affiliated with a community-based occupational therapy program serving high-risk youth for many years in the US, the principal investigator of the study used a sabbatical opportunity to explore services provided to high-risk youth in Hong Kong (HK). This paper reports preliminary findings obtained from an exploratory study of analyzing transcripts of 13 one-on-one interviews with service providers in HK. Results: Two major themes are discussed in this paper: the prevalent behavioral risks among high-risk youth as perceived by the service providers and the intervention approaches used by the service providers with the high-risk youth population in HK. Conclusion: Reflecting on the preliminary outcome of the study, the authors suggest that occupational therapy may contribute to mitigating youths’ risk factors through ecological occupational engagement

Professional residency in natural resources and environmental education

Since 1967, Teton Science School (TSS) has been an important resource in educating, training, and inspiring students of all ages. The school enjoys a reputation as the premier natural science education center in the northern Rocky Mountain region

The status of ecophilosophy and the ideology of nature.

Ecophilosophy is an attempt to render a new philosophy of nature, generated by the need to liberate nature from the inherently domineering disposition of humankind. Although I am sympathetic to this effort, I believe that the current ambiguity of its content (who or what is to survive) carries with it the potentiality for new forms of oppression. I argue that ecophilosophy suffers from a kind of Habermasian self-deception, taking on a vague concept of nature that deceptively appears to do the philosophical work of healing the epistemological gap between nature and humans. My reconstruction unifies this loosely-defined vision along the lines of an equivocal use of two key concepts, the domination of nature and nature itself, revealing the potentially subversive character of its implicitly universalist philosophy of nature. Ecophilosophers, rather than distinguishing themselves, fail to improve upon Francis Bacon\u27s suggestion that attention to nature will liberate us. Their satisfaction with ecological solutions indicates that they miss the essential ideological consequence of the modern project: the domination by some humans over others has been covered over by a self-deceptive belief in the liberating character of scientific methodology. By arguing for the emancipatory capacity of ecology, they get themselves into a Marcusian-like bind, advocating this new science while at the same time rejecting scientific rationality as a pivotal component of their notion of the domination of nature. Because of this they are forced to argue that ecology is qualitatively different, offering a new kind of rationality that contains the necessary ingredients for radically changing society. Ecophilosophers must reconsider the epistemologically naive and ideologically negative repercussions of this position as I demonstrate with an analysis of the potentially repressive relationships that exist between fourth world cultures and the environmental community. I conclude by subjecting the Habermasian, universalist framework to revision as indicated by the possibilities of a new eco-vision, emerging from the contextual episteme of a reworked ecofeminist perspective

FIVES: An integrated strategy for comprehension and vocabulary learning

This article describes a strategy that emphasizes the integration of all language and literacy skills for learning across content areas as well as the importance CCSS place on learners’ ability to ask questions about information, phenomena, or ideas encountered (Ciardiello, 2012/2013). FIVES is a strategy that meaningfully integrates research-based methodologies associated with reading, writing, speaking, listening, viewing, and visually representing for differentiated disciplinary literacy instruction related to authentic texts and issues. The strategy described can be universally applied across disciplines to develop high levels of competence with literacy processes and content

Shared Concepts Guiding the Practice of a Community Occupational Therapy Program Serving Youth with Psychosocial Challenges

Background: Occupational therapy services to youth with trauma experiences and mental health challenges may follow unique practice concepts that deserve to be explored and illuminated. The study aimed to explore and identify shared concepts that have been guiding the occupational therapy practice of a community-based program serving the youth population. Method: The qualitative study analyzed data from transcripts of one-on-one interviews with occupational therapists who serve youth clients in the community-based program. Using a grounded theory qualitative approach, the analysis aimed to highlight unique concepts that the occupational therapists employed in their day-to-day practice with youth who experience trauma and mental health challenges. Results: Twenty-five interview transcripts were analyzed and four major themes emerged from the analysis: trauma lens, practicing attentive empathy, complex development mindset, and therapeutic unstructured structure. Discussion: The interview data and emerged themes illuminated three interrelated concepts, which guide the occupational therapy practice of a community-based program serving youth with psychosocial challenges: the therapists’ cultivation of intellectual humility, a sense of shared humanity with their clients, and the skillful accommodation of clients’ personal and environmental contexts to promote engagement in occupation. Fidelity to these concepts during client-led occupational exploration supported youth expressions of positive identity, social connection, and valued occupational competencies, and is an approach worthy of further study

Impact of detectable monoclonal protein at diagnosis on outcomes in marginal zone lymphoma: A multicenter cohort study

Given the paucity of data surrounding the prognostic relevance of monoclonal paraprotein (M-protein) in marginal zone lymphoma (MZL), we sought to evaluate the impact of detecting M-protein at diagnosis on outcomes in patients with MZL in a large retrospective cohort. The study included 547 patients receiving first-line therapy for MZL. M-protein was detectable at diagnosis in 173 (32%) patients. There was no significant difference in the time from diagnosis to initiation of any therapy (systemic and local) between the M-protein and no M-protein groups. Patients with M-protein at diagnosis had significantly inferior progression-free survival (PFS) compared with those without M-protein at diagnosis. After adjusting for factors associated with inferior PFS in univariate models, presence of M-protein remained significantly associated with inferior PFS (hazard ratio, 1.74; 95% confidence interval, 1.20-2.54; P = .004). We observed no significant difference in the PFS based on the type or quantity of M-protein at diagnosis. There were differential outcomes in PFS based on the first-line therapy in patients with M-protein at diagnosis, in that, those receiving immunochemotherapy had better outcomes compared with those receiving rituximab monotherapy. The cumulative incidence of relapse in stage 1 disease among the recipients of local therapy was higher in the presence of M-protein; however, this did not reach statistical significance. We found that M-protein at diagnosis was associated with a higher risk of histologic transformation. Because the PFS difference related to presence of M-protein was not observed in patients receiving bendamustine and rituximab, immunochemotherapy may be a preferred approach over rituximab monotherapy in this group and needs to be explored further

Impact of early relapse within 24 months after first-line systemic therapy (POD24) on outcomes in patients with marginal zone lymphoma: A US multisite study

Progression of disease within 24 months (POD24) from diagnosis in marginal zone lymphoma (MZL) was shown to portend poor outcomes in prior studies. However, many patients with MZL do not require immediate therapy, and the time from diagnosis-to-treatment interval can be highly variable with no universal criteria to initiate systemic therapy. Hence, we sought to evaluate the prognostic relevance of early relapse or progression within 24 months from systemic therapy initiation in a large US cohort. The primary objective was to evaluate the overall survival (OS) in the two groups. The secondary objective included the evaluation of factors predictive of POD24 and the assessment of cumulative incidence of histologic transformation (HT) in POD24 versus non-POD24 groups. The study included 524 patients with 143 (27%) in POD24 and 381 (73%) in non-POD24 groups. Patients with POD24 had inferior OS compared to those without POD24, regardless of the type of systemic therapy received (rituximab monotherapy or immunochemotherapy) at diagnosis. After adjusting for factors associated with inferior OS in the univariate Cox model, POD24 remained associated with significantly inferior OS (HR = 2.50, 95% CI = 1.53-4.09, p = 0.0003) in multivariable analysis. The presence of monoclonal protein at diagnosis and those who received first-line rituximab monotherapy had higher odds of POD24 on logistic regression analysis. Patients with POD24 had a significantly higher risk for HT compared to those without POD24. POD24 in MZL might be associated with adverse biology and could be used as an additional information point in clinical trials and investigated as a marker for worse prognosis