Recreational Therapy Services and the Functional Independence of Inpatient Pediatric Population

Recreational Therapy (RT) is a relatively new and growing profession with an expanding body of literature. The benefits of RT services have been demonstrated through research studies for several decades. However; there is a lack of significant studies examining the efficacy of RT services in clinical settings; specifically in pediatric rehabilitation settings. In an effort to promote efficacy based research studies in the RT field, the American Therapeutic Recreation Association (ATRA) published a research agenda in 2003. This agenda highlighted the need for specific research areas in the field, including: (a) effects of leisure functioning on various aspects of health, (b) effect of leisure education on quality of life, (c) the effect of RT on overall independent functioning, and (d) effect of frequency and duration of contact with clients on RT outcomes. The current study aims to explore each of those impacts on the pediatric population. The purpose of the study is to determine if amount of recreational therapy services received during treatment significantly predicts changes in functional independence of pediatric patients in an in-patient rehabilitation setting.    The study will be an examination of existing evaluation data from patients of an in-patient rehabilitation hospital who received RT services over a eight year period (2000-2008). The data analyzed in this study will utilize formerly collected electronic medical records data from an existing research study titled Effects of Recreational Therapy on Functional Independence Measure (FIM Scores and Patient Satisfaction (RW 06-01-05). The data includes demographic information (e.g., age, gender), amount of total rehabilitative services received (recorded in 15 minute units), information related to diagnosis and functional independence measure impairment group codes and pre- and post-treatment total pediatric Functional Independence Measure (Wee-FIM) scores. Independent variables for this study include: (a) number of treatment units of PT, (b) number of treatment units of OT, (c) number of treatment units of SLP, (d) number of treatment units of RT, (e) number of treatment units of Psychology, (f) gender, (g) age at admission, (h) frequency of utilization of each treatment service (i) diagnosis, and (j) pre-test Wee-FIM Scores. The dependent variables for this study include (a) change in total Wee-FIM, (b) change in cognition Wee-FIM, (c) change in mobility Wee-FIM, and (d) change in psychosocial Wee-FIM (from admission to discharge). In cooperation with a data manager from PCMH, the anonymity of participants of the study will be protected by assigning a identification number unique to this study to each participant. No patient names or other identifiers will be included in the dataset.   Research questions include:  1. Does the amount of recreational therapy services received during treatment significantly predict changes in total Wee-FIM scores from admission to discharge?  2. Does the amount of recreational therapy services received during treatment significantly predict changes in mobility Wee-FIM scores from admission to discharge?  3. Does the amount of recreational therapy services received during treatment significantly predict changes in cognition Wee-FIM scores from admission to discharge?  4. Does the amount of recreational therapy services receive during treatment significantly predict changes in self-care Wee-FIM scores from admission to discharge?  5. Does the amount of recreational therapy services received during treatment significantly predict changes in psychological Wee-FIM scores from admission to discharge?  M.S

Lack of change in CA1 dendritic spine density or clustering in rats following training on a radial-arm maze task [version 2; peer review: 2 approved]

Background: Neuronal plasticity is thought to underlie learning and memory formation. The density of dendritic spines in the CA1 region of the hippocampus has been repeatedly linked to mnemonic processes. Both the number and spatial location of the spines, in terms of proximity to nearest neighbour, have been implicated in memory formation. To examine how spatial training impacts synaptic structure in the hippocampus, Lister-Hooded rats were trained on a hippocampal-dependent spatial task in the radial-arm maze. Methods: One group of rats were trained on a hippocampal-dependent spatial task in the radial arm maze. Two further control groups were included: a yoked group which received the same sensorimotor stimulation in the radial-maze but without a memory load, and home-cage controls. At the end of behavioural training, the brains underwent Golgi staining. Spines on CA1 pyramidal neuron dendrites were imaged and quantitatively assessed to provide measures of density and distance from nearest neighbour. Results: There was no difference across behavioural groups either in terms of spine density or in the clustering of dendritic spines. Conclusions: Spatial learning is not always accompanied by changes in either the density or clustering of dendritic spines on the basal arbour of CA1 pyramidal neurons when assessed using Golgi imaging

Genetic Diversity of PCR-Positive, Culture-Negative and Culture-Positive Mycobacterium ulcerans Isolated from Buruli Ulcer Patients in Ghana.

Culture of Mycobacterium ulcerans from Buruli ulcer patients has very low sensitivity. Thus confirmation of M. ulcerans infection is primarily based on PCR directed against IS2404. In this study we compare the genotypes obtained by variable number of tandem repeat analysis of DNA from IS2404-PCR positive cultures with that obtained from IS2404 positive, culture-negative tissue. A significantly greater genetic heterogeneity was found among culture-negative samples compared with that found in cultured strains but a single genotype is over-represented in both sample sets. This study provides evidence that both the focal location of bacteria in a lesion as well as differences in the ability to culture a particular genotype may underlie the low sensitivity of culture. Though preliminary, data from this work also suggests that mycobacteria previously associated with fish disease (M. pseudoshottsii) may be pathogenic for humans

No Change in Perceptual or Chronotropic Outcome When Altering Preferred Step Frequency for a Short Duration

IIntroduction: Millions of individuals incorporate jogging into their physical activity routines as a leisurely pursuit and as a way to achieve positive health outcomes. People appear to choose jogging speed and the associated step frequency on pure, natural preference. Understandably, kinesthetics are important, but another important underlying factor is metabolic cost. The purpose of this work was to investigate if preferred step frequency (at a preferred jogging pace) also minimizes perceived effort (Borg Rating of Perceived Exertion, 6-20; RPE) and chronotropic stress (heart rate; HR) during a ten-minute activity bout when compared with step frequencies altered by 5%. Methods: Recreationally-trained male subjects underwent two testing visits. The first visit was used to establish RPE and HR responses during a 10-minute jogging activity at preferred speed and step frequency. On a subsequent visit, between two and four days later, with preferred speed maintained, subjects were guided by metronome to strike at either 95% or 105% of their preferred step frequency. The 10-minute runs were randomized, crossed-over, and separated by 20 minutes. RPE and HR were analyzed by repeated measures ANOVA. Results: Fourteen subjects (age: 21.1 ± 0.95; body mass index: 23.2 ± 2.5) enrolled. Preferred jogging speed (speed. 6.4 ± 1.0 miles per hour; 10.2 ± 1.6 kilometers per hour) and step frequency (steps. 161.2 ± 10.3 steps/minute) were determined at the first visit, along with RPE (11.3 ± 1.7) and HR (166.4 ± 12.7). At the second visit, preferred speed was maintained while the frequency of foot-strike was altered. Neither differences in RPE (p = 0.252; 11.3 ± 1.7, 11.6 ± 1.9, 11.8 ± 1.5) nor HR (p = 0.547; 166.4 ± 12.7, 164.7 ± 14.9, 165.2 ± 15.3) were different when comparing the preferred, 95%, and 105% step frequency trials, respectively. Although anecdotal, some subjects verbalized displeasure with the change in pace and most all appeared to markedly alter the initial foot strike phase of the gait to meet the directed foot strike tempo. Discussion: Our data must be interpreted cautiously. While altering step frequency by 5% for a short duration does not appear to alter an individual’s RPE or HR appreciably, the result during longer duration activity may not be the same. In addition, the implications for biomechanical loading and metabolic cost were not presently investigated

Des Moines Area Community College Creative Writing Contest 1976-2001

Award-Winning Works For the Academic Year · 2000-2001https://openspace.dmacc.edu/creativewriting/1002/thumbnail.jp

Age-Related Kidney Transplant Outcomes: Health Disparities Amplified in Adolescence

IMPORTANCE The transition from pediatric to adult health care is a vulnerable time for patients with chronic conditions. We need to better understand the factors affecting the health of kidney transplant recipients during this transition. OBJECTIVE To determine the age at which renal transplant recipients are at greatest risk for graft loss. DESIGN, SETTING, AND PARTICIPANTS We performed a retrospective analysis of 168 809 first kidney-only transplant events from October 1987 through October 2010, in recipients up to age 55 years as reported by the Organ Procurement Transplantation Network Standard Transplant Analysis and Research Database. Recipient age at transplant was the primary predictor studied. Confounder and effect modifier covariates were identified and studied using Cox proportional hazard models. EXPOSURE Kidney-only transplant. MAIN OUTCOMES AND MEASURES Patient and renal graft survival, along with death-censored and non―death-censored information. RESULTS A total of 168 809 renal transplant events met the inclusion criteria. Recipients who received their first kidney transplant at age 14 to 16 years were at the highest risk of graft loss, with inferior outcomes starting at 1 and amplifying at 3, 5, and 10 years after transplant. Black adolescents were at disproportionately high risk of graft failure. The variables that had significant interaction with recipient age were donor type (deceased vs living) and insurance type (government vs private). Among 14-year-old recipients, the risk of death was 175% greater in the deceased donor-government insurance group vs the living donor―private insurance group (hazard ratio, 0.92 [95% CI, 0.90-0.94] vs 0.34 [95% CI, 0.33-0.36]), whereas patient survival rates in the living donor―government insurance and deceased donor―private insurance groups were nearly identical (hazard ratio, 0.61 [95% CI, 0.58-0.63] vs 0.54 [95% CI, 0.51-0.56]). CONCLUSIONS AND RELEVANCE Recipients aged 14 to 16 years have the greatest risk of kidney allograft failure. Black adolescents and those with government insurance are at even higher risk. Private insurance reduces risk of death across all ages. Comprehensive programs are needed for adolescents, especially for those at greater risk, to reduce graft loss during the transition from adolescence to adulthood

A Comparison of Temperatures Inside Protective Headgear With Indicators of Physiological Strain and Core Temperatures During Exercise in a Hot Environment

Introduction: Non-invasive temperature monitoring with a sensor mounted inside protective headgear such as a football or military helmet or a construction hardhat may be an effective method of detecting temperatures that are indicative of increased risk of heat illness. Hothead Technologies has developed a system for providing temperature information to medical personnel responsible for the health of the individual. Purpose: The purposes of this study were to establish the relationship between in-hardhat temperature (Tih) readings, markers of physiological strain and perceptual responses, and to determine the differences between the in-helmet temperature readings and core temperature (Tc) as measured by rectal (Tre) and esophageal (Tes) probes. Methods: Thirty males (age, 24.57 ± 4.32 years; height 180.51 ±7.06 cm; body mass, 81.06 ±9.35 kg; percent body fat, 13.76 ±5.11; VO2max, 46.84 ± 7.10 mL/Kg/min) completed two experimental trials separated by a minimum of one week: a continuous submaximal exercise (CSE) condition and a series of high intensity 30-second sprints (HIE) with a one-minute rest period between each sprint. Exercise in both conditions was carried out in a 36o C environment with a relative humidity of 40% while wearing a standard construction hardhat with a sensor mounted in the forehead area of the head strap, and continued until one of the following two criteria was met: the subject voluntarily terminated the session, or the subject’s Tc reached 39.5oC. Temperatures, heart rate, cardiorespiratory, and perceptual responses were monitored throughout, and balance error scoring system (BESS) and mental function tests were conducted before and after exercise. A physiological strain index (PSI) was calculated from Tc and HR. Results: CV- Calculated from final temp. Conclusion: The general agreement between the Tih and other temperature measures along with the consistency as indicated by the low coefficient of variation in the recordings of the Tih sensors at the point of termination suggest that this device may have application as a warning system for impending heat-related problems

An RNA structure-mediated, posttranscriptional model of human α-1-antitrypsin expression

Protein and mRNA expression are in most cases poorly correlated, which suggests that the posttranscriptional regulatory program of a cell is an important component of gene expression. This regulatory network is still poorly understood, including how RNA structure quantitatively contributes to translational control. We present here a series of structural and functional experiments that together allow us to derive a quantitative, structure-dependent model of translation that accurately predicts translation efficiency in reporter assays and primary human tissue for a complex and medically important protein, α-1-antitrypsin. Our model demonstrates the importance of accurate, experimentally derived RNA structural models partnered with Kozak sequence information to explain protein expression and suggests a strategy by which α-1-antitrypsin expression may be increased in diseased individuals

Stakeholder Theory and Marketing: Moving from a Firm-Centric to a Societal Perspective

This essay is inspired by the ideas and research examined in the special section on “Stakeholder Marketing” of the Journal of Public Policy & Marketing in 2010. The authors argue that stakeholder marketing is slowly coalescing with the broader thinking that has occurred in the stakeholder management and ethics literature streams during the past quarter century. However, the predominant view of stakeholders that many marketers advocate is still primarily pragmatic and company centric. The position advanced herein is that stronger forms of stakeholder marketing that reflect more normative, macro/societal, and network-focused orientations are necessary. The authors briefly explain and justify these characteristics in the context of the growing “prosociety” and “proenvironment” perspectives—orientations that are also in keeping with the public policy focus of this journal. Under the “hard form” of stakeholder theory, which the authors endorse, marketing managers must realize that serving stakeholders sometimes requires sacrificing maximum profits to mitigate outcomes that would inflict major damage on other stakeholders, especially society