Occupation-Based Practice in Occupational Therapy

Background: The positive impact of occupation and well-being has been documented throughout the literature, however, the direct link of using occupation-based practice (OBP) and improvement of client outcomes has not been well established. This research study considered what OBP is, what the constructs are that comprise it, and how facilitators and barriers impact its use. Results: Results of this grounded theory study included four main constructs of occupation-based practice (actual occupation, meaningful and purposeful value, therapeutic intent, and engaged participation) as well as the theory of OccupationalTherapist’s Dynamic Use of Occupation-Based Practice. This theory explains the dynamic process that a practitioner uses during each therapeutic interaction and how it impacts where on the continuum the interaction lies (medical model to occupation-based). Conclusion: The results of this study help inform the profession at the academic, continuing education, practice, and administrative levels view and understand occupation-based practice in a more concrete manner. The results of this study provide evidence for the creation of a measurement tool to further assess the use of occupation-based practice

Development of the Dynamic Model of Occupation-Based Practice

Background: Occupation-based practice is unique to occupational therapy, supported as effective in the literature, and promotes health and well-being for clients. There is no framework describing what occupation-based practice looks like, making the goal of infusing occupation into practice difficult. This research study aimed to develop a model of occupation-based practice, providing a framework with constructs, facilitators, and barriers for using occupation in practice. Method: A grounded theory study was completed with interviews and a focus group. Charmaz’s approach to grounded theory was used to analyze data and allow a model to emerge. Results: The dynamic model of occupation-based practice emerged with four constructs, including actual occupation, meaningful and purposeful value, therapeutic intent, and engaged participation. The model explains the ever-changing process of therapeutic interactions depicting the essence of the interaction along a continuum between a discrete model and occupation-based practice. Conclusion: The model derived from this study offers a framework to operationalize the approach to occupational therapy practice espoused by the profession’s leaders and theorists to provide uniquely occupational services. This model can inform the profession at the practice, academic, scholarly, and administrative levels to support enhanced practice, evaluate programs, and study occupation-based practice

Ramsay Hunt syndrome: Clinical analysis of 15 cases

The Ramsay Hunt syndrome (RHS) is characterized by acute facial nerve paresis and/or paralysis accompanied by a herpetic lesion on the external ear. Fifteen patients were evaluated and treated for RHS. After a detailed history was obtained, clinical examination was performed, and treatment was initiated based on steroids and acyclovir. The House-Brackmann grading system (HB I-VI) was used to evaluate the facial nerve function; this was further electrophysiologically assessed with the nerve excitability test (NET) and electro-neurography. In RHS cases, the most common accompanying findings were the cochleovestibular symptoms (73%) and in particular vertigo and balance disorder. The combined treatment of acyclovir with steroids resulted in satisfactory facial nerve function (HB I-II) in 75% of cases. The recovery was satisfactory in all the cases in which the NET was normal or diminished. In 4 cases in which the recovery was non-satisfactory (ΗΒΙΙΙ-V) no response was initially obtained in NET. In RHS, the possible neuritis and the inflammatory process which occur into the internal auditory canal may result in facial nerve dysfunction and cochleovestibular symptoms. The combined therapy of the antiviral agent acyclovir with the anti-inflammatory effect of steroids is recommended for the treatment of RHS. The NET was proved as the most useful method in the prognostication of RHS.The Ramsay Hunt syndrome (RHS) is characterized by acute facial nerve paresis and/or paralysis accompanied by a herpetic lesion on the external ear. Fifteen patients were evaluated and treated for RHS. After a detailed history was obtained, clinical examination was performed, and treatment was initiated based on steroids and acyclovir. The House-Brackmann grading system (HB I-VI) was used to evaluate the facial nerve function; this was further electrophysiologically assessed with the nerve excitability test (NET) and electro-neurography. In RHS cases, the most common accompanying findings were the cochleovestibular symptoms (73%) and in particular vertigo and balance disorder. The combined treatment of acyclovir with steroids resulted in satisfactory facial nerve function (HB I-II) in 75% of cases. The recovery was satisfactory in all the cases in which the NET was normal or diminished. In 4 cases in which the recovery was non-satisfactory (ΗΒΙΙΙ-V) no response was initially obtained in NET. In RHS, the possible neuritis and the inflammatory process which occur into the internal auditory canal may result in facial nerve dysfunction and cochleovestibular symptoms. The combined therapy of the antiviral agent acyclovir with the anti-inflammatory effect of steroids is recommended for the treatment of RHS. The NET was proved as the most useful method in the prognostication of RHS

Cornelia De Lange Syndrome and Cochlear Implantation

Introduction: Literature regarding the different degrees of hearing loss in patients with Cornelia de Lange syndrome (CDLS) reports that half of the affected patients exhibit severe to profound sensorineural hearing loss. We present the first pre-school child with CDLS who underwent cochlear implantation for congenital profound sensorineural hearing loss.   Case Report: A 3-year-old boy with CDLS underwent unilateral cochlear implantation for bilateral profound sensorineural hearing loss. He had characteristic facial features, bushy eyebrows and synophrys, limb anomalies, growth and mental retardation. Based on the results of postoperative speech perception and production tests, his gain in language skills and expressive vocabulary was modest. However, a cochlear implantation had a significant effect on auditory development, in terms of making him aware of sound localization and the different types of environmental sound.   Conclusion: Criteria for cochlear implantation are expanding and now include children with disabilities in addition to deafness, such as those with CDLS. Profoundly hearing-impaired children affected by borderline mental retardation should be considered as potential candidates for cochlear implantation

A preliminary economic evaluation of Marine Corps acquisition practices: UHF satellite communication ground terminal acquisitions

Economic theories and concepts are used to discuss allocating scarce fiscal resources for acquiring UHF satellite communication ground terminals. This thesis provides and overview of current acquisition practices and suggests how applied economics can explicitly aid in better decision making. Keywords: Command control and communications, Telecommunications, Demand, Supply, Acquisitions, Demand management. (KR)http://archive.org/details/preliminaryecono00psilNANAU.S. Marine Corps (U.S.M.C.) author

Video Head Impulse Test (vHIT): Value of Gain and Refixation Saccades in Unilateral Vestibular Neuritis

The aim of this study was to evaluate gain and refixation saccades (covert and overt) using a video head impulse test (vHIT) in the horizontal and vertical planes in patients after the onset of unilateral acute vestibular neuritis (AVN). Thirty-five patients were examined in the acute stage of AVN and at follow-up (range, 6–30 months); a control group of 32 healthy subjects also participated. At onset, the mean gain was significantly lower on the affected side in all of the semi-circular canal planes, mainly in the horizontal canal plane, and saccades (covert and overt) were more prevalent in the horizontal compared to the vertical canal planes. Multi-canal affection occurred more frequently (80% for gain, 71% for saccades) than isolated canal affection. At follow-up, which ranged from 6 to 30 months, the gain was recovered in all of the canals (anterior in 50%, horizontal in 42.8%, and posterior canal in 41.1% of cases), while covert and overt saccades were reduced in the horizontal and vertical planes. However, covert saccades were still recorded in a greater proportion (69%) than overt saccades (57%) in the horizontal plane and at a lower rate in the vertical planes. The compensatory mechanisms after AVN mainly involve the horizontal canal, as the refixation saccades—especially covert ones—were more frequently recorded in the horizontal than vertical canals

Hyperbaric Oxygen Therapy in the Treatment of Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss (SSHL) is a frustrating and frightening experience for a patient [...

The Effect of Anxiolytics on Tinnitus

Tinnitus is a perceptual disorder in which sound is perceived by the patient in the absence of an external or internal acoustic stimulation [...