Occupational Therapist’S Role In Addressing The Psychological Impacts Of Pain In Clients With Upper Extremity Conditions

Background & Purpose: The experience of pain is different for every client (Felman, 2020). There are various ways to feel and describe the pain (Felman, 2020). A maladaptive response to pain has been associated with increased pain and physical limitations in clients with upper extremity pain (Verhiel et al., 2019). Upper extremity impairments can result in the disruption of many activities of daily living and instrumental activities of daily living (American Occupational Therapy Association, 2014). Clients with upper extremity pain often resort to maladaptive coping strategies, such as catastrophic thinking (Verhiel et al., 2019). The most common psychological factors related to upper extremity pain include anxiety, depression, pain catastrophizing, and problems related to work and sleep dysfunction (Hamasaki et al., 2018). Despite the significance of upper extremity pain, many therapists do not formally address the psychological factors of pain. Some occupational therapists may lack confidence in addressing the psychological factors due to the social stigmas of mental health symptoms, the lack of time, and inadequate training about how to address psychological factors of upper extremity pain (Knaak et al., 2017; Vranceanu et al., 2017). The purpose of this scholarly project was to develop a product to address the needs of occupational therapy clients demonstrating psychological factors of pain related to upper extremity conditions. Based on best-practice evidence and models of practice, this scholarly project used the findings from the literature review to develop a guide that will aid occupational therapists with psychologically based interventions to address the psychological factors of pain with upper extremity conditions. Methodology: A needs assessment was conducted through a review of the literature to determine the needs of clients who are experiencing both pain due to upper extremity conditions and psychological symptoms that accompany that pain. PubMED, CINHAL, ClinicalKey, SAGEPub, Elsevier, and PsycINFO were searched using such combinations as: upper extremity pain AND psychological interventions AND occupational therapy, cognitive behavioral therapy AND pain management, cognitive distortions AND pain, Healthy coping skills AND pain. The Model of Human Occupation (MOHO) (Clifford O’Brien, 2017) was used to guide the creation and intended use of the product to assist occupational therapists in addressing the psychological factors of the pain of clients with upper extremity conditions. This model was applied to understand how the psychological factors of upper extremity pain can affect a client\u27s volition, habituation, performance capacity, and occupational identity (Clifford O’Brien, 2017). This scholarly project was informed, too, by a concurrent doctoral experience placement in an outpatient orthopedic practice setting. Outcome: This project resulted in a 4-part module for occupational therapists to use to address the needs in the areas of psychological impacts of pain for clients with upper extremity conditions. The target population is clients across the life span with upper extremity conditions who receive services in an outpatient occupational therapy orthopedic setting. This product includes intervention information to address the red flags of pain, cognitive distortions related to pain and restructuring pain thoughts, relaxation techniques, and learning to accept living with pain. This product will help occupational therapists establish specific needs and priorities of their clients’ concerning diagnoses and pain management. The product intends to add an important dimension to intervention, maximize the overall occupational performance (Clifford O’Brien, 2017), and contribute to the health and well-being of clients with upper extremity conditions

Occupational therapy intervention approaches for successful employment outcomes for individuals with an intellectual disability

“Disability is an umbrella term, covering impairments, activity limitations, and participation restrictions. Disability is thus not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives” (Boyt Schell & Gillen, 2019, pp. 1196). Disability is a natural part of the human experience, and does not inhibit an individual’s ability to successfully contribute to society. “Intellectual disability is a developmental disability that is diagnosed before the age of 18 and expected to last throughout life. It involves significant limitations in intellectual functioning and adaptive behavior” (Johnson & Blaskowtiz, 2017, p. 3). According to the US Bureau of Labor Statistics, persons with a disability have significantly lower employment rates than persons without a disability (2020). Disability is a natural part of the human experience, and does not inhibit an individual’s ability to successfully contribute to society. “The unemployment rate for adults with intellectual disability is more than twice as high as those without disabilities, with only 44% of adults with intellectual disability aged 21 to 64 years participating in the labor force (Johnson & Blaskowtiz, 2017, p.4). Legislation has been implemented to support individuals with intellectual disabilities including American Disability Act (ADA), Individuals with Disabilities Education Act (IDEA), and Workforce Innovation and Opportunity Act (WIOA) (Cleary & Persch, 2020)

Profile of patients with intellectual disability visiting a tertiary care center in western India

Background:Intellectual disability is commonly associated with variety of etio-pathological and co-morbid conditions influencing outcome of rehabilitative measures. Understanding of these factors helps in better management of disabled condition.Methods:A qualitative retrospective case record review, of patients with intellectual disability, visiting psychiatry department of a tertiary care hospital, within a period of one year, was conducted to assess their epidemiological and clinical profile.Results: Patients with Intellectual disability are brought to the hospital at all ages and commonly by their parents. Etiologically related various peri-natal factors (delayed birth cry and seizures being most common) as well as childhood medical conditions (epilepsy and recurrent respiratory/GI infections being most common) were commonly found in these patients. Milestones are delayed in almost 60-70% of cases whereas various physical and psychiatric conditions commonly co-existed with disability.Conclusion:Clinical profile of these patients demands a comprehensive evaluation and management apart from routine IQ assessment

Acinic cell carcinoma, papillary-cystic variant: a rare case diagnosed in fine needle aspiration cytology

Acinic Cell Carcinoma is a rarest malignant epithelial neoplasm arising from pleuripotent stem cells. ACC constitute 6% of all salivary gland tumor. Most common site is parotid. It is slowly growing tumor with female preponderance most commonly occur during fifth and sixth decades of life. Diagnosis by imaging study are complex, but USG is helpful in evaluating tumor. We are presenting a 9year female, complaint of a painless, freely movable, atraumatic swelling on left cheek measuring 2x1cm2, slowly enlarging since, 8 months. FNAC was performed from the swelling and routine stain (H and E, MGG, Pap) and special stain (PAS) was performed. On cytological smears, overall findings are suggestive of papillary-cystic variant of ACC which is difficult to diagnosed in cytology. PAS stain showed positivity for both intra-cytoplasmic granules and extra-cellular secretions. ACC is a slowly growing multi-potent malignant salivary gland tumor. Management is with surgery

Fraud Detection in Credit Card System Using Web Mining

Abstract: Now a day the usage of credit cards has dramatically increased. As credit card becomes the most popular mode of payment for both online as well as regular purchase, cases of fraud associated with it are also rising. Various techniques like classification, clustering and apriori of web mining will be integrated to represent the sequence of operations in credit card transaction processing and show how it can be used for the detection of frauds. Initially, web mining techniques trained with the normal behaviour of a cardholder. If an incoming credit card transaction is not accepted by the web mining model with sufficiently high probability, it is considered to be fraudulent. At the same time, the system will try to ensure that genuine transactions will not be rejected. Using data from a credit card issuer, a web mining model based fraud detection system will be trained on a large sample of labelled credit card account transactions and tested on a holdout data set that consisted of all account activity. Web mining techniques can be trained on examples of fraud due to lost cards, stolen cards, application fraud, counterfeit fraud, and mail-order fraud. The proposed system will be able to detect frauds by considering a cardholder"s spending habit without its significance. Usually, the details of items purchased in individual transactions are not known to any Fraud Detection System. The proposed system will be an ideal choice for addressing this problem of current fraud detection system. Another important advantage of proposed system will be a drastic reduction in the number of False Positives transactions. FDS module of proposed system will receive the card details and the value of purchase to verify, whether the transaction is genuine or not. If the Fraud Detection System module will confirm the transaction to be of fraud, it will raise an alarm, and the transaction will be declined

Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy Takotsubo cardiomyopathy occurs worldwide. The condition is thought to be responsible for 2% of all acute coronary syndromes’ cases presenting to hospitals. Although it has generally been considered a self-limiting disease, spontaneously resolving over the course of days to weeks, a subset of patients may present with symptoms arising from its complications, e.g., heart failure, pulmonary oedema, stroke, cardiogenic shock, or cardiac arrest. It occurs more commonly in postmenopausal women

The possible significance of trisomy 8 in acute myeloid leukemia

Background: Acute myeloid leukemia (AML) is a heterogeneous disorder that results from a block in the differentiation of haematopoietic progenitor cells along with uncontrolled proliferation. Trisomy 8 is the most common recurring numerical chromosomal aberrations in acute myeloid leukemia (AML). It occurs either as a sole anomaly or together with other additional chromosomal aberrations. The prognostic significance of trisomy 8 in presence of other additional chromosomal abnormality depends on clonal cytogenetic changes. The patients with trisomy 8 had shorter survival with significantly increased risk with other chromosomal abnormality.Methods: Total 139 patients were screened between January 2016 to November 2016 who were suspected of AML cases. Bone marrow cultures were set up using conventional cytogenetic methods. Chromosomal preparation was made and subjected to GTG banding technique. Banded metaphases were analysed and karyotyped for further analysis.Results: Cytogenetic evaluation of karyotyped of 139 suspected AML patients showed 52 with t(8;21)(q22;q22), 36 with t(15;17)(q22;q12), and 11 with inv(16)(p13;q22). The rest 40 cases found with additional chromosomal abnormalities, of which 16 were sole trisomy 8 and 24 cases were found with other chromosomal abnormalities In addition, only one person found with t(8;21) and trisomy 8, while  three person having t(15;17) with trisomy 8.Conclusions: AML is considered to be one of the most important cytogenetic prognostic determinants. Recurrent chromosomal translocation with trisomy 8 varying 1.9% for t(8;21) and 8.3% for t(15;17). In the present study trisomy 8 in AML with known favourable anomalies is very small. Therefore, it cannot be taken as a prognostic marker

Photon irradiation effects on electrical properties of n-ZnO/p-Si junctions for optoelectronic device

Simple high energy laser photon irradiation is a handy tool to tune the functional properties of wide band gap oxide-based devices. Present study reports on the effects of laser photon irradiation on electrical transport behaviour of n-ZnO/p-Si p-n junctions. The n-type conductivity of ZnO was optimised by doping of stoichiometric amount of Al in ZnO. The n-ZnO/p-Si junctions were grown on p-Si (100) substrate by pulsed laser deposition. The structural property was analysed by X-ray diffraction. Morphological study was done using atomic force microscopy (AFM) which shows smooth and mono-dispersed surfaces of the p-n junction. The current-voltage (I-V) characteristic of the n-ZnO/p-Si devices have been measured at room temperature in the dark and under illumination. Moreover, the effects of 532 nm visible laser light irradiation on the electric parameter of n-AZO/p-Si p-n junctions were investigated. The characteristic parameters of the junctions such as barrier height, ideality factor and series resistance were determined from the current-voltage measurement. The results show a promise of ZnO based diode structure for its optoelectronic applications

Photon irradiation effects on electrical properties of n-ZnO/p-Si junctions for optoelectronic device

667-672Simple high energy laser photon irradiation is a handy tool to tune the functional properties of wide band gap oxide-based devices. Present study reports on the effects of laser photon irradiation on electrical transport behaviour of n-ZnO/p-Si p-n junctions. The n-type conductivity of ZnO was optimised by doping of stoichiometric amount of Al in ZnO. The n-ZnO/p-Si junctions were grown on p-Si (100) substrate by pulsed laser deposition. The structural property was analysed by X-ray diffraction. Morphological study was done using atomic force microscopy (AFM) which shows smooth and mono-dispersed surfaces of the p-n junction. The current-voltage (I-V) characteristic of the n-ZnO/p-Si devices have been measured at room temperature in the dark and under illumination. Moreover, the effects of 532 nm visible laser light irradiation on the electric parameter of n-AZO/p-Si p-n junctions were investigated. The characteristic parameters of the junctions such as barrier height, ideality factor and series resistance were determined from the current-voltage measurement. The results show a promise of ZnO based diode structure for its optoelectronic applications

An evidenced based evaluation on the outcome of osteopathic manipulative treatment on postoperative coronary artery bypass and sternotomy patients

The recent COVID-19 pandemic caused a widespread strain on healthcare systems around the world, including the United States. With limited resources, such as healthcare staff and available beds in intensive care units (ICU), consideration must be placed on effective solutions. The goal of our study is to find evidence supporting the effectiveness of osteopathic manipulative treatment (OMT) on ICU length of stay for post-operative patients that have undergone coronary artery bypass graft (CABG) surgery via sternotomy. We believe our findings will increase awareness of application of the beneficial effects of OMT in critical care patients