First Year Occupational Therapy Students’ Clinical Reasoning Approach to Addressing Challenging Behaviors Related to Sensory Processing Using a Simulated Case Study

Occupational therapy students must be prepared to use clinical reasoning to select appropriate interventions for children with sensory processing disorders (SPDs). Although these interventions are typically taught in entry-level occupational therapy programs, there is little information regarding the method by which occupational therapy students are taught a clinical reasoning process to determine which sensory processing intervention to use with pediatric clients. A problem-solving framework called A SECRET was used to teach students clinical reasoning for children with SPDs, via an online, module-based course. Following the module, the students were tested with an online assessment tool regarding their ability to discriminate between appropriate and inappropriate intervention strategies, and to articulate their rationale to demonstrate how they clinically reasoned through a complex client case. Eight students participated in a focus group to provide their perceptions of the online delivery of the content and the A SECRET reasoning process. Five descriptive representations emerged from the qualitative data analysis: the A SECRET Process, Self-Regulation, the Occupational Therapy Practice Framework, Participation, and Safety/Security. The findings suggest an inherent value for online learning to assist occupational therapy students in their program’s first year to learn the A SECRET process and then clinically reason through a simulated case study

Sexual Harassment Experiences and Harmful Alcohol Use in a Military Sample: Differences in Gender and the Mediating Role of Depression

The current investigation identified the genderspecific prevalence of sexual harassment and assault experienced during U.S. military service and the negative mental and physical health correlates of these experiences in a sample of former reservists. We surveyed a stratified random sample of 3,946 former reservists about their experiences during military service and their current health, including depression, posttraumatic stress disorder, somatic symptoms, and medical conditions. Prevalence estimates and confidence intervals of sexual harassment and assault were calculated. A series of logistic regressions identified associations with health symptoms and conditions. Both men and women had a substantial prevalence of military sexual harassment and assault. As expected, higher proportions of female reservists reported sexual harassment (60.0% vs 27.2% for males) and sexual assault (13.1% vs 1.6% for males). For both men and women, these experiences were associated with deleterious mental and physical health conditions, with sexual assault demonstrating stronger associations than other types of sexual harassment in most cases. This investigation is the first to document high instances of these experiences among reservists. These data provide further evidence that experiences of sexual harassment and assault during military service have significant implications for the healthcare needs of military veterans

Flexible Forage Systems for Variable Water Supplies

The dairy industry in northern Victoria, Australia is primarily based on the border check irrigation of temperate forage species over the spring to autumn period. Traditionally, dairy cows have grazed the perennial species (white clover and perennial ryegrass) and annual pastures (based on short-lived ryegrasses and subterranean or Persian clover). However, due to a more variable climate – particularly a period where the annual rainfall has been significantly less than the long-term average – the summer irrigation allocations have been substantially lower and more variable than the preceding 20-30 years. Under this climate scenario, dairy farmers are re-evaluating their feed base to ensure that they are optimising forage production under conditions of less water (both rainfall and irrigation - Greenwood et al. 2006; Lawson and Kelly 2007). Research at the Department of Primary Industries at Tatura in northern Victoria is focussing on identifying forage species and management systems that are better adapted to the predicted future climate (of higher summer temperatures and greater plant water stress) than perennial ryegrass. Research on lucerne is evaluating the flexibility of this species to perform when both rainfall and irrigation vary greatly across seasons and years. The aim of research on tall fescue is to develop an effective grazing management system that will capitalise on its high dry matter potential through the summer

Solutions Network Formulation Report. Aerosol Polarimetry Sensor Measurements of Diffuse-to-Global Irradiance Ratio for Improved Forecasting of Plant Productivity and Health

Studies have shown that vegetation is directly sensitive to changes in the diffuse-to-global irradiance ratio and that increased percentage of diffuse irradiation can accelerate photosynthesis. Therefore, measurements of diffuse versus global irradiance could be useful for monitoring crop productivity and overall vegetative health as they relate to the total amount of particulates in the air that result from natural disasters or anthropogenic (manmade) causes. While the components of solar irradiance are measured by satellite and surface sensors and calculated with atmospheric models, disagreement exists between the results, creating a need for more accurate and comprehensive retrievals of atmospheric aerosol parameters. Two satellite sensors--APS and VIIRS--show promise for retrieving aerosol properties at an unprecedented level of accuracy. APS is expected to be launched in December 2008. The planned launch date for VIIRS onboard NPP is September 2009. Identified partners include the USDA s ARS, North Carolina State University, Purdue Climate Change Research Center, and the Cooperative Institute for Research in the Atmosphere at Colorado State University. Although at present no formal DSSs (decision support systems) require accurate values of diffuse-to-global irradiance, this parameter is sufficiently important that models are being developed that will incorporate these measurements. This candidate solution is aligned with the Agricultural Efficiency and Air Quality National Applications

Forecasting Plant Productivity and Health Using Diffuse-to-Global Irradiance Ratios Extracted from the OMI Aerosol Product

Atmospheric aerosols are a major contributor to diffuse irradiance. This Candidate Solution suggests using the OMI (Ozone Monitoring Instrument) aerosol product as input into a radiative transfer model, which would calculate the ratio of diffuse to global irradiance at the Earth s surface. This ratio can significantly influence the rate of photosynthesis in plants; increasing the ratio of diffuse to global irradiance can accelerate photosynthesis, resulting in greater plant productivity. Accurate values of this ratio could be useful in predicting crop productivity, thereby improving forecasts of regional food resources. However, disagreements exist between diffuse-to-global irradiance values measured by different satellites and ground sensors. OMI, with its unique combination of spectral bands, high resolution, and daily global coverage, may be able to provide more accurate aerosol measurements than other comparable sensors

Low cancer suspicion following experience of a cancer 'warning sign'

© 2015 The Authors. Published by Elsevier Ltd. Aim Lower socioeconomic status (SES) is associated with a higher risk of late-stage cancer diagnosis. A number of explanations have been advanced for this, but one which has attracted recent attention is lower patient knowledge of cancer warning signs, leading to delay in help-seeking. However, although there is psychometric evidence of SES differences in knowledge of cancer symptoms, no studies have examined differences in 'cancer suspicion' among people who are actually experiencing a classic warning sign. Methods A 'health survey' was mailed to 9771 adults (≥50 years, no cancer diagnosis) with a symptom list including 10 cancer 'warning signs'. Respondents were asked if they had experienced any of the symptoms in the past 3 months, and if so, were asked 'what do you think caused it?' Any mention of cancer was scored as 'cancer suspicion'. SES was indexed by education. Results Nearly half the respondents (1732/3756) had experienced a 'warning sign', but only 63/1732 (3.6%) mentioned cancer as a possible cause. Lower education was associated with lower likelihood of cancer suspicion: 2.6% of respondents with school-only education versus 7.3% with university education suspected cancer as a possible cause. In multivariable analysis, low education was the only demographic variable independently associated with lower cancer suspicion (odds ratio (OR) = 0.34, confidence interval (CI): 0.20-0.59). Conclusion Levels of cancer suspicion were low overall in this community sample, and even lower in people from less educated backgrounds. This may hinder early symptomatic presentation and contribute to inequalities in stage at diagnosis

Physician nutrition and cognition during work hours: effect of a nutrition based intervention

<p>Abstract</p> <p>Background</p> <p>Physicians are often unable to eat and drink properly during their work day. Nutrition has been linked to cognition. We aimed to examine the effect of a nutrition based intervention, that of scheduled nutrition breaks during the work day, upon physician cognition, glucose, and hypoglycemic symptoms.</p> <p>Methods</p> <p>A volunteer sample of twenty staff physicians from a large urban teaching hospital were recruited from the doctors' lounge. During both the baseline and the intervention day, we measured subjects' cognitive function, capillary blood glucose, "hypoglycemic" nutrition-related symptoms, fluid and nutrient intake, level of physical activity, weight, and urinary output.</p> <p>Results</p> <p>Cognition scores as measured by a composite score of speed and accuracy (Tput statistic) were superior on the intervention day on simple (220 vs. 209, p = 0.01) and complex (92 vs. 85, p < 0.001) reaction time tests. Group mean glucose was 0.3 mmol/L lower (p = 0.03) and less variable (coefficient of variation 12.2% vs. 18.0%) on the intervention day. Although not statistically significant, there was also a trend toward the reporting of fewer hypoglycemic type symptoms. There was higher nutrient intake on intervention versus baseline days as measured by mean caloric intake (1345 vs. 935 kilocalories, p = 0.008), and improved hydration as measured by mean change in body mass (+352 vs. -364 grams, p < 0.001).</p> <p>Conclusions</p> <p>Our study provides evidence in support of adequate workplace nutrition as a contributor to improved physician cognition, adding to the body of research suggesting that physician wellness may ultimately benefit not only the physicians themselves but also their patients and the health care systems in which they work.</p