Charting the path of clinical progress.
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Biomedical subjects
Publications and source records attributed to J Stout.
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Occupational therapists are well qualified for involvement in playground planning. They know how to eliminate architectural barriers, adapt equipment to maximize independence and functional levels, and use play in facilitating children's development. By participating in playground planning or adaptation, the occupational therapist can present play opportunities for children with disabilities, increase public awareness of occupational therapy, and extend the use of treatment modalities. This paper makes specific suggestions for planning and building to make the idea for a playground a realistic goal. A case example illustrates the planning of a playground in a hospital setting.
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This study used a year-long prospective design to assess linkages among distress, immunity, and illness. Serial blood samples were collected from 40 first-year medical students at the first, third, and fifth examination periods, as well as 1 month before each. There were significant decrements in the production of gamma-interferon by concanavalin A-stimulated lymphocytes obtained at the time of examinations. Antibody titers to Epstein-Barr virus (EBV) increased during examination periods, suggesting reactivation of latent EBV and therefore poorer cellular immune control of latent virus. We obtained data that suggest that T-cell killing by memory T lymphocytes of EBV transformed autologous B lymphocytes also declined during examination periods. The activity of a lymphokine, leukocyte migration inhibition factor, normally suppressed during recrudescence of herpes simplex virus type 2 infections, was altered during examination periods and an increase in both plasma and intracellular levels of cyclic AMP associated with examination stress was observed. An increase in the incidence of self-reported symptoms of infectious illness was also associated with examination periods. The data support the linkage between stress-related immunosuppression and health.
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This study assessed the enhancement of immunocompetence by relaxation and social contact in 45 geriatric residents of independent-living facilities. Subjects were randomly assigned to one of three protocols: relaxation training, social contact, or no contact. Subjects in the relaxation and social-contact conditions were seen individually three times a week for a month. Blood samples and self-report data were obtained at baseline, at the end of the intervention, and at a 1-month follow-up. At the end of the intervention, the relaxation group showed a significant increase in natural killer cell activity, and significant decreases in antibody titers to Herpes simplex virus and self-rated distress; the other two groups showed nonsignificant changes. There was a general increase in the T-lymphocyte response to phytohemagglutinin stimulation at the end of the intervention, with greater change at lower mitogen concentrations. These data suggest that cellular immunocompetence may be enhanced by psychosocial interventions.
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An epidemiological link was found between contamination of a hospital water-supply by Legionella pneumophila and by Pittsburgh pneumonia agent (PPA) and subsequent cases of nosocomial legionnaires' disease and Pittsburgh pneumonia. The extent of L pneumophila isolation from the water-supply paralleled the occurrence of disease. Whenever L pneumophila was isolated from more than 30% of ten selected water sites, nosocomial legionellosis occurred. The temperature of the hot water tanks was raised to 60-77 degrees C for 72 h, and water outlets were flushed for 30 min with hot water. A decline in numbers of L pneumophila and PPA in the water-supply was followed by a fall in the incidence of legionnaires' disease and Pittsburgh pneumonia. In addition, intermittent raising of the temperature in the hot water system decreased both the number of months in which disease occurred and the proportion of nosocomial pneumonias caused by these organisms.
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