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PubMed1991

Meaning ascribed to major professional concepts: a comparison of occupational therapy students and practitioners in the United States and Israel.

A number of concepts related to human performance, such as occupation, purposeful activity, function, work, doing, and play/leisure, are widely used in occupational therapy. Because these concepts are essential to the profession, we seek to understand their meaning. Many theorists in occupational therapy define and attribute different levels of importance to each of these concepts. The present study examines the professional (student vs. practitioner) and universal (American vs. Israeli) meanings of the six concepts named above. Four statistical methods were used: (a) a multivariate analysis of variance, (b) t tests and a sign test to analyze the Osgood semantic differential, and (c) Individual Differences in Multidimensional Scaling (Carroll & Chang, 1970). The results indicate that the American occupational therapists ascribed higher affective meanings than did all of the other groups to the concepts of purposeful activity, function, doing, and work. No difference was found for occupation and hobby, which rated high for all groups. Differences in the dimensions underlying the concepts between American and Israeli subjects suggest a cultural and linguistic influence on the meaning ascribed to the concepts.

Analysis of Variance↗
PubMedDate not supplied

Occupational performance needs of adolescents in alternative education programs.

OBJECTIVE: Alternative education programs are schools that accept students who have not been successful in the general education setting. This study focuses on developing a better understanding of the needs of students in three area alternative education schools. METHODS: A needs assessment was created and distributed to the staff of each school regarding the problem areas of alternative education students. Data were analyzed descriptively. RESULTS: Thirty-nine of 47 surveys were returned resulting in an overall return rate of 83%. The staff identified several potential deficit areas faced by the students in these alternative education programs. The most frequently identified deficits included poor time management skills, decreased healthy participation in hobbies and leisure activities, and a lack of healthy lifestyle behaviors. In addition, the staff reported that many students had cognitive deficits including reduced ability to follow multistep directions, impaired higher-level thinking skills, reduced attention span, and limited memory. CONCLUSION: The results of this study are consistent with literature that suggests the students in alternative education settings may have underlying deficits that interfere with learning and produce misbehaviors. The alternative education programs should be further explored as a potential practice area for occupational therapists.

Data Collection↗
PubMedDate not supplied

The ergonomics of caring for children: an exploratory study.

BACKGROUND: Caring for one's children is among the most ubiquitous of occupations. However, few studies have examined the ergonomic risks involved in parents caring for children at home. PURPOSE: The purpose of this study was to identify the frequency, type, and severity of musculoskeletal symptoms in parents of children less than 4 years old. The study further examined the factors that contribute to musculoskeletal pain in this sample. METHODS: A convenience sample of 130 parents with children younger than 4 years old completed a seven-page survey that included questions related to the parents' demographics, their musculoskeletal discomfort, their performance of child-care tasks with high biomechanical risks (such as carrying a child in a car seat), and parents' perceived psychological strain related to caring for their children. RESULTS: Ninety-two percent (92%) of the providers were mothers. Sixty-six percent (66%) of the sample reported the presence of musculoskeletal pain. The parts of the body most affected were the low back (48%), neck (17%), upper back (16%), and shoulders (11.5%). Factors associated with musculoskeletal pain were performing child-care tasks defined as having high biomechanical risks (p = .001), the perception that caring for children is highly demanding (p = .003), and performing hobbies less than 1 hour per week (p = .04). Parents' working status, age, and participation in other daily activities were not significantly related to musculoskeletal discomfort. CONCLUSION: This study demonstrates the high prevalence of musculoskeletal pain in parents of children under the age of 4 years. It underscores the association between physical and psychological factors in the development of musculoskeletal discomfort. It suggests the need for occupational therapy wellness programs that focus on preventing musculoskeletal discomfort and providing support for the parenting role.

Adult↗
PubMed1996

Evaluation of selected publications on reference values for lead in blood.

As a part of the global Tracy project, whose aim is to define metal concentrations in tissues and body fluids of reference populations, more than 1000 papers published from 1980 to 1994 were scrutinized that presented tentative reference values for lead in blood in occupationally unexposed adult populations. Ten studies exemplifying criteria for proper sampling, analysis and data treatment are presented and discussed. Levels of lead in blood are influenced by numerous factors. Accordingly, a wide variation in blood lead concentrations was observed. As an example, in a global study in 1983 of nonsmoking female schoolteachers, the geometric mean value for lead in blood varied from 52 micrograms. l-1 in Tokyo, Japan, up to 193 micrograms. l-1 in Mexico City. The Tracy survey demonstrates the importance of factors such as age, gender, ethnicity, food, drinking and smoking habits, hobbies, season and year of sampling, residential area, and geographic location. Lead in blood was shown to be both time and area specific. Thus it was not possible to establish a general reference value for lead in blood.

Adult↗
PubMed1999

Challenges to retrospective exposure assessment.

Retrospective exposure assessment has become a crucial component in the interpretation of occupational epidemiologic results. Many advances have been made over the last 2 decades, but substantial progress is still necessary to reduce the misclassification of exposure. The efforts needed include evaluating the validity and reliability of assessment methods, better documentation of the methods, use of exposure determinants to estimate exposure levels more accurately and reliably, and an increase in the understanding of industrial hygiene and biological measurement data and questionnaires, their limitations, and how to use them best. In addition, better characterization of exposures is necessary. This need includes evaluating dermal and ingestion hazards, incorporating nonoccupational sources of exposures, particularly hobbies, evaluating the effect of multiple chemicals, and exploring different exposure metrics.

Data Collection↗
PubMed1992

A case of human melioidosis originating in south-west Western Australia.

OBJECTIVE: To report the first human case of autochthonous melioidosis in temperate Australia (latitude 31 degrees 10'S) and to describe the extent of the presence of the causative agent, Pseudomonas pseudomallei, in southwest Western Australia. CLINICAL FEATURES: A 45-year-old man living on a hobby farm was admitted to hospital for investigation of lung lesions, weight loss and low grade fevers. P. pseudomallei was cultured from material from an aspiration biopsy of a mediastinal mass. INTERVENTION AND OUTCOME: The patient was successfully treated with a regimen of ceftazidime and trimethoprim-sulfamethoxazole. A review of epidemiological data showed that, since 1967, P. pseudomallei has been cultured from animals and soil in a region 50-250 km north-west of Perth, Western Australia, and that pockets of endemicity are found in the districts of Toodyay (where our patient's farm was), Chittering, Ballidu, Gidgegannup, Badgingarra, and Wongan Hills. CONCLUSION: The persistence of the bacterium in animals and soil in south-west Western Australia demonstrates abundantly that P. pseudomallei can exist opportunely beyond its traditional tropical habitat. It is likely that there will be further clinical cases of melioidosis originating in this region, and that the boundaries of endemicity in Australia will expand further.

Animals↗
PubMed1999

Characteristics of patients with community-acquired pneumococcal pneumonia.

OBJECTIVE: To describe the level of activity, independence and demographics of elderly people hospitalised with community-acquired pneumococcal pneumonia. DESIGN: Prospective descriptive study. SETTING: Seven university-affiliated hospitals and three community hospitals. PATIENTS: People aged over 55 years admitted to hospital with a clinical history consistent with pneumococcal pneumonia, a Streptococcus pneumoniae isolate in blood or sputum, and a chest x-ray consistent with pneumonia. Significant immunosuppression or certain comorbidities (parenchymal lung disease and end-stage renal failure) were exclusion criteria. MAIN OUTCOME MEASURE: Level of independence, assessed by participation in a range of standardised activities before the patient's illness. RESULTS: 82 patients met our case definition. Five refused to participate, leaving 77 evaluable patients. The patients had high levels of independence: 64 (83%; 95% confidence interval [CI], 73%-91%) lived in their own home and 69 (90%; 95% CI, 81%-95%) participated in regular hobbies. Exercise tolerance was good, with 43 (56%; 95% CI, 45%-68%) able to climb a flight of stairs and 59 (76%; 95% CI, 65%-85%) able to walk more than 50 m without stopping; 41 (53%; 95% CI, 41%-64%) could continue further than a kilometre. Mortality was low (9 patients; 12%) despite a high rate of bacteraemia (43 patients; 56%). Within the past five years, 59 (77%) had been hospitalised and 53 (69%) vaccinated with influenza vaccine. Only 7% had ever received pneumococcal vaccination. CONCLUSION: Pneumococcal pneumonia is not the "old man's friend". It represents a major cause of morbidity and mortality in otherwise well, active and independent older Australians. Hospitalisation and attendance for influenza vaccination may represent opportunities for pneumococcal vaccination.

Activities of Daily Living↗
PubMed1994

[Clinical feature and quality of life of urinary diversion patients with bladder cancer].

A clinical survey was performed on 95 cases who were treated by total cystectomy with urinary diversion at our hospital between August 1971 and March 1992. Urinary diversions were classified by ureterocutaneostomy (Group I) in 27 patients, ileal or colon conduit (Group II) in 45 and continent urinary reservoir (Group III) in 23. The patients ranged in age from 29 to 76 with an average age of 60.6 year and the male to female ratio was 68 to 27. Histopathological typing of bladder cancers showed 82 cases of transitional cell carcinoma, 8 cases of squamous cell carcinoma, 4 cases of adenocarcinoma, and 1 mixed carcinoma with transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma. At present, patients alive of Group I, II and III were 14, 27 and 16, respectively, totally 57 (60.0%) patients were alive. Five-year actuarial survival rates of Group I, II and III were 45.2%, 54.1%, and 56.8%, respectively. A questionnaire survey was carried out to assess the quality of life (QOL) of 57 alive patients. The analysis of replied questionnaire showed that even all patients of each groups adapted to the basic life activities after urinary diversion, though a step forward quality of life with hobby, travel and job were decreased postoperatively in 3 groups. We obtained results that the patients of Group III were more satisfactory with daily (bath) and social life (job) than the patients of Group I, II and preoperatively. We have a new comprehension of importance of enough informed consent and mental support to the urinary diversion patients preoperatively, and of a new operative procedure not to impair the QOL.

Adenocarcinoma↗
PubMed1997

Health-related quality of life after organ transplantation in childhood.

While sophisticated data on patient and graft survival are available, very little is known about the overall health-related quality of life (HRQOL) after organ transplantation (Tx) in childhood. We examined the perceived HRQOL of survivors of heart, liver and kidney Tx. A previously validated, age-appropriate, multidimensional questionnaire was completed by 59 survivors, currently aged 8-23 years, who had received an organ transplant in 1983-1994, at least 6 months prior to the study. The overall HRQOL score of the patients aged 8-11 was lower than that of the normal controls, while the HRQOL scores of the patients aged 12-15 and 16-23 were similar to those of the controls. However, the younger patients had more complex diseases. Compared to the controls, the patients reported more problems regarding their mobility, usual activities, and school and hobbies. In addition, the patients aged 8-11 reported more problems with eating, elimination, friends and ability to concentrate than the controls. There was an association between age at Tx and HRQOL, but no association between the type of Tx or time since Tx and HRQOL. The perceived emotional status of the patients was better than that of the controls, especially during and after adolescence. We conclude that to provide optimal care, patients HRQOL should be assessed. Although the survivors report problems, the overall HRQOL after Tx is good. The occurrence of complications before Tx appears to be a crucial factor as regards the long-term HRQOL of the survivors. Attention should be paid to treatment prior to Tx and to the timing of Tx in order to improve the HRQOL after Tx.

Adolescent↗
PubMed1994

Landing doctors takes more than money.

Competition for primary care physicians has gone from an amateur hobby to a professional sport in the past three months, with hospitals fighting each other, managed care companies and even employers for this valuable resource. The winners have learned that it takes money and a lot more to land the doctors.

Medical Staff, Hospital↗
PubMed1992

Cataract extraction: patient characteristics and preferences.

This paper reports the results of a comparative study of inpatient and day case patients undergoing a cataract extraction with intraocular lens implant. An assessment was made of their home circumstances, and included questions about their health and hobbies before and after surgery. The results show that patients were generally optimistic about their capabilities after the operation, and that most were pleased to have been randomly allocated to their particular group. There were no statistically significant differences between day cases and inpatients, suggesting a possibility of choice for patients within available resources.

Aged↗
PubMedDate not supplied

Life after retirement. Interview by Barbara J. Linney.

Are you thinking about retirement? Here are interviews with four physician executives who have made the transition. Some are recently retired, while others have been retired for many years. The good news is that all of them are productive and exploring interests and hobbies that their careers had taken precedence over. All of them were asked the following: (1) How have you felt about retirement? (2) What are some interesting things you've done? (3) What advice would you give to others who are planning for it?

Physician Executives↗
PubMed1999

[Functional capacity (dyspnea) and quality of life in patients with chronic obstructive lung disease (COPD): instruments of assessment and methodological aspects].

Functional capacity (dyspnea) and quality of life are important criteria for the assessment of disease impact and treatment outcome in patients with chronic obstructive pulmonary disease (COPD). We will review measures for dyspnea and quality of life with particular emphasis on their methodological properties. Because asthma and COPD exhibit important differences and are therefore not comparable, we discuss only those measures which have been verified methodologically in patients with COPD. A critical review of current measures for dyspnea reveals at best an only fair association between perceived dyspnea and physiological lung function, sharing not more than 30% of common variance. Moreover, the affective state of the patients, their individual adaptation level and further psychological variables serve as mediators between lung function and perceived dyspnea. However, several valid and reliable measures for dyspnea are available for research and clinical practice. While the term "quality of life" is rather broad and unspecified, many researches in the field prefer the more restrictive term "health-related quality of life (HRQOL), that is the quality of life as affected by health status. The concept of HRQOL encompasses the impact of the individual's health on his or her ability to perform activities of daily living such as social role functioning, home management, social and family relationships, self-care, mobility, recreation and hobbies. In the past 15 years there has been an increasing body of literature on the measurement of HRQOL in patients with COPD. Several disease-specific and generic instruments for the use in COPD patients have been published. There is a growing consensus about the methodological criteria a given instrument has to fulfill. These are validity, sensitivity (for change) and reliability. They have to be tested in patients suffering from the illness for which the HRQOL instrument is planned to be applied in clinical studies or routine. The disease-specific instruments are supposed to be more sensitive to small therapeutically induced changes. However, the empirical results in patients with COPD are mixed and do not clearly favour disease-specific instruments. Lung function, dyspnea measures and exercise tolerance as well do not correlate strongly with HRQOL. Most associations cover only between 10% and 16% of shared variance. Exercise tolerance is not well associated with lung function but correlates better with HRQOL. Nowadays we can rely on several measures for dyspnea and HRQOL which have been thoroughly verified methodologically in COPD patients. However, some disease-specific and generic instruments exhibit substantial flaws, so that they need to be revised and it seems better not to use them at present. Many methodological and conceptual questions remain unanswered in the field indicating a strong need for more research.

Dyspnea↗
PubMedDate not supplied

Stress management. What do you do to relax?

Stress has been identified as a leading cause of disease in our society. The dynamics of the healthcare administration profession cause managers to be easy victims of this contemporary disorder. Many people realize that an antidote to stress is leisure-time hobbies. To find out what managers do with their leisure time, MGMA conducted an informal poll of Association members. Their responses were enlightening, interesting, and sometimes amusing. Some managers share similar interests, while some are quite unique.

Health Facility Administrators↗
PubMed1998

[Differential diagnosis of mushroom poisoning].

Mushroom poisoning is a very urgent problem of internal medicine. Mushroom picking is one of the most popular hobbies in the Czech and Slovak Republic. This is one of the main reasons of the rising incidence of mushroom poisoning, incl. fatal cases. Mushroom poisoning is characterized by a very varied clinical picture which is reflected also in recent classification systems. The main objective of the present work is to draw attention to cardinal symptoms and signs of different types of mushroom poisoning which respect new findings in the diagnosis and differential diagnosis of mushroom poisoning.

Diagnosis, Differential↗
PubMed1999

The North American Menopause Society 1998 Menopause Survey. Part I: Postmenopausal women's perceptions about menopause and midlife.

OBJECTIVE: To collect information relevant to the mission of The North American Menopause Society (NAMS)--i.e., increasing understanding of menopause--by assessing perceptions held by postmenopausal women in the United States aged 50 to 65 years regarding their menopause transition and early postmenopausal years. DESIGN: During the period from June to July 1998, The Gallup Organization conducted 752 telephone interviews with a randomly selected sample of postmenopausal women aged 50 to 65 years from across the United States, based on questions developed by NAMS. In Part I of this survey, women were asked about their personal experiences with menopause, their health-related lifestyle changes since premenopause, their frequency of discussing menopause, and their rating of preparedness for menopause. Part II of this survey, including use of hormone replacement therapy as well as use of healthcare services, will be reported in a future communication from NAMS. RESULTS: The majority (51%) of the postmenopausal women surveyed reported being happiest and most fulfilled between the ages of 50 to 65 years, compared with when they were in their 20s (10%), 30s (17%), or 40s (16%). Many areas of their lives had improved since menopause, including family/home life, sense of personal fulfillment, ability to focus on hobbies or other interests, relationship with spouse/partner, and friendships. A majority (51%) said their sexual relationships had remained unchanged. Approximately three-quarters of women surveyed reported making some type of health-related lifestyle change, such as stopping smoking, at menopause/midlife. Women who had undergone hysterectomy expressed more improvement than women with an intact uterus, especially in the areas of sexual relationships, spouse/partner relationships, personal fulfillment, and physical health; data are not available regarding the health state of these women before surgery or whether they experienced surgical menopause, but this improvement did not appear to be the result of hormone replacement therapy. Women tended to look to women from their own generation for menopause-related information and believed that they have prepared the younger generation for menopause better than they were prepared by their mothers' generation. Those surveyed advised younger women to engage in healthful activities and become knowledgeable so that they could make informed health decisions. CONCLUSIONS: Although the postmenopausal women surveyed had differing views of menopause as well as their perceptions of postmenopause compared with premenopause, the majority viewed menopause and midlife as the beginning of many positive changes in their lives and health. Hysterectomy was a factor associated with improved sexual relationships, spouse/partner relationships, sense of personal fulfillment, and physical health.

Adaptation, Physiological↗
PubMed1999

[Professor Witold J. Orłowski. Obituary for 10th anniversary of his death].

The article presents an outline of Prof. W.J. Orłowski's (1918-1988) biography. He studied at Warsaw University (1936-1939) and Lódź University (1945-1947). He became interested in ophthalmology as early as before completing his studies. He graduated in medicine in 1950, few years later obtained doctor's degree and in 1961 received the thid degree (habilitation) and lectureship. From 1st June 1965 till 30th June 1988 he was Head of Ophthalmologic Clinic at Poznań Medical Academy. He wrote a considerable number of ophthalmologic textbooks, 208 research papers, and was an editor of textbooks and periodicals. Prof. W.J. Orłowski's scientific interest focused on retina diseases which resulted in founding Retinological Section in 1970, and thus starting to develop Polish retinology. As a humanist he rendered services to journalism where, as early as his high school time, he used to publish board bulletins, and edited periodicals including "Glass Houses", "The Forge at the Young", "Life of Youth". During his university studies he worked as journalist in "The Republic" and in "Lódź Daily". After graduating from university he continued his medical and journalist passions as author and editor for "Medical News", "Let's Live Longer", "The Eye Clinic". He was an outstanding expert in the history of ophthalmology. Prof. W.J. Orłowski was a man of a wide range of interests. His hobbies included stamps collecting and numismatics. He received wide recognition among both Polish and foreign ophthalmologists as well earned deep respect from his colleagues and students.

History, 20th Century↗
PubMedDate not supplied

[Risperidone in the treatment of psychotic, affective and behavioral symptoms associated to Alzheimer's disease].

INTRODUCTION: A total of 235 patients with diagnoses of Alzheimer's dementia together with psychotic and/or affective symptomatology, as well as behavioral disturbances was included in an open label postmarketing surveillance study. The study objectives were to asses: 1) risperidone efficiency in psychotic and affective symptomatology and behavioral disturbances; 2) risperidone influence in the patient's performance, 3) dosage range at which efficiency is observed; and 4) safety in this group of patients. Patients were observed during a six month period. Risperidone was used at a mean dosage of 1.23 +/- 0.86 mg daily (range: 0.5-4.5 mg daily). MATERIAL AND METHODS: Risperidone was assessed by the Clinical Global Impression (CGI), Geriatric Depression Scale (GDS), Neuropsychiatric Inventory (NPI), Clinical Deterioration Rating (CDR), UKU subscale for neurological side effects and spontaneous reports. Patients were evaluated at baseline, 15 days and months 1, 2, 4 and 6. Sixteen patients (6.8%) were excluded from the statistical analysis due to protocol violation. Fifty four patients (24.7%) dropped out. RESULTS: Risperidone produced a significant improvement in the mean total scores of CGI, NPI, GDS (patient's satisfaction, hope.) and CDR (judgment and problem solving, community affairs, hobbies.) scales. Extrapyramidal symptoms improved from day 15 onwards in patients who had received antipsychotic treatment previously; in naive treated patients these symptoms did not change during the study period. CONCLUSIONS: Risperidone was well tolerated. Only 6 (2. 7%) discontinued treatment due to adverse events. Ninety seven percent of the patients did not suffer any adverse event; the resting 2.7% suffered one or more side effects: sedation (1.4%), constipation (0.5%) and vomiting (0.5%) among others.

Alzheimer Disease↗