Thirty female outpatients with metastatic breast carcinoma were evaluated using two operational models constructed for the purpose of assessing and assigning a quantitative score for (A) extent of metastatic disease and (B) level of functional disability. These patients were drawn from the population of patients with disseminated breast carcinoma attending the medical oncology clinics at the Medical College of Virginia Tumor Clinics for a 49 day period in 1975. The data from this patient sample were used to test several hypotheses. Each patient underwent an initial screening procedure designed to clearly identify those patients with disseminated disease. This was followed by a preliminary evaluation involving related background information. The selected patient sample was then evaluated and scored on the operational models. The numerical data were tabulated and statistically analyzed for the full patient sample and subsequently for inclusive groupings using the following parameters: age, length of disease, length of disease free interval, duration of metastatic disease, clinic attended, and major metastatic sites. In addition, the distribution of the patient sample over functional classification categories, the frequency of specific disabilities, and related sample characteristics were tabulated and analyzed. A summary of the major findings of this research project are enumerated below: 1. There is a positive statistical correlation between the extent of metastatic disease and the level of disability and physical dysfunction for the full sample of patients with metastatic breast carcinoma. 2. Those patients over the age of 60, and those patients having their disease longer than 3.3 years do not exhibit significantly greater levels of functional disability than those patients under the age of 60 or those patients having their disease less than 3.3 years. 3. The length of the disease free interval, the duration of metastatic disease, and the tumor clinic attended did not have a significant effect on the extent of metastases or the level of physical dysfunction in these patients. 4. For each of the six major metastatic sites (lung, pleura, bone, liver, brain, and distant lymphatic or skin and soft tissue), there was a positive statistical correlation between the extent of metastatic disease and the level of physical dysfunction. The value for r exceeded .7 and was significant for each group except Group PD — those patients with pleural effusions. 5. Patients with pleural effusions had significantly less metastatic disease in comparison to the full patient sample. These patients also correlated the lowest between extent of metastases and level of functional disability. 6. Patients with liver metastases showed the highest correlation coefficient of any of the other groups; this value was significantly different from the full patient sample correlation coefficient. 7. Patients with brain metastases had significantly greater amounts of metastatic disease, and significantly greater levels of functional disability in comparison to all patients combined. 8. Patients with pleural effusions or bone metastases were less likely to have several additional anatomical sites involved with metastatic tumor. 9. Patients with lung, liver, brain, or skin and soft tissue — distant lymphatic involvement were more likely to have several additional anatomical sites involved with metastatic tumor. 10. There was a statistically uneven distribution of patients over a six category functional classification schema, the majority of patients not being severely dysfunctional. 11. Approximately three fourths of the patients with metastatic breast carcinoma would have the supportive goal selected for their rehabilitation needs. 12. Approximately one fourth of the patients could be classified as terminal or preterminal and would have the palliative goal selected for their rehabilitation needs. 13. Less than one third of the patient sample could be classified in performance status levels which would indicate that they need assistance of some kind to care for their personal needs, carry on normal daily activities, or return to part time employment, duties, or age-appropriate tasks. The physical therapy needs for this group are correspondingly greater.

<p> This participant-observer, phenomenological qualitative study explored the adult experience of a community circus class through an occupational therapy lens. Following 4 months of weekly participant-observation, semi-structured interviews were conducted with four adult beginner students in a community-based social circus class. Interviews were audio recorded, transcribed and analyzed using a grounded theory approach to identify six themes. Two themes addressed the structural supports of the class: <i>Meeting People Where They Are </i>, and <i>Culture and Competition</i>. Four themes were based on participant experiences and perceived outcomes: <i>Releasing Expectations, Trying, Learning</i>, and <i>Fun, Making Friends, Making Community, and Feeling Better</i>. Findings suggest that through the fun aspects of circus participation, students were able to confront and overcome physical, social, emotional and cognitive challenges. In this way, personal growth and quality of life were promoted. External supports enabled students to adopt an individualized approach to participation that encouraged self-awareness and self-assessment across multiple domains. Due to the scarcity of research investigating adult participation in circus, the therapeutic benefit of circus participation merits further investigation. Circus and occupational therapy may develop a mutually beneficial relationship on the basis of shared common philosophy and values. By working together, occupational therapy and circus may enhance their ability to address occupational justice, inclusivity, empowerment, connection, play and quality of life.</p>

Capstone Paper: Individual Case Study: The SOS Approach to Feeding

Adapting the Resources for Enhancing Alzheimer’s Caregivers Health (REACH) program for use in a nursing home setting OCT 7003 Capstone Paper

<p> Due to the limited research of speech language pathologists&rsquo; (SLP) working with patients with psychotic disorders, the purpose of this study was twofold. The first purpose was to investigate currently practicing SLPs&rsquo; confidence, competence, and knowledge when assessing and treating communication and swallowing disorders in these patients. The second purpose of this study was to highlight the importance and need to further research, provide more resources, and educate SLPs in this scope of practice. The present study utilized a 26 item survey, completed by 29 certified and licensed SLPs. This paper sought to identify correlations between an SLP&rsquo;s number of years of experience he or she has and their confidence levels when assessing and treating patients with psychotic disorders. Results of a correlational analyses showed that there was a weak correlation between the number of years of experience an SLP has and his or her confidence levels in identifying symptoms related to communication. There was also no statistical significance between the number of years of experience of an SLP and assessing and diagnosing communication impairments in patients with psychotic disorders. This study also investigated correlations between an SLP&rsquo;s number of training courses taken specific to patients with psychotic disorders and their confidence levels when assessing and treating these patients. Results revealed a strong positive correlation regarding the number of formal training courses specific to patients with psychotic disorders and the participant&rsquo;s level of confidence in accurately identifying symptoms related to speech and communication impairments. Given the paucity of research available for practicing SLPs in the assessment and treatment of patients with psychotic disorders, this study&rsquo;s results support the need for more research and education of SLPs serving this population. </p>

<p> The purpose of this study was to investigate if socioeconomic status has a direct impact upon the accessibility of speech-language resources. A secondary purpose was to identify the possible barriers experienced by parents when accessing speech-language pathology resources. Online questionnaires were completed by 31 parents who had at least one child between the ages of 0-18 with or without a speech-language or hearing disorder, and were currently or previously received services at either Tichenor Orthopedic Clinic for Children in Long Beach, CA or Sounds Smart Speech Therapy in Placentia, CA. Results indicated that inverse relationship between the income level and the number of barriers experienced when accessing resources exists (i.e., income level increases = number of barriers experienced decreases). The results further indicated that the higher level of parental education, the sooner the child will be diagnosed. Further research is necessary to assist speech-language pathologists in facilitating parent education and identification of children with speech-language deficits (i.e., delays and/or disorders) across socioeconomic levels.</p>

This study was concerned with the relationship between patient motivation for treatment in three of the various therapy sections of the Physical Medicine and Rehabilitation Service of the Veterans Administration General Medical and Surgical Hospital, Long Beach, California, and needs as measured by the Edwards Personal Preference Schedule. Of the six therapies under the direction of the Physical Medicine and Rehabilitation Service consideration was given to the following: Occupational Therapy (OT), Physical Therapy (PT), and Corrective Therapy (CT)

This study examines the relationship between an individual's health locus of control belief and four variables: previous job injury experience, the duration of work absence due to previous job injury, appointment keeping behavior, and the wage replacement ratio. Seventy-two subjects with job related injuries referred to an industrial physical therapist were administered the Multidimensional Health Locus of Control Scale (MHLC). There was an uneven distribution of subjects according to MHLC belief patterns with more subjects demonstrating a "pure internal" health locus of control belief. No significance (Q > .05) was found between our four variables associated with a job injury and a high powerful others (PHLC) and chance (CHLC) locus of control beliefs. Not all the subjects had experienced a previous job injury and, therefore, had not developed learned expectancies regarding this type of situation. Their health locus of control belief may be a general measure whereas for those subjects with prior job injury experience, the health locus of control for this situation is likely to be a more specific construct. The researcher concludes that a worker's belief that the external factors of chance or a significant powerful other may not relate to experience with previous injury on the job, the duration of previous job injuries, financial factors associated with job injury and the stage of the injury.

The purposes of this study were to: (1) describe posture and movement of non-disabled children while English horseback riding at a walk, (2) propose a developmental sequence for each of three components of body posture and movement: the upper extremity the lower extremity, and the head and trunk, and (3) describe age differences in posture and movement while riding. The study was designed as a cross-sectional descriptive study. Thirty children without disabilities: ten five-year-olds who had never received formal riding lessons; ten seven- and eight-year-olds who had received six months or less of formal riding lessons; and ten nine and ten-year-olds who had received seven months or more cf formal riding lessons; were videotaped while horseback riding at a walk. Posture and movement of the upper extremity, the lower extremity, and the head and trunk, were each described in writing and categories were established to summarize the different postures and movements observed within each component. Horseback riding literature, which describes an "advanced" form for English riding was consulted to propose a developmental sequence for each component. The frequency of occurrence of each category in each age group was determined and graphed with respect to age. This graph was compared with the sequence proposed after consulting the riding literature. As a result of the study, five categories of posture and movement were formed for each of the components. As a group, the children demonstrated 54 different combinations of component posture or movement while riding. Each age group demonstrated a different modal combination of component posture or movement. None of the developmental sequences proposed from riding literature were supported by the data. However, age differences observed in this study enabled new developmental sequences to be proposed for development of component posture in the task of English horseback riding.

This study was undertaken in order to investigate the effect of different feedback variables on isometric strength performance. The variables studied were auditory EMG biofeedback, knowledge of results, and verbal cues. Nineteen normal adult women volunteered as subjects for the study. Each subject performed nine isometric contractions of the triceps brachii muscle against the resistance of a cable tensiometer. One of three different types of feedback was given during each contraction in order to motivate subjects to generate as much force as possible. Feedback variables were applied in random order; each variable was used three times. Peak force readings were recorded from the cable tensiometer at the end of each trial. Force readings were converted into pounds by matching than to a calibration curve. The actual force values underwent analysis of variance to determine if one type of feedback variable was more effective in motivating subjects to put forth a maximum effort during isometric muscle contraction. Results showed that the type of variable used during task performance had no differing effect on the amount of tension generated. Thus, the null hypothesis that the application of either EMG biofeedback, knowledge of results, or verbal cueing has no "differing effect on the amount of force that is exerted during isometric contraction of the triceps brachii muscle could not be rejected.