The purpose of this study was to evaluate the evidence for the effectiveness of therapeutic ultrasound (US) therapy in the treatment of open wounds as an adjunct to the usual and customary treatment provided by physical therapists. An exhaustive search of all published studies on the effects of therapeutic ultrasound on open wounds was performed. Every article, which met certain criteria, was reviewed in detail. Criteria included the use of human subjects, animal subjects, or human cells in vitro, publication in referred journals indexed by MEDLINE, CINAHL and availability of full text in the English language. Fourteen studies met the selection criteria. A total of 31 possible outcomes were available from these studies. Outcomes were categorized as positive, negative or non-significant. The results indicated a total of seventeen positives, eight negatives and six non-significant outcomes. The results of the analysis indicate that there is evidence in the literature to suggest that therapeutic US is beneficial in the treatment of open wounds.

Caregivers are often under a great deal of stress while caring for their spouses with dementia. It is when the stress builds up and becomes overwhelming that the caregiver is at risk for developing depression. The primary objective of this study was to determine which cognitive and behavioral coping strategies are associated with lower levels of depression; once these strategies are identified, interventions can be established to educate these caregivers. Thirty-two spousal caregivers participated in this study. They each filled out a questionnaire, which contained three sections. The first section asked them for demographic information about themselves and their spouses; the second section consisted of a coping strategies scale; and, the third section contained a depression scale. Results of this study indicate that problem-focused coping strategies were associated with a lesser degree of depressive symptomatology, whereas most of the emotion-focused strategies were associated with a greater degree of depressive symptomatology among the present sample of spousal caregivers. In addition, no relationship was found between the length of time providing care to their spouses and their level of depression.

The purpose of this study was to examine the phenomenological aspect in the empowerment process of mothers of children with disabilities, and to determine if the coding categories used by Dunst & Trivette (1996) could be replicated. Three mothers of children with disabilities agreed to participate in the study. A semistructured interview was used to determine the specific events that lead to empowerment. Interviews were audio-taped and transcribed by the researcher. Fifteen coding categories and four majors themes of empowerment were identified. Triangulation was used to assure reliability and validity. The findings demonstrated that the coding stages of empowerment as outlined by Dunst & Trivette (1996) are reproducible, as well as the envisionment of the future for their children is the essence of empowerment for these mothers. Specific suggestions are made by which occupational therapists can facilitate the empowerment process of mothers who have children with disabilities.

This study investigated the effect of sleep position on breathing patterns of normal full term infants during quiet and active behavioral sleep states. Tidal volume, percent contribution of rib cage to tidal volume, and respiration rate were measured via respiratory inductive plethysmography (RIP) and pneumotachograph (PNT) in ten infants sleeping in supine versus right side-lying. Data was collected immediately following two consecutive feedings. Paired t tests and ANOVA comparisons showed no significant differences between the two postures (p < .05) in mean tidal volume (supine, M = 19.16, right side, M = 22.45), percent contribution of rib cage to tidal volume (supine, M = 30.55, right side M = 33.20), or respiration rate (supine, M = 49.13, right side, M = 49.37) during quiet sleep. Comparisons also showed no significant differences between the two postures (p < .05) in mean tidal volume (supine, M = 18.89, right side, M = 20.12), percent contribution of rib cage to tidal volume (supine, M = 6.43, right side, M = 6.97) or respiration rate (supine, M = 62.18, right side, M = 61.04) during active sleep. Therefore, no differences were found in the three respiratory variables measured between the supine and right side-lying positions. These findings suggest that infants may be positioned in either sleep position without detriment to respiratory function. This information may benefit occupational therapists and other health professionals involved in the education of parents on infant positioning and their respective advantages.

The present investigation was an attempt to explore the reproduction by schizophrenics of emotionally- toned and neutral material under conditions of immediate and delayed recall. The relationship of the reproductions to the degree of illness of the patient was also studied. For these purposes, two structurally equivalent meaningful prose paragraphs, one neutral in tone and the other strongly aggressive in tone, were presented individually to eighteen male patients diagnosed as schizophrenic who had been rank ordered in terms of degree of illness. Preceding the main investigation a pilot study was conducted with forty-five schizophrenics and eight normals, using the emotionally-toned stimulus material. Thirteen of the schizophrenics gave an unaided delayed recall. The purpose of the pilot study was to test the potential of the material to elicit a wide and symmetrical distribution of scores. It was also designed to assess differences between the initial and delayed recall of the schizophrenic subjects. The results showed statistically significant differences between the schizophrenics and the normals on all the quantitative measures with the exception of the importations. There were no differences between the initial and delayed recall. The stimulus material was effective in eliciting symmetrical distributions. In the initial learning session of the present investigation, the two types of material were presented in a counterbalanced order from subject to subject. The procedure of one-trial learning and immediate recall was followed. One week later an unaided recall of the two different stimulus materials was obtained. The results of the quantitative analysis showed only minor differences between the reproductions of the two types of material. The qualitative analysis showed evidence of differential treatment of the two materials by the subjects. It also showed differences in learning efficiency between the reproductions of the two materials, in favour of the emotionally-toned material. The learning scores for the initial recall session were significantly greater than for the delayed recall session, particularly for the emotionally-toned material. The only consistent correlation with degree of illness was in the delayed recall of the emotional material. It may be concluded that the schizophrenic reproductions in this study did not support the theory hypothesizing inferior recall of emotionally-toned material as opposed to neutral material. If anything, these subjects gave indications of following the normal pattern in this regard. Other results of the respective analyses were inconclusive, but invite further investigation. / Arts, Faculty of / Psychology, Department of / Graduate

Using Q-Methodology, this study sought to find empirical support for the three stage model of the Gestalt two-chair technique and the theory underlying how and why it is effective, put forth by L. S. Greenberg (1979; 1983). A structured Q-Sort was constructed using the factors of Conflict Resolution (CR) and the Gestalt concept of Contact (C) in a 2X2 factorial design. Each factor was divided into two levels CR - Resolved/Unresolved, C - Interruption-of-contact/Contact. The factors of CR and C were expected to interact before and after successful and unsuccessful therapy for decision-making. Individuals who were Unresolved in their decision-making were expected to experience Interruption-of-contact while individuals who were Resolved from an integrated sense of self were expected to experience being in Contact. The 85 item sort was validated by experts in Gestalt theory and therapy as representing the three stage model and the theory underlying it. Eight subjects, ambivalent about remaining in their marriages, performed the Q-Sort before and after 6 sessions of therapy using the two-chair technique. Moderate support was found for the 3 stages of the model, Opposition, Merging and Integration. Some support was found for the interaction of the factors of CR and C. Significant 2-way interaction was found for 1 subject before and after therapy considered successful according to the model. Significant 2-way interactions were found after successful therapy for four subjects but not before. Significant 2-way interactions were not found for subjects after unsuccessful therapy. When therapy was successful the factors of CR and C interacted as predicted. When therapy was not successful the factors of CR and C did not interact as predicted. The factors of CR and C did not interact for individuals who were experiencing a great deal of interruption-of-contact, indicating there is a possible pre-stage to the model where CR and C are independent of each other or where other factors may be involved. This study expanded the research on the Gestalt two-chair technique in several ways. It found some empirical support for the model and the theory underlying it. It found areas were CR and C do not interact as predicted by theory. It extended the range of application of research on two-chair technique from career decision-making to divorce decision-making. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

M.A. (Clinical Psychology) / Please refer to full text to view abstract

The purpose of this study was to obtain an understanding of older adults' perceptions of independence and the factors that allow them to remain living independently in the community. A questionnaire was mailed to a random sample of 500 community-based older adults. One hundred seventy eight questionnaires were returned (36%). Respondents were asked questions related to independence, self-health rating, functional difficulties, and social supports. Most respondents indicated Mental Health (97%), Physical Health (97%), Control of choices (97%), and Social Support Systems (93%) contributed to maintaining independence in the community. Age, education, fewer chronic health conditions, and a higher self-health rating were found to be significant predictors of actual independence. Family members were identified as the primary source of assistance with advice on major life decisions and financial matters. Findings indicate age, education, health status and the social support of family and friends all play an important role for older adults to live independently in the community. Occupational therapy could be instrumental in extending the health, highest level of independent functioning, and the number of years older adults remain living in the community.

Lexical decision and pronunciation tasks were used to investigate semantic priming, the finding that a word is quicker to recognize when it is preceded by a related than an unrelated stimulus. The first experiment involved a lexical decision task (LDT) in which skilled and less-skilled readers made decisions about letter strings that were preceded by conceptually-related or unrelated stimuli. The effects of time to process the prime and type of prime (word or picture) were examined. Word and picture priming effects were observed at short and long time intervals with skilled and less-skilled groups. Finding word priming was not surprising; there are prior studies that have documented priming by words. However, prior experiments on picture priming have methodological flaws such as multiple presentations of stimuli that make it unclear whether pictures can prime word targets through semantic and nonstrategic routes. The facilitation of word targets following word primes may be due to semantic relations as well as associative relations. While picture priming provides evidence of semantic priming, picture priming cannot be associative at a lexical level because no orthographic features are displayed. During the processing of a picture, information about the picture and its related concepts are activated which facilitates processing of a subsequently presented word. The effect of priming was greater with picture primes than word primes, perhaps because the associations were stronger between the picture-word pairs than the word-word pairs. Because priming in a LDT may be attributed to postlexical checking, priming was further investigated in a pronunciation task in which the strategy is not helpful. In Experiment 2, in which subjects pronounced words that were preceded by related or unrelated pictures, the priming effect was significant. Finding a picture priming effect is important; it supports the interactive view that pictures provide a context that affects the processes that occur before word recognition. Priming must be due to semantic associations between the picture prime and the words corresponding to related concepts. Word and picture priming can be explained by current models of lexical access.

The variability present in human locomotion has been an increasing area of study. Originally thought to be associated with pathology, recent evidence suggests that coordination variability may offer an adaptive mechanism. The purpose of this series of investigations was to describe the relation between stride characteristic variability and joint coordination variability during running among persons with and without patellofemoral pain. Second, the role of pain in the observed changes in movement variability among persons with patellofemoral pain was investigated. Finally, the presence of gait asymmetries and variability present between the lower extremities of persons with patellofemoral pain was addressed. Three-dimensional kinematic data were collected from bilateral lower extremities of eight subjects with unilateral patellofemoral pain, as well as eight non-impaired subjects. All subjects ran on a treadmill at fixed (2.68-m·s −1) and preferred speeds during four collection sessions, while reporting perceived pain. The initial session involved subjects running while experiencing pain, with the final three collections being reduced pain sessions. The patellofemoral subjects displayed increased stride length variability of both limbs during running at preferred speed compared to non-impaired subjects. Intralimb joint coordination variability across the entire stride was consistent between groups. Further analysis, however, revealed that during preferred speed running, the patellofemoral pain group displayed reduced variability in the thigh rotation:leg rotation coupling of the injured limb at heel-strike compared to the non-impaired group. A direct relation between pain and stride length variability was present, as both pain and stride length variability decreased simultaneously among subjects with patellofemoral pain. In addition, the level of variability among the thigh rotation:leg rotation coupling at heel-strike was observed to increase following pain reduction. Joint coordination asymmetry was consistent between subjects with and without patellofemoral pain. However, the patellofemoral pain group displayed greater variability in interlimb knee rotation. Additionally, the transverse and coronal planes revealed greater levels of asymmetry and variability than the sagittal plane for both groups, suggesting an adaptive role. While patellofemoral pain impacted stride length variability, it appeared to alter only the variability of transverse plane joint coordination. Future analyses may involve a task that elicits a greater pain response.