A review in the literature makes it evident that employment needs of the age 21 and over ID population are not being met; the employment rate for this population continues to be less than half of the employment rate of the general population (Siperstein et al., 2013). There is evidence that occupational therapy has the potential to meet the employment needs of this population, however, practice guidelines for occupational therapists working with this population are limited. This study recruited seven participants and interviewed them using a needs assessment approach to investigate the employment needs of the age 21 and over ID population in South Florida, from the perspective of all stakeholders, further define occupational therapy intervention and practice guidelines within this matter, and propose a program to meet that need under an occupational therapy scope of practice. After analyzing study transcriptions, summative topics, or codes, were noted to be repeated throughout the data. Topics included tips for: 1) successful employment, 2) barriers towards employment, 3) positive employment outcomes, and 4) proposed solutions. Recorded information is reported as part of study findings using synthesized participant comments.

Occupational therapy focuses on complex dynamic relationships between people, occupations and environments. For clients with spinal cord injuries (SCI), a way of improving the connection between these three aspects is by providing assistive technology (AT). A fundamental issue identified by consumers regarding AT provision was abandonment, which is caused by a mismatch between aspects of the person, the assistive product, and characteristics of the environment. One solution is engaging collaboratively with clients and recognizing individual needs, thereby allowing therapists to meet clients’ occupational expectations and provide clients with increased functional independence. During this capstone project, barriers to AT provision were identified through an extensive review of the literature, an online survey sent to 82 therapists, and a 90-hour residency with AT specialists. Respondents reported a need for further education on AT, that confidence with high-tech AT was lower than with low-tech AT, and a need for a simplified AT resource tool. This resulted in creation of an educational resource AT tool, in website format, called the Assistive Technology Prescription Tool for Occupational therapists (ATPT-OT). The ATPT-OT is a tool designed to enhance occupational therapists’ ability to identify and recommend AT for individuals with SCI during the prescription process.

The purpose of this study was to examine whether mother-administered moderate pressure massage intervention could improve self-regulation, which would result in improvements in play outcomes. It was posited that a child who is self-regulated may be more successful in his/her play and that moderate pressure massage could be an effective tool to improve self-regulation in preterm infants with decreased self-regulation. Participants in the study were five preterm children ranging from 12 to 18 months corrected age and their mothers. The study utilized an A-B nonconcurrent multiple baselines across subjects design in which each participant acted as his/her own control as well as a pretesting and posttesting component with objective measures. Baselines were of varying lengths, ranging from 3 to 7 weeks. Intervention of mother-administered massage was 6 weeks long for all participants. Three objective standardized measures were used in pretesting and posttesting. These measures included the Infant Toddler Social Emotional Assessment to measure self-regulation, the Revised Knox Preschool Play Scale to measure play age, and the Test of Playfulness to measure playfulness. Visual analogue scales, with mother generated behavioral goals related to the three standardized assessments, were scored weekly by the mothers. The results indicated that moderate pressure massage had a calming and regulating effect on the child and resulted in improvements in the child’s play skills and playfulness over the course of the 6 weeks of intervention. The important clinical implications are that this cost-effective, parent-administered technique can positively affect outcomes of improved self-regulation, playfulness, and play skills. In addition, the study contributes important information about the influence of self-regulation on the development of play and playfulness in preterm babies and on mothers’ participation in their baby’s intervention, which contributes to a family-centered approach.

PURPOSE: This sequential embedded mixed methods study first identified the ways in which occupational therapy leaders experience leadership, then explored the ways in which those same leaders utilized their professional training as occupational therapists within their practice of leadership. METHODS: The twelve participants held formal leadership positions in either academia, clinical practice, or professional associations. The ecology of human performance model of practice was utilized to frame the research study. Data was collected through an initial interview with all 12 participants and through leadership artifacts and a second interview with six participants. RESULTS: Three themes resulted from thematic analysis of initial interview: leadership journey, leadership deconstructed, and personal approach to leadership. The leadership artifacts were analyzed using a coding frame, which included four dimensions: occupational perspective of leadership, connections, leadership approach, and team mindset. Thematic analysis of the second round of interviews resulted in three themes: how they do leadership, leadership interaction, and reflection on leadership action. CONCLUSIONS: The participants described the construct of leader as a role consisting of contextually discrete leadership occupations. A number of parallels were identified between the practice of occupational therapy and the practice of leadership. The development of a personal leadership identity was found to occur over time and required some form of either internal or external recognition of leadership ability or outcome. The structure of this mixed methods design included a combination of two qualitative methods, which was novel to the occupational therapy literature.

The purpose of this capstone project is to develop an evidenced-based, innovative, and comprehensive occupational therapy evaluation and intervention protocol for breast cancer care. The contents of this paper will include an introduction into the current care provided to survivors, literature review on best practice in breast cancer care, outline of the procedures completed to discover what best practice care should be, results of these procedures, discussion of the results, and conclusion with proposed program and recommendations for further investigation. The concern investigated is the inconsistencies in care provided to survivors from the time of diagnosis throughout their lifespan or survivorship. A body of growing evidence supports the important need to address functional performance from the point of diagnosis through treatment and survivorship. A model of rehabilitation-based care has been put forward by the American Cancer Society as an optimal construct, however, there are significant inconsistencies in how this model is being leveraged to support breast cancer patients. These inconsistencies occur from cancer center to cancer center and even from physician to physician within the same cancer center. Participants in this capstone project include experts from the on-site residency, interviews with subject-matter experts and survivors as part of a focus group. The essential features of the methods used to discover best practice include a literature review, onsite residency, participation in an International Cancer Summit, continuing education, and completion of a focus group. Results indicate that additional services are needed in order to have an evidenced-based, innovative, and comprehensive occupational therapy breast cancer program. Conclusions provided aim to diminish inconsistencies in the current care being provided to this population.

Objective: Multiple sclerosis (MS) is one of the most common neurological diseases affecting adults of working age, and those of younger ages of onset have been increasingly recognized. Twenty-seven percent of people with MS (PwMS) are age 30 years old or younger. The burden of MS for young adults puts them at risk for poorer outcomes regarding their education, family planning, vocation, and social skills as they transition to adulthood. Fine motor (FM) skill impairment might impede performance within the daily occupations of young adults who are transitioning into adulthood. Few studies focus on the occupations and occupational performance of younger adults with MS. Method: Forty participants with MS between the ages of 18 to 30 were recruited to participate in a study. Two standardized measures were used to identify possible FM dexterity deficits and one standardized self-report was used to measure the perceived satisfaction and performance of occupations for this population. A semi-structured interview was conducted with a subgroup of 18 participants to understand the lived experiences of young adults with MS (YAwMS) and their FM performance during their occupations. Results: With quantitative and qualitative analysis, a relationship was suggested between FM scores and both perceived performance and satisfaction scores of an adapted performance measure. Conclusion: Young adults with MS perceive difficulties with occupations that are influenced by their FM status. It is recommended that occupational therapy professionals consider the motor skill needed to perform and complete occupations that specifically require FM skills.

Background: Functional Electrical Stimulation (FES) stimulates peripheral nerves via electrical current to evoke muscle contractions and when combined with lower extremity cycling (LE), creates patterned leg movements. Previous studies demonstrated FES cycling is safe and effective in the spinal cord injury and stroke populations with improvements seen in walking speed, muscle mass, and bone density. Few studies have applied FES cycling to a neurodegenerative disorder, such as multiple sclerosis (MS). The aim of this study is to assess the effect of an 8-week training program using FES cycling, compared to Cycling Only, in people with MS (PWMS). Methods: Using a sample of convenience, PWMS were recruited to participate and randomized to the FES Cycling group or the Cycling Only group. Both groups received training three-times per week for 8- weeks using a LE ergometer. Scores on the 6 Minute Walk Test (6MWT), Times 25-Foot Walk Test (T25FW), Five Times Sit-to-Stand (5XSST), and Timed Up and Go (TUG), and spatiotemporal measure of gait were collected at baseline, (before the 1st session), 4-weeks (before the 13th session), 8-weeks (after the 24th training session), and at 4-week follow-up. Scores on the MS Quality of Life-54 (MSQOL), Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale-12 (MSWS-12), and Activities-specific Balance Confidence Scale (ABC) were collected at baseline, 8-weeks, and at 4-week follow-up. Results: Fourteen participants (8 female, 6 male, mean age = 53.64 ± 10.16 years; Patient Determined Disease Steps (PDDS) mean = 3.71 ± .091) completed the training. Cycling power output significantly increased in both groups over time (FES Cycling, p = 0.03; Cycling only p = 0.004), but no differences were found between groups (p = 0.08). The Cycling Only group demonstrated a slightly larger effect size for power output than the FES Group (d = 0.72 vs. 0.66). Immediately after the intervention period, scores on the 6MWT, 5XSST, and MFIS, and subscores of the MSQOL-54 improved significantly, but changes did not consistently favor one group over the other (p >0.05). There were no significant differences between groups on any of the outcome measures. Conclusions: FES Cycling or Cycling Only may be an effective intervention for improving walking endurance, sit-to-stand, and QOL in PWMS. This unique pilot study compared FES cycling versus Cycling Only for PWMS using a customized progression protocol. Further research with larger sample sizes are needed to better understand the effects of FES Cycling on PWMS.

Background: The effect of trigger point dry needling (TDN) on myofascial trigger points (MTP) in Achilles tendinopathy are unknown. Objectives: To determine the feasibility of a large randomized controlled trial (RCT) to compare the effects of TDN to exercise in a patient population with Achilles tendinopathy. Methods: This single-factor, pretest-posttest control group design included 22 subjects between the ages of 24 and 65 years with Achilles tendinopathy. Subjects were randomly assigned to either a control group (MT+Ex) or experimental group (TDN+MT+Ex). Subjects in both groups completed 8 physical therapy treatment sessions over 4 weeks. The intervention for the TDN+MT+Ex group included TDN to MTPs in the gastrocnemius, soleus or tibialis posterior each session while the same soft tissue mobilization and exercise program was conducted in both groups. Results: Within group analysis was performed for each group at 4 week and 90 day follow up. Significant improvement (p < .05) was achieved for FAAM, NPRS, pain pressure threshold and strength in both groups at 4 weeks and 90 days. The GROC was significant for MT + Ex at 90 days. The MCID for the FAAM, GROC were surpassed in both groups at 4 weeks and 90 days. NPRS surpassed the MCID for the MT + Ex group at 4 weeks. Conclusion: A large RCT to investigate the effects of TDN on MTP in Achilles tendinopathy is feasible with modifications. Recommendations: Special considerations for data collection sites should be given to the health care system, insurance payor, and financial burden to subjects.

Experts have called for greater diversity in the nursing workforce; however, men remain underrepresented in the nursing profession. The presence of cultural dissonance among male nursing students has been documented in prior research but little is known about their values that are culturally influenced. The purpose of this study was to understand and interpret the meaning of core professional nursing values to male baccalaureate nursing students. The research question was: what is the meaning of core professional nursing values to nursing students who are men. The study setting was an undergraduate baccalaureate school of nursing in the Midwest. Using a purposive, convenience sampling method and van Manen's interpretive phenomenological method, ten semistructured interviews were conducted with nine participants. Documents and images were also analyzed. Data analysis followed the hermeneutic process. The overarching theme of this study was caring, illustrated by the metaphor of a puzzle. In the first theme, entering program with pieces of the puzzle of caring, participants' personal values aligned with those of the nursing profession and professional values began to form before the nursing education experience. The second theme, finding more pieces of caring, included subthemes of disconnect and change in professional nursing values during the nursing program. Caring as patient-centered relationships (theme three) involved patient interactions, honesty, teamwork, respect and dignity, and privacy/confidentiality. A fourth theme of caring as helping was described in subthemes of altruism, empathy/compassion, advocacy, and competency and safety. Solving the puzzle of caring was theme five, as participants described learning through clinical experiences, both recognizing values and failing to see them demonstrated in nursing practice. Implications for nurse educators include values clarification and development, experiential teaching strategies, cultural sensitivity, teamwork, and conflict management. Inclusive workplace environments, where nursing and organizational practices reflect professional values, may enhance nurse satisfaction, recruitment, retention, and patient care. Further research is needed; strategies to enhance professional values development and core professional nursing values in different cultures warrant further study. Theories of nursing values that are culturally appropriate could be developed and tested. Implications for public policy include academic-practice partnerships, inclusive admission and hiring practices that promote diversity, and identification of common values in the profession.

This quantitative, retrospective, multivariate, non-experimental study examined the first-time performance of 2,673 academic nurse educators who took the CNE examination between September 28, 2005 and September 30, 2011. Post-positivism and Abbott's system of the professions theory served as the philosophical and theoretical underpinnings of this original research which attempted to determine if a relationship existed between educational preparation or years of full-time faculty employment (independent variables) and first-time pass/fail performance on the CNE examination and in each of content areas (dependent variables). The Chi-square test of independence revealed the lack of a statistically significant relationship between educational preparation and first-time pass/fail performance on the CNE examination. Independent t-tests revealed a statistically significant relationship between Option B study participants and content area three (use assessment and evaluation strategies), (t[2,671] = -2.20, p = .03); four (participate in curriculum design and evaluation of program outcomes), (t[2,671] = -2.06, p = .04); and six (engage in scholarship, service, and leadership), (t[2,671] = -2.34, p = .02). Binary logistic regression revealed that a one year increase in full-time employment resulted in a 1.05 times greater likelihood of passing the CNE examination (OR = 1.05; 95% CI 1.03, 1.06; p = .00). Last, simple linear regression revealed that years of full-time faculty employment contributed to 3.2% of the variability within content area four, 2.8% within content area six, and 2.1% within content area three. The results of this study provide insight about faculty development and mentoring needs, present evidence to policy makers and nursing education leaders, and offer guidance to curricula developers.