Dunn's Model of Sensory Processing: An Investigation of the Axes of the Four-Quadrant Model in Healthy Adults.

We examined the behavioral response (BR) and threshold (T) axes of Dunn's four-quadrant model of sensory processing (1997). We assessed whether they are ordinal ranges and if variation is associated with other similarly described characteristics: Introversion/Extraversion (I/E) of Eysenck's personality model (Sato, 2005), and somatosensory event related potentials (SERP) and their gating (Davies & Gavin, 2007). From healthy adults (n = 139), we obtained: Adult/Adolescent Profile (A/ASP, Brown & Dunn, 2002) and Eysenck's Personality Questionnaire, Brief Version (Sato, 2005) scores and peak amplitude and gating factor of SERP P50. We found that BR scores did not differ across normative categories of the A/ASP, but T scores significantly increased along the axis. I/E scores did not vary with BR scores. There were no differences or correlations in P50 amplitudes and gating with T scores. The findings suggest that the BR axis may not reflect a construct with ordinal range, but the T axis may. Dunn's concept of BR appears to be distinct from Eysenck's concept of I/E. SERP and its gating may not be directly reflective of sensory processing thresholds in healthy adults. Conclusions are limited by having few participants with passive behavior regulation or low threshold patterns of processing.

The influence of the number of toys in the environment on toddlers' play.

We tested the hypothesis that an environment with fewer toys will lead to higher quality of play for toddlers. Each participant (n=36) engaged in supervised, individual free play sessions under two conditions: Four Toy and Sixteen Toy. With fewer toys, participants had fewer incidences of toy play, longer durations of toy play, and played with toys in a greater variety of ways (Z=-4.448, p<0.001, r=-0.524; Z=2.828, p=0.005, r=0.333; and Z=4.676, p<0.001, r=0.55, respectively). This suggests that when provided with fewer toys in the environment, toddlers engage in longer periods of play with a single toy, allowing better focus to explore and play more creatively. This can be offered as a recommendation in many natural environments to support children's development and promote healthy play.

A team-based interprofessional education course for first-year health professions students.

BACKGROUND AND PURPOSE: Interprofessional education (IPE) is required within pharmacy education, and should include classroom-based education along with experiential interprofessional collaboration. For classroom-based education, small-group learning environments may create a better platform for engaging students in the essential domain of interprofessional collaboration towards meaningful learning within IPE sub-domains (interprofessional communication, teams and teamwork, roles and responsibilities, and values and ethics). Faculty envisioned creating a small-group learning environment that was inviting, interactive, and flexible using situated learning theory. This report describes an introductory, team-based, IPE course for first-year health-professions students; it used small-group methods for health-professions students' learning of interprofessional collaboration. EDUCATIONAL ACTIVITY AND SETTING: The University of Toledo implemented a 14-week required course involving 554 first-year health-sciences students from eight professions. The course focused on the Interprofessional Education Collaborative's (IPEC) Core Competencies for Interprofessional Collaboration. Students were placed within interprofessional teams of 11-12 students each and engaged in simulations, standardized-patient interviews, case-based communications exercises, vital signs training, and patient safety rotations. Outcomes measured were students' self-ratings of attaining learning objectives, perceptions of other professions (from word cloud), and satisfaction through end-of-course evaluations. FINDINGS: This introductory, team-based IPE course with 554 students improved students' self-assessed competency in learning objectives (p < 0.01, Cohen's d = 0.9), changed students' perceptions of other professions (via word clouds), and met students' satisfaction through course evaluations. DISCUSSION AND SUMMARY: Through triangulation of our various assessment methods, we considered this course offering a success. This interprofessional, team-based, small-group strategy to teaching and learning IPE appeared helpful within this interactive, classroom-based course.

The Effect of Positional Support on Tolerance of Wakeful Prone in Infants.

Supervised wakeful prone promotes motor milestones. Indications are that many infants do not receive adequate prone, with poor tolerance as a contributing factor. A common suggestion is the use of positional support. AIMS: This study has two main purposes: (1) To determine whether varied levels of positional support affect the duration of time spent in prone, and (2) to determine the effect of positional support with respect to infant size. METHODS: A convenience sample of 32 healthy infants ranging in size, aged 3.3 ± 0.04 months, were placed in prone in three counterbalanced randomized levels of positional support: a flat blanket (Blanket condition), a rolled blanket (Roll condition), and a pillow (Boppy condition). RESULTS: There were significant differences in time spent in prone with the Boppy condition affording infants up to three more min in prone across three repeated trials. There were no significant interaction effects between condition and infant size measurements. CONCLUSIONS: These results provide evidence for increasing positional support, such as through use of a Mini Boppy®, to facilitate tolerance for prone for infants of all sizes.

Apps in therapy: occupational therapists' use and opinions.

To gather information on occupational therapy practitioners' use and opinions of apps, an online survey was distributed to occupational therapy practitioners licensed in the state of Ohio. The survey sought information regarding clinical populations and skill areas for which apps are used, potential barriers to use of apps and preferred apps/app features. OTs working in medical and education-based settings and with clients of all ages responded to the survey. Over half (53%) reported not using apps in therapy, with "not having access to the technology at work" being the leading reason endorsed. Of practitioners who did report using apps, the majority used them with ≤25% of their case load and primarily used tablets to do so. Clinicians indicated that they use apps for a wide variety of reasons, including to promote skill building and to support the therapeutic process. Preferred features included the ability to grade difficulty up/down, multiple uses and accurate feedback. Recommendations from peers were the most commonly reported way respondents found new apps. The results suggest that occupational therapy practitioners employ clinical reasoning when implementing apps in therapy. Possible ways to improve access to apps for therapists who would like to implement them are discussed. Implications for Rehabilitation Many occupational therapy practitioners are using apps with at least a portion of their caseloads. Therapists select apps based on peer recommendations, most commonly selecting those which promote skill building and support the therapeutic process. More therapists might make use of apps if potential barriers were reduced or eliminated, including availability of technology in the clinical practice setting, therapist training and education, therapist input into app development and an enhanced evidence base.

Association between dysfunctional elimination syndrome and sensory processing disorder.

OBJECTIVE. We explored whether sensory processing disorder (SPD) is related to dysfunctional elimination syndrome (DES). METHOD. We used the Vancouver Nonneurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome Questionnaire and the Short Sensory Profile with participants who sought treatment of DES (n = 19) and healthy control participants (n = 55). RESULTS. Significantly more children with DES (53%) had SPD than was reported for the general population (p < .001; Ahn, Miller, Milberger, & McIntosh, 2004). Control participants did not have a greater rate of SPD (p = .333). We found a significant association between the occurrence of DES and SPD, χ²(1) = 20.869, p < .001, and a significant correlation between test scores (Spearman's ρ = -.493, Rs² = .243, p < .001). CONCLUSION. Many children with DES may also have SPD, suggesting that a child's sensory processing pattern would be an important aspect that could influence the plan of care.

Occupational therapy practitioners' knowledge and perceptions of childhood asthma and cystic fibrosis.

This study surveyed pediatric occupational therapy practitioners regarding their knowledge and perceptions about the chronic respiratory diseases (CRDs) asthma and cystic fibrosis which affect the functioning and quality of life for millions of children. Surveys were mailed to 250 members of the Ohio Occupational Therapy Association's pediatric member support group. Though 104 occupational therapy practitioners returned completed surveys, only the 82 who were currently practicing in pediatric settings were included in analysis. Respondents scored an average of 77% (SD = 10%) on a test of knowledge about asthma and cystic fibrosis. Respondents demonstrated several misperceptions about of the effects of these diseases on everyday life. A large majority (91%) endorsed one or more roles for occupational therapy with children with chronic respiratory diseases. Respondents indicated that confusion about the role of occupational therapy is a barrier to practice with children with CRDs. The results may prompt educational curricula to make adjustments, while continuing education courses may expand in addressing CRDs.

Morphological and functional reorganization of rat medial prefrontal cortex in neuropathic pain.

Neuropathic pain is a chronic pain that results from lesion or dysfunction of the nervous system. Depression and cognitive decline are often coupled to chronic pain, suggesting the involvement of cortical areas associated with higher cognitive functions. We investigated layer 2/3 pyramidal neurons in acute slices of the contralateral medial prefrontal cortex (mPFC) in the rat spared nerve injury (SNI) model of neuropathic pain and found morphological and functional differences between the mPFC of SNI and sham-operated animals. Basal, but not apical, dendrites of neurons from SNI rats are longer and have more branches than their counterparts in sham-operated animals; spine density is also selectively increased in basal dendrites of neurons from SNI rats; the morphological changes are accompanied by increased contribution to synaptic currents of the NMDA component. Interestingly, the NMDA/AMPA ratio of the synaptic current elicited in mPFC neurons by afferent fiber stimulation shows linear correlation with the rats' tactile threshold in the injured (but not in the contralateral) paw. Our results not only provide evidence that neuropathic pain leads to rearrangement of the mPFC, which may help defining the cellular basis for cognitive impairments associated with chronic pain, but also show pain-associated morphological changes in the cortex at single neuron level.

Dendritic D-type potassium currents inhibit the spike afterdepolarization in rat hippocampal CA1 pyramidal neurons.

In CA1 pyramidal neurons, burst firing is correlated with hippocampally dependent behaviours and modulation of synaptic strength. One of the mechanisms underlying burst firing in these cells is the afterdepolarization (ADP) that follows each action potential. Previous work has shown that the ADP results from the interaction of several depolarizing and hyperpolarizing conductances located in the soma and the dendrites. By using patch-clamp recordings from acute rat hippocampal slices we show that D-type potassium current modulates the size of the ADP and the bursting of CA1 pyramidal neurons. Sensitivity to alpha-dendrotoxin suggests that Kv1-containing potassium channels mediate this current. Dual somato-dendritic recording, outside-out dendritic recordings, and focal application of dendrotoxin together indicate that the channels mediating this current are located in the apical dendrites. Thus, our data present evidence for a dendritic segregation of Kv1-like channels in CA1 pyramidal neurons and identify a novel action for these channels, showing that they inhibit action potential bursting by restricting the size of the ADP.

Voltage-dependent potassium currents during fast spikes of rat cerebellar Purkinje neurons: inhibition by BDS-I toxin.

We characterized the kinetics and pharmacological properties of voltage-activated potassium currents in rat cerebellar Purkinje neurons using recordings from nucleated patches, which allowed high resolution of activation and deactivation kinetics. Activation was exceptionally rapid, with 10-90% activation in about 400 mus at +30 mV, near the peak of the spike. Deactivation was also extremely rapid, with a decay time constant of about 300 mus near -80 mV. These rapid activation and deactivation kinetics are consistent with mediation by Kv3-family channels but are even faster than reported for Kv3-family channels in other neurons. The peptide toxin BDS-I had very little blocking effect on potassium currents elicited by 100-ms depolarizing steps, but the potassium current evoked by action potential waveforms was inhibited nearly completely. The mechanism of inhibition by BDS-I involves slowing of activation rather than total channel block, consistent with the effects described in cloned Kv3-family channels and this explains the dramatically different effects on currents evoked by short spikes versus voltage steps. As predicted from this mechanism, the effects of toxin on spike width were relatively modest (broadening by roughly 25%). These results show that BDS-I-sensitive channels with ultrafast activation and deactivation kinetics carry virtually all of the voltage-dependent potassium current underlying repolarization during normal Purkinje cell spikes.

Differential expression of TASK channels between horizontal interneurons and pyramidal cells of rat hippocampus.

Among the electrophysiological properties differentiating stratum oriens horizontal interneurons from pyramidal neurons of the CA1 hippocampal subfield are the more depolarized resting potential and the higher input resistance; additionally, these interneurons are also less sensitive to ischemic damage than pyramidal cells. A differential expression of pH-sensitive leakage potassium channels (TASK) could contribute to all of these differences. To test this hypothesis, we studied the expression and properties of TASK channels in the two cell types. Electrophysiological recordings from acute slices showed that barium- and bupivacaine-sensitive TASK currents were detectable in pyramidal cells but not in interneurons and that extracellular acidification caused a much stronger depolarization in pyramidal cells than in interneurons. This pyramidal cell depolarization was paralleled by an increase of the input resistance, suggesting the blockade of a background conductance. Single-cell reverse transcription-PCR experiments showed that the expression profile of TASK channels differ between the two cell types and suggested that these channels mediate an important share of the leakage current of pyramidal cells. We suggest that the different expression of TASK channels in these cell types contribute to their electrophysiological differences and may result in cell-specific sensitivity to extracellular acidification in conditions such as epilepsy and ischemia.

R-type calcium channels contribute to afterdepolarization and bursting in hippocampal CA1 pyramidal neurons.

Action potentials in pyramidal neurons are typically followed by an afterdepolarization (ADP), which in many cells contributes to intrinsic burst firing. Despite the ubiquity of this common excitable property, the responsible ion channels have not been identified. Using current-clamp recordings in hippocampal slices, we find that the ADP in CA1 pyramidal neurons is mediated by an Ni2+-sensitive calcium tail current. Voltage-clamp experiments indicate that the Ni2+-sensitive current has a pharmacological and biophysical profile consistent with R-type calcium channels. These channels are available at the resting potential, are activated by the action potential, and remain open long enough to drive the ADP. Because the ADP correlates directly with burst firing in CA1 neurons, R-type calcium channels are crucial to this important cellular behavior, which is known to encode hippocampal place fields and enhance synaptic plasticity.