Understanding Policy Influences on Health and Occupation Through the Use of the Life Course Health Development (LCHD) Framework.

Life course health development (LCHD) is a framework that considers the transactional nature of risks and protective factors along the life trajectory and how this context influences health. Public policies, from health care to education to social services to labor laws, have many goals, including lessening and eliminating health disparities, yet inequities in health services and outcomes remain. Policy is a contextual factor that may be overlooked when examining influences on health and occupation. As such, the LCHD framework may assist occupational therapy practitioners in understanding the influences of policy-both successes and failures-on occupation. In this article, we introduce the principles of LCHD and use this framework to illustrate analysis of a policy example of paid family leave, demonstrating how gaps in or unintended consequences of policy may contribute to disparities in health and occupation for certain populations.

Comparison of intubating laryngeal mask airway and fiberoptic bronchoscopy for endotracheal intubation in patients undergoing cervical discectomy.

BACKGROUND AND AIMS: Direct laryngoscopy is hazardous in patients with cervical posterior intervertebral disc prolapse (PIVD) as it may worsen the existing cord compression. To achieve smooth intubation, many adjuncts such as fiberoptic bronchoscope (FOB), video laryngoscopes, lighted stylets, and intubating laryngeal mask airways (ILMAs) are available. However, there is a paucity of literature comparing ILMA with fiberoptic intubation in patients with PIVD. Hence, this study was designed to compare the effectiveness of ILMA technique with FOB to accomplish endotracheal intubation in patients undergoing cervical discectomy. MATERIAL AND METHODS: Sixty patients of age group 20-60 years, of American Society of Anesthesiologists status I or II, were enrolled in this prospective and randomized study. They were allocated to one of the two groups, ILMA group and FOB group. The patients were intubated orally using either equipment, after dexmedetomidine premedication and induction of general anesthesia. Chi-square and Fisher exact tests were used to find the significance of study parameters on a categorical scale. Paired samples t-test and Student's t-test were used to find the significance of study parameters on a continuous scale. Significance was assessed at 5% level of significance. RESULTS: Bronchoscopy was a faster method of securing airway as compared with ILMA (38.13 ± 11.52 vs. 29.83 ± 13.75 s). Tracheal intubation was successful in all 60 patients (100%), belonging to both groups. CONCLUSION: ILMA and FOB were comparable with regards to ease of intubation in terms of time, the number of attempts and hemodynamic stability.

Evaluation of Bone Graft (Hydroxyapatite + Platelet-Rich Plasma) Alone and in Combination with Diode Laser in Management of Infrabony Defect.

Objective: The current study looked at how well bone graft (hydroxyapatite + platelet-rich plasma (PRP)) and a diode laser treated infrabony defects. Materials and Method: Twenty patients with bilateral infrabony deficiency were treated in a split-moth evaluation with bone graft (hydroxyapatite + PRP) alone (group I) (control) and bone graft combined with a diode laser (group II) (test). Clinical and radiologic measures such as the relative clinical attachment level (RCAL), probing depth (PD), gingival index (GI), and plaque index (PI) were recorded at baseline, 3 months later, and 6 months later in all patients. Result: At the 6-month follow-up, there was a decline in the plaque index, probing depth, gingival index, and relative clinical attachment level. Conclusion: When compared across groups, the intrabony pocket was significantly reduced with either the bone graft (hydroxyapatite + PRP) or in conjunction with the laser.

Mapping the Evolving Ideas of Occupational Justice: A Critical Analysis.

The values of occupational therapy are grounded in justice, and its origins in activism and advocacy. Enabling individuals to participate in meaningful occupations to enhance health and well-being was the genesis of the profession that answered a call to justice. Occupational science brought focus to understand humans as occupational beings and made justice more visible in the discourse. A systematic mapping review was undertaken to deconstruct how notions of occupational justice (OJ) have been woven in the literature. The ideas of OJ were dominant in 40 out of the 120 articles that met the study's inclusion criteria. OJ was represented mainly in the context of disadvantaged groups and dissonance in practice. For OJ to influence policy, the focus on the individuals' experiences of occupational injustices must be seen as transacting with systems and policies that contribute to participation inequities in groups and populations.

The illusion of client-centred practice.

AIM: A critical analysis of occupational therapy practice in the corporate health care culture in a free market economy was undertaken to demonstrate incongruence with the profession's philosophical basis and espoused commitment to client-centred practice. FINDINGS: The current practice of occupational therapy in the reimbursement-driven practice arena in the United States is incongruent with the profession's espoused philosophy and values of client-centred practice. Occupational therapy differentiates itself from medicine's expert model aimed at curing disease and remediating impairment, by its claim to client-centred practice focused on restoring health through occupational enablement. Practice focused on impairment and function is at odds with the profession's core tenet, occupation, and minimizes the lasting impact of interventions on health and well-being. The profession cannot unleash the therapeutic power of human occupation in settings where body systems and body functions are not occupation-ready at the requisite levels for occupational participation. CONCLUSION: Client-centred practice is best embodied by occupation-focused interventions in the natural environment of everyday living. Providing services that are impairment-focused in unfamiliar settings is not a good fit for client-centred practice, which is the unique, authentic, and sustainable orientation for the profession.

Scholarship and research in occupational therapy education.

OBJECTIVE. The purpose of this study was to identify a baseline or benchmark for faculty engagement and productivity in occupational therapy education scholarship and research. METHOD. A custom-designed survey was emailed to 2,225 faculty members. The survey included questions on basic demographic information and education scholarship (e.g., use of evidence to inform teaching, frequency and nature of involvement in education scholarship. RESULTS. A total of 520 faculty members (23%) completed the survey. Of these, 450 (86.5%) identified themselves as full-time core faculty, and only their responses were analyzed. Although 90% of the faculty respondents engaged in scholarly teaching, only 34% identified education as an area of content expertise, and only 16% reported frequent involvement with education scholarship. Instructional methods were the primary area of study. CONCLUSION. A need exists to build research capacity for education research and more diversification of education research topics, including professional socialization and competencies.

Comparison of curcumin with intralesional steroid injections in Oral Submucous Fibrosis - A randomized, open-label interventional study.

INTRODUCTION: Oral Submucous Fibrosis (OSMF) is precancerous condition caused by areca nut chewing characterized by restricted mouth opening, burning sensation and stiffness & blanching of oral mucosa. Complete regression of the condition had not been achieved in all cases with any of the present treatment regimens. Curcumin is (diferuloylmethane), a yellow pigment in curry powder, exhibits anti-oxidant, anti-inflammatory, and pro-apoptotic activities. Hence an interventional study was undertaken to establish the efficacy of curcumin in OSMF patients. SETTINGS & DESIGN: A randomized open label, interventional study was conducted in forty patients with clinically and histologically proven Oral Submucous Fibrosis. MATERIALS & METHODS: Forty patients with clinically and histologically proven Oral Submucous Fibrosis were selected for the study and were randomly divided into 2 groups. The first group was treated with weekly intralesional injection of 4 mg Dexamethasone & 1500 I.U Hyaluronidase and the second group by oral administration of two Curcumin tablets (Turmix 300 mg) per day for 3 months each. Improvement of burning sensation, interincisal distance and tongue protrusion was evaluated on a weekly basis. RESULTS: Burning sensation improved in both the groups from early to late stages. Complete resolution of burning sensation was noted with turmix. The mean increase in interincisal distance was 3.13 mm and 1.25 mm respectively in groups 1 &2. The interincisal distance improved in both the groups, with significant results at the end of first month. Tongue protrusion showed greater recovery at the end of 1st month in group 1 when compared with group 2. CONCLUSION: Turmix is beneficial and effective in reducing burning sensation in early OSMF patients.

Service learning: meaningful, community-centered professional skill development for occupational therapy students.

The profession of Occupational Therapy advocates for new and emerging areas of practice that more fully embrace our moral responsibility to address significant social injustices that exist in our communities (Kronenberg, Algado, & Pollard, 2005). The service-learning pedagogy is impacted by the philosophical and theoretical influences of John Dewey, the mission and purpose of American higher education including Boyer's (1994) call for an engaged citizenry, and the social vision of occupational therapy. The pedagogy of service learning provides a natural context for students to experience community practice while contributing to reducing existing social injustices. This paper provides an overview of service learning (SL) as a philosophical and pedagogical approach in occupational therapy education, key processes in developing successful service learning experiences and community partnerships to support service learning. Characteristics of effective service learning, assessment of community and institutional outcomes of service learning and the scholarship of service learning are also discussed. Most importantly, strategies for developing service learning scholarship, an important but frequently neglected requisite to validate any educational practice, are delineated. The authors conclude that service learning provides educators with an opportunity to provide students with experiences in natural, community contexts while developing life-long commitment to civic engagement and social responsibility.