Assistive technology and specific learning disability: a case report.

Specific Learning Disability is an educational category within special education that identifies an impairment area such as reading, writing, or math despite a student's intelligence. Individualized Education Plan teams address learning disabilities with educational interventions and accommodations. One accommodation for students with a specific learning disability is assistive technology. Occupational therapists need evidence to inform decision-making regarding assistive technology tools to meet the individualized needs of students with learning disabilities. This case report describes how a school-based occupational therapist evaluated one student's assistive technology needs to accommodate her specific learning disability in reading and writing. This evaluation resulted in student-specific and evidence-based recommendations pertinent to age, need, and preferences. Reported outcomes include increased independence with accessing educational materials, increased access to age-appropriate reading material, and increased pleasure reading participation.

Impact of Changing Distance-Learning Formats in Physical Therapy Professional Education.

AIMS: In early 2020, the COVID-19 pandemic caused a majority of higher education to shift content delivery formats to allow for social distancing to decrease spread of the virus. The purpose of this investigation was to discover physical therapy students' perceived impact from changing from a synchronous videoconferencing format to a more hybrid program format. METHODS: A qualitative case study design bounded by the time of switching formats due to the pandemic was chosen (March 2020 through September 2020). Physical therapy students participated in an agreement survey (n=38) and semi-structured interviews (n=12). Survey and interview data were coded and analyzed to form categories and themes of discovered perspectives. RESULTS: Students' perceived proficiency of hands-on skill was negatively affected. Cross-campus student and faculty interactions improved. Students felt changing formats would not result in detrimental effects on their overall learning nor on their career potential as physical therapists. DISCUSSION: Educators in entry-level professional physical therapy programs utilizing distance-education models should consider and adjust timing of hands-on skill instruction to match didactic content to encourage better connection and clinical application. Distance-learning educators should foster more interaction with students who may feel isolated. Interaction between distance-separated cohorts can reduce feelings of competition and inequality between campus locations and create improved learning communities.

Triassic stem caecilian supports dissorophoid origin of living amphibians.

Living amphibians (Lissamphibia) include frogs and salamanders (Batrachia) and the limbless worm-like caecilians (Gymnophiona). The estimated Palaeozoic era gymnophionan-batrachian molecular divergence1 suggests a major gap in the record of crown lissamphibians prior to their earliest fossil occurrences in the Triassic period2-6. Recent studies find a monophyletic Batrachia within dissorophoid temnospondyls7-10, but the absence of pre-Jurassic period caecilian fossils11,12 has made their relationships to batrachians and affinities to Palaeozoic tetrapods controversial1,8,13,14. Here we report the geologically oldest stem caecilian-a crown lissamphibian from the Late Triassic epoch of Arizona, USA-extending the caecilian record by around 35 million years. These fossils illuminate the tempo and mode of early caecilian morphological and functional evolution, demonstrating a delayed acquisition of musculoskeletal features associated with fossoriality in living caecilians, including the dual jaw closure mechanism15,16, reduced orbits17 and the tentacular organ18. The provenance of these fossils suggests a Pangaean equatorial origin for caecilians, implying that living caecilian biogeography reflects conserved aspects of caecilian function and physiology19, in combination with vicariance patterns driven by plate tectonics20. These fossils reveal a combination of features that is unique to caecilians alongside features that are shared with batrachian and dissorophoid temnospondyls, providing new and compelling evidence supporting a single origin of living amphibians within dissorophoid temnospondyls.

Exploring the Intensity, Frequency, and Duration of Pediatric Constraint Induced Movement Therapy Published Research: A Content Analysis.

Constraint Induced Movement Therapy (CIMT) utilizes a behavioral approach to neurorehabilitation involving constraint of an unaffected upper extremity which forces the use of the affected extremity. There is substantial evidence supporting the effectiveness of CIMT among both children and adults. The purpose of this study was to explore the frequency, intensity, and duration parameters across the published clinical outcomes related to pediatric CIMT (pCIMT) among children and youth populations. A content analysis approach was used to search the following databases Google Scholar, OT seeker, American Occupational Therapy Association special interest section, Medline, EbscoHost, and Cinhal. A total of 141 studies were identified via the initial search, with 51 studies meeting inclusion criteria. The findings revealed that 100% of the studies included restraint of the non-affected upper extremity, 73% incorporated repetitive task-oriented training, but less than half prescribed home practice strategies. Further, only 34% of the studies reviewed included all three components of CIMT. Outpatient hospital clinics and home-based settings were the most utilized settings for research studies. The mean minutes per session was M = 205.53, SD = 164.99. As part of the plan of care, the duration and frequency of therapy both had similar means (~M = 3.60) and standard deviations (~SD = 1.65). There was a significant variance of hours during (SD = 139.54) and outside of therapy (SD = 130.06). The results of this study, together with other emerging evidence, can assist practitioners in prescribing dosages dependent on the setting, the pediatric client, and their current functional status.

Returning to the roots: resolution, reproducibility, and robusticity in the phylogenetic inference of Dissorophidae (Amphibia: Temnospondyli).

The phylogenetic relationships of most Paleozoic tetrapod clades remain poorly resolved, which is variably attributed to a lack of study, the limitations of inference from phenotypic data, and constant revision of best practices. While refinement of phylogenetic methods continues to be important, any phylogenetic analysis is inherently constrained by the underlying dataset that it analyzes. Therefore, it becomes equally important to assess the accuracy of these datasets, especially when a select few are repeatedly propagated. While repeat analyses of these datasets may appear to constitute a working consensus, they are not in fact independent, and it becomes especially important to evaluate the accuracy of these datasets in order to assess whether a seeming consensus is robust. Here I address the phylogeny of the Dissorophidae, a speciose clade of Paleozoic temnospondyls. This group is an ideal case study among temnospondyls for exploring phylogenetic methods and datasets because it has been extensively studied (eight phylogenetic studies to date) but with most (six studies) using a single matrix that has been propagated with very little modification. In spite of the conserved nature of the matrix, dissorophid studies have produced anything but a conserved topology. Therefore, I analyzed an independently designed matrix, which recovered less resolution and some disparate nodes compared to previous studies. In order to reconcile these differences, I carefully examined previous matrices and analyses. While some differences are a matter of personal preference (e.g., analytical software), others relate to discrepancies with respect to what are currently considered as best practices. The most concerning discovery was the identification of pervasive dubious scorings that extend back to the origins of the widely propagated matrix. These include scores for skeletal features that are entirely unknown in a given taxon (e.g., postcrania in Cacops woehri) and characters for which there appear to be unstated working assumptions to scoring that are incompatible with the character definitions (e.g., scoring of taxa with incomplete skulls for characters based on skull length). Correction of these scores and other pervasive errors recovered a distinctly less resolved topology than previous studies, more in agreement with my own matrix. This suggests that previous analyses may have been compromised, and that the only real consensus of dissorophid phylogeny is the lack of one.

Perinatal Maternal Mental Health and Breastfeeding Are Associated with Infant and Toddler Sensory Profiles.

Infants' sensory processing may impact their development and daily functioning in multiple domains, as does the mental health of their mothers. Little research has been conducted exploring the novel construct of sensory processing in relation to maternal mental health and arguably one of the most important co-occupations during this sensitive time (i.e., breastfeeding), which may also be impacted by maternal mental health. Therefore, this study aims to explore associations between maternal mental health, the co-occupation of breastfeeding, and the sensory processing profiles of infants. Specifically, a sample of maternal-offspring dyads was examined from pre-gestation through the infant's age of 18 months. Mothers completed well-validated and contemporary self-report questionnaires of mental health (i.e., depression and anxiety symptom severity) and sensory processing across time points. Findings yielded statistically significant relationships between maternal prenatal and postnatal anxiety and depression symptom severity and infants' sensory processing profiles. Further connections were found between infants' sensory processing profiles and both duration and frequency of breastfeeding. The study provides health care professionals with additional perspectives on how maternal mental health status and breastfeeding may be related to infants' sensory processing profiles.

Implementation of a patient-collected audio recording audit & feedback quality improvement program to prevent contextual error: stakeholder perspective.

BACKGROUND: Using patient audio recordings of medical visits to provide clinicians with feedback on their attention to patient life context in care planning can improve health care delivery and outcomes, and reduce costs. However, such an initiative can raise concerns across stakeholders about surveillance, intrusiveness and merit. This study examined the perspectives of patients, physicians and other clinical staff, and facility leaders over 3 years at six sites during the implementation of a patient-collected audio quality improvement program designed to improve patient-centered care in a non-threatening manner and with minimal effort required of patients and clinicians. METHODS: Patients were invited during the first and third year to complete exit surveys when they returned their audio recorders following visits, and clinicians to complete surveys annually. Clinicians were invited to participate in focus groups in the first and third years. Facility leaders were interviewed individually during the last 6 months of the study. RESULTS: There were a total of 12 focus groups with 89 participants, and 30 leadership interviews. Two hundred fourteen clinicians and 800 patients completed surveys. In a qualitative analysis of focus group data employing NVivo, clinicians initially expressed concerns that the program could be disruptive and/or burdensome, but these diminished with program exposure and were substantially replaced by an appreciation for the value of low stakes constructive feedback. They were also significantly more confident in the value of the intervention in the final year (p = .008), more likely to agree that leadership supports continuous improvement of patient care and gives feedback on outcomes (p = .02), and at a time that is convenient (p = .04). Patients who volunteered sometimes expressed concerns they were "spying" on their doctors, but most saw it as an opportunity to improve care. Leaders were supportive of the program but not yet prepared to commit to funding it exclusively with facility resources. CONCLUSIONS: A patient-collected audio program can be implemented when it is perceived as safe, not disruptive or burdensome, and as contributing to better health care.

Student Perspectives of Integrated Clinical Practicum Experiences in Physical Therapy Education: A Pilot Study.

PURPOSE: The goal of this pilot study was to discover students' perspective of clinical practicum experiences utilized for accreditation-required Integrated Clinical Experiences in doctor of physical therapy education. This study aimed to learn how students perceived the value of participating in institution-based clinical practicum experiences and the perceived utility and value of these clinical practicum experiences to their future careers in physical therapy. PROCEDURES: A case study design using an agreement survey followed by randomized semi-structured interviews with a cohort of physical therapy students provided the data to inform investigators of student perspectives regarding clinical practicum experiences. FINDINGS: Students overwhelmingly agreed that practicum adds value to their education and was worth the time spent. Students reflected that practicum was a strength of their education, provided and built upon skills above the didactic curriculum, and improved their ability to perform during full-time clinical education experiences. Students perceived that full-time clinical education experiences would have greater effect on their future career direction than clinical practicum experiences. CONCLUSION: Students perceived that clinical practicum experiences are valuable in their physical therapy education, in preparation for full-time clinical education experiences, and for beginning careers as physical therapists, but do not influence their future career direction.

Preparing Advanced Clinicians and Practitioners: A Model for Mentorship in Occupational Therapy Practice.

Mentoring is essential at all stages of a professional career. However, little has been written about the effectiveness of programs for practicing clinicians. This study was designed to address the need for evidence about the effectiveness of formal mentorship programs by describing the impact of the STAR mentorship program on a group of clinicians specializing in sensory integration and processing challenges. This study utilized an exploratory, retrospective, survey research design. Course evaluations were examined from 240 subjects following participation in a one-week, small group mentorship training program. Qualitative methods were adapted for use in this study. Sixteen codes, with operational definitions, were developed to analyze the surveys. Ninety-six percent indicated that the program met or exceeded their expectations; only 12.5% had a negative comment. Impact on psychosocial function was reflected by 22% of the participants. Comments related to impact on career function were indicated by 45% of the participants. Ninety-four percent provided positive comments about the program structure, and 74% responded with positive comments regarding content of the program. Positive outcomes were associated with this one mentorship program, suggesting a need for more in-person, structured mentored learning experiences. Mentorship is recommended as a method to address the growing need within the profession to support career development, build knowledge, skill and attitudes, and aspirations/commitment as well as enhance professionalism/professional development.

Weighted Blankets and Sleep Quality in Children with Autism Spectrum Disorders: A Single-Subject Design.

The purpose of the study was to explore the efficacy of weighted blanket applications and sleep quality in children with autism spectrum disorder and behavioral manifestations of sensory processing deficits. Two 4-year-old participants diagnosed with autism spectrum disorder who also experienced sleep disturbances took part in a single-subject design study. Objective sleep measures and caregiver surveys were tracked for a baseline period of eight days, followed by a 14-day weighted blanket intervention and a seven-day withdrawal phase. Caregiver reports and objective data were evaluated using visual analysis and the percentage of non-overlapping data methods. The results suggest minimal changes in sleep patterns as a result of the weighted blanket intervention. The findings based on using a weighted blanket intervention were enhanced morning mood after night use and a significantly decreased time to fall asleep for participants, though they were not strong enough to recommend for clinical use. Future directions include single-subject and cohort-designed studies exploring the efficacy of weighted blankets with increasing sleep quality among children with autism.

Evaluation of a Patient-Collected Audio Audit and Feedback Quality Improvement Program on Clinician Attention to Patient Life Context and Health Care Costs in the Veterans Affairs Health Care System.

Importance: Evidence-based care plans can fail when they do not consider relevant patient life circumstances, termed contextual factors, such as a loss of social support or financial hardship. Preventing these contextual errors can reduce obstacles to effective care. Objective: To evaluate the effectiveness of a quality improvement program in which clinicians receive ongoing feedback on their attention to patient contextual factors. Design, Setting, and Participants: In this quality improvement study, patients at 6 Department of Veterans Affairs outpatient facilities audio recorded their primary care visits from May 2017 to May 2019. Encounters were analyzed using the Content Coding for Contextualization of Care (4C) method. A feedback intervention based on the 4C coded analysis was introduced using a stepped wedge design. In the 4C coding schema, clues that patients are struggling with contextual factors are termed contextual red flags (eg, sudden loss of control of a chronic condition), and a positive outcome is prospectively defined for each encounter as a quantifiable improvement of the contextual red flag. Data analysis was performed from May to October 2019. Interventions: Clinicians received feedback at 2 intensity levels on their attention to patient contextual factors and on predefined patient outcomes at 4 to 6 months. Main Outcomes and Measures: Contextual error rates, patient outcomes, and hospitalization rates and costs were measured. Results: The patients (mean age, 62.0 years; 92% male) recorded 4496 encounters with 666 clinicians. At baseline, clinicians addressed 413 of 618 contextual factors in their care plans (67%). After either standard or enhanced feedback, they addressed 1707 of 2367 contextual factors (72%), a significant difference (odds ratio, 1.3; 95% CI, 1.1-1.6; P = .01). In a mixed-effects logistic regression model, contextualized care planning was associated with a greater likelihood of improved outcomes (adjusted odds ratio, 2.5; 95% CI, 1.5-4.1; P < .001). In a budget analysis, estimated savings from avoided hospitalizations were $25.2 million (95% CI, $23.9-$26.6 million), at a cost of $337 242 for the intervention. Conclusions and Relevance: These findings suggest that patient-collected audio recordings of the medical encounter with feedback may enhance clinician attention to contextual factors, improve outcomes, and reduce hospitalizations. In addition, the intervention is associated with substantial cost savings.

Histological skeletochronology indicates developmental plasticity in the early Permian stem lissamphibian Doleserpeton annectens.

Doleserpeton annectens is a small-bodied early Permian amphibamiform, a clade of temnospondyl amphibians regarded by many workers to be on the lissamphibian stem. Most studies of this taxon have focused solely on its anatomy, but further exploration of other aspects of its paleobiology, such as developmental patterns, is critical for a better understanding of the early evolutionary history of lissamphibians. Here, we present a histological analysis of growth patterns in D. annectens that utilizes 60 femora, the largest sample size for any Paleozoic tetrapod. We identified pervasive pairs of closely spaced lines of arrested growth (LAGs), a pattern that indicates a marked degree of climatic harshness and that would result in two cessations of growth within a presumed single year. We documented a wide degree of variation compared to previous temnospondyl skeletochronological studies, reflected in the poor correlation between size and inferred age, but this observation aligns closely with patterns observed in extant lissamphibians. Furthermore, sensitivity analyses conducted by subsampling our dataset at more typical sample sizes for paleontological studies produced a wide range of results. This includes biologically improbable results and exceptionally well-fit curves that demonstrate that low sample size can produce potentially misleading artifacts. We propose that the weak correlation between age and size represents developmental plasticity in D. annectens that typifies extant lissamphibians. Detection of these patterns is likely only possible with large sample sizes in extinct taxa, and low sample sizes can produce false, misleading results that warrant caution in drawing paleobiological interpretations from such samples.

Postcranial anatomy and histology of Seymouria, and the terrestriality of seymouriamorphs.

Seymouria is the best known of the seymouriamorphs, a group of Permo-Carboniferous reptiliomorphs with both terrestrial and aquatic taxa. The majority of research on Seymouria has focused on cranial anatomy, with few detailed descriptions or illustrations of the postcrania. We utilized neutron computed tomography (nCT) and histological sampling to provide updated, detailed figures that clarify details of the postcranial anatomy and to assess the development and histology of Seymouria through specimens from the early Permian Richards Spur locality. The correlation of morphological and histological data indicate rapid metamorphosis in this terrestrially capable stem amniote, with the youngest specimen being postmetamorphic despite being distinctly younger than premetamorphic individuals of Discosauriscus, the only other seymouriamorph to have been histologically sampled. The microanatomical data (e.g., semi-open medullary cavity) also substantiate the hypothesis that Seymouria was terrestrial based on interpretation of external features, although the persistence of a modestly developed medullary spongiosa in comparison to either Discosauriscus or to other co-occurring terrestrial tetrapods suggests additional nuances that require further exploration. In the absence of clearly recognizable postmetamorphic stages in several seymouriamorph taxa, it is difficult to determine the evolutionary trajectory of terrestriality within the clade. Our analysis provides the first histological characterization of the life history of Seymouria and highlights the need for further study of seymouriamorph ontogeny.

A Cohort Study of Relations Among Caregiver-Infant Co-Occupation and Reciprocity.

Co-occupation is the mutual engagement of two people in a shared occupation. Recent research has investigated co-occupational activities during sensitive periods to inform clinical practice. However, there remains a dearth of applied research to bridge gaps between research and practice within salient co-occupational relationships between caregivers and infants. The study applied co-occupational constructs of physicality, emotionality, and intentionality within caregiver-infant dyads across infancy. These constructs were examined in relation to caregiver-infant reciprocity in other domains (i.e., language, motor, and affective) to determine the overlapping features of reciprocal co-occupation with established aspects of reciprocity. Results suggest that as infants transitioned into toddlerhood and became more mobile and intentional in behavior, there were observable changes in caregiver-infant reciprocity. Caregiver utterances, affect, touch, and co-occupation were significantly related within and across time, highlighting the need for more studies to disentangle these relations in reference to infant development.

A redescription of the late Carboniferous trematopid Actiobates peabodyi from Garnett, Kansas.

Dissorophoids are a diverse clade of predominantly Permo-Carboniferous temnospondyls with a wide geographic distribution and broad ecological diversity. Each of the various dissorophoid clades first appears in the late Carboniferous, but their records are relatively sparse and fragmentary compared to those of the early Permian when dissorophoids reach their peak diversity and distribution, particularly in terrestrial environments where they are by far the most taxonomically diverse clade of non-amniote tetrapods. This provides an impetus for further study of the late Carboniferous terrestrial dissorophoids in order to contextualize the early stages in the clade's radiation into terrestrial ecosystems. Here we present a redescription of the late Carboniferous trematopid Actiobates peabodyi from Kansas, USA, which is represented by a nearly complete skeleton and which represents the earliest occurrence of trematopids in North America. Only the skull was previously described, and the taxon has been largely overlooked in the context of early terrestrial dissorophoid evolution. Here, we provide an updated cranial description, the first postcranial description, and a discussion of the position of A. peabodyi in the context of olsoniform evolution. Our most significant finding is the characterization of postcranial anatomy that is highly similar to that of later trematopid taxa. This high degree of conservatism indicates that the earliest trematopids were already well adapted for terrestrial environments, and post-Carboniferous radiations of olsoniforms may be attributed to an expansion of the dryland terrestrial environments in which these taxa already thrived, rather than to novel acquisition of adaptive features later in the clade's evolution.

A new varanopid synapsid from the early Permian of Oklahoma and the evolutionary stasis in this clade.

Varanopids are a basal clade of small- to medium-sized non-therapsid synapsids, whose range extends from the late Pennsylvanian to the late middle Permian, and are found in North America, Russia, Europe and South Africa. The greatest varanopid diversity is observed at the fossiliferous cave deposits near Richards Spur, Oklahoma, well known for the preservation of a complex early Permian upland community. Two previously described varanopids, Mycterosaurus and Varanops, are known only from fragmentary disarticulated material at Richards Spur. A third putative varanopid, Basicranodon fortsillensis, represented by a partial parasphenoid, has been synonymized with Mycterosaurus longiceps. This study reports on a new varanopid taxon, represented by substantially more complete material, including three nearly complete skulls. Such comprehensive cranial material allows for a detailed study of the taxon and its relationship to other varanopids. This new varanopid bears great morphological similarity to Mesenosaurus romeri from the middle Permian Mezen River Basin of northern Russia. Phylogenetic analysis recovers a sister relationship between this taxon and Me. romeri. This relationship, in conjunction with a detailed morphological comparison, supports the placement of this taxon within Mesenosaurus, as a new species, Me. efremovi. These results reveal an unexpected extension of the geographical and temporal range of Mesenosaurus, contributing to our understanding of varanopid dispersal. The extended persistence of this basal clade of predatory synapsids, underscored by the apparent evolutionary stasis of this genus, is unusual among Palaeozoic tetrapods. This phenomenon implies an exceptionally high degree of extended ecological resilience across major faunal and environmental transitions.

Retention of fish-like odontode overgrowth in Permian tetrapod dentition supports outside-in theory of tooth origins.

Teeth are often thought of as structures that line the margins of the mouth; however, tooth-like structures called odontodes are commonly found on the dermal bones of many Palaeozoic vertebrates including early jawless fishes. 'Odontode' is a generalized term for all tooth-like dentine structures that have homologous tissues and development. This definition includes true teeth and the odontodes of early 'fishes', which have been recently examined to gain new insights into the still unresolved origin of teeth. Two leading hypotheses are frequently referenced in this debate: the 'outside-in' hypothesis, which posits that dermal odontodes evolutionarily migrate into the oral cavity, and the 'inside-out' hypothesis, which posits that teeth originated in the oropharyngeal cavity and then moved outwards into the oral cavity. Here, we show that, unlike the well-known one-to-one replacement patterns of marginal dentition, the palatal dentition of the early Permian tetrapods, including the dissorophoid amphibian Cacops and the early reptile Captorhinus, is overgrown by a new layer of bone to which the newest teeth are then attached. This same overgrowth pattern has been well documented in dermal and oral odontodes (i.e. teeth) of early fishes. We propose that this pattern represents the primitive condition for vertebrates and may even predate the origin of jaws. Therefore, this pattern crosses the fish-tetrapod transition, and the retention of this ancestral pattern in the palatal dentition of early terrestrial tetrapods provides strong support for the 'outside-in' hypothesis of tooth origins.

New material of the 'microsaur' Llistrofus from the cave deposits of Richards Spur, Oklahoma and the paleoecology of the Hapsidopareiidae.

The Hapsidopareiidae is a group of "microsaurs" characterized by a substantial reduction of several elements in the cheek region that results in a prominent, enlarged temporal emargination. The clade comprises two markedly similar taxa from the early Permian of Oklahoma, Hapsidopareion lepton and Llistrofus pricei, which have been suggested to be synonymous by past workers. Llistrofus was previously known solely from the holotype found near Richards Spur, which consists of a dorsoventrally compressed skull in which the internal structures are difficult to characterize. Here, we present data from two new specimens of Llistrofus. This includes data collected through the use of neutron tomography, which revealed important new details of the palate and the neurocranium. Important questions within "Microsauria" related to the evolutionary transformations that likely occurred as part of the acquisition of the highly modified recumbirostran morphology for a fossorial ecology justify detailed reexamination of less well-studied taxa, such as Llistrofus. Although this study eliminates all but one of the previous features that differentiated Llistrofus and Hapsidopareion, the new data and redescription identify new features that justify the maintained separation of the two hapsidopareiids. Llistrofus possesses some of the adaptations for a fossorial lifestyle that have been identified in recumbirostrans but with a lesser degree of modification (e.g., reduced neurocranial ossification and mandibular modification). Incorporating the new data for Llistrofus into an existing phylogenetic matrix maintains the Hapsidopareiidae's (Llistrofus + Hapsidopareion) position as the sister group to Recumbirostra. Given its phylogenetic position, we contextualize Llistrofus within the broader "microsaur" framework. Specifically, we propose that Llistrofus may have been fossorial but was probably incapable of active burrowing in the fashion of recumbirostrans, which had more consolidated and reinforced skulls. Llistrofus may represent an earlier stage in the step-wise acquisition of the derived recumbirostran morphology and paleoecology, furthering our understanding of the evolutionary history of "microsaurs."

Exploring the parameters of intensity, frequency, and duration within the constraint induced movement therapy published research: A content analysis.

BACKGROUND: Neurological rehabilitation specialists must determine appropriate dosage, consisting of frequency, intensity, and duration of specified treatments. OBJECTIVE: The objective of this study was to perform a content analysis of the current literature related to dosage (duration, frequency and intensity) for constraint-induced movement therapy (CIMT) in the adult population. METHODS: A content analysis was conducted which yielded 62 scholarly articles. RESULTS: The frequency of CIMT ranged from 1 to 7 days per week with the average frequency being 4.98 days. The duration of CIMT, ranged from 2 to 10 weeks with the average duration 3.14 weeks. All three components of dosage were reported collectively in outcomes studies conducted in inpatient settings and rehabilitation clinics. CONCLUSIONS: The findings provide a groundwork for evidence based practice for clinician in the application of CIMT dosage with consideration of settings and CIMT components.

Exploring the Influence of an E-Learning Sensory Processing-Based Module for Graduate Level Occupational Therapy Students on Clinical Reasoning: A Pilot Study.

The purpose of this study was to explore the effectiveness of a series of online, module-based instructional reusable learning objects (RLOs) targeted at entry-level, 1st year, Master of Occupational Therapy students. The content of the RLOs addressed knowledge and implementation of A SECRET, a parental reasoning approach for children with a sensory processing disorder, specifically sensory over responsiveness. Nine RLOs were developed and embedded within a commonly used learning management system. Participants (n = 8) were evaluated regarding their ability to discriminate between appropriate and inappropriate A SECRET strategies using a selected-response assessment. The participants' overall average score was 68%, a positive finding given the novelty of the instruction, assessment, and the content.