Occupational Therapy in a Community-Based Prevention Program

Occupational Therapists have shifted their practice base from a primarily medical model to one involving many different services within the community. Members of this discipline as well as those of the entire health-care field have discovered that preventionj based programs better anticipate and meet consumer needs. The community program described here serves 3, 4, and 5-year -old socio-culturally disadvantaged preschoolers. The program occurs weekly in a local library and includes the librarian's story hour and special activities designed and implemented by the occupational therapists. By observing each child's behavior, occupational therapists can compare normal growth and development with a particular population. The design and delivery of such programs is influenced by many factors including, but not limited to, financing, community values and institutions, and the occupational therapist's understanding of prevention. Increased understanding, as well as the potential application, of occupational therapy's contribution to the prevention of health related problems are further enhanced by the utilization of this program as a field training site for occupational therapy students.     

Chapter 4. The Intervention Process

Abstract

The qualitative research methods used by the author to study one parent-child activity group are shared. This qualitative research study documented what the participants of a parent-child activity group on a child psychiatric inpatient unit reported about their experiences with each other and how these participants interacted with each other in the group over the course of eight months. The group was studied through     

Attending to the fear in your eyes: Facilitated orienting and delayed disengagement

Fearful facial expressions convey threat-related information and automatically elicit modulations in spatial attention. The eye-region appears to be a particularly important feature for recognising and responding to fearful faces. However, it is unknown as to whether or not fearful eyes initiate modulations in spatial attention. In the current study, three dot-probe experiments with fearful and neutral eye stimuli were performed. The results of Experiment 1 demonstrate that fearful eyes capture spatial attention through facilitated attentional orienting to threat and delayed attentional disengagement from threat. In Experiments 2 and 3, these attentional effects were replicated, while ruling out the influence of overall size/shape and brightness differences between fearful and neutral eyes, respectively. Thus, fearful eye-whites appear to be a salient feature of fearful facial expressions that elicit modulations in spatial attention.     

Blurring of emotional and non-emotional memories by taxing working memory during recall

Memories that are recalled while working memory (WM) is taxed, e.g., by making eye movements (EM), become blurred during the recall + EM and later recall, without EM. This may help to explain the effects of Eye Movement and Desensitisation and Reprocessing (EMDR) in the treatment of post-traumatic stress disorder (PTSD) in which patients make EM during trauma recall. Earlier experimental studies on recall + EM have focused on emotional memories. WM theory suggests that recall + EM is superior to recall only but is silent about effects of memory emotionality. Based on the emotion and memory literature, we examined whether recall + EM has superior effects in blurring emotional memories relative to neutral memories. Healthy volunteers recalled negative or neutral memories, matched for vividness, while visually tracking a dot that moved horizontally (“recall + EM”) or remained stationary (“recall only”). Compared to a pre-test, a post-test (without concentrating on the dot) replicated earlier findings: negative memories are rated as less vivid after “recall + EM” but not after “recall only”. This was not found for neutral memories. Emotional memories are more taxing than neutral memories, which may explain the findings. Alternatively, transient arousal induced by recall of aversive memories may promote reconsolidation of the blurred memory image that is provoked by EM.     

Cognitive mediation of intervention effects on physical exercise: Causal models for the adoption and maintenance stage

Objective: To investigate how the effects of a group-based intervention program (MoVo-LISA) on exercise behaviour were mediated by cognitive variables. Different causal models mapping the short-term (adoption) and long-term (maintenance) intervention effects were tested using path analyses.

Design: N?=?220 in-patients of a rehabilitation clinic were assigned to an usual care or intervention group (quasi-experimental design). Questionnaire-based assessment was conducted at baseline; discharge; and at six weeks, six months and 12 months post discharge.

Measures: The potential mediator variables were outcome expectations, self-efficacy, strength of goal intention (intention strength), self-concordance, action planning and barrier management.

Results: Observed intervention effects on exercise behaviour (p?<?0.05) were mediated by intention strength at the adoption and maintenance stages, by action planning only at the adoption, and by barrier management only at the maintenance stage. Self-efficacy and outcome expectations were only indirectly involved in these mediations by affecting intention strength and self-concordance.

Conclusion: This is the first study to track the cognitive mediation processes of intervention effects on exercise behaviour over a long time-period by differentiating the adoption and maintenance stages of behaviour change. The findings emphasise the importance of deconstructing intervention effects (modifiability vs. predictive power of a mediator) to develop more effective interventions.     

Less Engagement in Pleasurable Activities Is Associated With Poorer Quality of Life for Veterans With Comorbid Postdeployment Conditions

The presence of multiple comorbid conditions is common after combat deployment and complicates treatment. A potential treatment approach is to target shared mechanisms across conditions that maintain poorer health-related quality of life (HRQOL). One such mechanism may be decrements in pleasurable activities. Impairment in pleasurable activities frequently occurs after deployment and may be associated with poorer HRQOL. In this brief report, we surveyed 126 veterans who had previously sought an assessment at a Veterans Affairs postdeployment health clinic and assessed pleasurable activities, HRQOL, and postdeployment health symptoms. Forty-three percent of veterans met our criteria for all 3 postdeployment conditions (posttraumatic stress disorder, depression, and chronic widespread physical symptoms). Greater engagement in pleasurable activities was associated with better HRQOL for all veterans regardless of type or level of postdeployment health symptoms. Future research should study if interventions that encourage veterans with postdeployment health conditions to engage in pleasurable activities are effective rehabilitation strategies.     

On the internal structure of Guinier-Preston zones in Al-3 at.% Ag

High-angle annular dark-field scanning transmission electron microscopy has been employed to study partially decomposed Al-3 at.% Ag. After solutionizing at 550°C and quenching to room temperature, samples of an Al-3 at.% Ag single crystal were aged for short times at 105, 140 and 180°C. Independent of the ageing temperature for these early stages, Guinier-Preston zones with a diameter of about 3 nm are found. Most of these zones consist of a silver-depleted core surrounded by a silver-rich shell. The shell structure is not uniformly pronounced. Irregularly shaped Guinier-Preston zones are common, but the shell structure dominates. No indication of different structures of the Guinier-Preston zones in Al-3 at.% Ag was found after short ageing at the three different temperatures. The shell model for Guinier-Preston zones in aluminium-rich Al-Ag alloys, which was previously proposed on the basis of X-ray and neutron scattering experiments, is thus appropriate to describe the structure of the Guinier-Preston zones in the early stages of the decomposition.     

Enactment effects and integration processes in younger and older adults’ memory for actions

The present study investigates the mental processes that are applied to previously attended items of working memory. In an object-switching task, participants counted the number of sequentially presented objects. In Experiment 1 the processing time increased when the object category switched from the prior trial compared to a repetition. More importantly, the further in the past the last instance of a current category was presented, the more processing time was necessary—an observation suggesting passive decay rather than inhibition of previously attended items. However, results differed when only two object categories were employed. Experiment 2 suggests that the lack of a clear indication of decay with small numbers of categories was due to participants’ expectancy of category switches rather than repetitions. Taken together, the results suggest that working memory items become less accessible the longer they have not been attended to, when strategic processes are controlled.     

Some effects of alcohol and eye movements on cross-race face learning

This study examines the impact of acute alcohol intoxication on visual scanning in cross-race face learning. The eye movements of a group of white British participants were recorded as they encoded a series of own-and different-race faces, under alcohol and placebo conditions. Intoxication reduced the rate and extent of visual scanning during face encoding, reorienting the focus of foveal attention away from the eyes and towards the nose. Differences in encoding eye movements also varied between own-and different-race face conditions as a function of alcohol. Fixations to both face types were less frequent and more lingering following intoxication, but in the placebo condition this was only the case for different-race faces. While reducing visual scanning, however, alcohol had no adverse effect on memory, only encoding restrictions associated with sober different-race face processing led to poorer recognition. These results support perceptual expertise accounts of own-race face processing, but suggest the adverse effects of alcohol on face learning published previously are not caused by foveal encoding restrictions. The implications of these findings for alcohol myopia theory are discussed.