Principles of Occupational Therapy Group Outcome Assessment in Mental Health

In today's penurious health care climate, occupational therapists must scrutinize their practice and substantiate their interventions in order to remain viable service providers. This article proposes a method of occupational therapy outcomes assessment in mental health care that is rooted in client-centered functional outcomes. Since little consensus exists on which instruments are most effective, this article begins with an outline of broadly accepted principles for assessment of patient outcomes in mental health. Next, we describe a practical method for selecting outcomes measures in interdisciplinary settings. Finally, we offer pragmatic solutions to address barriers to outcome assessment.     

The secluded minds of violent patients

In this paper, I will present two violent patients suffering from severe Personality Disorders, illustrating the changes that can arise during the course of several years' psychoanalytic treatment in high security hospital. Progress was monitored using the Operationalised Psychodynamic Diagnostics (OPD) system. The clinical presentations will indicate how secluded these patients' minds are to themselves and to those involved in their care. The psychoanalytic treatment, as one part of the overall treatment, is described to show how the secluded parts of the patients'' minds can be approached, including references to the regular regressions that arise, provoked by ‘getting better’.     

Revisions and Regret: The Cost of Changing your Mind

Decision reversals often imply improved decisions. Yet, people show a strong resistance against changing their minds. These are well‐established findings, which suggest that changed decisions carry a subjective cost, perhaps by being more strongly regretted. Three studies were conducted to explore participants' regret when making reversible decisions and to test the hypothesis that changing one's mind will increase post‐outcome regret. The first two studies employed the Ultimatum game and the Trust game. The third study used a variant of the Monty Hall problem. All games were conducted by individual participants playing interactively against a computer. The outcomes were designed to capture a common characteristic of real‐life decisions: they varied from rather negative to fairly positive, and for every outcome, it was possible to imagine both more and less profitable outcomes. In all experiments, those who changed their minds reported much stronger post‐outcome regret than those who did not change, even if the final outcomes were equally good (Experiments 2 and 3) or better (Experiment 1).This finding was not because of individual differences with respect to gender, tendency to regret, or tendency to maximize. Previous studies have found that those who change from a correct to wrong option regret more than those who select a wrong option directly. This study indicates that this finding is a special case of a more general phenomenon: changing one's mind seems to come with a cost, even when one ends up with favorable outcomes. Copyright © 2011 John Wiley & Sons, Ltd.     

Psychodynamic psychotherapy for children and adolescents: a critical review of the evidence base

For many years psychoanalytic and psychodynamic therapies have been considered to lack a credible evidence-base and have consistently failed to appear in lists of ‘empirically supported treatments’. This study systematically reviews the research evaluating the efficacy and effectiveness of psychodynamic psychotherapy for children and young people. The researchers identified 34 separate studies that met criteria for inclusion, including nine randomised controlled trials. While many of the studies reported are limited by sample size and lack of control groups, the review indicates that there is increasing evidence to suggest the effectiveness of psychoanalytic psychotherapy for children and adolescents. The article aims to provide as complete a picture as possible of the existing evidence base, thereby enabling more refined questions to be asked regarding the nature of the current evidence and gaps requiring further exploration.     

Predictors of willingness to register as an organ donor among dutch adolescents

Abstract

In order to identify relevant determinants of organ donor registration among Dutch adolescents, a school-based cross-sectional survey was conducted among 145 high school students. Fifty-one percent of respondents indicated they were willing to register as organ donors and 80% reported a positive general attitude towards registration. Various misconceptions about the registration and donation procedure were identified. On average only moderate knowledge levels related to organ donation were found. In order of strongest association, negative outcome expectancies, past behaviour and experience, positive outcome expectancies, and social outcome expectancies proved to be significant predictors of willingness to register as organ donors. Self-efficacy was indirectly associated with willingness via outcome expectancies. Knowledge about organ donation was not significantly associated with willingness. The results suggest that in order to persuade adolescents to register as organ donors, refutational messages will have to be developed to counterargue the prevailing negative outcome expectancies related to organ donation and registration as an organ donor.     

Affective and health-related outcome expectancies for physical activity in older adults

This study tests the effects of affective and health-related outcome expectancies on physical exercise, assuming stronger direct and indirect (via intention) effects from affective outcome expectancy to physical exercise than from health-related outcome expectancy to exercise. Physical exercise and social cognitive variables were assessed at baseline, and 6- and 12-month follow-up in 335 older adults (60–95 years of age). Applying structural equation modelling, there was a direct effect from affective, but not from health-related outcome expectancy on intentions and behaviour. Also, the indirect effect from self-efficacy on physical exercise via affective outcome expectancy was significant, whereas the mediation via health-related outcome expectancy was not. These findings emphasise the relative importance of affective versus health-related outcome expectancies in predicting intentions and physical exercise in older adults and highlight the importance to separate these facets at a conceptual level to enhance both theory development and health promotion.     

Neuropsychological Functioning in Children with Medium Chain Acyl Coenzyme A Dehydrogenase Deficiency (MCADD): The Impact of Early Diagnosis and Screening on Outcome

Children with medium chain acyl coenzyme A dehydrogenase deficiency (MCADD) have been reported to be at high risk for neurocognitive deficits. However this has not been systematically studied and little is known about the exact nature of neuropsychological sequelae or of the impact of early diagnosis and screening on outcome. We examined cognitive and adaptive outcome in children with MCADD (N?=?38, age range: 2 years, 2 months – 10 years, 3 months) diagnosed either through a newborn screening program (tandem mass spectrometry/MSMS) or upon clinical presentation. There was no evidence of overall intellectual impairment in either groups but there was some suggestion of poorer verbal and specific executive functioning (i.e., planning) abilities in the unscreened cohorts. Adaptive functioning was relatively intact with the exception of reduced Daily Living Skills in both our screened and unscreened groups. Early diagnosis and greater number of hospitalizations were related to higher verbal, communication, and socialization skills. Overall, our results highlight the importance of early diagnosis and management for children with MCADD.     

Preparation and properties of a left-handed metamaterial composite

A left-handed metamaterial (a YIG/Ag composite with adjustable negative permittivity and permeability) was prepared by an in situ synthesis process, and its characterisation, microstructure, electrical conductivity, dielectric loss and magnetic properties studied. A negative permittivity behaviour with a Fano-like resonance is ascribed to plasma oscillation of delocalised electrons from silver conducting networks. As the silver content increases, the turbine loss increases, which greatly enhances the electromagnetic wave consumption capacity inside the material and leads to a stronger electromagnetic absorption and shielding performance. The dielectric loss near the percolation threshold is due to the combined effects of polarisation and conduction. The capacitive character is responsible for positive permittivity, and the inductive character leads to negative permittivity. LC resonance results in the Fano-like resonance, leading to the permittivity changing from negative to positive. Gyromagnetic spin rotation, domain wall motion and percolation characteristic of YIG/Ag composites cause frequency dispersion of the permeability. The YIG/Ag composite with double negative characteristics provides prospects for electromagnetic shielding application.     

The 328 cm−1 infrared absorption band in type Ia diamonds

Abstract

A defect-induced peak at 328 cm^?1 in the infrared absorption spectrum of type Ia diamonds is confirmed to belong with the other absorptions (in particular, the B′ localised mode near 1370 cm^?1 and the D component of the lattice vibrations) which are associated with the {100} platelets found in these crystals. It is suggested that this absorption and other weaker absorptions found in its vicinity may be due to the bending vibrations of atomic bonds in the platelets.     

Diffusion kinetics for divacancies in the bcc lattice

In this letter we employ high-precision Monte Carlo simulations to investigate tracer diffusion kinetics for diffusion via divacancies in the bcc lattice. We utilize the mechanisms originally identified by Mehrer in which the divacancy can move by nearest-neighbour jumps with stable first-nearest-neighbour, second-nearest-neighbour and fourth-nearest-neighbour configurations of the divacancy. The tracer correlation factor and the 'impurity-form' correlation factor were found to be some 4-6% lower than those found by the matrix method. The tracer diffusion data and isotope effect for sodium were revisited in terms of monovacancy and divacancy contributions. The main change is a revision upwards from 0.55 to 0.61 of the j K kinetic factor for divacancies.