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Functional Use (functional + use)
Selected AbstractsConstraint-induced movement therapy (CIMT): Pediatric applicationsDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2009Kathleen Brady Abstract The purpose of this article is to describe theoretical and research bases for constraint-induced movement therapy (CIMT), to discuss key features and variations in protocols currently in use with children, and to review the results of studies of efficacy. CIMT has been found to be an effective intervention for increasing functional use of the hemiparetic upper extremity in adults with chronic disability from stroke. CIMT developed out of behavioral research on the phenomenon of "learned nonuse" of an upper extremity, commonly observed following sensory and/or motor CNS injury, in which failure to regain use persists even after a period of partial recovery. CIMT includes three key elements: (1) constraining the use of the less-impaired upper extremity (UE); (2) intensive, repetitive daily therapist-directed practice of motor movements with the impaired UE for an extended period (2,3 weeks); and (3) shaping of more complex action patterns through a process of rewarding successive approximations to the target action. Mechanisms responsible for success are thought to be separate but complementary, that is, operant conditioning (reversal of learned nonuse) and experience-driven cortical reorganization. CIMT has recently been extended to children with hemiparesis secondary to perinatal stroke or other CNS pathology. Numerous case studies, as well as a small number of randomized controlled or controlled clinical trials have reported substantial gains in functional use of the hemiplegic UE following CIMT with children. Protocols vary widely in terms of type of constraint used, intensity and duration of training, and outcome measures. In general, all report gains in functional use, with minimal or no adverse effects. Continued research is needed, to clarify optimal protocol parameters and to further understand mechanisms of efficacy. © 2009 Wiley-Liss, Inc. Dev Disabil Res Rev 2009;15:102,111. [source] Using the Rorschach for exploring the concept of transitional space within the political context of the Middle EastINTERNATIONAL JOURNAL OF APPLIED PSYCHOANALYTIC STUDIES, Issue 1 2005Shira Tibon Abstract The paper presents an application of a new Rorschach index, the Reality,Fantasy Scale (RFS) for evaluating the extent to which educated Israeli Jews and Arabs manifest a similar adaptive and functional ability in preserving psychic transitional space. The RFS is a psychodynamic oriented diagnostic tool, based on Exner's (1993) Comprehensive System for scoring and interpreting the Rorschach, and designed to operationalize Winnicott's (1971) concept of potential space. The scale is based on a paradigm that conceptualizes the Rorschach task as inviting the subject to enter the intermediate transitional space between inner and outer reality. The RFS ranges from ,5 to +5, and a score of zero indicates adaptive and functional use of potential space. The results point to a basic similarity between two groups of Jewish (n = 41) and Arab (n = 14) non-patients both using adaptively inner space between reality and fantasy. These results are discussed in terms of current psychoanalytic thought of relationality, political psychology research, cross-cultural personality assessment, and the empirical study of psychoanalytic concepts. Copyright © 2005 Whurr Publishers Ltd. [source] Effectiveness of primary conservative management for infants with obstetric brachial plexus palsyINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2005Andrea Bialocerkowski PhD MAppSc(Phty) GradDipPublicHealth Executive summary Background, Obstetric brachial plexus palsy, a complication of childbirth, occurs in 1,3 per 1000 live births internationally. Traction and/or compression of the brachial plexus is thought to be the primary mechanism of injury and this may occur in utero, during the descent through the birth canal or during delivery. This results in a spectrum of injuries that vary in severity, extent of damage and functional use of the affected upper limb. Most infants receive treatment, such as conservative management (physiotherapy, occupational therapy) or surgery; however, there is controversy regarding the most appropriate form of management. To date, no synthesised evidence is available regarding the effectiveness of primary conservative management for obstetric brachial plexus palsy. Objectives, The objective of this review was to systematically assess the literature and present the best available evidence that investigated the effectiveness of primary conservative management for infants with obstetric brachial plexus palsy. Search strategy, A systematic literature search was performed using 14 databases: TRIP, MEDLINE, CINAHL, AMED, Web of Science, Proquest 5000, Evidence Based Medicine Reviews, Expanded Academic ASAP, Meditext, Science Direct, Physiotherapy Evidence Database, Proquest Digital Dissertations, Open Archives Initiative Search Engine, Australian Digital Thesis Program. Those studies that were reported in English and published over the last decade (July 1992 to June 2003) were included in this review. Selection criteria, Quantitative studies that investigated the effectiveness of primary conservative management for infants with obstetric brachial plexus palsy were eligible for inclusion in this review. This excluded studies that solely investigated the effect of primary surgery for these infants, management of secondary deformities and the investigation of the effects of pharmacological agents, such as botulinum toxin. Data collection and analysis, Two independent reviewers assessed the eligibility of each study for inclusion into the review, the study design used and its methodological quality. Where any disagreement occurred, consensus was reached by discussion. Studies were assessed for clinical homogeneity by considering populations, interventions and outcomes. Where heterogeneity was present, synthesis was undertaken in a narrative format. Results, Eight studies were included in the review. Most were ranked low on the Hierarchy of Evidence (no randomised controlled trials were found), and had only fair methodological quality. Conservative management was variable and could consist of active or passive exercise, splints or traction. All studies lacked a clear description of what constituted conservative management, which would not allow the treatment to be replicated in the clinical setting. A variety of outcome instruments were used, none of which had evidence of validity, reliability or sensitivity to detect change. Furthermore, less severely affected infants were selected to receive conservative management. Therefore, it is difficult to draw conclusions regarding the effectiveness of conservative management for infants with obstetric brachial plexus palsy. Conclusions, There is scant, inconclusive evidence regarding the effectiveness of primary conservative intervention for infants with obstetric brachial plexus palsy. Further research should be directed to develop outcome instruments with sound psychometric properties for infants with obstetric brachial plexus palsy and their families. These outcome instruments should then be used in well-designed comparative studies. [source] Polylactide copolymers: Effect of copolymer ratio and end capping on their propertiesADVANCES IN POLYMER TECHNOLOGY, Issue 2 2005D. M. Bigg Abstract Racemic copolymers of polylactic acid were investigated to determine the effect of copolymer ratio on melting point, degree of crystallinity, mechanical properties, and processing behavior. The copolymer ratio was found to have a strong influence on the crystallization behavior of the polymer. In addition to the ratio of the L -form to a random mixture of the D and L forms of the lactic acid in the copolymer, the effect of the polymer's molecular weight was examined. The copolymers were produced from the lactide form of the monomer to achieve weight average molecular weights above 100,000. The molecular weight had a profound influence on processability and rate of crystallization. Other notable factors influencing the properties and processing of the copolymers were the concentration of residual monomer in the polymer, the processing time-temperature history, and the extent of molecular weight degradation during processing. An important factor in the commercial development of biodegradable polymers is the ability to control the rate of degradation. Ideally, the polymer should not degrade during functional use, but degrade quite rapidly when discarded. This paper discusses various aspects associated with the control of the rate of degradation of polylactide copolymers; both from the perspective of stabilizing the polymer during processing and product use, and subsequently accelerating the rate of degradation after disposal. Of particular interest are the influences of molecular weight, crystallinity, end capping, and plasticization. © 2005 Wiley Periodicals, Inc. Adv Polym Techn 24:69,82, 2005; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/adv.20032 [source] Community as practice: social representations of community and their implications for health promotionJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 2 2007Christine Stephens Abstract Health promotion researchers and practitioners have increasingly turned to community-based approaches. Although there has been much work around the diverse understandings of the term in areas such as community psychology and sociology, I am concerned with how such understandings relate directly to community health research and practice. From a discursive perspective ,community' is seen as a socially constructed representation that is used variously and pragmatically. However, from a wider view, community can be seen as a matter of embodied practice. This paper draws on social representations theory to examine the shifting constructions of ,community', the functional use of those understandings in social life, and the practices that suggest that it is important to attend to their use in particular contexts. Accordingly, the paper argues that meanings of community in the health promotion or public health context must be seen as representations used for specific purposes in particular situations. Furthermore, the broader notion of embodied practice in social life has implications for community participation in health promotion. Copyright © 2007 John Wiley & Sons, Ltd. [source] Functional Outcomes after Circumferential Pharyngoesophageal ReconstructionTHE LARYNGOSCOPE, Issue 7 2005Jan S. Lewin PhD Abstract Objective: To determine functional speech and swallowing outcomes, morbidity, and complication rates after reconstruction of circumferential pharyngoesophageal defects using a jejunal versus an anterolateral thigh (ALT) flap. Study Design: Retrospective analysis. Methods: We reviewed the medical records of 58 patients with circumferential pharyngoesophageal defects, 27 with ALT flap reconstruction, and 31 with jejunal interposition. We compared complication rates, intensive care unit (ICU) and hospital stays, nutritional intake, number of tracheoesophageal punctures (TEPs) performed, TE speech fluency, and functional use. Modified barium swallow studies assessed swallowing physiology. Results: Patient characteristics were similar. Total flap loss occurred in one (3.7%) patient with an ALT flap and two (6.5%) patients with jejunal interposition (P = 1.000), fistula in two (7.4%) ALT patients and one (3.2%) jejunal patient (P = .5931), and anastomotic stricture in four (15%) ALT patients and six (19.4%) jejunal patients (P = .7371). ICU and hospital stays were greater for jejunal patients (P = .001, <.001, respectively). TEPs were performed in eight jejunal patients and nine ALT patients. Eighty-nine percent of ALT patients and 63% of jejunal patients were fluent, whereas 78% of ALT patients and 25% of jejunal patients used TE speech to communicate. Ninety-one percent of ALT patients and 73% of jejunal patients resumed oral intake (P = .151). The most common causes of dysphagia were impaired tongue base retraction (62% jejunum) and disordered motility (62% jejunum, 67% ALT). Conclusions: For circumferential pharyngoesophageal reconstruction, the ALT flap results in similar complication rates, but shorter ICU and hospital stays, and better speech and swallowing compared with jejunal reconstruction. [source] Sex Categorization Among Preschool Children: Increasing Utilization of Sexually Dimorphic CuesCHILD DEVELOPMENT, Issue 5 2010Kerri L. Johnson Two studies examined how children between ages 4 and 6 use body shape (i.e., the waist-to-hip-ratio [WHR]) for sex categorization. In Study 1 (N = 73), 5- and 6-year-olds, but not 4-year-olds, selected bodies with increasingly discrepant WHRs to be "most like a man" and "most like a woman." Similarly, sex category judgments made by 5- and 6-year-olds, but not 4-year-olds, varied with WHR. In Study 2 (N = 41), eye movements indicated the functional use of waist and hips in sex categorization. Visual scanning behavior predicted the degree of association between WHR and judgment. Collectively, these results suggest that the ability to exploit sexual dimorphism to compel categorization develops between the ages of 4 and 6. Implications for theories of gender development and psychological essentialism are discussed. [source] Functional and Edible Uses of Soy Protein ProductsCOMPREHENSIVE REVIEWS IN FOOD SCIENCE AND FOOD SAFETY, Issue 1 2008Preeti Singh ABSTRACT:, Consumers are becoming increasingly interested in healthful foods and are open to soy protein ingredients. Soybeans as food are very versatile and a rich source of essential nutrients. They are also an excellent source of good-quality protein, comparable to other protein foods, and suitable for all ages. Adverse nutritional and other undesirable effects followed by the consumption of raw soybean meal have been attributed to the presence of endogenous inhibitors of digestive enzymes and lectins, as well as poor digestibility. To improve the nutritional quality of soy foods, inhibitors and lectins are generally inactivated by heat or eliminated by fractionation during food processing. Soybeans provide an alternative source of protein for people who are allergic to milk protein. Soy protein is highly digestible (92% to 100%) and contains all essential amino acids. Although relatively low in methionine, it is a good source of lysine. Soy-protein products contain a high concentration of isoflavones, up to 1 g/kg. Increased acceptance of soy proteins is due to unmatched qualities like good functional properties in food applications, high nutritional quality, abundance, availability, and low cost. At present the various forms of soy proteins are primarily utilized for their functional effects rather than their nutritional properties. This article summarizes the integrated overview of the widely available, scattered information about the nutritional and functional uses of the soy proteins when applied in food systems and intends to present the most current knowledge with an interest to stimulate further research to optimize their beneficial effects. [source] |