Group items tagged

This article provides a summary by AOTA's Evidence-Based Practice Project of current evidence available in multiple areas which OT is involved with adults with TBI. By providing a summary of the current evidence available, OTs looking to be involved in research can use this information to create new research questions and see in which areas more evidence is needed to support OT. The areas summarized include arousal and alertness of people in a coma, motor function, cognitive impairment, visual-perceptual impairment, psychosocial/behavioral/emotional impairments, areas of occupation, and social participation.

The MoCA screen is commonly used for individuals with Parkinson's Disease. The current study is a follow up from an original study. Thus, the aim of this pilot study was to develop an initial version of a new scoring procedure for the MoCA which considers the subtests' power to detect cognitive symptoms in PD, and to test whether it improves the ability to discriminate PD patients without cognitive impairment from patients with MCI and PD dementia. Screening procedures have high value as a time-economic, easy to use tool for a first step in detecting cognitive impairment in clinical practice, but will unlikely outweigh the reliability and validity of a neuropsychological test battery. The sensitivity of the MoCA increased from 68.8% to 81.3% while maintaining a specificity of 75% when using the weighted measurements. This means that more cognitively impaired subjects were detected in both patient groups. Since the sensitiviy increased it greater serves the purpose of a screen, to identify patients with cognitive impairments. The authors suggest this algorithm of weighting subtests may be applicable to patients with PD and other populations as historically some subtests of the MoCA have been too simple for non-demented patients.

Guidelines to the Occupational Therapy Code of Ethics This is a really handy resource that provides a quick glance at the different elements of the Occupational Therapy Code of Ethics. It lists ten sections of professional behaviors under the code of ethics and each have a subset of behaviors which are appropriate under that section. The first professional behavior listed is honesty. "Professionals must be honest with themselves, must be honest with all whom they come in contact with, and must know their strengths and limitations" (AOTA, 2005). The second behavior listed is communication. "Communication is important in all aspects of occupational therapy. Individuals must be conscientious and truthful in all facets of written, verbal, and electronic communication" (AOTA, 2005). The third area of professional behavior is ensuring the common good. "Occupational therapy personnel are expected to increase awareness of the profession's social responsibilities to help ensure the common good" (AOTA, 2005). The fourth professional behavior is competence. "Occupational therapy personnel are expected to work within their areas of competence and to pursue opportunities to update, increase, and expand their competence" (AOTA, 2005). The fifth area of professional behavior is confidential and protected information. "Information that is confidential must remain confidential. This information cannot be shared verbally, electronically, or in writing without appropriate consent. Information must be shared on a need-to-know basis only with those having primary responsibilities for decision making" (AOTA, 2005). The sixth professional behavior area is conflict of interest. "Avoidance of real or perceived conflict of interest is imperative to maintaining the integrity of interactions" (AOTA, 2005). The seventh professional behavior area is impaired practitioner. "Occupational therapy personnel who cannot competently perform their duties after reasonable accommodati

Performance on MoCA subtests was compared at these MMSE cutoffs to determine profiles of early cognitive difficulties. The MoCA detected cognitive impairment not detected by the MMSE in a high proportion of participants, and this impairment was evident across various subtests. The MoCA appears to be a sensitive screening test for detection of early cognitive impairment.

NBCOT carefully screens for behaviors considered illegal, unethical or impaired.

NBCOT carefully screens for behaviors considered illegal, unethical or impaired.

The MoCA also measures a wider range of abilities including executive functions, a higher level cognitive ability required for the implementation of goal-directed behavior and the process of creating and fulfilling a plan. For these reasons, the MoCA was chosen as the comparator assessment of cognition in this study. The cut off score for the MoCA has widely been research and inconclusive. The original cut off score was 26/30 for normal cognition, however many argue the score is too low. This study suggests a computerized battery (CBS- Cambridge Brain Sciences Battery) for patients scoring 23-26, that have a borderline cognitive impairment in order to classify them as impaired or unimpaired. Five tasks from the original 12 of the CBS were chosen to assess aspects of short-term memory, attention, reasoning, and planning. Results: Only two of the tasks were able to distinguish between impaired and unimpaired. Utilizing these tasks in conjunction with the MoCA provides more information regarding testers that fall in the "borderline" category 23-26. The older adults were accepting of the electronic technology.

The BCAT's utility for identifying dementia versus mild cognitive impairment was excellent, with a sensitivity of .99, a specificity of .77, and an area under the receiver-operatingcharacteristic (ROC) curve of .95. Executive control, contextual memory, and attentional capacity items were the best predictors of diagnostic category and of instrumental activities of daily living. From a clinical standpoint, it is recommended a BCAT cut score of 37/38 for differentiating between persons with dementia and those with MCI. This means that patients who have scores of 37 and below are likely to have dementia. This research utilized a population residing in assisted living facilities. Future studies should address a cut off for mild cognitive impairment and non-impaired and community dwelling adults.

The article explores the validity of the LACLS-5 (Allen's cognitive level screen) to assess and distinguish adults living in the community with mild cognitive impairment (MCI) and mild dementia. Individuals with mild dementia scored less on all clinical measures than cognitively normal (CN) individuals, however individuals with MCI scored intermediately compared to CN adults. LACLS-5 was able to adequately discriminate between CN and dementia and between MCI and dementia but was unable to reliably distinguish between CN and MCI. Despite these results of tool's inability to distinguish between CN and MCI, LACLS-5 was found to be a significantly effective tool to assess functional cognition.

The findings of this article showed that those with CHF reported significant reductions in participation in all four domains. The main domain was activity retention (leisure, IADLs and social). Results for depression, cognition, and participation showed that those with CHF have functioning problems and depressive symptoms were present. However, there was no correlation between memory and attention performance. This study was limited to the sample size because it was less than 30. It also stated few participants did not complete the study because of fatigue and scheduling issues, but it never stated how many dropped out. This may affect population validity of the study because it is unknown if there was mortality. Also, the 27 subjects used were all from the same hospital (convenient sample) and this may also pose a threat to population validity. The results of the study suggest that management of CHF should expand in focus from physical functioning and physically demanding activities to consider cognitive and psychological functioning in the context of all life situations. Occupational therapy can play a vital role in helping those with CHF and their psychosocial impairments (decreasing depression), while getting them back into the community and functioning in their everyday tasks, which may also reduce symptoms of depression. I used this article because the facility I'm at now admits a lot of cardiac patients and many have depressive symptoms as they are recovering from their cardiac impairments and returning to their everyday lives in the community.

This article discusses the impact of an educational intervention in DVD format focused on strengthening the mental health practices of occupational therapists working with older adults in long-term care settings. Thirty occupational therapists were selected to participate in the pretest-posttest design. The therapists completed a knowledge and attitude questionnaire, as well as completed chart reviews of therapists' caseloads three months prior to watching the videos. After watching the DVD and three months had past, the therapists participating in the study completed the same knowledge and attitude questionnaire and chart reviews once more. The results showed a 20%-30% increase in correct answers on the questionnaire. The chart reviews also showed that therapists spent increased time addressing patients' mood, depression and cognitive impairments, as well as conduct more screenings for depression and cognitive impairments. The conclusion stated that educational interventions with therapists could significantly increase the quality of mental health practices in occupational therapy.

Individuals experiencing mental health disorders are susceptible to impairments in occupational functioning due to decreased concentration, memory, thought processes, insight, judgement, decision-making, reality orientation, regulating emotions, understanding perception, motivation, and psycho-motor activity. This is a quantitative study out of the South American Journal of Occupation Therapy that studied the effects of slow vs. fast tempo of music on symptoms of psychosis during occupation. There were 160 individuals with diagnosed psychological disorders in a psych hospital in South Africa. The subjects participated in a leatherwork activity while listening to either fast paced/upbeat music or low tempo/slow music. Attention/focus, ability to follow instructions, directedness towards the activity, and motivation were measured in groups of individuals who had psycho-motor agitation or psycho-motor inhibition psychosis. The study found that listening to music during an activity has the ability to improve all three variables in both agitation and inhibited-motor psychosis. Fast-paced tempo significantly improves attention in individuals with inhibited motor-psychosis. The ability to follow instructions improved in both fast and slow tempo music for both agitated and inhibited individuals. Directedness and motivation did not significantly improve in any of the groups. This study indicates that music can improve the ability to perform occupations and activities in individuals with mental health disorders. Music is very individualized and it may be difficult for OT practitioners to work with groups of individuals when introducing music. IT is important for an OT to gather a good understanding of a patient's preferences and determine if they would be a good candidate for the use of music during therapy. More research is recommended in this area to further determine the effects of music on occupation in this population.