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Background: Late nephrology referral, before initiation of dialysis treatment, is associated with adverse outcome., Objectives: To investigate the implications of late nephrology referral on mortality among dialysis patients in Israel., Methods: We retrospectively analyzed 200 incident dialysis patients. Patients were defined as late referrals if they started dialysis less than 3 months after their first nephrology consultation. Survival rates and risk factors for mortality were analyzed, Results: The early referral (ER) group comprised 118 patients (59%) and the late referral (LR) group 82 patients (41%). The mortality rate was 44.5% (53 patients) in the ER and 68% (n = 56) in the LR group. The 4 year survival rate was 41.1% in the ER and 18.7% in the LR group (P < 0.0001). The mortality rate increased with late nephrology referral (HR 1.873, 95% CI 1.133-3.094), with age (HR 1.043 for each year, 95% CI 1.018-1.068), with diabetes (HR 2.399, CI 1.369-4.202), and with serum albumin level (HR 0.359 for an increase of each 1 g/dl, 95% CI 0.242-0.533). The median survival time was higher for the ER group in women, in patients younger than 70, and in diabetic patients. A trend for longer survival time was found in non-diabetic patients. Survival time was not increased in early referred patients older than 70 and in male patients., Conclusions: Late nephrology referral is associated with an overall higher mortality rate in dialysis patients. The survival advantage of early referral may have a different significance in specific subgroups. The timing of nephrology referral should be considered as a modifiable risk factor for mortality in patients with end-stage renal disease.

The aim of the current study was to compare varied dimensions of participation in leisure activities among school-aged children ages 10-16 with and without disabilities. The Children Leisure Activity Scale (CLASS) was administrated to 294 children, 81 with and 213 without physical disability. Two-way MANCOVA revealed significant differences between the frequency of participation in leisure activities of the study groups: an effect of disability F(4,265=239.57; p<0.001, η(2)=0.78); an effect of gender F(4,265=3.35; p<0.01, η(2)=0.05); and an interaction effect between gender and disability F(4,265=5.23; p<0.001, η(2)=0.64). Children with disabilities, and mostly girls, were found at risk to participate in a narrower variety of activities that involved fewer social interactions. Using linear regressions for each group two different models were identified. Using the CLASS the study contributes evidence-based data regarding children at risk for leisure participation. In addition, the research further established the discriminate validity of the CLASS., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

This article presents research that explores how female occupational therapists define and experience their professional caring role. The research analyses the relation between female occupational therapists' self-perception, their moral stand and their professional behaviour as patients' advocates. Caring for others, helping people in need, being responsible for the good of others; these and other calls of duty have been a major theme in defining the roles of occupational therapists as well as of other health care professionals. In the present study, seven female occupational therapists from the New York metropolitan area participated. For the collection of the data the researcher interviewed each of the participant, using in-depth ethnographic interviews. From the research main theme named 'self-perception as a caring person', four sub-themes were identified: (a) the perception of being a caring person; (b) being a caring person leads to becoming an occupational therapist; (c) being available to patients; and (d) protecting and helping patients. In this article the first three sub-themes are briefly described. The focus is on the fourth one. It analyses how the interviewees' self-perceptions as caring individuals are central to their moral decision-making process and to their involvement in patients' advocacy as part of their role and functions in occupational therapy.

A number of concepts related to human performance, such as occupation, purposeful activity, function, work, doing, and play/leisure, are widely used in occupational therapy. Because these concepts are essential to the profession, we seek to understand their meaning. Many theorists in occupational therapy define and attribute different levels of importance to each of these concepts. The present study examines the professional (student vs. practitioner) and universal (American vs. Israeli) meanings of the six concepts named above. Four statistical methods were used: (a) a multivariate analysis of variance, (b) t tests and a sign test to analyze the Osgood semantic differential, and (c) Individual Differences in Multidimensional Scaling (Carroll & Chang, 1970). The results indicate that the American occupational therapists ascribed higher affective meanings than did all of the other groups to the concepts of purposeful activity, function, doing, and work. No difference was found for occupation and hobby, which rated high for all groups. Differences in the dimensions underlying the concepts between American and Israeli subjects suggest a cultural and linguistic influence on the meaning ascribed to the concepts.

This study analyzes the time allocation patterns at work of a sample group of Israeli occupational therapists who function in different roles and specialty areas. The sample consisted of 89 female occupational therapists working in the areas of physical impairment, rehabilitation, psychiatry, and pediatrics. Subjects recorded all of their activities during one work week and rated 23 previously identified occupational therapy activities according to perceived levels of importance. The results indicated that, on the whole, occupational therapists in all areas devoted at least two-thirds of their time to treatment-related activities (direct and indirect treatment). The results led us to conclude that the time allocation patterns used may have been conducive to "burnout." Therefore, to facilitate professional growth, we recommend that priorities be set and followed and also that role definitions be adhered to more strictly.