Search

This pretest/posttest study investigated the effectiveness of an interdisciplinary program in which occupational therapists and speech-language pathologists used a combination of video modeling, scenario-based learning, guided discussion, and reflection on the development of interpersonal skills and work readiness among students with disabilities. This study examined 20 high school and postgraduate transitional students enrolled full-time in Life Skills Support classrooms in two rural high schools. Participants completed 21 dynamic and interactive group sessions which included video modeling, scenario-based learning, guided discussion, and reflection. Sessions were completed once a week, for one hour, and focused on enhancing interpersonal skills, cognitive skills, work habits, and performance skills. Sessions were delivered via an interdisciplinary model with participants' primary occupational therapist and speech-language pathologist. Results of the paired-samples t-test found a statistically significant increase in the Becker Work Adjustment Profile-2 scores in three categories: Cognitive Skills, Work Performance, and Broad Work Adjustment. All students showed growth on Goal Attainment Scaling (GAS) T-scores; 18 of the 20 students achieved GAS T-scores greater than threshold performance.

Objective: Cranial base chordomas are difficult lesions to treat. The endoscopic endonasal approach (EEA) takes advantage of the natural sinus corridor and may provide a less invasive approach for these midline tumors., Methods: Patients undergoing EEA for chordomas were selected from a database of more than 800 consecutive patients undergoing EEA at the University of Pittsburgh Medical Center and were retrospectively evaluated. Additionally, a systematic review of the literature of endoscopic endonasally resected chordomas was performed and compared with our personal experience., Results: Twenty patients (8 females and 12 males) underwent 26 endoscopic EEAs for cranial base chordomas. Eight chordomas (40%) were recurrent. Treatment of the 12 newly diagnosed chordomas included 8 total resections (66.7%), 2 near total resections (16.7%), and 2 subtotal resections (16.7%). Treatment of the 8 recurrent chordomas included 1 gross total resection (12.5%), 2 near total resections (25.0%), and 5 subtotal resections (62.5%). Two patients (10%) had recurrences, and 5 patients (25%) progressed during the mean follow-up period of 13 months (range, 1-45 months). Five patients (25%) underwent re-resection, 1 patient was lost to follow-up, and 1 patient died secondary to progression of disease. There was 1 intraoperative vascular complication with no sequelae. The cerebrospinal fluid leak rate was 25%, and there were no cases of bacterial meningitis. The incidence of a new permanent neurological complication was 5%. A systematic review of the literature yielded a total of 26 cases of chordomas resected via a completely endoscopic endonasal technique., Conclusion: Endoscopic endonasal resection of cranial base chordomas is safe once adequate experience is gained with the technique. This approach provides the potential for, at the least, similar resections compared with traditional cranial base approaches while potentially limiting morbidity.