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Per every 100,000 persons internationally, 9.4 healthy life years were lost due to Anorexia Nervosa. Anorexia Nervosa requires intensive care from a multitude of healthcare professionals; however, ...

Critical thinking is the process of analyzing and evaluating thinking to make decisions. Critical thinking exposes assumptions, biases, and beliefs that influence clinical reasoning. This scoping review sought to explore instructional approaches for advancing students' critical thinking in healthcare education. Through analysis of 15 articles, no common definition of critical thinking emerged, nor consensus found on measurement or instructional methods. Some alternative instructional methods such as case-based learning, reflective guided questions, and multiple case exposures, when compared to lecture, did significantly impact learner critical thinking. To determine if critical thinking is an instructional method that would impact implicit biases and healthcare outcomes, five author recommendations are offered from gaps in the existing literature to provide a pathway for future research. To effectively prepare students for clinical practice, long term outcomes are necessary to assess if critical thinking skills can be taught and become part of a professional growth mindset.

The purpose of this study was to assess the validity of the Weekly Calendar Planning Activity Middle/High School (WCPA) in adolescents with acquired brain injuries (ABI). We recruited neurotypical controls ( n = 27) and adolescents with ABI ( n = 14) to complete a 90-min battery of cognitive tests. Adolescents with ABI were further divided into mild and severe groups by Glasgow Coma Scale Score and compared with controls. Mann–Whitney U tests revealed significant differences ( p = .05) on the WCPA between groups in total time to complete and rules followed. Between the controls and severe group, a significant difference ( p = .05) was found for total time spent, errors, rules followed, strategies used, and accurate appointments ( p = .01). Moderate correlations were found between the WCPA and neuropsychological tests (ρ = .31–.45). The WCPA is a valid performance-based assessment of functional cognition that can be used to detect deficits in adolescents with severe ABI.

The risk of violent behavior is known to be higher for patients who suffer from a severe mental disorder. However, specific prediction tools for clinical work in prison psychiatry are lacking. In this single-center study, two violence risk assessment tools (Forensic Psychiatry and Violence Tool, "FoVOx," and Mental Illness and Violence Tool, "OxMIV") were applied to a prison hospital population with a primary psychotic or bipolar disorder and subsequently compared. The required information on all items of both tools was obtained retrospectively for a total of 339 patients by evaluation of available patient files. We obtained the median and inter-quartile range for both FoVOx and OxMIV, and their rank correlation coefficient along with 95% confidence intervals (CIs)-for the full cohort, as well as for cohort subgroups. The two risk assessment tools were strongly positively correlated (Spearman correlation = 0.83; 95% CI = 0.80-0.86). Such a high correlation was independent of nationality, country of origin, type of detention, schizophrenia-spectrum disorder, previous violent crime and alcohol use disorder, where correlations were above 0.8. A lower correlation was seen with patients who were 30 years old or more, married, with affective disorder and with self-harm behavior, and also in patients without aggressive behavior and without drug use disorder. Both risk assessment tools are applicable as an adjunct to clinical decision making in prison psychiatry.

Aims To explore the pharmacodynamics of mycophenolic acid (MPA) through inosine monophosphate dehydrogenase (IMPDH) capacity measurement and purine levels in peripheral blood mononuclear cells (PBMC) longitudinally during the first year after renal transplantation (TX). Methods PBMC were isolated from renal recipients 0-4 days prior to and 6-9 days, 5-7 weeks and 1 year after TX (before and 1.5 hours after dose). IMPDH capacity and purine (guanine and adenine) levels were measured in stimulated and nonstimulated PBMC. Results Twenty-nine patients completed the follow-up period, of whom 24 received MPA. In stimulated PBMC, the IMPDH capacity (pmol 10-6 cells min-1 ) was median (interquartile range) 127 (95.8-147) before TX and thereafter 44.9 (19.2-93.2) predose and 12.1 (4.64-23.6) 1.5 hours postdose across study days after TX. The corresponding IMPDH capacity in nonstimulated PBMC was 5.71 (3.79-6.93), 3.35 (2.31-5.62) and 2.71 (1.38-4.08), respectively. Predose IMPDH capacity in nonstimulated PBMC increased with time, reaching pre-TX values at 1 year. In stimulated PBMC, both purines were reduced before (median 39% reduction across days after TX) and after (69% reduction) dose compared to before TX. No alteration in the purine levels was observed in nonstimulated PBMC. Patients needing dose reductions during the first year had lower pre-dose IMPDH capacity in nonstimulated PBMC (1.87 vs 3.00 pmol 10-6 cells min-1 , P = .049) at 6-9 days. Conclusion The inhibitory effect of MPA was stronger in stimulated PBMC. Nonstimulated PBMC became less sensitive to MPA during the first year after TX. Early IMPDH capacity appeared to be predictive of dose reductions.

Collaborative team learning prepares future practitioners using well-crafted, guided collaborative learning activities. Collaborative learning distributes responsibility across team members as they engage socially to build knowledge and learner skills. Critical thinking is a learner skill that is fostered through challenging the team of learners’ assumptions through ill-defined, complex real-life cases that defy easy solutions. The ability of occupational therapists to create effective discharge plans has been found to positively alter hospital recidivism. By offering a Jigsaw Case focused on discharge planning at several points in time across the service delivery continuum of care, a team of learners engaged in collaborative learning. We offer a complete Jigsaw Case experience supported by the literature of best practice that faculty can use as an example to tailor their own case based on circumstances and contexts.

Rationale: The NLST (National Lung Screening Trial) reported a 20% reduction in lung cancer mortality with low-dose computed tomography screening; however, important questions on how to optimize screening remain, including which selection criteria are most accurate at detecting lung cancers and what nodule management protocol is most efficient. The PLCOm2012 (Prostate, Lung, Colorectal and Ovarian) Cancer Screening Trial 6-year and PanCan (Pan-Canadian Early Detection of Lung Cancer) nodule malignancy risk models are two of the better validated risk prediction models for screenee selection and nodule management, respectively. Combined use of these models for participant selection and nodule management could significantly improve screening efficiency. Objectives: The ILST (International Lung Screening Trial) is a prospective cohort study with two primary aims: 1) Compare the accuracy of the PLCOm2012 model against U.S. Preventive Services Task Force (USPSTF) criteria for detecting lung cancers and 2) evaluate nodule management efficiency using the PanCan nodule probability calculator-based protocol versus Lung-RADS. Methods: ILST will recruit 4,500 participants who meet USPSTF and/or PLCOm2012 risk ≥1.51%/6-year selection criteria. Participants will undergo baseline and 2-year low-dose computed tomography screening. Baseline nodules are managed according to PanCan probability score. Participants will be followed up for a minimum of 5 years. Primary outcomes for aim 1 are the proportion of individuals selected for screening, proportion of lung cancers detected, and positive predictive values of either selection criteria, and outcomes for aim 2 include comparing distributions of individuals and the proportion of lung cancers in each of three management groups: next surveillance scan, early recall scan, or diagnostic evaluation recommended. Statistical powers to detect differences in the four components of primary study aims were ≥82%. Conclusions: ILST will prospectively evaluate the comparative accuracy and effectiveness of two promising multivariable risk models for screenee selection and nodule management in lung cancer screening. Clinical trial registered with www.clinicaltrials.gov (NCT02871856).

Entry-level occupational therapy doctorate (OTD) students receive education and training to interpret and disseminate evidenced-based literature. However, these students are often missing the clinical experience to identify clinically relevant questions that impact occupational outcomes. Conversely, occupational therapy practitioners have the clinical experience to determine clinically appropriate questions but often encounter time, budget, and setting constraints on researching and learning up-to-date evidence-based practice assessment and intervention techniques. The purpose of this paper is to describe the development and design of an exploratory educational project in which OTD students utilized clinically relevant questions identified by local occupational therapy practitioners to disseminate evidence-based literature in the form of continuing competency in-services to clinicians as it related to their clinical practice setting. Nineteen sites participated and 33 one-hour presentations were presented to clinical sites in the local area and within the occupational therapy student body. Students reflected that this was a positive learning experience and a valuable component of the course.

Executive deficits are commonly reported in children with sickle cell anemia. Earlier identification of executive deficits would give more scope for intervention, but this cognitive domain has not been routinely investigated due to a lack of age-appropriate tasks normed for preschool children. In particular, information relating to patient performance on an executive task that reflects an everyday activity in the classroom could provide important insight and practical recommendations for the classroom teacher at this key developmental juncture as they enter the academic domain. The performance of 22 children with sickle cell anemia was compared to 24 matched control children on the Preschool Executive Task Assessment. Findings reveal that children with sickle cell anemia are performing poorer than their matched peers on this multi-step assessment. In particular, children with sickle cell anemia required more structured support to shift focus after a completed step, as reflected by poorer scores in the quantitative Sequencing and Completion domains. They also required more support to stay on task, as seen by poorer ratings in the qualitative Distractibility domain. Child Health Research Charitable Incorporated Organization National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust University College London

Using descriptive case studies, this paper describes a short-term mentoring program using goal attainment scaling for young adults with sickle cell disease (SCD). Two participants received three and seven visits, respectively, before dropping out of the program with no significant change in goal attainment scores. Although the program supported meaningful individualized goals, repeated and cumulative effects of hospitalizations, sickle cell pain episodes, family health issues, unsafe location of residence, and transportation appeared to remain significant barriers for to achieve stated goals. While the value of an individualized, community-based mentoring experience that addresses goal attainment remains unanswered, this project documents the complex and health barriers of young adults living with SCD.

Earlier identification of executive deficits in preschool children using an ecological approach would give more scope for intervention. The Preschool Executive Task Assessment (PETA) was developed to resemble an everyday age-appropriate task in order to examine the self-direction and integration of executive functions during a multistep task. It was designed so that performance can be evaluated in a microanalytic way and so individualized feedback and support can be easily communicated. The utility of the PETA was assessed with 166 three-to five-year olds. Results showed improved performance with increasing age and verbal intellectual quotient as well as good task reliability and utility. Evidence for influence of socioeconomic status, gender, and use of self-talk was also observed. Clinical applications and future directions of this novel measure are discussed. Child Health Research Charitable Incorporated Organization National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust University College London Great Ormond Street Hospital Children’s Charity

Occupational therapy practitioners are qualified to address the emergence of functional deficits from cancer-related cognitive impairments (CRCI); however, they have reported a need to address gaps in their knowledge of CRCI. The purpose of this study was to comprehensively design, disseminate and examine the impact of implementing a face-to-face continuing education seminar designed to enhance occupational therapy practitioners’ knowledge of CRCI in adults and older adults. After completing a needs assessment and designing the seminar, the seminar was piloted with occupational therapy students (n = 64) where student feedback guided modifications to the seminar’s content, design and evaluation. The final CRCI seminar was presented at 15 facilities throughout the continuum of care with 130 occupational therapy practitioners. Participants’ CRCI knowledge increased significantly after the seminar (Z = -9.623, p performance (96%, n = 123) and perceived patient outcomes (94%, n = 119) in the future. The seminar was both an effective method for increasing practitioners’ short-term CRCI knowledge and a well-received method of dissemination.

Critical thinking is an essential component to the occupational therapy process that is a timely skill with the rapid pace of change in our healthcare system. Critical thinking exposes assumptions, biases, beliefs and points of view and challenges a shift in epistemology by asking, ‘how do we know what we believe to know?’ Case studies are a tool to engage the learner in critical thinking and are commonly employed in occupational therapy curricula. Social determinants of health (SDH) describe environmental circumstances that affect health. The authors propose that SDH, embedded in case studies, serve as a threshold concept. A threshold concept serves as a means of transformative learning and promotion of critical thinking in occupational therapy education. Social determinants of health taught through case study presentation represent the authentic complex lives of those therapists serve, bolster student critical thinking, and help to consider the multiple perspectives that may challenge long held beliefs. Qualitative content analysis of 59 case studies for SDH content across one curriculum and five semesters, revealed cases built on client factors and foundational knowledge with missed opportunity to add SDH context. Eleven guidelines for case development are proposed to foster transformational learning. Intentional instructional approaches can assist educational programs to develop the professional change agents needed to serve communities and populations with a larger goal of health equity.

Service-learning experiences immerse students in authentic situations and build partnerships with community agencies to support the health of those we serve in practice. Most occupational therapy curriculum evaluations do not systematically capture community agency benefits. Through the use of qualitative interviews and Q Methodology, the Community Agency Capacity Questionnaire (CACQ) was developed to capture the agency experience in these partnerships. This paper describes the iterative analytic process that resulted in the CACQ with 29 statements covering 6 domains: programming, evaluation, partnership, staff, funding, and marketing. The CACQ offers a means to identify outcomes from the service-learning partners' perspective.

BACKGROUND Young adults with chronic health conditions can experience barriers to work performance, ability, and their present and future worker roles. OBJECTIVE Work readiness resources can expand individuals' work skills, abilities, and interests. METHODS Five work readiness tools are presented (1) building an occupational profile, (2) generating environmental strategies, (3) on-the-job strategy use, and exploration of online tools (4) O*NET® and (5) O*NET® Interest Profiler, along with two theories (Knowles's Andragogy and Lawton's Ecological Model) to guide tool use. RESULTS Use of these tools can assist young adults to better manage their health and expand their vocational identities for success at work. CONCLUSIONS These approaches and tools support health professionals, community partners, and vocational organizations in their efforts to help young adults with chronic conditions.

Emerging adulthood defines transition to employment, higher education, and domestic life. This study describes the development of an assessment of self-reported participation in a range of age-appropriate activities. Item selection was established from literature review, feedback from youth and professionals, the former Adolescent Activity Card Sort (AACS), and the original Activity Card Sort (ACS). Iterative item selection occurred with three separate samples of emerging adults and six professionals. Test–retest reliability was evaluated. The Adolescent and Young Adult Activity Card Sort (AYA-ACS) consists of chores (11 items), leisure (13), social (10), health and fitness (9), work (10), education (8), and parenting (9). Test–retest reliability showed significant moderate to substantial Kappa agreement (.48-.85) for all domains except parenting (κ = .15). This preliminary study describes the development of the AYA-ACS to be used with individuals who encounter challenges when transitioning to young adulthood.

Cancer-related cognitive impairments (CRCI) can limit participation in meaningful activities before, during, and after cancer treatment. This study explored occupational therapists’ perceived knowledge gaps and needs regarding CRCI in adults and older adults. An online survey was sent to a convenience sample of 60 practitioners at facilities throughout the continuum of care and 176 directors and faculty in accredited occupational therapy programs. Using a snowball sampling approach, recipients were asked to forward the survey to other occupational therapists. One hundred seven occupational therapists participated. The majority (92%) responded that it would be beneficial to attend a face-to-face continuing education program; preferences for the content and design of a continuing competency seminar are described. These findings support the development and delivery of continuing competence programs tailored toward occupational therapists’ CRCI knowledge needs.

At-risk high school students face many challenges to occupational justice that lead to disconnection from school. They often are occupationally deprived and alienated, leading them to engage in risky behaviors such as gang involvement and substance abuse. They also tend to drop out of school, restricting employment opportunities and ability to maximize their occupational potential. High school students at risk for dropout may benefit from occupational therapy; however, they typically do not receive services or support without an educational diagnosis. Although often an overlooked role for school-based occupational therapists, program development may promote needed school connectedness sought by students at risk and prevent dropout.

This pilot study aimed to investigate the activity participation of young adults with high-functioning autism (HFA) living in Taiwan. Eleven young adults with HFA, their caring adults, and 11 matched typically developing youth were recruited across Taiwan. The Adolescent and Young Adult Participation Sort-Taiwanese version (AYAPS-T) was administered to all three groups to compare the activity participation. In addition, youth with HFA identified activities in which they desired to participate and barriers hindering their participation. The results of this study suggest that youth with H FA had lower participation rates in activities across different domains than their typically developing peers. Youth with HFA were able to identify the activities they desired to do and the barriers hindering their participation. No significant differences in participation were found between the results reported by the caring adults and youth with HFA. Occupational therapy practitioners may work on eliminating the personal and environmental barriers that impede participation as youth with HFA transition out of secondary school.

Awareness of the impact of poverty on early childhood participation is crucial in providing adequate and effective services for young children and their families. Through a university—community partnership to support Head Start teachers to broaden their developmental evaluations, the Preschool Activity Card Sort (PACS) was administered to the parents of 81 preschoolers in a semi-structured interview format. Fifty-two (64%) of the children were served by a Head Start program and 29 (36%) were a convenience sample control group. Results from the PACS demonstrate that all of the preschoolers participate in a range of age-appropriate activities. Comparison between the Head Start and control groups revealed differences, with Bonferroni correction, in participation in community mobility ( p = .000). It is imperative to provide opportunities for early childhood participation because many community activities are implicitly tied to school readiness. To fully meet the needs of families in impoverished communities, occupational therapists need to seek out the voice of parents and focus on learning opportunities arising naturally in the context of daily living and community experiences.

The aim of this study was to compare executive function abilities of 8- to 12-year-old children with sickle cell disease (SCD) with a matched control sample. The measures included the parent and teacher Behavior Rating Inventory of Executive Function (BRIEF); the Delis-Kaplan Executive Function System (D-KEFS), Free Sorting Test and Color Word Interference Test; and the Children's Kitchen Task Assessment (CKTA), a new performance measure.Twenty-two children with SCD were recruited from one hematology clinic and 22 community children, matched on characteristics of age, gender, and race, were selected from a larger sample of controls for comparison. Parents and teachers completed rating scales.As hypothesized, children with SCD scored significantly lower than matched controls on Digit Span Forward; on 5 of the 9 D-KFES Color Word Interference and Sorting tasks; on CKTA organization, initiation, and task completion; and on the BRIEF's parent and teacher Metacognitive Index (MI) and Global Executive Composite (GEC) scores.Cognitive and performance evaluations indicate lower executive function among children with SCD. Results substantiate the need for evaluative triangulation for children with SCD: Neurocognitive testing supported by performance testing, and adult reflection of a child's daily performance compared to other children. These elements will provide rich data to create educational support for children with SCD who have frequent hospitalizations, school absences, and the potential presence of cerebral vascular accident symptomology.

Two years after high school, adolescents with disabilities struggle with employment, independent living, and continuing education. These struggles call for school-based occupational therapists to take a role to impact outcomes. The perceptions of occupational therapists within transition services in a large Midwestern coalition were examined. Through semistructured interviews with 4 nonoccupational therapy transition professionals and a focus group with occupational therapists, 3 themes emerged: (a) “I couldn't even begin to describe the essential functions of an occupational therapist”; (b) “Unless the kids get direct services, which a lot of these kids aren't, I don't have any part in their transition services”; and (c) “I don't feel that [OT] is looked at as a priority in transition.” Occupational therapy continues to be underutilized in school-based transition services. Suggestions are provided to enhance the role within system-wide delivery changes.

An understanding of participation patterns in preschool-aged children with an autism spectrum disorder will allow the occupation therapy practitioner to focus on goals relevant to the child and family. This study compares participation patterns and barriers to participation in children with an autism spectrum disorder with those of children with no diagnosis. Using the Preschool Activity Card Sort, parent interviews revealed children with an autism diagnosis participate in fewer preschool activities of self-care, community mobility, vigorous leisure, sedentary leisure, social interaction, chores, and education than children with no diagnosis. Reasons for non-participation generally focused on child behaviors; parents gave opportunities to participate, but the child, for a variety of reasons, could not capitalize on the opportunity. Practitioners can assist the family in managing the child's responses and behavior in a wide range of preschool activities.

This study investigated the late effects of childhood cancer on participation and quality of life. Ninety-two percent of survivors (9 to 18 years of age) reported living with late effects of lower extremity pain and numbness, memory and attention deficits, and fatigue, depression, or both. Semistructured interviews with 25 survivors using the Canadian Occupational Performance Measure and the Adolescent Activity Card Sort captured frequencies, interests, and barriers for a range of activities. Survivors reported diminished engagement in vigorous leisure activities, chores, and community activities. Lower engagement in social activities was correlated with lower quality of life scores, as measured by the Pediatric Cancer Quality of Life Inventory-32. Despite these findings of significant cognitive and physical problems, none of the 25 survivors had individualized education programs in school, nor were any receiving occupational therapy at the time the survey was completed. The findings emphasize the importance of advocacy for occupational therapy services for survivors of childhood cancer and examination of adolescent survivor participation in, and goals for, typical activities.

OBJECTIVE. This study developed and explored the validity of the Children's Kitchen Task Assessment (CKTA), a performance assessment of executive function. METHOD. The development of the CKTA is described. Children were given the CKTA and neuropsychological assessments of executive functioning. Parents completed the Parent Behavior Rating Inventory of Executive Function (Parent BRIEF). RESULTS. Forty-nine typically developing children ages 8 to 12 years participated in this study. Interrater reliability and internal consistency were established. Preliminary evidence of discriminant validity was reflected in significant differences on neuropsychological tests and the Parent BRIEF between high- and low-scoring CKTA groups. Age-related differences in CKTA performance further supported discriminant validity. Support for concurrent validity was observed in moderate correlations with established neuropsychological tests. CONCLUSION. Preliminary results suggest the CKTA is a valid performance assessment that evaluates the level of cognitive assistance children require to complete a challenging functional activity.

About 20% of colorectal cancer (CRC) patients show some kind of familiarity, which might be caused by yet unknown combinations of low penetrance susceptibility genes. We aimed to identify genetic factors for familial CRC (fCRC) in a unique study design that includes phenotypic extremes as represented by fCRC cases and ‘hyper-normal’ controls without CRC history and no adenomatous polyps on colonoscopy. Candidate gene variants were determined by allele-specific amplification (SLC10A2 c.169C>T and c.171G>T) and restriction fragment length polymorphism assays (CCND1 c.870A>G; CDH1 –160C>A; TP53 R72P; VDR T2M). In total, 98 patients with fCRC, 96 patients with sporadic CRC, and 220 hyper-normal controls were included. The minor allele of the CDH1 –160C>A polymorphism occurred significantly more often in controls compared to fCRC cases (OR = 0.664; p = 0.042). Homozygosity of the minor allele was significantly associated with affiliation to the control group (OR = 0.577; p = 0.029), indicating that both heterozygous and homozygous carriers of the common allele are at-risk for CRC. With respect to the CCND1 c.870A>G mutation, comparison of fCRC and sporadic CRC cases showed that A/A homozygosity was more common than G/G homozygosity among fCRC patients compared to controls (OR = 2.119; p = 0.045). However, no differences in allele or genotype frequencies were detected between sporadic CRC cases and controls, and no associations were observed for SLC10A2, TP53, and VDR polymorphisms. We report a potential association of variants in the CCND1 and CDH1 genes with fCRC using a unique study design with phenotypic extremes.

Young adults with an autism spectrum disorder (ASD) struggle to assume adult roles. This research assessed the feasibility of using the Adolescent and Young Adult Activity Card Sort (AYA-ACS) with emerging adults with high functioning ASD. Two phases were utilized during this research: (1) comparing the activity participation reported by emerging adults with an ASD and that reported by their caring adult; (2) examining the barriers to participation reported. Preliminary results demonstrate that the AYA-ACS appears to be a reliable and valid method of identifying emerging adults' participation strengths as well as personal and environmental challenges in a variety of age-appropriate activities. The AYA-ACS could assist service providers by providing an understanding of the challenges to participation faced by this population and aid in developing client centered interventions.

Measuring the participation of preschoolers (children between 3 and 6 years of age) with disabilities in everyday activites has become a professional mandate for occupational therapists. This study outlines the development of the Preschool Activity Card Sort, which can establish a child's occupational profile through parent interview. Six of the nine International Classification of Functioning, Disability and Health activity and participation domains are included in the Preschool Activity Card Sort. A literature review and an analysis of parent time logs were used to compile photographs of preschoolers engaged in typical activities. Parents respond to these photographs during discussion about their child's participation in these everyday activities. When a child does not participate in age-appropriate activities, the Preschool Activity Card Sort helps determine whether it is due to child, family, or environmental barriers. Identifying these barriers assists the therapist and the family in determining therapeutic goals.

Objective: Endoscopic extraperitoneal radical prostatectomy (EERPE) and robot-assisted laparoscopic prostatectomy (RALP) are minimally invasive surgical techniques to treat localized prostate cancer. We report the outcome and complications of these two techniques conducted by one individual surgeon. Patients and Methods: 86 patients underwent EERPE between January 2008 and June 2011, and 100 patients underwent RALP between August 2011 and October 2012. All surgeries were performed by one single surgeon. Results: The patients of the EERPE and RALP groups had similar clinical characteristics in PSA, prostate volume and D'Amico classification, and were significantly different in their age and BMI as well as in the number of prior surgeries. RALP surgeries were significantly slower (183 vs. 157 min) but also involved lower blood loss (147 vs. 245 ml). Pathological stages and positive surgical margins were similar in both groups. Complications were assessed by the Clavien-Dindo classification. 6 patients in the EERPE group and 3 patients of the RALP group suffered major complications (IIIb-IV). Conclusion: Altogether our results indicate that the learning curve for RALP was short after experience with EERPE. We hypothesize that this is more a result of the surgical experience of the surgeon with the EERPE than on the robotic technique.

OBJECTIVE. We compared abilities and strategy use of at-risk youth aged 16–21 yr with those of a community sample of high school students using a performance measure of executive function, the Weekly Calendar Planning Activity (WCPA). METHOD. We recruited students from an alternative school for at-risk youth (n = 113) and from community high schools in the same region (n = 49). We collected demographic information from and administered the WCPA to both groups. RESULTS. The at-risk group made more errors, used fewer strategies, and broke more rules than the community group; however, the groups were similar in average time for planning and task completion. Moderate relationships were found between WCPA and academic performance in the at-risk group. CONCLUSION. Comparison of at-risk and community youth provides support for discriminant validity of the WCPA and indicates that the WCPA is useful in identifying adolescents who are at risk for occupational performance deficits.

OBJECTIVE. We piloted the Weekly Calendar Planning Activity (WCPA), a performance-based measure of executive function (EF), to establish a baseline for at-risk adolescents. METHOD. Participants were 113 youths ages 16–21 who were enrolled at a charter school for youth returning to high school after dropping out. We administered the WCPA and collected demographic information. RESULTS. On average, participants spent 15.9 min on the WCPA, made 7.9 errors, and followed 4.0 of 5 possible rules. No ceiling effect was observed in overall accuracy. Participants used a mean of 3.1 strategies (standard deviation = 1.9) while completing the WCPA. Participants who used more strategies spent more time planning and completing the task and were more accurate. CONCLUSION. The WCPA may be useful to occupational therapists as a performance measure of EF. This assessment allows evaluation of complex task performance, strategy use, self-evaluation of performance, and error patterns, which can be used in developing intervention strategies.

The purpose of this pilot research was to translate the Adolescent and Young Adult Participation Sort into Taiwanese (AYAPS-T), an assessment tool measuring the activity participation and the self-identified barriers of youth transitioning into adulthood. The study included five phases: translation, cultural adaptation, taking photographs, field testing for content validity and pilot testing of test–retest reliability. A literature review, expert review and translation with back-translation were conducted for the initial activities. The activities were then edited on the basis of the feedback of 23Taiwanese youth for content validity. Test–retest reliability (intraclass correlation coefficient = 0.91) of the AYAPS-T reported by 22 Taiwanese youth was high. With the activities designed to meet the developmental needs of young adults, the methodology of sorting photographs, the barrier list to identify possible obstacles and some psychometric properties established, the AYAPS-T serves as a reliable and valid tool to identify engagement of young adults in their occupations. Because of the nature of a pilot study, results are limited by a small sample size and limited evidence of psychometric properties. Psychometric properties such as interrater reliability and internal consistency as well as construct validity and concurrent validity need to be tested on a larger sample size. Copyright © 2013 John Wiley & Sons, Ltd.

The karyotype ofCestrum aurantiacum was analyzed for the presence of coldsensitive regions (CSRs) and other types of constitutive heterochromatin. A range of techniques was employed including the fluorescent DAPI, chromomycin/DAPI double staining and actinomycin D/DAPI counter-staining, and the non-fluorescent C-banding applied as single or sequential staining, sequential N-banding and silver impregnation. Four classes of constitutive heterochromatin were recognized: CSRs, nucleolar organizers, non-nucleolar chromomycin-positive bands, and indifferently fluorescent bands. The banded karyotype ofC. aurantiacum is compared with those of otherCestrum species. The sectionsHabrothamnus andCestrum are not karyologically distinct.

Cold-induced mitotic under-condensation of certain chromosome segments is a rare phenomenon in plants. There are about 11 genera of monocotyledons and only 3 of dicotyledons, where species are known to have such cold-sensitive regions (CSRs). The molecular causes of cold-induced undercondensation are not clear, and no consistent cytochemical characteristics of CSRs are known. Recently we have presented a chromosome banding analysis on CSRs and their relation to constitutive heterochromatin inCestrum parqui (Solanaceae), a species of sect.Cestrum. The present study is concerned with a similar analysis inC. strigillatum of sect.Cestrum, and inC. fasciculatum andC. elegans of sect.Habrothamnus. Chromomycin/DAPI fluorescent double staining, sequential C-banding, and sequential silver impregnation were applied. The species differ in detail but are similar qualitatively. Four classes of heterochromatin can be discriminated. (1) CSRs, with banding properties indicating AT-rich constitutive heterochromatin. After cold-treatment CSR heterochromatin can be silver-impregnated from interphase, as chromocentres, to metaphase, as undercondensed segments. CSRs are subject to frequent heteromorphy. (2) Nucleolar organizers. Two pairs were identified in the karyotypes. Banding properties indicate GC-rich heterochromatin. The nucleolar organizing regions are less evident and their silver-reducing capability reduces during metaphase. (3) Non-nucleolar CMA-positively fluorescing bands. These are minute, polymorphic, positively C-stained, and restricted to one or a few sites in the karyotypes. (4) Indifferently fluorescing, positively C-stained bands. They occur on centromeres, some chromosome ends, and clustered over the chromosome arms. They are mostly very delicate and do not resist harsh banding treatments. — The species investigated here andC. parqui resemble each other qualitatively in heterochromatin classes (1), (2), and (3), but differ much in banding properties of class (4). Therefore, heterochromatin characteristics in the genus are not so uniform as the present results inC. strigillatum, C. fasciculatum, andC. elegans appear to show.