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Further consolidation and clarity regarding occupation as a means to foster change in interventions are needed. The study aimed to utilize the knowledge of occupational scholars to systematically determine what is required to use occupation as means to foster change within occupation-based interventions and to generate a conceptual model from those results. Group Concept Mapping involved the following: preparation, generation of ideas, structuring of statements, data analysis, interpretation of maps, and development of conceptual model. Fifty-two international occupational scholars brainstormed 125 ideas. A cluster rating map with nine clusters posed the foundation for a conceptual model with seven themes, namely, artful use of occupation, evidence-based use of occupation, collaboration to promote occupation, coordinating intervention fit, client factors, sociocultural context, and structural influences. The conceptual model, capturing dimensions and dynamics required for using occupation to foster change, may guide future research into occupation-based interventions.

The transition from driving to driving cessation in older adulthood is considered a major life transition where resulting disruptions can impact sense of self. Such transitions at this life stage o...

The aim of this study was to investigate how female sex workers perceive and describe meaning when engaging in the non-sanctioned occupation of sex work. Method: In-depth semi-structured interviews...

Background: Half of the Danish population is overweight or obese. Obesity can negatively impact health and daily life. The Danish National Board of Health´s guidelines for weight loss programmes to the Danish municipalities, recommends multidisciplinary teams, including occupational therapy, and interventions targeting diet, exercise, psychosocial coping, and everyday life. Aim: To describe the structure and content of obesity programmes offered by the 98 municipalities in Denmark, including details such as the health professionals, programme recipients, dose, structure, content, and the role of occupational therapists. Method: A quantitative content analysis was conducted on 234 published Danish municipal weight loss programmes. Programme descriptions were identified through internet searches using both sundhed.dk and Google.com. Results: Various health professionals conducted the programmes, and five involved occupational therapists. Programmes targeted children, adolescent and adults. Dose, structure and content were heterogeneous. Conclusion: The majority of the programmes were neither evidence-based, nor did they follow recommendations from Danish National Board of Health. Few programmes addressed the role of habits or social participation. Occupational therapists appear to be under-utilized as providers of the programmes. Significance: Occupational therapists have a role to play in weight loss programmes, because of their training in activity analysis and their consideration of people, environments, and occupations. These components are included in the recommendations about psychosocial aspects and everyday life from the Danish National Board of Health.

Segmented filamentous bacteria (SFB) are unique immune modulatory bacteria colonizing the small intestine of a variety of animals in a host-specific manner. SFB exhibit filamentous growth and attach to the host’s intestinal epithelium, offering a physical route of interaction. SFB affect functions of the host immune system, among them IgA production and T-cell maturation. Until now, no human-specific SFB genome has been reported. Here, we report the metagenomic reconstruction of an SFB genome from a human ileostomy sample. Phylogenomic analysis clusters the genome with SFB genomes from mouse, rat and turkey, but the genome is genetically distinct, displaying 65–71% average amino acid identity to the others. By screening human faecal metagenomic datasets, we identified individuals carrying sequences identical to the new SFB genome. We thus conclude that a unique SFB variant exists in humans and foresee a renewed interest in the elucidation of SFB functionality in this environment., Hans Jonsson et al. report the metagenomic reconstruction of the genome of a potentially immune modulatory segmented filamentous bacteria (SFB) from a human ileostomy sample. They demonstrate that the genome clusters closely with SFB genomes from other species. They also detect the unique SFB variant in human faecal metagenomics datasets.

SummarySegmented filamentous bacteria (SFB) colonize the small intestine of a variety of animals in a host-specific manner. SFB are physically attached to the host’s intestinal epithelium and affect several functions related to the immune system, among them IgA production and T-cell maturation. Until now, no human-specific SFB genome had been described. Here, we report the metagenomic reconstruction of an SFB genome from a human ileostomy sample. Phylogenomic analysis clusters the genome with the SFB genomes from mouse, rat and turkey, but the genome is genetically distinct, displaying 65-71% average amino acid identity to the other genomes, and is tentatively unique for the human small intestine. By screening human faecal metagenomic datasets, we identified individuals carrying sequences identical to the new SFB-genome. We thus conclude that a unique SFB variant exists in humans and we foresee a renewed interest in the elucidation of SFB functionality in this environment.

Background Nursing procedures that are routinely performed in the intensive care unit (ICU) are assumed to have minimal side effects. However, these procedures may sometimes cause physiological changes that negatively affect the patient. We hypothesized that physiological changes associated with routine nursing procedures in the ICU are common. Methods A clinical observational study of 16 critically ill patients in a nine-bed mixed university hospital ICU. All nursing procedures were observed, and physiological data were collected and subsequently analyzed. Minor physiological changes were defined as minimal changes in respiratory or circulatory variables, and major physiological changes were marked as hyper/hypotension, bradycardia/tachycardia, bradypnea/tachypnea, ventilatory distress, and peripheral blood oxygen desaturation. Results In the 16 patients, 668 procedures generated 158 major and 692 minor physiological changes during 187 observational hours. The most common procedure was patient position change, which also generated the majority of the physiological changes. The most common major physiological changes were blood oxygen desaturation, ventilatory distress, and hypotension, and the most common minor changes were arterial pressure alteration, coughing, and increase in respiratory rate. Conclusion In this pilot study, we examined physiological changes in connection with all regular routine nursing procedures in the ICU. We found that physiological changes were common and sometimes severe.

Introduction: A major threat to healthy ageing is accidental falls causing individual suffering as well as increasing costs for society. The aim of this study was to compare and evaluate a multifactorial falls-prevention programme, with ordinary falls prevention in primary healthcare. Method: Eligible patients were community-dwelling older adults (+65) who had fallen within the last 6 months or were concerned about falling. Participants (n = 131) were randomized to an intervention or control group. The primary outcome was measure of falls and the secondary was fear of falling. Results: There was a significant decrease in the risk of falls and fear of falling at 12 months in favour of the intervention group. When comparing groups over time, including baseline measures, only fear of falling remained significant. Conclusion: Small-group learning environments in combination with learning by doing, could be an effective approach for the translation of knowledge into everyday life and valued activities leading to a decrease in falls and fear of falling. Multifactorial and multi-disciplinary approaches against falls in a small-group learning environment could be effective in preventing falls and reducing fear of falling among older adults at risk.

Lactobacillus reuteri is an inhabitant of the gastrointestinal (GI) tract of mammals and birds and several strains of this species are known to be effective probiotics. The mechanisms by which L. reuteri confers its health‐promoting effects are far from being fully understood, but protection of the mucosal barrier is thought to be important. Leaky gut is a state of abnormal intestinal permeability with implications for the pathophysiology of various gastrointestinal disorders. Enterotoxigenic Escherichia coli (ETEC) can invade the intestinal mucosa and induce changes in barrier function by producing enterotoxin or by direct invasion of the intestinal epithelium. Our hypothesis was that L. reuteri can protect the mucosal barrier, and the goal of the study was to challenge this hypothesis by monitoring the protective effect of L. reuteri strains on epithelial dysfunction caused by ETEC. Using an infection model based on the porcine intestinal cell line IPEC‐J2, it was demonstrated that pretreatment of the cells with human‐derived L. reuteri strains (ATCC PTA 6475, DSM 17938 and 1563F) and a rat strain (R2LC) reduced the detrimental effect of ETEC in a dose‐dependent manner, as monitored by permeability of FITC‐dextran and transepithelial electrical resistance (TEER). Moreover, the results revealed that ETEC upregulated proinflammatory cytokines IL‐6 and TNF α and decreased expression of the shorter isoform of ZO‐1 (187 kDa) and E‐cadherin. In contrast, pretreatment with L. reuteri DSM 17938 and 1563F downregulated expression of IL‐6 and TNF α , and led to an increase in production of the longer isoform of ZO‐1 (195 kDa) and maintained E‐cadherin expression. Interestingly, expression of ZO‐1 (187 kDa) was preserved only when the infected cells were pretreated with strain 1563F. These findings demonstrate that L. reuter i strains exert a protective effect against ETEC‐induced mucosal integrity disruption.

This study aimed to evaluate the effectiveness of a multi-disciplinary, client-centered, fall prevention program on the experiences of participation and autonomy in everyday occupations among community-dwelling older adults. In total, 131 older adults (65+) were included and randomly allocated into two groups. Intention-to-treat analysis was used. Results of this pilot study showed that the program had a limited effect on the subjective experiences of participation and autonomy in everyday occupations among the participants. However, a trend of increased perceived participation and a decrease in the experience of perceived problems with participation among the participants in the intervention group was shown. Perceived participation and autonomy seem to be subjective experiences, and they seem to vary depending on the individual. To properly understand the impact of fall prevention interventions on participation and autonomy, measurements that capture both subjective and objective experiences are essential to use.

This article reports a comprehensive review of the research conducted regarding occupational balance. A scoping study method was used to explore and describe current research about occupational balance and to identify research gaps. Twenty-two articles published between 2009 and 2014 met the inclusion criteria. The articles reported studies conducted in eight countries on four continents, but the majority were conducted in Europe and North America. The articles contributed to knowledge about the concept itself, its importance, levels of occupational balance, and the relationship between occupational balance and health and well-being. They also described what is important for occupational balance or how to enhance/create/recreate it and differences between people. Several research gaps were identified which include the need for studies about perceptions of occupational balance among people beyond western societies. Furthermore, systematic research is warranted with regards to levels of occupational balance, and how to enhance it.

Lactobacillus reuteri, a symbiotic inhabitant of the gastrointestinal tract in humans and animals, is marketed as a probiotic. The ability to adhere to intestinal epithelial cells and mucus is an interesting property with regard to probiotic features such as colonization of the gastrointestinal tract and interaction with the host. Here, we present a study performed to elucidate the role of sortase (SrtA), four putative sortase-dependent proteins (SDPs), and one C-terminal membrane-anchored cell surface protein ofLactobacillus reuteriATCC PTA 6475 in adhesion to Caco-2 cells and mucusin vitro. This included mutagenesis of the genes encoding these proteins and complementation of mutants. A null mutation inhmpref0536_10255encodingsrtAresulted in significantly reduced adhesion to Caco-2 cells and mucus, indicating involvement of SDPs in adhesion. Evaluation of the bacterial adhesion revealed that of the five putative surface protein mutants tested, only a null mutation in thehmpref0536_10633gene, encoding a putative SDP with an LPxTG motif, resulted in a significant loss of adhesion to both Caco-2 cells and mucus. Complementation with the functional gene on a plasmid restored adhesion to Caco-2 cells. However, complete restoration of adhesion to mucus was not achieved. Overexpression ofhmpref0536_10633in strain ATCC PTA 6475 resulted in an increased adhesion to Caco-2 cells and mucus compared with the WT strain. We conclude from these results that, among the putative surface proteins tested, the protein encoded byhmpref0536_10633plays a critical role in binding ofLactobacillus reuteriATCC PTA 6475 to Caco-2 cells and mucus. Based on this, we propose that this LPxTG motif containing protein should be referred to as cell and mucus binding protein A (CmbA).

Objective: It has been suggested that the prevention of disability and falls should be conducted from a client-centred approach, especially when it includes how individuals learn new strategies in everyday life. In addition, programmes for the prevention of falls need to be multi-professional and multidisciplinary in order to be effective. In preventive work with clients, using the approach of client-centredness, the therapists work together with the clients to enable them to achieve occupational goals. There are few studies in fall prevention that have explored group leaders’ experiences, i.e. studies that focus on the experiences of group leaders when working from a client-centred approach. Methods. This study aims to explore, by the use of focus-group interviews, the therapists’ experiences of being group leaders in a fall-prevention programme that applied the ideas and approaches described above. Results: The analysis revealed that a change in the role of being a group leader had taken place during the intervention process. Three primary categories pertaining to this process were identified: (i) the group leaders moved between the role of expert and the role of facilitator; the group climate (ii) facilitated the translation of expert knowledge to applied knowledge; and (iii) increased awareness as a prerequisite for change.

BACKGROUND: Daily routine ventilator-filter exchange interrupts the integrity of the ventilator circuit. We hypothesized that this might reduce positive airway pressure in mechanically ventilated ICU patients, inducing alveolar collapse and causing impaired oxygenation and compliance of the respiratory system. METHODS: We studied 40 consecutive ICU subjects (PaO2/FIO2 ratio ≤ 300 mm Hg), mechanically ventilated with pressure-regulated volume control or pressure support and PEEP ≥ 5 cm H2O. Before the filter exchange, (baseline) tidal volume, breathing frequency, end-inspiratory plateau pressure, and PEEP were recorded. Compliance of the respiratory system was calculated; FIO2, blood pressure, and pulse rate were registered; and PaO2, PaCO2, pH, and base excess were measured. Measurements were repeated 15 and 60 min after the filter exchange. In addition, a bench test was performed with a precision test lung with similar compliance and resistance as in the clinical study. RESULTS: The exchange of the filter took 3.5 ± 1.2 s (mean ± SD). There was no significant change in PaO2 (89 ± 16 mm Hg at baseline vs 86 ± 16 mm Hg at 15 min and 88 ± 18 mm Hg at 60 min, P = .24) or in compliance of the respiratory system (41 ± 11 mL/cm H2O at baseline vs 40 ± 12 mL/cm H2O at 15 min and 40 ± 12 mL/cm H2O at 60 min, P = .32). The bench study showed that auto-triggering by the ventilator when disconnecting from the expiratory circuit kept the tracheal pressure above PEEP for at least 3 s with pressure controlled ventilation. CONCLUSIONS: This study showed that a short disconnection of the expiratory ventilator circuit from the ventilator during filter exchange was not associated with any significant deterioration in lung function 15 and 60 min later. This result may be explained by auto-triggering of the ventilator with high inspiratory flows during the filter exchange, maintaining airway pressure. (ISRCTN.org registration ISRCTN76631800.)

In Sweden, a new type of program called ”Active lifestyle all your life” has been developed in primary care. It is a multidisciplinary program aimed at the decrease of accidental falls and at promotion of the health benefits of staying engaged in valued occupations. As one part of the evaluation of this program, this study aimed to explore and understand if, and how, participating in the program influenced each individual's everyday life narratives. Data was collected using a narrative approach with repeated interviews focusing on participation and engagement in valued occupations in the context of accidental fall. Thematic analysis showed that increased awareness related to new ways of thinking and acting among the informants was the over aching theme concerning how the program influenced their everyday life. This increased awareness was experienced as going beyond the cognitive understanding leading to a behavior change and new habits.

International partnerships are a mechanism for supporting the academic development of occupational therapy and promoting cultural competence. This case study describes the factors that have helped to sustain a post-qualifying programme implemented by five higher education institutions in Denmark, the Netherlands, Sweden, Switzerland and the UK since 1999. Data collection methods were documentary analysis and the reflections of a purposive sample of six key informants. Cohort and outcome data, from 193 students from 31 countries who enrolled between 1999 and 2011, are reported. Each cohort comprises students from an average of eight countries to optimize inter-cultural dialogue. Four factors support sustainability. These are 1) supportive professional European networks; 2) timeliness and alignment with European higher education policy; 3) partnership structures and processes that emphasize joint decision making and accountability; and 4) the stimulus and satisfaction associated with internationalization. The main limitations are considering the OT-EuroMaster as an intrinsic case study and using opportunistic data collection that undermines the rigor and transferability of the findings. Future opportunities include doctoral networks, transnational research and sharing our curricula design with other Regions to spread the collaborative, capacity building endeavours more widely.

Objective: To describe and understand the lived experience and to identify what characterizes the phenomenon of participation in everyday occupations after stroke, in Tehran, Iran. Methods: Eight individuals with stroke, who had previously been admitted to a neurological hospital ward in Tehran, were interviewed in-depth on one occasion. Data were collected and analysed using the Empirical, Phenomenological, Psychological method. Results: The findings identified 3 main characteristics of the phenomenon of participation in everyday occupations as being: (i) I cannot do activities as before; (ii) I am not the same person – discovery of a different self; (iii) I am not living my life. Conclusion: Enabling participation after stroke within a client-centred paradigm in this socio-cultural context requires consideration of the essential meaning of this concept as characterized by the dynamic process between the characteristics of “doing”, “identity”, and “living life”. The study highlights how the provision of efficient rehabilitation services in this Eastern context requires attention to both “doing” and to “identity” in rehabilitation interventions, in order to enable individuals to adapt to their new lives after stroke and to “live their lives”.

The influence of mutual spousal interrelations in domains such as health and wellbeing has been demonstrated, but little is known about the domain of everyday activities of couples in late life. In the present explorative study, we considered all of the activities participating couples talked about to be their everyday activities. Its aim was to understand, over time, changes in everyday activities as experienced by late-life community-dwelling couples. In a two-year period, 41 individual and joint interviews were conducted with 8 couples, who were purposefully selected from the Longitudinal Aging Study Amsterdam. Analyses involved the construction of couple narratives and constant comparisons within and across couples. Changing everyday activities in late-life couples was interpreted to be a two-way process of (1) converging, and (2) keeping up, which occurred in three fluid phases. Converging was a slow inward movement with a shift towards diminished everyday activities performed in a smaller world. Keeping up was an outward movement in order to resist the converging process by using everyday activities as a means to keep fit, physically and mentally, and to connect with the wider social world. In the first phase, couples maintained their unique linked activity pattern. In the second phase, spouses resisted converging by keeping up. In the third phase, spouses co-performed everyday activities closely together. The findings support the need to develop couple-oriented interventions that aim to enhance the couples' functioning in the domain of everyday activities. © 2012 Elsevier Inc.

The burden of cancer taking a form of a chronic illness warrants a shift in the health care delivery to address the many neglected functional impacts (physical-psychosocial and occupational dysfunctions) from cancer. Balancing the current traditional medical care (that focuses on the tumour/illness), with the essential non-medical tasks of dayto- day participation and self-care tasks are both needed for cancer conditions that now requires care over indefinite period. This paper aims to highlight occupational-participation as an expansion of the international classification of functioning (ICF)’s concept of participation, to encapsulate a holistic approach for better functional outcomes and occupational wellbeing in the emerging field of cancer survivorship. Occupational-participation, a central construct in the field of Occupational Therapy, is the person’s engagement in work, play and daily living which is necessary for health and well-being. Cancer survivors can be empowered toward healthy occupational-participation to attain a healthy, ‘health-after-cancer’ status via a model of ‘occupationalparticipation for cancer survivorship’ (MOP.CS). The model is novel for addressing this missing link where its focus on occupational-participation living, can be used for designing seamless intervention programs for the connection to a “healthy-although-ill” living for cancer survivors.

This article presents the life stories of four older women in Vienna in order to better understand the role of occupation in the course of ageing. A qualitative life-story method in the narrative tradition was used as a design of this multiple case study. The stories presented extend beyond an illness or deficit narrative and contribute to a more multifaceted narrative of the subjective experience of ageing in occupational terms in connection with identity. The women did not perceive themselves as old or sick despite problems in mobility, the presence of chronic disease and advanced age. This was associated with their engagement in occupation that was meaningful and linked to their identity. Engaging occupation is the means to continue, test, and adapt to the ageing self. Because occupation is like a litmus-test of one's identity and capacities, the women used it as a measure of change while ageing. Using Atchley's continuity theory, the attempt of the four older women to maintain a balance between adapting and struggling to continue their occupations is discussed in relation to their identity. The results expand Atchley's continuity theory by adding an occupational perspective.

Objective: Participation as a concept has come into focus as an important aspect of wellbeing and derives from the International Classification of Functioning, Disability and Health. This qualitative study aimed to increase understanding of how hand deformities caused by rheumatic disease influence the individual's potential to continue participating in society by taking into account other people's attitudes. Method: Interviews were carried out with 11 participants with hand deformity associated with a rheumatic disease. Analyses were conducted using comparative methodology and hermeneutic interpretation. Findings: Participation was described as an experience that arises during involvement in an activity or a social context. All the participants experienced restricted participation across a variety of situations. Hand deformity, combined with physical environment, personal attributes and the attitudes of others, was an obstacle to the achievement of full participation. It also became obvious that the participants were not able to consider only the impact of hand deformity without acknowledging other consequences of their rheumatic condition. Conclusion: Personal and contextual factors intertwine and influence the lived experience of participation and the ability to participate. A perspective in rehabilitation that addresses only functions or performance might hinder taking the experience of participation into consideration.

Co-occupation refers to activities that require the participation of two or more people. While knowledge about co-occupation is expanding, few empirical studies have sought to advance the understanding of co-occupation in late life. The current study used interview data from one couple who participated in a longitudinal 2-year qualitative study among community-dwelling older couples plus photographs taken of them engaged in one of their most valued co-occupations: going for a walk together. The couple selected photographs, discussed the meanings they attributed to them and created a photo story. The photo selection and interview transcripts were analysed using Interpretative Phenomenological Analysis. The findings consist of the couple's photo story and four themes that represent the meanings of this co-occupation: (1) Together but also individual; (2) It has always been like that; (3) Experiencing freedom and (4) Being eager to come across new things. The findings have implications for understanding the concept of co-occupation by bringing the importance of personalised meanings in co-occupation to the fore and by suggesting the importance of continuity of meanings of co-occupation for maintaining both individual and couple identities. Maintaining meaningful co-occupation might thereby contribute to health and well-being in late life. © 2012 Taylor & Francis Group, LLC. All rights reserved.

The objective of this study was to psychometrically evaluate the Persian version of the Occupational Gaps Questionnaire (OGQ-P) and LiSat-11 checklist, and to describe occupational gaps after stroke and their relation to aspects of functioning and perceived life satisfaction. A total of 102 individuals who had experienced a stroke were assessed for their occupational gaps, aspects of functioning, and life satisfaction. Psychometric analyses of the Persian versions of the OGQ and LiSat-11 were completed and the measures were applied for using univariate and multivariate analyses. The results provided evidence of internal scale validity, person response validity, and sensitivity for the instruments. The participants perceived the most common occupational gaps in “helping and supporting others.” Furthermore, perceived physical function including activities of daily living ability, motor function, and perceived life satisfaction were the most influential variables for the prediction of occupational gaps. It is essential to address the occupations such as “helping and supporting others” that are important from an individual perspective but overlooked in rehabilitation. A combination of physical function, motor function, and life satisfaction can predict occupational gaps after stroke.

Lactobacilli are known to prevent colonization by many pathogens; nevertheless, the mechanisms of their protective effect are largely unknown. In this work, we investigated the role of lactobacilli during infection of epithelial cells with group A streptococci (GAS). GAS cause a variety of illnesses ranging from noninvasive disease to more severe invasive infections, such as necrotizing fasciitis and toxic shock-like syndrome. Invasion of deeper tissues is facilitated by GAS-induced apoptosis and cell death. We found that lactobacilli inhibit GAS-induced host cell cytotoxicity and shedding of the complement regulator CD46. Further, survival assays demonstrated that lactic acid secreted by lactobacilli is highly bactericidal toward GAS. In addition, lactic acid treatment of GAS, but not heat killing, prior to infection abolishes the cytotoxic effects against human cells. Since lipoteichoic acid (LTA) of GAS is heat resistant and cytotoxic, we explored the effects of lactic acid on LTA. By applying such an approach, we demonstrate that lactic acid reduces epithelial cell damage caused by GAS by degrading both secreted and cell-bound LTA. Taken together, our experiments reveal a mechanism by which lactobacilli prevent pathogen-induced host cell damage.

Background. Stress-related ill health, e.g. burnout, is of great concern worldwide. Effective rehabilitation programs need to be developed and their therapeutic aspects understood. Purpose. To explore and describe how women with stress-related ill health who are on sick leave experience the rehabilitation process in a therapeutic garden and how these experiences connect to their everyday lives. Methods. This longitudinal study used methods from grounded theory. Five women completed three semi-structured interviews at three weekly intervals during rehabilitation and one interview three months after. Data were analyzed using a constant comparative approach. Findings. A secure environment facilitated engagement in activities that provided feelings of enjoyment. These experiences inspired participants to add enjoyable activities in their everyday lives, contributing to occupational balance, despite worries of not be able to continue performing enjoyable activities. Implications. Effective rehabilitation programs need to focus on enjoyable activities in a protective environment to support achievement of occupational balance.

This paper summarizes the results of five related studies of the retirement process from an occupational perspective. A group of 32 Swedish men and women were followed longitudinally over the retirement transition in repeated interviews that were analysed using a narrative methodology. The results showed that the freedom that comes with retirement could be experienced as a paradox when few demands or expectations were present in their lives. The analysis of the narratives also revealed that the presence or absence of engaging occupations was critical for the experience of a good life as retiree. These results are consistent with Laslett's definition of developmental life tasks appropriate for persons entering the ‘Third Age’, which begins at retirement and are offering freedom and possibilities for new engagement. The results have implications on possible arenas where an occupational perspective could contribute to knowledge in support of individual engagement in retirement and in social policies regarding volunteer work. One example is shown how occupational therapists have initiated community preventive work to enhance. engaging occupation in retirement. As these studies are limited to participants from one country, further studies in other countries and in other cultures about the retirement transition is needed to expand knowledge. Copyright © 2010 John Wiley & Sons, Ltd.

Introduction: This explorative study aimed to chart the participation experiences of children with disabilities enrolled in mainstream schools. Method: The participants were 14 students with disabilities, with good communication skills, aged between 8 and 11 years and attending school in Portugal. The data were collected through open-ended interviews and analysed employing a psychological phenomenological method. Findings: The findings suggest that participation at school took three forms: equal participation, special task participation and onlooker participation. Those three forms contrasted with situations of non-participation, in which the children felt completely excluded. Each form of participation and non-participation presented different performance characteristics and was influenced by the social environment. Conclusion: The findings of this study provide insights that enhance the understanding of children's inclusion in mainstream schools, as well as the individual's experience of participation.

Wakalim is a spiced traditional Ethiopian fermented beef sausage. Early stages (0–12 h) of wakalim fermentation were dominated by lactic acid bacteria and aerobic mesophilic bacteria including staphylococci and members of Enterobacteriaceae. Gram-negative bacteria were below detectable level after day 4 of fermentation. Staphylococci were detected at low levels (around 4 log cfu/g) until the end of fermentation. Lactic acid bacteria grew and dominated the flora at the end of fermentation. Various species of Lactobacillus and Pediococcus initiated the fermentation and the lactic flora was finally dominated by Lb. plantarum1 and Ped. pentosaceus1. The pH of the fermenting wakalim dropped from 5.5 0.22 to 4.1 0.19 while the titratable acidity increased from 0.09 to 0.6% in the course of fermentation. Moreover, moisture content of the fermenting wakalim dropped from 66.5% 2.12 to 22.0% 0.71 during the 6 days of fermentation. Molecular characterization, using 16S rDNA partial sequence analysis and repetitive sequence-based polymerase chain reaction, of the isolates confirmed some of the earlier phenotypic identification made based on API carbohydrate fermentation profile. Some of the strains were, however, identified as different species of the same genus or entirely different genus. The findings of this study are the first 4

This exploratory case‐study aims to understand an older couple's experience of their everyday occupations after a stroke. Data were collected through individual and joint interviews conducted during multiple home visits over a period of 7 months, 3 years after the stroke. Analysis resulted in two personal narratives and one joint narrative. The main finding is that their current occupational life is fully intertwined. The couple acts as one entity, conceptualized as one body, three hands and two minds, in their everyday occupations; in timing, coordinating, balancing, orchestrating and assisting. The findings challenge an individualistic view of occupation and suggest a complementary view paying attention to the interdependency of people and the interaction with their close social environment as being part of one complex social system.

Occupational balance is a prominent concept in occupational therapy and in society at large, and could be a key concept in that it may enhance understanding of the link between occupation and health. Because there is a lack of empirical evidence, the aim of this study was to critically examine the existing assumptions regarding occupational balance. An open narrative approach was applied to include the life context of the participants and to deliberately exclude predefinitions of the concept. From 10 reconstructed life stories, which were analyzed individually, three new dimensions of occupational balance related to health and grounded in the data were developed: a balance between challenging versus relaxing occupations and activities, activities meaningful for the individual and activities meaningful in a sociocultural context, and activities intended to care for oneself and activities intended to care for others. These three dimensions of occupational balance may be key concepts for future research.

Lactobacilli are normal inhabitants of our microbiota and are known to protect against pathogens. Neisseria gonorrhoeae is a human specific pathogenic bacterium that colonises the urogenital tract where it causes gonorrhoea. In this study we analysed early interactions between lactobacilli and gonococci and investigated how they compete for adherence to human epithelial cervical cells. We show that lactobacilli adhere at various levels and that the number of adherent bacteria does not correlate to the level of protection against gonococcal infection. Protection against gonococcal adhesion varied between Lactobacillus species. Lactobacillus crispatus, Lactobacillus gasseri and Lactobacillus reuteri were capable of reducing gonococcal adherence while Lactobacillus rhamnosus was not. Lactobacillus strains of vaginal origin had the best capacity to remain attached to the host cell during gonococcal adherence. Further, we show that gonococci and lactobacilli interact with each other with resultant lactobacilli incorporation into the gonococcal microcolony. Hence, gonococci bind to colonised lactobacilli and this complex frequently detaches from the epithelial cell surface, resulting in reduced bacterial colonisation. Also, purified gonococcal pili are capable of removing adherent lactobacilli from the cell surface. Taken together, we reveal novel data regarding gonococcal and lactobacilli competition for adherence that will benefit future gonococcal prevention and treatments.

Aims Welander distal myopathy (WDM) and myotonic dystrophy type 1 (DM1) are conditions characterized by gradually impaired hand function. Measurement of hand function is therefore important in therapy for patients. However, to date reliability of common hand function test instruments for these patients has not been evaluated. The aim of the study was to test intra-rater reliability (test-retest) of the hand function testing instruments: the Grippit®, Grip Ability Test (GAT), hand-held myometer (Microfet2TM) and Purdue Pegboard in patients with WDM and DM1. In addition, inter-rater reliability of these instruments was tested in DM1 patients. Methods For test-retest, the two patient groups (16 patients in each group) were tested on 2 consecutive weeks, on the same day of the week and at the same time of day. During the second week, the DM1 patients were randomly tested either before or after retest for inter-rater reliability. Results Mainly good–very good (intra-class correlation coefficient≥0.61) intra-rater and inter-rater reliability were found in three out of four instruments tested: the Purdue Pegboard, Grippit and the hand-held myometer for both WDM and DM1 patients. Conclusions The instruments are thus considered reliable for evaluating hand function in patients with WDM and DM1. However, the GAT and pinch grip measured with the Grippit® need to be interpreted with caution, as the reliability of these instruments varied from fair to good.

Current conceptualizations of occupation reflect a direction in thinking that addresses societal and political needs rather than how occupation relates to human development and well‐being. The fields of occupational science and occupational therapy need to move in new directions to develop theories about occupation that matter for people. Drawing from a longitudinal study of Swedish workers who went into retirement, an alternative way to conceptualize and categorize occupation, based on people's actual experiences is proposed. Using this categorization, it is argued that some occupations are more important than others and that they contribute to well‐being to a greater degree than others.

To be able to function as a probiotic, bacteria have to survive the passage through the gastrointestinal tract. We have examined survival and gene expression of Lactobacillus reuteri ATCC 55730 after a sudden shift in environmental acidity to a pH close to the conditions in the human stomach. More than 80% of the L. reuteri cells survived at pH 2.7 for 1 h. A genomewide expression analysis experiment using microarrays displayed 72 differentially expressed genes at this pH. The early response to severe acid shock in L. reuteri differed from long-term acid adaptation to milder acid stress studied in other lactic acid bacteria. The genes induced included the following: clpL , genes putatively involved in alterations of the cell membrane and the cell wall; genes encoding transcriptional regulators; phage genes; and genes of unknown function. Two genes, clpL , encoding an ATPase with chaperone activity, and lr1516, encoding a putative esterase, were selected for mutation analyses. The mutants were significantly more sensitive to acid than the wild type was. Thus, these genes could contribute to the survival of L. reuteri in the gastrointestinal tract.

Eighteen bacterial isolates from millet, buckwheat and rye flour were identified as Lactobacillus reuteri. Genomic fingerprinting (rep-PCR) revealed that they represented five strains and phylogenetic analyses using multi locus sequence analysis (MLSA) showed that all clustered with strains of rodent origin. Two strains (SU12-3 and SU18-3) from different phylogenetic clades were used in fermentations of six varieties of barley, both untreated and heat-treated (with inactivated indigenous enzymes) flour. They were compared with two probiotic strains of human origin (DSM 17938 and ATCC PTA 6475), one previously isolated sourdough strain (LTH 5531) and one strain of Lactobacillus plantarum (36E). Analyses of growth (CFU) and metabolism (1H-NMR) revealed differences at species level, with L. plantarum showing a higher capacity to assimilate nutrients without help of the cereal enzymes. Similarities were observed between L. reuteri strains isolated from sourdough, while the greatest differences between L. reuteri strains were observed between strains 6475 and 17938. Multivariate analysis of the metabolic profiles revealed clear clustering according to flour treatment, species of bacteria and barley variety and to some extent also bacterial strain. Possible bioactive compounds such as γ-aminobutyric acid (GABA), 1,3- propanediol (sign of reuterin production) and histamine were identified and quantified.

Heat shock proteins (HSPs) are a set of highly conserved proteins that can serve as intestinal gate keepers in gut homeostasis. Here, effects of a probiotic, Lactobacillus rhamnosus GG (LGG), and two novel porcine isolates, Lactobacillus johnsonii strain P47-HY and Lactobacillus reuteri strain P43-HUV, on cytoprotective HSP expression and gut barrier function, were investigated in a porcine IPEC-J2 intestinal epithelial cell line model. The IPEC-J2 cells polarized on a permeable filter exhibited villus-like cell phenotype with development of apical microvilli. Western blot analysis detected HSP expression in IPEC-J2 and revealed that L. johnsonii and L. reuteri strains were able to significantly induce HSP27, despite high basal expression in IPEC-J2, whereas LGG did not. For HSP72, only the supernatant of L. reuteri induced the expression, which was comparable to the heat shock treatment, which indicated that HSP72 expression was more stimulus specific. The protective effect of lactobacilli was further studied in IPEC-J2 under an enterotoxigenic Escherichia coli (ETEC) challenge. ETEC caused intestinal barrier destruction, as reflected by loss of cell–cell contact, reduced IPEC-J2 cell viability and transepithelial electrical resistance, and disruption of tight junction protein zonula occludens-1. In contrast, the L. reuteri treatment substantially counteracted these detrimental effects and preserved the barrier function. L. johnsonii and LGG also achieved barrier protection, partly by directly inhibiting ETEC attachment. Together, the results indicate that specific strains of Lactobacillus can enhance gut barrier function through cytoprotective HSP induction and fortify the cell protection against ETEC challenge through tight junction protein modulation and direct interaction with pathogens.

Sammanfattning Syfte Syftet med denna systematiska litteraturstudie är att sammanställa aktuella forskningsresultat om vilken fysisk träning som behandling kan ge eventuell positiv effekt för personer med diagnosen migrän med avseende på frekvensen, intensiteten och durationen vid migrän. Frågeställningar - Kan träning minska frekvensen, intensiteten och durationen vid migrän? - Vilken typ av träning kan minska konsekvenserna vid migrän? Metod En systematisk litteraturstudie där litteratursökningen utfördes i databaserna PubMed, PEDro och Cochrane. Totalt inkluderades fem studier som analyserades närmare. Studierna kvalitetsgranskades enligt PEDro-scale. Evidensgradering utfördes genom Statens Beredning för Medicinsk Utvärderings (SBU) graderingsmetod. Resultat Det finns ett starkt vetenskapligt stöd för att frekvensen vid migrän minskar, ett måttligt starkt vetenskapligt stöd för att intensiteten vid migrän minskar och ett begränsat vetenskapligt stöd för att durationen minskar med träning som behandling vid migrän. En indikation finns att läkemedelskonsumtionen minskar, dock utgör studierna ett otillräckligt vetenskapligt underlag. Det finns ett otillräcklig vetenskapligt underlag gällande längden på träningsperioden, längden per tillfälle och antalet träningstillfällen. Det finns stark evidens för att träningen ska utföras på en submaximal nivå. En indikation finns att konditionsträning kan fungera som behandling vid migrän, dock är det vetenskapliga underlaget otillräckligt. Slutsats Träning som förebyggande behandling kan minska konsekvenserna vid migrän. Träningens effekter kan minska frekvensen, intensitet och durationen vid migrän. Ingen slutsats kan dras gällande tidsåtgången för träningen. Intensiteten i träningen bör vara submaximal. Konditionsträning kan fungera som behandling vid migrän. Fler studier i området krävs för att kunna ge tydligare riktlinjer. Studier med hög kvalitet efterlyses. Abstract Aim The purpose of this systematic literature review is to compile current research on the physical exercise as treatment is possible to have a positive effect for people diagnosed with migraine with respect to the frequency, intensity and duration of migraine. Questions- Can exercise reduce the frequency, intensity and duration of migraine?- What type of exercise can reduce the impact of migraine? Method A systematic study of the literature search was performed in the database PubMed, PEDro and Cochrane. Five studies were included and analyzed. The quality of the studies was examined according to the Pedro-scale. The evidence grade was performed by using Statens Beredning för Medicinsk Utvärdering (SBU) grading method. Results When exercise is used as a treatment for migraine, there is strong scientific evidence that the frequency of migraine decreases, moderately strong scientific evidence that the intensity of migraine decreases and limited scientific evidence that the duration decreases. The results indicated that the drug consumption is decreased when exercise is used on regular basis, however the studies show insufficient scientific evidence. There is insufficient scientific data regarding the length of the training period, the length per session and the number of training sessions. There is strong evidence that the exercise should be performed at a sub-maximal level. Cardiovascular exercise might be an effective and suitable treatment for migraine, but the scientific evidence is insufficient. Conclusions Exercise as a preventive treatment can reduce the impact of migraine. The effects of exercise can reduce the frequency, intensity and duration of migraine. No conclusion can be drawn regarding the duration of the training. The intensity of the exercise should be on a sub-maximal level, and aerobic exercise can be used. However, more studies in this important area are required to provide appropriate guidelines. Studies with high quality is necessary.

Pre-processing of spectroscopic data is commonly applied to remove unwanted systematic variation. Possible loss of information and ambiguity regarding discarded variation are issues that complicate pre-treatment of data. In this paper, OPLS methodology is applied to evaluate different techniques for pre-processing of spectroscopic data gathered from a batch process. The objective is to present a rational scheme for analysis of pre-processing in order to understand the influence and effect of pre-treatment. O2PLS uses linear regression to divide the systematic variation in X and Y into three parts; one part with joint X – Y covariation, i.e. related to both X and Y , one part of X with Y -orthogonal variation and one part of Y with X -orthogonal variation. All of the investigated pre-treatment methods removed an additive baseline as expected. In the analysis of raw and differentiated data variation associated with the baseline was found in the Y -orthogonal part of X . Orthogonal information was also found in Y , which suggests that this pre-processing procedure not only removed variation. This would have been more difficult to detect without the O2PLS model since both raw and differentiated data must be analysed simultaneously. Development of a knowledge based strategy with OPLS methodology is an important step towards eliminating trial and error approaches to pre-processing.

Pharmaceutical production is at present characterized by static processes where quality is guaranteed by controlling the purity of the final product. Achieving better control throughout the process, as a means for improving product quality, is one of the objectives of the PAT initiative by the FDA. A data set consisting of 11 batches characterized by UV spectroscopy together with process data was used in this study. Design of experiments was used to introduce controlled process variation in test batches. The objective was to investigate possible advantages of MSPC using a combined data set, compared to separate models of the respective data sets. Individual models for the separate data sets show that they contain complementary information. A major advantage of combining spectroscopic and process data is that deviations that would go unnoticed using just an individual model can be detected and interpreted. All process manipulations were detected by the combined data set model. Implementation of these methods to batch processes in primary and secondary pharmaceutical production is feasible. An enhanced understanding of the process together with control tools should lead to a well-understood process and, ultimately, real time release. © 2006 American Institute of Chemical Engineers AIChE J, 2006

The aim of this study was to describe how people with developmental disabilities experienced the use of time aids one year after their introduction by an occupational therapist. Data were obtained through semi-structured interviews. The analysis was performed using a phenomenographic qualitative approach. The results showed that independence and autonomy should be considered as two separate phenomena. Increased independence did not always lead to increased autonomy or vice versa. Four different relationships between these two phenomena were found. They all illustrate the different priorities of the participants and different levels of independence and autonomy. Concerning the usability of time aids, the occupational therapist has to recognize the importance of having frequent communication with the client to understand the phenomena that may affect the use of the aids. The occupational therapist should always try to involve both the client and significant support persons while introducing time aids. Future research in time aids with clients with developmental disabilities could involve multiple interviews with participants combined with participant observations and interviews.

With increasing availability of different process analysers multiple data sources are commonly available and this will impose new challenges and enable new types of investigations. The ability to s ...

The Experience Sampling Methodology (ESM) being elaborated within flow theory provides a unique opportunity to collect data about occupational experiences. Both four‐ and eight‐channel models have been developed, to capture various dimensions of people's lived experience. However neither of these models seems suitable for analysis and discussion of balance within everyday life and its relationship to other factors such as well‐being. The purpose of this study was to analyse balance of everyday occupations from a novel experiential viewpoint, using an alternative model in which the eight channels are condensed into three dimensions; High Matched Experiences, High Not Matched Experiences and Low Challenge Experiences. A secondary analysis of published data from four cross‐cultural ESM‐studies with a total of 159 participants from three countries was conducted. The results show a similar pattern in all samples, with Low Challenge Experiences comprising barely half of the pattern and the other two di...

Performance, nutrient digestibility, feeding behaviour, diarrhoea frequency and faecal microbial diversity was studied in weaned piglets allotted to dry feed (diet A), liquid feed with water (diet B) or liquid feed with wet wheat-distillers grain (diet C). There were no differences in digestibility of organic matter and energy, and the performance was similar between piglets fed liquid diets. Piglets fed diet A spent more time on eating/drinking compared with piglets fed liquid diets. The frequency of diarrhoea decreased (p < 0.05) from from diet A (11 out of 16) to diet B (6 out of 16) and further to diet C (1 out 16). The type of diet did not affect the diversity of coliform bacteria or lactobacilli, but the composition of the Lactobacillus flora was changed. The lower diarrhoea frequency when feeding diet C may be due to a prophylactic effect induced by the inclusion of wet wheat-distillers grain in the diet.

The aim of this study was to evaluate hand function and self-rated occupational performance before and after specific hand training in five participants with myotonic dystrophy (MD) type 1. MD is the commonest of the muscular dystrophies with adult onset and is associated with muscle weakness, wasting and myotonia. Compensatory techniques and strategies are mostly offered as the only intervention therapy. In the present study, the participants were their own controls using pre- and post-test measures. Each participant was tested at intervals a total of nine times before and nine times after hand training. A hand-held myometer (Microfet2), Grippit, Purdue Pegboard and self-rated myotonia were used as outcome measures. Occupational performance was assessed pre- and post-test using the Canadian Occupational Performance Measurement (COPM) in which the participants rated their own performance and satisfaction in five self-chosen occupational performance areas. The participants performed hand training for a total of three months, three times per week using a specific resistance training programme including Theraputty, a silicone-based putty. Hand function was significantly increased and a positive change in self-rated occupational performance was noted after the training period. This study indicates that hand training has a positive effect on hand function, i.e. motor function and occupational performance. The present results need to be replicated in a controlled study including a larger number of patients and over a longer period of time.