Search

Objective: Region-specific maps of cancer incidence, mortality, late detection rates, and screening rates can be very helpful in the planning, targeting, and coordination of cancer control activities. Unfortunately, past efforts in this area have been few, and have not used appropriate statistical models that account for the correlation of rates across both neighboring regions and different cancer types. In this article we develop such models, and apply them to the problem of cancer control in the counties of Minnesota during the period 1993–1997. Methods: We use hierarchical Bayesian spatial statistical methods, implemented using modern Markov chain Monte Carlo computing techniques and software. Results: Our approach results in spatially smoothed maps emphasizing either cancer prevention or cancer outcome for breast, colorectal, and lung cancer, as well as an overall map which combines results from these three individual cancers. Conclusions: Our methods enable us to produce a more statistically accurate picture of the geographic distribution of important cancer prevention and outcome variables in Minnesota, and appear useful for making decisions regarding targeting cancer control resources within the state.

This experimental study was designed to examine the attitude changes and exercise adherence of a group of sedentary minority women.Fifty sedentary Mexican American women participated in a 9-month, biweekly education and exercise program that was preceded by a 6-month program initiation composed of weekly interactions to facilitate trust between participants and researchers.Compared to Mexican American and Caucasian control groups, the experimental participants displayed significant changes in scores on the Exercise Benefits and Barriers Scales (EBBS) at three, six, and nine months. Adherence to the physical activity program was 84%. At pre-test, the Mexican American participants and controls displayed significantly lower EBBS scores than the Caucasian controls.The results of this study are examined in light of existing reports on the facilitation of attitudes toward exercise, exercise adherence and health promotion particularly in regard to understanding the barriers to physical activity for minorities. The findings of this study are particularly important given the paucity of research about health promotion for individuals who belong to minority groups.

AIDS has affected or will affect virtually every provider of health care. The purpose of this study was to determine the quantity of HIV/AIDS-related curricula in programs of occupational therapy across the United States. A survey was distributed to the program directors of all accredited technical, undergraduate, and graduate programs in the United States. Of the 137 surveys mailed, 95 were returned, yielding a 69%% response rate. Results of the survey indicated that graduate and undergraduate professional programs devoted an average of six classroom hours to this topic while technical programs averaged three classroom hours, with the majority of program directors indicating there is no need for further HIV/AIDS related curricula in their respective programs.

Through use of an ABAB design and momentary time‐sampling procedure, 10 elderly members of an adult day care center were observed for their social responses during two separate baseline (A) and intervention (B) conditions. Intervention consisted of an intergenerational nursery school. Baseline data were obtained before the program started and when school was not in session. Repeated‐measure ANOVA indicates that the elderly participants showed significantly higher levels of social interaction and significantly lower levels of solitary productive behaviors when the preschool program was in session than when it was not.

Therapists from a sensory integration tradition use a combination of clinical observations along with Postrotary Nystagmus Test (PRN) to assess vestibular function in children with learning and behavioral problems. The validity and reliability of the PRN as a measure of vestibular system integrity has been questioned because it is administered with eyes open, thereby resulting in complex visual-vestibular interctions in addition to identifying whether ocular motor skills, as indicated by visual pursuit and fixation, correlated with an already identified cluster of clinical observations related to vestibular functions. Significant positive correlations were found between ocular motor skills and the vestibular-related clinical observations. These results demonstrate the significance of the interaction between the vestibular and visual systems.

The CHRNA7 gene, which encodes the α7 nicotinic acetylcholine receptor (α7*nAChR), has been implicated as a candidate gene in schizophrenia. Expression of the α7*nAChR mRNA and protein are reduced in multiple regions of post-mortem brain from patients diagnosed with schizophrenia. Transcriptional regulation may therefore be an important mechanism for the regulation of this gene. A 230-bp proximal promoter fragment, necessary for transcription in cultured neuroblastoma cells, was used to study a putative AP-2α binding site. Mutation of the site indicates that AP-2α plays a negative role in regulating CHRNA7 transcription. This was confirmed through knockdown and overexpression of AP-2α. Electrophoretic mobility shift assays (EMSAs) identified positive DNA-protein interaction at this same site, and supershift assays indicate that the complex includes AP-2α. The interaction was confirmed in cells using chromatin immunoprecipitation (ChIP). DNA methylation was discovered as an anomalous mechanism for CHRNA7 regulation in one cell line. These studies suggest a role for AP-2α regulation of CHRNA7 mRNA expression in multiple tissues during development.

The purposes of this article are to review some of the common causes and symptoms of Post-Traumatic Stress Disorder (PTSD), particularly as it applies to combat-related trauma experienced by the Vietnam veteran, and to offer a variety of treatment activities. These activities may be graded for use with other types of combat-related trauma or other forms of PTSD. The activities are listed so that they may be used cumulatively. to result in a final ceremony that becomes a ritual for the resolution of ambivalent emotions and/or the expression and release of powerful negative feelings of guilt, rage, or hurt. The objective is for these activities to be included with other treatment approaches aimed at enabling the client to let go of past trauma and make a positive transition to healthful and productive living.

Multiple genetic linkage studies support the hypothesis that the 15q13–14 chromosomal region contributes to the etiology of schizophrenia. Among the putative candidate genes in this area are the α7 nicotinic acetylcholine receptor gene (CHRNA7) and its partial duplication, CHRFAM7A. A large chromosomal segment including the CHRFAM7A gene locus, but not the CHRNA7 locus, is deleted in some individuals. The CHRFAM7A gene contains a polymorphism consisting of a 2 base pair (2 bp) deletion at position 497–498 bp of exon 6. We employed PCR-based methods to quantify the copy number of CHRFAM7A and the presence of the 2 bp polymorphism in a large, multi-ethnic population. The 2 bp polymorphism was associated with schizophrenia in African Americans (genotype p = 0.005, allele p = 0.015), and in Caucasians (genotype p = 0.015, allele p = 0.009). We conclude that the presence of the 2 bp polymorphism at the CHRFAM7A locus may have a functional significance in schizophrenia.

The alpha7 neuronal nicotinic acetylcholine receptor subunit gene (CHRNA7) is localized in a chromosomal region (15q14) linked to schizophrenia in multiple independent studies. CHRNA7 was selected as the best candidate gene in the region for a well-documented endophenotype of schizophrenia, the P50 sensory processing deficit, by genetic linkage and biochemical studies.Subjects included Caucasian-Non Hispanic and African-American case-control subjects collected in Denver, and schizophrenic subjects from families in the NIMH Genetics Initiative on Schizophrenia. Thirty-five single nucleotide polymorphisms (SNPs) in the 5'-upstream regulatory region of CHRNA7 were genotyped for association with schizophrenia, and for smoking in schizophrenia.The rs3087454 SNP, located at position -1831 bp in the upstream regulatory region of CHRNA7, was significantly associated with schizophrenia in the case-control samples after multiple-testing correction (P=0.0009, African American; P=0.013, Caucasian-Non Hispanic); the association was supported in family members. There was nominal association of this SNP with smoking in schizophrenia.The data support association of regulatory region polymorphisms in the CHRNA7 gene with schizophrenia.

The hypothesis that the 15q13-15 region of chromosome 15 contains a gene that contributes to the etiology of schizophrenia is supported by multiple genetic linkage studies. The alpha7 neuronal nicotinic acetylcholine receptor (CHRNA7) gene was selected as the best candidate gene in this region for molecular investigation, based on these linkage findings and biological evidence in both human and rodent models. CHRNA7 receptors are decreased in expression in postmortem brain of schizophrenic subjects. A dinucleotide marker, D15S1360, in intron two of the CHRNA7 gene is genetically linked to an auditory gating deficit found in schizophrenics and half of the first-degree relatives of patients. Single strand conformation polymorphism (SSCP) and sequence analyses of DNA from schizophrenic and control individuals identified 33 variants in the coding region and intron/exon borders of the CHRNA7 gene and its partial duplication, dupCHRNA7; common polymorphisms were mapped. Twenty-one variants were found in the exons, but non-synonymous changes were rare. Although the expression of CHRNA7 is decreased in schizophrenia, the general structure of the remaining receptors is likely to be normal.

Region-specific maps of cancer incidence, mortality, late detection rates, and screening rates can be very helpful in the planning, targeting, and coordination of cancer control activities. Unfortunately, past efforts in this area have been few, and have not used appropriate statistical models that account for the correlation of rates across both neighboring regions and different cancer types. In this article we develop such models, and apply them to the problem of cancer control in the counties of Minnesota during the period 1993-1997.We use hierarchical Bayesian spatial statistical methods, implemented using modern Markov chain Monte Carlo computing techniques and software.Our approach results in spatially smoothed maps emphasizing either cancer prevention or cancer outcome for breast, colorectal, and lung cancer, as well as an overall map which combines results from these three individual cancers.Our methods enable us to produce a more statistically accurate picture of the geographic distribution of important cancer prevention and outcome variables in Minnesota, and appear useful for making decisions regarding targeting cancer control resources within the state.

T his special issue was developed in response to the increasing interest in qualitative research in occupational therapy. Since becoming Editor of The Occupational Therapy Journal of Research I have observed a substantial increase in the number of manuscripts with qualitative approaches submitted for editorial review. As Krefting (1991) pointed out, "models used to evaluate quantitative research are seldom relevant to qualitative research" (p.214). This issue of the Journal emerged from discussions with Jeffrey Gliner, PhD, regarding the need for continued discussion and assessment of evaluative criteria for critically reviewing qualitative research. "Too frequently, qualitative research is evaluated against criteria appropriate to quantitative research and is found to be lacking" (Krefting, 1991, p. 214). The criteria posed in Gliner's lead-off article and highlighted in the research studies included in this issue continue discussions already initiated by Hasselkus (1991), Krefting (1991), and others regarding obtaining and honing criteria for the assessment of qualitative research. Ultimately, this will enhance the rigor, trustworthiness, and quality of research published in our field. In The Occupational Therapy Journal of Research in 1982 Kielhofner pointed out the relevance of qualitative methodologies to occupa

New York City hospitalization rates were analyzed to investigate whether tuberculosis (TB) hospitalizations declined after implementation of directly observed therapy QOOT) for TB. TB hospitalization rates mirrored incidence rates in pattern but not in magnitude. Rates have declined significantly following widespread implementation of DOT in 1993.

Objective. What is the role of occupational therapists with regard to clients’ spirituality? What activities address spirituality in occupational therapy? Whom do practitioners think should be responsible for helping clients with their spiritual needs? The objectives of this study were to address these and other related questions by validating a previously used questionnaire and establishing a baseline of occupational therapists’ opinions and practices about spirituality and therapy on which future research can be built. Method. A previously piloted questionnaire was revised to investigate the opinions of 500 U.S. registered occupational therapists about spirituality and therapy. The 54% return rate yielded a sample of 270 respondents. Results. Nearly 79% of the respondents agreed that the questionnaire accurately measured their opinions about therapy and spirituality. Spirituality is an important part of life for 89% of the respondents, helps 79% with daily job responsibilities, and is viewed as a very important dimension of health and rehabilitation by 84%. However, 63% were either undecided or disagreed that addressing spirituality was within the scope of occupational therapy practice. Conclusion. In general, the respondents reported that spirituality is important and helpful in their personal lives and a very important dimension of the health and rehabilitation of their clients. However, less than 40% of the respondents indicated that addressing clients’ spiritual needs was within the scope of their professional practice, and the majority (82%) reported that their academic training did not prepare them to address the spiritual needs of clients. The questionnaire, now validated with a national sample, may be used for follow-up studies to further investigate the role of spirituality in health and rehabilitation.

The alpha7 neuronal nicotinic acetylcholine receptor subunit gene (CHRNA7) has been implicated as a candidate gene for schizophrenia, and for an auditory sensory processing deficit found in the disease, by both genetic linkage at 15q14 and biochemical data. The expression of CHRNA7 is reduced in several brain regions in schizophrenic subjects compared with control subjects. This study presents DNA sequence analysis of the core promoter region for CHRNA7 in schizophrenic and control subjects.Single-strand conformation polymorphism analysis and DNA sequencing were used for mutation screening of the core promoter in the CHRNA7 gene. The sample included subjects from 166 schizophrenic families and 165 controls. Controls had no evidence of current or past psychosis and had auditory evoked potentials recorded.Multiple polymorphic patterns were identified in the CHRNA7 core promoter in both schizophrenic and control subjects. Functional analysis of polymorphisms indicated that transcription was reduced. The prevalence of functional promoter variants was statistically greater in schizophrenic subjects than in the controls. Presence of an alpha7 promoter polymorphism in controls was associated with failure to inhibit the P50 auditory evoked potential response.Although linkage disequilibrium with other genetic alterations cannot be excluded, the CHRNA7 core promoter variants, found in this study, may contribute to a common pathophysiologic feature of schizophrenia.