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Full-Text Articles in Medicine and Health Sciences

The Ethical Dilemma Of Blowing The Whistle: Research Misconduct And Its Reporters, David Sottile Oct 2018

The Ethical Dilemma Of Blowing The Whistle: Research Misconduct And Its Reporters, David Sottile

The Hilltop Review

Research misconduct is a widespread issue that affects the credibility of science as a discipline. While a relatively small number of researchers engage directly in research misconduct, there is a larger number of researchers that are aware of research misconduct and do not report it. This permits falsified research to be disseminated throughout the scientific community. It is important to analyze both those engaging in research misconduct as well as those that are aware. The case example of Stephen E. Breuning is used throughout the paper. Stephen E. Breuning is a scientist that engaged in research misconduct that collaborated with ...


Medical Tourism And Its Effect On United State Healthcare Industry In A Highly Connected Global Landscape, Katarina Haist Oct 2018

Medical Tourism And Its Effect On United State Healthcare Industry In A Highly Connected Global Landscape, Katarina Haist

The Hilltop Review

For centuries people have traveled to other countries to obtain the best healthcare. Traditionally these popular destinations were highly developed countries; the trend of people traveling to less developed areas for treatment is relatively new. The average person is more connected to the world around them than ever before through globalization. Information about the best practices are more widely available than ever before. The importance of physical barriers to business such as geography and time are being eliminated. Due to this “flattening” per Friedman, the competition and expertise for areas in Science, Technology, Engineering, and Mathematics (STEM) can be shifted ...


Integrating Art And Narrative To Enhance Quality Of Life In Palliative Care, Jennifer Fortuna Oct 2018

Integrating Art And Narrative To Enhance Quality Of Life In Palliative Care, Jennifer Fortuna

The Open Journal of Occupational Therapy

Lacie Lee Wallace, a mixed-media artist from Wheeling, West Virginia, is featured on the cover of the Fall 2018 issue of The Open Journal of Occupational Therapy (OJOT). The photograph depicts Lacie holding a self-portrait painted by artist CeCey Rose. Lacie’s physical appearance in the photograph is strikingly different from the physical appearance of the woman featured in the painting. The portrait was created 4 years before Lacie was diagnosed with advanced stage colon cancer. In the year following the diagnosis, Lacie lost nearly 100 lbs. as a result of an aggressive treatment regimen. When the palliative care team ...


Critical Reflections On Self-Management Support In Chronic Disease: The Value Of Occupational Therapy In Health Promotion, Brocha Z. Stern Oct 2018

Critical Reflections On Self-Management Support In Chronic Disease: The Value Of Occupational Therapy In Health Promotion, Brocha Z. Stern

The Open Journal of Occupational Therapy

No abstract provided.


The Biopsychosocial Model: Application To Occupational Therapy Practice, Keith Gentry, Karen Snyder, Beth Barstow, Jordan Hamson-Utley Oct 2018

The Biopsychosocial Model: Application To Occupational Therapy Practice, Keith Gentry, Karen Snyder, Beth Barstow, Jordan Hamson-Utley

The Open Journal of Occupational Therapy

Despite the call for the profession to embrace a more integrated and holistic approach to practice, therapists may be faced with practical challenges, including issues relating to client caseloads, productivity demands, scheduling, entrenched practices, limitations on service imposed by payer sources, and staffing and budgetary restraints, to name but a few. Due to these limitations, current occupational therapy practice may be predisposed to adopt a more reductive approach to the evaluation and treatment of symptoms, underlying biological pathologies, and resulting impairments and disabilities. Therefore, psychological and social factors may be neglected, resulting in an unbalanced, fragmented, and incomplete approach to ...


Use Of A Journal Club During Level Ii Fieldwork To Facilitate Confidence And Skills For Evidence-Based Practice, Kelly A. Lavin Oct 2018

Use Of A Journal Club During Level Ii Fieldwork To Facilitate Confidence And Skills For Evidence-Based Practice, Kelly A. Lavin

The Open Journal of Occupational Therapy

Level II fieldwork students should have an opportunity to engage in the process of evidence-based practice (EBP) firsthand; however, ensuring that EBP is visible to students is often a challenge for fieldwork educators. This study investigated if the use of a journal club during a Level II, psychosocial fieldwork placement would increase the students’ confidence and perceived abilities in using skills required for EBP. A descriptive study via survey design was used for the study. The participants consisted of two cohorts (n = 10) of occupational therapy graduate students. The results indicate that the students perceived an increase in their ability ...


Hearing Voices Simulation: Impact On Occupational Therapy Students, Rebecca Ozelie, Paige Panfil, Nicole Swiderski, Elizabeth Walz Oct 2018

Hearing Voices Simulation: Impact On Occupational Therapy Students, Rebecca Ozelie, Paige Panfil, Nicole Swiderski, Elizabeth Walz

The Open Journal of Occupational Therapy

Auditory hallucinations, which are symptoms of schizophrenia, can significantly disrupt individuals’ daily lives. Occupational therapists (OTs) can address both the daily needs of people with schizophrenia and address cultural stigmas against mental illness. To combat stigma and increase empathy for patients with mental illnesses, auditory hallucinations simulations were developed. The purpose of this study was to determine if the Hearing Voices That Are Distressing (HVTAD) Simulation impacts OT students’ attitudes toward patients with auditory hallucinations and to explore the students’ perceptions of the simulation’s effectiveness as a teaching method. The participants completed a pretest Attitudes to Mental Illness Questionnaire ...


International Occupational Therapy Faculty Perceptions Regarding Doctoral Level Education, Bernadette Mineo, Beth Hathaway, Monali Kadkade Oct 2018

International Occupational Therapy Faculty Perceptions Regarding Doctoral Level Education, Bernadette Mineo, Beth Hathaway, Monali Kadkade

The Open Journal of Occupational Therapy

Over the past decade a debate has ensued in the US regarding the clinical doctorate in occupational therapy (OT) and whether to require a doctorate to become an occupational therapist. Little discussion has occurred regarding the potential implications on the global community of occupational therapists, and there have been no attempts to ascertain the views of international OT faculty and practitioners. This study surveyed international OT faculty regarding their perceived need for and value of graduate education, particularly at the doctoral level, for OT faculty and practitioners in their countries. Fifty-three OT faculty from WFOT approved programs in eight countries ...


Cross-Cultural Service Learning As Pedagogy For Character Development In Occupational Therapy Doctoral Students, Heather Y.Z. St. Peters, Nathan Short Oct 2018

Cross-Cultural Service Learning As Pedagogy For Character Development In Occupational Therapy Doctoral Students, Heather Y.Z. St. Peters, Nathan Short

The Open Journal of Occupational Therapy

Occupational therapists must demonstrate a broad spectrum of knowledge, clinical reasoning skills, and professionalism to be effective practitioners. Development of ethical practice must begin with the educational process to shape character traits as building blocks of moral reasoning. This article puts forth a cross-cultural service learning curricular module as lived experience for development of character traits in occupational therapy students. This mixed methods study investigated lived experience in the form of cross-cultural service learning as a pedagogy for development of character traits, as measured by the CIVIC, necessary to navigate professional ethical standards. Findings suggest a cross-cultural lived experience for ...


Burnout Among Filipino Occupational Therapists: A Mixed Methods Analysis, Rod Charlie Delos Reyes Oct 2018

Burnout Among Filipino Occupational Therapists: A Mixed Methods Analysis, Rod Charlie Delos Reyes

The Open Journal of Occupational Therapy

Background: There is a shortage of practicing occupational therapists in the Philippines, with approximately one Filipino occupational therapist per 30,000 stakeholders. One of the possible consequences is the experience of burnout among therapists.

Method: A two-phase mixed methods study using a sequential explanatory approach was used. The first phase involved the administration of the Maslach Burnout Inventory – Human Services Survey (MBI-HSS) with a survey questionnaire that supplied demographic and work-related factors through an online platform. The results were analyzed using frequency distribution and measures of central tendency. Relationships were analyzed using Spearman’s Rho and Cramer’s V. The ...


Exploring Parents’ Experiences Of Raising A Child With Sensorimotor Impairments And Expectations For Leisure Participation, Emily A. Eicher, Camille Skubik-Peplaski, Shirley P. O'Brien, Anne Fleischer Oct 2018

Exploring Parents’ Experiences Of Raising A Child With Sensorimotor Impairments And Expectations For Leisure Participation, Emily A. Eicher, Camille Skubik-Peplaski, Shirley P. O'Brien, Anne Fleischer

The Open Journal of Occupational Therapy

Background: The objective of this descriptive study was to study parents’ experiences of raising a child with sensorimotor impairments and how leisure pursuits impact their expectations of their children. The development and participation in leisure activities is different for these children and could affect the parents’ hopes and dreams for their child’s future.

Method: Six children between 5 and 8 years of age, with sensorimotor impairments, participated in a movement program that was held for eight sessions at an outpatient pediatric clinic to address praxis and sensory processing impairments. Six parent dyads were interviewed during the fifth, sixth, seventh ...


Medication Management In Home Health Care Occupational Therapy Practice, Julie Blum, Jennifer Fogo, Judith Malek-Ismail Oct 2018

Medication Management In Home Health Care Occupational Therapy Practice, Julie Blum, Jennifer Fogo, Judith Malek-Ismail

The Open Journal of Occupational Therapy

Background: Many community-dwelling adults do not adhere to their medication regimen, which results in high rates of emergency department visits and subsequent hospital admissions. Occupational therapists, as members of the home health care team, provide medication management in the occupational therapy scope of practice. There is sparse information in the literature regarding occupational therapists’ involvement in medication management in home health care practice.

Methods: The researchers interviewed nine occupational therapists practicing in home health care. Using a qualitative interpretive phenomenological study, the researchers explored the participants’ experiences addressing medication management.

Results: The researchers identified three themes: professional reasoning, interprofessional involvement ...


Quality Of Life, Stress Perception, And Quality Of Social Networks In Persons Living With Brain Injury: An Exploration Of The Effectiveness Of A Community-Based Program, Barbara P. White, Abigail Brinkman, Barbara P. Kresge, Lisa Couture Oct 2018

Quality Of Life, Stress Perception, And Quality Of Social Networks In Persons Living With Brain Injury: An Exploration Of The Effectiveness Of A Community-Based Program, Barbara P. White, Abigail Brinkman, Barbara P. Kresge, Lisa Couture

The Open Journal of Occupational Therapy

Background: This paper examines specific program elements of a community-based program for individuals living with brain injury. Results from a previous study suggested that members who attended regularly reported lower stress perception, higher quality of life perception, and higher social connectedness than did peers living in the community without such supports. In this study, we sought to understand reasons for their perceptions about how the program may have been helpful in shaping their perspectives of living with the effects of brain injury.

Methods: An explanatory case-study approach was applied, using multiple cases. Nine individuals were randomly selected from a subsample ...


Concept Mapping And The Co-Op Approach With Adolescents With Autism Spectrum Disorder: Exploring Participant Experiences, Jessie Wilson, Angela Mandich, Lilian Magalhaes, Kaity Gain Oct 2018

Concept Mapping And The Co-Op Approach With Adolescents With Autism Spectrum Disorder: Exploring Participant Experiences, Jessie Wilson, Angela Mandich, Lilian Magalhaes, Kaity Gain

The Open Journal of Occupational Therapy

Background: To explore the experiences of adolescents with ASD participating in a novel occupationally based intervention.

Methods: The intervention used concept mapping in combination with the CO-OP approach with 10 adolescents with ASD in a 4-week program focused on developing life skills they deemed as important in their transition to adulthood. A descriptive qualitative approach was employed using deductive thematic analysis informed by Self-Determination Theory and occupationally relevant theoretical frameworks. This study is part of a larger feasibility project and focuses on the analysis of participant reflections and researcher field notes.

Results: Five themes emerged: finding a sense of balance ...


Challenges And Resources Available For Mothers In Opiate Recovery: A Qualitative Study, Michelle A. Suarez, Wendy Horton-Bierema, Caitlyn E. Bodine Oct 2018

Challenges And Resources Available For Mothers In Opiate Recovery: A Qualitative Study, Michelle A. Suarez, Wendy Horton-Bierema, Caitlyn E. Bodine

The Open Journal of Occupational Therapy

Background: Opiate abuse and addiction in women during childbearing years has led to a sharp increase in neonatal abstinence syndrome (NAS). Babies born with NAS are at risk for significant health and developmental deficits. Through understanding the challenges experienced by mothers in opiate recovery, and the resources available to this group, sensitive and effective treatment can be developed to ameliorate the impact of NAS on the child and the family.

Method: This qualitative interview study provides insight into the experience of becoming a mother for women in opiate recovery.

Results: Themes from the interviews include deep love for the baby ...


Decolonialism In The Profession: Reflections From Wfot, Diane Powers-Foltz Dirette Oct 2018

Decolonialism In The Profession: Reflections From Wfot, Diane Powers-Foltz Dirette

The Open Journal of Occupational Therapy

No abstract provided.


Grandparent Caregivers’ Perceptions And Lived Experiences: Their Health And Wellbeing, Access To Health And State Of Health Services In Zimbabwe, Magen M. Mutepfa Dr Sep 2018

Grandparent Caregivers’ Perceptions And Lived Experiences: Their Health And Wellbeing, Access To Health And State Of Health Services In Zimbabwe, Magen M. Mutepfa Dr

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

The study explored the perceptions and lived experiences of self-rated health, access to health, and state of health services for grandparent caregivers in Zimbabwe. In–depth interviews using semi-structured interview guides were carried out to elicit perceptions of lived experiences from grandparent caregivers (N=31; Mean age= 65.7; SD= 10.7). The data was thematically analysed and the software Nvivo 10 was used to help categorize emergent themes. The study found that grandparent caregivers experienced multiple chronic and complex self-rated health conditions (e.g., High blood pressure (HBP), arthritis, diabetes, hypertension, back pain, and heart problems), which influenced their ...


Conflicts, Concerns And Family Circumstances In Custodial Grandmothers Over 8 Years, Cristina Noriega, Carol Musil, Jaclene Zauszniewski, Camille Warner Sep 2018

Conflicts, Concerns And Family Circumstances In Custodial Grandmothers Over 8 Years, Cristina Noriega, Carol Musil, Jaclene Zauszniewski, Camille Warner

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Although many grandmothers raising grandchildren experience transitions in their roles as family strains and circumstances change, little longitudinal data has been examined. This qualitative study assessed the relationships between custodial grandmothers’ appraisals of their family conflicts and concerns and family circumstances across eight years. Participants were thirty-five Ohio grandmothers who were raising their grandchildren in 2006-2007 and provided additional self-report survey data in 2008-2009 and 2014-2015. Data were gathered from open-ended questions that were analyzed through conventional content analysis. The reported concerns were financial and emotional difficulties, grandchildren outcomes, mental and physical health of the grandchild and other family members ...


Kinship Diversion In The District Of Columbia: A Review Of Local Practice To Inform National Policy, Marla P. Spindel, Beth A. Stekler, Stephanie Ridgway Mcclellan Sep 2018

Kinship Diversion In The District Of Columbia: A Review Of Local Practice To Inform National Policy, Marla P. Spindel, Beth A. Stekler, Stephanie Ridgway Mcclellan

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This article addresses a practice commonly known in the child welfare community as “kinship diversion,” where a child welfare agency informally places children with relatives as an alternative to foster care. While evidence predominantly shows that abused and neglected children have better outcomes when they are placed with relatives when they cannot remain safely at home, serious concerns about these children’s safety and well-being arise when the placement with relatives is informal. Indeed, it is often not understood that these same relatives can be approved as foster parents and can receive essential financial assistance and supportive services to help ...


Primary Care Physician Delivered Brief Behavioral Intervention For Adult Obesity And Associated Health Conditions, Julia C. Huston Aug 2018

Primary Care Physician Delivered Brief Behavioral Intervention For Adult Obesity And Associated Health Conditions, Julia C. Huston

Dissertations

Obesity is a chronic health condition with prevalence rates that have continued to rise steadily over the past 30 years to the point that it has now been declared a global epidemic and a serious public health concern. Obesity is associated with significant physical and economic costs, primarily resulting from co-occurring health conditions that increase the risk of morbidity including type II diabetes, hypertension, dyslipidemia, stroke, coronary heart disease, and respiratory problems. Despite the dissemination of several obesity treatments, including pharmacotherapy, lifestyle modification, and bariatric surgery, the prevalence and severity of obesity continues to rise. Federal guidelines recommend the use ...


Beta-Testing Of An Interactive Multimedia Computer Program Of Exposure Therapy For Ptsd, Marie C. Barrett Aug 2018

Beta-Testing Of An Interactive Multimedia Computer Program Of Exposure Therapy For Ptsd, Marie C. Barrett

Dissertations

Posttraumatic Stress Disorder (PTSD) results in significant impairment for the individual and substantial costs to society. Research indicates that cognitive behavioral psychotherapy (CBT) is the most effective treatment for PTSD and that among CBT treatments, exposure therapy is the treatment technique with the strongest evidence to recommend it for PTSD treatment. Computerized programs that deliver evidenced-based treatments offer a potential solution to barriers that prevent individuals from accessing and completing treatment. The present study evaluates the clinical and practical functionality of a computer-based program designed for the treatment of PTSD. Results indicate that completion of the program is associated with ...


Qualitative Analogue Study On Student Therapist’S Reactions To Client Suicidality, Cynthia A. Beevers Aug 2018

Qualitative Analogue Study On Student Therapist’S Reactions To Client Suicidality, Cynthia A. Beevers

Dissertations

Suicidal clients are a reality for both professional and student therapists providing counseling (Chemtob et al., 1988; Dexter-Mazza & Freeman, 2003; Goodman, 1995; Howard, 2000; Jacobson, Ting, Sanders, & Harrington, 2004; Kleespies, Penk, & Forsyth, 1993; Kleespies, Smith, & Becker, 1990; Mackelprang, Karle, & Cash, 2014; McAdams & Foster, 2000). Previous research has investigated the experiences of professional therapists working with suicidal clients, but little is known about student therapists’ experiences with suicidal clients. Only two studies were found investigating the experiences of student therapists working with suicidal clients (Kleespies et al., 1993; Kleespies et al., 1990). However, in the two studies explicitly focusing on student therapists’ experiences with suicidal clients, participants were doctoral students from clinical or counseling psychology programs that were in their pre-doctoral internship. No information was found regarding the experiences of student therapists currently attending a master’s degree program. Further, both studies exploring the experiences of doctoral students working with suicidal clients used a retrospective design ...


Training Pediatric Primary Care Providers In Behavior Management Strategies, Kate Burger Aug 2018

Training Pediatric Primary Care Providers In Behavior Management Strategies, Kate Burger

Dissertations

Childhood mental health disorders are a significant public health concern in the United States. It is estimated that every year 13 to 20% of children living in the United States experience a mental health disorder (National Research Council and Institute of Medicine, 2009). Despite the clear need for mental health care, less than half (45.6%) of children with one or more emotional, behavioral, or developmental conditions receive treatment from a mental health professional (The National Survey of Children's Health, 2007). There is growing evidence that integrating mental health services into pediatric primary care can result in increased treatment ...


Demonstrating Functional Analytic Psychotherapy As An Independent Variable In Efficacy Research: A New Measure Of Treatment Fidelity, Lindsey E. Knott Aug 2018

Demonstrating Functional Analytic Psychotherapy As An Independent Variable In Efficacy Research: A New Measure Of Treatment Fidelity, Lindsey E. Knott

Dissertations

Functional Analytic Psychotherapy (FAP) is a contextual behavior therapy that takes an in session, in vivo focus to improve client outcomes. This in vivo (IV) focus is distinctive of FAP and involves the therapist utilization of contingencies in session to decrease problematic response classes and increase more adaptive response classes (i.e., a differential reinforcement procedure). This contingent responding is proposed to be FAP’s mechanism of action leading to client change. FAP efficacy research mainly consists of small n single-case studies or group designs combing FAP with another CBT intervention. Maitland & Gaynor (2012) offered recommendations for increasing FAP efficacy research, including the development of a reliable measure to determine whether a therapist implemented the distinguishing features of FAP. Maitland and Gaynor (2016) developed a 10-item fidelity measure, called the FAP Adherence Form (FAP-AF), to assess for aspects of FAP across 5 items and distinguish it from supportive listening (SL) assessed over 4 items. The measure was used in two FAP outcome studies (Maitland & Gaynor, 2016; Maitland et al., 2016) and it distinguished FAP ...


Incidence Of Head Injury Among Synchronized Skaters: Rates, Risks, And Behaviors, Gretchen L. Mohney Aug 2018

Incidence Of Head Injury Among Synchronized Skaters: Rates, Risks, And Behaviors, Gretchen L. Mohney

Dissertations

Data regarding risk and rates for head injury and concussion specific to the sport of synchronized skating is absent from literature. This study investigated the rate and risk for head injury and concussion as a function of team level, identified behaviors to include education, neurocognitive baseline screening and protective equipment utilization, and the implementation of return to sport protocols.

An anonymous cross-sectional survey was implemented at the 2018 U.S. Synchronized Skating Championships. Participants were female members of a qualifying team, ages 13 and older, at the intermediate participation level and higher. The survey response rate was 42% (520/1232 ...


The Relationship Between Hypermobile Joints And Tendonitis, Rachel Braden, Nicole Coughlin Jul 2018

The Relationship Between Hypermobile Joints And Tendonitis, Rachel Braden, Nicole Coughlin

Occupational Therapy Graduate Student Evidenced-Based Research Reviews

No abstract provided.


Overcoming Barriers By Doing Things Differently, Jennifer Fortuna Jul 2018

Overcoming Barriers By Doing Things Differently, Jennifer Fortuna

The Open Journal of Occupational Therapy

Tom Yendell, an artist based in Hampshire, England, provided the cover art for the Summer 2018 issue of The Open Journal of Occupational Therapy (OJOT). “Silk Flowers” is a mouth painting made from acrylic on silk. Born a bilateral congenital amputee, Tom has learned to use his toes the same ways others use their hands. Tom relies little on aids and adaptations in his everyday life. He believes learning to do things your own way is empowering. As a world-renowned mouth and foot painter, Tom is a living example of how barriers can be overcome by doing things differently. Through ...


Development And Evaluation Of A Collaborative Model Level Ii Fieldwork Program, Annmarie T. Kinsella, Catherine V. Piersol Jul 2018

Development And Evaluation Of A Collaborative Model Level Ii Fieldwork Program, Annmarie T. Kinsella, Catherine V. Piersol

The Open Journal of Occupational Therapy

This project developed a Collaborative Model Level II Fieldwork (CM-FWII) program to evaluate the effect of the program on fieldwork educator and student understanding of the model and changes in knowledge, perceptions, and satisfaction. Four fieldwork educators (FWEd) were recruited from two pediatric and two adult practice settings. Eight occupational therapy (OT) students met participation criteria and agreed to participate. A pre/post design was used to evaluate change in knowledge and perceptions. Satisfaction with the collaborative model (CM) was examined after the 12-week fieldwork rotation. Analysis procedures included a priori coding, calculation of frequency distributions, and thematic analysis of ...


Sexual Functioning In Occupational Therapy Education: A Survey Of Programs, Kate Eglseder, Sheridan Webb, Miranda Rennie Jul 2018

Sexual Functioning In Occupational Therapy Education: A Survey Of Programs, Kate Eglseder, Sheridan Webb, Miranda Rennie

The Open Journal of Occupational Therapy

Despite the importance of sexuality to overall quality of life and well-being for individuals with disabilities, occupational therapy practitioners continue to under-address this issue. One possibility for the lack of attention in this area is the comfort and knowledge level of practitioners. In their seminal work, Payne, Greer, and Corbin (1988) surveyed occupational therapy programs in the United States in an effort to identify the amount of sexuality education provided. This study was aimed at identifying current trends in the provision of sexuality education for occupational therapy students. Despite the nearly 30-year gap in this area of research, and the ...


How Service Dogs Enhance Veterans’ Occupational Performance In The Home: A Qualitative Perspective, Terry K. Crowe, Mylinh T. Nguyen, Brenda G. Tryon, Stephanie Barger, Victoria Sanchez Jul 2018

How Service Dogs Enhance Veterans’ Occupational Performance In The Home: A Qualitative Perspective, Terry K. Crowe, Mylinh T. Nguyen, Brenda G. Tryon, Stephanie Barger, Victoria Sanchez

The Open Journal of Occupational Therapy

Background: This qualitative study explored the lives of veterans diagnosed with posttraumatic stress disorder (PTSD) and/or traumatic brain injury (TBI) and how the partnerships with their service dogs supported improved occupational performance in their homes.

Method: Semi-structured individual interviews were conducted with six veterans with PTSD and/or TBI who graduated and received their service dogs from the Paws and Stripes Program in Albuquerque, NM. Home activities of daily living (self-care, household tasks, leisure activities, and family and friend relationships) guided the interview questions. The individual interviews were audio recorded, transcribed, and coded using qualitative data analysis software. Preliminary ...