Digital Commons Network^™

Cultivating The Growing Self, Kelly Allen

The Open Journal of Occupational Therapy

Khanna Blithe O. Cortes-Amores, MAOT, OTRP, clinician, assistant professor at Cebu Doctors’ University, and co-founder of The Growing Self, a mental health occupational therapy clinic in Cebu, Philippines, provided the cover art for the fall issue of The Open Journal of Occupational Therapy (OJOT). The watercolor painting, titled Peace (2017), features a dreamlike image of a serene female figure with hair that merges into the limbs and branches of a tree. A leafy green vine winds upward around her torso, becomes transparent as it partly overlays her face, and defines the crown of her head. Colorful abstract petal and earthen …

The Importance Of The New Caregiver Codes In Occupational Therapy, Jayna Niblock, Elizabeth G. Hunter, Carli Dimeo, Jackson Miller, Manali George, Allison M. Martin, Samantha M. Barefoot

The Open Journal of Occupational Therapy

Occupational therapists play a critical role in supporting caregivers, a role that continues to grow with the rising number of unpaid family caregivers. Evidence shows that occupational therapists-led caregiver interventions, ranging from skills training to problem-solving and environmental modifications, significantly improve both caregiver and client outcomes. In 2024 and 2025, new Caregiver Training Services (CTS) and Current Procedural Terminology (CPT) codes were introduced, enabling occupational therapists to bill and allowing for reimbursement of caregiver education directly tied to client goals. While these codes offer a transformative opportunity to formalize and fund caregiver support, their adoption has been limited because of …

An Occupational Revolution: Reclaiming What Matters, Carol Lambdin-Pattavina, Wendy B. Stav, Nicole Quint, Sandee M. Dunbar

The Open Journal of Occupational Therapy

Intentional use of the word occupation to describe why, what, and how we do as occupational therapists and occupational therapy assistants is central to maintaining our professional identity and to centering occupation in everyday practice. Throughout occupational therapy's history, using occupation, as opposed to words such as task or activity, has fallen both in and out of favor in practice and education in the United States. Some argue that task and activity, while not reflective of the nuances of the word occupation, including meaning and purpose, are more accessible to external audiences than occupation, which is often confused with …

Policy Solutions For Traumatic Brain Injury: Advancing New York State's First Tbi Special Needs Assisted Living Program, Dianne Schwarz, Natalie F. Douglas

The Open Journal of Occupational Therapy

Traumatic Brain Injury (TBI) presents long-term challenges that are poorly addressed by traditional assisted living and nursing home models. In New York State, individuals with moderate to severe TBI are often placed in settings unequipped to provide cognitive, behavioral, and neurorehabilitative care. This policy and advocacy paper proposes the establishment of a Special Needs Assisted Living Program (SNALP) specifically for individuals with TBI. Drawing from clinical expertise, stakeholder engagement, and a discontinued but promising pilot program, this manuscript outlines the systemic barriers to TBI-specific care, including regulatory gaps, lack of Medicaid reimbursement, and limited public awareness. The proposed model integrates …

Occupational Therapy Student Perceptions Of Sexuality And Intimacy Education: A Cross-Sectional Study, Jennifer H. Barnett, Amanda K. Giles

The Open Journal of Occupational Therapy

Sexuality and intimacy are meaningful activities within the scope of occupational therapy (OT), encompassing valued roles and occupations that contribute significantly to a person’s health, well-being, and identity. Despite acknowledgement of their importance, many occupational therapists overlook these areas during routine assessment and intervention because of feelings of insufficient knowledge, comfort, and confidence. This study used a cross-sectional design to electronically survey 149 occupational therapy doctoral (OTD) students across their first, second, or third year of education to determine their perceptions of sexuality and intimacy education. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed via codebook …

Integrating Behavioral Health Practice Approaches And Occupational Therapy: Curricular Considerations, Kaylynn M. Garrison, Susan C. Burwash

The Open Journal of Occupational Therapy

Occupational Therapy programs preparing occupational therapists to work in the field need to enhance students' education surrounding mental/behavioral health (MH/BH) needs. Thus, a curricular approach is needed that not only includes OT conceptual practice models but also those practice approaches used in MH/BH care. Creating educational experiences that include knowledge from inside and outside OT establishes theoretical foundations that better equip students entering practice to address mental health needs of their clients. Further, educators can assist students to appraise the fit between specific practice approaches and OT practice. A review of current MH/BH literature found three common practice approaches used …

Exploring Career Pathways Of The Occupational Therapy Afwc Role: A Review Of Push, Pull, And Stay Factors, Kimberley Persons, Patricia Laverdure, Elizabeth Lequieu, Elizabeth D. Deiuliis

The Open Journal of Occupational Therapy

Academic Fieldwork Coordinators (AFWCs) are essential to occupational therapy (OT) education, yet little is known about the career pathways, retention, and attrition associated with this role. With increasing faculty turnover, understanding the factors that influence AFWC career decisions is critical. This mixed-methods study surveyed 187 OT educators across the US, including current, former, and never-serving AFWCs. A researcher-designed Qualtrics survey gathered demographic, quantitative, and open-ended qualitative data. Quantitative data were analyzed using chi-square tests; qualitative responses underwent thematic analysis. Respondents reported psychological (e.g., burnout, satisfaction), job (e.g., mentoring, administrative burden), organizational (e.g., support, workload), and leadership/team (e.g., recognition, collaboration) factors …

Optimizing Academic Success For Otd Students: A Lassi-Based Pre/Posttest Study On Intervention Effectiveness, Mica Rutschke, Dailen Castillo, Lauren Peyton

The Open Journal of Occupational Therapy

Graduate students frequently experience heightened anxiety that can interfere with academic performance, well-being, and persistence in graduate programs. This pilot study explored the effectiveness of a targeted academic intervention for Occupational Therapy Doctorate (OTD) students using the Learning and Study Strategies Inventory (LASSI) as a pre/post assessment tool. Ten first-year OTD students completed the LASSI at program entry and again after participating in a faculty-led intervention focused on growth mindset and anxiety management strategies. The intervention included a lunch-hour educational session on evidence-based techniques, such as mindfulness, test-taking skills, cognitive reframing, and stress regulation. Faculty advisors also used individualized LASSI …

Deliberate Practice In Occupational Therapy Education: A Conceptual Model For Professional Growth, Suzanne Marasco, Matthew A. Witenstein

The Open Journal of Occupational Therapy

In response to national calls for a more representative health care workforce, this conceptual paper proposes the Model of Deliberate Occupational Therapy Practice (MDOTP), which aims to enhance pedagogical strategies related to supporting, engaging, and leveraging students’ unique cultural and experiential assets. Grounded in the scholarship of integration, authors draw from three theoretical frameworks, Funds of Knowledge, Therapeutic Use of Self, and Street-Level Bureaucracy, to provide a robust foundation for refining psychosociocultural approaches in occupational therapy education. After describing the MDOTP, a subsequent set of Guiding Principles (encourage reflective practice, development of the professional self, incorporate community-based learning, and promote …

School-Based Executive Function Guideline (Sb-Efg): A Practice Guideline For Executive Function Assessment And Intervention In School-Based Practice, Ida Koraitem, Amanda Sarafian, Lenin Grajo

The Open Journal of Occupational Therapy

Executive functioning (EF) is comprised of various cognitive skills, such as working memory, inhibitory control, and cognitive flexibility, which monitor and guide goal-directed behavior and set a foundation on which healthy development may occur. Although the impact of EF skills on school participation has increasingly been recognized over the years, there are limited occupational therapy models that help occupational therapists integrate EF intervention into school-based practice. Children with limitations in EF have unique needs and challenges that impact school participation; therefore, it is imperative that occupational therapists address EF in school-based practice. This author- developed practice guideline discusses essential elements …

The Empower Model: A Framework For Fostering Neurodivergent Occupational Participation And Supporting Neurodiversity-Affirming Occupational Therapy Practice, Bryden Carlson-Giving

The Open Journal of Occupational Therapy

Neurodivergent occupations are ways of embodying life and experiencing the world that speak true to their neurotype; they are vivid, complex, and need to be fostered by the occupational therapy profession. Though the neurodiversity movement is garnering increased attention in the profession, the medical model of disability remains the dominating lens influencing occupational therapy services. Neuronormativity remains the ideal form of participation, which can lead to occupational therapists manifesting occupational marginalization with their neurodivergent clients. To date, there is a lack of practical frameworks supporting occupational therapists in integrating neurodiversity-affirming and anti-ableist principles into everyday occupational therapy practice. This paper …

Occupational Therapy For Ostomy Patients In Acute Care: A Case Series, Carolina Orozco, John V. Rider, Pamela Morales

The Open Journal of Occupational Therapy

Background: Ostomy surgery, which diverts stool or urine through an abdominal stoma, significantly impacts individuals’ physical and psychosocial functioning. Skilled education and training are required to promote independence in ostomy self-care. Occupational therapists are uniquely equipped to address these needs through holistic, person-centered approaches.

Method: This retrospective descriptive case series examines the integration of occupational therapy services, including ostomy-specific evaluation and intervention, for three patients in an acute care hospital.

Results: Three cases, varying in age, diagnosis, and functional status, demonstrate individualized occupational therapy interventions targeting activities of daily living, instrumental activities of daily living, and health management, emphasizing ostomy …

Interventions For Lgbtq+ Youth: A Scoping Review To Support Occupational Therapy Practice In The United States, Ricardo D. Ramirez, Iris Nosek, Alexandrea Guiritan, Annalise Valente, Francinne Fotopoulos, Jennifer Westrick

The Open Journal of Occupational Therapy

Background: Youth in the lesbian, gay, bisexual, transgender, queer/questioning, and other dissident genders and sexualities (LGBTQ+) community face extensive health disparities and dynamic political landscapes. Occupational therapy (OT) has potential to support LGBTQ+ youth; however, there is limited guidance for occupational therapists and occupational therapy assistants seeking to implement evidence-based interventions with this population. Therefore, the purpose of this scoping review was to examine interventions within the scope of OT to support LGBTQ+ youth.

Method: We used Arksey and O'Malley’s framework to guide this scoping review and searched five databases: PubMed, Scopus, PsycINFO, CINAHL, and Google Scholar. Using …

Autism And Air Travel, Joceline Rodriguez, Riley Rynders, Mckenzie Guth, Divya Sood

The Open Journal of Occupational Therapy

Background: Autistic children frequently encounter several difficulties during travel, especially in airport environments. This research study aimed to investigate the perceptions of parents of autistic children, as well as airport and airline staff, regarding the support available and barriers these children encounter during air travel.

Method: A qualitative descriptive design was used, involving data collection through interviews with two distinct groups of participants: airport and airline staff (n = 4) and caregivers of autistic children (n = 5).

Results: Caregiver participants shared that having access to quiet spaces, sensory rooms, and more readily available information on accommodation …

Group Occupational Therapy Sessions Using Hippotherapy: Growth Of Resilience And Leadership In Youth Facing Adversity, Marra I. Robert, Julie Jacob, Gerry Conti, Laura Alegre

The Open Journal of Occupational Therapy

Background: Youth experiencing adversity face significant challenges and are more likely to experience mental health concerns, low self-confidence, and difficulty with leadership skills, impacting their future occupational potential. This study examined the impact of using hippotherapy in a group occupational therapy intervention on the resilience, mental health, and leadership of youth facing adversity.

Method: Twenty-one youth experiencing adversity participated in a 10-week group occupational therapy intervention. Using a single-group pretest/posttest mixed-methods design, the Resilience Scale for Children and Adolescents (RSCA) was administered pr and postintervention alongside structured interviews.

Results: Quantitative results indicated statistically significant improvements in emotional …

Experiences Of Parents Of Children Diagnosed With Eating Disorders, Elizabeth C. Larson Traver, Crystal C. Barchacky

The Open Journal of Occupational Therapy

Background: Eating disorders are diagnoses found throughout the world regardless of race, gender, and age. Recovery for these diagnoses are typically demanding and on-going, leading parents and caregivers of those diagnosed to face substantial stress throughout the process. While many treatments use caregivers as agents of change, these are established with the client in mind and do little to aid the families through their own stress and decline in well-being.

Method: This qualitative phenomenological study explored the lived experiences of 10 caregivers during their children's recovery through in-depth interviews regarding that time of their lives. Participants were recruited via …

Promoting The Well-Being Of Refugee Students Through A Kawa-Guided Occupational Therapy Intervention: A Mixed-Methods Study, Suzanne Brederson, Heidi Baist, Jennifer E. Lape

The Open Journal of Occupational Therapy

Background: Refugee students newly enrolled in U.S. schools encounter academic, socialization, and mental health challenges because of trauma, language barriers, and cultural differences. Many have had limited or interrupted access to formal education in their home country. This study aimed to gain the perspectives of refugee students on their lived experiences and explore the impact of an occupational therapy intervention guided by the Kawa model on the well-being of this student population.

Methods: The researchers employed a convergent mixed-methods design. Refugee students (n = 8) created Kawa models, which provided rich, qualitative data. Participants completed pre and posttest surveys. Quantitative …

Effects Of The Lsvt Big® On Occupational Performance And Functional Skills In Parkinson’S Disease: A Case Study, Sandra J. Allen, Madison Gumm, Donald Stapleton, Lexee Trainer, Lydia Workman

The Open Journal of Occupational Therapy

Background: Parkinson’s disease (PD) leads to motor decline and reduced occupational performance. Limited evidence addresses if gains from the LSVT BIG® are sustained, particularly in occupation-focused outcomes.

Objective: This single-subject study evaluated the effects of the LSVT BIG® on occupational performance and functional skill outcomes in a 69-year-old woman with PD, and whether improvements were sustained 8 weeks postintervention.

Methods: The participant completed 16 1-hr LSVT BIG® sessions over 4 weeks. Outcomes included the Canadian Occupational Performance Measure (COPM), the Performance Assessment of Self-Care Skills (PASS), the Five Times Sit to Stand (FTSTS), and the Functional Reach Test (FRT). …

Solving The Problem Of Non-Linear Data In The Health Care Professions Using Spline Regression, Heather Staal, Rob Lyerla, Diane Powers Dirette

The Open Journal of Occupational Therapy

No abstract provided.

Hidden Thermal Signatures Reveal The Microclimatic Influence Of Scheduled Cave Tourism, Matt Rowberry, John Gunn, Andrew Smith

International Journal of Speleology

Tourist activity is widely recognised as a source of cave microclimate disturbance, yet visitor-induced variability is difficult to distinguish from natural environmental fluctuations. The coronavirus pandemic created a natural experiment at Poole’s Cavern, United Kingdom, in which periods of complete closure could be compared with contrasting visitor access regimes. Two years of high resolution temperature records from six monitoring points were analysed. Harmonic regression and a state space model removed deterministic diurnal cycles and lower frequency temperature variability. The remaining residual variability differed systematically among visitor access regimes and between daytime and nighttime conditions. Spectral analysis of the residuals identified …

Spec-232: The Dynamics Of Covariant Viscoelastic Membrane Shifting — Three-Dimensional Spatial Bulk Emergence As The Dynamic Inflation Velocity Of Two-Dimensional Quantum Substrates, Christopher L. Eckes

Defensive Publications Series

This technical disclosure presents a rigorous, non-perturbative mathematical and thermodynamic proof establishing that three-dimensional (3D) spatial volume is not a primary coordinate layer of the universe, but rather the empirical validation of an underlying two-dimensional (2D) boundary information substrate. Under this model, 3D volume explicitly manifests as the localized physical velocity of 2D membrane information shifting. By translating spatial depth into a chronological latency function driven by field acceleration, we derive the z-axis from non-equilibrium boundary thermodynamics. We provide a complete theoretical framework, ASCII-mapped mathematical matrices, operational Python scripts verifying tensor conversions, and explicit tabletop experimental verification methodologies to validate …

Fpga-Resident Guardrail Fabric For Large Language Model Security, Privacy, And Safety Enforcement, Barry Qi Yuan

Defensive Publications Series

A system is proposed herein for hardware-interlocked release of artificial intelligence (AI) prompts, retrieved context, model responses, tool requests, and tool results. Release-critical state remains under chip control, and each guarded object reaches RELEASED only through an atomic commit binding the object digest and sequence, the applicable guardrail action, a protected-state update, a package epoch, and cryptographically authenticated enforcement evidence; failure leaves the original destination disabled. The system combines deterministic controls, a placement-flexible semantic model operating within a signed quality envelope on approved measured, attested, or host-isolated compute, and authenticated escalation for unresolved or high-consequence cases while the hardware interlock …

Towards A Mechanism For Artificial Intelligence Into University Education For Environmental Architecture A Comparative Analytical Study To Evaluate The Impact Of Artificial Intelligence On Self- Learning In Environmental Design., Heba Mahrous Ali Abd El-Aal

Mansoura Engineering Journal

Architectural education is a field that uniquely targets the creativity and continuous development of architecture students. This is especially true within environmental architecture, which relies on diverse spatial and temporal variables that create unique interactions for students, based on the specific concept of environmental design.

Quality Of Life And Religiosity Of Breast Cancer Patients Undergoing Adjuvant Ultra-Hypofractionated Radiotherapy With Sequential Tumor Bed Boost: A Pilot Study, Efrosyni Kypraiou, Ioannis Koukourakis, Andromachi Kougioumtzopoulou, Kalliopi Platoni, Marina Chalkia, Kyveli Zourari, Efstathios Efstathopoulos, Nikolaos Kelekis, Anna Zygogianni, Vassilis Kouloulias

Turkish Journal of Medical Sciences

Background/aim: Quality of life (QoL) is an important parameter that should be taken into account when assessing treatment efficacy in cancer patients. The FAST-FORWARD radiotherapy (RT) regimen (5-day schedule) for early-stage breast cancer has been reported by both physicians and patients to be associated with toxicity comparable to that of longer schedules. However, the impact of the addition of a tumor bed boost to ultrahypofractionated RT on patient QoL has not been extensively reported to date.

Materials and methods: QoL was assessed before and after RT and again 3 months later in 24 patients with early-stage breast cancer who underwent …

Multicentre Real-World Outcomes Of Reference Bevacizumab And Two Biosimilars In Treatment-Naïve Neovascular Age-Related Macular Degeneration ​, Eyüpcan Şensoy, Mehmet Çitirik, Burhan Başkan, Hasan Öncül, Abdullah Beyoğlu

Turkish Journal of Medical Sciences

Background/aim: Bevacizumab biosimilars are increasingly used as alternatives to reference bevacizumab in ophthalmic practice, but comparative real-world evidence in treatment-naïve neovascular age-related macular degeneration (nAMD) remains limited. In this study, the short-term anatomical, functional, and documented safety outcomes associated with bevacizumab, bevacizumab-bvzr (Zirabev), and bevacizumab-awwb (Mvasi) were evaluated in treatment-naïve patients with nAMD in a multicentre real-world setting.

Materials and methods: This multicentre retrospective cohort included 250 treatment-naïve eyes with nAMD from 16 centres in Türkiye that completed a 3-month loading regimen with the same bevacizumab agent. Central macular thickness (CMT) was the prespecified primary longitudinal outcome; best-corrected visual acuity …

Factors Associated With Relapse In Anca-Associated Vasculitis: A Single-Center Retrospective Cohort Study ​, Serdar Sezer, Şeyda Yi̇ği̇tbaşi, Zehra Karaman Ongun, Emi̇ne Uslu, Müçteba Enes Yayla, Aşkin Ateş, Tahsi̇n Murat Turgay

Turkish Journal of Medical Sciences

​

Background/aim: Relapse remains common in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). We examined factors associated with relapse after remission.

Materials and methods: We retrospectively reviewed 130 adults with AAV followed between January 2015 and May 2026, all of whom achieved remission after induction therapy. Demographics, disease subtype, serology, organ involvement, baseline laboratory values, treatments, and relapse were recorded. Relapse was defined as recurrent vasculitic activity after remission requiring escalation/ modification of immunosuppressive therapy. Time from remission to first relapse was analyzed using Cox proportional hazards regression, with serious infection modeled as a time-dependent covariate. No imputation was undertaken.

Results: …

Turkish Translation, Cultural Adaptation, And Validation Of The Patient-Reported Villalta Scale For The Diagnosis Of Postthrombotic Syndrome In Patients With Vascular Behçet Disease ​, Tuğçe Kübra Güneş, Murat Karabacak, Mehmet Umut Çapar, Tüli̇n Ergun, Rafi̇ Haner Di̇reskeneli̇, Fatma Ali̇baz Öner

Turkish Journal of Medical Sciences

Background/aim: Lower extremity deep vein thrombosis (DVT) constitutes 70% of all vascular findings related to Behçet disease (BD). Postthrombotic syndrome (PTS) is a serious complication of DVT that develops due to chronic venous insufficiency and decreases the patient’s quality of life. The physician-reported Villalta scale is a widely used and validated diagnostic tool for diagnosing and evaluating the severity of PTS. However, the necessity of physical examination by a physician burdens the clinician during routine practice. For that reason, a patient-reported Villalta scale was developed and validated. This study aimed to translate the patient-reported Villalta scale into Turkish and validate …

Baseline 18f-Fdg Pet/Ct-Derived Metabolic Parameters And Intratumoral Heterogeneity In Relation To Survival In Bone Sarcomas ​, Hali̇m Özçevi̇k, Müge Öner Tamam, Meryem Eslem Bi̇çen Altin, Cüneyt Tamam, Merve Nur Acar Tayyar, Mehmet Mesut Sönmez

Turkish Journal of Medical Sciences

Background/aim: This study assessed correlations between intratumoral heterogeneity, survival outcomes, and baseline 18F-FDG PET/ CT-derived semiquantitative metabolic parameters and histological subtype in patients with bone sarcomas.

Materials and methods: We retrospectively analyzed 44 patients with biopsy-proven bone sarcomas who underwent baseline 18F-FDG PET/CT before treatment. Total lesion glycolysis, metabolic tumor volume, heterogeneity indices (HI1, HI2, HI3), and semiquantitative standardized uptake parameters (SUVmax, SUVmean, SUVpeak, and SUVmin), all derived from the primary tumor, were examined. SUVmin and SUVmax AUCs were compared using the DeLong test. Kaplan–Meier survival analysis, Cox regression, correlation analysis, and ROC analysis were used to assess associations with …

Epicardial Adipose Tissue Thickness And Aortic Elasticity In Seronegative And Seropositive Rheumatoid Arthritis: A Comparative Evaluation Of Subclinical Cardiometabolic Burden ​, Abdullah Nabi̇ Aslan, Yunus Emre Özbebek

Turkish Journal of Medical Sciences

Background/aim: Rheumatoid arthritis (RA) is a systemic inflammatory disease associated with both joint pathology and elevated cardiovascular disease risk. Epicardial adipose tissue thickness (EATT) and aortic elasticity parameters are emerging cardiometabolic markers associated with systemic inflammation and subclinical atherosclerosis. Although the relationship between EATT, aortic elasticity parameters, and RA has been increasingly documented, differences in these parameters between seronegative rheumatoid arthritis and seropositive rheumatoid arthritis remain underexplored.

Materials and methods: Of the 396 consecutive patients with RA, only those free of established cardiovascular disease and uncontrolled cardiovascular risk factors were included. As a result, 80 patients with RA and 43 …

Impact Of Weather Changes On Pediatric Trauma: A Detailed Demographic Analysis ​, Nuri̇ Koray Ülgen, Ali̇ Sai̇d Nazligül, Ni̇hat Yi̇ği̇t, Sadik Emre Ergi̇noğlu, Arslan Kağan Arslan, Mehmet Orçun Akkurt

Turkish Journal of Medical Sciences

Background/aim: Pediatric trauma creates substantial emergency and orthopedic workload, and fluctuations in volume may affect staffing and resources. This study investigated the associations of ambient temperature, precipitation, and calendar characteristics with pediatric orthopedic trauma consultations and fracture events, including age-, sex-, and fracture-location-specific patterns.

Materials and methods: All pediatric trauma-related consultations were requested from the Department of Orthopedics and Traumatology by the emergency department between June 1, 2023, and June 1, 2024, were retrospectively analyzed. Consultation and fracture data were aggregated daily. Negative binomial regression was used for count outcomes, temperature nonlinearity was tested using a quadratic term, and weighted …