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Occupational therapy

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Comprehensive Occupational Therapy In A Breast Cancer Program, Nicole Renee Scheiman Jan 2018

Comprehensive Occupational Therapy In A Breast Cancer Program, Nicole Renee Scheiman

Occupational Therapy Program Student Theses, Dissertations and Capstones

The purpose of this capstone project is to develop an evidenced-based, innovative, and comprehensive occupational therapy evaluation and intervention protocol for breast cancer care. The contents of this paper will include an introduction into the current care provided to survivors, literature review on best practice in breast cancer care, outline of the procedures completed to discover what best practice care should be, results of these procedures, discussion of the results, and conclusion with proposed program and recommendations for further investigation. The concern investigated is the inconsistencies in care provided to survivors from the time of diagnosis throughout their lifespan or …


The Cognitive And Functional Impact Of Open Heart Surgery: A Pilot Study Including Three Common Procedures (Coronary Artery Bypass Graft, Heart Valve Replacement, And Left Ventricular Assist Device), Robert Fix Jan 2018

The Cognitive And Functional Impact Of Open Heart Surgery: A Pilot Study Including Three Common Procedures (Coronary Artery Bypass Graft, Heart Valve Replacement, And Left Ventricular Assist Device), Robert Fix

Theses and Dissertations

This study investigated the impact of open heart surgery (Coronary Artery Bypass Graft, Heart Valve Replacement, or Left Ventricular Assist Device placement) on cognition, functional performance, and mood in the three months following surgery. The Montreal Cognitive Assessment (MoCA), Kettle Test (KT), Physical Self Maintenance Scale (PSMS), and Hospital Anxiety and Depression Scale (HD) measured global cognition, functional cognition, functional performance, and mood states, respectively.

Thirteen male participants (ages 38 – 75) completed assessments at four time points -- when they were scheduled for surgery, within one week prior to surgery, before hospital discharge after surgery, and three months after …


Increasing Self-Efficacy Through Role Emerging Placements: Implications For Occupational Therapy Experiential Learning, Amy Mattila, Elizabeth D. Deiuliis, Ann B. Cook Jan 2018

Increasing Self-Efficacy Through Role Emerging Placements: Implications For Occupational Therapy Experiential Learning, Amy Mattila, Elizabeth D. Deiuliis, Ann B. Cook

Journal of Occupational Therapy Education

Fieldwork education is an essential component of occupational therapy curriculum design and student development. Today’s students are faced with a variety of challenges in the changing, diverse healthcare system, and educators need to ensure there are placements that best prepare them for these demands. Role emerging fieldwork offers an opportunity to not only meet the curricular requirements of fieldwork education, but also afford students the chance to develop confidence and skills unique to this kind of placement. The purpose of this explanatory case study was to explore graduate occupational therapy students’ self-efficacy before and after a Level I role emerging …


A Qualitative Exploration Of Transformative Learning Within An Online Leadership Course, Melissa M. Sweetman Jan 2018

A Qualitative Exploration Of Transformative Learning Within An Online Leadership Course, Melissa M. Sweetman

Journal of Occupational Therapy Education

As the profession of occupational therapy enters its second century of existence, it is important to recognize that for continued sustainability and strength through the effects of healthcare reform, strong leadership is required. While experts agree that leadership development for occupational therapists needs to begin in the classroom setting, there is little existing research on occupational therapy leadership education. Built upon a theoretical framework of the transformative learning theory, this qualitative study sought to determine whether students in an online leadership course within a post-professional doctor of occupational therapy degree program believed they experienced a transformation in their leadership knowledge …


Impact Of Men's Shed On Social Participation And Health Outcomes, Joshua Grimmer Dec 2017

Impact Of Men's Shed On Social Participation And Health Outcomes, Joshua Grimmer

Honors Theses

This paper will explore the concept of a community-based organization, known as a Men’s Shed. The purpose of the research is to determine the positive impacts the North Belfast Men’s Shed has on social participation and overall health outcomes. The key factors observed in this study were the safe environment, camaraderie, social acceptance, and variety of activities the shed offers. The study included a sample of 11 men primarily over the age of 60. At the time of the study, all of the men were retired or unemployed and came from diverse occupational backgrounds. A set of semi-structure questions was …


Using Virtual Reality To Improve Sitting Balance, Alice Kay Barnes Dec 2017

Using Virtual Reality To Improve Sitting Balance, Alice Kay Barnes

Graduate Theses/Dissertations

This thesis focuses on using virtual reality (VR) to enhance sitting balance and core strength. It is a study in how to create a VR exercise program which is interesting enough to keep players/patients motivated, but comfortable to play and not overwhelming to the senses. The software used for this study was written with the hope that a later version of it might be used with occupational/physical therapy patients one day. For this master’s thesis, the initial testing has been done with healthy volunteers. The software incorporates what developers know thus far about designing for VR, and it is hoped …


A Review Of Occupation And Impairment Based Assessments Used In Occupational Therapy, Mariana D'Amico Dec 2017

A Review Of Occupation And Impairment Based Assessments Used In Occupational Therapy, Mariana D'Amico

OCCUPATION: A Medium of Inquiry about Health through Occupation

Objective: The objective of this paper was to analyze the psychometrics, efficacy, and usefulness of assessments to measure occupational performance and occupation-based outcomes.

Methodology: Eight Doctor of Occupational Therapy Students at Nova Southeastern University, along with their professor, analyzed and appraised 46 commonly used assessments to discover and explore the assessments’ purposes, theory-bases, psychometric properties, and usefulness as outcome measures.

Results: We found that many high quality assessments exist and meet the standards for validity and reliability. Although some assessments are client-centered and useful, some still require additional research to strengthen their psychometric properties.

Conclusion: Some widely used assessments …


The Pathway To The Use Of A Structured And Supported Approach To Debriefing, Anne H. Zachry, S. B. Lancaster Nov 2017

The Pathway To The Use Of A Structured And Supported Approach To Debriefing, Anne H. Zachry, S. B. Lancaster

Faculty Presentations

Debriefing plays a critical role in the transfer of knowledge in simulation education. Various methods are used in the debriefing process based on a variety of factors; this presentation sheds light on the pathway to the use of a structured and supported approach as traversed in the Department of Occupational Therapy at the University of Tennessee Healthcare Center as well as reflections and lessons learned along the way. Engagement in this session will allow learners to further develop their debriefing skills through exposure to information about strategies to use in the debriefing process that can be used as part of …


The Contribution Of Technology To The Development And Sustainability Of An Occupational Therapy Community Of Learners In Doctoral Education, Susan Toth-Cohen, Phd, Otr/L, Mary Gozza-Cohen, Phd, Sandra Schefkind, Otd, Otr/L, Faota Oct 2017

The Contribution Of Technology To The Development And Sustainability Of An Occupational Therapy Community Of Learners In Doctoral Education, Susan Toth-Cohen, Phd, Otr/L, Mary Gozza-Cohen, Phd, Sandra Schefkind, Otd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

This case study describes the pivotal role of technology in developing a community of practice (COP) designed for post professional occupational therapists that enabled doctoral students, alumni and faculty to share information and insights about topics, initiatives and research critical to the Occupational Therapy field. The COP evolved through ongoing development of the post-professional occupational therapy doctorate (PPOTD) program at Jefferson University in Philadelphia.

The conceptual foundation for the COP moved beyond an initial focus on course delivery to an emphasis on development, implementation, and sustainability of a vibrant learning community. Transformation of the COP was greatly facilitated through the …


Movement Without Boundaries, Jennifer Fortuna Oct 2017

Movement Without Boundaries, Jennifer Fortuna

The Open Journal of Occupational Therapy

Johnson Simon, an artist based in West Palm Beach, FL, provided the cover art for the Fall 2017 edition of The Open Journal of Occupational Therapy (OJOT). “Dancing in Motion” is a 36” x 60” painting made from acrylic on canvas. Johnson always wanted to become a dancer. He was born with cerebral palsy, and therefore physical limitations make it difficult for Johnson to coordinate his body movements. Through use of vibrant colors and bold strokes, Johnson’s expressionist paintings evoke movement and motion. Occupational therapy helped Johnson discover his artistic abilities. Painting empowered him to move without limitations.


Occupational Therapy Students In Norway: Do Their Approaches To Studying Vary By Year In The Program?, Tore Bonsaksen, Mikkel M. Thørrisen, Talieh Sadeghi Oct 2017

Occupational Therapy Students In Norway: Do Their Approaches To Studying Vary By Year In The Program?, Tore Bonsaksen, Mikkel M. Thørrisen, Talieh Sadeghi

The Open Journal of Occupational Therapy

Approaches to studying may be influenced by students’ age, maturity, and experience in higher education. Students’ approaches to studying may develop toward deep and/or strategic approaches and away from a surface approach as they move through the curriculum, which is generally considered a positive development. This study aimed to identify differences in approaches to studying among first-, second-, and third-year students enrolled in an occupational therapy program. Three cohorts of students (n = 160) from one university college completed the Approaches and Study Skills Inventory for Students (ASSIST) along with sociodemographic information. One-way analyses of variance were used to …


Educating Occupational Therapists In The Use Of Theory And Evidence To Enhance Supervision Practice, Melanie J. Roberts, Deborah Fitzgerald, Matthew Molineux Oct 2017

Educating Occupational Therapists In The Use Of Theory And Evidence To Enhance Supervision Practice, Melanie J. Roberts, Deborah Fitzgerald, Matthew Molineux

The Open Journal of Occupational Therapy

This paper describes the implementation of a unique learning experience aimed at enhancing the quality of supervision practice in occupational therapy at the Gold Coast Hospital and Health Service. The package was designed by experienced occupational therapy educators based on adult, blended, and flipped learning approaches with content developed following administration of a standardized tool and semi-structured interviews. The learning package focused particularly on the logistics of supervision and the use of occupational therapy theory and evidence with supervision. The training for supervising therapists included a workshop and pre and post workshop learning activities. This collaborative research approach to designing …


Joint Attention And Occupations For Children And Families Living With Autism Spectrum Disorder: A Scoping Review, Verna G. Eschenfelder, Christina M. Gavalas Oct 2017

Joint Attention And Occupations For Children And Families Living With Autism Spectrum Disorder: A Scoping Review, Verna G. Eschenfelder, Christina M. Gavalas

The Open Journal of Occupational Therapy

Background: Research reports that children living with autism spectrum disorder (ASD) may demonstrate deficits in social, emotional, behavioral, and communication skills, which adversely affect social participation and occupational engagement. Joint attention skills constitute any nonverbal communication that captures the attention of another to create a shared interactional experience. The components of joint attention can be targeted through intervention to promote occupational engagement in childhood co-occupations.

Methods: A scoping review process was applied in the current study. Nineteen studies met the inclusion criteria to be analyzed through critical appraisal of topics and use of a matrix.

Results: Evidence indicates that joint …


Music As A Modality To Improve Function And Participation In Occupational Therapy Services For Individual's With Alzheimer's-Dementia In Skilled Nursing Facilities, Courtney Denson Oct 2017

Music As A Modality To Improve Function And Participation In Occupational Therapy Services For Individual's With Alzheimer's-Dementia In Skilled Nursing Facilities, Courtney Denson

MOT Student Capstones

Currently, there is little research to support the positive effects on the use of music with individuals suffering from Alzheimer's-Dementia. For individuals with Alzheimer's-Dementia, further research is needed to explore treatment options appropriate for promoting occupational performance, and positive outcomes with participation in occupational therapy services. The following Capstone project will elaborate on an experimental study that identifies the benefits of utilizing a Music As a Modality program for individuals residing in a suburban area skilled nursing facility (SNF) that have the diagnosis of Alzheimer's-Dementia. Research completed throughout this project will help to support the need for use of music …


Fall Risk Reduction Using Lifestyle-Integrated Functional Exercise (Life), Kayla Comer, Tiffany Huang, Kelly Schmidt, Matthew Tong Oct 2017

Fall Risk Reduction Using Lifestyle-Integrated Functional Exercise (Life), Kayla Comer, Tiffany Huang, Kelly Schmidt, Matthew Tong

Student Research Posters

As the population and longevity of older adults’ increases, the prevalence of falls is becoming an ever-growing issue. One in three adults aged 65 years and older experience a fall each year. Falls in older adults may lead to sedentary behavior, decreased independence, and lower quality of life. Evidence has shown that traditional exercise programs emphasizing strength and balance exercises can decrease the fall risk in older adults, but may be difficult to sustain over time. Emerging evidence suggests that exercises that are integrated into daily life may have a more lasting effect in reducing fall risk in older adults. …


Collaborative Practices In Special Education: An Exploratory Study, Evelyn Tang, Blanka Pentek, Laura Greiss Hess, Katherine Sadoff Oct 2017

Collaborative Practices In Special Education: An Exploratory Study, Evelyn Tang, Blanka Pentek, Laura Greiss Hess, Katherine Sadoff

Student Research Posters

Professional collaboration in special education is essential for student success (Barnes & Turner, 2000). However, IDEA legislation does not guide how such collaboration should take place (Pub. L. 108–446). The Conceptual Model for Collaboration (CMC) created by Czuleger and colleagues (2016) described professional collaborative practices of a transdisciplinary team at a special education center. The purpose of this study was to examine the CMC in a broader context.


Functional Cognitive Activities For Adults With Traumatic Brain Injury: Pilot Case Studies, Karen Huang, Ashley Cook, Ajay Pala Oct 2017

Functional Cognitive Activities For Adults With Traumatic Brain Injury: Pilot Case Studies, Karen Huang, Ashley Cook, Ajay Pala

Student Research Posters

These pilot case studies investigated the effectiveness of the Functional Cognitive Activities for Adults with Brain Injury: A Sequential Approach (FCA) in generalizing functional cognitive skills across meaningful occupations for adults with traumatic brain injury (TBI). This quasi-experimental pretest-posttest design consisted of two participants with TBI. Both participants received occupation-based intervention sessions twice a week and equaled a total of 14 sessions each. For pretest, the two participants were given three assessments to track changes with aspects of functional cognition and engagement in occupations: the Canadian Occupational Performance Measure (COPM), Kohlman Evaluation of Living Skills (KELS), and Goal Attainment Scale …


Perceived Stress Levels May Impact Upper Extremity Function Among Women Treated For Breast Cancer, Mary Insana Fisher, Anne Fleischer, Kimbery Parent, Renee Roberts, Megan Mcclure, Lynn Hendricks Oct 2017

Perceived Stress Levels May Impact Upper Extremity Function Among Women Treated For Breast Cancer, Mary Insana Fisher, Anne Fleischer, Kimbery Parent, Renee Roberts, Megan Mcclure, Lynn Hendricks

EKU Faculty and Staff Scholarship

Women treated for breast cancer report ongoing disability in their involved upper extremity, however, often objective measures do not appear to explain the level of perceived dysfunction. The purpose of this study was to investigate the relationship between perceived stress level, fear of physical activity and self-reported upper extremity function among women treated for breast cancer.


Opening A Student-Run Pro Bono Occupational Therapy Pediatric Clinic, Anne H. Zachry Sep 2017

Opening A Student-Run Pro Bono Occupational Therapy Pediatric Clinic, Anne H. Zachry

Faculty Presentations

This presentation described the opening of a student-run pro bono pediatric therapy clinic that provides services to children/families who are economically disadvantaged. The benefits of participation for students and clients were reviewed, and fund-raising and the development of a mission statement were discussed.


Female Veterans: Satisfying Patterns Of Daily Activities As Defined By The Life Balance Model, Chloe Hillpot, Kerry A. Macdonald, Laura A. Rohr Jul 2017

Female Veterans: Satisfying Patterns Of Daily Activities As Defined By The Life Balance Model, Chloe Hillpot, Kerry A. Macdonald, Laura A. Rohr

Mental Health

This phenomenological case study explored the occupational needs and life satisfaction of one female veteran upon reintegration into civilian life. One female veteran, with 23 years of military service, participated in a semi-structured telephone interview. Results demonstrated that military service negatively impacted the participant’s social interactions, physical and mental wellbeing, and ability to cope with stressors, indicating military service posed difficulties for the participant to engage in meaningful occupations upon reintegration. Recommendations included development of occupation-based interventions using the Person Environment and Occupation framework, and further research to identify appropriate services to facilitate successful reintegration into society for female veterans.


Building Bridges Through Meaningful Occupation, Jennifer Fortuna Jul 2017

Building Bridges Through Meaningful Occupation, Jennifer Fortuna

The Open Journal of Occupational Therapy

Mary Block, MS, OTR/L, an occupational therapist and artist based in Illinois, provided the cover art for the Summer 2017 issue of The Open Journal of Occupational Therapy (OJOT). Generations is a sculpture made from concrete that measures 240 x100 in. (6.096 x 2.54 m). The piece was commissioned by Mary’s home town, the Village of Deerfield, IL. Mary always knew she wanted to be an artist. When competing paradigms altered Mary’s career path, the field of occupational therapy helped her to shape a new worldview. In uncertain times, meaningful occupation empowered Mary to start over again where she originally …


Occupational Therapy In Primary Care: Structures And Processes That Support Integration, Brenda Koverman, Lydia Royeen, Mary Stoykov Jul 2017

Occupational Therapy In Primary Care: Structures And Processes That Support Integration, Brenda Koverman, Lydia Royeen, Mary Stoykov

The Open Journal of Occupational Therapy

Few studies have outlined the processes and structures needed to develop and integrate occupational therapy into a primary care provider’s office setting. This paper focuses on implementation of the clinic model of occupational therapy in primary care and is intended to address the deficiencies in current literature, including detailed program development steps. Barriers identified in the 8-week pilot program and the successful development of a reimbursable occupational therapy service in primary care will be discussed. The results of the implementation of occupational therapy in primary care are positive. The providers have accepted and embraced the distinct value of occupational therapy …


Interprofessional Primary Care: The Value Of Occupational Therapy, Sue Dahl-Popolizio, Oaklee Rogers, Sherry Lynne Muir, Jennifer Carroll, Lesley Manson Jul 2017

Interprofessional Primary Care: The Value Of Occupational Therapy, Sue Dahl-Popolizio, Oaklee Rogers, Sherry Lynne Muir, Jennifer Carroll, Lesley Manson

The Open Journal of Occupational Therapy

The authors explore the training and expertise of occupational therapists and the cost benefit of the strategic use of occupational therapists as members of the interprofessional primary care (PC) team. PC practices can optimize successful and cost-effective patient care delivery, outcomes, and access to care by using interprofessional care teams and allowing physicians to off-load patients whose issues relate to routines and habits and do not require diagnostic or prescriptive intervention. This, and the occupational therapist’s ability to obtain reimbursement for his or her services, demonstrates that this professional can be an invaluable addition to the integrated PC team. The …


Occupational Therapy In Primary Care: Determining Receptiveness Of Occupational Therapists And Primary Care Providers, Sue Dahl-Popolizio, Sherry Lynne Muir, Kaila Davis, Sabrina Wade, Rachael Voysey Jul 2017

Occupational Therapy In Primary Care: Determining Receptiveness Of Occupational Therapists And Primary Care Providers, Sue Dahl-Popolizio, Sherry Lynne Muir, Kaila Davis, Sabrina Wade, Rachael Voysey

The Open Journal of Occupational Therapy

Background: Primary care (PC) is an emerging practice setting for occupational therapy; however, few occupational therapists currently practice in this setting due to barriers, including uncertainty about reimbursement and the role of occupational therapists. This pilot study aimed to determine if PC providers and occupational therapists are receptive to occupational therapists as integrated interprofessional PC team members if barriers to inclusion are addressed.

Method: After a brief educational paragraph explaining potential occupational therapy contributions to PC teams, the participants accessed a link to survey questions regarding their personal level of receptiveness to occupational therapy in PC. The questions comprised …


Occupational Therapy’S Role In An Interprofessional Student-Run Free Clinic: Challenges And Opportunities Identified, Oaklee Rogers, Andrea Heck, Lindsey Kohnert, Pooja Paode, Liz Harrell Jul 2017

Occupational Therapy’S Role In An Interprofessional Student-Run Free Clinic: Challenges And Opportunities Identified, Oaklee Rogers, Andrea Heck, Lindsey Kohnert, Pooja Paode, Liz Harrell

The Open Journal of Occupational Therapy

Student-run free clinics (SRFCs) provide services to underserved populations while enhancing student education. Occupational therapy (OT) participation in integrated care SRFCs is an emerging area of practice and enhances the interprofessional model necessary for holistic patient care. The Student Health Outreach for Wellness (SHOW) organization, located in Phoenix, Arizona, is a SRFC comprised of three state universities that incorporates nine different health professional programs to deliver interprofessional care, including OT. The SHOW clinic provides direct care services where student volunteers practice clinical and interprofessional skills under the guidance of licensed health care providers. OT preceptors and students participate in team-based …


Determining The Feasibility, Content Validity, And Internal Consistency Of A Newly Developed Care Coordination Scale For People With Brain Injury, Brian P. Johnson, Mark V. Johnston Jul 2017

Determining The Feasibility, Content Validity, And Internal Consistency Of A Newly Developed Care Coordination Scale For People With Brain Injury, Brian P. Johnson, Mark V. Johnston

The Open Journal of Occupational Therapy

Background: With the increasing complexity of care, people with disabilities and supportive significant others (SSO) must often coordinate key aspects of their own care, but no validated scale currently exists to comprehensively characterize the activities done to manage and coordinate their care.

Method: This study aimed to improve the feasibility, acceptability, and content validity of the Care and Service Coordination and Management (CASCAM) scale and to test its internal consistency. Questionnaire items were administered to 23 individuals with acquired brain injury and 17 SSO.

Results: Respondents confirmed content validity and that the instrument addresses important care coordination and management issues. …


Exploring The Value Of Interprofessional Collaboration Between Occupational Therapy And Design: A Pilot Survey Study, Amy Wagenfeld, Lori Reynolds, Tamar Amiri Jul 2017

Exploring The Value Of Interprofessional Collaboration Between Occupational Therapy And Design: A Pilot Survey Study, Amy Wagenfeld, Lori Reynolds, Tamar Amiri

The Open Journal of Occupational Therapy

Background: Consistent with the American Occupational Therapy Association’s Vision 2025, interprofessional partnerships between occupational therapy and designers is necessary to “maximize health, well-being, and quality of life for all people . . . through effective solutions that facilitate participation in everyday living” (2016, para 1). Occupational therapy’s knowledge of the person-environment-occupation fit appears to make us well suited to collaborate with design teams to create environments that facilitate optimal function and promote health and well-being (Ainsworth & de Jonge, 2014).

Method: Two short closed-ended online questionnaires were designed to gain an understanding of designer and occupational therapy practitioner impressions of …


Identifying Themes When Using A Community-Based Participatory Research (Cbpr) Approach With Men Living In Abstinence-Based Recovery Housing, Rachel Morrison, Jade Sharrer, Jason Clements Jul 2017

Identifying Themes When Using A Community-Based Participatory Research (Cbpr) Approach With Men Living In Abstinence-Based Recovery Housing, Rachel Morrison, Jade Sharrer, Jason Clements

Community Based

This abstract will be available for download after an embargo period


The Effect Of Occupational Therapy Play-Based Interventions On Cooperative Behavior In Elementary School Aged Children With Autism Spectrum Disorder, Shaunna Kelder, Jennifer E. Langill, Carol A. Reiss, Nicole F. Socia Jul 2017

The Effect Of Occupational Therapy Play-Based Interventions On Cooperative Behavior In Elementary School Aged Children With Autism Spectrum Disorder, Shaunna Kelder, Jennifer E. Langill, Carol A. Reiss, Nicole F. Socia

Pediatrics

The purpose of this study was to explore the perceptions of occupational therapy practitioners regarding the effect play-based interventions have on cooperative behaviors in elementary school aged children with autism spectrum disorder (ASD). While occupational therapy practitioners use a variety of interventions involving play to enhance skills related to social, self-regulation and communication, the concept of how play affects cooperative behavior, specifically in children with ASD, has not been readily identified. This qualitative research project utilized an anonymous survey to collect the perceptions of occupational therapists (OT) and certified occupational therapy assistants (COTA). The intent of the survey was to …


The Use Of Sensory Spaces In Schools, Syeda S. Mahmood, Erin E. Mallekoote, Ashley Rister Jun 2017

The Use Of Sensory Spaces In Schools, Syeda S. Mahmood, Erin E. Mallekoote, Ashley Rister

Pediatrics

Objective: This mixed methods continuing line of inquiry was conducted in order to identify how occupational therapists (OTs) report that sensory spaces are being used in Michigan public school settings. This includes who uses the spaces, what purpose the space serves, and the training that individuals utilizing the spaces have received.

Methods: A link to a survey, which was adapted from Abbot, Wills, and Hanert (2015), was posted on the Michigan Alliance of School Physical and Occupational Therapists’ (MASPOT) listServ and Michigan Occupational Therapy Association’s (MiOTA) facebook page in June of 2016 in order to recruit participations. The …