Medicine and Health Sciences Commons^™

Extra-Axial Cerebrospinal Fluid Volumes From 6 To 24 Months Of Age Are Associated With Poorer Executive Function At School-Age In Children With And Without Autism, Yichi Zhang, Robert C Mckinstry, Natasha Marrus, John R Pruett Jr., Et Al.

2020-Current year OA Pubs

BACKGROUND: Abnormally increased extra-axial cerebrospinal fluid (EA-CSF) volume is present as early as 6 months in infants later diagnosed with autism and is associated with symptom severity at the age of diagnosis, but it is unknown whether early EA-CSF enlargement has long-term impacts on other clinical domains. Executive function (EF) deficits are frequently observed in children with autism and are linked with worse academic outcomes, higher anxiety, and lower adaptive functioning. The current study examines the association between EA-CSF volume at infancy and EF at school age in a longitudinally phenotyped cohort of children with either high (HL) or low …

Peace Innovation And Healing: A Design Justice Framework To Support Change Processes, Strengthen Relationships, Foster Trust, And Build Community, Michelle Helman

Peace and Conflict Studies Journal Conference

Many organizations aiming to achieve peace and health equity outcomes often focus their design processes and innovation efforts externally without addressing how their organizational culture can unintentionally reproduce the very harms they are trying to address. The purpose of this qualitative design research study is to explore the role of a design justice framework in piloting a Peace Innovation Project aimed at facilitating an organizational culture change process. Specifically, the study focuses on better understanding how integrating a design justice approach could support research collaborators to center equity and justice as core components in building a culture of peace and …

Embodying Design Justice: A Peace Education Framework To Strengthen Relationships, Foster Trust And Build Community, Michelle Helman

Peace and Conflict Studies Journal Conference

BACKGROUND

Groups working toward creating peace and equity often focus on external innovation without addressing internal culture shifts necessary to navigate change and achieve their goals. Michelle’s doctoral research and practice address this challenge through a design research study and peace innovation project focused on organizational culture transformation through a design justice framework. Findings suggest that interweaving the framework with storytelling, arts, and embodiment practices are key to support people in navigating change processes to strengthen relationships, foster trust, and build community.

ABOUT

The workshop offers an applied learning experience for participants to explore the concepts of design and innovation …

Reconstructing Life One Clay Pot At A Time, Kelly Allen

The Open Journal of Occupational Therapy

Kate Lewis, a ceramicist and teaching artist based in Grand Rapids, MI, created the artwork for the Winter 2026 issue of the Open Journal of Occupational Therapy (OJOT). The image features a collection of heart-shaped ceramic pinch pots, produced after she was told she may never be able to move her left arm again. She created them on the recommendation of an occupational therapist who understood the value of meaningful occupations for recovery. These vessels represent a pivotal shift in Kate’s rehabilitation from Complex Regional Pain Syndrome (CRPS). Diagnosed in 2018 after sustaining an injury to her wrist, the minor …

Meeting Population Health Needs: Are Occupational Therapy Health Promotion Programs Scalable?, Tracy Chippendale, Szu-Wei Chen

The Open Journal of Occupational Therapy

No abstract provided.

Facilitators And Barriers To Sustainable Global Rehabilitation Projects, Fredrick Pociask, Rosanne Dizazzo-Miller

The Open Journal of Occupational Therapy

The sustainability of projects addressing significant rehabilitation needs in lower-resource countries is considered one of the most critical outcomes of these initiatives. While some information is available from public health and medical projects on promoting sustainability, less evidence exists on facilitators and barriers to the sustainability of global rehabilitation development projects. Interviews with eleven medical and rehabilitation professionals, each with over 8 years of experience in global project development, contributed to the discussion of barriers and facilitators for sustainability with direct implications for occupational therapy practice and research. The presence of established professional standards was a distinctive facilitator, and disruptions …

Brain Gains: A Review Of Remediation Treatment Strategies Using Exercise Following Traumatic Brain Injury, Jessica Smith, Kristin Biggins, Loriann Helgeson

The Open Journal of Occupational Therapy

In this Opinions in the Profession article, we explore remediation treatment strategies using exercise for recovery from post-traumatic brain injury and aim to justify the use of such treatment in the occupational therapy profession to increase skills for functional gain. Common treatment strategies used by occupational therapists after brain injury are compensatory strategies, indicating the client learns a new way to perform the task. Though effective, it is also necessary to consider how remediation and neuroplasticity are essential. Teaching new approaches to complete tasks results in functional gains; however, focusing on foundational skills using exercises to relearn motor patterns to …

Professional Standards As Gateways, Not Barriers, In Occupational Therapy, Ryan Thomure

The Open Journal of Occupational Therapy

No abstract provided.

Understanding Graduate Occupational Therapy Educators’ Use Of Trauma-Informed Approaches In The Classroom, Sean M. Brim

The Open Journal of Occupational Therapy

Traumatic events can alter the brain structure and affect cognitive capacities and academic performance. Educators at all grade levels are responsible for supporting students through trauma-informed approaches. Previous trauma-informed research focused on K–12 education levels. The experience of graduate-level occupational therapy educators who have applied trauma-informed approaches to improve student learning have not been explored. This general qualitative study explored the experiences of occupational therapy educators who used trauma-informed approaches. The conceptual framework was the trauma-informed care model. Ten graduate-level occupational therapy educators with at least 1 year of teaching experience were recruited and participated in semi structured interviews. Data …

Perceived Educational Value Of Different Types Of Simulation In Occupational Therapy Education: A Mixed-Methods Study, Marie-Eve Bolduc, Barbara Shankland, Bernadette Nedelec

The Open Journal of Occupational Therapy

Simulation is an important instructional method in occupational therapy (OT) programs. However, it remains unclear if the various types of simulation hold the same educational value. The objective of this study was to determine the perceived educational value of three different types of simulations (role-play between students, live scenarios with simulated patients [SPs] and tele-simulation with SPs) and the factors that contributed to a higher educational value. This cross-sectional study used a sequential explanatory mixed-methods design. An online questionnaire was used, and two focus groups were conducted to develop a richer understanding of the answers obtained in the questionnaire. Forty-two …

Investigating The Efficacy Of An Online Multigenerational Awareness Course For Occupational Therapy Students – A Pilot Study, Susan Blair, Barbara M. Doucet, Jerilyn Callen, Kirsten Davin, Shelby Hutchinson

The Open Journal of Occupational Therapy

In today’s multigenerational society, particularly in health care settings, thriving can be challenging because of generational differences. Occupational therapy educational programs (OTEPs) prepare students for work environments where three to four different generations may be present. This study examines the effectiveness of an online multigenerational awareness (MGA) course. The secondary objectives include increasing students’ knowledge of enhanced multigenerational collaboration and communication strategies in preparation for future clinical practice. A pilot group of eight participants from various university departments reviewed the course content and completed preenrollment and postenrollment surveys, providing feedback regarding the applicability and perceived usefulness of the multigenerational awareness …

Intentional Resiliency Mentoring: A Mixed Methods Study Exploring A Pilot Mentorship Program For Occupational Therapy Students, Courtney J. Taylor, Ana K. Brussa, Kate G. Barlow

The Open Journal of Occupational Therapy

Because of high levels of reported stress, occupational therapy (OT) students’ ability to employ interpersonal skills and professionally manage conflicts is impeded. This mixed methods pilot study investigated the impact of an Intentional Relationship Model (IRM) informed mentorship program on OT students’ perceived stress and self-efficacy for interpersonal communication. Students (N = 21) completed pre and posttests of the Self Efficacy for Therapeutic Use of Self Scale (SETUS) and the Perceived Stress Scale (PSS-10). Six monthly mentor journals (N = 6) were collected to further explore the student experience. Quantitative findings demonstrated students’ (N = 21) ability to manage stress …

Occupational Therapy Students’ Perspectives On Using Virtual Reality Simulation In Preparation For Objective Structured Clinical Examinations: A Qualitative Study, Pegah Firouzeh, Craig R. St. Jean, Christine Ha, Mary Roduta Roberts

The Open Journal of Occupational Therapy

The use of virtual reality (VR) simulations in clinical education has been receiving increased research attention. The purpose of this study was to investigate first-year occupational therapy (OT) students’ experiences using a VR-simulated clinical interview as part of their preparation for a client history-taking Objective Structured Clinical Examination (OSCE). This qualitative study used focus groups to understand students’ (n = 20) perceptions of the effect of VR simulation on learning and exam readiness. We also explored students’ perceptions of the simulation’s authenticity, strengths, and weaknesses. Qualitative data analysis was conducted to identify codes and develop categories in association with the …

Ruth Coleman Denard (1906-2002): One Of The First Registered Black Occupational Therapists, Mirline Milien

The Open Journal of Occupational Therapy

The experiences and contributions of underrepresented groups in the occupational therapy profession are insufficiently explored and largely absent from occupational therapy education. For instance, the narratives of early Black occupational therapists and students are virtually nonexistent in the literature. As the profession moves toward greater inclusivity, it is essential to uncover these hidden stories and legacies to better understand the profession’s evolution and help shape its future. This article highlights Ruth Coleman Denard, one of the first registered Black occupational therapists in the United States, and provides an overview of her career trajectory. Historical research methods, including a review of …

An Occupation-Based Review Of Assessments Used In Pediatric Occupational Therapy Practice, Alysha Skuthan, Wendy B. Stav, Gracyn Mcvey, Jennifer Martinez, Marissa Hunter, Erin Diroll, Maureen Flanagan

The Open Journal of Occupational Therapy

Assessment tools are a critical component of the occupational therapy evaluation process. Despite the profession’s push toward occupation-centered practice, the classification of assessment tools as occupation-based versus skill-based does not exist. An occupation-based review of pediatric occupational therapy assessment tools was completed and scored according to the Occupation-Based Practice Assessment to classify assessment tools on a continuum of discrete or skill-based to occupation-based. Of the top 11 most frequently used tools, four were classified as occupation-based, three were classified as intermediate, and four were classified as discrete. In total, only 36% of commonly selected assessment tools are occupation-based. Pediatric occupational …

Maternal Role Transition: A Quality Of Life Frame Of Reference For Mothering After Nicu, Wendy Gaughan, Kathryn A. Lemonda

The Open Journal of Occupational Therapy

Occupational therapists are uniquely skilled to address the needs of a new mother and the infant during transition to motherhood, as acquisition of this new role may cause a role strain with other previously held roles. New mothers to infants requiring a neonatal intensive care unit (NICU) hospitalization experience additional stressors and considerations during this role transition. The Maternal Role Transition (MRT) Frame of Reference is a novel, community-based approach to facilitate attainment and integration of mothering occupations and address role strain during the perinatal period. MRT is rooted in the theoretical foundations of Maternal Role Attainment Theory, Self Efficacy …

Rehabilitation Habits And Roles: The Dual Impact Of Iadls And Psychosocial Interventions Poststroke, William Sit, Ryan Hulla, Veronica Smith, Joanna Ruiz, Steve Abraham

The Open Journal of Occupational Therapy

Background: This randomized study assessed an 8-week program for stroke survivors at an outpatient center in the United States. The program focuses on a holistic approach to recovery through habits and roles.

Method: Two researchers randomly divided 19 participants (N = 19) into two groups, with each group focusing on two distinct programs: the Occupational Therapy Instrumental Activities of Daily Living (IADLs) program and the Psychosocial Modules (PS) program for stroke survivors. Participants attended weekly group sessions and individual phone sessions, which reinforced learned strategies, provided personalized guidance, and ensured adherence to program goals. The Canadian Occupational Performance …

Enhancing Self-Esteem In Adolescents During Acute Inpatient Psychiatric Hospitalization: A Mixed Methods Study, Praveen Injeti, Julie D. Kugel, Dragana Krpalek, Liane Hewitt, Lida Gharibvand

The Open Journal of Occupational Therapy

Background: Low self-esteem (LSE) can negatively impact adolescent mental health, leading to suicidal ideation (SI). Social stressors, such as peer rejections, are considered a source of stress that can contribute to LSE, SI, and subsequent admission to psychiatric facilities. This study aimed to assess the effectiveness of an occupational therapy intervention to improve self-awareness and self-esteem during short-term hospitalization.

Method: The research used a mixed methods approach to evaluate the impact of a psychoeducational intervention by an occupational therapist on 16 adolescents. The Rosenberg Self-esteem Scale (RSES) was used before the intervention (pretest), immediately after the intervention (posttest …

A Polyvagal And Sensory Integration And Processing Approach To Supporting Development In Young Children With Autism, Catherine Cavaliere, Nadia Rust, Michelle Rogowski, Alyssa Calderone, Rebecca Marash, Amy Zdrodowski, John Damiao

The Open Journal of Occupational Therapy

Background: The polyvagal theory presents a framework for understanding the autonomic nervous system’s role in influencing behavior, engagement, and connection. Children with autism experience regulation and sensory integration and processing differences that impact their sense of felt safety and engagement in their environment. The Safe and Sound Protocol (SSP) is an auditory program designed to stimulate the vagal system and support nervous system regulation.

Methods: A retrospective multiple subject pretest-posttest design was used to examine the impact of the SSP on regulation, engagement, and skill acquisition in children with autism ages 2 to 3 enrolled in an early intervention center …

More Than Covering Ears: A Clinical Inventory For Characterizing Decreased Sound Tolerance (I-Dst) In Autism, Tana B. Carson, Angela Medina, Katherine L. Long, Yuxi Qiu, Monica Noriega

The Open Journal of Occupational Therapy

Background: Decreased sound tolerance (DST) is among the most common and distressing forms of sensory over-responsivity experienced by children with autism spectrum disorders. DST includes hyperacusis and misophonia, among others, and can limit participation in daily activities. Recently, a new screening tool, the Pediatric Hyperacusis and Misophonia Questionnaire (PMHQ-4) has been developed to allow health professionals to better identify and differentiate these conditions using a single assessment. Additional clinical tools are needed to further characterize DST symptoms to facilitate treatment planning after diagnosis.

Methods: In this mixed-methods study n = 15 parents of autistic children 6 to 17 …

State Of The Journal: Advancing And Promoting Frames Of Reference For Occupational Therapy Practice, Diane Powers Dirette

The Open Journal of Occupational Therapy

No abstract provided.

Beyond The Exam Room: Pediatricians Advocating Through State Aap, Heidi Sallee, Kelly Kreisler, Thuylinh Pham

Grand Rounds

1. Evaluate the current political climate and effects on child health at a National and State level.
2. Identify key child health policy issues for the states of Missouri and Kansas.
3. Use different forms of advocacy to share personal expertise.
4. Partner with state AAP Chapters to improve child health outcomes locally.

Precision Education In Health Sciences Education: A Call-To-Action For Developing An Interprofessional Strategy., Arvie Vitente, Jennifer Bosworth, Robert Sweet, Rebecca Cozzi, Christopher Galloway, Piotr Szczurek, Melanie Obispo-Young, Eron Bozec, Erica Brkovic, Tina Bobo, Jennifer Lubinski

Rehabilitation Sciences Department Faculty Articles

Introduction. Growing learner diversity, expanding biomedical knowledge, and rapid clinical digitization have exposed the limits of on-size-fits-all health sciences training. Competency-Based Education (CBE) has sharpened the focus on outcomes, yet many programs still move learners through fixed sequences, infrequent assessments, and retrospective remediation. Precision Education (PE) offers a complementary, data-enabled approach that uses learning analytics, artificial intelligence (AI), and continuous feedback loops. Embedded within CBE, PE converts competencies from static milestones into dynamic trajectories that can be measured, visualized, and adjusted in real time across the curriculum. This abstract highlights the need for an interprofessional strategy to design, fund, …

Teriparatide Use In Osteopenic Patients Undergoing Single-Level Lumbar Fusion Associated With Decreased 2-Year Revision Rates, Mitchell K. Ng, Ariel N. Rodriguez, Abigail Razi, Ahmed K. Emara, Brian T. Ford, Ameer Tabbaa, Divya Gouni, Jacquelyn J. Xu, Paul G. Mastrokostas, Jad Bou Monsef, Afshin E. Razi

Rothman Institute Papers

Context:  Low bone density is common among lumbar fusion patients and increases the risks of pseudarthrosis, hardware failure, and revision. Teriparatide improves bone mass and fusion in osteoporosis, but its benefit in osteopenia or normal bone remains uncertain.

Aims:  To evaluate the association between teriparatide exposure and (1) postoperative complications, (2) 90-day readmission, and (3) 2-year reoperation, stratified by bone health status (osteoporotic, osteopenic, and normal) in patients undergoing single-level lumbar fusion.

Setting and Design:  A retrospective cohort study using the PearlDiver database from 2010 to 2021 identified patients undergoing single-level lumbar fusion.

Subjects and Methods:  Patients on teriparatide were …

Retention On Buprenorphine For Opioid Use Disorder In Justice-Involved Individuals: A Retrospective Cohort Study, Andrea Yatsco, Francine R Vega, Audrey Sarah Cohen, Marylou Cardenas-Turanzas, James R Langabeer, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

Criminal justice system (CJS) involvement is common among individuals with opioid use disorder (OUD), yet limited research examines retention in medications for OUD (MOUD) within community settings. This study assessed whether CJS involvement predicted retention on buprenorphine/naloxone and explored related demographic and clinical factors. A retrospective cohort included adults (n = 367) enrolled in a low-barrier outpatient MOUD program in Texas (January 2022–April 2024). CJS involvement was identified from program records. Retention was measured as the number of continuous days with buprenorphine/naloxone prescriptions. Analyses used univariate tests, logistic regression, and nonparametric kernel regression. Nearly one-quarter (24.8%) were CJS-involved. Retention at …

Exploring Resource Profiles Among Trauma Exposed Youth: An Identity-Focused, Cultural, And Person-Centered Approach, Ogechi “Cynthia” Onyeka, Jessica Szu-Chi Cheng, Sina Sanei, Shaunna L. Clark, Caitlin M. Pinciotti, Andrew G. Guzick, Eric A. Storch, Sunita M. Stewart, Jessica Sandoval, Cynthia Garza

School of Medicine Publications

Objective: Resilience is a multi-faceted construct comprised of both internal and external resources that support adaptive functioning following trauma exposure. The role of resilience in ameliorating internalizing symptoms may depend on its typology as opposed to its presence alone, suggesting the existence of distinct subpopulations with heterogeneous resource profiles. The current study employs Latent Profile Analysis (LPA) to identify and characterize profiles of resilience-related resources among youth exposed to trauma from an identity-focused, cultural lens.

Method: Patterns of resources were examined in 1538 youth (Mage = 13.4, 51.9 % female) from a large longitudinal registry of trauma exposed youth in …

Knowledge, Attitude, And Practice Of Pharmacovigilance And Adverse Drug Reactions Reporting Among Healthcare Providers In The Middle East: A Systematic Review, Amina H. Saleem, Harith Kh. Al-Qazaz, Omer Q. Allela, Ramadan M. Elkalmi

BioMed Visions Journal

The main purpose of pharmacovigilance (PV) is to ensure medication safety through detecting, assessing, and preventing adverse drug reactions (ADRs). Healthcare providers (HCPs) are the main contributors in PV systems all over the world. However, their knowledge, attitudes, and practices (KAP) of PV and ADRs reporting vary among different medical professions and different countries.

Aim: To assess the knowledge, attitudes, and practices among the HCPs in the Middle East, toward PV and ADRs reporting.

Methods: A systematic review was performed. EBSCO, PubMed, and Semantic Scholar, FreeFullPDF and Google Scholar were searched for articles published from January 2014 to December 2024. …

Developing Pharmacy Education: Review Of Virtual Reality Technology In Improving Clinical Training And Learning Skill Development, Samer Imad Mohammed, Mohammed Khudhair Hasan, Mohammad Yawuz Jamal

BioMed Visions Journal

Incorporating modern technology into education is becoming imperative. Numerous pharmacy institutions are incorporating virtual reality (VR) technology training into their curricula to enhance educational experience. This review examines the current state, historical evolution, and application of VR programs in pharmacy education and training. The review also provides details about the main challenges and limitations associated with the use of this technology. The VR technology, including virtual laboratories and simulations, significantly improves clinical training and educational outcomes. The utilization of VR in clinical teaching encounters numerous barriers, including ethical concerns and technological constraints, as well as other restrictions in its execution …

The Impact Of Vdr Gene And Biochemical Indicators In Osteoporosis, Sabah Subhi Ismael Barani, Mohammed Abdullah Ajeel, Safwan Jasim Sultan

BioMed Visions Journal

Osteoporosis is a disorder caused by bone remodeling imbalance in which bone resorption outpaces bone production, resulting in weaker bone structure. Factors such as heredity and insufficient calcium and vitamin D consumption.

This study included an examination of 80 female patients of different ages (40–58 years) in Mosul. The participants were divided into two groups: 20 individuals served as the control group, while the rest 60 were osteoporotic women based on clinical cases and taking X ray DEXA. The blood samples are divided into two parts serum for biochemical tests and blood for genetic diversity in genes associated to Vitamin …

Postoperative Duodenal Stricture In A Neonate With Duodenal Atresia – Innovative Approach And Lessons Learned, Raniah I. Alnaser, Dr Mussalam L Alobaidy, Dr Fawaz A. Alassaf, Dr Mohammed N. Abed

BioMed Visions Journal

Background and aim: Duodenal atresia (DoA) is a congenital condition that is characterized by complete or incomplete duodenal obstruction. This condition needs urgent surgical intervention that carries risks of postoperative complications especially in low-birth-weight babies and with associated comorbidities. The success rate of the surgical procedure was reported to be higher than 90%. This case study details a neonate’s clinical course reporting the challenge in the management of delayed stricture and malnutrition after the primary surgery.

Case presentation and results: A female neonate was born at 38 weeks of gestation with 2.6 kg weight. During the immediate postnatal period, she …