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IntroductionOccupational therapy is emerging as a profession within the context of emergency care, specifically within emergency departments. Emerging professional practice should be underpinned by an evidence base supported by research. As such, this critical review examines, analyses and summarises published and unpublished research concerning occupational therapy in Emergency Departments in order to support emerging practice.MethodResearch evidence was sought from database platforms, the Internet and grey sources by searching using key words and search terms. Critical analysis of each piece of evidence was undertaken and the analyses were synthesised into a critical review of the literature.ResultsTwenty-three potentially relevant papers were found, 16 met the criteria for further inclusion and seven were critically analysed. The quality of the papers varied and often lacked sufficient methodological detail for robust review. Although not all study sample sizes were small, variable methodological quality means findings can only be taken into professional practice with caution.ConclusionBased on current evidence, there can only be a limited understanding of occupational therapy, including practice models and efficacy, within emergency departments at this time. There is a need for large-scale, well-designed research studies of occupational therapy within emergency departments.

BACKGROUND As with cases of sporadic gastrointestinal stromal tumor (GIST), familial GIST syndrome arises from mutations in KIT or PDGFRA. Only a few dozen such families have been described in the literature. METHODS Cases of 2 individuals from 2 different newly described kindreds with familial GIST syndrome were retrospectively reviewed. Pertinent immunohistochemical stains, including CD117, CD34, DOG1, desmin, and S100, were performed. Samples from each case were sent to outside facilities for molecular analysis. A review of the relevant literature was performed and the number of familial GIST syndrome cases reported was updated through July 2014. RESULTS In case 1, a woman 40 years of age with a family history of GIST presented with abdominal pain and gastrointestinal bleeding. Biopsy of a gastric mass revealed spindle-cell type GIST. Molecular analysis revealed a heterozygous mutation of p.Asp579del in exon 11 of KIT. The patient was placed on imatinib therapy and an initial positive response was demonstrated by imaging. Disease regression was seen on computed tomography, and several GIST tumors were surgically resected. The patient has had stable disease since surgery. In case 2, an asymptomatic woman 29 years of age presented for screening due to a family history of GIST. One small nodule was noted in her stomach and another was noted in the duodenum; both were surgically resected. The patient recovered well following surgery. The GIST in this patient was noted to have similar histological, immunohistochemical, and molecular findings as case 1. CONCLUSIONS Imatinib has often been shown to be an effective therapy in both the familial and sporadic forms of GIST. There is no standard protocol for addressing the surveillance of patients with spindle-cell type GIST seen in the setting of familial GIST syndrome and with a p.Asp579del mutation of exon 11 on KIT.

Evaluation is a core component of the occupational therapy process. To draw meaningful conclusions about the effectiveness of occupational therapy practice, it is essential that therapists consider not only what outcomes are achieved, but also reflect on how interventions are delivered. We suggest that incorporating the concept of ‘treatment fidelity’ into clinical practice offers therapists a means of differentiating between interventions and demonstrating clearer links between occupational therapy practice and successful client outcomes. In so doing, practitioners can highlight more explicitly the unique contribution of occupational therapy interventions.

By using weekly records on efficiency for four production lines in a Finnish food-processing plant during the period 1999–2005, the authors investigate the effects on production line performance once changes in Human Resource Management (HRM) practices were instituted. Using time-series methods to estimate structural change models, the authors were able to determine the extent to which specific HR policies—the introduction of teams, company-wide profit-sharing, and a group system of performance-related pay (PRP)—affected workers' efficiency, even though production technology remained the same. As predicted, the authors found that in three of the four production lines, when PRP was added to teams, productivity increased from between 9 and 20%, highlighting the importance of the complementarity between employee participation and incentive pay.

The British Pain Society and British Geriatric Society have collaborated to produce comprehensive pain management guidelines based on an extensive systematic review of the available literature by a professional multidisciplinary group. This guidance reviews the epidemiology and management of pain in older people with the aim of providing best practice recommendations for the management of pain by all health professionals working with older adults in any care setting and emphasises the importance of a multimodal approach in the management of pain in older people. Assessment of pain in older people has not been covered within this guidance but can be found in a separate document (http://britishpainsociety.org/book_pain_older_people.pdf).

Background:\ud Persistent pain is prevalent within the ageing population and impacts daily functioning. Measuring daily functioning using conventional measures is problematic and novel technologies offer an alternative way of observing these behaviours.\ud \ud Methods:\ud This study aimed to consider the use of a wearable camera as a method of exploring a range of day-to-day patterns of functioning of older adults living with persistent pain. This study followed a mixed methods design. A purposive sample of 13 older adults (65±) with persistent pain (pain >3 months) took part in this study. Two younger adults (

The authors investigate whether productivity is greater if firms use employee involvement (EI) in decision making and financial participation (FP) as complementary practices. Based on representative panel data from Finnish manufacturing firms, the study uses diverse specifications to examine different theoretical explanations of the productivity effects of complementarities. The authors find virtually no evidence to support the theory of complementarities when EI and FP are simply measured by their incidence. They do find some evidence for complementarities using cross-sectional data (controlling for several covariates that related work has found to be important for firm performance) and also when analyses use measures of the intensity of FP. In accounting for differences in empirical findings across varying settings, the findings suggest that outcomes depend on the institutional context and are sensitive to variation in measurement and analytical methods.

The United Kingdom (UK) today is an ethnically diverse society. Legislation and the profession's own code of conduct highlight the need for occupational therapists to engage in culturally sensitive practice. This article comprises a contextual analysis of transcultural occupational therapy in the UK based upon a review of the research published in the British Journal of Occupational Therapy during 1990–1997. The article focuses initially on terminology to allow a clearer understanding of the issues surrounding transcultural service provision, and the dominant models currently used to conceptualise and implement transcultural practice in health care are also outlined. Discussion of both provides the contextual basis for an analysis of the research. From the material examined, it appears that cultural sensitivity needs to be developed at all levels before occupational therapists can be said to be providing an equitable service to the ethnically diverse communities of the UK.

This article introduces occupational therapists to some of the legislation regarding homelessness and to the research that has been conducted into current trends and the causes of the problem. Health-related issues and the help available for homeless people are highlighted. Finally, the role of occupational therapy as described in the literature is outlined.

Using data for various years, including new data for 1973–84, the authors examine the scope, nature, determinants, and effects of Japanese employee stock ownership plans (ESOPs). In 1988, of firms listed on Japan's eight stock exchange markets, 91% had an ESOP, and the average (non-executive) employee plan participant owned stock worth about $14,000. Probit estimates for a sample of manufacturing firms show that firms were more likely to adopt ESOPs when recent business performance was below average, the capital/labor ratio was relatively low, and employment growth was relatively fast. Evidence is also found that ESOPs enhanced enterprise productivity. The authors argue that ESOPs have played an important, and largely overlooked, role in the success of the Japanese economy over the past two decades.

The hamster cheek pouch provides a suitable model system for the mucous-membrane irritation testing of dental materials. Poor retention of materials or difficulties in histopathological interpretation caused by surgical artifacts have been reported in published techniques. We describe a new "pouch-in-pouch" technique for mucous membrane irritation tests. The retention rate of polymer discs was 97% and 87% at 14 and 35 days, respectively. Clear differentiation was obtained between the tissue reaction to the test materials and the surgical procedure. Polymer discs containing dibutyltin diacetate (DBTD) or di-butyl phthalate (DBP) as plasticizer resulted in epithelial changes, including epithelial atypia, early papillomas, and areas resembling dysplasia. The potentially pre-malignant nature of these changes requires further investigation.

We examine the factors affecting the performance of state-owned enterprises (SOEs) during early transition to a market economy. Data come from a longitudinal study of a representative sample of Bulgarian SOEs for the period from 1989 (the last year under communism) to 1993 (three years after major macroeconomic shifts). We investigate how changes in authority structure, work organization, technology, marketing strategy, and organizational boundaries during these years affected organizational performance in 1993. We also assess the degree of path dependence in performance and the role of competitive industry conditions. Numerous organizational changes made by SOEs during early transition had little effect on performance. Yet organizational performance from 1989 to 1993 was highly path-dependent, although this dependence was mediated by the competitive conditions: Stronger markets displayed less path dependence. Overall the results favor the interpretations derived from selected neo-institutional and ecological perspectives of organizational sociology over neoclassical economic interpretations.

While it is known that anorexia nervosa patients show a wide range of sexual knowledge, attitudes and practices, the psychosexual histories of bulimia patients have not been studied. in this paper the psychosexual histories of 20 bulimic patients and 20 matched control subjects are presented. Bulimic patients were more likely to experience orgasm with masturbation, were more likely to have experimented with anal intercourse, and were more ilkely to describe their libido as ‘above average’. Control subjects were more likely to experience orgasm during sexual intercourse. Bulimic patients associated high body weights with unattractiveness, and tended to withdraw from social and sexual activity at high weights. In other aspects of their sexual behaviour, and in their attitudes to sexual matters, the two groups were similar.

The crevice corrosion susceptibility of cold-worked Type 316LVM stainless steel, cast Co-Cr-Mo, wrought Co-Cr-W-Ni, non-nitrided and nitrided Ti-6Al-4V ELI, and c.p. Ti, Grades 1 and 4, was studied in vitro by means of a crevice cell. Occlusion was created by interfacing a disc specimen and a Teflon bar. Specimens were mechanically prepared through 2-4 μm Al2O3 and passivated in 30% HNO3, followed by steam sterilization. Tests were performed in a deaerated Ringer's solution, maintained at pH = 7 and 37°C. Anodic polarization was conducted potentiostatically at pre-selected levels, and resultant currents were monitored: stainless steel, 50 and 100 mV (S.C.E.), 450 min; non-stainless materials, 600 mV, 1000 min. Results for the stainless steel demonstrated that a HNO3 passivation treatment reduced its crevice corrosion susceptibility. For the non-stainless steel materials, no crevice corrosion susceptibility was observed, although a dulling and discoloration of c.p. Ti was evident. Recognizing that 600 mV is in excess of the O2 reduction potential in vivo, it was concluded that, in the absence of fretting, implants of these non-stainless steel materials would not experience significant corrosion loss under crevice conditions.

An evaluation has been made of the soft polymer gel systems of the type used as prosthodontic short-term denture-lining materials. The purpose of the study was to determine the effect upon gel strength and gelation time produced by variations in the composition of the plasticizer liquids. Poly(ethylmethacrylate) co-polymers were mixed with combinations of ethyl alcohol and the esters dibutyl phthalate (DBP), butylphthalyl butylglycolate (BPBG), and benzyl salicylate (BS). The relative rate of gelation of plasticizer polymer compositions was obtained by means of a reciprocating rheometer. The gelation rate was found to increase rapidly with an increase in the ethyl alcohol content. Significantly shorter gelation times were also found with liquids containing the lower-molecular-weight esters. A linear relationship was found between the ethyl alcohol content and the log of the gelation time. The higher-molecular-weight esters produced the strongest gel. A linear relationship was found between the gelation (log) times and the seven-day puncture strength. The ratio of polymer to plasticizer liquid was found to have a very significant influence upon the puncture strength and gelation time. Molecular weight or molecular volume of the ester plasticizers was found to have a greater influence on gel formation than the cohesive energy parameter. The strong polar bonding of ethyl alcohol was found to have a significant influence on both the rate of gel formation and the subsequent gel strength. The data indicate that controlled variations in the characteristics of plasticity and gel strength of dental soft polymer systems can be made to suit different clinical prosthodontic requirements.

In vitro corrosion behavior of γ2-containing and γ2-free dental amalgams was examined under crevice conditions which simulated the amalgam-tooth interface. By means of potentiostatic testing, currentdensity/time behavior and integrated anodic current were measured for 16 hr. All of the amalgams demonstrated crevice corrosion susceptibility. Crevice corrosion propagation for γ2-free vs. γ2-containing amalgams was characterized by lower acceleration and maximum rates during the most dynamic period. Integrated anodic current results were correlated with marginal breakdown ratings reported in two clinical investigations. Strong and significant coefficients were found between integrated current and marginal breakdown ratings when γ2-containing and γ 2-free amalgams were correlated as a single group, but not when correlated separately.

A conventional (γ 2-containing) dental amalgam was fatigue-tested at 1800 and 80 cycleslmin, employing uni-axial, sinusoidal loading, with R = -8. Compressive, tensile, and creep tests were conducted to characterize the alloy's static mechanical behavior. Tests were performed at 37°C on specimens which were aged for seven days, at 37°C. Fatigue-tested specimens were microscopically examined for fracture surface appearance and crack path. The amalgam demonstrated a frequency dependence and a significant reduction in fracture strength due to fatigue loading. The fatigue crack path was primarily intergranular in the γ 1 phase and inclined at approximately 45° to the principal stress axis. These observations are characteristic of some metals when subjected to low-frequency, elevated temperature testing where significant grain boundary sliding occurs, and therefore suggest a creep-fatigue interaction for this alloy.

The available theoretical and empirical evidence on the economic effects of alternative 'sharing arrangements' is partially reviewed. From this, as well as consideration of other non-economic arguments, is derived a package of initiatives in workplace democratization and participation for the US. The package has two halves. First are proposals to expand the sectors in which workers have majority ownership and control. The discussion outlines which industries should be emphasized, the appropriate enabling legislation and how this might be financed. There follows a discussion of policies designed to encourage more modest expansions in worker ownership, participation and profits.