Search

Posttraumatic stress disorder commonly occurs among U.S. military veterans. Therapeutic horseback riding (THR) has emerged as an adjunct therapy. We explored 20 veterans’ perceived benefits, drawbacks and views of a 6-week THR program. Participants had confirmed diagnoses of posttraumatic stress disorder, traumatic brain injury, or both. Veterans rode the same horse weekly, the same day, at the same time. Data were collected as part of a randomized clinical trial testing the effects of THR on Post-Traumatic Stress Disorder. Veterans responded to an open-ended questionnaire. Content analysis was used for data analysis. Benefits were “Connection to the Horse,” “Relaxing,” “180 Degree Change,” and “Meeting New People.” Drawbacks were “None,” “Struggle to Get There,” “Pain,” “Too Short,” and “It is Structured.” Overall perceptions were “I Absolutely Loved It,” “Feel Again,” “The Horse,” “The People,” and “No Worries.” Participants viewed THR as positive. Findings may elucidate why THR may be clinically beneficial.

Background Stenotrophomonas maltophilia is a multidrug-resistant Gram-negative bacillus that has been implicated in serious nosocomial infections. This microbe has also been isolated from sinus cultures in refractory chronic rhinosinusitis (CRS). The goal of this study was to elucidate the implications of S. maltophilia–positive cultures in the setting of CRS. The objectives of the study were (1) to define clinical and microbiological characteristics and (2) to assess management strategy and overall outcomes of S. maltophilia–positive sinus cultures in CRS patients. Methods A retrospective review was performed of 101 patients over a 5-year period. Results The mean age was 56.9 years with a female/male ratio of 1.1:1. Previous sinus surgery had been performed in 90.1% of patients. Greater than 97% of patients had been given antibiotics in the previous 6 months. The most common presenting symptom was discolored nasal drainage (76.2%) with endoscopic evidence of pus or crusting in 83.2% of cases. Monotherapy with trimethoprim sulfamethoxazole (TMX) or fluoroquinolones was used in 41 and 26%, respectively. This intervention resulted in overall symptom and endoscopic improvement in 70% of cases. Conclusion The presence of S. maltophilia isolates on culture are associated with clinically relevant symptoms and endoscopic findings in patients with refractory CRS. Despite its multidrug-resistant nature, monotherapy with TMX or fluoroquinolones appears to be effective in providing patients with bacterial infection with symptom relief in a majority of cases.

This article reports a three-part study comparing the effects of whole-language practice versus traditional basal instruction on children's reading attitudes. In Experiment 1, children in two whole-language elementary schools (Grades 1–5, N=485) and children in two traditional schools (Grades 1–5, N=433) responded to the Elementary Reading Attitude Survey (ERAS). Although significant main effects of grade level and gender were observed, there was no main effect of instructional approach. The possibility that whole language had been too broadly defined was addressed in a second study. In Experiment 2, Bergeron's (1990) definition was used to identify a third whole-language school, meeting more specific criteria. All students in Grades 1–5 ( N=713) were compared with the original basal group. Only the recreational ERAS subscale was administered because of the inapplicability of certain items of the academic subscale to the new whole-language setting. As before, no main effect of approach was observed, nor was any interaction of approach with other factors significant. Experiment 3 involved follow-up structured observations of two first-grade teachers in the second whole-language school. The attitude means of these teachers' classes differed significantly. Although the two teachers exhibited many similarities, notable differences emerged that warrant further study in order to examine a possible causal relationship between practice and attitude. Important differences in practice within a general whole-language philosophy may affect reading attitude differentially.

The rehabilitation of the pulmonary patient in the home care setting is interdisciplinary. In this article, the core team consists of the physical and the occupational therapists. The team may be altered by the patient's needs. The authors present a basic home care model including a patient manual designed to increase the patient's awareness of the important part he or she plays in the recovery process. The goal is to ultimately increase the patient's quality of life.