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INTRODUCTION Persons who become displaced due to situations such as war and natural disasters face extreme challenges in maintaining their occupational repertoires. This study aimed to explore the occupational lives of Syrians under temporary protection in Turkey. METHODS This mixed method study used a cross-sectional design with a predominantly qualitative focus. Syrians living under temporary protection in Turkey were interviewed using the Canadian Occupational Performance Measure (COPM) to identify their perceived performance problems in the areas of self-care, productivity, and leisure. Additional probes were used to explore participants' reasoning for the choice of occupations and scoring, and occupational changes since arriving in Turkey. Socio-demographics were collected on the participants' age, gender, educational level, marital status, monthly house budget, social security, and number of persons within the household. Thematic analysis was used to undercover themes from the qualitative data. RESULTS Thirty Syrians living under temporary protection in Turkey in Hatay province participated in this study (mean age: 29.66 ± 7.97 years [range = 18 to 50 years]): 16 women (mean age: 28.64 ± 8.04 years) and 14 men (mean age: 30.56 ± 8.05 years). Participants identified more significant problems in their performance of productive and leisure occupations than in self-care occupations. The following themes emerged: (a) having a house of our own: meeting basic needs and completing activities of daily living; (b) no money for shopping: past everyday occupations now luxuries; (c) feeling valued and important: having the ability but no job; (d) living day to day: Education, career, and marriage on hold; and (e) enjoyment in life: leaving behind family, friends, and occupational spaces. CONCLUSION Syrians living in temporary protection in Turkey experience uncertainty within their occupational lives. Participants were able to meet their basic needs; however, precarity of employment limited their participation in previous occupations contracting their repertoires.

Occupational Therapy Evidence in Practice for Mental Health is an accessible and informative guide to the application of theory and the evidence-base to contemporary clinical practice. Fully updated throughout, chapters cover a range of mental health issues, approaches and settings, including service user and carer involvement, group work, services for older people, interventions, forensic mental health, and managing depression.

The purpose of this study was to explore children's everyday outdoor occupations in context. A naturalistic observational approach was employed to record the observed outdoor occupations of children in Mbarara, Uganda. Thematic analysis, through pattern formation and constant comparative analysis, was used to uncover categories and themes in the data. Patterns emerged from the data revealing two overarching categories containing three themes: 1) types of occupations: play, work and nothing in particular and 2) characteristics of occupational engagement: being in peer groups, having fun and using materials in the environment. The themes reveal that children's occupations are both similar and different across minority and majority world cultures and that children's occupations are contextually situated and flexible in nature. A limitation of the study was that the observational approach made identification of children's ages subjective. Subsequent studies should explore children's experiences of occupational engagement using interviews and focus groups. Copyright © 2010 John Wiley & Sons, Ltd.

ephrology advanced practitio-ners are involved in every aspect of renal medicine, and what they do is as unique as they are. Advanced practitioners (AP) include nurse practitioners (NP), physician assistants (PA), and clinical nurse specialists (CNS).Surveys by the National Kidney Foundation (NKF), the Renal PhysiciansAssociation (RPA), and the Academy of Nephrology Physicians Association that looked at AP job descriptions revealed the diverse scope of their practice. While all participate in caring for renal patients, their individual duties cover the entire spectrum of nephrology. Depending on the practice needs, an AP may perform history and physicals, dictate discharge summaries, make hospital rounds, and take after-hours calls. Many APs are providers in chron-ic kidney disease (CKD) clinics and in nephrology clinics. In addition, they round in hemodialysis and peritoneal dialysis clinics. Their duties here include writing and modifying dialysis prescriptions and providing for patient needs. They are also involved in transplantation, often seeing patients and potential donors in transplant evaluation and following the patient after transplant in the hospital and clinic. In addition, some APs are utilized as surgi-cal fi rst assistants. Advanced practitioners are actively involved in research and often direct research studies.

Intradialytic exercise is both safe and beneficial for patients; however, worldwide, despite evidence to support its efficacy, it is underutilized. A pilot project in a large inner city hemodialysis unit demonstrated the benefits of introducing a program to improve physical function among the participants.

The present study was conducted to determine whether triplet pregnancies are associated with a significantly worse perinatal outcome than twin pregnancies. Maternal and neonatal outcome was evaluated in 15 triplet and twin pregnancies that were matched for maternal age, race, type of medical insurance, delivery mode, parity, and history of previous preterm delivery. Preterm labor occurred significantly more often in triplet than in twin gestations (80 versus 40%), as did preterm delivery (87 versus 26.7%). Triplets had a significantly lower mean birth weight (1720 versus 2475 g) and gestational age at delivery (33 versus 36.6 weeks). In addition, 53.3% of triplet pregnancies but only 6.7% of twin pregnancies had one or more neonates with intrauterine growth retardation. Discordancy also occurred more frequently in triplets than in twins (66.7 versus 13.3%). The mean averaged neonatal hospital stay was significantly higher in triplets (29 versus 8.5 days), and triplets had a fivefold increased risk of requiring neonatal intensive care as compared with twins. However, there were no significant differences between the groups in maternal morbidity or major neonatal complications such as respiratory distress syndrome or intraventricular hemorrhage. We believe that these data will be useful in counseling patients with respect to the anticipated perinatal outcome of triplet pregnancies.