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Since the inception of the profession of occupational therapy a century ago, a clarion call to link health with occupation and occupational engagement has been heard. For decades, leaders in the profession have emphasized the need for prevention and health promotion as well as for development of assessments and models linking health with occupation. This article addresses the need for an increased presence of occupational therapy in health and wellness, emphasizing participation over performance, to optimize the health, well-being, and quality of life of individuals, communities, and populations.

•Uses imaging techniques (rsfMRI, graph theory, DTI, NODDI) to study age and injury impacts on brain connectivity and structure.•Determines age-specific brain connectivity and white matter alterations following repetitive brain injuries.•Identifies key brain hubs like the thalamus and motor cortex, showing distinct age-related changes.•Finds 53% of brain regions significantly affected by age, injury type, or their interaction post-injury.•Examines young and aged mice (22 months) to address gaps in research on later age brain injuries. Traumatic brain injuries (TBI) present a major public health challenge, demanding an in-depth understanding of age-specific symptoms and risk factors. Aging not only significantly influences brain function and plasticity but also elevates the risk of hospitalizations and death following TBIs. Repetitive mild TBIs (rmTBI) compound these issues, resulting in cumulative and long-term brain damage in the brain. In this study, we investigate the impact of age on brain network changes and white matter properties following rmTBI by employing a multi-modal approach that integrates resting-state functional magnetic resonance imaging (rsfMRI), graph theory analysis, diffusion tensor imaging (DTI), and neurite orientation dispersion and density imaging (NODDI). Our hypothesis is that the effects of rmTBI are worsened in aged animals, with this group showing more pronounced alterations in brain connectivity and white matter structure. Utilizing the closed-head impact model of engineered rotational acceleration (CHIMERA) model, we conducted rmTBIs or sham (control) procedures on young (2.5–3-months-old) and aged (22-months-old) male and female mice to model high-risk groups. Functional and structural imaging unveiled age-related reductions in communication efficiency between brain regions, while injuries induced opposhigh-risking effects on the small-world index across age groups, influencing network segregation. Functional connectivity analysis also identified alterations in 79 out of 148 brain regions by age, treatment (sham vs. rmTBI), or their interaction. Injuries exerted pronounced effects on sensory integration areas, including insular and motor cortices. Age-related disruptions in white matter integrity were observed, indicating alterations in various diffusion directions (mean diffusivity, radial diffusivity, axial diffusivity, and fractional anisotropy) and density neurite properties (dispersion index, intracellular and isotropic volume fraction). Neuroinflammation, assessed through Iba-1 and GFAP markers, correlated with higher dispersion in the optic tract, suggesting a neuroinflammatory response in injured aged animals compared to sham aged. These findings offer insight into the interplay between age, injuries, and brain connectivity, shedding light on the long-term consequences of rmTBI.

Artificial intelligence (AI)-supported systems have transformative applications in the humanitarian sector but they also pose unique risks for human rights, even when used with the best intentions. Drawing from research and expert consultations conducted across the globe in recent years, this paper identifies key points of consensus on how humanitarian practitioners can ensure that AI augments – rather than undermines – human interests while being rights-respecting. Specifically, these consultations emphasized the necessity of an anchoring framework based on international human rights law as an essential baseline for ensuring that human interests are embedded in AI systems. Ethics, in addition, can play a complementary role in filling gaps and elevating standards above the minimum requirements of international human rights law. This paper summarizes the advantages of this framework, while also identifying specific tools and best practices that either already exist and can be adapted to the AI context, or that need to be created, in order to operationalize this human rights framework. As the COVID crisis has laid bare, AI will increasingly shape the global response to the world's toughest problems, especially in the development and humanitarian sector. To ensure that AI tools enable human progress and contribute to achieving the Sustainable Development Goals, humanitarian actors need to be proactive and inclusive in developing tools, policies and accountability mechanisms that protect human rights.

OBJECTIVE. Hurricane Sandy was the second largest and costliest hurricane in U.S. history to affect multiple states and communities. This article describes the lived experiences of 24 occupational therapy students who lived through Hurricane Sandy using the Recovery Model to frame the research. METHOD. Occupational therapy student narratives were collected and analyzed using qualitative methods and framed by the Recovery Model. Directed content and thematic analysis was performed using the 10 components of the Recovery Model. RESULTS. The 10 components of the Recovery Model were experienced by or had an impact on the occupational therapy students as they coped and recovered in the aftermath of the natural disaster. CONCLUSION. This study provides insight into the lived experiences and recovery perspectives of occupational therapy students who experienced Hurricane Sandy. Further research is indicated in applying the Recovery Model to people who survive disasters.

Obesity is a complex, multidimensional challenge that compromises occupational participation for children and families. Children who are overweight or obese are at serious risk for being stigmatized, bullied, or marginalized, and they often are medically compromised. They cope daily with occupational participation issues at home, in school, on playgrounds, and in their communities. Prevention and health promotion assessment and intervention in occupational therapy are imperative for the profession to make a significant and sustainable difference in the lives of these children and families. Innovative client- and occupation-centered programming promotes health, well-being, and quality of life for this population. It is incumbent upon occupational therapy practitioners to prevent occupational marginalization, deprivation, and alienation while promoting occupational justice for children who are overweight or obese.

Background Severe headache is a hallmark clinical feature of spontaneous subarachnoid hemorrhage (SAH), affecting nearly 90% of patients during index hospitalization, regardless of the SAH severity or presence of a culprit aneurysm. Up to 1 in 4 survivors of SAH experience chronic headaches, which may be severe and last for years. Data guiding the optimal management of post-SAH headache are lacking. Opioids, often in escalating doses, remain the guideline-recommended mainstay of acute therapy, but pain relief remains suboptimal. Methods This study is a case series of adult patients who received bilateral pterygopalatine fossa (PPF) blockade for the management of refractory headaches after spontaneous SAH (aneurysmal and non-aneurysmal) at a single tertiary care center. We examined pain scores and analgesic requirements before and after block placement. Results Seven patients (median age 54 years, 3 men, four aneurysmal and three non-aneurysmal) received a PPF-block between post-bleed day 6–11 during index hospitalization in the neurointensive care unit. The worst pain recorded in the 24-h period before the block was significantly higher than in the period 4 h after the block (9.1 vs. 3.1; p  = 0.0156), and in the period 8 h after the block (9.1 vs. 2.8; p  = 0.0313). The only complication was minor oozing from the needle insertion sites, which subsided completely with gauze pressure within 1 min. Conclusions PPF blockade might constitute a promising opioid-sparing therapeutic strategy for the management of post-SAH headache that merits further prospective controlled randomized studies.

Presenilin-1 (PS1), the catalytic core of the aspartyl protease γ-secretase, regulates adult neurogenesis. However, it is not clear whether the role of neurogenesis in hippocampal learning and memory is PS1-dependent, or whether PS1 loss of function in adult hippocampal neurogenesis can cause learning and memory deficits. Here we show that downregulation of PS1 in hippocampal neural progenitor cells causes progressive deficits in pattern separation and novelty exploration. New granule neurons expressing reduced PS1 levels exhibit decreased dendritic branching and dendritic spines. Further, they exhibit reduced survival. Lastly, we show that PS1 effect on neurogenesis is mediated via β-catenin phosphorylation and notch signaling. Together, these observations suggest that impairments in adult neurogenesis induce learning and memory deficits and may play a role in the cognitive deficits observed in Alzheimer's disease.

Background Pregabalin (PGB) is an effective adjunctive treatment for focal epilepsy and acts by binding to the alpha2-delta subunit of voltage-gated calcium channels to reduce excitatory neurotransmitter release. Limited data exist on its use in the neurocritical care setting, including cyclic seizures—a pattern of recurrent seizures occurring at nearly regular intervals. Although the mechanism underpinning cyclic seizures remains elusive, spreading excitation linked to spreading depolarizations may play a role in seizure recurrence and periodicity. PGB has been shown to increase spreading depolarization threshold; hence, we hypothesized that the magnitude of antiseizure effect from PGB is more pronounced in patients with cyclic versus noncyclic seizures in a critically ill cohort with recurrent seizures. Methods We conducted a retrospective case series of adults admitted to two academic neurointensive care units between January 2017 and March 2019 who received PGB for treatment of seizures. Data collected included demographics, etiology of brain injury, antiseizure medications, and outcome. Continuous electroencephalogram recordings 48 hours before and after PGB administration were reviewed by electroencephalographers blinded to the administration of antiseizure medications to obtain granular data on electrographic seizure burden. Cyclic seizures were determined quantitatively (i.e., < 50% variation of interseizure intervals for at least 50% of consecutive seizures). Coprimary outcomes were decrease in hourly seizure burden in minutes and decrease in seizure frequency in the 48 hours after PGB initiation. We used nonparametric tests for comparison of seizure frequency and burden and segmented linear regression to assess PGB effect. Results We included 16 patients; the median age was 69 years, 11 (68.7%) were women, three (18.8%) had undergone a neurosurgical procedure, and five (31%) had underlying epilepsy. All seizures had focal onset; ten patients (62.5%) had cyclic seizures. The median hourly seizure burden over the 48 hours prior to PGB initiation was 1.87 min/hour (interquartile range 1.49–8.53), and the median seizure frequency was 1.96 seizures/hour (interquartile range 1.06–3.41). In the 48 hours following PGB (median daily dose 300 mg, range 75–300 mg), the median number of seizures per hour was reduced by 0.80 seizures/hour (95% confidence interval 0.19–1.40), whereas the median hourly seizure burden decreased by 1.71 min/hour (95% confidence interval 0.38–3.04). When we compared patients with cyclic versus noncyclic seizures, there was a relative decrease in hourly seizure frequency (− 86.7% versus − 2%, p  = 0.04) and hourly seizure burden (− 89% versus − 7.8%, p  = 0.03) at 48 hours. Conclusions PGB was associated with a relative reduction in seizure burden in neurocritically ill patients with recurrent seizures, especially those with cyclic seizures, and may be considered in the therapeutic arsenal for refractory seizures. Whether this effect is mediated via modulation of spreading depolarization requires further study.

The purpose of this phenomenological study was to answer the broad questions: what do professional caregivers for the dying think about what they do, and how does that thinking influence their practice in end-of-life care? The participants were 12 hospice professionals working in four specific disciplines: occupational therapy, physical therapy, social work, and nursing. Indepth interviews were conducted and audiotaped, and transcripts were printed. Constant comparison and thematic analysis was performed. One overarching theme and five subthemes were generated. The central theme, \"promoting a good death,\" emerged from the data, as the participants continually discussed health, wellness, and quality-of-life work in which they engaged that were discipline-specific yet overlapping. The subthemes that emerged were: holism; framing and re-framing practice; client- and family-centered care; being with dying; and interdisciplinary team. All participants concluded that their work emanated from a health and wellness lens, and that quality of life at the end of life was their ultimate goal. Quality of life, for each discipline, included doing, being, and becoming one's authentic self until the end of life.