Comprehensive exam
REM Rapid eye movement
"active sleep". 25% of the night. 90 minutes after falling asleep and they every 90 minutes afterwards.
sympathetic nervous system
"fight or flight" increased levels of epinephrine, norepinephrine, and cortisol. increased heart rate and blood pressure, dilated pupils, inhibited salivation and digestion
NREM non-rapid eye movement
"quiet sleep", tissue growth and repair occur. 75% of the night, consists of stages 1-3
parasympathic nervous system
"rest and digest" increased blood flow to internal organs, decreased breathing rate
nondeclarative (implicit) memory
)type of long-term memory including memory for skills, procedures, habits, and conditioned responses. These memories are not conscious but are implied to exist because they affect conscious behavior (type of long-term memory that stands in contrast to explicit memory in that it doesn't require conscious thought. It allows you to do things by rote)
Type I error:
- Incorrectly reject H0 when H0 is true. Claim a difference exists that does not exist (false positive)
Hypotheses Null hypothesis(H0): μ1=μ2
-There is no difference between the means
alpha is often set at
.05 that's our p-value
The standard alpha value (α) or level of significance that most researchers use is:
0.05
Within-group comparison
1 group of subjects is tested under all conditions and each subject acts as their own control. One-way repeated measures design
Statistical Tests for continuous numerical data
1. .Paired t-test (same people tested 2 times, before and after values). 2.Student t-test (Independent samples) (two groups of people). 3.Analysis of Variance (ANOVA) (t test for 3 or more groups)
meaningful coherence
1. Achieves what it purports to be about- does it achieve purpose? 2. Uses methods and procedures that fit its stated goals 3. Meaningfully interconnects literature, research questions/foci, findings, and interpretations with each other- how does it all flow together? is there an alignment between the paradigm and the work?
Hierarchical control of action
1. Conceptual level- goal of action. 2. Response system level- goal translated into action. 3. Motor implementation level- physical action
significant contriubition
1. Conceptually/theoretically-extend knowledge?. 2. Practically- is the knowledge useful? Or morally help decide good? specifically in your chosen setting/context. 3. Heuristically- prompts curiosity or empowers? moves you to action?. 4. Methodologically- presents a new method?
ethics
1. Procedural ethics- do no harm, avoid deception, informed consent, ensure privacy/confidentiality. 2. Situational and culturally specific ethics- ethical issues that arise in specific contexts or sample populations. 3. Relational ethics- being aware of one's own role and impact on relationships and treating participants as whole people
sincerity
1. Self-reflexivity about subjective values, biases, and inclinations of researcher. 2. Transparency about methods and challenges
credibility
1. Thick description, concrete detail, explication of tacit (non-textual) knowledge, and showing rather than telling 2. Triangulation or crystallization 1. Triangulation (positivist)- to converge on a single reality 2. Crystallization (interpretivist)- to construct a multi-faceted, more complicated, and therefore more credible picture of the context 3. Multivocality- inclusion of multiple voices; analyze a variety of views and highlight divergent or disagreeable standpoints; self-aware of how their own and their participants' subjectivities vary in the field; facilitated by collaboration with participants 4. Member reflections- allow for sharing and dialoguing with participants about the study's findings, provide opportunities for questions, critique, feedback, affirmation and collaboration
types of incontinence
1. Transient- acute onset due to unexpected illness 2. Established/persistent- can only be managed vs cured 3. Urgent incontinence- overactive bladder, usually associated with leakage. "key in the lock" syndrome 4. Stress incontinence- related to lifting heavy things 5. Mixed incontinence- both stress and urgent 6. Overflowing incontinence- leakage 7. Functional incontinence- can't go to the bathroom when you need due to lack of functional mobility
1. UMN vs LMN lesions
1. UMN- paresis/paralysis, hyperstiffness, hypertonicity, hyper-reflexia. 2. LMN- atrophy, fasciculations, fibrillations, flaccid paralysis, loss of reflexes
During her guest lecture, Lauren Lopez, OTD, OTR/L, discussed how OTAC decides on priorities during the legislative process. Which designation represents bills that "... may be directly related to OT practitioners, but do not require intensive action."
1B
How many components of evidence based practice are there?
4
how many ventricles are within the brain?
4 ventricles (ventricles are filled with CSF)
how many layers does the cortex has?
6 layers. major output layer is layer 5
balints syndrome
A condition caused by brain damage in which a person has difficulty focusing attention to one object at a time. damage to bilateral posterior parietal and occipital regions
Statistical Significance
A number that expresses the probability that the results of a study could have occurred purely by chance. The amount of risk you are willing to assume when conducting a study.
What is the difference between a "sanction" and an "exclusion" in regards to your ability to practice as an OT?
A sanction is a disciplinary action on your state issued license while an exclusion means that you are no longer eligible for direct or indirect federal funding for your services
What are ways that you can prepare to be a Fieldwork Educator, as discussed by Dr. Karen Park?
AOTA Fieldwork Educators Certificate Program, literature: OT Practice, AJOT, books, and state and National courses at conferences
As discussed in the guest lecture from AOTA staff, what does it mean to move from "volume" to "value" in regards to occupational therapy services?
Achieving better outcomes for clients may increase your reimbursement
According to Northouse (2015), leadership skills are currently more of a focus in contemporary leadership research than inherent traits. What are the 3 core leadership skills discussed in the Module 1 lecture?
Administrative, interpersonal, & conceptual
Ms. Laura Deary, COTA/L discussed supervision of aides and certified occupational therapy assistants (COTA/L). Which of the following is true regarding supervision of aides and COTA/Ls?
Aides are not licensed occupational therapy practitioners. They cannot independently provide skilled occupational therapy services.
Name the 3 components of stress response, according to Selye's General Adaptation Syndrome.
Alarm - SNS aroused; sympathetic nerves and adrenal medulla secrete corticosteroids. Resistance - mobilization of resources to end stress-producing event; SNS prepares for fight or flight. Exhaustion - depletion of resources; allostatic overload → disease or death
Common types of bias in cohort studies:
Attrition bias- loss to follow-up. Selection bias (in retrospective studies)
Reliability means you will produce the same test results...
Between raters Over time Over circumstances
Why is it important for a leader to promote and support continuing professional development (CPD) according to Davis (2019) in his chapter, "Professional Development," in the OT Manager text?
CPD can contribute to improved employee retention, CPD is a commitment to ongoing knowledge and skill acquisition which promotes life-long learning, CPD can contribute to improved patient care quality
Level of significance
Called the alpha value (or α ). Standard level of significance most researchers use is 0.05 o There is a 5% risk that the difference between 2 groups or difference between scores pretest and posttest is not a true difference but occurred by chance. There is a 95% chance that the difference is a true difference When researchers want to be really sure they use 0.01
What types of test is used for categorical data
Chi square and Fisher exact
Cross-sectional
Collects data on an outcome and exposure/treatment variables at one point in time. Can provide information on prevalence, trends over time, & associations between variables.
During her guest lecture, Dr. Lauren Fox Macmillan discussed the concept of "competence vs capacity." Which of the following statements are true regarding that concept?
Competence is a legal term used to craft legal orders such as conservatorship or guardianship or a person and/or estate
What is true about a systematic review?
Complies extensive research into a manageable size. Less expensive and faster to complete than a primary study. Can help determine if results are consistent across studies and generalize them
Patients in one rehab unit are provided with a new intervention. They are compared to a group of patients at another rehab unit that do not receive the new intervention. This is an example of:
Concurrent control group
Beyond Federal and State regulations, what are other sources of OT policy identified by Komblau in her chapter, "Understanding the Law (2019), in the OT Manager text?
Consensus statements developed by panels of experts and practice guidelines that are informed by a systematic review of evidence
According to Braveman (2019) in his chapter, "Perspectives on Management," in the OT Manager text, which management function involves providing guidance and oversight of employees?
Directing
Age-related macular degeneration
Dry- thinning, white/yellow deposits of fatty protein. Fuzzy, blurred spot in central vision, decreased visual acuity. Wet- abnormal blood vessel growth. White-out or dark blurriness in central vision; straight lines look wavy; decreased intensity of color brightness
How can you record the brains electricity?
EEG electroencephalogram
The Office of Inspector General (OIG) defines a model compliance program as including the following 7 elements
Education, Policies & Procedures, Risk-based Monitoring, Auditing, Governance & Board Reporting, Sanctions, Help & Reporting
As discussed in Dr. Jordan's lecture, what is the most common means of financing healthcare costs in the United States?
Employee-sponsored private health insurance (ESI)
what is a paired t-test?
Evaluates whether the mean difference in paired scores is different from zero (same participants in each group e.g. pre-post tests)
what is a students t-test?
Evaluates whether two group means are different from each other (different participants in each group). Equal or unequal variances need to be considered.
What is a between group comparison study design when you have 2 or more independent variables and subjects randomly assigned to various combinations of these 2 variables?
Factorial design
Which scenario below describes a situation of increased risk of ethical or moral distress?
Financial incentives for OTs are tied to quantity of billable units
Research that draws on the researcher's own first-hand experience and involves an individual narrative of what it is like to live with a disability is called:
First person phenomenology
According to Arabit (2019) which of the following is not listed as a type of mentorship?
Formal meeting Peer-to-Peer Mentoring Telehealth Mentoring Informal Mentoring The Answer is telehealth
Confidence Intervals
Gives an estimated range of values which is likely to include an unknown population parameter, the estimated range being calculated from a given set of sample data. A 95% confidence interval suggest you can be 95% confident that the true mean of the population exists between those two values.
Patient H.M. suffered from several temporal lobe epilepsy. As treatment, the doctors removed sections from both medial temporal lobes, including the hippocampus. Which type of memory was impaired? Unimpaired?
Graded anterograde amnesia Overtime, decreased errors in mirror tracing task (procedural memory unimpaired)
The California OT Practice Act (CA B&P Code 2570.3) delineates 3 areas as "advanced practice" for the licensed CA OT. The 3 areas are:
Hand therapy, PAMS, & swallowing
.The AOTA practice guidelines assist:
Health and social service planning teams to determine need of OT. Researchers and practitioners to determine effectiveness of outcome measure. Policy, education and health care benefit analysts to understand the appropriateness of services
Brown-Sequard Syndrome
Hemisection of spinal cord. symptoms include interruptions of pain/temp, sensation CONTRALATERAL to lesion. Interruption of discriminative touch and conscious prop IPSILATERAL to lesion. Paralysis occurs ipsilateral
The idea that meanings can never be fixed and are always emergent, contextual and historical comes from:
Hermeneutic phenomenology
Interpretive paradigm (constructivist/constructionist)
Hermeneutics: holistic understanding
Relapse/set back more likely to happen when someone is HALT
Hungry, angry, lonely, tired
type II error
Incorrectly accept H0 when Ha is true. Conclude there is no effect when there is (false negative)
Name two signs of an UMN lesion.
Increased reflexes, weakness, increased tone
Dr. Shawn Roll discussed the additional benefits of Workers Compensation Coverage. What does Workers Compensation Coverage include beyond direct medical costs?
Indemnity costs (disability and death benefits)
AOTA has identified 6 Strategic Target Areas in the Centennial Vision. Which Target Area below is NOT one identified by AOTA?
Integrative Health Productive Aging Work and Industry Child and Youth The answer is integrative health
"I see a spider" (stimulus) → "My heart is pounding" (response)→ "I am afraid" (feeling) This is reflective of which psychological theory of emotion?
James-Lange Theory Modern-modified Jamesian view: stimulus → response → INTERPRETATION → feeling
Smith and Concordia in their chapter, "Why is Policy Important?" (2019) in the OT Manager text, define a process of political influence through policy. Which response below contains the correct sequence of that process?
Literacy, Acumen, Competence, Influence
Cohen's d
Measures difference between two group means reported in standard deviation units. · Examples: A comparison of pretest to posttest difference with an effect size of d=0.5 means the group changed one-half of a standard deviation. If an effect size for an intervention and control group
Payment policy directly influences the practice of occupational therapy. How might Medicaid policy impact access and delivery of occupational therapy services?
Medicaid rules and regulations are defined by each state and in some states, occupational therapy may not be a covered service for Medicaid beneficiaries
What are ways to broaden your search for articles?
Move up the Mesh tree and Reduce the number of concepts
What does it mean when the confidence interval for odds ratio includes 1?
No significant difference between groups
Chi-square test
Nonparametric statistic, used to analyze frequencies or proportions ·Sum of differences in each cell from what is observed versus what would be expected
What determines the external validity of a study?
Number of participants, reported as N
The NBCOT provides a credentialing exam for qualified applicants. Once you pass the exam, and assuming you keep your NBCOT credential current and you are licensed to practice in your state, how may you correctly identify yourself?
OTR/L
Which of the following statements capture risks of social media use?
OTs could disclose PHI in their use of social media if they discuss their clients, worksite, or clinical tasks and OTs that post unprofessional or offensive materials could risk their employment status
Which statement below correctly describes the concept of "organizational ethics" as discussed in the chapter "Organizational Ethics," (Slater, 2019)
Organizational ethics should be evident in the culture of an institution and should therefore be reflected in the beliefs, values, attitudes, ideologies, practices, customs, and language.
Non-nociceptive pain
Pain that usually does not have obvious tissue injury. pathological, no beneficial function
According to Braveman (2019) in his chapter, "Perspectives on Management," in the OT Manager text, what does PDSA, a tool for continuous quality improvement (CQI), stand for?
Plan, Do, Study, Act
Which definition below is correct:
Policies are the guidelines or laws that drive process and procedure
Some key factors to consider in policy development and evaluation identified in lecture include:
Policy that is reflective of societal values
What are the three areas defined by the Institute for Healthcare Improvement (IHI) as the "Triple Aim" (Roberts & Alpasan, 2019, p. 236)?
Population Health, Experience of Care, Per Capita Cost
What does PICO stand for?
Population, intervention, comparison, and outcome
what is the difference between positivist and post postivist?
Positivist: realist/functional: single true reality already exists out there in the world, is waiting to be discovered and post-positivist: human's understanding of reality is inherently partial, capturing reality is improbable
The amygdala receives input from _________ and sends output to _____________
Receives input from every sensory modality (viscera, PFC, hippocampus, other higher level regions) Sends output to regulatory systems, cognitive and motor systems
Which action below does Erler (2019) state can be implemented to prevent and reduce moral distress in the OT Manager Text chapter, "Moral Distress"?
Recognize and name situations of moral distress
view dependent recognition
Recognizing an object from different views and no matter what view you are able to identify what it is.
Licensure of OTs under the CA OT Practice Act (CA B&P Code 2570.3) serves the following function(s)
Regulate the professional activity of OT practitioners, Protect the scope of OT practice, Protect consumers and the public
Confounding- involves error in the interpretation of what may be accurate measurements.
Relationship with the exposure. Relationship with the outcome even in the absence of the exposure. Not on the causal pathway. Uneven distribution in comparison groups
Define retrograde and anterograde amnesia.
Retrograde - unable to remember events BEFORE injury Anterograde - unable to form new memories
Common types of bias in case-control studies:
Selection bias- knowledge of exposure status influences identification of diseased and non-diseased study subjects. Recall bias- knowledge of disease status influences the determination of exposure status
In her chapter, "Foundations of OT Leadership and Management," in the OT Manager text, Stoffel (2019) describes key qualities of the concept of "Servant Leadership." Which of the following statements regarding the concept of "Servant Leadership" is accurate?
Servant leaders downplay hierarchical structures in order to work in a collaborative style
Bonferroni adjustment for P value
Several comparisons/analyses were being made on the same sample, which may risk inflate the value of α (α error) if each test is performed at the same 0.05 criterion. To reduce Type I error (claim a difference that does not exist), the level of significance is divided by the number of comparisons
According to Bream in her chapter, "Becoming a Change Agent" (2019) in the OT Manager text, which of the following concepts is one of 7 key principles for becoming and supporting "change agents"?
Sharing ideas as a catalyst for change
In table 1 on a quantitative study what does the number after +/- mean. For example if Age shows as 8.9+/-3.5, what is 3.5 representing?
Standard Deviation
Cohen's "Rules-of-Thumb
Standardized mean difference effect size o small = 0.20 o medium = 0.50 o large = 0.80
What is a meta-analysis?
Statistical combination of at least 2 studies to produce a single estimate of the effect of an intervention.
What part of the brain is most impacted in individuals with Parkinson's Disease? What treatment can help these individuals and why?
Substantia Nigra, L-dopa since the dopaminergic cells project from the substantia nigra project to the striatum impacting motor control.
The CA Board of OT (CBOT) may discipline a licensee by:
Suspending or revoking your OT license
According to the False Claim Act (FCA), it is illegal to submit claims for payment to third party payers that you know or should know are false:
TRUE
Name the four brain regions involved in novelty detection and attention reorientation.
Temporoparietal junction, middle temporal gyrus, middle frontal gyrus, and inferior frontal gyrus
Inferential statistics are often divided into 2 categories
Tests of differences (e.g., t-tests, analysis of variance). Test of relationships (e.g., correlations and regressions). Test is conducted to determine if difference or relationship is statistically significant.
Which of the following scenarios pose a risk for OTs to be in violation of the Anti-Kickback Statute (AKS)?
Thank you gifts or payments to referring providers, Free or below fair market rate for clinical space, and Discounting or waiving co-pays or providing free services for certain patients (without hardship documentation)
What is inter-rater reliability?
The degree to which multiple respondents will give the same results for a given target
Phenomenology is the best research method for what type of human phenomena?
The lived experience of being diagnosed with a chronic condition
An alpha value of 0.05 means:
There is a 5% risk that the difference between 2 groups is not a true difference but occurred by chance. There is a 95% chance that the difference is a true difference.
A low p value (at least <0.05) indicates:
There is a lower chance to find the effect simply due to chance
An OT is studying the effects of level of exercise and location on the recovery of patients, and randomly allocates the patients into 4 groups based on the intensity (moderate or vigorous) and the location (community or home). What type of study design is this?
Two-Way Factorial Design
Fisher Exact Test
Using chi square tests when the data set is small can be a problem. · Rule of thumb: If expected value in any of the cells is less than 5, then use Fisher Exact Test. Expected value is not the same as the actual value. When in doubt, use Fisher.
What is the "Value Proposition" when describing quality?
Value = Quality + Service (or outcome) over Cost
When is a Pearson correlation used?
Variables are continuous and normally distributed
When would a student t-test be used?
When there are different participants in each group.
According to Haskins & Hanson in their chapter, "Evolution and Future of OT Service Delivery" (2019) in the OT Manager text, legislation has had and continues to have strong influence over which aspect of OT practice?
Which populations can be served by OT, How OT services are reimbursed, Where OT services can be provided
What type of memory is demonstrated when you recite a phone number.
Working memory Chunking strategies *
A type II error means that you:
You incorrectly accept H0 when Ha is true
A type 1 error means:
You incorrectly reject the null hypothesis when the null hypothesis is true.
Z-scores on Probability Curve
Z-score: a value from converting data point to "standardized" value o What is the likelihood that this value occurred oCorrespond to the standard deviation from the mean
generator potential
a change within the receptor cell in response to an outside energy
integrative agnosia
a failure to integrate parts into wholes in visual perception
The four key facets of phenomenology include all of the following
a. The focus on lived experience. b. The phenomenological attitude. c. Transformative relational process.
MeSH terms do all of the following EXCEPT:
a.search synonyms and word variations b.has features to broaden/ narrow a search c. Return to the newest unindexed articles d. can be combined with keywords ANSWER C
Fibromyalgia
abnormal processing of pain signals. non restorative sleep, fatigue, tenderness of muscle, stiffness, and aching pain
what is cerebrospinal fluid responsible for?
absorbs shock and provides nutrients to brain
Where does an an action potential start?
action potential starts at the axon hillock and travels down the length of an axon. When an AP reaches the axon terminal, it triggers the release of neurotransmitter into the synapse
biological theory of aging
addresses aging processes at the organism, molecular, and cellular level.
● 3 core leadership skills
administrative- manage people/resources and technical competence. interpersonal- socially perceptive, emotional intelligence, managing conflict. conceptual- problem solving, strategic planning, creating a vision
Which of the following are benefits of professional development (Davis, 2019)?
advancement opportunities
chronological age
age since birth
free radical theory
aging changes are due to the production of free radicals
Standard Error/Standard error of the mean
an estimate of the spread of variables for the population. It is calculated by dividing the standard deviation by the square root of the N (number of participants in the study). It is an estimate of how far the sample mean of this study is from the population mean.
what is participatory action research?
approach to research that seeks to understand the world by trying to change it, collaboratively and following reflection
what are phantom pains?
areas of the spinal cord/brain lose input from the missing limb. brain remaps of sensory circuitry to another part of the body. Tanged sensory wires. for example cheek is touched and it seems like missing hand is still being touched, may also stimulate damaged nerve endings, scar tissue at site of amputation, and physical memory of pain in affected area
definition of rich rigor
article uses sufficient, abundant, appropriate and complex theoretical constructs, data and time in field, sample(s), context(s), data collection and analysis process
What the 5 steps in EBP?
ask, acquire, appraise, apply, audit
lower motor neuron lesions
atrophy, fasciculations, flaccid paralysis, decrease of reflexes
what does white matter consist of?
axons
where do action potentials occur?
axons
4 aspects of evidence based practice
best research evidence, patient's values and circumstances, clinical expertise, information from practice context
what is scotoma?
blindness in part of the visual field. lesion to cranial 6
what is a scotmoa?
blindness in part of the visual field. lesion to cranial nerve 6
facial expressions
both hemispheres can produce spontaneous expression but only the left hemisphere is for voluntarily expressions
the following symptoms refer to which diagnosis: interruption of pain/temp. sensation contralateral to the lesion, interruption of discriminative touch and conscious proprioception information ipsilateral to the lesion, paralysis ipsilateral to the lesion?
brown sequard syndrome
Cataracts
build up of lens protein leading to cloudiness, blurriness, faded colors, halos of light. Makes vision blurry and affects color discrimination
lesion analysis
can occur post-mortem, look at tissues/vascularity. to look at slices, fixate brain, slice brain, put in petri dish, looks at slice by slice
What is the most common feature of individuals diagnosed with Balint's Syndrome?
can only recognize one object at a time
Animal models: genetic knock-outs
can take out genes we hypothesize are associated with certain conditions/behaviors. For example, knocking out gene we think is related to fear conditioning, knockout mice cant remember what tone is paired with shock, and arent able to learn fear conditioning
alexia
cant recognize letters and read
An observational study examines people who have carpal tunnel syndrome and compares their past risk factors, including past occupations and medical history. What kind of observational study is this?
case-control
what does the basal ganglia include?
caudate, putamen, and globus pallidus. important for movement
what does the gray matter consist of?
cell bodies
american disabilities act 1990
civil rights law that prohibited discrimination of people with disabilites in public; unfunded mandate
what is central deafness?
cns
adult day health care
community based program serving older adults and adults with chronic conditions/viabilities that might otherwise require higher level of care
what is the PACE program of all-inclusive care for the elderly
community services- speciality services (ex: dentist, doctor, community outings). in home service -caregivers, home visits by nurses or therapists, install grab bars, provide equipment. PACE center- transportation, activities, therapy, meals. 55+ in service area of pace program, certified as needing nursing level care, be able to live safely in community. Pace is middle ground between snf and home, paid by goverment.
Can protein needs be met using only plant proteins?
complementary proteins- combination of 2 or more protein sources that together provide a sufficient amount of essential amino acids
What is servant leadership?
conceptualizing, emotional healing, putting followers first, helping followers grow/succeed, behaving ethically, empowering, creating value for community
sociological theory of aging
consider the context in which aging occurs and the demands of the activities and the environments
Social Security Act
created medicare and medicaid
Hart, in her chapter, "Becoming an Advocate" (2019) in the OT Manager text, describes levels of advocacy. Which level of advocacy is described in the following quote, "Ensure that their clients and colleagues understand and can articulate what OT is."
daily practice
optic ataxia
damage to dorsal stream. intact perception but impaired action. can recognize card but fumble moving it
what is conduction deafness?
damage to outer ear, eardrum, and middle ear
what is optic ataxia?
damage to the dorsal stream. intact perception, impaired action.
visual objective agnosia/apperceptive agnosia
damage to ventral stream. impaired perception and visual recognition but intact action. an inability to name or describe the use for an object placed in front of you when just looking at it. You'll still be able to reach for it and pick it up. You can also use your sense of touch to identify what it is or its use once you're holding it
what is critical paradigm?
data can not be separated by ideology
What is the net output of the indirect pathway of basal ganglia?
decreased movement
what is prosopagnosia?
deficit in ability to recognize faces.
Parkinson's disease
degeneration in substantia nigra
receptor cells
detect particular enegeries/chemicals
ruffini's ending
detect stretch, slow adapting
Pacinian corpuscles
detects vibration, located deep within the skin, large borders and fast adapting
range
difference between the largest and lowest value
spatial encoding
different receptors respond to stimuli in different locations and receptors cells will only respond to stimulation within its receptive field
Presbyopia
difficulty with near vision/reading. Loss of elasticity in ciliary muscle and suspensory ligament
Capgras syndrome
disconnect between visual recognition and emotional processing regions (amygdala) due to brain damage. feel like familiar people/objects/pets are imposters
What kind of measurement would be used to describe number of falls?
discrete
migraines
disorder of sensory processing that amplifies nociceptive signals in the trigeminal thalamo cortical pathways.
5 ways to be a leader today
do good therapy, document well, stay informed, be a member/get involved, present & publish your work
intergrative agnosia
do not see objects holistically. dont see parts of an object as an integrated whole
Which visual pathway is responsible for encoding the location of objects in space?
dorsal stream
Double Diassociation
double dissociation studies show that one part of the brain does something that another part does not
This study designs to used to localize function to one part of the brain
double dissociation study
What are meninges?
dura mater (outermost, tough mother), arachnoid space (middle layer), Pia mater (inner most, soft mother)
medicare
eligibility 65+, run by local coverage determinants
SAMSHA's wellness model
emotion, financial, social, spiritual, occupational, physical, intellectual, environmental
working memory
encodes info visually in working memory. phonological loop the voice inside your head, repeating and saying it
3 components of memory
encoding, storage, retrieval (acquisition, retention, retrieval)
central sensitivity syndrome
excessive responsiveness of central neurons that outlasts initial tissue injury. increased spontaneous activity, increased responsiveness to inputs, and expansion of receptive fields. Phantom pain is an example of this
Hyperalgesia
excessive sensitivity to stimuli that are normally mildly painful in injured tissue
continuing care retirement communities
expensive place with multiple levels of care.
Which study design is suited for when the intervention is under the control of the researcher?
experimental
what is burden of casuality?
experimental studies are trying to provide evidence for a casual relationship the intervention & desired outcome
What is the failure to perceive or act on stimuli contralateral to the lesion when presented simultaneously with a stimulus ipsilateral to the lesion?
extinction
what is the pathway of the eye?
eye --> optic nerve --> optic chiasm --> optic tract --> lateral geniculate nucleus --> visual cortex
this type of imaging provides strong spatial resolution but poor temporal resolution
fMRI
unilateral neglect
failure to perceive or act on the stimuli contralateral to the lesion when presented simultaneously with a stimulus ipsilateral to the lesion
Messiner's corpuscles
fast adapting receptors responsible for form information, concentrated on fingertips, tongue, lips
Qualitative research is better for understanding the experience/clinical questions about meaning
feasibility, appropriateness, and meaningfulness can also be informed by qual research
Wernicke's aphasia
fluent, nonsensical speech, left posterior cortical damage, comprehension deficit and not typically aware.
Cohort- Exposure-oriented
follows a cohort of subjects who are likely to develop a certain outcome. Can provide data concerning the timing of the outcome & can define possible causal factors. Can be retrospective or prospective.
Which of the following is NOT an identified principle in the AOTA OT Code of Ethics (2015)?
freedom
selective optimization with compensation
fundamental mechanisms; selection, optimization, compensation. Manage the dynamics between gains and losses as one grows older in order to successfully age
what is optogenetics?
genetic engineering: use virus engineered with light-sensitive ion channel promoter from algae and inject into mouse brain
shared governance
give frontline staff responsibilities for making decisions related to their practice. a decision-making model based on accountability, equity, ownership. Benefits: way to implement change, improve patient outcomes/care/satisfaction, increase staff morale/job satisfaction, facilitate personal/professional growth, increases staff autonomy and improves communication between teams
Well elderness study I
goal to assess whether a preventive OT lifestyle redesign leads to improved health and well-being in ethnically-diverse, independent living older people
leadership coherence/sustainability
guided by core values, enact values via action, share characteristics that support capacity & legacy building
the cortex is is lumpy and includes what?
gyrus=bump, sulcus=groove, fissure=deep groove
Anarchic Hand
hand makes goal-direction actions that are not in accord with the person's intentions
nocioceptive pain
has a function and we want to address it such a bruises, fractures, etc.
whawhat is magnetic resonance imaging/MRI?
head placed in strong magnetic field, protons align with magnetic field, a radio pulse is sent toward the head and protons waver from their alignment. MRI machine measures how long it takes from protons to re-align.
temporal lobe is responsible for
hearing, memory, object recognition
physical activity has a positive impact on:
heart function, atherosclerosis, plasma lipid/lipoprotein, healthier distribution of body fat
what are functional brain scanning good for?
helps to understand the functions of particular brain areas in healthy and damaged brains, look at functional connectivity between brain areas. used pre surgery because cant tell function by structure only. For example; just because most people have language in the left hemisphere cant assume everyone has it all in the left hemisphere
what are structural brain scanning good for?
helps use see where the brain damage has occurred, can help correlate deficit with damage, can look at how connections between particular areas contribute to deficits in patients, used pre surgery
what is diffusion tensor imaging?
helps with white matter tracking (tracking neurons), watching the flow of water because water flows down axons. Good for patients with MS beacuse can really be used for anything (damaged to cell body from stroke
what is transcranial magnetic stimulation/TMS?
hold magnet coil over person's head and pass current throughout. turning magnet on/off are beneath coil on/off. can turn off area for specific amount of time and see if person stops doing tasks. types of TMS are single pulse in the motor cortex, usually causes an excitation in the brain. rTMS are multiple pulses in a short interval, usually causes a "temporary lesion"
variance
how far a set of numbers is spread out
rich rigor
how much articles uses sufficient, abundant, appropriate and complex aspects. 1. Theoretical constructs- is the construct chosen. appropriate 2. Date and time in field- abundant or sufficient enough to establish rigor. 3. Sample(s)- sample relevant? enough diversity to reflect complexity?. 4. Context(s)- appropriate or not. 5. Data collection and analysis processes- what did the researchers do? was the process appropriate, sufficient, complex?
Older Americans Act of 1965
improve community social services for older persons and established admin on aging
Factorial design
includes 2 or more independent variables; subjects randomly assigned to various combination of levels of the 2 variables
With _____________, there is increased power:
increased sample size
action stage
individuals modify their behavior, experiences, and environment to overcome their problems. Lasts longer than most expect, need to use the appropriate "process of change". This stage lasts at least 6 months Approach: consultant
what is grounded theory?
inductive, iterative, and comparative method that provides systematic guidelines for gathering, synthesizing, analyzing, and conceptualizing qualitative data for the purpose of theory construction. Purpose is to generate or discover a theory. Studies people's experience with a process and creates a theory of how that process works
What is positron emission tomography (PET)?
inject radioactively labeled compound into the blood stream, detectors detect radioactive emissions and build an image of where in the brain the radioactive substance is concentrated. helps to localize function
what is sensorineural deafness?
innear ear, cochlea, CN 8
cue invariance
insensitive to specific visual cues. for example dog recognized in drawing, real life, outline, etc
conduction aphasia
intact speech production & comprehension but impaired repetition
contemplation stage
intending to change problems in the foreseeable future, usually within 6 months. higher self efficacy/confidence, evaluates pros & cons and therefore ambivalent to changing. Approach= Socratic teacher
preparation stage
intending to take action in the near future, usually within a month. more confident regarding control of problem behaviors, pros of changing outweigh the cons. Approach: experienced coach
What refers to the extent to which the results in a study reflect the truth about what happened within this particular study?
internal validity
2 types of autonomous motivation
intrinsic- you do the behavior/occupation becasue you find it interesting and enjoyable. extrinsic- you do the behavior because it leads to a consequence you want (ex: someone with diabetes will take insulin extrinsically because makes them feel good and healthy and not intrinsically because it hurts)
Interquartile Range
is the inner 50% of participants in the example below that would be those patients that stayed in the hospital from 14 - 28 days. Where a range is a measure of where the beginning and end are in a set, an interquartile range is a measure of where the bulk of the values lie.
wilson's disease
issues with copper metabolism. muscular rigidity, tremor, weakness, loss of liver function
theory of mind
knowing that other people's mind can have different knowledge that what is in your own mind (right hemisphre)
fear of falling (FOF)
lasting concern about falling that can lead to an individual avoiding activities that they remain capable of performing. consequences: fall, functional decline, restricted activity, depression, anxiety, decreased QOL & balance confidence. signs of FOF: touch/hold onto objects during standing/ambulation; walk very slowly, take small steps, limit movement, express anxiety/FOF
According to AOTA's levels of evidence, a comparative trial is what level?
level II
What AOTA level of evidence is a single group study?
level III
What AOTA level of evidence is a narrative / conceptual review?
level V
What is Probability (p-value)?
level of significance, denoted by α (alpha value) · Low p-value (at least <.05) indicates: o Lower chance to find the effect simply due to chance o Probability of the found difference due to chance is low o Reject null hypothesis: - No effect/ there is a difference between the groups
short term memory
limit of 7 items but can be influenced by strategies that rely on prefrontal cortex such as chunking. Primacy (first words) vs recency (last words) effects
Low P value indiciated
lower chance that the effect is due to change and higher probability that its real effect
what is clarity method?
make brain transparent and image using light microscope after clearing away fat
what are event related potentials/ERPs?
measure a continous EEG while subject performs a psychological task. average the EEG waveform surrounding an event of interests(a stimulus or response). disadvantage low spatial resolution (hard to localize). advantage good temporal resolution
Which descriptive statistic will be provided for non-normal (non-parametric) data?
medians
temporal lobe
memory, object recognition, & hearing
psychological age
mental health and cognitive health
Single-Subject Design-
method of evaluating the effect of an experimental method on observable behavior (outcome) through repeated measures over time
single subject design
method of evaluation the effect of an experimental method on observable behavior (outcome) through repeated measures over time
What are simple carbohydrates?
more refined- rapidly absorbed- provide sugar rush/high. Fruits without skin, soft drinks, sweets, honey, agave, potatoes without skin, white bread, marinara sauce, etc.
what is central cord syndrome?
most common incomplete spinal cord injury, typically due to cervical hyperextension from a fall. more sensory/motor impairment in hands and arms compared to legs because of the corticospinal tract's topographical organization of the upper extremities
Which type of regression would you see when you have more than one independent variable?
multivariate regression
What is epistemology?
nature of knowledge, study of knowledge
what is ontology?
nature of reality, study of the nature of being
Hungtington's Chorea
neuronal degeneration in small part of the striatum, leading to hyperkinetic movement
premotor cortex function
neurons represent abstract action goals; action/movement based processing
what is the function of electrical activity in the brain?
neurons use electrical signals to transmit information quickly over larger directions. Neurons use electrical signals to represent and process information like a computer
age related changes
normal changes for older adulthood
Pre contemplation stage
not intending to change their behavior in the foreseeable future. lack of awareness, denial, dont believe they can change, present for therapy due to external pressures. Approach: nurturing parent
The ________ hypothesis states that there is no difference between the means.
null
prospective study
observations are made looking forward. Pros- Can identify "diagnosis" & confounders clearly at onset, can be more clearly documented, & can measure temporal sequence of onset & outcome
retrospective study
observations made from existing data. Pros- Data is already available, involves large numbers Cons- Definitions may change over time, follow-up times may be inconsistent
the cortex includes which 4 lobes?
occipital lobe, temporal lobe, parietal lobe, and frontal lobe
life span development theory
ontogenetic develop is biologically and socio-culturally constructed. events at each stage affect future development. more variability in older adulthood than childhood. 1. Evolutionary selection benefits decrease. 2. Need for cultural resources increase. 3. Efficacy of cultural resources decrease.
Crossover design
order of treatment systematically varied. half of subjects receive treatment A->B, other half receive B->A
spinothalamic tract
pain and temperature
allodynia
pain evoked by stimulus that wouldnt normally cause pain for example a sunburn (put ALOEddyna vera for sunburn pain)
complex regional pain syndrome
pain, vascular changes, and atrohpy-aberrant response to trauma. severe pain, red or pale skin color, sweating, edema, stiff and swollen joint, disuse of limb is primary precipitating factor. common example is a fracture keep having symptoms even during healing
Dyesthesia
painful abnormal sensation
parathesia
painless abnormal sensation (tingling, prickling) when our foot falls asleep (PARA-painless)
upper motor neuron lesion
paresis/paralysis, hyper stiffness, hypertonicity, increased reflexes
4 parts of insurance Part A-D
part A: hospital insurance, primarily inpatient, SNF, hospice, home health. Part B: medical insurance, primarily outpatient, DME, mental health services, therapy, preventative services, other. Part C: medicare advantage- incentivized to keep you healthy to save money. Part D: medicare prescription drug coverage- has donut hold coverage
what is a Computerized axial tomography/CAT scan?
passes x-rays through the head at various angles and uses a computer to reconstruct images of the brain. Disadvantages: uses a lot of radiation/x-rays
Continuity theory
past experiences, decisions, and behaviors form the foundation for the present and future. 1. Goal of adapting to changes is to maintain patterns of thought, activities, and habits. 2. Strategies used for adaptation come from past experiences
Termination stage
people have completed the change process and no longer have to work to prevent relapse. May be able to terminate if they attain max self-efficacy or confidence and minimum temptation to engage int their problem behavior
Case-control- Outcome-oriented
people who have had intervention are compared to people who have not, after the outcome has occurred. Can identify variables that may predict the condition. Retrospective.
basal ganglia function
performance of sequences of motor steps
Ex-PLISSIT Model
permission giving at all stages. Limited information, specific suggestions, intensive therapy
What phase of a traditional clinical trial is an efficacy study?
phase 2
biological age
physiological changes, often focus on deterioration and malfunction of body
frontal lobe is responsible for
planning, self-monitoring, personality, and motor control
what are paradigms?
preferred ways of understanding reality, building knowledge, and gathering information about the world
what are the qualitative research key features?
primacy of data, contextualization, immersion in the setting, the 'emic' perspective, use of thick description, and importance of reflexivity
Vivir mi vida study
primary care, examine mediators, evaluate cost-effectiveness. Mechanisms of change include: 1. Behavior change- prompting focus on activity-health link (OT focus), activating patients (CHW) 2. Health behavior change- adaptive coping, heart healthy habits, physical activity
power
probability of correctly rejecting the null hypothesis (H0) and conclude that the alternative hypothesis (Ha) is true. From hypothesis, correctly claim that difference really exist. Prior to study need to determine minimum sample size to detect difference/ effect
Which of the following most accurately describes the policy development process that we engaged in for our policy forum?
problem definition
what is narrative inquiry?
process of gathering information for the purpose of research through storytelling
life style redesign
process of implementing self-directed, personally meaningful changes to one's lifestyle and daily routines that promote health and enhance QOL. decrease risk for chronic conditions and better manage existing conditions
Presbycusis
progressive deterioration of hearing associated w/aging, mainly involving higher frequencies
what is a angiogram?
provides image of arteries in the brain, helps most with stroke, can look for blockages
function of cerebellum
purkinje cells receive input from spinal cord regarding position of the limbs, trunk, head, neck, and eyes. functions for balance, gait
animal models: intracellular recordings
put electrodes inside of the brain, can record from single or population of neurons. only done on humans when we have to put electrode in for clinical reasons
what is the wada test?
put one entire hemisphere to sleep to see the function of the other hemisphere
what is quantatative research good for?
quantitate research is better for understanding the effectiveness of interventions
aerobic/cardio exercise
raises heart rate/consumes oxygen over sustained period of time from repetitive movement of large muscle. Mod intensity = 50-70% of max heart rate. Vigorous= 70-85% of max heart rate.
This term describes a method based on chance in which participants of a clinical study are assigned to comparison and treatment groups
randomization
What is positivist?
reality is observable, stable, measurable. Focus on prediction and explanation (causal relationships), universal laws and rules exist, can be identified. Distance between research and those studied to avoid bias
What is interpretivist?
reality is socially constructed, multiple realities or interpretations of a single event/phenomenon, focus on understanding human experience and meaning, cannot understand experience without understanding context, researcher is the main tool, participants interact with researcher and their values, perspective, language shape the research
view/dependent/invariant
recognition depends of vantage point and requires matching distinct sensory inputs to view-dependent representations
what is object constancy?
recognize objects in countless situations. same object despite viewing point, illumination, surroundings
Korsakoff's syndrome
related to long-term alcoholism. Anterograde amnesia and confabulation (made up stories)
worthy topic
relevant, timely, significant, interesting
well elderness study II
replicated previous results, examine mediating mechanisms, and focus from efficacy -> effectiveness.
what is inuiting?
research attempts to be open and meet the phenomenon in a fresh a way as possible, bracketing out habitual ways of perceiving the world
resonance
research influences, affects, or moves particular reader or a variety of audiences through: aesthetics, evocation representation- does the reading influence, affect or move you? naturalistic generalizations- a feeling of knowing a feeling of being there. Transferable findings- feel that your could apply it your life or practice
definition of credibility
research is marked by thick description, concrete detail, explication of tacit knowledge, and showing rather than telling, triangulation or crystallization, multivolicaity, member reflections
what is phenomenology?
research method used to describe how human beings experience a certain phenomenon. best studies the lived experience, meanings can never be fixed - they are always emergent, contextual, and historical. Researchers are urged to be reflexive about how their previous experience, knowledge, and assumptions might have impacted the research
what is the order of stages of an action potential?
resting membrane potential, threshold, depolarization, re-polarization, hyper polarization, refractory period
If observations are made from existing data they are called?
restrospective
rods vs. cones
rods are helpful for peripheral vision and respond to dim light and cones help with color and acuity
social
role transition, relationships, social support, and societal views
this describes the phenomenon of action potentials jumping from node to node
saltatory conduction
geronotology
science of aging
psychological theory of aging
seek to explain the multiple changes in the individual behavior in the middle and later years of the life span, boundaries addressed are amorphous
age groups
seniors: 55+ Old adult 65+ young -old 55-77, 65-75 old old: 75+ oldest old 85+
What type of the tasks are represented in the supplemental motor cortex?
sequential and bilateral tasks
supplementary motor cortex function
sequential or bilateral tasks *holds motor program*
geriatrics
services for people who are old
negative skewed distribution
skewed to the left
Positive skewed distribution
skewed to the right
Merkel's disc
slow adapting receptors. concentrated on fingertips, tongue, lips
Broca's aphasia
slow labored speech, left anterior cortical damage.issue with spontaneous speech, tend to repeat, listening comprehension if affected when gramma is unusual and indirect (your speech is BROCKEN)
resilience and trauma in childhood
social support mitigates negative outcomes, overreaction of HPA axis may be calmed via effective self-control and positive sense of self.
what are the different types of fiber?
soluble which helps lower LDL cholesterol. Examples are oatmeal, barley, lentils, peas, beans, flaxseeds. Insoluble which do not dissolve in water, promotes movement through GI system. Examples are fruit skins, darky leafy vegetables, wheat bran
standard deviation
square root of variance. measure how spread out the data points are from the mean. A low std dev means the data points are close to the mean. a high std dev implies more spread of data surrounding the mean
What is the general adaptation syndrome?
stage 1- alarm, "fight or flight." stage 2- resistance, PNS activation. stage 3= exhaustion, susceptibility to disease or death if unable to return to homeostasis)
What is methodology?
strategies for gathering, collecting analyzing data
definition of sincerity
study is characterized by self reflectivity and transparency. self reflexivity is about subjective values, biases, and inclinations of the researcher. Transparency about the methods and challenges
Based on the hierarchy of evidence, which article is considered the best resource for information regarding a topic?
systematic review
Highest on the hierarchy of treatment effectiveness
systematic review & meta -anlysis
What are complex carbohydrates?
take long to digest, have more fiber. provide sustained energy, vegetables, fruits with skin, whole grains (more fiber)
gustatory pathway
taste is ipsilaterally represented
humans: behavioral methods
tests which test for certain aspect of behavior. for example, letter matching tasks show that we process vowels differently than consonants
what is allostasis?
the active process by which the body responds to daily events and maintains homeostasis
type 2 diabetes
the body does not produce enough insulin or the cells ignore the insulin. linked to obesity and physical inactivity
Type 1 diabetes
the body does not produce insulin. sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells
declarative memory
the cognitive information retrieved from explicit memory; knowledge that can be declared (ex:The name of your fifth-grade teacher, name of pet growing up, etc)
what is identification threshold?
the lowest concentration which a stimulus can be identified
what is absolute threshold?
the lowest intensity at which a stimulus can be detected 50% of the time . The lower the absolute threshold, the greater the sensitivity
what is difference threshold?
the smallest difference between 2 stimuli that people can perceive 50% of the time. sometimes called the "just noticeable difference"
what is ethonography?
the study of social interaction and culture groups, gathers observations, interviews, and documentary data to produce detailed accounts of different social phenomena. ● Ethnography techniques: thick description, reflexivity, triangulation
what is allostatic overload?
the wear and tear that results from either too much stress or from inefficient management of stressors
What does the cerebral cortex do?
thin 3mm layer of cell bodies on the outer surface of the brain. The seat of higher cognitive functions
According to the California Occupational Therapy Practice Act (CA B&P Code 2570.3), a licensed occupational therapist can supervise a maximum of ___________ full time Occupational Therapy Assistants.
three
Life Course Perspective
to understand older people now, need to know their past. 1. Emphasizes social and cultural factors (macro -> micro) that might influence the aging experience over time. 2. Pathways between life phases and circumstances in early life affect later life health
what is amusia?
tone deaf
definition of worthy topic
topic of the research is relevant, timely, significant, interesting
DCML
touch and proprioception
center-surround receptive field works by:
touch in the center exciting, touch in surround inhibiting, and touch outside receptive field having no effect
Associative agnosia
unable to access conceptual knowledge from visual input, i.e. recognize object but don't know how objects are used, etc.
associative agnosia
unable to access conceptual knowledge from visual input. for example recognize object but don't know how objects are used (left side lesion) for example can recognize they are looking at an umbrella but have no clue what it is used for
Anosognosia for Hemiplegia
unaware of deficit on one side of the body.usually only present in acute stage of illness; often make up reasons why they aren't moving, or claim to have moved
what is PAR participatory action research?
understanding, mutual involvement, change, and a process that promotes personal growth. Creates knowledge and action directly useful to a community
Randomized block design
used when an extraneous factor might influence differences between groups; in order to control for this effect, this variable is built into the design as an IV ("blocking variable")
what is a functional MRI/fMRI?
uses MRI techniques to map functional changes in brain activity. measures changes in cerebral flow (more active part of brain uses oxygen). disadvantages: poor temporal resolution. subjects performs a psychological task in the scanner
strength training exercise
uses resistance to build muscle strength.
visual cortex includes
v1 primary- responds to bars of light at a particular orientation. V4- color vision. v5- motion perception.
what is axiology?
values associated with areas of research and theorizing
occipital lobe is responsible for
vision
parietal lobe is responsible for
visuospatial functions, somatosensory, motor
parietal lobe
visuospatial, somatosensory, & motor
types of attention
voluntary- intentionally attend. reflexive- stimulus driven processes in which a sensory event (loud bang) captures our attention. Overt- turning head to orient towards a stimulus. cover- appear to attend to something but attend to another thing (cocktail part effect- commonly covertly shift auditory attention to more interesting conversation)
ventral stream
what. identification of objects. damage leads to agnosia
mirror nuerons
when you see an action, you stimulate doing the action as if you are doing it yourself. observing another's action activates one's own motor areas.
dorsal stream
where. location of objects in space
dorsal stream
where/how. localization of objects in space
Maintenance stage
working to consolidate the gains they made during the action in order to be free from risks from relapse. Begins 6 months after action. Maintenance may last from 6 months to 5 years
whats tracys big 8 tent criteria include?
worthy topic, rich rigor, sincerity, credibility, resonance, significant contribution ethics, and meaningful coherence
One-way Analysis of Variance (ANOVA)
•Applied when 3 or more group means are compared. •Unlike t-test based on t-statistic, ANOVA based on the F statistic, which is a ratio of between groups treatment effects to within-group variability. •Unlike variance used in t-test, ANOVA calculates sum of squares (SS) to show the variability of scores within a sample.
what is post-modern/poststructuralist paradigm?
■ Reality and knowledge= fragmented, multiple, situation, multi-faceted ■ Crisis of representation: rhizomatic (meaning of words is changing) ■ Pastiche: endless appropriation and recycling of older cultural forms to make new but familiar forms ■ Hyperreality: many representations or signifiers are constructed and consumed but lack a specific "real" referent ■ Deconstructionism and difference: methods of data analysis to dismantle text and accentuate foundational word oppositions
