Mr. M is a 54-year-old man diagnosed with retinitis pigmentosa who was referred to occupational therapy for orientation and mobility training, and the Kawa model was used to assess his life flow, challenges, support system, and set goals to improve his independence, mobility, and work through education and environmental modifications.
Accessible Living Through Home Modificationsginaarroyo
Learn how home modifications can enhance independent living for individuals with disabilities and individuals aging in place. Occupational therapy promotes home safety and greater independence for caregivers and their loved ones.
Accessible Living Through Home Modificationsginaarroyo
Learn how home modifications can enhance independent living for individuals with disabilities and individuals aging in place. Occupational therapy promotes home safety and greater independence for caregivers and their loved ones.
According to the American Occupational Therapy Association, occupational therapists and occupational therapy assistants help people participate in the things they want and need to do through the therapeutic use of everyday activities, or occupations.
Any rehabilitation team is comprised of different types of specialists who deal with the physical, emotional and spiritual needs of the patient. Find here a description of a few of them along with their responsibilities.
OT for Kids - Introduction to the assessment, treatment and development of ha...Nathan Varma
OT for Kids introduction to free handwriting course is an introductory crash course in handwriting development and the necessary underlying skills needed for fluent accurate writing.
Learning objectives:
Upon completion of this course, participants will be able to:
Have a basic understanding of the necessary underlying components of writing
Introduction to underlying skills needed for writing
Understand the impact of core strength and good posture on writing
Core strength and the impact on writing
Sitting posture and the impact on writing
Have a basic understanding of activities that can improve the skills needed for accurate writing
Individual activities
Group activities
Have an understanding of the definition of:
Visual perception skills
Hand strength
Fine motor skills
Visual closure
Form recognition and form constancy
Understand what adaptive equipment is available to children with poor writing
Pencil grips
Sloped writing boards
Summary
Where and when is the event being run?
Our free Introduction to handwriting event will be run on Saturday 18th October 2014 from 9am - 4pm in central Manchester at our clinic:
3 - 5 St John Street
Deansgate
Manchester
M3 4DN
The clinic is located just off Deansgate, with Deansgate train station less than 5 minutes walk and Piccadilly station about 20 minutes walk away.
Outcomes in Occupational Therapy (& Assistive Technology)will wade
An overview of the aspects of Outcomes in Occupational Therapy with the latter part of the presentation focusing on the challenges of Assistive Technology and AAC. Please see http://citeulike.org/user/willwade/tag/outcomes for further reading.
This presentation was prepared for educating the patients with stroke and their caregivers about the role of Occupational Therapy in stroke. It gives a very BRIEF over view about OT in stroke rehabilitation
According to the American Occupational Therapy Association, occupational therapists and occupational therapy assistants help people participate in the things they want and need to do through the therapeutic use of everyday activities, or occupations.
Any rehabilitation team is comprised of different types of specialists who deal with the physical, emotional and spiritual needs of the patient. Find here a description of a few of them along with their responsibilities.
OT for Kids - Introduction to the assessment, treatment and development of ha...Nathan Varma
OT for Kids introduction to free handwriting course is an introductory crash course in handwriting development and the necessary underlying skills needed for fluent accurate writing.
Learning objectives:
Upon completion of this course, participants will be able to:
Have a basic understanding of the necessary underlying components of writing
Introduction to underlying skills needed for writing
Understand the impact of core strength and good posture on writing
Core strength and the impact on writing
Sitting posture and the impact on writing
Have a basic understanding of activities that can improve the skills needed for accurate writing
Individual activities
Group activities
Have an understanding of the definition of:
Visual perception skills
Hand strength
Fine motor skills
Visual closure
Form recognition and form constancy
Understand what adaptive equipment is available to children with poor writing
Pencil grips
Sloped writing boards
Summary
Where and when is the event being run?
Our free Introduction to handwriting event will be run on Saturday 18th October 2014 from 9am - 4pm in central Manchester at our clinic:
3 - 5 St John Street
Deansgate
Manchester
M3 4DN
The clinic is located just off Deansgate, with Deansgate train station less than 5 minutes walk and Piccadilly station about 20 minutes walk away.
Outcomes in Occupational Therapy (& Assistive Technology)will wade
An overview of the aspects of Outcomes in Occupational Therapy with the latter part of the presentation focusing on the challenges of Assistive Technology and AAC. Please see http://citeulike.org/user/willwade/tag/outcomes for further reading.
This presentation was prepared for educating the patients with stroke and their caregivers about the role of Occupational Therapy in stroke. It gives a very BRIEF over view about OT in stroke rehabilitation
Descriptive power point lecture for geriatic carers highlighting basic anatomy and basic facts about the eye and eye problems ;Aging and the eye, common eye disorders, symptoms and signs,
care of the eyes and prevention of blindness and injury for the elderly,
care of the eyes for the blind or visually impaired elderly and mobility concerns for the blind and visually impaired.
Diagnosis and Management of Special Populations Part II 2010Dominick Maino
Diagnosis and Management of Special Populations presents the latest in the assessment and treatment of those with physical, cognitive, and behavioral abnormalities. Up to date information concerning the etiology, prevalence/incidence and physical/cognitive findings of individuals with developmental disabilities (Cerebral palsy, Down syndrome, Fragile X syndrome, autism, acquired/traumatic brain injury) will be discussed. New diagnostic and treatment techniques are reviewed. The eye care practitioner will be able to confidently provide eye and vision care for those with disability at the end of this presentation.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Top Effective Soaps for Fungal Skin Infections in India
Rp case study using kawa model
1. KAWA MODEL
FACULTY OF HEALTH SCIENCES
NAME: KHOR WAI ON
MATRIX NUMBER: A124590
PROGRAM/YEAR: OCCUPATIONAL THERAPY/ 4TH YEAR
SUBJECT: NNNK 4065 ORIENTATION AND MOBILITY
CLINICAL PLACEMENT
2. INTRODUCTION
• According to ICD – 9:
– Retinitis Pigmentosa (RP) is a name to a group of
hereditary disease that cause degeneration of retina.
– Progressive deterioration:
1. Loss of night or low light vision due to affected Rod.
2. Peripheral vision may deteriorate until left only straight-ahead
or “tunnel vision”.
3. Cones concentrated in the center of the retina (macula) may
slowly lose function, resulting in central blurred vision lacking
color perception.
– A form of RP known as Usher's syndrome also causes
nerve damage creating deafness.
– Research underway for artificial retina & replacement
of defective genes.
3. PRELIMINARY INFORMATION
Description
Name Mr. M
Age 54
Gender Male
Marital status Married
Race Malay
Religion Islam
Occupation Admin assistant
Diagnosis Retinitis Pigmentosa
Date referred to OT clinic 19.4.12
Referred by Optometrist
4. KAWA MODEL
Ryuboku
(Driftwood)
Mizu (Water)
Iwa (Rocks)
KAWA Model was used as
conceptual model of
practice, frame of Torimaki: Kawa no
reference, assessment tool soku –heki (river
and modality to this client. side-wall) and Kawa
no zoko (river floor)
5. Mr. M’s Kawa
Phase 1: Active and
disease free.
Phase 2: married life,
Phase 4: Accident, DM started after.
RP gets severe
affecting more
aspects of life Phase 3: surgery at both legs.
Blur vision and hearing
problem started, RP detected.
6. WATER
(Life Flow and Overall Occupations)
Subjectively:
• Family History:
Client
– Among siblings, client was the only one with RP.
– Married at the age of 25.
7. WATER
(Life Flow and Overall Occupations)
• Medical History:
– Blur vision and partial hearing loss started since
2004 – detected RP
– Surgical history: both leg surgery in year 2004 due
to swelling at both legs.
– Other illnesses:
• DM 20 years back (Insulin injection)
• HPT (Given medication)
– Medication:
• Insulin injection
8. WATER
(Life Flow and Overall Occupations)
• Work History:
– Pre-morbid
• Client was a bus driver – One secondary school for over
10 years. .
– Post-morbid
• Switch job to administrative assistant in the same school
year 2009.
• Not planning to retire so soon.
• Leisure:
– Pre-morbid
• Gardening, travel around and jog in evening at park.
– Post-morbid
• Watching television, reading newspaper, and listening to radio.
9. WATER
(Life Flow and Overall Occupations)
• Routine:
Time Working Days Week Days
7.00 am Wake up, bath and Wake up, bath, watch
breakfast television and breakfast
8.00 am – 10.00 am Go to work Newspaper and nap
10.00am – 12.00pm Go back home and Lunch, newspaper and
lunch television
12.00pm – 3.00pm Newspaper and nap Newspaper and relax
3.00pm – 5.00pm Go back to work Listen to radio and nap
5.00pm – 10.00pm Dinner, television, and Dinner, television and
newspaper radio
10.00pm Sleeps Sleeps
* Client read 3 sets of newspapers a day.
10. WATER
(Life Flow and Overall Occupations)
Objectively:
• Self Care
– ADL using MBI scored 98/100 indicating minimum
dependency level – minimal supervision for stair
climbing.
– IADL scored 6/6, fully independent.
• Phone, shopping, housekeeping, mode of transportation,
medications, and finances.
11. ROCKS
Subjectively:
Visual
Risk of limitation
falls
Feel helpless
Unable to travel
around freely
Weakness
at legs
Berg’s Balance Test biVABA
Cross sectional view Mr. M’s river diagram
12. ROCKS
(Obstacles and challenges, Circumstances that block life flow
and cause dysfunction/disability)
Objectively:
• Balance – Assessed using Berg’s Balance Test scoring
40/56 indicates medium risk of falls.
• From assessment, noted that client losses balance
when:
– Sudden change of position.
– Standing with feet together or in-front of each other.
– Standing with one leg.
– Standing for more than 10 minutes.
13. ROCKS
(Obstacles and challenges, Circumstances that block life flow
and cause dysfunction/disability)
• From file:
– Distance vision RE 6/12 and LE 6/12
– Near vision N20@ 40 cm – able to read newspaper without
glasses on.
i. 1/12 for Right eye.
• Visual – Assessed using biVABA. ii. 1/12 for Left eye.
• From assessment, noted that: iii. 1/4 for both eyes
together
– Visual acuity – Snellen chart
– Client’s pupil does not constrict instantly in respond to light
stimulation. ( 1 – 2 minutes to respond)
– Size of pupil changes very slightly in respond to
accommodation.
– Visual field – unable to see in all 6 position for red dot.
– Kinetic 2 person confrontation test, client has limited vertical
visual field – only less than 10 degree for both eyes.
14.
15.
16. RIVER WALLS & FLOOR
Friends
School
House
Colleagues principle
Children Wife & physical
environment
Cross sectional view
Family Work
Mr. M’s river diagram
17. RIVER WALLS & FLOOR
(Physical and Social Environment)
• Social Environment:
1. Family
– Staying with wife, son and daughter.
– Currently son is the one that drives client around.
– Children has limited knowledge about client’s condition and
technique in sighted guide.
– If necessary, son will take leave to bring client for medical
check up, close relationship with client – can joke around.
– Wife will stop work and stay at home to take care of client
soon.
18. RIVER WALLS & FLOOR
(Physical and Social Environment)
2. Friends
– His used to go out and hang out with friends at restaurant.
3. Work
– Other colleagues that were new wasn’t satisfy with client.
– Client’s office table was situated at the end of the room with
clutters and narrow pathway.
– Client was not given much work in office.
• House Environment:
– 4th floor Flat without lift.
– Cemented stairs with handle.
– 2 Sitting toilet.
19. Strong sense Stable
Motivated to Reluctant to
of financial
remain active take medication
responsibility income
Self coping
Reluctant to use
skill
walking aids
DRIFTWOOD
Cross sectional view
Mr. M’s river diagram
20. Strong sense Stable
Motivated to Reluctant to
of financial
remain active take medication
responsibility income
Self coping
Reluctant to use
skill
walking aids
Visual
Risk of limitation
falls
Feel helpless
Unable to travel
around freely
Weakness
Friends at legs
School
House
Colleagues principle
Children Wife & physical
environment
Cross sectional view
Family Work
Mr. M’s river diagram
21. PROBLEM IDENTIFICATION
1) Client was not taking other medication – not knowing
implication.
2) Client reluctant to use walking aids – dignity.
3) Client was unable to travel freely - limited visual function
and has medium risk of fall due to weakness at both legs.
Visual function limitation includes:
i. Response to light.
ii. Response to accommodation.
iii. Limitation on vertical visual field.
4) Misunderstanding between client and colleagues due to
lack of psycho-education for both client and colleagues.
5) Feeling helpless - not able to perform effectively at work.
22. TREATMENT AIMS
Short Term Goal:
1. Educate client and care-giver – importance of
medication intake and the condition itself.
2. Reduce risk of falls – home and community.
3. To improve client’s mobility around community.
4. Increase client’s efficiency in work.
5. Improve social interaction between client and
other colleagues in work place.
23. Strong sense Stable
Motivated to Reluctant to
of financial
remain active take medication
responsibility income
Self coping
Reluctant to use
skill
walking aids
1
Visual
Risk of limitation
falls
Feel helpless
Unable to travel
around freely 2 4
5 Weakness
Friends at legs
3
School
House
Colleagues principle
Children Wife & physical
environment
Cross sectional view
Family Work
Mr. M’s river diagram
24. Strong sense Stable
Motivated to
of financial
remain active
responsibility income
Self coping
skill
Visual
Risk of limitation
falls
Unable to travel
around freely
Weakness
Friends at legs
School
House
Colleagues principle
Children Wife & physical
environment
Cross sectional view
Family Work
Mr. M’s river diagram
26. TREATMENT
Treatment implemented: (10.5.12)
1. Education to both client and care-giver (son) about
the condition includes: (STG 1)
Etiology
Progression
Client’s current functionality level
2. Environmental (home) modification
recommendation: (STG 2)
Marking and labeling technique. (E.g., stairs)
Lighting
27. TREATMENT
Treatment implemented: (17.5.12)
3. Teach client and care-giver sighted guide technique:
(STG 3)
Approaching narrow space
Approaching stairs
Guiding client to sit on chair
Approaching a doorway.
4. Further assess on client’s color perception
– Assessment: non-standardized (using 6 different
colored rings)
– Results: client able to recognize red, green, orange but
seeing yellow as white, blue as greenish blue, and pink
as orange-light red.
28. TREATMENT
5. Expose client to walking aids that are suitable to
client including education on it. (STG 2)
– Method: Consulted with client without showing.
– Results: Client re-considered and agreed to try.
Future plan:
6. Home visit – possible physical environment &
identification with client on possible purposeful
activities. (STG 2 & 3)
7. Work place visit: (STG 4 & 5)
Job place physical environment modification and task
modification.
Educate other colleagues and employer about client’s
condition.
29. TREATMENT
Based on LTG:
LTG 1
• Pre-retirement planning – preparation in exploring and
then legitimize a new activity patterning for retirement.
• Elements for successful retirement: life roles,
purposeful activity, and maximizing function.
– Alternative: volunteerism or part-time employment.
– New interest exploration.
LTG 2
• Orientation and Mobility program – with cane.
30. PROGNOSIS
Rehabilitative: (Good)
• Cooperative and compliant to treatment given.
• Strong family support.
• Client was very motivated to improve himself.
*RP is a degenerative disorder.
*Client has other illnesses other than RP.
31. REFERENCES:
1. International Classification of Disease (ICD-9-CM:
362.1, 362.74, 362.76)
2. Mitchell S., Maxine S., & Stephen G., 2007. Low
Vision Rehabilitation: A Practical Guide for Occupational
Therapy. SLACK Incorporated.
3. Sandra C., 2003. Elder Care in Occupational Therapy. 2nd
Edition. SLACK Incorporated.
4. Michael K. Iwama, 2006. The Kawa Model: Culturally
Relevant Occupational Therapy. Churchill Livingstone
Elsevier.