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Chief Operating Officer: Christopher Bluhm Director of Communications: Laura Collins Director of Marketing: Beth Ledford Editor: Ted McKenna Associate Editor: Andrew Waite CE Articles Editor: Maria Elena E. Louch Art Director: Carol Strauch Production Manager: Sarah Ely Director of Sales & Corporate Relations: Jeffrey A. Casper Sales Manager: Tracy Hammond Advertising Assistant: Clark Collins
FEATURES
Transdisciplinary Playgroup
Tina Champagne, Chairperson, Mental Health Special Interest Section Donna Costa, Chairperson, Education Special Interest Section Michael J. Gerg: Chairperson, Work & Industry Special Interest Section Tara Glennon, Chairperson, Administration & Management Special Interest Section Kim Hartmann, Chairperson, Special Interest Sections Council Leslie Jackson, Chairperson, Early Intervention & School Special Interest Section Gavin Jenkins, Chairperson, Technology Special Interest Section Tracy Lynn Jirikowic: Chairperson, Developmental Disabilities Special Interest Section Teresa A. May-Benson: Chairperson, Sensory Integration Special Interest Section Lauro A. Munoz: Chairperson, Physical Disabilities Special Interest Section Regula Robnett, Chairperson, Gerontology Special Interest Section Missi Zahoransky, Chairperson, Home & Community Health Special Interest Section
AOTA President: Florence Clark Executive Director: Frederick P. Somers Chief Public Affairs Officer: Christina Metzler Chief Financial Officer: Chuck Partridge Chief Professional Affairs Officer: Maureen Peterson
2012 by The American Occupational Therapy Association, Inc. OT Practice (ISSN 1084-4902) is published 22 times a year, semimonthly except only once in January and December, by The American Occupational Therapy Association, Inc., 4720 Montgomery Lane, Bethesda, MD 20814-3425; 301-652-2682. Periodical postage is paid at Bethesda, MD, and at additional mailing offices. U.S. Postmaster: Send address changes to OT Practice, AOTA, PO Box 31220, Bethesda, MD 20824-1220. Canadian Publications Mail Agreement No. 41071009. Return Undeliverable Canadian Addresses to PO Box 503, RPO West Beaver Creek, Richmond Hill ON L4B 4R6. Mission statement: The American Occupational Therapy Association advances the quality, availability, use, and support of occupational therapy through standard-setting, advocacy, education, and research on behalf of its members and the public. Annual membership dues are $225 for OTs, $131 for OTAs, and $75 student members, of which $14 is allocated to the subscription to this publication. Subscriptions in the U.S. are $142.50 for individuals and $216.50 for institutions. Subscriptions in Canada are $205.25 for individuals and $262.50 for institutions. Subscriptions outside the U.S. and Canada are $310 for individuals and $365 for institutions. Allow 4 to 6 weeks for delivery of the first issue. Copyright of OT Practice is held by The American Occupational Therapy Association, Inc. Written permission must be obtained from AOTA to reproduce or photocopy material appearing in OT Practice. A fee of $15 per page, or per table or illustration, including photographs, will be charged and must be paid before written permission is granted. Direct requests to Permissions, Publications Department, AOTA, or through the Publications area of our Web site. Allow 2 weeks for a response.
COVER PHOTOGRAPH COURTESY OF UNIVERSITY OF NEW ENGLAND
DEPARTMENTS
News Capital Briefing
Mental Health: Emphasizing Function and Performance
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Practice Perks
Evidence Perks
Evidence Exchange: New Research Repository Created by AOTAs Evidence-Based Practice Project
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Response to Intervention
Your Questions Answered
In the Classroom
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Calendar
CE Article
Discuss OT Practice articles at www.OTConnections.org in the OT Practice Magazine Public Forum. Send e-mail regarding editorial content to otpractice@aota.org. Go to www.otpractice.org/currentissue to read OT Practice online. Visit our Web site at www.aota.org for contributor guidelines, and additional news and information.
OT Practice serves as a comprehensive source for practical information to help occupational therapists and occupational therapy assistants to succeed professionally. OT Practice encourages a dialogue among members on professional concerns and views. The opinions and positions expressed by contributors are their own and not necessarily those of OT Practices editors or AOTA. Advertising is accepted on the basis of conformity with AOTA standards. AOTA is not responsible for statements made by advertisers, nor does acceptance of advertising imply endorsement, official attitude, or position of OT Practices editors, Advisory Board, or The American Occupational Therapy Association, Inc. For inquiries, contact the advertising department at 800-877-1383, ext. 2715. Changes of address need to be reported to AOTA at least 6 weeks in advance. Members and subscribers should notify the Membership department. Copies not delivered because of address changes will not be replaced. Replacements for copies that were damaged in the mail must be requested within 2 months of the date of issue for domestic subscribers and within 4 months of the date of issue for foreign subscribers. Send notice of address change to AOTA, PO Box 31220, Bethesda, MD 20824-1220, e-mail to members@aota.org, or make the change at our Web site at www.aota.org. Back issues are available prepaid from AOTAs Membership department for $16 each for AOTA members and $24.75 each for nonmembers (U.S. and Canada) while supplies last.
News
AOTA News
n January, the latest group of Emerging Leaders received training at AOTA headquarters. Read the article at www. aota.org/news/aotanews/emerg ing-leader-2012 to see how they are helping to ensure continued development of strong leaders within the profession as the Association carries out the goals of the Centennial Vision. Information on applying for the 2013 program will be available in September.
nterested in neuromuscular disorders? Tune in March 12 at 3:00 pm EST to participate in a pediatric virtual chat on identifying early signs for the disorders. For more, visit www.talkshoe.com/tc/73733. You can also listen to past chats at this site.
Industry News
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oud better get movieing. Submissions to AOTAs 2012 video contest, which
ake part in the Occupational Therapy Global Day of Service on February 25 and show the world just how important our profession is. Suggestions for volunteer activities include mentoring within the community, organizing activities for underserved children, doing safety checks for persons who are aging in place, and participating in neighborhood cleanups or playground repairs. For more information, go to www.promotingot.org.
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FEBRUARY 20, 2012 WWW.AOTA.ORG
A O TA B u l l e T I N B O A r d
OUTSTANDING RESOURCES FROM
SKILLS
R MOTO
Response to Intervention (RtI) for At Risk Learners: Advocating for Occupational Therapys Role in General Education
(CEonCD) G. Frolek Clark & J. Polichino Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). esponse to Intervention (RtI) is being nationally implemented to ensure high-quality instruction and data-based decision making within the general educational system. In this new course, opportunities will be highlighted for occupational therapy within RtI frameworks in public education. This course also provides an overview of core components of RtI, the role of occupational therapists at each tier, and case studies illustrating contributions by occupational therapists. $68 for members, $97 for nonmembers. Order #4876. http:// store.aota.org/view/?SKU=4876
Also Available as Self-Paced Clinical Course. Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). $259 for members, $359 for nonmembers. Order #3023. http://store.aota.org/view/?SKU=3023.
Occupational Therapy Services for Children and Youth Under IDEA, 3rd Edition L. Jackson
his update to the bestseller provides authoritative, accurate information and resources about occupational therapy practice in schools, preschools, early intervention, and other settings, such as child care. It is essential for occupational therapists and occupational therapy assistants (including educators and students) and also is useful for parents, teachers, administrators, policymakers, and child advocates. $65 for members, $89 for nonmembers. Order #1177A. http://store. aota.org/view/?SKU=1177A
Bulletin Board is written by Jennifer Folden, AOTA marketing specialist.
Rely on this brief tool to help you easily assess fine, gross, and visual motor skillsusing hands-on, functional activities that appeal to youngsters!
Scaled scores for fine, gross, and visual-motor skills Individualized workbooks for each child to simulate early school activities: writing, drawing, tracing, and cutting Progress scores to help you measure change over time
800.627.7271
PsychCorp.com
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Questions? Call 800-SAY-AOTA (members); 301-652-AOTA (nonmembers and local callers); TDD: 800-377-8555
Copyright 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 6523 02/12 A3F
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prAcTIce perKs
Q A
Amanda Kessler
Sometimes I encounter clients who experience domestic violence. I dont want to ignore this aspect of their life, but I am not sure how to address this topic. How can I address the specific domestic violenceinduced psychological and social issues that ultimately affect occupational performance?
You are not alone; often, clinicians are concerned about how to address this delicate issue with their clients. Yet occupational therapy practitioners are quite capable of providing evaluations and interventions that address the consequences of domestic violence. The AOTA statement Occupational Therapy Services for Individuals Who Have Experienced Domestic Violence1can provide guidance. This statement reviews what domestic violence encompasses, the impact it has on individuals and families, possible areas of occupational performance dysfunction, and potential occupational therapy interventions for a variety of individuals. Domestic violence is defined as a learned pattern of coercive behavior designed to exert power and control over a person in an intimate relationship through intimidation, threats, and harmful or harassing behavior.2 It can occur in the form of physical violence (e.g., hitting), psychological violence (e.g., verbal abuse, harassment), sexual abuse, and/or economic abuse (e.g., controlling finances). Domestic violence occurs in relationships involving all races, ages, sexual orientation, and socioeconomic status. Although women are abused in 85% to 95% of domestic violence cases,3 men are also abused. Children, older adults, and the extended family also suffer. Experiencing domestic violence can significantly affect various aspects of an individuals daily life and routine. Adults may struggle with work performance and sustainment, parenting, home management, money management, coping skills, and self-confidence. Children who have witnessed domestic violence may have low selfesteem, impaired social skills, and/or poor academic performance. The occupational therapy service delivery process occurs in collaboration with survivors, abusers, family members, and other service providers.1 Occupational therapy practitioners are skilled at establishing and maintaining a therapeutic relationship, conducting interviews, fostering interpersonal communication, developing therapeutic groups and programs, promoting health and wellness, and understanding the effects that social conditions have on occupational performance. Occupational therapy evaluation and assessment should be client centered and occupation based, identifying intrinsic and extrinsic factors that support or hinder performance of desired occupations. Occupational therapy interventions with survivors of domestic violence should emphasize building self-esteem and empowerment, regardless of whether the individual is able to leave the domestic violence relationship. Using a cognitive-behavioral approach is helpful to increase insight and problem solving of the client experiencing domestic abuse. Other interventions for domestic abuse survivors may address modeling strategies (such as parenting skills), budgeting, improving concentration, remediating life skills, providing stress management, and teaching coping strategies. Alternatively, occupational therapy practitioners may collaborate with other professionals to provide interventions to abusers, including training in social skills, anger and stress management, parenting skills, and assertiveness. We must also remember to regard our clients with empathy and provide a nonjudgmental, safe environment for service delivery. Using our therapeutic rapport with clients, we can open the door to communicating about concerns regarding domestic violence and provide holistic care through occupational therapy interventions that empower our clients and address their occupational needs. Lastly, it is important to remember that as health care professionals, occupational therapy practitioners have an ethical responsibility to take actions that promote the health and safety of individuals affected by domestic violence. Although reporting child abuse is mandated, some states also mandate reporting suspected abuse of adults, especially those with disabilities and older adults. Practitioners can refer to www.aaos.org/about/abuse/ststatut. asp for specific state requirements for reporting family violence. n
References
1. American Occupational Therapy Association. (2011). Occupational therapy services for individuals who have experienced domestic violence. American Journal of Occupational Therapy, 65, S32S45. doi:10.5014/ajot.2011.65S32 2. Meuer, T., Seymour, A. & Wallace, H. (2002). Domestic violence. In National victim assistance academy textbook (Chapt. 9). Retrieved November 29, 2011, from http:// www.valor-national.org/ovc/chapter9.html 3. Fisher, J., & Shelton, A. (2006). Survivors of domestic violence: Demographics and disparities in visitors to an interdisciplinary specialty clinic. Community Health, 29, 118130. Amanda Kessler, MS, OTR/L, is an assistant professor of occupational therapy at West Virginia University.
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AOTAInc.: April is OT MonthStart celebrating OT Month today and keep going all year! Promote OT Month awareness http://ow.ly/8IJmM #OTMonth 27 January AOTAIncPR: Falling in love, with autism. OT called in to NPRs @totn about teaching dating to her clients with autism http://ow.ly/8AO3S 20 January AOTAInc.: Congrats! RT @uab_shp: #OT professor Beth Barstow wins national writing award for story published in #AJOT. http://bit.ly/wgtuPG
13 January
AOTAInc.: AOTA Video highlighting VCU OT Alum Audrey Kane & OT student Jessica Lynn treating
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Your employer asks you to do something that you consider unethical. What would you do?
Answer the poll and see results: http://ow.ly/8AtaY
January 20 at 10:23am
7 people like this. Fanny Marzanh At the end of the day each one of us has to answer for our own actions. There is a reason why we have licenses. I dont have a problem letting anybody know if I have to. Without a license, I could not work anywhere.
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Join Karen Jacobs at the 2012 Annual Conference & Expo and attend her Slagle Lecture
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cAleNdAr
To advertise your upcoming event, contact the OT Practice advertising department at 800-877-1383, 301-652-6611, or otpracads@aota.org. Listings are $99 per insertion and may be up to 15 lines long. Multiple listings may be eligible for discount. Please call for details. Listings in the Calendar section do not signify AOTA endorsement of content, unless otherwise specified. Look for the AOTA Approved Provider Program (APP) logos on continuing education promotional materials. The APP logo indicates the organization has met the requirements of the full AOTA APP and can award AOTA CEUs to OT relevant courses. The APP-C logo indicates that an individual course has met the APP requirements and has been awarded AOTA CEUs. February
one day seminar is an overview of a sensory motor approach to feeding applicable for all ages and diagnoses. A three part oral-motor program will be introduced, followed by a brief discussion of medical, behavioral and sensory motor issues which impact feeding. The development of the oral motor skills needed for feeding and intelligible speech production will be reviewed. A foundation for planning and implementing sensory diets will be presented. The focus of the afternoon will be a hands-on sampling of pre-feeding exercises and specific feeding techniques. This course is offered for .6 CEU. Appropriate for OTs/COTAs/SLPs. Contact The Learners Workshop, 516-374-3377; info@thelearnersworkshop.com or to register, visit our website www.thelearnersworkshop.com. A light breakfast as well as a lunch will be included. Contact Glen Gillen at 212-305-1648 or gg50@ columbia.edu.
Baltimore, MD
Mar. 1819
Torrance, CA
13th annual research symposium is devoted to research on postural control, motor learning, motor planning, and early sensory and motor indicators of autism and DCD. Earn 12 contact hours/1.2 CEUs through AOTA. Pre-Conference Institutes: I. Feb. 2223, Measuring the Fidelity of Ayres Sensory Integration Intervention; Presenters: Diane Parham, PhD, OTR/L, FAOTA, & Zoe Mailloux, MA, OTR/L, FAOTA. II. Feb. 2223, Applying Ayres Sensory Integration in School-Based Practice; Presenters: Lisa Test, OTD, OTR/L, Sarah Field, MA, OTR/L, & Anahita Daruwalla, MA, OTR/L. Contact Hours: 9 (.9 CEUs). Visit www.pediatrictherapynetwork.org for further information and to register.
R2K 2012: Early Development, Sensory Integration, and Movement. Pediatric Therapy Networks
Feb. 2425
OTR/L, MS, FAOTA. Over 22 years specializing in design/build services, technologies, injury prevention, and ADA/504 consulting for homes/jobsites. Start a private practice or add to existing services. Extensive manual. AOTA APP+NbCOT CE Registry. Also ongoing internet and 2-day on-site training. Contact: Abilities OT Services, Inc. 410-358-7269 or info@aotss.com. Group, COMBO, personal mentoring, and 2 for 1 discounts. Calendar/info at www.AOTSS.com. Seminar sponsorships available nationally.
Milwaukee, WI
March
A-ONE CERTIFICATION: Assessing Cognitive Perceptual Dysfunction Through ADL and Mobility. This course is designed to train OTs in objec-
Mar. 1014
back funds and budgets, and therapists are left with minimal supplies to meet the needs of their patients. This course teaches therapists how to look at common objects in a new and creative way for use in their work settings. A virtual tour is taken through hardware and home improvement stores to identify tools that are inexpensive and valuable when making modifications for patients. A cookbook of creative treatment plans is provided, with items that cost less than $5. For additional courses, information, and registration, visit our Web site at www.chscontinuing.uwm.edu or call 414-227-3123.
Occupational Therapy on a Shoestring Budget: Using Everyday Objects to Achieve Extraordinary Results. Many rehabilitation facilities are cutting
Mar. 23
Toms River, NJ
Mar. 4
tively assessing the impact of cognitiveperceptual impairments (e.g., neglect, agnosias, spatial dysfunction, apraxia, body scheme disorders) on ADL and mobility, highlighting our unique contribution to this practice area. Limited enrollment. AOTA CEUs.
Milwaukee, WI
Management of Flexor and Extensor Repairs of the Hand. This course will provide in-depth cov-
Mar. 24
erage of repair and rehabilitation following tendon injury in the hand. Anatomy will be reviewed, and types of surgical repairs and their resulting
Continuing Education
LEAD. INFLUENCE.
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eMplOYMeNT OppOrTuNITIes
National Faculty
A.T. Still University, Arizona School of Health Sciences, Department of Occupational Therapy
invites applications for a newly created faculty position at the assistant or associate professor level to teach in the residential entry-level Master of Science Degree Program, conduct facultyled student research projects, and participate in the development of a postprofessional online doctoral degree program. Responsibilities include teaching, scholarship, mentoring, and service. Rank and salary are commensurate with experience and qualifications. Qualifications: PhD or other research doctoral degree and 4 years of teaching experience preferred. Candidates with a postprofessional masters degree near completion of doctoral degree will also be considered. The ideal candidate will also demonstrate excellence in teaching at the graduate level, a clinical background in the area of adult neuro-rehabilitation, and an interest in scholarly activity. Candidates must be eligible for and agree to secure occupational therapy licensure in Arizona. ATSU is a fully-accredited graduate health professions institution offering doctoral degrees in physical therapy (entry level and postprofessional), osteopathic medicine, dentistry, and audiology. Masters programs are offered in occupational therapy, athletic training, and physician assistant studies. Opportunities for interdisciplinary education and research are available and encouraged. As the founding school of osteopathic medicine, ATSU is committed to the integration of body, mind, and spirit. Additional information can be obtained from our Web site at www.atsu.edu. The residential Occupational Therapy Program is located on the Mesa, Arizona, campus, close to the Phoenix metropolitan area. Mesa is an eclectic mix of museums, culture, and heritage set in the beautiful Southwest, offering year-round opportunities for outdoor recreational activities, with nearby lakes, canyons, golf courses, and the Superstition Mountains. Interested applicants should fill out an application at www.atsu.edu/contact/app_distributed.pdf and send a cover letter and curriculum vita to: Christina Griffin, PhD, OTR/L, FAOTA Chair, Occupational Therapy Search Committee
EOE
5850 E. Still Circle, Mesa, AZ 85206 Phone: 480-219-6075 E-mail: hraz@atsu.edu International
F-5837
ALBERTA HEALTH SERVICES IS INVITING TALENTED OCCUPATIONAL THERAPISTS TO JOIN OUR TEAM
Do you want to practice to your full scope? Do you want to be part of a dynamic team environment that encourages professional development and active involvement in your job? Do you want your contributions to be supported and valued? Then why not consider working and living in Alberta. Joining our team of Occupational Therapists will afford you the opportunity to enjoy an incomparable standard of living in whichever community you choose to work. Alberta does not charge Provincial Sales Tax and has the lowest personal income tax of any province in Canada. Imagine spending time with family and friends while enjoying Albertas first class amenities and exploring the natural beauty of the province. We welcome you to apply.
Advantages
excellent wages & benefits outstanding educational opportunities employ your full scope of practice relocation packages temporary accomodation bursary opportunities
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And why.
Is there a gap in your overall health coverage?
Rising dental costs can take a bite out of your family budget. Making matters worse, many employers are cutting dental benefits during these turbulent economic times, which could result in a costly gap in your familys health coverage. Fortunately, as a valued AOTA member, you and your family are guaranteed acceptance in the AOTA Group Enhanced Dental Insurance Plan that can help insulate your family against skyrocketing dental bills. Highlights include:
Benefits for preventive care, emergency care, orthodontics for dependent children and more See the dentist you want with no network restrictions Exclusive group rates help to keep premium costs down Each day the work you do helps shape a future worth smiling about. This dental insurance plan is just one way the AOTA Group Insurance Program helps shape the future of the ones you love. For information on plan features, costs, eligibility, renewability, limitations and exclusions, call toll-free 1-800-503-9230 or visit www.aotainsurance.com.
AR Ins. Lic. #245544 CA Ins. Lic. #0633005 d/b/a in CA Seabury & Smith Insurance Program Management
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The Group Enhanced Dental Insurance Plan is underwritten by The United States Life Insurance Company in the City of New York. Coverage may vary or may not be available in all states.
55989, 55511, 55812, 55814 (1/12) 2012 Seabury & Smith, Inc. AG-9024
Education Article
(one contact hour and 1.25 NBCOT PDU). See page CE-7 for details.
ABSTRACT
Community mobility includes all the ways in which people move about in the world in order to access goods and services and remain engaged in occupations beyond their homes. In reference to older adults, much of the focus both professionally and societally has been on driving status as opposed to a broader consideration of mobility options and the capacity to use them. This article seeks to expand the sphere of occupational therapy involvement into more diverse realms of community mobility and offers an overview of potential roles and resources for occupational therapy practitioners.
LEARNING OBJECTIvES
After reading this article, you should be able to: 1. Categorize forms of community mobility and their relative rates of use by older adults in the United States. 2. Recognize the relationship between community mobility and well-being for older adults. 3. Identify community mobility challenges specific to people with age-related limitations. 4. Identify specific strategies occupational therapy practitioners can implement to address community mobility options and needs. 5. Differentiate between local, regional, and national transportation and community mobility resources beneficial to clients.
Master, 2011). Among seniors, approximately 90% of all trips are taken in private automobiles, either as the primary driver or as a passenger in someone elses car (Pucher & Renne, 2003). For seniors who do not drive, access to other modes of transportation is crucial. The rates of social isolation and depression experienced by seniors who transition through driving cessation are well-documented (Fonda, Wallace, & Herzog, 2001; Marottoli et al., 1997; Ragland, Satariano, & MacLeod, 2005; Taubman-Ben-Ari, Mikulincer, & Gillath, 2004) and can serve as a call to action to address community mobility options for nondrivers. Even for seniors who drive, however, having a wide range of affordable and accessible transportation options is vitally important to maintaining social and familial contacts and supporting overall well-being (AARP, 2005). The primary goal of this article is to broaden the scope of concern about senior transportation from driving to comprehensive community mobility. Information and resources are provided to facilitate the work of occupational therapy practitioners who collaborate with older adults and transportation systems to ensure safe and effective travel. Background information regarding forms of travel is presented first, followed by examples of both specific and general roles occupational therapy practitioners can play in addressing community mobility and the resources to help enact them.
INTRODUCTION
It is widely acknowledged that the population profile of the United States is rapidly growing older. In line with this demographic shift, many issues related to aging are gaining increased societal attention; one of the most common issues addressed within the last 2 decades is the safety and well-being of older drivers. The attention devoted to driving is not surprising, given that people in the United States use passenger cars as their primary mode of transportation to a greater extent than any other country in the world (NationFEbRUARY 2012
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OT PRACTICE, 17(3)