The sexualities of men who have same-sex desires yet identify as straight have attracted significant attention in recent years. We present findings from interviews with 100 such men, whom we recruited while they were seeking sex with men online, and examine the logics that allow them to maintain an identity as straight. Our sample is somewhat unique in that it included men across a wide age range (from 18 to 70), and also because many of our participants are white adult US men who are married or in stable relationships with women. Based on their patterns of sexual interpretation, we discuss how these men make their same-sex desires and behaviours consistent with a primary selfidentification as straight. We argue that, in the process of maintaining identities as straight men, they change the definition of heterosexuality, in effect turning it into a considerably elastic category that is perceived as fully compatible with having and enacting same-sex desires.

This article examines the logics of self-identification among men who have same-sex desires and behaviours and consider themselves to be straight. We draw from interviews conducted in the USA with 100 straight-identified men who have same-sex desires and 40 partners of such men. Our data allow us to reject two misconceptions. One is the idea that these men are actually gay or bisexual but refuse to accept those identities. We argue instead that these men see themselves as straight and therefore it is important to understand what specifically they mean by that. The second misconception links straight-identified men who have same-sex desires and behaviours to the racialised discourse of the so-called down low (or 'DL') in the USA. While the DL typically is depicted as involving African American and Latino men, most of our participants are White. Moving beyond these misconceptions, we propose that health educators must acknowledge flexibilities in the definition of heterosexuality and use an expanded definition as a starting point to envision, together with these men, how to more effectively engage them in HIV prevention and health promotion.

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The medical intensive care unit (MICU) presents a challenging environment within the health care arena. Patients in the MICU are at risk for occupational deprivation, due to a lack of opportunities for purposeful movements and activities, which further impedes recovery.Occupational deprivation occurs when people are not afforded equal opportunities to participate in desired occupations. Mind-body interventions might be a tool for occupational therapists to use a preparatory method to improve patients' physical and psychological health, leading to increased performance and participation in occupations while in the MICU. The purpose of this study was to explore the use of mind-body interventions delivered by an occupational therapist in a MICU. The patient in our case study was within normal ranges for all physiological and mental status variables during the mind-body interventions. Therefore, this study demonstrates that it is feasible for an occupational therapist with proper training and credential to elicit mind-body interventions in this setting, with this patient.iii ACKNOWLEDGMENTS I would like to express my deep gratitude to the many individuals who have helped me through this process. First and foremost, I would like to recognize my mentor, Dr. Arlene Schmid, for her incredible guidance, encouragement, and patience over the past two years.Thank you for your support, for challenging me, and for helping me fall in love with research. I would like to thank Amanda Hoffman, for her dedication to research and to the profession of occupational therapy, for her advice and support, and most importantly for being flexible and willing to take on this project. Your help in every aspect of this thesis was imperative for success. I would like to thank Lindsay Laxton and Katie Freeman for their time, support, and feedback during this process. I also owe great thanks to my committee members, Dr. Matt Malcolm and Dr. Doug Coatsworth; their feedback, guidance, and insight was hugely influential in this process. I would like to thank my colleagues Megan Roney and Kristin Turner for their encouragement, advice, and enjoyment. Working with you ladies was a pleasure. I would like to thank my family for their continual support of this thesis, and in every aspect of my life. Lastly, I would like to thank the Department of Occupational Therapy at Colorado State University and the University of Colorado Hospital for providing me the opportunity to be involved in this project.

Importance: Occupational therapy use in the neurological critical care unit (NCCU) may relate to patient factors, but data about these relationships remain unpublished. Objective: To examine how patient factors predict NCCU occupational therapy use and intervention types. Design: Retrospective cohort study of electronic health records data from adults admitted to the NCCU between May 2013 and September 2015. Setting: NCCU in a large, urban academic hospital. Participants: Adults (age ≥18 yr; N = 1,134) admitted to the NCCU. Measures: Using length of stay (LOS), number of comorbidities, Glasgow Coma Scale (GCS) score, gender, age, and racial–ethnic minority status as independent variables, separate regression models identified predictors for each dependent variable: receipt of NCCU occupational therapy, occupational therapy onset (days after admission), and receipt of self-care or home management (ADL–Home); functional activities or cognitive training (Func–Cog); and therapeutic exercise (Ther-Ex). Results: Four hundred twenty patients (37.0%) received occupational therapy in the NCCU. Receipt of occupational therapy was positively associated with LOS, number of comorbidities, GCS score, and age. Earlier occupational therapy onset was associated with higher GCS score and shorter LOS. Receipt of ADL–Home or Func–Cog interventions was significantly predicted by number of occupational therapy sessions, but patients with longer LOS were less likely to receive ADL–Home interventions. Receipt of Ther-Ex interventions became less likely as GCS score increased. Conclusions and Relevance: Patients are more likely to receive occupational therapy services if they are older and have a longer NCCU LOS, more comorbidities, and a higher level of consciousness. What This Article Adds: A patient’s level of consciousness is clearly associated with occupational therapy utilization and hospital outcomes, but it should not be the only factor considered when prioritizing patients for NCCU occupational therapy services. Compared with patients who were more awake and alert, patients with a lower level of consciousness had a later onset of occupational therapy, which suggests an opportunity for NCCU occupational therapists to collaborate with physicians in the modification of sedation protocols to enable early rehabilitation.