A national survey of experiential learning in occupational therapy education: implications for fieldwork

The current Accreditation Council for Occupational Therapy Education (ACOTE) Standards include a provision for the use of experiential learning methods as level I fieldwork experiences by entry-level occupational therapy (OT) education programs (ACOTE, 2018). Included in these experiences are two specific types of simulation: simulated environments and standardized patients. Earlier versions of the ACOTE Standards did not allow for the use of simulation as level I fieldwork experiences. This provision may help mitigate a shortage of level I and level II fieldwork placements and allow academic programs to provide consistent quality level I fieldwork across students (American Occupational Therapy Association [AOTA], 2017). This use of simulation as a fieldwork training method is an emerging area of OT education that has limited research on its use and best practice. This doctoral project sought to contribute to the existing knowledge by conducting a research study which investigated the use of both simulated environments and standardized patients by academic programs, as well as identifying the primary supports and barriers to its implementation. The project included the creation, distribution, and analysis of a national survey of entry-level OT programs. The survey found that the main barrier and support to implementation of simulation was funding and that private institutions are more likely to utilize standardized patients than public institutions. The results of this study will help inform future ACOTE Standards, provide both the American Occupational Therapy Association and ACOTE with additional information to help determine how to best provide resources for academic programs that facilitate successful implementation of the simulation methods, and help identify programs that can participate in the dissemination of best practice in the use of simulation as fieldwork experiences. The author recommends that ACOTE should also consider mandating the use of simulation, along with other experiential learning activities, as partial fulfillment of level I fieldwork requirements, to allow for better access to funding, decrease the fieldwork burden on traditional fieldwork sites, and allow for more consistent level I fieldwork experiences

Toxic Cyanobacteria Aerosols: Tests of Filters for Cells

Aerosolization of toxic cyanobacteria released from the surface of lakes is a new area of study that could uncover a previously unknown route of exposure to toxic cyanobacteria. Since toxic cyanobacteria may be responsible for adverse human health effects, methods and equipment need to be tested and established for monitoring these airborne bacteria. The primary focus of this study was to create controlled laboratory experiments that simulate natural lake aerosol production. I set out to test for the best type of filter to collect and analyze the aerosolized cells as small as 0.2-2.0 µm, known as picoplankton. To collect these aerosols, air was vacuumed from just above a sample of lake water passing through either glass fiber filters (GFF) or 0.22 µm MF-Millipore™ membrane filters (0.22 Millipore™). Filter collections were analyzed through epiflourescence microscopy for determining cell counts. Data analysis revealed that 0.22 Millipore™ filters were the best option for cell enumeration providing better epiflourescence optical quality and higher cell counts

Barriers, Challenges, and Supports to the Implementation of Standardized Patients and Simulated Environments by Occupational Therapy Education Programs

A national survey examined the implementation rates, barriers, challenges, and supports to implementation of two types of simulation (standardized patients and simulated environments) by entry-level occupational therapy education programs in the United States. It also sought to identify relationships between program characteristics and implementation of these types of simulation. An online survey inquiring about academic program characteristics and use of simulation was sent to all occupational therapy and occupational therapy assistant programs in the United States in 2017 prior to the implementation of the 2018 Accreditation Council for Occupational Therapy Education Standards and the onset of the COVID-19 Pandemic. Data were analyzed using both statistical and content analysis. There were 97 responses to the survey, with an approximate response rate of 23.8%. Thirty-eight percent of responses used standardized patients and 70% used simulated environments in their didactic coursework. Programs at private institutions were more likely to use standardized patients than programs at public institutions (Cramer’s V=0.229; p=0.024). Funding was the most cited support, challenge, and barrier to the use of standardized patients. Physical space was the most cited support and challenge for the use of simulated environments, with funding as the most cited barrier. Study results indicate that adequate funding, space, and potentially other resources are needed for successful implementation of these types of simulation. Future research should further study the barriers and supports to implementation of simulation by occupational therapy academic programs as well as further examination of implementation rates

Inflammatory monocytes require type I interferon receptor signaling to activate NK cells via IL-18 during a mucosal viral infection

The requirement of type I interferon (IFN) for natural killer (NK) cell activation in response to viral infection is known, but the underlying mechanism remains unclear. Here, we demonstrate that type I IFN signaling in inflammatory monocytes, but not in dendritic cells (DCs) or NK cells, is essential for NK cell function in response to a mucosal herpes simplex virus type 2 (HSV-2) infection. Mice deficient in type I IFN signaling, Ifnar(-/-) and Irf9(-/-) mice, had significantly lower levels of inflammatory monocytes, were deficient in IL-18 production, and lacked NK cell-derived IFN-gamma. Depletion of inflammatory monocytes, but not DCs or other myeloid cells, resulted in lower levels of IL-18 and a complete abrogation of NK cell function in HSV-2 infection. Moreover, this resulted in higher susceptibility to HSV-2 infection. Although Il18(-/-) mice had normal levels of inflammatory monocytes, their NK cells were unresponsive to HSV-2 challenge. This study highlights the importance of type I IFN signaling in inflammatory monocytes and the induction of the early innate antiviral response

Volume 43, Number 2, June 2023 OLAC Newsletter

Digitized June 2023 issue of the OLAC Newsletter

Importance of Tree-and Species-Level Interactions with Wildfire, Climate, and Soils in Interior Alaska: Implications for Forest Change Under a Warming Climate

The boreal zone of Alaska is dominated by interactions between disturbances, vegetation, and soils. These interactions are likely to change in the future through increasing permafrost thaw, more frequent and intense wildfires, and vegetation change from drought and competition. We utilize an individual tree-based vegetation model, the University of Virginia Forest Model Enhanced (UVAFME), to estimate current and future forest conditions across sites within interior Alaska. We updated UVAFME for application within interior Alaska, including improved simulation of permafrost dynamics, litter decay, nutrient dynamics, fire mortality, and postfire regrowth. Following these updates, UVAFME output on species-specific biomass and stem density was comparable to inventory measurements at various forest types within interior Alaska. We then simulated forest response to climate change at specific inventory locations and across the Tanana Valley River Basin on a 2 × 2 km2 grid. We derived projected temperature and precipitation from a five-model average taken from the CMIP5 archive under the RCP 4.5 and 8.5 scenarios. Results suggest that climate change and the concomitant impacts on wildfire and permafrost dynamics will result in overall decreases in biomass (particularly for spruce (Picea spp.)) within the interior Tanana Valley, despite increases in quaking aspen (Populus tremuloides) biomass, and a resulting shift towards higher deciduous fraction. Simulation results also predict increases in biomass at cold, wet locations and at high elevations, and decreases in biomass in dry locations, under both moderate (RCP 4.5) and extreme (RCP 8.5) climate change scenarios. These simulations demonstrate that a highly detailed, species interactive model can be used across a large region within Alaska to investigate interactions between vegetation, climate, wildfire, and permafrost. The vegetation changes predicted here have the capacity to feed back to broader scale climate-forest interactions in the North American boreal forest, a region which contributes significantly to the global carbon and energy budgets

Higher Activity of the Inducible Nitric Oxide Synthase Contributes to Very Early Onset Inflammatory Bowel Disease

OBJECTIVES: The NOS2 gene encodes for the inducible nitric oxide synthase (iNOS), responsible for nitric oxide (NO) production, which contributes to antimicrobial and antipathogenic activities. Higher levels of both iNOS and NO-induced damage have been observed in inflammatory bowel disease (IBD) patients. NOS2 may have a role in a specific subset of IBD patients with severe and/or extensive colitis. Therefore, the aim of this study is to examine the role of NOS2 in such a subset, very early onset IBD (VEO-IBD). METHODS: Seventeen tag single nucleotide polymorphisms (SNPs) in the NOS2 gene were successfully genotyped in VEO-IBD patients. Genetic associations were replicated in an independent VEO-IBD cohort. Functional analysis for iNOS activity was performed on the most significantly associated functional variant. RESULTS: The NOS2 rs2297518 SNP was found to be associated in VEO-IBD in two independent cohorts. Upon combined analysis, a coding variant (S608L) showed the strongest association with VEO-IBD (Pcombined=1.13 × 10−6, OR (odds ratio)=3.398 (95% CI (confidence interval) 2.02–5.717)) as well as associations with VEO-Crohn's disease and VEO-ulcerative colitis (UC). This variant also showed an association with UC diagnosed between 11 and 17 years of age but not with adult-onset IBD (>17 years). B-cell lymphoblastoid cell lines genotyped for the risk variant as well as Henle-407 cells transfected with a plasmid construct with the risk variant showed higher NO production. Colonic biopsies of VEO-IBD patients showed higher immunohistochemical staining of nitrotyrosine, indicating more nitrosative stress and tissue damage. CONCLUSIONS: These studies suggest the importance of iNOS in genetic susceptibility to younger IBD presentation due to higher NO production

Volume 42, Number 4, December 2022 OLAC Newsletter

Digitized December 2022 issue of the OLAC Newsletter

Volume 43, Number 3, September 2023 OLAC Newsletter

Digitized September 2023 issue of the OLAC Newsletter