Promising Practice: Book Studies as Professional Development for Rural Teachers

This promising practice article describes conducting book studies as professional development in rural communities. In this article, we share our understanding of the importance of this type of professional development in rural schools, as well as considerations for those who wish to start something similar in their districts

Supporting Gifted Education in Rural Schools

In this “promising practices” piece, we draw from lessons learned from a larger research study exploring how alternative identification processes and curricular interventions might influence gifted education programming for students in rural school districts. In the larger study we sought to (a) increase the number of rural students identified for gifted education services and (b) provide support for those programs in the form of a place-based language arts curriculum. As we implemented an innovative identification and curricular option for historically underrepresented students from low-income rural areas, we encountered hurdles stemming from four sources: conceptions of giftedness, teacher time and expertise, expectations for students, and fidelity of implementation. This article illuminates those challenges and discusses efforts to mitigate them and negotiate a path through to success—seeing the possible rather than limitations set forth by imposed systems affecting rural schools and communities

The 2023 Whippoorwill Award: The 2023 Whippoorwill Award: Complex Representations of Rural Identities and Places

Announcing the 2023 Whippoorwill Award winners

Interventions for Persons with Mild Cognitive Impairment (MCI) An Evidence-Based Practice Project

This Evidence-Based Practice (EBP) project addressed the following question: What occupational therapy and multidisciplinary/interprofessional interventions are most effective for addressing mild cognitive impairment (MCI) to improve occupational performance, functional cognition, participation, well-being, quality of life, and caregiver burden

Auditory Integration Interventions for Children with Autism and Developmental Disabilities: An Evidence-Based Practice Project

After extensive review of select auditory integration interventions including Auditory Integration Therapy (AIT), The Listening Program (TLP), and Therapeutic Listening (TL), we can conclude that many of these interventions have not been examined for use with children and adolescents with autism spectrum disorder (ASD). Although some the research we found showed slight improvements in our investigated outcomes, many of them did not analyze the primary long-term outcomes of interest for occupational therapy including performance, participation, and engagement. Specialized training is required for therapists to facilitate AIT, TLP, and TL with their clients. Courses are costly ranging from $365-$2400, which further detracts the practicality of these interventions. All three of our auditory interventions were either not reviewed by the expert review groups or were investigated but not recommended. Additionally, some insurance companies and the United States Federal Drug Administration do not approve of some of the interventions and equipment required due to safety concerns and lack of evidence (UnitedHealthcare, 2016). Our preliminary recommendations are that these interventions are a Level 5. A Level 5 means that the treatment is designated as an untested/experimental treatment and/or is potentially harmful (WI Department of Health Services, 2014). Additionally, the results may not be a direct outcome of AIT, TLP, and TL due to a variety of limitations and gaps in research. Because of these gaps and limitations we can conclude that the existing research is of poor quality. Given the chosen study design in a majority of these articles, we cannot make definite conclusions that these interventions caused the differences in the outcomes. Also, due to case study designs and small sample sizes, the results cannot be generalized to the larger population. Conflicting recommendations exist for further on these auditory integration interventions. Therefore, individuals interested in conducting research should be aware of these cautions

Impact of Tobacco Control Interventions on Smoking Initiation, Cessation, and Prevalence: A Systematic Review

Background. Policymakers need estimates of the impact of tobacco control (TC) policies to set priorities and targets for reducing tobacco use. We systematically reviewed the independent effects of TC policies on smoking behavior. Methods. We searched MEDLINE (through January 2012) and EMBASE and other databases through February 2009, looking for studies published after 1989 in any language that assessed the effects of each TC intervention on smoking prevalence, initiation, cessation, or price participation elasticity. Paired reviewers extracted data from studies that isolated the impact of a single TC intervention. Findings. We included 84 studies. The strength of evidence quantifying the independent effect on smoking prevalence was high for increasing tobacco prices and moderate for smoking bans in public places and antitobacco mass media campaigns. Limited direct evidence was available to quantify the effects of health warning labels and bans on advertising and sponsorship. Studies were too heterogeneous to pool effect estimates. Interpretations. We found evidence of an independent effect for several TC policies on smoking prevalence. However, we could not derive precise estimates of the effects across different settings because of variability in the characteristics of the intervention, level of policy enforcement, and underlying tobacco control environment

Clinically actionable mutation profiles in patients with cancer identified by whole-genome sequencing

Next-generation sequencing (NGS) efforts have established catalogs of mutations relevant to cancer development. However, the clinical utility of this information remains largely unexplored. Here, we present the results of the first eight patients recruited into a clinical whole-genome sequencing (WGS) program in the United Kingdom. We performed PCR-free WGS of fresh frozen tumors and germline DNA at 75× and 30×, respectively, using the HiSeq2500 HTv4. Subtracted tumor VCFs and paired germlines were subjected to comprehensive analysis of coding and noncoding regions, integration of germline with somatically acquired variants, and global mutation signatures and pathway analyses. Results were classified into tiers and presented to a multidisciplinary tumor board. WGS results helped to clarify an uncertain histopathological diagnosis in one case, led to informed or supported prognosis in two cases, leading to de-escalation of therapy in one, and indicated potential treatments in all eight. Overall 26 different tier 1 potentially clinically actionable findings were identified using WGS compared with six SNVs/indels using routine targeted NGS. These initial results demonstrate the potential of WGS to inform future diagnosis, prognosis, and treatment choice in cancer and justify the systematic evaluation of the clinical utility of WGS in larger cohorts of patients with cancer

Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders

Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed analyses of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyper-activity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders, identifying three groups of inter-related disorders. Meta-analysis across these eight disorders detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning prenatally in the second trimester, and play prominent roles in neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.Peer reviewe

The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer