Use of Assessments in Occupational Therapy Physical Disability Settings

Background: The aim of this study is to evaluate occupational therapists’ (OTs) perceptions and use of informal observation and formal assessments in order to understand if differences exist between acute care and non-acute care occupational therapy (OT) adult physical disability settings. Non-acute settings may include but are not limited to home health, inpatient rehabilitation, transitional care, outpatient rehabilitation, and long term care. Methods: Study design involved a nonexperimental survey. Qualtrics software was utilized to disseminate the survey across a five-state region to the population under study. Response rate included 88 OTs who answered consistently to the questions analyzed. Data analyses utilizing Statistical Package for the Social Sciences (SPSS) Statistics 23 was then conducted. Findings: OTs in both types of settings utilize informal observations more often compared to formal assessments. However, the acute care setting was found to have used informal assessments 17% more of the time. A positive relationship exists between increasing years of experience and feelings of validity and ease of use of informal observations. Trends were recognized in the number of years spent in OT practice regarding use of assessments. Conclusion: Findings enhance understanding of OT practice in acute care as compared to other adult physical disability settings in regards to the use of assessments. Implications involve the incorporation of teaching concepts of informal observations to the OT curriculum as well as enhancing future practitioners’ understandings of validity and reliability. The findings highlight the need for the development of formal assessments that consider the constraints of practice environments in order to enable their use. Implications for future study involve further investigation on the impact of years of experience in assessment use as well as additional studies to enhance understanding of occupational therapy in acute care

Metformin treatment for diabetes mellitus correlates with progression and survival in colorectal carcinoma

BACKGROUND: Diabetes mellitus is unfavorably associated with cancer risk. The purpose of this multi-disciplinary project was to evaluate a possible association of diabetes mellitus and other comorbidities and their treatment with progression of colorectal cancer. PATIENTS AND METHODS: We investigated the correlation between pathological characteristics and clinical course, including comorbidities in 1004 Czech patients diagnosed and surgically treated for colorectal adenocarcinoma (CRC) between 1999 and 2016. RESULTS: In our data set, CRC patients treated with metformin due to coexisting diabetes mellitus type 2 (T2DM) developed fewer distant metastases which clinically correlates with slower CRC progression. Survival in metformin subgroup was longer, particularly in men with CRC. Osteoporosis may be a negative factor of survival in CRC patients. CONCLUSIONS: Our findings also indicate that aging, higher tumor grade and TNM stage, coexistence of selected endocrine disorders, and metabolic abnormalities may change the tumor microenvironment and impact survival in colorectal cancer, although mechanism of these observations yet to be explained. Patients with diabetes mellitus type 2 treated with metformin may represent the altered microenvironment with specifically tuned metabolic molecular responses and with various epigenetic characteristics. More awareness and increased understanding of the mechanisms underlying the positive effect of metformin on patients' survival could offer insight into new treatment methods and permit more individualized treatment plans.Web of Science13239238

Some psychological benefits of urban nature: Mental vitality from time spent in nearby nature.

A one-time era of vast energy and natural resources allowed an industrial civilization to emerge and flourish. This gift of resources allowed for the building of modern society’s infrastructure and the flood of goods and services. Those resources, however, were never limitless. The coming decline in resource availability and quality will significantly alter individual and community life patterns, and initiate a drawn-out transition to a new normal. These changes in the biophysical basis of everyday life will tax our social, emotional and attentional capacities. Individuals will struggle to remain clearheaded and effective while coping with immutable biophysical limits. It is here that psychology will play a major role since what is being faced is not a technological or political challenge but an existential one. Psychological research posits that time spent in nature restores our mental effectiveness, emotional outlook and subjective well-being. Furthermore, the full psychological benefits of nature may not require exceptional natural environments such as scenic parks, exquisite gardens or immense green spaces. Everyday nature, even that judged to be mundane, may suffice. This is an important notion since nature in small-scale neighborhood settings is inexpensive to maintain and widely accessible to the vast majority of people. This chapter explores this idea, first by developing the theoretical basis for using ordinary nature to restore mental and social effectiveness and second by presenting a study of two designed residential neighborhoods that differ dramatically on the quality and amount of nearby nature. Results of the study are consistent with theory and prior research in indicating that residents who committed to spending time outdoors in their neighborhood showed greater mental clarity and effectiveness, regardless of the quality of the surrounding natural settings. Considered together, the theory and results support the suggestion that exposure to nearby nature significantly benefits mental functioning even in the absence of superlative design features. Time spent in everyday nature, which is available to most people, is as effective as experiencing the breathtaking beauty of extraordinary natural settings. The chapter presents these findings as having important implications for citizens who must maintain their mental clarity and emotional stability while responding to trying environmental circumstances. Even under a business-as-usual resource scenario, budget constraints and existing land use patterns make it difficult to create new natural areas. A scenario that includes a reduction of net energy surplus and a descent in natural resource availability makes these findings all the more useful.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/136087/1/De Young, R., K. Scheuer, T. Brown, T. Crow & J. Stewart (2017) Some psychological benefits of urban nature, in Columbus, A. M. (Ed.) Advances in Psychology Research 116 (Pp. 93-120).pdfDescription of De Young, R., K. Scheuer, T. Brown, T. Crow & J. Stewart (2017) Some psychological benefits of urban nature, in Columbus, A. M. (Ed.) Advances in Psychology Research 116 (Pp. 93-120).pdf : Main articl

Application of missing feature theory to the recognition of musical instruments in polyphonic audio

A system for musical instrument recognition based on a Gaussian Mixture Model (GMM) classifier is introduced. To enable instrument recognition when more than one sound is present at the same time, ideas from missing feature theory are incorporated. Specifically, frequency regions that are dominated by energy from an interfering tone are marked as unreliable and excluded from the classification process. The approach has been evaluated on clean and noisy monophonic recordings, and on combinations of two instrument sounds. These included random chords made from two isolated notes and combinations of two realistic phrases taken from commercially available compact discs. Classification results were generally good, not only when the decision between reliable and unreliable features was based on the knowledge of the clean signal, but also when it was solely based on the pitch and harmonic overtone series of the interfering sound

Widely used, short 16S rRNA mitochondrial gene fragments yield poor and erratic results in phylogenetic estimation and species delimitation of amphibians.

BACKGROUND The 16S mitochondrial rRNA gene is the most widely sequenced molecular marker in amphibian systematic studies, making it comparable to the universal CO1 barcode that is more commonly used in other animal groups. However, studies employ different primer combinations that target different lengths/regions of the 16S gene ranging from complete gene sequences (~ 1500 bp) to short fragments (~ 500 bp), the latter of which is the most ubiquitously used. Sequences of different lengths are often concatenated, compared, and/or jointly analyzed to infer phylogenetic relationships, estimate genetic divergence (p-distances), and justify the recognition of new species (species delimitation), making the 16S gene region, by far, the most influential molecular marker in amphibian systematics. Despite their ubiquitous and multifarious use, no studies have ever been conducted to evaluate the congruence and performance among the different fragment lengths. RESULTS Using empirical data derived from both Sanger-based and genomic approaches, we show that full-length 16S sequences recover the most accurate phylogenetic relationships, highest branch support, lowest variation in genetic distances (pairwise p-distances), and best-scoring species delimitation partitions. In contrast, widely used short fragments produce inaccurate phylogenetic reconstructions, lower and more variable branch support, erratic genetic distances, and low-scoring species delimitation partitions, the numbers of which are vastly overestimated. The relatively poor performance of short 16S fragments is likely due to insufficient phylogenetic information content. CONCLUSIONS Taken together, our results demonstrate that short 16S fragments are unable to match the efficacy achieved by full-length sequences in terms of topological accuracy, heuristic branch support, genetic divergences, and species delimitation partitions, and thus, phylogenetic and taxonomic inferences that are predicated on short 16S fragments should be interpreted with caution. However, short 16S fragments can still be useful for species identification, rapid assessments, or definitively coupling complex life stages in natural history studies and faunal inventories. While the full 16S sequence performs best, it requires the use of several primer pairs that increases cost, time, and effort. As a compromise, our results demonstrate that practitioners should utilize medium-length primers in favor of the short-fragment primers because they have the potential to markedly improve phylogenetic inference and species delimitation without additional cost

Do pupils at research-informed schools actually perform better? Findings from a study at English schools

Across the globe, many national, state, and district level governments are increasingly seeking to bring about school ‘self improvement’ via the fostering of change, which, at best, is based on or informed by research, evidence, and data. According to the conceptualisation of research-informed education as inquiry cycle, it is reasoned that there is value in combining the approaches of data-based decision-making and evidence-informed education. To put this assumption to test, a data-set based on 1457 staff members from 73 English primary schools (school year 2014/2015) was (re-)analysed in this paper. Not only survey information about trust among colleagues, organisational learning and the research use climate was used (cf. Brown et al., 2016), but also the results from the most recent school inspections and the results from standardised assessment at the end of primary school. Of particular interest was, as to whether the perceived research use climate mediates the association between organisational learning and trust at school on the one hand and the average pupil performance on the other, and whether schools that were rated as ‘outstanding’, ‘good’, or ‘requires improvement’ in their most recent school inspection differ in that regard. Data was analysed based on multi-level structural equation modelling. The originality of this paper lies in challenging common claims that teachers’ engagement with research supports development processes at schools and pupil performance. Our findings indicate that schools with a higher average value of trust among colleagues report more organisational and research informed activities, but also demonstrate better results in the average pupil performance assessment at the end of the school year. This was particularly true for schools rated as ‘good’ in previous school inspections. In contrast, both ‘outstanding’ schools and schools that ‘require improvement’ appeared to engage more with research evidence, even though the former seemed not to profit from it. Accordingly, the conclusion is drawn that a comprehensive model of research-informed education contributes to more conceptual clarity in future research, and based on that, contribute to theoretical development

A soluble endoplasmic reticulum factor as regenerative therapy for Wolfram syndrome

Endoplasmic reticulum (ER) stress-mediated cell death is an emerging target for human chronic disorders, including neurodegeneration and diabetes. However, there is currently no treatment for preventing ER stress-mediated cell death. Here, we show that mesencephalic astrocyte-derived neurotrophic factor (MANF), a neurotrophic factor secreted from ER stressed cells, prevents ER stress-mediated β cell death and enhances β cell proliferation in cell and mouse models of Wolfram syndrome, a prototype of ER disorders. Our results indicate that molecular pathways regulated by MANF are promising therapeutic targets for regenerative therapy of ER stress-related disorders, including diabetes, retinal degeneration, neurodegeneration, and Wolfram syndrome

Hierarchical rose-petal surfaces delay the early-stage bacterial biofilm growth

A variety of natural surfaces exhibit antibacterial properties; as a result significant efforts in the past decade have been dedicated towards fabrication of biomimetic surfaces that can help control biofilm growth. Examples of such surfaces include rose petals, which possess hierarchical structures like the micro-papillae measuring tens of microns and nano-folds that range in the size of 700 ±100 nm. We duplicated the natural structures on rose-petal surfaces via a simple UV-curable nanocasting technique, and tested the efficacy of these artificial surfaces in preventing biofilm growth using clinically relevant bacteria strains. The rose-petal structured surfaces exhibited hydrophobicity (contact angle~130.8º ±4.3º) and high contact angle hysteresis (~91.0° ±4.9°). Water droplets on rose-petal replicas evaporated following the constant contact line mode, indicating the likely coexistence of both Cassie and Wenzel states (Cassie-Baxter impregnating wetting state). Fluorescent microscopy and image analysis revealed the significantly lower attachment of Staphylococcus epidermidis (86.1± 6.2% less) and Pseudomonas aeruginosa (85.9 ±3.2% less) on the rose-petal structured surfaces, compared with flat surfaces over a period of 2 hours. Extensive biofilm matrix was observed in biofilms formed by both species on flat surfaces after prolonged growth (several days), but was less apparent on rose-petal biomimetic surfaces. In addition, the biomass of S. epidermidis (63.2 ±9.4% less) and P. aeruginosa (76.0 ±10.0% less) biofilms were significantly reduced on the rose-petal structured surfaces, in comparison to the flat surfaces. By comparing P. aeruginosa growth on representative unitary nano-pillars, we demonstrated that hierarchical structures are more effective in delaying biofilm growth. The mechanisms are two-fold: 1) the nano-folds across the hemispherical micro-papillae restrict initial attachment of bacterial cells and delay the direct contacts of cells via cell alignment, and 2) the hemispherical micro-papillae arrays isolate bacterial clusters and inhibit the formation of a fibrous network. The hierarchical features on rose petal surfaces may be useful for developing strategies to control biofilm formation in medical and industrial contexts

Intragenic CFTR Duplication and 5T/12TG Variant in a Patient with Non-Classic Cystic Fibrosis

Cystic fibrosis (CF) is an autosomal recessive disorder characterized by the accumulation of sticky and heavy mucus that can damage several organs. CF shows variable expressivity in affected individuals, but it typically causes respiratory and digestive complications as well as congenital bilateral absence of the vas deferens in males. Individuals with classic CF usually have variants that produce a defective protein from both alleles of the CFTR gene. Individuals with other variants may present with classic, non-classic, or milder forms of CF due to lower levels of functional CFTR protein. This article reports the genetic analysis of a female with features of asthma and mild or non-classic CF. CFTR sequencing demonstrated that she is a carrier for a maternally derived 5T/12TG variant. Deletion/duplication analysis by multiplex ligation-dependent probe amplification (MLPA) showed the presence of an intragenic paternally derived duplication involving exons 7-11 of the CFTR gene. This duplication is predicted to result in the production of a truncated CFTR protein lacking the terminal part of the nucleotide-binding domain 1 (NBD1) and thus is likely to be a non-functioning allele. The combination of this large intragenic duplication and 5T/12TG is the probable cause of the mild or non-classic CF features in this individual