If Reasoning, Reflection, and Evidence-Based Practice are Essential to Practice, We Must Define Them

Reasoning, reflection, and evidence-based practice are considered essential to the delivery of high-quality occupational therapy services. These skills are highlighted in occupational therapy practice acts and educational standards. Unfortunately, although clearly integral to practice, reasoning, reflection, and evidence-based practice are rarely and inconsistently defined in the profession of occupational therapy. Because the terms reasoning, reflection, and evidence-based practice are used so frequently, and so often their definitions are assumed, occupational therapy students may be unclear on how they will be evaluated and, ultimately, what they will be expected to do in practice in relation to these skills. Through a review of literature, this paper identifies the need for clear conceptualizations of professional skills in occupational therapy and synthesizes the significance of reasoning, reflection, and evidence-based practice to both the education of occupational therapy students and the practice of occupational therapy. This Opinions in the Profession paper seeks to begin a discussion around actions required to advance occupational therapy as a profession through the process of clarifying how these skills are conceptualized, taught, and implemented to promote clear language in literature, education, and practice with the hope of positively impacting therapy services

Defining Reasoning, Reflective Practice, and Evidence-Based Practice in Occupational Therapy Education: A Delphi Study

Reasoning, reflective practice, and evidence-based practice are essential skills for occupational therapy practitioners, but it is unclear how these skills are defined in occupational therapy education. We used Delphi methodology to explore educator conceptualizations of clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. Eligible participants on the Delphi expert panel were required to have been an educator in an occupational therapy program for at least three years at the master’s level or higher, to be a current occupational therapy educator, based in the United States, and available across multiple survey rounds. Nine participants completed all three survey rounds. Among members of the expert panel there was continued moderate disagreement about terminology related to reasoning and there were some discrepancies between expert perspectives and the occupational therapy literature. However, these educators largely agreed on key features of the complex constructs. Consistency about the use of these terms will support both education and research related to essential professional skills

Relationships Between Reasoning, Reflective Practice, and Evidence-Based Practice: Educators’ Perspectives

Many models of professional thinking exist within occupational therapy, but the relationships among reasoning, reflective practice, and evidence-based practice as essential skills for practice are not clear. Because occupational therapy educators impart these skills to students, understanding how educators conceptualize relationships among skills is necessary. We used Delphi methodology to explore educator conceptualizations of the relationships among clinical reasoning, professional reasoning, reflective practice, and evidence-based practice. Inclusion criteria were: an educator in an occupational therapy program for at least three years at the master’s level or higher, currently an occupational therapy educator based in the United States, and available across multiple survey rounds. Nine participants completed all three survey rounds. Participants agreed that the four skills are reciprocally related to one another, with some discrepancies surrounding differing conceptualizations of clinical and professional reasoning. Additionally, relationships were understood to be non-linear and complex. Continued exploration of how these essential skills are related to one another is needed to support future exploration of how they are integrated in occupational therapy education and how this influences practice

DHODH modulates transcriptional elongation in the neural crest and melanoma

Melanoma is a tumour of transformed melanocytes, which are originally derived from the embryonic neural crest. It is unknown to what extent the programs that regulate neural crest development interact with mutations in the BRAF oncogene, which is the most commonly mutated gene in human melanoma1. We have used zebrafish embryos to identify the initiating transcriptional events that occur on activation of human BRAF(V600E) (which encodes an amino acid substitution mutant of BRAF) in the neural crest lineage. Zebrafish embryos that are transgenic for mitfa:BRAF(V600E) and lack p53 (also known as tp53) have a gene signature that is enriched for markers of multipotent neural crest cells, and neural crest progenitors from these embryos fail to terminally differentiate. To determine whether these early transcriptional events are important for melanoma pathogenesis, we performed a chemical genetic screen to identify small-molecule suppressors of the neural crest lineage, which were then tested for their effects on melanoma. One class of compound, inhibitors of dihydroorotate dehydrogenase (DHODH), for example leflunomide, led to an almost complete abrogation of neural crest development in zebrafish and to a reduction in the self-renewal of mammalian neural crest stem cells. Leflunomide exerts these effects by inhibiting the transcriptional elongation of genes that are required for neural crest development and melanoma growth. When used alone or in combination with a specific inhibitor of the BRAF(V600E) oncogene, DHODH inhibition led to a marked decrease in melanoma growth both in vitro and in mouse xenograft studies. Taken together, these studies highlight developmental pathways in neural crest cells that have a direct bearing on melanoma formation

Implications of adult sex ratios for natal dispersal in a cooperative breeder

In cooperatively breeding species, sexually mature individuals may delay natal dispersal and become subordinates, helping a dominant pair raise offspring. To understand how cooperative breeding evolved, it is important to determine the mechanisms leading to delayed dispersal. Adult sex ratio (ASR) variation may affect dispersal by limiting breeding vacancies available to the more abundant sex, and cooperative breeders often have a more biased ASR than noncooperative breeders. However, no studies of cooperative breeders have related ASR at both the local and population level with dispersal. Using the long-term Seychelles warbler, Acrocephalus sechellensis, data set, we tested the influence of population-wide and local ASR, and density, on natal dispersal of yearlings. Our ASR - density hypothesis predicts that the probability of natal dispersal is lower when the ASR is biased towards the sex of the focal individual, but only when the population density is high. Dispersal was associated with population density and population-wide ASR in males, but not in females; males were more likely to delay dispersal when ASR was male biased and density was high. Our findings illustrate a complex association between demographic factors and cooperative breeding and suggest that individuals alter their dispersal behaviour in response to the demographic composition of the population

Three red suns in the sky: A transiting, terrestrial planet in a triple M-dwarf system at 6.9 pc

We present the discovery from Transiting Exoplanet Survey Satellite (TESS) data of LTT 1445Ab. At a distance of 6.9 pc, it is the second nearest transiting exoplanet system found to date, and the closest one known for which the primary is an M dwarf. The host stellar system consists of three mid-to-late M dwarfs in a hierarchical configuration, which are blended in one TESS pixel. We use MEarth data and results from the Science Processing Operations Center data validation report to determine that the planet transits the primary star in the system. The planet has a radius of ${1.38}_{-0.12}^{+0.13}$ ${R}_{\oplus }$, an orbital period of ${5.35882}_{-0.00031}^{+0.00030}$ days, and an equilibrium temperature of ${433}_{-27}^{+28}$ K. With radial velocities from the High Accuracy Radial Velocity Planet Searcher, we place a 3σ upper mass limit of 8.4 ${M}_{\oplus }$ on the planet. LTT 1445Ab provides one of the best opportunities to date for the spectroscopic study of the atmosphere of a terrestrial world. We also present a detailed characterization of the host stellar system. We use high-resolution spectroscopy and imaging to rule out the presence of any other close stellar or brown dwarf companions. Nineteen years of photometric monitoring of A and BC indicate a moderate amount of variability, in agreement with that observed in the TESS light-curve data. We derive a preliminary astrometric orbit for the BC pair that reveals an edge-on and eccentric configuration. The presence of a transiting planet in this system hints that the entire system may be co-planar, implying that the system may have formed from the early fragmentation of an individual protostellar core.Accepted manuscrip

fMRI evidence of ‘mirror’ responses to geometric shapes

Mirror neurons may be a genetic adaptation for social interaction [1]. Alternatively, the associative hypothesis [2], [3] proposes that the development of mirror neurons is driven by sensorimotor learning, and that, given suitable experience, mirror neurons will respond to any stimulus. This hypothesis was tested using fMRI adaptation to index populations of cells with mirror properties. After sensorimotor training, where geometric shapes were paired with hand actions, BOLD response was measured while human participants experienced runs of events in which shape observation alternated with action execution or observation. Adaptation from shapes to action execution, and critically, observation, occurred in ventral premotor cortex (PMv) and inferior parietal lobule (IPL). Adaptation from shapes to execution indicates that neuronal populations responding to the shapes had motor properties, while adaptation to observation demonstrates that these populations had mirror properties. These results indicate that sensorimotor training induced populations of cells with mirror properties in PMv and IPL to respond to the observation of arbitrary shapes. They suggest that the mirror system has not been shaped by evolution to respond in a mirror fashion to biological actions; instead, its development is mediated by stimulus-general processes of learning within a system adapted for visuomotor control

Cervicovaginal mucus barrier properties during pregnancy are impacted by the vaginal microbiome

Introduction Mucus in the female reproductive tract acts as a barrier that traps and eliminates pathogens and foreign particles via steric and adhesive interactions. During pregnancy, mucus protects the uterine environment from ascension of pathogens and bacteria from the vagina into the uterus, a potential contributor to intrauterine inflammation and preterm birth. As recent work has demonstrated the benefit of vaginal drug delivery in treating women’s health indications, we sought to define the barrier properties of human cervicovaginal mucus (CVM) during pregnancy to inform the design of vaginally delivered therapeutics during pregnancy. Methods CVM samples were self-collected by pregnant participants over the course of pregnancy, and barrier properties were quantified using multiple particle tracking. 16S rRNA gene sequencing was performed to analyze the composition of the vaginal microbiome. Results Participant demographics differed between term delivery and preterm delivery cohorts, with Black or African American participants being significantly more likely to delivery prematurely. We observed that vaginal microbiota is most predictive of CVM barrier properties and of timing of parturition. Lactobacillus crispatus dominated CVM samples showed increased barrier properties compared to polymicrobial CVM samples. Discussion This work informs our understanding of how infections occur during pregnancy, and directs the engineering of targeted drug treatments for indications during pregnancy

No Association between Personality and Candidate Gene Polymorphisms in a Wild Bird Population

Consistency of between-individual differences in behaviour or personality is a phenomenon in populations that can have ecological consequences and evolutionary potential. One way that behaviour can evolve is to have a genetic basis. Identifying the molecular genetic basis of personality could therefore provide insight into how and why such variation is maintained, particularly in natural populations. Previously identified candidate genes for personality in birds include the dopamine receptor D4 (DRD4), and serotonin transporter (SERT). Studies of wild bird populations have shown that exploratory and bold behaviours are associated with polymorphisms in both DRD4 and SERT. Here we tested for polymorphisms in DRD4 and SERT in the Seychelles warbler (Acrocephalus sechellensis) population on Cousin Island, Seychelles, and then investigated correlations between personality and polymorphisms in these genes. We found no genetic variation in DRD4, but identified four polymorphisms in SERT that clustered into five haplotypes. There was no correlation between bold or exploratory behaviours and SERT polymorphisms/haplotypes. The null result was not due to lack of power, and indicates that there was no association between these behaviours and variation in the candidate genes tested in this population. These null findings provide important data to facilitate representative future meta-analyses on candidate personality genes

Mentoring Impact on Leader Efficacy Development: A Field Experiment

While practitioners and scholars tout the importance of mentorship in leader development, few studies have empirically determined whether mentoring actually positively impacts a leader’s development, and if so, in what ways. In a longitudinal field experiment, we examined how a targeted mentorship program that unfolded over 6 months enhanced the development of protégés’ leader efficacy and performance. Results showed that the targeted mentorship intervention increased protégés’ level of leader efficacy more than a comparison intervention that was based on a more eclectic leadership education program delivered in a group setting. Leader efficacy then predicted rated leader performance. Both protégés’ preferences for feedback and trust in the mentor served as important moderators in contributing to the development of leader efficacy. Findings from this longitudinal field experiment could be used by educational institutions and other organizations to enhance their mentorship programs in content, focus, and evaluation of impact