Improving Empathy of Occupational Therapy Students Through Reading Literary Narratives

This study explored the impact of teaching empathy to occupational therapy students through the close reading of literary narratives. The study defined empathy as a dynamic process involving Theory of Mind (ToM), emotional resonance, and empathy as a willful act. Empathy is an espoused value of occupational therapy challenged by the modern demands of the market-driven health care system, and research suggests reading literary narratives, or stories with qualities of literature, facilitates greater empathy. Prior studies have also indicated that practicing with greater empathy improves health outcomes and makes occupational therapy sessions more client centered. In this study, a quasi-experimental design was used on occupational therapy students (n = 31) in a graduate level rehabilitation course that involved the close reading, or critical reflection, of literary narratives to teach empathy. Close reading is a teaching process through which students critically read and reflect on literary narratives through instructor-guided reflection. Study findings on the pre and post-test surveys of students found a statistically significant improvement in scores (p \u3c .05) on the Jefferson Scale of Empathy (JSE). No differences were found between pre and post-test surveys of the Reading the Mind in the Eyes Test (RMET). The JSE measures empathic awareness, while the RMET measures aspects of empathic performance. Study limitations included mid-course changes due to the COVID-19 pandemic and the potential impact of social desirability on perceptions of empathy. Study findings suggest the close reading of literary narratives may be an effective learning tool to teach empathic-centered care to occupational therapy students

PhD

dissertationFor a peptide vaccine to be effective in generating an antibody response, it generally must incorporate both B cell epitopes, against which the antibody response is to be directed, and T cell epitopes, which are responsible for stimulating helper T cells. The first part of this work is concerned with the question, How well can a T cell epitope replace the carrier protein from which it is derived?" To answer this question two studies were done: an initial, direct comparison between a protein (the Fab' fragment of murine monoclonal anti-fluorescein antibody 9-40) coupled to hen egg lysozyme (HEL) and the same protein coupled to the immunodominant T cell epitope from HEL for BIO.A (H-2a) mice, along with negative controls, and a second, dose response study with fluorescein (FL) as the B cell epitope attached to a multiple antigenic peptide (MAP) version of this T cell epitope, along with positive and negative controls (HEL and a MAP in which the epitope sequence was replaced by glycine residues, respectively). This study showed a half-sigmoidal curve for the FL-(T epitope) immunogen, no response to the negative control except at the highest dose used, and a fairly constant and high response for both the experimental MAP and the fluoresceinated HEL. The initial study described above gave a very specific anti-idiotype response for the (9-40)Fab'-HEL construct. Another, follow-up study comparing a peptide mimic based on an important idiotope, the third complementarity determining region of the heavy chain (the CDR-H3 loop), to the intact idiotype was also conducted. In this study the peptide mimic of the CDR-H3 loop was the B cell epitope; it was also coupled to HEL. The question being addressed was, "How well can an idiotope peptide mimic replace its parent idiotype?" B10.A mice were immunized with (B epitope)-HEL, (9-40)Fab'-HEL, (B epitope) + HEL mixed together, or just the B epitope. The essential issue was crossreactivity, and this was observed to increase with succeeding immunizations. Molecular dynamics simulations with generalized Born implicit solvation or particle mesh Ewald electrostatics were also used to provide insight into the structural basis of idiotopic phenomena

PhD

dissertationFor a peptide vaccine to be effective in generating an antibody response, it generally must incorporate both B cell epitopes, against which the antibody response is to be directed, and T cell epitopes, which are responsible for stimulating helper T cells. The first part of this work is concerned with the question, How well can a T cell epitope replace the carrier protein from which it is derived?" To answer this question two studies were done: an initial, direct comparison between a protein (the Fab' fragment of murine monoclonal anti-fluorescein antibody 9-40) coupled to hen egg lysozyme (HEL) and the same protein coupled to the immunodominant T cell epitope from HEL for BIO.A (H-2a) mice, along with negative controls, and a second, dose response study with fluorescein (FL) as the B cell epitope attached to a multiple antigenic peptide (MAP) version of this T cell epitope, along with positive and negative controls (HEL and a MAP in which the epitope sequence was replaced by glycine residues, respectively). This study showed a half-sigmoidal curve for the FL-(T epitope) immunogen, no response to the negative control except at the highest dose used, and a fairly constant and high response for both the experimental MAP and the fluoresceinated HEL. The initial study described above gave a very specific anti-idiotype response for the (9-40)Fab'-HEL construct. Another, follow-up study comparing a peptide mimic based on an important idiotope, the third complementarity determining region of the heavy chain (the CDR-H3 loop), to the intact idiotype was also conducted. In this study the peptide mimic of the CDR-H3 loop was the B cell epitope; it was also coupled to HEL. The question being addressed was, "How well can an idiotope peptide mimic replace its parent idiotype?" B10.A mice were immunized with (B epitope)-HEL, (9-40)Fab'-HEL, (B epitope) + HEL mixed together, or just the B epitope. The essential issue was crossreactivity, and this was observed to increase with succeeding immunizations. Molecular dynamics simulations with generalized Born implicit solvation or particle mesh Ewald electrostatics were also used to provide insight into the structural basis of idiotopic phenomena

Empathic Instruction through Literary Narratives: A Quasi-Experimental Study of an Occupational Therapy Course

This study examines concerns within the field of occupational therapy on the growing disconnect between the profession’s roots and espoused beliefs in empathic-centered care, and the modern realities of health care. In particular, the study examined whether the empathy levels of occupational therapy students would change after a course involving the close reading of literary narratives. Close reading of literary narratives has correlated with improved levels of empathy. Empathy is defined as a four-step dynamic process involving Theory of Mind (ToM), emotional resonance, emotional regulation, and empathy as a willful act. Initial study of the proposed curriculum found improved scores on the Jefferson Scale of Empathy (JSE) between pre and post-test class surveys, and no difference between pre and post-test surveys of the Reading the Mind in the Eyes Test (RMET). The JSE and RMET measures aspects of ToM, emotional resonance and empathic regulation. The outside factors of gender, education, GPA, and novels did not play a consequential role in the findings. Limitations in the study included mid-course changes in the curriculum design due to the COVID-19 pandemic. In particular, the change from in person to a strictly online recorded format. Another limitation was the potential influence of social desirability on student self-reported levels of empathy. Implications of the study are a call for an ongoing dialogue and proposed curriculum to meet occupational therapy’s espoused values within the modern demands of healthcare

Flesh and spirit onstage: chronotopes of performance in medieval English theatre

This study uses Mikhail Bakhtin\u27s chronotope, which is the informing principle of one\u27s experience of space and time, to explore different relations among space, time, actors, and audience in medieval theatre. Relations between the material and spiritual worlds as understood in the Middle Ages are considered in the context of relations between performers and audience members with two goals. First, I explore how the ontological status of the metaworld created through performance changed in the context of specific chronotopes. Second, I explore how diverse religious discourses affected medieval modes of representation. This study posits three chronotopes of performance informing medieval theatrical experience. In the sacramental chronotope, disciplined bodies moved through spiritual geographies in Latin liturgical dramas to bring participants into contact with an ontologically superior divine world. The consubstantial chronotope operated from an ontology of self-sufficiency locating power in the individual\u27s body rather than in a superior being. Within the consubstantial chronotope, performance, and representation more generally, was understood as a tool for the contemplation of ideas rather than as a vehicle for bringing performers into contact with an ontologically substantive world. The transubstantial chronotope works within an ontology of community that constructs performances as sites of cultural contestation and engagement. The communal mystery plays performed on Corpus Christi day in medieval England created a space and time for communicative bodies to tell shared narratives in a ritual effort to strengthen, purify, and heal souls. Performance within the transubstantial chronotope was uniquely open to metalinguistic and dialogic play, allowing the imaginative metaworld of the performance to function as innerly persuasive discourse possessing its own ontological weight and agency. Having explored these three chronotopes, this study examines the heterochronotopic quality of medieval English morality plays. I conclude with an analysis of a recent production of the Chester mystery cycle, Yimmimingaliso: The Mysteries. Using a variety of different languages in performance, as well as different languages of performance, this production evoked something of the transubstantial chronotope of medieval England

PhD

dissertationFor a peptide vaccine to be effective in generating an antibody response, it generally must incorporate both B cell epitopes, against which the antibody response is to be directed, and T cell epitopes, which are responsible for stimulating helper T cells. The first part of this work is concerned with the question, How well can a T cell epitope replace the carrier protein from which it is derived?" To answer this question two studies were done: an initial, direct comparison between a protein (the Fab' fragment of murine monoclonal anti-fluorescein antibody 9-40) coupled to hen egg lysozyme (HEL) and the same protein coupled to the immunodominant T cell epitope from HEL for BIO.A (H-2a) mice, along with negative controls, and a second, dose response study with fluorescein (FL) as the B cell epitope attached to a multiple antigenic peptide (MAP) version of this T cell epitope, along with positive and negative controls (HEL and a MAP in which the epitope sequence was replaced by glycine residues, respectively). This study showed a half-sigmoidal curve for the FL-(T epitope) immunogen, no response to the negative control except at the highest dose used, and a fairly constant and high response for both the experimental MAP and the fluoresceinated HEL. The initial study described above gave a very specific anti-idiotype response for the (9-40)Fab'-HEL construct. Another, follow-up study comparing a peptide mimic based on an important idiotope, the third complementarity determining region of the heavy chain (the CDR-H3 loop), to the intact idiotype was also conducted. In this study the peptide mimic of the CDR-H3 loop was the B cell epitope; it was also coupled to HEL. The question being addressed was, "How well can an idiotope peptide mimic replace its parent idiotype?" B10.A mice were immunized with (B epitope)-HEL, (9-40)Fab'-HEL, (B epitope) + HEL mixed together, or just the B epitope. The essential issue was crossreactivity, and this was observed to increase with succeeding immunizations. Molecular dynamics simulations with generalized Born implicit solvation or particle mesh Ewald electrostatics were also used to provide insight into the structural basis of idiotopic phenomena