Addressing Occupational Performance Deficits in a Religious Setting: A Pediatric Case Report

Background: The purpose of this pediatric case report is to document how occupational therapy assisted a family with a child who has a diagnosis of ASD and the religious clergy increase the child’s participation in activities in the religious context. Method: The pediatric case report uses an exploratory approach to explore the process of evaluating challenging psychosocial behaviors and implementing contextual and personal strategies to increase participation in meaningful occupations. Results: As a result of the occupational therapy recommendations and follow-up consultations, the client demonstrated a reduction in behaviors that were a barrier to her participation in meaningful activities in a religious context. Most notably observed were reductions with verbalizations, excessive movement, verbal outbursts (high volume), wandering, and fighting. Conclusions: Occupational therapists have a role in addressing the behavioral and emotional challenges that may prevent children with ASD from participating in meaningful religious activities valued by families and their communities. The strategies recommended as a part of this case report represent strategies commonly used in the home, community, and school-based settings. However, this case pediatric report highlights the application of psychosocial/behavioral and contextual recommendations in religious contexts

Addressing Occupational Performance Deficits in a Religious Setting: A Pediatric Case Report

Background: The purpose of this pediatric case report is to document how occupational therapy assisted a family with a child who has a diagnosis of ASD and the religious clergy increase the child’s participation in activities in the religious context. Method: The pediatric case report uses an exploratory approach to explore the process of evaluating challenging psychosocial behaviors and implementing contextual and personal strategies to increase participation in meaningful occupations. Results: As a result of the occupational therapy recommendations and follow-up consultations, the client demonstrated a reduction in behaviors that were a barrier to her participation in meaningful activities in a religious context. Most notably observed were reductions with verbalizations, excessive movement, verbal outbursts (high volume), wandering, and fighting. Conclusions: Occupational therapists have a role in addressing the behavioral and emotional challenges that may prevent children with ASD from participating in meaningful religious activities valued by families and their communities. The strategies recommended as a part of this case report represent strategies commonly used in the home, community, and school-based settings. However, this case pediatric report highlights the application of psychosocial/behavioral and contextual recommendations in religious contexts

Hormone-dependent control of developmental timing through regulation of chromatin accessibility

Specification of tissue identity during development requires precise coordination of gene expression in both space and time. Spatially, master regulatory transcription factors are required to control tissue-specific gene expression programs. However, the mechanisms controlling how tissue-specific gene expression changes over time are less well understood. Here, we show that hormone-induced transcription factors control temporal gene expression by regulating the accessibility of DNA regulatory elements. Using the Drosophila wing, we demonstrate that temporal changes in gene expression are accompanied by genome-wide changes in chromatin accessibility at temporal-specific enhancers. We also uncover a temporal cascade of transcription factors following a pulse of the steroid hormone ecdysone such that different times in wing development can be defined by distinct combinations of hormone-induced transcription factors. Finally, we show that the ecdysone-induced transcription factor E93 controls temporal identity by directly regulating chromatin accessibility across the genome. Notably, we found that E93 controls enhancer activity through three different modalities, including promoting accessibility of late-acting enhancers and decreasing accessibility of early-acting enhancers. Together, this work supports a model in which an extrinsic signal triggers an intrinsic transcription factor cascade that drives development forward in time through regulation of chromatin accessibility

Lysine 27 of replication-independent histone H3.3 is required for Polycomb target gene silencing but not for gene activation.

Proper determination of cell fates depends on epigenetic information that is used to preserve memory of decisions made earlier in development. Post-translational modification of histone residues is thought to be a central means by which epigenetic information is propagated. In particular, modifications of histone H3 lysine 27 (H3K27) are strongly correlated with both gene activation and gene repression. H3K27 acetylation is found at sites of active transcription, whereas H3K27 methylation is found at loci silenced by Polycomb group proteins. The histones bearing these modifications are encoded by the replication-dependent H3 genes as well as the replication-independent H3.3 genes. Owing to differential rates of nucleosome turnover, H3K27 acetylation is enriched on replication-independent H3.3 histones at active gene loci, and H3K27 methylation is enriched on replication-dependent H3 histones across silenced gene loci. Previously, we found that modification of replication-dependent H3K27 is required for Polycomb target gene silencing, but it is not required for gene activation. However, the contribution of replication-independent H3.3K27 to these functions is unknown. Here, we used CRISPR/Cas9 to mutate the endogenous replication-independent H3.3K27 to a non-modifiable residue. Surprisingly, we find that H3.3K27 is also required for Polycomb target gene silencing despite the association of H3.3 with active transcription. However, the requirement for H3.3K27 comes at a later stage of development than that found for replication-dependent H3K27, suggesting a greater reliance on replication-independent H3.3K27 in post-mitotic cells. Notably, we find no evidence of global transcriptional defects in H3.3K27 mutants, despite the strong correlation between H3.3K27 acetylation and active transcription

Increased tissue factor expression on circulating monocytes in chronic HIV infection: relationship to in vivo coagulation and immune activation

HIV infection is associated with an increased risk of thrombosis; and as antiretroviral therapy has increased the lifespan of HIV-infected patients, their risk for cardiovascular events is expected to increase. A large clinical study found recently that all-cause mortality for HIV+ patients was related to plasma levels of interleukin-6 and to D-dimer products of fibrinolysis. We provide evidence that this elevated risk for coagulation may be related to increased proportions of monocytes expressing cell surface tissue factor (TF, thromboplastin) in persons with HIV infection. Monocyte TF expression could be induced in vitro by lipopolysaccharide and flagellin, but not by interleukin-6. Monocyte expression of TF was correlated with HIV levels in plasma, with indices of immune activation, and with plasma levels of soluble CD14, a marker of in vivo lipopolysaccharide exposure. TF levels also correlated with plasma levels of D-dimers, reflective of in vivo clot formation and fibrinolysis. Thus, drivers of immune activation in HIV disease, such as HIV replication, and potentially, microbial translocation, may activate clotting cascades and contribute to thrombus formation and cardiovascular morbidities in HIV infection