Examining Minimal Important Change of the Self-Assessment Scale of Clinical Reasoning in Occupational Therapy

The purpose of the study was to establish and quantify the minimal important change (MIC) value necessary to determine gains or losses in clinical reasoning during student fieldwork assignments as measured by the Self-Assessment of Clinical Reasoning in Occupational Therapy (SA-CROT). This multicenter prospective longitudinal study was conducted with students on their occupational therapy fieldwork in Japan. Two anchor-based methods were used to estimate the MIC values: a receiver operating characteristic-based method and a predictive modeling-based method. The MIC was adjusted based on the percentage of participants who exhibited improvement. Administered were the SA-CROT and the Global Rating of Change (GRC) scale as an anchor. A total of 111 students from 11 occupational therapy educational programs in Japan responded (response rate 29%). Overall, there was a significant difference (p \u3c .001, effect size was r = .80) in SA-CROT before and after fieldwork, and 81% of students showed improvement in the GRC scale. The adjusted MIC value was 3.69, with 95% confidence interval of 2.29–4.97. This anchor-based, adjusted MIC value is the most reliable value to interpret the changes in SA-CROT before and after fieldwork. The SA-CROT\u27s MIC value can be used as a cut-off point from a learner-centered perspective when considering educational methods and environments in fieldwork

Genetic Predisposition To Acquire a Polybasic Cleavage Site for Highly Pathogenic Avian Influenza Virus Hemagglutinin

Highly pathogenic avian influenza viruses with H5 and H7 hemagglutinin (HA) subtypes evolve from low-pathogenic precursors through the acquisition of multiple basic amino acid residues at the HA cleavage site. Although this mechanism has been observed to occur naturally only in these HA subtypes, little is known about the genetic basis for the acquisition of the polybasic HA cleavage site. Here we show that consecutive adenine residues and a stem-loop structure, which are frequently found in the viral RNA region encoding amino acids around the cleavage site of low-pathogenic H5 and H7 viruses isolated from waterfowl reservoirs, are important for nucleotide insertions into this RNA region. A reporter assay to detect nontemplated nucleotide insertions and deep-sequencing analysis of viral RNAs revealed that an increased number of adenine residues and enlarged stem-loop structure in the RNA region accelerated the multiple adenine and/or guanine insertions required to create codons for basic amino acids. Interestingly, nucleotide insertions associated with the HA cleavage site motif were not observed principally in the viral RNA of other subtypes tested (H1, H2, H3, and H4). Our findings suggest that the RNA editing-like activity is the key mechanism for nucleotide insertions, providing a clue as to why the acquisition of the polybasic HA cleavage site is restricted to the particular HA subtypes. IMPORTANCE Influenza A viruses are divided into subtypes based on the antigenicity of the viral surface glycoproteins hemagglutinin (HA) and neuraminidase. Of the 16 HA subtypes (H1 to -16) maintained in waterfowl reservoirs of influenza A viruses, H5 and H7 viruses often become highly pathogenic through the acquisition of multiple basic amino acid residues at the HA cleavage site. Although this mechanism has been known since the 1980s, the genetic basis for nucleotide insertions has remained unclear. This study shows the potential role of the viral RNA secondary structure for nucleotide insertions and demonstrates a key mechanism explaining why the acquisition of the polybasic HA cleavage site is restricted to particular HA subtypes in nature. Our findings will contribute to better understanding of the ecology of influenza A viruses and will also be useful for the development of genetically modified vaccines against H5 and H7 influenza A viruses with increased stability

Protective Efficacy of Neutralizing Monoclonal Antibodies in a Nonhuman Primate Model of Ebola Hemorrhagic Fever

Ebola virus (EBOV) is the causative agent of severe hemorrhagic fever in primates, with human case fatality rates up to 90%. Today, there is neither a licensed vaccine nor a treatment available for Ebola hemorrhagic fever (EHF). Single monoclonal antibodies (MAbs) specific for Zaire ebolavirus (ZEBOV) have been successfully used in passive immunization experiments in rodent models, but have failed to protect nonhuman primates from lethal disease. In this study, we used two clones of human-mouse chimeric MAbs (ch133 and ch226) with strong neutralizing activity against ZEBOV and evaluated their protective potential in a rhesus macaque model of EHF. Reduced viral loads and partial protection were observed in animals given MAbs ch133 and ch226 combined intravenously at 24 hours before and 24 and 72 hours after challenge. MAbs circulated in the blood of a surviving animal until virus-induced IgG responses were detected. In contrast, serum MAb concentrations decreased to undetectable levels at terminal stages of disease in animals that succumbed to infection, indicating substantial consumption of these antibodies due to virus replication. Accordingly, the rapid decrease of serum MAbs was clearly associated with increased viremia in non-survivors. Our results indicate that EBOV neutralizing antibodies, particularly in combination with other therapeutic strategies, might be beneficial in reducing viral loads and prolonging disease progression during EHF

チイキ ノ ツヨミ ヲ タカメル コウシュウ エイセイ カンゴ ギジュツ ヲ シュウトク スル シミュレーション プログラム WEB フキュウバン ノ ジツヨウセイ ニ カンスル イケン シュウシュウ チョウサ

【目的】地域の強みを高める公衆衛生看護技術（以下技術）を習得するシナリオベースのシミュレーションプログラムのWEB 普及版（以下WEB 普及版）の実践現場での実用性について、意見を収集することである。【方法】研究参加者は、全国の子育て世代包括支援センターと地域包括支援センター20施設に勤務する常勤保健師24名であり、2020年度、プログラム体験前後に、質問紙にて意見収集調査を行った。【結果】研究参加者は年齢・経験ともに幅広い層であり、WEB 普及版が有効かを尋ねたところ、9割以上が、とてもそう思う、そう思うと回答していた。また、技術習得のためにシミュレーションを用いることが有効かについては、プログラムを体験した全員が、とてもそう思う、そう思うと回答しており、自由記載でもプログラムについて、効果を感じているという意見があった。プログラム体験後の各技術の実施度得点と自信度得点は、ともに合計点と1項目を除く下位項目で、体験前より高値を示し、22項目中8項目で有意差が見られた（P<0.05）。【結論】本プログラムのWEB 普及版には一定の汎用性と実用性があことが示唆された。研究報告Report

Gender Differences of Brain Activity in the Conflicts Based on Implicit Self-Esteem

Objectives The purpose of this study was to evaluate the effectiveness of an occupational therapy program for health promotion among healthy elderly by a randomized controlled trial.Methods Participants were 220 community-dwelling healthy elderly, 65 years of age or older. They were assigned randomly to: an experimental group receiving a 15–session MOHO program consisting of lectures and seminars about personal causation, values, interests, roles, habits, motor skills, process skills, communication and interaction skills, and environment; a control group which received a 15–session crafts program or no treatment. Quality of life was compared between groups using the MOS 36–Item Short–Form Health Survey (SF–36), WHO/QOL–26 (QOL26) and Life Satisfaction Index Z. The Fisher\u27s exact test and the t-test were used to assess differences between the twogroups.Results The follow-up rates for the experimental and control groups were 71％ and 72％. The experimental group comprised 80 people (mean age±SD, 71.1±4.68 years) and the control group 79 (71.4±4.66 years). Mean change of the following items for the experimental group was significantly greaterfrom that of the control group: a BP of SF–36 (P＝0.05); and an environment score of QOL26 (P＝0.02).Conclusion The findings provide evidence that the MOHO program can meet coping and influence needs, thus improving QOL. We further conclude that the MOHO program is an effective interventional method for improvement of literacy about health and occupation

Gender differences of brain activity in the conflicts based on implicit self-esteem.

There are gender differences in global and domain-specific self-esteem and the incidence of some psychiatric disorders related to self-esteem, suggesting that there are gender differences in the neural basis underlying one's own self-esteem. We investigated gender differences in the brain activity while subjects (14 males and 12 females) performed an implicit self-esteem task, using fMRI. While ventromedial prefrontal cortex (vmPFC) was significantly activated in females, medial and dorsomedial PFC (dmPFC) were activated in males in the incongruent condition (self = negative) compared with the congruent condition (self = positive). Additionally, scores on the explicit self-esteem test were negatively correlated with vmPFC activity in females and positively correlated with dmPFC activity in males. Furthermore, the functional relationships among the regions found by direct gender comparisons were discussed based on the somatic-marker model. These showed that, compared to males, females more firmly store even the incongruent associations as part of their schematic self-knowledge, and such associations automatically activate the neural networks for emotional response and control, in which vmPFC plays a central role. This may explain female cognitive/behavioral traits; females have more tendency to ruminate more often than males, which sometimes results in a prolonged negative affect

Comparisons of Rosenberg scores, response times in IAT, and IAT effects in males and females.

<p>(A) Rosenberg self-esteem scores in males and females. There was no significant gender difference. (B) Response times for each main condition in IAT. (C) The mean IAT scores in males and females. There was no gender difference in the IAT scores. Error bars indicate standard error.</p