Addressing societal trends impacting occupational therapy : technology integration and cultural diversity

This commentary presents a critical analysis of prior published work by the PhD candidate within the field of occupational therapy. Occupational therapy is a discipline which promotes participation in daily life activities (occupations) across the lifespan, from children with developmental delay to older adults managing the functional impact of chronic disease. The integration of technology and increased cultural diversity among patient populations are two major trends impacting teaching and practice, representing the themes of this commentary. The studies regarding technology highlight effectiveness of specific technologies, perceptions of specialty clinicians regarding technology-based clinical resources, as well as the physical impact of mobile technology use. The studies regarding cultural diversity focus specifically on international service learning (ISL) as pedagogy for the development of cultural competence for future occupational therapists. The collective findings of the studies make a novel contribution to the literature, evaluating the efficacy of a specific app-based technology, analyzing the musculoskeletal impact of mobile technology use, exploring clinician’ perceptions of technology integration in clinical settings, as well as providing support for ISL as a pedagogy for culturally-competent practice

Cross-Cultural Service Learning as Pedagogy for Character Development in Occupational Therapy Doctoral Students

Occupational therapists must demonstrate a broad spectrum of knowledge, clinical reasoning skills, and professionalism to be effective practitioners. Development of ethical practice must begin with the educational process to shape character traits as building blocks of moral reasoning. This article puts forth a cross-cultural service learning curricular module as lived experience for development of character traits in occupational therapy students. This mixed methods study investigated lived experience in the form of cross-cultural service learning as a pedagogy for development of character traits, as measured by the CIVIC, necessary to navigate professional ethical standards. Findings suggest a cross-cultural lived experience for occupational therapy doctoral students providing seating and mobility services in Guatemala significantly impacted character traits associated with professional ethical standards. Similar lived experience embedded in an occupational therapy curriculum may contribute to character development to guide ethical practice for the next generation of occupational therapists

Exploring the Impact of Service Learning in Haiti on the Cultural Competence of OTD Students

As society trends towards increased cultural diversity, the need for cultural competence in the field of occupational therapy (OT) becomes more acute. Immersion in another culture within the curriculum offers the student an opportunity to put their knowledge into practice and recognize the need to competently interact with members of another culture. This study explored the impact of a service learning trip to Haiti, providing seating and mobility services, on all four factors of cultural intelligence (CQ; i.e., metacognitive CQ, cognitive CQ, motivational CQ, behavioral CQ) for occupational therapy doctoral (OTD) students. Using the cultural intelligence scale (CQS), a one-group pretest-posttest design with a paired-samples t-test (α \u3c 0.05) rejected the null hypotheses to support service learning as a pedagogy which enhanced the four factors of CQ for the sample. With increased emphasis on producing culturally sensitive OTD professionals, service learning projects in a cross-cultural setting as a pedagogy extend beyond skill development (e.g., wheelchair fittings) to building coping strategies for interacting with clients (metacognitive CQ), enhancing knowledge of culture (cognitive CQ), persisting to overcome any cultural barriers (motivational CQ), and building the behavioral repertoire (behavioral CQ) of occupational therapists. Contrasting the results from this study with research into the efficacy of short-term study tours, service learning positively impacts behavioral CQ, whereas short-term study tours do not have the same impact. This article details the service learning project and provides recommendations for future research

Defining Mobile Tech Posture: Prevalence and Position Among Millennials

Background: Mobile technologies have revolutionized daily life, significantly impacting ADLs and IADLs, as well as use of the hand and upper extremity. The primary objectives of this study are to (a) provide a formal goniometric description of mobile tech posture and (b) examine the prevalence of this sub-optimal posture among a group of graduate students. Method: This study used a cross-sectional study design. Comprehensive goniometric measurements of the neck and upper extremity were taken with participants (N = 46) using their mobile devices while texting or using the Internet. Handheld usage data from the iPhone Screen Time feature (iOS 12) was collected from a sample of healthy young adults. Results: The participants spent an average of 143 min per day using mobile technology. Comprehensive goniometric measurements highlighted positions of clinical concern, including cervical spine flexion, scapular protraction, elbow flexion, and wrist ulnar deviation with thumb flexion. Discussion: Findings aligned with prior research suggesting several hr per day of handheld mobile technology use among young adults. Mobile tech posture, as described by goniometric trends, includes several positions of concern for musculoskeletal imbalance or cumulative trauma disorders (e.g., cubital tunnel syndrome; De Quervain’s tenosynovitis). Further research is recommended to examine broader societal trends and impact on occupational performance

Cross-Cultural Service Learning as Pedagogy for Character Development in Occupational Therapy Doctoral Students

Occupational therapists must demonstrate a broad spectrum of knowledge, clinical reasoning skills, and professionalism to be effective practitioners. Development of ethical practice must begin with the educational process to shape character traits as building blocks of moral reasoning. This article puts forth a cross-cultural service learning curricular module as lived experience for development of character traits in occupational therapy students. This mixed methods study investigated lived experience in the form of cross-cultural service learning as a pedagogy for development of character traits, as measured by the CIVIC, necessary to navigate professional ethical standards. Findings suggest a cross-cultural lived experience for occupational therapy doctoral students providing seating and mobility services in Guatemala significantly impacted character traits associated with professional ethical standards. Similar lived experience embedded in an occupational therapy curriculum may contribute to character development to guide ethical practice for the next generation of occupational therapists

Long-Term Impact of International Service Learning: Cultural Competence Revisited

As cultural diversity continues to rise globally, there is an evident need for culturally competent care, especially within the client-centered field of occupational therapy. Previous research has shown that occupational therapy doctoral (OTD) students who participated in international service-learning demonstrated an immediate positive impact on their cultural competence. The current study revisits these same doctoral students to examine the long-term impact of international service-learning experiences at six-month, one-year, two-year, and three-year intervals following the initial experience. The researchers conducted a mixed methods study with a pre-test post-test design, utilizing the Cultural Intelligence Scale (CQS), as well as qualitative responses in the form of written reflection. Results emphasized the significant short-term impact on the CQS, with the entire sample (N=40) demonstrating statistically significant results immediately after the experience on all four factors: metacognition, cognition, motivational, and behavioral. Metacognition demonstrated significant long-term impact at the three-year and one-year intervals. Other factors of the CQS remained above baseline levels, however, were not statistically significant. It appears international service-learning has an immediate impact but does “decay” over time, encouraging additional experience to solidify change. Implications and limitations are presented

Student-led Special Interest Groups as a Model for Inclusion of Specialty Hand Content in OTD Curriculum

This article presents a student-led special interest group within a doctorate of occupational therapy (OTD) program as a model to supplement the core curriculum for inclusion of specialty content related to hand therapy. Consisting of advanced educational modules, research article review and discussion, as well as related service projects, the group provides ancillary benefits as well as networking opportunities for student participants. An initial program evaluation demonstrates efficacy as students reported a positive impact on various areas of professional and clinical skills to support specialization in hand therapy upon graduation. The student-driven nature of this experiential learning approach provides more robust content without taxing often limited financial and faculty resources of occupational therapy programs. This model may be generalizable to other areas of occupational therapy practice to provide specialty content for various student interest areas at the academic level, encouraging specialization for new graduates to continue to provide advanced care to diverse populations

Methionine Sulfoxide Reductase A (MsrA) Deficient Mycoplasma genitalium Shows Decreased Interactions with Host Cells

Mycoplasma genitalium is an important sexually transmitted pathogen that affects both men and women. In genital-mucosal tissues, it initiates colonization of epithelial cells by attaching itself to host cells via several identified bacterial ligands and host cell surface receptors. We have previously shown that a mutant form of M. genitalium lacking methionine sulfoxide reductase A (MsrA), an antioxidant enzyme which converts oxidized methionine (Met(O)) into methionine (Met), shows decreased viability in infected animals. To gain more insights into the mechanisms by which MsrA controls M. genitalium virulence, we compared the wild-type M. genitalium strain (G37) with an msrA mutant (MS5) strain for their ability to interact with target cervical epithelial cell lines (HeLa and C33A) and THP-1 monocytic cells. Infection of epithelial cell lines with both strains revealed that MS5 was less cytotoxic to HeLa and C33A cell lines than the G37 strain. Also, the MS5 strain was more susceptible to phagocytosis by THP-1 cells than wild type strain (G37). Further, MS5 was less able to induce aggregation and differentiation in THP-1 cells than the wild type strain, as determined by carboxyfluorescein diacetate succinimidyl ester (CFSE) labeling of the cells, followed by counting of cells attached to the culture dish using image analysis. Finally, MS5 was observed to induce less proinflammatory cytokine TNF-α by THP-1 cells than wild type G37 strain. These results indicate that MsrA affects the virulence properties of M. genitalium by modulating its interaction with host cells

Intracellular Water Exchange for Measuring the Dry Mass, Water Mass and Changes in Chemical Composition of Living Cells

We present a method for direct non-optical quantification of dry mass, dry density and water mass of single living cells in suspension. Dry mass and dry density are obtained simultaneously by measuring a cell’s buoyant mass sequentially in an H[subscript 2]O-based fluid and a D[subscript 2]O-based fluid. Rapid exchange of intracellular H[subscript 2]O for D[subscript 2]O renders the cell’s water content neutrally buoyant in both measurements, and thus the paired measurements yield the mass and density of the cell’s dry material alone. Utilizing this same property of rapid water exchange, we also demonstrate the quantification of intracellular water mass. In a population of E. coli, we paired these measurements to estimate the percent dry weight by mass and volume. We then focused on cellular dry density – the average density of all cellular biomolecules, weighted by their relative abundances. Given that densities vary across biomolecule types (RNA, DNA, protein), we investigated whether we could detect changes in biomolecular composition in bacteria, fungi, and mammalian cells. In E. coli, and S. cerevisiae, dry density increases from stationary to exponential phase, consistent with previously known increases in the RNA/protein ratio from up-regulated ribosome production. For mammalian cells, changes in growth conditions cause substantial shifts in dry density, suggesting concurrent changes in the protein, nucleic acid and lipid content of the cell.National Cancer Institute (U.S.). Physical Sciences-Oncology Center (U54CA143874)National Institutes of Health (U.S.) (Center for Cell Division Process Grant P50GM6876)National Institutes of Health (U.S.) (Contract R01CA170592)United States. Army Research Office (Institute for Collaborate Biotechnologies Contract W911NF-09-D-0001

PPARα Deficiency in Inflammatory Cells Suppresses Tumor Growth

Inflammation in the tumor bed can either promote or inhibit tumor growth. Peroxisome proliferator-activated receptor (PPAR)α is a central transcriptional suppressor of inflammation, and may therefore modulate tumor growth. Here we show that PPARα deficiency in the host leads to overt inflammation that suppresses angiogenesis via excess production of the endogenous angiogenesis inhibitor thrombospondin-1 and prevents tumor growth. Bone marrow transplantation and granulocyte depletion show that PPARα expressing granulocytes are necessary for tumor growth. Neutralization of thrombospondin-1 restores tumor growth in PPARα-deficient mice. These findings suggest that the absence of PPARα activity renders inflammatory infiltrates tumor suppressive and, thus, may provide a target for inhibiting tumor growth by modulating stromal processes, such as angiogenesis