Regenerative Rehabilitation and Genomics: Implications for Occupational Therapy

The completion of the human genome project has paved the way for health care practitioners to use genetic and environmental information to tailor medical treatment. This innovative approach to health care is rapidly evolving, and occupational therapists need to be aware of the impact it will have on future practice. Regenerative rehabilitation is a product of knowledge and techniques from the fields of rehabilitation and regenerative medicine with the common goal to restore function. Occupational therapists have the potential to play a significant role in regenerative rehabilitation research and implementation. The purpose of this article is to (a) increase understanding of genomics, regenerative medicine, and regenerative rehabilitation as they pertain to occupational therapy practice; (b) provide examples of how occupational therapy can contribute to and use evidence in the field of regenerative rehabilitation; and (c) advocate for the integration of these emerging techniques and technologies in occupational therapy training

Using a metaphor to help couples rebuild trust after an affair

When couples present for therapy following the discovery of infidelity by one of the partners, there are often conflicting feelings by the betrayed. On the one hand, the betrayed partner feels that..

Use of Standardized Patient Encounters as Predictors of Fieldwork Performance: A Pilot Study

Background: Although standardized patient encounters (SPEs) are being used in occupational therapy (OT) education, limited literature exists on the value these experiences have on OT student learning outcomes and preparation for fieldwork. This study sought to examine if SPEs had the potential to predict Level II A fieldwork performance. Method: This study used a retrospective analysis of 35 entry-level OT students. Independent variables included demographics (enrollment in an entry-level OT master\u27s or doctoral degree, age, and overall grade point average) and SPE performance. The fieldwork Level II A final performance evaluation score was used as the dependent variable. Hierarchical regression analysis was used with demographic variables as the first model to compare the addition of SPEs in predicting Level II A fieldwork performance scores. Results: The full model of demographics and SPE was statistically significant and accounted for 29% of the variance in the fieldwork Level II A performance scores (p = .031). SPEs accounted for an additional statistically significant amount of variance (17%), above and beyond demographic variables (p = .012). Discussion: These results indicate the potential value of SPEs in identifying students requiring additional preparation before embarking on clinical practice in their Level II A fieldwork

Functional Cognition: An Opportunity to Highlight the Role of Occupational Therapy in Post-Concussion Care

As concern surrounding concussion and the associated long-term effects grow, a continued need for comprehensive, holistic concussion care emerges. Occupational therapists are well-equipped to address the wide variety of symptoms and deficits that clients may experience post-concussion. Functional cognition is one area in which occupational therapists can demonstrate their unique value on the interdisciplinary treatment team. In this Opinions in the Profession paper, we describe how occupational therapists are poised to further establish their role in post-concussion care by becoming the primary discipline for assessing and treating functional cognition. The aim of this paper is to outline the role of occupational therapy in post-concussion care in regard to becoming the primary discipline for assessing and treating functional cognition and distinguishing occupational therapists as experts in functional cognition. Implications for practice, education, and research are discussed

A statistical approach to finding overlooked genetic associations

<p>Abstract</p> <p>Background</p> <p>Complexity and noise in expression quantitative trait loci (eQTL) studies make it difficult to distinguish potential regulatory relationships among the many interactions. The predominant method of identifying eQTLs finds associations that are significant at a genome-wide level. The vast number of statistical tests carried out on these data make false negatives very likely. Corrections for multiple testing error render genome-wide eQTL techniques unable to detect modest regulatory effects.</p> <p>We propose an alternative method to identify eQTLs that builds on traditional approaches. In contrast to genome-wide techniques, our method determines the significance of an association between an expression trait and a locus with respect to the set of all associations to the expression trait. The use of this specific information facilitates identification of expression traits that have an expression profile that is characterized by a single exceptional association to a locus.</p> <p>Our approach identifies expression traits that have exceptional associations regardless of the genome-wide significance of those associations. This property facilitates the identification of possible false negatives for genome-wide significance. Further, our approach has the property of prioritizing expression traits that are affected by few strong associations. Expression traits identified by this method may warrant additional study because their expression level may be affected by targeting genes near a single locus.</p> <p>Results</p> <p>We demonstrate our method by identifying eQTL hotspots in <it>Plasmodium falciparum </it>(malaria) and <it>Saccharomyces cerevisiae </it>(yeast). We demonstrate the prioritization of traits with few strong genetic effects through Gene Ontology (GO) analysis of Yeast. Our results are strongly consistent with results gathered using genome-wide methods and identify additional hotspots and eQTLs.</p> <p>Conclusions</p> <p>New eQTLs and hotspots found with this method may represent regions of the genome or biological processes that are controlled through few relatively strong genetic interactions. These points of interest warrant experimental investigation.</p

Increasing Occupational Engagement by Addressing Psychosocial and Occupational Factors of Chronic Pain: A Case Report

Background: Chronic pain can significantly disrupt occupational engagement through physical, psychological, and social domains. Because pain is a subjective experience influenced by numerous factors, it has the capacity to become increasingly complex. Evidence supports addressing chronic pain through a biopsychosocial approach and promoting health and well-being through occupational engagement. Method: This case report describes the implementation of psychosocial and occupation-focused assessments and interventions for a 68-year-old client with chronic pain and increased symptoms of depression, anxiety, and pain catastrophizing. The use of an occupation-focused time-use assessment (Occupational Experience Profile), psychosocial assessments, and pain assessments guided intervention development. Occupational therapy intervention consisted of evidence-based approaches to address well-being and the pain experience through motivational interviewing, acceptance and commitment therapy, therapeutic exercises, pain neuroscience education, and graded exposure to occupational engagement. Results: The client demonstrated significant progress, and although pain was still present at discharge, he had met all client-directed goals. Outcome measures at discharge indicated improvements in depression, anxiety, catastrophizing thoughts about pain, and occupational engagement. Conclusion: Using a biopsychosocial approach, occupational therapists can incorporate psychosocial and occupation-focused assessments and interventions to increase quality of life and occupational engagement, improve overall well-being, and support clients in living well with chronic pain

A Mathematical Theory of Stochastic Microlensing I. Random Time-Delay Functions and Lensing Maps

Stochastic microlensing is a central tool in probing dark matter on galactic scales. From first principles, we initiate the development of a mathematical theory of stochastic microlensing. Beginning with the random time delay function and associated lensing map, we determine exact expressions for the mean and variance of these transformations. We characterize the exact p.d.f. of a normalized random time delay function at the origin, showing that it is a shifted gamma distribution, which also holds at leading order in the limit of a large number of point masses at a general point of the lens plane. For the large number of point masses limit, we also prove that the asymptotic p.d.f. of the random lensing map under a specified scaling converges to a bivariate normal distribution. We show analytically that the p.d.f. of the random scaled lensing map at leading order depends on the magnitude of the scaled bending angle due purely to point masses as well as demonstrate explicitly how this radial symmetry is broken at the next order. Interestingly, we found at leading order a formula linking the expectation and variance of the normalized random time delay function to the first Betti number of its domain. We also determine an asymptotic p.d.f. for the random bending angle vector and find an integral expression for the probability of a lens plane point being near a fixed point. Lastly, we show explicitly how the results are affected by location in the lens plane. The results of this paper are relevant to the theory of random fields and provide a platform for further generalizations as well as analytical limits for checking astrophysical studies of stochastic microlensing.Comment: New layout, more details and discussion. To appear, Journal of Mathematical Physic