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

Enhancing Simulation Fidelity in Occupational Therapy Education: Considerations for Standardized Patient Training and Implementation

The use of high-fidelity simulation and standardized patients (SPs) in occupational therapy (OT) education is expanding. However, the implementation of simulation varies across programs, leading to inconsistent outcomes and research limitations. Furthermore, details on SP use and training are lacking in OT literature. This article aims to provide OT educators with considerations for improving simulation fidelity by effectively using highly trained SPs. For example, recruiting SPs from diverse backgrounds is necessary to improve sociological fidelity, and proper training of SPs is required to ensure psychological fidelity. This article also emphasizes the need for standardized training for SPs and recommends following the Association of Standardized Patient Educators (ASPE) guidelines to ensure best practices in OT education. Adequate SP training and ongoing professional development are essential for maintaining simulation fidelity during SP experiences and optimizing student learning outcomes. Implementing SP experiences within the OT curriculum, SP recruitment and training, case development, pre-briefing, and debriefing processes are discussed, with recommendations from current evidence and the authors’ experience at an institution accredited by the Society for Simulation in Healthcare. Trained SPs can enhance simulation fidelity and provide students with realistic and compelling learning experiences, better preparing them for fieldwork and clinical practice. While further research is needed to explore the efficacy of SP encounters in OT education and the student experience, this article reinforces the need to standardize the use and training of SPs to enhance simulation fidelity and support the reliability and validity of future research efforts surrounding the use of SPs

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

Survey of Pain Curriculum Among Entry-Level Occupational Therapy Programs in the United States

Occupational therapy practitioners address pain management across settings, populations, and the lifespan. Occupational therapy practitioners offer unique contributions to pain management through biopsychosocial approaches, targeting supported self-management and occupational engagement. Comprehensive pain education is necessary to prepare entry-level occupational therapy practitioners to address pain in practice, yet no standards exist in entry-level occupational therapy education. This survey describes the status of pain-related education in entry-level occupational therapy programs across the United States. A total of 41 entry-level occupational therapy programs completed the survey. Total instructional time for pain content was reported to be an average of 9.68 hours, ranging from 1 to 30 hours, indicating significant variability. Average lecture (4.88 hours) and lab-based (5.05 hours) time devoted to pain content were similar. More time was devoted to teaching pain interventions (4.91 hours) than pain assessments (2.82 hours). Most programs integrated pain content throughout the curriculum (73%). One program utilized a standardized pain curriculum (International Association for the Study of Pain Occupational Therapy Curriculum). Open-ended questions revealed a breadth of evidence-based resources, pain assessments, and interventions covering all domains of the biopsychosocial model of pain. The majority of faculty (61%) felt their current amount of pain education was insufficient, citing the need for increased time and educational activities for pain education across all program years. Given the essential and unique role of occupational therapy practitioners in pain management, improving pain education and practitioner competence is an important consideration across entry-level occupational therapy education. Further discussion is needed regarding educational standards and entry-level occupational therapy curricula relating to pain management

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