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The transition from expert occupational therapy practice to academic educator is stressful and complex, involving the development of a new professional identity. In 2020-21 COVID-19 created a new challenge for recently employed academics, who were in this transition process. This study utilized participatory research to explore the impact of COVID-19 on six new occupational therapy lecturers who were employed immediately before and during the pandemic. The participatory research approach simultaneously engaged participants in research processes and aimed to promote researcher development. Three focus groups were conducted to explore participants experiences before, during and after COVID-19 restrictions. Focus groups transcripts were coded and analyzed thematically. Four themes were identified: 1) Discovery 2) Turbulence 3) Survival and 4) Reflections were linked to an overarching analogy. Covid19 accelerated the transition to teaching as participants discovered effective strategies for teaching online through trial and error, with little available support. The easing of restrictions brought new challenges and anxieties for participants unfamiliar with classroom teaching. The study highlights the complexity of transitioning to academia, and the importance of peer and team support during the first two years. The participatory research process utilized in this study provided an opportunity to reflect back on the transition process while developing researcher skills and experience.

Using a learning theory is key when designing simulation-based learning linked to allied health professional placements to ensure the purposeful selection of educational methods and to understand how it may assist learners in achieving desired learning outcomes. A narrative review was undertaken to identify the learning theories reported in simulation-based learning linked to allied health professional placements and how the learning outcomes aligned with the reported theories. Only eight of the 25 reviewed studies explicitly reported a learning theory, with minimal attempt to link them to the learning experience. Educators are encouraged to develop an understanding of the breadth and depth of learning theories and how they can best align these with the desired learning outcomes to allow the best fit for purpose. As a result, the authors have developed a practical guide to assist educators in designing simulation-based learning to better understand how learning theories could be incorporated and the anticipated outcomes that could be measured.

Online asynchronous courses require close attention to course design to ensure there are strategies in place to foster social presence to build stronger senses of community and to motivate students to engage (content, peers and instructors). Judicious use of social media may serve this purpose. Since its inception, social media, Twitter in particular, has been employed in higher education courses for teaching and learning experiences with a notable impact on student engagement and social presence. This research examines students' use of Twitter for assessment and interaction in the online asynchronous classroom from 2014 to 2018, to determine if there has been an increase in the length, amount or content within Tweets, and if students report stronger engagement and interaction following the use of Twitter for assessment. While results indicate such a connection exists, students were more focused on completing course requirements than creating connections or interacting with others, and were bothered by the constraints of the Tweet length.

There is a notable lack of opportunity for students in pre-service professional training programs and faculty in higher education to collaborate and work together, across disciplines within a common area of professional expertise. In this case, a faculty learning community (FLC) was formed to create a set of video-based simulations based on relevant topics for Committee on Special Education (CSE) meetings, used to inform the development of an Individualized Education Program. These materials were made available across departments and universities, establishing a common language and set of CSE practices. Additionally, a structured three-level text reading and discussion provided faculty with an opportunity for professional development, networking, and scholarship. The project was completed following Cox's 16 Recommendations for a Faculty Learning Community as a guideline for the successful implementation of the project, the creation of course materials, and analysis of faculty learning outcomes. It is important to note that the FLC process applies to a wide range of disciplines as a means of engaging faculty in responsive and reflective teaching practices as well as professional development.

Developing as a scholar is a critical aspect of graduate school. In this article, we use an autoethnographic approach to explore our experiences in a newly redeveloped interdisciplinary graduate course. The course was designed to emphasize interdisciplinary scholarship and to encourage students' awareness of their own developing epistemological, ontological, and axiological commitments. In this paper, we identify themes that arose from the final class paper, in which the students/researchers reflected on our development as emerging scholars. Through this course we developed an understanding of the value of interdisciplinarity, the cultural embeddedness of knowledge, and our own responsibilities as researchers in relation to social structures of power and marginalization. Our analyses of our experiences suggests that reflections on our own positionality and axiology are important for developing our identities as emerging scholars and that becoming a scholar may be more about the process than an end goal. We conclude with a discussion of how our learning in this course may be relevant for other instructors and emerging scholars.

ObjectiveTo describe the participation of racial and ethnic minority groups (REMGs) in gynecologic oncology trials.MethodsGynecologic oncology studies registered on ClinicalTrials.gov between 2007 and 2020 were identified. Trials with published results were analyzed based on reporting of race/ethnicity in relation to disease site and trial characteristics. Expected enrollment by race/ethnicity was calculated and compared to actual enrollment, adjusted for 2010 US Census population data.Results2146 gynecologic oncology trials were identified. Of published trials (n = 252), 99 (39.3%) reported race/ethnicity data. Recent trials were more likely to report these data (36% from 2007 to 2009; 51% 2013-2015; and 53% from 2016 to 2018, p = 0.01). Of all trials, ovarian cancer trials were least likely to report race/ethnicity data (32.1% vs 39.3%, p = 0.011). Population-adjusted under-enrollment for Blacks was 7-fold in ovarian cancer, Latinx 10-fold for ovarian and 6-fold in uterine cancer trials, Asians 2.5-fold in uterine cancer trials, and American Indian and Alaska Native individuals 6-fold in ovarian trials. Trials for most disease sites have enrolled more REMGs in recent years - REMGs made up 19.6% of trial participants in 2007-2009 compared to 38.1% in 2016-2018 (p

Background & aimsBiliary atresia (BA) is poorly understood and leads to liver transplantation (LT), with the requirement for and associated risks of lifelong immunosuppression, in most children. We performed a genome-wide association study (GWAS) to determine the genetic basis of BA.MethodsWe performed a GWAS in 811 European BA cases treated with LT in US, Canadian and UK centers, and 4,654 genetically matched controls. Whole-genome sequencing of 100 cases evaluated synthetic association with rare variants. Functional studies included whole liver transcriptome analysis of 64 BA cases and perturbations in experimental models.ResultsA GWAS of common single nucleotide polymorphisms (SNPs), i.e. allele frequencies >1%, identified intronic SNPs rs6446628 in AFAP1 with genome-wide significance (p = 3.93E-8) and rs34599046 in TUSC3 at sub-threshold genome-wide significance (p = 1.34E-7), both supported by credible peaks of neighboring SNPs. Like other previously reported BA-associated genes, AFAP1 and TUSC3 are ciliogenesis and planar polarity effectors (CPLANE). In gene-set-based GWAS, BA was associated with 6,005 SNPs in 102 CPLANE genes (p = 5.84E-15). Compared with non-CPLANE genes, more CPLANE genes harbored rare variants (allele frequency

Abstract Background The Community Oriented Primary Care Project Model (COPC) has been well studied globally as well as in the United States as a way to provide both community-centered primary care and to engage in community based research. Rural trainees through the University of Illinois College of Medicine’s Rural Medical Education Program (RMED) and Rural Pharmacy Education Program (RPHARM) students through the University of Illinois Chicago College of Pharmacy have participated in a COPC project as a capstone to a four month longitudinal, immersive community-based experience in a rural primary care setting. The purpose of this study was to assess the type of projects implemented through a rural health professions curriculum over a 30 year project period. . Methods A research team reviewed projects on 30 elements; including topic and demographics. Patterns in COPC topics and rurality of the location in which the COPC project were also examined by using 2021 U.S. Census Bureau population data and Rural Urban Commuting Area (RUCA) Code. Results COPC projects were categorized into 31 main topic areas with mental health being the most prevalent topic area covered by projects (n = 67, 15.7%) followed by 43 (10.1%) projects that focused on nutrition/exercise, and 41 (9.6%) focused on substance use (presented as a separate category from mental health in this analysis). Conclusions For three decades, COPC themes reflect priority health issues in rural communities while providing a scholarly activity for health profession student trainees Past projects have also been implemented in highly rural areas where research is not often conducted. The COPC research process can be easily replicated in other trainee models such as to fulfill ACGME requirements of scholarly activity and can provide a template for trainees of this model to implement community-engaged research in the future.

Abstract Evidence from preclinical animal models suggests that the stress-buffering function of the endocannabinoid (eCB) system may help protect against stress-related reductions in hippocampal volume, as is documented in major depressive disorder (MDD). However, stress exposure may also lead to dysregulation of this system. Thus, pathways from marked stress histories, such as childhood maltreatment (CM), to smaller hippocampal volumes and MDD in humans may depend on dysregulated versus intact eCB functioning. We examined whether the relation between MDD and peripheral eCB concentrations would vary as a function of CM history. Further, we examined whether eCBs moderate the relation of CM/MDD and hippocampal volume. Ninety-one adults with MDD and 62 healthy comparison participants (HCs) were recruited for a study from the Canadian Biomarker Integration Network in Depression program (CAN-BIND-04). The eCBs, anandamide (AEA) and 2-arachidonylglycerol (2-AG), were assessed from blood plasma. Severe CM history was assessed retrospectively via contextual interview. MDD was associated with eCBs, though not all associations were moderated by CM or in the direction expected. Specifically, MDD was associated with higher AEA compared to HCs regardless of CM history, a difference that could be attributed to psychotropic medications. MDD was also associated with higher 2-AG, but only for participants with CM. Consistent with hypotheses, we found lower left hippocampal volume in participants with versus without CM, but only for those with lower AEA, and not moderate or high AEA. Our study presents the first evidence in humans implicating eCBs in stress-related mechanisms involving reduced hippocampal volume in MDD.

Abstract Background It is challenging to predict long-term outcomes of interventions without understanding how they work. Health economic models of public health interventions often do not incorporate the many determinants of individual and population behaviours that influence long term effectiveness. The aim of this paper is to draw on psychology, sociology, behavioural economics, complexity science and health economics to: (a) develop a toolbox of methods for incorporating the influences on behaviour into public health economic models (PHEM-B); and (b) set out a research agenda for health economic modellers and behavioural/ social scientists to further advance methods to better inform public health policy decisions. Methods A core multidisciplinary group developed a preliminary toolbox from a published review of the literature and tested this conceptually using a case study of a diabetes prevention simulation. The core group was augmented by a much wider group that covered a broader range of multidisciplinary expertise. We used a consensus method to gain agreement of the PHEM-B toolbox. This included a one-day workshop and subsequent reviews of the toolbox. Results The PHEM-B toolbox sets out 12 methods which can be used in different combinations to incorporate influences on behaviours into public health economic models: collaborations between modellers and behavioural scientists, literature reviewing, application of the Behaviour Change Intervention Ontology, systems mapping, agent-based modelling, differential equation modelling, social network analysis, geographical information systems, discrete event simulation, theory-informed statistical and econometric analyses, expert elicitation, and qualitative research/process tracing. For each method, we provide a description with key references, an expert consensus on the circumstances when they could be used, and the resources required. Conclusions This is the first attempt to rigorously and coherently propose methods to incorporate the influences on behaviour into health economic models of public health interventions. It may not always be feasible or necessary to model the influences on behaviour explicitly, but it is essential to develop an understanding of the key influences. Changing behaviour and maintaining that behaviour change could have different influences; thus, there could be benefits in modelling these separately. Future research is needed to develop, collaboratively with behavioural scientists, a suite of more robust health economic models of health-related behaviours, reported transparently, including coding, which would allow model reuse and adaptation.

This research examines the use of teaching triads to the classroom-wide implementation of "Stay, Play & Talk" a peer-mediated social skills program for children in an inclusive Kindergarten classroom in Ontario, Canada. This research used prompting through peers to increase initiations and responses between children identified as having social communicative difficulties and children who were typically developing. Utilising a single-subject, multiple-baseline across participants design, the research investigates the impact of a prompting through peers intervention during teaching triads on the number of utterances (defined as verbal communicative behaviour that is an initiation or response to a peer or adult) for three five-year-old participants identified as having social communication deficits. After exposure to the peer-mediated intervention, results indicate that all three participants demonstrated an increase in their social communication skills with their typically-developing peers.

Weight stigma is the negative social judgment of people based on their weight. Despite the negative consequences of weight stigma, its prevalence is well-documented including within the physical activity (PA) landscape. Research shows that a wide range of PA-related professionals hold negative attitudes toward fat people, including physical education teachers, kinesiology students, and fitness trainers. This article describes a collaboration across disciplines and fields to develop a weight stigma reduction intervention for exercise professionals. Weight Inclusive Thinking for Fitness Spaces (WIT FITS) is a two-hour, self-paced, interactive online course grounded in the Health at Every Size® paradigm and research-informed strategies for improving exercise professionals' attitudes toward fatness and fostering weight inclusivity in fitness settings. WIT FITS was the result of a three-year interdisciplinary collaboration with scholars from pedagogy, public health, sport and exercise psychology, and nutrition. Community partners involved in the development, implementation, and evaluation of WIT FITS included body liberation activists, web and instructional designers, and campus recreation leaders.

Purpose: Research shows peer health education programs on university campuses can support students in pursuing sustainable health-related behavior changes. However, few programs deliver peer health education through a nondiet, weight-inclusive framework. Research shows that health educators who challenge the status quo of diet culture and weight-focused health interventions may face unique challenges when sharing this perspective with others. Thus, the purpose of this study was to examine the experiences of peer educators who provided critical health education by introducing a nondiet, weight-inclusive approach to health. Design/methodology/approach: Five health coaches from a university health coaching program at a mid-sized southwestern university participated in a semi-structured interview. The data were analyzed through interpretative phenomenological analysis. Findings: Peer educators faced numerous challenges when introducing nondiet, weight-inclusive approaches such as lacking credibility as a peer to challenge weight-centric messages, feeling conflicted about honoring clients' autonomy when clients are resistant to a weight-inclusive approach and feeling uncomfortable when discussing client vulnerabilities. Peer educators also identified several strategies that helped them navigate these challenges such as being intentional with social media, using motivational interviewing to unpack clients' concerns about weight, and seeking group supervision. Originality/value: Given the reality that health coaches will face challenges sharing weight-inclusive health approaches, educators and supervisors should explicitly incorporate strategies and training methods to help peer health coaches prepare for and cope with such challenges. More research is also needed to examine effective ways to introduce weight-inclusive approaches to college students.

In recent years, clean air policies have led to reductions in air pollution across China. Alongside this, emerging carbon neutrality (CN) policies that aim to address the impacts of climate change may also deliver air quality (AQ) co-benefits or climate penalties. Different CN policies will lead to different changes in volatile organic compound (VOC), NOx and particulate matter (PM) emissions, which will in turn impact the photochemical production of secondary pollutants such as ozone (O3). It is currently unclear how different combinations of AQ and CN policies may impact in situ O3 production across China in the future. A detailed chemical box model incorporating the Master Chemical Mechanism was developed to investigate the impact of combined AQ and CN policies on O3 formation in Beijing. The Multi-resolution Emission Inventory model for Climate and air pollution research (MEIC) and the Dynamic Projection model for Emissions in China (DPEC) were used to estimate future pollutant mixing ratios, relative to ambient observations of 35 VOCs, NOx, CO and aerosol surface area (ASA) during the APHH-Beijing 2017 summer campaign. The most ambitious policy scenario, “Ambitious Pollution 1.5D Goals”, led to the largest reduction in O3 production by 2060 but was not the most impactful scenario for reducing O3 production between 2030–2045. Larger reductions were observed under the “Ambitious Pollution Neutral Goals” policy, which focuses on achieving net zero by 2060. O3 production was found to be most sensitive to changes in the OLE2 group of VOCs (alkenes where kOH>7×104 ppm−1 min−1; a 5 % increase in OLE2 increased simulated O3 production by 1.12 %). However, reducing less reactive but higher concentration species in Beijing (such as short-chain alkanes) led to larger reductions in O3 production under all scenarios. O3 production was not sensitive to changes in ASA, with a 69 % decrease in ASA leading to a change of % in O3. However, doubling biogenic VOCs in the model further increased O3 production in 2060 under all future scenarios by up to 18 %, indicating that the influence of future climate-induced changes in biogenic emissions may have a significant impact on in situ O3 formation in Beijing. This study highlights that the emission trajectories of certain specific VOCs are highly influential in determining possible future O3 air quality effects that may arise from increasing ambient temperatures and decarbonisation in Beijing.

Abstract Background Assisted living (AL) is an increasingly common residential setting for persons with dementia; yet concerns exist about sub-optimal care of this population in AL given its lower levels of staffing and services. Our objectives were to (i) examine associations between AL setting (dementia care vs. other), COVID-19 pandemic waves, and prevalent antipsychotic, antidepressant, anti-dementia, benzodiazepine, and anticonvulsant drug use among residents with dementia/cognitive impairment, and (ii) explore associations between resident and home characteristics and prevalent medication use. Methods We conducted a population-based, repeated cross-sectional study using linked clinical and health administrative databases for all publicly funded AL homes in Alberta, Canada, examined between January 2018 - December 2021. The quarterly proportion of residents dispensed a study medication was examined for each setting and period (pandemic vs. comparable historical [2018/2019 combined]) focusing on four pandemic waves (March-May 2020, September 2020-February 2021, March-May 2021, September-December 2021). Log-binomial GEE models estimated prevalence ratios (PR) for period (pandemic vs. historical periods), setting (dementia care vs. other) and period-setting interactions, adjusting for resident (age, sex) and home (COVID-19 cases, health region, ownership) characteristics. Results On March 1, 2020, there were 2,779 dementia care and 3,013 other AL residents (mean age 83, 69% female) with dementia/cognitive impairment. Antipsychotic use increased during waves 2–4 in both settings, but this was more pronounced in dementia care than other AL during waves 3 and 4 (e.g., adjusted [adj]PR 1.20, 95% CI 1.14–1.27 vs. adjPR 1.09, 95% CI 1.02–1.17, interaction p = 0.023, wave 3). Both settings showed a statistically significant but modest increase in antidepressant use and decrease in benzodiazepine use. For dementia care AL residents only, there was a statistically significant increase in gabapentinoid use during several waves (e.g., adjPR 1.32, 95% CI 1.10–1.59, wave 3). Other than a modest decrease in prevalent anti-dementia drug use for both settings in wave 2, no other significant pandemic effects were observed. Conclusions The persistence of the pandemic-associated increase in antipsychotic and antidepressant use in AL residents coupled with a greater increase in antipsychotic and gabapentinoid use for dementia care settings raises concerns about the attendant risks for residents with cognitive impairment.

Abstract Background Accompanied by activation of the NOD-like receptor protein 3 (NLRP3) inflammasome, aberrant connexin 43 (Cx43) hemichannel-mediated ATP release is situated upstream of inflammasome assembly and inflammation and contributes to multiple secondary complications of diabetes and associated cardiometabolic comorbidities. Evidence suggests there may be a link between Cx43 hemichannel activity and inflammation in the diabetic kidney. The consequences of blocking tubular Cx43 hemichannel-mediated ATP release in priming/activation of the NLRP3 inflammasome in a model of diabetic kidney disease (DKD) was investigated. We examined downstream markers of inflammation and the proinflammatory and chemoattractant role of the tubular secretome on macrophage recruitment and activation. Methods Analysis of human transcriptomic data from the Nephroseq repository correlated gene expression to renal function in DKD. Primary human renal proximal tubule epithelial cells (RPTECs) and monocyte-derived macrophages (MDMs) were cultured in high glucose and inflammatory cytokines as a model of DKD to assess Cx43 hemichannel activity, NLRP3 inflammasome activation and epithelial-to-macrophage paracrine-mediated crosstalk. Tonabersat assessed a role for Cx43 hemichannels. Results Transcriptomic analysis from renal biopsies of patients with DKD showed that increased Cx43 and NLRP3 expression correlated with declining glomerular filtration rate (GFR) and increased proteinuria. In vitro, Tonabersat blocked glucose/cytokine-dependant increases in Cx43 hemichannel-mediated ATP release and reduced expression of inflammatory markers and NLRP3 inflammasome activation in RPTECs. We observed a reciprocal relationship in which NLRP3 activity exacerbated increased Cx43 expression and hemichannel-mediated ATP release, events driven by nuclear factor kappa-B (NFκB)-mediated priming and Cx43 hemichannel opening, changes blocked by Tonabersat. Conditioned media (CM) from RPTECs treated with high glucose/cytokines increased expression of inflammatory markers in MDMs, an effect reduced when macrophages were pre-treated with Tonabersat. Co-culture using conditioned media from Tonabersat-treated RPTECs dampened macrophage inflammatory marker expression and reduced macrophage migration. Conclusion Using a model of DKD, we report for the first time that high glucose and inflammatory cytokines trigger aberrant Cx43 hemichannel activity, events that instigate NLRP3-induced inflammation in RPTECs and epithelial-to-macrophage crosstalk. Recapitulating observations previously reported in diabetic retinopathy, these data suggest that Cx43 hemichannel blockers (i.e., Tonabersat) may dampen multi-system damage observed in secondary complications of diabetes.