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Food is medicine (FIM) interventions are a strategy for preventing and managing chronic disease via diet. These interventions often combine the provision of food with access to behavior change support (e.g., from registered dietitians (RDs)), though the ideal approach for the latter is not fully elucidated. The objective of this study is to evaluate integrated motivational interviewing (MI) from an RD (RDMI) on outcomes among adults living with and beyond cancer (LWBC) with overweight and obesity enrolled in a FIM intervention (Clinicaltrials.gov: NCT03489213 (02/09/2018)). Specifically, RDMI with autonomy in the mode of delivery (i.e., phone, email, text, video) and dose (frequency) was offered within a 6-month intensive FIM intervention followed by a 6-month step-down maintenance phase. Dose and engagement with RDMI were measured. There were 52 and 33 participants who requested RDMI during the intensive and maintenance phases, respectively. Completion of ≥ 1 RDMI telephonic encounter significantly predicted weight loss post-intervention (R 2  = 0.07, p = 0.03); there were no differences in dose, engagement, or weight loss based on the mode of delivery. The dose during the intensive intervention was moderately and significantly correlated with weight loss post-intervention and maintenance (r = 0.43, p < 0.01; r = 0.33, p = 0.02, respectively); there was a weak correlation for engagement at the same follow-up points (r = 0.28 and r = 0.15). In conclusion, higher doses of RDMI improved weight loss for adults LWBC with overweight or obesity. Careful consideration of the implementation of MI from providers, including RDs, in the context of cancer-focused FIM interventions should be further examined., Competing Interests: Declarations. Conflict of Interest: The authors declare no competing interests., (© 2024. The Author(s) under exclusive licence to American Association for Cancer Education.) more...

Importance: It is critical for providers to use evidence-based interventions to address mental health and behavioral barriers to occupational performance during early childhood., Objective: To identify evidence-based interventions within the scope of occupational therapy practice to improve mental health and positive behavior for children ages 0-5 yr and their families., Data Sources: PsycINFO, Cochrane, ERIC, MEDLINE, and OTseeker databases were searched for publications from 2010 through March 2017., Study Selection and Data Collection: This review was completed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Risk of bias was assessed for each article using either A Measurement Tool to Assess Systematic Reviews (AMSTAR) or the Cochrane method. Articles meeting inclusion criteria were critically appraised., Findings: Forty-six articles met inclusion criteria and were organized into three themes: touch-based interventions (n = 9), parent-child interaction therapy (PCIT; n = 4), and instruction-based interventions (n = 33). Statistically significant findings and overall risk of bias supported the use of touch-based interventions, PCIT, and parent training., Conclusions and Relevance: The evidence indicates that touch-based interventions can improve infant self-regulation (strong), social behavior, and attachment (moderate) and reduce maternal stress, anxiety, and depression (low). Moderate-strength evidence supports PCIT to improve child behavior. The evidence indicates that parent training can improve parent behavior, maternal-infant attachment (strong), and parent mental health (moderate). Teacher training can improve mental health and behavior (moderate). Group-based parent training and sleep training have insufficient support (low)., What This Article Adds: Occupational therapy professionals working with children younger than age 5 yr can use the results of this systematic review to guide clinical decision making related to mental health and behavioral outcomes., (Copyright © 2020 by the American Occupational Therapy Association, Inc.) more...

This special issue of the American Journal of Occupational Therapy on interventions for children and youth highlights the current developments in and evidence for the effectiveness of occupational therapy interventions and psychometric properties of assessments for children and youth. In this guest editorial, we identify various factors that challenge the implementation of evidence-based strategies in daily clinical practice. We assert that scholars, educators, and practitioners need to address several strategic steps. To facilitate critical consumption of evidence in practice, efforts need to be made to build capacity for evidence production and evidence use through implementation science and to ensure that evidence-based practice is not only taught but also reflectively applied across the educational curriculum and that clinicians are given more access to resources that are easy to translate to daily clinical practice., (Copyright © 2020 by the American Occupational Therapy Association, Inc.) more...

Objective: Anxiety disorders are the most prevalent psychological disorders among children and youths. There is growing interest in intervention options for anxiety. Yoga is widely used in clinical, school, and community settings, but consolidated sources outlining its effectiveness in reducing anxiety are limited., Method: This systematic review examined the evidence base (1990-2014) for yoga interventions addressing anxiety among children and adolescents (ages 3-18 yr)., Results: We identified 2,147 references and found 80 articles that were eligible for full-text review. The final analysis included 16: 6 randomized controlled trials, 2 nonrandomized preintervention-postintervention control-group designs, 7 uncontrolled preintervention-postintervention studies, and 1 case study., Conclusion: Nearly all studies indicated reduced anxiety after a yoga intervention. However, because of the wide variety of study populations, limitations in some study designs, and variable outcome measures, further research is needed to enhance the ability to generalize and apply yoga to reduce anxiety., (Copyright © 2015 by the American Occupational Therapy Association, Inc.) more...

Objective: To examine interventions addressing work, activities of daily living (ADLs), instrumental activities of daily living (IADLs), education, and sleep for people with autism spectrum disorder., Method: A total of 23 studies were identified, and 9 work-, 11 ADL/IADL-, and 3 education-related interventions were examined. No sleep studies were identified., Results: Use of mobile and tablet technologies for vocational skills was supported. Support for ADL/IADL intervention is variable, with indications that Cognitive Orientation to Occupational Performance, sensory integration, and contextual interventions may increase occupational performance. Preliminary evidence suggests that daily yoga and brief exercise may improve classroom performance and behavior; group physical activities may assist with school readiness variables. Evidence for using technologies for IADLs was limited, as was evidence determining effective interventions for feeding and eating issues., Conclusions: Studies investigating interventions related to sleep are lacking. More studies are needed in all areas, presenting opportunities for the expansion of science-driven occupational therapy practice and research for people with ASD., (Copyright © 2015 by the American Occupational Therapy Association, Inc.) more...

Children with autism spectrum disorders often exhibit co-occurring sensory processing problems and receive interventions that target self-regulation. In current practice, sensory interventions apply different theoretic constructs, focus on different goals, use a variety of sensory modalities, and involve markedly disparate procedures. Previous reviews examined the effects of sensory interventions without acknowledging these inconsistencies. This systematic review examined the research evidence (2000-2012) of two forms of sensory interventions, sensory integration therapy and sensory-based intervention, for children with autism spectrum disorders and concurrent sensory processing problems. A total of 19 studies were reviewed: 5 examined the effects of sensory integration therapy and 14 sensory-based intervention. The studies defined sensory integration therapies as clinic-based interventions that use sensory-rich, child-directed activities to improve a child's adaptive responses to sensory experiences. Two randomized controlled trials found positive effects for sensory integration therapy on child performance using Goal Attainment Scaling (effect sizes ranging from .72 to 1.62); other studies (Levels III-IV) found positive effects on reducing behaviors linked to sensory problems. Sensory-based interventions are characterized as classroom-based interventions that use single-sensory strategies, for example, weighted vests or therapy balls, to influence a child's state of arousal. Few positive effects were found in sensory-based intervention studies. Studies of sensory-based interventions suggest that they may not be effective; however, they did not follow recommended protocols or target sensory processing problems. Although small randomized controlled trials resulted in positive effects for sensory integration therapies, additional rigorous trials using manualized protocols for sensory integration therapy are needed to evaluate effects for children with autism spectrum disorders and sensory processing problems., (© The Author(s) 2014.) more...

Background: Tumour necrosis factor-α inhibitors (TNFαIs) are used for treatment of inflammatory disorders. There is evidence linking these agents with occurrence of malignancies. For four out of five TNFαIs the Food and Drug Administration (FDA) label states, 'melanoma has been reported in patients treated with these agents'., Objectives: To determine whether a statistically significant association exists between administration of TNFαIs and development of malignant melanoma., Methods: We searched the FDA Adverse Event Reporting System (FAERS) database for terms related to melanoma and TNFαIs for detection of safety signals. We also searched a large urban academic electronic medical record (EMR) database for which we calculated the relative risk (RR) of melanoma in subjects exposed to TNFαIs vs. nonexposed subjects., Results: There were 972 reports of melanoma associated with a TNFαI identified in the FAERS database, with 69 reports among individuals using more than one TNFαI. A safety signal was detected for infliximab, golimumab, etanercept and adalimumab, but not certolizumab pegol. For TNFαIs as a class of drugs, a safety signal was detectable in the FAERS database, and RR was significant in the EMR database. For the EMR cohort, 6045 patients were exposed to TNFαIs and 35 cases of melanoma were detected. Significance for RR was detected for adalimumab (RR 1·8, P = 0·02) and etanercept (RR 2·35, P = 0·0004 < 0·001)., Conclusions: We identified a significant association between exposure to TNFαIs and malignant melanoma in two different analyses. Our findings add to existing evidence linking these agents with the occurrence of malignant melanoma. Additional investigations are required to explore this association further along with the risk of melanoma with TNFαI therapy., (© 2013 British Association of Dermatologists.) more...

OBJECTIVE. We sought to determine the association between minimal depression, upper-extremity (UE) impairment, and UE motor function in a cohort of participants with subacute stroke. METHOD. We conducted a retrospective, secondary analysis of an interventional study. Correlational analyses were performed using the following outcome measures: the UE section of the Fugl-Meyer Assessment (FM), the functional ability section of the Arm Motor Ability Test (AMAT), and the Beck Depression Inventory (BDI-II). RESULTS. We found a negative correlation between BDI-II and both the FM (-.120, p = .196) and the AMAT (-.110, p = .275); however, this correlation was not statistically significant. Women exhibited higher depression scores (8.75 ± 0.78) than men (6.29 ± 0.46; p = .008). CONCLUSION. Low levels of depression are not associated with UE motor impairment and function in people with minimal to moderate UE disability levels. Poststroke depression occurs more frequently in women, warranting additional research on sex-specific differences. Given the proliferation of UE therapies targeting this group, this information is important for effective therapy planning and implementation., (Copyright © 2013 by the American Occupational Therapy Association, Inc.) more...

The influenza A viral genome consists of eight negative-sense, single stranded RNA molecules, individually packed with multiple copies of the influenza A nucleoprotein (NP) into viral ribonulceoprotein particles (vRNPs). The influenza vRNPs are enclosed within the viral envelope. During cell entry, however, these vRNP complexes are released into the cytoplasm, where they gain access to the host nuclear transport machinery. In order to study the nuclear import of influenza vRNPs and the replication of the influenza genome, it is useful to work with isolated vRNPs so that other components of the virus do not interfere with these processes. Here, we describe a procedure to purify these vRNPs from the influenza A virus. The procedure starts with the disruption of the influenza A virion with detergents in order to release the vRNP complexes from the enveloped virion. The vRNPs are then separated from the other components of the influenza A virion on a 33-70% discontinuous glycerol gradient by velocity sedimentation. The fractions obtained from the glycerol gradient are then analyzed on via SDS-PAGE after staining with Coomassie blue. The peak fractions containing NP are then pooled together and concentrated by centrifugation. After concentration, the integrity of the vRNPs is verified by visualization of the vRNPs by transmission electron microscopy after negative staining. The glycerol gradient purification is a modification of that from Kemler et al. (1994)(1), and the negative staining has been performed by Wu et al. (2007).(2). more...

There is an urgent need to coat the surfaces of medical devices, including implants, with antimicrobial agents to reduce the risk of infection. A peptide array technology was modified to permit the screening of short peptides for antimicrobial activity while tethered to a surface. Cellulose-amino-hydroxypropyl ether (CAPE) linker chemistry was used to synthesize, on a cellulose support, peptides that remained covalently bound during biological assays. Among 122 tested sequences, the best surface-tethered 9-, 12-, and 13-mer peptides were found to be highly antimicrobial against bacteria and fungi, as confirmed using alternative surface materials and coupling strategies as well as coupling through the C and N termini of the peptides. Structure-activity modeling of the structural features determining the activity of tethered peptides indicated that the extent and positioning of positive charges and hydrophobic residues were influential in determining activity. more...

The influenza A genome consists of eight single-stranded RNA molecules, each associated with an oligomeric core of the structural protein, nucleoprotein, to form a distinct viral ribonucleoprotein (vRNP) complex. vRNPs are the entities responsible for the transcription and replication of the influenza viral RNAs in the nuclei of host cells. Thus, nuclear targeting and localization of the vRNPs are a critical step in the infection and life cycle of influenza A. We have recently shown that the nuclear import of vRNPs derived from influenza A virions is independently mediated by two nuclear localization sequences (NLSs) on nucleoprotein: NLS1, spanning residues 1-13 at the N terminus, and NLS2, spanning residues 198-216 in the middle of the protein, with NLS1 being the principal mediator. To better understand the structural basis for the differences in the ability of NLS1 and that of NLS2 to mediate nuclear import of influenza vRNPs, we analyzed the levels of surface exposure of these NLSs on vRNPs by both dot blotting and immunogold labeling of vRNPs in their native state. We found that NLS1 is much more accessible to its corresponding antibody compared with NLS2. Electron microscopy of immunogold-labeled vRNPs further showed that 71% of vRNPs were labeled with one to six gold particles located throughout the vRNP for NLS1. In contrast, less than 10% of vRNPs were labeled with an antibody against NLS2, usually with a single gold particle located at one end of the vRNP. In addition, a regular periodicity of repeat was observed with gold particles labeling for NLS1, indicative of a highly regular helical conformation present in the vRNPs. These findings provide the underlying structural basis for the enhanced ability of NLS1 in mediating nuclear import of influenza vRNPs and add to our understanding of the ultrastructural features of vRNP complexes derived from influenza A virions. more...

A rare primary malignant fibrous histiocytoma of the pleura is described. The tumor was found in an elderly male and was followed for more than ten years without treatment. At the terminal stage, the patient developed a malignant pleural effusion, which contained mainly histiocytelike, rounded forms with many bizarre and multinucleated giant tumor cells. The main tumor mass was characterized by dual fibroblastlike and histiocytelike cellular components and a storiform growth pattern. In the solid areas, the tumor cells were mainly fibroblastlike spindle-shaped forms, which produced collagen. The tumor cells in the loose, vascular areas and in the effusion were predominantly histiocytelike, with some exhibiting phagocytic activity. We believe that this is the first reported case of a malignant fibrous histiocytoma of the pleura with a malignant effusion showing a preferential histiocytelike differentiation of tumor cells in the fluid environment. more...