Spirituality in Occupational Therapy: Do We Practice What We Teach?

This mixed-method study examined the responses of 97 occupational therapists on the subject of spirituality in occupational therapy practice. The inclusion of spirituality into the Occupational Therapy Practice Framework (2008) implies that clinicians address spirituality as a component of client-centered practice. This research revealed a gap between education, theory, and practice as evidenced in the quantitative and qualitative data. Although occupational therapy is intended to be holistic, therapists require a more complete understanding of what spirituality is and what the role of the occupational therapist is when addressing spirituality in evaluation or treatment. The discussion of this research provides information for future occupational therapy educators and educational programs as they seek to incorporate the construct of spirituality into curricula.     

Immobility reaction at birth in newborn infant

Objective

To describe an immobility reaction (IR) that was not previously reported at or immediately after birth in human newborns.

Method

We analyzed 31 videos of normal term vaginal deliveries recorded from Time 0 of birth defined as the as the moment that lies between the birth of the thorax and the pelvis of the infant. We searched for perinatal factors associated with newborn's IR.

Results

IR at birth was observed in 8 of the 31 newborns. The main features of their behavior were immobilization, frozen face, shallow breathing and bradycardia. One of the 8 newborns had sudden collapse 2 h after birth. We found significant relationships between maternal prenatal stress (PS) and IR (p = .037), and a close to significant one between infants’ lividness at Time 0 and IR (p = .053). The first breath of the 31 newborns occurred before and was not associated with the first cry (p < .001).

Discussion

The main features of IR at birth are similar to those of the universal most severe response to severe stress or danger. The relationship with PS suggests that children who had IR at birth might be at risk for similar disorders as those associated with PS. Sudden neonatal collapse of one of the IR newborns needs further research to determine if they are at risk for sudden infant death syndrome.

Conclusion

This first report of an IR reaction at birth in human infants could open up new paths for improving early neonatal care. Further research is needed for maternal PS, stress hormones, umbilical cord blood pH measurements in IR newborns. The challenge of education and support for parents of IR newborns is outlined.     

Differential components of reactivity and attentional control predicting externalizing behavior

The present study examined the contribution of early reactivity and regulation on externalizing behavior in preadolescence. Moreover, subcomponents of attentional control (i.e., attention shifting and attention focusing) and negative reactivity (i.e., sadness and anger) were examined individually to test whether a specific combination of factors uniquely contributed to the outcome. A subset of data were utilized from the ongoing, longitudinal RIGHT Track project (N = 404), in which parents reported on individual factors at age 4 and teachers reported on externalizing behavior at age 10. A hierarchical linear regression analysis revealed a significant interaction between anger reactivity and attention shifting when controlling for early externalizing behavior, where children with high levels of anger and low levels of attention shifting experienced the greatest increase in externalizing behavior over time. An increased focus on specificity is needed in research on the interplay between reactivity and regulation in the prediction of externalizing behavior.     

Autonomy Support and Structure Enhance Children's Memory and Motivation to Reminisce: A Parental Training Study

Thirty parents observed their preschoolers (M _age = 4;2) experience a standardized laboratory event and discussed the event with their child later that day. Children's memory for this event was subsequently tested at two delay intervals. Prior to the laboratory event, parents were randomly assigned to receive either autonomy-support training (Condition A) or elaborative-structure training (Condition B); training followed the event. Autonomy support-trained parents became more autonomy-supportive following the training; structure-trained parents became more structurally elaborative. Short-term experimenter–child memory interviews took place 2 weeks after the laboratory event; children of autonomy support-trained parents appeared more engaged in this memory interview, while children of structure-trained parents provided more recall and more thematically coherent memory narratives. Long-term experimenter–child interviews took place 8 months after the laboratory event; children of autonomy support-trained parents provided more information in the directed phase of this interview and appeared more engaged in the interview. The effects of high parental autonomy support and high elaborative structure for children's memory and motivation to reminisce are discussed.     

Proximodistal exploration in motor learning as an emergent property of optimization

To harness the complexity of their high‐dimensional bodies during sensorimotor development, infants are guided by patterns of freezing and freeing of degrees of freedom. For instance, when learning to reach, infants free the degrees of freedom in their arm proximodistally, that is, from joints that are closer to the body to those that are more distant. Here, we formulate and study computationally the hypothesis that such patterns can emerge spontaneously as the result of a family of stochastic optimization processes, without an innate encoding of a maturational schedule. In particular, we present simulated experiments with an arm where a computational learner progressively acquires reaching skills through adaptive exploration, and we show that a proximodistal organization appears spontaneously, which we denote PDFF (Proximo Distal Freezing and Freeing of degrees of freedom). We also compare this emergent organization between different arm morphologies—from human‐like to quite unnatural ones—to study the effect of different kinematic structures on the emergence of PDFF.     

Molecular Tumor Boards: Ethical Issues in the New Era of Data Medicine

The practice and development of modern medicine requires large amounts of data, particularly in the domain of cancer. The future of personalized medicine lies neither with “genomic medicine” nor with “precision medicine”, but with “data medicine” (DM) (big data, data mining). The establishment of this DM has required far-reaching changes, to establish four essential elements connecting patients and doctors: biobanks, databases, bioinformatic platforms and genomic platforms. The “transformation” of scientific research areas, such as genetics, bioinformatics and biostatistics, into clinical specialties has generated a new vision of care. Molecular tumor boards (MTB) are one response to these changes and are now providing better access to next-generation sequencing (NGS) and new cancer treatments to patients with inoperable or metastatic cancers, and those for whom the usual treatment has failed. However, MTB face a crucial ethical challenge: maintaining and improving the trust of patients, clinicians, researchers and industry in academic medical centers supported by private or public funding rather than providing genetic data directly to private companies. We believe that, in this era of DM, appropriate modern digital communication networks will be required to maintain this trust and to improve the organization and effectiveness of the system. There is, therefore, a need to reconsider the form and content of informed consent (IC) documents at all academic medical centers and to introduce dynamic and electronic informed consent (e-IC).     

Spatial numerical associations in preschoolers

ABSTRACT

Three-to-five-year-old French children were asked to add or remove objects to or from linear displays. The hypothesis of a universal tendency to represent increasing number magnitudes from left to right led to predict a majority of manipulations at the right end of the rows, whatever children's hand laterality. Conversely, if numbers are not inherently associated with space, children were expected to favour laterality-consistent manipulations. The results showed a strong tendency to operate on the right end of the rows in right-handers, but no preference in left-handers. These findings suggest that the task elicited a left-to-right oriented representation of magnitudes that counteracted laterality-related responses in left-handed children. The young age of children and the lack of a developmental trend towards right preference weaken the hypothesis of a cultural origin of this oriented representation. The possibility that our results are due to weaker brain lateralisation in left-handers compared to right-handers is addressed in Discussion section.     

Worry and rumination: do they prolong physiological and affective recovery from stress?

Background: Anxiety and depression have been linked to repetitive negative self-regulation styles in the form of worry and rumination respectively. Following predictions of the metacognitive model [Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove: Erlbaum], the current study compared the effect on recovery from stress of three strategies: worry, rumination, and distraction using a stress exposure paradigm. It was predicted that worry and/or rumination would be associated with delayed recovery on physiological and/or self-report indices when compared to distraction.

Method: Fifty-four participants were randomly assigned to one of the self-regulation conditions and then completed a modified version of the Trier Social Stress Test [TSST; Kirschbaum, C., Pirke, K. M., & Hellhammer, D. H. (1993). The “TSST” – A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28, 76–81. doi:10.1159/000119004]. Skin conductance and negative affect (NA) measurements were obtained at six different time points.

Results: Skin conductance indicated a prolonged recovery in the rumination condition when compared with the distraction condition. Individuals in the worry condition reported an immediate-delayed recovery from stress marked by higher NA scores in comparison to the distraction condition.

Conclusions: These findings may provide important insights into the effects of different forms of repetitive negative thinking on physiological and psychological recovery from stress. The different response patterns observed are discussed within the context of the metacognitive model.     

Frequency of finger looking during finger counting is related to children's working memory capacities

Finger counting can be useful in solving arithmetic problems, noticeably because it reduces the working memory demand of mental calculations. However, proprioceptive information might not be sufficient to keep track of the number of fingers raised during problem solving, and visual input may play an important role in this process. The present study was designed to address this question and shows that 8-year-old children look at their fingers in 60% of the trials during finger counting when solving additive problems. Moreover, our results reveal that the frequency of finger looking is negatively correlated with working memory capacities and is higher for more difficult problems. These findings suggest that finger looking is recruited in managing the cognitive demand of the arithmetic task, probably by providing additional external cues to monitor the number of steps that have to be incremented during finger counting.