Biological, Behavioral, and Ethical Considerations of Prader-Willi Syndrome: A Primer for Behavior Analysts.

Prader-Willi syndrome (PWS) is a rare genetic disorder typically characterized by hyperphagia, hypotonia, intellectual disabilities, insistence on routines, and obsession and compulsion related to food. Although current medical interventions primarily include growth hormones to address the biological symptoms of the individual, behavioral therapy is an alternative option for skill acquisition and decreasing problem behaviors. There is a growing need for applied behavior analysis (ABA) research on targeting problem behaviors and teaching requisite skills to individuals with this syndrome. This article reviews the current literature on PWS, highlights treatments and their limitations, suggests how ABA providers can provide ethical services, and proposes future research needs with this syndrome.

Dermal mast cells affect the development of sunlight-induced skin tumours.

Ultraviolet (UV) radiation contained in sunlight is considered a major risk in the induction of skin cancer. While mast cells are best known for their role in allergic responses, they have also been shown to play a crucial role in suppressing the anti-tumour immune response following UV exposure. Evidence is now emerging that UV may also trigger mast cell release of cutaneous tissue remodelling and pro-angiogenic factors. In this review, we will focus on the cellular and molecular mechanisms by which UV recruits and then activates mast cells to initiate and promote skin cancer development.

The immune-modulating cytokine and endogenous Alarmin interleukin-33 is upregulated in skin exposed to inflammatory UVB radiation.

The cellular and molecular mechanisms by which UV radiation modulates inflammation and immunity while simultaneously maintaining skin homeostasis is complex and not completely understood. Similar to the effects of UV, IL-33 has potent immune-modulating properties that are mediated by the downstream induction of cytokines and chemokines. We have discovered that exposure of mice in vivo or human skin samples ex vivo to inflammatory doses of UVB induced IL-33 expression within the epidermal and dermal skin layers. Using a combination of murine cell lines and primary human cells, we demonstrate that both UV and the oxidized lipid platelet activating factor induce IL-33 expression in keratinocytes and dermal fibroblasts. Highlighting the significance of these results, we found that administering IL-33 to mice in vivo suppressed the induction of Th1-mediated contact hypersensitivity responses. This may have consequences for skin cancer growth because UV-induced squamous cell carcinomas that evade immunological destruction were found to express significantly higher levels of IL-33. Finally, we demonstrate that dermal mast cells and skin-infiltrating neutrophils closely associate with UV-induced IL-33-expressing fibroblasts. Our results therefore identify and support a role for IL-33 as an important early danger signal produced in response to inflammation-inducing UV radiation.

An exploration of participation in leisure activities post-stroke.

AIM: The purpose of this study was to illuminate the experiences of older adults' return to leisure activities, following rehabilitation, post-stroke. METHOD: A phenomenological approach was used to explore the experiences of re-engaging in leisure occupations post-stroke. In-depth interviews were conducted with five community-dwelling individuals (three men, two women) aged 68-74 years who had experienced a stroke in the past year. Data were analysed using thematic analysis. FINDINGS: Four themes emerged: (i) Re-engaging in leisure activities, (ii) acceptance of physical limitations post-stroke, (iii) gratitude for help and support and (iv) looking forward to the future. CONCLUSION: Implications revealed that post-stroke interventions need a more occupation-focussed approach, including return to leisure at an earlier stage of stroke rehabilitation.

1000 fieldwork hours: analysis of multi-site evidence.

BACKGROUND: Internationally, the World Federation of Occupational Therapists has established a minimum of 1,000 hours as the fieldwork standard. PURPOSE: To examine student development in fieldwork across placements to determine if students achieve entry-level competence after completion of 1,000 hours of fieldwork. METHODS: Archival data (N=400) from six occupational therapy programs were analyzed to examine the acquisition of fieldwork competency over time as measured by the Competency Based Fieldwork Evaluation Scale. FINDINGS: Competency scores increased with each fieldwork placement, the majority of students achieved entry-level scores upon completion of their final fieldwork placement. While, on average, some competency scores exceeded entry level by 1,000 hours, Practice Knowledge, Clinical Reasoning, and Facilitating Change fell just short. IMPLICATIONS: The identification of a plan for addressing the lower ratings in these three competencies should be considered.