This review highlighted the fact that few studies examined the use of simulation in nursing education through learning theories and via assessment of core competencies. It also identified observational tools used to assess competencies in action, as holistic and context-dependent constructs.

These conflicting results called into question the validity of localization of a QTL by linkage followed by the use of a congenic strain made with an incomplete chromosome coverage. To resolve this issue, we constructed five new congenic strains, designated C17S.L1 to C17S.L5, that completely spanned the Ϯ2 LOD confidence interval supposedly containing the QTL. Each congenic strain was made by replacing a segment of the DSS rat by that of the normotensive Lewis (LEW) rat. The only section to be LL homozygous is the region on Chr 17 specified in a congenic strain, as evidenced by a total genome scan. The results showed that BPs of C17S.L1 and C17S.L2 were lower (P Ͻ 0.04) than that of DSS rats. In contrast, BPs of C17S.L3, C17S.L4, and C17S.L5 were not different (P Ͼ 0.6) from that of DSS rats. Consequently, a BP QTL must be located in an interval of ϳ15 cM shared between C17S.L1 and C17S.L2 and unique to them both, as opposed to C17S.L3, C17S.L4, and C17S.L5. The present study illustrates the importance of thorough chromosome coverage, the necessity for a genome-wide screening, and the use of "negative" controls in physically mapping a QTL by congenic strains.Dahl salt-sensitive rat; normotensive Lewis rat; congenic strain; congenic substrain THE PRESENCE OF A BLOOD PRESSURE (BP) quantitative trait locus (QTL) on rat chromosome 17 (Chr 17) was originally hinted on by linkage analyses of an F2 population derived from a cross between the Dahl salt-sensitive (DSS) and Lewis (LEW) rats (6). The maximum LOD score supporting this localization was 2.9, which constitutes a suggestive linkage (6). Subsequently, another group of investigators using a different model of salt-sensitive hypertension, the Sabra strain, independently localized a QTL by linkage to a similar region, but with a higher LOD score of 3.43 (27). Employing recombinant inbred strains derived from crosses between the spontaneously hypertensive (SHR) and Brown Norway (BN) rats (22), a separate group of investigators did not find linkage to BP, but they found linkage to the left ventricular mass in a region on Chr 17 distant from the interval containing the BP QTL reported in DSS and Sabra rats (6, 27). Recently, researchers studying cardiac hypertrophy associated with pulmonary hypertension (28) showed that a QTL for right ventricular mass was localized to a Chr 17 region close to the BP QTL in DSS (6) and Sabra (27) strains. Finally, linkage analysis based on the Lyon rats also showed that a QTL on Chr 17 was involved in controlling metabolic homeostasis and BP (3).Nevertheless, the BP QTL localization (6) was questioned because a congenic strain made by replacing a segment of the DSS chromosome with that of LEW did not show any BP effect (12). Due to a lack of markers at the time, the entire Ϯ2 LOD support interval harboring the QTL was not replaced in that study (12). Consequently, the validity of the QTL could not be verified.For the convenience of presentation and discussion, the congenic strain previously made (12) is designated as congenic 1. Beca...

Pursuing fully a suggestion from linkage analysis that there might be a quantitative trait locus (QTL) for blood pressure (BP) in a chromosome (Chr) 2 region of the Dahl salt-sensitive rat (DSS), four congenic strains were made by replacing various fragments of DSS Chr 2 with those of Lewis (LEW). Consequently, a BP QTL was localized to a segment of around 3 cM or near 3 Mb on Chr 2 by comparative congenics. The BP-augmenting alleles of this QTL originated from the LEW rat, a normotensive strain compared with DSS. The dissection of a QTL with such a paradoxical effect illustrated the power of congenics in unearthing a gene hidden in the context of the whole animal system, presumably by interactions with other genes. The locus for the angiotensin II receptor AT-1B (Agtr1b) is not supported as a candidate gene for the QTL because a congenic strain harboring it did not have an effect on BP. There are approximately 19 known and unknown genes present in the QTL interval. Among them, no standout candidate genes are reputed to affect BP. Thus the QTL will likely represent a novel gene for BP regulation.

Elongation factor Tu (EF-Tu), encoded by tuf genes, carries aminoacyl-tRNA to the ribosome during protein synthesis. Duplicated tuf genes (tufA and tufB), which are commonly found in enterobacterial species, usually coevolve via gene conversion and are very similar to one another. However, sequence analysis of tuf genes in our laboratory has revealed highly divergent copies in 72 strains spanning the genus Yersinia (representing 12 Yersinia species). The levels of intragenomic divergence between tufA and tufB sequences ranged from 8.3 to 16.2% for the genus Yersinia, which is significantly greater than the 0.0 to 3.6% divergence observed for other enterobacterial genera. We further explored tuf gene evolution in Yersinia and other Enterobacteriaceae by performing directed sequencing and phylogenetic analyses. Phylogenetic trees constructed using concatenated tufA and tufB sequences revealed a monophyletic genus Yersinia in the family Enterobacteriaceae. Moreover, Yersinia strains form clades within the genus that mostly correlate with their phenotypic and genetic classifications. These genetic analyses revealed an unusual divergence between Yersinia tufA and tufB sequences, a feature unique among sequenced Enterobacteriaceae and indicative of a genus-wide loss of gene conversion. Furthermore, they provided valuable phylogenetic information for possible reclassification and identification of Yersinia species.

Demand for post-acute stroke and traumatic brain injury (TBI) rehabilitation outweighs resource availability. Every day, clinicians face the challenging task of deciding which patient will benefit or not from rehabilitation. The objectives of this scoping review were to map and compare factors reported by clinicians as influencing referral or admission decisions to post-acute rehabilitation for stroke and TBI patients, to identify most frequently reported factors and those perceived as most influential. We searched four major databases for articles published between 1946 and January 2021. Articles were included if they reported clinician's perceptions, investigated referral or admission decisions to postacute rehabilitation and focused on stroke or TBI patients. Twenty articles met inclusion criteria. The International Classification of Functioning, Disability and Health framework was used to guide data extraction and summarizing. Patient-related factors most frequently reported by clinicians were patient's age, mental status prior to stroke or TBI and family support. The two latter were ranked amongst the most influential by clinicians working with stroke patients, whereas age was ranked of low importance. Organizational factors were reported to influence decisions (particularly availability of post-acute care services) as well as clinicians' characteristics (e.g., knowledge). Moreover, clinicians' prediction of patient outcome ranked amongst the most important driver of referral or admission 3 decisions by clinicians working with stroke patients. Findings highlight the complex nature of decision-making regarding patient selection for rehabilitation and provide insight on important factors frontline clinicians need to consider when having to make rapid decisions in high-pressured acute care environments.

Most research on the definition of competency and its application in health professionals' education programs is focused on semantic matters, while contextual influences are rarely discussed or solely presented as background context. The aim of this article is to gain a comprehensive understanding of the issues raised by definitions of competency and to describe the contextual factors that have given rise to those definitions. This is achieved by presenting the results of a literature review that synthesized different conceptualizations of competency. We analyzed relevant literature listed in the CINAHL, Embase, MEDLINE, and PsycINFO databases as of 2015. The results show that authors define competency based on two diverging driving forces: one aimed at professional regulation and the other at professional emancipation. The analysis revealed common grounds between these perspectives. From these common grounds we discuss the possibility of conceptualizing competency on a continuum instead of perpetuating the dichotomized discourses presented in the current literature. The integration of both perspectives gives the opportunity to rethink policies, structures and strategies of professional education toward an integrated perspective of professional development situated in a lifelong learning enterprise, achieving both minimal professional standards and excellence in healthcare practices from initial education throughout a career.

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Introduction Daily childcare can be challenging for parents with a physical disability who have young children. Occupational therapists are valuable facilitators to family participation. However, occupational therapists have reported significant gaps in knowledge when documenting the parenting role of parents with a physical disability in occupational therapy practice. This study explored and described the parenting assessment methods used with parents with a physical disability in the scientific literature. Methods A scoping review was conducted, and search results were reviewed by two separate reviewers. The search strategy was applied to five databases (Embase, CINAHL, MEDLINE, HaPI, PsycInfo). Numerical and thematic analyses were conducted. Results Four thousand one hundred fifty articles were screened, and 73 relevant scientific articles were included. Seventy‐six assessment methods were identified, including 20 assessment instruments with few reported population‐specific psychometric studies. Most assessments were conducted via interviews (n = 45), followed by questionnaires (n = 27), and only six were performance based. Parenting practices and experience were the two dimensions most assessed, with little attention given to parenting responsibility. Mothers with multiple sclerosis, spinal cord injury, rheumatoid arthritis, and cerebral palsy were the most assessed. Conclusion Further research is needed to develop specific, multidimensional, and validated parenting assessments for all parents with a physical disability, including performance‐based assessments. Formal assessments should be conducted by professionals, including occupational therapists, who have the necessary training.