Passing the NBCOT Examination: Preadmission, Academic, and Fieldwork Factors

All occupational therapy students are required to successfully complete the certification examination administered by the National Board for Certification in Occupational Therapy (NBCOT) before they can practice independently. The need to repeat the examination can result in stress, anxiety, and financial hardship. This paper explores the relationship of preadmission factors, academic and fieldwork performance, and demographic variables to successful first-time attempts on the certification examination for occupational therapists. Data were gathered from 144 student files in a Master of Occupational Therapy (MOT) Program at a single university. Of the sample, 82% passed and 18% failed their first NBCOT test trial. Considered independently, preadmission recommendation letters and writing sample scores, graduate MOT program GPA, lack of MOT program difficulty, fieldwork self-reports, and gender predicted NBCOT certification examination outcomes. When considered together in logistic regression models predicting outcome, this combination of factors correctly predicted 86.2% of student outcomes (or 20% to 32% of the variance in certification examination success), with OT program GPA and preadmission recommendation scores predicting unique outcome variance. This information may be helpful to admissions committees as well as to occupational therapy faculty as they identify strategies and practices to facilitate first-time test taking success on the NBCOT certification examination

Sex differences in health at ages 11, 13 and 15

This paper tests the hypothesis of an emerging or increasing female excess in general ill-health and physical symptoms, as well as psychological distress, during early to mid-adolescence. Self-reported data on general health (longstanding illness and health in the last 12 months), recent symptoms (classified as ‘physical’ and ‘malaise’) and depressive mood were obtained from a large, Scottish, school-based cohort at ages 11, 13 and 15. Generally high levels of health problems at age 11 tended to increase with age, these increases being greater for females than males, not only in respect of depression and ‘malaise’ symptoms, but also limiting illness, ‘poor’ self-rated health, headaches, stomach problems and dizziness. The consequence, by age 15, is the emergence of a female excess in general ill-health and depressive mood, and a substantial strengthening of the small excess in both ‘physical’ and ‘malaise’ symptoms already apparent at 11 years. These findings are discussed in relation to explanations for the adult female excess in poorer health, and the emergence of a female excess of depression during adolescence

Recognising female sexual dysfunction as an essential aspect of effective diabetes care

The following literature review will focus on sexual dysfunction in women living with diabetes, drawing on international studies in this specialist field. The key aim of this paper is generate a greater understanding and recognition of the issues facing these women and to determine a more proactive approach to identification, consultation and potential treatment options. The main findings highlight the unique role practitioners have with women with diabetes and how to facilitate partnership working. Nurses have the most frequent contact with people living with diabetes in any healthcare system. Nurses’ knowledge about sexuality in relation to diabetes should improve patient education, recognition and could signal undiagnosed or increased risk of sexual dysfunction to enable treatment so care can be optimised accordingl

Sexual Satisfaction and the Importance of Sexual Health to Quality of Life Throughout the Life Course of U.S. Adults

Discussions about sexual health are uncommon in clinical encounters, despite the sexual dysfunction associated with many common health conditions. Understanding of the importance of sexual health and sexual satisfaction among US adults is limited

Construct validity of the PROMIS® sexual function and satisfaction measures in patients with cancer

Background With data from a diverse sample of patients either in treatment for cancer or post-treatment for cancer, we examine inter-domain and cross-domain correlations among the core domains of the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction measures (PROMIS® SexFS) and the corresponding domains from conceptually-similar measures of sexual function, the International Index of Erectile Function and the Female Sexual Function Index. Findings Men (N=389) and women (N=430) were recruited from a tumor registry, oncology clinics, and an internet panel. The PROMIS SexFS, International Index of Erectile Function, and Female Sexual Function Index were used to collect participants’ self-reported sexual function. The domains shared among the measures include desire/interest in sexual activity, lubrication and vaginal discomfort/pain (women), erectile function (men), orgasm, and satisfaction. We examined correlations among different domains within the same instrument (discriminant validity) and correlations among similar domains measured by different instruments (convergent validity). Correlations demonstrating discriminant validity ranged from 0.38 to 0.73 for men and 0.48 to 0.74 for women, while correlations demonstrating convergent validity ranged from 0.62 to 0.83 for men and 0.71 to 0.92 for women. As expected, correlations demonstrating convergent validity were higher than correlations demonstrating discriminant validity, with one exception (orgasm for men). Conclusions Construct validity was supported by convergent and discriminant validity in a diverse sample of patients with cancer. For patients with cancer who may or may not have sexual dysfunction, the PROMIS SexFS measures provide a comprehensive assessment of key domains of sexual function and satisfaction

4-1BBL-containing leukemic extracellular vesicles promote immunosuppressive effector regulatory T cells

Chronic and acute myeloid leukemia evade immune system surveillance and induce immunosuppression by expanding proleukemic Foxp31 regulatory T cells (Tregs). High levels of immunosuppressive Tregs predict inferior response to chemotherapy, leukemia relapse, and shorter survival. However, mechanisms that promote Tregs in myeloid leukemias remain largely unexplored. Here, we identify leukemic extracellular vesicles (EVs) as drivers of effector proleukemic Tregs. Using mouse model of leukemia-like disease, we found that Rab27adependent secretion of leukemic EVs promoted leukemia engraftment, which was associated with higher abundance of activated, immunosuppressive Tregs. Leukemic EVs attenuated mTOR-S6 and activated STAT5 signaling, as well as evoked significant transcriptomic changes in Tregs. We further identified specific effector signature of Tregs promoted by leukemic EVs. Leukemic EVs-driven Tregs were characterized by elevated expression of effector/tumor Treg markers CD39, CCR8, CD30, TNFR2, CCR4, TIGIT, and IL21R and included 2 distinct effector Treg (eTreg) subsets: CD301CCR8hiTNFR2hi eTreg1 and CD391TIGIThi eTreg2. Finally, we showed that costimulatory ligand 4-1BBL/CD137L, shuttled by leukemic EVs, promoted suppressive activity and effector phenotype of Tregs by regulating expression of receptors such as CD30 and TNFR2. Collectively, our work highlights the role of leukemic extracellular vesicles in stimulation of immunosuppressive Tregs and leukemia growth. We postulate that targeting of Rab27a-dependent secretion of leukemic EVs may be a viable therapeutic approach in myeloid neoplasms

Mental Health of Parents and Life Satisfaction of Children: A Within-Family Analysis of Intergenerational Transmission of Well-Being

This paper addresses the extent to which there is an intergenerational transmission of mental health and subjective well-being within families. Specifically it asks whether parents’ own mental distress influences their child’s life satisfaction, and vice versa. Whilst the evidence on daily contagion of stress and strain between members of the same family is substantial, the evidence on the transmission between parental distress and children’s well-being over a longer period of time is sparse. We tested this idea by examining the within-family transmission of mental distress from parent to child’s life satisfaction, and vice versa, using rich longitudinal data on 1,175 British youths. Results show that parental distress at year t-1 is an important determinant of child’s life satisfaction in the current year. This is true for boys and girls, although boys do not appear to be affected by maternal distress levels. The results also indicated that the child’s own life satisfaction is related with their father’s distress levels in the following year, regardless of the gender of the child. Finally, we examined whether the underlying transmission correlation is due to shared social environment, empathic reactions, or transmission via parent-child interaction

Regrouping: Organized Activity Involvement and Social Adjustment Across the Transition to High School

Although organized activities (OAs) have been established as important contexts of development, limited work has examined the role of OAs across the high school transition in buffering adolescents\u27 social adjustment by providing opportunities for visibility and peer affiliation. The transition to high school is characterized by numerous changes and OAs may provide an important setting for establishing and maintaining peer relationships during this tumultuous time. This study included 151 8th grade U.S. students (58% male) who were assessed across the transition to high school (spring of 8th and 9th grade). Continuous involvement in academic activities across the transition and becoming involved (i.e., initiation) in community/service activities following the transition was associated with fewer depressive symptoms in the spring of 9th grade. Continuous involvement in sports and initiation of academic activities was associated with having more friendships. In addition, links between OAs and loneliness were only evident among females. There appear to be significant social benefits for OA involvement

Differential expression of CD49a and CD49b determines localization and function of tumor-infiltrating CD8(+) T cells

CD8(+) T-cell infiltration and effector activity in tumors are correlated with better overall survival of patients, suggesting that the ability of T cells to enter and remain in contact with tumor cells supports tumor control. CD8(+) T cells express the collagen-binding integrins CD49a and CD49b, but little is known about their function or how their expression is regulated in the tumor microenvironment (TME). Here, we found that tumor-infiltrating CD8(+) T cells initially expressed CD49b, gained CD49a, and then lost CD49b over the course of tumor outgrowth. This differentiation sequence was driven by antigen-independent elements in the TME, although T-cell receptor (TCR) stimulation further increased CD49a expression. Expression of exhaustion markers and CD49a associated temporally but not mechanistically. Intratumoral CD49a-expressing CD8(+) T cells failed to upregulate TCR-dependent Nur77 expression, whereas CD69 was constitutively expressed, consistent with both a lack of productive antigen engagement and a tissue-resident memory-like phenotype. Imaging T cells in live tumor slices revealed that CD49a increased their motility, especially of those in close proximity to tumor cells, suggesting that it may interfere with T-cell recognition of tumor cells by distracting them from productive engagement, although we were not able to augment productive engagement by short-term CD49a blockade. CD49b also promoted relocalization of T cells at a greater distance from tumor cells. Thus, our results demonstrate that expression of these integrins affects T-cell trafficking and localization in tumors via distinct mechanisms, and suggests a new way in which the TME, and likely collagen, could promote tumor-infiltrating CD8(+) T-cell dysfunction.Experimental cancer immunology and therap