Occupational Therapy Approach in a Children’s Ministry Outreach Program

The 16-week capstone project took place in the children’s ministry department of the Dream Center of Lakeland, a community center based in Lakeland, Florida. The Dream Center is a faith-based organization that carries out its mission through providing resources and services to the local community such as a food and clothes pantries, women’s health clinic, meal programs, accessible computer lab, and mentorship groups. Specifically, the current capstone project focused on the youth served by the Dream Center’s children’s outreach program, KIDS CLUB. The children served by this program come from low socioeconomic status (SES) backgrounds and range in age from kindergarten through fifth grade. The focus areas for the capstone project were program development and education. The program development focus area involved the creation of developmentally appropriate curriculum and group activities related to occupation-based and sensory-based needs of the youth. The education focus area included the provision of resources and education to volunteers on effective behavior management and TIC strategies when working with the children in the outreach program. This capstone project serves as an example of how a consulting occupational therapist can identify a need within a faith-based community center and apply clinical reasoning to provide targeted intervention at a community level to children from low SES backgrounds

Art Narration as a Language Sampling Context

The differences in language constructs elicited in a video narration language sampling context and an art narration language sampling context were investigated. A quasi-experimental counterbalanced design was utilized to assess the effects of the language sampling contexts on the language constructs elicited. The subjects were six boys and six girls, ages four and a half to six years, with normally developing language. Age-matched pairs were randomly placed in one of two groups. Group A was exposed to the video narration context followed by the art narration context. Group B was exposed to the art narration context followed by the video narration context. Language samples were taken in both the art narration context and the video narration context. The language constructs examined included: mean length of utterance, type-token ratio, range in utterance length, semantic roles, fourteen grammatical morphemes, negation, noun phrase elaboration, verb phrase elaboration, sentence types and clause structure. Mean length of utterance, range in utterance length, and type-token ratio were statistically analyzed using two-tailed t-tests. A statistically significant difference was not found between the two conditions for mean length of utterance, type-token ratio, or range in utterance length. The final eight language constructs examined were descriptively analyzed. Differences were found in certain aspects of each of these constructs. Analysis also revealed that the final context subjects were exposed to generally elicited a greater frequency of occurrence of the language constructs examined, regardless of the order of the conditions. These findings suggest that art narration is a valid means for sampling language and that the more a child is familiarized with a stimulus the greater the narrative elaboration of the story

Lysyl-tRNA synthetase as a drug target in malaria and cryptosporidiosis

Malaria and cryptosporidiosis, caused by apicomplexan parasites, remain major drivers of global child mortality. New drugs for the treatment of malaria and cryptosporidiosis, in particular, are of high priority; however, there are few chemically validated targets. The natural product cladosporin is active against blood- and liver-stage; Plasmodium falciparum; and; Cryptosporidium parvum; in cell-culture studies. Target deconvolution in; P. falciparum; has shown that cladosporin inhibits lysyl-tRNA synthetase (; Pf; KRS1). Here, we report the identification of a series of selective inhibitors of apicomplexan KRSs. Following a biochemical screen, a small-molecule hit was identified and then optimized by using a structure-based approach, supported by structures of both; Pf; KRS1 and; C. parvum; KRS (; Cp; KRS). In vivo proof of concept was established in an SCID mouse model of malaria, after oral administration (ED; 90; = 1.5 mg/kg, once a day for 4 d). Furthermore, we successfully identified an opportunity for pathogen hopping based on the structural homology between; Pf; KRS1 and; Cp; KRS. This series of compounds inhibit; Cp; KRS and; C. parvum; and; Cryptosporidium hominis; in culture, and our lead compound shows oral efficacy in two cryptosporidiosis mouse models. X-ray crystallography and molecular dynamics simulations have provided a model to rationalize the selectivity of our compounds for; Pf; KRS1 and; Cp; KRS vs. (human); Hs; KRS. Our work validates apicomplexan KRSs as promising targets for the development of drugs for malaria and cryptosporidiosis

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Speech-Language Pathologists in Disaster Management: Team Roles

Purpose: Disaster management is a topic that is multi-faceted and intricately maintained by the professionals who volunteer their expertise and time to assist those who have been affected by an unforeseen disaster. Creating a well-rounded and effective team is of immense importance during disaster situations; speech-language pathologists (SLPs) can provide vital skills in the realm of communication, feeding, and other areas. However, the role of SLPs within the disaster management team is not well documented in the literature. The purpose of the study was to identify awareness, involvement, and training of SLPs in disaster management cycles through exploration of their self-reported knowledge, skills, and roles in order to better understand their likelihood of response and potential collaborative roles within the team. Method: To explore how SLPs view themselves as part of the disaster management cycle, a cross-sectional survey study was designed. The study specifically targeted licensed, SLPs within the state of Florida. Results: There were 216 viable survey responses to analyze. Upon rendering of the data, a descriptive and correlational analysis was conducted to further examine how speech-language professionals perceive their fit in the arena of disaster management. SLPs who responded to this survey were primarily white, 40–49-year-old females who had experienced some form of disaster. Most respondents reported receiving no training for disaster management; however, they indicated that SLPs and other healthcare professionals have unique skills that could contribute to disaster cycles. Although there was reportedly limited training and guidance available and minimal professional experience with disaster, SLPs who reported having professional experience with disaster cycles, indicated an increased likelihood of participating in future disaster response. Conclusions: Similar to interdisciplinary teams found in clinical practice, healthcare professionals need training and education about their roles to form teams to holistically address the needs of clients in all disaster management stages. Analyses show SLPs feel they could provide important contributions to the interdisciplinary disaster management team; however, they have not had adequate professional experience or training

Speech-Language Pathologists and Disaster Management: Team Roles

Purpose: Disaster management is a topic that is multi-faceted and intricately maintained by professionals who volunteer their expertise and time to assist those who have been affected by an unforeseen disaster. Creating a well-rounded and effective team is of immense importance during disaster situations. Speech-language pathologists can provide vital skills in the realm of communication, feeding, and other areas. However, the role of speech language pathologists within the disaster management team is not well documented in the literature. The purpose of the study was to identify awareness, involvement, and training of speech language pathologists in disaster management stages through exploration of their self-reported knowledge, skills, and roles to better understand their likelihood of response and potential collaborative roles within a disaster management team. Method: To gather data on self-reported awareness, knowledge, skills, participation, training, and perceptions of speech language pathologists as part of the disaster management stage, a cross-sectional survey study was designed. The study specifically targeted licensed speech language pathologists within the state of Florida. Results: There were 216 viable survey responses to analyze. Descriptive and correlational analyses were conducted to examine how speech-language professionals perceive their fit in the arena of disaster management. Speech language pathologists who responded to this survey were primarily white, 40–49-year-old females who had experienced some form of disaster. Most respondents reported receiving no training in disaster management; however, they indicated that speech language pathologists and other healthcare professionals have unique skills that could contribute to disaster management stages. Although there was reportedly limited training and guidance available and minimal professional experience with disaster, speech language pathologists who reported having professional experience with disaster stages, indicated an increased likelihood of participating in future disaster management. Conclusions: Similar to interdisciplinary teams found in clinical practice, healthcare professionals need training and education about their roles to form teams to address the needs of individuals in all disaster management stages. Analyses indicated that speech language pathologists perceive themselves, and other healthcare professionals, could provide meaningful contributions to the disaster management team; however, they have not had adequate professional experience or training

Risk of developing subsequent primary lung cancer after receiving radiation for breast cancerCentral MessagePerspective

Background: Radiotherapy (RT) is integral to breast cancer treatment, especially in the current era that emphasizes breast conservation. The aim of our study was to determine the incidence of subsequent primary lung cancer after RT exposure for breast cancer over a time span of 3 decades to quantify this risk over time as modern oncologic treatment continues to evolve. Methods: The SEER (Surveillance, Epidemiology, and End Results) database was queried from 1988 to 2014 for patients diagnosed with nonmetastatic breast cancer. Patients who subsequently developed primary lung cancer were identified. Multivariable regression modeling was performed to identify independent factors associated with the development of lung cancer stratified by follow up intervals of 5 to 9 years, 10 to 15 years, and >15 years after breast cancer diagnosis. Results: Of the 612,746 patients who met our inclusion criteria, 319,014 (52%) were irradiated. primary lung cancer developed in 5556 patients (1.74%) in the RT group versus 4935 patients (1.68%) in the non-RT group. In a multivariable model stratified by follow-up duration, the overall HR of developing subsequent ipsilateral lung cancer in the RT group was 1.14 (P = .036) after 5 to 9 years of follow-up, 1.28 (P = .002) after 10 to 15 years of follow-up, and 1.30 (P = .014) after >15 years of follow-up. The HR of contralateral lung cancer was not increased at any time interval. Conclusions: The increased risk of developing a primary lung cancer secondary to RT exposure for breast cancer is much lower than previously published. Modern RT techniques may have contributed to the improved risk profile, and this updated study is important for counseling and surveillance of breast cancer patients