Examination of Potential Factors to Predict Fieldwork Performance: A Program Evaluation Project

This program evaluation project evaluated the validity of a hypothesized model for predicting fieldwork performance using data of 121 occupational therapy students from a single university. The first aim was to evaluate the hypothesized relationships between observed measures (e.g., admission GPAs) and proposed latent factors (e.g., academic achievement) for predictor and outcome variables. Factor analysis of the outcome variable revealed a three-factor structure, measured by 13 items from the Fieldwork Performance Evaluation for the Occupational Therapy Student. However, factor analyses of the predictor variables did not support the proposed latent factors: Academic Achievement and Professional Potential. The second aim was to evaluate the hypothesized effects of predictor variables on level II fieldwork performance. Results of the structural equation modeling (SEM) analysis supported some of the hypothesized relationships. The model was a good fit to the data; however, the final SEM model only accounted for 16.4% of the variance. Results showed that four of the eight observed variables were predictive. Two academic measures (i.e., admission overall GPA and science GPA) and two non-academic measures (i.e., Myer’s Briggs Thinking type indicator and number of observation hours) demonstrated small predictive relationships with Evaluation Skills. Admission overall GPA and thinking type indicator had positive predictive relationships; whereas, admission science GPA and number of hours had inverse relationships. None of the observed variables predicted the other two fieldwork performance factors: Professional Behaviors and Intervention Skills. Although the results of this project did not fully support the hypothesized model, some interesting findings emerged for future exploration

Admission Requirements and Practices in Entry-Level Occupational Therapy Programs

When establishing admission processes for entry-level doctoral programs, admission requirements for master-level programs provide a comparison for consideration. The purpose of this study was to provide information about admission practices for graduate-level occupational therapy programs. The three aims included: 1) to describe admission requirements of a sample of entry-level master’s programs; 2) to examine the relationship between attrition and admission requirements for the sample; and 3) to provide a summary of admission requirements used by entry-level master and doctoral programs in the United States. Results of the study provided a synthesis of information about admission requirements that included programs’ minimum pre-admission grade point average, Graduate Record Examination (GRE) requirements, and interview processes (e.g., format, time, personnel). A review of the websites for 172 entry-level master’s and doctoral programs across the United States provided a comprehensive description of national admission requirements. Results of a survey of 31 master’s level programs provided information on student demographics (e.g., race/ethnicity, gender), admission requirements, and attrition information for the cohorts admitted in a single year. Survey results also examined the relationship between attrition and admission requirements. Educational programs have opportunities, responsibilities, and challenges associated with the selection of the most qualified applicants to meet academic and professional behavior standards. Periodic examination of admission processes within and across occupational therapy education programs is important for the integrity of the profession

Weight management during teenage pregnancy: Issues to consider when developing appropriate support

Teenage pregnancy is more prevalent in areas of high obesity, compared to areas where obesity levels are low. Risks associated with maternal obesity in pregnant teenagers include pre-eclampsia and caesarean delivery. To reduce these risks, pregnant teenagers need to be supported to gain a healthy weight in pregnancy. This includes encouraging these women to eat healthily through providing appropriate information including online or smartphone apps in conjunction with face-to-face support. These young women also need encouragement to be physically active. This support must be tailored to the teenage population considering their specific barriers and facilitators to behaviour change. Midwives with the aid of a multidisciplinary team play a key role in encouraging these healthy behaviours

Prebiotic potential of a maize-based soluble fibre and impact of dose on the human gut microbiota

Dietary management of the human gut microbiota towards a more beneficial composition is one approach that may improve host health. To date, a large number of human intervention studies have demonstrated that dietary consumption of certain food products can result in significant changes in the composition of the gut microbiota i.e. the prebiotic concept. Thus the prebiotic effect is now established as a dietary approach to increase beneficial gut bacteria and it has been associated with modulation of health biomarkers and modulation of the immune system. Promitor™ Soluble Corn Fibre (SCF) is a well-known maize-derived source of dietary fibre with potential selective fermentation properties. Our aim was to determine the optimum prebiotic dose of tolerance, desired changes to microbiota and fermentation of SCF in healthy adult subjects. A double-blind, randomised, parallel study was completed where volunteers (n = 8/treatment group) consumed 8, 14 or 21 g from SCF (6, 12 and 18 g/fibre delivered respectively) over 14-d. Over the range of doses studied, SCF was well tolerated Numbers of bifidobacteria were significantly higher for the 6 g/fibre/day compared to 12g and 18g/fibre delivered/day (mean 9.25 and 9.73 Log10 cells/g fresh faeces in the pre-treatment and treatment periods respectively). Such a numerical change of 0.5 Log10 bifidobacteria/g fresh faeces is consistent with those changes observed for inulin-type fructans, which are recognised prebiotics. A possible prebiotic effect of SCF was therefore demonstrated by its stimulation of bifidobacteria numbers in the overall gut microbiota during a short-term intervention

Exploring the views of young women and their healthcare professionals on dietary habits and supplementation practices in adolescent pregnancy: a qualitative study

Background: Nutrition is a modifiable factor affecting foetal growth and pregnancy outcomes. Inadequate nutrition is of particular concern in adolescent pregnancies with poor quality diet and competing demands for nutrients. The aim of this study was to explore knowledge and understanding of nutrition advice during adolescent pregnancy,and identify barriers and facilitators to dietary change and supplementation use in this vulnerable population. Methods: Semi-structured interviews were conducted with young women and key antenatal healthcare providers: midwives, family nurses and obstetricians. Doncaster, Manchester and London were chosen as sites offering different models of midwifery care alongside referral to the Family Nurse Partnership programme. Results: A total of 34 young women (adolescents aged 16–19 years) and 20 health professionals were interviewed. Young women made small changes to their dietary intake despite limited knowledge and social constraints. Supplementation use varied; the tablet format was identified by few participants as a barrier but forgetting to take them was the main reason for poor adherence. Health professionals provided nutrition information but often lack the time and resources to tailor this appropriately. Young women’s prime motivator was a desire to have a healthy baby; they wanted to understand the benefits of supplementation and dietary change in those terms. Conclusion: Pregnancy is a window of opportunity for improving nutrition but often constrained by social circumstances. Health professionals should be supported in their role to access education, training and resources which build their self-efficacy to facilitate change in this vulnerable population group beyond the routine care they provide

Tumour brain: pre‐treatment cognitive and affective disorders caused by peripheral cancers

People that develop extracranial cancers often display co-morbid neurological disorders, such as anxiety, depression and cognitive impairment, even before commencement of chemotherapy. This suggests bidirectional crosstalk between non-CNS tumours and the brain, which can regulate peripheral tumour growth. However, the reciprocal neurological effects of tumour progression on brain homeostasis are not well understood. Here, we review brain regions involved in regulating peripheral tumour development and how they, in turn, are adversely affected by advancing tumour burden. Tumour-induced activation of the immune system, blood–brain barrier breakdown and chronic neuroinflammation can lead to circadian rhythm dysfunction, sleep disturbances, aberrant glucocorticoid production, decreased hippocampal neurogenesis and dysregulation of neural network activity, resulting in depression and memory impairments. Given that cancer-related cognitive impairment diminishes patient quality of life, reduces adherence to chemotherapy and worsens cancer prognosis, it is essential that more research is focused at understanding how peripheral tumours affect brain homeostasis

Prebiotic effects on calcium absorption and bone metabolism

Adolescence is a critical time for reaching peak bone mass to prevent the risk of osteoporosis later in life. Dietary fibers and non-digestible oligosaccharides (NDO) are being investigated as a means to improve mineral metabolism and bone health through their unique interactions with colonic microflora. Bacteria residing in the colon are able to ferment ingested NDO thereby altering the luminal environment of the colon, which has been associated with increased absorption of calcium. The purpose of this body of work was to determine the effects of galactooligosaccharide (GOS) and soluble corn fiber (SCF) on calcium absorption and retention in adolescent children. To study the effects of GOS, a randomized, double-blind, placebo-controlled cross-over design was used to assess the effects of daily consumption of 0, 5, and 10 g GOS on calcium absorption in 10–12 year old, premenarcheal girls. GOS was provided in milk-based smoothies twice daily and consumed for 3 weeks. Calcium absorption tests were performed at the end of each 3-week period during a 2-day clinical visit. During this time, the girls consumed controlled diets with 1300 mg calcium per day, and all urine and fecal samples were collected for 48 hours after dual stable-isotope administration. Fractional calcium absorption was calculated based on urinary calcium isotope excretion and expressed as a ratio of excess 44Ca and 43Ca. GOS had a moderately positive effect on fractional calcium absorption (p=0.0132) with the 5 g treatment having the greatest impact on calcium absorption (Control=0.39 ± 0.10, 5 g GOS=0.43 ± 0.10, 10 g GOS=0.40 ± 0.13). Bifidobacteria composition was also significantly increased with GOS consumption when compared to baseline measurements before intervention. Overall, results from this investigation suggest that a modest intake of GOS is effective at increasing fractional calcium absorption in young girls. Soluble corn fiber effects on calcium absorption were evaluated during two, 3-week metabolic balance sessions of a randomized, placebo-controlled, crossover study in adolescent girls and boys, aged 12–15 years. The effects of 0 and 12 g/d SCF on calcium absorption and balance were studied under the condition of a controlled diet containing 600 mg daily calcium. Diet composites, fecal and urine samples were collected daily and analyzed for calcium content. Fractional calcium absorption was calculated as the ratio of excess 44Ca and 43Ca in the urine after accounting for natural abundance and administered doses. Pairwise comparisons revealed a significant difference in fractional calcium absorption at 48 h with SCF treatment increasing absorption by 12% compared to control (0.664 ± 0.129 and 0.595 ± 0.142, respectively; p=0.0239). SCF treatment had no effect on calcium balance. In summary, results from this study suggest that the addition of 12 g/d SCF has positive effects on calcium absorption in adolescent children with calcium intakes below daily recommended levels. Overall, results from these investigations support that prebiotics have a broad application in adolescent children. Using a variety of NDO products it may be possible to influence calcium absorption in both boys and girls on a range of calcium intakes. The moderate levels of prebiotics used in these studies increased calcium absorption in children ranging from 10 to 15 years of age indicating that if consumed at such achievable levels, they may positively impact the development of peak bone mass

Exercise and/or Genistein Treatment Impact Gut Microbiota and Inflammation after 12 Weeks on a High-Fat, High-Sugar Diet in C57BL/6 Mice

Genistein (Gen) and exercise (Exe) have been postulated as potential strategies to ameliorate obesity, inflammation, and gut microbiota (GM) with promising results. However, the impact of the combination of both Exe and Gen is yet to be investigated. We aimed to analyze the impacts of Exe, Gen, and their combined effects on GM and inflammation in mice after a 12-week high-fat, high-sugar diet (HFD). Eighty-three C57BL/6 mice were randomized to control, HFD, HFD + Exe, HFD + Gen, or HFD + Exe + Gen. The V4 region of the 16S rRNA gene was analyzed with Illumina MiSeq. Serum samples were used to analyze interleukin (Il)-6 and Tumor Necrosis Factor alpha (TNF-alpha). The HFD + Exe and HFD + Exe + Gen treatments resulted in significantly greater microbial richness compared to HFD. All the treatments had a significantly different impact on the GM community structure. Ruminococcus was significantly more abundant after the HFD + Exe + Gen treatment when compared to all the other HFD groups. Exe + Gen resulted in serum Il-6 concentrations similar to that of controls. TNF-alpha concentrations did not differ by treatment. Overall, Exe had a positive impact on microbial richness, and Ruminococcus might be the driving bacteria for the GM structure differences. Exe + Gen may be an effective treatment for preventing HFD-induced inflammation

Exercise and/or Genistein Do Not Revert 24-Week High-Fat, High-Sugar Diet-Induced Gut Microbiota Diversity Changes in Male C57BL/6J Adult Mice

The gut microbiota (GM) has been hypothesized to be a potential mediator in the health benefits of exercise and diet. The current literature is focused on the prevention effects of exercise and diet and could benefit from exploring whether these treatments alone or combined can treat obesity via the gut microbiome. This study aimed to explore the effects of genistein, exercise, and their synergistic effect to revert diet-induced obesity and gut microbiota changes. A total of 57 male adult C57BL/6 mice were randomized to 24 weeks of unpurified diet (chow) or a high-fat, high-sugar diet (HFD; 60% fat total energy). After the first 12 weeks, animals on the HFD were randomized into: HFD + chow, HFD, HFD + exercise (HFD + Exe), HFD + genistein (HFD + Gen), and HFD + Exe + Gen. We compared the body weight change between groups after 24 weeks. GM (α-diversity and ß-diversity) was profiled after sequencing the 16S rRNA gene by Illumina MiSeq. HFD + Exe + Gen significantly (p < 0.05) decreased weight gain relative to the HFD with only HFD + chow reverting the body weight change to that of chow. All diets including HFD reduced the GM richness (observed amplicon sequence variants) relative to chow with the HFD + Gen and HFD + Exe resulting in significantly lower phylogenetic diversity compared to the HFD. Data did not support an additive benefit to the GM for HFD + Gen + Exe. HFD + Exe + Gen showed a greater capacity to revert diet-induced obesity in adult male mice, but it was not as effective as switching from HFD to chow. Lifestyle treatment of HFD-induced obesity including exercise and genistein resulted in a reduction in weight gain and GM richness, but switching from HFD to chow had the greatest potential to revert these characteristics toward that of lean controls