Exploring Sleep Health Among Occupational Therapy Students

A substantial number of health-professional graduate students do not follow the national recommendation of obtaining at least seven hours of sleep per day. Decreased sleep duration and quality are strongly associated with daytime sleepiness and dysfunction, academic burnout, low academic performance, and mental health symptoms and disorders. However, limited research exists on sleep health among occupational therapy (OT) graduate students. Thus, the purpose of this study was to explore OT graduate student perspectives on sleep and to measure their sleep duration, quality, and practices to inform sleep promotion strategies for increased student well-being. A mixed-method study with a cross-sectional design was conducted. Occupational therapy graduate student participants engaged in a focus group and completed the Sleep Practices and Attitudes Questionnaire (SPAQ) along with a survey of demographic characteristics. Nineteen participants completed all aspects of the study. Participants slept an average of 6.75 hours per weekday night and rated their sleep quality an average of 3.47 out of 5 on a Likert scale (1: restless; 5: restful). The majority of participants (68.4%; n=13) reported feeling unrefreshed upon waking, and 78.9% (n=15) reported tiredness during the day. Three major themes emerged from the focus group data: 1) sleep prioritization and practice, 2) sleep knowledge versus action, and 3) occupational balance. This study is one of the first to assess sleep health among OT graduate students. Findings contribute to sleep health literature and may guide programming in sleep health promotion and graduate student well-being

Identification of Mental States and Interpersonal Functioning in Borderline Personality Disorder

Atypical identification of mental states in the self and others has been proposed to underlie interpersonal difficulties in borderline personality disorder (BPD), yet no previous empirical research has directly examined associations between these constructs. We examine 3 mental state identification measures and their associations with experience-sampling measures of interpersonal functioning in participants with BPD relative to a healthy comparison (HC) group. We also included a clinical comparison group diagnosed with avoidant personality disorder (APD) to test the specificity of this constellation of difficulties to BPD. When categorizing blended emotional expressions, the BPD group identified anger at a lower threshold than did the HC and APD groups, but no group differences emerged in the threshold for identifying happiness. These results are consistent with enhanced social threat identification and not general negativity biases in BPD. The Reading the Mind in the Eyes Test (RMET) showed no group differences in general mental state identification abilities. Alexithymia scores were higher in both BPD and APD relative to the HC group, and difficulty identifying one’s own emotions was higher in BPD compared to APD and HC. Within the BPD group, lower RMET scores were associated with lower anger identification thresholds and higher alexithymia scores. Moreover, lower anger identification thresholds, lower RMET scores, and higher alexithymia scores were all associated with greater levels of interpersonal difficulties in daily life. Research linking measures of mental state identification with experience-sampling measures of interpersonal functioning can help clarify the role of mental state identification in BPD symptoms

Impulsivity, Rejection Sensitivity, and Reactions to Stressors in Borderline Personality Disorder

This research investigated baseline impulsivity, rejection sensitivity, and reactions to stressors in individuals with borderline personality disorder compared to healthy individuals and those with avoidant personality disorder . The borderline group showed greater impulsivity than the avoidant and healthy groups both in a delay-discounting task with real monetary rewards and in self-reported reactions to stressors; moreover, these findings could not be explained by co-occurring substance use disorders. Distress reactions to stressors were equally elevated in both personality disorder groups (relative to the healthy group). The borderline and avoidant groups also reported more maladaptive reactions to a stressor of an interpersonal versus non-interpersonal nature, whereas the healthy group did not. Finally, self-reported impulsive reactions to stressors were associated with baseline impulsivity in the delay-discounting task, and greater self-reported reactivity to interpersonal than non-interpersonal stressors was associated with rejection sensitivity. This research highlights distinct vulnerabilities contributing to impulsive behavior in borderline personality disorder

THE EFFECTS OF CLEAT LOCATION ON MUSCLE RECRUITMENT STRATEGIES OF CYCLING

Foot placement may play an important role in muscle recruitment patterns and affect cycling performance. The purpose of this study was to determine if magnitude of activation increased in more proximal muscles when a more posterior compared to standard cleat location is used. Surface electromyography (8 muscles) and kinematics were collected from 11 experienced cyclists pedalling at 80 rpm rate during standard and posterior cleat location conditions. Root mean square (RMS) EMG were analyzed using paired t-tests. Peak RMS magnitude and crank angle of peak RMS were affected by cleat conditions. Posterior cleat locations alter the magnitude and muscular recruitment strategies of seated cycling when compared to neutral cleat placement

Xylem surfactants introduce a new element to the cohesion-tension theory

Vascular plants transport water under negative pressure without constantly creating gas bubbles that would disable their hydraulic systems. Attempts to replicate this feat in artificial systems almost invariably result in bubble formation, except under highly controlled conditions with pure water and only hydrophilic surfaces present. In theory, conditions in the xylem should favor bubble nucleation even more: there are millions of conduits with at least some hydrophobic surfaces, and xylem sap is saturated or sometimes supersaturated with atmospheric gas and may contain surface-active molecules that can lower surface tension. So how do plants transport water under negative pressure? Here, we show that angiosperm xylem contains abundant hydrophobic surfaces as well as insoluble lipid surfactants, including phospholipids, and proteins, a composition similar to pulmonary surfactants. Lipid surfactants were found in xylem sap and as nanoparticles under transmission electron microscopy in pores of intervessel pit membranes and deposited on vessel wall surfaces. Nanoparticles observed in xylem sap via nanoparticle-tracking analysis included surfactant-coated nanobubbles when examined by freeze-fracture electron microscopy. Based on their fracture behavior, this technique is able to distinguish between dense-core particles, liquid-filled, bilayer-coated vesicles/liposomes, and gas-filled bubbles. Xylem surfactants showed strong surface activity that reduces surface tension to low values when concentrated as they are in pit membrane pores. We hypothesize that xylem surfactants support water transport under negative pressure as explained by the cohesion-tension theory by coating hydrophobic surfaces and nanobubbles, thereby keeping the latter below the critical size at which bubbles would expand to form embolisms

Current Sheet and Reconnection Inflow-Outflow Observations During Solar Eruptions

Magnetic reconnection is widely accepted as a dominant source of energy during solar flares; however, observations of it have been indirect and/or incomplete. Using the suite of instruments available spanning wavelength space, we will provide observations and measurements of both the inputs and outputs predicted from reconnection in the form of inflows preceding outflows (i.e. supra-arcade downflows, supra-arcade downflowing loops, upflows, and disconnection events). We will also present evidence for current sheets through which reconnection is expected to occur and discuss current sheet motion during flare progression

Economic costs and health-related quality of life for hand, foot and mouth disease (HFMD) patients in China.

BACKGROUND: Hand, foot and mouth disease (HFMD) is a common illness in China that mainly affects infants and children. The objective of this study is to assess the economic cost and health-related quality of life associated with HFMD in China. METHOD: A telephone survey of caregivers were conducted in 31 provinces across China. Caregivers of laboratory-confirmed HFMD patients who were registered in the national HFMD enhanced surveillance database during 2012-2013 were invited to participate in the survey. Total costs included direct medical costs (outpatient care, inpatient care and self-medication), direct non-medical costs (transportation, nutrition, accommodation and nursery), and indirect costs for lost income associated with caregiving. Health utility weights elicited using EuroQol EQ-5D-3L and EQ-Visual Analogue Scale (VAS) were used to calculate associated loss in quality adjusted life years (QALYs). RESULTS: The subjects comprised 1136 mild outpatients, 1124 mild inpatients, 1170 severe cases and 61 fatal cases. The mean total costs for mild outpatients, mild inpatients, severe cases and fatal cases were $201 (95$187, $215),$1072 (95%CI $999,$1144), $3051 (95$2905, $3197) and$2819 (95%CI $2068,$3571) respectively. The mean QALY losses per HFMD episode for mild outpatients, mild inpatients and severe cases were 3.6 (95%CI 3.4, 3,9), 6.9 (95%CI 6.4, 7.4) and 13.7 (95%CI 12.9, 14.5) per 1000 persons. Cases who were diagnosed with EV-A71 infection and had longer duration of illness were associated with higher total cost and QALY loss. CONCLUSION: HFMD poses a high economic and health burden in China. Our results provide economic and health utility data for cost-effectiveness analysis for HFMD vaccination in China

NK cell exhaustion in the tumor microenvironment

Natural killer (NK) cells kill mutant cells through death receptors and cytotoxic granules, playing an essential role in controlling cancer progression. However, in the tumor microenvironment (TME), NK cells frequently exhibit an exhausted status, which impairs their immunosurveillance function and contributes to tumor immune evasion. Emerging studies are ongoing to reveal the properties and mechanisms of NK cell exhaustion in the TME. In this review, we will briefly introduce the maturation, localization, homeostasis, and cytotoxicity of NK cells. We will then summarize the current understanding of the main mechanisms underlying NK cell exhaustion in the TME in four aspects: dysregulation of inhibitory and activating signaling, tumor cell-derived factors, immunosuppressive cells, and metabolism and exhaustion. We will also discuss the therapeutic approaches currently being developed to reverse NK cell exhaustion and enhance NK cell cytotoxicity in the TME

The Development of a Well-Being Program for Occupational Therapy Graduate Students

High levels of stress among occupational therapy graduate students have led to the adoption of unhealthy coping habits such as poor nutrition, little exercise, and disrupted sleep. In response, many institutions have explored programming and even curricular changes to support student well-being. However, very few are built upon a strong theoretical foundation to address holistic well-being. Therefore, this paper describes how logic modeling was used to develop a student well-being program based on Facilitating Learning and Occupational Well-Being Using Research-Based Initiatives for Student Health (FLOURISH), a theoretical approach rooted in the Person-Environment-Occupation Performance Model. A well-being program delivered via a virtual community of practice for entry-level students at a Midwestern occupational therapy program was created to decrease stress and enhance overall well-being for the performance of learning. The program consisted of eight 50-minute sessions that met once per week and included topics of physical, mental, sociocultural, environmental, and occupational well-being. The student well-being program is one viable option that shows promise to empower students with a theoretical approach to address personal and professional well-being, which has the potential to translate into professional practice. In this article, we describe the well-being program and the theoretical approach in detail and illustrate how it can be used to improve occupational therapy student well-being