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Career development learning (CDL) is an approach to developing student employability that enables students to reflect on and plan their future careers through engaging in activities outside or within their degree. Building on literature arguing for the benefits of integrating CDL within curriculum, this study examines academics' perceived roles facilitating CDL. Informed by the principles and processes of Interpretive Phenomenological Analysis (IPA), 55 academics were interviewed from one institution, enabling responses to be examined through a common lens of teaching, policy and governance structures. Findings demonstrate that while some participants broadly understood the value of CDL, the term CDL is not well known. Further, while CDL strategies within teaching contexts occur, they are mostly unplanned or dialogic. This paper presents a taxonomy of current practice, featuring 11 diverse roles for facilitating CDL within curriculum grouped as absent, implicit and explicit approaches. The paper offers recommendations for a university-wide agenda for employability that features CDL strategies embedded across core curricula.

BackgroundThere is significant interest in treatment de-escalation for human papillomavirus-associated (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) patients given the generally favourable prognosis. However, 15-30% of patients recur after primary treatment, reflecting a need for improved risk-stratification tools. We sought to develop a molecular test to risk stratify HPV+ OPSCC patients.MethodsWe created an immune score (UWO3) associated with survival outcomes in six independent cohorts comprising 906 patients, including blinded retrospective and prospective external validations. Two aggressive radiation de-escalation cohorts were used to assess the ability of UWO3 to identify patients who recur. Multivariate Cox models were used to assess the associations between the UWO3 immune class and outcomes.FindingsA three-gene immune score classified patients into three immune classes (immune rich, mixed, or immune desert) and was strongly associated with disease-free survival in six datasets, including large retrospective and prospective datasets. Pooled analysis demonstrated that the immune rich group had superior disease-free survival compared to the immune desert (HR = 9.0, 95% CI: 3.2-25.5, P = 3.6 × 10-5) and mixed (HR = 6.4, 95% CI: 2.2-18.7, P = 0.006) groups after adjusting for age, sex, smoking status, and AJCC8 clinical stage. Finally, UWO3 was able to identify patients from two small treatment de-escalation cohorts who remain disease-free after aggressive de-escalation to 30 Gy radiation.InterpretationWith additional prospective validation, the UWO3 score could enable biomarker-driven clinical decision-making for patients with HPV+ OPSCC based on robust outcome prediction across six independent cohorts. Prospective de-escalation and intensification clinical trials are currently being planned.FundingCIHR, European Union, and the NIH.

The vast majority of studies investigating participation in, persistence through, and consequences of postsecondary education focus on educational attainment status among the so-called traditional population of collegegoers between the ages of 18 and 24. This narrow focus leaves largely invisible the role that an expanding set of educational trajectories throughout adulthood plays in shaping social stratification. Using 35-plus and 20 years of follow-up data from the US National Longitudinal Survey of Youth (NLSY)’s 1979 and 1997 cohorts, we find that a substantial share within each cohort is attaining education well into adulthood, and that these trajectories are patterned according to key social and demographic characteristics. In both cohorts, racial/ethnic differences in educational attainment grew over time and, for those attaining the same degree, members of historically disadvantaged groups did so at an older age. Cohort differences in trajectories emerged, however, when considering the intersection of race/ethnicity and socialized gender. Through careful descriptive analysis of two generational cohorts, our study makes clear the role of educational trajectories in the process of cumulative (dis)advantage across the life course, as well as across generations.

Through the development and field testing of an instrument designed to measure youth social capital in the context of postsecondary transitions, this research addresses the need for theory-driven measures of social capital among youth. The results offer preliminary evidence that dimensions of youth social capital, including network structure and network content, can be reliably measured and that these dimensions of social capital are interrelated in a manner consistent with theory. The results also offer initial support for the validity of the social capital construct within the domain of youth postsecondary transitions. Taken together, the findings provide a foundation for continued research that might surmount inadequate measures and theoretical disputes to encompass more careful and rigorous empirical scrutiny when it comes to the measurement of social capital among children and adolescents.

Introduction: Limited data on 24-hour movement behaviors of children aged 5–8 years exist globally. We describe the prevalence and sociodemographic associations of meeting physical activity (PA), sedentary recreational screen time (ST), and sleep guidelines among children from 11 jurisdictions in the US-Affiliated Pacific region. Methods: Cross-sectional representative data from 1192 children aged 5–8 years living in the US-Affiliated Pacific region were drawn from the baseline 2012–2014 Children's Healthy Living Program. Sleep and moderate- to vigorous-intensity PA were calculated from accelerometry. ST and sociodemographic data were collected from caregiver surveys. The percentage of children meeting the Asia-Pacific 24-hour movement guidelines for PA (≥60 min/d of moderate- to vigorous-intensity PA), sleep (≥9 and ≤ 11 h/d) and ST (≤2 h/d) were calculated. Generalized linear mixed models were used to examine associations with adiposity and sociodemographic variables. Results: Twenty-seven percent (95% confidence interval, 24.6–30.0) of children met integrated guidelines; 98% (96.2–98.0) met PA, 78% (75.4–80.0) met sleep, and 35% (32.6–38.0) met ST guidelines. Females (adjusted odds ratio = 1.40 [95% confidence interval, 1.03–1.91]) and those living in lower-middle-income jurisdictions (2.29 [1.49–3.54]) were more likely to meet ST guidelines. Overweight children (0.62 [0.40–0.96]), those aged 8 years (0.39 [0.22–0.69]), and children with caregivers of an education level of high school or beyond (0.44 [0.29–0.68]) were less likely to achieve ST guidelines. Children from midrange annual household incomes were less likely to meet combined guidelines (0.60 [0.39–0.92]). Conclusions: Three-quarters of children are not meeting integrated Asia-Pacific 24-hour movement guidelines. Future strategies for reducing ST and increasing integrated guidelines compliance are needed. [ABSTRACT FROM AUTHOR]

We report 2 patients with coinheritance of the X-linked bleeding disorders hemophilia A and hemophilia B. We describe the family pedigrees, clinical features, and genotyping. The case report addresses the key clinical questions of how to manage patients with both hemophilia A and B and how to counsel families regarding recurrence risk. The patients with coinherited hemophilia A and B require a combination of factor VIII and factor IX replacement to achieve hemostasis. We calculated the estimated genomic meiotic recombination frequency between F8 and F9 to be 38%. The findings in these cases are consistent with this calculation. These findings provide critical information for management of families with coinherited hemophilia A and B.

In recent years, most U.S. states have revised policy by providing schools at least some flexibility to move away from the Carnegie unit system, with its focus on credits and "seat time," toward competency-based policies that link student advancement to mastery of content. Yet, there is little systematically collected information about how competency-based education is implemented, making it difficult to evaluate the impact on student outcomes. Using data from 600 students in grades 9-12 and confirmatory factor analytic techniques, we report initial reliability and validity results from the pilot administration of a survey designed to capture student exposure to elements that have been described as essential to a competency-based, student-centered model for learning and instruction. These elements include mastery-based progression, personalization, flexible assessment, and the development of specific skills and dispositions. Results suggest that the survey offers a way to reliably measure and study variation in the implementation of competency-based education. Importantly, the survey provides a way to capture implementation from the student perspective, leveraging the fact that student reports about their classroom experiences may be a particularly reliable source of information about instructional practice.

Objective: Synovial fluid (SF)–derived T cells are frequently studied as a proxy for investigating the synovial tissue (ST) T cell infiltrate in inflammatory arthritis. However, because ST is the primary site of inflammatory activity, there is debate as to whether SF provides a true reflection of the ST T cell population. Methods: In this study, we used single‐cell RNA sequencing paired with single‐cell T cell receptor (TCR) sequencing to directly compare memory T cells from paired samples of SF and ST from six patients with inflammatory arthritis to investigate their similarity in terms of TCR repertoire and T cell subset composition. Results: The TCR repertoires of SF and ST T cells were strikingly similar, particularly for CD8+ T cells. A median of 49% of the total CD8+ TCR repertoire in SF was shared with ST, compared with 20% shared with blood. Similarly, 47% of the ST CD8+ TCR repertoire was shared with SF compared to 25% with blood. Furthermore, once the effect of collagenase digestion on gene expression by ST T cells had been accounted for, the frequencies of specific CD8+ and CD4+ T cell subsets were, in general, similar in SF and ST and were distinct from blood. Conclusion: Our results suggest that T cells migrate and equilibrate between the SF and ST and maintain similar phenotypes in both sites. We conclude that SF is an appropriate proxy for investigating the T cell infiltrate in inflamed synovium, particularly in terms of investigating the TCR repertoire. [ABSTRACT FROM AUTHOR]

Career development learning (CDL) equips students with the skills, knowledge and resources to navigate their careers amidst dynamic work and learning environments. While CDL is known to be facilitated by central careers services in higher education institutions, embedding CDL activities within the curriculum is purported to be an effective approach to generate meaningful reflections that prepare students for their future lives. This study examined academics' perceptions and applications of CDL to understand the extent to which CDL is currently practiced in the curriculum. At one institution, interviews were conducted with 55 academics teaching across 101 subjects and in various disciplines. Findings demonstrate that most CDL is delivered informally or in isolation without a structured framework, highlighting the need to improve purposeful integration of CDL in the curriculum. Recommendations point to greater adoption of strategic institution-wide approaches to CDL, which ultimately impact students' employability choices, career decision-making, and preparation for the workforce. [ABSTRACT FROM AUTHOR]

Objectives This mixed-methods systematic review aimed to identify and synthesize knowledge of the characteristics, content, and preferred format of information to support people with inflammatory arthritis (IA) to take MTX. Methods A literature search using MEDLINE, The Cochrane Library, EMBASE, CINAHL, PsychInfo, GreyEU, Web of Science and Open Dissertation was conducted to identify all studies published from 2000 to December 2022. Included studies detailed factors related to MTX information needs of people aged ≥18 years with IA published in English. The Joanna Briggs Institute Guidelines (JBI) for convergent integrated mixed-methods systematic reviews were followed using validated tools for data extraction and quality. The data was analysed using reflexive thematic analysis. Results Thirteen studies (seven quantitative, two mixed-methods and four qualitative) were included, involving 3425 adults, mainly female n  = 2434 (71%), age 20–84 years. An overarching theme of a requirement for person-centred care was developed, with three interlinking themes: (1) accepting the need for treatment with MTX, (2) concerns about taking MTX, and (3) a need for tailored information and support. Limitations of the evidence included the use of heterogeneous outcome measures and instruments for measuring information needs. Conclusion People with IA have individual, multifaceted information and support needs about MTX that are often unresolved when a one-size-fits-all approach is used. The findings of this review can inform rheumatology training to support a person-centred approach to identifying and addressing the specific needs and concerns and development of consistent easy-to-understand accessible MTX information. [ABSTRACT FROM AUTHOR]

Using data from the "Educational Longitudinal Study of 2002" and structural equation modeling techniques, this study focuses on the unique experiences of Hispanic adolescents who maintain bachelor's degree expectations through the end of high school. Results indicate that the degree to which Hispanic students' college expectations are aligned with the completion of key college-going actions during high school is strongly associated with their later level of college enrollment. The relationship between parent resources, including parent social capital, and engagement in college-aligned actions among Hispanic youth, however, appears less straightforward.