Dynamic regulation of basement membrane protein levels promotes egg chamber elongation in Drosophila

AbstractBasement membranes (BMs) are sheet-like extracellular matrices that provide essential support to epithelial tissues. Recent evidence suggests that regulated changes in BM architecture can direct tissue morphogenesis, but the mechanisms by which cells remodel BMs are largely unknown. The Drosophila egg chamber is an organ-like structure that transforms from a spherical to an ellipsoidal shape as it matures. This elongation coincides with a stage-specific increase in Type IV Collagen (Col IV) levels in the BM surrounding the egg chamber; however, the mechanisms and morphogenetic relevance of this remodeling event have not been established. Here, we identify the Collagen-binding protein SPARC as a negative regulator of egg chamber elongation, and show that SPARC down-regulation is necessary for the increase in Col IV levels to occur. We find that SPARC interacts with Col IV prior to secretion and propose that, through this interaction, SPARC blocks the incorporation of newly synthesized Col IV into the BM. We additionally observe a decrease in Perlecan levels during elongation, and show that Perlecan is a negative regulator of this process. These data provide mechanistic insight into SPARC's conserved role in matrix dynamics and demonstrate that regulated changes in BM composition influence organ morphogenesis

The Project Approach Meta-Project: Inquiry-Based Learning in Undergraduate Early Childhood Teacher Education

This article describes a case study involving the planning, phases, and outcomes of an exploration of the Project Approach led by four teacher candidates as part of an undergraduate early childhood teacher preparation program. Four undergraduate junior-level teacher candidates investigated the phases of the Project Approach during their junior year; this work took place during a 26-week learning module comprised of a seminar and part-time student teaching placement in a preschool setting. The candidates aligned the stages of their investigation with the phases of the Project Approach, which provided a framework complementary to that of action research, within which the candidates directed their own exploration of essential issues of early childhood pedagogy and curriculum. This investigation took place both at the Loyola and at a preschool in which the Project Approach was in use. Candidates assumed the role of the teacher and led actual projects with preschoolers; these served as culminating events for their project. In addition, at the conclusion of the module, candidates planned and hosted a session at which they shared documentation of their learning and outcomes of the investigation for an audience of university faculty and other teacher candidates. Candidates demonstrated an increased understanding of the Project Approach and a greater appreciation for its use with preschoolers. They also identified perceived advantages and challenges of implementing projects in various types of early childhood settings. Candidates exhibited high levels of collaboration with mentor co-teacher educators, and acquired knowledge and skills that informed their roles in guiding preschoolers through project planning and investigation during student teaching

A Review of Electronic Devices to Assess Inhaler Technique

Multiple electronic devices exist that provide feedback on the accuracy of patient inhaler technique. Our purpose is to describe the inhaler technique feedback provided by these devices, including specific technique steps measured, how feedback is displayed, target of feedback (patient, provider, researcher), and compatibility with inhaler type (metered-dose inhaler [MDI], diskus, etc.)

Development and description of a theory-driven, evidence-based, complex intervention to improve adherence to treatment for tuberculosis in the UK: the IMPACT study

Background: Tuberculosis (TB) has a significant treatment burden for patients, requiring at least six months of anti-TB treatment (ATT) with multiple medicines. Ensuring good adherence to ATT is central to global TB strategies, including those in high-income, low-TB incidence (HILI) settings. For adherence interventions to be successful and deliverable, they need to address the personal and environmental factors influencing patient and provider behaviour. // Purpose: This paper describes the application of theory and research evidence to inform the design process of the IMPACT manualised intervention to support ATT adherence for adults with TB disease in the United Kingdom (UK). It also provides a full description of the resulting intervention. // Methods: We synthesised findings from our formative research (qualitative and quantitative scoping reviews and patient and carer interviews) and supplemented these with clinic observations, a literature review, and healthcare provider interviews. Findings were mapped to the guiding theoretical framework (Perceptions and Practicalities Approach) which was operationalised to design the intervention components and content. An Intervention Development Group (IDG) of relevant stakeholders were consulted to adapt the intervention to local clinical settings. // Results: The pragmatic, deliverable components and content for the IMPACT intervention included: (1) an enhanced, structured, risk assessment to systematically identify risk factors for non-adherence plus locally-adapted guidance to mitigate these; and (2) patient educational materials (an animated video and interactive patient booklet) about TB and its treatment, to communicate the need for treatment and address common concerns. // Conclusions: Using a theory– and evidence– based approach incorporating stakeholder input, we have developed a multi-component, pragmatic, manualised intervention, which addresses patients’ personal barriers to adherence within local service resources to improve adherence to ATT within UK TB services

Brane-world Cosmologies with non-local bulk effects

It is very common to ignore the non-local bulk effects in the study of brane-world cosmologies using the brane-world approach. However, we shall illustrate through the use of three different scenarios, that the non-local bulk-effect ${\cal P}_{\mu\nu}$ does indeed have significant impact on both the initial and future behaviour of brane-world cosmologies.Comment: 17 pages, no figures, iopart.cls, submitted to CQ

The Means/Side-Effect Distinction in Moral Cognition: A Meta-Analysis

Experimental research suggests that people draw a moral distinction between bad outcomes brought about as a means versus a side effect (or byproduct). Such findings have informed multiple psychological and philosophical debates about moral cognition, including its computational structure, its sensitivity to the famous Doctrine of Double Effect, its reliability, and its status as a universal and innate mental module akin to universal grammar. But some studies have failed to replicate the means/byproduct effect especially in the absence of other factors, such as personal contact. So we aimed to determine how robust the means/byproduct effect is by conducting a meta-analysis of both published and unpublished studies (k = 101; 24,058 participants). We found that while there is an overall small difference between moral judgments of means and byproducts (standardized mean difference = 0.87, 95% CI 0.67 – 1.06; standardized mean change = 0.57, 95% CI 0.44 – 0.69; log odds ratio = 1.59, 95% CI 1.15 – 2.02), the mean effect size is primarily moderated by whether the outcome is brought about by personal contact, which typically involves the use of personal force

Benchmarking the prevalence of care problems in UK care homes using the LPZ-i: a feasibility study

Background: UK care homes have no mechanism for counting, collating or analyzing prevalence of care problems to benchmark quality of care. This study investigated the feasibility of the International Prevalence Measurement of Quality of Care (LPZ-i) for benchmarking in UK care homes and described facilitators and challenges to implementation. Method: The pressure care and incontinence modules of the LPZ-i were implemented in a purposive sample of UK care homes. Interviews and focus groups with regional co-ordinators, NHS and care home staff who had been involved in implementation. Data were analysed using a framework approach. Results: 26 care homes and 489 residents implemented the LPZ-I modules. 60 pressure ulcers were reported in 41 (8.4%) of residents.325(66% of residents were incontinent of urine, faeces or both. It was demonstrated that it was possible to use prevalence data to benchmark care between UK care homes and against homes overseas. 38 participants took part in focus groups and interviews which revealed the importance of existing relational working with care homes as a basis for implementation. Care homes reported improved identification and management of pressure ulcers and incontinence in response to the audit. However, care home staff could not interpret or analyse data from the audit or use it to drive quality improvement. Conclusion: Implementing the LPZ-i was possible, delivered data appropriate for benchmarking, was well received by care home and NHS staff, and appeared to lead to changes in practice. More widespread implementation of the LPZ-i is feasible, subject to improving the data and quality improvement competencies amongst care home staff

Developing the Principles of Falls Management in Care Homes: An expert Consensus Process

Context: Managing falls in care homes requires an individualised approach for each resident with involvement of staff from care homes and the wider health and social care system. A large randomised controlled trial evaluating an individualised falls management programme (Action FALLS) demonstrated positive findings. However, the delivery of the key components of such programmes is still unclear. Greater understanding of the core components of falls management programmes is needed to support future implementation research.Objective: To establish expert consensus on the core components of falls management for older care home residents.Methods: A modified Nominal Group Technique included the development of a draft set of principles through a scoping review of the grey literature (published elsewhere) and a one-off online nominal group with care home staff and clinicians. Following the group, a single online survey was circulated to gain agreement on the final principles.Findings: 10 participants (including healthcare professionals, care home managers, and care home staff) took part in the online nominal group. Thirty-five core principles of falls management were developed within the domains of theoretical approach, assessments, interventions, training, time points, wider systems, and governance and reporting.Limitations: Since a small number of experts took part in this consensus process from a large and diverse care home sector, it is important to consider the principles as providing support for future implementation work.Implications: These core principles provide a foundation to guide care homes in managing falls in care home residents. Further research is needed to develop implementation strategies and test the feasibility of embedding the principles in routine practice