Managing the Impact of Advanced Complex Illness on Family Caregiver and Professional Caregiver Stress: A Role for Palliative Care.

With the increasing health care needs of an ageing population and the projected shortfall in the US healthcare workforce, an increasing number of patients with advanced complex illness will require care at home. Up to 90 percent of this care is provided by unpaid family or informal caregivers. Caregiver stress is a challenge for both family caregivers and members of the health care team responsible for medical care. Using clinical cases, the authors describe an innovative health service delivery model that links specialty palliative care services provided by palliative care certified registered nurse practitioners (CRNPs) to the patient\u27s primary and specialty physicians. Optimizing Advanced Complex Illness Support (OACIS) is an interdisciplinary program that provides inpatient, outpatient and home-based palliative care services, and also serves as a platform for the support of both family and professional caregivers

Methods for CRISPR/Cas9 Xenopus tropicalis tissue-specific multiplex genome engineering

In this chapter, we convey a state-of-the art update to the 2014 Nakayama protocol for CRISPR/Cas9 genome engineering in Xenopus tropicalis (X. tropicalis). We discuss in depth, gRNA design software and rules, gRNA synthesis, and procedures for tissue- and tissue-specific CRISPR/Cas9 genome editing by targeted microinjection in X. tropicalis embryos. We demonstrate the methodology by which any standard equipped Xenopus researcher with microinjection experience can generate F0 CRISPR/Cas9 mediated mosaic mutants (crispants) within one to two work-week(s). The described methodology allows CRISPR/Cas9 efficiencies to be high enough to read out phenotypic consequences, and thus perform gene function analysis, in the F0 crispant. Additionally, we provide the framework for performing multiplex tissue-specific CRISPR/Cas9 experiments generating crispants mosaic mutant in up to four genes simultaneously, which can be of importance for Laevis researchers aiming to target by CRISPR/Cas9 both the S and L homeolog of a gene simultaneously. Finally, we discuss off-target concerns, how to minimize these and ways to rapidly bypass reviewer off-target critique by exploiting the advantages of X. tropicalis