Palliative care for people with dementia living at home: a systematic review of interventions

Background: The European Association for Palliative Care White Paper defined optimal palliative care in dementia based on evidence and expert consensus. Yet, we know little on how to achieve this for people with dementia living and dying at home. Aims: To examine evidence on home palliative care interventions in dementia, in terms of their effectiveness on end-of-life care outcomes, factors influencing implementation, the extent to which they address the European Association for Palliative Care palliative care domains and evidence gaps. Design: A systematic review of home palliative care interventions in dementia. Data sources: The review adhered to the PRISMA guidelines and the protocol was registered with PROSPERO (CRD42018093607). We searched four electronic databases up to April 2018 (PubMed, Scopus, Cochrane library and CINAHL) and conducted lateral searches. Results: We retrieved eight relevant studies, none of which was of high quality. The evidence, albeit of generally weak quality, showed the potential benefits of the interventions in improving end-of-life care outcomes, for example, behavioural disturbances. The interventions most commonly focused on optimal symptom management, continuity of care and psychosocial support. Other European Association for Palliative Care domains identified as important in palliative care for people with dementia, for example, prognostication of dying or avoidance of burdensome interventions were under-reported. No direct evidence on facilitators and barriers to implementation was found. Conclusions: The review highlights the paucity of high-quality dementia-specific research in this area and recommends key areas for future work, for example, the need for process evaluation to identify facilitators and barriers to implementing interventions.Peer reviewedFinal Published versio

Writing Across Campus: Using Authentic Writing Experiences to Help Pre-Service Teachers Learn to Teach Writing

This study demonstrates the impact asynchronous discussion boards had on cross-college preservice teachers writing and writing instruction understanding. Participants from two universities in writing methods courses participated in discussion boards to learn about writing instruction. Students in the groups not only asked higher-level depth of knowledge questions to each other, but they also began to focus their responses and comments about their future teaching and instructional practices. Students built a stronger community of writers than students in previous courses that read, responded, and replied to peers

Die funktionelle Rolle von Diaphanous verwandten Forminen in der Zellmigration

To characterize the role of mDia2/Drf3 in mammalian cells, an EGFP-tagged active Drf3 variant, lacking the C-terminal DAD-domain (Drf3ΔDAD), was generated. Expression of EGFP-Drf3ΔDAD in B16-F1 mouse melanoma cells strongly induced the formation of filopodia tipped by the formin. Interestingly, Drf3ΔDAD–containing filopodia frequently thickened at their tips after protruding beyond the cell periphery. Yet, actin filament spacing in these filopodia was largely independent of filopodial width, as determined by electron microscopy. In addition to that, Drf3ΔDAD levels and F-actin amounts showed a linear correlation in these filopodia tips. Thus, thickening of Drf3ΔDAD-induced filopodia tips occurs through de novo actin filament nucleation. This indicates nucleation of actin filaments to be the predominant mechanism of actin filament generation in filopodia, rather than simple elongation of pre-existing lamellipodial filaments. FMNL2 emerged as potential additional regulator of filopodia, but also lamellipodia formation. Active EGFP-tagged FMNL2 was strongly enriched at the tips of protruding lamellipodia and filopodia in B16-F1 cells. FMNL2 interacted with active Cdc42 and Rac1 in vitro. Interestingly, co-expression of Cdc42, but not Rac, was sufficient to mediate accumulation of EGFP-tagged FMNL2 at the tips of lamellipodia and filopodia. In addition, FMNL2 appeared to be regulated by N-terminal myristoylation. Although myristoylation was not essential for interaction of the formin with Cdc42 and proper subcellular targeting, both the lipid modification and active Cdc42 contribute to localisation and activation by counteracting autoinhibition. In vitro polymerisation assays indicated that FMNL2 does not promote actin filament nucleation, but instead elongation powered by profilin. In vivo the presence of FMNL2 was relevant for efficient cell motility, significantly expanding the repertoire of Cdc42 effectors directly promoting actin filament assembly in migration.Filopodien sind protrusive Strukturen, die aus Bündeln von unverzweigten Aktinfilamenten bestehen. Um die funktionelle Rolle des Diaphanous verwandten Formins Drf3 in der Filopodienbildung genauer zu charakterisieren wurde durch Deletion der DAD-Domäne ein konstitutiv aktives Drf3 (Drf3ΔDAD) hergestellt. Expression von Drf3ΔDAD in B16-F1 Mausmelanomzellen induzierte die Bildung von Filopodien, an deren Spitze das Formin angereichert war. In einigen Fällen konnte beobachtet werden, dass sich Drf3ΔDAD induzierte Filopodien verdickten, nachdem sie das umgebende Aktinnetzwerk verlassen hatten. Elektronenmikroskopische Untersuchungen ergaben, dass dieses auf eine erhöhte Anzahl an Aktinfilamenten in der Spitze der Filopodien zurückzuführen war, wobei die Packdichte konstant blieb. Außerdem bestand eine lineare Korrelation von F-Aktin zu Drf3ΔDAD. Zusammengenommen zeigt dieses, dass das Verdicken der Filopodien durch de novo Nukleation von Aktinfilamenten zu erklären ist. Zusätzlich zu Drf3 ist das Formin FMNL2 ein potentieller Kandidat, der zur Bildung von Filopodien aber auch Lamellipodien betragen könnte. In B16-F1 Zellen lokalisiert ein aktives EGFP-getaggtes FMNL2 an der Spitze von Filopodien und Lamellipodien. In Vitro interagiert FMNL2 mit aktivem Cdc42 und aktivem Rac1, aber nur die Koexpression von aktivem Cdc42 ist ausreichend, um die Anreicherung des Formins im Lamellipodium zu vermitteln. Des Weiteren trägt eine N-terminale Myristoylierung zur Regulation von FMNL2 bei. Obwohl diese Lipidmodifikation weder für die Lokalisation im Lamellipodium noch für die Interaktion mit Cdc42 essentiell ist, tragen die Myristoylierung und Cdc42 vermutlich durch Aufheben der Autoinhibition zur Lokalisation von FMNL2 bei. In Vitro Aktinpolymerisationsassays zeigten, dass FMNL2 nicht als Aktinnukleator fungiert, sondern im Zusammenspiel mit Profilin die Elongation von bestehenden Aktinfilamenten unterstützt. In Vivo kontrolliert FMNL2 die effiziente Zellmigration

Plant Immunity Directly or Indirectly Restricts the Injection of Type III Effectors by the \u3ci\u3ePseudomonas syringae\u3c/i\u3e Type III Secretion System

Plants perceive microorganisms by recognizing microbial molecules known as pathogen-associated molecular patterns (PAMPs) inducing PAMP-triggered immunity (PTI) or by recognizing pathogen effectors inducing effector-triggered immunity (ETI). The hypersensitive response (HR), a programmed cell death response associated with ETI, is known to be inhibited by PTI. Here, we show that PTI-induced HR inhibition is due to direct or indirect restriction of the type III protein secretion system’s (T3SS) ability to inject type III effectors (T3Es). We found that the Pseudomonas syringae T3SS was restricted in its ability to inject a T3E-adenylate cyclase (CyaA) injection reporter into PTI-induced tobacco (Nicotiana tabacum) cells. We confirmed this restriction with a direct injection assay that monitored the in planta processing of the AvrRpt2 T3E. Virulent P. syringae strains were able to overcome a PAMP pretreatment in tobacco or Arabidopsis (Arabidopsis thaliana) and continue to inject a T3E-CyaA reporter into host cells. In contrast, ETI-inducing P. syringae strains were unable to overcome PTI-induced injection restriction. A P. syringae pv tomato DC3000 mutant lacking about one-third of its T3E inventory was less capable of injecting into PTI-induced Arabidopsis plant cells, grew poorly in planta, and did not cause disease symptoms. PTI-induced transgenic Arabidopsis expressing the T3E HopAO1 or HopF2 allowed higher amounts of the T3E-CyaA reporter to be injected into plant cells compared to wild-type plants. Our results show that PTI-induced HR inhibition is due to direct or indirect restriction of T3E injection and that T3Es can relieve this restriction by suppressing PTI

Relationship Reciprocation Modulates Resource Allocation in Adolescent Social Networks: Developmental Effects

Adolescence is characterized as a period of social reorientation toward peer relationships, entailing the emergence of sophisticated social abilities. Two studies (Study 1: N = 42, ages 13–17; Study 2: N = 81, ages 13–16) investigated age group differences in the impact of relationship reciprocation within school-based social networks on an experimental measure of cooperation behavior. Results suggest development between mid- and late adolescence in the extent to which reciprocation of social ties predicted resource allocation. With increasing age group, investment decisions increasingly reflected the degree to which peers reciprocated feelings of friendship. This result may reflect social-cognitive development, which could facilitate the ability to navigate an increasingly complex social world in adolescence and promote positive and enduring relationships into adulthood