Developing a Holistic Competence Model for Telenursing Practice: Perspectives from Telenurses and Managers of Telemedical Service Centres

Telenurse’s work performance determines the quality and the efficiency of the service and strongly influences the acceptance of patients and healthcare professionals. Considering this important role, qualification and training of telenurses is of utmost importance for the success of telemedicine providers and the future of telemedicine. However, in Germany the profession “telenurse” is not yet established, nor is there a standardised education programme for telenurses. Purpose: In our study, we seek to identify and describe needed competencies from the perspectives of employees and employers in telemedicine service centres. We develop a systematic competencies concept fundamental for a specific telenurse education curriculum. Methods: We designed an exploratory study as a series of semi-standardised interviews with telenurses and the management of telenursing centres, focusing on knowledge, skills and attitudes needed in telenursing practice. Results: By including the perspectives of employers and employees, we provide a broad view on the skills and competencies needed. We show that telenursing requires a great variety of competencies that can be structured into four categories: professional, methodological, personal and social competencies. Conclusion: Our study provides a comprehensive approach to key competencies of telenurses. The results set out a framework for the development of skills and competencies considering the perception of the telenurse-workplace not only from employers but also from employee’s perspective

Structural basis for complex formation between human IRSp53 and the translocated intimin receptor Tir of enterohemorrhagic E. coli.

Actin assembly beneath enterohemorrhagic E. coli (EHEC) attached to its host cell is triggered by the intracellular interaction of its translocated effector proteins Tir and EspF(U) with human IRSp53 family proteins and N-WASP. Here, we report the structure of the N-terminal I-BAR domain of IRSp53 in complex with a Tir-derived peptide, in which the homodimeric I-BAR domain binds two Tir molecules aligned in parallel. This arrangement provides a protein scaffold linking the bacterium to the host cell's actin polymerization machinery. The structure uncovers a specific peptide-binding site on the I-BAR surface, conserved between IRSp53 and IRTKS. The Tir Asn-Pro-Tyr (NPY) motif, essential for pedestal formation, is specifically recognized by this binding site. The site was confirmed by mutagenesis and in vivo-binding assays. It is possible that IRSp53 utilizes the NPY-binding site for additional interactions with as yet unknown partners within the host cell

Why Are Daphnia in Some Lakes Sicker? Disease Ecology, Habitat Structure, and the Plankton

© 2010 American Institute of Biological Sciences. Permalink: http://www.bioone.org/doi/abs/10.1525/bio.2010.60.5.6DOI: 10.1525/bio.2010.60.5.6Some aspects of habitat seem to enhance the spread of disease whereas others inhibit it. Here, we illustrate and identify mechanisms that connect habitat to epidemiology using a case study of disease in plankton. We see a pronounced relationship between the basin shapes of lakes and fungal (Metschnikowia bicuspidata) disease in the zooplankton grazer Daphnia dentifera. As we work through seven mechanisms that could explain why Daphnia in some lakes are sicker, we can eliminate some hypotheses (i.e., those relating an index of lake productivity to disease through host density, links between resource quality and transmission rate, and variation in host susceptibility) and find support for others involving food-web actors (e.g., selective predation on infected hosts by fishes, “sloppy predation” by an invertebrate, a possible dilution effect in V-shaped lakes). Furthermore, we identify physical mechanisms (gravity currents, turbulence) that could lead to greater transport of fungal spores to habitat occupied by Daphnia hosts in U-shaped lakes. These results highlight how habitat structure, through its effects on food-web structure and physical processes, can shape wildlife disease