Stereotyping as a Major Barrier to Achievement of Interprofessional Education Competencies: A Narrative Literature Review

Purpose: A major advancement in interprofessional(IP) practice and education has been the introduction of the Interprofessional Education Collaborative (IPEC) core competencies. The purpose of this study is to explore stereotyping as a barrier to achievement of the IPEC competencies. Methods: There has been research into barriers to interprofessional collaboration and some barrier themes have occurred. But to this point, nothing has been studied on barriers to the use of the IPEC core competencies. This study aims to show barriers to achievement of the IPEC competencies through a narrative literature review. Articles were selected from three databases: CINAHL, Medline and ERIC were utilized in this review using the search terms “Interprofessional collaboration” and “Stereotyping”. Results: In articles used to review barriers to interprofessional collaboration, an underlying theme of negative stereotyping about different professions appears to be in place. Themes include: Differences in history and culture, fears of diluted professional identity, differences in language and jargon, and concerns regarding clinical responsibility. Conclusion: A literature review of studies on implementation of interprofessional activities, with correlations to the IPEC core competencies as a framework suggest that stereotyping may be a major barrier to implementation and achievement of the IPEC competencies

Defending, contesting and rejecting formal drinker categories:how UK university students identify as ‘light-drinkers’ or ‘non-drinkers’

Definitions of drinker ‘categories’ (e.g., ‘light drinkers’) typically ignore the role of self-identification involved in drinking practices. To explore this, we presented self-identified ‘non’ or ‘light’ drinkers with official formal definitions of ‘light’ and ‘binge’ drinking as found in public health and academic research. A qualitative design was adopted. Semi-structured interviews with ten 18–27-year-old UK University students self-identifying as non-/light-drinkers were analysed using critical discourse analysis. A first data pattern saw participants working to defend and maintain self-identified ‘light drinker’ status in the face of contradictions to such claims. A second pattern involved participant challenges to the rigidity and legitimacy of formal drinking categories. A third pattern reflected participants' rhetorical work to hold at bay or reject disavowed and stigmatised drinking categories (e.g., ‘alcoholic’). Interviews suggested how formal definitions could create ideological dilemmas for participants, partly through investment in how formally defined drinker categories connected with recent personal drinking practices. Our data helps explain why units-based drinking guidelines may be poorly understood. More nuanced use of ‘drinker categories’ in units-based drinking guidelines could strengthen the visibility and credibility of alcohol health messages or could be drawn on in digital interventions designed to encourage moderate consumption behaviour by delivering personalised feedback.</p

The Influence of Energetic Factors on Biomarkers of Postmenopausal Breast Cancer Risk

Strong and consistent evidence exists that physical activity reduces breast cancer risk by 10-25 %, and several proposed biologic mechanisms have now been investigated in randomized, controlled, exercise intervention trials. Leading hypothesized mechanisms relating to postmenopausal breast cancer include adiposity, endogenous sex hormones, insulin resistance, and chronic low-grade inflammation. In addition, other pathways are emerging as potentially important, including those involving oxidative stress and telomere length, global DNA hypomethylation, immune function, and vitamin D exposure. Recent exercise trials in overweight/obese postmenopausal women implicate weight loss as a mechanism whereby exercise induces favorable changes in circulating estradiol levels and other biomarkers as well. Still it is plausible that some exercise-induced biomarker changes do not require loss of body fat, whereas others depend on abdominal fat loss. We highlight the latest findings from randomized, controlled trials of healthy postmenopausal women, relating exercise to proposed biomarkers for postmenopausal breast cancer risk

Responsiveness of EORTC QLQ-C30, QLQ-CR38 and FACT-C quality of life questionnaires in patients with colorectal cancer

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to compare the responsiveness of the European Organization for Research and Treatment (EORTC) quality of life questionnaires (QLQ-C30, QLQ-CR38) and the Functional Assessment of Cancer Therapy-colorectal version 4 questionnaire (FACT-C).</p> <p>Method</p> <p>This prospective study included 127 patients with colorectal cancer: 71 undergoing chemotherapy and 56 radiation therapy. Responsiveness statistics included the Standardized Response Mean (SRM) and the Effect Size (ES). The patient's overall assessment of his/her change in state of health status was the reference criterion to evaluate the responsiveness of the QoL questionnaires.</p> <p>Results</p> <p>34 patients perceived their health as stable and 17 as improved between the first and the fourth courses of chemotherapy. 21 patients perceived their health as stable and 22 as improved between before and the last week of radiotherapy.</p> <p>The responsiveness of the 3 questionnaires differed according to treatments. The EORTC QLQ-C30 questionnaire was more responsive in patients receiving chemotherapy, particulary functional scales (SRM > 0.55). The QLQ-CR38 and the FACT-C questionnaires provided little clinically relevant information during chemotherapy or radiotherapy.</p> <p>Conclusion</p> <p>The EORTC QLQ-C30 questionnaire appears to be more responsive in patients receiving chemotherapy.</p

Spectroscopic Confirmation of a z=2.79 Multiply Imaged Luminous Infrared Galaxy Behind the Bullet Cluster

We report spectroscopic confirmation and high-resolution infrared imaging of a z=2.79 triply-imaged galaxy behind the Bullet Cluster. This source, a Spitzer-selected luminous infrared galaxy (LIRG), is confirmed via polycyclic aromatic hydrocarbon (PAH) features using the Spitzer Infrared Spectrograph (IRS) and resolved with HST WFC3 imaging. In this galaxy, which with a stellar mass of M*=4e9 Msun is one of the two least massive ones studied with IRS at z>2, we also detect H_2 S(4) and H_2 S(5) pure rotational lines (at 3.1 sigma and 2.1 sigma) - the first detection of these molecular hydrogen lines in a high-redshift galaxy. From the molecular hydrogen lines we infer an excitation temperature T=377+68-84 K. The detection of these lines indicates that the warm molecular gas mass is 6(+36-4)% of the stellar mass and implies the likely existence of a substantial reservoir of cold molecular gas in the galaxy. Future spectral observations at longer wavelengths with facilities like the Herschel Space Observatory, the Large Millimeter Telescope, and the Atacama Pathfinder EXperiment (APEX) thus hold the promise of precisely determining the total molecular gas mass. Given the redshift, and using refined astrometric positions from the high resolution imaging, we also update the magnification estimate and derived fundamental physical properties of this system. The previously published values for total infrared luminosity, star formation rate, and dust temperature are confirmed modulo the revised magnification; however we find that PAH emission is roughly a factor of five stronger than would be predicted by the relations between the total infrared and PAH luminosity reported for SMGs and starbursts in Pope et al. (2008).Comment: 8 pages, 4 figures, accepted to Ap

Design, assessment, and in vivo evaluation of a computational model illustrating the role of CAV1 in CD4+ T-lymphocytes

Caveolin-1 (CAV1) is a vital scaffold protein heterogeneously expressed in both healthy and malignant tissue. We focus on the role of CAV1 when overexpressed in T-cell leukemia. Previously, we have shown that CAV1 is involved in cell-to-cell communication, cellular proliferation, and immune synapse formation; however, the molecular mechanisms have not been elucidated. We hypothesize that the role of CAV1 in immune synapse formation contributes to immune regulation during leukemic progression, thereby warranting studies of the role of CAV1 in CD4+ T-cells in relation to antigen-presenting cells. To address this need, we developed a computational model of a CD4+ immune effector T-cell to mimic cellular dynamics and molecular signaling under healthy and immunocompromised conditions (i.e., leukemic conditions). Using the Cell Collective computational modeling software, the CD4+ T-cell model was constructed and simulated under CAV1+/+, CAV1+/−, and CAV1−/− conditions to produce a hypothetical immune response. This model allowed us to predict and examine the heterogeneous effects and mechanisms of CAV1 in silico. Experimental results indicate a signature of molecules involved in cellular proliferation, cell survival, and cytoskeletal rearrangement that were highly affected by CAV1 knock out. With this comprehensive model of a CD4+ T-cell, we then validated in vivo protein expression levels. Based on this study, we modeled a CD4+ T-cell, manipulated gene expression in immunocompromised versus competent settings, validated these manipulations in an in vivo murine model, and corroborated acute T-cell leukemia gene expression profiles in human beings. Moreover, we can model an immunocompetent versus an immunocompromised microenvironment to better understand how signaling is regulated in patients with leukemia

Spatially resolved stellar, dust and gas properties of the post-interacting Whirlpool Galaxy system

Using infrared imaging from the Herschel Space Observatory, observed as part of the VNGS, we investigate the spatially resolved dust properties of the interacting Whirlpool galaxy system (NGC 5194 and NGC 5195), on physical scales of 1 kpc. Spectral energy distribution modelling of the new infrared images in combination with archival optical, near- through mid-infrared images confirms that both galaxies underwent a burst of star formation ~370-480 Myr ago and provides spatially resolved maps of the stellar and dust mass surface densities. The resulting average dust-to-stellar mass ratios are comparable to other spiral and spheroidal galaxies studied with Herschel, with NGC 5194 at log M(dust)/M(star)= -2.5+/-0.2 and NGC 5195 at log M(dust)/M(star)= -3.5+/-0.3. The dust-to-stellar mass ratio is constant across NGC 5194 suggesting the stellar and dust components are coupled. In contrast, the mass ratio increases with radius in NGC 5195 with decreasing stellar mass density. Archival mass surface density maps of the neutral and molecular hydrogen gas are also folded into our analysis. The gas-to-dust mass ratio, 94+/-17, is relatively constant across NGC 5194. Somewhat surprisingly, we find the dust in NGC 5195 is heated by a strong interstellar radiation field, over 20 times that of the ISRF in the Milky Way, resulting in relatively high characteristic dust temperatures (~30 K). This post-starburst galaxy contains a substantial amount of low-density molecular gas and displays a gas-to-dust ratio (73+/-35) similar to spiral galaxies. It is unclear why the dust in NGC 5195 is heated to such high temperatures as there is no star formation in the galaxy and its active galactic nucleus is 5-10 times less luminous than the one in NGC 5194, which exhibits only a modest enhancement in the amplitude of its ISRF.Comment: 26 pages, 24 figures, Accepted for publication in Ap

The Formation of Massive Cluster Galaxies

We present composite 3.6 and 4.5 micron luminosity functions for cluster galaxies measured from the Spitzer Deep, Wide-Field Survey (SDWFS) for 0.3<z<2. We compare the evolution of m* for these luminosity functions to models for passively evolving stellar populations to constrain the primary epoch of star formation in massive cluster galaxies. At low redshifts (z < 1.3) our results agree well with models with no mass assembly and passively evolving stellar populations with a luminosity-weighted mean formation redshift zf=2.4 assuming a Kroupa initial mass function (IMF). We conduct a thorough investigation of systematic biases that might influence our results, and estimate systematic uncertainites of Delta zf=(+0.16-0.18) (model normalization), Delta zf=(+0.40-0.05) (alpha), and Delta zf=(+0.30-0.45) (choice of stellar population model). For a Salpeter type IMF, the typical formation epoch is thus strongly constrained to be z ~2-3. Higher formation redshifts can only be made consistent with the data if one permits an evolving IMF that is bottom-light at high redshift, as suggested by van Dokkum et al 2008. At high redshift (z > 1.3) we also witness a statistically significant (>5sigma) disagreement between the measured luminosity function and the continuation of the passive evolution model from lower redshifts. After considering potential systematic biases that might influence our highest redshift data points, we interpret the observed deviation as potential evidence for ongoing mass assembly at this epoch.Comment: 17 pages, 14 figures, accepted for publication in Ap