Like Day and NIght: On Becoming a Teacher in Two Distinct Professional Cultures in Rural Saskatchewan

Framed within ecological and institutional ethnography perspectives, and situated within a larger study of beginning teachers in the Canadian province of Saskatchewan, this paper focuses on the dramatically different experiences of one beginning teacher who happened to secure half-time contracts in two rural schools within commuting distance of one another. His account of these experiences and how he makes sense of them orient researchers to the broad social, economic, and material conditions that organize the mutually dependent work of parents and teachers. This analysis contributes to beginning teacher research by affirming the value of personal stories of learning to teach, moving beyond studies of individual adaptation to fixed notions of professional success, and opening to scrutiny the shared conditions of early and later career teachers as they are institutionally and discursively organized, thus promoting appreciation of the complexities of learning to teach attuned to variation in local rural circumstances

Nursing transfer of accountability at the bedside: partnering with patients to pilot a new initiative in Ontario community hospitals

The transfer of accountability (TOA) for a patient from one nurse to another at change of shift is an important opportunity to exchange essential patient care information, as well as to enhance the safety and quality of patient care. This study was undertaken to explore nurses’, patients’ and family members’ perceptions associated with the implementation of bedside nurse to nurse TOA. Focus groups were conducted pre-implementation (two with nurses and two with patients and family members) and post-implementation (six with nurses and two with patients and family members). The focus groups were audio-recorded, transcribed and analysed using directed content analysis. Findings were divided into positive outcomes and challenges to bedside nurse to nurse TOA. Positive outcomes included increased patient safety, more informed patients more consistent use of whiteboards in the patient rooms, better engagement with family via the whiteboard and increased family involvement, confirmation of information between nurses, increased accountability between nurses, and personal introduction/icebreaker of the new nurse. The inclusion of the Patient Partners on the project team was a key success factor for the project. Challenges included a perception of lengthened time required for TOA and increased workload, lack of privacy and potential breaches of confidentiality, patient fear and lack of comprehension, lack of clarity in TOA processes, and inconsistent application of the procedures. Hospital administrators and nurse leaders can use these findings to anticipate and understand change associated with bedside TOA as seen by both nurses and patients/families

Phylogeography of the Endangered Otago Skink, Oligosoma otagense: Population Structure, Hybridisation and Genetic Diversity in Captive Populations

Climatic cooling and substantial tectonic activity since the late Miocene have had a pronounced influence on the evolutionary history of the fauna of New Zealand's South Island. However, many species have recently experienced dramatic range reductions due to habitat fragmentation and the introduction of mammalian predators and competitors. These anthropogenic impacts have been particularly severe in the tussock grasslands of the Otago region. The Otago skink (Oligosoma otagense), endemic to the region, is one of the most critically endangered vertebrates in New Zealand. We use mitochondrial DNA sequence data to investigate the evolutionary history of the Otago skink, examine its population genetic structure, and assess the level of genetic diversity in the individuals in the captive breeding program. Our data indicate that the Otago skink diverged from its closest relatives in the Miocene, consistent with the commencement of tectonic uplift of the Southern Alps. However, there is evidence for past introgression with the scree skink (O. waimatense) in the northern Otago-southern Canterbury region. The remnant populations in eastern Otago and western Otago are estimated to have diverged in the mid-Pliocene, with no haplotypes shared between these two regions. This divergence accounts for 95% of the genetic diversity in the species. Within both regions there is strong genetic structure among populations, although shared haplotypes are generally evident between adjacent localities. Although substantial genetic diversity is present in the captive population, all individuals originate from the eastern region and the majority had haplotypes that were not evident in the intensively managed populations at Macraes Flat. Our data indicate that eastern and western populations should continue to be regarded as separate management units. Knowledge of the genetic diversity of the breeding stock will act to inform the captive management of the Otago skink and contribute to a key recovery action for the species

Using LongSAGE to Detect Biomarkers of Cervical Cancer Potentially Amenable to Optical Contrast Agent Labelling

Sixteen longSAGE libraries from four different clinical stages of cervical intraepithelial neoplasia have enabled us to identify novel cell-surface biomarkers indicative of CIN stage. By comparing gene expression profiles of cervical tissue at early and advanced stages of CIN, several genes are identified to be novel genetic markers. We present fifty-six cell-surface gene products differentially expressed during progression of CIN. These cell surface proteins are being examined to establish their capacity for optical contrast agent binding. Contrast agent visualization will allow real-time assessment of the physiological state of the disease process bringing vast benefit to cancer care. The data discussed in this publication have been submitted to NCBIs Gene Expression Omnibus (GEO, http://www.ncbi.nlm.nih.gov/geo/) and are accessible through GEO Series accession number GSE6252

Better data for teachers, better data for learners, better patient care: college-wide assessment at Michigan State University's College of Human Medicine

When our school organized the curriculum around a core set of medical student competencies in 2004, it was clear that more numerous and more varied student assessments were needed. To oversee a systematic approach to the assessment of medical student competencies, the Office of College-wide Assessment was established, led by the Associate Dean of College-wide Assessment. The mission of the Office is to ‘facilitate the development of a seamless assessment system that drives a nimble, competency-based curriculum across the spectrum of our educational enterprise.’ The Associate Dean coordinates educational initiatives, developing partnerships to solve common problems, and enhancing synergy within the College. The Office also works to establish data collection and feedback loops to guide rational intervention and continuous curricular improvement. Aside from feedback, implementing a systems approach to assessment provides a means for identifying performance gaps, promotes continuity from undergraduate medical education to practice, and offers a rationale for some assessments to be located outside of courses and clerkships. Assessment system design, data analysis, and feedback require leadership, a cooperative faculty team with medical education expertise, and institutional support. The guiding principle is ‘Better Data for Teachers, Better Data for Learners, Better Patient Care.’ Better data empowers faculty to become change agents, learners to create evidence-based improvement plans and increases accountability to our most important stakeholders, our patients

HER2 overexpression and amplification is present in a subset of ovarian mucinous carcinomas and can be targeted with trastuzumab therapy

<p>Abstract</p> <p>Background</p> <p>The response rate of ovarian mucinous carcinomas to paclitaxel/carboplatin is low, prompting interest in targeted molecular therapies. We investigated HER2 expression and amplification, and the potential for trastuzumab therapy in this histologic subtype of ovarian cancer.</p> <p>Methods</p> <p>HER2 status was tested in 33 mucinous carcinomas and 16 mucinous borderline ovarian tumors (BOT)). Five cases with documented recurrence and with tissue from the recurrence available for testing were analyzed to determine whether HER2 amplification status changed over time. Three prospectively identified recurrent mucinous ovarian carcinomas were assessed for HER2 amplification and patients received trastuzumab therapy with conventional chemotherapy.</p> <p>Results</p> <p>Amplification of HER2 was observed in 6/33 (18.2%) mucinous carcinomas and 3/16 (18.8%) BOT. HER2 amplification in primary mucinous carcinomas was not associated with an increased likelihood of recurrence. The prospectively identified recurrent mucinous carcinomas showed overexpression and amplification of HER2; one patient's tumor responded dramatically to trastuzumab in combination with conventional chemotherapy, while another patient experienced an isolated central nervous system recurrence after trastuzumab therapy.</p> <p>Conclusion</p> <p>HER2 amplification is relatively common in ovarian mucinous carcinomas (6/33, 18.2%), although not of prognostic significance. Trastuzumab therapy is a treatment option for patients with mucinous carcinoma when the tumor has HER2 amplification and overexpression.</p

Comprehensive serial analysis of gene expression of the cervical transcriptome

<p>Abstract</p> <p>Background</p> <p>More than half of the approximately 500,000 women diagnosed with cervical cancer worldwide each year will die from this disease. Investigation of genes expressed in precancer lesions compared to those expressed in normal cervical epithelium will yield insight into the early stages of disease. As such, establishing a baseline from which to compare to, is critical in elucidating the abnormal biology of disease. In this study we examine the normal cervical tissue transcriptome and investigate the similarities and differences in relation to CIN III by Long-SAGE (L-SAGE).</p> <p>Results</p> <p>We have sequenced 691,390 tags from four L-SAGE libraries increasing the existing gene expression data on cervical tissue by 20 fold. One-hundred and eighteen unique tags were highly expressed in normal cervical tissue and 107 of them mapped to unique genes, most belong to the ribosomal, calcium-binding and keratinizing gene families. We assessed these genes for aberrant expression in CIN III and five genes showed altered expression. In addition, we have identified twelve unique HPV 16 SAGE tags in the CIN III libraries absent in the normal libraries.</p> <p>Conclusion</p> <p>Establishing a baseline of gene expression in normal cervical tissue is key for identifying changes in cancer. We demonstrate the utility of this baseline data by identifying genes with aberrant expression in CIN III when compared to normal tissue.</p

Up regulation in gene expression of chromatin remodelling factors in cervical intraepithelial neoplasia

<p>Abstract</p> <p>Background</p> <p>The highest rates of cervical cancer are found in developing countries. Frontline monitoring has reduced these rates in developed countries and present day screening programs primarily identify precancerous lesions termed cervical intraepithelial neoplasias (CIN). CIN lesions described as mild dysplasia (CIN I) are likely to spontaneously regress while CIN III lesions (severe dysplasia) are likely to progress if untreated. Thoughtful consideration of gene expression changes paralleling the progressive pre invasive neoplastic development will yield insight into the key casual events involved in cervical cancer development.</p> <p>Results</p> <p>In this study, we have identified gene expression changes across 16 cervical cases (CIN I, CIN II, CIN III and normal cervical epithelium) using the unbiased long serial analysis of gene expression (L-SAGE) method. The 16 L-SAGE libraries were sequenced to the level of 2,481,387 tags, creating the largest SAGE data collection for cervical tissue worldwide. We have identified 222 genes differentially expressed between normal cervical tissue and CIN III. Many of these genes influence biological functions characteristic of cancer, such as cell death, cell growth/proliferation and cellular movement. Evaluation of these genes through network interactions identified multiple candidates that influence regulation of cellular transcription through chromatin remodelling (<it>SMARCC1</it>, <it>NCOR1</it>, <it>MRFAP1 </it>and <it>MORF4L2</it>). Further, these expression events are focused at the critical junction in disease development of moderate dysplasia (CIN II) indicating a role for chromatin remodelling as part of cervical cancer development.</p> <p>Conclusion</p> <p>We have created a valuable publically available resource for the study of gene expression in precancerous cervical lesions. Our results indicate deregulation of the chromatin remodelling complex components and its influencing factors occur in the development of CIN lesions. The increase in SWI/SNF stabilizing molecule <it>SMARCC1 </it>and other novel genes has not been previously illustrated as events in the early stages of dysplasia development and thus not only provides novel candidate markers for screening but a biological function for targeting treatment.</p

Physical and emotional nourishment: Food as the embodied component of loving care of elderly family relatives

Purpose This purpose of this study is to examine the fluidity of family life which continues to attract attention. This is increasingly significant for the intergenerational relationship between adult children and their elderly parents. Using practice theory, the aims are to understand the role of food in elderly families and explore how family practices are maintained when elderly transition into care. Design/methodology/approach A phenomenological research approach was used as the authors sought to build an understanding of the social interactions between family and their lifeworld. Findings This study extends theory on the relationship between the elderly parent and their family and explores through practice theory how families performed their love, how altered routines and long standing rituals provided structure to the elderly relatives and how care practices were negotiated as the elderly relatives transitioned from independence to dependence and towards care. A theoretical framework is introduced that provides guidance for the transition stages and the areas for negotiation. Research limitations/implications This research has implications for food manufacturers and marketers, as the demand for healthy food for the elderly is made more widely available, healthy and easy to prepare. The limitations of the research are due to the sample located in East Yorkshire only. Practical implications This research has implications for brand managers of food manufacturers and supermarkets that need to create product lines that target this segment by producing healthy, convenience food. Social implications It is also important for health and social care policy as the authors seek to understand the role of food, family and community and how policy can be devised to provide stability in this transitional and uncertain lifestage. Originality/value This research extends the body of literature on food and the family by focussing on the elderly cared for and their family. The authors show how food can be construed as loving care, and using practice theory, a theoretical framework is developed that can explain the transitions and how the family negotiates the stages from independence to dependence