Teach Students, Empower Patients, Act Collaboratively and Meet Health Goals: An Early Interprofessional Clinical Experience in Transformed Care

Purpose: Transformation of care teaching is often didactic and conceptual instead of practical and operational. Clinical environments, slow to transform, limit student exposure to key experiences that characterize transformed care. We describe the design and implementation of TEAM Clinic (Teach students, Empower patients, Act collaboratively, Meet health goals) – an early clinical learning experience to address this gap. Methods: The TEAM Clinic curriculum was based on a review of existing curricula and best practice recommendations for the transformation of care. Three key elements were selected as the focus for a low-volume, high-service clinic: patient centeredness, interprofessional collaboration and team-based care. Learners and medically and socially complex patients were recruited for voluntary participation and completed anonymous surveys about the experience during and afterward. Results: Nine first-year medical students, two first-year social work students and one pharmacy resident were integrated into the interprofessional team. Students were assigned roles adapted to their level and skill set; deliberate interprofessional pairing was assigned to broaden perspectives on scope and role of team members. Upon completion of this two-semester experience, 11 of the 12 learners returned surveys; all rated the experience as positive (strongly agree or agree) on the Authentic Clinical Interprofessional Experience – Evaluation of Interprofessional Site tool. Patient surveys indicated satisfaction with multiple aspects of the visit. Conclusion: TEAM Clinic provided a practical example of transformation of care teaching in a not-yet-transformed environment. Logistical barriers included space, schedule and staffing. Facilitators included alignment with the goals of core curricula and faculty. Limitations included that this description of these curricula and this pilot come early in our longitudinal development of TEAM Clinic, constraining our ability to measure behavioral changes around interprofessional education, teamwork or patient centeredness. Next steps would examine the trajectory to these outcomes in the preclinical student group

College Algebra (ABAC)

This Grants Collection for College Algebra was created under a Round Ten ALG Textbook Transformation Grant. Affordable Learning Georgia Grants Collections are intended to provide faculty with the frameworks to quickly implement or revise the same materials as a Textbook Transformation Grants team, along with the aims and lessons learned from project teams during the implementation process. Documents are in .pdf format, with a separate .docx (Word) version available for download. Each collection contains the following materials: Linked Syllabus Initial Proposal Final Reporthttps://oer.galileo.usg.edu/mathematics-collections/1036/thumbnail.jp

Statistics (ABAC)

This Grants Collection for Statistics was created under a Round Ten ALG Textbook Transformation Grant. Affordable Learning Georgia Grants Collections are intended to provide faculty with the frameworks to quickly implement or revise the same materials as a Textbook Transformation Grants team, along with the aims and lessons learned from project teams during the implementation process. Documents are in .pdf format, with a separate .docx (Word) version available for download. Each collection contains the following materials: Linked Syllabus Initial Proposal Final Reporthttps://oer.galileo.usg.edu/mathematics-collections/1037/thumbnail.jp

Jitka Smutná, Jan Vlasák - acting and pedagogic method

This thesis is a study of an acting and educational method of two distinguished Czech actors, Jitka Smutná and Jan Vlasák. Based on selected roles I tried to conclude how both actors approach their characters, and how reviewers perceive their effort, so that I could define what is typical for their acting and dramatic art as a whole. In the chapter THEY I further explore how Smutna and Vlasak approach their students - in what manner they form them, and what they consider important in acting training

Ciprofloxacin-eluting nanofibers inhibits biofilm formation by pseudomonas aeruginosa and a Methicillin-resistant Staphylococcus aureus

CITATION: Ahire, J. J., Neveling, D. P., Hattingh, M., & Dicks, L. M. T. 2015. Ciprofloxacin-eluting nanofibers inhibits biofilm formation by Pseudomonas aeruginosa and a Methicillin-resistant Staphylococcus aureus. PLoS ONE, 10(4), doi:10.1371/journal.pone.0123648.The original publication is available at http://journals.plos.org/plosone/Publication of this article was funded by the Stellenbosch University Open Access Fund.Pseudomonas aeruginosa and Staphylococcus aureus are commonly associated with hospital- acquired infections and are known to form biofilms. Ciprofloxacin (CIP), which is normally used to treat these infections, is seldom effective in killing cells in a biofilm. This is mostly due to slow or weak penetration of CIP to the core of biofilms. The problem is accentuated by the release of CIP below MIC (minimal inhibitory concentration) levels following a rapid (burst) release. The aim of this study was to develop a drug carrier that would keep CIP above MIC levels for an extended period. Ciprofloxacin was suspended into poly(D,Llactide) (PDLLA) and poly(ethylene oxide) (PEO), and electrospun into nanofibers (CIP-F). All of the CIP was released from the nanofibers within 2 h, which is typical of a burst release. However, 99% of P. aeruginosa PA01 cells and 91% of S. aureus Xen 30 cells (a methicillinresistant strain) in biofilms were killed when exposed to CIP-F. CIP levels remained above MIC for 5 days, as shown by growth inhibition of the cells in vitro. The nanofibers were smooth in texture with no bead formation, as revealed by scanning electron and atomic force microscopy. A single vibration peak at 1632 cm-1, recorded with Fourier transform infrared spectroscopy, indicated that CIP remained in crystal form when incorporated into PDLLA: PEO. No abnormalities in the histology of MCF-12A breast epithelial cells were observed when exposed to CIP-F. This is the first report of the inhibition of biofilm formation by CIP released from PDLLA: PEO nanofibers.http://www.plosone.org/Pseudomonas aeruginosa and Staphylococcus aureus are commonly associated with hospital- acquired infections and are known to form biofilms. Ciprofloxacin (CIP), which is normally used to treat these infections, is seldom effective in killing cells in a biofilm. This is mostly due to slow or weak penetration of CIP to the core of biofilms. The problem is accentuated by the release of CIP below MIC (minimal inhibitory concentration) levels following a rapid (burst) release. The aim of this study was to develop a drug carrier that would keep CIP above MIC levels for an extended period. Ciprofloxacin was suspended into poly(D,Llactide) (PDLLA) and poly(ethylene oxide) (PEO), and electrospun into nanofibers (CIP-F). All of the CIP was released from the nanofibers within 2 h, which is typical of a burst release. However, 99% of P. aeruginosa PA01 cells and 91% of S. aureus Xen 30 cells (a methicillinresistant strain) in biofilms were killed when exposed to CIP-F. CIP levels remained above MIC for 5 days, as shown by growth inhibition of the cells in vitro. The nanofibers were smooth in texture with no bead formation, as revealed by scanning electron and atomic force microscopy. A single vibration peak at 1632 cm-1, recorded with Fourier transform infrared spectroscopy, indicated that CIP remained in crystal form when incorporated into PDLLA: PEO. No abnormalities in the histology of MCF-12A breast epithelial cells were observed when exposed to CIP-F. This is the first report of the inhibition of biofilm formation by CIP released from PDLLA: PEO nanofibers.Publishers Versio

Copper-containing anti-biofilm nanofiber scaffolds as a wound dressing material

CITATION: Ahire, J. J., et al. 2016. Copper-containing anti-biofilm nanofiber scaffolds as a wound dressing material. PLoS ONE, 11(3):e0152755, doi:10.1371/journal.pone.0152755.The original publication is available at http://journals.plos.org/plosoneCopper particles were incorporated into nanofibers during the electrospinning of poly-D,L-lactide (PDLLA) and poly(ethylene oxide) (PEO). The ability of the nanofibers to prevent Pseudomonas aeruginosa PA01 and Staphylococcus aureus (strain Xen 30) to form biofilms was tested. Nanofibers containing copper particles (Cu-F) were thinner (326 ± 149 nm in diameter), compared to nanofibers without copper (CF; 445 ± 93 nm in diameter). The crystalline structure of the copper particles in Cu-F was confirmed by X-ray diffraction (XRD). Copper crystals were encapsulated, but also attached to the surface of Cu-F, as shown scanning transmission electron microscopy (STEM) and transmission electron microscopy (TEM), respectively. The copper particles had no effect on the thermal degradation and thermal behaviour of Cu-F, as shown by thermogravimetric analysis (TGA) and differential scanning calorimeter (DSC). After 48 h in the presence of Cu-F, biofilm formation by P. aeruginosa PA01 and S. aureus Xen 30 was reduced by 41% and 50%, respectively. Reduction in biofilm formation was ascribed to copper released from the nanofibers. Copper-containing nanofibers may be incorporated into wound dressings.http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0152755Publisher's versio

X-ray diffraction (XRD) patterns of nanofibers with copper particles (Cu-F), nanofibers without copper particles (CF) and copper particles (Cu).

<p>X-ray diffraction (XRD) patterns of nanofibers with copper particles (Cu-F), nanofibers without copper particles (CF) and copper particles (Cu).</p

A and C: Biofilm formation recorded for <i>P</i>. <i>aeruginosa</i> PA01 and C: <i>S</i>. <i>aureus</i> Xen 30, respectively.

<p>Biofilm formation is expressed as optical density of crystal violet-stained cells. B and D: viable cell numbers recorded for <i>P</i>. <i>aeruginosa</i> PA01 and C: <i>S</i>. <i>aureus</i> Xen 30, respectively. E: Biofilm images recorded with a light microscope. CIP-F = nanofibers containing ciprofloxacin (CIP), CF = nanofibers without CIP, control = no nanofibers and no CIP. Data points presented are the average of three independent experiments (mean ± standard deviation). * <i>p</i> < 0.05.</p

A: Release of ciprofloxacin (CIP) from PDLLA: PEO nanofibers immediately after immersion into PBS, and 2, 3, 4, 6, 24 and 48 h thereafter, B: <i>in vitro</i> antimicrobial activity of CIP-containing nanofibers (CIP-F) against <i>P</i>. <i>aeruginosa</i> PA01 and <i>S</i>. <i>aureus</i> Xen 30, C: cell density of <i>P</i>. <i>aeruginosa</i> PA01 exposed to nanofibers without CIP (CF) and D: cell density of <i>S</i>. <i>aureus</i> Xen 30 exposed to CF and CIP-F.

<p>The control was without nanofibers and without CIP. Data points represent an average reading recorded from three disks per time point and three independent experiments (mean ± standard deviation). * <i>p</i> < 0.05. <i>ns</i>: not significant.</p

Changes in viable cell numbers and biofilm formation by <i>P</i>. <i>aeruginosa</i> PA01 and <i>S</i>. <i>aureus</i> Xen 30 in the presence of copper particles electrospun into nanofibers (Cu-F) and nanofibers without copper particles (CF).

<p>Cells not treated with copper and not cultured in the presence of nanofibers serves as control (labelled c). Incubation was at 37°C. Readings were taken at 3, 6, 24 and 48h. (a) Number of viable cells of <i>P</i>. <i>aeruginosa</i> PA01, (b) total biofilm formation by cells of <i>P</i>. <i>aeruginosa</i> PA01, (c) number of viable cells of <i>S</i>. <i>aureus</i> Xen 30 and (d) total biofilm formation by cells of <i>S</i>. <i>aureus</i> Xen 30. Biofilm formation was determined by staining with crystal violet and recording OD readings at 595 nm. Data points presented are the average of three independent experiments (mean ± standard deviation). * <i>p< 0</i>.<i>05</i>.</p