How competent are healthcare professionals in working according to a bio-psycho-social model in healthcare? : the current status and validation of a scale

Background : Over the past decades, there has been a paradigm shift from a purely biomedical towards a bio-psycho-social (BPS) conception of disability and illness, which has led to a change in contemporary healthcare. However, there seems to be a gap between the rhetoric and reality of working within a BPS model. It is not clear whether healthcare professionals show the necessary skills and competencies to act according to the BPS model. Objective : The aim of this study was (1) to develop a scale to monitor the BPS competencies of healthcare professionals, (2) to define its factor-structure, (3) to check internal consistency, (4) test-retest reliability and (5) feasibility. Design and Setting : Item derivation for the BPS scale was based on qualitative research with seven multidisciplinary focus groups (n = 58) of both patients and professionals. In a cross-sectional study design, 368 healthcare professionals completed the BPS scale through a digital platform. An exploratory factor analysis was performed to determine underlying dimensions. Statistical coherence was expressed in item-total correlations and in Cronbach's alpha coefficient. An intra-class-correlation coefficient was used to rate the test-retest reliability. Results : The qualitative study revealed 45 items. The exploratory factor analysis showed five underlying dimensions labelled as: (1) networking, (2) using the expertise of the client, (3) assessment and reporting, (4) professional knowledge and skills and (5) using the environment. The results show a good to strong homogeneity (item-total ranged from 0.59 to 0.79) and a strong internal consistency (Cronbach's alpha ranged from 0.75 to 0.82). ICC ranged between 0.82 and 0.93. Conclusion : The BPS scale appeared to be a valid and reliable measure to rate the BPS competencies of the healthcare professionals and offers opportunities for an improvement in the healthcare delivery. Further research is necessary to test the construct validity and to detect whether the scale is responsive and able to detect changes over time

Overlapping functionality of the Pht proteins in zinc homeostasis of streptococcus pneumoniae

Streptococcus pneumoniae is a globally significant pathogen that causes a range of diseases, including pneumonia, sepsis, meningitis, and otitis media. Its ability to cause disease depends upon the acquisition of nutrients from its environment, including transition metal ions such as zinc. The pneumococcus employs a number of surface proteins to achieve this, among which are four highly similar polyhistidine triad (Pht) proteins. It has previously been established that these proteins collectively aid in the delivery of zinc to the ABC transporter substrate-binding protein AdcAII. Here we have investigated the contribution of each individual Pht protein to pneumococcal zinc homeostasis by analyzing mutant strains expressing only one of the four pht genes. Under conditions of low zinc availability, each of these mutants showed superior growth and zinc accumulation profiles relative to a mutant strain lacking all four genes, indicating that any of the four Pht proteins are able to facilitate delivery of zinc to AdcAII. However, optimal growth and zinc accumulation in vitro and pneumococcal survival and proliferation in vivo required production of all four Pht proteins, indicating that, despite their overlapping functionality, the proteins are not dispensable without incurring a fitness cost. We also show that surface-attached forms of the Pht proteins are required for zinc recruitment and that they do not contribute to defense against extracellular zinc stress

The first histidine triad motif of phtd is critical for zinc homeostasis in Streptococcus pneumoniae

Streptococcus pneumoniae is the world's foremost human pathogen. Acquisition of the first row transition metal ion zinc is essential for pneumococcal colonization and disease. Zinc is acquired via the ATP-binding cassette transporter AdcCB and two zinc-binding proteins, AdcA and AdcAII. We have previously shown that AdcAII is reliant upon the polyhistidine triad (Pht) proteins to aid in zinc recruitment. Pht proteins generally contain five histidine (His) triad motifs that are believed to facilitate zinc binding and therefore play a significant role in pneumococcal metal ion homeostasis. However, the importance and potential redundancy of these motifs have not been addressed. We examined the effects of mutating each of the five His triad motifs of PhtD. The combination of in vitro growth assays, active zinc uptake, and PhtD expression studies show that the His triad closest to the protein's amino terminus is the most important for zinc acquisition. Intriguingly, in vivo competitive infection studies investigating the amino- and carboxyl-terminal His triad mutants indicate that the motifs have similar importance in colonization. Collectively, our new insights into the contributions of the individual His triad motifs of PhtD, and by extension the other Pht proteins, highlight the crucial role of the first His triad site in zinc acquisition. This study also suggests that the Pht proteins likely play a role beyond zinc acquisition in pneumococcal virulence

Extremely low amphibian roadkill probability on busy bicycle paths

Road mortality can have a significant negative impact on amphibian population survival. Amphibian roadkill and how to avoid it are therefore widely studied, mostly on car roads but limitedly on bicycle paths. We investigated whether amphibian mortality on bicycle paths in Bargerveen, a Dutch Natura 2000 site, was affected by the number of passing cyclists and crossing amphibians. We investigated four transects on a daily basis during most of the amphibian spring migration in 2021. We counted and identified (to species level) all killed amphibians; further, we used cyclist counters and toad fences to assess the number of passing bicycles and crossing amphibians, respectively. We found 11 killed smooth newts Lissotriton vulgaris, out of 5,037 that crossed the bicycle paths. Although 11,453 anurans crossed, we found no killed anurans. The occurrence of killed smooth newts was not affected by the number of passing bicycles or crossing newts. The probability of being killed was extremely low for crossing smooth newts (0.22 %) and anurans (0 %), possibly because cyclists successfully avoid cycling over amphibians. Future monitoring should occur from early February to late November to include the complete active period of amphibians including juvenile dispersal, and across multiple successive years because amphibian numbers can vary largely between years. During our study period, however, amphibian mortality on bicycle paths in Bargerveen seems no threat to populations, despite the high numbers of cyclists

On the development of an artificial intervertebral disc

Degenerative disc disease is one of the causes of low back pain. There are two major surgical interventions: spinal fusion and implantation of an artificial intervertebral disc. Spinal fusion alters the biomechanics of the spine, which may lead to further degeneration of the surrounding tissues and the discs at adjacent levels. An artificial intervertebral disc could prevent this. Existing devices, however, do not comply, so it was decided to develop a new artificial intervertebral disc, consisting of a core with two endplates. This thesis describes the requirements for such an artificial intervertebral disc and presents the design of the endplates

Noxious mechanosensation - molecules and circuits.

Drugs that block mechanically-evoked pain would be useful for many common pain conditions, but appropriate drug development targets have yet to be defined. There is increasing evidence that both peripheral sensory neuron wiring patterns as well as the expression of transducing molecules are important for modality specific pain sensations. Progress in identifying the cell types, candidate transducing molecules and wiring patterns involved in mechanosensation has been dramatic over the past few years. Here we focus on potential mechano-transducing channels, and the relevant cell types and wiring patterns that provide clues for new analgesic drug development strategies

Zinc stress induces copper depletion in Acinetobacter baumannii

Background: The first row transition metal ions zinc and copper are essential to the survival of many organisms, although in excess these ions are associated with significant toxicity. Here, we examined the impact of zinc and copper stress on Acinetobacter baumannii, a common opportunistic pathogen. Results: We show that extracellular zinc stress induces a copper-specific depletion phenotype in A. baumannii ATCC 17978. Supplementation with copper not only fails to rescue this phenotype, but further exacerbates the copper depletion. Extensive analysis of the A. baumannii ATCC 17978 genome identified 13 putative zinc/copper resistance efflux pumps. Transcriptional analyses show that four of these transporters are responsive to zinc stress, five to copper stress and seven to the combination of zinc and copper stress, thereby revealing a likely foundation for the zinc-induced copper starvation in A. baumannii. In addition, we show that zinc and copper play crucial roles in management of oxidative stress and the membrane composition of A. baumannii. Further, we reveal that zinc and copper play distinct roles in macrophage-mediated killing of this pathogen. Conclusions: Collectively, this study supports the targeting of metal ion homeostatic mechanisms as an effective antimicrobial strategy against multi-drug resistant bacterial pathogens.Karl A. Hassan, Victoria G. Pederick, Liam D. H. Elbourne, Ian T. Paulsen, James C. Paton, Christopher A. McDevitt and Bart A. Eijkelkam

Microstructured optical fiber-based biosensors: reversible and nanoliter-scale measurement of zinc ions

Published: May 6, 2016Sensing platforms that allow rapid and efficient detection of metal ions would have applications in disease diagnosis and study, as well as environmental sensing. Here, we report the first microstructured optical fiber-based biosensor for the reversible and nanoliter-scale measurement of metal ions. Specifically, a photoswitchable spiropyran Zn(2+) sensor is incorporated within the microenvironment of a liposome attached to microstructured optical fibers (exposed-core and suspended-core microstructured optical fibers). Both fiber-based platforms retains high selectivity of ion binding associated with a small molecule sensor, while also allowing nanoliter volume sampling and on/off switching. We have demonstrated that multiple measurements can be made on a single sample without the need to change the sensor. The ability of the new sensing platform to sense Zn(2+) in pleural lavage and nasopharynx of mice was compared to that of established ion sensing methodologies such as inductively coupled plasma mass spectrometry (ICP-MS) and a commercially available fluorophore (Fluozin-3), where the optical-fiber-based sensor provides a significant advantage in that it allows the use of nanoliter (nL) sampling when compared to ICP-MS (mL) and FluoZin-3 (μL). This work paves the way to a generic approach for developing surface-based ion sensors using a range of sensor molecules, which can be attached to a surface without the need for its chemical modification and presents an opportunity for the development of new and highly specific ion sensors for real time sensing applications.Sabrina Heng, Christopher A. McDevitt, Roman Kostecki, Jacqueline R. Morey, Bart A. Eijkelkamp, Heike Ebendorff-Heidepriem, Tanya M. Monro, and Andrew D. Abel