Which Motivational Behaviors Impact Success in a Clinical Anatomy Course for Entry Level Doctor of Physical Therapy Students?

Objectives: The motivational behavior of self-efficacy for learning and performance was correlated with academic success in Doctor of Physical Therapy (DPT) students taking clinical anatomy, the first foundational course in the program. Students’ motivation strategies have been reported to be important factors in academic success, however, these strategies have not been investigated in DPT students. Therefore, the purpose of this study was to determine if course grade in clinical anatomy was correlated with the motivation subscales of the Motivated Strategies for Learning Questionnaire (MSLQ).Materials and Methods: The MSLQ was administered to 33first-year DPT students who consented to participate in the study. Correlation (Pearson r zero order) between the subscales and final course grade in clinical anatomy were determined. Results: Self-efficacy for learning and performance was correlated with course grade (r(31)=.44, p \u3c.05), while intrinsic and extrinsic goal orientation, task value, control of learning beliefs, and test anxiety, were poorly correlated. Conclusions: The results of the current study, indicating that self-efficacy for learning and performance is correlated with academic success, could be utilized in DPT programs to broaden admission processes, and aid in the development of remedial curricular and teaching strategies to support students identified with poor self-efficacy for learning and performance

A longitudinal analysis of symptom clusters in cancer patients and their sociodemographic predictors

Context: Exploring the relationships between concurrent symptoms or “symptom clusters” (SCs) longitudinally may complement the knowledge gained from the traditional approach of examining individual symptoms or SCs crosssectionally. Objectives: To identify consistent SCs over the course of one year and determine the possible associations between SCs and demographic and medical characteristics, and between SCs and emotional distress. Methods: This study was an exploratory longitudinal analysis of SCs in a large sample of newly diagnosed cancer patients. Patients provided symptom assessment data at baseline, three, six, and 12 months. A factor analysis was conducted (controlling for the patient over time) on pain, fatigue, anxiety, depression, sleep, weight change, and food intake items to identify clusters. A panel regression on each cluster explored associations with demographic and medical characteristics and distress. Results: In total, 877 patients provided baseline data, with 505 retained at 12 months. Three SCs explained 71% of the variance. The somatic cluster included pain, fatigue, and sleep; the psychological cluster included anxiety and depression; and the nutrition cluster consisted of weight and food intake. Low income and treatment with radiation or chemotherapy predicted higher somatic symptom burden. Younger age, being female, low income, and treatment with surgery predicted more psychological symptomatology. Older age and treatment with surgery predicted higher nutritional burden. Patients with higher somatic, psychological, and nutritional symptom burden reported higher distress. Conclusion: The presence of SCs across the first year of diagnosis supports the need for routine and ongoing screening for the range of symptoms that may be experienced by patients. Further work is needed to develop interventions that better target individual symptoms that cluster, as well as the entire cluster itself

Reduction of calcium release site models via optimized state aggregation

Background Markov chain models of calcium release sites in living cells exhibit stochastic dynamics reminiscent of the experimentally observed phenomenon of calcium puffs and sparks. Such models often take the form of stochastic automata networks in which the transition probabilities for each of a large number of intercellular channel models depend on the local calcium concentration and thus the state of nearby channels. The state-space size in such compositionally defined calcium release site models increases exponentially as the number of channels increases, which is referred to as “state-space explosion”. Methods In order to overcome the state-space explosion problem, we utilized the idea of “coarse graining” and implemented an automated procedure that reduces the state space by aggregating and lumping states of the full release site model. For a given state aggregation scheme, the transition rates between reduced states are chosen consistent with the conditional probability distribution among states within each group. A genetic algorithm-based approach is then applied to select the state aggregation schemes that lead to reduced models that approximate the observable behaviors of the full model. Results The genetic algorithm-based approach is implemented in Matlab®; and applied to two different release site models. The approach found reduced models that approximate the full model in the number of open channels, spark statistics, and the jump probability matrix as a function of time. Conclusions A novel automated genetic algorithm-based searching technique is implemented to find reduced calcium release site models that approximate observable behaviors of the full Markov chain models that possess intractable state-spaces. As compared to the full model, the reduced models produce quantitatively similar results using significantly less computational resources

Superresolution Modeling of Calcium Release in the Heart

Stable calcium-induced calcium release (CICR) is critical for maintaining normal cellular contraction during cardiac excitation-contraction coupling. The fundamental element of CICR in the heart is the calcium (Ca2+) spark, which arises from a cluster of ryanodine receptors (RyR). Opening of these RyR clusters is triggered to produce a local, regenerative release of Ca2+ from the sarcoplasmic reticulum (SR). The Ca2+ leak out of the SR is an important process for cellular Ca2+ management, and it is critically influenced by spark fidelity, i.e., the probability that a spontaneous RyR opening triggers a Ca2+ spark. Here, we present a detailed, three-dimensional model of a cardiac Ca2+ release unit that incorporates diffusion, intracellular buffering systems, and stochastically gated ion channels. The model exhibits realistic Ca2+ sparks and robust Ca2+ spark termination across a wide range of geometries and conditions. Furthermore, the model captures the details of Ca2+ spark and nonspark-based SR Ca2+ leak, and it produces normal excitation-contraction coupling gain. We show that SR luminal Ca2+-dependent regulation of the RyR is not critical for spark termination, but it can explain the exponential rise in the SR Ca2+ leak-load relationship demonstrated in previous experimental work. Perturbations to subspace dimensions, which have been observed in experimental models of disease, strongly alter Ca2+ spark dynamics. In addition, we find that the structure of RyR clusters also influences Ca2+ release properties due to variations in inter-RyR coupling via local subspace Ca2+ concentration ([Ca2+]ss). These results are illustrated for RyR clusters based on super-resolution stimulated emission depletion microscopy. Finally, we present a believed-novel approach by which the spark fidelity of a RyR cluster can be predicted from structural information of the cluster using the maximum eigenvalue of its adjacency matrix. These results provide critical insights into CICR dynamics in heart, under normal and pathological conditions.peerReviewe

Cuidados de saúde e território: um debate em torno de uma abordagem integrada

As alterações que, essencialmente no decurso da última década, têm surgido nos domínios económico, político e social, com repercussões no âmbito dos serviços de saúde, justificam um repensar dos processos de formulação de políticas da saúde. De facto, este conjunto de alterações coloca em discussão as noções de equidade e eficiência à luz das dinâmicas territoriais, obrigando ao reajustamento das perspetivas teórico-concetuais predominantes e à revisão de estratégias de intervenção vulgarmente utilizadas neste campo. Neste texto, procura esclarecer-se a relação entre cuidados de saúde e território tendo por base dois fatores: a natureza geográfica de acessibilidade aos cuidados de saúde atendendo, quer à dicotomia urbano/rural, quer às recentes tendências de reorganização de vários sistemas de saúde numa ótica de racionalização de recursos e de centralização de serviços, e as implicações no modo como os serviços de saúde passam a organizar-se territorialmente e se articulam, quer entre si, quer com o modelo de organização dos sistemas urbanos existentes. O objetivo é, justamente, refletir sobre esses desafios que, agudizados perante o atual contexto, se colocam às decisões políticas no âmbito dos cuidados de saúde e, consequentemente, discutir possíveis estratégias de intervenção que se afigurem mais territorialmente integradas