An investigation of the relationship between interprofessional education, interprofessional attitudes, and interprofessional practice

Study aims: This study aimed to explore: the interprofessional attitudes of first- and final-year healthcare students, recent graduates, and senior healthcare professionals; the influences upon those attitudes (including participation in interprofessional education (IPE)); how attitudes change over time and between groups; and the factors influencing interprofessional interaction in education and practice settings. Methods and methodology: This study used a mixed methods convergent parallel design. Quantitative data were collected from first- and final-year healthcare students using the Attitudes to Health Professionals Questionnaire. A control group of first-year students who had not participated in the IPL programme was used to determine the effect of participation in the Interprofessional Learning (IPL) programme. Data from first- and final-year students were compared to explore changes in interprofessional attitudes during students’ training. Qualitative data were collected from first- and final-year students using focus groups and from graduates and senior healthcare professionals using individual interviews. These data provided insight into the attitudes of participants to IPE and practice and into factors that influence their attitude towards interprofessional interaction and other professions. Key findings: The interprofessional attitudes of first-year students who participated in the IPL programme are more positive than those of the control group, but this effect does is not sustained with final-year students. Students’ attitudes towards the IPL programme are mixed, but graduates’ views are more positive. The qualitative data showed there are many factors aside from participating in the IPL programme that influence the interprofessional attitudes, and these factors affect the attitudes of all participants. Conclusions: IPE is a viable way of improving students’ interprofessional attitudes. Ensuring that students value IPE and that IPE addresses issues influencing student attitudes should produce graduates who will be better equipped to deal with the necessity of interprofessional working, benefitting patients, and meeting the evolving needs of the health service

Coping During the Time of Covid: Mental Health and Changes in Religious Practices

While rituals, particularly religious rituals, have long been the focus of anthropological research, they have only recently become a focus of psychological research. Ritual is defined as 1) predefined sequences of behavior characterized by rigidity, formality, and repetition that are 2) causally opaque, and 3) embedded in a larger system of symbolism and meaning (Hobson et al., 2017; Lawson & McCauley, 1990; Wen et al., 2020). Religious rituals appear to provide three primary regulatory functions for individuals: regulation of emotions, of the performance of goal states, and of social connections (Hobson, et al., 2017). Because of the importance of ritual in emotion regulation, one would expect 1) experiencing an emotional deficit should elicit more ritualistic behavior and 2) enacting rituals should thereby reduce emotional deficits (Hobson, et al., 2017). The current study compared self-reports of anxiety and depression before and during the Covid pandemic with type, frequency, and importance of religious ritual participation. It was hypothesized that, for those for whom religious rituals were an important facet of life, ritual participation would be negatively related to levels of anxiety and depression during the pandemic. Surveys were completed by 122 students at a small, Midwestern liberal arts university. The results indicate that while participation in personal religious behavior such as private prayer and scripture reading did not change during the pandemic, participation in scripted religious rituals did decrease slightly. Both before and during the pandemic individuals rated personal devotional practices such as prayer and scripture reading as more important than participation in personal or corporate religious rituals. Inconsistent with previous research, there was not a relationship between religious belief and behavior with mental health outcomes such as anxiety and depression. Most people who reported an increase in anxiety and depression during the pandemic indicated that at least part of the reason for the increase was their inability to worship in person with others. However, overall depression and anxiety scores were not related to reported increases or decreases in religious ritual participation during the pandemic. Conversely, for those reporting that their anxiety and depression increased at least partly due to the inability to worship publicly with others, changes in depression and anxiety scores were inversely related to continued ritual practices during the pandemic, supporting the hypotheses of this study. Overall, these data indicate a complex relationship among religious ritual participation, personal devotional practices, and mental health outcomes

Metabolic compensation activates pro-survival mTORC1 signaling upon 3-phosphoglycerate dehydrogenase inhibition in osteosarcoma

Osteosarcoma is the most common pediatric and adult primary malignant bone cancer. Curative regimens target the folate pathway, downstream of serine metabolism, with high-dose methotrexate. Here, the rate-limiting enzyme in the biosynthesis of serine from glucose, 3-phosphoglycerate dehydrogenase (PHGDH), is examined, and an inverse correlation between PHGDH expression and relapse-free and overall survival in osteosarcoma patients is found. PHGDH inhibition in osteosarcoma cell lines attenuated cellular proliferation without causing cell death, prompting a robust metabolic analysis to characterize pro-survival compensation. Using metabolomic and lipidomic profiling, cellular response to PHGDH inhibition is identified as accumulation of unsaturated lipids, branched chain amino acids, and methionine cycle intermediates, leading to activation of pro-survival mammalian target of rapamycin complex 1 (mTORC1) signaling. Increased mTORC1 activation sensitizes cells to mTORC1 pathway inhibition, resulting in significant, synergistic cell death in vitro and in vivo. Identifying a therapeutic combination for PHGDH-high cancers offers preclinical justification for a dual metabolism-based combination therapy for osteosarcoma

A Randomized Controlled Evaluation of the Efficacy of an Ankle-Foot Cast on Walking Recovery Early After Stroke: SWIFT Cast Trial

Background. Timely provision of an ankle-foot orthosis (AFO) orthotist customized for individuals early after stroke can be problematic. Objective. To evaluate the efficacy of a therapist-made AFO (SWIFT Cast) for walking recovery. Methods.This was a randomized controlled, observer-blind trial. Participants (n = 105) were recruited 3 to 42 days poststroke.All received conventional physical therapy (CPT) that included use of “off-the-shelf” and orthotist-made AFOs. People allocated to the experimental group also received a SWIFT Cast for up to 6 weeks. Measures were undertaken before randomization, 6 weeks thereafter (outcome), and at 6 months after stroke (follow-up). The primary measure was walking speed. Clinical efficacy evaluation used analysis of covariance. Results. Use of a SWIFT Cast during CPT sessions wassignificantly higher (P < .001) for the SWIFT Cast (55%) than the CPT group (3%). The CPT group used an AFO in 26% of CPT sessions, compared with 11% for the SWIFT Cast group (P = .005). At outcome, walking speed was 0.42 (standard deviation [SD] = 0.37) m/s for the CPT group and 0.32 (SD = 0.34) m/s for the SWIFT Cast group. Follow-up walking speed was 0.53 (SD = 0.38) m/s for the CPT group and 0.43 (0.34) m/s for the SWIFT Cast group. Differences, after accounting for minimization factors, were insignificant at outcome (P = .345) and follow-up (P = .360). Conclusion and implications.SWIFT Cast did not enhance the benefit of CPT, but the control group had greater use of another AFO. However, SWIFT Cast remains a clinical option because it is low cost and custom-made by therapists who can readily adapt it during the rehabilitation period

NuSTAR and Chandra observations of new X-ray transients in the central parsec of the Galaxy

We report NuSTAR and Chandra observations of two X-ray transients, SWIFT J174540.7$-$290015 (T15) and SWIFT J174540.2$-$290037 (T37), which were discovered by the Neil Gehrels Swift Observatory in 2016 within $r\sim1$ pc of Sgr A*. NuSTAR detected bright X-ray outbursts from T15 and T37, likely in the soft and hard states, with 3-79~keV luminosities of $8\times10^{36}$ and $3\times10^{37}$ erg/s, respectively. No X-ray outbursts have previously been detected from the two transients and our Chandra ACIS analysis puts an upper limit of $L_X \lesssim 2 \times10^{31}$ erg/s on their quiescent 2-8 keV luminosities. No pulsations, significant QPOs, or type I X-ray bursts were detected in the NuSTAR data. While T15 exhibited no significant red noise, the T37 power density spectra are well characterized by three Lorentzian components. The declining variability of T37 above $\nu \sim 10$ Hz is typical of black hole (BH) transients in the hard state. NuSTAR spectra of both transients exhibit a thermal disk blackbody, X-ray reflection with broadened Fe atomic features, and a continuum component well described by Comptonization models. Their X-ray reflection spectra are most consistent with high BH spin ($a_{*} \gtrsim 0.9$) and large disk density ($n_e\sim10^{21}$ cm$^{-3}$). Based on the best-fit ionization parameters and disk densities, we found that X-ray reflection occurred near the inner disk radius, which was derived from the relativistic broadening and thermal disk component. These X-ray characteristics suggest the outbursting BH-LMXB scenario for both transients and yield the first BH spin measurements from X-ray transients in the central 100 pc region.Comment: 15 pages, 7 figures, accepted for publication in Ap