Improving multidisciplinary team working to support integrated care for people with frailty amidst the COVID-19 pandemic

Multidisciplinary team (MDT) working is essential to optimise and integrate services for people who are frail. MDTs require collaboration. Many health and social care professionals have not received formal training in collaborative working. This study investigated MDT training designed to help participants deliver integrated care for frail individuals during the Covid-19 pandemic. Researchers utilised a semi-structured analytical framework to support observations of the training sessions and analyse the results of two surveys designed to assess the training process and its impact on participants knowledge and skills. 115 participants from 5 Primary Care Networks in London attended the training. Trainers utilised a video of a patient pathway, encouraged discussion of it, and demonstrated the use of evidence-based tools for patient needs assessment and care planning. Participants were encouraged to critique the patient pathway, reflect on their own experiences of planning and providing patient care. 38% of participants completed a pre-training survey, 47% a post-training survey. Significant improvement in knowledge and skills were reported including understanding roles in contributing to MDT working, confidence to speak in MDT meetings, using a range of evidence-based clinical tools for comprehensive assessment and care planning. Greater levels of autonomy, resilience, and support for MDT working were reported. Training proved effective; it could be scaled up and adopted to other settings

Reliable microsatellite genotyping of the Eurasian badger (Meles meles) using faecal DNA

The potential link between badgers and bovine tuberculosis has made it vital to develop accurate techniques to census badgers. Here we investigate the potential of using genetic profiles obtained from faecal DNA as a basis for population size estimation. After trialling several methods we obtained a high amplification success rate (89%) by storing faeces in 70% ethanol and using the guanidine thiocyanate/silica method for extraction. Using 70% ethanol as a storage agent had the advantage of it being an antiseptic. In order to obtain reliable genotypes with fewer amplification reactions than the standard multiple-tubes approach, we devised a comparative approach in which genetic profiles were compared and replication directed at similar, but not identical, genotypes. This modified method achieved a reduction in polymerase chain reactions comparable with the maximumlikelihood model when just using reliability criteria, and was slightly better when using reliability criteria with the additional proviso that alleles must be observed twice to be considered reliable. Our comparative approach would be best suited for studies that include multiple faeces from each individual. We utilized our approach in a well-studied population of badgers from which individuals had been sampled and reliable genotypes obtained. In a study of 53 faeces sampled from three social groups over 10 days, we found that direct enumeration could not be used to estimate population size, but that the application of mark–recapture models has the potential to provide more accurate results

Effects of PTSD and MDD Comorbidity on Psychological Changes during Surf Therapy Sessions for Active Duty Service Members

Together, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are debilitating and commonly comorbid; however, the effects of this comorbidity on psychological outcomes during exercise programs, such as surf therapy, have not been examined. This study compared changes in depression/anxiety and positive affect during surf therapy sessions between active duty service members with comorbid PTSD and MDD and those with either disorder alone. The study applied DSM-5 criteria to baseline self-report measures to assign probable disorder status, and used a longitudinal design involving repeated measurements to assess outcomes within 6 weekly sessions. Service members completed validated self-report questionnaires using the Patient Health Questionnaire-4 and the Positive Affect Schedule before and after each session. Within surf therapy sessions, both the comorbid and single disorder groups reported significant improvements in symptoms of depression/anxiety and positive affect. However, those with comorbid PTSD and MDD experienced significantly greater reductions in depression/anxiety (beta = -1.22, p = .028) and significantly greater improvements in positive affect (beta = 3.94, p = .046) compared with the single disorder group. Surf therapy appears to have global effects on psychological symptom reduction and may be a useful adjunctive intervention for the treatment of comorbid PTSD and MDD in both clinical and community health settings

Effects of PTSD and MDD Comorbidity on Psychological Changes during Surf Therapy Sessions for Active Duty Service Members

Together, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are debilitating and commonly comorbid; however, the effects of this comorbidity on psychological outcomes during exercise programs, such as surf therapy, have not been examined. This study compared changes in depression/anxiety and positive affect during surf therapy sessions between active duty service members with comorbid PTSD and MDD and those with either disorder alone. The study applied DSM-5 criteria to baseline self-report measures to assign probable disorder status, and used a longitudinal design involving repeated measurements to assess outcomes within 6 weekly sessions. Service members completed validated self-report questionnaires using the Patient Health Questionnaire-4 and the Positive Affect Schedule before and after each session. Within surf therapy sessions, both the comorbid and single disorder groups reported significant improvements in symptoms of depression/anxiety and positive affect. However, those with comorbid PTSD and MDD experienced significantly greater reductions in depression/anxiety (beta = -1.22, p = .028) and significantly greater improvements in positive affect (beta = 3.94, p = .046) compared with the single disorder group. Surf therapy appears to have global effects on psychological symptom reduction and may be a useful adjunctive intervention for the treatment of comorbid PTSD and MDD in both clinical and community health settings

Moringa oleifera Improves Skeletal Muscle Metabolism and Running Performance in Mice

Background: Recent estimates suggest that 7% of Americans use plant-derived nutritional supplements to treat a variety of complications and/or to improve athletic performance and skeletal muscle health. Unfortunately, these supplements are largely unregulated and understudied. For example, Moringa oleifera (M. oleifera) is a subtropical plant and is routinely used to treat inflammation, diabetes, obesity, cancer and HIV. However, the mechanism of action of M. oleifera has not been fully elucidated, thus the purpose of this study is to evaluate the role of M. oleifera as a novel ergogenic aid to improve exercise performance by driving peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α)-dependent signaling pathways implicated in mitochondrial biogenesis and oxidative metabolism in skeletal muscle tissue. Methods: Adult male C57BL/6 mice were treated with 1.0 g of M. oleifera (N = 20) per day or vehicle control (N = 20) for a total of 5 weeks. Following 3 weeks of supplementation, half of each group (RUN) was given access to running wheels every night for 2 weeks (Remaining half = SED), distances ran were recorded daily. After treatment protocols were complete, the gastrocnemius muscles were excised and assayed for known markers of mitochondrial biogenesis, angiogenesis, endurance capacity, and capillary density using immunohistochemistry and RT-PCR. Results: Our results showed a significant increase in average distance run in the M. oleifera + SED and M. oleifera + RUN groups. This physiological trend was consistent with the molecular profile of key metabolic markers, i.e., there was an increase in levels of PGC-1α, PPARγ, SDHB, SUCLG1, VEGF, PGAM-2, PGK1, and MYLPF in the M. oleifera treated groups compared to vehicle + SED. Moreover, M. oleifera also increased CSA and decreased markers of protein degradation. Conclusions: This data suggests that M. oleifera has the potential to be an ergogenic aid via enhancing energy metabolism in adult skeletal muscle by increasing the expression of key metabolic markers, including those involved in glycolysis, oxidative phosphorylation, mitochondrial biogenesis and angiogenesis

The effects of an experimental programme to support students’ autonomy on the overt behaviours of physical education teachers

Although the benefits of autonomy supportive behaviours are now well established in the literature, very few studies have attempted to train teachers to offer a greater autonomy support to their students. In fact, none of these studies has been carried out in physical education (PE). The purpose of this study is to test the effects of an autonomy-supportive training on overt behaviours of teaching among PE teachers. The experimental group included two PE teachers who were first educated on the benefits of an autonomy supportive style and then followed an individualised guidance programme during the 8 lessons of a teaching cycle. Their behaviours were observed and rated along 3 categories (i.e., autonomy supportive, neutral and controlling) and were subsequently compared to those of three teachers who formed the control condition. The results showed that teachers in the experimental group used more autonomy supportive and neutral behaviours than those in the control group, but no difference emerged in relation to controlling behaviours. We discuss the implications for schools of our findings

Gene Mapping by Chromosome Microdissection and Microisolation in the Chicken

A chromosome microdissection and microisolation technique in combination with filter hybridization was developed for chromosomal localization of cloned chicken genes. The DNA was obtained from microdissected chromosome regions of metaphase spreads. Dissected DNA was amplified by polymerase chain reaction (PCR). The chicken MHC gene located on the nucleolar chromosome and β-actin gene located on chromosome 2q were chosen as tests for the procedure and then detected by dot blot analysis using amplified chromosomal DNA probed with biotinylated DNA. The study establishes the technique of using chromosome microdissection and microisolation for localization of cloned genes as a complementary or alternative approach to both in situ DNA/chromosome hybridization and fluorescent in situ hybridization

Enrichment of CpG island shore region hypermethylation in epigenetic breast field cancerization

While changes in DNA methylation are known to occur early in breast carcinogenesis and the landscape of breast tumour DNA methylation is profoundly altered compared with normal tissue, there have been limited efforts to identify DNA methylation field cancerization effects in histologically normal breast tissue adjacent to tumour. Matched tumour, histologically normal tissue of the ipsilateral breast (ipsilateral-normal), and histologically normal tissue of the contralateral breast (contralateral-normal) were obtained from nine women undergoing bilateral mastectomy. Laser capture microdissection was used to select epithelial cells from normal tissue, and neoplastic cells from tumour for genome-scale measures of DNA methylation with the Illumina HumanMethylationEPIC array. We identified substantially more CpG loci that were differentially methylated between contralateral-normal and tumour (63,271 CpG loci q \u3c 0.01), than between ipsilateral-normal and tumour (38,346 CpG loci q \u3c 0.01). We identified differential methylation in ipsilateral-normal relative to contralateral-normal tissue (9,562 CpG loci p \u3c 0.01). In this comparison, hypomethylated loci were significantly enriched for breast cancer-relevant transcription factor binding sites including those for ESR1, FoxA1, and GATA3 and hypermethylated loci were significantly enriched for CpG island shore regions. In addition, progression of shore hypermethylation was observed in tumours compared to matched ipsilateral normal tissue, and these alterations tracked to several well-established tumour suppressor genes. Our results indicate an epigenetic field effect in surrounding histologically normal tissue. This work offers an opportunity to focus investigations of early DNA methylation alterations in breast carcinogenesis and potentially develop epigenetic biomarkers of disease risk

Charting the future of cancer health disparities research: A position statement from the American Association for Cancer Research, the American Cancer Society, the American Society of Clinical Oncology, and the National Cancer Institute

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138314/1/caac21404_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138314/2/caac21404.pd