Evidence-driven Diagnosis and Treatment of Acute Urinary Tract Infections in Long-term Care

Misdiagnosis of asymptomatic bacteriuria as a urinary tract infection continues to occur, leading to the overuse of antibiotics. Due to the growing elderly population in long-term care facilities (LTCFs), LTCFs can play a critical role in antimicrobial stewardship. Urinary tract infections are a starting point for moving toward antimicrobial stewardship, since urinary tract infections are common in LTCFs. A retrospective chart review of 156 cases with suspected urinary tract infections (UTIs) was completed in a LTCF. The purpose of the scholarly project was to assess diagnostic and treatment practices for UTIs and compare them to a diagnostic and treatment algorithm. The overarching finding of the scholarly project was that this particular LTCF’s management of UTIs did not correspond with the selected algorithm’s recommendations. Because the elderly frequently have complex and confounding health factors related to UTIs, the selected algorithm did not adequately capture the nuances for UTI diagnosis in the elderly population. As currently published, the algorithm is not generalizable to elderly women in LTCFs. The symptoms component of the diagnostic portion of the algorithm may benefit from further revision for use in the elderly population. Small-scale change at LTCFs could include encouragement of watchful waiting and improved use of guidelines for antibiotic treatment

The Leadership Role in Online Support Programs for Beginning Teachers

As distance learning opportunities foster a wide array for online mentoring, program administrators are in need of research supporting the successful development and management of such efforts. This qualitative research examined the leadership perspectives, skills, and strategies involved in developing and administering an online support program (also referred to as electronic mentoring) designed to help beginning teachers transition into the profession and improve their retention (National Commission on Teaching and America\u27s Future, 2003). The population was comprised of all known programs established to date in the United States. Interviews were conducted of 28 program administrators representing 20 online programs for new teachers. Data were collected via interviews and triangulated with multiple artifacts. Consistent with practices by Strauss and Corbin (2007), data were analyzed using open, axial, and selective coding to identify, organize, and relate categories and themes. Through this analysis process, the core category, The Leadership Role in Online Support Programs for Beginning Teachers, emerged and was based upon the interrelationships among five subcategories: (a) needs and benefits of participants, (b) program development, (c) professional development, (d) technology considerations, and (e) leadership strategies. The grounded theory resulting from these findings concluded that, successful administrators need to develop a detailed plan for online programs, weighing necessary program components including (a) an educationally diverse program team; (b) early establishment of program goals; (c) reliable methods of assessment of outcomes using constant formative evaluation; (d) a secure, reliable, non-evaluative environment; (e) training in effective online communications and relationship building; and (f) a value-added experience for participants. The leadership role of online support programs for beginning teachers requires administrators to have an in-depth understanding of the developmental needs of new teachers in concert with principles of adult learning theory and means of maximizing professional development. Of greater import than technology skills were the ability to effectively communicate online and manage in a collaborative, facilitative, ever-changing environment. Future studies should examine requirements for participants\u27 online engagement, comparative technology for online support systems, roles adopted by facilitators, and methods of assessment of program effectiveness

Discovery of a small molecule agonist of phosphatidylinositol 3-kinase p110α that reactivates latent HIV-1

Combination antiretroviral therapy (cART) can effectively suppress HIV-1 replication, but the latent viral reservoir in resting memory CD4+ T cells is impervious to cART and represents a major barrier to curing HIV-1 infection. Reactivation of latent HIV-1 represents a possible strategy for elimination of this reservoir. In this study we describe the discovery of 1,2,9,10-tetramethoxy-7H-dibenzo[de,g]quinolin-7-one (57704) which reactivates latent HIV-1 in several cell-line models of latency (J89GFP, U1 and ACH-2). 57704 also increased HIV-1 expression in 3 of 4 CD8+-depleted blood mononuclear cell preparations isolated from HIV-1-infected individuals on suppressive cART. In contrast, vorinostat increased HIV-1 expression in only 1 of the 4 donors tested. Importantly, 57704 does not induce global T cell activation. Mechanistic studies revealed that 57704 reactivates latent HIV-1 via the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. 57704 was found to be an agonist of PI3K with specificity to the p110a isoform, but not the p110β, δ or γ isoforms. Taken together, our work suggests that 57704 could serve as a scaffold for the development of more potent activators of latent HIV-1. Furthermore, it highlights the involvement of the PI3K/Akt pathway in the maintenance of HIV-1 latency. © 2014 Doyon et al

The effect of curricular and extracurricular activities on university students? entrepreneurial intention and competences

This study examines how the alliance-building process affects the intention to enter into international alliances in the case of small and medium-sized enterprises (SMEs). From a psychological perspective (Perceived Behavioural Control), the authors analyse the alliance-building process as an inhibitor of the international collaboration intention, considering to what extent the experience affects the intention of the partners involved. The study explores these hypotheses based on a sample of 220 Spanish SMEs. The results provide empirical evidence showing that the intention to develop international alliances is negatively affected by the search and the selection process as well as by the negotiation of the agreement, which reduces the intention to establish an international agreement. In addition, the intention is moderated by the experience of the SME manager. Moreover, there is a negative relationship between the extent of the SME manager's international experience and the intention to develop an international alliance

Differential expression of the brassinosteroid receptor-encoding BRI1 gene in Arabidopsis

Abstract Brassinosteroid (BR)-regulated growth and development in Arabidopsis depends on BRASSINOSTEROID INSENSITIVE 1 (BRI1), the BR receptor that is responsible for initiating the events of BR signalling. We analysed the temporal and spatial regulation of BRI1 expression using stable transgenic lines that carried BRI1 promoter:reporter fusions. In both seedlings and mature plants the tissues undergoing elongation or differentiation showed elevated BRI1 gene activity, and it could be demonstrated that in the hypocotyl this was accompanied by accumulation of the BRI1 transcript and its receptor protein product. In seedlings the BRI1 promoter was also found to be under diurnal regulation, determined primarily by light repression and a superimposed circadian control. To determine the functional importance of transcriptional regulation we complemented the severely BR insensitive bri1-101 mutant with a BRI1-luciferase fusion construct that was driven by promoters with contrasting specificities. Whereas the BRI1 promoter-driven transgene fully restored the wild phenotype, expression from the photosynthesisassociated CAB3 and the vasculature-specific SUC2 and ATHB8 promoters resulted in plants with varying morphogenic defects. Our results reveal complex differential regulation of BRI1 expression, and suggest that by influencing the distribution and abundance of the receptor this regulation can enhance or attenuate BR signalling

Insight on genes affecting tuber development in potato upon <i>Potato spindle tuber viroid</i> (PSTVd) infection

Potato (Solanum tuberosum L) is a natural host of Potato spindle tuber viroid (PSTVd) which can cause characteristic symptoms on developing plants including stunting phenotype and distortion of leaves and tubers. PSTVd is the type species of the family Pospiviroidae, and can replicate in the nucleus and move systemically throughout the plant. It is not well understood how the viroid can affect host genes for successful invasion and which genes show altered expression levels upon infection. Our primary focus in this study is the identification of genes which can affect tuber formation since viroid infection can strongly influence tuber development and especially tuber shape. In this study, we used a large-scale method to identify differentially expressed genes in potato. We have identified defence, stress and sugar metabolism related genes having altered expression levels upon infection. Additionally, hormone pathway related genes showed significant up- or down-regulation. DWARF1/DIMINUTO, Gibberellin 7-oxidase and BEL5 transcripts were identified and validated showing differential expression in viroid infected tissues. Our study suggests that gibberellin and brassinosteroid pathways have a possible role in tuber development upon PSTVd infection