Incorporating Interprofessional Simulations in Dietetics Education

Introduction: Simulations are commonly used in medical and nursing education, but little research has been done into the outcomes of including simulations in curriculums for dietetics students. Furthermore, to our knowledge, no research has been published regarding the outcomes of multiple-patient interprofessional simulations in dietetics education. Methods: In this study, a registered dietitian modified existing simulated patient cases used in the KUMC School of Nursing to include nutrition components. Dietetics students (n=16) and senior nursing students (n=42) participated in simulations together. Pre-test and post-tests were developed to measure dietetics students' knowledge of roles of healthcare professionals and confidence in communicating. Differences between tests were analyzed using the Wilcoxan Rank Sum test. The Kruskall-Wallis test was used to analyze whether students who had completed clinical experiences had significantly different responses compared to students who were beginning clinical experiences. Statistical significance was set at pResults: For questions that had a correct and incorrect answer, the mean post-test score was higher (64.06%) than the mean pre-test score (60.94%) for dietetics students, however this difference was not statistically significant. No difference was seen between students with regard to clinical experience. 87.5% of students felt the simulation helped them learn roles of other healthcare professionals, while 93.8% of students felt the simulation enhanced their appreciation for interprofessional teamwork. 93.8% of students indicated this activity enhanced their interprofessional communication skills. The mean post-test score was lower (67.03%) than the mean pre-test score (72.53%) for the nursing students. Qualitative analysis of students' responses to open-ended questions identified several key themes. Mean accuracy of the dietetics students' assessment notes was 73%. Conclusion: Multi-patient interprofessional simulations are an effective way to expose dietetics students to other health professionals, but additional modifications to the existing cases are needed in order to prompt more interprofessional dialogue within the simulation

SB 226: Amendments to the Quality Basic Education Act

The Act requires each local board of education to adopt a complaint resolution process to be used by its local school system to address parents’ or permanent guardians’ complaints alleging that harmful material has been provided or is currently available to a minor student

Elective surgery after Covid-19: how can we bring waiting lists down?

Elective surgery was suspended during the pandemic. Surgical Registrar Katie Young explains the challenges of clearing the backlog and trying to bring down waiting times

PDE8 controls CD4(+) T cell motility through the PDE8A-Raf-1 kinase signaling complex

The levels of cAMP are regulated by phosphodiesterase enzymes (PDEs), which are targets for the treatment of inflammatory disorders. We have previously shown that PDE8 regulates T cell motility. Here, for the first time, we report that PDE8A exerts part of its control of T cell function through the V-raf-1 murine leukemia viral oncogene homolog 1 (Raf-1) kinase signaling pathway. To examine T cell motility under physiologic conditions, we analyzed T cell interactions with endothelial cells and ligands in flow assays. The highly PDE8-selective enzymatic inhibitor PF-04957325 suppresses adhesion of in vivo myelin oligodendrocyte glycoprotein (MOG) activated inflammatory CD4(+) T effector (Teff) cells to brain endothelial cells under shear stress. Recently, PDE8A was shown to associate with Raf-1 creating a compartment of low cAMP levels around Raf-1 thereby protecting it from protein kinase A (PKA) mediated inhibitory phosphorylation. To test the function of this complex in Teff cells, we used a cell permeable peptide that selectively disrupts the PDE8A-Raf-1 interaction. The disruptor peptide inhibits the Teff-endothelial cell interaction more potently than the enzymatic inhibitor. Furthermore, the LFA-1/ICAM-1 interaction was identified as a target of disruptor peptide mediated reduction of adhesion, spreading and locomotion of Teff cells under flow. Mechanistically, we observed that disruption of the PDE8A-Raf-1 complex profoundly alters Raf-1 signaling in Teff cells. Collectively, our studies demonstrate that PDE8A inhibition by enzymatic inhibitors or PDE8A-Raf-1 kinase complex disruptors decreases Teff cell adhesion and migration under flow, and represents a novel approach to target T cells in inflammation

Harnessing Whole Genome Polygenic Risk Scores to Stratify Individuals Based on Cardiometabolic Risk Factors and Biomarkers at Age 10 in the Lifecourse - Brief Report

In this study, we investigated the capability of polygenic risk scores to stratify a cohort of young individuals into risk deciles based on 10 different cardiovascular traits and circulating biomarkers. METHODS: We first conducted large-scale genome-wide association studies using data on adults (mean age 56.5 years) enrolled in the UK Biobank study (n=393 193 to n=461 460). Traits and biomarkers analyzed were body mass index, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein B, apolipoprotein A-I, C-reactive protein and vitamin D. Findings were then leveraged to build whole genome polygenic risk scores in participants from the Avon Longitudinal Study of Parents and Children (mean age, 9.9 years) which were used to stratify this cohort into deciles in turn and analyzed against their respective traits. RESULTS: For each of the 10 different traits assessed, we found strong evidence of an incremental trend across deciles (all P<0.0001). Large differences were identified when comparing top and bottom deciles; for example, using the apolipoprotein B polygenic risk scores there was a mean difference of 13.2 mg/dL for this established risk factor of coronary heart disease in later life. CONCLUSIONS: Although the use of polygenic prediction in a clinical setting may currently be premature, our findings suggest they are becoming increasingly powerful as a means of predicting complex trait variation at an early stage in the lifecourse

The Determinants of Reported Personal and Household Hygiene Behaviour: A Multi-Country Study.

A substantial proportion of the total infectious disease burden world-wide is due to person-to-person spread of pathogens within households. A questionnaire-based survey on the determinants of hand-washing with soap and cleaning of household surfaces was conducted in at least 1000 households in each of twelve countries across the world (N = 12,239). A structural equation model of hygiene behaviour and its consequences derived from theory was then estimated on this dataset for both behaviours, using a maximum likelihood procedure. The analysis showed that the frequency of handwashing with soap is significantly related to how automatically it is performed, and whether or not someone is busy, or tired. Surface cleaning was strongly linked to possessing a cleaning routine, the perception that one is living in a dirty environment and that others are doing the behaviour, whether one has a strong sense of contamination, as well as a felt need to keep one's surroundings tidy. Being concerned with good manners is also linked to the performance of both behaviours. This study is the first to identify the role of manners, orderliness and routine on hygiene behaviours globally. Such findings should prove helpful in designing programs to improve domestic hygiene practices

Investigating the Swimming of Microbial Pathogens Using Digital Holography.

To understand much of the behaviour of microbial pathogens, it is necessary to image living cells, their interactions with each other and with host cells. Species such as Escherichia coli are difficult subjects to image: they are typically microscopic, colourless and transparent. Traditional cell visualisation techniques such as fluorescent tagging or phase-contrast microscopy give excellent information on cell behaviour in two dimensions, but no information about cells moving in three dimensions. We review the use of digital holographic microscopy for three-dimensional imaging at high speeds, and demonstrate its use for capturing the shape and swimming behaviour of three important model pathogens: E. coli, Plasmodium spp. and Leishmania spp

X-ray analysis of the proper motion and pulsar wind nebula for PSR J1741-2054

We obtained six observations of PSR J1741-2054 using the $Chandra$ ACIS-S detector totaling $\sim$300 ks. By registering this new epoch of observations to an archival observation taken 3.2 years earlier using X-ray point sources in the field of view, we have measured the pulsar proper motion at $\mu =109 \pm 10 {\rm mas\ yr}^{-1}$ in a direction consistent with the symmetry axis of the observed H$\alpha$ nebula. We investigated the inferred past trajectory of the pulsar but find no compelling association with OB associations in which the progenitor may have originated. We confirm previous measurements of the pulsar spectrum as an absorbed power law with photon index $\Gamma$=2.68$\pm$0.04, plus a blackbody with an emission radius of (4.5$^{+3.2}_{-2.5})d_{0.38}$ km, for a DM-estimated distance of $0.38d_{0.38}$ kpc and a temperature of $61.7\pm3.0$ eV. Emission from the compact nebula is well described by an absorbed power law model with a photon index of $\Gamma$ = 1.67$\pm$0.06, while the diffuse emission seen as a trail extending northeast of the pulsar shows no evidence of synchrotron cooling. We also applied image deconvolution techniques to search for small-scale structures in the immediate vicinity of the pulsar, but found no conclusive evidence for such structures.Comment: 7 pages, 8 figures, 4 Tables; Accepted by Ap