Parent assessment of medical student skills in ambulatory pediatrics

Background: Partnership with parents is a vital part of pediatric medical education, yet few studies have examined parent attitudes towards learners in pediatric settings. Methods: Questionnaires were used to determine parent and student assessment of professional and clinical skills (primary outcome) and parent attitudes towards 3rd year medical students (secondary outcome) at the University of Alberta. Chi Square, Kendall’s Tau and Kappa coefficients were calculated to compare parent and student responses in 8 areas: communication, respect, knowledge, listening, history taking, physical examination, supervision, and overall satisfaction. Results: Overall satisfaction with medical student involvement by parents was high: 56.7% of all parents ranked the encounter as ‘excellent’. Areas of lesser satisfaction included physician supervision of students. Compared to the parent assessment, students tended to underrate many of their skills, including communication, history taking and physical exam. There was no relationship between parent demographics and their attitude to rating any of the students’ skills. Conclusions: Parents were satisfied with medical student involvement in the care of their children. Areas identified for improvement included increased supervision of students in both history taking and physical examination. This is one of the largest studies examining parent attitudes towards pediatric students. The results may enhance undergraduate curriculum development and teaching in pediatric ambulatory clinics and strengthen the ongoing partnership between the community and teaching clinics

Digitalkommunikasjon i sosiale medier: Bedriftenes mulighet til å bli kjent med kundene slik at de kan utvikle produkter og tjenester kundene vil ha

Bachelor i Service Management, 2012Formålet med denne bacheloroppgaven er å finne ut hvordan bedriftene kan bruke Facebook til å kommunisere sine servicetjenester. Vi ser at dette kan besvares med hvordan Facebook benyttes rent teknisk, men vi har valgt å besvare spørsmålet med teoretisk forankring i kundeorientert markedsføringsteori. Med bakgrunn i våre teoretiske funn fant vi det interessant å se på hvordan bedriftene opplever denne formen for markedsføring, og hvordan de ser for seg å praktisere den. Vi valgte derfor å intervjue to informanter med forskjellige utgangspunkt. Vi ønsket å finne ut om disse hadde noen holdningsbaserte forskjeller i sin oppfatning av Facebook, og videre hvordan det påvirker dem vedrørende markedsføring i sosiale medier. Vi benyttet kvalitativ metode med strukturerte dybdeintervjuer for å finne svar på våre spørsmål. Vi utarbeidet intervjuguide og tapet intervjuene før vi transkriberte dataene og fikk disse godkjent av informantene som en slags kvalitetssikring før vi analyserte våre funn. Vi kom fram til at empirien i stor grad samsvarer med teorien, og at det ikke fantes noen grunnleggende holdningsbaserte forskjeller av betydning mellom informantene. Det vi fant, var at den ene har troen på Facebook i dag, mens den andre ser for seg effekten av markedsføring på Facebook litt fram i tid. En interessant observasjon vi kan tenke oss å undersøke nærmere ved en senere anledning med et større utvalg av populasjon.Vi har også satt av kapittel 4 til å illustrere egne erfaringer som administrator på våre informanters Facebook-plattformer. Vi gjorde noen små forsøk på disse sidene gjennom våren hvor vi mener å kunne se ulik grad av delaktighet fra kundene/tilhengerne på ulike innlegg. Våre samlede funn viser at Facebook er et godt egnet sted for kommunikasjon mellom bedriftene og kundene, som videre danner grunnlag for at bedriftene kan lytte til kundene slik at de kan utvikle produkter og tjenester som kundene vil ha.Engelsk sammendrag (abstract):The use of digital communication in social media The purpose of this bachelor thesis is to find out how companies can use Facebook to communicate their services. This could be answered with how Facebook is used technically, but we have chosen to answer the question from a customer oriented marketing theory view. Based on our theoretical findings, we found it interesting to see how companies are experiencing this style of marketing, and how they envision themselves to practice it. We therefore chose to interview two informants with different starting points. We wanted to find out whether they had any different approach based on their perception of Facebook, and on how it affects their marketing via social media. In order to find answers to our questions we used the qualitative methods with in-depth interviews. We created an interview guide and recorded the interviews before we transcribed the data. Before we analyzed the data, it was approved by the informants to make sure the quality was good. We found that empirical data are largely consistent with the theory, and that there were no significance differences between the informants. But we found that one informant has faith in Facebook today, while the second informant thought the impact of marketing on Facebook is for the future. At a later time we would like to investigate this interesting observation with a larger sample of the population. Section 4 is illustrating our own experiences as administrators on our informants Facebook sites. We have made some experiments at these sites, where we think we could see different levels of participation from customers/fans on the various articles. Our findings show that Facebook is a suitable place for communication between companies and customers, which creates an arena for companies to listen to customers with a goal to develop products and services that customers want

PKB/SGK-resistant GSK-3 signaling following unilateral ureteral obstruction

Background/Aims: Renal tissue fibrosis contributes to the development of end-stage renal disease. Causes for renal tissue fibrosis include obstructive nephropathy. The development of renal fibrosis following unilateral ureteral obstruction (UUO) is blunted in gene-targeted mice lacking functional serum- and glucocorticoid-inducible kinase SGK1. Similar to Akt isoforms, SGK1 phosphorylates and thus inactivates glycogen synthase kinase GSK-3. The present study explored whether PKB/SGK-dependent phoshorylation of GSK-3α/β impacts on pro-fibrotic signaling following UUO. Methods: UUO was induced in mice carrying a PKB/SGK-resistant GSK-3α/β (gsk-3KI) and corresponding wild-type mice (gsk-3WT). Three days after the obstructive injury, expression of fibrosis markers in kidney tissues was analyzed by quantitative RT-PCR and western blotting. Results: GSK-3α and GSK-3β phosphorylation was absent in both, the non-obstructed and the obstructed kidney tissues from gsk-3KI mice but was increased by UUO in kidney tissues from gsk-3WT mice. Expression of α-smooth muscle actin, type I collagen and type III collagen in the non-obstructed kidney tissues was not significantly different between gsk-3KI mice and gsk-3WT mice but was significantly less increased in the obstructed kidney tissues from gsk-3KI mice than from gsk-3WT mice. After UUO treatment, renal β-catenin protein abundance and renal expression of the β-catenin sensitive genes: c-Myc, Dkk1, Twist and Lef1 were again significantly less increased in kidney tissues from gsk-3KI mice than from gsk-3WT mice. Conclusions: PKB/SGK-dependent phosphorylation of glycogen synthase kinase GSK-3 contributes to the pro-fibrotic signaling leading to renal tissue fibrosis in obstructive nephropathy

Herbivores reduce seedling recruitment in alpine plant communities

publishedVersio

Psychomotor therapy targeting anger and aggressive behaviour in individuals with mild or borderline intellectual disabilities:A systematic review

Background: Poor anger regulation is considered a risk factor of aggression in individuals with mild or borderline intellectual disabilities. Psychomotor therapy (PMT) targets anger regulation through body- and movement-oriented interventions. This study aims to inform practitioners on efficacy and research-base of PMT in this population. Method: This systematic review evaluated nine studies which met inclusion criteria in terms of participants, intervention procedures, outcomes and certainty of evidence. Results: Seven studies revealed a substantial reduction of aggressive behaviour or anger. Certainty of evidence was rated inconclusive in most cases due to absence of experimental control. Conclusions: We can conclude that body-oriented PMT, involving progressive relaxation and meditation procedure "Soles of the Feet", is a promising approach. However, the paucity of studies and methodological limitations preclude classifying it as an evidence-based practice. This suggests stronger methodological research and research aimed at PMT's mechanisms of action (e.g., improved interoceptive awareness) is warranted.</p

Immune-mediated loss of transgene expression from virally transduced brain cells is irreversible, mediated by IFNγ, perforin, and TNFα, and due to the elimination of transduced cells

The adaptive immune response to viral vectors reduces vector-mediated transgene expression from the brain. It is unknown, however, whether this loss is caused by functional downregulation of transgene expression or death of transduced cells. Herein, we demonstrate that during the elimination of transgene expression, the brain becomes infiltrated with CD4 and CD8 T cells and that these T cells are necessary for transgene elimination. Further, the loss of transgene-expressing brain cells fails to occur in the absence of IFNγ, perforin, and TNFα receptor. Two methods to induce severe immune suppression in immunized animals also fail to restitute transgene expression, demonstrating the irreversibility of this process. The need for cytotoxic molecules and the irreversibility of the reduction in transgene expression suggested to us that elimination of transduced cells is responsible for the loss of transgene expression. A new experimental paradigm that discriminates between downregulation of transgene expression and the elimination of transduced cells demonstrates that transduced cells are lost from the brain upon the induction of a specific antiviral immune response. We conclude that the anti-adenoviral immune response reduces transgene expression in the brain through loss of transduced cellsFil: Zirger, Jeffrey M.. Cedars Sinai Medical Center; Estados Unidos. University of California at Los Angeles. School of Medicine; Estados UnidosFil: Puntel, Mariana. University of California at Los Angeles. School of Medicine; Estados Unidos. Cedars Sinai Medical Center; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Bergeron, Josee. Cedars Sinai Medical Center; Estados Unidos. University of California at Los Angeles. School of Medicine; Estados UnidosFil: Wibowo, Mia. University of California at Los Angeles. School of Medicine; Estados Unidos. Cedars Sinai Medical Center; Estados UnidosFil: Moridzadeh, Rameen. University of California at Los Angeles. School of Medicine; Estados Unidos. Cedars Sinai Medical Center; Estados UnidosFil: Bondale, Niyati. Cedars Sinai Medical Center; Estados Unidos. University of California at Los Angeles. School of Medicine; Estados UnidosFil: Barcia, Carlos. Cedars Sinai Medical Center; Estados Unidos. University of California at Los Angeles. School of Medicine; Estados UnidosFil: Kroeger, Kurt M.. University of California at Los Angeles. School of Medicine; Estados Unidos. Cedars Sinai Medical Center; Estados UnidosFil: Liu, Chunyan. University of California at Los Angeles. School of Medicine; Estados Unidos. Cedars Sinai Medical Center; Estados UnidosFil: Castro, Maria Graciela. University of California at Los Angeles. School of Medicine; Estados Unidos. Cedars Sinai Medical Center; Estados Unidos. University of Michigan; Estados UnidosFil: Lowenstein, Pedro R.. Cedars Sinai Medical Center; Estados Unidos. University of California at Los Angeles. School of Medicine; Estados Unidos. University of Michigan; Estados Unido

APOBEC Mutagenesis Is Concordant between Tumor and Viral Genomes in HPV-Positive Head and Neck Squamous Cell Carcinoma

APOBEC is a mutagenic source in human papillomavirus (HPV)-mediated malignancies, including HPV+ oropharyngeal squamous cell carcinoma (HPV + OPSCC), and in HPV genomes. It is unknown why APOBEC mutations predominate in HPV + OPSCC, or if the APOBEC-induced mutations observed in both human cancers and HPV genomes are directly linked. We performed sequencing of host somatic exomes, transcriptomes, and HPV16 genomes from 79 HPV + OPSCC samples, quantifying APOBEC mutational burden and activity in both host and virus. APOBEC was the dominant mutational signature in somatic exomes. In viral genomes, there was a mean of five (range 0–29) mutations per genome. The mean of APOBEC mutations in viral genomes was one (range 0–5). Viral APOBEC mutations, compared to non-APOBEC mutations, were more likely to be low-variant allele fraction mutations, suggesting that APOBEC mutagenesis actively occurrs in viral genomes during infection. HPV16 APOBEC-induced mutation patterns in OPSCC were similar to those previously observed in cervical samples. Paired host and viral analyses revealed that APOBEC-enriched tumor samples had higher viral APOBEC mutation rates (p = 0.028), and APOBEC-associated RNA editing (p = 0.008), supporting the concept that APOBEC mutagenesis in host and viral genomes is directly linked and occurrs during infection. Using paired sequencing of host somatic exomes, transcriptomes, and viral genomes, we demonstrated for the first-time definitive evidence of concordance between tumor and viral APOBEC mutagenesis. This finding provides a missing link connecting APOBEC mutagenesis in host and virus and supports a common mechanism driving APOBEC dysregulation

PENYULUHAN STUNTING DALAM MENINGKATKAN GIZI ANAK,IBU HAMIL, DAN LANSIA DI DESA TEWANG PAJANGAN KECAMATAN KURUN KABUPATEN GUNUNG MAS

Salah satu kegiatan mahasiswa adalah Kuliah Kerja Nyata Tematik (KKN-T), yang mana termasuk kegiatan pengabdian masyarakat. Dalam tulisan ini diangkat topik Stunting yang merupakan kegiatan penyuluhan kepada anak-anak dan orang tua betapa pentingnya kebutuhan gizi anak yang tercukupi di Desa Tewang Pajangan Kecamatan Kurun, Kabupaten Gunung Mas, Provinsi Kalimantan Tengah. Hasil kegiatan berupa penyuluhan tentang stunting serta peningkatan gizi dengan pembagian makanan dan minuman kepada ibuhamil dan lansia. Berupa bubur kacang hijau, pisang, teh kotak dan kuebasah/buatan teruntuk lansia sedangkan teruntuk ibu hamil dan anak – anak berupa bubur kacang hijau, pisang, dan susu kotak indomilk. Hal ini dilakukan sebagai salah satustrategi untuk meningkatkan mutu gizi perseorangan, keluarga dan masyarakat melalui perbaikan polakonsumsi makan dan perilaku sadar giz