Cultivating Acute Care Rehabilitation Team Collaboration Using the Kawa Model

Purpose: Effective healthcare team collaboration is imperative for quality client-centered care, job satisfaction, and overall morale. Rehabilitation team collaboration can be impacted by high productivity demands, differing backgrounds of individual team members, and the unpredictable healthcare environment. The Kawa (river) model, a culturally-neutral model of occupational therapy practice, has been shown to improve communication and collaboration with its use of metaphors, but its utility in various contexts to enhance collaborative practice is still being explored. The purpose of this study was to implement an evidence-based teambuilding intervention with use of the Kawa model to investigate the impact on acute care rehabilitation team collaboration. Method: A 5-week pretest-posttest study was completed with a group of eight rehabilitation team members, consisting of occupational therapists, physical therapists, and a speech language pathologist, in an acute care setting. Pre and post-surveys were utilized to gather quantitative and qualitative data on perceptions of team collaboration, knowledge of the Kawa model, and the model’s utility for collaboration. Results: Outcomes showed overall mean improvements in agreement that the Kawa model provides a common method of communication, and 100% of the participants agreed or strongly agreed that use of the Kawa model can improve acute care rehabilitation team collaboration. Qualitative post-survey responses indicated an enhanced understanding of the components of effective team collaboration. Conclusions & Recommendations: Team collaboration was cultivated with use of the Kawa model. The model provided a successful method for the acute care team to openly discuss and collaboratively problem-solve how to maximize their team flow. Further study of the Kawa model’s utility to improve collaboration in various contexts with broader participant groups is recommended, as well as study of longitudinal effects of a teambuilding intervention with use of the Kawa model

Use of an Adaptive Climbing Program to Improve Social Skills in Children with Developmental Delays: A Feasibility Study

Purpose: A repeated measures single-group feasibility study was used to investigate the potential success and feasibility of an adaptive climbing program including group social skills activities to positively impact social skills in children with developmental delays. Methods: A convenience sample of 10 children aged 4 to 12 years participated in six social skills activity groups and adaptive climbing sessions at a rock-climbing facility in North Carolina. Trained observers measured targeted social skills via an author-generated social skills tracking form. Results: A paired t-test indicates a statistically significant improvement in social skills from session 1 to session 6 (pConclusions: Outcomes suggest participation in a community-based adaptive climbing program that involves group social skills activities may be beneficial for promoting social skill development in children with developmental delays. Opportunities exist for occupational therapists to partner with climbing gyms or other organizations to develop and tailor programming specific to each child’s developmental level and needs

The Dynamic Use of the Kawa Model: A Scoping Review

Background: The Kawa model, a framework to guide culturally relevant occupational therapy, has gained recognition and become more widely used in practice. Research on the model thus far, while still relatively sparse, provides guidance for the model’s use, including its strengths and facets that require further exploration to support its use and effectiveness in dynamic ways. Method: A scoping review was completed to gather, organize, appraise, and synthesize the current research evidence on use of the model. Results: Findings support the Kawa model’s culturally flexible application and its capacity to garner client-centered qualitative information, as well as to build therapeutic relationships in a variety of settings. Challenges to the model’s use include therapists’ inexperience limiting effectiveness and the need for additional quantitative assessment measures to supplement the qualitative findings gathered during use of the Kawa. Limitations to this review include author preconceptions, homogeneity among the authors, and inclusion of non-peer-reviewed theses. Conclusion: The Kawa model is an adaptable tool to examine and enhance well-being. It may be most effective when used by experienced therapists and in conjunction with other relevant tools. Further research is recommended to continue to evaluate its dynamic use

Mechanism of activation of the prokaryotic channel ELIC by propylamine: A single-channel study.

Prokaryotic channels, such as Erwinia chrysanthemi ligand-gated ion channel (ELIC) and Gloeobacter violaceus ligand-gated ion channel, give key structural information for the pentameric ligand-gated ion channel family, which includes nicotinic acetylcholine receptors. ELIC, a cationic channel from E. chrysanthemi, is particularly suitable for single-channel recording because of its high conductance. Here, we report on the kinetic properties of ELIC channels expressed in human embryonic kidney 293 cells. Single-channel currents elicited by the full agonist propylamine (0.5-50 mM) in outside-out patches at -60 mV were analyzed by direct maximum likelihood fitting of kinetic schemes to the idealized data. Several mechanisms were tested, and their adequacy was judged by comparing the predictions of the best fit obtained with the observable features of the experimental data. These included open-/shut-time distributions and the time course of macroscopic propylamine-activated currents elicited by fast theta-tube applications (50-600 ms, 1-50 mM, -100 mV). Related eukaryotic channels, such as glycine and nicotinic receptors, when fully liganded open with high efficacy to a single open state, reached via a preopening intermediate. The simplest adequate description of their activation, the "Flip" model, assumes a concerted transition to a single intermediate state at high agonist concentration. In contrast, ELIC open-time distributions at saturating propylamine showed multiple components. Thus, more than one open state must be accessible to the fully liganded channel. The "Primed" model allows opening from multiple fully liganded intermediates. The best fits of this type of model showed that ELIC maximum open probability (99%) is reached when at least two and probably three molecules of agonist have bound to the channel. The overall efficacy with which the fully liganded channel opens was ∼102 (∼20 for α1β glycine channels). The microscopic affinity for the agonist increased as the channel activated, from 7 mM for the resting state to 0.15 mM for the partially activated intermediate state

Heterogeneity of cell membrane structure studied by single molecule tracking

Heterogeneity in cell membrane structure, typified by microdomains with different biophysical and biochemical properties, is thought to impact on a variety of cell functions. Integral membrane proteins act as nanometre-sized probes of the lipid environment and their thermally-driven movements can be used to report local variations in membrane properties. In the current study, we have used total internal reflection fluorescence microscopy (TIRFM) combined with super-resolution tracking of multiple individual molecules, in order to create high-resolution maps of local membrane viscosity. We used a quadrat sampling method and show how statistical tests for membrane heterogeneity can be conducted by analysing the paths of many molecules that pass through the same unit area of membrane. We describe experiments performed on cultured primary cells, stable cell lines and ex vivo tissue slices using a variety of membrane proteins, under different imaging conditions. In some cell types, we find no evidence for heterogeneity in mobility across the plasma membrane, but in others we find statistically significant differences with some regions of membrane showing significantly higher viscosity than others

Mechanism of gating and partial agonist action in the glycine receptor

Ligand-gated ion channels mediate signal transduction at chemical synapses and transition between resting, open, and desensitized states in response to neurotransmitter binding. Neurotransmitters that produce maximum open channel probabilities (Po) are full agonists, whereas those that yield lower than maximum Po are partial agonists. Cys-loop receptors are an important class of neurotransmitter receptors, yet a structure-based understanding of the mechanism of partial agonist action has proven elusive. Here, we study the glycine receptor with the full agonist glycine and the partial agonists taurine and γ-amino butyric acid (GABA). We use electrophysiology to show how partial agonists populate agonist-bound, closed channel states and cryo-EM reconstructions to illuminate the structures of intermediate, pre-open states, providing insights into previously unseen conformational states along the receptor reaction pathway. We further correlate agonist-induced conformational changes to Po across members of the receptor family, providing a hypothetical mechanism for partial and full agonist action at Cys-loop receptors

Compact Localized States in Electric Circuit Flatband Lattices

We generate compact localized states in an electrical diamond lattice, comprised of only capacitors and inductors, via local driving near its flatband frequency. We compare experimental results to numerical simulations and find very good agreement. We also examine the stub lattice, which features a flatband of a different class where neighboring compact localized states share lattice sites. We find that local driving, while exciting the lattice at that flatband frequency, is unable to isolate a single compact localized state due to their non-orthogonality. Finally, we introduce lattice nonlinearity and showcase the realization of nonlinear compact localized states in the diamond lattice. Our findings pave the way of applying flatband physics to complex electric circuit dynamics

The activation mechanism of α1β2γ2S and α3β3γ2S GABAA receptors

The α1β2γ2 and α3β3γ2 are two isoforms of γ-aminobutyric acid type A (GABAA) receptor that are widely distributed in the brain. Both are found at synapses, for example in the thalamus, where they mediate distinctly different inhibitory postsynaptic current profiles, particularly with respect to decay time. The two isoforms were expressed in HEK293 cells, and single-channel activity was recorded from outside-out patches. The kinetic characteristics of both isoforms were investigated by analyzing single-channel currents over a wide range of GABA concentrations. α1β2γ2 channels exhibited briefer active periods than α3β3γ2 channels over the entire range of agonist concentrations and had lower intraburst open probabilities at subsaturating concentrations. Activation mechanisms were constructed by fitting postulated schemes to data recorded at saturating and subsaturating GABA concentrations simultaneously. Reaction mechanisms were ranked according to log-likelihood values and how accurately they simulated ensemble currents. The highest ranked mechanism for both channels consisted of two sequential binding steps, followed by three conducting and three nonconducting configurations. The equilibrium dissociation constant for GABA at α3β3γ2 channels was ∼2.6 µM compared with ∼19 µM for α1β2γ2 channels, suggesting that GABA binds to the α3β3γ2 channels with higher affinity. A notable feature of the mechanism was that two consecutive doubly liganded shut states preceded all three open configurations. The lifetime of the third shut state was briefer for the α3β3γ2 channels. The longer active periods, higher affinity, and preference for conducting states are consistent with the slower decay of inhibitory currents at synapses that contain α3β3γ2 channels. The reaction mechanism we describe here may also be appropriate for the analysis of other types of GABAA receptors and provides a framework for rational investigation of the kinetic effects of a variety of therapeutic agents that activate or modulate GABAA receptors and hence influence synaptic and extrasynaptic inhibition in the central nervous system

Crowd-Driven Deep Learning Tracks Amazon Deforestation

The Amazon forests act as a global reserve for carbon, have very high biodiversity, and provide a variety of additional ecosystem services. These forests are, however, under increasing pressure, coming mainly from deforestation, despite the fact that accurate satellite monitoring is in place that produces annual deforestation maps and timely alerts. Here, we present a proof of concept for rapid deforestation monitoring that engages the global community directly in the monitoring process via crowdsourcing while subsequently leveraging the power of deep learning. Offering no tangible incentives, we were able to sustain participation from more than 5500 active contributors from 96 different nations over a 6-month period, resulting in the crowd classification of 43,108 satellite images (representing around 390,000 km2). Training a suite of AI models with results from the crowd, we achieved an accuracy greater than 90% in detecting new and existing deforestation. These findings demonstrate the potential of a crowd–AI approach to rapidly detect and validate deforestation events. Our method directly engages a large, enthusiastic, and increasingly digital global community who wish to participate in the stewardship of the global environment. Coupled with existing monitoring systems, this approach could offer an additional means of verification, increasing confidence in global deforestation monitoring