Interleukin-3 promotes susceptibility in a mouse model of Cutaneous leishmaniasis

Cutaneous leishmaniasis (CL), a vector-borne infectious disease caused by protozoan parasites of the genus Leishmania, is one of the most important neglected infectious diseases worldwide. Currently, 10 million people in 82 (mostly developing) countries are infected. Those infected develop ulcerative skin lesions on exposed parts of the body, causing serious disability and permanent scarring. All mice are susceptible to infection with Leishmania major, however, the outcome of infection is different depending on the mouse strain. For example, resistant C57BL/6 mice develop lesions, which like in humans, ultimately heal. In contrast, lesions in susceptible BALB/c mice progressively worsen, ultimately resulting in mortality. Resistance or susceptibility to Leishmania parasites is largely dependent on whether the host’s CD4+ T cells develop into Th1 or Th2 effector cells, respectively. Resistant Th1 responses are typically driven by cytokines like interleukin (IL)-12 and interferon-which promotes healing and parasite clearance. In contrast, susceptible Th2 responses are marked by elevated IL-4 production which inactivates the mechanisms of effective parasite clearance and promotes disease progression through an ineffective, antibody-dominated humoral response. IL-3 is a cytokine which promotes hematopoiesis and has the ability to act on numerous cell lineages. In particular, IL-3 appears to have specialized functions in regards to the activation of basophils. For example, IL-3 has been shown to be indispensable for increases in basophil numbers in response to certain infections. Moreover, IL-3 has been shown to increase the functional ability of basophils as IL-3-stimulated basophils are shown to secrete higher levels of IL-4. IL-3 is primarily secreted by activated CD4+ effector T cells, the same cells which are so influential in determining resistance and susceptibility to CL. However, the role of IL 3 during the response to CL remains largely unknown. In the present study we show that infected mice genetically deficient in IL-3 (IL-3 -/- mice) develop smaller lesions, have a lower parasite burdens, and express lower levels of B cells in draining lymph nodes as compared to infected IL-3 +/+ mice. These data suggest IL-3 promotes susceptibility to Leishmania infection and may play an important role in the development of a Th2 immune response characteristic of susceptible BALB/c mice

Exploring experiences, barriers, and enablers to home- and class-based exercise in rotator cuff tendinopathy: A qualitative study

This document is the Accepted Manuscript version of the following article: Fiona M. Sandford, Thomas A. B. Sanders, R. Nutr, and Jeremy S. Lewis, ‘Exploring experiences, barriers, and enablers to home- and class-based exercise in rotator cuff tendinopathy: A qualitative study’, Journal of Hand Therapy, Vol. 30 (2): 193-199, June 2017. The final, definitive version is available online at doi: https://doi.org/10.1016/j.jht.2017.05.001Abstract Study Design Qualitative study. Introduction Adherence is paramount to the successful outcome of exercise-based treatment. Purpose of Study The barriers and enablers to adherence to a home- and class-based exercise program were explored in this qualitative study. Methods Semi-structured interviews were carried out to establish common themes relating to the participants' experiences during a year-long randomized controlled trial. Results/Discussion Twelve participants were interviewed. The main enablers to exercise were highlighted as equipment, perceived benefit from the exercises, and longer and more intensive monitoring. Barriers included the lack of motivation, lack of equipment, and pain. Conclusions Implications for practice are incorporating enablers and addressing barriers including self-discharge from classes; the importance of longer term follow-up and the benefits of adopting exercise into a well-established routine may provide potential benefits. Level of Evidence N/A.Peer reviewedFinal Accepted Versio

Systematic review and conceptual framework for health literacy training in health professions education

Purpose: This review investigates health literacy education interventions for health professions students in higher education settings with the aim of identifying core elements for the first conceptual framework for a health literacy curriculum. Method: A systematic literature search based on pre-specified inclusion criteria was conducted across education and health peer-reviewed literature - Academic Search Complete; CINAHL; MEDLINE (OVID); ProQuest Health & Medicine; SCOPUS (Elsevier); Australian Education Index Plus Text (AEIPT); Education Research Complete; ERIC; ProQuest Education. Twenty-eight peer-reviewed primary studies were found to be eligible and were systemically examined. Data on intervention characteristics, evaluation methods and key outcomes were extracted and content analysed. Results: Numerous health professions were represented in the examined studies, with undergraduate students principally targeted. The large majority of interventions reported positive results. Significant heterogeneity was found in instructional methods, evaluation instruments and outcomes. Instructional approaches ranged from single didactic to clinical and community placement interventions. Less than 40% of interventions used a pre/post evaluation design and control groups were used in only 3 of the included studies. The most successful interventions were found to be those that offered numerous training sessions and integrated knowledge and skill acquisition particularly when patient communication and assessment skills were developed within real-world settings with patients or community members. Review findings informed a draft health literacy training framework for conceptualizing multiple dimensions of health literacy training structure, design and assessment. Discussion/conclusion: Core aspects and best practice teaching elements for health professions health literacy training were identified. It was found that overall, this is an underdeveloped domain in the health professions education field. Future research should focus on identifying an agreed definition of health literacy for this field and structure and process opportunities for health literacy inter-professional education. Also needed is a much better understanding of the impact of health literacy training on specific health profession students, and over what time period to enable targeted curriculum and workforce education planning

Evaluation of an Innovative Student-Led Work Disability Prevention Program

A university-based, role-emerging fieldwork placement for occupational therapy students has been developed to provide work disability prevention services for university managers and workers. Over five years, 24 students have provided holistic interventions across 18 departments. The purpose of this project was to formally evaluate the perceptions of the program and the impact of services on managers and workers and to examine the experience of participating students. A utilization-focused evaluation approach was used as the guiding framework for this project. Methods included a retrospective review of reports and educational materials, a manager and worker survey, and a review of results from an existing student survey. The retrospective review of reports and educational materials demonstrated that students utilized a comprehensive and holistic lens that considered the interaction between the person, environment, and occupation. Workers and managers reported they were satisfied and found that services were beneficial. The majority reported changing their work setup or work habits after receiving student services to prevent workplace disability. Students reported overwhelmingly positive responses about the placement, with 96% (n=23) of students agreeing that they had an excellent experience and 100% (n=24) of students agreeing they were able to use their acquired knowledge. This paper describes the formal evaluation process and the outcomes of the project. Findings support the benefits of a partnership with human resources and occupational therapy in developing a role-emerging placement that benefits students, workers, and the organization and promotes the value of occupational therapy in workplace disability prevention and health promotion

Improvements in the Colorado ammonia model by simultaneous computations of extremes in flow and water chemistry

November 1993.This publication is a product of the Natural Resources Law Center, a research and public education center at the University of Colorado School of Law.Includes bibliographical references (page 18).The present study reports the results of an analysis of association for extremes in pH, temperature, and low flow at 12 sites in Colorado for which an extensive data record is available (21 years at 12 or more samples per year). Statistical study of data for these sites showed no general relationship between flow and percent unionized ammonia at any station. Within periods of low flow, there was no parametric association between percent unionized ammonia and low flow. A nonparametric test of association between percent unionized ammonia and low flows that 8 of the stations have a random association of the two variables, i.e., the expected value of percent unionized ammonia during a period of low flow is equal to the mean value rather than an extreme value. At four of the stations, the association of low flow with percent unionized ammonia was nonrandom. Three of these showed a negative association, i.e., the percent unionized ammonia was significantly lower than the mean during periods of low flow. At a single station (the South Platte River near Kersey), there was a significant positive association, albeit a rather loose one, between percent unionized ammonia and extreme low flows; the lowest 5th percentile of low-flow values showed a mean of the 77th percentile unionized ammonia. These findings suggest modifications of models that are used in computing maximum total ammonia for permits. The assumption of strong association between the least favorable flows (low flow) and least favorable percent unionized ammonia (high percent unionized ammonia) is not justified by field information and may result in overly stringent ammonia control requirements for point source discharges.Grant no. 14-08-0001-G2008/2, Project no. 12; financed in part by the U.S. Dept. of the Interior, Geological Survey, through the Colorado Water Resources Research Institute

Homelessness and the meaning of home: rooflessness or rootlessness?

This paper has several objectives. These are: (1) to analyse the meaning of homelessness in the light of recent contributions on the meaning of home: (2) to criticize some current perspectives on homelessness as a social problem; (3) to identify and explore a number of different dimensions of the meaning of home and homelessness; (4) to reassess the evidence on the context of home and homelessness, and re-examine the meaning of homelessness in the light of that reassessed evidence; and (5) to explain the political meaning of homelessness as expressed in official definitions, legislation and state provision (or lack of it)

Creating Connections: An Early Look at the Integration of Behavioral Health and Primary Care into Accountable Care Organizations

Despite the potential benefits of models that integrate behavioral health and primary care, fiscal, structural, and cultural barriers prevent organizations from pursuing them. Accountable care organizations (ACOs) may be better positioned to implement integrated care because of modified reimbursement structures with an emphasis on care coordination. This report showcases integration approaches at two ACOs. The first uses a colocation plus collaboration model that improves connectivity between providers through proximity and improved sharing of information. The second uses a model that adds behavioral health specialists to the primary care team to bolster the capacity of PCPs in managing mental health and substance abuse conditions. We identify two factors that enable successful implementation: participation in an ACO and selection of an appropriate model of integration. External partners can support the spread of integrated models of care through education and collaborative learning

The relationship between cell phone use and identity theft

The growth of mobile phone use has paralleled increased reports of identity theft. Identity theft can result in financial loss and threats to a victim\u27s personal safety. Although trends in identity theft are well-known, less is known about individual cell phone users\u27 attitudes toward identity theft and the extent to which they connect it to cell phone use. The purpose of this qualitative study was to determine how cell phone use is affected by attitudes toward privacy and identity theft. The study was based on social impact theory, according to which people\u27s attitudes and behavior are affected by the strength and immediacy of others\u27 attitudes and behavior. The research questions concerned the extent to which participants connected cell phone use with decreasing privacy and increasing cybercrime, how the use of biometrics affected cell phone users\u27 attitudes and behavior, and what steps can be taken to reduce the misuse of private information associated with cell phone use. Data collection consisted of personal interviews with representatives from 3 groups: a private biometrics company, individual cell phone users who earn more than {dollar}55,000 a year, and individual cell phone users who earn less than {dollar}55,000 a year. Interviews were transcribed and coded for themes and patterns. Findings showed that interviewees were more likely to see identity theft as a problem among the public at large than in the industries in which they worked. Participants recommended a variety of measures to improve cell phone security and to reduce the likelihood of identity theft: passwords, security codes, voice or fingerprint recognition, and encryption. The implications for positive social change include informing government officials and individual users about the use and abuse of cell phones in order to decrease violations of privacy and identity theft while still promoting national security

The Problem of Confirmation in the Everett Interpretation

I argue that the Oxford school Everett interpretation is internally incoherent, because we cannot claim that in an Everettian universe the kinds of reasoning we have used to arrive at our beliefs about quantum mechanics would lead us to form true beliefs. I show that in an Everettian context, the experimental evidence that we have available could not provide empirical confirmation for quantum mechanics, and moreover that we would not even be able to establish reference to the theoretical entities of quantum mechanics. I then consider a range of existing Everettian approaches to the probability problem and show that they do not succeed in overcoming this incoherence