Exploration of Health Care Needs Among Sudanese Refugee Women

Many Sudanese refugees that have resettled in the United States have experienced severe trauma and loss during their migration, as well as physical, social, and psychological struggles in their continued adaptation to living in a new country. This study explored the healthcare needs of Sudanese women as they transition to living in the United States. Community-Based Collaborative Action Research (CBCAR) provided a framework for the study. Qualitative descriptive design using focus groups was utilized to explore the healthcare needs of Sudanese Women. Eighteen women participated in the study, which consisted of five educational sessions that were immediately followed by five audio-taped focus groups. The educational seminars presented topics such as parenting skills, preventative health practices, childhood illnesses, and emotional well-being. Focus groups allowed for a confidential setting in which women were able to reflect on the information presented, as well as verbalize topics that they would like to receive more education on in the future. Three themes were identified that reflected experience of Sudanese women. These included being pulled between two worldviews in ways of parenting and communicating with children, multiple difficulties maneuvering within the US health care system, and internal struggles in meeting emotional needs in their transition to living in the United States. This study may contribute to the empowerment of Sudanese women by providing them with a greater understanding and ability to maneuver within the US healthcare system. This partnering interchange may also increase nursing knowledge in offering culturally competent care to the Sudanese community and other refugee populations that have resettled in the United States.University of Kansas School of Nursing. Bachelor of Science in Nursing Honors Progra

Altered cannabinoid receptor expression in pancreatic islets in experimental model of uraemia

Background: Uraemia leads to a number of metabolic and hormonal disorders including defective carbohydrate metabolism. Endocannabinoids exert their effect on insulin and glucagon secretion via activation of specific receptors named CB1 and CB2. For this reason and the absence of reports on location and immunoreactivity of CB1, CB2 receptors compared to immunoreactivity of insulin- and glucagon-secreting cells in experimental uraemia, the author decided to investigate this issue. The aim of the present study was the immunohistochemical localisation and evaluation of cannabinoid receptors (CB1, CB2), insulin and glucagon in the pancreatic islets of uraemic rats. Materials and methods: Fragments of the rat’s pancreas were collected 28 days after surgical resection of one kidney and removal of 70% of the other kidney cortex. Paraffin-embedded sections were stained with haematoxylin-eosin and immunohistochemical reactions were performed with the use of a specific antibody against CB1-, CB2-receptors, insulin and glucagon. Results: It was revealed the decreased immunoreactivity of the CB1 receptor and higher intensity of the immunohistochemical reaction against CB2 receptor as compared to the value in the control animals. Significantly higher immunoreactivity of glucagon-positive cells and weaker immunoreactivity of insulin-positive cells were observed in pancreatic islets of uraemic rats. Conclusions: The obtained results indicate the involvement of cannabinoid receptors in the pathomechanism of carbohydrate metabolism disorders, associated with abnormal secretion of hormones by the α and β cells in uraemia

Functional Differences in Engineered Myocardium from Embryonic Stem Cell-Derived versus Neonatal Cardiomyocytes

Stem cell-derived cardiomyocytes represent unique tools for cell- and tissue-based regenerative therapies, drug discovery and safety, and studies of fundamental heart-failure mechanisms. However, the degree to which stem cell-derived cardiomyocytes compare to mature cardiomyocytes is often debated. We reasoned that physiological metrics of engineered cardiac tissues offer a means of comparison. We built laminar myocardium engineered from cardiomyocytes that were differentiated from mouse embryonic stem cell-derived cardiac progenitors or harvested directly from neonatal mouse ventricles, and compared their anatomy and physiology in vitro. Tissues assembled from progenitor-derived myocytes and neonate myocytes demonstrated similar cytoskeletal architectures but different gap junction organization and electromechanical properties. Progenitor-derived myocardium had significantly less contractile stress and slower longitudinal conduction velocity than neonate-derived myocardium, indicating that the developmental state of the cardiomyocytes affects the electromechanical function of the resultant engineered tissue. These data suggest a need to establish performance metrics for future stem cell applications

Loss of Ccbe1 affects cardiac-specification and cardiomyocyte differentiation in mouse embryonic stem cells

Understanding the molecular pathways regulating cardiogenesis is crucial for the early diagnosis of heart diseases and improvement of cardiovascular disease. During normal mammalian cardiac development, collagen and calcium-binding EGF domain-1 (Ccbe1) is expressed in the first and second heart field progenitors as well as in the proepicardium, but its role in early cardiac commitment remains unknown. Here we demonstrate that during mouse embryonic stem cell (ESC) differentiation Ccbe1 is upregulated upon emergence of Isl1- and Nkx2.5- positive cardiac progenitors. Ccbe1 is markedly enriched in Isl1-positive cardiac progenitors isolated from ESCs differentiating in vitro or embryonic hearts developing in vivo. Disruption of Ccbe1 activity by shRNA knockdown or blockade with a neutralizing antibody results in impaired differentiation of embryonic stem cells along the cardiac mesoderm lineage resulting in a decreased expression of mature cardiomyocyte markers. In addition, knockdown of Ccbe1 leads to smaller embryoid bodies. Collectively, our results show that CCBE1 is essential for the commitment of cardiac mesoderm and consequently, for the formation of cardiac myocytes in differentiating mouse ESCs.Fundacao para a Ciencia e Tecnologia (FCT) [SFRH/BD/82280/2011]; FCT [SFRH/BPD/46506/2008, CEDOC/2015/36/iNOVA4Health/Multi/04462, SFRH/BPD/87114/2012, PTDC/SAU-ENB/121095/2010, HMSP-ICT/0039/2013]; Fundacao para a Ciencia e Tecnologia / Ministerio da Educacao e Ciencia [UID/Multi/04462/2013]; FEDER under the PT2020 Partnership Agreemen

Improving functional maturation of human pluripotent stem cells derived cardiomyocytes through metabolic understanding

In vitro differentiation of human pluripotent stem cells into cardiomyocytes (hPSC-CMs) is a crucial process to enable their application in cell therapy and drug discovery. Nevertheless, despite the remarkable efforts over the last decade towards the optimization of cardiac differentiation protocols, generated hPSC-CMs are still immature, closely reminiscent of fetal cardiomyocytes in what regards structure, metabolism and function. In this study, we aim to overcome this hurdle by devising a novel metabolic-based strategy to improve hPSC-CMs generation and functionality. Noteworthy, we integrated structural and functional analyses of hPSC-CM with powerful “omics” technologies (proteomics, transcriptomics, metabolomics and fluxomics) as complementary analytical tools to support process optimization and product characterization. We relied on the aggregation of hPSC-derived cardiac progenitors to establish a scalable differentiation protocol capable of generating highly pure CM aggregate cultures. Whole-transcriptome analysis and 13C-metabolic flux analysis demonstrated that a three-dimensional (3D) and agitated-based culture environment enhances metabolic maturation of hPSC-CMs. When compared to static monolayer, 3D cultures of hPSC-CMs displayed down-regulation of genes involved in glycolysis and lipid biosynthesis and increased expression of genes involved in OXPHOS. Accordingly, 3D hPSC-CMs had lower fluxes through glycolysis and fatty acid synthesis and increased TCA-cycle activity. We then assessed if alteration of culture medium composition to mimic in vivo substrate usage during cardiac development improved further hPSC-CM maturation in vitro. Our results showed that shifting hPSC-CMs from glucose-containing to galactose- and fatty acid-containing medium promotes their fast maturation into adult-like CMs with higher oxidative metabolism, transcriptional signatures closer to those of adult ventricular tissue, higher myofibril density and alignment, improved calcium handling, enhanced contractility, and more physiological action potential kinetics. “-Omics” analyses showed that addition of galactose to culture medium improves total oxidative capacity of the cells and ameliorates fatty acid oxidation avoiding the lipotoxicity that results from cell exposure to high fatty acid levels. This study demonstrated that metabolic shifts during differentiation/maturation of hPSC-CM are a cause, rather than a consequence, of the phenotypic and functional alterations observed. The metabolic-based strategy established herein holds technical and economic advantages over the existing protocols due to its scalability, simplicity and ease of application. Improved maturation and functionality of in vitro generated hPSC-CM will excel their application in cell therapy, drug discovery and cardiac disease modeling. Funding: This work was supported by FCT-funded projects CardioRegen (HMSP-ICT/0039/2013), NETDIAMOND (SAICTPAC/0047/2015) and MetaCardio (Ref.032566). iNOVA4Health Research Unit (LISBOA-01-0145-FEDER-007344) is also acknowledged

Intensifying the manufacture of hiPSC therapy products through metabolic and process understanding

In vitro differentiation of human induced pluripotent stem cells into specific lineages such as cardiomyocytes (hPSC-CM) and hepatocytes (hPCS-Hep) is a crucial process to enable their application in cell therapy and drug discovery. Nevertheless, despite the remarkable efforts over the last decade towards the implementation of protocols for hPSC expansion and differentiation, there are some technological challenges remaining include the low scalability and differentiation yields. Additionally, generated cells are still immature, closely reminiscent of fetal/embryonic cells in what regards phenotype and function. In this study, we aim to overcome this hurdle by devising bioinspired and integrated strategies to improve the generation and functionality of these hiPSC-derivatives. We also applied robust multi-parametric techniques including proteomics, transcriptomics, metabolomics and fluxomics as complementary analytical tools to support bioprocess optimization and product characterization. We cultured hiPSC as 3D aggregates in stirred-tank bioreactors (STB) operated in perfusion and used a capacitance probe for in situ monitoring of cell growth/differentiation. After cell expansion, the hepatic differentiation step was integrated by addition of key soluble factors and controlling the dissolved oxygen concentration at various stages of the process to generate populations enriched for definitive endoderm, hepatocyte progenitors and mature hepatocytes. The analyses of hepatic markers expression throughout the stages of the differentiation confirmed that hepatocyte differentiation was improved in 3D spheroids when compared to 2D culture. Noteworthy, these hiPSC-HLC exhibited functional characteristics typical of hepatocytes (albumin production, glycogen storage and CYP450 activity). We also demonstrate the potential of dielectric spectroscopy to monitor cell expansion and hepatic differentiation in STB. For CM differentiation, we relied on the aggregation of hPSC-derived cardiac progenitors to establish a scalable differentiation protocol capable of generating highly pure CM aggregate cultures. We assessed if alteration of culture medium composition to mimic in vivo substrate usage during cardiac development improved further hPSC-CM maturation in vitro. Our results showed that shifting hPSC-CMs from glucose-containing to galactose- and fatty acid-containing medium promotes their fast maturation into adult-like CMs with higher oxidative metabolism, transcriptional signatures closer to those of adult ventricular tissue, higher myofibril density and alignment, improved calcium handling, enhanced contractility, and more physiological action potential kinetics. “-Omics” analyses showed that addition of galactose to culture medium and culturing the cells under perfusion improves total oxidative capacity of the cells and ameliorates fatty acid oxidation. This study demonstrated that metabolic shifts during differentiation/maturation of hPSC-CM are a cause, rather than a consequence, of the phenotypic and functional alterations observed. The metabolic-based strategy established herein holds technical and economic advantages over the existing protocols due to its scalability, simplicity and ease of application. Funding: This work was supported by FCT-funded projects NETDIAMOND (SAICTPAC/0047/2015), MetaCardio (Ref.032566) and FCT/ERA-Net (ERAdicatPH; Ref. E-Rare3/0002/2015). iNOVA4Health Research Unit (LISBOA-01-0145-FEDER-007344) is also acknowledged

Engaging Citizens in Environmental Monitoring via Gaming

Citizen science is quickly becoming one of the most effective tools for the rapid and low-cost collection of environmental information, filling a long recognized gap in in-situ data. Incentivizing citizens to participate, however, remains a challenge, with gaming being widely recognized as an effective solution to overcome the participation barrier. Building upon well-known gaming mechanics, games provide the user with a competitive and fun environment. This paper presents three different applications that employ game mechanics and have generated useful information for environmental science. Furthermore, it describes the lessons learnt from this process to guide future efforts

Crowdsourcing In-Situ Data on Land Cover and Land Use Using Gamification and Mobile Technology

Citizens are increasingly becoming involved in data collection, whether for scientific purposes, to carry out micro-tasks, or as part of a gamified, competitive application. In some cases, volunteered data collection overlaps with that of mapping agencies, e.g., the citizen-based mapping of features in OpenStreetMap. LUCAS (Land Use Cover Area frame Sample) is one source of authoritative in-situ data that are collected every three years across EU member countries by trained personnel at a considerable cost to taxpayers. This paper presents a mobile application called FotoQuest Austria, which involves citizens in the crowdsourcing of in-situ land cover and land use data, including at locations of LUCAS sample points in Austria. The results from a campaign run during the summer of 2015 suggest that land cover and land use can be crowdsourced using a simple protocol based on LUCAS. This has implications for remote sensing as this data stream represents a new source of potentially valuable information for the training and validation of land cover maps as well as for area estimation purposes. Although the most detailed and challenging classes were more difficult for untrained citizens to recognize, the agreement between the crowdsourced data and the LUCAS data for basic high level land cover and land use classes in homogeneous areas (ca. 80%) shows clear potential. Recommendations for how to further improve the quality of the crowdsourced data in the context of LUCAS are provided so that this source of data might one day be accurate enough for land cover mapping purposes

The Journal of BSN Honors Research, Volume 5, Issue 1, Summer 2012

University of Kansas School of Nursing. Bachelor of Science in Nursing Honors ProgramExploration Of Health Care Needs Among Sudanese Refugee Women - Albin, J M, Domian, E. Is There An App For That? Developing An Evaluation Rubric For Apps For Use With Adults With Special Needs - Buckler, T, Peterson, M. The Relationship Between Nursing Characteristics And Pain Care Quality - Davis, E, Dunton, N. The Relationship Between Sleep And Night Eating On Weight Loss In Individuals With Severe Mental Illness - Huynh, Thu Nhi, Hamera, E. Examining Nurse Leader/Manager-Physician Communication Strategies: A Pilot Study - Jantzen, M, Ford, D J. Comparison Of Personal, Health And Family Characteristic Of Children With And Without Autism - Martin, A, Bott, M J. Association Between Obstructive Sleep Apnea And Postoperative Adverse Events - Nielsenshultz, Y, Smith, C, Bott, M, Schultz, M P, Cole, C. Challenges Associated With Partnering With Sudanese Refugee Women In Addressing Their Health Issues - Pauls, K L, Baird, M B. Complementary Therapy To Relieve Pediatric Cancer Therapy-Related Symptoms In The Usa - Slaven, A, Williams, P D

Assessing the quality of crowdsourced in-situ land-use and land cover data from FotoQuest Austria application

With the proliferation of mobile phones and the rise of citizen science, the question of whether citizens can be used to complement traditional land surveys, e.g. the Land Use / Cover Area frame statistical Survey (LUCAS), needs further consideration. LUCAS is the European reference dataset for land use and land cover statistics. It is produced every three years using paid surveyors to collect information on land cover and land use at more than 270,000 point locations across all EU states. LUCAS has very strict protocols on data collection and a two-step system to ensure the quality of the data collected. To complement LUCAS, IIASA has developed the FotoQuest Austria (http://fotoquest.at/) app, which aims to engage citizens in exploring Austrian landscapes, geo-tagging land use and land cover across the country using a simplified version of the LUCAS protocol. The app shows the location of nearby points, and once at the location, volunteers take pictures in four cardinal directions and at the point location, recording the type of land use and land cover from a list of options in the app. Implementation of the simplified protocol uses the mobile technology to record the location, the angles of inclination of the phone when taking the pictures, the compass directions and the precision of the GPS to restrict when users can take photographs. These measures were employed to ensure high quality data collection. FotoQuest Austria has been running since the summer of 2015 with more than 2500 points on the ground and more than 12500 pictures collected by volunteers. Advantages of such an approach include the collection of a denser sample and a more frequent revisit time than the 3 year update cycle of LUCAS, which may then be used to detect ongoing change. Additionally, the involvement of citizens in getting to know their surrounding landscapes is a very valuable process and can be a positive vehicle for raising awareness of possible environmental conflicts and issues. This paper compares the results from this ongoing campaign with data from LUCAS. The presentation also outlines the lessons learned and highlights the minimum requirements needed to collect high quality data from volunteers. Recommendations for use of the app to complement LUCAS surveying and its application to other domains will also be discussed