Qualitative Analysis of Student Physical Therapist Reflective Writing: Does an Interprofessional Discharge Planning Simulation Increase their Understanding of the Role they play In Discharge Planning?

Purpose: The Core Competencies for Entry-Level Practice in Acute Care Physical Therapy provides an expectation of entry-level practice in acute care for physical therapists including discharge planning (DP). Physical therapists (PT), despite having appropriate clinical reasoning and unique skills for determining the functional abilities of patients, are less often a part of the DP process. The purpose of this study was to determine, by use of qualitative analysis of reflective writing, if an interprofessional discharge planning simulation will increase students’ understanding of the role of physical therapy in DP. Methods: Students from physical therapy (n=57), undergraduate nursing (n=36), graduate nurse practitioners (n=2), and social work (n=37) participated in a simulation enhanced interprofessional education (Sim-IPE) DP meeting utilizing simulated participants. DPT students were required to complete a reflection paper on this activity. Reflection papers were reviewed and analyzed to identify trends and main themes regarding the role of physical therapist in the discharge planning process. In addition, and sub-themes were then identified through secondary analysis. Results: Three main themes and seven sub-themes were established based on the direct responses to the reflective questions. The first main theme was that it is imperative to identify the main discharge issue particularly as it relates to patient safety and fall risk and to resolve this issue through the DP process. The second main theme was understanding the roles and responsibilities of an interprofessional DP team. The third theme was the identification of the gaps in knowledge with a lack of understanding of the DP process and insurance regulations. Conclusions: DPT students’ gained better understanding of the PT’s role on the healthcare team as it relates to DP; however, there was a belief that other professions were unaware of the PT’s role. The use of a Sim-IPE DP meeting may improve knowledge regarding the discharge process and the role of the PT

Phosphoethanolamine N-methyltransferase (PMT-1) catalyses the first reaction of a new pathway for phosphocholine biosynthesis in Caenorhabditis elegans

The development of nematicides targeting parasitic nematodes of animals and plants requires the identification of biochemical targets not found in host organisms. Recent studies suggest that Caenorhabditis elegans synthesizes phosphocholine through the action of PEAMT (S-adenosyl-L-methionine:phosphoethanolamine N-methyltransferases) that convert phosphoethanolamine into phosphocholine. Here, we examine the function of a PEAMT from C. elegans (gene: pmt-1; protein: PMT-1). Our analysis shows that PMT-1 only catalyses the conversion of phosphoethanolamine into phospho-monomethylethanolamine, which is the first step in the PEAMT pathway. This is in contrast with the multifunctional PEAMT from plants and Plasmodium that perform multiple methylations in the pathway using a single enzyme. Initial velocity and product inhibition studies indicate that PMT-1 uses a random sequential kinetic mechanism and is feedback inhibited by phosphocholine. To examine the effect of abrogating PMT-1 activity in C. elegans, RNAi (RNA interference) experiments demonstrate that pmt-1 is required for worm growth and development and validate PMT-1 as a potential target for inhibition. Moreover, providing pathway metabolites downstream of PMT-1 reverses the RNAi phenotype of pmt-1. Because PMT-1 is not found in mammals, is only distantly related to the plant PEAMT and is conserved in multiple parasitic nematodes of humans, animals and crop plants, inhibitors targeting it may prove valuable in human and veterinary medicine and agriculture

Analysis of Respiratory Syncytial Virus Preclinical and Clinical Variants Resistant to Neutralization by Monoclonal Antibodies Palivizumab and/or Motavizumab

Background. Palivizumab is a US Food and Drug Administration–approved monoclonal antibody for the prevention of respiratory syncytial virus (RSV) lower respiratory disease in high-risk infants. Motavizumab, derived from palivizumab with enhanced antiviral activity, has recently been tested in humans. Although palivizumab escape mutants have been generated in the laboratory, the development of resistant RSV in patients receiving palivizumab has not been reported previously