Plain language communication as a priority competency for medical professionals in a globalized world

This brief report aims to highlight the impact of globalization – the international movement of goods, people, and ideas – on patient-provider communication in medical training and practice, and how the implementation of plain language communication training as a core competency for care providers can mitigate this impact. Globalization influences both patient and provider population diversity, which presents challenges with regard to patient-provider communication, particularly in cases of limited health literacy. Plain language communication - the delivery of information in a simple, succinct, and accurate manner - can help address these challenges. Training in plain language communication, however, is not a part of standard education for health care providers. Based on a synthesis of relevant literature pertaining to globalization, plain language communication, and medical education curricula, it is hoped that the information presented establishes the need for plain language communication as a core competency in medical education to enable providers to better meet the needs of an increasingly globalized health system

Communicating climate change risk: A content analysis of ipcc\u27s summary for policymakers

This study investigated the effectiveness of climate change risk communication in terms of its theoretical potential to stimulate recipients\u27 awareness and behavioral change. We selected the summary for policy makers (SPM) of the most recent Intergovernmental Panel on Climate Change (IPCC) report in order to conduct a content analysis; the extended parallel process model and construal level theory served as conceptual lenses to perform the analysis. Specifically, we evaluated to what extent the SPM included informational elements of threat, efficacy and psychological distance related to climate change. The results showed that threat information was prominently present, but efficacy information was less frequently included, and when it was, more often in the latter parts of the SPM. With respect to construal level it was found that in the IPCC report concrete representations were used only sparingly. Theoretical relevance and implications for climate change risk communication with key audiences are discussed

Increased Expression of SVCT2 in a New Mouse Model Raises Ascorbic Acid in Tissues and Protects against Paraquat-Induced Oxidative Damage in Lung

A new transgenic mouse model for global increases in the Sodium Dependent Vitamin C transporter 2 (SVCT2) has been generated. The SVCT2-Tg mouse shows increased SVCT2 mRNA levels in all organs tested and correspondingly increased ascorbic acid (ASC) levels in all organs except liver. The extent of the increase in transporter mRNA expression differed among mice and among organs. The increased ASC levels did not have any adverse effects on behavior in the SVCT2-Tg mice, which did not differ from wild-type mice on tests of locomotor activity, anxiety, sensorimotor or cognitive ability. High levels of SVCT2 and ASC were found in the kidneys of SVCT2-Tg mice and urinary albumin excretion was lower in these mice than in wild-types. No gross pathological changes were noted in kidneys from SVCT2-Tg mice. SVCT2 immunoreactivity was detected in both SVCT2 and wild-type mice, and a stronger signal was seen in tubules than in glomeruli. Six treatments with Paraquat (3x10 and 3x15 mg/kg i.p.) were used to induce oxidative stress in mice. SVCT2-Tg mice showed a clear attenuation of Paraquat-induced oxidative stress in lung, as measured by F2-isoprostanes. Paraquat also decreased SVCT2 mRNA signal in liver, lung and kidney in SVCT2-Tg mice

Novel digital food photos resource enhances knowledge of nutrition and dietetics students

A robust knowledge of food composition, the Australian food supply and cooking methods is integral to dietetics practice. Students learn these concepts across a variety of subjects, however a new dietetics subject in 2009 and a faculty based learning and teaching grant provided a timely opportunity to develop innovative new digital resources for students to enhance their food composition knowledge. One-hundred and sixty high quality digital food photographs were developed and nutrient composition data were added, before making the resource accessible to students via their eLearning sites. The primary aim of this study was to assess the views and experiences of first and fourth year students regarding the usefulness and application of the digital food photos resource in developing their food composition knowledge. The secondary aim was to identify and explore other potential applications of the resource and recommendations for future upgrades. Forty students completed an online survey and six took part in semi-structured qualitative interviews, which were facilitated by the same two researchers, before being digitally recorded and transcribed verbatim. Preliminary findings highlighted that students found the resource to be an interactive and valuable contributor to their knowledge, I loved it. I absolutely loved it. Like I sat on it for hours going through it (S1). All of the fourth year respondents said they would use the resource again, as did 83% of the first year students. A revised edition is currently being developed with 180 additional photographs and student feedback about further nutrients, symbols used and future commercial applications

The BAT AGN Spectroscopic Survey -- XVIII. Searching for Supermassive Black Hole Binaries in the X-rays

Theory predicts that a supermassive black hole binary (SMBHB) could be observed as a luminous active galactic nucleus (AGN) that periodically varies on the order of its orbital timescale. In X-rays, periodic variations could be caused by mechanisms including relativistic Doppler boosting and shocks. Here we present the first systematic search for periodic AGNs using $941$ hard X-ray light curves (14-195 keV) from the first 105 months of the Swift Burst Alert Telescope (BAT) survey (2004-2013). We do not find evidence for periodic AGNs in Swift-BAT, including the previously reported SMBHB candidate MCG+11$-$11$-$032. We find that the null detection is consistent with the combination of the upper-limit binary population in AGNs in our adopted model, their expected periodic variability amplitudes, and the BAT survey characteristics. We have also investigated the detectability of SMBHBs against normal AGN X-ray variability in the context of the eROSITA survey. Under our assumptions of a binary population and the periodic signals they produce which have long periods of hundreds of days, up to $13$% true periodic binaries can be robustly distinguished from normal variable AGNs with the ideal uniform sampling. However, we demonstrate that realistic eROSITA sampling is likely to be insensitive to long-period binaries because longer observing gaps reduce their detectability. In contrast, large observing gaps do not diminish the prospect of detecting binaries of short, few-day periods, as 19% can be successfully recovered, the vast majority of which can be identified by the first half of the survey.Comment: 17 pages, including 8 figures and 4 tables. Accepted for publication in Ap

BAT AGN spectroscopic survey - XV: the high frequency radio cores of ultra-hard X-ray selected AGN

We have conducted 22 GHz radio imaging at 1 arcsec resolution of 100 low-redshift AGN selected at 14–195 keV by the Swift-BAT. We find a radio core detection fraction of 96 per cent, much higher than lower frequency radio surveys. Of the 96 radio-detected AGN, 55 have compact morphologies, 30 have morphologies consistent with nuclear star formation, and 11 have sub-kpc to kpc-scale jets. We find that the total radio power does not distinguish between nuclear star formation and jets as the origin of the radio emission. For 87 objects, we use optical spectroscopy to test whether AGN physical parameters are distinct between radio morphological types. We find that X-ray luminosities tend to be higher if the 22 GHz morphology is jet-like, but find no significant difference in other physical parameters. We find that the relationship between the X-ray and core radio luminosities is consistent with the L_R/L_X ∼ 10⁻⁵ of coronally active stars. We further find that the canonical fundamental planes of black hole activity systematically overpredict our radio luminosities, particularly for objects with star formation morphologies

The Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study protocol: a cross-sectional, lifespan, multidisciplinary examination of healthy cognitive ageing.

BACKGROUND: As greater numbers of us are living longer, it is increasingly important to understand how we can age healthily. Although old age is often stereotyped as a time of declining mental abilities and inflexibility, cognitive neuroscience reveals that older adults use neural and cognitive resources flexibly, recruiting novel neural regions and cognitive processes when necessary. Our aim in this project is to understand how age-related changes to neural structure and function interact to support cognitive abilities across the lifespan. METHODS/DESIGN: We are recruiting a population-based cohort of 3000 adults aged 18 and over into Stage 1 of the project, where they complete an interview including health and lifestyle questions, a core cognitive assessment, and a self-completed questionnaire of lifetime experiences and physical activity. Of those interviewed, 700 participants aged 18-87 (100 per age decile) continue to Stage 2 where they undergo cognitive testing and provide measures of brain structure and function. Cognition is assessed across multiple domains including attention and executive control, language, memory, emotion, action control and learning. A subset of 280 adults return for in-depth neurocognitive assessment in Stage 3, using functional neuroimaging experiments across our key cognitive domains.Formal statistical models will be used to examine the changes that occur with healthy ageing, and to evaluate age-related reorganisation in terms of cognitive and neural functions invoked to compensate for overall age-related brain structural decline. Taken together the three stages provide deep phenotyping that will allow us to measure neural activity and flexibility during performance across a number of core cognitive functions. This approach offers hypothesis-driven insights into the relationship between brain and behaviour in healthy ageing that are relevant to the general population. DISCUSSION: Our study is a unique resource of neuroimaging and cognitive measures relevant to change across the adult lifespan. Because we focus on normal age-related changes, our results may contribute to changing views about the ageing process, lead to targeted interventions, and reveal how normal ageing relates to frail ageing in clinicopathological conditions such as Alzheimer's disease.The Cambridge Centre for Ageing and Neuroscience (Cam-CAN) research was supported by the Biotechnology and Biological Sciences Research Council (grant number BB/H008217/1).This is the final published version of the article. It first appeared from BioMed Central via http://dx.doi.org/10.1186/s12883-014-0204-

TGFb2 induces the soluble isoform of CTLA-4 – implications for CTLA-4 based checkpoint inhibitor antibodies in malignant melanoma

FUNDING This work was funded by the Chief Scientist’s office, Scotland grant no. ETM/280. Acknowledgments Microscopy was performed in the Microscopy and Histology Core Facility at the University of Aberdeen. Flow cytometry was performed in the Iain Fraser Cytometry Centre. We are very grateful to our lab manager Ms. Gill Moir for her assistance with this work and also to the many BSc/MSc project students who worked on this project. We are extremely grateful for all of the volunteer melanoma patient donors and healthy donors that supported this work. FA-F received an Elphinstone PhD scholarship funded by the School of Medicine, Medical Sciences & Nutrition at the University of Aberdeen.Peer reviewedPublisher PD

BASS XXXIX: Swift-BAT AGN with changing-look optical spectra

Changing-look (CL) AGN are unique probes of accretion onto supermassive black holes (SMBHs), especially when simultaneous observations in complementary wavebands allow investigations into the properties of their accretion flows. We present the results of a search for CL behaviour in 412 Swift-BAT detected AGN with multiple epochs of optical spectroscopy from the BAT AGN Spectroscopic Survey (BASS). 125 of these AGN also have 14-195 keV ultra-hard X-ray light-curves from Swift-BAT which are contemporaneous with the epochs of optical spectroscopy. Eight CL events are presented for the first time, where the appearance or disappearance of broad Balmer line emission leads to a change in the observed Seyfert type classification. Combining with known events from the literature, 21 AGN from BASS are now known to display CL behaviour. Nine CL events have 14-195 keV data available, and five of these CL events can be associated with significant changes in their 14-195 keV flux from BAT. The ultra-hard X-ray flux is less affected by obscuration and so these changes in the 14-195 keV band suggest that the majority of our CL events are not due to changes in line-of-sight obscuration. We derive a CL rate of 0.7-6.2 per cent on 10-25 year time-scales, and show that many transitions happen within at most a few years. Our results motivate further multi-wavelength observations with higher cadence to better understand the variability physics of accretion onto SMBHs.Comment: 14 pages, 7 figures, plus appendix. v2: updated references. Published in MNRA

The BAT AGN Spectroscopic Survey. XVIII. Searching for Supermassive Black Hole Binaries in X-Rays

Theory predicts that a supermassive black hole binary (SMBHB) could be observed as a luminous active galactic nucleus (AGN) that periodically varies on the order of its orbital timescale. In X-rays, periodic variations could be caused by mechanisms including relativistic Doppler boosting and shocks. Here we present the first systematic search for periodic AGNs using 941 hard X-ray light curves (14–195 keV) from the first 105 months of the Swift Burst Alert Telescope (BAT) survey (2004–2013). We do not find evidence for periodic AGNs in Swift-BAT, including the previously reported SMBHB candidate MCG+11−11−032. We find that the null detection is consistent with the combination of the upper-limit binary population in AGNs in our adopted model, their expected periodic variability amplitudes, and the BAT survey characteristics. We have also investigated the detectability of SMBHBs against normal AGN X-ray variability in the context of the extended ROentgen Survey with an Imaging Telescope Array (eROSITA) survey. Under our assumptions of a binary population and the periodic signals they produce, which have long periods of hundreds of days, up to 13% true periodic binaries can be robustly distinguished from normal variable AGNs with the ideal uniform sampling. However, we demonstrate that realistic eROSITA sampling is likely to be insensitive to long-period binaries because longer observing gaps reduce their detectability. In contrast, large observing gaps do not diminish the prospect of detecting binaries of short, few-day periods, as 19% can be successfully recovered, the vast majority of which can be identified by the first half of the survey