Health care leadership development and training: progress and pitfalls

Roberta E Sonnino1,2 1Department of Surgery, Division of Pediatric Surgery, Wayne State University School of Medicine, Detroit, MI, USA; 2RES Coaching LLC, Locust Hill, VA, USA Abstract: Formal training in the multifaceted components of leadership is now accepted as highly desirable for health care leaders. Despite natural leadership instincts, some core leadership competencies (“differentiating competencies”) must be formally taught or refined. Leadership development may begin at an early career stage. Despite the recognized need, the number of comprehensive leadership development opportunities is still limited. Leadership training programs in health care were started primarily as internal institutional curricula, with a limited scope, for the development of faculty or practitioners. More comprehensive national leadership programs were developed in response to the needs of specific cohorts of individuals, such as programs for women, which are designed to increase the ranks of senior women leaders in the health sciences. As some programs reach their 20th year of existence, outcomes research has shown that health care leadership training is most effective when it takes place over time, is comprehensive and interdisciplinary, and incorporates individual/institutional projects allowing participants immediate practical application of their newly acquired skills. The training should envelop all the traditional health care domains of clinical practice, education, and research, so the leader may understand all the activities taking place under his/her leadership. Early career leadership training helps to develop a pipeline of leaders for the future, setting the foundation for further development of those who may chose to pursue significant leadership opportunities later in their career. A combination of early and mid-to-late career development may represent the optimal training for effective leaders. More training programs are needed to make comprehensive leadership development widely accessible to a greater number of potential health care leaders. This paper addresses the skills that health care leaders should develop, the optimal leadership development concepts that must be acquired to succeed as a health care leader today, some resources for where such training may be obtained, and what gaps are still present in today’s system. Keywords: leadership competencies, leadership traits, leadership skills, health care, training&nbsp

Liposomes functionalized with GT1b ganglioside with high affinity for amyloid \u3b2-peptide

Alzheimer's Disease (AD) is a neurodegenerative disorder that affects millions of individuals world-wide. Accumulation of amyloid-\u3b2 peptide (A\u3b2) in the brain, and its aggregation into oligomers, fibrils and plaques, plays a central role in the onset and development of AD. Starting from this observation, the E.C. FP7 project "NAD" (Nanoparticles for therapy and diagnosis of Alzheimer's disease) is involved in the design of nanoparticles that recognize and remove brain A\u3b2. Previous investigations by NAD Consortium have already produced nanoparticles containing anionic phospholipids or curcumin-analogues able to bind A\u3b2 with very high affinity, to inhibit fibril formation and to reduce A\u3b2 toxicity in-vitro. Starting from the observation that ganglioside GT1b binds A\u3b2 in vitro, we have synthesized liposomes, composed of sphingomyelin and cholesterol and containing GT1b ganglioside, and investigated their affi nity towards A\u3b2 peptide. Surface Plasmon Resonance experiments showed a good interaction of liposomes with A\u3b2 fibrils, displaying Kd values between 125 and 150 nM. Moreover, A\u3b2 aggregation into fi brils, measured by Thiofl avin T and Congo Red binding assays, was reduced of about 50%, after two weeks of monomeric peptide incubation in the presence of GT1b-containing liposomes. The ability of GT1b-containing liposomes, and the other liposomes previously described by NAD research, to bind A\u3b2 and to reduce fi brils formation, increases the interest in studying them as possible future diagnostic and therapeutic tools for the treatment of Alzheimer Disease

Lipid-based nanoparticles with high binding affinity for amyloid-\u3b21-42 peptide

The neurotoxic beta-amyloid peptide (A\u3b2), formed in anomalous amounts in Alzheimer\u2019s disease (AD), is released as monomer and then undergoes aggregation forming oligomers, fibrils and plaques in diseased brains. A\u3b2 aggregates are considered as possible targets for therapy and/or diagnosis of AD. Since nanoparticles (NPs) are promising vehicles for imaging probes and therapeutic agents, we realized and characterized two types of NPs (liposomes and solid lipid nanoparticles, 145 and 76 nm average size, respectively) functionalized to target A\u3b21\u201342 with high affinity. Preliminary immunostaining studies identified anionic phospholipids [phosphatidic acid (PA) and cardiolipin (CL)] as suitable A\u3b21\u201342 ligands. PA/CL-functionalized, but not plain, NPs interacted with A\u3b21\u201342 aggregates as indicated by ultracentrifugation experiments, in which binding reaction occurred in solution, and by Surface Plasmon Resonance (SPR) experiments, in which NPs flowed onto immobilized A\u3b21\u201342. All these experiments were carried out in buffered saline. SPR studies indicated that, when exposed on NPs surface, PA/CL display very high affinity for A\u3b21\u201342 fibrils (22\u201360 nm), likely because of the occurrence of multivalent interactions which markedly decrease the dissociation of PA/CL NPs from A\u3b2. Noteworthy, PA/CL NPs did not bind to bovine serum albumin. The PA/CL NPs described in this work are endowed with the highest affinity for A\u3b2 so far reported. These characteristics make our NPs a very promising vector for the targeted delivery of potential new diagnostic and therapeutic molecules to be tested in appropriate animal models