Norma’s project - a research study into the sexual assault of older women in Australia

INTRODUCTION Norma’s Project was conceived in response to the experience of Norma, the mother of one of the four researchers involved in the project. Norma was a confused and vulnerable 83 year old woman who was sexually assaulted by a male staff member during a respite stay in a residential aged care facility in 2011. Norma was able to tell her story coherently and consistently, and she was able to identify her attacker. She was fortunate that her daughter and others, including police and sexual assault workers, listened and believed her account, tried to bring the perpetrator to justice, and worked hard to make her feel safe again. Nonetheless, given the lack of forensic evidence, the case against the perpetrator was not strong enough for a successful court action to be prosecuted. The idea of older women as victims of sexual assault is relatively recent and little understood. However, it is becoming increasingly evident that, despite the silence that surrounds the topic, such assaults occur in many settings and circumstances. The lack of community awareness can be partly attributed to commonly held assumptions that older women are asexual. How, then, can they be the target of sexual assault? What is unimaginable and unacceptable becomes unsayable or invisible. The significant gaps in knowledge about the sexual assault of older women present a major obstacle to the development of frameworks and strategies for prevention and intervention. Consequently the Norma’s Project research team sought funding from the Australian Department of Social Services to address the gaps and increase our understandings of the settings, social contexts and vulnerabilities associated with the sexual assault of older women. The project aims to increase awareness of this important issue both within the community and amongst service providers, and to strengthen the community’s ability to prevent, respond to and speak out about the sexual assault of older women

Got Milk? The Impact of Heifer International\u27s Livestock Donation Programs in Rwanda on Nutritional Outcomes

International animal donation programs have become an increasingly popular way for people living in developed countries to transfer resources to families living in developing countries. We evaluate the impact of Heifer International’s dairy cow and meat goat donation programs in Rwanda. We find that the program substantially increases dairy and meat consumption among Rwandan households who were given a dairy cow or a meat goat, respectively. We also find marginally statistically significant reductions in weight-for-height z-scores and weight-for-age z-scores of about 0.4 standard deviations among children aged 0-5 years in households that were recipients of meat goats, and reductions in heightfor- age z-scores of about 0.5 standard deviations among children in households that received dairy cows. Our results suggest that increasing livestock ownership in developing countries may significantly increase consumption of nutrient dense animal-source foods and improve nutrition outcomes

How the Integration of Telehealth and Coordinated Care Approaches Impact Health Care Service Organization Structure and Ethos: Mixed Methods Study

Background Coordinated care and telehealth services have the potential to deliver quality care to chronically ill patients. They can both reduce the economic burden of chronic care and maximize the delivery of clinical services. Such services require new behaviors, routines, and ways of working to improve health outcomes, administrative efficiency, cost-effectiveness, and user (patient and health professional) experience. Objective The aim of this study was to assess how health care organization setup influences the perceptions and experience of service managers and frontline staff during the development and deployment of integrated care with and without telehealth. Methods As part of a multinational project exploring the use of coordinated care and telehealth, questionnaires were sent to service managers and frontline practitioners. These questionnaires gathered quantitative and qualitative data related to organizational issues in the implementation of coordinated care and telehealth. Three analytical stages were followed: (1) preliminary analysis for a direct comparison of the responses of service managers and frontline staff to a range of organizational issues, (2) secondary analysis to establish statistically significant relationships between baseline and follow-up questionnaires, and (3) thematic analysis of free-text responses of service managers and frontline staff. Results Both frontline practitioners and managers highlighted that training, tailored to the needs of different professional groups and staff grades, was a crucial element in the successful implementation of new services. Frontline staff were markedly less positive than managers in their views regarding the responsiveness of their organization and the pace of change. Conclusions The data provide evidence that the setup of health care services is positively associated with outcomes in several areas, particularly tailored staff training, rewards for good service, staff satisfaction, and patient involvement

Sick and tired : sickness behaviour, polyparasitism and food stress in a gregarious mammal

Although sickness behaviour in response to non-lethal parasites has been documented in wild animals, it remains unclear how social and environmental stress might also shape an animal’s behavioural response to parasitism, nor do we know whether simultaneous infection with more than one parasite changes the way animals respond. Here, we combine physiological, environmental, behavioural and parasite measures to investigate behavioural responses to infection in wild vervet monkeys (Chlorocebus pygerythrus) living in a semi-arid region of South Africa. We quantified both activity budget and behavioural predictability to investigate the occurrence of sickness behaviour and infection with two non-lethal gastrointestinal parasite genera. Higher parasite load was linked to an increase in the time spent resting. However, the nature of the relationship with other behaviours was contingent on both the parasite genus in question and parasite species interacted, highlighting the importance of considering co-infection. Overall, food availability was the dominant predictor of behavioural change suggesting that, for monkeys living in a more extreme environment, coping with ecological stress may override the ability to modulate behaviour in response to other physiological stressors. Our findings provide insight into how animals living in harsh environments find ways to cope with parasite infection, avoidance and transmission. SIGNIFICANCE STATEMENT : Sickness behaviour is a suite of behaviours that occur in response to infection that may serve as an adaptive response to cope with infection. For wild animals, the ability to express sickness behaviour will be modulated by the presence of other competing stressors. Hence, the patterns shown are likely to be more complex than under captive conditions, which is where most of our knowledge of sickness behaviour comes from. Using physiological, environmental, behavioural and parasite measures, we demonstrate that although vervet monkeys (Chlorocebus pygerythrus) living in a semi-arid region of South Africa do exhibit sickness behaviours, this is contingent on the parasite genus in question. Further, food availability was the dominant predictor of behavioural change suggesting that, for monkeys living in a more extreme environment, coping with severe ecological stress may override the ability to express sickness behaviour in an adaptive fashion.National Research Foundation (South Africa), Natural Science and Engineering Research Council of Canada (NSERC) Discovery Grants, the Canada Research Chairs Program, a Leakey Foundation Franklin Mosher Baldwin Memorial Fellowship and a Senior Post-doctoral Fellowship at the University of Pretoria.http://link.springer.com/journal/265hj2022Mammal Research Institut

Reversible Resistance Induced by FLT3 Inhibition: A Novel Resistance Mechanism in Mutant FLT3-Expressing Cells

Clinical responses achieved with FLT3 kinase inhibitors in acute myeloid leukemia (AML) are typically transient and partial. Thus, there is a need for identification of molecular mechanisms of clinical resistance to these drugs. In response, we characterized MOLM13 AML cell lines made resistant to two structurally-independent FLT3 inhibitors.MOLM13 cells were made drug resistant via prolonged exposure to midostaurin and HG-7-85-01, respectively. Cell proliferation was determined by Trypan blue exclusion. Protein expression was assessed by immunoblotting, immunoprecipitation, and flow cytometry. Cycloheximide was used to determine protein half-life. RT-PCR was performed to determine FLT3 mRNA levels, and FISH analysis was performed to determine FLT3 gene expression.We found that MOLM13 cells readily developed cross-resistance when exposed to either midostaurin or HG-7-85-01. Resistance in both lines was associated with dramatically elevated levels of cell surface FLT3 and elevated levels of phosphor-MAPK, but not phospho-STAT5. The increase in FLT3-ITD expression was at least in part due to reduced turnover of the receptor, with prolonged half-life. Importantly, the drug-resistant phenotype could be rapidly reversed upon withdrawal of either inhibitor. Consistent with this phenotype, no significant evidence of FLT3 gene amplification, kinase domain mutations, or elevated levels of mRNA was observed, suggesting that protein turnover may be part of an auto-regulatory pathway initiated by FLT3 kinase activity. Interestingly, FLT3 inhibitor resistance also correlated with resistance to cytosine arabinoside. Over-expression of FLT3 protein in response to kinase inhibitors may be part of a novel mechanism that could contribute to clinical resistance

What does it take to make integrated care work? A ‘cookbook’ for large-scale deployment of coordinated care and telehealth

The Advancing Care Coordination & Telehealth Deployment (ACT) Programme is the first to explore the organisational and structural processes needed to successfully implement care coordination and telehealth (CC&TH) services on a large scale. A number of insights and conclusions were identified by the ACT programme. These will prove useful and valuable in supporting the large-scale deployment of CC&TH. Targeted at populations of chronic patients and elderly people, these insights and conclusions are a useful benchmark for implementing and exchanging best practices across the EU. Examples are: Perceptions between managers, frontline staff and patients do not always match; Organisational structure does influence the views and experiences of patients: a dedicated contact person is considered both important and helpful; Successful patient adherence happens when staff are engaged; There is a willingness by patients to participate in healthcare programmes; Patients overestimate their level of knowledge and adherence behaviour; The responsibility for adherence must be shared between patients and health care providers; Awareness of the adherence concept is an important factor for adherence promotion; The ability to track the use of resources is a useful feature of a stratification strategy, however, current regional case finding tools are difficult to benchmark and evaluate; Data availability and homogeneity are the biggest challenges when evaluating the performance of the programmes

The relationship between lung disease severity and the sputum proteome in cystic fibrosis.

BackgroundProteomics can reveal molecular pathways of disease and provide translational perspectives to inform clinical decision making. Although several studies have previously reported the cystic fibrosis airway proteome, the relationship with severity of lung disease has not been characterised. The objectives of this observational study were to investigate differences in the CF sputum proteome associated with disease severity and identify potential markers of disease with translational potential.MethodsSputum samples from healthy volunteers and cystic fibrosis subjects (some prescribed modulator therapies) were analysed using liquid-chromatography tandem mass spectrometry. Severity of lung disease was based on baseline spirometry (percentage predicted forced expiratory volume in 1 s, FEV1%).ResultsMultiple sputum proteins (108 increased; 202 decreased) were differentially expressed in CF (n = 38) and healthy volunteers (n = 32). Using principal component analysis and hierarchical clustering, differences in sputum proteome were observed associated with progressive lung function impairment. In CF subjects, baseline FEV1% correlated with 87 proteins (positive correlation n = 20, negative n = 67); most were either neutrophil derived, or opposed neutrophil-driven oxidant and protease activity.ConclusionPredictable and quantifiable changes in the CF sputum proteome occurred associated with progressive lung function impairment, some of which might have value as markers of disease severity in CF sputum. Further work validating these markers in other patient cohorts and exploring their clinical utility is needed

Dollar Works 2: Impact Evaluation Summary

This is the summary report. The full report is also available.This archival publication may not reflect current scientific knowledge or recommendations. Current information available from the University of Minnesota Extension: https://www.extension.umn.edu.Dollar Works 2 education is effective for money behaviors, financial satisfaction, and access to financial information when delivered in a sixhour dosage. The impact evaluation study was with community participants who are considered high risk in the financial education field. If financial education can be effective for this population, it will be effective with groups that have fewer problems and tend to seek solutions to their financial issues. This study was conducted during a time that the economic environment was difficult for many people including these who participated in the study. Dollar Works 2 is a personal financial education program developed by the University of Minnesota Extension

Dollar Works 2: Impact Evaluation Report

This is the full report. A summary report is also available.This archival publication may not reflect current scientific knowledge or recommendations. Current information available from the University of Minnesota Extension: https://www.extension.umn.edu.Dollar Works 2 education is effective for money behaviors, financial satisfaction, and access to financial information when delivered in a six-hour dosage. The impact evaluation study was with community participants who are considered high risk in the financial education field. If financial education can be effective for this population, it will be effective with groups that have fewer problems and tend to seek solutions to their financial problems. This study was conducted during a time when the economic environment was difficult for many people including those who participated in the study. Dollar Works 2 is a personal financial education program that was developed by the University of Minnesota Extension

Veterinary trypanocidal benzoxaboroles are peptidase-activated prodrugs

Livestock diseases caused by Trypanosoma congolense, T. vivax and T. brucei, collectively known as nagana, are responsible for billions of dollars in lost food production annually. There is an urgent need for novel therapeutics. Encouragingly, promising antitrypanosomal benzoxaboroles are under veterinary development. Here, we show that the most efficacious subclass of these compounds are prodrugs activated by trypanosome serine carboxypeptidases (CBPs). Drug-resistance to a development candidate, AN11736, emerged readily in T. brucei, due to partial deletion within the locus containing three tandem copies of the CBP genes. T. congolense parasites, which possess a larger array of related CBPs, also developed resistance to AN11736 through deletion within the locus. A genome-scale screen in T. brucei confirmed CBP loss-of-function as the primary mechanism of resistance and CRISPR-Cas9 editing proved that partial deletion within the locus was sufficient to confer resistance. CBP re-expression in either T. brucei or T. congolense AN11736-resistant lines restored drug-susceptibility. CBPs act by cleaving the benzoxaborole AN11736 to a carboxylic acid derivative, revealing a prodrug activation mechanism. Loss of CBP activity results in massive reduction in net uptake of AN11736, indicating that entry is facilitated by the concentration gradient created by prodrug metabolism.</p