Interprofessional Faculty Development: Integration of Oral Health into the Geriatric Diabetes Curriculum, from Theory to Practice.

Georgia Dounis,1 Marcia Ditmyer,2 Susan VanBeuge,3 Sue Schuerman,4 Mildred McClain,1 Kiki Dounis,1,5 Connie Mobley21Department of Clinical Sciences, 2Department of Biomedical Sciences, 3Department of Physiological Nursing, 4Department of Physical Therapy, University of Nevada Las Vegas School of Dental Medicine, Las Vegas, NV, USA; 5Department of Family Medicine, University of Nevada School of Medicine, Reno, NV, USABackground: Health care workforce shortages and an increase demand for health care services by an older demographic challenged by oral–systemic conditions are being recognized across health care systems. Demands are placed on health care professionals to render coordinated delivery of services. Management of oral–systemic conditions requires a trained health care workforce to render interprofessional patient-centered and coordinated delivery of health care services. The purpose of this investigation was to evaluate the effectiveness of an interprofessional health care faculty training program.Methods: A statewide comprehensive type 2 diabetes training program was developed and offered to multidisciplinary health care faculty using innovative educational methods. Video-recorded clinically simulated patient encounters concentrated on the oral–systemic interactions between type 2 diabetes and comorbidities. Post-encounter instructors facilitated debriefing focused on preconceptions, self-assessment, and peer discussions, to develop a joint interprofessional care plan. Furthermore, the health care faculty explored nonhierarchical opportunities to bridge common health care themes and concepts, as well as opportunities to translate information into classroom instruction and patient care.Results: Thirty-six health care faculty from six disciplines completed the pre-research and post-research assessment survey to evaluate attitudes, knowledge, and perceptions following the interprofessional health care faculty training program. Post-training interprofessional team building knowledge improved significantly. The health care faculty post-training attitude scores improved significantly, with heightened awareness of the unique oral–systemic care needs of older adults with type 2 diabetes, supporting an interprofessional team approach to care management. In addition, the health care faculty viewed communication across disciplines as being essential and interprofessional training as being vital to the core curriculum of each discipline. Significant improvement occurred in the perception survey items for team accountability and use of uniform terminology to bridge communication gaps.Conclusion: Attitude, knowledge, and perceptions of health care faculty regarding interprofessional team building and the team approach to management of the oral–systemic manifestations of chronic disease in older adults was improved. Uniform language to promote communication across health professionals, care settings, and caregivers/patients, was noted. Interprofessional team building/care planning should be integrated in core curricula.Keywords: team building, patient-centered care, oral–systemic, older adult

The development of a toxicity database using freshwater macroinvertebrates, and its application to the protection of South African water resources

There is a growing international trend towards the protection of freshwater resources from pollution by imposing instream guidelines and specified waste-discharge conditions. Current methods for devising freshwater quality guidelines are based on species sensitivity distributions (SSDs) that are used to identify pollutant concentrations, ensuring the protection of a modelled percentage of species (95% protection is a common goal). SSDs are derived from the toxicity test results of as many taxa as possible for each polluting substance. Waste-discharge licences can be for single substances, specified in terms of chemical concentrations, and derived in conjunction with instream guidelines; or for complex mixtures, specified in terms of toxic units. In both cases toxicity test results are the core data used. The emphasis on SSDs calls into question the species constituting the test populations. It is likely that SSDs based in part on the responses of local organisms will achieve superior site-specific ecological protection. Until the early 1990s, there were very few data on the tolerances of South African freshwater organisms. In the intervening decade, the Unilever Centre for Environmental Water Quality at Rhodes University has developed a toxicity database that, to date, records the responses of 21 South African freshwater taxa to 26 single-substance pollutants or mixtures. This is the most comprehensive database of South African toxicity responses available and has been used in the drawing up of methods and guidelines to protect water resources. This paper aims to make these data available and to describe applications of the data using selected case studies

Identifying Efficient Transport Pathways in Early-Wood Timber: Insights from 3D X-ray CT Imaging of Softwood in the Presence of Flow

Funder: Leverhulme Trust; doi: http://dx.doi.org/10.13039/501100000275Abstract: Wider use of timber has the potential to greatly reduce the embodied carbon of construction. Improved chemical treatment could help overcome some of the barriers to wider application of timber, by furthering the durability and/or mechanical properties of this natural material. Improving timber treatment by treating the whole volume of a piece of timber, or tailored sections thereof, requires sound understanding and validated modelling of the natural paths for fluid flow through wood. In this study we carry out a robust analysis of three-dimensional X-ray CT measurements on kiln-dried softwood in the presence of flow and identify small portions of early-wood which are uniquely capable of transporting fluids—herein ‘efficient transport pathways’. We successfully model the effects of these pathways on the liquid uptake by timber by introducing a spatial variability in the amount of aspiration of the bordered pits following kiln drying. The model demonstrates that fluid advances along these efficient transport paths between 10 and 30 times faster than in the remainder of the timber. Identifying these efficient transport pathways offers scope to improve and extend the degree to which timber properties are enhanced at an industrial scale through processes to impregnate timber

Comparative Genomics of Cell Envelope Components in Mycobacteria

Mycobacterial cell envelope components have been a major focus of research due to their unique features that confer intrinsic resistance to antibiotics and chemicals apart from serving as a low-permeability barrier. The complex lipids secreted by Mycobacteria are known to evoke/repress host-immune response and thus contribute to its pathogenicity. This study focuses on the comparative genomics of the biosynthetic machinery of cell wall components across 21-mycobacterial genomes available in GenBank release 179.0. An insight into survival in varied environments could be attributed to its variation in the biosynthetic machinery. Gene-specific motifs like ‘DLLAQPTPAW’ of ufaA1 gene, novel functional linkages such as involvement of Rv0227c in mycolate biosynthesis; Rv2613c in LAM biosynthesis and Rv1209 in arabinogalactan peptidoglycan biosynthesis were detected in this study. These predictions correlate well with the available mutant and coexpression data from TBDB. It also helped to arrive at a minimal functional gene set for these biosynthetic pathways that complements findings using TraSH

Reactions of pulmonary emphysema patients before and after VRS - Forcusing on the rehabilitation, activity, surgery -

今まで内科的治療が主体であった肺気腫に対して,近年外科的治療(Volume Reduction Surgery 以後VRSと略す)が行われるようになった｡VRSを受ける患者の看護では,手術前後において, リハビリテーション(以後リハビリと略す)や機能回復に向けてのケアが必要不可欠とされる。そこで,本研究は肺気腫患者の適切な看護援助を検討するために,手術前後に示す肺気腫患者のリハビリや活動に対する反応を明らかにすることを目的とした｡対象者は当病棟に入院している肺気腫患者8名(VRS手術前8名,手術後はそのうちの6名である)で, リハビリ, 日常生活活動,呼吸,手術などについて,面接ならびに観察による調査を行った｡分析の結果,手術前においてリハビリでは≪義務感≫,頑張って行えば呼吸が楽になるという≪期待感≫,≪サポート≫,≪不安≫が,活動では≪活動の制限≫,手術では呼吸が楽になるのではという≪期待感≫,≪おまかせ≫,≪いちかばちかの賭け≫,≪不安≫,≪回復に向けての欲求の高まり≫が明らかになった｡手術後においてリハビリでは≪呼吸が楽になるための手段≫が, 日常生活活動では≪今の状態よりは良くなると いう期待感≫が,手術では≪達成感≫ と≪身体的苦痛≫が,将来については≪ささやかな欲求≫が明らかになった｡Pulmonary emphysema has been mainly treated with medicine, but recently VRS(volume reduction surgery) has been receiving much attention. In nursing care for VRS patients, it is important to help the patient improve his/her daily activities and recover physical function smoothly after surgery. The purpose of this study is to clarify the reactions of pulmonary emphysema patients before and after VRS for appropriate nursing. The subjects were eight pulmonary emphysema patients at a ward in Okayama University Hospital, but six of them completed both before and after VRS data collection. The data were collected by interview and observation, and from medical and nursing records. Contents of the interview included rehabilitation, daily activities, respiratory symptoms, operative stress, and so on. The results were as follows : , , , and on rehabilitation, on activity, , , , , and on surgery were extracted as pre-operative patients's reactions. on rehabilitation, on activity, and on surgery, on future were extracted as post-operative patients's reactions