Certified Medical Assistants (CMA) the Key to a More Efficient Healthcare System? An Investigation into the Roles and Functions of CMAs and State Scope-of-Practice Laws

The delivery of care has changed dramatically in the past two decades to improve efficiency and quality of care. The shift from disease-centered care to patient-centered care has prompted new roles in healthcare to emerge. One of the fastest growing healthcare professions is Medical Assistants (MA). The MA role is changing and has the potential to meet the demands of a rapidly evolving health care system. This study investigates the differences in scope of practice for CMAs, identifies the roles CMAs fill in patient care, identifies gaps in the workforce, and proposes solutions for addressing these gaps.Master of Science in Public Healt

Lack of pairing during meiosis triggers multigenerational transgene silencing in Caenorhabditis elegans

Transgenes can be permanently silenced in a single generation via a previously described small RNA-induced epigenetic silencing (RNAe) mechanism, which is promoted by the presence of a perfect Piwi-interacting RNA (piRNA) target site. In this study, we identify a previously unidentified mechanism capable of silencing single-copy transgenes that lack perfect piRNA target sites and that is triggered by a lack of chromosomal pairing during meiosis for multiple generations. Multigenerational RNAe can lead to reversible or permanent transgene silencing and may provide insight into variability in the expression of single-copy transgenes or single-copy genomic insertions, which are commonly used in experimental biology. Our analysis of “multigenerational RNAe” also offers new insights into potentially common epigenetic silencing events relevant to genome expression in the germline and embryo

A Competência em Informação (Coinfo) na perspectiva da educação inclusiva

Tese (doutorado)—Universidade de Brasília, Faculdade de Ciência da Informação, Programa de Pós-Graduação em Ciência da Informação, 2017.Discute os desafios da sociedade da informação no que tange à promoção e garantia de uma educação inclusiva a partir de uma agenda estabelecida em ambiências supranacionais, internacionais e multilaterais. Destaca a necessidade de formação de professores para lidar com necessidades informacionais emergentes da prática educativa, em especial quando aplicada a pessoas com deficiência. Neste contexto, situa nos aspectos interdisciplinares entre Ciência da Informação e Educação, contribuições relacionadas tanto à inclusão quanto à atuação de docentes da Educação Básica. Admite os pressupostos teóricos e práticos da temática Competência em Informação – termo adotado para o conceito de Information Literacy – como alternativa de formação de docentes da Educação Básica na perspectiva de uma educação inclusiva. Propõe a utilização de um percurso metodológico baseado nas contribuições de estudos sobre o Paradigma Indiciário de Ginzburg o qual é composto por uma fase exploratória e uma fase aplicada. Na fase exploratória utiliza a produção científica de Ciência da Informação, especialmente nos trabalhos divulgados no Encontro Nacional de Pesquisa e Pós graduação em Ciência da Informação para identificar tendências de pesquisa sobre Competência em Informação e possíveis relações com a inclusão. Discute estas tendências relacionando-as com a tridimensionalidade que o termo inclusão propõe, a saber, inclusão social, inclusão digital e inclusão relacionada a pessoas com deficiência. Realiza a aplicação de pré testes (denominados de Pré Testes Indiciais) em situações de formação de professores. Adicionalmente analisa 18 modelos de Competência em Informação desenvolvidos em contextos internacionais cuja síntese permitiu propor grade básica para elaboração de um modelo de Competência em Informação. Na fase aplicada admite a influência teórica de conceitos de mediação como norteador da prática. Adicionalmente utiliza como método de abordagem a problematização e como técnica o desenvolvimento de um curso de formação de professores com 22 professores de uma escola púbica do Distrito Federal. Utilizou recursos didáticos originais elaborados para esta pesquisa, combinados com procedimentos de utilização e avaliação do modelo pedagógico para formação de professores em Competência em Informação numa perspectiva inclusiva. Na fase aplicada analisa a utilização deste modelo nas atividades, objetivos e habilidades propostas nas três etapas em que se estrutura, nomeadamente, pré-busca, busca propriamente dita e pós-busca. As atividades foram desenvolvidas e analisadas principalmente nas duas etapas do modelo- pré-busca e busca. Atividades de pós-busca não foram realizadas, visto que exigiriam abordagem longitudinal. Os resultados das atividades mostraram que a proposta pedagógica desenvolvida e aplicada é útil para a formação de professores de Educação Básica, em Competência em Informação numa perspectiva inclusiva.This research discusses the challenges of the information society regarding the promotion and assurance of an inclusive education based on an agenda established in supranational, international and multilateral environments. It highlights the need for teacher training to deal with informational needs emerging from educational practice, especially when applied to people with disabilities. In this context, it focuses on the interdisciplinary aspects between Information Science and Education contributions related to the inclusion and also the performance of Basic Education teachers. It admits the theoretical and practical assumptions of the theme Information Competency - a term adopted to the Information Literacy concept - as an alternative to Basic Education teachers’ training from the perspective of an inclusive education. It offers the use of a methodological path based on the contributions from studies on the Ginzburg Evidential Paradigm which is composed by an exploratory phase and an applied phase. In the exploratory phase it uses the scientific production of Information Science, especially in the works published in the National Meeting of Research and Postgraduate in Information Science to identify research trends about Information Competency and its possible relation to inclusion. It discusses those trends by relating them to the tridimensionality proposed by the term inclusion, namely, social inclusion, digital inclusion and inclusion related to people with disabilities. It performs the application of pre-tests (called Evidential Pre-tests) in situations of teacher training. Additionally it analyzes 18 models of Information Competency developed in international contexts which synthesis allowed proposing a basic grade to elaborate an Information Competency model. In the applied phase, it admits the theoretical influence of mediation concepts as a guide to the practice. Additionally it uses the problematization as an approach method and as technique the development of a teacher training course with 22 teachers from a public school in the Federal District. It used original didactic resources elaborated for this research combined with use and evaluation procedures of the pedagogical model for teachers’ training in Information Competency through an inclusive perspective. In the applied phase, it analyzes the use of this model on the activities, goals and abilities proposed through the three stages in which it is structured, namely pre-search, search itself and post-search. The activities were developed and analyzed mainly in the model stages of pre-search and search. Post-search activities were not performed, as they would require a longitudinal approach. The results of the activities showed that the pedagogical proposal developed and applied is useful to Basic Education teachers’ training in Information Competency through an inclusive perspective

Lack of pairing during meiosis triggers multigenerational transgene silencing in Caenorhabditis elegans

Single-copy transgenes in Caenorhabditis elegans can be subjected to a potent, irreversible silencing process termed small RNA-induced epigenetic silencing (RNAe). RNAe is promoted by the Piwi Argonaute protein PRG-1 and associated Piwi-interacting RNAs (piRNAs), as well as by proteins that promote and respond to secondary small interfering RNA (siRNA) production. Here we define a related siRNA-mediated silencing process, termed “multigenerational RNAe,” which can occur for transgenes that are maintained in a hemizygous state for several generations. We found that transgenes that contain either GFP or mCherry epitope tags can be silenced via multigenerational RNAe, whereas a transgene that possesses GFP and a perfect piRNA target site can be rapidly and permanently silenced via RNAe. Although previous studies have shown that PRG-1 is typically dispensable for maintenance of RNAe, we found that both initiation and maintenance of multigenerational RNAe requires PRG-1 and the secondary siRNA biogenesis protein RDE-2. Although silencing via RNAe is irreversible, we found that transgene expression can be restored when hemizygous transgenes that were silenced via multigenerational RNAe become homozygous. Furthermore, multigenerational RNAe was accelerated when meiotic pairing of the chromosome possessing the transgene was abolished. We propose that persistent lack of pairing during meiosis elicits a reversible multigenerational silencing response, which can lead to permanent transgene silencing. Multigenerational RNAe may be broadly relevant to single-copy transgenes used in experimental biology and to shaping the epigenomic landscape of diverse species, where genomic polymorphisms between homologous chromosomes commonly result in unpaired DNA during meiosis

Characteristics of Herbal Medicine Users and Adverse Events Experienced in South Korea: A Survey Study

Background. This survey aimed to investigate the characteristics of users and nonusers of herbal medicine and the adverse events experienced due to herbal medicines in South Korea. Methods. The questionnaire consisted of safety, using experience, using type, usage and nonusage reason, purchase location, and adverse events of herbal medicine. The survey was administered by online. Results. Of the total 1,134 respondents, 726 (64.0%) considered herbal medicine safe, and 693 (61.1%) answered that they have taken herbal medicines within the past year. Most common place to purchase them was “TKM hospital or clinic” (63.6%), and most participants (72.2%) took a decoction from a TKM institution. The biggest reason for taking them was for “health improvement” (57.3%), and the reasons for not using them was “medication not necessary” (63.7%). Among those who took herbal medicines, 46 experienced adverse events, and the most frequently reported symptoms were digestive disorders (52.2%). Of the 46 participants who experienced adverse events, 20 (43.5%) were treated by TKM doctors. Conclusions. This study suggests that regulation of herbal medicines is needed in order to resolve problems related to the safety of herbal medicines

Herbal Medicines for Treating Metabolic Syndrome: A Systematic Review of Randomized Controlled Trials

Objective. The aim of this systematic review is to evaluate the efficacy and safety of herbal medicines in the management of metabolic syndrome. Materials and Methods. On December 9, 2015, we searched PubMed, EMBASE, Cochrane Library, SCOPUS, AMED, CNKI, KoreaMed, KMBASE, OASIS, and J-STAGE with no restriction on language or published year. We selected randomized controlled trials that involved patients with metabolic syndrome being treated with herbal medicines as intervention. The main keywords were “Chinese herbal medicines”, “metabolic syndrome”, and “randomized controlled trials”. Herbal substances which were not based on East Asian medical theory, combination therapy with western medicines, and concurrent diseases other than metabolic syndrome were excluded. The risk of bias was assessed by Cochrane’s “Risk of Bias” tool. The protocol or review was registered in PROSPERO (an international prospective register of systematic reviews) (CRD42014006842). Results. From 1,098 articles, 12 RCTs were included in this review: five trials studied herbal medicines versus a placebo or no treatment, and seven trials studied herbal medicines versus western medicines. Herbal medicines were effective on decreasing waist circumference, blood glucose, blood lipids, and blood pressure. Conclusion. This study suggests the possibility that herbal medicines can be complementary and alternative medicines for metabolic syndrome

Experiences Providing Medical Assistance during the Sewol Ferry Disaster Using Traditional Korean Medicine

Background. This study aimed to investigate medical records using traditional Korean medicine (TKM) in Sewol Ferry disaster in 2014 and further explore the possible role of traditional medicine in disaster situation. Methods. After Sewol Ferry accident, 3 on-site tents for TKM assistance by the Association of Korean Medicine (AKOM) in Jindo area were installed. The AKOM mobilized volunteer TKM doctors and assistants and dispatched each on-site tent in three shifts within 24 hours. Anyone could use on-site tent without restriction and TKM treatments including herb medicine were administered individually. Results. The total of 1,860 patients were treated during the periods except for medical assistance on the barge. Most patients were diagnosed in musculoskeletal diseases (66.4%) and respiratory diseases (7.4%) and circulatory diseases (8.4%) followed. The most frequently used herbal medicines were Shuanghe decoction (80 days), Su He Xiang Wan (288 pills), and Wuji powder (73 days). Conclusions. TKM in medical assistance can be helpful to rescue worker or group life people in open shelter when national disasters occur. Therefore, it is important to construct a rapid respond system using TKM resources based on experience

Additional file 1: of Smoking cessation programmes using traditional medicine in Korea

Guideline on Health Insurance supported smoking cessation treatment. (PDF 3560 KB