Informative material for patient empowerment in sensitive situations

Women diagnosed with HPV face a hard-to-understand disease that may impact their psychological and physical health and may pose challenges communicating with healthcare providers in sensitive settings. We posit patient empowerment through targeted educational materials can improve sensitive communication and lead to better health outcomes. This study measured the impact of a patient-empowerment process used in a gynecology clinic for HPV patients to improve sensitive communication during medical-related meetings and on subsequent patient empowerment outcomes. The empowerment process was based on expert-vetted informative material made accessible in the physician’s waiting room on tablet devices. Communication between physicians and patients was measured during medical visits via a direct observation, encoding process. Empowerment items were tested following medical visits. The results were compared to a control group that received non-medical, lifestyle material. 237 female, gynecology patients from a large, private clinic participated. Using expert-vetted, relevant material to enhance patient education in a clinical setting results in higher levels of patient empowerment. Physician interaction impacts patient empowerment as do various communication behaviors and this can lead to positive health outcomes. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

Possible Origin of Memory in Earthquakes: Real catalogs and ETAS model

Earthquakes are one of the most devastating natural disasters that plague society. A skilled, reliable earthquake forecasting remains the ultimate goal for seismologists. Using the detrended fluctuation analysis (DFA) and conditional probability (CP) methods we find that memory exists not only in inter-occurrence seismic records, but also in released energy as well as in the series of the number of events per unit time. Analysis of the conventional earthquake model (Epidemic Type Aftershock Sequences, ETAS) indicates that earthquake memory can be reproduced only for a narrow range of model's parameters. This finding, therefore provides additional accuracy on the model parameters through tight restrictions on their values in different worldwide regions and can serve as a testbed for existing earthquake forecasting models

Receptor Heteromerization Expands the Repertoire of Cannabinoid Signaling in Rodent Neurons

A fundamental question in G protein coupled receptor biology is how a single ligand acting at a specific receptor is able to induce a range of signaling that results in a variety of physiological responses. We focused on Type 1 cannabinoid receptor (CB1R) as a model GPCR involved in a variety of processes spanning from analgesia and euphoria to neuronal development, survival and differentiation. We examined receptor dimerization as a possible mechanism underlying expanded signaling responses by a single ligand and focused on interactions between CB1R and delta opioid receptor (DOR). Using co-immunoprecipitation assays as well as analysis of changes in receptor subcellular localization upon co-expression, we show that CB1R and DOR form receptor heteromers. We find that heteromerization affects receptor signaling since the potency of the CB1R ligand to stimulate G-protein activity is increased in the absence of DOR, suggesting that the decrease in CB1R activity in the presence of DOR could, at least in part, be due to heteromerization. We also find that the decrease in activity is associated with enhanced PLC-dependent recruitment of arrestin3 to the CB1R-DOR complex, suggesting that interaction with DOR enhances arrestin-mediated CB1R desensitization. Additionally, presence of DOR facilitates signaling via a new CB1R-mediated anti-apoptotic pathway leading to enhanced neuronal survival. Taken together, these results support a role for CB1R-DOR heteromerization in diversification of endocannabinoid signaling and highlight the importance of heteromer-directed signal trafficking in enhancing the repertoire of GPCR signaling

Scaling laws in earthquake memory for interevent times and distances

Over the past decades much effort has been devoted towards understanding and forecasting natural hazards. However, earthquake forecasting skill is still very limited and remains a great scientific challenge. The limited earthquake predictability is partly due to the erratic nature of earthquakes and partly to the lack of understanding the underlying mechanisms of earthquakes. To improve our understanding and potential forecasting, here we study the spatial and temporal long-term memory of interevent earthquakes above a certain magnitude using lagged conditional probabilities. We find, in real data, that the lagged conditional probabilities show long-term memory for both the interevent times and interevent distances and that the memory functions obey scaling and decay slowly with time, while, at a characteristic time, the decay crossesover to a fast decay. We also show that the ETAS model, which is often used to forecast earthquake events, yields scaling functions of the temporal and spatial interevent intervals which are not consistent with those of real data

Emergence of Novel Streptococcus iniae Exopolysaccharide-Producing Strains following Vaccination with Nonproducing Strains ▿ †

Streptococcus iniae is a major pathogen of fish, producing fatal disease among fish species living in very diverse environments. Recently, reoccurrences of disease outbreaks were recorded in rainbow trout (Oncorhynchus mykiss, Walbaum) farms where the entire fish population was routinely vaccinated. New strains are distinguished from previous strains by their ability to produce large amounts of extracellular polysaccharide that is released into the medium. Present findings indicate that the extracellular polysaccharide is a major antigenic factor, suggesting an evolutionary selection of strains capable of extracellular polysaccharide production