Tactics for Designing Probes to Explore Parents' Differing Perspectives on Family Technology Use

Experiences of technology use in everyday family life can be complex. In particular, tensions can arise when parents have differing perspectives on their family's technology use. This paper describes design tactics we used to create a probe collection that successfully supported explorations of these differing perspectives, and to uncover the tensions involved whilst remaining sensitive to any existing conflict. The tactics created opportunities for conversation between parents and to shift their individual perspectives. These tactics helped to raise the awareness sets of parents' had of each other's perspectives on their family's technology use. Unexpected insights emerged that even surprised our participants, when they were asked to invert their point of view to imagine how their technologies might experience domestic life. Furthermore, deeper insights emerged when participants' responses to individual probes were viewed together, as a collection

Graph-Based Shape Analysis Beyond Context-Freeness

We develop a shape analysis for reasoning about relational properties of data structures. Both the concrete and the abstract domain are represented by hypergraphs. The analysis is parameterized by user-supplied indexed graph grammars to guide concretization and abstraction. This novel extension of context-free graph grammars is powerful enough to model complex data structures such as balanced binary trees with parent pointers, while preserving most desirable properties of context-free graph grammars. One strength of our analysis is that no artifacts apart from grammars are required from the user; it thus offers a high degree of automation. We implemented our analysis and successfully applied it to various programs manipulating AVL trees, (doubly-linked) lists, and combinations of both

Evaluation of the effectiveness of a workshop using simulated patients to train students in problem identification and problem solving

Conference Theme: From Classroom to Clinic: Opportunities and Challenges in e-LearningAwarded of Merit for Best Poster CompetitionPURPOSE: This study aimed to evaluate the effectiveness of role play to train medical students in history taking, problem identification and problem synthesis, and to assess whether the use of patient-educators as simulated patients enhances student learning outcomes. METHOD: This study adopted a mixed method two-armed quasi-experimental study design. In the 2012-13 academic year, all 180 third year medical students at the University of Hong Kong participated in the Problem Solving Workshop during the Family Medicine rotation. Students were randomly assigned into two groups: the intervention group had four simulated patients role playing their own clinical cases whereas the control group had workshop facilitators role playing the same cases. Before and after the workshop, the students watched a videotaped clinical consultation and completed a Medical Record Form. Students paired up to role play as a doctor to take a history ...postprin

Evaluation of the effectiveness of a workshop using simulated patients to train students in problem identification and problem solving

Conference Theme: From Classroom to Clinic: Opportunities and Challenges in e-LearningAwarded of Merit for Best Poster CompetitionPURPOSE: This study aimed to evaluate the effectiveness of role play to train medical students in history taking, problem identification and problem synthesis, and to assess whether the use of patient-educators as simulated patients enhances student learning outcomes. METHOD: This study adopted a mixed method two-armed quasi-experimental study design. In the 2012-13 academic year, all 180 third year medical students at the University of Hong Kong participated in the Problem Solving Workshop during the Family Medicine rotation. Students were randomly assigned into two groups: the intervention group had four simulated patients role playing their own clinical cases whereas the control group had workshop facilitators role playing the same cases. Before and after the workshop, the students watched a videotaped clinical consultation and completed a Medical Record Form. Students paired up to role play as a doctor to take a history ...postprin

Exploring how to involve patient support group volunteers in medical education

Conference Theme: From Classroom to Clinic: Opportunities and Challenges in e-LearningINTRODUCTION: Patient contact is an indispensable part of medical education. It helps students to build integrated skills for history taking, communication, physical examination, and clinical reasoning. The role of patients in education may be passive, such as in bedside teaching, or it may be active, such as when the patient serves as a patient-teacher. Community volunteers who have had first hand illness experiences can be a very valuable resource for the training of undergraduate medical students, however, knowing where and how to recruit these individuals remains a challenge. A patient support group is an association of people sharing common interests and experiences regarding health-related matters. Members of such organisations are often experienced in discussing their disease and sharing ways to cope with the challenges of ...postprin

Engaging family doctors to participate in curriculum development of undergraduate community-based learning

Conference Theme: From Classroom to Clinic: Opportunities and Challenges in e-LearningINTRODUCTION: The MBBS program at the University of Hong Kong (HKU) has been undergoing a curriculum review. One objective is to enhance community-based learning. Family doctors are the community’s frontline healthcare providers, and many take students for attachments. They are well-placed to advice on curriculum. This study aimed to seek the views of family doctors regarding curriculum design and outcomes for undergraduate learning. METHODS: This was a mixed-method semi-qualitative study. A questionnaire was posted to all doctors involved in Family Medicine teaching at HKU regarding curriculum content, structure, and barriers to teaching. Responses were analysed descriptively. Highly-rated teachers were interviewed to identify desired student outcomes and explore how to implement new teaching ...postprin

The breast cancer somatic 'muta-ome': tackling the complexity

Acquired somatic mutations are responsible for approximately 90% of breast tumours. However, only one somatic aberration, amplification of the HER2 locus, is currently used to define a clinical subtype, one that accounts for approximately 10% to 15% of breast tumours. In recent years, a number of mutational profiling studies have attempted to further identify clinically relevant mutations. While these studies have confirmed the oncogenic or tumour suppressor role of many known suspects, they have exposed complexity as a main feature of the breast cancer mutational landscape (the 'muta-ome'). The two defining features of this complexity are (a) a surprising richness of low-frequency mutants contrasting with the relative rarity of high-frequency events and (b) the relatively large number of somatic genomic aberrations (approximately 20 to 50) driving an average tumour. Structural features of this complex landscape have begun to emerge from follow-up studies that have tackled the complexity by integrating the spectrum of genomic mutations with a variety of complementary biological knowledge databases. Among these structural features are the growing links between somatic gene disruptions and those conferring breast cancer risk, mutually exclusive coexistence and synergistic mutational patterns, and a clearly non-random distribution of mutations implicating specific molecular pathways in breast tumour initiation and progression. Recognising that a shift from a gene-centric to a pathway-centric approach is necessary, we envisage that further progress in identifying clinically relevant genomic aberration patterns and associated breast cancer subtypes will require not only multi-dimensional integrative analyses that combine mutational and functional profiles, but also larger profiling studies that use second- and third-generation sequencing technologies in order to fill out the important gaps in the current mutational landscape

A metabolite-derived protein modification integrates glycolysis with KEAP1-NRF2 signalling.

Mechanisms that integrate the metabolic state of a cell with regulatory pathways are necessary to maintain cellular homeostasis. Endogenous, intrinsically reactive metabolites can form functional, covalent modifications on proteins without the aid of enzymes1,2, and regulate cellular functions such as metabolism3-5 and transcription6. An important 'sensor' protein that captures specific metabolic information and transforms it into an appropriate response is KEAP1, which contains reactive cysteine residues that collectively act as an electrophile sensor tuned to respond to reactive species resulting from endogenous and xenobiotic molecules. Covalent modification of KEAP1 results in reduced ubiquitination and the accumulation of NRF27,8, which then initiates the transcription of cytoprotective genes at antioxidant-response element loci. Here we identify a small-molecule inhibitor of the glycolytic enzyme PGK1, and reveal a direct link between glycolysis and NRF2 signalling. Inhibition of PGK1 results in accumulation of the reactive metabolite methylglyoxal, which selectively modifies KEAP1 to form a methylimidazole crosslink between proximal cysteine and arginine residues (MICA). This posttranslational modification results in the dimerization of KEAP1, the accumulation of NRF2 and activation of the NRF2 transcriptional program. These results demonstrate the existence of direct inter-pathway communication between glycolysis and the KEAP1-NRF2 transcriptional axis, provide insight into the metabolic regulation of the cellular stress response, and suggest a therapeutic strategy for controlling the cytoprotective antioxidant response in several human diseases

Myosin Light Chain Kinase Mediates Intestinal Barrier Disruption following Burn Injury

Background: Severe burn injury results in the loss of intestinal barrier function, however, the underlying mechanism remains unclear. Myosin light chain (MLC) phosphorylation mediated by MLC kinase (MLCK) is critical to the pathophysiological regulation of intestinal barrier function. We hypothesized that the MLCK-dependent MLC phosphorylation mediates the regulation of intestinal barrier function following burn injury, and that MLCK inhibition attenuates the burn-induced intestinal barrier disfunction. Methodology/Principal Findings: Male balb/c mice were assigned randomly to either sham burn (control) or 30 % total body surface area (TBSA) full thickness burn without or with intraperitoneal injection of ML-9 (2 mg/kg), an MLCK inhibitor. In vivo intestinal permeability to fluorescein isothiocyanate (FITC)-dextran was measured. Intestinal mucosa injury was assessed histologically. Tight junction proteins ZO-1, occludin and claudin-1 was analyzed by immunofluorescent assay. Expression of MLCK and phosphorylated MLC in ileal mucosa was assessed by Western blot. Intestinal permeability was increased significantly after burn injury, which was accompanied by mucosa injury, tight junction protein alterations, and increase of both MLCK and MLC phosphorylation. Treatment with ML-9 attenuated the burn-caused increase of intestinal permeability, mucosa injury, tight junction protein alterations, and decreased MLC phosphorylation, but not MLCK expression

The association of health literacy with adherence in older 2 adults, and its role in interventions: a systematic meta-review

Background: Low health literacy is a common problem among older adults. It is often suggested to be associated with poor adherence. This suggested association implies a need for effective adherence interventions in low health literate people. However, previous reviews show mixed results on the association between low health literacy and poor adherence. A systematic meta-review of systematic reviews was conducted to study the association between health literacy and adherence in adults above the age of 50. Evidence for the effectiveness of adherence interventions among adults in this older age group with low health literacy was also explored. Methods: Eight electronic databases (MEDLINE, ERIC, EMBASE, PsycINFO, CINAHL, DARE, the Cochrane Library, and Web of Knowledge) were searched using a variety of keywords regarding health literacy and adherence. Additionally, references of identified articles were checked. Systematic reviews were included if they assessed the association between health literacy and adherence or evaluated the effectiveness of interventions to improve adherence in adults with low health literacy. The AMSTAR tool was used to assess the quality of the included reviews. The selection procedure, data-extraction, and quality assessment were performed by two independent reviewers. Seventeen reviews were selected for inclusion. Results: Reviews varied widely in quality. Both reviews of high and low quality found only weak or mixed associations between health literacy and adherence among older adults. Reviews report on seven studies that assess the effectiveness of adherence interventions among low health literate older adults. The results suggest that some adherence interventions are effective for this group. The interventions described in the reviews focused mainly on education and on lowering the health literacy demands of adherence instructions. No conclusions could be drawn about which type of intervention could be most beneficial for this population. Conclusions: Evidence on the association between health literacy and adherence in older adults is relatively weak. Adherence interventions are potentially effective for the vulnerable population of older adults with low levels of health literacy, but the evidence on this topic is limited. Further research is needed on the association between health literacy and general health behavior, and on the effectiveness of interventions