Interprofessional Education Lab Manual And Workbook

This laboratory manual was designed to educate and develop integrated healthcare practices essential in delivering person-centered care. Participants will develop their ability to distinguish the role of their own profession and other healthcare professionals collaborating in the care coordination and case management of patients. The content and team-oriented activities in this manual provide guidance on advancing leadership and communication principles necessary for effective interprofessional communication and team collaboration. The well-researched material is tailored to build on the strengths of participants, while also identifying and encouraging areas for improvement.https://scholarworks.gvsu.edu/books/1027/thumbnail.jp

Ten thousand voices on marine climate change in Europe: different perceptions among demographic groups and nationalities

Over the past few decades, substantial funding has been directed towards improving scientific understanding and management of impacts of climate change in the marine environment. Following concerns that the key messages from these studies were not reaching the public, a comprehensive opinion poll of 10,000 European citizens in 10 countries was conducted to establish levels of awareness, concern, and trust among different demographic groups (by age, gender, proximity to the coast) and nationalities. Citizens exhibited varying levels of self-declared ‘informedness’ and concern. Citizens from Germany, Italy and Spain claimed to be the most informed on marine climate change issues; those from Czech Republic, Netherlands and Estonia claimed to be least informed. Respondents were least aware of ocean acidification and most aware of melting sea ice, pollution and overfishing. Citizens of Italy suggested that they were generally most concerned about marine climate change issues. Respondents from coastal areas claimed to be both more informed and more concerned than those living inland, as did females and older age groups (54-64 years). European citizens obtain information about climate change in the seas and ocean from different sources, particularly television and the internet. Trust in the various media sources varies among countries and demographic groups. Television is trusted most in Estonia, Germany and Ireland and least in France. The internet is trusted most in Italy, Czech Republic and Estonia, but least in France and the United Kingdom. 18-24 year olds are the biggest users of the internet, but trust this source less than older age groups. Academic scientists or those working for environmental NGOs are trusted more than scientists working for government or industry. Citizens from France are more trusting of industry than any other country polled. In terms of policy actions, most respondents highlighted mitigation measures as opposed to local-scale adaptation. Younger participants prioritised actions associated with reducing carbon emissions, whereas older age groups prioritised improving coastal defences. Successful adaptation to the impacts of climate change requires public engagement and support for policy decisions, and the use of different approaches to take account of differences among demographic groups and nationalities

Public awareness, concerns, and priorities about anthropogenic impacts on marine environments

Numerous international bodies have advocated the development of strategies to achieve the sustainability of marine environments. Typically, such strategies are based on information from expert groups about causes of degradation and policy options to address them, but these strategies rarely take into account assessed information about public awareness, concerns, and priorities. Here we report the results of a pan-European survey of public perceptions about marine environmental impacts as a way to inform the formation of science and policy priorities. On the basis of 10,106 responses to an online survey from people in 10 European nations, spanning a diversity of socioeconomic and geographical areas, we examine the public’s informedness and concern regarding marine impacts, trust in different information sources, and priorities for policy and funding. Results show that the level of concern regarding marine impacts is closely associated with the level of informedness and that pollution and overfishing are two areas prioritized by the public for policy development. The level of trust varies greatly among different information sources and is highest for academics and scholarly publications but lower for government or industry scientists. Results suggest that the public perceives the immediacy of marine anthropogenic impacts and is highly concerned about ocean pollution, overfishing, and ocean acidification. Eliciting public awareness, concerns, and priorities can enable scientists and funders to understand how the public relates to marine environments, frame impacts, and align managerial and policy priorities with public demand

Comida natural para perros Bobby Pet

Hoy en día, el mercado peruano del sector de mascotas crece a pasos agigantados, adicional a ello casi el 50% de los hogares tiene una mascota. Además, se ha detectado que uno de los grandes problemas es que existen pocas marcas que ofrecen comida natural para perros que son buenas para las mascotas, pero a precios muy elevados. En el presente trabajo, Bobby Pet tiene como objetivo desarrollar una propuesta dirigida al propietario, basada en satisfacer las necesidades de los dueños de mascotas (perros) que buscan una alimentación saludable y cumpla con los nutrientes y minerales que la mascota necesita. Se validó el proyecto a través del estudio de mercado cualitativo realizado a una muestra de 15 personas que cuentan con mascotas desde hace varios años y se ha realizado una encuesta a 100 personas que cuentan con mascotas. Realizamos el análisis externo e interno del proyecto, en el que se identificó factores que tienen o podrían tener una repercusión a lo largo del proyecto. Con toda la información recopilada, se elaboró el plan de marketing, luego de proyectar las ventas y calcular los costos de producción, gastos administrativos y operaciones, se procedió a calcular la rentabilidad del proyecto aplicando los indicadores, arrojando muy buenos resultados para poder realizar el proyecto. El análisis financiero del proyecto es positivo. Para los accionistas el proyecto ofrece una rentabilidad máxima (TIR) de 54.79% mientras que el costo de oportunidad que exigen es de 15.21% (COK).Today the Peruvian market for the pet sector is growing by leaps and bounds, in addition to this, almost 50% of households have a pet. In addition, it has been found that one of the big problems is that there are few brands that offer natural dog food that are good for pets, but at very high prices. The present work Bobby Pet aims to develop a proposal aimed at the owner, based on meeting the needs of pet owners (dogs) who seek a healthy diet and meet the nutrients and minerals that the pet needs. The project was validated through a qualitative market study carried out with a sample of 15 people who have had pets for several years and a survey of 100 people who have pets was carried out. We carry out the external and internal analysis of the project, in which factors that have or could have an impact throughout the project were identified. With all the information collected, the marketing plan was developed, after projecting sales and calculating production costs, administrative expenses and operations, the profitability of the project was calculated by applying the indicators, yielding very good results to be able to carry out the project. The financial analysis of the project is positive. For shareholders, the project offers a maximum profitability (IRR) of 54.79% while the opportunity cost, they demand is 15.21% (COK).Trabajo de investigació

Public engagement with marine climate change issues: (Re)framings, understandings and responses

Climate change impacts on marine environments have been somewhat neglected in climate change research, particularly with regard to their social dimensions and implications. This paper contributes to addressing this gap through presenting a UK focused mixed-method study of how publics frame, understand and respond to marine climate change-related issues. It draws on data from a large national survey of UK publics (N = 1,001), undertaken in January 2011 as part of a wider European survey, in conjunction with in-depth qualitative insights from a citizens’ panel with participants from the East Anglia region, UK. This reveals that discrete marine climate change impacts, as often framed in technical or institutional terms, were not the most immediate or significant issues for most respondents. Study participants tended to view these climate impacts ‘in context’, in situated ways, and as entangled with other issues relating to marine environments and their everyday lives. Whilst making connections with scientific knowledge on the subject, public understandings of marine climate impacts were mainly shaped by personal experience, the visibility and proximity of impacts, sense of personal risk and moral or equity-based arguments. In terms of responses, study participants prioritised climate change mitigation measures over adaptation, even in high-risk areas. We consider the implications of these insights for research and practices of public engagement on marine climate impacts specifically, and climate change more generally

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Twenty two cases of canine neural angiostronglyosis in eastern Australia (2002-2005) and a review of the literature

Cases of canine neural angiostrongylosis (NA) with cerebrospinal fluid (CSF) evaluations in the peer-reviewed literature were tabulated. All cases were from Australia. A retrospective cohort of 59 dogs was contrasted with a series of 22 new cases where NA was diagnosed by the presence of both eosinophilic pleocytosis and anti-Angiostrongylus cantonensis immunloglobulins (IgG) in CSF, determined by ELISA or Western blot. Both cohorts were drawn from south east Queensland and Sydney. The retrospective cohort comprised mostly pups presented for hind limb weakness with hyperaesthesia, a mixture of upper motor neurone (UMN) and lower motor neurone (LMN) signs in the hind limbs and urinary incontinence. Signs were attributed to larval migration through peripheral nerves, nerve roots, spinal cord and brain associated with an ascending eosinophilic meningo-encephomyelitis. The contemporary cohort consisted of a mixture of pups, young adult and mature dogs, with a wider range of signs including (i) paraparesis/proprioceptive ataxia (ii) lumbar and tail base hyperaesthesia, (iii) multi-focal central nervous system dysfunction, or (iv) focal disease with neck pain, cranial neuropathy and altered mentation. Cases were seen throughout the year, most between April and July (inclusive). There was a preponderance of large breeds. Often littermates, or multiple animals from the same kennel, were affected simultaneously or sequentially. A presumptive diagnosis was based on consistent signs, proximity to rats, ingestion/chewing of slugs or snails and eosinophilic pleocytosis. NA was diagnosed by demonstrating anti-A. cantonensis IgG in CSF. Detecting anti-A. cantonensis IgG in serum was unhelpful because many normal dogs (20/21 lb dogs; 8/22 of a hospital population) had such antibodies, often at substantial titres. Most NA cases in the contemporary series (19/22) and many pups (16/38) in the retrospective cohort were managed successfully using high doses of prednisolone and opioids. Treatment often included antibiotics administered in case protozoan encephalomyelitis or translocated bacterial meningitis was present. Supportive measures included bladder care and physiotherapy. Several dogs were left with permanent neural deficits. Dogs are an important sentinel species for NA. Human cases and numerous cases in tawny frogmouths were reported from the same regions as affected dogs over the study period

Shared heritability and functional enrichment across six solid cancers

Correction: Nature Communications 10 (2019): art. 4386 DOI: 10.1038/s41467-019-12095-8Quantifying the genetic correlation between cancers can provide important insights into the mechanisms driving cancer etiology. Using genome-wide association study summary statistics across six cancer types based on a total of 296,215 cases and 301,319 controls of European ancestry, here we estimate the pair-wise genetic correlations between breast, colorectal, head/neck, lung, ovary and prostate cancer, and between cancers and 38 other diseases. We observed statistically significant genetic correlations between lung and head/neck cancer (r(g) = 0.57, p = 4.6 x 10(-8)), breast and ovarian cancer (r(g) = 0.24, p = 7 x 10(-5)), breast and lung cancer (r(g) = 0.18, p = 1.5 x 10(-6)) and breast and colorectal cancer (r(g) = 0.15, p = 1.1 x 10(-4)). We also found that multiple cancers are genetically correlated with non-cancer traits including smoking, psychiatric diseases and metabolic characteristics. Functional enrichment analysis revealed a significant excess contribution of conserved and regulatory regions to cancer heritability. Our comprehensive analysis of cross-cancer heritability suggests that solid tumors arising across tissues share in part a common germline genetic basis.Peer reviewe

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients