An Innovative Interprofessional Course: Cultural Humility and Competence

As we tackle the disproportionate burden of chronic illness and access to quality health care of an increasingly diverse population, it is critical to infuse cultural and linguistic competence in all sectors of health care training. To reach the Healthy People 2020 goal of eliminating health disparities, health and human services education must provide the knowledge and experience to understand the root causes of health disparities, as well as strategies to advance ongoing cultural and linguistic competence

Treatment with exenatide once weekly or twice daily for 30 weeks is associated with changes in several cardiovascular risk markers

Background Dyslipidemia and type 2 diabetes are two of the most significant risk factors for the development of cardiovascular disease. Measurement of lipoprotein subclasses provides important information about derangements in lipid metabolism and helps refine cardiovascular risk assessment. Exenatide, a glucagon-like peptide 1 receptor agonist, improved glycemic control, obesity, hypertension, and dyslipidemia in patients with type 2 diabetes in clinical trials. Methods In the DURATION-1 trial, patients with type 2 diabetes were treated with exenatide once weekly or twice daily for 30 weeks. This post hoc analysis evaluated the impact of exenatide on lipoprotein subclasses in 211 DURATION-1 patients using vertical auto profile methodology and the Statistical Package for the Social Sciences general linear model adjusted for glycosylated hemoglobin (HbA1c) and weight. Results Baseline lipids and high sensitivity C-reactive protein were normal overall based on the standard lipid panel. Once-weekly exenatide reduced apolipoprotein B and the apolipoprotein B to apolipoprotein A1 ratio (P \u3c 0.05), independent of glycemic improvement and weight loss. A significant shift in lipoprotein pattern away from small, dense low-density lipoprotein-4 cholesterol was also observed (P \u3c 0.05). Exenatide once weekly increased high-density lipoprotein-2 cholesterol, even after adjustment for changes in HbA1c and weight (P \u3c 0.05). Triglycerides, very low-density lipoprotein cholesterol, and high sensitivity C-reactive protein were reduced with both the once-weekly and twice-daily exenatide regimens (P \u3c 0.05). Conclusion In this post hoc analysis, exenatide significantly improved a number of cardiovascular risk markers. Continuous exenatide exposure with exenatide once weekly elicited a greater response than did immediate-release exenatide twice daily, generally independent of glycemic improvement and weight loss. Thus, in addition to improving glycemic control, exenatide induced favorable changes in lipid and lipoprotein metabolism and decreased systemic inflammation

Teaching Cultural Humility and Competence: A Multi-disciplinary Course for Public Health and Health Services Students

Poster on the interdisciplinary Cultural Humility and Competence course taught at the Jefferson School of Population Health for the past several years. Overall Course Aim: Why a multi-disciplinary cultural humility competence course? An in-depth and advanced understanding of cultural diversity, health inequities and cultural competence in inter-professional health and human service delivery and administration. Facilitate development of cultural competence and humility in one\u27s self, colleagues and the work environment and its application to practice

"We came to Canada and we were going to make it": oral history, agency, and post-Second World War Dutch immigrant children and adolescents in Alberta

This project reconceptualizes the immigrant child in a way that underscores their experience as distinct from that of an adult. There is little qualitative research on the histories of Dutch child immigrants and the findings in this thesis draw attention to and help fill this gap. By highlighting the life stories of school-aged Dutch children in southern Alberta and focusing on the complexities they faced during integration, there is opportunity to rethink what has been documented about their roles in the family migration process. This thesis shows how post-Second World War child immigrant memories are worthy of exploration as they serve to enrich our understanding of how children exercised agency and demonstrated independent thought while adjusting to unfamiliar cultural and social practices

Zombie journals: designing a technological infrastructure for a precarious graduate student journal

Open access article. Creative Commons Attribution Non-commercial License (CC-BY-NC) applies.Background: The Meeting of the Minds graduate student journal is edited primarily by students from our Masters programme. This means that our editorial board is subject to high annual turnover and that our technological infrastructure and workflow needed to be easy to train for, accommodate differing levels of technological skill and editorial interest, and provide archiving that did not require a continuing interest in the journal by future generations of students. Analysis: This article provides a detailed and comparative account of the "off-the-shelf" systems and software used in developing the journal with an explanation of the rationale behind our choices. Conclusion and implications: The choices we made can be adopted by other journals interested in a low-cost, "future-proof" approach to developing a publishing infrastructure.Ye

"Let's start a journal!": the multidisciplinary graduate student journal as educational opportunity

Sherpa Romeo green journal. Open access article. Creative Commons Attribution 4.0 International License (CC BY 4.0) applies.The University of Lethbridge is a medium-sized, primarily undergraduate, comprehensive research university on the Canadian Prairies in Alberta. It has a small but growing graduate school, within which most students are studying at the masters level. For many years, the graduate student elected representative body, the Graduate Students Association (GSA), has sponsored an annual refereed conference, Meeting of the Minds. In 2015 the GSA decided to supplement this conference with an accompanying journal, also called Meeting of the Minds. This article discusses the lessons learned in establishing this journal and overseeing its first two years of operations (and first year of publication). The article concentrates on two sets of problems: 1) philosophical, economic, and sociological issues that arose at the conceptual level while establishing a multidisciplinary, institution-focused graduate journal; and 2) technical, bibliographic, organizational, and economic issues encountered in attempting to address these conceptual concerns and ensure the long-term viability of the research accepted and published. Although the journal was not able to solve all the problems that arose during the first two years of operation, several solutions on the organizational, technological, economic, and bibliographic levels were developed that might be used by others establishing similar scholar- or student-led journals.Ye

Relaxin, a pleiotropic vasodilator for the treatment of heart failure

Relaxin is a naturally occurring peptide hormone that plays a central role in the hemodynamic and renovascular adaptive changes that occur during pregnancy. Triggering similar changes could potentially be beneficial in the treatment of patients with heart failure. The effects of relaxin include the production of nitric oxide, inhibition of endothelin, inhibition of angiotensin II, production of VEGF, and production of matrix metalloproteinases. These effects lead to systemic and renal vasodilation, increased arterial compliance, and other vascular changes. The recognition of this has led to the study of relaxin for the treatment of heart failure. An initial pilot study has shown favorable hemodynamic effects in patients with heart failure, including reduction in ventricular filling pressures and increased cardiac output. The ongoing RELAX-AHF clinical program is designed to evaluate the effects of relaxin on the symptoms and outcomes in a large group of patients admitted to hospital for acute heart failure. This review will summarize both the biology of relaxin and the data supporting its potential efficacy in human heart failure

A plasmid DNA-launched SARS-CoV-2 reverse genetics system and coronavirus toolkit for COVID-19 research

The recent emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the underlying cause of Coronavirus Disease 2019 (COVID-19), has led to a worldwide pandemic causing substantial morbidity, mortality, and economic devastation. In response, many laboratories have redirected attention to SARS-CoV-2, meaning there is an urgent need for tools that can be used in laboratories unaccustomed to working with coronaviruses. Here we report a range of tools for SARS-CoV-2 research. First, we describe a facile single plasmid SARS-CoV-2 reverse genetics system that is simple to genetically manipulate and can be used to rescue infectious virus through transient transfection (without in vitro transcription or additional expression plasmids). The rescue system is accompanied by our panel of SARS-CoV-2 antibodies (against nearly every viral protein), SARS-CoV-2 clinical isolates, and SARS-CoV-2 permissive cell lines, which are all openly available to the scientific community. Using these tools, we demonstrate here that the controversial ORF10 protein is expressed in infected cells. Furthermore, we show that the promising repurposed antiviral activity of apilimod is dependent on TMPRSS2 expression. Altogether, our SARS-CoV-2 toolkit, which can be directly accessed via our website at https://mrcppu-covid.bio/, constitutes a resource with considerable potential to advance COVID-19 vaccine design, drug testing, and discovery science

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival