Parkinson\u27s Disease and Occupational Therapy: Evidence Based Practice

The therapeutic benefit of occupational therapy with Parkinson\u27s disease has not been studied in great detail. The purpose of this Scholarly Project was to provide extensive and comprehensive evidence-based information about Parkinson\u27s disease as it applies to occupational therapists. This information was utilized to generate clinical guidelines in the form of a user-friendly manual meant for practicing OTs in treating Parkinson\u27s disease. An extensive literature review was performed using PubMed to determine current evidence-based practice that occupational therapists and other rehabilitation therapists were currently using. Following the review of literature, a needs assessment was completed per survey directed towards practicing OTs. The goal of the survey was to validate the need for these guidelines throughout the country. The user-friendly manual is based on the Ecological Model of Human Performance using establish/restore, adapt/modify and prevent as intervention strategies. The product is titled Guidelines for Occupational Therapists in Treating Parkinson\u27s disease. It consists of four portions, the first focuses on a brief introduction to the disease, the next explains the general neuroscience behind the disease, the third portion gives a brief overview of medical interventions including pharmacological and surgical. The fourth part of the product consists of the evidence-based guidelines for OTs to follow when treating persons with Parkinson\u27s disease. Occupational therapy offers many benefits to persons with Parkinson\u27s disease, including modification and/or adaptation of activities of daily living CADLs) with or without the use of adaptive equipment. Other intervention areas OTs may focus on are: therapeutic exercise routines, caregiver education, joint movement coordination, energy conservation and social skills · training. This user-friendly manual will provide occupational therapists with the necessary information to treat persons with Parkinson\u27s disease using evidence based guidelines

AYA cancer care indispensable in caring for testicular cancer patients

Each year approximately 3,900 adolescents and young adults aged 18 to 39, AYAs, are confronted with a cancer diagnosis. Together they make up 3.5% of the total number of cancer patients. This patient group requires additional support due to the unique physical, psychological and social challenges faced by young adults with cancer. Testicular cancer is the most common in young men. From a clinical point of view nutrition and exercise, family and friends, work/education and reintegration, insurance, emotions and sexuality are common themes among patients with testicular cancer. Age-specific AYA care should therefore be an integral part of the care of patients with testicular cancer.</p

Adolescent Coping and Family Functioning in the Family of a Child with Autism

Autism is on the rise at an alarming rate. Autism impacts all members of a family including siblings. There is much research that examines the etiology of autism but there is little research that explores, from the sibling perspective, what it is like to have a sibling with autism. There are studies that examine coping and the perception of family functioning from the parent perspective, but there are few studies that examine coping and perception of family functioning from the adolescent perspective. The Resiliency Model of Family Stress, Adjustment, and Adaptation (McCubbin & McCubbin, 1993) guided this exploratory, correlational study. The purpose of this study was to examine the coping strategies used by adolescent siblings of children with autism and to examine how these coping strategies influence their perception of family functioning. Qualitative data were collected to help inform the quantitative results. Adolescents 11-21 years of age were recruited through the Interactive Autism Network and completed the measures online via Survey Monkey. The most commonly used coping strategy, as measured by ACOPE, for adolescents in this study was seeking diversion. Females more frequently than males used the coping strategies developing social support, investing in close friends, and relaxing. The younger adolescents used an increased number of and more varied coping strategies than older adolescents. The adolescents perceived that their families functioned in the unhealthy range on five of the seven subscales on the Family Assessment Device with no statistically significant differences between males and females or between age groups on perception of family functioning. Path analysis using multiple regression revealed significant negative relationships between coping strategies, self-concept, satisfaction with the sibling relationship, and family functioning and explained 44.2% of the variance in the proposed model. The results of this study provide a better understanding of the complexities that adolescents who have siblings with autism encounter. Further research is needed to explore additional factors that influence family functioning including examining family functioning with adolescents with typically developing siblings. The development of coping strategies in children and adolescents also needs further exploration.Ph.D.NursingUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/64809/1/sjvliem_1.pd

Twisted Pair Transmission Line Coil -- A Flexible, Self-Decoupled and Extremely Robust Element for 7T MRI

This study evaluates the performance of a twisted pair transmission line coil as a transceive element for 7T MRI in terms of physical flexibility, robustness to shape deformations, and interelement decoupling. Each coil element was created by shaping a twisted pair of wires into a circle. One wire was interrupted at the top, while the other was interrupted at the bottom, and connected to the matching circuit. Electromagnetic simulations were conducted to determine the optimal number of twists per length (in terms of B$_1^+$ field efficiency, SAR efficiency, sensitivity to elongation and interelement decoupling properties) and for investigating the fundamental operational principle of the coil through fields streamline visualization. A comparison between the twisted pair coil and a conventional loop coil in terms of B$_1^+$ fields, maxSAR10g, and stability of $S_{11}$ when the coil was deformed, was performed. Experimentally measured interelement coupling between individual elements of multichannel arrays was also investigated. Increasing the number of twists per length resulted in a more physically robust coil. Poynting vector streamline visualization showed that the twisted pair coil concentrated most of the energy in the near field. The twisted pair coil exhibited comparable B$_1^+$ fields and improved maxSAR10g to the conventional coil but demonstrated exceptional stability with respect to coil deformation and a strong self-decoupling nature when placed in an array configuration. The findings highlight the robustness of the twisted pair coil, showcasing its stability under shape variations. This coil holds great potential as a flexible RF coil for various imaging applications using multiple-element arrays, benefiting from its inherent decoupling.Comment: Revised version; 20 pages, 16 figures, preprin

An asymmetric junctional mechanoresponse coordinates mitotic rounding with epithelial integrity

Epithelia are continuously self-renewed, but how epithelial integrity is maintained during the morphological changes that cells undergo in mitosis is not well understood. Here, we show that as epithelial cells round up when they enter mitosis, they exert tensile forces on neighboring cells. We find that mitotic cell–cell junctions withstand these tensile forces through the mechanosensitive recruitment of the actin-binding protein vinculin to cadherin-based adhesions. Surprisingly, vinculin that is recruited to mitotic junctions originates selectively from the neighbors of mitotic cells, resulting in an asymmetric composition of cadherin junctions. Inhibition of junctional vinculin recruitment in neighbors of mitotic cells results in junctional breakage and weakened epithelial barrier. Conversely, the absence of vinculin from the cadherin complex in mitotic cells is necessary to successfully undergo mitotic rounding. Our data thus identify an asymmetric mechanoresponse at cadherin adhesions during mitosis, which is essential to maintain epithelial integrity while at the same time enable the shape changes of mitotic cells

A mechanical G2 checkpoint controls epithelial cell division through E-cadherin-mediated regulation of Wee1-Cdk1

Epithelial cell divisions are coordinated with cell loss to preserve epithelial integrity. However, how epithelia adapt their rate of cell division to changes in cell number, for instance during homeostatic turnover or wounding, is not well understood. Here, we show that epithelial cells sense local cell density through mechanosensitive E-cadherin adhesions to control G2/M cell-cycle progression. As local cell density increases, tensile forces on E-cadherin adhesions are reduced, which prompts the accumulation of the G2 checkpoint kinase Wee1 and downstream inhibitory phosphorylation of Cdk1. Consequently, dense epithelia contain a pool of cells that are temporarily halted in G2 phase. These cells are readily triggered to divide following epithelial wounding due to the consequent increase in intercellular forces and resulting degradation of Wee1. Our data collectively show that epithelial cell division is controlled by a mechanical G2 checkpoint, which is regulated by cell-density-dependent intercellular forces sensed and transduced by E-cadherin adhesions.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved

An asymmetric junctional mechanoresponse coordinates mitotic rounding with epithelial integrity

Epithelia are continuously self-renewed, but how epithelial integrity is maintained during the morphological changes that cells undergo in mitosis is not well understood. Here, we show that as epithelial cells round up when they enter mitosis, they exert tensile forces on neighboring cells. We find that mitotic cell–cell junctions withstand these tensile forces through the mechanosensitive recruitment of the actin-binding protein vinculin to cadherin-based adhesions. Surprisingly, vinculin that is recruited to mitotic junctions originates selectively from the neighbors of mitotic cells, resulting in an asymmetric composition of cadherin junctions. Inhibition of junctional vinculin recruitment in neighbors of mitotic cells results in junctional breakage and weakened epithelial barrier. Conversely, the absence of vinculin from the cadherin complex in mitotic cells is necessary to successfully undergo mitotic rounding. Our data thus identify an asymmetric mechanoresponse at cadherin adhesions during mitosis, which is essential to maintain epithelial integrity while at the same time enable the shape changes of mitotic cells

A Fluorescence-Based High-Throughput Assay for the Discovery of Exchange Protein Directly Activated by Cyclic AMP (EPAC) Antagonists

Background: The discovery, more than ten years ago, of exchange proteins directly activated by cAMP (EPAC) as a new family of intracellular cAMP receptors revolutionized the cAMP signaling research field. Extensive studies have revealed that the cAMP signaling network is much more complex and dynamic as many cAMP-related cellular processes, previously thought to be controlled by protein kinase A, are found to be also mediated by EPAC proteins. Although there have been many important discoveries in the roles of EPACs greater understanding of their physiological function in cAMP-mediated signaling is impeded by the absence of EPAC-specific antagonist. Methodology/Principal Findings: To overcome this deficit, we have developed a fluorescence-based high throughput assay for screening EPAC specific antagonists. Our assay is highly reproducible and simple to perform using the ‘‘mix and measure’ ’ format. A pilot screening using the NCI-DTP diversity set library led to the identification of small chemical compounds capable of specifically inhibiting cAMP-induced EPAC activation while not affecting PKA activity. Conclusions/Significance: Our study establishes a robust high throughput screening assay that can be effectively applied for the discovery of EPAC-specific antagonists, which may provide valuable pharmacological tools for elucidating th

The nucleoporin RanBP2 tethers the cAMP effector Epac1 and inhibits its catalytic activity

Direct interaction between the catalytic domain of Epac1 and the nuclear pore component RanBP2 blocks Epac1 catalytic activity and downstream cAMP signaling

The future of EPAC-targeted therapies: agonism versus antagonism

yesPharmaceutical manipulation of cAMP levels exerts beneficial effects through the regulation of the exchange protein activated by cAMP (EPAC) and protein kinase A (PKA) signalling routes. Recent attention has turned to the specific regulation of EPAC isoforms (EPAC1 and EPAC2) as a more targeted approach to cAMP-based therapies. For example, EPAC2-selective agonists could promote insulin secretion from pancreatic β cells, whereas EPAC1-selective agonists may be useful in the treatment of vascular inflammation. By contrast, EPAC1 and EPAC2 antagonists could both be useful in the treatment of heart failure. Here we discuss whether the best way forward is to design EPAC-selective agonists or antagonists and the current strategies being used to develop isoform-selective, small-molecule regulators of EPAC1 and EPAC2 activity