Perceptions of the Delivery of Group and Individual Writing Telehealth Interventions for Students 7 to 12 Years of Age using Two Virtual Platforms: A Pilot Study

Background: Existing evidence supports occupational therapy’s (OT) role in improving handwriting skills; however, evidence is limited regarding the delivery of virtual intervention. Method: This pilot study reviewed the use of a virtual interprofessional writing program for five children 7 to 12 years of age that addressed both handwriting (OT) and spelling (speech-language pathology) skills. The program included eight weekly sessions using Microsoft Teams (first four sessions) and Cisco WebEx (last four sessions). A parent survey consisting of 14 questions was conducted to gauge overall satisfaction with the program as well as learn about platform preferences. In addition, the occupational therapists provided insights from using the features of the two platforms. Results: Overall, the families were satisfied with the virtual program, the primary strengths being the engagement of their child, the materials used in the program, and skill development. The occupational therapists identified various features of the virtual platforms that impacted their use for individual and group interventions. Conclusion: Information from this pilot study can be used to help clinicians when preparing for the virtual delivery of OT services. It also provided feedback from parents that is consistent with previous literature about strengths and weaknesses of virtual services

Determining glioblastoma proteome changes in response to lateral ventricle neural stem cells

Glioblastoma (GBM) is the most common and malignant primary tumor in adults. When GBM tumors are located close to the lateral ventricle they display a more aggressive recurrence pattern and negatively impact patient survival. These findings suggest the involvement of the subventricular zone neurogenic niche in GBM malignancy. To define the inter-cellular communication between neural stem cells and GBM cells, we optimized a tool to determine cell-specific proteomic changes of GBM cells in response to neural stem cell proximity. We cloned the mutated methionyl-tRNA synthetase (MetRS) gene into the lentiviral plasmid MetRS puro. MetRS allows for incorporation of azide-tagged methionine analog azidonorleucine (ANL) into newly formed proteins, effectively labeling proteins synthesized by expressing cells. We utilized the pLKO.1 vector backbone allowing puromycin resistance as a selection method. The MetRS L274 modification was confirmed, as only MetRS-transduced cells of both commercial HEK and primary GBM1A cell lines selectively incorporated ANL. Following verification, we successfully packaged the plasmid into a lentivirus. We transduced primary human fetal neural stem cell (hfNSC) and GBM lines and selected the MetRS-expressing cells by puromycin exposure. After 96 hours, wild type (WT) cells died while successfully transduced cells exhibited resistance and the ANL-compatible MetRS enzyme. Co-cultures consisting of MetRS-transduced GBM and WT hfNSCs were used to simulate a similar environment of glioblastoma neighboring lateral ventricles. Proteome Profiler results showed a significant downregulation of an angiogenesis inhibitor and upregulation of malignancy promoting proteins in GBM1A. Going forward, this analysis method will be used for cell-specific proteomics in vivo

Visit complexity, diagnostic uncertainty, and antibiotic prescribing for acute cough in primary care: a retrospective study

Background: Guidelines and performance measures recommend avoiding antibiotics for acute cough/acute bronchitis and presume visits are straightforward with simple diagnostic decision-making. We evaluated clinician-assigned diagnoses, diagnostic uncertainty, and antibiotic prescribing for acute cough visits in primary care. Methods: We conducted a retrospective analysis of acute cough visits – cough lasting ≤21 days in adults 18–64 years old without chronic lung disease – in a primary care practice from March 2011 through June 2012. Results: Of 56,301 visits, 962 (2%) were for acute cough. Clinicians diagnosed patients with 1, 2, or ≥ 3 cough-related diagnoses in 54%, 35%, and 11% of visits, respectively. The most common principal diagnoses were upper respiratory infection (46%), sinusitis (10%), acute bronchitis (9%), and pneumonia (8%). Clinicians prescribed antibiotics in 22% of all visits: 65% of visits with antibiotic-appropriate diagnoses and 4% of visits with non-antibiotic-appropriate diagnoses. Clinicians expressed diagnostic uncertainty in 16% of all visits: 43% of visits with antibiotic-appropriate diagnoses and 5% of visits with non-antibiotic-appropriate diagnoses. Clinicians expressed uncertainty more often when prescribing antibiotics than when not prescribing antibiotics (30% vs. 12%; p < 0.001). As the number of visit diagnoses increased from 1 to 2 to ≥ 3, clinicians were more likely to express diagnostic uncertainty (5%, 25%, 40%, respectively; p < 0.001) and prescribe antibiotics (16%, 25%, 41%, respectively; p < 0.001). Conclusions: Acute cough may be more complex and have more diagnostic uncertainty than guidelines and performance measures presume. Efforts to reduce antibiotic prescribing for acute cough should address diagnostic complexity and uncertainty that clinicians face

Primary care clinicians’ perceptions about antibiotic prescribing for acute bronchitis: a qualitative study

Background: Clinicians prescribe antibiotics to over 65% of adults with acute bronchitis despite guidelines stating that antibiotics are not indicated. Methods: To identify and understand primary care clinician perceptions about antibiotic prescribing for acute bronchitis, we conducted semi-structured interviews with 13 primary care clinicians in Boston, Massachusetts and used thematic content analysis. Results: All the participants agreed with guidelines that antibiotics are not indicated for acute bronchitis and felt that clinicians other than themselves were responsible for overprescribing. Barriers to guideline adherence included 6 themes: (1) perceived patient demand, which was the main barrier, although some clinicians perceived a recent decrease; (2) lack of accountability for antibiotic prescribing; (3) saving time and money; (4) other clinicians’ misconceptions about acute bronchitis; (5) diagnostic uncertainty; and (6) clinician dissatisfaction in failing to meet patient expectations. Strategies to decrease inappropriate antibiotic prescribing included 5 themes: (1) patient educational materials; (2) quality reporting; (3) clinical decision support; (4) use of an over-the-counter prescription pad; and (5) pre-visit triage and education by nurses to prevent visits. Conclusions: Clinicians continued to cite patient demand as the main reason for antibiotic prescribing for acute bronchitis, though some clinicians perceived a recent decrease. Clinicians felt that other clinicians were responsible for inappropriate antibiotic prescribing and that better pre-visit triage by nurses could prevent visits and change patients’ expectations. Electronic supplementary material The online version of this article (doi:10.1186/s12875-014-0194-5) contains supplementary material, which is available to authorized users

Refining the Maritime Foundations of Andean Civilization: How Plant Fiber Technology Drove Social Complexity During the Preceramic Period.

Moseley's (1975) Maritime Foundations of Andean Civilization hypothesis challenges, in one of humanity's few pristine hearths of civilization, the axiom that agriculture is necessary for the rise of complex societies. We revisit that hypothesis by setting new findings from La Yerba II (7571-6674 Cal bp) and III (6485-5893 Cal bp), Río Ica estuary, alongside the wider archaeological record for the end of the Middle Preceramic Period on the Peruvian coast. The La Yerba record evinces increasing population, sedentism, and "Broad Spectrum Revolution" features, including early horticulture of Phaseolus and Canavalia beans. Yet unlike further north, these changes failed to presage the florescence of monumental civilization during the subsequent Late Preceramic Period. Instead, the south coast saw a profound "archaeological silence." These contrasting trajectories had little to do with any relative differences in marine resources, but rather to restrictions on the terrestrial resources that determined a society's capacity to intensify exploitation of those marine resources. We explain this apparent miscarriage of the Maritime Foundations of Andean Civilization (MFAC) hypothesis on the south coast of Peru by proposing more explicit links than hitherto, between the detailed technological aspects of marine exploitation using plant fibers to make fishing nets and the emergence of social complexity on the coast of Peru. Rather than because of any significant advantages in quality, it was the potential for increased quantities of production, inherent in the shift from gathered wild Asclepias bast fibers to cultivated cotton, that inadvertently precipitated revolutionary social change. Thereby refined, the MFAC hypothesis duly emerges more persuasive than ever.We thank the members of the One River Project including Agathe Dupeyron, Vincent Haburaj, Oliver Huamán, Leidy Santana, and Fraser Sturt; the Ministerio de Cultura del Perú for granting permission for archaeological fieldwork (under Resoluciones Directorales No. 933-2012-DGPC-VMPCIC/ MC, 19 December 2012, No. 386-2014-DGPA-VMPCIC/MC, 22 August 2014, and No. 290-2015-DGPAVMPCIC/MC, 17 July 2015) and the export of samples for dating; the director of the Museo Regional de Ica Susana Arce; don Alberto Benavides Ganoza and the people of Samaca for facilitating fieldwork; the Leverhulme Trust (grant number RPG-117); the late Don Alberto Benavides de la Quintana (grant number RG69428); and the NERC Radiocarbon facility (grant number NF/2013/2/2) for funding

Revisiting Frederic Engel’s hypothesis: how The Lomas determine the distribution of preceramic archaeology on Peru’s southern coast

Frédéric Engel (1981:24), el pionero de los estudios del Precerámico en el Perú, argumentó que la distribución de los sitios arqueológicos durante el Holoceno temprano fue determinada por “la capacidad de las lomas” –oasis estacionales producidos por la humedad oceánica que están presentes a lo largo de la costa del Perú– una proposición que aún se encuentra en debate. Nosotros evaluaremos las ideas de Engel basándonos en datos de sitios arqueológicos del Precerámico Medio (hasta 4500 años cal AP) ubicados dentro y cerca de las lomas de la costa sur del Perú.The pioneer of Preceramic archaeology in Peru, Frédéric Engel (1981: 24), argued that archaeological site distribution during the Early Holocene, was defined by the ‘fog oasis situation’ of lomas –the seasonal oases sustained by ocean fogs that flourish along the arid Pacific coast of Peru– a proposition that remains much debated. Here we reassess Engel’s ideas using archaeological findings from Middle Preceramic archaeological sites (to c. 4500 cal BP) from alongside and within the lomas of the south coast of Peru.Sociedad Argentina de Antropologí

3B11-N, a monoclonal antibody against MERS-CoV, reduces lung pathology in rhesus monkeys following intratracheal inoculation of MERS-CoV Jordan-n3/2012

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was identified in 2012 as the causative agent of a severe, lethal respiratory disease occurring across several countries in the Middle East. To date there have been over 1,600 laboratory confirmed cases of MERS-CoV in 26 countries with a case fatality rate of 36%. Given the endemic region, it is possible that MERS-CoV could spread during the annual Hajj pilgrimage, necessitating countermeasure development. In this report, we describe the clinical and radiographic changes of rhesus monkeys following infection with 5×106 PFU MERS-CoV Jordan-n3/2012. Two groups of NHPs were treated with either a human anti-MERS monoclonal antibody 3B11-N or E410-N, an anti-HIV antibody. MERS-CoV Jordan-n3/2012 infection resulted in quantifiable changes by computed tomography, but limited other clinical signs of disease. 3B11-N treated subjects developed significantly reduced lung pathology when compared to infected, untreated subjects, indicating that this antibody may be a suitable MERS-CoV treatment

The Right to Refuse Reporter Disclosure for Child Abuse and Neglect Reports

This paper discusses the Tennessee 112th General Assembly House Bill 0908, the issues it is trying to ameliorate, and the potential effects its passage could have on social work practice. House Bill 908 attempts to amend Title 37 of Tennessee Code Annotated, relative to reports of child abuse, neglect, or child sexual abuse. If passed, this bill would prevent the Tennessee Department of Children’s Services (DCS) from investigating any reported cases of child abuse if the reporter refuses to leave their name and contact information. It would also allow the accused to petition the court to reveal the identity of the reporter if they believe the report was made with the intention to harass. The proponents of this bill often refer to trauma caused by false reports, which often involves an associated loss of the custody of their children to the state for a certain amount of time or the burden of costs affiliated with hiring an attorney during investigations. Those in opposition to this bill refer to the rarity of false reports, how anonymous reports are often made anonymously to protect the reporter’s safety, and how there are already measures in place under Tennessee state law to prevent false reports. Using a social work lens, research indicates that HB 908 may potentially cause more harm than good. However, the issue of false reporting addressed in this bill is still one of importance, that we believe can be addressed in other ways. This paper will offer an analysis of the legislation whilst exploring other approaches to this problem that do not involve removing the option of anonymous reporting