Facilitating transitions to adult healthcare for youth with disabilities: resources for occupational therapy practitioners

Healthcare transition is the transfer from pediatric to adult health services and the development of related functional competencies (Sharma, O’Hare, Antonelli, & Sawici, 2014), including self-management, health self-advocacy, and health IADL performance. An estimated 4.5 million youth aged 12-18 have special healthcare needs, a number that has grown over time (McManus et al., 2013). As this mounting population enters adulthood, healthcare transition has become a topic of increasingly intense attention and research among health providers, policymakers, and disability advocacy groups (Betz, O'Kane, Nehring, & Lobo, 2016; McManus et al., 2013). However, many youth with disabilities do not successfully transition to adult healthcare settings or assume responsibility for adult health activities (Betz et al., 2016; McManus et al., 2013). There is a need for professionals to support and train youth to successfully transition to adult healthcare and to foster their abilities to manage their health and achieve positive health and participation outcomes. Occupational therapists (OT) have the opportunity to facilitate improved healthcare transitions and support youth through other contexts of transition to adulthood that mutually influence healthcare transition, including post-secondary education, vocations, independent living, and adult-oriented community and social activities (Ferris, Ferris, Okumura, Cohen, & Hooper, 2015). Facilitating Transitions to Adult Healthcare for Youth with Disabilities: Resources for OT Practitioners is a theory-driven and evidence-based continuing education program for OT practitioners. The course introduces a socio-ecological model to analyze the interrelated factors that influence healthcare transition and participation outcomes, and reviews current multidisciplinary research on healthcare transition interventions. The course aims to increase learners’ healthcare transition knowledge, increase learners’ self-efficacy in meeting the needs of this population, and in the long term, increase the OT profession’s participation in healthcare transition activities

Isothermal DNA amplification strategies for duplex microorganism detection

[EN] A valid solution for micro-analytical systems is the selection of a compatible amplification reaction with a simple, highly-integrated efficient design that allows the detection of multiple genomic targets. Two approaches under isothermal conditions are presented: recombinase polymerase amplification (RPA) and multiple displacement amplification (MDA). Both methods were applied to a duplex assay specific for Salmonella spp. and Cronobacter spp., with excellent amplification yields (0.2 8.6 108 fold). The proposed approaches were successfully compared to conventional PCR and tested for the milk sample analysis as a microarray format on a compact disc (support and driver). Satisfactory results were obtained in terms of resistance to inhibition, selectivity, sensitivity (101 102 CFU/mL) and reproducibility (below 12.5%). The methods studied are efficient and cost-effective, with a high potential to automate microorganisms detection by integrated analytical systems working at a constant low temperature.Funding projects MINECO CTQ2013-45875-R and GV PrometeoII/2014/040. MECD provided S.S.F with a PhD grant.Santiago Felipe, S.; Tortajada-Genaro, LA.; Morais, S.; Puchades, R.; Maquieira Catala, Á. (2015). Isothermal DNA amplification strategies for duplex microorganism detection. Food Chemistry. 174:509-515. https://doi.org/10.1016/j.foodchem.2014.11.080S50951517

Advances in Microfluidics and Lab-on-a-Chip Technologies

Advances in molecular biology are enabling rapid and efficient analyses for effective intervention in domains such as biology research, infectious disease management, food safety, and biodefense. The emergence of microfluidics and nanotechnologies has enabled both new capabilities and instrument sizes practical for point-of-care. It has also introduced new functionality, enhanced sensitivity, and reduced the time and cost involved in conventional molecular diagnostic techniques. This chapter reviews the application of microfluidics for molecular diagnostics methods such as nucleic acid amplification, next-generation sequencing, high resolution melting analysis, cytogenetics, protein detection and analysis, and cell sorting. We also review microfluidic sample preparation platforms applied to molecular diagnostics and targeted to sample-in, answer-out capabilities

“Design and fabrication of a microfluidic device for near-single cell mRNA isolation using a copper hot embossing master

We describe investigations toward a disposable polymer-based chip for the isolation of eukaryotic mRNA. This work focuses here on the improvement of the fabrication methods for rapid prototyping and the actual application at lowest RNA concentrations with total channel volumes of 3.5 μL. Messenger RNA isolation was achieved using paramagnetic oligo (dT)25 beads within a microfluidic channel which incorporated a sawtooth microstructured design to aid in mixing. The structures were shown to facilitate mixing beteen two fluids in parallel flow when compared to a channel without structures. The chip was fabricated by means of hot embossing poly(methyl methacrylate) (PMMA) using a copper master. Copper was used as the master material due to its excellent thermal, mechanical, and electroplating properties. Fabrication of the master consisted of the structuring of a polished copper plate using KMPR 1050 as an electroplating mold for forming the microchannel structures. The copper master was found to be much more robust than traditional silicon masters used for prototyping. The use of KMPR enabled the generation of high straight walls in contrast to SU-8 masters. In addition, embossing times were able to be decreased by a factor of 3 due to improved heat conduction and avoidance of a lengthy and delicate de-embossing step

PMMA biosensor for nucleic acids with integrated mixer and electrochemical detection

This paper discusses the design, microfabrication and use of an electrochemical biosensor based on a polymer substrate for cost effectiveness and disposability. As model analyte, amplified hsp70 mRNA from Cryptosporidium parvum was chosen. Microfluidic channels were fabricated in poly(methyl methacrylate) (PMMA) using hot embossing with a copper master. The electrochemical transducer, an interdigitated ultramicroelectrode array (IDUA) was also realized directly on the PMMA surface. First, the unstructured PMMA surface was UV functionalized. An 8 min UV treatment resulted in a carboxylic acid density of approximately 8 nmol/cm2 on the PMMA surface. The surface carboxylic acid groups were then conjugated to cystamine using water-soluble carbodiimide chemistry. Gold (200 nm) was then evaporated onto the thiol-functionalized surface. Using standard photolithography techniques, the IDUA containing 10 μm wide electrodes with 5 μm gaps was then formed followed by a gold etch. The PMMA surface containing the microchannel was subsequently bonded to the PMMA surface containing the IDUA using UV-assisted thermal bonding. The additional UV treatment also served to decrease the water contact angle of the surface from 62.5° ± 0.7° to 48.4° ± 0.2° thus, aiding with the capillary flow in the device. The hsp70 mRNA was isolated from C. parvum oocysts and amplified using nucleic acid sequence-based amplification (NASBA). The amplicon was detected in a sandwich hybridization assay with capture probe-coated superparamagnetic beads and reporter probe-tagged liposomes. The liposomes entrapped potassium ferro/ferrihexacyanide to enable amperometric quantification of the amplicon on the IDUA. Amplified mRNA from only 1 oocyst was detectable with this PMMA biosensor. The final detection device measured approximately 10 mm × 40 mm × 3 mm and contained two detection channels for dual analyses