Introducing Interprofessional Education and Care Concepts in a Geriatric Multilevel Centre: Development and Introduction of a Toolkit for Staff and Students

Background: Although interprofessional education (IPE) is not new, there has been limited research in IPE focused on the care of older adults. The objective of this study was to develop and implement an interprofessional education and care (IPE/C) toolkit, to help staff and students understand and apply the concepts of IPE/C.Methods and Findings: Focus groups identified staff and students’ understanding of IPE/C and informed development of an IPE/C toolkit comprised of IPE/C tools and resources. Five clinical teams (N = 51) attended workshops that introduced the toolkit and educated teams about IPE/C. Focus group participants had heard of but had limited exposure to IPE/C. Responses to the Attitudes Toward Health Care Teams (ATHT) questionnaire indicated a positive trend on all questions; 2 questions in subscale 1 were statistically significant (p = .01 & p = .005), indicating a positive attitude toward teams and teamwork. Several limitations were identified, including inconsistent attendance at workshops, scheduling challenges, and limited physician participation.Conclusions: This pilot project provided baseline data on staff and students’ understanding of and attitudes toward IPE/C in a multilevel geriatric centre and demonstrated that an IPE/C toolkit delivered via team workshops can enhance healthcare team attitudes. Next steps include expanding the rollout to other teams and introducing the toolkit to all staff and students

Respiratory simulator for robotic respiratory tract treatments

Robotic healthcare is a growing and multi-faceted field where robots help perform surgery, remotely provide care to patients, aid in supplying various physical therapies and further medical research. Robotic simulators of human physiology provide a powerful platform to advance the development of novel treatments, prostheses and therapies. This study focuses on the design, building, testing and characterisation of a novel simulator of the human respiratory system. The comparison between healthy subjects breathing and coughing physiological values and the values achieved utilising our novel bioinspired respiratory simulator shows that the latter is able to reproduce peak flow rates and volumes

Heterodimerization of Arabidopsis calcium/proton exchangers contributes to regulation of guard cell dynamics and plant defense responses

Arabidopsis thaliana cation exchangers (CAX1 and CAX3) are closely related tonoplast-localized calcium/proton (Ca²⁺/H⁺) antiporters that contribute to cellular Ca²⁺ homeostasis. CAX1 and CAX3 were previously shown to interact in yeast; however, the function of this complex in plants has remained elusive. Here, we demonstrate that expression of CAX1 and CAX3 occurs in guard cells. Additionally, CAX1 and CAX3 are co-expressed in mesophyll tissue in response to wounding or flg22 treatment, due to the induction of CAX3 expression. Having shown that the transporters can be co-expressed in the same cells, we demonstrate that CAX1 and CAX3 can form homomeric and heteromeric complexes in plants. Consistent with the formation of a functional CAX1-CAX3 complex, CAX1 and CAX3 integrated into the yeast genome suppressed a Ca²⁺-hypersensitive phenotype of mutants defective in vacuolar Ca²⁺ transport, and demonstrated enzyme kinetics different from those of either CAX protein expressed by itself. We demonstrate that the interactions between CAX proteins contribute to the functioning of stomata, because stomata were more closed in cax1-1, cax3-1, and cax1-1/cax3-1 loss-of-function mutants due to an inability to buffer Ca²⁺ effectively. We hypothesize that the formation of CAX1-CAX3 complexes may occur in the mesophyll to affect intracellular Ca²⁺ signaling during defense responses.Bradleigh Hocking, Simon J. Conn, Murli Manohar, Bo Xu, Asmini Athman, Matthew A. Stancombe, Alex R. Webb, Kendal D. Hirschi and Matthew Gilliha

A Bioinspired Active Robotic Simulator of the Human Respiratory System

Pathologies affecting the respiratory system can lead to a debilitating decrease in quality of life and can be fatal. To test medical devices and implants for the human respiratory system, a simulation system that can reproduce multiple respiratory features is necessary. Currently available respiratory simulators only focus on reproducing flow rate profiles of breathing while coughing simulators focus on aerosol analysis. In this paper we propose a novel, bioinspired robotic simulator that can physically replicate both breathing and coughing flow rate characteristics of healthy adults. We conducted a study on 31 healthy adult participants to gather the flow rate measurement of normal breathing, deep breathing, breathing while running and coughing. Coughing flow rate profiles vary considerably between participants, making an accurate simulation of coughs a challenge. To enable cough flow rate simulation, a new methodology based on the identification of four cough phases, Attack, Decay, Sustain and Release (ADSR) and their parametrization was devised. This methodology leads to the unprecedented ability to reproduce diverse and complex coughing flow rate profiles. Our simulator is able to reproduce respiratory flows with a root mean square error (RMSE) of 1.8 L/min between normal participant breathing and its simulation, 5% of the maximum flow rate simulated for that participant (pMFR), an RMSE of 10.08 L/min for deep breathing, 18% of the pMFR and an RMSE of 13.29 L/min for exertion breathing, 17% of pMFR. For the simulation of an average cough we recorded an RMSE of 51.43 L/min, 13% of the pMFR and for a low flow rate cough an RMSE of 12.38 L/min, 9.5% of the pMFR. The presented simulator matches the fundamentals of human breathing and coughing, advancing the current capability of respiratory system simulators

Ethnic/Racial Differences in Peer and Parent Influence on Adolescent Prescription Drug Misuse

ABSTRACT: Purpose: To describe ethnic/racial group differences in prescription drug misuse within a nationally representative sample of US adolescents. Also to identify potential sociocultural influences on this health risk behavior. Methods: A secondary data analysis was conducted on the public-use data of the 2010 National Survey of Drug Use and Health using the records of 12-to 17-year-old African American, Hispanic, and white participants (N 5 18,614). Logistic and Poisson regression analyses focused on examining the predictive role of perceived parental and peer substance use disapproval on adolescents' prescription drug misuse and how these social influences varied by ethnic group. Results: Within this sample, 10.4% of adolescents endorsed misusing 1 or more subtypes of prescription drugs. The results showed significant ethnic group differences in rates of prescription drug misuse such that white adolescents reported the highest rates and African American adolescents reported the lowest rates of prescription drug misuse. Rates of misuse for Hispanic adolescents fell in between. Importantly, perceived parental and peer substance use disapproval decreased the likelihood of prescription drug misuse most significantly among white adolescents compared to Hispanic and African American adolescents. Furthermore, influence of disapproval differed by the type of substance, indicating ethnic group differences in disapproval, such as views of alcohol versus marijuana use. Conclusions: These findings provide new ethnic group-specific information about the role that the attitudes of peers and parents on substance use may play in whether adolescents misuse prescription drugs. Future studies should explore possible parent/peer-related socialization mechanisms, which may account for these ethnic group differences. (J Dev Behav Pediatr 35:257-265, 2014) Index terms: adolescents, substance abuse, prescription drugs, health risk, ethnic minority health

Bioenergy II: Characterization of the Pesticide Properties of Tobacco Bio-Oil

Pyrolysis converts biomass such as agricultural and forestry waste into bio-oil, preserving some chemicals while creating other, new ones. Nicotine, a chemical present in tobacco leaves and a known pesticide, was found to remain intact during pyrolysis. As expected, insecticidal properties were observed for tobacco bio-oil. Pesticide characteristics of tobacco bio-oil have been observed on the Colorado potato beetle (CPB), a pest currently resistant to all major insecticides, as well as a few bacteria and fungi that do not currently respond well to chemical treatment. Unexpectedly, nicotine-free fractions of the bio-oil were also found to be highly lethal to the beetles and successful at inhibiting the growth of select microorganisms. Through GC-MS, it was found that the active, nicotine-free fractions were rich in phenolics, chemicals likely created from lignin during pyrolysis. While bio-oils in general are known to contain phenolic chemicals, such as cresols, to our best knowledge, quantitative analysis has not been performed to determine if these chemicals are solely responsible for the observed pesticide activities. Based on GC-MS results, ten of the most abundant chemicals, eight of which were phenolic chemicals, were identified and examined through bio-assays. A mixture of these chemicals at the concentration levels found in the bio-oil did not account for the bio-oil activity towards the microorganisms. Tobacco bio-oil may have potential as a pesticide, however, further analyses using liquid chromatography is necessary to identify the remaining active chemicals

Variation for N uptake system in maize: genotypic response to N supply

An understanding of the adaptations made by plants in their nitrogen (N) uptake systems in response to reduced N supply is important to the development of cereals with enhanced N uptake efficiency (NUpE). Twenty seven diverse genotypes of maize (Zea mays, L.) were grown in hydroponics for 3 weeks with limiting or adequate N supply. Genotypic response to N was assessed on the basis of biomass characteristics and the activities of the nitrate ([Formula: see text]) and ammonium ([Formula: see text]) high-affinity transport systems. Genotypes differed greatly for the ability to maintain biomass with reduced N. Although, the N response in underlying biomass and N transport related characteristics was less than that for biomass, there were clear relationships, most importantly, lines that maintained biomass at reduced N maintained net N uptake with no change in size of the root relative to the shoot. The root uptake capacity for both [Formula: see text] and [Formula: see text] increased with reduced N. Transcript levels of putative [Formula: see text] and [Formula: see text] transporter genes in the root tissue of a subset of the genotypes revealed that predominately ZmNRT2 transcript levels responded to N treatments. The correlation between the ratio of transcripts of ZmNRT2.2 between the two N levels and a genotype's ability to maintain biomass with reduced N suggests a role for these transporters in enhancing NUpE. The observed variation in the ability to capture N at low N provides scope for both improving NUpE in maize and also to better understand the N uptake system in cereals.Trevor Garnett, Darren Plett, Vanessa Conn, Simon Conn, Huwaida Rabie, J. Antoni Rafalski, Kanwarpal Dhugga, Mark A. Tester and Brent N. Kaise

ATF4 couples MYC-dependent translational activity to bioenergetic demands during tumour progression.

The c-Myc oncogene drives malignant progression and induces robust anabolic and proliferative programmes leading to intrinsic stress. The mechanisms enabling adaptation to MYC-induced stress are not fully understood. Here we reveal an essential role for activating transcription factor 4 (ATF4) in survival following MYC activation. MYC upregulates ATF4 by activating general control nonderepressible 2 (GCN2) kinase through uncharged transfer RNAs. Subsequently, ATF4 co-occupies promoter regions of over 30 MYC-target genes, primarily those regulating amino acid and protein synthesis, including eukaryotic translation initiation factor 4E-binding protein 1 (4E-BP1), a negative regulator of translation. 4E-BP1 relieves MYC-induced proteotoxic stress and is essential to balance protein synthesis. 4E-BP1 activity is negatively regulated by mammalian target of rapamycin complex 1 (mTORC1)-dependent phosphorylation and inhibition of mTORC1 signalling rescues ATF4-deficient cells from MYC-induced endoplasmic reticulum stress. Acute deletion of ATF4 significantly delays MYC-driven tumour progression and increases survival in mouse models. Our results establish ATF4 as a cellular rheostat of MYC activity, which ensures that enhanced translation rates are compatible with survival and tumour progression

The Local Interstellar Ultraviolet Radiation Field

I have used the Hipparcos Input Catalog, together with Kurucz model stellar atmospheres, and information on the strength of the interstellar extinction, to create a model of the expected intensity and spectral distribution of the local interstellar ultraviolet radiation field, under various assumptions concerning the albedo a of the interstellar grains. (This ultraviolet radiation field is of particular interest because of the fact that ultraviolet radiation is capable of profoundly affecting the chemistry of the interstellar medium.) By comparing my models with the observations, I am able to conclude that the albedo a of the interstellar grains in the far ultraviolet is very low, perhaps a = 0.1. I also advance arguments that my present determination of this albedo is much more reliable than any of the many previous (and conflicting) ultraviolet interstellar grain albedo determinations. Beyond this, I show that the ultraviolet background radiation that is observed at high galactic latitudes must be extragalactic in origin, as it cannot be backscatter of the interstellar radiation field.Comment: Astrophysical Journal, in press; 9 figures + 16 text page