Inclusive education for students with severe or profound and multiple learning difficulties: Identification of influencing factors and challenges

In the study reported on here we examined the extent of pre-service teachers’ supportiveness for educational inclusion (EI) of students with severe or profound and multiple learning difficulties (SPMLD) in order to identify their attitudinal predictors, as well as the challenges faced in such a process. An attitudinal survey with 33 items was developed to collect data from 542 participants. The results show that the attitudes/beliefs of pre-service teachers (ABpST) regarding inclusion were moderate to positive and strengthened across the teachers’ knowledge and experiences. However, some variations, based on their characteristics and study constructs were revealed. The findings also illustrate the combined effects of practical knowledge and courses, besides teaching and working  experiences in shaping ABpST attitudes towards inclusion of SPMLD students. The implications of these results for educators and national education institutions and other international universities are discussed. Keywords: attitude/beliefs; educational inclusion; pre-service teachers; SPMLD student

Ultrastructural studies on the salivary glands of ticks : Haemaphysalis leachii leachii (Audouin) (Ixodoidea: Ixodidae) and Ornithodoros (Ornithodoros) moubata (Murray) (Ixodoidea: Argasidae)

Salivary glands of the unfed tick Haemaphysalis leachii contain four types of alveoli. Type I alveoli have the morphological characteristics of transporting epithelia. Types II, III and IV are granule-secreting alveoli and are considered to secrete the enzymes and cement components required during feeding. After female attachment, types II, III and IV alveoli are initially concerned with the secretion of granular materials but become involved with fluid secretion as feeding progresses. Salivary glands of the unfed ticks Ornithodoros moubata contain two types of alveoli. Type I is similar to that of H. leachii. Type II are granule-secreting alveoli but structurally differ from those of H. leachii. These alveoli do not secrete cement and are not significantly active during feeding. Salivation processes in the tick H. leachii and 0. moubata seem to be mainly under neural control

Capitalizing on Opportunities for Reaching Patients: Utilization of Providers in Delivering Medication Therapy Management (MTM) Services

Class of 2018 AbstractSpecific Aims: The specific aim of the project is the study the impact of connecting with primary care providers of eligible patients to complete MTM services though pharmacist-delivered CMRs. Our primary working hypothesis is that provider engagement though the Provider Outreach Program (POP) will allow more patients to receive MTM services than the standard MTM process. Methods: This study used a descriptive, retrospective design. Inclusion criteria for this study consisted of patients enrolled in the Provider Outreach Program. Beneficiaries of the program were the patients with two or more chronic conditions and taking multiple prescription medications eligible to receive MTM services as part of their Medicare Part D or individual prescription coverage. Since this study will be from 21 states and over a period of 4.75 months the estimated sample size was calculated to be roughly 53,000. The independent variable is the Provider Outreach Program (POP). The POP targets patients that the standard MTM process is unable to reach by directly contacting providers to increase the number of patients who benefit from MTM services. Demographics for all study participants consist of Medicare qualifying patients (65 years or older, disability, or end-stage renal disease). Descriptive variables will be participating state, total faxes sent, medication list received, POP CMRs completed, total outbound calls, standard CMRs completed, and reasons for denial of communication. The descriptive variables were analyzed by calculating percentages and totals for continuous variables (total faxes sent, medication lists received, POP CMRs completed, standard CMRs completed, and total outbound calls). Main Results: Of the total 52,170 faxes sent, 9,043 medication lists were received (17.9%) from PCPs. There was a 3.8-fold difference in successful CMR completion rates between the POP (16.4%) and the standard MTM program (4.3%). Conclusions: The POP can be utilized as a method to strengthen the outcomes of the standard process to increase the number of patients who benefit from MTM services.This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Librarian and Clinical Instructor, Pharmacy Practice and Science, [email protected]

The thermodynamics of DNA loop formation, from J to Z

The formation of DNA loops is a ubiquitous theme in biological processes, including DNA replication, recombination and repair, and gene regulation. These loops are mediated by proteins bound at specific sites along the contour of a single DNA molecule, in some cases many thousands of base pairs apart. Loop formation incurs a thermodynamic cost that is a sensitive function of the length of looped DNA as well as the geometry and elastic properties of the DNA-bound protein. The free energy of DNA looping is logarithmically related to a generalization of the Jacobson-Stockmayer factor for DNA cyclization, termed the J factor. In the present article, we review the thermodynamic origins of this quantity, discuss how it is measured experimentally and connect the macroscopic interpretation of the J factor with a statistical-mechanical description of DNA looping and cyclization

Endoscopic Retrograde Cholangiopancreatography–Induced Splenic Injury in a Patient With Sleeve Gastrectomy

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure with significant complications. Splenic hematoma is an extremely rare but known complication following ERCP that has been increasingly reported in the past several years. We report the case of a 44-year-old patient with a history of sleeve gastrectomy who underwent an ERCP that was complicated by both acute pancreatitis and splenic hematoma. She was managed conservatively under close monitoring in the intensive care unit. Clinicians should be aware of this potentially life-threatening complication to make a prompt diagnosis and begin early appropriate management

Two forms of short-interval intracortical inhibition in human motor cortex

Background: Pulses of transcranial magnetic stimulation (TMS) with a predominantly anterior-posterior (AP) or posterior-anterior (PA) current direction over the primary motor cortex appear to activate distinct excitatory inputs to corticospinal neurons. In contrast, very few reports have examined whether the inhibitory neurons responsible for short-interval intracortical inhibition (SICI) are sensitive to TMS current direction. Objectives: To investigate whether SICI evaluated with AP and PA conditioning stimuli (CSPA and CSAP) activate different inhibitory pathways. SICI was always assessed using a PA-oriented test stimulus (TSPA). Methods: Using two superimposed TMS coils, CSPA and CSAP were applied at interstimulus intervals (ISI) of 1–5 ms before a TSPA, and at a range of different intensities. Using a triple stimulation design, we then tested whether SICI at ISI of 3 ms using opposite directions of CS (SICICSPA3 and SICICSAP3) interacted differently with three other forms of inhibition, including SICI at ISI of 2 ms (SICICSPA2), cerebellum-motor cortex inhibition (CBI 5 ms) and short-latency afferent inhibition (SAI 22 ms). Finally, we compared the effect of tonic and phasic voluntary contraction on SICICSPA3 and SICICSAP3. Results: CSAP produced little SICI at ISIs = 1 and 2 ms. However, at ISI = 3 ms, both CSAP and CSPA were equally effective at the same percent of maximum stimulator output. Despite this apparent similarity, combining SICICSPA3 or SICICSAP3 with other forms of inhibition led to quite different results: SICICSPA3 interacted in complex ways with CBI, SAI and SICICSPA2, whereas the effect of SICICSAP3 appeared to be quite independent of them. Although SICICSPA and SICICSAP were both reduced by the same amount during voluntary tonic contraction compared with rest, in a simple reaction time task SICICSAP was disinhibited much earlier following the imperative signal than SICICSPA. Conclusions: SICICSPA appears to activate a different inhibitory pathway to that activated by SICICSAP. The difference is behaviourally relevant since the pathways are controlled differently during volitional contraction. The results may explain some previous pathological data and open the possibility of testing whether these pathways are differentially recruited in a range of tasks

Nuttalliella namaqua: A Living Fossil and Closest Relative to the Ancestral Tick Lineage: Implications for the Evolution of Blood-Feeding in Ticks

Ticks are monophyletic and composed of the hard (Ixodidae) and soft (Argasidae) tick families, as well as the Nuttalliellidae, a family with a single species, Nuttalliella namaqua. Significant biological differences in lifestyle strategies for hard and soft ticks suggest that various blood-feeding adaptations occurred after their divergence. The phylogenetic relationships between the tick families have not yet been resolved due to the lack of molecular data for N. namaqua. This tick possesses a pseudo-scutum and apical gnathostoma as observed for ixodids, has a leathery cuticle similar to argasids and has been considered the evolutionary missing link between the two families. Little knowledge exists with regard to its feeding biology or host preferences. Data on its biology and systematic relationship to the other tick families could therefore be crucial in understanding the evolution of blood-feeding behaviour in ticks. Live specimens were collected and blood meal analysis showed the presence of DNA for girdled lizards from the Cordylid family. Feeding of ticks on lizards showed that engorgement occurred rapidly, similar to argasids, but that blood meal concentration occurs via malpighian excretion of water. Phylogenetic analysis of the 18S nuclear and 16S mitochondrial genes indicate that N. namaqua grouped basal to the main tick families. The data supports the monophyly of all tick families and suggests the evolution of argasid-like blood-feeding behaviour in the ancestral tick lineage. Based on the data and considerations from literature we propose an origin for ticks in the Karoo basin of Gondwanaland during the late Permian. The nuttalliellid family almost became extinct during the End Permian event, leaving N. namaqua as the closest living relative to the ancestral tick lineage and the evolutionary missing link between the tick families

Biomolecular simulations: From dynamics and mechanisms to computational assays of biological activity

Biomolecular simulation is increasingly central to understanding and designing biological molecules and their interactions. Detailed, physics‐based simulation methods are demonstrating rapidly growing impact in areas as diverse as biocatalysis, drug delivery, biomaterials, biotechnology, and drug design. Simulations offer the potential of uniquely detailed, atomic‐level insight into mechanisms, dynamics, and processes, as well as increasingly accurate predictions of molecular properties. Simulations can now be used as computational assays of biological activity, for example, in predictions of drug resistance. Methodological and algorithmic developments, combined with advances in computational hardware, are transforming the scope and range of calculations. Different types of methods are required for different types of problem. Accurate methods and extensive simulations promise quantitative comparison with experiments across biochemistry. Atomistic simulations can now access experimentally relevant timescales for large systems, leading to a fertile interplay of experiment and theory and offering unprecedented opportunities for validating and developing models. Coarse‐grained methods allow studies on larger length‐ and timescales, and theoretical developments are bringing electronic structure calculations into new regimes. Multiscale methods are another key focus for development, combining different levels of theory to increase accuracy, aiming to connect chemical and molecular changes to macroscopic observables. In this review, we outline biomolecular simulation methods and highlight examples of its application to investigate questions in biology. This article is categorized under: Molecular and Statistical Mechanics > Molecular Dynamics and Monte‐Carlo Methods Structure and Mechanism > Computational Biochemistry and Biophysics Molecular and Statistical Mechanics > Free Energy Method

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112