Clinical Pastoral Education Down Under: Supervision within Clinical Pastoral Education Programs in Victoria, Australia

Authors describe their experiences of conducting clinical pastoral education in Victoria, Australia, the strengths and challenges

Solenochilus Springeri (White & St. John, 1868) from the Pennsylvanian of Southern Iowa

The unique Pennsylvanian nautilid Solenochilus springeri is described with reference to material from the lower Cherokee Group (Atokan or Desmoinesian) of Marion County, Iowa, and the Bloyd Formation (Morrowan) of northwestern Arkansas. The species was based originally on a specimen, now lost, from Adair County, Iowa; a neotype is selected from the Marion County collections. The detailed morphology of the pair of dorsolateral spines which characterize mature Solenochilus is described for the first time. These spines, whose length approximates the width of the mature body chamber, are hollow throughout. Each spine originated as a lateral expansion of a prominent dorsolateral ridge located on the umbilical shoulder

Stenolobulites n. gen., Early Permian ancestor of predominantly Late Permian Paragastrioceratid subfamily Pseudogastrioceratinae

20 p., 10 fig.http://paleo.ku.edu/contributions.htm

Prevalence of atrial fibrillation in a regional Victoria setting, findings from the crossroads studies (2001–2003 and 2016–2018)

Objective: To estimate the prevalence of atrial fibrillation (AF) in regional Victoria at two time points (2001-2003 and 2016-2018), and to assess the use of electrocardiogram rhythm strips in a rural, community-based study for AF investigation. Design: Repeated cross-sectional design involving survey of residents of randomly selected households and a clinic. Predictors of AF were assessed using Firth penalised logistic regression, as appropriate for rare events. Setting: Goulburn Valley, Victoria. Participants: Household residents aged >= 16years. Non-pregnant participants aged 18+ were eligible for the clinic. Main outcome measures: Atrial fibrillation by 12 lead electrocardiogram (earlier study) or electrocardiogram rhythm strip (AliveCor (R) device) (recent study). Results: The age standardised prevalence of AF was similar between the two studies (1.6% in the 2001-2003 study and 1.8% in the 2016-2018 study, 95% confidence interval of difference -0.010, 0.014, p = 0.375). The prevalence in participants aged >= 65years was 3.4% (1.0% new cases) in the recent study. Predictors of AF in the earlier study were male sex, older age and previous stroke, while in the recent study they were previous stroke and self-reported diabetes. AliveCor (R) traces were successfully classified by the in-built algorithm (91%) vs physician (100%). Conclusion: The prevalence of AF among community-based participants in regional Victoria was similar to predominantly metropolitan-based studies, and was unchanged over time despite increased rates of risk factors. Electrocardiogram rhythm strip investigation was successfully utilised, and particularly benefited from physician overview

Patients’ and caregivers’ contested perspectives on spiritual care for those affected by advanced illnesses: A qualitative descriptive study

Context; Spiritual care refers to practices and rituals addressing spiritual/religious concerns. It supports coping with loss and finding hope, meaning, and peace. Although integral to palliative care, its implementation is challenging. Objective: To understand an Australian cohort of patients’ and caregivers’ perspectives about experiencing and optimizing spiritual care in the context of advanced illness. Methods: Patients and caregivers of patients with #12 month prognosis were recruited from a broader spiritual study via criterion sampling and agreed to opt-in interviews. Participants from an Australian, metropolitan health service received a spiritual care definition and were interviewed. Transcripts were analyzed using qualitative description. Results: 30 patients (17 male; mean age 70 years) and 10 caregivers (six male; mean age 58.9 years) participated. 27 identified as Christian, and 10 had no religion. Participants described multifaceted and contested beliefs about spirituality. Many queried the tangibility of spirituality, but all valued respectful staff who affirmed personhood, that is, each individual’s worth, especially when care exceeded expectations. They also resonated with positive organizational and environmental tones that improved holistic well-being. Participants stressed the importance of the hospital’s welcoming context and skilled care, which comforted and reassured. Conclusion: Although many patients and caregivers did not resonate with the term ‘‘spiritual care,’’ all described how the hospital’s hospitality could affirm their values and strengthen coping. The phrase ‘‘spiritual care and hospitality’’ may optimally articulate and guide care in similar, pluralist inpatient palliative care contexts, recognizing that such care encompasses an interplay of generalist and specialist pastoral care staff and organizational and environmental qualities

“Life within the person comes to the fore”: Pastoral workers’ practice wisdom on using arts in palliative care

Background: Pastoral care (also chaplaincy, spiritual care) assists people to find meaning, personal resources, and connection with self, others, and/or a higher power. Although essential in palliative care, there remains limited examination of what pastoral workers do. This study examined how pastoral workers use and consider the usefulness of art-based modalities. Methods: Qualitative research was used to examine the practice wisdom (tacit practice knowledge) of pastoral workers experienced in using visual arts and music in palliative care. Two focus groups were conducted. Thematic analysis was informed by grounded theory. Results: Six pastoral workers shared information. Three themes emerged. First, pastoral workers use arts as “another tool” to extend scope of practice by assisting patients and families to symbolically and more deeply contemplate what they find “sacred.” Second, pastoral workers’ art affinities inform their aims, assessments, and interactions. Third, pastoral workers perceive that art-based modalities can validate, enlighten, and transform patients and families through enabling them to “multisensorially” (through many senses) feel recognized, accepted, empowered, and/or close to God. Key elements involved in the work’s transformative effects include enabling beauty, ritual, and the sense of “home” being heard, and legacy creation. Discussion and Conclusion: Pastoral workers interpret that offering art-based modalities in palliative care can help patients and families to symbolically deal with painful memories and experiences, creatively engage with that deemed significant, and/or encounter a sense of transcendence. Training in generalist art-based care needs to be offered in pastoral education

Host cell deformability is linked to transmission in the human malaria parasite Plasmodium falciparum

available in PMC 2013 July 01.Gametocyte maturation in Plasmodium falciparum is a critical step in the transmission of malaria. While the majority of parasites proliferate asexually in red blood cells, a small fraction of parasites undergo sexual conversion and mature over 2 weeks to become competent for transmission to a mosquito vector. Immature gametocytes sequester in deep tissues while mature stages must be able to circulate, pass the spleen and present themselves to the mosquito vector in order to complete transmission. Sequestration of asexual red blood cell stage parasites has been investigated in great detail. These studies have demonstrated that induction of cytoadherence properties through specific receptor–ligand interactions coincides with a significant increase in host cell stiffness. In contrast, the adherence and biophysical properties of gametocyte-infected red blood cells have not been studied systematically. Utilizing a transgenic line for 3D live imaging, in vitro capillary assays and 3D finite element whole cell modelling, we studied the role of cellular deformability in determining the circulatory characteristics of gametocytes. Our analysis shows that the red blood cell deformability of immature gametocytes displays an overall decrease followed by rapid restoration in mature gametocytes. Intriguingly, simulations suggest that along with deformability variations, the morphological changes of the parasite may play an important role in tissue distribution in vivo. Taken together, we present a model, which suggests that mature but not immature gametocytes circulate in the peripheral blood for uptake in the mosquito blood meal and transmission to another human host thus ensuring long-term survival of the parasite.National Institutes of Health (U.S.) (R01A107755801)National Institutes of Health (U.S.) (R01HL094270)Singapore–MIT Alliance for Research and Technology ((SMART) Infectious Diseases Interdisciplinary Research Group)Singapore-MIT Alliance (Advanced Materials for Micro and Nano Systems Programme)Alexander von Humboldt-Stiftung (Feodor Lynen Research Fellowship

Deformability limits of Plasmodium falciparum-infected red blood cells

Splenic filtration of infected red blood cells (RBCs) may contribute to innate immunity and variable outcomes of malaria infections. We show that filterability of individual RBCs is well predicted by the minimum cylindrical diameter (MCD) which is calculated from a RBC's surface area and volume. The MCD describes the smallest diameter tube or smallest pore that a cell may fit through without increasing its surface area. A microfluidic device was developed to measure the MCD from thousands of individual infected RBCs (IRBCs) and uninfected RBCs (URBCs). Average MCD changes during the blood-stage cycle of Plasmodium falciparum were tracked for the cytoadherent strain ITG and the knobless strain Dd2. The MCD values for IRBCs and URBCs raise several new intriguing insights into how the spleen may remove IRBCs: some early-stage ring-IRBCs, and not just late-stage schizont-IRBCs, may be highly susceptible to filtration. In addition, knobby parasites may limit surface area expansions and thus confer high MCDs on IRBCs. Finally, URBCs, in culture with IRBCs, show higher surface area loss which makes them more susceptible to filtration than naive URBCs. These findings raise important basic questions about the variable pathology of malaria infections and metabolic process that affect volume and surface area of IRBCs

PRIMO: an interactive homology modeling pipeline

The development of automated servers to predict the three-dimensional structure of proteins has seen much progress over the years. These servers make calculations simpler, but largely exclude users from the process. In this study, we present the PRotein Interactive MOdeling (PRIMO) pipeline for homology modeling of protein monomers. The pipeline eases the multi-step modeling process, and reduces the workload required by the user, while still allowing engagement from the user during every step. Default parameters are given for each step, which can either be modified or supplemented with additional external input. PRIMO has been designed for users of varying levels of experience with homology modeling. The pipeline incorporates a user-friendly interface that makes it easy to alter parameters used during modeling