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competency by design

Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose body mass index is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
October 19, 2016: Minerva Anestesiologica
Zhen-Yu Guan, Chao-Wei Huang, Mei-Ching Huang, Chih-Yu Wu, Hui-Yu Liu, Shih-Torng Ding, Hsien-Yeh Chen
Multifunctional biomaterial surfaces can be created by controlling the competing adsorption of multiple proteins. To demonstrate this concept, bone morphogenetic protein 2 (BMP-2) and fibronectin were adsorbed to the hydrophobic surface of polychloro-para-xylylene. The resulting adsorption properties on the surface depended on the dimensional and steric characteristics of the selected protein molecule, the degree of denaturation of the adsorbed proteins, the associated adsorption of interphase water molecules within the protein layers, and the aggregation of proteins in a planar direction with respect to the adsorbent surface...
October 11, 2016: Colloids and Surfaces. B, Biointerfaces
Jenny M Pedersen, Yoo-Sik Shim, Vaibhav Hans, Martin B Phillips, Jeffrey M Macdonald, Glenn Walker, Melvin E Andersen, Harvey J Clewell, Miyoung Yoon
Accurate prediction of metabolism is a significant outstanding challenge in toxicology. The best predictions are based on experimental data from in vitro systems using primary hepatocytes. The predictivity of the primary hepatocyte-based culture systems, however, is still limited due to well-known phenotypic instability and rapid decline of metabolic competence within a few hours. Dynamic flow bioreactors for three-dimensional cell cultures are thought to be better at recapitulating tissue microenvironments and show potential to improve in vivo extrapolations of chemical or drug toxicity based on in vitro test results...
2016: Frontiers in Bioengineering and Biotechnology
Marion A David, Stéphane Orlowski, Roger K Prichard, Shaima Hashem, François André, Anne Lespine
Macrocyclic lactones (ML) are important anthelmintics used in animals and humans against parasite nematodes, but their therapeutic success is compromised by the spread of ML resistance. Some ABC transporters, such as p-glycoproteins (Pgps), are selected and overexpressed in ML-resistant nematodes, supporting a role for some drug efflux proteins in ML resistance. However, the role of such proteins in ML transport remains to be clarified at the molecular level. Recently, Caenorhabditis elegans Pgp-1 (Cel-Pgp-1) has been crystallized, and its drug-modulated ATPase function characterized in vitro revealed Cel-Pgp-1 as a multidrug transporter...
September 15, 2016: International Journal for Parasitology, Drugs and Drug Resistance
Silvia Colella, Marco Mazzeo, Aurora Rizzo, Giuseppe Gigli, Andrea Listorti
Incubating in the rise of the perovskite photovoltaic era, an intelligent material design allows now for a fine tune of the properties, targeting also light-emitting applications. Herein benefits derive from the use of low dimensional and nanostructured perovskites, marginally exploited in photovoltaic devices, allowing for exciton engineering and for intrinsic resonating structures. By evaluating halide perovskites, envisioning light-emitting applications, particular attention is dedicated to the role that this material can effectively play in the field...
October 14, 2016: Journal of Physical Chemistry Letters
Lori A Stolz, Uwe Stolz, J Matthew Fields, Turandot Saul, Michael Secko, Matthew J Flannigan, Johnathan M Sheele, Robert P Rifenburg, Anthony J Weekes, Elaine B Josephson, John Bedolla, Dana M Resop, Jonathan Dela Cruz, Megan Boysen-Osborn, Terrell Caffery, Charlotte Derr, Rimon Bengiamin, Gerardo Chiricolo, Brandon Backlund, Jagdipak Heer, Robert J Hyde, Srikar Adhikari
OBJECTIVES: Emergency ultrasound (EUS) has been recognized as integral to the training and practice of emergency medicine (EM). The Council of Emergency Medicine Residency-Academy of Emergency Ultrasound (CORD-AEUS) consensus document provides guidelines for resident assessment and progression. The Accredited Council for Graduate Medical Education (ACGME) has adopted the EM Milestones for assessment of residents' progress during their residency training which includes demonstration of procedural competency in bedside ultrasound...
October 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Eszter Szilassy, Jess Drinkwater, Marianne Hester, Cath Larkins, Nicky Stanley, William Turner, Gene Feder
We describe the development of an evidence-based training intervention on domestic violence and child safeguarding for general practice teams. We aimed - in the context of a pilot study - to improve knowledge, skills, attitudes and self-efficacy of general practice clinicians caring for families affected by domestic violence. Our evidence sources included: a systematic review of training interventions aiming to improve professional responses to children affected by domestic violence; content mapping of relevant current training in England; qualitative assessment of general practice professionals' responses to domestic violence in families; and a two-stage consensus process with a multi-professional stakeholder group...
October 14, 2016: Health & Social Care in the Community
Sheila Cyril, Julie Green, Jan M Nicholson, Kingsley Agho, Andre M N Renzaho
BACKGROUND: Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services...
2016: PloS One
Emily A Ruden, David P Way, Rollin W Nagel, Fern Cheek, Alex J Auseon
BACKGROUND: Best practices in the teaching of performance and interpretation of echocardiography to cardiology fellows are unknown, and thus, it has traditionally been performed through an apprenticeship model. This review summarizes the existing literature describing evidence-based teaching of echocardiography. METHODS: A comprehensive search of multiple scientific and educational databases included prospective studies describing an educational intervention for teaching echocardiography to physicians...
October 13, 2016: Echocardiography
Susanne Salmela, Camilla Koskinen, Katie Eriksson
AIMS: To identify the distinctive foundations of the care culture and how nurse leaders (NL) can manage and strengthen these in a quest for ethically sustainable caring cultures. BACKGROUND: Sustainability presupposes an ethical leadership, a management of the good care and a well-educated staff, but research on NLs as managers of ethically sustainable caring cultures is not available. DESIGN: The study has a quantitative design with elements of a qualitative research approach...
October 12, 2016: Journal of Advanced Nursing
Gabrielle Weidemann, Amy McAndrew, Evan J Livesey, Ian P L McLaren
The Perruchet effect constitutes a robust demonstration that it is possible to dissociate conditioned responding and expectancy in a random partial reinforcement design across a variety of human associative learning paradigms. This dissociation has been interpreted as providing evidence for multiple processes supporting learning, with expectancy driven by cognitive processes that lead to a Gambler's fallacy, and the pattern of conditioned responding (CRs) the result of an associative learning process. An alternative explanation is that the pattern of CRs is the result of exposure to the unconditioned stimulus (US)...
October 2016: Journal of Experimental Psychology. Animal Learning and Cognition
Oliver Mauthner, Veerle Claes, Jeremy Walston, Sandra Engberg, Isabelle Binet, Michael Dickenmann, Déla Golshayan, Karine Hadaya, Uyen Huynh-Do, Stefano Calciolari, Sabina De Geest
AIM: To present the rationale, design and methodology of the GERAS project, which examines whether assessment of frailty and mild cognitive impairment could enhance risk prediction for biomedical, psychosocial outcomes and foster efficient resource allocation in kidney transplantation. BACKGROUND: For the burgeoning cohort of older patients considered for kidney transplantation, evidence gaps regarding frailty and mild cognitive impairment limit clinical decision-making and medical management...
October 12, 2016: Journal of Advanced Nursing
Yunhao Tan, Jonathan C Kagan
The receptors of the mammalian innate immune system are designed for rapid microbial detection, and are located in organelles that are conducive to serve these needs. However, emerging evidence indicates that the sites of microbial detection are not the sites of innate immune signal transduction. Rather, microbial detection triggers the movement of receptors to regions of the cell where factors called sorting adaptors detect active receptors and promote downstream inflammatory responses. These findings highlight the critical role that membrane trafficking pathways play in the initiation of innate immunity to infection...
October 12, 2016: Traffic
Peter Nicklen, Jennifer L Keating, Stephen Maloney
BACKGROUND: Case-based learning (CBL) is an educational approach where students work in small, collaborative groups to solve problems. Web-conferencing software provides a platform to present information and share concepts that are vital to CBL. Previous studies have found that participants were resistant to change associated with implementing e-learning; however, strategies to reduce this resistance have not been explored. OBJECTIVE: This study was designed to explore student preconceptions and understanding of remote-online case-based learning (RO-CBL)...
April 28, 2016: JMIR Med Educ
René Cardeña, Idania Valdez-Vazquez, Germán Buitrón
Purple non-sulfur bacteria generate hydrogen and polyhydroxybutyrate (PHB) as a mechanism for disposing of reducing equivalents generated during substrate consumption. However, both pathways compete for the reducing equivalents released from bacteria growing under certain substrates, thus the formation of hydrogen or PHB is detrimental to the formation of each other. The effect of mixtures of acetic, propionic and butyric acids on the formation of H2 and PHB was evaluated using Box-Behnken design. A bacterial community mainly constituted by Rhodopseudomonas palustris was used as inoculum...
October 11, 2016: Bioprocess and Biosystems Engineering
Tatiana Traboulsi, Mohamed El Ezzy, James Gleason, Sylvie Mader
About 70% of breast tumors express estrogen receptor alpha (ERα), which mediates the proliferative effects of estrogens on breast epithelial cells, and are candidates for treatment with antiestrogens, steroidal or non-steroidal molecules designed to compete with estrogens and antagonize ERs. The variable patterns of activity of antiestrogens (AEs) in estrogen target tissues and the lack of systematic cross-resistance between different types of molecules have provided evidence for different mechanisms of action...
October 11, 2016: Journal of Molecular Endocrinology
Henry Patrick Knapp
Once an emergency occurs, companies find themselves competing for diminishing resources. Companies mired in confusion and debate often fail to obtain the resources necessary for a speedy recovery and fail to meet the expectations of their various interested parties. Unfortunately, it is during these emergencies that the firm is judged. Unfavourable evaluations of a company by customers, the government and/or the general public result in lost future revenue through contracts that are either not renewed or cancelled, as well as disqualification from tenders and lost bids...
2016: Journal of Business Continuity & Emergency Planning
Christine L Gray, Brian W Pence, Lynne C Messer, Jan Ostermann, Rachel A Whetten, Nathan M Thielman, Karen O'Donnell, Kathryn Whetten
BACKGROUND: Communities and nations seeking to foster social responsibility in their youth are interested in understanding factors that predict and promote youth involvement in public activities. Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in resource-poor settings. Understanding whether and how OSC are engaged in civic activities is important for community and world leaders who need to provide care for OSC and ensure their involvement in sustainable development...
October 11, 2016: Globalization and Health
Antoine Tanet, Annik Hubert-Barthelemy, Graciela C Crespin, Nicolas Bodeau, David Cohen, Catherine Saint-Georges
INTRODUCTION: Individuals with autism spectrum disorder (ASD) who also exhibit severe-to-moderate ranges of intellectual disability (ID) still face many challenges (i.e., less evidence-based trials, less inclusion in school with peers). METHODS: We implemented a novel model called the "Developmental and Sequenced One-to-One Educational Intervention" (DS1-EI) in 5- to 9-year-old children with co-occurring ASD and ID. The treatment protocol was adapted for school implementation by designing it using an educational agenda...
2016: Frontiers in Pediatrics
Jenny Z Zhang, Katarzyna P Sokol, Nicholas Paul, Elisabet Romero, Rienk van Grondelle, Erwin Reisner
The integration of the water-oxidation enzyme photosystem II (PSII) into electrodes allows the electrons extracted from water oxidation to be harnessed for enzyme characterization and to drive novel endergonic reactions. However, PSII continues to underperform in integrated photoelectrochemical systems despite extensive optimization efforts. Here we carried out protein-film photoelectrochemistry using spinach and Thermosynechococcus elongatus PSII, and we identified a competing charge transfer pathway at the enzyme-electrode interface that short-circuits the known water-oxidation pathway...
October 10, 2016: Nature Chemical Biology
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