Critical Partner Research Articles

Development of the Quality of Life in Youth Services Scale (QOLYSS): Content-Related Validity Evidence Based on Adolescents’ and Expert Reviewers’ Perspectives

Despite increased interest in the quality of life of younger populations, the quality of life of youngsters in vulnerable situations such as those in youth services remains under-researched. To gain insight into critical ingredients for understanding and enhancing the lives of these youngsters, appropriate assessment tools are needed. This study focuses on providing content-related validity evidence for the new Quality of Life in Youth Services Scale (QOLYSS) for adolescents in youth services. A sequential approach to item generation, refinement, and evaluation is presented. The initial item bank is devised by means of a thorough literature search and evaluated against findings from qualitative research among adolescents in youth services. In addition, a three-round international expert panel (N = 5) is convened to align identified items to the adopted quality of life framework, and to provide evidence on domain representation and relevance. Last, input is collected from adolescents in youth services themselves. More specifically, 20 group discussions and 13 individual interview sessions are organized to support 21 adolescents in critically assessing the content of the item bank on level of relevance, clarity, and coverage. The expert panel resulted in a provisional scale of 262 unique items that, based on adolescents’ input, is further reduced to a set of 88 items. Adolescents omitted items because of divergent reasons (e.g., content-overlap, self-evident character of the items, level of irrelevance). Explanatory qualitative information on the item selection process is provided. This study provides a detailed understanding of the content-related validity evidence of a new multidimensional quality of life scale. Moreover, it highlights the importance of acknowledging youngsters as critical partner in quality of life research and assessment.

Can’t drive today? The impact of driving restrictions on bikeshare ridership in Mexico City

The Mexico City government has introduced policies to reduce pollution from cars, including a license-plate based driving restriction and a bikeshare. When restrictions are in place, people need to find transportation alternatives. This research leverages the random nature of driving restrictions to explore whether people use bikeshare when driving is restricted due to poor air quality. Negative binomial models were used to study these effects using data from 2016 to 2019. Results indicate that restricted days exhibit approximately 17% lower bikeshare use (10–24% decrease, 95% CI) for non-peak traffic hours compared to regular days. However, ridership increases during peak traffic hours. Morning ridership increases up to 12.5% (3–22% increase, 95% C.I) and evening ridership increases up to 16.2% (5–27.6% increase, 95% C.I). The analysis suggests that the poor environmental conditions may buffer bikeshare system use increases and that bikeshare can be a critical partner in local transportation infrastructure.

Caveolin-1 is Involved in Regulating the Biological Response of Cells to Nanosecond Pulsed Electric Fields.

Nanosecond pulsed electric fields (nsPEFs) induce changes in the plasma membrane (PM), including PM permeabilization (termed nanoporation), allowing free passage of ions into the cell and, in certain cases, cell death. Recent studies from our laboratory show that the composition of the PM is a critical determinant of PM nanoporation. Thus, we hypothesized that the biological response to nsPEF exposure could be influenced by lipid microdomains, including caveolae, which are specialized invaginations of the PM that are enriched in cholesterol and contain aggregates of important cell signaling proteins, such as caveolin-1 (Cav1). Caveolae play a significant role in cellular signal transduction, including control of calcium influx and cell death by interaction of Cav1 with regulatory signaling proteins. Present results show that depletion of Cav1 increased the influx of calcium, while Cav1 overexpression produced the opposite effect. Additionally, Cav1 is known to bind and sequester important cell signaling proteins within caveolae, rendering the binding partners inactive. Imaging of the PM after nsPEF exposure showed localized depletion of PM Cav1 and results of co-immunoprecipitation studies showed dissociation of two critical Cav1 binding partners (transient receptor potential cation channel subfamily C1 (TRPC1) and inositol trisphosphate receptor (IP3R)) after exposure to nsPEFs. Release of TRPC1 and IP3R from Cav1 would activate downstream signaling cascades, including store-operated calcium entry, which could explain the influx in calcium after nsPEF exposure. Results of the current study establish a significant relationship between Cav1 and the activation of cell signaling pathways in response to nsPEFs.

Utilizing Partnerships to Identify Community Needs and Analyze Network Collaboration in Public Health

Objective: LinkedUp is a multi-sector partnership focused on linking older teens (ages 17-19) to sexual and reproductive health (SRH) services at school-based health centers (SBHCs) in Mississippi. The purpose of this study was to examine key partnerships in LinkedUp development, focusing on community needs that initiated the formation of the partnership, and patterns of collaboration among these partners. Methods: In 2018, researchers conducted interviews (N = 3) and focus groups (N = 9) with Mississippi school administrators and high school and college students. In 2019, evaluators examined collaboration between these community partners (N = 6) using an interorganizational network analysis survey. Results: Thematic analyses of qualitative data indicated a need to commit to linking older teens to SRH services by increasing communication/ planning among community stakeholders. Network analysis scores included an average network density of 1, strength of tie of 3.04, and degree centrality of 4.6 (SD = 1.4) for partners. Conclusions: Our findings illustrate how community stakeholders inform the development of a public health program as critical partners during both needs assessment and program development phases. This information can be used by practitioners and policymakers interested in addressing complex, community-level health issues.

Iqgap3-Ras axis drives stem cell proliferation in the stomach corpus during homoeostasis and repair

ObjectiveTissue stem cells are central regulators of organ homoeostasis. We looked for a protein that is exclusively expressed and functionally involved in stem cell activity in rapidly proliferating isthmus stem...

Hearing Loss.

Hearing loss is highly prevalent and may significantly affect how we age. Although the population is aging, relatively few adults receive treatment for hearing loss. Internists are a critical partner to audiologists and otolaryngologists in caring for the adult population with hearing loss. This review provides a primer on diagnosing and managing hearing loss.

Developing Productive Skills through an Interactive Approach: Present to Learn

This paper aims at presenting an interactive approach that was implemented on Arab Open University (AOU) students to enrich their productive skills namely speaking, oral presentation and writing skills. The researcher aimed at establishing a community of practice through a blended learning environment which considers non-traditional multicultural leaner. This community of practice presents a combination of face-to-face facilitated learning, e-learning and self-study. The researcher applied “Present to Learn” approach on AOU students employing Johari Windows Model to develop the identified productive skills and break the students’ stage fright through collaboration in groups. An observation checklist was developed to check the students’ oral presentation and writing prompts. In addition, a questionnaire was developed to measure the students’ satisfaction towards the applied interactive approach and their assessment of the whole experiment. It was observed that cooperative work especially with having critical partners has improved the students’ performance achievement through learning from each other in one group and competing with other groups. The collected feedback from the questionnaire was in favour of applying this approach on more groups which was implemented across three consecutive academic semesters. Moreover, the students’ end results were statistically analysed and a correlation between high performance achievement and active participation inside and outside the class was drawn. The results have shown that students who participated by giving presentations reflecting their group work obtained higher grades than those who failed to work with others or did not give any presentations.

STAKEHOLDERS INVOLVEMENT IN MITIGATING DISASTER PREVALANCE FOR EFFECTIVE DISASTER MANAGEMENT

A literature search showed that studies on the categorization and roles of stakeholders engaged in disaster management are still in dearth. This could not be unrelated to the global trend of natural and man-made disasters. The objective of this research is therefore to examine the role played by stakeholders in combating the incidence of disasters in our modern culture. An audit of suitable writing is the method utilized to collect fitting data. The investigation found diverse strategies of categorizing calamity administration partners in past investigate. This investigates, after investigating current writing, distinguished critical partners, counting but not limited to government and its parastatals, NGOs, benefactors, the private segment, media, the scholarly world, territorial collaboration, community / citizen and the prompt environment. Based on the concept of partners, the acceptance that much might be fulfilled within the locale of calamity administration in case all partners are completely recognized, well-coordinated and regarded. In conclusion, this inquires about offers supportive information on the part of partners in relieving the rate of catastrophes to ensure productive administration of fiascos.

Learning health systems, embedded research, and data standards-recommendations for healthcare system leaders.

Learning health systems that conduct embedded research require infrastructure for the seamless adoption of clinical interventions; this infrastructure should integrate with electronic health record (EHR) systems and enable the use of existing data. As purchasers of EHR systems, and as critical partners, sponsors, and consumers of embedded research, healthcare organizations should advocate for EHR system functionality and data standards that will increase the capacity for embedded research in clinical settings. As stakeholders and proponents for EHR data standards, healthcare leaders should support standards development and promote local adoption to support quality healthcare, continuous improvement, innovative data-driven interventions, and the generation of new knowledge. “Standards-enabled” health systems will be positioned to address emergent and critical research questions, including those related to coronavirus disease 2019 (COVID-19) and future public health threats. The role of a data standards officer or champion could enable health systems to realize this goal.

Causality, poetics, and grammatology: the role of computation in machine seeing

Digitised collections and born digital items, such as photos or video, exist beyond the scale of human viewing. New methods are required to read, understand and work with the data, resulting in computation becoming increasingly central to both creation of a cultural reality and as the interpretative tool and practice. If artists’ look, then how might a machine see as a critical tool? Developing work on computational culture and the Next Rembrandt project as unstable digital object, this paper considers how the medium affects computational critical practice. Drawing on Heidegger’s view of causality and Derrida’s grammatology, this paper explores how the medium acts a locus between the human and machine readings and the remediations that occur within the reading. This is developed as through a reading of how the interface translates the signs and symbols and how this affects the reading. By reconsidering the critical assemblage and using it to think with, the human and the machine are seen as critical partners. Attending to the materialities of the reading through a playful approach that decentres potential meaning encourages us to glimpse beneath the surface and gestures towards a critical practice as understanding both computation and its materiality.

The service user voice in shaping mental health policy

Abstract Background Over the last 7 years CMH Malta provided holistic evidence for a mental health strategic framework with the regular input of patients, families, NGOs and civil society. Methods This evidence featured in published Annual Reports, conference presentations, bilateral meetings, and media interventions. The National Mental Health Strategy 2020-2030 was published in July 2019. CMH proffered advice, experience and supporting documents to the Strategy Team. 80% of the action points in the strategy reflect CMH recommendations. Results The philosophy of care should emphasise person-centred multi-disciplinary care. The primary health care system must be an effective gatekeeper providing mental health promotion and care in the community thus preventing hospital admissions. Acute psychiatric care must be provided within the acute general hospital setting with active support of A&E and 24/7 intervention services that deal promptly with emergencies. Transition of youngsters to adult psychiatry and of adults to old age psychiatry should be flexible. Community-based rehabilitation is required for Adult Psychiatry, Child/Adolescent/Youth Psychiatry, Old Age Psychiatry, Forensic Psychiatry and Learning Disability. Policymakers must provide care options for older persons with chronic mental disorders, safe settings for youngsters with severely challenging behaviour, and shelters for persons suffering from substance misuse who resist treatment or rehabilitation. Conclusions Implementation of the Mental Health Strategy requires substantial capital investment and new resources. Service re-engineering and synergy are necessary to avoid duplication and waste. Better complements of professionals must be available to provide alternative therapies to the current medical pharmacological model. Key messages Patients, families, NGOs and civil society are critical partners in strategy development. Action points and implementation plans must reflect service user views and advice.

Social determinants of health, adverse childhood experiences, and maternal-infant relationship

Abstract Background Low strength of maternal-infant relationship (MIR) is consistently associated with early childhood obesity risk. Because obesity often persists once it develops, primary prevention is needed early. Home visiting programs support families with social determinants of health (SDH) and adverse childhood experiences (ACEs); SDH and ACEs contribute to health inequities. Addressing SDH and ACEs may facilitate improvements in MIR and ultimately mitigate early childhood obesity risk. Limited to no research has examined the association between ACEs, SDH, and MIR. In the context of a national, evidence-based home visiting program, we asked: are SDH and ACEs associated with low MIR? Methods This sample includes 6,972 children ages 0–<24 months enrolled in the Parents as Teachers home visiting program across the United States from sites using the Life Skills Progression (LSP) instrument through February 2020. Low MIR is dichotomized from a 1-5 scale, with low scores reflecting low nurturing, bonding, and responsiveness. We used the literature, theory, and a stepwise logistic regression model-building process to identify a parsimonious model for MIR. Results Preliminary results reflect 34.2% Hispanic or Latino, 22.7% non-Hispanic Black, 35.3% non-Hispanic Other race; 83.9% low income; 36.9% low education; and 13.4% mothers scoring low for MIR. Notable findings from modeling include: physical ACEs, captured here as child abuse or neglect (OR: 5.01, 95% CI: 4.10-6.11); mental illness ACEs, captured here as a mother/parent with mental illness (OR: 1.31, 95% CI: 1.05-1.63), or the mother/parent treated violently (OR: 1.95, 95% CI: 1.56-2.40). Protective associations include mothers' support of child development and self-esteem scores. Conclusions Understanding the complex interplay of SDH, ACEs, and MIR is critical for developing interventions that address “upstream” family characteristics in order to mitigate early childhood obesity risk. ACEs play a predominant role. Key messages This is the first known study to concurrently examine maternal-infant relationship, social determinants of health, and adverse childhood experiences. Home visiting programs may be critical partners in addressing these needs given their reach.

Are Fatty Acids Gluconeogenic Precursors?

It is widely accepted that the tricarboxylic acid (TCA) cycle is a critical partner for gluconeogenesis (GNG) in hepatocytes. Although researchers in the 1950s showed, using radiolabeled long-chain fatty acids, that acetate derived from fatty acid β-oxidation contributes carbon to glucose, fatty acids are not included on lists of gluconeogenic precursors in many textbooks of biochemistry and nutritional biochemistry. Here, by following the flow of carbon atoms through the mitochondrial TCA cycle and into cytosolic GNG, it is shown that carbons in acetyl-CoA derived from fatty acid β-oxidation will be found in glucose. Specifically, it is evident that, after the condensation of acetyl-CoA and oxaloacetate (OAA) to make citrate at the start of the TCA cycle, the 2 carbons lost from the cycle as carbon dioxide come from OAA, not acetyl-CoA. Carbons from acetyl-CoA are retained as the cycle progresses toward malate, and when malate exits the mitochondrion for GNG, carbons that originated in acetyl-CoA and OAA are found to contribute equally to glucose. With influx of other critical precursors into the TCA cycle and efflux of malate into the cytosol for GNG, the TCA cycle is in balance. During fasting-induced GNG, there is a net gain of glucose in glucogenic cells; however, the fact that there is no net gain in the TCA cycle is irrelevant as far as precursors are concerned. Given the physiological importance of fat as a source of reserve energy, and knowing that some cell types rely on glucose as their primary supplier of energy, a role for fatty acids in glucose production aligns both with intuition and with evidence provided by a careful look at the biochemistry and older isotope studies. Hopefully, subsequent editions of textbooks will list fatty acids among the gluconeogenic precursors.

Chromatin profiling reveals relocalization of lysine-specific demethylase 1 by an oncogenic fusion protein

ABSTRACT Paediatric cancers commonly harbour quiet mutational landscapes and are instead characterized by single driver events such as the mutation of critical chromatin regulators, expression of oncohistones, or expression of oncogenic fusion proteins. These events ultimately promote malignancy through disruption of normal gene regulation and development. The driver protein in Ewing sarcoma, EWS/FLI, is an oncogenic fusion and transcription factor that reshapes the enhancer landscape, resulting in widespread transcriptional dysregulation. Lysine-specific demethylase 1 (LSD1) is a critical functional partner for EWS/FLI as inhibition of LSD1 reverses the transcriptional activity of EWS/FLI. However, how LSD1 participates in fusion-directed epigenomic regulation and aberrant gene activation is unknown. We now show EWS/FLI causes dynamic rearrangement of LSD1 and we uncover a role for LSD1 in gene activation through colocalization at EWS/FLI binding sites throughout the genome. LSD1 is integral to the establishment of Ewing sarcoma super-enhancers at GGAA-microsatellites, which ubiquitously overlap non-microsatellite loci bound by EWS/FLI. Together, we show that EWS/FLI induces widespread changes to LSD1 distribution in a process that impacts the enhancer landscape throughout the genome.

Understanding microglial diversity and implications for neuronal function in health and disease.

Genetic data implicate microglia as central players in brain health and disease, urging the need to better understand what microglia do in the brain. Microglia are critical partners in neuronal wiring and function during development and disease. Emerging literature suggests that microglia have diverse functional roles, raising the intriguing question of which functions of microglia become impaired in disease to undermine proper neuronal function. It is also becoming increasingly clear that microglia exist in heterogeneous cell states. Microglial cell states appear context‐dependent, that is, age, sex, location, and health of their microenvironment; these are further influenced by external signaling factors including gut microbiota and lipid metabolites. These data altogether suggest that microglia exist in functional clusters that impact, and are impacted by, surrounding neuronal microenvironment. However, we still lack understanding of how we can translate microglia cell states into function. Here, we summarize the state‐of‐the‐art on the diverse functions of microglia in relation to neuronal health. Then, we discuss heterogeneity during developing, healthy adult and diseased brains, and whether this may be predetermined by origin and/or regulated by local milieu. Finally, we propose that it is critical to gain high‐resolution functional discernment into microglia‐neuron interactions while preserving the spatial architecture of the tissue. Such insight will reveal specific targets for biomarker and therapeutic development toward microglia‐neuron crosstalk in disease.

Malaysia’s Posture in the Indo-Pacific Construct

The Indo-Pacific (IP), the region covering the Indian Ocean and the Pacific Region, is concurrently shaping the posture of international affairs. As a littoral state and critical partner in the IP construct, Malaysia’s responses to this stance are inevitable due to its geostrategic location in the construct. This article argues that Malaysia’s posture vis-à-vis the IP as that of a ‘neutralist’. The discussion is divided into two sections. The first section describes weaknesses in the quadrilateral security dialogues (Quad) centrality using the features of regional security complex theory (RSCT). The second section discusses Malaysia’s neutrality vis-à-vis the IP construct. The article argues that, while opportunities can be seen in terms of strengthening the existing relations and tapping into new areas of partnership, Malaysia may face challenges in the form of marginalisation and entrapment. Apprehension is still prominent; therefore, the concept is in a ‘wait and see’ mode. The article concludes that the catalyst is found by drawing a more effective vision of the concept and is the key, particularly if the IP aspires to attract and appeal to Southeast Asian countries such as Malaysia.

Self-care as an ethical obligation for nurses.

As members of the largest and most trusted healthcare profession, nurses are role models and critical partners in the ongoing quest for the health of their patients. Findings from the American Nurses Association Health Risk Appraisal suggested that nurses give the best patient care when they are operating at the peak of their own wellness. They also revealed that 68% of the surveyed nurses place their patients' health, safety, and wellness before their own. Globally, several nursing codes of ethics include the requirement of self-care. Often, these codes embed the responsibility to protect and promote one's own health within the clearly described obligation to provide safe patient care. The American Nurses Association Code of Ethics for Nurses is unique in that it states explicitly that nurses must adopt self-care as a duty to self in addition to their duty to provide care to patients. One of the basic assumptions of Watson's Philosophy and Science of Caring is that caring science is the essence of nursing and the foundational disciplinary core of the profession. Watson's theory of human caring provides support for the engagement in self-care. Two important value assumptions of Watson's Caritas are that "we have to learn how to offer caring, love, forgiveness, compassion, and mercy to ourselves before we can offer authentic caring and love to others" and we also must "treat ourselves with loving-kindness and equanimity, gentleness, and dignity before we can accept, respect, and care for others within a professional caring-healing model." Embedded within several caritas processes is an outline for a holistic approach to caring for self and others that can guide nurses to improve their mental, physical, emotional, and spiritual health.

Determinants of caregiver burden of persons with disabilities in a rural district in Egypt

BackgroundFamily caregivers are critical partners in the plan of care of people with disabilities. The study aims to demonstrate the factor structure and internal consistency of the Caregiver Burden Inventory (CBI) among the studied caregivers of disabled persons and to determine the effects of patients’ and caregivers’ characteristics on the burden and its dimensions.MethodsA cross-sectional study among 260 family caregivers of disabled patients was carried out in a randomly chosen rural area, Minia, Egypt, 2019. Exploratory factor analysis (EFA) was conducted to determine the factorial validity of the CBI. Multiple linear regression was used to identify the significant factors affecting the burden.ResultsFactor analysis resulted in a five-factor solution using 20 items (four for each dimension) accounting for 72.7% of the total variance. The CBI and its dimensions showed high internal consistency (Cronbach’s alpha value > 0.70). Education of caregiver, family income, mental impairments, and mixed disabilities were significant predictors of total CBI burden.ConclusionsCBI is an effective multidimensional measure of the caregiver burden of disabled subjects. Caregivers experienced a distinct level of burden that is determined by caregiver and care recipient characteristics. Therefore, support and individualized counseling services should be optimized.

Addressing Kentucky's Physician Shortage While Securing a Network for a Research-Intensive, Referral Academic Medical Center: Where Public Policy Meets Effective Clinical Strategic Planning.

A critical shortage of physicians is looming in the United States. The situation in Kentucky is especially dire, especially in rural areas. Class size constraints have resulted in the University of Kentucky College of Medicine (UK COM) unable to admit over 100 qualified Kentuckians each year. This article describes how leadership at University of Kentucky committed to addressing the state physician shortage while simultaneously strengthening relationships with critical partners through the establishment of two 4-year UK COM regional medical campuses. Based on criteria (such as a commitment to educating physicians, ample patients, sufficient willing physician preceptors, etc.), partners selected were Med Center Health, the leading health care system in southwestern Kentucky, and St. Elizabeth Healthcare, the predominant health care system in northern Kentucky. These regional campuses allow UK COM to expand its class size to 201 and total enrollment to 804, increasing from historically 70 to currently 120 graduates per year expected to practice in Kentucky. Critical to the success of this expansion is the buy-in of leadership and the Admissions Committee to consider students with a wider range of Medical College Admission Test scores. The regional clinical partners have substantially increased their teaching opportunities, with a greater ability to attract physicians. Both partners have made substantial financial contributions in support of the regional campuses. These relationships have energized UK COM engagement with its area alumni and have resulted in fewer Kentuckians referred out of state for advanced specialty care. Partnerships are also occurring with UK COM to increase graduate medical education offerings at the regional sites, fulfilling the vision of "training Kentuckians in Kentucky to practice in Kentucky."

Public Health Is Essential: COVID-19's Learnable Moment for Medical Education.

The COVID-19 pandemic, an unprecedented challenge for this generation of physicians and for the health care system, has reawakened calls to strengthen the United States’ public health systems. This global event is also a “learnable moment” for medical education—an opportunity to decisively incorporate public health, including public health systems, through the continuum of medical education. Although medical educators have made progress in integrating public health content into medical curricula, “public health” is not a phrase that is consistently used in curricular standards, and public health colleagues are not identified as unique and essential partners to improve and protect health. The COVID-19 crisis has demonstrated how a strong public health system is necessary to support the health of patients and populations, as well as the practice of medicine. Partnerships between medical and public health communities, through individual- and population-based interventions, can also more effectively combat more common threats to health, such as chronic diseases, health inequities, and substance abuse.To achieve a more effective medicine–public health relationship in practice, curricula across the continuum of medical education must include explanations of public health systems, the responsibilities of physicians to their local and state governmental public health agencies, and opportunities for collaboration. Medical education should also prepare physicians to advocate for public health policies, programs, and funding in order to improve and protect the health of their patients and communities. Pandemic COVID-19 demonstrates with laser focus that all physicians are part of public health systems and that public health content has a distinct and critical place across the continuum of medical education to prepare physicians to participate in, collaborate with, and advocate for public health systems.