Perspectives of carers on medication management in dementia:lessons from collaboratively developing a research proposal

Background: The need for carers to manage medication-related problems for people with dementia living in the community raises dilemmas, which can be identified by carers and people with dementia as key issues for developing carer-relevant research projects.A research planning Public Patient Involvement (PPI) workshop using adapted focus group methodology was held at the Alzheimer's Society's national office, involving carers of people with dementia who were current members of the Alzheimer's Society Research Network (ASRN) in dialogue with health professionals aimed to identify key issues in relation to medication management in dementia from the carer viewpoint. The group was facilitated by a specialist mental health pharmacist, using a topic guide developed systematically with carers, health professionals and researchers. Audio-recordings and field notes were made at the time and were transcribed and analysed thematically. The participants included nine carers in addition to academics, clinicians, and staff from DeNDRoN (Dementias and Neurodegenerative Diseases Research Network) and the Alzheimer's Society. Findings. Significant themes, for carers, which emerged from the workshop were related to: (1) medication usage and administration practicalities, (2) communication barriers and facilitators, (3) bearing and sharing responsibility and (4) weighing up medication risks and benefits. These can form the basis for more in-depth qualitative research involving a broader, more diverse sample. Discussion. The supported discussion enabled carer voices and perspectives to be expressed and to be linked to the process of identifying problems in medications management as directly experienced by carers. This was used to inform an agenda for research proposals which would be meaningful for carers and people with dementia. © 2014 Poland et al.; licensee BioMed Central Ltd.

Programmed cell death (PCD) processes begin extremely early in Alstroemeria petal senescence

-In the Liliaceous species Alstroemeria, petal senescence is characterized by wilting and inrolling, terminating in abscission 8-10 d after flower opening. -In many species, flower development and senescence involves programmed cell death (PCD). PCD in Alstroemeria petals was investigated by light (LM) and transmission electron microscopy (TEM) (to study nuclear degradation and cellular integrity), DNA laddering and the expression programme of the DAD-1 gene. -TEM showed nuclear and cellular degradation commenced before the flowers were fully open and that epidermal cells remained intact whilst the mesophyll cells degenerated completely. DNA laddering increased throughout petal development. Expression of the ALSDAD-1 partial cDNA was shown to be downregulated after flower opening. -We conclude that some PCD processes are started extremely early and proceed throughout flower opening and senescence, whereas others occur more rapidly between stages 4-6 (i.e. postanthesis). The spatial distribution of PCD across the petals is discussed. Several molecular and physiological markers of PCD are present during Alstroemeria petal senescence. © New Phytologist (2003).

Characterization of a novel lipoxygenase-independent senescence mechanism in Alstroemeria peruviana floral tissue

The role of lipoxygenase (lox) in senescence ofAlstroemeria peruviana flowers was investigated using a combination of in vitro assays and chemical profiling of the lipid oxidation products generated. Phospholipids and galactolipids were extensively degraded during senescence in both sepals and petals and the ratio of saturated/unsaturated fatty acids increased. Lox protein levels and enzymatic activity declined markedly after flower opening. Stereochemical analysis of lox products showed that 13-lox was the major activity present in both floral tissues and high levels of 13-keto fatty acids were also synthesized. Lipid hydroperoxides accumulated in sepals, but not in petals, and sepals also had a higher chlorophyll to carotenoid ratio that favors photooxidation of lipids. Loss of membrane semipermeability was coincident for both tissue types and was chronologically separated from lox activity that had declined by over 80% at the onset of electrolyte leakage. Thus, loss of membrane function was not related to lox activity or accumulation of lipid hydroperoxides per se and differs in these respects from other ethylene-insensitive floral tissues representing a novel pattern of flower senescence.

Cysteine protease gene expression and proteolytic activity during senescence of Alstroemeria petals

The functional life of the flower is terminated by senescence and/or abscission. Multiple processes contribute to produce the visible signs of petal wilting and inrolling that typify senescence, but one of the most important is that of protein degradation and remobilization. This is mediated in many species through protein ubiquitination and the action of specific protease enzymes. This paper reports the changes in protein and protease activity during development and senescence of Alstroemeria flowers, a Liliaceous species that shows very little sensitivity to ethylene during senescence and which shows perianth abscission 8-10 d after flower opening. Partial cDNAs of ubiquitin (ALSUQ1) and a putative cysteine protease (ALSCYP1) were cloned from Alstroemeria using degenerate PCR primers and the expression pattern of these genes was determined semi-quantitatively by RT-PCR. While the levels of ALSUQ1 only fluctuated slightly during floral development and senescence, there was a dramatic increase in the expression of ALSCYP1 indicating that this gene may encode an important enzyme for the proteolytic process in this species. Three papain class cysteine protease enzymes showing different patterns of activity during flower development were identified on zymograms, one of which showed a similar expression pattern to the cysteine protease cDNA.

Fiber-type transitions and satellite cell activation in low-frequency-stimulated muscles of young and aging rats

We examined satellite cell content and the activity of satellite cell progeny in tibialis anterior muscles of young (15 weeks) and aging (101 weeks) Brown Norway (BN) rats, after they were exposed for 50 days to a standardized and highly reproducible regime of chronic low-frequency electrical stimulation. Chronic low-frequency electrical stimulation was successful in inducing fast-to-slow fiber-type transformation, characterized by a 2.3-fold increase in the proportion of IIA fibers and fourfold and sevenfold decreases in the proportion of IID/X and IIB fibers in both young and aging BN rats. These changes were accompanied by a twofold increase in the satellite cell content in both the young and aging groups; satellite cell content reached a level that was significantly higher in the young group (p < .04). The total muscle precursor cell content (i.e., satellite cells plus progeny), however, did not differ between groups, because there was a greater number of satellite cell progeny passing through the proliferative and differentiative compartments of the aging group. The resulting 1.5-fold increase in myonuclear content was similar in the young and aging groups. We conclude that satellite cells and satellite cell progeny of aging BN rats possess an unaltered capacity to contribute to the adaptive response.

Low gravity rotational culture and the integration of immunomodulatory stem cells reduce human islet allo-reactivity

Modification of human islets prior to transplantation may improve long-term clinical outcome in terms of diabetes management, by supporting graft function and reducing the potential for allo-rejection. Intragraft incorporation of stem cells secreting beta (β)-cell trophic and immunomodulatory factors represents a credible approach, but requires suitable culture methods to facilitate islet alteration without compromising integrity. This study employed a three-dimensional rotational cell culture system (RCCS) to achieve modification, preserve function, and ultimately influence immune cell responsiveness to human islets. Islets underwent intentional dispersal and rotational culture-assisted aggregation with amniotic epithelial cells (AEC) exhibiting intrinsic immunomodulatory potential. Reassembled islet constructs were assessed for functional integrity, and their ability to induce an allo-response in discrete T-cell subsets determined using mixed islet:lymphocyte reaction assays. RCCS supported the formation of islet:AEC aggregates with improved insulin secretory capacity compared to unmodified islets. Further, the allo-response of peripheral blood mononuclear cell (PBMC) and purified CD4+ and CD8+ T-cell subsets to AEC-bearing grafts was significantly (p < 0.05) attenuated. Rotational culture enables pre-transplant islet modification involving their integration with immunomodulatory stem cells capable of subduing the allo-reactivity of T cells relevant to islet rejection. The approach may play a role in achieving acute and long-term graft survival in islet transplantation.

Effects of climate variability on transparency and thermal structure in subtropical, monomictic Lake Annie, Florida

Lake Annie is a small (37 ha), relatively deep (21 m) sinkhole lake on the Lake Wales Ridge (LWR) of central Florida with a long history of study, including monthly limnological monitoring since June, 1983. The record shows high variability in Secchi disc transparency, which ranged from < 1 to 15 m with a trend toward decreasing values over the latter decade of record. We examined available regional meteorological, groundwater and limnological data to determine the drivers and thermal consequences of variability in water transparency. While total nutrient concentrations and chlorophyll-a were highest during years of low transparency, stepwise regression showed that none of these had a signifi cant effect on transparency after water color was taken into account. Repeated years of high precipitation between 1993–2005 caused an increase in water table height, increasing the transport of dissolved substances from the vegetated watershed into the lake. Groundwater stage explained 73 % of the interannual variability in water transparency. Transparency, in turn, explained 85 % of the interannual variability in the heat budget for the lake, which ranged from 1.8 × 108 to 4.1 × 108 Joules m–2 yr–1, encompassing the range reported across Florida lakes. While surface water temperature was not affected by transparency, depths below 5 m warmed faster during the stratifi ed period during years having a lower rate of light extinction. We show that an increase in precipitation of 20 cm per year reduces the depth of the summer euphotic zone and thermocline by 1.9 and 1.6 m, respectively, and causes a 1-month reduction in the duration of winter mixing in this monomictic lake. Because biota have been shown to respond to shifts in light and heat distribution of much smaller magnitude than exhibited here, our work suggests that subtle changes in precipitation linked to climate fl uctuations may have signifi cant physical as well as biotic consequences.

Multidecadal climate oscillations detected in a transparency record from a subtropical Florida lake

Synchronous interannual variability in water transparency observed in neighboring lakes has been linked to regional precipitation and resultant runoff of dissolved organic material, but many climate forcings oscillate over time scales longer than most limnological records can detect. A strong relationship (R2 5 0.86) between transparency and the previous two years’ rainfall and lake stage in a 25-yr record from a Florida lake enabled us to hindcast transparency from a longer 75-yr record of rainfall and lake stage. Predictions revealed a ,30-yr cycle in transparency linked to the Atlantic Multidecadal Oscillation (AMO). Transparency was greatest (4–8 m) in the cool phase of the AMO (,1962–1993) associated with below-average rainfall in south Florida and lowest (0.1– 3.0 m) during two warm phases (,1932–1961, 1994–present) associated with above-average, but more variable, annual rainfall. Models that predict effects of large-scale hydrologic restoration projects on solute export from South Florida’s expansive wetlands need to account for recent entry into a warm AMO phase, where teleconnections between the AMO phases and runoff are opposite of those shown for the U.S. interior.

Seagrass ecosystems as a globally significant carbon stock

The protection of organic carbon stored in forests is considered as an important method for mitigating climate change. Like terrestrial ecosystems, coastal ecosystems store large amounts of carbon, and there are initiatives to protect these ‘blue carbon’ stores. Organic carbon stocks in tidal salt marshes and mangroves have been estimated, but uncertainties in the stores of seagrass meadows—some of the most productive ecosystems on Earth—hinder the application of marine carbon conservation schemes. Here, we compile published and unpublished measurements of the organic carbon content of living seagrass biomass and underlying soils in 946 distinct seagrass meadows across the globe. Using only data from sites for which full inventories exist, we estimate that, globally, seagrass ecosystems could store as much as 19.9 Pg organic carbon; according to a more conservative approach, in which we incorporate more data from surface soils and depth-dependent declines in soil carbon stocks, we estimate that the seagrass carbon pool lies between 4.2 and 8.4 Pg carbon. We estimate that present rates of seagrass loss could result in the release of up to 299 Tg carbon per year, assuming that all of the organic carbon in seagrass biomass and the top metre of soils is remineralized.

Metaphor: The Hidden Link between Visual Literacy and Learning

Visual Thinking Strategies (VTS) have been proven to enhance learning abilities in children. This study will examine how the use of metaphor might affect the development of fourth graders’ verbal and written abilities at three schools in the Miami-Dade County Public School system.

Seagrass sediments as a global carbon sink: Isotopic constraints

Seagrass meadows are highly productive habitats found along many of the world's coastline, providing important services that support the overall functioning of the coastal zone. The organic carbon that accumulates in seagrass meadows is derived not only from seagrass production but from the trapping of other particles, as the seagrass canopies facilitate sedimentation and reduce resuspension. Here we provide a comprehensive synthesis of the available data to obtain a better understanding of the relative contribution of seagrass and other possible sources of organic matter that accumulate in the sediments of seagrass meadows. The data set includes 219 paired analyses of the carbon isotopic composition of seagrass leaves and sediments from 207 seagrass sites at 88 locations worldwide. Using a three source mixing model and literature values for putative sources, we calculate that the average proportional contribution of seagrass to the surface sediment organic carbon pool is ∼50%. When using the best available estimates of carbon burial rates in seagrass meadows, our data indicate that between 41 and 66 gC m−2 yr−1 originates from seagrass production. Using our global average for allochthonous carbon trapped in seagrass sediments together with a recent estimate of global average net community production, we estimate that carbon burial in seagrass meadows is between 48 and 112 Tg yr−1, showing that seagrass meadows are natural hot spots for carbon sequestration.

Student Knowledge and Perceptions of Islam and the Arab and Muslim World

Students’ knowledge and perceptions of Islam and the Arab and Muslim world were assessed at three schools to evaluate the effectiveness of the current pedagogy and curriculum. Results show that students have little knowledge of the subject, say that they get most of their information from their teachers, have fairly positive perceptions of Islam and the Arab and Muslim world, and have suggestions to improve the curriculum.

Global Learning and the Human Capability Approach: Florida International University Case Study

This case study traced the process in which Florida International University engaged to determine what students want and need from their undergraduate education. Using grounded theory, the authors discovered that the process was reflective of the human capability approach in the development of its global learning student learning outcomes.

Creating Permeable Boundaries: Inclusive Educators in a Global Society

The authors pose a redefinition of inclusive education and inclusive educators. They describe four promising strategies that educators might use to reflect on social justice as a curricular focal point, problematize inclusive education, and help students create more permeable boundaries between themselves and those who are different.

Social Justice as a Disposition for Teacher Education Programs: Why is it Such a Problem?

The authors question the actions of National Council for Accreditation of Teacher Education (NCATE) leadership for removing social justice in the glossary of terms to describe dispositions for education graduates, trace the origins of the multiple discourses surrounding social justice, and argue for problematizing social justice issues.