Working towards integrated client-oriented care and services: A qualitative study of the perceptions of Finnish health and social care professionals

Introduction Client orientation is an essential principle that underlines the delivery of high-quality health and social care. Despite this, little is known about how the health and social care professionals perceive this principle. The aim of this qualitative study was to describe the integrated perceptions of health and social care professionals of client orientation and the requirements for competencies and care and service systems. Methods The 29 participants were Finnish health and social care professionals and the data were collected with asynchronous online discussions in a closed Internet-based group from November 2017 to January 2018 and analysed with inductive content analysis. Results Client orientation was a core value in health and social care and services due to the humane approach required and the client's rights and responsibilities. It also required the professionals to have specific competencies and collaborate. The system elements that supported client orientation were an integrating and responsive service system, service availability and accessibility, guidance, leadership, resources and the effective use of technology. Discussion Professionals need additional training and structural support from their organizations if they were to deliver efficient, flexible, high-quality client-oriented health and social care and services.

3D printing of tough double-network hydrogel and using it as scaffold to construct tissue-like hydrogel composite

To mimic biological tissues with large toughness such as cartilage, it is highly desired to fabricate stable and tough hydrogels with intricate shapes to act as a structural support. Extrusion-based...

Online, Hybrid, and Face-to-Face Learning Through the Eyes of Faculty, Students, Administrators, and Instructional Designers: Lessons Learned and Directions for the Post-Vaccine and Post-Pandemic/COVID-19 World

This exploratory study builds upon the expertise of a panel of faculty, administrators, students, and instructional designers (IDs) who lived through the pandemic and dealt with the associated challenges firsthand. These participants provided insight on how to establish systems that would create successful online teaching and learning opportunities in the post-vaccine and post-pandemic world. Four major themes emerged: (a) integrating technology to facilitate and enhance education; (b) structural support and resources needed to build sound processes for effective online education; (c) establishing faculty presence to facilitate learning; and (d) joint ownership and responsibility of learning—everyone must play a part. These themes have been described in light of theoretical frameworks, such as the Technological Pedagogical and Content Knowledge (TPACK) model, Community of Inquiry (COI), and Continuous Quality Improvement (CQI). Finally, evidence-based tips will allow academic institutions to successfully emerge out of the pandemic while still making plans to adjust and adapt in the post-vaccine world.

Pectin-Based Scaffolds for Tissue Engineering Applications

Tissue engineering (TE) is an interdisciplinary field that was introduced from the necessity of finding alternative approaches to transplantation for the treatment of damaged and diseased organs or tissues. Unlike the conventional procedures, TE aims at inducing the regeneration of injured tissues through the implantation of customized and functional engineered tissues, built on the so-called ‘scaffolds’. These provide structural support to cells and regulate the process of new tissue formation. The properties of the scaffold are essentials, and they can be controlled by varying the biomaterial formulation and the fabrication technology used to its production. Pectin is emerging as an alternative biomaterial to non-degradable and high-cost petroleum-based biopolymers commonly used in this field. It shows several promising properties including biocompatibility, biodegradability, non-toxicity and gelling capability. Pectin-based formulations can be processed through different fabrication approaches into bidimensional and three-dimensional scaffolds. This chapter aims at highlighting the potentiality in using pectin as biomaterial in the field of tissue engineering. The most representative applications of pectin in preparing scaffolds for wound healing and tissue regeneration are discussed.

Characterization of Composite Nano-Bioscaffolds Based on Collagen and Supercritical Fluids-Assisted Decellularized Fibrous Extracellular Matrix

Nano-bioscaffolds obtained from decellularized tissues have been employed in several medical applications. Nano-bioscaffolds could provide structural support for cell attachment and a suitable environment with sufficient porosity for cell growth and proliferation. In this study, a new combined method constitutes a decellularization protocol to remove the tissue and cellular molecules from porcine dermis for preparation of nano-bioscaffolds with fibrous extracellular matrix via pre- and post-treatment of supercritical fluids. The supercritical fluids-assisted nano-bioscaffolds were characterized by peptide identification, infrared spectrum of absorption, morphology, histological observations, DNA quantification, and hemocompatibility. Further, the resulting nano-bioscaffolds could be employed to obtain new cross-linked composite nano-bioscaffold containing collagen and acellular matrix.

Outcomes From a Novel Graduate Medical Education Leadership Program in Advancing Diversity, Equity, and Inclusion

ABSTRACT Background Academic medicine needs more diverse leadership from racial/ethnic minorities, women, people with disabilities, and LGBTQIA+ physicians. Longitudinal structural support programs that bring together underrepresented in medicine (UiM) and non-UiM trainees are one approach to build leadership and scholarship capacity in diversity, equity, and inclusion (DEI). Objective To describe the creation, satisfaction with, and feasibility of a Leadership Education in Advancing Diversity (LEAD) Program and evaluate scholars' changes in self-efficacy, intended and actual behavior change, and outputs in leadership and DEI scholarship. Methods In 2017, we created the LEAD Program, a 10-month longitudinal, single institution program that provides residents and fellows (“scholars”) across graduate medical education (GME) with leadership training and mentorship in creating DEI-focused scholarship. In the first 3 cohorts (2017–2020), we assessed scholars' self-efficacy, actual and planned behavior change, and program satisfaction using IRB-approved, de-identified retrospective pre-/post-surveys. We measured scholarship as the number of workshops presented and publications developed by the LEAD scholars. We used descriptive statistics and paired 2-tailed t tests to analyze the data. Results Seventy-five trainees completed LEAD; 99% (74 of 75) completed the retrospective pre-/post-surveys. There was statistically significant improvement in scholars' self-efficacy for all learning objectives. All trainees thought LEAD should continue. LEAD scholars have created workshops and presented at local, regional, and national conferences, as well published their findings. Scholars identified the greatest benefits as mentorship, developing friendships with UiM and ally peers outside of their subspecialty, and confidence in public speaking. Conclusions LEAD is an innovative, feasible GME-wide model to improve resident and fellow self-efficacy and behaviors in DEI scholarship and leadership.

Acinetobacter baumannii Can Survive with an Outer Membrane Lacking Lipooligosaccharide Due to Structural Support from Elongasome Peptidoglycan Synthesis

Gram-negative bacteria have a multilayered cell envelope with a layer of cross-linked polymers (peptidoglycan) sandwiched between two membranes. Peptidoglycan was long thought to exclusively provide rigidity to the cell providing mechanical strength.

Laparoscopic Vaginoplasty Procedure Using a Modified Peritoneal Pull-Down Technique with Uterine Strand Incision in Patients with Mayer–Rokitansky–Küster–Hauser Syndrome: Kisu Modification

Various vaginoplasty procedures have been developed for patients with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome. Here, we describe a novel laparoscopic vaginoplasty procedure, known as the Kisu modification, using a pull-down technique of the peritoneal flaps with additional structural support to the neovaginal apex using the incised uterine strand in patients with MRKH syndrome. Ten patients with MRKH syndrome (mean age at surgery: 23.9 ± 6.5 years, mean postoperative follow-up period: 17.3 ± 3.7 months) underwent construction of a neovagina via laparoscopic vaginoplasty. All surgeries were performed successfully without complications. The mean neovaginal length at discharge was 10.3 ± 0.5 cm. Anatomical success was achieved in all patients, as two fingers were easily introduced, the neovagina was epithelialized, and the mean neovaginal length was 10.1 ± 1.0 cm 1 year postoperatively. No obliteration, granulation tissue formation at the neovaginal apex, or neovaginal prolapse was recorded. Five of the 10 patients attempted sexual intercourse and all five patients were satisfied with the sexual activity, indicating functional success. Although the number of cases in this case series is few, our favorable experience suggests that the Kisu modification of laparoscopic vaginoplasty procedure is an effective, feasible, and safe approach for neovaginal creation in patients with MRKH syndrome.

Advances in Use of Nanomaterials for Musculoskeletal Regeneration

Since the worldwide incidence of bone disorders and cartilage damage has been increasing and traditional therapy has reached its limits, nanomaterials can provide a new strategy in the regeneration of bones and cartilage. The nanoscale modifies the properties of materials, and many of the recently prepared nanocomposites can be used in tissue engineering as scaffolds for the development of biomimetic materials involved in the repair and healing of damaged tissues and organs. In addition, some nanomaterials represent a noteworthy alternative for treatment and alleviating inflammation or infections caused by microbial pathogens. On the other hand, some nanomaterials induce inflammation processes, especially by the generation of reactive oxygen species. Therefore, it is necessary to know and understand their effects in living systems and use surface modifications to prevent these negative effects. This contribution is focused on nanostructured scaffolds, providing a closer structural support approximation to native tissue architecture for cells and regulating cell proliferation, differentiation, and migration, which results in cartilage and bone healing and regeneration.

Hydrothermal Synthesis of Co3O4/ZnCo2O4 Core-Shell Nanostructures for High-Performance Supercapacitors

Supercapacitive properties of Co/ZnCo oxide composite with a core-shell nanostructure (Co3O4/ZnCo2O4) prepared directly onto a nickel foam substrate by a two-step hydrothermal method were investigated. The synthesized core-shell structure consisted of some ~40-100 nm in thick flaky ZnCo2O4 deposits coated onto the surface of Co3O4 nanorods measuring ~150 nm in diameter. The specific capacitance value of the Co3O4/ZnCo2O4 core-shell nanostructure synthesized by hydrothermal at 130°C for a ZnCo2O4 deposition time of 2 h can attain 1804 F/g at a scan rate of 5 mV/s. Furthermore, the core-shell structured electrode still exhibited a relatively good capacitance retention of more than 93% after 3000 CV cycles due to the superior structural support of Co3O4 scaffolds. The Co3O4/ZnCo2O4 core-shell structure exhibits excellent electrochemical performances and, as such, is one of the more promising active materials in pseudocapacitor applications.