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Abstract Background Academic institutions worldwide are embedding interprofessional education (IPE) into their health/social services education programs in response to global evidence that this leads to interprofessional collaborative practice (IPC). The World Health Organization (WHO) is holding its 193 member countries accountable for Indicator 3–06 (‘IPE Accreditation’) through its National Health Workforce Accounts. Despite the major influence of accreditation on the quality of health and social services education programs, little has been written about accreditation of IPE. Case study Canada has been a global leader in IPE Accreditation. The Accreditation of Interprofessional Health Education (AIPHE) projects (2007–2011) involved a collaborative of eight Canadian organizations that accredit pre-licensure education for six health/social services professions. The AIPHE vision was for learners to develop the necessary knowledge, skills and attitudes to provide IPC through IPE. The aim of this paper is to share the Canadian Case Study including policy context, supporting theories, preconditions, logic model and evaluation findings to achieve the primary project deliverable, increased awareness of the need to embed IPE language into the accreditation standards for health and social services academic programs. Future research implications are also discussed. Conclusions As a result of AIPHE, Canada is the only country in the world in which, for over a decade, a collective of participating health/social services accrediting organizations have been looking for evidence of IPE in the programs they accredit. This puts Canada in the unique position to now examine the downstream impacts of IPE accreditation.

Abstract Phosphate and glyphosate molecules compete for sorption sites in soil. The objective of this study was to quantify the impact of Olsen P concentrations in two contrasting soils on phosphate and glyphosate sorption. Soils were a sandy clay loam soil rich in iron oxides (SCL-Fe2O3) and a clay loam soil rich in calcium carbonates (CL-CaCO3). The phosphate Freundlich sorption coefficient (Kf) ranged from 3 to 68 L1/n mg1–1/n kg− 1 in the SCL-Fe2O3 and from 21 to 76 L1/n mg1–1/n kg− 1 in the CL-CaCO3. Glyphosate sorption coefficient (Kd) ranged from 293 to 1173 L kg− 1 in the SCL-Fe2O3 but only 99 to 141 L kg− 1 in the CL-CaCO3. Glyphosate Kd and phosphate Kf values decreased significantly with increasing Olsen P concentrations in both soils. Glyphosate Kd values were further significantly reduced when phosphate was added to the slurry solutions, but phosphate Kf values were not impacted by the presence of glyphosate in solutions. We conclude that annual phosphate fertilizer applications leave phosphate concentrations in Prairie soils to the extent that soils have a lesser capacity to retain glyphosate and phosphate that are subsequently applied, but glyphosate residues will not influence phosphate sorption.

Antimicrobial resistance (AMR) in bacteria is the end result of a multitude of factors. Some of the key factors beyond innate resistance include antimicrobial selective pressure (1–5), acquisition of a foreign genetic resistance element(s) (1–5), clonal dissemination (1) and new mutations (2,3,5); factors vary for different species and geographical locations. Increased global antimicrobial use is the foremost reason for the spread of AMR in the community setting (1). Social networks of individuals (households, schools and child care facilities) have served both as a reservoir for these bacteria and as a common route for their transmission. Similarly, hospitals, nursing homes and long-term care facilities have also served as reservoirs for antibiotic-resistant organisms, and the discharge of patients from these facilities contributes to the spread of resistance within communities. In addition, the use of antimicrobials in food animals has been an important contributing cause (1). In the preantibiotic era, the mortality of patients infected with Staphylococcus aureus bacteremia exceeded 80%. Although the introduction of penicillin in the early 1940s significantly improved the prognosis of patients with staphylococcal infection, penicillin-resistant staphylococci were recognized within two years of its use (4,6). More than 80% of both community- and hospital-acquired staphylococcal isolates were resistant to penicillin by the late 1960s. This transfer of resistance, from the hospital setting to communities, is a well-established pattern that recurs with each new wave of AMR (6). For example, the introduction of methicillin in 1961 was quickly followed by reports of methicillin-resistant isolates in hospitals, and is now seen regularly in community-based infections (6). Health care-associated strains of methicillin-resistant S aureus (HA-MRSA) have been known to cause a wide variety of infections (eg, wound infections, catheter-associated bacteremias or prosthesis infections). Community-acquired MRSA (CA-MRSA) has emerged as the causative agent of serious individual cases and outbreaks of skin and soft tissue infections and sepsis. Infections have been noted among those without the usual HA-MRSA risk factors (history of hospitalization or other institutionalization, antibiotic use, dialysis and chronic wounds), and outbreaks have been reported in well-defined epidemiological groups (children in child care facilities, athletes, military recruits and prison inmates) (1,7). CA-MRSA is distinguished from HA-MRSA, in part, by the type of staphylococcal chromosomal cassette – a mobile chromosomal element that carries the methicillin resistance gene mec. However, there is a progressive blurring of the two categories. HA-MRSA is also disseminated in the community (for example, MRSA has been transmitted from hospital patients to their household contacts), and CA-MRSA has entered health care settings and caused outbreaks in hospitals (1). Vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing organisms that are resistant to ceph-alosporins and monobactams, and penicillin-resistant Streptococcus pneumoniae have also evolved through a combination of acquired foreign genetic material, antibiotic selective pressure and clonal dissemination (1). Vancomycin-resistant enterococci have been associated with the use of growth promoters in food animals, especially in Europe (1), and extended-spectrum beta-lactamase-producing Gram negatives, especially Klebsiella and Escherichia coli, have been increasingly noted as a source of community-acquired infections (8). Similarly, penicillin-resistant S pneumoniae, a common cause of otitis media, sinusitis, community-acquired pneumonia, meningitis and bacteremia, has emerged in the past few decades – first identified more than 20 years after the introduction of penicillin (1,8). Although the ultimate impact of AMR in the community is still uncertain, reducing the development and limiting the spread of resistant organisms should be a public health priority. The two most urgent proven strategies to effect this goal are to limit antimicrobial use to prevent selective pressure, and to enhance infection prevention and control practices, including basic hand hygiene, to prevent clonal dissemination (1,2,9,10). Several national and regional groups in Canada are currently investigating AMR issues, and numerous policy and practice guidance documents have been produced. Despite these efforts, public health leaders and practitioners across Canada have argued that knowledge and practice gaps still exist on the issue of AMR, particularly in community settings. With the assistance of an expert advisory group, the National Collaborating Centre for Infectious Diseases (NCCID) identified projects that could help reduce the burden of community-acquired AMR in Canada. The goal of one project was to describe population-level interventions to reduce the development and transmission of community-associated AMR. NCCID issued a call for proposals in the summer of 2008, and in the fall of 2008, a selection process was undertaken that included peer review by independent, external experts. Three proposals were selected for NCCID funding: Antimicrobial use and resistance in pigs and chickens: A review of the science, policy and control practices from farm to slaughter – Leigh B Rosengren, Sheryl P Gow and J Scott Weese. A review of alternative practices to antimicrobial use for disease control in the commercial feedlot – Carl S Ribble, Tyler Stitt, S Iwasawa, Lorraine Toews and Craig Stephen. Strategies to control community-associated antimicrobial resistance among enteric bacteria and methicillin-resistant Staphylococcus aureus in Canada – Jeff Wilson, John Conly, Thomas Wong, Gayatri Jayaraman, Jan Sargeant, Andrew Papadopoulos, Virginia Young, Melanie Quist-Moyer and Sharon Bauer. Drafts of the comprehensive reviews were read by a minimum of five independent reviewers. Feedback was compiled and provided to the authors for incorporation. The authors presented their general findings at a community-acquired AMR consultation hosted by the NCCID in February 2010. The consultation, which included 50 experts from human, animal and environmental health fields, allowed the reviews to be further refined. Proceedings from the consultation are available on the NCCID website (www.nccid.ca/en/caamr-consultation-feb10). The subsequent pages present the executive summaries of the three reviews (the full comprehensive reviews are available online at http://nccid.ca/en/amr-reviews). The first two reviews focus on antimicrobial use and resistance in animals raised for food, namely pigs and chickens (11) and cattle (12). The third review discusses strategies to control community-acquired AMR among human enteric bacteria and MRSA (7). It is hoped that these papers will lead to further discussion and research into the most effective strategies to reduce the development and spread of AMR.

Data explosion in bioinformatics in recent years has led to new challenges for researchers to develop novel techniques to discover new knowledge from the avalanche of omics data (e.g., genomics, proteomics, transcriptomics). These data are embedded with a wealth of information including frequently repeated patterns (i.e., sequence motifs). In genomics, deoxyribonucleic acid (DNA) sequence motifs are short repeated contiguous frequent subsequences located in the prompter region. Due to the high volume and various degrees of veracity of these DNA datasets generated by the next-generation sequencing techniques, sequence motif mining from DNA sequences poised a major challenge in bioinformatics. In this article, we present a distributed sequential algorithm—which uses the MapReduce programming model on a cluster of homogeneous distributed-memory system running on an Apache Spark computing framework—for DNA sequence motif mining. Experimental results show the effectiveness of our algorithm in Spark-based data analytics of sequence motifs in large omics data.

BACKGROUND: Experimental functional analysis is an assessment methodology to identify the environmental factors that maintain problem behavior in individuals with developmental disabilities and in other populations. Functional analysis provides the basis for the development of reinforcement-based approaches to treatment. METHODS: This article reviews the procedures, validity, and clinical implementation of the methodological variations of functional analysis and function-based interventions. RESULTS: We present six variations of functional analysis methodology in addition to the typical functional analysis: brief functional analysis, single-function tests, latency-based functional analysis, functional analysis of precursors, and trial-based functional analysis. We also present the three general categories of function-based interventions: extinction, antecedent manipulation, and differential reinforcement. CONCLUSIONS: Functional analysis methodology is a valid and efficient approach to the assessment of problem behavior and the selection of treatment strategies.

Pyocin typing of 82 Pseudomonas aeruginosa strains, collected from different Iranian clinical sources, revealed that one isolate, P. aeruginosa 42A, produced pyocin S2, a protease-sensitive bacteriocin. Pyocin S2 production was induced by mitomycin C (2 µg/mL) in the pyocin S2 producer P. aeruginosa 42A. Pyocin S2 was purified using ion exchange chromatography with CM-Sepharose CL-6B and sodium phosphate buffer (pH 8) from an 80% ammonium sulfate precipitate of whole-cell lysates. Pyocin activity of the fractions was detected using the Govan spot testing method. The purity of the active fraction was confirmed by SDS–PAGE, where a single band with a molecular mass of 74 kDa was detected. Cytotoxic effects of purified pyocin S2 and partially purified pyocin from P. aeruginosa 42A on the human tumor cell lines HepG2 and Im9 and the normal human cell line HFFF (Human Foetal Foreskin Fibroblast) were studied by the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. The results demonstrated that partially purified pyocin and pyocin S2 exhibited substantial inhibitory effects on the growth of the tumor cell lines HepG2 and Im9, while no inhibitory effects were observed on the normal cell line HFFF. Pure lipopolysaccharide was used as a control and was found to have no inhibitory effect on any of the cell lines tested.Key words: Pseudomonas aeruginosa, pyocin, cytotoxicity, MTT assay.

Abstract Background Wheezes and crackles are well-known signs of lung diseases, but can also be heard in apparently healthy adults. However, their prevalence in a general population has been sparsely described. The objective of this study was to determine the prevalence of wheezes and crackles in a large general adult population and explore associations with self-reported disease, smoking status and lung function. Methods We recorded lung sounds in 4033 individuals 40 years or older and collected information on self-reported disease. Pulse oximetry and spirometry were carried out. We estimated age-standardized prevalence of wheezes and crackles and associations between wheezes and crackles and variables of interest were analyzed with univariable and multivariable logistic regressions. Results Twenty-eight percent of individuals had wheezes or crackles. The age-standardized prevalence of wheezes was 18.6% in women and 15.3% in men, and of crackles, 10.8 and 9.4%, respectively. Wheezes were mostly found during expiration and crackles during inspiration. Significant predictors of expiratory wheezes in multivariable analyses were age (10 years increase - OR 1.18, 95%CI 1.09–1.30), female gender (1.45, 1.2–1.8), self-reported asthma (1.36, 1.00–1.83), and current smoking (1.70, 1.28–2.23). The most important predictors of inspiratory crackles were age (1.76, 1.57–1.99), current smoking, (1.94, 1.40–2.69), mMRC ≥2 (1.79, 1.18–2.65), SpO2 (0.88, 0.81–0.96), and FEV1 Z-score (0.86, 0.77–0.95). Conclusions Nearly over a quarter of adults present adventitious lung sounds on auscultation. Age was the most important predictor of adventitious sounds, particularly crackles. The adventitious sounds were also associated with self-reported disease, current smoking and measures of lung function. The presence of findings in two or more auscultation sites was associated with a higher risk of decreased lung function than solitary findings.

Background: Many older adults rely on a manual wheelchair for mobility but typically receive little, if any, training on how to use their wheelchair effectively and independently. Standardized skill training is an effective intervention, but limited access to clinician trainers is a substantive barrier. Enhancing Participation in the Community by Improving Wheelchair Skills (EPIC Wheels) is a 1-month monitored home training program for improving mobility skills in older novice manual wheelchair users, integrating principles from andragogy and social cognitive theory. The purpose of this study is to determine whether feasibility indicators and primary clinical outcome measures of the EPIC Wheels program are sufficiently robust to justify conducting a subsequent multi-site randomized controlled trial. Methods: A 2 × 2 factorial randomized controlled trial at two sites will compare improvement in wheelchair mobility skills between an EPIC Wheels treatment group and a computer-game control group, with additional wheelchair use introduced as a second factor. A total of 40 community-dwelling manual wheelchair users at least 55 years old and living in two Canadian metropolitan cities (n = 20 × 2) will be recruited. Feasibility indicators related to study process, resources, management, and treatment issues will be collected during data collection and at the end of the study period, and evaluated against proposed criteria. Clinical outcome measures will be collected at baseline (pre-randomization) and post-intervention. The primary clinical outcome measure is wheelchair skill capacity, as determined by the Wheelchair Skills Test, version 4.1. Secondary clinical outcome measures include wheelchair skill safety, satisfaction with performance, wheelchair confidence, life-space mobility, divided-attention, and health-related quality of life. Discussion: The EPIC Wheels training program offers several innovative features. The convenient, portable, economical, and adaptable tablet-based, home program model for wheelchair skills training has great potential for clinical uptake and opportunity for future enhancements. Theory-driven design can foster learning and adherence for older adults. Establishing the feasibility of the study protocol and estimating effect size for the primary clinical outcome measure will be used to develop a multi-site randomized controlled trial to test the guiding hypotheses. Trial registration: Clinical Trials NCT01740635 .