Tight Junction Protein Abundance and Apoptosis During Involution of Rat Mammary Glands.

To examine tight junction protein abundance and apoptosis of epithelial cells at the onset of involution in rodent mammary glands, milk accumulation and mammary engorgement were induced by teat-sealing with an adhesive for 0, 6, 12, 18, 24, and 36 h (n = 6 per group) at peak lactation. In non-sealed control glands, histological analysis confirmed a lactating phenotype, indicating suckling by pups throughout the experiment. In contrast, alveoli of teat-sealed glands were distended within 6 h, with maximal luminal size observed by 12 h of non-suckling. By 18 h following teat-sealing, an involuting phenotype was observed, indicated by alveolar lumina engorged with milk vesicles and increased leukocytes. Relative to non-sealed glands, mammary apoptosis was increased in engorged glands 18 h following teat-sealing. The abundance of ZO-1 and occludin proteins was decreased in engorged glands by 12 and 18 h, respectively, following teat-sealing. In contrast, the claudin-1 22 kDa band was increased by 6 h and peaked at 12-18 h, whereas the 28 kDa band declined by 36 h, relative to controls. There were no temporal changes in ZO-1, occludin, and claudin-1 22 kDa proteins within control glands, although there were minor differences in claudin-1 28 kDa. These data indicate that intramammary milk accumulation due to cessation of milk removal is associated with mammary apoptosis. The apoptotic event is preceded by a rapid loss of abundance of ZO-1, occludin and an initial increase in claudin-1. The loss of cell-cell communication may initiate involution and apoptosis of mammary epithelial cells and is a localized intramammary event, occurring only in non-suckled glands. J. Cell. Physiol. 232: 2075-2082, 2017. © 2016 Wiley Periodicals, Inc.

Patient involvement in rheumatology outpatient service design and delivery: a case study.

BACKGROUND: Patient involvement is increasingly recognized as important within the UK National Health Service to ensure that services delivered are relevant to users' needs. Organizations are encouraged to work with service users to achieve excellence in care. Patient education can improve health outcomes and reduce health-care costs. Mobile technologies could play a vital role in this. AIM: Patient-centred development of innovative strategies to improve the experience of rheumatology outpatients. CASE STUDY: The Group Rheumatology Initiative Involving Patients (GRIIP) project was set up in 2013 as a joint venture between patients, clinicians, academics and management at a London hospital. The project saw (i) the formation of an independent patient group which provided suggestions for service improvement - outcomes included clearer signs in the outpatient waiting area, extended phlebotomy opening hours and better access to podiatry; (ii) a rolling patient educational evening programme initiated in 2014 with topics chosen by patient experts - feedback has been positive and attendance continues to grow; and (iii) a mobile application (app) co-designed with patients launched in 2015 which provides relevant information for outpatient clinic attendees and data capture for clinicians - downloads have steadily increased as users adopt this new technology. CONCLUSION: Patients can effectively contribute to service improvement provided they are supported, respected as equals, and the organization is willing to undergo a cultural change.

Determining the Use and Perceived Effectiveness of a Point-of-Purchase Cafeteria Nutrition Education Program.

The Eat Smart Heart Beat Cafeteria Program (ESCP) is a point-of-purchase nutrition education program (PPNEP), which was developed by the Ottawa-Carleton Health Department (OCHD). The intent of this program was to increase the awareness and availability of lower-fat, higher-fibre foods in cafeterias. The purpose of this study was to evaluate the ESCP using a Feedback Questionnaire. The questionnaire was developed primarily to determine the use of the ESCP manual and to evaluate the users' perceived effectiveness of this program. Purchasers of the ESCP were asked to complete the questionnaire one year after they received the program resources. Forty of the 88 program recipients (45%) returned the questionnaire. Most responses were from nutritionists or dietitians, health service managers and occupational health workers. Most respondents represented large workplaces (more than 250 employees) such as hospitals, government, health units and educational institutions. Of the 40 respondents, 10 implemented the program and indicated that they were moderately to very satisfied with all of the resources and that they would continue using the program. The 30 respondents who reported not using the program indicated that this was mainly due to time constraints. The ESCP has the potential to increase the awareness and availability of lower-fat, higher-fibre foods. Therefore, it is recommended that the program be continued in a ready-to-use format to increase its usability. Further research is needed to clarify the effects of the ESCP on behaviour change.