A qualitative exploration of the client experience of inter-professional practice in the delivery of ActivePlus: a combined smoking cessation and physical activity intervention.

BACKGROUND: Research investigating interprofessional practice (IPP) frameworks has predominately focused on the service delivery of IPP or educating practitioners through interprofessional education. Minimal research has addressed client outcomes or the experience of clients with IPP in real world contexts. In this paper, we explore the experience of seven participants in the ActivePlus program, an IPP-based smoking cessation intervention combined with physical activity promotion. METHODS: Participants informed on their program experiences through post-program in-depth interviews. A thematic analysis drew out themes pertaining to participant experiences of the joint practice element of the IPP model of care. RESULTS: Analysis identified two major themes: the joint practice experience, and the client-centered approach of the IPP model of care. Participants reflected on the ways that having two health practitioners in joint sessions benefited their intervention experience, as well as providing some critical feedback. Participants also reported observing and valuing aspects of client-centered practice that strengthened the rapport within the practitioner-client team and aided their behaviour change progress. The client-centered practice was instrumental in overcoming initial teething issues with joint session delivery and alleviating pre-program participant concerns about being outnumbered by multiple practitioners. CONCLUSION: Despite some early teething issues, participants reported a positive acceptance of the IPP and joint session delivery model, which added value to the overall ActivePlus program. Results from this research can provide practitioners with a client perspective on the key aspects they perceive as important in IPP joint session delivery. Further investigation into the client perception in similar interventions is recommended with larger samples and non-clinical groups.

Tumor suppression in mice lacking GABARAP, an Atg8/LC3 family member implicated in autophagy, is associated with alterations in cytokine secretion and cell death.

GABARAP belongs to an evolutionary highly conserved gene family that has a fundamental role in autophagy. There is ample evidence for a crosstalk between autophagy and apoptosis as well as the immune response. However, the molecular details for these interactions are not fully characterized. Here, we report that the ablation of murine GABARAP, a member of the Atg8/LC3 family that is central to autophagosome formation, suppresses the incidence of tumor formation mediated by the carcinogen DMBA and results in an enhancement of the immune response through increased secretion of IL-1ß, IL-6, IL-2 and IFN-γ from stimulated macrophages and lymphocytes. In contrast, TGF-ß1 was significantly reduced in the serum of these knockout mice. Further, DMBA treatment of these GABARAP knockout mice reduced the cellularity of the spleen and the growth of mammary glands through the induction of apoptosis. Gene expression profiling of mammary glands revealed significantly elevated levels of Xaf1, an apoptotic inducer and tumor-suppressor gene, in knockout mice. Furthermore, DMBA treatment triggered the upregulation of pro-apoptotic (Bid, Apaf1, Bax), cell death (Tnfrsf10b, Ripk1) and cell cycle inhibitor (Cdkn1a, Cdkn2c) genes in the mammary glands. Finally, tumor growth of B16 melanoma cells after subcutaneous inoculation was inhibited in GABARAP-deficient mice. Together, these data provide strong evidence for the involvement of GABARAP in tumorigenesis in vivo by delaying cell death and its associated immune-related response.

Glycinergic input of small-field amacrine cells in the retinas of wildtype and glycine receptor deficient mice.

Amacrine cells are known to express strychnine-sensitive glycine receptors (GlyRs), however, it is not known which of the four GlyRalpha subunits (alpha1-4) are expressed in this diverse group of cells. Herein, we studied the presence of glycine activated currents and spontaneous inhibitory postsynaptic currents (sIPSCs) of amacrine cells in the mouse retina. By recording glycinergic currents in retinal slices of wildtype mice and of mice deficient in GlyRalpha subunits (Glra1spd-ot, Glra2-/-, Glra3-/-), we could classify AII and narrow-field amacrine cells (NF, Types 5, 6, 7) on the basis of their alpha-subunit composition. Glycinergic sIPSCs of AII cells displayed medium fast kinetics (mean decay time constant tau=11+/-2 ms), which were completely absent in the Glra3-/- mouse, indicating that synaptic GlyRs of AII cells mainly contain the alpha3 subunit. Glycinergic sIPSCs of NF cells had slow kinetics (tau=27+/-6.8 ms) that were significantly prolonged in Glra2-/- mice (tau=69+/-16 ms). These data show that morphologically distinct amacrine cells express different sets of GlyRs.

Rescue of exocytosis in botulinum toxin A-poisoned chromaffin cells by expression of cleavage-resistant SNAP-25. Identification of the minimal essential C-terminal residues.

Botulinum neurotoxin (BoNT) types A and B selectively block exocytosis by cleavage of SNAP-25 and synaptobrevin, respectively; in humans, many months are required for full recovery from the resultant neuromuscular paralysis. To decipher the molecular basis for such prolonged poisoning, intoxication in adreno-chromaffin cells was monitored over 2 months. Exocytosis from BoNT/B-treated cells resumed after 56 days because of the appearance of intact synaptobrevin. However, inhibition continued in BoNT/A-treated cells, throughout the same interval, with a continued predominance of cleaved SNAP-25-(1-197) over the intact protein. When recovery from poisoning was attempted by transfection of the latter cells with the gene encoding full-length SNAP-25-(1-206), no restoration of exocytosis ensued even after 3 weeks. To ascertain if this failure was because of the persistence of the toxin's protease activity, the cells were transfected with BoNT/A-resistant SNAP-25 constructs; importantly, exocytosis was rescued. C-terminal truncation of the toxin-insensitive SNAP-25 revealed that residues 1-201, 1-202, 1-203 afforded a significant return of exocytosis, unlike shorter forms 1-197, -198, -199, or -200; accordingly, mutants M202A or L203A of full-length SNAP-25 rescued secretion. These findings give insights into the C-terminal functional domain of SNAP-25, demonstrate the longevity of BoNT/A protease, and provide the prospect of a therapy for botulism.