Shared mental models of cancer survivorship care.

Quality cancer survivorship care relies on care continuity within the healthcare team. The purpose of this study was to explore the perspectives of healthcare team members regarding cancer survivorship care using the framework of shared mental models. Semi-structured interviews of cancer survivors, primary support individuals, oncology providers, primary care providers and registered nurses were completed. Data were extrapolated to seven primary themes with associated secondary themes. Primary themes included survivor definition and identity, care setting, team member roles, care gaps, survivor needs, barriers to care and facilitators of care. Through these themes, participants emphasised the individuality of the survivorship experience, acknowledged care gaps and described ongoing needs of cancer survivors. Information provision and communication were noted as care facilitators. Through clarification of team member roles, healthcare providers will be equipped to promote cancer survivor transition by focusing on care continuity, communication and collaboration.

Surgical safety checklists briefings: Perceived efficacy and team member involvement.

Researchers have shown inconsistencies in compliance, outcomes and attitudes of surgical team members related to surgical safety checklist briefings. The purpose of this study was to examine surgical circulator and scrub practitioners' perceptions of safety checklist briefings and team member involvement, and to identify potential improvements in the process based on those perceptions. An anonymous survey was conducted with members of the Association of periOperative Registered Nurses (AORN) and the Association of Surgical Technologists (AST). Questions focused on perceptions of checklist briefing efficacy and team member involvement in safety practices. From the 346 usable responses, a third respondent group of self-identified perioperative leaders emerged. Significant results were obtained related to leaders' perceptions, post-procedure briefings and various perceptions of team member involvement. Study results indicate that variances in safety practices continue as perceived by surgical team members thus presenting opportunities for further examination and improvement of processes in reducing surgical errors.

cIAP1 and cIAP2 limit macrophage necroptosis by inhibiting Rip1 and Rip3 activation.

Cellular inhibitor of apoptosis proteins (cIAPs) have emerged as important anti-cell death mediators, particularly in cancer. Although they are known to be expressed in immune tissue, their specific immune function remains unclear. We observed that degradation of cIAPs with SMAC mimetic (SM) results in death of primary bone-marrow-derived macrophages. SM-induced death of macrophages occurred by programmed necrosis (necroptosis), which was dependent on TNF receptor expression. Consistent with necroptosis, SM-induced death of macrophages was abrogated by inhibition of receptor interacting protein 1 (Rip1) kinase signaling or by receptor interacting protein 3 (Rip3) knockdown. SM-induced necroptosis was also dependent on inhibition of SM-induced apoptosis due to the expression of the endogenous caspase inhibitor, xIAP. We found that cIAPs limit Rip3, and to a lesser extent Rip1, expression via post-transcriptional mechanisms, leading to inhibition of the Rip1-Rip3 death complex (necrosome). Reduced cIAP activity in vivo, via SM treatment or specific knockout of either cIAP, resulted in elevated macrophage cell death and compromised control of an intracellular bacterium, Listeria monocytogenes. These results show that cIAPs have an important role in limiting programmed necrosis of macrophages, which facilitates effective control of a pathogen.