Learning to implement Smart Healthy Age-Friendly Environments

To develop trainings on the implementation of smart healthy age-friendly environments for people who aim to support, for example, their parents, their neighbours or local community, there are precautionary measures that have to be taken into account: the role of the facilitator (volunteer or self-employed), the level of skills, the needs of the end-users, training content and methodologies together with the sustainability of the learning. This article examines these aspects, based on desk research and expert interviews in the Smart Healthy Age-Friendly Environments (SHAFE) fields.

Alternative splicing of exon 37 of FBN1 deletes part of an 'eight-cysteine' domain resulting in the Marfan syndrome

A child and his father had the skeletal and cardiovascular manifestations of Marfan syndrome due to a heterozygous G+5 --> T transversion in intron 37 of the FBN1 gene. Cultured dermal fibroblasts preferentially used an alternative splice site in exon 37 that resulted in the loss of the 3' 48 nucleotides of this exon. The translational reading frame was maintained with deletion of lysine 1568 to threonine 1582 and splitting of the codons for glycine 1567 and serine 1583 to yield GCC for alanine. The deletion removed two cysteine residues as well as a potential N-linked oligosaccharide attachment site from the '8-cysteine' domain encoded by exons 37 and 38.

Multiple epiphyseal dysplasia and pseudoachondroplasia due to novel mutations in the calmodulin-like repeats of cartilage oligomeric matrix protein

A child with a mild form of pseudoachondroplasia was heterozygous for a deletion of 12 nucleotides from exon 10 of the cartilage oligomeric matrix protein (COMP) gene. It resulted in the deletion of valine 513 to lysine 516 from the eighth calmodulin-like repeat of COMP monomers. A child with the Fairbank's type of multiple epiphyseal dysplasia was also heterozygous for a COMP mutation. It substituted cysteine 371 by serine in the fourth calmodulin-like repeat. Both mutations were likely to alter the conformation and calcium binding of the mutant COMP protein chains. These findings support the proposal that deletions and insertions within the calmodulin-like domain produce pseudoachondroplasia, while amino acid substitutions with this domain may produce either pseudoachondroplasia or multiple epiphyseal dysplasia.

Preoperative ICU tours: are they helpful?

BACKGROUND: Although preoperative education decreases the anxiety of patients and family members, the usefulness of a preoperative tour of the ICU has not been studied. In this study, the effect of an ICU tour on the anxiety levels of patients (n = 92) and family members (n = 91) before and after cardiac surgery was examined. METHODS: Using a pretest-posttest quasi-experimental design, patients and family members were assigned to a control group, which received preoperative teaching only (patients, n = 48; family members, n = 48), or to an experimental group, which received preoperative teaching with an ICU tour (patients, n = 44; family members, n = 43). Patients and family members completed two measures of anxiety, the State Trait Anxiety Inventory and a visual analog scale, before and after the intervention. After their first postoperative visit, family members completed the measures again. Repeated measures analysis of variance was used to compare anxiety levels after the intervention. In addition, patients completed the Patient Perception of the ICU Tour Questionnaire after transfer from the ICU. RESULTS: Although patients and family members had a decrease in anxiety after cardia surgery teaching, the decrease was not due to an ICU tour. However, the majority of patients who toured the ICU perceived the tour as beneficial and recommended a tour for future patients. CONCLUSIONS: ICU tours are included in many cardiac surgery educational programs. The majority of patients in this study perceived a benefit or a future benefit from an ICU tour, even though the tour did not significantly reduce the anxiety of the patients or family members.

Preoperative ICU tours: are they helpful?

BACKGROUND

Although preoperative education decreases the anxiety of patients and family members, the usefulness of a preoperative tour of the ICU has not been studied. In this study, the effect of an ICU tour on the anxiety levels of patients (n = 92) and family members (n = 91) before and after cardiac surgery was examined.

METHODS

Using a pretest-posttest quasi-experimental design, patients and family members were assigned to a control group, which received preoperative teaching only (patients, n = 48; family members, n = 48), or to an experimental group, which received preoperative teaching with an ICU tour (patients, n = 44; family members, n = 43). Patients and family members completed two measures of anxiety, the State Trait Anxiety Inventory and a visual analog scale, before and after the intervention. After their first postoperative visit, family members completed the measures again. Repeated measures analysis of variance was used to compare anxiety levels after the intervention. In addition, patients completed the Patient Perception of the ICU Tour Questionnaire after transfer from the ICU.

RESULTS

Although patients and family members had a decrease in anxiety after cardia surgery teaching, the decrease was not due to an ICU tour. However, the majority of patients who toured the ICU perceived the tour as beneficial and recommended a tour for future patients.

CONCLUSIONS

ICU tours are included in many cardiac surgery educational programs. The majority of patients in this study perceived a benefit or a future benefit from an ICU tour, even though the tour did not significantly reduce the anxiety of the patients or family members.

Abnormal extracellular matrix in Ehlers-Danlos syndrome type IV due to the substitution of glycine 934 by glutamic acid in the triple helical domain of type III collagen

A unique substitution of glycine 934 by glutamic acid in the triple helical domain of type III collagen was identified in a proband with Ehlers-Danlos syndrome type IV. The substitution was due to the transition of G 3302 to A in alpha 1(III) cDNA which is encoded by exon 46 of COL3A1. It resulted in a severe deficiency of type III collagen in fibroblast cultures and dermis. Dilatation of the endoplasmic reticulum of the dermal fibroblasts was probably due to the failure of these cells to secrete type III collagen molecules containing one or more mutant alpha 1(III) chains. The dermal collagen fibrils were narrow, but their constituent type III collagen molecules contained predominantly normal alpha 1(III) chains. As a results, the major effect of the substitution of glycine 934 by glutamic acid was to severely reduce the amount of normal type III collagen available for the formation of heterotypic collagen fibrils in the extracellular matrix.

Isolation and characterization of insertion mutants in E1A of adenovirus type 5

We have constructed a series of insertion mutations at 18 sites in the coding sequences of early region 1A (E1A) of human adenovirus type 5 (Ad5). At each site we have introduced three types of mutation: a 39-bp insertion specifying a 13-aa residue oligopeptide, a 39-bp insertion containing chain termination codons in all three reading frames, and a "collapsed" insert of 6-bp forming a conventional linker insertion mutation. All mutants were sequenced to determine the precise location, structure, and orientation of the inserts. The mutants were assayed for their abilities to trans-activate and to repress using transient expression assays in HeLa cells cotransfected with the E1A mutant plasmids and a reporter plasmid containing the bacterial beta-galactosidase (lac Z) gene under the control of Ad5 early promoters. The mutants were also tested for their ability to transform baby rat kidney cells in cooperation with either E1B or the ras oncogene. Each mutant was rescued into virus and infectivity was compared in HeLa and 293 cells. In addition, E1A protein synthesis was analyzed in cells infected with the mutant viruses and the insertions were found to have pronounced but unpredictable effects on electrophoretic mobility of E1A proteins in SDS-polyacrylamide gels. The results of functional assays indicated that only mutations mapping in, or deleting, the unique region of the 13 S mRNA product had any effect on ability to trans-activate and that a perfect correlation existed between ability of a mutant to trans-activate and to replicate efficiently in HeLa cells or to transform baby rat kidney cells in an E1A plus E1B mediated assay. In contrast, insertions near conserved region 2 of exon I and in the NH2-terminal portion of exon II significantly reduced repression activity but left transforming activity with E1B or with ras essentially unaffected suggesting that the repression function of E1A is separate from, or at least nonessential in, transformation.