Rolle der Diabetesberatung im digitalen Zeitalter

Digitization has long since taken hold in the diabetes sector. Digital support including pumps, rtCGM (CGM: continuous glucose monitoring, rtCGM: real time CGM), iscCGM (intermittent scanning CGM), apps as well as measuring devices with pattern recognition and a reminder function has become commonplace in many areas. Training to become a diabetes advisor provides diabetes professionals with appropriate basic knowledge to advise the patient in self-management with technical support. Continuous medical training to empower and support patients in health literacy, data protection and the use of telemedicine is imperative.     

Binding of Clostridium botulinum C3 exoenzyme to intact cells

C3 from Clostridium botulinum (C3) specifically modifies Rho GTPases RhoA, RhoB, and RhoC by mono-ADP-ribosylation. The confined substrate profile of C3 is the basis for its use as pharmacological tool in cell biology to study cellular functions of Rho GTPases. Although C3 exoenzyme does not possess a cell-binding/-translocation domain, C3 is taken up by intact cells via an unknown mechanism. In the present work, binding of C3 to the hippocampus-derived HT22 cells and J774A.1 macrophages was characterized. C3 bound concentration-dependent to HT22 and J774A.1 cells. Pronase treatment of intact cells significantly reduced both C3 binding and C3 cell entry. Removal of sugar residues by glycosidase F treatment resulted in an increased binding of C3, but a reduced cell entry. To explore the involvement of phosphorylation in the binding process of C3, intact HT22 and J774A.1 cells were pre-treated with vanadate prior to incubation with C3. Inhibition of de-phosphorylation by vanadate resulted in an increased binding of C3. To differentiate between intracellular and extracellular phosphorylation, intact cells were treated with CIP (calf intestine phosphatase) to remove extracellular phosphate residues. The removal of phosphate residues resulted in a strong reduction in binding of C3 to cells. In sum, the C3 membranous binding partner is proteinaceous, and the glycosylation as well as the phosphorylation state is critical for efficient binding of C3.     

Uptake of Clostridium botulinum C3 Exoenzyme into Intact HT22 and J774A.1 Cells

The Clostridium botulinum C3 exoenzyme selectively ADP-ribosylates low molecular weight GTP-binding proteins RhoA, B and C. This covalent modification inhibits Rho signaling activity, resulting in distinct actin cytoskeleton changes. Although C3 exoenzyme has no binding, the translocation domain assures that C3 enters cells and acts intracellularly. C3 uptake is thought to occur due to the high concentration of the C3 enzyme. However, recent work indicates that C3 is selectively endocytosed, suggesting a specific endocytotic pathway, which is not yet understood. In this study, we show that the C3 exoenzyme binds to cell surfaces and is internalized in a time-dependent manner. We show that the intermediate filament, vimentin, is involved in C3 uptake, as indicated by the inhibition of C3 internalization by acrylamide, a known vimentin disruption agent. Inhibition of C3 internalization was not observed by chemical inhibitors, like bafilomycin A, methyl-β-cyclodextrin, nocodazole or latrunculin B. Furthermore, the internalization of C3 exoenzyme was markedly inhibited in dynasore-treated HT22 cells. Our results indicate that C3 internalization depends on vimentin and does not depend strictly on both clathrin and caveolae.     

Topical Versus Injectable Analgesics in Simple Laceration Repair: An Integrative Review

Simple lacerations that need suture repair are a common occurrence encountered by nurse practitioners in practice. Clinicians often wonder which form of analgesia is best when repairing a minor skin laceration. Pain management during the procedure is often undertreated, allowing negative patient consequences to arise. This integrative review examines what is known about the differences of topical versus local injection of analgesia products. The review also examines the advantages and disadvantages of each application and highlights findings for nurse practitioners to make evidence-based decisions regarding laceration repair.     

The assessment of fitness to stand trial for defendants with an intellectual disability: A proposed assessment procedure involving mental health professionals and lawyers

Guidelines for mental health professionals regarding an assessment of fitness to stand trial procedure that is functional, context‐dependent and pragmatic (Grisso, 1988) are clearly required; no published tool exists in Australia. This article addresses Victorian legal criteria as outlined by the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 based upon the Presser criteria. It is argued that the procedure should include the lawyer's predictions regarding the complexity of the forthcoming trial and the ability of the defendant to communicate, together with the mental health professional's assessment of the capacity of the defendant to make decisions. Current difficulties in assessing fitness to stand trial will be presented and an assessment procedure to overcome them is proposed.     

‘It’s important that we learn too’: Empowering parents to facilitate participation in physical activity for children and youth with disabilities

Aim: The actions and behaviors of parents have been identified as key factors that influence a child’s participation in physical activity. However, there is limited knowledge of how parents can be supported to embody facilitative roles. This study aimed to explore how an ecological intervention encourages parents of children with disabilities to develop as facilitators, to enable ongoing physical activity participation in a child’s local environment.

Methods: A qualitative design using grounded theory was employed. Forty four parents (26 mothers, 18 fathers) of 31 children with a range of disabilities (mean age 12y 6m (SD 2y 2m); 18 males) partaking in the Local Environment Model intervention at Beitostolen Healthsports Centre in Norway participated in the study. Data were derived from the triangulation of semi-structured interviews and participant observation. Data analysis was an iterative approach of constant comparison, where data collection, memo writing, open, axial and selective coding analysis, were undertaken simultaneously. Findings were consolidated into a model describing the central phenomenon and its relationship to other categories.

Results: Thematic concepts uncovered in this study describe a social process of parent learning and empowerment, comprising three primary components; (i) active ingredients of the intervention that enabled learning and empowerment to transpire, (ii) parent learning and empowerment as a process, and (iii) related outcomes.

Conclusion: A family-centered approach, encompassing family-to-family support, may enhance physical activity participation outcomes for children and youth with disabilities.