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Article ; Online: From Noise to Music: Reframing the Role of Context in Clinical Reasoning.

Penner, John C / Schuwirth, Lambert / Durning, Steven J

2024 Volume 39, Issue 5, Page(s) 851–857

MeSH term(s)	Humans ; Clinical Reasoning ; Music/psychology
Language	English
Publishing date	2024-01-19
Publishing country	United States
Document type	Journal Article ; Editorial
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-024-08612-1
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Article ; Online: Double-duty caregivers enduring COVID-19 pandemic to endemic: "It's just wearing me down".

Parmar, Jasneet / L'Heureux, Tanya / Lobchuk, Michelle / Penner, Jamie / Charles, Lesley / St Amant, Oona / Ward-Griffin, Catherine / Anderson, Sharon

PloS one

2024 Volume 19, Issue 4, Page(s) e0298584

Abstract: The COVID-19 pandemic has considerably strained health care providers and family caregivers. Double-duty caregivers give unpaid care at home and are employed as care providers. This sequential mixed-method study, a survey followed by qualitative ... ...

Abstract	The COVID-19 pandemic has considerably strained health care providers and family caregivers. Double-duty caregivers give unpaid care at home and are employed as care providers. This sequential mixed-method study, a survey followed by qualitative interviews, aimed to comprehensively understand the experiences of these Canadian double-duty caregivers amidst the pandemic and the transition to the endemic phase. The multi-section survey included standardized assessments such as the Double-duty Caregiver Scale and the State Anxiety Scale, along with demographic, employment-related, and care work questions. Data analysis employed descriptive and linear regression modeling statistics, and content analysis of the qualitative data. Out of the 415 respondents, the majority were female (92.5%) and married (77.3%), with 54.9% aged 35 to 54 years and 29.2% 55 to 64 years. 68.9% reported mental health decline over the past year, while 60.7% noted physical health deteriorated. 75.9% of participants self-rated their anxiety as moderate to high. The final regression model explained 36.8% of the variance in participants' anxiety levels. Factors contributing to lower anxiety included more personal supports, awareness of limits, younger age, and fewer weekly employment hours. Increased anxiety was linked to poorer self-rated health, and both perceptions and consequences of blurred boundaries. The eighteen interviewees highlighted the stress of managing additional work and home care during the pandemic. They highlighted the difficulty navigating systems and coordinating care. Double-duty caregivers form a significant portion of the healthcare workforce. Despite the spotlight on care and caregiving during the COVID-19 pandemic, the vital contributions and well-being of double-duty caregivers and family caregivers have remained unnoticed. Prioritizing their welfare is crucial for health systems as they make up the largest care workforce, particularly evident during the ongoing healthcare workforce shortage.
MeSH term(s)	Humans ; Male ; Female ; Caregivers/psychology ; Pandemics ; COVID-19/epidemiology ; Canada ; Health Personnel/psychology
Language	English
Publishing date	2024-04-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0298584
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Article ; Online: Summative content analysis of the recommendations from Project ECHO Ontario Autism.

Jane, Alanna / Kanigsberg, Lisa / Patel, Anmol / Eldon, Salina / Anagnostou, Evdokia / Brian, Jessica / Penner, Melanie

Frontiers in rehabilitation sciences

2023 Volume 4, Page(s) 1096314

Abstract: Background: Practitioners report a lack of knowledge and confidence in treating autistic children, resulting in unmet healthcare needs. The Extension of Community Healthcare Outcomes (ECHO) Autism model addresses this through discussion of participant- ... ...

Abstract	Background: Practitioners report a lack of knowledge and confidence in treating autistic children, resulting in unmet healthcare needs. The Extension of Community Healthcare Outcomes (ECHO) Autism model addresses this through discussion of participant-generated cases, helping physicians provide best-practice care through co-created recommendations. Recommendations stemming from ECHO cases have yet to be characterized and may help guide the future care of autistic children. Our objective was to characterize and categorize case discussion recommendations from Project ECHO Ontario Autism to better identify gaps in clinician knowledge. Methods: We conducted a summative content analysis of all ECHO Ontario Autism case recommendations to identify categories of recommendations and their frequencies. Two researchers independently coded recommendations from five ECHO cases to develop the coding guide. They then each independently coded all remaining cases and recommendations from three cycles of ECHO held between October 2018 to July 2021, meeting regularly with the ECHO lead to consolidate the codes. A recommendation could be identified with more than one code if it pertained to multiple aspects of autism care. Categories from the various codes were identified and the frequency of each code was calculated. Results: Of the 422 recommendations stemming from 62 cases, we identified 55 codes across ten broad categories. Categories included accessing community resources ( Conclusion: This is the first time that recommendations from ECHO Autism have been characterized and grouped into categories. Our results show that advice for autism identification and management spans many different facets of community-based care. Specific attention should be paid to providing continued access to education about autism, streamlining referrals to allied health providers, and a greater focus on patient- and family-centered care. Physicians should have continued access to autism education to help fill knowledge gaps and to facilitate families' service navigation.
Language	English
Publishing date	2023-03-30
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-6861
ISSN (online)	2673-6861
DOI	10.3389/fresc.2023.1096314
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Article ; Online: Cu(I) Binding to Designed Proteins Reveals a Putative Copper Binding Site of the Human Line1 Retrotransposon Protein ORF1p.

Pinter, Tyler B J / Ervin, Catherine S / Deb, Aniruddha / Penner-Hahn, James E / Pecoraro, Vincent L

Inorganic chemistry

2022 Volume 61, Issue 12, Page(s) 5084–5091

Abstract: Long interspersed nuclear elements-1 (L1) are autonomous retrotransposons that encode two proteins in different open reading frames (ORF1 and ORF2). The ORF1p, which may be an RNA binding and chaperone protein, contains a three-stranded coiled coil (3SCC) ...

Abstract	Long interspersed nuclear elements-1 (L1) are autonomous retrotransposons that encode two proteins in different open reading frames (ORF1 and ORF2). The ORF1p, which may be an RNA binding and chaperone protein, contains a three-stranded coiled coil (3SCC) domain that facilitates the formation of the biologically active homotrimer. This 3SCC domain is composed of seven amino acid (heptad) repeats as found in native and designed peptides and a stammer that modifies the helical structure. Cysteine residues occur at three hydrophobic positions (2
MeSH term(s)	Binding Sites ; Copper ; Humans ; Long Interspersed Nucleotide Elements ; Open Reading Frames ; Protein Binding ; Retroelements
Chemical Substances	Retroelements ; Copper (789U1901C5)
Language	English
Publishing date	2022-03-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	1484438-2
ISSN	1520-510X ; 0020-1669
ISSN (online)	1520-510X
ISSN	0020-1669
DOI	10.1021/acs.inorgchem.2c00057
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Article: The Paper Chase: A Team Science Training Exercise.

Perry, Kristin J / Mutignani, Lauren M / Gette, Jordan / Kinney, Kerry L / Gissandaner, Tre D / Penner, Francesca / Wen, Alainna / Regan, Timothy / Lim, Crystal

Training and education in professional psychology

2023 Volume 18, Issue 1, Page(s) 13–20

Abstract: Over the past few decades of psychological research, there has been an important increase in both the application of multidisciplinary or collaborative science and in training and research that emphasizes social justice and cultural humility. In the ... ...

Abstract	Over the past few decades of psychological research, there has been an important increase in both the application of multidisciplinary or collaborative science and in training and research that emphasizes social justice and cultural humility. In the current paper, we report on the use of the "Paper Chase" as a team science training and research experience that also facilitates cultural humility in research and when working in teams. The Paper Chase is a synchronous writing exercise originally conceptualized by a cohort of health service psychology interns to reduce lag time between manuscript writing and submission (Schaumberg et al., 2015). The Paper Chase involves a group of trainees coming together for a predetermined amount of time (e.g., 9 or more hours) with the aim of writing and submitting a full manuscript for publication. In the current paper, we extend a previous report on the Paper Chase by formally linking the training experience to the four phases of team science: development, conceptualization, implementation, and translation. We also discuss ways in which the Paper Chase as a training experience can promote cultural humility. Finally, we provide updated recommendations for successfully completing a Paper Chase project. Overall, the authors of this manuscript who were predoctoral psychology interns across two recent cohorts at one academic medical center reported positive experiences from the Paper Chase. In addition, the current study suggests the Paper Chase can be used as one activity that facilitates critical training in team science.
Language	English
Publishing date	2023-05-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2260442-X
ISSN	1931-3926 ; 1931-3918
ISSN (online)	1931-3926
ISSN	1931-3918
DOI	10.1037/tep0000448
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Article ; Online: A comparison of post-ruminal provision of Ca-gluconate and Ca-butyrate on growth performance, gastrointestinal barrier function, short-chain fatty acid absorption, intestinal histology, and brush-border enzyme activity in beef heifers.

Watanabe, Daniel H M / Doelman, John / Steele, Michael A / Guan, Le L / Seymour, Dave J / Penner, Gregory B

Journal of animal science

2023 Volume 101

Abstract: The objective of this study was to compare the effects of post-ruminal provision of Ca-butyrate (CaB) when delivered via abomasal dosing, and Ca-gluconate (CaG) when provided ruminally using a rumen protected form or using an unprotected form via ... ...

Abstract	The objective of this study was to compare the effects of post-ruminal provision of Ca-butyrate (CaB) when delivered via abomasal dosing, and Ca-gluconate (CaG) when provided ruminally using a rumen protected form or using an unprotected form via abomasal dosing on short-chain fatty acid (SCFA) concentration throughout the GIT, nutrient digestibility, GIT barrier function, ruminal SCFA absorption, ruminal morphometrics, intestinal brush border enzyme activity, and blood parameters for beef heifers. Thirty-two beef heifers fitted with ruminal cannulas were used in a randomized complete block design and assigned to one of four treatments: 1) negative control (ruminal infusion of double-distilled water; CON); 2) abomasal infusion of CaB (AB; 0.0029% of BW); 3) abomasal infusion of CaG (AG; 0.0077% of BW); and 4) ruminal infusion of a hydrogenated fat-embedded CaG (RG; 0.0192% of BW) to provide ruminal protection. Excluding CON, treatments were designed to deliver the same amount of butyrate in the small intestine. Heifers were housed in individual pens and DMI was limited to 95% of voluntary intake to minimize a potential confounding effect of DMI on treatment responses. Total GIT barrier function was assessed on day 17 and SCFA disappearance was evaluated on day 21 using the temporarily isolated and washed reticulo-rumen technique. On day 28, heifers were slaughtered, and ruminal and colonic digesta were collected to assess SCFA concentration. Additionally, ruminal, jejunal, and colonic tissues were collected to assess SCFA fluxes and regional barrier function ex vivo using the Ussing chamber technique. For colonic digesta, both AB and CaG treatments reduced the proportion of acetate (P < 0.05) and increased the proportion on propionate (P < 0.05) compared to CON. Relative to CON, AB but not CaG treatments increased in vivo ruminal disappearance of total SCFA (P = 0.01), acetate (P = 0.03), propionate (P = 0.01), and butyrate (P > 0.01). Treatments did not affect (P ≥ 0.10) acetate and butyrate fluxes in the ruminal and colonic tissues when measured ex vivo; however, when compared with CON, AB tended to decrease (P = 0.09) mannitol flux across ruminal tissue. In addition, mannitol flux was affected (P < 0.01) by region, with greater mannitol flux across the jejunum than rumen and colon. We conclude that while both abomasal infusion of CaB and CaG affect the molar proportion of acetate and propionate in the colon, only abomasal CaB stimulated ruminal SCFA absorption for growing beef heifers.
MeSH term(s)	Cattle ; Animals ; Female ; Butyrates/pharmacology ; Butyrates/metabolism ; Diet/veterinary ; Propionates/metabolism ; Microvilli ; Fatty Acids, Volatile/metabolism ; Gluconates/metabolism ; Intestinal Absorption ; Rumen/metabolism ; Animal Feed/analysis ; Fermentation ; Digestion/physiology
Chemical Substances	Butyrates ; Propionates ; Fatty Acids, Volatile ; Gluconates
Language	English
Publishing date	2023-02-17
Publishing country	United States
Document type	Randomized Controlled Trial, Veterinary ; Journal Article
ZDB-ID	390959-1
ISSN	1525-3163 ; 0021-8812
ISSN (online)	1525-3163
ISSN	0021-8812
DOI	10.1093/jas/skad050
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Article: What affected UK adults' adherence to medicines during the COVID-19 pandemic? Cross-sectional survey in a representative sample of people with long-term conditions.

Penner, L S / Armitage, C J / Thornley, T / Whelan, P / Chuter, A / Allen, T / Elliott, R A

Zeitschrift fur Gesundheitswissenschaften = Journal of public health

2023 , Page(s) 1–14

Abstract: Aim: Medicines non-adherence is associated with poorer outcomes and higher costs. COVID-19 affected access to healthcare, with increased reliance on remote methods, including medicines supply. This study aimed to identify what affected people's ... ...

Abstract	Aim: Medicines non-adherence is associated with poorer outcomes and higher costs. COVID-19 affected access to healthcare, with increased reliance on remote methods, including medicines supply. This study aimed to identify what affected people's adherence to medicines for long-term conditions (LTCs) during the pandemic. Subject and methods: Cross-sectional online survey of UK adults prescribed medicines for LTCs assessing self-reported medicines adherence, reasons for non-adherence (using the capability, opportunity and motivation model of behaviour [COM-B]), medicines access and COVID-19-related behaviours. Results: The 1746 respondents reported a mean (SD) of 2.5 (1.9) LTCs, for which they were taking 2.4 (1.9) prescribed medicines, 525 (30.1%) reported using digital tools to support ordering or taking medicines and 22.6% reported medicines non-adherence. No access to at least one medicine was reported by 182 (10.4%) respondents; 1048 (60.0%) reported taking at least one non-prescription medicine as a substitute; 409 (23.4%) requested emergency supply from pharmacy for at least one medicine. Problems accessing medicines, being younger, male, in the highest socioeconomic group and working were linked to poorer adherence. Access problems were mostly directly or indirectly related to the COVID-19 pandemic. Respondents were generally lacking in capabilities and opportunities, but disruptions to habits (automatic motivation) was the major reason for non-adherence. Conclusion: Navigating changes in how medicines were accessed, and disruption of habits during the COVID-19 pandemic, was associated with suboptimal adherence. People were resourceful in overcoming barriers to access. Solutions to support medicines-taking need to take account of the multiple ways that medicines are prescribed and supplied remotely. Supplementary information: The online version contains supplementary material available at 10.1007/s10389-022-01813-0.
Language	English
Publishing date	2023-01-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1149070-6
ISSN	2198-1833 ; 0943-1853
ISSN	2198-1833 ; 0943-1853
DOI	10.1007/s10389-022-01813-0
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Article ; Online: The Neural Circuitry of Reward During Sustained Threat.

Penner, Anne E / White, Emma / Stoddard, Joel / Gowin, Joshua L

Cognitive, affective & behavioral neuroscience

2021 Volume 22, Issue 1, Page(s) 134–144

Abstract: Reward processing is important for understanding behavior in psychopathology. Opportunities to earn money activate the ventral striatum, as shown by the monetary incentive delay (MID) task. Anxiety conditions have been modeled by presenting shocks and ... ...

Abstract	Reward processing is important for understanding behavior in psychopathology. Opportunities to earn money activate the ventral striatum, as shown by the monetary incentive delay (MID) task. Anxiety conditions have been modeled by presenting shocks and startling sounds. To further investigate the co-occurrence of an anxiety condition and a rewarding stimulus, we modified the MID to include a sustained threat of scream. This study investigated neural patterns of the MID task with an uncertain threat of a startling scream. Forty-three young adults completed a functional MRI scan. The task included two conditions (scream and safe) and three cues (gain $5, gain $0, lose $5). Analyses included a whole brain, group analysis using a linear mixed-effects model and a paired t-test. The whole brain analysis revealed a main effect of cue, with increased ventral striatal activation (F
MeSH term(s)	Brain Mapping ; Cues ; Humans ; Magnetic Resonance Imaging/methods ; Motivation ; Reward ; Ventral Striatum/diagnostic imaging ; Young Adult
Language	English
Publishing date	2021-08-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2029088-3
ISSN	1531-135X ; 1530-7026
ISSN (online)	1531-135X
ISSN	1530-7026
DOI	10.3758/s13415-021-00938-1
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Zs.A 5947: Show issues

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Article ; Online: Invited review: Effect of subacute ruminal acidosis on gut health of dairy cows.

Plaizier, J C / Mulligan, F J / Neville, E W / Guan, L L / Steele, M A / Penner, G B

Journal of dairy science

2022 Volume 105, Issue 9, Page(s) 7141–7160

Abstract: Subacute ruminal acidosis (SARA) is assumed to be a common disease in high-yielding dairy cows. Despite this, the epidemiological evidence is limited by the lack of survey data. The prevalence of SARA has mainly been determined by measuring the pH of ... ...

Abstract	Subacute ruminal acidosis (SARA) is assumed to be a common disease in high-yielding dairy cows. Despite this, the epidemiological evidence is limited by the lack of survey data. The prevalence of SARA has mainly been determined by measuring the pH of ruminal fluid collected using rumenocentesis. This may not be sufficiently accurate, because the symptoms of SARA are not solely due to ruminal pH depression, and ruminal pH varies among sites in the rumen, throughout a 24-h period, and among days. The impact of SARA has mainly been studied by conducting SARA challenges in cows, sheep, and goats based on a combination of feed restriction and high-grain feeding. The methodologies of these challenges vary considerably among studies. Variations include differences in the duration and amount of grain feeding, type of grain, amount and duration of feed restriction, number of experimental cows, and sensitivity of cows to SARA challenges. Grain-based SARA challenges affect gut health. These effects include depressing the pH in, and increasing the toxin content of, digesta. They also include altering the taxonomic composition of microbiota, reducing the functionality of the epithelia throughout the gastrointestinal tract (GIT), and a moderate inflammatory response. The effects on the epithelia include a reduction in its barrier function. Effects on microbiota include reductions in their richness and diversity, which may reduce their functionality and reflect dysbiosis. Changes in the taxonomic composition of gut microbiota throughout the GIT are evident at the phylum level, but less evident and more variable at the genus level. Effects at the phylum level include an increase in the Firmicutes to Bacteroidetes ratio. More studies on the effects of a SARA challenge on the functionality of gut microbiota are needed. The inflammatory response resulting from grain-based SARA challenges is innate and moderate and mainly consists of an acute phase response. This response is likely a combination of systemic inflammation and inflammation of the epithelia of the GIT. The systemic inflammation is assumed to be caused by translocation of immunogenic compounds, including bacterial endotoxins and bioamines, through the epithelia into the interior circulation. This translocation is increased by the increase in concentrations of toxins in digesta and a reduction of the barrier function of epithelia. Severe SARA can cause rumenitis, but moderate SARA may activate an immune response in the epithelia of the GIT. Cows grazing highly fermentable pastures with high sugar contents can also have a low ruminal pH indicative of SARA. This is not accompanied by an inflammatory response but may affect milk production and gut microbiota. Grain-based SARA affects several aspects of gut health, but SARA resulting from grazing high-digestible pastures and insufficient coarse fiber less so. We need to determine which method for inducing SARA is the most representative of on-farm conditions.
MeSH term(s)	Acidosis/veterinary ; Animals ; Diet/veterinary ; Edible Grain ; Female ; Inflammation/veterinary ; Rumen/microbiology ; Sheep ; Sheep Diseases
Language	English
Publishing date	2022-07-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	242499-x
ISSN	1525-3198 ; 0022-0302
ISSN (online)	1525-3198
ISSN	0022-0302
DOI	10.3168/jds.2022-21960
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Article ; Online: C3/CD11b-Mediated Leishmania major Internalization by Neutrophils Induces Intraphagosomal NOX2-Mediated Respiratory Burst but Fails to Eliminate Parasites and Induces a State of Stalled Apoptosis.

Ranson, Adam J / Carneiro, Matheus B / Perks, Benjamin / Penner, Robert / Melo, Leon / Canton, Johnathan / Egen, Jackson / Peters, Nathan C

Journal of immunology (Baltimore, Md. : 1950)

2023 Volume 211, Issue 1, Page(s) 103–117

Abstract: Recruited neutrophils are among the first phagocytic cells to interact with the phagosomal pathogen Leishmania following inoculation into the mammalian dermis. Analysis of Leishmania-infected neutrophils has revealed alterations in neutrophil viability, ... ...

Abstract	Recruited neutrophils are among the first phagocytic cells to interact with the phagosomal pathogen Leishmania following inoculation into the mammalian dermis. Analysis of Leishmania-infected neutrophils has revealed alterations in neutrophil viability, suggesting that the parasite can both induce or inhibit apoptosis. In this study, we demonstrate that entry of Leishmania major into murine neutrophils is dependent on the neutrophil surface receptor CD11b (CR3/Mac-1) and is enhanced by parasite opsonization with C3. Infected neutrophils underwent robust NADPH oxidase isoform 2 (NOX2)-dependent respiratory burst based on detection of reactive oxygen species within the phagolysosome but largely failed to eliminate the metacyclic promastigote life cycle stage of the parasite. Infected neutrophils displayed an "apoptotic" phosphatidylserine (PS)-positive phenotype, which was induced by both live and fixed parasites but not latex beads, suggesting that PS expression was parasite specific but does not require active infection. In addition, neutrophils from parasite/neutrophil coculture had increased viability, decreased caspase 3, 8, and 9 gene expression, and reduced protein levels of both the pro and cleaved forms of the classical apoptosis-inducing executioner caspase, Caspase 3. Our data suggest that CD11b-mediated Leishmania internalization initiates respiratory burst and PS externalization, followed by a reduction in both the production and cleavage of caspase 3, resulting in a phenotypic state of "stalled apoptosis."
MeSH term(s)	Animals ; Mice ; Apoptosis ; Caspase 3/metabolism ; Leishmania major/metabolism ; Macrophage-1 Antigen/metabolism ; Mammals/metabolism ; Neutrophils/metabolism ; Parasites/metabolism ; Respiratory Burst
Chemical Substances	Caspase 3 (EC 3.4.22.-) ; Cybb protein, mouse (EC 1.6.3.-) ; Macrophage-1 Antigen ; Itgam protein, mouse
Language	English
Publishing date	2023-05-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3056-9
ISSN	1550-6606 ; 0022-1767 ; 1048-3233 ; 1047-7381
ISSN (online)	1550-6606
ISSN	0022-1767 ; 1048-3233 ; 1047-7381
DOI	10.4049/jimmunol.2200720
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