[Impact of an e-learning program regarding patients' harmful alcohol consumption on the knowledge, attitudes and perceived competencies of nurses from an acute care hospital: a pretest-posttest-study]. / Auswirkungen eines E-Learning zum gesundheitsschädigenden Alkohol-konsum auf Wissen, Einstellung und Kompetenzen von Pflegefachpersonen im Akutspital ­ Eine Prätest-Posttest-Studie.

Impact of an e-learning program regarding patients' harmful alcohol consumption on the knowledge, attitudes and perceived competencies of nurses from an acute care hospital: a pretest-posttest-study Abstract. BACKGROUND: Harmful alcohol consumption is associated with approximately 1600 deaths in Switzerland annually, and is the third-largest risk factor for various diseases worldwide. It has been shown that through early identification of problematic drinking behaviours along with preventive intervention, alcohol-related illnesses and mortality can be reduced. Therefore, nurses play a crucial role for patients with alcohol problems. However, the most common reasons for nurses not providing preventive intervention are a lack of knowledge, personal attitudes and uncertainty. Learning programs hold the potential for influencing these factors. AIM: The aim of this study was to assess the impact of an e-learning program regarding patients' harmful alcohol consumption on the knowledge, attitudes and perceived competencies of nurses in an acute care hospital. METHOD: A pretest-posttest-study was conducted with 33 registered nurses prior to and upon completion of the e-learning program. Data was collected from December 2013 to March 2014 using a literature-based questionnaire. RESULTS: It was shown that knowledge and perceived competencies significantly improved from pre-test to post-test. No significant differences were measured with regard to the attitudes. CONCLUSIONS: The results suggest that the alcohol e-learning program could be used to enhance nurses' knowledge and perceived competencies, both of which are related to the reduction of uncertainty and improvement of confidence. To foster non-judgemental attitudes towards affected people, classroom courses are recommended in addition to the e-learning program and the implementation of directives.

Interaction between Tiam1 and the Arp2/3 complex links activation of Rac to actin polymerization.

The Rac-specific GEF (guanine-nucleotide exchange factor) Tiam1 (T-lymphoma invasion and metastasis 1) regulates migration, cell-matrix and cell-cell adhesion by modulating the actin cytoskeleton through the GTPase, Rac1. Using yeast two-hybrid screening and biochemical assays, we found that Tiam1 interacts with the p21-Arc [Arp (actin-related protein) complex] subunit of the Arp2/3 complex. Association occurred through the N-terminal pleckstrin homology domain and the adjacent coiled-coil region of Tiam1. As a result, Tiam1 co-localizes with the Arp2/3 complex at sites of actin polymerization, such as epithelial cell-cell contacts and membrane ruffles. Deletion of the p21-Arc-binding domain in Tiam1 impairs its subcellular localization and capacity to activate Rac1, suggesting that binding to the Arp2/3 complex is important for the function of Tiam1. Indeed, blocking Arp2/3 activation with a WASP (Wiskott-Aldrich syndrome protein) inhibitor leads to subcellular relocalization of Tiam1 and decreased Rac activation. Conversely, functionally active Tiam1, but not a GEF-deficient mutant, promotes activation of the Arp2/3 complex and its association with cytoskeletal components, indicating that Tiam1 and Arp2/3 are mutually dependent for their correct localization and signalling. Our data suggests a model in which the Arp2/3 complex acts as a scaffold to localize Tiam1, and thereby Rac activity, which are both required for activation of the Arp2/3 complex and further Arp2/3 recruitment. This 'self-amplifying' signalling module involving Tiam1, Rac and the Arp2/3 complex could thus drive actin polymerization at specific sites in cells that are required for dynamic morphological changes.