Contrary to common perception, telehealth is not simply a substitute for in-person care. With an array of modalities—live audio–video, asynchronous patient communication, and remote patient monitoring, to name a few—telehealth creates entirely new avenues of care delivery ( Table 1 ). Although our current care model is reactive—relying on episodic visits to an office or hospital—telehealth allows us to be proactive, filling in the gaps to provide a continuum of care. Widespread uptake of telehealth has created fertile ground for long-overdue health system reform. In this study, we describe essential next steps: redefine telehealth clinical appropriateness, evolve payment models, provide necessary training, and reimagine the patient–physician interaction.
Maintenance of cell polarity and tissue architecture are essential in preventing neoplasia. Three different protein complexes control cellular polarity, including the Par3/aPKC/Par6 complex, the Crumbs/Pals/Patj complex and the Scribble/Dlg/Lgl complex. Of these, only the loss of Lgl promotes massive tissue growth and cellular migration in Drosophila as well as altered cellular polarity. Humans have two well-conserved homologs, Hugl1 and Hugl2. Expression of Hugl1 is downregulated, lost, or mutated in many cancers, including colorectal, endometrial, hepatocellular carcinoma, malignant melanomas, and breast cancer. We have previously examined the role of Hugl1 and Hugl2 in breast epithelial cells and found that Hugl1 loss results in a failure of growth control, gain of mesenchymal phenotypes, and a loss of both apicobasal and planar polarity. We have now determined that these phenotypes represent a fundamental change in cellular differentiation and that loss of Hugl1 results in cellular transdifferentiation. Loss of Hugl1 expression in breast epithelial cells results in the induction of a mixed-phenotype population (composed of CD44high/CD49flow and CD44low/CD49fhigh), whose growth and migration are driven by the Epidermal Growth Factor Receptor (EGFR). These populations exhibit increased anchorage-independent growth and form soft agar colonies in an EGF-dependent manner, and these behaviors are selectively enhanced in the CD44high/CD49flow population. Hugl1 loss results in the mislocalization of EGFR, resulting in TAZ and SLUG nuclear translocation. Together, these data indicate that when Hugl1 is lost in normal epithelial cells, polarity loss is accompanied by a transdifferentiation and increased anchorage-independent growth and migration. Citation Format: Erin Greenwood, David Ebertz, Anthony Fabiano, Joyce A. Schroeder. Loss of Hugl1 induces an EGF-dependent cellular transdifferentiation. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Breast Cancer Research; Oct 17-20, 2015; Bellevue, WA. Philadelphia (PA): AACR; Mol Cancer Res 2016;14(2_Suppl):Abstract nr A16.
The purpose of this chapter is to propose a framework for achieving an ethical culture in the post-bureaucratic era. The authors emphasize the necessity of informal dialogue and employee empowerment, and examine the role that personal values have in the post-bureaucratic work environment. Next, this chapter explores the appraisal of personal values and asserts that modern organizations will need similar strategies in order to identify and develop an effective ethical culture. The last portion of this chapter addresses three employee virtues that are helpful in the design and implementation of an ethical culture. Over and above appraising the values of an organization, this chapter provides a modern account for the definition of values and discusses methods for appraising each virtue while also proposing some alternatives for measuring employee loyalty, integrity and perseverance.
The purpose of this chapter is to propose a framework for achieving an ethical culture in the post-bureaucratic era. The authors emphasize the necessity of informal dialogue and employee empowerment, and examine the role that personal values have in the post-bureaucratic work environment. Next, this chapter explores the appraisal of personal values and asserts that modern organizations will need similar strategies in order to identify and develop an effective ethical culture. The last portion of this chapter addresses three employee virtues that are helpful in the design and implementation of an ethical culture. Over and above appraising the values of an organization, this chapter provides a modern account for the definition of values and discusses methods for appraising each virtue while also proposing some alternatives for measuring employee loyalty, integrity and perseverance.
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