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The horticultural therapist uses a variety of tools, techniques, and accommodations. Participants in horticultural therapy programs have an array of therapeutic goals, interests, abilities, and levels of functioning, and they represent diverse cultural backgrounds and ages. As a result, the horticultural therapist must be flexible and accommodate a range of populations in order to create a welcoming therapeutic environment and deliver person-centric services that enable, engage, and promote each person’s growth and development through horticultural activities. The therapist’s careful and appropriate application of communication techniques, such as active listening and prompting, and use of adaptive technology, including tools with safety or design features that enable task completion, isessential for client engagement. Implementation of safety protocols within program workspace and garden settings fosters a positive culture and atmosphere of safety among participants and staff members. Especially important are considerations for accessibility and use of plants, other materials, tools, and garden features. In addition, universally designed indoor and outdoor environments that appeal to a wide range of people enhance client experiences inside and outside the horticultural therapy program. The horticultural therapist is encouraged to employ creative problemsolving to enhance client accessibility and engagement fully.

There is an undeniable concern among the elderly about the mental changes they experience as they grow older. In general, the elderly tend to regard mental deterioration as a pathological condition, however these changes should be considered inherent in the aging process and in the last few years cognitive stimulation programs have been developed in order to address these concerns among the elderly. The purpose of this study is to analyze the influence of a cognitive training program on 53 subjects with age-related memory loss. The results of cognitive performance have been compared with a control group consisting of 51 subjects with no cognitive training. Moreover, this research analyses the relationship between cognitive changes and the variation in the perceived quality of life of the elderly people in both groups. The results show significant changes in the test group, demonstrating improved cognitive performance and quality of life perception.

Colorectal cancer is a leading cause of cancer-related deaths worldwide. Early diagnosis and treatment of colorectal cancer is the key to improving survival rates and as such a need exists to identify patients who may benefit from adjuvant chemotherapy. The dysregulation of the ubiquitin-proteasome system (UPS) has been implicated in oncogenesis and cancer cell survival, and proteasome inhibitors are in clinical use for a number of malignancies including multiple myeloma. In our study, we examined the protein expression of several key components of the UPS in colorectal cancer using immunohistochemistry to determine expression levels of ubiquitinylated proteins and the proteasomal subunits, 20S core and Rpt4 in a cohort of 228 patients with colon cancer. Multivariate Cox analysis revealed that neither the intensity of either ubiquitinylated proteins or the 20S core was predictive in either Stage II or III colon cancer for disease free survival or overall survival. In contrast, in Stage II patients increased Rpt4 staining was significantly associated with disease free survival (Cox proportional hazard ratio 0.605; p = 0.0217). Our data suggest that Rpt4 is an independent prognostic variable for Stage II colorectal cancer and may aid in the decision of which patients undergo adjuvant chemotherapy.

Brooklyn Botanic Garden's Project Green Reach (PGR) is a children's program that has offered garden-based youth education since 1990. PGR focuses on Grade K-8 students and teachers from local Title I schools who work in teams on garden and science projects. In this exploratory study, the authors used field observations, document analysis, and past participant interviews to investigate PGR's program, model informal science education, and document the influence of the program on urban youth. In all, 7 themes emerged: (a) participants' challenging home and school environments, (b) changes in academic and interdisciplinary skills, (c) changes in science and gardening skills, (d) increased environmental awareness, (e) social and personal growth, (f) a positive life experience, and (g) the cultural significance of the program.

Little is known about the origin of basal-like breast cancers, an aggressive disease that is highly similar to BRCA1-mutant breast cancers. p63 family proteins that are structurally related to the p53 suppressor protein are known to function in stem cell regulation and stratified epithelia development in multiple tissues, and p63 expression may be a marker of basal-like breast cancers. Here we report that ΔNp63 isoforms of p63 are transcriptional targets for positive regulation by BRCA1. Our analyses of breast cancer tissue microarrays and BRCA1-modulated breast cancer cell lines do not support earlier reports that p63 is a marker of basal-like or BRCA1 mutant cancers. Nevertheless, we found that BRCA1 interacts with the specific p63 isoform ΔNp63γ along with transcription factor isoforms AP-2α and AP-2γ. BRCA1 required ΔNp63γ and AP-2γ to localize to an intronic enhancer region within the p63 gene to upregulate transcription of the ΔNp63 isoforms. In mammary stem/progenitor cells, siRNA-mediated knockdown of ΔNp63 expression resulted in genomic instability, increased cell proliferation, loss of DNA damage checkpoint control, and impaired growth control. Together, our findings establish that transcriptional upregulation of ΔNp63 proteins is critical for BRCA1 suppressor function and that defects in BRCA1-ΔNp63 signaling are key events in the pathogenesis of basal-like breast cancer. Cancer Res; 71(5); 1933–44. ©2011 AACR.

The mismatch between supply and demand in organ donation is well documented. Although there are many reasons for this mismatch, failure of health professionals to identify potential donors or to gain consent from bereaved relatives is considered to be significant. Such failures may be due to the attitudes of health professionals themselves towards becoming organ donors. This study focuses on the level of commitment shown by health care professionals and their student equivalents to organ donation, and assesses the ways in which they identify themselves as potential organ donors. These findings are evaluated and suggestions for future practice are offered.

e21147 Background: Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast carcinoma is prognostic. Predictive biomarkers for pCR include early response to NAC, estrogen receptor (ER) negativity, HER2 positivity, and high Ki67. We assessed whether absence of fluoro-deoxy glucose (FDG) uptake measured by standardized uptake value (SUV) after NAC would predict pCR. Methods: We identified 23 patients (pts) who had PET/CT scanning pre and post NAC. We examined breast cancer subtype, chemotherapy (CT) regimen, number of cycles of CT given, clinical and pathological staging data and changes in SUV in the breasts and lymph nodes pre and post NAC. pCR was defined as no residual cancer in the breast or axillary lymph nodes. Results: Median age at diagnosis was 46 years (IQR; 37 to 56). Median tumor size at diagnosis was 30mm (IQR; 25 to 43) and 19 pts (83%) had node positive breast cancer. Most tumors were ductal (n=22) with 1 lobular cancer. Preoperatively 95% received all CT. All HER2+ pts received Trastuzumab. Anthracycline/taxane based regimens were most frequently given in 22 cases, 1 received lapatinib/trastuzumab. Five tumors (21.7%) were ER+/HER2+; 14 (60.9%) ER+/HER2-; 2 (8.7%) ER-/HER2+ and 2 (8.7%) were ER-/HER2-. All tumors were high (n=9, 39.1%) or intermediate grade (n=14, 61%). SUV was significantly lower post NAC (p=0.035). We observed no SUV uptake in breast or lymph nodes in 15 cases (65.2%) post NAC, these corresponded to; ER+HER2+ 4/5 (80%); ER+HER2- 7/15 (46.7%); ER-HER2- 2/2(100%), ER-HER2+ 2/2(100%). Absent SUV uptake post NAC was associated with a pCR (breast and lymph nodes) in 5/15 (33%) of pts (ER+HER2+ n=1, ER+HER2- n=1, ER-HER2- n=2, ER-HER2+ n=1). Ten of 15 tumors (67%) had no SUV uptake in the breast post NAC and 7 (47%) were associated with a pCR. There was a trend toward increased odds of pCR with no SUV uptake post NAC (OR 2.76; 95% CI 0.85 to 8.94: P= 0.09). Overall rate of pCR was 21.7% (n=5). Conclusions: A non-statistically significant trend toward increased odds of pCR with no SUV uptake post NAC was observed. Larger subtype-specific breast cancer cohorts will be required to determine the value of PET/CT as a predictive biomarker for pCR.

In the cytoplasm of well-spread cultured normal fibroblasts, actin is organized into a network of cables that run the length of the cell just inside the adherent cell membrane. A diffuse matrix replaces the cables in fibroblasts that have become tumorigenic as a result of oncogenic transformation. We have found a similar disruption in actin organization in cultured skin fibroblasts (passage 6-10) obtained by biopsy from patients with the inherited colonic cancer, adenomatosis of the colon and rectum (ACR). Because ACR is inherited as an autosomal dominant trait, about half the children of ACR patients will develop colon cancer, but they typically remain asymptomatic until at least the second decade of life. Actin distribution within cultured cells from children of ACR patients was identical either to that seen in cultured cells from normal persons or to that seen in cultured cells from ACR patients. The two different patterns were independent of age, sex, drug treatment, or infections of the donors. Apparently, this class of colonic carcinoma is accompanied by a systemic aberration in the organization of fibroblast cytoplasm, and this aberration can be detected by immunofluorescent localization of actin within cultured skin fibroblasts, prior to manifestation of any colonic symptoms.