Legislative Smoking Bans for Reducing Exposure to Secondhand Smoke and Smoking Prevalence: Opportunities for Georgians

Background: Secondhand smoke, which is also referred to as environmental tobacco smoke and passive smoke, is a known human carcinogen. Secondhand smoke also causes disease and premature death in nonsmoking adults and children. Methods: We summarize studies of secondhand smoke in public places before and after smoking bans, as well as studies of cardiovascular and respiratory disease before and after such bans. Results: To protect the public from the harmful effects of secondhand smoke, smoke-free legislation is an effective public health measure. Smoking bans in public places, which have been implemented in many jurisdictions across the U.S. and in other countries, have the potential to influence social norms and reduce smoking behavior. Conclusions: Through legislative smoking bans for reducing secondhand smoke exposure and smoking prevalence, opportunities exist to protect the health of Georgians and other Americans and to reduce health care costs. These opportunities include increasing the comprehensiveness of smoking bans in public places and ensuring adequate funding to quit line services

Insights from Snowboard Pedagogy for the Legal Studies Instructor

This paper intends to inform and avail instructors of pedagogical approaches proven effective in winter sports environments, specifically in the sport of snowboarding, that we suggest may be particularly effective in teaching business law to non-law students in undergraduate business programs. We join other scholars in examining the approach to teaching business law to non-law students in an effort to develop the knowledge and skills necessary to manage the “dynamic and untidy” legal issues that business professionals deal with, while mitigating the difficult and confusing subject matter and pedagogy associated with business law courses. Broadly speaking, teaching requires the acquisition of skills and knowledge; teaching law, the practice of law, and snowboarding are no different. Undergraduate business law courses are an essential accompaniment to the suite of curricula associated with various majors within business schools, such as management, accounting, economics and supply chain. It is particularly important for business school students to develop and retain skills and knowledge associated with legal studies for several reasons. Students’ exposure to legal studies concepts is typically limited, yet the topics are critical for developing the conceptual skill to understand and work within the broader business environment. A basic understanding of business law can help managers make sound business decisions, and in the wake of corporate scandals over the last twenty years, an awareness of the legal environment of business is ever more urgent. One important way that business law courses develop students’ knowledge and conceptual skills is through the critical thinking required to identify legal issues in cases presented and to apply abstract legal concepts to the management of those legal issues. This is often a difficult challenge for students; mastery requires high-impact learning experiences and significant applied practice. The same can be said of snowboarding knowledge and skills. A snowboard instructor can talk about snowboarding with a new athlete, but the athlete can only learn how to snowboard by the significant applied practice of snowboarding. Business law instruction is similar to snowboarding instruction in a number of other, more specific ways. In both domains, it is critical that students receive frequent instruction on how to perform relevant skills and feedback on performance to improve at their craft. The learning curve is steep for both business law and snowboarding students – concepts are often not intuitive, they can be overwhelming, and it can be a frustrating and painful process. A common reason that snow sports enthusiasts give for avoiding snowboarding is the steep and often physically painful learning curve that must be endured. In undergraduate business law courses, students are given background for the cases they study, yet spillover from law school pedagogy often means that business law instructors are hesitant to engage in high-touch practices that lead to internalized learning. Snowboard pedagogy provides several key insights into learning involving a shift from transmitting knowledge to facilitating active learning. We believe these insights have the potential to enhance dramatically student learning of business law concepts. In this paper, we explore snow-sport pedagogy, snowboarding in particular, to gather specific insights into how to improve business law instruction in business schools. We first present a brief background describing the dominant paradigm in business law education, drawing from select scholarly literature on legal studies education in business, and then introduce sport and snow-sport pedagogy, including connections to legal studies pedagogy. We then turn specifically to snowboarding pedagogy, discussing how the development of the field generated specific pedagogical approaches in response to the nature of snowboarding as a sport. In particular, snowboard instructors have proven to be innovative and encouraged to disrupt pedagogical boundaries. Here, we offer specific core insights from snowboard pedagogy and how they may be applied to business law instruction

The learner’s perspective in GP teaching practices with multi-level learners: a qualitative study

BACKGROUND Medical students, junior hospital doctors on rotation and general practice (GP) registrars are undertaking their training in clinical general practices in increasing numbers in Australia. Some practices have four levels of learner. This study aimed to explore how multi-level teaching (also called vertical integration of GP education and training) is occurring in clinical general practice and the impact of such teaching on the learner. METHODS A qualitative research methodology was used with face-to-face, semi-structured interviews of medical students, junior hospital doctors, GP registrars and GP teachers in eight training practices in the region that taught all levels of learners. Interviews were audio-recorded and transcribed. Qualitative analysis was conducted using thematic analysis techniques aided by the use of the software package N-Vivo 9. Primary themes were identified and categorised by the co-investigators. RESULTS 52 interviews were completed and analysed. Themes were identified relating to both the practice learning environment and teaching methods used.A practice environment where there is a strong teaching culture, enjoyment of learning, and flexible learning methods, as well as learning spaces and organised teaching arrangements, all contribute to positive learning from a learners' perspective.Learners identified a number of innovative teaching methods and viewed them as positive. These included multi-level learner group tutorials in the practice, being taught by a team of teachers, including GP registrars and other health professionals, and access to a supernumerary GP supervisor (also termed "GP consultant teacher"). Other teaching methods that were viewed positively were parallel consulting, informal learning and rural hospital context integrated learning. CONCLUSIONS Vertical integration of GP education and training generally impacted positively on all levels of learner. This research has provided further evidence about the learning culture, structures and teaching processes that have a positive impact on learners in the clinical general practice setting where there are multiple levels of learners. It has also identified some innovative teaching methods that will need further examination. The findings reinforce the importance of the environment for learning and learner centred approaches and will be important for training organisations developing vertically integrated practices and in their training of GP teachers.This project was supported by a grant from General Practice Education and Training through Coast City Country General Practice Training. This project was approved for conduct by the ANU Human Research Ethics Committee (protocol number 2011/415)

Expression of neurogenin3 reveals an islet cell precursor population in the pancreas

Differentiation of early gut endoderm cells into the endocrine cells forming the pancreatic islets of Langerhans depends on a cascade of gene activation events controlled by transcription factors including the basic helix-loop-helix (bHLH) proteins. To delineate this cascade, we began by establishing the position of neurogenin3, a bHLH factor found in the pancreas during fetal development. We detect neurogenin3 immunoreactivity transiently in scattered ductal cells in the fetal mouse pancreas, peaking at embryonic day 15.5. Although not detected in cells expressing islet hormones or the islet transcription factors Isl1, Brn4, Pax6 or PDX1, neurogenin3 is detected along with early islet differentiation factors Nkx6.1 and Nkx2.2, establishing that it is expressed in immature cells in the islet lineage. Analysis of transcription factor-deficient mice demonstrates that neurogenin3 expression is not dependent on neuroD1/BETA2, Mash1, Nkx2.2, Nkx6.1, or Pax6. Furthermore, early expression of neurogenin3 under control of the Pdx1 promoter is alone sufficient to drive early and ectopic differentiation of islet cells, a capability shared by the pancreatic bHLH factor, neuroD1/BETA2, but not by the muscle bHLH factor, MyoD. However, the islet cells produced in these transgenic experiments are overwhelmingly α cells, suggesting that factors other than the bHLH factors are required to deviate from a default α cell fate. These data support a model in which neurogenin3 acts upstream of other islet differentiation factors, initiating the differentiation of endocrine cells, but switching off prior to final differentiation. The ability to uniquely identify islet cell precursors by neurogenin3 expression allows us to determine the position of other islet transcription factors in the differentiation cascade and to propose a map for the islet cell differentiation pathway

Strong variation in weathering of layered rock maintains hillslope‐scale strength under high precipitation

The evolution of volcanic landscapes and their landslide potential are both dependent upon the weathering of layered volcanic rock sequences. We characterize critical zone structure using shallow seismic Vp and Vs profiles and vertical exposures of rock across a basaltic climosequence on Kohala peninsula, Hawai’i, and exploit the dramatic gradient in mean annual precipitation (MAP) across the peninsula as a proxy for weathering intensity. Seismic velocity increases rapidly with depth and the velocity–depth gradient is uniform across three sites with 500–600 mm/yr MAP, where the transition to unaltered bedrock occurs at a depth of 4 to 10 m. In contrast, velocity increases with depth less rapidly at wetter sites, but this gradient remains constant across increasing MAP from 1000 to 3000 mm/yr and the transition to unaltered bedrock is near the maximum depth of investigation (15–25 m). In detail, the profiles of seismic velocity and of weathering at wet sites are nowhere monotonic functions of depth. The uniform average velocity gradient and the greater depths of low velocities may be explained by the averaging of velocities over intercalated highly weathered sites with less weathered layers at sites where MAP > 1000 mm/yr. Hence, the main effect of climate is not the progressive deepening of a near‐surface altered layer, but rather the rapid weathering of high permeability zones within rock subjected to precipitation greater than ~1000 mm/yr. Although weathering suggests mechanical weakening, the nearly horizontal orientation of alternating weathered and unweathered horizons with respect to topography also plays a role in the slope stability of these heterogeneous rock masses. We speculate that where steep, rapidly evolving hillslopes exist, the sub‐horizontal orientation of weak/strong horizons allows such sites to remain nearly as strong as their less weathered counterparts at drier sites, as is exemplified by the 50°–60° slopes maintained in the amphitheater canyons on the northwest flank of the island. Copyright © 2017 John Wiley & Sons, Ltd.Seismic velocity profiles across a basalt climosequence in Hawai’i reveal that above a particular precipitation threshold, rapid weathering of high‐permeability layers produces intercalated low‐velocity horizons and dramatically lowers the average seismic velocity of the rock section. However, less permeable layers remain relatively unweathered and thus still contribute significantly to the mechanical competence of the profile, which may explain maintenance of steep‐walled canyons under high precipitation rates. Such observations challenge a top‐down model of progressive weathering (i.e. weakening) of the substrate and therefore suggest that high strength can be maintained even under high precipitation rates, if horizontally layered horizons of different weathering potential exist.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143701/1/esp4290.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143701/2/esp4290_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143701/3/esp4290-sup-0001-SupplementaFiles_FINAL.pd

ROCK signaling promotes collagen remodeling to facilitate invasive pancreatic ductal adenocarcinoma tumor cell growth

Pancreatic ductal adenocarcinoma (PDAC) is a major cause of cancer death; identifying PDAC enablers may reveal potential therapeutic targets. Expression of the actomyosin regulatory ROCK1 and ROCK2 kinases increased with tumor progression in human and mouse pancreatic tumors, while elevated ROCK1/ROCK2 expression in human patients, or conditional ROCK2 activation in a KrasG12D/p53R172H mouse PDAC model, was associated with reduced survival. Conditional ROCK1 or ROCK2 activation promoted invasive growth of mouse PDAC cells into three‐dimensional collagen matrices by increasing matrix remodeling activities. RNA sequencing revealed a coordinated program of ROCK‐induced genes that facilitate extracellular matrix remodeling, with greatest fold‐changes for matrix metalloproteinases (MMPs) Mmp10 and Mmp13. MMP inhibition not only decreased collagen degradation and invasion, but also reduced proliferation in three‐dimensional contexts. Treatment of KrasG12D/p53R172H PDAC mice with a ROCK inhibitor prolonged survival, which was associated with increased tumor‐associated collagen. These findings reveal an ancillary role for increased ROCK signaling in pancreatic cancer progression to promote extracellular matrix remodeling that facilitates proliferation and invasive tumor growth

Proactive Management of Pneumonia Epizootics in Bighorn Sheep in Montana—Project Update

Pneumonia epizootics are a major challenge for effective management of bighorn sheep (Ovis canadensis). Approximately half of the herds in Montana have suffered die-offs since the 1980s, many of which were pneumonia events. A set of models that identify risk of pneumonia and the best management decisions given that risk would be of great value for proactive management of pneumonia epizootics. Our first objective is to design and test a risk model that will help predict a herd’s risk of pneumonia. We hypothesize that various factors increase risk through pathogen exposure, pathogen spread, and disease susceptibility. Analysis of these factors comparing herds with and without recent pneumonia histories using Bayesian logistic regression will allow us to design a risk model. Our second objective is to develop a proactive decision model that incorporates estimates of pneumonia risk to help evaluate costs and benefits of alternative proactive actions appropriate to those estimates. We will use a Structured Decision Making framework, which provides a deliberative, transparent, and defensible decision-making process that is particularly valuable in complex decision-making environments such as wildlife disease management. Together the resulting risk and decision models, to be completed this year, will help managers estimate pneumonia risk and identify the best management action based on both the severity of each herd’s predicted risk and costs and benefits of competing management alternatives. Ultimately, this project will demonstrate the development and application of risk and decision models for proactive wildlife health programs in Montana Fish, Wildlife and Parks

A Survey of OB / GYN Physicians' Training & Current Practice Patterns in Breast Care

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94493/1/tbj12028.pd

Cardiovascular Disease in Women—Challenges Deserving a Comprehensive Translational Approach

Heart disease in women is associated with high levels of morbidity and mortality. Although many of the underlying causes are similar for both genders, cardiovascular disease among women has some unique features, including higher coronary heart disease mortality, higher frequency of sudden cardiac death without previous symptoms, and increased mortality among older women compared to men following a myocardial infarction. During recent years, increasing efforts have been placed on identifying preventive measures, but translation of knowledge from epidemiological studies and clinical trials remain incomplete, particularly in women. The recent launch of the National Institutes of Health’s Clinical and Translational Science Award program offers opportunities to address these gaps and represent a unique opportunity to foster a new generation of researchers familiar with important issues regarding women’s cardiovascular health