Toxicity, metabolism and applied uses of 3,4-didehydroretinol

The comparative potencies of the all-trans isomers of 3,4-didehydroretinyl acetate (A2), retinyl acetate (A1), and retinoic acid (RA) to induce terata, embryolethality, and behavioral disruptions in offspring of timed-pregnant Sprague-Dawley rats was evaluated. Single equimolar doses (1-352 [mu]mol/kg BW) of the retinoids were given orally in corn oil on day 8.5 of gestation. All retinoids tested were teratogenic and embryolethal at dose ranges of 35-352 [mu]mol/kg BW. Embryolethality also occurred with both A2 and RA at 11 [mu]mol/kg BW. Biochemical profiles of both maternal and fetal tissue indicated that increased teratogenicity and embryolethality in A2 dosed groups correlated with enhanced concentration of maternal and fetal RA. Both RA and A2 were more toxic and teratogenic than A1, possibly due to differences in transport and metabolism;Development and spontaneous motor behavior of six-week old pups from retinoid dosed dams were also evaluated. Live birth rates were reduced in groups receiving A2, though no external abnormalities were observed, regardless of the treatment received. Control and treated pups were paired and tested using a computer pattern recognition system (RAPID). Significant changes in motor behavior patterns were evident in males whose dams were dosed with 3.5 [mu]mol A2/kg BW and in females whose dams received 1 [mu]mol A2/kg BW. No significant behavioral effects were seen in males in either the A1 or RA groups;The vitamin A status of low-income pregnant women (n = 57) during the third trimester of pregnancy was assessed by use of A2 in the modified relative dose response (MRDR) assay. Non-Hispanic White (45), Hispanic (6), Afro-American (5), and Asian (1) women were recruited from public health programs in central Iowa. Twenty six percent of the study population were found to be in a marginal vitamin A status with MRDR values ≥0.03, whereas 9% had values ≥0.06. The Hispanic and Afro-American groups seemed to be most at risk, with 50% and 40% (respectively) of the MRDR values ≥0.03 and 33% and 20% (respectively) ≥0.06. Clearly, this study identifies a portion of the U.S. population at high risk of vitamin A inadequacy

Missouri EATs: Cultivating community food systems through community engagement

The University of Missouri Extension Missouri EATs program connects local stakeholders to build and strengthen their community’s food system. Missouri EATs (which stands for Engage, Act, and Transform) is a community development program designed to engage people to identify local assets and needs; help them develop a plan to act on their top priorities; and make lasting changes to transform their local food system. The broad goal of Missouri EATs is to create healthy, resilient, and equitable community-based food systems. The starting point is a community-wide in-person or on-line forum for participants to engage in an informed and facilitated discussion about the food system. This event is the first step of a larger community organizing process that engages communities to make positive changes over time. The format allows for broad discussions related to local agriculture, hunger, health, and related topics. It relies heavily on local input from community members in general and those representing of local business and agencies. The forum results in a Food System Action Plan, which is a tool used to keep communities engaged after the event and guide their ongoing effort. Communities may choose to hold a combination of small working group meetings, community meals, or quarterly meetings to keep things moving in a positive direction. Annual meetings are encouraged to provide updates and reengage community members. The forum and subsequent activities may all be adapted for an on-line environment

University of Missouri Extension Metropolitan Foods System Team

University of Missouri Extension established a Metropolitan Food Systems Team in September 2011 with the goal of creating a framework for the identification, development and implementation of Extension food system programming in and near Missouri’s urban areas. The membership and activities of the team have shifted over the years with various personnel changes and different topics of interest in the state, but overall, the goal of the team has remained the same. The work of this team can provide ideas for other states of the role that Extension can play in helping to strengthen urban and peri-urban food systems. We outline specific elements that have contributed to our team’s successes and recommendations to other University Extension systems who may be interested in developing a similar initiative. Since its formation, the team has developed several Extension curricula, including Stock Healthy, Shop Healthy (which has been implemented nationally) and Selling Local Foods; and had the opportunity to visit two other state Extension programs to learn about their urban food systems work. The team held a conference for producers, buyers and food system stakeholders in all of Missouri’s metropolitan areas. The team has also established a food systems website (https://extension2.missouri.edu/programs/food-systems) which serves as valuable clearinghouse of information of the various resources that MU Extension has available in each of the different sectors of the food system. Rather than categorizing information by only the academic discipline that developed those resources, the website groups the information by sectors including 1) grow/produce/harvest, 2) deliver/process, 3) market/distribute, 4) display/purchase, 5) prepare/consume, 6) surplus/waste. This is a useful resource for internal Extension personnel, but also for external groups looking for resources. In 2019, the team engaged in a strategic planning process to determine our best approach for future work in light of new Extension and state initiatives around regional food systems. One of the main benefits of this team is that it brings together Extension personnel working in various disciplines from different parts of the state, which has enabled the team members to learn about ongoing and future initiatives occurring in other disciplines and areas of the state that are of interest to others. This multi-disciplinary approach has fostered extensive collaboration between different disciplines in projects that team members may have otherwise worked on independently or only within a single discipline. This presentation will help provide recommendations on implementing similar teams, based on our experiences

Die Rangfolge psychischer und sozialer Prädiktoren und Kriterien für die Prognose Herztransplantierter

Bei 44 Herztransplantierten wurden präoperativ und bis zu einem und drei Jahre postoperativ psychiatrisch/psychologische Untersuchungen durchgeführt und psychosoziale Daten erhoben. Die Prädiktoren und Kriterien für eine gute Prognose wurden ihrer Rangfolge nach hierarchisiert. Es ergab sich folgende Prädiktorrangfolge: 1. die eindeutige Motivation und der unauffällige psychopathologische Befund, 2. der gute soziale Rückhalt und die vor der Transplantation zum Ausdruck gebrachte positive Berufsperspektive, 3. das Bewußtsein der Geborgenheit durch die Familie und die reife psychologische Verarbeitung der Herzerkrankung und der bevorstehenden Herztransplantation, 4. der fortgeschrittene Schweregrad der Herzerkrankung (Schweregrad IV NYHA), 5. der relativ geringe Fernsehkonsum (weniger als an 4 Abenden), und 6. u. a. noch lebende Eltern und das Vorhandensein von Kindern. Für die 7 prognostischen Kriterien ließ sich folgendeKriterienrangfolge ermitteln: 1. die soziale Reintegration, 2. die Lebenszufriedenheit, 3. die Compliance und der psychopathologische Befund, 4. die berufliche Rehabilitation, und 5. die körperliche Belastbarkeit und der körperliche Zustand. Die Studie zeigt, daß es eine unterschiedliche Gewichtung psychosozialer Faktoren vor und nach der Herztransplantation gibt, und daß die soziale Reintegration der beste Indikator für eine erfolgreiche Herztransplantation ist.44 patients underwent psychiatric/psychological and psychosocial examinations before and for one to three years after heart transplantation. Predictors and prognostic criteria for a good result were established according to the rank of their significance. The rank sequence for the predictors were 1. strong motivation and absence of psychiatric symptomatology, 2. good social support and determination to return to work after transplantation, 3. the feeling of being cared for by the family and a mature psychological coping with the heart disease and the expected transplantation, 4. advanced heart failure (stage IV NYHA), 5. watching TV less than 4 evenings a week, 6. parents still living and having one’s own children. The rank sequence for the 7 prognostic criteria for a good result after heart transplantation were 1. social reintegration, 2. being content with life. 3. good compliance and absence of psychopathology, 4. returning to work, and 5. physical exercise tolerance and general physical condition. The study shows that there is a different magnitude of significance for psychosocial factors before and after heart transplantation and that social reintegration is the best indicator for a good result after heart transplantation

Using conversation analysis to explore feedback on resident performance

Feedback on clinical performance of residents is seen as a fundamental element in postgraduate medical education. Although literature on feedback in medical education is abundant, many supervisors struggle with providing this feedback and residents experience feedback as insufciently constructive. With a detailed analysis of real-world feedback conversations, this study aims to contribute to the current literature by deepening the understanding of how feedback on residents’ performance is provided, and to formulate recommendations for improvement of feedback practice. Eight evaluation meetings between program directors and residents were recorded in 2015–2016. These meetings were analyzed using conversation analysis. This is an ethno-methodological approach that uses a data-driven, iterative procedure to uncover interactional patterns that structure naturally occurring, spoken interaction. Feedback in our data took two forms: feedback as a unidirectional activity and feedback as a dialogic activity. The unidirectional feedback activities prevailed over the dialogic activities. The two diferent formats elicit diferent types of resident responses and have diferent implications for the progress of the interaction. Both feedback format

Judging residents' performance:a qualitative study using grounded theory

BACKGROUND: Although program directors judge residents' performance for summative decisions, little is known about how they do this. This study examined what information program directors use and how they value this information in making a judgment of residents' performance and what residents think of this process. METHODS: Sixteen semi-structured interviews were held with residents and program directors from different hospitals in the Netherlands in 2015-2016. Participants were recruited from internal medicine, surgery and radiology. Transcripts were analysed using grounded theory methodology. Concepts and themes were identified by iterative constant comparison. RESULTS: When approaching semi-annual meetings with residents, program directors report primarily gathering information from the following: assessment tools, faculty members and from their own experience with residents. They put more value on faculty's comments during meetings and in the corridors than on feedback provided in the assessment tools. They are influenced by their own beliefs about learning and education in valuing feedback. Residents are aware that faculty members discuss their performance in meetings, but they believe the assessment tools provide the most important proof to demonstrate their clinical competency. CONCLUSIONS: Residents think that feedback in the assessment tools is the most important proof to demonstrate their performance, whereas program directors scarcely use this feedback to form a judgment about residents' performance. They rely heavily on remarks of faculty in meetings instead. Therefore, residents' performance may be better judged in group meetings that are organised to enhance optimal information sharing and decision making about residents' performance

Design and evaluation of a clinical competency committee

Introduction In postgraduate medical education, group decision-making has emerged as an essential too

Toxicity, metabolism and applied uses of 3,4-didehydroretinol

The comparative potencies of the all-trans isomers of 3,4-didehydroretinyl acetate (A2), retinyl acetate (A1), and retinoic acid (RA) to induce terata, embryolethality, and behavioral disruptions in offspring of timed-pregnant Sprague-Dawley rats was evaluated. Single equimolar doses (1-352 [mu]mol/kg BW) of the retinoids were given orally in corn oil on day 8.5 of gestation. All retinoids tested were teratogenic and embryolethal at dose ranges of 35-352 [mu]mol/kg BW. Embryolethality also occurred with both A2 and RA at 11 [mu]mol/kg BW. Biochemical profiles of both maternal and fetal tissue indicated that increased teratogenicity and embryolethality in A2 dosed groups correlated with enhanced concentration of maternal and fetal RA. Both RA and A2 were more toxic and teratogenic than A1, possibly due to differences in transport and metabolism;Development and spontaneous motor behavior of six-week old pups from retinoid dosed dams were also evaluated. Live birth rates were reduced in groups receiving A2, though no external abnormalities were observed, regardless of the treatment received. Control and treated pups were paired and tested using a computer pattern recognition system (RAPID). Significant changes in motor behavior patterns were evident in males whose dams were dosed with 3.5 [mu]mol A2/kg BW and in females whose dams received 1 [mu]mol A2/kg BW. No significant behavioral effects were seen in males in either the A1 or RA groups;The vitamin A status of low-income pregnant women (n = 57) during the third trimester of pregnancy was assessed by use of A2 in the modified relative dose response (MRDR) assay. Non-Hispanic White (45), Hispanic (6), Afro-American (5), and Asian (1) women were recruited from public health programs in central Iowa. Twenty six percent of the study population were found to be in a marginal vitamin A status with MRDR values ≥0.03, whereas 9% had values ≥0.06. The Hispanic and Afro-American groups seemed to be most at risk, with 50% and 40% (respectively) of the MRDR values ≥0.03 and 33% and 20% (respectively) ≥0.06. Clearly, this study identifies a portion of the U.S. population at high risk of vitamin A inadequacy.</p