Medical Students\u27 Knowledge of Midwifery Practice After Didactic and Clinical Exposure

Information concerning the student outcomes of interdisciplinary education is limited. The purpose of this study was to identify the knowledge of third‐year medical students regarding the practice of certified nurse‐midwives (CNMs). A 1‐page survey instrument was developed and pretested. The instrument was administered as a pre‐ and posttest at the beginning and end of 7 Obstetrics and Gynecology rotations at 2 medical school clinical campuses of a large Midwestern medical school. Direct interaction with CNMs improved knowledge of collaborative practice arrangements and roles. This was particularly evident in knowledge areas related to CNM prescriptive authority. The medical students who had direct experience with CNMs expressed more interest in working with them in the future than those who lacked the exposure. Collaborative, interdisciplinary education of medical students appeared to promote improved understanding of roles and capabilities

Herpes Simplex Virus Latency in Cultured Cells

The molecular basis of herpes simplex virus (HSV) latency has been investigated by analysis of a latent interaction between HSV and cells in culture. An in vitro latency system for HSV, based on previous work by E. Notarianni and C. M. Preston, has been characterised, in which incubation at a supraoptimal temperature converts HSV to a latent state within tissue culture cells. Human foetal lung (HFL) cells were infected at low multiplicity with HSV and, following adsorption, the cultures were shifted to 42C for 6 days, then downshifted to a temperature permissive for HSV replication for a further 4 to 6 days. During the latter incubation period no virus was usually detectable and the HSV was considered to be in a latent state. HSV could be reactivated from this latent state at high efficiency by intertypic superinfection of the cultures with HSV mutants or with human cytomegalovirus. To define the HSV gene products involved in latency, the behaviour of various temperature-sensitive (ts), insertion (in) and deletion (dl) mutants of HSV in the in vitro latency system was examined. The rationale behind this approach is that mutants which fail to become established in a latent state, or which fail to reactivate latent HSV, must lack functions involved in establishment or reactivation, respectively. Two mutants of HSV type 1 (HSV-1) used in these studies, tsK and inl 411, do not synthesise active immediate early (IE) polypeptide Vmw175 and are blocked at a very early stage of the virus replication cycle, and a third mutant of HSV-1, d11403, does not produce IE polypeptide Vmw110, but otherwise exhibits a pattern of protein synthesis indistinguishable from that of wt HSV-1. All mutants tested were able to establish latency in HFL fibroblasts and could be reactivated by intertypic superinfection with HSV or with human cytomegalovirus, showing that no viral DNA synthesis and little or no viral gene expression is necessary for the establishment of latency in vitro, and that at most the viral proteins involved are IE polypeptides Vmw12, Vmw63, Vmw68, Vmw175 or Vmw110, the early polypeptide Vmw136, and, possibly, components of the input virion. Reactivation of latent HSV-2 was achieved by superinfection with tsK or in1411. However, superinfection with d11403 failed to reactivate latent HSV-2 as a consequence of a deletion in the region of the genome encoding Vmw110, strongly suggesting that Vmw110, which is known to regulate gene expression by trans-activation, is required for reactivation in the in vitro latency system. The results presented do not indicate whether Vmw110 acts alone or in conjunction with one or more of the virion components and/or the other IE polypeptides, excluding Vmwl75. Harris et al. (1989) have recently shown that Vmw110 alone can reactivate latent HSV in vitro. One possibility is that a block in viral gene expression occurs at a very early stage in the viral cycle, either as the direct cause or as a consequence of establishment of latency, and that the block can be released by the Vmw110 gene product, thereby allowing HSV to continue into the lytic cycle. The latent state of HSV DNA in vivo appears to be Endless' and is therefore either circular, concatemeric or integrated via regions of the genome other than the termini. A recent report shows that the majority of latent HSV DNA in vivo is extrachromosomal, suggesting that latent HSV DNA in vivo is not likely to be integrated into cellular DNA. The physical nature of the HSV DNA in the in vitro latency system described has been determined. The relative proportion of latent HSV genomes, initially present in vitro at 0.03-0.1 copies per cell, was selectively increased and the presence of joint and terminal fragments of HSV in latent HSV DNA was investigated by the use of a modified Southern hybridisation procedure. During the 4

Changing Lives Through Literature: Implementation & Evaluation

The CLTL program at the Juvenile probation department works with court involved youth between the ages of 12 – 19 years of age. The program is designed to explore prosocial character themes through the use of literature. The program facilitators select short stories, poems, music lyrics, and/or short films that center around themes for example, respect, love, education, violence, family, friendship, leadership, and the like. The judge, probation officer, facilitators and youth read the literature together, then discuss what the author is trying to get across. Then the level of discussion shifts to what reading do they identify with personally or have seen in their community. The last 10 - 15 minutes the participants do a reflective write on what they read and discussed. Each semester the UMass students conduct a tour for the youth at UMass Boston, and have the youth meet with the pre-collegiate programs on campus. The program starts in the first week of each semester and goes on for 11 weeks

One Health Aotearoa: a transdisciplinary initiative to improve human, animal and environmental health in New Zealand

The following article, Harrison, S., Baker, M.G., Benschop, J. et al. One Health Outlook 2, 4 (2020), was published online by BMC on31 January 2020 at: https://doi.org/10.1186/s42522-020-0011-0. It is © The Author(s) 2020, but is Open Access and is distributedunder the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), whichpermits unrestricted use, distribution, and reproduction in any medium, provided that appropriate credit is given to the originalauthor(s) and the source, a link is provided to the Creative Commons license, and any changes are indicated. Permission to republishthe paper here has been obtained from the authors, and no changes have been made to the text

Analysis of immune responses to attenuated alcelaphine herpesvirus 1 formulated with and without adjuvant

The experimental vaccine for bovine malignant catarrhal fever consists of viable attenuated alcelaphine herpesvirus 1 (AlHV-1) derived by extensive culture passage, combined with an oil-in-water adjuvant, delivered intramuscularly. This immunisation strategy was over 80% effective in previous experimental and field trials and protection appeared to be associated with induction of virus-neutralising antibodies. Whether the vaccine virus is required to be viable at the point of immunisation and whether adjuvant is required to induce the appropriate immune responses remains unclear. To address these issues two studies were performed, firstly to analyse immune responses in the presence and absence of adjuvant and secondly, to investigate immune responses to vaccines containing adjuvant plus viable or inactivated AlHV-1.The first study showed that viable attenuated AlHV-1 in the absence of adjuvant induced virus-specific antibodies but the titres of virus-neutralising antibodies were significantly lower than those induced by vaccine containing viable virus and adjuvant, suggesting adjuvant was required for optimal responses. In contrast, the second study found that the vaccine containing inactivated (>99.9%) AlHV-1 induced similar levels of virus-neutralising antibody to the equivalent formulation containing viable AlHV-1.Together these studies suggest that the MCF vaccine acts as an antigen depot for induction of immune responses, requiring adjuvant and a suitable antigen source, which need not be viable virus. These observations may help in directing the development of alternative MCF vaccine formulations for distribution in the absence of an extensive cold chain

Addition of the FTD Module to the Neuropsychiatric Inventory improves classification of frontotemporal dementia spectrum disorders

Most neuropsychiatric symptoms (NPS) common in frontotemporal dementia (FTD) are currently not part of the Neuropsychiatric Inventory (NPI). We piloted an FTD Module that included eight extra items to be used in conjunction with the NPI. Caregivers of patients with behavioural variant FTD (n = 49), primary progressive aphasia (PPA; n = 52), Alzheimer's dementia (AD; n = 41), psychiatric disorders (n = 18), presymptomatic mutation carriers (n = 58) and controls (n = 58) completed the NPI and FTD Module. We investigated (concurrent and construct) validity, factor structure and internal consistency of the NPI and FTD Module. We performed group comparisons on item prevalence, mean item and total NPI and NPI with FTD Module scores, and multinomial logistic regression to determine its classification abilities. We extracted four components, together explaining 64.1% of the total variance, of which the largest indicated the underlying dimension 'frontal-behavioural symptoms'. Whilst apathy (original NPI) occurred most frequently in AD, logopenic and non-fluent variant PPA, the most common NPS in behavioural variant FTD and semantic variant PPA were loss of sympathy/empathy and poor response to social/emotional cues (part of FTD Module). Patients with primary psychiatric disorders and behavioural variant FTD showed the most severe behavioural problems on both the NPI as well as the NPI with FTD Module. The NPI with FTD Module correctly classified more FTD patients than the NPI alone. By quantifying common NPS in FTD the NPI with FTD Module has large diagnostic potential. Future studies should investigate whether it can also prove a useful addition to the NPI in therapeutic trials

Inflammation, insulin resistance, and diabetes-mendelian randomization using CRP haplotypes points upstream

Background Raised C-reactive protein (CRP) is a risk factor for type 2 diabetes. According to the Mendelian randomization method, the association is likely to be causal if genetic variants that affect CRP level are associated with markers of diabetes development and diabetes. Our objective was to examine the nature of the association between CRP phenotype and diabetes development using CRP haplotypes as instrumental variables. Methods and Findings We genotyped three tagging SNPs (CRP + 2302G > A; CRP + 1444T > C; CRP + 4899T > G) in the CRP gene and measured serum CRP in 5,274 men and women at mean ages 49 and 61 y (Whitehall II Study). Homeostasis model assessment-insulin resistance (HOMA-IR) and hemoglobin A1c (HbA1c) were measured at age 61 y. Diabetes was ascertained by glucose tolerance test and self-report. Common major haplotypes were strongly associated with serum CRP levels, but unrelated to obesity, blood pressure, and socioeconomic position, which may confound the association between CRP and diabetes risk. Serum CRP was associated with these potential confounding factors. After adjustment for age and sex, baseline serum CRP was associated with incident diabetes (hazard ratio = 1.39 [95% confidence interval 1.29-1.51], HOMA-IR, and HbA1c, but the associations were considerably attenuated on adjustment for potential confounding factors. In contrast, CRP haplotypes were not associated with HOMA-IR or HbA1c (p=0.52-0.92). The associations of CRP with HOMA-IR and HbA1c were all null when examined using instrumental variables analysis, with genetic variants as the instrument for serum CRP. Instrumental variables estimates differed from the directly observed associations (p=0.007-0.11). Pooled analysis of CRP haplotypes and diabetes in Whitehall II and Northwick Park Heart Study II produced null findings (p=0.25-0.88). Analyses based on the Wellcome Trust Case Control Consortium (1,923 diabetes cases, 2,932 controls) using three SNPs in tight linkage disequilibrium with our tagging SNPs also demonstrated null associations. Conclusions Observed associations between serum CRP and insulin resistance, glycemia, and diabetes are likely to be noncausal. Inflammation may play a causal role via upstream effectors rather than the downstream marker CRP