Nebraska Legislative Planning Committee 2014 Report: Policy Briefs

The Nebraska Legislature\u27s Planning Committee was created in 2009 with the passage of LB 653 in order to help establish a process of long-term state planning with the Nebraska Legislature. The committee was created to assist state government in identifying emerging trends, assets and challenges of the state and the long-term implications of the decisions made by the Nebraska Legislature. Efforts during the first two years of the committee focused on the development of a database. The goals and benchmarks included in the database were developed and approved by the Legislature\u27s Planning Committee to present a common-sense and data-driven assessment of key areas important to Nebraskans\u27 quality of life. This database was a joint initiative with the Nebraska Legislature\u27s Planning Committee and the University of Nebraska at Omaha’s College of Public Affairs and Community Service. The database was presented in a report that consisted of the data and summaries of the data for each of the nine categories of benchmarks established by the Planning Committee. Each year, the Planning Committee is in charge of updating the data for all benchmarks in each category. It is hoped that this will be of instrumental assistance to Legislators and staff as they craft and debate legislation each Session. Beginning in 2012 the Planning Committee’s report included Policy Briefs. These Policy Briefs address some of the issues that were identified when reviewing the indicators presented in the database. The purpose of the Policy Briefs is to identify and explore in greater depth issues identified by the evidence presented. The Policy Briefs do not recommend specific policies but rather describe options and considerations that relate to the issues. The nine Policy Briefs contained in this report focus on a variety of areas: (1) two briefs focus on education, one on the impact of changing births on Nebraska’s school aged children and the other a program evaluation of a scholarship and mentoring program; (2) three briefs focus on government finance, one on the use of government debt, one on concerns about local government pensions and one on the uses of Nebraska Universal Service Funds; (3) three briefs focus on health‐related issues, one on adults with mental health disabilities and their caregivers, one on the impact of pediatric cancer on the survivors, their families and the state, and one on the impacts of food deserts and food insecurity; and (4) one brief focuses on the availability of public transit in rural Nebraska

EFFORT study:Comparing impact of operation and assisted reproductive technologies on fertility for women with deep infiltrating endometriosis - study protocol for a multicentre randomised trial

INTRODUCTION: Deep infiltrating endometriosis (DIE) affecting the rectum or sigmoid colon is associated with infertility, severe pain and decreased quality of life. As most women with DIE are young, many have a pregnancy intention. Treatment possibilities of endometriosis-associated infertility are surgery or assisted reproductive technologies (ART). However, no studies have compared the two interventions directly. Therefore, this study aims to determine the cumulative pregnancy rate (CPR) and the live birth rate (LBR) after first-line surgery compared with first-line ART for women with rectosigmoid DIE and a pregnancy intention. METHODS AND ANALYSIS: Multicentre, parallel-group, randomised trial of women with rectosigmoid DIE and a pregnancy intention for at least 6 months in Aarhus, Denmark and Bordeaux, France. 352 women aged 18–38 years are randomised 1:1 to either surgical management (shaving, disc excision or segmental resection) or ART management (at least two in vitro fertilisation or intracytoplasmic sperm injection procedures if not pregnant after the first cycle). Women in the surgical intervention group will attempt to get pregnant by either spontaneous conception or ART, depending on the endometriosis fertility index score. Primary outcome measures are CPR and LBR at 18 months’ follow-up. Secondary outcomes are: Non-viable pregnancies, time to pregnancy, pain score, quality of life, complication rate, bowel and bladder function, endocrine and inflammatory profile, number of oocytes, blastocysts, frozen embryos and blastocyst morphology score within 18 months after either intervention. ETHICS AND DISSEMINATION: Conduct of this study is approved by the Danish National Committee on Health Research Ethics and Comité de Protection des Personnes Ile de France VIII. Study participants must sign an informed consent form. The results will be presented at national and international conferences and published in international peer-reviewed journals. TRIAL REGISTRATION NUMBER: This trial is registered at ClinicalTrials.gov (no. NCT04610710). PROTOCOL VERSION: The Danish National Committee on Health Research Ethics: Fifth protocol version approved 7 September 2020 (no. 1-10-72-96-20). Comité de Protection des Personnes Ile de France VIII: Version 1.1 22JAN2021 the 9 March 2021

Novel understanding of ABC transporters ABCB1/MDR/P-glycoprotein, ABCC2/MRP2, and ABCG2/BCRP in colorectal pathophysiology

AIM: To evaluate ATP-binding cassette (ABC) transporters in colonic pathophysiology as they had recently been related to colorectal cancer (CRC) development. METHODS: Literature search was conducted on PubMed using combinations of the following terms: ABC transporters, ATP binding cassette transporter proteins, inflammatory bowel disease, ulcerative, colitis, Crohns disease, colorectal cancer, colitis, intestinal inflammation, intestinal carcinogenesis, ABCB1/P-glycoprotein (P-gp/CD243/MDR1), ABCC2/multidrug resistance protein 2 (MRP2) and ABCG2/breast cancer resistance protein (BCRP), Abcb1/Mdr1a, abcc2/Mrp2, abcg2/Bcrp, knock-out mice, tight junction, membrane lipid function. RESULTS: Recently, human studies reported that changes in the levels of ABC transporters were early events in the adenoma-carcinoma sequence leading to CRC. A link between ABCB1, high fat diet and gut microbes in relation to colitis was suggested by the animal studies. The finding that colitis was preceded by altered gut bacterial composition suggests that deletion of Abcb1 leads to fundamental changes of host-microbiota interaction. Also, high fat diet increases the frequency and severity of colitis in specific pathogen-free Abcb1 KO mice. The Abcb1 KO mice might thus serve as a model in which diet/environmental factors and microbes may be controlled and investigated in relation to intestinal inflammation. Potential molecular mechanisms include defective transport of inflammatory mediators and/or phospholipid translocation from one side to the other of the cell membrane lipid bilayer by ABC transporters affecting inflammatory response and/or function of tight junctions, phagocytosis and vesicle trafficking. Also, diet and microbes give rise to molecules which are potential substrates for the ABC transporters and which may additionally affect ABC transporter function through nuclear receptors and transcriptional regulation. Another critical role of ABCB1 was suggested by the finding that ABCB1 expression identifies a subpopulation of pro-inflammatory Th17 cells which were resistant to treatment with glucocorticoids. The evidence for the involvement of ABCC2 and ABCG2 in colonic pathophysiology was weak. CONCLUSION: ABCB1, diet, and gut microbes mutually interact in colonic inflammation, a well-known risk factor for CRC. Further insight may be translated into preventive and treatment strategies

«Ambulant akutteam - Et sikkerhetsbelte for mennesker i psykisk krise?»

The objective of this study is to contribute with in-depth knowledge based on persons’ subjective experiences within mental health crisis and support and help from a Crisis Resolution/Home Treatment (CR/HT) team. The study has a qualitative, exploratory design and qualitative interviews were conducted with seven persons. They have experiences with both inpatient treatment in hospitals and support from a CR/HT teams. The informants revealed a variety of experiences as service users in the different helping contexts. The experiences of the CR/HT team’s accessibility, availability and flexibility, was highlighted as important.  The Service users felt they were taken more seriously and met as a fellow human being in the home setting as opposed to hospital ward. The informants also emphasized how the CR/HT team helped them to feel more safe and secure. This study offers some in-depth insights of being on the receiving end of mental health services. It is important to include experience based user knowledge in the evidence base of practice development

Multi-walled carbon nanotube-physicochemical properties predict the systemic acute phase response following pulmonary exposure in mice

Pulmonary exposure to multi-walled carbon nanotubes (MWCNTs) has been linked to an increased risk of developing cardiovascular disease in addition to the well-documented physicochemical-dependent adverse lung effects. A proposed mechanism is through a strong and sustained pulmonary secretion of acute phase proteins to the blood. We identified physicochemical determinants of MWCNT-induced systemic acute phase response by analyzing effects of pulmonary exposure to 14 commercial, well-characterized MWCNTs in female C57BL/6J mice pulmonary exposed to 0, 6, 18 or 54 μg MWCNT/mouse. Plasma levels of acute phase response proteins serum amyloid A1/2 (SAA1/2) and SAA3 were determined on day 1, 28 or 92. Expression levels of hepatic Saa1 and pulmonary Saa3 mRNA levels were assessed to determine the origin of the acute phase response proteins. Pulmonary Saa3 mRNA expression levels were greater and lasted longer than hepatic Saa1 mRNA expression. Plasma SAA1/2 and SAA3 protein levels were related to time and physicochemical properties using adjusted, multiple regression analyses. SAA3 and SAA1/2 plasma protein levels were increased after exposure to almost all of the MWCNTs on day 1, whereas limited changes were observed on day 28 and 92. SAA1/2 and SAA3 protein levels did not correlate and only SAA3 protein levels correlated with neutrophil influx. The multiple regression analyses revealed a protective effect of MWCNT length on SAA1/2 protein level on day 1, such that a longer length resulted in lowered SAA1/2 plasma levels. Increased SAA3 protein levels were positively related to dose and content of Mn, Mg and Co on day 1, whereas oxidation and diameter of the MWCNTs were protective on day 28 and 92, respectively. The results of this study reveal very differently controlled pulmonary and hepatic acute phase responses after MWCNT exposure. As the responses were influenced by the physicochemical properties of the MWCNTs, this study provides the first step towards designing MWCNT that induce less SAA

Digitalisering af OSKE – En digitaliseret eksamen på godt og ondt

I denne artikel vil vi kort beskrive den digitale OSKE og logistikken forbundet med denne eksamens form. Herudover vil vi beskrive en case fra det digitaliserede simulerede laboratorium og sætte denne en i konteksten under OSKE’en