Letter from Emma L. Leighton, Shelburne, New Hampshire, to Anne Whitney, Boston, Massachusetts, 1912 February 20

https://repository.wellesley.edu/whitney_correspondence/2695/thumbnail.jp

Letter from Jane A. Leighton, Shelburne, New Hampshire, to Anne Whitney, Boston, Massachusetts, 1912 March 3

https://repository.wellesley.edu/whitney_correspondence/2696/thumbnail.jp

Serum Biochemistry and Serum Cortisol Levels of Immobilized and Hunted Muskoxen (Ovibos moschatus) from Northern Canada

Muskoxen (Ovibos moschatus) are Arctic-adapted ruminants native to the Arctic regions of Canada, Alaska, and Greenland. Little is known about the serum biochemistry and serum cortisol of this species, or the effects of chemical immobilization on serum biochemical parameters. This study aimed to describe blood chemistry parameters and cortisol levels in hunted, tame, and chemically immobilized muskoxen and to examine differences in blood chemistry parameters and levels of stress associated with different capture techniques. Serum was collected from 91 adult female muskoxen in northern Canada. For analysis, these muskoxen were classified into six groups, five of free-ranging muskoxen (10 animals shot from snowmobiles near Kugluktuk, Nunavut; 18 chemically immobilized from a helicopter near Kugluktuk; 8 chemically immobilized from a helicopter near Norman Wells, Northwest Territories; 17 shot from snowmobiles near Cambridge Bay, Nunavut; 33 chemically immobilized from a snowmobile near Kugluktuk) and one of tame muskoxen (five tame animals maintained on pasture near Saskatoon, Saskatchewan). All samples were analyzed for cortisol, and 26 serum biochemistry parameters were measured in serum collected from three of the six groups (n = 36). Comparison of four groups showed that serum cortisol levels of muskoxen chemically immobilized from a helicopter near Kugluktuk were significantly higher(p < 0.05) than those of muskoxen chemically immobilized from snowmobiles or shot. A comparison of serum biochemistry from the groups of muskoxen shot and immobilized near Kugluktuk found that serum sodium, creatinine, phosphorus, magnesium, and creatine kinase were significantly higher (p < 0.05) in hunted muskoxen than in chemically immobilized animals, while urea, glucose and gamma glutamyl transferase were significantly higher (p < 0.05) in immobilized muskoxen. Most serum biochemical parameters, however, were similar to those of captive muskoxen. This evidence of differences between hunted and immobilized muskoxen in several serum biochemistry parameters will contribute to further research on the effects of immobilization and other health assessments in this species.Le boeuf musqué (Ovibos moschatus) est un ruminant adapté à l’Arctique qui est natif des régions arctiques du Canada, de l’Alaska et du Groenland. On en sait peu à propos de la biochimie du sérum et du cortisol du sérum de cette espèce ou encore, à propos des effets de l’immobilisation chimique sur les paramètres biochimiques du sérum. Cette étude visait à décrire les paramètres de la chimie du sang et les taux de cortisol chez les boeufs musqués chassés, apprivoisés et chimiquement immobilisés, de même qu’à examiner les différences sur le plan des paramètres de la chimie du sang et des degrés de stress en fonction de diverses méthodes de capture. Du sérum a été prélevé auprès de 91 femelles adultes du nord du Canada. Aux fins de l’analyse, ces boeufs musqués ont été classés en six groupes, dont cinq des groupes étaient composés de boeufs musqués en liberté (10 des boeufs avaient été tirés depuis des motoneiges près de Kugluktuk, au Nunavut; 18 avaient été chimiquement immobilisés à partir d’un hélicoptère près de Kugluktuk; 8 avaient été chimiquement immobilisés à partir d’un hélicoptère près de Norman Wells, dans les Territoires du Nord-Ouest; 17 avaient été tirés depuis des motoneiges près de Cambridge Bay, au Nunavut; 33 avaient été chimiquement immobilisés depuis une motoneige près de Kugluktuk) et l’autre groupe était composé de boeufs musqués apprivoisés (5 bêtes évoluant dans des pâturages près de Saskatoon, en Saskatchewan). Dans tous les cas, le cortisol des échantillons a été analysé, puis 26 paramètres biochimiques du sérum ont été mesurés à partir du sérum recueilli chez trois des six groupes (n = 36). Les comparaisons établies pour quatre des groupes ont permis de constater que les taux de cortisol du sérum des boeufs musqués chimiquement immobilisés à partir d’un hélicoptère près de Kugluktuk étaient considérablement plus élevés (p < 0,05) que ceux des boeufs musqués qui avaient été chimiquement immobilisés depuis une motoneige ou qui avaient été tirés. La comparaison de la biochimie du sérum chez les boeufs musqués tirés et immobilisés près de Kugluktuk a permis de déceler que le sodium du sérum, la créatinine, le phosphore, le magnésium et la créatine kinase étaient considérablement plus élevés (p < 0,05) chez le boeuf musqué chassé que chez le boeuf musqué chimiquement immobilisé, tandis que l’urée, le glucose et la gamma-glutamyl-transférase étaient considérablement plus élevés (p < 0,05) chez le boeuf musqué immobilisé. Cependant, la plupart des paramètres biochimiques du sérum étaient semblables à ceux des boeufs musqués en captivité. Ces différences évidentes sur le plan de nombreux paramètres biochimiques du sérum entre le boeuf musqué chassé et le boeuf musqué immobilisé permettront d’approfondir les recherches sur les effets de l’immobilisation et d’autres évaluations de santé de cette espèce

Advancing Genetic Selection and Behavioral Genomics of Working Dogs Through Collaborative Science

The ancient partnership between people and dogs is struggling to meet modern day needs, with demand exceeding our capacity to safely breed high-performing and healthy dogs. New statistical genetic approaches and genomic technology have the potential to revolutionize dog breeding, by transitioning from problematic phenotypic selection to methods that can preserve genetic diversity while increasing the proportion of successful dogs. To fully utilize this technology will require ultra large datasets, with hundreds of thousands of dogs. Today, dog breeders struggle to apply even the tools available now, stymied by the need for sophisticated data storage infrastructure and expertise in statistical genetics. Here, we review recent advances in animal breeding, and how a new approach to dog breeding would address the needs of working dog breeders today while also providing them with a path to realizing the next generation of technology. We provide a step-by-step guide for dog breeders to start implementing estimated breeding value selection in their programs now, and we describe how genotyping and DNA sequencing data, as it becomes more widely available, can be integrated into this approach. Finally, we call for data sharing among dog breeding programs as a path to achieving a future that can benefit all dogs, and their human partners too

Wild Bird Influenza Survey, Canada, 2005

Of 4,268 wild ducks sampled in Canada in 2005, real-time reverse transcriptase–PCR detected influenza A matrix protein (M1) gene sequence in 37% and H5 gene sequence in 5%. Mallards accounted for 61% of samples, 73% of M1-positive ducks, and 90% of H5-positive ducks. Ducks hatched in 2005 accounted for 80% of the sample

A qualitative evaluation of the impact of a palliative care course on preregistration nursing students' practice in Cameroon

Background Current evidence suggests that palliative care education can improve preregistration nursing students’ competencies in palliative care. However, it is not known whether these competencies are translated into students’ practice in the care of patients who are approaching the end of life. This paper seeks to contribute to the palliative care evidence base by examining how nursing students in receipt of education report transfer of learning to practice, and what the barriers and facilitators may be, in a resource-poor country. Methods We utilised focus groups and individual critical incident interviews to explore nursing students’ palliative care learning transfer. Three focus groups, consisting of 23 participants and 10 individual critical incident interviews were conducted with preregistration nursing student who had attended a palliative care course in Cameroon and had experience caring for a patient approaching the end of life. Data was analysed thematically, using the framework approach. Results The results suggest that nursing students in receipt of palliative care education can transfer their learning to practice. Students reported recognizing patients with palliative care needs, providing patients with physical, psychosocial and spiritual support and communicating patient information to the wider care team. They did however perceive some barriers to this transfer which were either related to themselves, qualified nurses, the practice setting or family caregivers and patients. Conclusion The findings from this study suggest that nursing student in receipt of palliative care education can use their learning in practice to provide care to patients and their families approaching the end of life. Nevertheless, these findings need to be treated with some caution given the self-reported nature of the data. Demonstrating the link between preregistration palliative care education and patient care is vital to ensuring that newly acquired knowledge and skills are translated and embedded into clinical practice. This study also has implications for advocating for palliative care policies and adequately preparing clinical placement sites for students’ learning and transfer of learning

Multifactorial falls prevention programme compared with usual care in UK care homes for older people: Multicentre cluster randomised controlled trial with economic evaluation

Objectives: To determine the clinical and cost effectiveness of a multifactorial fall prevention programme compared with usual care in long term care homes. Design: Multicentre, parallel, cluster randomised controlled trial. Setting: Long term care homes in the UK, registered to care for older people or those with dementia. Participants: 1657 consenting residents and 84 care homes. 39 were randomised to the intervention group and 45 were randomised to usual care. Interventions: Guide to Action for Care Homes (GtACH): a multifactorial fall prevention programme or usual care. Main outcome measures: Primary outcome measure was fall rate at 91-180 days after randomisation. The economic evaluation measured health related quality of life using quality adjusted life years (QALYs) derived from the five domain five level version of the EuroQoL index (EQ-5D-5L) or proxy version (EQ-5D-5L-P) and the Dementia Quality of Life utility measure (DEMQOL-U), which were self-completed by competent residents and by a care home staff member proxy (DEMQOL-P-U) for all residents (in case the ability to complete changed during the study) until 12 months after randomisation. Secondary outcome measures were falls at 1-90, 181-270, and 271-360 days after randomisation, Barthel index score, and the Physical Activity Measure-Residential Care Homes (PAM-RC) score at 91, 180, 270, and 360 days after randomisation. Results: Mean age of residents was 85 years. 32% were men. GtACH training was delivered to 1051/1480 staff (71%). Primary outcome data were available for 630 participants in the GtACH group and 712 in the usual care group. The unadjusted incidence rate ratio for falls between 91 and 180 days was 0.57 (95% confidence interval 0.45 to 0.71, P<0.001) in favour of the GtACH programme (GtACH: six falls/1000 residents v usual care: 10 falls/1000). Barthel activities of daily living indices and PAM-RC scores were similar between groups at all time points. The incremental cost was £108 (95% confidence interval −£271.06 to 487.58), incremental QALYs gained for EQ-5D-5L-P was 0.024 (95% confidence interval 0.004 to 0.044) and for DEMQOL-P-U was 0.005 (−0.019 to 0.03). The incremental costs per EQ-5D-5L-P and DEMQOL-P-U based QALY were £4544 and £20 889, respectively. Conclusions: The GtACH programme was associated with a reduction in fall rate and cost effectiveness, without a decrease in activity or increase in dependency. Trial registration: ISRCTN34353836

A multidomain decision support tool to prevent falls in older people: the FinCH cluster RCT

BackgroundFalls in care home residents are common, unpleasant, costly and difficult to prevent.ObjectivesThe objectives were to evaluate the clinical effectiveness and cost-effectiveness of the Guide to Action for falls prevention in Care Homes (GtACH) programme.DesignA multicentre, cluster, parallel, 1 : 1 randomised controlled trial with embedded process evaluation and economic evaluation. Care homes were randomised on a 1 : 1 basis to the GtACH programme or usual care using a secure web-based randomisation service. Research assistants, participating residents and staff informants were blind to allocation at recruitment; research assistants were blind to allocation at follow-up. NHS Digital data were extracted blindly.SettingOlder people’s care homes from 10 UK sites.ParticipantsOlder care home residents.InterventionThe GtACH programme, which includes care home staff training, systematic use of a multidomain decision support tool and implementation of falls prevention actions, compared to usual falls prevention care.OutcomesThe primary trial outcome was the rate of falls per participating resident occurring during the 90-day period between 91 and 180 days post randomisation. The primary outcome for the cost-effectiveness analysis was the cost per fall averted, and the primary outcome for the cost–utility analysis was the incremental cost per quality adjusted life-year. Secondary outcomes included the rate of falls over days 0–90 and 181–360 post randomisation, activity levels, dependency and fractures. The number of falls per resident was compared between arms using a negative binomial regression model (generalised estimating equation).ResultsA total of 84 care homes were randomised: 39 to the GtACH arm and 45 to the control arm. A total of 1657 residents consented and provided baseline measures (mean age 85 years, 32% men). GtACH programme training was delivered to 1051 staff (71% of eligible staff) over 146 group sessions. Primary outcome data were available for 630 GtACH participants and 712 control participants. The primary outcome result showed an unadjusted incidence rate ratio of 0.57 (95% CI 0.45 to 0.71; p < 0.01) in favour of the GtACH programme. Falls rates were lower in the GtACH arm in the period 0–90 days. There were no other differences between arms in the secondary outcomes. Care home staff valued the training, systematic strategies and specialist peer support, but the incorporation of the GtACH programme documentation into routine care home practice was limited. No adverse events were recorded. The incremental cost was £20,889.42 per Dementia Specific Quality of Life-based quality-adjusted life-year and £4543.69 per quality-adjusted life-year based on the EuroQol-5 dimensions, five-level version. The mean number of falls was 1.889 (standard deviation 3.662) in the GtACH arm and 2.747 (standard deviation 7.414) in the control arm. Therefore, 0.858 falls were averted. The base-case incremental cost per fall averted was £190.62.ConclusionThe GtACH programme significantly reduced the falls rate in the study care homes without restricting residents’ activity levels or increasing their dependency, and was cost-effective at current thresholds in the NHS.Future workFuture work should include a broad implementation programme, focusing on scale and sustainability of the GtACH programme.LimitationsA key limitation was the fact that care home staff were not blinded, although risk was small because of the UK statutory requirement to record falls in care homes.Trial registrationThis trial is registered as ISRCTN34353836.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 9. See the NIHR Journals Library website for further project information

Systematic, comprehensive, evidence-based approach to identify neuroprotective interventions for motor neuron disease: using systematic reviews to inform expert consensus

Objectives: Motor neuron disease (MND) is an incurable progressive neurodegenerative disease with limited treatment options. There is a pressing need for innovation in identifying therapies to take to clinical trial. Here, we detail a systematic and structured evidence-based approach to inform consensus decision making to select the first two drugs for evaluation in Motor Neuron Disease-Systematic Multi-arm Adaptive Randomised Trial (MND-SMART: NCT04302870), an adaptive platform trial. We aim to identify and prioritise candidate drugs which have the best available evidence for efficacy, acceptable safety profiles and are feasible for evaluation within the trial protocol. Methods: We conducted a two-stage systematic review to identify potential neuroprotective interventions. First, we reviewed clinical studies in MND, Alzheimer’s disease, Huntington’s disease, Parkinson’s disease and multiple sclerosis, identifying drugs described in at least one MND publication or publications in two or more other diseases. We scored and ranked drugs using a metric evaluating safety, efficacy, study size and study quality. In stage two, we reviewed efficacy of drugs in MND animal models, multicellular eukaryotic models and human induced pluripotent stem cell (iPSC) studies. An expert panel reviewed candidate drugs over two shortlisting rounds and a final selection round, considering the systematic review findings, late breaking evidence, mechanistic plausibility, safety, tolerability and feasibility of evaluation in MND-SMART. Results: From the clinical review, we identified 595 interventions. 66 drugs met our drug/disease logic. Of these, 22 drugs with supportive clinical and preclinical evidence were shortlisted at round 1. Seven drugs proceeded to round 2. The panel reached a consensus to evaluate memantine and trazodone as the first two arms of MND-SMART. Discussion: For future drug selection, we will incorporate automation tools, text-mining and machine learning techniques to the systematic reviews and consider data generated from other domains, including high-throughput phenotypic screening of human iPSCs