Pathophysiology of infections by the gastric trichostrongylid Obeliscoides in a rabbit model system

Thesis (Ph.D.) University of Alaska Fairbanks, 1991The gastric trichostrongylid parasite Obeliscoides sp. was isolated from Alaskan snowshoe hares (Lepus americanus) and passaged 3 times in laboratory rabbits (Oryctolagus cuniculus). Despite its low fertility, the isolate persisted, often as occult infections, for up to 45 weeks and produced physiologic effects in clinically normal rabbits. Prominent eosinophilic and hyperplastic lesions of the gastric mucosa occurred during post-inoculation weeks (PIW) 2-15, while mononuclear aggregations were seen in older infections. Gastric lesion severity was directly related to size of the Obeliscoides population, which declined over time and was smaller in secondary infections. Anorexia occurred within 3 weeks of infective larval inoculation in 12 (of 21) primary and 2 (of 10) secondary infections. Serum total protein, albumin, and the A/G ratio were significantly reduced in anorectic infected rabbits compared to fasted uninfected rabbits. Fecal N excretion was significantly increased between PIW 1 and 5 in rabbits with primary infections, and during PIW 1 and 2 for those with secondary infections. Nitrogen absorption was enhanced during PIW 5-15 of primary infection. Serum gastrin concentrations, determined for the first time in Obeliscoides-infected rabbits by radioimmunoassay, were significantly elevated in primary infections during PIW 6 and 7, while hypokalemia was apparent during PIW 5. Hypermagnesemia occurred in both primary and secondary infections between PIW 8 and 15. Other serum constituents and concentrations of N, Ca and P in the gastrointestinal tract and feces remained largely unchanged. Total mean retention time (TMRT), 31.8 h, and GI turnover time (GITT), 26.3 h, of the fiber component (determined with Ce-141-marked fiber $>$355 microns) were significantly prolonged in secondary infections during PIW 16 to 26. TMRT (53.0 h) and GITT (57.0 h) of the liquid component (using Cr-51 EDTA), were determined for the first time in rabbits, and were not significantly changed by Obeliscoides infection. Persisting populations of this Obeliscoides isolate caused physiologic and pathologic alterations in clinically healthy rabbits. Because these effects were similar to those seen in ruminant Ostertagia spp. infections, this laboratory model could be useful in understanding the pathophysiology of costly production losses that occur in parasitized commercial livestock

Compulsory Patent Licensing: Is It a Viable Solution in the United States

As technology continues to advance at a rapid pace, so do the number of patents that cover every aspect of making, using, and selling these innovations. In 1996, to compound the rapid change of technology, the U.S. Supreme Court affirmed that business methods are also patentable. Hence in the current environment, scores of patents, assigned to many different parties, may cover a single electronic device or software--making it increasingly impossible to manufacture an electronic device without receiving a cease and desist letter or other notice from a patentee demanding a large royalty or threatening an injunction. Companies, particularly those in the high technology sector, have been asserting for some time now that they are under constant threat of lawsuits that threaten to shut them down. As a result, numerous radical changes to the U.S. Patent Act and patent practice before the U.S. Patent & Trademark Office have been proposed. Certain proposed changes, however, are meeting with resistance because of a reliance on long term patent protection and exclusivity of patent rights by different industries. Notwithstanding, certain foreign governments have already enacted provisions making it possible to obtain a compulsory patent license in the event that a patentee is not practicing his invention or is simply refusing to license the rights to his invention for a reasonable royalty fee

A humanisation approach for the management of Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome-Hypermobility Type (JHS/EDS-HT).

Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome-Hypermobility Type (JHS/EDS-HT) is a complex and multisystemic condition which significantly impacts on a person's health and well-being and is challenging for health professionals (HPs) to manage. People with JHS/EDS-HT and HPs recognise the individual nature and the complexities of the condition. There is a requirement to understand the condition within the context of the individual human dimensions of illness and healing. The aim of this paper is to explore the management of this condition using a theoretical model referred to as the Humanisation Framework.  It is suggested that using the philosophical dimensions of this framework will empower HPs and those with JHS/EDS-HT to work together to proactively manage this condition. The eight dimensions of the Humanisation Framework facilitate an experiential understanding of the person within their context and environment, providing a constructive adjunct to the evidence-based management of those with JHS/EDS-HT. The humanisation framework was developed for health and social care and uses the philosophy behind well-being and what makes well-being possible. This paper explores how HPs may use aspects of the framework to understand the condition and empower and motivate those with JHS/EDS-HT to be active participants in their own well-being

“Flipped” Clinical Rotations: A Novel Approach

Background: Near the beginning of the COVID-19 pandemic in the United States, medical students were pulled out of all in-person patient care activities. This resulted in massive disruption to the required clinical rotations (clerkships), necessitating creative curricular solutions to ensure continued education for medical students. Approach: In response to the lockout, our school adopted a “flipped” clinical rotations model that assigned students to remote learning activities prior to in-person patient care activities. This approach allowed students to continue their clinical education virtually with a focus on knowledge for practice while awaiting return to the shortened in-person portions of their rotation. In planning the modified clinical curriculum, educational leaders adhered to several guiding principles including ensuring flexible remote curricular components that would engage students in active learning, designating that no rotation would be completely virtual, and completing virtual educational activities and standardised exams before students returned to in-person experiences. Evaluation: End of rotation evaluations and standardised exam scores were analysed to determine the effectiveness of this model. Despite the disruption associated with the pandemic and the rapid implementation of the “flipped” rotations, students continued to rate the overall experiences as highly as traditional clinical rotations. Students also performed similarly on standardised exams when compared to cohorts from other classes at the same experience level. Implications: While borne out of necessity during a pandemic, the lessons learned from our implementation of a “flipped” rotations model can be applied to address problems of capacity and clinical preparedness in the clinical setting

Anorexia nervosa in males: similarities and differences to anorexia nervosa in females

INTRODUCTION Previous single case reports of males with anorexia nervosa from our database focused on the roles of gender and general personal identity conflicts and panic/guilt over the consequences of impulsivity in precipitating out the illness (Davis & Crisp, 1993; Fry & Crisp, 1989; Toms & Crisp, 1972), the growth stunting but reversible effects of early onset (Toms & Crisp, 1972), and a 35-year long follow-up of a case first seen in 1959 (Crisp, 1995). Our first reported series of 13 male patients (Crisp & Toms, 1972) drew attention to the many similarities to a female population but emphasised, descriptively, the high prevalence of psychiatric morbidity in the parents, often bound in with phobic avoidance behaviours and commonly coupled with over-protectiveness of the patient during childhood

Using Social Marketing to Engage Extension Audiences: Lessons from an Effort Targeting Woodland Owners

Social marketing involves applying traditional commercial marketing techniques to public good outcomes. We share findings from use of this approach in reaching woodland owners to promote sustainable forestry in southwest Wisconsin. We experimentally tested three direct mail campaigns. Each included two offers—a free handbook and a free forester visit, but the campaigns varied in terms of landowner segments and marketing messages. Key results across the campaigns include consistent performance of the offers (handbook 17%–19%, forester visit 3%–5%) but varied effects of segment and message. Our results suggest that social marketing can pay dividends in reaching landowners and, potentially, other Extension clientele, but there is more to learn

The Rockingham County senior community assessment : an action-oriented community diagnosis ; findings and next steps of action

The Rockingham County Senior Community Assessment project was conducted from October of 2006 through April of 2007 by a five-member student team from the University of North Carolina at Chapel Hill, School of Public Health, Department of Health Behavior and Health Education. The student team worked under the guidance of two preceptors, Brittan Williams, MPH, CHES, of the Rockingham County Department of Public Health, and Debbie Mason, BS, CHES, of Rockingham County Healthy Carolinians. The Rockingham County Senior Community Assessment (RCSCA) was conducted using a health education tool known as Action-Oriented Community Diagnosis (AOCD). The AOCD process addresses a wide variety of factors in the community that contribute to health, such as social and economic factors as well as community dynamics, with the goal of generating community-owned action steps for positive change. This report presents a synthesis of the multiple steps taken in completion of the RCSCA, beginning with collection and analysis of secondary data that provided an overview of what life was like for seniors in the community. Getting to know the community, or “gaining entrée” to the community itself, was an ongoing process that began with a county tour and continued with team attendance at important community meetings and events. The team also collected primary data through interviews and focus groups with 17 local service providers and 21 community members, who possessed a broad knowledge of community functioning. From this data, the team identified four community strengths and ten community challenges. The strengths were family and senior relationships, religion, caring community, and an abundance of resources available for seniors. The challenges, listed below as theme, or summary, statements, included awareness of services, Alzheimer’s and dementia, transportation, the insurance gap, and streamlining services. Following the analysis of all collected data, the findings were presented to the community through the Rockingham County Senior Community Forum, held on April 20, 2007. Topics explored in-depth were based on identified challenges. The forum marked the end of the student team’s work in Rockingham County and was primarily intended to transfer ownership of findings to the community. Specific action steps for change were generated through a discussion of important themes selected by the Forum Planning Committee: Theme 1: Seniors are often unaware of the services and events that are available to them throughout the county. Action Steps: Initiate a letter writing campaign, working with the Council on Aging and potentially the News and Record, to help make the needs and desires of seniors known. Contact Home Health Care and Caregivers of Rockingham County as a way of spreading awareness to homebound seniors. Contact ministerial groups of Eden and Reidsville to investigate working with church groups to increase service awareness. Theme 2: Although the county offers some mental health services, adequate care does not exist for the growing concerns surrounding Alzheimer’s and dementia among seniors and support for their families. Action Steps: Heavily advertise an upcoming information session at the Carolina House of Reidsville for those affected by and those interested in learning more about Alzheimer’s. Acquire a list of county services and distribute at nutrition sites and senior events, specifically the Senior Games, to educate Rockingham County community members about the services that are currently offered in the county for seniors. Theme 3: Given Rockingham County’s geographic layout and the shortage of consistent, low cost transportation, seniors have difficulty using transportation to access services and activities. Action Steps: Include information on available transportation options/rates for seniors from Council on Aging transportation services in the next Center for Active Retirement newsletter. Attend and present information about available transportation options at upcoming meetings with both the Service Providers Network and the Rockingham County Planning Meeting for Services to the Elderly. Call WLOE about a potential radio spot to discuss transportation. Investigate potential advertising options for transportation services in local utility bills. Contact local newspapers and churches to post transportation information in their bulletins. Help create flyers to be distributed to advertise Council on Aging transportation services. Contact the Council on Aging to get information on their transportation services and to discuss collaboration options. Theme 4: Due to age and income restrictions for current health insurance options, seniors may fall into a gap where they do not have sufficient health insurance to cover medical costs. Action Steps: Take this theme to the Rockingham Senior Service Providers meeting. Create a resource guide focusing on insurance issues and advice for seniors. Distribute resource guide at churches, physician’s offices, Meals on Wheels, pharmacies, and through home health services. Create a resource team to present information about resources at local organizations such as churches, Meals on Wheels, pharmacies, and home health services. Vote for candidates who want to address the insurance gap. Theme 5: While many service providers work together efficiently and productively, communication and service delivery is not always streamlined. Action Steps: Contact Region G Agency on Aging to host an online resource. Look into creating a free Rockingham community page, network, and bulletin board online. Create a list of resources that promote, advertise, and publicize events for seniors. Create a senior newspaper. Secure funding for the senior newspaper. Based on the process as a whole, the team makes the following recommendations for future work in the Rockingham County senior community: The term “senior” may include individuals younger than 65, and care should be taken to recognize that some members of the county who are not 65 or older identify themselves as members of the senior community. County demographics are changing, and attention should be paid to the senior members of different ethnic groups, especially the Latino population. Future work with seniors should include a focus on isolated and homebound seniors. Given the number of existing quality services for seniors in the county, efforts should include building upon what is already available. Service providers and community members should place increasing awareness of services and events at the forefront of all efforts. Use of multiple communication methods, including direct mail, the Internet, and radio, will be an important component of raising senior awareness in the future and should be considered in service and health promotion efforts. Grassroots networking among seniors, with the purpose of sharing resources, should be recognized and increased, utilizing the informal ties that already exist. Religion is an important component of life, and church networks should be investigated as a channel for improving life for seniors. Broader participation in the county’s existing senior service provider groups/networks should be encouraged, making coordination key. Collaboration on developed action steps will be crucial in moving towards their successful implementation, especially given the overlap in many of the steps that were developed. This document is intended to be a working document, one that will provide the senior community and senior service providers with a foundation from which to move forward into the future. Background summary, methods used in the RCSCA, detailed findings from the primary data, and a discussion of the forum and resulting action steps are offered in the following pages. The team presents the report with the hope that positive change can be made for the kind, generous, and thoughtful senior residents of Rockingham County and those who work tirelessly to enrich and improve their lives.Master of Public Healt

The Impact of Aging on Brain Pituitary Adenylate Cyclase Activating Polypeptide Pathology and Cognition in Mice and Rhesus Macaques

Pituitary adenylate cyclase activating polypeptide (PACAP) is associated with Alzheimer\u27s disease (AD), but its age-related effects are unknown. We chose the rhesus macaque due to its closeness to human anatomy and physiology. We examined four variables: aging, cognitive performance, amyloid plaques and PACAP. Delayed nonmatching-to-sample recognition memory scores declined with age and correlated with PACAP levels in the striatum, parietal and temporal lobes. Because amyloid plaques were the only AD pathology in the old rhesus macaque, we further studied human amyloid precursor protein (hAPP) transgenic mice. Aging was associated with decreased performance in the Morris Water Maze (MWM). In wild type (WT) C57BL/6 mice, the performance was decreased at age 24-26 month whereas in hAPP transgenic mice, it was decreased as early as 9-12 month. Neuritic plaques in adult hAPP mice clustered in hippocampus and adjacent cortical regions, but did not propagate further into the frontal cortex. Cerebral PACAP protein levels were reduced in hAPP mice compared to age-matched WT mice, but the genetic predisposition dominated cognitive decline. Taken together, these data suggest an association among PACAP levels, aging, cognitive function and amyloid load in nonhuman primates, with both similarities and differences from human AD brains. Our results suggest caution in choosing animal models and in extrapolating data to human AD studies