Factoring child care into the welfare to work equation: lessons from Massachusetts and Rhode Island

Child care supports are important in helping welfare recipients make the transition to work. Two states in New England enacted different welfare programs, and studies of these different state programs both attest to how adequate and affordable child care can influence a mother's decision to go to work.Welfare ; Child care - Massachusetts ; Child care - Rhode Island

Recent two-feldspar, Ti-in-biotite, and garnet-biotite geothermometry of the Frontenac terrane and Adirondack Lowlands, Grenville Province, Canada and the United States

Reconstructing the assembly of the Middle Proterozoic Adirondack Mountains and surrounding regions is difficult due to high-grade metamorphism, igneous intrusions, faulting, erosion, and dense cover. A 2008/2009 Keck Geology Consortium Project devoted itself to collecting petrological and structural data in the Adirondack Lowlands and into the Frontenac terrane of Ontario with the hypothesis that a shear zone near the St. Lawrence River, the Black Lake Shear Zone (BLSZ), may be a tectonic boundary representing the welding of the Adirondacks onto the rest of the Precambrian core. In this study, to determine if or if not the BLSZ is a discontinuity, we used garnet-biotite, Ti-in-biotite, and two-feldspar geothermometry and we examined the geochemistry of Adirondack Lowlands and Frontenac terrane pelites. Rare-earth elements and trace element concentrations reveal a shale protolith for the Adirondack Lowlands pelites and most likely for the Frontenac terrane pelites. The mineralogy reflects upper amphibolite facies conditions in the Adirondack Lowlands and granulite facies conditions in the Frontenac terrane. Geothermometry from all three thermometers confirmed higher temperatures in the Frontenac terrane than in the Adirondack Lowlands, but lack of samples due to cover near the BLSZ makes it difficult to determine if this temperature difference is gradual or abrupt. Temperature results varied greatly between geothermometers with Ti-in-biotite results being approximately 200°C higher than two-feldspar temperature results. These inconsistencies between geothermometers may be due to problems with calibrations or fluid infiltration in association with the shear zone. The region requires more work as every new study helps to construct the history of the Adirondack Mountains

EphB signalling in rat prostate development

In male mammals, the formation of the prostate gland is driven by androgens and involves cell-cell signalling between mesenchymal and epithelial cells. Gene profiling studies of prostate mesenchyme, using serial analysis of gene expression (SAGE), identified many transcripts that encode potential regulators of prostate development. The studies identified transcripts expressed in the ventral mesenchymal pad (VMP), a subset of the prostate mesenchyme known to express key growth factors and to regulate prostate organ development. These candidate mRNAs were used in a whole mount in-situ hybridisation (WISH) screen to identify those showing mesenchyme specific expression. The transcripts selected for WISH analysis were placed in three groups. The first group of transcripts were identified as enriched in the VMP based upon statistical analysis of their SAGE tag count. The second group of transcripts shared a SAGE tag count that was not statistically significant, and were a control for the first group. The third group encompassed transcripts that encoded either secretory or transmembrane proteins that were likely mediators of cell-cell communication. From 194 candidates, 30 were analysed by WISH and 13 were identified as mesenchymal. The tyrosine kinase receptor, EphB3, was selected from the WISH analysis and its role in prostate development was examined.EphB signalling has been characterised as a chemotactic guidance cue in neuronal development and has also been implicated in organogenesis of the kidney, lung and colon. The Eph tyrosine kinase family is the largest of its type and is divided into two classes of receptor, Eph A and EphB. The EphB family has five receptors (EphB 1-4, B6) and three ligands (EphrinBl-3) in mammals. The EphrinB ligands are transmembrane proteins.PCR analysis was used to examine the expression of the EphB and EphrinB transcripts in the developing rat prostate. The PCR analysis showed that mRNAs for the EphB2 and EphB3 receptors, and the EphrinB 1 and EphrinB2 ligands, were highly expressed in the rat prostate compared with the other EphB and EphrinB family members. The PCR analysis did not establish whether EphB receptors or EphrinB ligands were expressed in epithelia, mesenchyme or both. The EphB2 and EphB3 receptors, and the EphrinB 1 and EphrinB2 ligands, were further characterised by WISH, quantitative real-time PCR and immunohistochemical analysis during prostate development. At both the mRNA and protein levels, EphB3 and EphrinB 1 were expressed in a restricted area of the prostate mesenchyme, in close association with the developing epithelial buds. The EphB3 and EphrinB 1 transcripts were detected by the SAGE analysis, suggesting that they were expressed in the mesenchyme. The EphB2 and EphrinB2 transcripts were not detected by the SAGE analysis, suggesting that they were expressed in the epithelium. The EphB2 receptor and EphrinB2 ligand were predominantly expressed in the developing epithelial buds, as shown by immunohistochemical analysis. The SAGE analysis of VMP mesenchyme identified EphB3 and EphrinB 1 but not EphB2 and EphrinB2. This was consistent with their expression in mesenchyme or epithelium respectively.The addition of EphB2-Fc and EphB3-Fc to in vitro organ cultures of neonatal prostates, acting as a ligand trap, decreased prostate growth. The addition of EphrinB 1-Fc and EphrinB2-Fc ligands increased prostate organ size. The addition of EphrinB 1-Fc and EphrinB2-Fc produced a significant increase in the mesenchymal and epithelial cell proliferation rates. This increase in cell proliferation in response to EphrinB 1-Fc and EphrinB2-Fc was consistent with the observed increase in prostate organ size. The addition of EphB2-Fc and EphB3-Fc produced no significant increase in the mesenchymal and epithelial cell proliferation rates. This lack of a significant increase in cell proliferation in response to EphB2-Fc and EphB3-Fc was consistent with the observed decrease in prostate organ size. These findings suggest a role for EphB signalling in the regulation of prostate growth.The addition of either EphB-Fc or EphrinB-Fc proteins to in vitro organ cultures resulted in a decrease epithelial branching morphogenesis. Larger epithelial buds were observed in organs treated with EphrinB 1-Fc and EphrinB2-Fc, when compared to control organs. No visible change in the size of the epithelial buds was observed in response to EphB-Fc9 treatment. Furthermore, p63 and Smooth Muscle Actin immunohistochemical analysis of EphrinBl-Fc and EphrinB2-Fc treated organs showed larger epithelial buds, and proliferation analysis showed greater epithelial cell proliferation in EphrinB-Fc treated organs. The increased size of each epithelial bud may be caused by the decreased epithelial branching and the increased epithelial proliferation rate, in response to the addition of EphrinB-Fc proteins. These findings suggest a role for EphB-EphrinB signalling in the regulation of prostate epithelial branching.Collectively, we report the first reported functional link between EphB signalling and prostate development. EphB-EphrinB signalling may act as a novel juxtacrine or autocrine signal within the mesenchyme or as a novel paracrine signalling mechanism during prostate organogenesis

Role of Extracellular Vesicles in Neuroinflammatory Progression and Mitochondrial Functional Alterations

Inflammation within the central nervous system (CNS), termed neuroinflammation, is a defining characteristic of many neuropathological conditions, including Alzheimer’s disease (AD) and stroke. Certain inflammatory mediators activate the transcription factor NF-κB, which induces transcription of many pro-inflammatory genes, including miR-34a and miR-146a. Several target candidate genes of these miRNAs encode for proteins of the mitochondrial electron transport chain. In our studies, we demonstrate that in response to inflammatory stimuli, such as TNF-α, the expression of miR-34a and -146a is significantly increased in several CNS cell types, and in their secreted extracellular vesicles (EVs). Exposure to TNF-α-derived EVs significantly increases cellular bioenergetics in naïve recipient cells, with a concurrent increase in reactive oxygen species, indicative of impaired mitochondrial function. Further, using an animal model of experimental transient middle cerebral artery occlusion, we assess the effects of intermittent systemic LPS exposure, with long recovery periods, on stroke infarct volume. Relative to saline controls, animals repeatedly exposed to LPS have significantly larger cortical infarcts, and lower mRNA expression of autophagy genes. Inflammation-induced reduction in autophagy may lead to post-stroke increases in apoptosis. Together, these data suggest that the modulation of miR-146a and miR-34a in response to neuroinflammatory stimuli may mediate the loss of mitochondrial integrity and function of cells, and that EVs significantly impair mitochondrial function in recipient cells. Further, intermittent systemic inflammation significantly alters the neuroinflammatory response within the brain, leading to increased stroke infarct volumes

The Relationship Education Workshop and Its Impact on Learned Healthy Relationship Outcomes and Self-Compassion in the Emerging Adulthood Population

The present study examined the effectiveness of the Relationship Education workshop (Davila, 2020) on several outcome measures for its target population, emerging adults. The Relationship Education workshop is comprised of two consecutive three hour sessions which take place a week apart. Participants were recruited from a southeastern state university campus. Participants were given a thorough and group-discussion based didactic focusing on the relationship competency skills of insight, mutuality, and emotion regulation with other core focuses, including relational decision making and adaptive relationship beliefs. Participants who completed the Relationship Education workshop were hypothesized to show improvement in these target domains as compared to their waitlist condition peers. Self-compassion is also a lesser targeted skill interwoven throughout the workshop, and relates highly to several of the core skills taught. A mediation model was proposed for the association of workshop participation and self-compassion mediated by learned relationship knowledge from the Relationship Education workshop. 61 participants (n=30 workshop, n=31 control) completed baseline, post-workshop completion, and one-month follow-up measures for all variables of interest. Repeated measures analyses of variance were used to test outcomes related to the relationship competency skills as well as relational decision making and adaptive relationship beliefs. A mediation model utilizing the bootstrapping sampling method was proposed for the association of workshop participation with self-compassion as mediated by learned relationship knowledge. Results indicated that workshop participants had better long term outcomes in mutuality, emotion-regulation, relational decision making, and adaptive relationship beliefs as compared to those in the waitlist condition. The mediation model proposed was significant, indicating that learned relationship knowledge functioned as a mediator on the association between workshop participation and self-compassion. Those that were in the workshop condition displayed higher self-compassion scores at the final post-test, and these scores were mediated by the learned relationship knowledge (learning targets of the workshop). Findings from the present study contribute to the early outcome data for this relationship workshop and provide evidence of effectiveness for a different population from those initially tested

Improving Patient Understanding of Emergency Department Discharge Instructions

Introduction: Previous studies have shown that patients in the emergency department (ED) are frequently given incomplete discharge instructions that are written at least four grade levels above the recommended sixth-grade reading level, leading to poor understanding. Our aims in this study were to implement standardized discharge instructions containing six key components written at a more appropriate reading level for common emergency department (ED) diagnoses to improve patient understanding. Methods: We conducted this study in a 20-bed ED at an urban Veteran’s Administration hospital. Data was collected via in-person patient and clinician interviews. Patient interviews were conducted after patients received their discharge instructions. We compared patient responses to clinician responses and marked them as incorrect, partially correct, or correct with a score of 0, 0.5, or 1, respectively. The maximum possible score for each interview was six. Six key components of discharge instructions were asked about: diagnosis; new medications; at-home care; duration of illness; reasons to return; and follow-up. There were 25 patients in the pre-intervention group and 20 in the intervention group with the standardized set of instructions. We performed a Mann-Whitney U test on the total interview scores in the control and intervention groups and conducted a sub-analysis on the individual scores for each of the six key components. Results: The patients in the intervention demonstrated a statistically significant increase in patient-clinician correlation when compared to the patients in the pre-intervention group overall (P < 0.05), and two of the six key components of the discharge instructions individually showed statistically significant increase in patient-clinician correlation when standardized discharge instructions were used. Conclusion: Patients who received the standardized discharge instructions had improved understanding of their discharge instructions. Future opportunities extending off this pilot study include expanding the number of diagnoses for which standardized instructions are used and investigating patient-centered outcomes related to these instructions

Case 3 : The Missing Four Million: Working to Increase the Case Finding Rate for People with TB

Paru Hari, an Accredited Social Health Activist (ASHA), lives in Bihar, India, one of the poorest states in the country. Paru is involved in daily outreach within her community to facilitate community member access to health care facilities, administer medications, treat minor ailments, and generate health awareness. The majority of her work involves antenatal checkups, immunizations, and mild sickness treatments. However, with Bihar reporting approximately 70,000 new cases of tuberculosis (TB) annually and many cases going unreported and undiagnosed (Fathima, Varadharajan, Krishnamurthy, Ananthkumar & Mony, 2015; RESULTS Canada, 2018b), Paru decided to take action. She proposed that ASHAs act as TB educators and household screeners for patients who have TB because she was tired of watching people in her community suffer and die from a treatable disease. Paru decided to visit Dr. Tisha Guru, Bihar state’s Regional ASHA Program Director, to share her concerns about how best to integrate TB educational activities and household screening programs into her daily routine. For Paru to gain a clear understanding of what she needs to know to identify TB patients and what they require during diagnosis and treatment, Dr. Guru suggested that she accompany patients from the initial stages of their diagnosis through to treatment. Although Paru did not have an extensive medical background, she knew that the ASHA program required a great deal of funding to ensure it was sustainable and that the necessary resources were available for TB testing and care to be integrated into their daily work. Paru knew action needed to be taken, not only to continue the ASHA program but, more importantly, to help patients who were being overlooked by the current health care system. Paru worked alongside Dr. Guru to identify the key stakeholders who could effectively communicate the critical need for improved TB surveillance, educational activities, and household screening programs into the services ASHAs provided