Cardiovascular consequences of cortisol excess

Cushing's syndrome is a consequence of primary or, more commonly, secondary oversecretion of cortisol. Cardiovascular disease is the major cause of morbidity and mortality in Cushing's syndrome, and excess risk remains even in effectively treated patients. The cardiovascular consequences of cortisol excess are protean and include, inter alia, elevation of blood pressure, truncal obesity, hyperinsulinemia, hyperglycemia, insulin resistance, and dyslipidemia. This review analyses the relationship of cortisol excess, both locally and at tissue level, to these cardiovascular risk factors, and to putative mechanisms for hypertension. Previous studies have examined correlations between cortisol, blood pressure, and other parameters in the general population and in Cushing's syndrome. This review also details changes induced by short-term cortisol administration in normotensive healthy men

Effective Schooling in Rural Alaska: Information for the Rural Effective Schools Project

Because rural Alaska educators were skeptical of the applicability to their teaching situations of various educational research results, researchers randomly surveyed rural Alaskan teachers to provide background information for the Rural Effective Schools Project and for educators who want to help rural schools increase their effectiveness. Three hundred four teachers (96% of those surveyed) responded by mail to questions about the use and effectiveness of teaching practices recommended nationally and for American Indian children, their preferred instructional methods, and their personal job satisfaction. In general, rural Alaskan teachers did not report frequent use of nationally recommended practices; rather , they used practices advocated in American Indian research literature such as hands-on and self-paced instruction. Only about half the teachers regularly assigned homework. Most expected their students to complete high school, but not to attend or complete college. Only about 40% felt their students' academic ability met or could be expected to meet national averages. For many teachers, academic progress represented a problem. Though satisfied with many aspects of their jobs, rural teachers reported frustrating relationships with district centers and little opportunity for professional growth. These findings have significant implications for the Rural Effective Schools Project. (SB)Alaska State Dept. of Education, Juneau; National Inst. of Education (ED) , Washington DC.Ye

Doctor, Lawyer, Indian Chief The Educational and Occupational Aspirations, Plans, and Preferences of Eskimo Students on the Lower Yukon

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The Scientist-In-Residence Program: Final Evaluation

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Stable dietary isotopes and mtDNA from Woodland period southern Ontario people: results from a tooth sampling protocol

AbstractBioarchaeological research must balance scholarly commitment to the generation of new knowledge, descendants' interests in their collective past, and the now common practice of rapid re-interment of excavated human remains. This paper documents the first results of a negotiated protocol built on the retention of one tooth per archaeologically derived skeleton, teeth that can then be used for destructive testing associated with ancient DNA and stable isotope investigations. Seven archaeological sites dating from the 13th to 16th centuries provided 53 teeth, 10 of which were subdivided between DNA and isotope labs. All tooth roots yielded haplogroup results, and five provided more detailed sequence results. Stable isotopes of carbon and nitrogen document heavy reliance on maize among all individuals, as well as reliance on a diverse range of fish. This work establishes baseline mtDNA information for Northern Iroquoians, and confirms the value of using dental tissues for dietary reconstruction. Particularly when human remains are fragmentary or co-mingled, this approach holds promise for ongoing incorporation of bioarchaeology into reconstructions of past peoples' lives

Being More Realistic About Reasons: On Rationality and Reasons Perspectivism

This paper looks at whether it is possible to unify the requirements of rationality with the demands of normative reasons. It might seem impossible to do because one depends upon the agent’s perspective and the other upon features of the situation. Enter Reasons Perspectivism. Reasons perspectivists think they can show that rationality does consist in responding correctly to reasons by placing epistemic constraints on these reasons. They think that if normative reasons are subject to the right epistemic constraints, rational requirements will correspond to the demands generated by normative reasons. While this proposal is prima facie plausible, it cannot ultimately unify reasons and rationality. There is no epistemic constraint that can do what reasons perspectivists would need it to do. Some constraints are too strict. The rest are too slack. This points to a general problem with the reasons-first program. Once we recognize that the agent’s epistemic position helps determine what she should do, we have to reject the idea that the features of the agent’s situation can help determine what we should do. Either rationality crowds out reasons and their demands or the reasons will make unreasonable demands

Using the Tea Bag Index to unravel how interactions between an antibiotic (Trimethoprim) and endocrine disruptor (17a-estradiol) affect aquatic microbial activity: Supporting Dataset 1

The constant release of complex mixture of pharmaceuticals, including antimicrobials and endocrine disruptors, into the aquatic environment. These have the potential to affect aquatic microbial metabolism and alter biogeochemical cycling of carbon and nutrients. We used the Tea Bag Index (TBI) for decomposition within a series of contaminant exposure experiments to test how interactions between an antibiotic (trimethoprim) and endocrine disruptor (17a-estradiol) affects microbial activity in an aquatic system. The TBI is a citizen science tool used to test microbial activity by measuring the differential degradation of green and rooibos tea as proxies for labile and recalcitrant organic matter decomposition. Here we present the raw data on pharmaceutical exposures and the mass loss of the Rooibos and Green tea bags within the experiment. From Tea Bag mass loss we then calculated the Stabilisation Factor (S) and Initial Decomposition Rate of the labile organic matter fraction

Student Leadership and Extended Learning Programs in Alaska: Rationale and Methods of Evaluation

Prepared for Division of Educational Program Support Department of Education State of AlaskaYe

Development and evaluation of an innovative model of inter-professional education focused on asthma medication use

BACKGROUND: Inter-professional learning has been promoted as the solution to many clinical management issues. One such issue is the correct use of asthma inhaler devices. Up to 80% of people with asthma use their inhaler device incorrectly. The implications of this are poor asthma control and quality of life. Correct inhaler technique can be taught, however these educational instructions need to be repeated if correct technique is to be maintained. It is important to maximise the opportunities to deliver this education in primary care. In light of this, it is important to explore how health care providers, in particular pharmacists and general medical practitioners, can work together in delivering inhaler technique education to patients, over time. Therefore, there is a need to develop and evaluate effective inter-professional education, which will address the need to educate patients in the correct use of their inhalers as well as equip health care professionals with skills to engage in collaborative relationships with each other. METHODS: This mixed methods study involves the development and evaluation of three modules of continuing education, Model 1, Model 2 and Model 3. A fourth group, Model 4, acting as a control. Model 1 consists of face-to-face continuing professional education on asthma inhaler technique, aimed at pharmacists, general medical practitioners and their practice nurses. Model 2 is an electronic online continuing education module based on Model 1 principles. Model 3 is also based on asthma inhaler technique education but employs a learning intervention targeting health care professional relationships and is based on sociocultural theory. This study took the form of a parallel group, repeated measure design. Following the completion of continuing professional education, health care professionals recruited people with asthma and followed them up for 6 months. During this period, inhaler device technique training was delivered and data on patient inhaler technique, clinical and humanistic outcomes were collected. Outcomes related to professional collaborative relationships were also measured. DISCUSSION: Challenges presented included the requirement of significant financial resources for development of study materials and limited availability of validated tools to measure health care professional collaboration over time