High fat diet causes depletion of intestinal eosinophils associated with intestinal permeability.

The development of intestinal permeability and the penetration of microbial products are key factors associated with the onset of metabolic disease. However, the mechanisms underlying this remain unclear. Here we show that, unlike liver or adipose tissue, high fat diet (HFD)/obesity in mice does not cause monocyte/macrophage infiltration into the intestine or pro-inflammatory changes in gene expression. Rather HFD causes depletion of intestinal eosinophils associated with the onset of intestinal permeability. Intestinal eosinophil numbers were restored by returning HFD fed mice to normal chow and were unchanged in leptin-deficient (Ob/Ob) mice, indicating that eosinophil depletion is caused specifically by a high fat diet and not obesity per se. Analysis of different aspects of intestinal permeability in HFD fed and Ob/Ob mice shows an association between eosinophil depletion and ileal paracelullar permeability, as well as leakage of albumin into the feces, but not overall permeability to FITC dextran. These findings provide the first evidence that a high fat diet causes intestinal eosinophil depletion, rather than inflammation, which may contribute to defective barrier integrity and the onset of metabolic disease

Threshold concepts: Impacts on teaching and learning at tertiary level

This project explored teaching and learning of hard-to-learn threshold concepts in first-year English, an electrical engineering course, leadership courses, and in doctoral writing. The project was envisioned to produce disciplinary case studies that lecturers could use to reflect on and refine their curriculum and pedagogy, thereby contributing to discussion about the relationship between theory and methodology in higher education research (Shay, Ashwin, & Case, 2009). A team of seven academics investigated lecturers’ awareness and emergent knowledge of threshold concepts and associated pedagogies and how such pedagogies can afford opportunities for learning. As part of this examination the lecturers also explored the role of threshold concept theory in designing curricula and sought to find the commonalities in threshold concepts and their teaching and learning across the four disciplines. The research highlights new ways of teaching threshold concepts to help students learn concepts that are fundamental to the disciplines they are studying and expand their educational experiences. Given that much of the international research in this field focuses on the identification of threshold concepts and debates their characteristics (Barradell, 2013; Flanagan, 2014; Knight, Callaghan, Baldock, & Meyer, 2013), our exploration of what happens when lecturers use threshold concept theory to re-envision their curriculum and teaching helps to address a gap within the field. By addressing an important theoretical and practical approach the project makes a considerable contribution to teaching and learning at the tertiary level in general and to each discipline in particular

The association between hemoglobin concentration and neurologic outcome after cardiac arrest.

PURPOSE: The purpose of the study is to determine the association between hemoglobin concentration (Hgb) and neurologic outcome in postarrest patients. METHODS: We conducted a retrospective cohort study using the Penn Alliance for Therapeutic Hypothermia (PATH) cardiac arrest registry. Inclusion criteria were resuscitated cardiac arrest (inhospital or out of hospital) and an Hgb value recorded within 24 hours of return of spontaneous circulation. The primary outcome was favorable neurologic status at hospital discharge. Survival to hospital discharge was a secondary outcome. RESULTS: There were 598 eligible patients from 21 hospitals. Patients with favorable neurologic outcome had significantly higher median Hgb in the first 2 hours (12.7 vs 10.5 g/dL; P \u3c .001) and 6 hours (12.6 vs 10.6 g/dL; P \u3c .001) postarrest. Controlling for age, pulseless rhythm, etiology, location of arrest, receipt of targeted temperature management, hematologic or metastatic malignancy, or preexisting renal insufficiency, there was a significant relationship between Hgb and neurologic outcome within the first 6 hours after arrest (odds ratio, 1.23; 95% confidence interval, 1.09-1.38) and survival to hospital discharge (odds ratio, 1.20; 95% confidence interval, 1.08-1.34). CONCLUSION: Higher Hgb after cardiac arrest is associated with favorable neurologic outcome, particularly within the first 6 hours. It is unclear if this effect is due to impaired oxygen delivery or if Hgb is a marker for more severe illness

Investigating the relationship between HIV testing and risk behaviour in Britain: National Survey of Sexual Attitudes and Lifestyles 2000.

OBJECTIVES: To estimate the prevalence of, and identify factors associated with, HIV testing in Britain. DESIGN: A large, stratified probability sample survey of sexual attitudes and lifestyles. METHODS: A total of 12,110 16-44 year olds completed a computer-assisted face-to-face interview and self-interview. Self-reports of HIV testing, i.e. the timing, reasons for and location of testing, were included. RESULTS: A total of 32.4% of men and 31.7% of women reported ever having had an HIV test, the majority of whom were tested through blood donation. When screening for blood donation and pregnancy were excluded, 9.0% of men and 4.6% of women had had a voluntary confidential HIV test (VCT) in the past 5 years. However, one third of injecting drug users and men who have sex with men had a VCT in the past 5 years. VCT in the past 5 years was significantly associated with age, residence, ethnicity, self-perceived HIV risk, reporting greater numbers of sexual partners, new sexual partners from abroad, previous sexually transmitted infection diagnosis, and injecting non-prescribed drugs for men and women, and same-sex partners (men only). Whereas sexually transmitted disease clinics were important sites for VCT, general practice accounted for almost a quarter of VCT. CONCLUSION: HIV testing is relatively common in Britain; however, it remains largely associated with population-based blood donation and antenatal screening programmes. In contrast, VCT remains highly associated with high-risk (sexual or drug-injecting) behaviours or population sub-groups at high risk. Strategies to reduce undiagnosed prevalent HIV infection will require further normalization and wider uptake of HIV testing

Role of healthcare workers in early epidemic spread of Ebola: policy implications of prophylactic compared to reactive vaccination policy in outbreak prevention and control.

Ebola causes severe illness in humans and has epidemic potential. How to deploy vaccines most effectively is a central policy question since different strategies have implications for ideal vaccine profile. More than one vaccine may be needed. A vaccine optimised for prophylactic vaccination in high-risk areas but when the virus is not actively circulating should be safe, well tolerated, and provide long-lasting protection; a two- or three-dose strategy would be realistic. Conversely, a reactive vaccine deployed in an outbreak context for ring-vaccination strategies should have rapid onset of protection with one dose, but longevity of protection is less important. In initial cases, before an outbreak is recognised, healthcare workers (HCWs) are at particular risk of acquiring and transmitting infection, thus potentially augmenting early epidemics. We hypothesise that many early outbreak cases could be averted, or epidemics aborted, by prophylactic vaccination of HCWs. This paper explores the potential impact of prophylactic versus reactive vaccination strategies of HCWs in preventing early epidemic transmissions. To do this, we use the limited data available from Ebola epidemics (current and historic) to reconstruct transmission trees and illustrate the theoretical impact of these vaccination strategies. Our data suggest a substantial potential benefit of prophylactic versus reactive vaccination of HCWs in preventing early transmissions. We estimate that prophylactic vaccination with a coverage >99% and theoretical 100% efficacy could avert nearly two-thirds of cases studied; 75% coverage would still confer clear benefit (40% cases averted), but reactive vaccination would be of less value in the early epidemic. A prophylactic vaccination campaign for front-line HCWs is not a trivial undertaking; whether to prioritise long-lasting vaccines and provide prophylaxis to HCWs is a live policy question. Prophylactic vaccination is likely to have a greater impact on the mitigation of future epidemics than reactive strategies and, in some cases, might prevent them. However, in a confirmed outbreak, reactive vaccination would be an essential humanitarian priority. The value of HCW Ebola vaccination is often only seen in terms of personal protection of the HCW workforce. A prophylactic vaccination strategy is likely to bring substantial additional benefit by preventing early transmission and might abort some epidemics. This has implications both for policy and for the optimum product profile for vaccines currently in development

Influence of Gender Streamed (Boys’ and Girls’ Only) Classes on Coeducational Secondary Schools’ Mathematics Teachers Perceptions in Nakuru, Uasingishu, Kericho and Baringo Counties of Kenya

The skills acquired in mathematics provide a country with a human resource that is highly educated and able to tackle most of the country’s social economic problems. However, the performance of students at the KCSE mathematics examinations in Kenya has been dismal for many years. In addition, majority of the girls in particular have been performing poorly in the subject compared to the boys. As a possible remedy to this, single sex classes within coeducational secondary schools were created. There is however limited research, which has been carried out to  compare mathematics teachers’ perceptions between single and mixed sex classes in coeducational  secondary schools in Kenya. Therefore, this study was designed to find out the effects this intervention. The study adopted an ex post facto causal comparative research design. A sample of 203 mathematics teachers from county and sub county co-educational secondary schools (those with mixed sex and single sex classes) in Nakuru, Uasingishu, Kericho and Baringo counties of Kenya participated in the study. Data was obtained using self-report questionnaires for mathematics teachers. The instrument was pilot tested and validated to improve it before actual data collection. A Chronbach alpha reliability coefficient was calculated and an index of 0.87 obtained. The collected data was analyzed using descriptive statistics and ANOVA at a significant level of alpha (α) equal to 0.05.The findings show that mathematics teachers’ perceptions of their classes are positive irrespective of the class gender composition. The findings further show that there were no statistically significant differences in their perceptions between single sex and mixed sex classrooms in both the sub county and county schools.  The results from the study have yielded valuable information that may inform the intervention in Kenya’s coeducational secondary schools and advice policy makers, teachers and administrators of the schools on appropriate measures to undertake to enhance its effectiveness in the teaching and learning of mathematics. Keywords: Gender streamed classes, mathematics teachers, Perceptions, Coeducational secondary schools