Spermatogenesis in Branchipus Vernalis : Part III. Secondary Spermatocyte, Spermatid and Spermatozoon

Author Institution: Department of Anatomy, Ohio State Universit

Spermatogenesis in Branchipus Vernalis : Part I. The Testis and Spermatogonial Divisions

Author Institution: Department of Anatomy, Ohio State Universit

Decreasing the Peril of Antimicrobial Resistance Through Enhanced Health Literacy in Outpatient Settings: An Underrecognized Approach to Advance Antimicrobial Stewardship

© 2020, The Author(s). Globally, antimicrobial resistance (AMR) is a serious problem causing 700,000 deaths annually. By 2050, AMR is expected to cause approximately 10 million deaths globally each year if allowed to increase at the present rate. Many individuals have limited knowledge regarding appropriate antibiotic use and AMR. Most antibiotic use occurs in the outpatient setting, with approximately 30% of antibiotics prescribed deemed unnecessary. Antimicrobial stewardship (AMS) is a means to reduce inappropriate antibiotic use and AMR. While existing AMS efforts generally focus on the inpatient setting, a significant gap is present in the outpatient setting. A common theme across various national action plans to reduce AMR is the need for education and awareness. The importance of communicating information in a manner easily comprehended by the patient in addition to productive clinician–patient dialogue cannot be overestimated. Enhancing the public’s and patients’ AMS health literacy is an underrecognized approach to help address AMR. We describe Four Core Elements of Enhancing AMS Health Literacy in the Outpatient Setting, utilizing the Centers for Disease Control and Prevention’s framework: (1) leadership commitment, (2) intervention/action, (3) tracking/reporting, and (4) education/expertise. We call upon leaders in outpatient settings to embrace this approach to curb inappropriate antimicrobial use

Addressing Inequity: Expanding Access to College-Level Courses for High School Students

The opportunity to take college courses in high school (dual enrollment) is becoming increasingly prevalent, but access is not equitably distributed. Certain populations, such as economically disadvantaged students and students who are members of racial and ethnic groups historically underrepresented in college, are less likely to take dual enrollment courses. This paper presents findings from an evaluation of the College and Career Readiness Expansion Project, an effort to expand participation in dual enrollment courses within the context of broader changes in high schools. A quasi-experimental impact study showed that the project successfully expanded access, particularly for economically disadvantaged students. Implementation data showed that the schools participating in the project used a variety of strategies to expand access, including (1) understanding and using data; (2) increasing students’ awareness of college courses and their importance; (3) supporting students’ college readiness; (4) removing eligibility barriers; and (5) providing support for students taking college classes

Altruismo normal y patológico

La bibliografía psicoanalítica sobre altruismo es escasa, a pesar de todo lo que se ha escrito sobre este tema desde una perspectiva sociobiológica. Freud (1917) describió por primera vez el concepto en "Teoría de la Libido y Narcisismo". En 1946, Anna Freud acuñó la expresión "renuncia altruista" para describir la psicodinámica del comportamiento altruista en un grupo de sujetos inhibidos que mostraban impulsos de origen neurótico a hacer el bien a los demás. La utilidad y aplicabilidad clínica de esta formulación, junto con la frecuente coexistencia de masoquismo y altruismo, animó a los psicoanalistas a considerar toda forma de altruismo como fundamentada en el masoquismo. Desde entonces se ha producido una fusión de los dos conceptos en gran parte de la bibliografía analítica. En este artículo se revisa la comprensión psicoanalítica del altruismo y se propone una ampliación del concepto hasta incluir una forma normal. Se describen cinco tipos de altruismo: protoaltruismo, altruismo generativo, altruismo conflictivo, pseudoaltruismo y altruismo psicótico. El protoaltruismo tiene raíces biológicas y puede ser observado en los animales. En los humanos, el protoaltruismo incluye la crianza y protección tanto materna como paterna. El altruismo generativo es el placer no conflictivo en auspiciar el éxito y/o el bienestar de otro. El altruismo conflictivo es altruismo generativo que ha sido arrastrado al conflicto, pero en el cual el placer y la satisfacción del otro (un sustituto en representación del sujeto) se disfruta verdaderamente. El pseudoaltruismo se origina en un conflicto y sirve como mecanismo defensivo que oculta el sadomasoquismo subyacente. El altruismo psicótico es definido como las formas, a veces extravagantes, de comportamiento cuidador y la consecuente autorrenuncia observadas en individuos psicóticos, frecuentemente basadas en fenómenos delirantes. Consideramos que la ¿renuncia altruista¿ de Anna Freud combina aspectos tanto de altruismo conflictivo como de pseudoaltruismo. Se discuten dos ejemplos clínicos