The development of a clinical site : expectations of key participants.

In Massachusetts, as well as in other states, a mentoring model called the clinical site, has recently emerged. A clinical site is a public school which serves as a laboratory for student teachers. It has a corps of experienced teachers trained to serve as mentors to the student teachers, and usually includes a pre-practicum component for a local teacher training program. Proponents of clinical sites assume that there are significant professional benefits for the mentors and the school itself, as well as for the student teachers. However, it is unclear exactly what those benefits are and to what degree there is agreement among the various proponents of the clinical site concept as to the nature of those benefits. This study was designed to closely examine the expectations of the participants involved in the developmental phase of a University of Massachusetts clinical site at Greenfield High School, Greenfield Massachusetts. Interns, mentors, school administrators, and university faculty were interviewed about their expectations of the clinical site project. All participants expressed expectations consistent with the assumptions which are driving the current move to reform schools by making them centers for the study of teaching and learning. Like many teachers in the United States, the Greenfield High School teachers feel professionally isolated, and see the clinical site as a possible antidote to that isolation. They also expect the clinical site to provide teachers with opportunities to play new professional roles in the education of novice teachers. Administrators anticipate that newly energized teachers will create a ripple effect felt by everyone in the school district, including themselves. Many of the reasons why interns chose to do their student teaching at a clinical site are based on their expectation that the clinical site would mitigate against their anxieties about student teaching in general and the isolation of a remote placement in particular. Interns foresaw an experience at the clinical site which would allow them to interact with a number of professionals who were ready to help them. Beyond their primary expectation of providing their students with a more cohesive student teaching experience, university staff look to the clinical site for their own professional stimulation, and as a source of new knowledge and research. Although the expectations expressed by the participants do not conflict with one another, the economic and political climate in Massachusetts will make it difficult for the program to meet all of them, especially those which create new (not additional) roles for teachers and professors

WebEase: Development of a Web-Based Epilepsy Self-Management Intervention

People with epilepsy must adopt many self-management behaviors, especially regarding medication adherence, stress management, and sleep quality. In response to the need for theory-based self-management programs that people with epilepsy can easily access, the WebEase Web site was created and tested for feasibility, acceptability, and usability. This article discusses the theoretical background and developmental phases of WebEase and lessons learned throughout the development process. The WebEase research team developed content for the Web site on the basis of social cognitive theory, the transtheoretical model of behavior change, and motivational interviewing. Formative research and development of the WebEase program included a literature search, computer use survey, a focus group, and review by content experts and consumers. The program has 2 main components: 1) the modules, which provide a tailored opportunity for learning, reflection, and goal setting, and 2) MyLog, a place to enter daily information

Higher occurrence of nausea and vomiting after total hip arthroplasty using general versus spinal anesthesia: an observational study.

BACKGROUND: Under the assumption that postoperative nausea and vomiting (PONV) may occur after total hip arthroplasty (THA) regardless of the anesthetic technique used, it is not clear whether general (GA) or spinal (SA) anesthesia has higher causal effect on this occurrence. Conflicting results have been reported. METHODS: In this observational study, we selected all elective THA interventions performed in adults between 1999 and 2008 in a Swiss orthopedic clinic under general or spinal anesthesia. To assess the effect of anesthesia type on the occurrence of PONV, we used the propensity score and matching methods, which allowed us to emulate the design and results of an RCT. RESULTS: Among 3922 procedures, 1984 (51 %) patients underwent GA, of which 4.1 % experienced PONV, and 1938 underwent SA, of which 3.5 % experienced PONV. We found that the average treatment effect on the treated, i.e. the effect of anesthesia type for a sample of individuals that actually received spinal anesthesia compared to individuals who received GA, was ATET = 2.00 % [95 % CI, 0.78-3.19 %], which translated into an OR = 1.97 [95 % CI 1.35; 2.87]. CONCLUSION: This suggests that the type of anesthesia is not neutral regarding PONV, general anesthesia being more strongly associated with PONV than spinal anesthesia in orthopedic surgery

Zebrafish hoxd4a Acts Upstream of meis1.1 to Direct Vasculogenesis, Angiogenesis and Hematopoiesis

10.1371/journal.pone.0058857PLoS ONE83

Human Immune System Development and Rejection of Human Islet Allografts in Spontaneously Diabetic NOD-Rag1null IL2rγnull Ins2Akita Mice

OBJECTIVE: To create an immunodeficient mouse model that spontaneously develops hyperglycemia to serve as a diabetic host for human islets and stem cell-derived beta-cells in the absence or presence of a functional human immune system. RESEARCH DESIGN AND METHODS: We backcrossed the Ins2(Akita) mutation onto the NOD-Rag1(null) IL2rgamma(null) strain and determined 1) the spontaneous development of hyperglycemia, 2) the ability of human islets, mouse islets, and dissociated mouse islet cells to restore euglycemia, 3) the generation of a human immune system following engraftment of human hematopoietic stem cells, and 4) the ability of the humanized mice to reject human islet allografts. RESULTS: We confirmed the defects in innate and adaptive immunity and the spontaneous development of hyperglycemia conferred by the IL2rgamma(null), Rag1(null), and Ins2(Akita) genes in NOD-Rag1(null) IL2rgamma(null) Ins2(Akita) (NRG-Akita) mice. Mouse and human islets restored NRG-Akita mice to normoglycemia. Insulin-positive cells in dissociated mouse islets, required to restore euglycemia in chemically diabetic NOD-scid IL2rgamma(null) and spontaneously diabetic NRG-Akita mice, were quantified following transplantation via the intrapancreatic and subrenal routes. Engraftment of human hematopoietic stem cells in newborn NRG-Akita and NRG mice resulted in equivalent human immune system development in a normoglycemic or chronically hyperglycemic environment, with \u3e50% of engrafted NRG-Akita mice capable of rejecting human islet allografts. CONCLUSIONS: NRG-Akita mice provide a model system for validation of the function of human islets and human adult stem cell, embryonic stem cell, or induced pluripotent stem cell-derived beta-cells in the absence or presence of an alloreactive human immune system

The Sexual Development and Education of Preschool Children: Knowledge and Opinions from Doctors and Nurses

This descriptive study was carried out in order to determine the knowledge levels and attitudes of doctors and nurses regarding children’s sexual development and sex education. The study was conducted with doctors and nurses who work at various clinics of two state hospitals located in the province of Istanbul. The data collection tool consisted of 58 questions. The Statistical Program for the Social Sciences, version 18.0 (SPSS 18.0) was used for data analysis. It was determined that females comprised the majority of the respondents (61 %) and were over 36 years of age (54.1 %) (37.81 ± 8.82). Of the participants in the study, 63.5 % had bachelor’s degrees and 62.1 % were medical doctors. It was determined that the number of correct responses given by the respondents regarding some behaviors observed in children aged between 3 and 6 years and children’s sexual development and sex education showed significant differences according to age group (p = 0.007), marital status (p = 0.004), the status of having children (p = 0.004), educational status (p = 0.005) and occupation (p = 0.000). However, in a review of the study findings, it was observed that culture had an important impact on sex-related approaches and that embarrassment and shyness is very common

Demographic and Psychological Predictors of Parent–Adolescent Communication About Sex: A Representative Statewide Analysis

Sexual communication is a principal means of transmitting sexual values, beliefs, expectations, and knowledge between parents and children. Although this area has received considerable research attention, more studies with representative samples are needed to assure that findings are reflective of populations of interest. A representative statewide sample of households with adolescents (N = 907) from a large and diverse state in the United States was employed to examine the content and extent of sexual communication between parents and their adolescents, and the influence of selected primary demographic (age and gender), socio-demographic (Hispanic ethnicity, education, and religious attendance), and psychological (self-reported comfort, knowledge, and sexual communication difficulties) factors on the number of topics discussed. More than two-thirds of the parents reported experiencing some type of sexual communication difficulty, such as developmental concerns and embarrassment. Hierarchical regression results indicated that self-reported comfort, knowledge, and sexual communication difficulties strongly predicted the number of topics discussed, beyond the effect of demographic variables. These findings reinforce the notion that sexual communication between parents and adolescents can be universally challenging, and parents of both genders, all ages, and all socio-demographic characteristics might benefit from education and support

A Novel Role for the Centrosomal Protein, Pericentrin, in Regulation of Insulin Secretory Vesicle Docking in Mouse Pancreatic β-cells

The centrosome is important for microtubule organization and cell cycle progression in animal cells. Recently, mutations in the centrosomal protein, pericentrin, have been linked to human microcephalic osteodysplastic primordial dwarfism (MOPD II), a rare genetic disease characterized by severe growth retardation and early onset of type 2 diabetes among other clinical manifestations. While the link between centrosomal and cell cycle defects may account for growth deficiencies, the mechanism linking pericentrin mutations with dysregulated glucose homeostasis and pre-pubertal onset of diabetes is unknown. In this report we observed abundant expression of pericentrin in quiescent pancreatic β-cells of normal animals which led us to hypothesize that pericentrin may have a critical function in β-cells distinct from its known role in regulating cell cycle progression. In addition to the typical centrosome localization, pericentrin was also enriched with secretory vesicles in the cytoplasm. Pericentrin overexpression in β-cells resulted in aggregation of insulin-containing secretory vesicles with cytoplasmic, but not centrosomal, pericentriolar material and an increase in total levels of intracellular insulin. RNAi- mediated silencing of pericentrin in secretory β-cells caused dysregulated secretory vesicle hypersecretion of insulin into the media. Together, these data suggest that pericentrin may regulate the intracellular distribution and secretion of insulin. Mice transplanted with pericentrin-depleted islets exhibited abnormal fasting hypoglycemia and inability to regulate blood glucose normally during a glucose challenge, which is consistent with our in vitro data. This previously unrecognized function for a centrosomal protein to mediate vesicle docking in secretory endocrine cells emphasizes the adaptability of these scaffolding proteins to regulate diverse cellular processes and identifies a novel target for modulating regulated protein secretion in disorders such as diabetes

Prolonged COVID-19 symptom duration in people with systemic autoimmune rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

OBJECTIVE: We investigated prolonged COVID-19 symptom duration, defined as lasting 28 days or longer, among people with systemic autoimmune rheumatic diseases (SARDs). METHODS: We analysed data from the COVID-19 Global Rheumatology Alliance Vaccine Survey (2 April 2021-15 October 2021) to identify people with SARDs reporting test-confirmed COVID-19. Participants reported COVID-19 severity and symptom duration, sociodemographics and clinical characteristics. We reported the proportion experiencing prolonged symptom duration and investigated associations with baseline characteristics using logistic regression. RESULTS: We identified 441 respondents with SARDs and COVID-19 (mean age 48.2 years, 83.7% female, 39.5% rheumatoid arthritis). The median COVID-19 symptom duration was 15 days (IQR 7, 25). Overall, 107 (24.2%) respondents had prolonged symptom duration (≥28 days); 42/429 (9.8%) reported symptoms lasting ≥90 days. Factors associated with higher odds of prolonged symptom duration included: hospitalisation for COVID-19 vs not hospitalised and mild acute symptoms (age-adjusted OR (aOR) 6.49, 95% CI 3.03 to 14.1), comorbidity count (aOR 1.11 per comorbidity, 95% CI 1.02 to 1.21) and osteoarthritis (aOR 2.11, 95% CI 1.01 to 4.27). COVID-19 onset in 2021 vs June 2020 or earlier was associated with lower odds of prolonged symptom duration (aOR 0.42, 95% CI 0.21 to 0.81). CONCLUSION: Most people with SARDs had complete symptom resolution by day 15 after COVID-19 onset. However, about 1 in 4 experienced COVID-19 symptom duration 28 days or longer; 1 in 10 experienced symptoms 90 days or longer. Future studies are needed to investigate the possible relationships between immunomodulating medications, SARD type/flare, vaccine doses and novel viral variants with prolonged COVID-19 symptoms and other postacute sequelae of COVID-19 among people with SARDs