Effects of pituitary pars intermedia dysfunction and Prascend (pergolide tablets) treatment on endocrine and immune function in horses.

It remains unclear how pituitary pars intermedia dysfunction (PPID) and pergolide treatment (Prascend [pergolide tablets]) affect endocrine and immune function in horses. To evaluate these effects, blood was collected regularly from 28 university-owned horses (10 Non-PPID, 9 PPID control [PC], and 9 PPID treatment [PT]) over approximately 15 mo. Pergolide treatment was initiated after Day 0 collections. Analyses included ACTH, insulin, total cortisol, free cortisol, complete blood counts, plasma myeloperoxidase, and cytokine/receptor gene expression in basal whole blood and in vitro stimulations (PMA/ionomycin, heat-inactivated Rhodococcus equi, and heat-inactivated Escherichia coli) of whole blood and peripheral blood mononuclear cells (PBMCs). The results were analyzed using a linear mixed model (SAS 9.4) with significance set at P < 0.05. Significant group (P = 0.0014) and group-by-time (P = 0.0004) effects were observed in resting ACTH such that PT horses differed from Non-PPID horses only at Day 0. PT horses had significantly lower changes in ACTH responses to thyrotropin-releasing hormone stimulation tests than PC horses at non-fall time points only, mid-late February 2018 (P = 0.016) and early April 2018 (P = 0.0172). When PT and PC horses did not differ, they were combined before comparison to Non-PPID horses. No significant group or group-by-time effects were seen in resting insulin, total cortisol, or free cortisol; however, significant time effects were observed in these measures. PPID horses had lower absolute lymphocyte (P = 0.028) and red blood cell (P = 0.0203) counts than Non-PPID horses. In unstimulated whole blood, PPID horses had increased IL-8 expression compared with Non-PPID horses (P = 0.0102). In addition, PPID horses had decreased interferon γ production from PBMCs after stimulation with R. equi (P = 0.0063) and E. coli (P = 0.0057) and showed increased transforming growth factor ß expression after E. coli stimulation (P = 0.0399). The main limitations of this study were a limited sample size and an inability to truly randomize the PPID horses into treatment groups. Resting ACTH is likely the best choice for determining successful responses to pergolide. Neither PPID nor pergolide appears to influence insulin, total cortisol, and free cortisol. As measured, systemic immune function was altered in PPID horses, and it is likely that these horses are indeed at increased risk of opportunistic infection. Despite reducing ACTH, pergolide treatment did not appear to influence immune function.

Failing to fail: clinicians' experience of assessing underperforming dental students.

INTRODUCTION: Anecdotal evidence within a UK dental school indicated that staff's grading did not always match their evaluation of students' clinical proficiency. The invalid assessment of underperforming students, which has considerable ramifications, has been reported internationally for students of nursing and medicine, but a database search revealed no accounts for dental education. AIM: To develop an understanding of clinicians' approaches to assessing underperforming dental students. METHODOLOGY: Seventeen clinical staff were interviewed (eleven females, six males). Interviews were recorded and transcribed verbatim. A grounded theory methodology was used, with simultaneous data collection and analysis. The main analytical technique was constant comparison. FINDINGS: Participants' shared basic problem was Assessing undergraduate students, expressed as how they evaluated and used the assessment system or perceived others to do so. The core category, which explains what clinical staff do to manage their difficulties with assessment, was identified as Failing to Fail and has three subcategories: Evaluating the Assessment System, Shielding the Student and Protecting Myself. CONCLUSION: This study has substantiated the complexity of failing to fail and confirmed that some causes are shared across healthcare professions, although insufficient staff discussion, the avoidance of confrontation and the impact of negative student attitude are not reported elsewhere or are minor findings. It is recommended that clinical staff receive additional training in assessment and that they are made more aware of their learning needs, their attitudes and beliefs. Increased discussion between staff about assessment and about students known to be in difficulty is essential.

Body image and weight consciousness among South Asian, Italian and general population women in Britain.

Italians in Britain have low rates of coronary heart disease while South Asians have high rates, which correspond to a tendency to central abdominal fat deposition and overweight. World variations in attitudes to body size are thought to be related to economic security. This cross-sectional study employed a range of measures including photographic silhouettes of known BMI to investigate the attitudes of 259 South Asian, Italian and general population women (aged 20-42 years) towards body size. Migrants are compared with British-born minority members. Our results indicate that although migrant South Asians were less happy with their weight than migrant Italians, fewer had tried to lose weight in the past or had experienced external pressures to change their bodies. More migrant South Asians than Italians or general population women equated one of the four largest shapes (BMI 28-38) with health and successful reproduction. All groups wanted to resemble one of the two thinnest shapes, equating them with longevity, likelihood of marriage and job success. British-born South Asians generally showed a considerable degree of convergence towards general population women's negative attitudes to large body size, but British-born Italians' attitudes were significantly more negative even than general population women. The study's conclusions were that South Asian health beliefs are an important focus of resistance to slimness. The tendency of migrant South Asians to equate large size with health contrasts with the opposing views of Italian and general population women. British-born South Asians' views are modifying from those of migrants, but significant differences remain when compared with general population women and British-born Italians. Present differences in economic security offer only a partial explanation; South Asian attitudes may be explained by economic insecurity in the past.