Development of the equine gut microbiota.

Shortly after birth the mammalian gut is colonized, by a transient microbiota, highly susceptible to environment and diet, that eventually stabilizes and becomes the resident gut microbiota. In a window of opportunity during the colonization, oral tolerance is established towards resident bacteria. In this study, the development of the equine gut microbiota was investigated in ten foals from parturition until post weaning. We found great differences in the core species of the gut microbiota composition between time-matched samples on Day 7 and 20 post-partum. Between day 20 and Day 50 post-partum, we saw the gut microbiota became increasingly dominated by fiber fermenting species. After Day 50, no significant changes in species abundance were observed. Gene expression analysis of pro- and anti-inflammatory cytokines in the blood revealed no significant changes before and after weaning. In summary, relative stability of the gut microbiota was reached within 50 days post-partum and, weaning did not have a major impact on the microbial composition.

Expression of immune regulatory genes correlate with the abundance of specific Clostridiales and Verrucomicrobia species in the equine ileum and cecum.

Billions of bacteria inhabit the gastrointestinal tract. Immune-microbial cross talk is responsible for immunological homeostasis, and symbiotic microbial species induce regulatory immunity, which helps to control the inflammation levels. In this study we aimed to identify species within the equine intestinal microbiota with the potential to induce regulatory immunity. These could be future targets for preventing or treating low-grade chronic inflammation occurring as a result of intestinal microbial changes and disruption of the homeostasis. 16S rRNA gene amplicon sequencing was performed on samples of intestinal microbial content from ileum, cecum, and colon of 24 healthy horses obtained from an abattoir. Expression of genes coding for IL-6, IL-10, IL-12, IL-17, 18 s, TNFα, TGFß, and Foxp3 in the ileum and mesenteric lymph nodes was measured by qPCR. Intestinal microbiota composition was significantly different in the cecum and colon compared to the ileum, which contains large abundances of Proteobacteria. Especially members of the Clostridiales order correlated positively with the regulatory T-cell transcription factor Foxp3 and so did the phylum Verrucomicrobia. We conclude that Clostridiales and Verrucomicrobia have the potential to induce regulatory immunity and are possible targets for intestinal microbial interventions aiming at regulatory immunity improvement.

The impact of regionalization programs on patterns of perinatal care.

A questionnaire developed to assess changes in patterns of perinatal care related to regionalization programs was sent to all 505 members of The American College of Obstetricians and Gynecologists in the state of Massachusetts. Respondents reported changes in facilities, services, educational experience, and referral and transfer patterns. The implications of these changes are discussed.

The closure of maternity services in Massachusetts. The impact on the obstetricians.

A survey is presented of Massachusetts physicians who were staff members at hospitals which closed their obstetric services. Both personal and practice impacts are presented as well as the physicians' evaluation of their present maternity units in comparison to the closed units. The personal impact on responding physicians was small. Few reported significant financial or patient loss. While significant practice changes were reported, adverse comments were few, and the present obstetric unit was viewed as an improvement over the closed unit in ever one-half the cases. These findings support the concept of consolidation as a component of programs for regional planning of maternity care.

Trends in obstetric-gynecologic academic manpower--1983.

Since 1980 medical school faculty growth has essentially ceased, in comparison to earlier substantial increases. Women are represented in full-time faculty positions in a larger proportion than among practicing obstetrician-gynecologists. Subspecialist numbers on faculties have increased, with a small decline in generalist obstetrician-gynecologists. Despite the current plateau, medical school departments project a 36% increase in faculty members during the next five years, and an even larger increase in faculty involved in research.

Obstetric-gynecologic academic manpower--1986.

Full-time faculty numbers in academic departments of obstetrics-gynecology have resumed growth in the last three years, and now average 18.3 per department. Women are represented in a larger proportion than among practicing specialists. Faculty subspecialists are increasing in numbers, but their trend is toward practice rather than academic positions. Research involves 61% of the MD faculty. Chairmen predict major growth in faculty positions and in research over the next five years.

Regional planning--effects on the obstetrician-gynecologist.

Both the precepts and the impact of regional planning for maternity care are often misunderstood. Here, a summary of 8 separate studies in 5 geographic regions describes the reactions of obstetrician-gynecologists to systems of regional planning, as well as their use of the system and the impact of regional planning on their practices. Overall, few physicians acquired new obstetric privileges, and closure of maternity services had limited impact on their practices. Approximately 50% of the physicians referred some patients to level 2 or 3 units, but only 25% actually transferred patients in a given year. The perceptions of a majority of physicians were of improvement in patient services and physician education as a result of regional planning activities. Recommendations are offered for additional needed studies of regional planning efforts.

Professional liability insurance in obstetrics-gynecology.

A geographically stratified sample of Fellows and Junior Fellows of The American College of Obstetricians and Gynecologists (ACOG) responded to a questionnaire, describing the source, coverage, and cost of their professional liability insurance, and the effects this had on patterns of practice. Most physicians carry primary professional liability coverage, although 6% do not. The majority pay less than $8000/year for a wide variety of dollar coverages. Less than half of the surveyed obstetrician-gynecologists carry excess/umbrella liability insurance, and a majority pay less than $2000/year for this coverage. The liability problem has not had a substantial effect on restricting the number of obstetrician-gynecologists, but it has had a major effect on patterns of practice.

Academic manpower for obstetrics and gynecology in the United States.

All 119 medical schools in the United States provided information for a study of academic manpower conducted by the Association of Professors of Gynecology and Obstetrics (APGO). The average number of full-time faculty members per medical school is 13.2, with 2 positions vacant per school. Subspecialists are concentrated in university medical school departments, which also have large residency programs. A perceived need for 46% more faculty over the next 5 years will probably aggravate the shortage.

Testosterone changes during vicarious experiences of winning and losing among fans at sporting events.

Basking in reflected glory, in which individuals increase their self-esteem by identifying with successful others, is usually regarded as a cognitive process that can affect behavior. It may also involve physiological processes, including changes in the production of endocrine hormones. The present research involved two studies of changes in testosterone levels among fans watching their favorite sports teams win or lose. In the first study, participants were eight male fans attending a basketball game between traditional college rivals. In the second study, participants were 21 male fans watching a televised World Cup soccer match between traditional international rivals. Participants provided saliva samples for testosterone assay before and after the contest. In both studies, mean testosterone level increased in the fans of winning teams and decreased in the fans of losing teams. These findings suggest that watching one's heroes win or lose has physiological consequences that extend beyond changes in mood and self-esteem.

Hip fracture incidence in New Zealand, revisited.

AIM: Earlier predictions of the incidence of hip fractures in the older adult population suggested that by 2011 the rate would rise to epidemic proportions. The purpose of this study was to compare the number hip fractures occuring in New Zealand from 1988 to 1999 with the hip fracture rate predicted in 1990 by Rockwood, Horne and Cryer. METHODS: Data on the number of patients admitted to New Zealand hospitals with a diagnosis of fractured neck of femur were obtained, and compared with weighted regression and baseline predictions of Rockwood et al. RESULTS: The numbers of hip fractures for females, from 1988 to 1993, were similar to the number predicted, yet have been significantly lower than stated predictions since 1995. For males, hip fracture numbers since 1995 were less than the weighted regressions predicted (NS). CONCLUSIONS: Numbers of hip fractures since 1995 have been fewer than predicted. Possible reasons for maintaining the rates of hospitalisation due to fractured neck of femur at pre-1995 levels, are discussed.

Creating a child abuse policy that reflects an ethic of care.

The primary purpose of child abuse policy is to guide the action of health care providers and so ensure that the fundamental rights of those the policy intended to protect are not compromised. This discussion paper explores the ethical considerations underlying child abuse policy from bioethical and from caring ethical perspectives, both of which are outlined briefly. A process that could be used to create or analyse existing child abuse policy, in relation to underlying ethical considerations, definitions of child abuse, level of health care, resourcing needs and relationship to employment policy is outlined. A hypothetical example of such a policy is used to illustrate elements of this process. Assuming that policy is designed to direct action, it is argued that if child abuse policies were rewritten to reflect an ethic of care the quality and scope of health care provided to children and their families would improve. Consequently, stated government objectives of improving child health services, as well as primary health care aims of achieving equitable, accessible and affordable health care for children in New Zealand would be better facilitated.

Level crossings and zero-field splitting in the {Cr8}-cubane spin cluster studied using inelastic neutron scattering and magnetization.

Inelastic neutron scattering (INS) in variable magnetic field and high-field magnetization measurements in the millikelvin temperature range were performed to gain insight into the low-energy magnetic excitation spectrum and the field-induced level crossings in the molecular spin cluster {Cr(8)}-cubane. These complementary techniques provide consistent estimates of the lowest level-crossing field. The overall features of the experimental data are explained using an isotropic Heisenberg model, based on three distinct exchange interactions linking the eight Cr(III) paramagnetic centers (spins s = 3/2), that is supplemented with a relatively large molecular magnetic anisotropy term for the lowest S = 1 multiplet. It is noted that the existence of the anisotropy is clearly evident from the magnetic field dependence of the excitations in the INS measurements, while the magnetization measurements are not sensitive to its effects.