Synthetic amyloid beta does not induce a robust transcriptional response in innate immune cell culture systems.

BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disease that impacts nearly 400 million people worldwide. The accumulation of amyloid beta (Aß) in the brain has historically been associated with AD, and recent evidence suggests that neuroinflammation plays a central role in its origin and progression. These observations have given rise to the theory that Aß is the primary trigger of AD, and induces proinflammatory activation of immune brain cells (i.e., microglia), which culminates in neuronal damage and cognitive decline. To test this hypothesis, many in vitro systems have been established to study Aß-mediated activation of innate immune cells. Nevertheless, the transcriptional resemblance of these models to the microglia in the AD brain has never been comprehensively studied on a genome-wide scale. METHODS: We used bulk RNA-seq to assess the transcriptional differences between in vitro cell types used to model neuroinflammation in AD, including several established, primary and iPSC-derived immune cell lines (macrophages, microglia and astrocytes) and their similarities to primary cells in the AD brain. We then analyzed the transcriptional response of these innate immune cells to synthetic Aß or LPS and INFγ. RESULTS: We found that human induced pluripotent stem cell (hIPSC)-derived microglia (IMGL) are the in vitro cell model that best resembles primary microglia. Surprisingly, synthetic Aß does not trigger a robust transcriptional response in any of the cellular models analyzed, despite testing a wide variety of Aß formulations, concentrations, and treatment conditions. Finally, we found that bacterial LPS and INFγ activate microglia and induce transcriptional changes that resemble many, but not all, aspects of the transcriptomic profiles of disease associated microglia (DAM) present in the AD brain. CONCLUSIONS: These results suggest that synthetic Aß treatment of innate immune cell cultures does not recapitulate transcriptional profiles observed in microglia from AD brains. In contrast, treating IMGL with LPS and INFγ induces transcriptional changes similar to those observed in microglia detected in AD brains.

Sociability increases survival of adult female giraffes.

Studies increasingly show that social connectedness plays a key role in determining survival, in addition to natural and anthropogenic environmental factors. Few studies, however, integrated social, non-social and demographic data to elucidate what components of an animal's socio-ecological environment are most important to their survival. Female giraffes (Giraffa camelopardalis) form structured societies with highly dynamic group membership but stable long-term associations. We examined the relative contributions of sociability (relationship strength, gregariousness and betweenness), together with those of the natural (food sources and vegetation types) and anthropogenic environment (distance from human settlements), to adult female giraffe survival. We tested predictions about the influence of sociability and natural and human factors at two social levels: the individual and the social community. Survival was primarily driven by individual- rather than community-level social factors. Gregariousness (the number of other females each individual was observed with on average) was most important in explaining variation in female adult survival, more than other social traits and any natural or anthropogenic environmental factors. For adult female giraffes, grouping with more other females, even as group membership frequently changes, is correlated with better survival, and this sociability appears to be more important than several attributes of their non-social environment.

Voices of clients and caregivers in a maternity home.

The purpose of this study was to examine the perceived health-related needs of women who spent part of their pregnancy, labor, delivery, and immediate postpartum days in a maternity residence that provided adoption placement services. The method was qualitative; semistructured interviews and content analysis were used. The authors concluded that the perceived needs of this population were essentially congruent with those of the nurse caregivers. Information and support in labor were cited as primary needs. The authors suggest that this population may significantly underestimate postpartal needs. A second finding was that these mothers seemed to express a heightened sense of joy and relief in their newborn's health, which may reflect the compressed time they have to demonstrate maternal behaviors.

Developing a culturally competent work force: an opportunity for collaboration.

This article describes a collaborative project formed between three major community systems--education, health care, and the business sector--to respond to the specialized cultural needs of a growing Hispanic population in a large public health care system in Dallas, TX. Two specific strategies, short-term cultural immersion and the development of a nurse exchange program with a "sister" hospital in Mexico, assist health care personnel to learn the language and the culture of Mexico. Findings from process evaluation suggest that these initiatives are essential and beneficial to changing individual views and developing knowledge and skills. Community partnerships requiring a significant commitment to a continuum of efforts from top administrative levels to the individual level facilitate institutional responses to the challenge of developing a culturally skilled health work force.

Assessment of professional nursing students' knowledge and attitudes about patients of diverse cultures.

This study examined personal attitudes of 152 Bachelors of Science in Nursing (BSN), registered nurse (RN) to BSN, and master's students enrolled in a school of nursing in the southwestern United States toward culturally diverse patients and their perceived knowledge of specific cultural practices and culture-specific skills. Three instruments were used to collect data: the Ethnic Attitude Scale-Part I, the Transcultural Questionnaire, and a demographic survey. Findings reveal that students in all three programs had a relatively low knowledge base about specific cultural groups. The only statistically significant difference found in attitudes, perceived knowledge of cultural patterns, or perceived cultural skills by program was the slightly higher perceived ability of generic BSN students to distinguish between concepts such as ethnocentrism and discrimination, intra- and intercultural diversity, and ethnicity and culture. Similar to other studies of measurement of provider attitudes and perceived cultural knowledge, the results of this study reinforce the struggle experienced by educators and the challenges faced by health care administrators grappling with teaching and delivering culturally competent care. The findings imply that nurse educators need to examine alternate models and teaching strategies to move students along the continuum of cultural learning.

Distance education programs: defining issues of assessment, accessibility, and accommodation.

Identification and resolution of a variety of issues is imperative to establishing effective distance education via telecommunications. In this first-hand experience, the authors describe selected issues and possible responses inherent in the development and implementation of a new teaching modality. The decision to pursue distance education by telecommunications should be made only after a thorough examination of the needs, the required resources, and the changes to be expected. Advance planning is essential for problem solving.

Maternal-infant clinical nurse specialist performance assessment: development of an evaluation tool.

The Maternal-Infant Clinical Nurse Specialist Performance Evaluation Tool was developed to assist students to enact certain role behaviors of the clinical nurse specialist (CNS) in maternal-infant nursing and to provide faculty with a measurement of such behaviors for the purpose of student clinical evaluation. Items for the behaviorally-anchored, criterion-referenced tool were derived from current standards of CNS practice, expected competencies of the CNS as reported in the literature, and program and course objectives. Initial use of the tool with graduate students in the maternal-infant specialty indicated a valid and reliable rationale for continued use. Since the categories of the tool represent common CNS roles, it should be applicable to other specialties.

Maternal-infant clinical nurse specialist performance assessment: reliability and validity of an evaluation tool.

The Maternal-Infant Clinical Nurse Specialist Performance Evaluation Tool was used to evaluate the clinical performance of two classes of graduate students (n = 7, n = 4) enrolled in maternal-infant clinical practicums. When used by raters very familiar with the tool, i.e., those participating in its development, it yielded valid (.90) and reliable (.93) ratings of performance. When used by raters with limited familiarity with the tool, both validity and reliability declined but were still quite acceptable (.68 and .81, respectively). Better training for such raters should produce even more useful results. These results warrant continued cautious, monitored use of the tool in maternal-infant nursing. The generic content of the tool offers the possibility of its generalization to other specialties.

Predictors of birth outcome among Hispanic immigrant women.

Eliminating racial and ethnic disparities in health is a major goal of Healthy People 2010. Health care providers and institutions can address the specialized cultural expectations and needs of Hispanic Americans by assessing acculturation status of the population, an intervening variable in patient compliance, and health outcomes. This article reports on maternal acculturation status and the relationship to birth outcomes of 382 Hispanic pregnant women in the southwest United States. The majority of these women were Mexican-oriented and had healthy pregnancies and healthy birth outcomes. Findings support the hypothesis that traditional Mexican cultural practices serve protective functions for the childbearing woman.

Acculturation status, birth outcomes, and family planning compliance among Hispanic teens.

This study examined acculturation status, selected demographic and pregnancy indices, and the relationship to birth outcomes and family planning patterns among a convenience sample of 63 Hispanic adolescents aged 13 to 19 years and attending community-based prenatal clinics. Findings suggest that Hispanic teenagers who are the first generation in the United States and traditional in their world view are compliant with prenatal and postpartum care and have healthy babies and birth outcomes. Gravidity and gestational age of the infant were significant predictors of birth weight, accounting for 30% of the variability in birth weight. Generation in the United States accounted for 8% of the variance in family planning compliance. Higher gravidity was associated with increased infant birth weight and a decreased likelihood for return for family planning visits during the 1st year postbirth. Teens who were first generation in the United States were more likely to return for family planning visits during the 1st year. School nurses are in a pivotal position to design intervention programs that build on traditional cultural prescriptions for healthy behaviors during and after pregnancy.

Where does culture fit in outcomes management?

The authors describe the concept of cultural competence and ways in which culture, a structure of care variable, is important to the delivery of culturally competent care. The role of culture in outcomes assessment and management is explored. The culture of the patient, the health care professional, and the organization is examined as it influences the potential to deliver culturally competent care. Strategies for developing a culturally competent work force are proposed with examples from ongoing projects in a large metroplex in the southwestern part of the United States.