Impact of a dissemination strategy on family day care educators' intentions to adopt outdoor free play guidelines introduced in response to COVID-19: a randomized controlled trial.

In 2021, guidelines for early childhood education and care were released recommending children are provided access to outdoor areas during all free play sessions to reduce the risk of coronavirus disease of 2019 transmission, aligning with the existing recommendations to increase children's physical activity. There is a need to understand how to disseminate guidelines in this setting as dissemination is a prerequisite of adoption and implementation. This randomized controlled trial explored the impact of a video-based strategy to disseminate guidelines on family day care educators' intentions to adopt outdoor free play guidelines. Educators (N = 255) were randomized to receive a video (intervention) or text-based (usual care) resource via email describing recommendations. Educators were invited to participate in a post-intervention survey at 5-week follow-up assessing intentions to adopt guidelines. The secondary outcomes included knowledge, beliefs about capabilities, beliefs about consequences, social/professional role and identity, goals, implementation of guidelines, acceptability of resource and intervention reach. There was no statistically significant difference between groups in intentions to adopt guidelines [ß = 0.01 (95% confidence interval -0.50 to 0.52), P = 0.97], nor for any secondary outcomes. Further investigation is needed to identify effective dissemination strategies in the family day care setting to increase the adoption of public health guidelines.

Inhibition of neurosphere proliferation by IFNgamma but not IFNbeta is coupled to neuronal differentiation.

Interferons are produced following neural damage as part of the inflammatory response and may thus affect neural stem cell function. We compared the effects of interferon-gamma and interferon-beta on the proliferation and differentiation of adult murine neural progenitors. Both interferons inhibited neurosphere proliferation due to cell cycle arrest in G1 but only interferon-gamma induced neuronal differentiation. Both interferons induced differential phosphorylation of STAT proteins and a modest and late upregulation of the cell cycle regulator p27 but not several other likely cell cycle regulators. Thus in neural progenitor cells, anti-proliferative effects of interferons are not necessarily linked to differentiation.

Electrophoretic protein transfer applied to immunoelectrophoresis.

A method for electrophoretic transfer of a crossed immunoelectrophoretic (CIE) pattern from an agarose gel onto a nitrocellulose sheet is described. The CIE pattern to be transferred was formed using Nonidet P-40 solubilized, bovine herpes virus-1 (BHV-1) induced antigens and bovine hyperimmune serum. An autoradiogram of a CIE pattern, formed using [35S]methionine-labeled NP-40 solubilized, BHV-1 induced antigens and bovine hyperimmune serum, was used as a control pattern. Both antigen and antibody were transferred to the nitrocellulose sheet. This was demonstrated by the ability of transferred antigen to react with specific antibody detected by the addition of 125I-labeled anti-species antibody and transferred antibody to react with both [35S]methionine-labeled antigen and 125I-labeled protein A. This method has application for determining the specificity of monospecific sera for individual arcs in CIE patterns.

Probable interaction of sodium divalproex with benzodiazepines.

1. After drug discontinuation and 1 week placebo washout, 12 patients with panic disorders received, for 6 weeks, either placebo or sodium divalproex. During 6 consecutive weeks, alternate medication was given. 2. Severity of panic and anxiety attacks was improved only in patients receiving sodium divalproex as a first medication. 3. Protracted benzodiazepine effects may occur in the dichotomous antipanic activity of sodium divalproex.

Identification of bovine herpesvirus-1 polypeptides involved in serum neutralization.

Bovine herpesvirus (infectious bovine rhinotracheitis virus)-infected cell antigens were solubilized with Nonidet P-40. The crude antigen extract was separated by reaction with bovine hyperimmune serum in line immunoelectrophoresis; individual immunoprecipitates were used to immunize rabbits. Rabbit sera possessing serum neutralizing activity were analyzed by reaction with crude antigen extract in immunoprecipitation sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot. Four virus-specified glycopeptides, with molecular weights of 69-75K, 77-81K, 82-92K and 108-115K, appeared to be involved in inducing serum neutralizing antibody.

Decline in infant mortality of Alaskan Yupik Eskimos from 1960 to 1980.

A 1960-62 study of southwestern Alaskan Eskimos documented an infant mortality rate--102.6 deaths per 1,000 live births--that was four times greater than that of U.S. whites. In 1980-81, 20 years after the original study, a similar cohort was identified in this population so that changes in infant mortality and other birth characteristics could be examined. Average birth weight and the amount of prenatal care received by the mothers increased from 1960 to 1980. Birth weight and prenatal visits were positively correlated. Results of the followup also revealed a 1980-81 infant mortality rate--17.1 deaths per 1,000 live births--that was less than a fifth of the 1960-62 rate and no longer significantly different from the national rate. Major changes associated with the decrease in mortality during the first 28 days of life (neonatal mortality) were a significant increase in the proportion of infants born in hospitals and an associated decrease in the number of deaths of infants weighing less than 2,500 grams at birth. The reduction in mortality during the rest of the first year of life was related to a decrease in deaths due to infectious diseases, particularly measles and pertussis. Changes in infant mortality reflect the increased availability of health care in this region, improved immunization programs, and the establishment of the Bethel Prematernal Home in Bethel, AK.

Comparative pathogenicity of nine US porcine reproductive and respiratory syndrome virus (PRRSV) isolates in a five-week-old cesarean-derived, colostrum-deprived pig model.

One hundred forty-six 5-week- old cesarean-derived, colostrum-deprived (CDCD) pigs were inoculated intranasally with 1 of 9 US porcine reproductive and respiratory syndrome virus (PRRSV) isolates. Differences were found in severity of clinical respiratory disease, rectal temperatures (P < or = 0.001), gross lung lesions (P < or = 0.001), and microscopic lung lesions (P < or = 0.05). Gross lung lesions were generally most severe 10 days postinoculation and were distributed primarily in the cranial, middle, and accessory lobes and ventromedial portion of the caudal lung lobes. Mean gross lung lesion scores estimating the percentage of lung affected by pneumonia at 10 days postinoculation ranged from 16.7% +/- 2.8% (mean +/- SEM, n = 10) for isolate ISU-51 to 62.4% +/- 5.7% (n = 10) for isolate ISU-28. Microscopic lung lesions were characterized by hyperplastic and hypertrophied type 2 pneumocytes, septal infiltration by mononuclear cells, and accumulation of necrotic alveolar exudate. Lymph node follicular hyperplasia and focal necrosis was seen with all 9 isolates. This CDCD pig model was useful for demonstration of significant differences in pathogenicity among US PRRSV isolates. This difference in pathogenicity may help explain the variation of severity of clinical disease observed in field outbreaks of porcine reproductive and respiratory syndrome and should provide for meaningful comparison of PRRSV genotypes.

Resuscitation skills of first year postgraduate doctors.

The resuscitation skills of twenty seven doctors in their preregistration year were examined using a series of mock clinical scenarios and theoretical testing. All failed to reach basic life support standards of the American Heart Association and major deficiencies were revealed in the provision of ventilatory support, pharmacological therapy and the use of resuscitation equipment. Specific educational deficiencies that were apparent included: (1) early initial training without subsequent revision or testing; (2) the inadequate gaining of practical skills and equipment familiarity during the trainee intern and first year house officer years; and (3) an ill defined curriculum of emergency care that was fragmented between specialties and between lay and medical teachers.

Fluid balance charts: do they measure up?

Many current nursing activities are performed without regular reviews of their usefulness. The recording of fluid gains and losses on a fluid balance chart is one such activity. This article explores the practice of fluid monitoring on the wards of a university teaching hospital.

Toxicology information and computer sources for the medical practitioner.

This paper addresses the importance of toxicology information in medical practice. It begins by describing the role of clinical toxicology in dealing with health hazards that result from exposure to hazardous chemicals. This is followed by an overview of reference sources of practical value to physicians. Among the types of information considered are books, journals, fact sheets, abstracting/indexing tools, computer services, and organizations. Training resources are also presented. An appendix provides full details on accessing the toxicology resources cited in the body of the paper.

Growth hormone promotes proliferation of adult neurosphere cultures.

OBJECTIVES: Growth hormone (GH) and its receptor (GHR) are widely expressed in the CNS. During development, GH signaling regulates both proliferation of neural progenitor cells as well as their differentiation into neurons and glia. Here we have examined the effect of GH signaling on adult subventricular zone derived neural progenitor cells cultured as neurospheres. DESIGN: GH was added to adult wild-type (WT) neurosphere cultures and neurosphere growth measured using the MTT cell proliferation assay. To examine the influence of endogenous GH production on neural progenitors, neurospheres derived from GH receptor knockout (GHRKO) mice were examined by measuring neurosphere sizes and Ki67 and TUNEL immunoreactivity. In addition, neurosphere growth curves were compared following long term culture. Finally, the differentiation of WT vs. GHRKO neurospheres was compared using immunocytochemistry for betaIII-tubulin and GFAP. RESULTS: While GH alone was insufficient to support neurosphere formation, it enhanced neurosphere growth by 20% in the presence of epidermal growth factor and fibroblast growth factor-2. Compared to wildtype neurospheres, GHRKO neurospheres were smaller, contained fewer proliferating cells and exhibited reduced self-renewal in long term culture. Addition of GH increased STAT5 phosphorylation levels in neurosphere cells. Upon differentiation, GHRKO neurospheres showed accelerated neurogenesis, although over time similar numbers of betaIII-tubulin positive neurons were generated by cells of both genotypes. CONCLUSIONS: GH functions as an autocrine mitogen in adult neurosphere cultures and promotes proliferation of neural progenitor cells as well as self-renewal of neurosphere cultures. In addition, signaling through the GHR appeared to delay neuronal differentiation in adult neurospheres.

Measuring anaesthetic outcomes.

We have identified some of the most frequently measured anaesthetic outcomes and their independent risk factors, and discussed the limitations and advantages in using various risk adjustment strategies. Many studies suggest that preoperative assessments may contribute to preventing the occurrence of anaesthetic-related morbidity and mortality, and to high levels of patient satisfaction. The use of health status measurements as a preoperative screening tool in assessing anaesthetic risk offers a potential area for future work. Research into measuring anaesthetic outcomes in a reliable and valid manner will be an important tool in improving standards of anaesthetic practice and in delivering quality anaesthesia to our patients.

Therapeutic activity of pretazettine on Ehrlich ascites carcinoma: adjuvant effect on standard drugs in ABC regimen.

A narcissus alkaloid, pretazettine hydrochloride (PTZ), has been shown to be active against Ehrlich ascites carcinoma. The Ehrlich cells are more sensitive to PTZ in DBA/2 mice than in Swiss mice. The therapeutic activity of the individual standard drugs in ABC (adriamycin, BCNU, and cyclophosphamide) regimen against Ehrlich ascites carcinoma has been increased remarkably by the adjuvant therapy of PTZ following the preliminary use of standard drugs. The independent inhibitory action of PTZ on cellular protein synthesis in the presence of the DNA-binding agent has been demonstrated in KB-cell cultures. Adriamycin-pretreated KB cells are found to be more sensitive to PTZ than nontreated cells.

Antioxidant and cytotoxic effects of bilirubin on neonatal erythrocytes.

Bilirubin, the breakdown product of heme from erythrocytes, accumulates in the neonate in the first days of life. In recent years, the antioxidant properties of bilirubin have been demonstrated in vitro and in vivo, yet it is clear that bilirubin can be toxic to cells. To study the range in which bilirubin exerts its beneficial effect, we used erythrocytes derived from cord blood and incubated them with 0-60 mg/dL bilirubin combined with 3 g/dL BSA (bilirubin/BSA) to mimic physiologic and pathologic conditions. Oxidative stress was induced by incubating the erythrocytes with a solution of 0.6 mM H2O2 and 0.15 M CuSO4 to generate hydroxyl radical mediated injury. The loss of fluorescence of cis-parinaric acid and the degree of protein oxidation of erythrocyte membranes were assessed. Additionally, we determined erythrocyte membrane integrity, glucose-6 phosphate dehydrogenase activity, and adenosine triphosphatase activity before and after incubation with bilirubin/BSA. Incubation with bilirubin/BSA at concentrations up to 60 mg/dL and a bilirubin/BSA molar ratio of two was associated with dose-dependent protection of erythrocytes against lipid peroxidation. However, concentrations of bilirubin equal to or exceeding 30 mg/dL and a bilirubin:BSA ratio of one were associated with increased protein oxidation, decreased erythrocyte glucose-6 phosphate dehydrogenase and adenosine triphosphatase activity, and altered cell membrane integrity. We conclude that bilirubin, at physiologic concentrations, protects neonatal red blood cells against oxidative stress in the presence of physiologic concentrations of BSA but that bilirubin concentrations of 30 mg/dL or higher and a bilirubin:BSA ratio of greater than one are associated with significant cytotoxicity.