The Healthcare Travelling Roadshow: a qualitative study of a rural community engagement initiative in Canada.

INTRODUCTION: Youth from rural communities face significant challenges in the pursuit of healthcare training. Healthcare trainees with a rural background are more likely than those without to practice rurally as healthcare professionals. The Healthcare Travelling Roadshow (HCTRS) is an initiative in Canada that provides rural youth with exposure to healthcare careers, while providing healthcare students with exposure to rural opportunities, and an interprofessional education experience. To the authors' knowledge, this is the first description of an initiative for rural university-high school healthcare career outreach that involves near-peer teaching, highly interactive sessions, and an interprofessional focus. METHODS: Ten HCTRSs took place throughout northern rural and remote British Columbia between 2010 and 2017. Questionnaires were delivered to youth in a pilot research project in 2010. Healthcare students and community members completed questionnaires for ongoing program evaluation from 2010 to 2017. Quantitative elements were graded on a five-point Likert scale. Qualitative elements were analyzed thematically. RESULTS: Participants indicated that the program was very successful (4.71, 95% confidence interval (CI) 4.63-4.79), would likely encourage healthcare students to consider rural practice (4.12, 95%CI 3.98-4.26), and that it inspired local youth to consider careers in health care much or very much (4.45, 95%CI 4.35-4.55). Qualitative analysis led to description of four themes: (1) sincerity and interactivity sparking enthusiasm, (2) learning through rural exposure and community engagement, (3) healthcare student personal growth and (4) interprofessional collaboration and development. Open-ended feedback identified successes outside of the primary goals and illustrated how this program could act in a multi-faceted way to promote healthcare recruitment and retention. Constructive comments emphasized the importance of taking a balanced approach to planning the HCTRS, ensuring the goals of the HCTRS are best met, while meeting the needs of the host communities as much as possible. CONCLUSIONS: The HCTRS is an interdisciplinary experience that successfully engages rural youth, healthcare students, and community stakeholders. Participants consistently indicated that it encouraged rural youth towards healthcare careers and healthcare students towards rural practice. Success of the program requires meaningful engagement with multiple academic and community stakeholders.

The incidence and structure of the fabella in a South African cadaver sample.

The fabella, a sesamoid bone located in the tendon of the lateral head of the gastrocnemius muscle, was dissected from 102 lower limbs of 51 cadavers of age range 40-95 years (mean, 75.5 ± 14.5 years). The incidence of this sesamoid was determined as were its dimensions and radiological and histological features. The fabella was present in 23.5% of individuals, and it was bilaterally located in 50% of cases. It had an equal likelihood of occurring in males or females (P = 0.60), and in either right or left lower limb (P = 1.0). The consistency of the fabella was mostly bony (72.2%), a variety predominantly seen in male subjects. The mean diameters were 9.98 ± 0.9 mm and 8.78 ± 1.23 mm in males and females, respectively, with a statistically significant difference of P = 0.033. Histologically, bony fabellae had a core of spongy bone surrounded by compact bone, whereas nonbony fabellae were characterized by fibrocartilage.

Acute ethanol administration causes malformations but does not affect cranial morphometry in neonatal mice.

Ethanol is a known teratogen and has been implicated in the etiology of human fetal alcohol syndrome (FAS), which is characterized by distinct craniofacial abnormalities such as microcephaly, agnathia, and ocular aberrations. Attempts at quantifying the craniofacial anomalies arising from ethanol exposure have largely been limited to radiographic evaluation in postnatal rats. Such studies discount the role of the cranial soft tissue in the morphology of FAS. We present a study whose aim was to conduct measurements of the entire head including soft and hard tissue in full-term fetuses of mice by means of a digital analyzer, while at the same time comparing stained skeletal tissues in treated and untreated animals. Thirteen pregnant C57BL/6J mice were fed with 25% ethanol (vol/vol) on gestation days (E) 6, 7, and 8, whereas 10 pregnant mice received water only. Fetuses were retrieved from the animals just before delivery on E18, digitally photographed, measured, and assessed for abnormalities. Ethanol-exposed mice showed a number of abnormalities such as anophthalmia and agnathia, but these were not significantly increased over those from nontreated fetuses (P=.5). Birth weight (P=.5), crown-rump length (P=.8), and mandibular length (P=.9) were also not significantly reduced compared to control fetuses. However, defects in some cranial bones and degrees of ossification that trailed same-stage controls were observed in treated animals, at a nonstatistically significant level (P=.14). Acute maternal ingestion of alcohol in mice during pregnancy may not cause a significant increase in craniofacial or skeletal defects when evaluated at term. However, these effects may be latent, manifesting postnatally. The postnatal ability of mice for recovery from alcohol-induced birth defects deserves further investigation.

Nuanced but significant: how ethanol perturbs avian cranial neural crest cell actin cytoskeleton, migration and proliferation.

Children with fetal alcohol syndrome (FAS) display striking craniofacial abnormalities. These features are proposed to result from perturbations in the morphology and function of cranial neural crest cells (cNCCs), which contribute significantly to the craniofacial complex. While certain pathways by which this may occur have been suggested, precise teratogenic mechanisms remain intensely investigated, as does the question of the teratogenic dose. The present study focused on examining how avian cNCC actin cytoskeleton, migratory distance, and proliferation are affected ex vivo by exposure to ethanol concentrations that simulate maternal intoxication. Chick cNCCs were cultured in 0.2% and 0.4% v/v ethanol. Distances migrated by both ethanol-treated and control cells at 24 and 48 h were recorded. Following phalloidin immunocytochemistry, treated and control cNCCs were compared morphologically and quantitatively. Apoptosis and proliferation in control versus treated cNCCs were also studied. Chick cNCCs cultured in ethanol lost their spindle-like shapes and their ordered cytoskeleton. There was a significant stage-dependent effect on cNCC migration at 24 h (p = 0.035), which was greatest at stage 10 (HH). Ethanol treatment for 48 h revealed a significant main effect for ethanol, chiefly at the 0.4% level. There was also an interaction effect between ethanol dose and stage of development (stage 9 HH). Actin microfilament disruption was quantitatively increased by ethanol at the doses studied while cNCC proliferation was increased but not significantly. Ethanol had no effect on cNCC apoptosis. At ethanol levels likely to induce human FAS, avian cNCCs exhibit various subtle, potentially significant changes in morphology, migration, and proliferation, with possible consequences for fated structures.

High incidence of the os peroneum in a cadaver sample in Johannesburg, South Africa: possible clinical implications?

This study set out to investigate the incidence of the os peroneum in a cadaver sample from Johannesburg, South Africa and to note how bio-demographic parameters affect such incidence. The os peroneum (OP) is a sesamoid bone frequently found in the tendon of the fibularis longus muscle (FLM), as it passes on the plantar aspect of the cuboid bone. While this bone is often an incidental dissection room or radiological finding, OP fractures, with or without associated rupture of the fibularis (peroneus) longus tendons have been reported. Some investigators have also suggested that the presence of the OP may render the tendon of the FLM susceptible to avulsion injuries. The reported incidences of the OP range between 8 and 26%. These data have emanated by and large from radiographic rather than dissection studies, and the influences of biological indices such as age, sex, population group of origin, and side of the body on these incidences remain largely unknown. Forty cadavers (average age = 75 years) were dissected. Os peronei were present in 36 of these cadavers (90.0%), with 96% of them occurring bilaterally. This bilateral incidence was statistically significant (P = 0.007), but there was no significant difference in age (P = 0.38), sex (P = 0.97), or population group (P = 0.17). We hope that the unusually high incidence of the OP reported here will stimulate further research into possible predisposing factors as well as into the speculated associations between sesamoid occurrence, osteoarthritis, and tendon injuries.