Organotypic human lung bud microarrays identify BMP-dependent SARS-CoV-2 infection in lung cells.

Although lung disease is the primary clinical outcome in COVID-19 patients, how SARS-CoV-2 induces lung pathology remains elusive. Here we describe a high-throughput platform to generate self-organizing and commensurate human lung buds derived from hESCs cultured on micropatterned substrates. Lung buds resemble human fetal lungs and display proximodistal patterning of alveolar and airway tissue directed by KGF. These lung buds are susceptible to infection by SARS-CoV-2 and endemic coronaviruses and can be used to track cell type-specific cytopathic effects in hundreds of lung buds in parallel. Transcriptomic comparisons of infected lung buds and postmortem tissue of COVID-19 patients identified an induction of BMP signaling pathway. BMP activity renders lung cells more susceptible to SARS-CoV-2 infection and its pharmacological inhibition impairs infection by this virus. These data highlight the rapid and scalable access to disease-relevant tissue using lung buds that recapitulate key features of human lung morphogenesis and viral infection biology.

The community orientation of social model and medical model recovery programs.

This paper examines the extent to which two social model programs and one medical model program operating in the same county were able to establish links between their programs and the community at large. Emphasis on community and environment is a hallmark of social model programs, suggesting that more effective links will have been established at those programs than at the medical model program. Items from the community orientation subscale of the Social Model Philosophy Scale provide a guide for this qualitative analysis. Community resources considered include self-help 12-step programs, as well as community agencies chartered to address employment, education, family counseling, and housing. All three programs were found to have a strong emphasis on Alcoholics Anonymous (AA)/Narcotics Anonymous (NA). At the medical model program (MMP), patients were exposed to three to five AA or NA meetings per week during their 10-day stay, although for the most part, meetings in the MMP had few, if any, outsiders. The social model programs exposed residents to a number of different AA and NA meetings, both at the program and in the community over a period of months. The MMP program was found to have minimal links with the community for employment, education, or other services. The MMP program counselors did try to make referrals to other substance abuse programs upon release from the hospital, and to insure that patients had somewhere to go for shelter after being discharged. In contrast, social model programs encouraged residents to utilize community resources for health, education, and social service needs.

An historical and developmental analysis of social model programs.

This review synthesizes the philosophy, development, history, and current status of the philosophy of social or community model of recovery and of Social Model Programs (SMPs) based on an analysis of the available literature, much of it outside traditional sources. The social-community model of recovery evolved out of Alcoholics Anonymous (AA), and has a distinctive program philosophy with different assumptions, knowledge, and practice than professionally based treatment models. SMPs began in the 1940s in California, evolving by the 1980s into a continuum of recovery services that are publicly funded, legally incorporated nonprofit organizations. The characteristics of SMPs are described and the range of services are presented, including social setting detoxification, residential recovery homes, non-residential neighborhood recovery centers and sober living houses. SMPs are staffed exclusively by recovering alcoholics and their structure is based on the 12 traditions of AA, which emphasize democratic group processes with shared and rotated leadership and a minimal hierarchy. Cost effectiveness data suggest that residential social model programs average approximately $2,700 per stay versus $4,400 for other residential approaches, yet may offer similar outcomes in terms of substance use and improvement employment or family function.

Functional capacity evaluations of persons with chronic fatigue immune dysfunction syndrome.

Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) is estimated to affect 2 to 5 million people in the United States. Despite its high incidence, persons with CFIDS have been neglected by the medical community mainly because there is no singular confirming diagnostic test or proven effective treatment. The CFIDS population is incorrectly stereotyped as upper-middle-class, white, female hypochondriacs; consequently, symptoms often are belittled or ignored. In reality, CFIDS is a severe medical condition that affects women, men, and children of any race and often causes long-term or total disability. The results of a modified functional capacity evaluation developed by the author and completed on 86 persons with CFIDS between 1988 and 1990 confirm that this population has severe physical and cognitive disabilities that affect their professional, familial, and social lives. The results of these evaluations are used to present a profile of persons with CFIDS that can serve as a basis for understanding this population and for guiding intervention.

Evaluating primary prevention: the california "winners" alcohol program.

The "Winners" program was a three year primary prevention effort sponsored by the California Department of Alcohol and Drug Programs. The demonstration attempted to alter drinking behavior through the use of paid mass media messages and community-based educational and organizational strategies. The evaluation design included three communities: a media plus community organization and education site; a media only site; and, a comparison site. This article describes the "Winners" program and presents some results of the evaluation. The findings are discussed in terms of their implications for prevention efforts in general.

Physical and occupational therapy for arthritic patients: a cooperative effort among hospital departments.

The importance of a team approach for optimum management of arthritis is recognized, but small hospitals and clinics may have difficulty supporting a team when the number of arthritic patients treated by any one department is not large. A cooperative effort of our 500-bed hospital's sections of rheumatology, physical medicine, and orthopedic surgery provides a physical therapist and an occupational therapist to work exclusively with arthritic patients. By working across departmental lines the therapists perform enough services to pay their salaries. Patients benefit not only from the availability of therapist specialists but also from continuity of care. Presence of the therapists has permitted extension of care to a satellite clinic and to patients' homes. The cooperating sections have acquired personnel and capabilities not available to them if acting independently.